Question of the Week #1


Dr. Linda Aiken, renowned nurse researcher, states that “85% of nurses’ time is spent in ‘workarounds’—trying to solve problems caused by management decisions up the line.”  Do you agree with her findings?  If so, give us an example of a “workaround” that you recently encountered, and how you worked around it.



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3 responses to “Question of the Week #1

  1. Debbie

    Administration called the lab and had them loan a machine to one of the doctors offices because they were going to be inspected. The doctor office closed for the weekend on Thursday without returning the machine. A doctor in our facility wanted to run a test that only that machine could run. The lab called me to tell me the test could not be done, why and to let the doctor know. When I informed the doctor, he told me to call the supervisor to bring the machine back to the hospital. I called the supervisor and she gave me the telephone numbers to call. I was unable to get any of the numbers answered so I had to call the supervisor again. This time I told her I did all I could do and it was her turn. The machine took 9 hours to be returned but the doctor got his test results by the end of my shift.

    • DD-RN

      I believe the percentage is higher than 85%. Examples abound – workarounds, and working within dysfunctional “systems” (I hesitate to even use that word for the pitiful attempts at “defining” the way the work should be done) is every day, every shift.
      How many nurses have so much paperwork dumped on them that the paperwork takes longer than patient care? How much of that paperwork/online work is duplicated? How much is innefficiently organized? Disorganized to the point that there are PostIt notes all over the place with tips and tricks of how to find/do things? How many nurses can actually understand the “policy statements”, typically written as well as consumer-goods instructions that were translated into 8 or 9 languages before making it into English? How many of these “policies” or (don’t get me started on this one) “processes” have not just duplications, but missing steps, missing information, incorrect information, and contradicatory instructions?
      How many nurses work in a setting where they are provided with what they need to meet the criteria dumped on them?
      Current management practices seem to be at their nadir: how could it possibly get any worse?

  2. I have been a nurse since 1961 when I graduated from a Diploma School of Nursing. We were advised to enroll in college to get our degrees as we graduated. And I dare say many of my classmates did just that. I obtained a BS in Nursing, a Masters in Cardiovascular Nursing and a post maters Certificate as an Acute Care Nurse Practitioner. For the last twelve years I have worked as a nurse practitioner and I come into contact with nurses for all sorts of educational backgrounds. It is very interesting that the nurses who need the most direction and have the least ability to solve problems are those with Associates Degrees. Two years just does not give the student enough time to developed the problem solving skills necessary for nursing and as we all know problem solving is the majority of our jobs.
    The recommendation for BSN degrees as the basic entry level for Professional Nursing was pushed in the mid 1960’s and it was during this time that the New York State Blueprint for Nursing was first put forth which gave a timetable for requiring a bachelors degree for all professional nurses. Unfortunately, it was not carried out because nurses complained that there were insufficient programs for them to obtain a degree. The concept of a bachelor’s degree being the basic entry level of education is not new and is the only way to become an engineer, teacher, journalist, or a myriad of other professions. Some even require more than a bachelors degree like law, medicine, dentistry, social work and psychology. Why do we in nursing allow the Assiciates Degree as the entry level into our profession when we are dealing with patients lives every day. We need more education not less. We have talked about this for more than fifty years; don’t you think that it is about time that we did something about it!

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