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Case Study Journal Wk 2

Case Study Journal
Jose Lima Coto
West Coast University
NURS 440: Issues and Trends in Nursing
Prof. Gilmore
April 10, 2022
Interactive Case Study Journal
As we talked about last week, being involved in policy making is imperative for nurses. Nurses
are highly skilled workers who make critical decisions involving patient care. A nurse’s job requires
careful observation, analysis, interpretation, and decision making. In an understaffed unit, nurses must
care for more patients while providing the same level of care. This means spending less time in analyzing
and interpreting findings as well as less time reviewing patient’s information and performing tasks in a
rushed manner. Nurses must be involved in policymaking to ensure proper care of their patients and to
avoid burnout which can lead to medication errors and adverse outcomes for patients and staff alike.
Providing proper care is a value central to nursing and not a priority to institutions or government
policymakers. Institutions seek to increase profits, and proper staffing is not their priority. Government
agencies and policymakers lack the understanding and inside view of what it takes to work in healthcare
and make decisions for those who they cannot relate. Mandatory overtime is an unsafe practice as it
increases burnout in nurses and can lead to increased mistakes in care and medication administration
(Garrett, 2008)
Mandatory overtime is counterproductive in nature and can lead to an increase in frequency of
errors, fatigue, and nurse burnout. Hospital administration should invest in appropriate and safe staffing
rations to increase patient safety, decrease errors and liability, and increase employee retention.
During the case study, nurses are discussing scheduling practices by management and how they
have worked extra shifts for months. One nurse stated that she made a medication error due to being
fatigued and expressed her concern over making another error due to being overworked. The attached
schedule shows that most nurses are scheduled to work nine days in a row. Not only is working so many
days in a row unsafe, but it is also illegal in California (California Labor Code, n.d.)
The nurses in the case study talk about an increase of central line infections on the unit and how
she believes is directly related to the understaffing and mandatory overtime being required of them.
Evidence shows appropriate staffing in nursing units is critical to improving patient outcomes and
satisfaction in patient care. Improving working conditions for nurses improves ideal patient care and
decreases adverse outcomes such as medication errors (American Nurses Association, n.d.).
Although not a nurse, I am a surgical technologist and work alongside doctors and nurses alike.
Our unit does not have mandatory overtime but does expect staff to be on call during weekends and
nights. It is assigned to all nursing and tech staff, and it can range from twelve hours to twenty-four
continuous hours. It has happened once to me where I was on 24hr call and was called in to work. Due to
the nature of my job, I worked 24 hours straight with only one break every 12-hour period. Not only was I
tired, but I felt sick. I felt that not only my movements were sluggish and poorly coordinated, but my
critical reasoning suffered greatly. In a healthcare setting, having this kind of impediment can prove to be
unsafe, if not deadly to our patients.
After completing the agonizing 24-hour shift, I did not feel it was safe to drive home, however a
small cup of coffee provided me with enough alertness to drive the 16-mile trip home. As I was driving, I
unknowingly stared off with no awareness of my surroundings until my car’s collision alert startled me
and made me realize I was speeding into a much slower car. Fortunately, I made it home safe, but I swore
to never do that again. I now choose to split my 24hr call shift into two weekends which is more
manageable and safer for our patients and for me.
The staffing issues scenario closely relates to experiences I’ve had in the past. It is important to
ensure that we practice our profession in a safe manner to protect our patients and protect ourselves.
American Nurses Association. (n.d.). Nurse staffing. ANA. Retrieved April 17, 2022, from
section. Retrieved April 17, 2022, from
Garrett, C. (2008). The effect of nurse staffing patterns on medical errors and Nurse Burnout. AORN
Journal, 87(6), 1191–1204. https://doi.org/10.1016/j.aorn.2008.01.022
West Coast University. (2022, April). Staffing Issues Interactive Case Study. Retrieved from West Coast
University Interactive Case Study Journal: https://webapps.srmapp.net/CanvasContent/SF/WCU_NURS_440_OL_TEMPLATE/Presentations/Nurs440%20Overstaffing/