W

hen I started my nursing career nine years ago, I was confident that my nursing education prepared me with the fundamentals of the profession — anatomy and physiology, pharmacology, clinical skills, and more. What I wasn’t prepared for was that some of the basic aspects of health that we ensure for our patients, like nutrition, rest, and removal from constant stressors, aren’t necessarily guaranteed for nurses.

In a national online collaborative forum with my fellow nurses about the future of the nursing workforce, many themes emerged. One that I took to heart is that nurses need undisturbed break time on each shift to balance the emotional and physical demands required to provide high-quality care to patients and to keep more front-line nurses at the bedside.

The solution may appear obvious: Just take a break. But nurses can’t do that if staffing isn’t adequate to meet patient care needs. It’s well-documented that patient care suffers when units are short-staffed, leading to more adverse but avoidable events such as medication errors, infections, and even death. Nurses are more likely to experience fatigue, burnout, and injuries on the job. Harder to measure, but just as much a factor, is the low morale and job dissatisfaction that results when there aren’t enough nurses to adequately cover a unit.

advertisement

Solving the problem of missed breaks starts with getting nurses who are immediately responsible for their patients’ care to admit they aren’t able to take them. That’s not easy, especially when managers and supervisors respond by challenging time management skills and saying, “Everybody else takes a break; why can’t you?”

Actually, everybody else isn’t taking breaks — they just aren’t admitting it.

Ideally, nurses scheduled for 12-hour shifts should get a minimum of three 15-minute breaks and one uninterrupted meal period. Many hospital policies offer this as a guideline. But the reality of patient demands and short-staffed units means we are lucky to get five minutes to ourselves. We tend to put our patients’ needs first before we sit down, go to the bathroom, or grab a bite to eat. At the end of the day, we’re exhausted with the added weight of knowing we face the same challenges tomorrow.

My nurse coworkers at Harborview Medical Center in Seattle joined me in solving this unsustainable nursing norm. We surveyed our colleagues to learn about break time. On average, over a two-week period every nurse had missed at least two meals and 10 of their 15-minute breaks — time that could have offered quiet space to cope with the demands of caring for severely injured or ill patients, a visit to the restroom, or a warm meal instead of a crumbled energy bar.

We shared our findings with our management team and together created a six-month pilot project to add four full-time nurses to two acute-care units. Every day, two relief nurses cover the patient care assignments of staff nurses while they take their breaks. Really take them. We finally got the time to eat and recharge, even go outside for a few minutes, because we trusted that these seasoned nurses would respond to our patients just as we would.

After just a few months, nurses on those two units reported increased satisfaction with the new break system. Just as important, we saw better patient outcomes — there was a sharp decline in patient falls and medication errors compared to the units that continued the old system where nurses use a “buddy system” to cover each other’s patients during breaks. The pilot project was so successful that relief nurses have become part of our unit’s regular staffing plan.

An additional bonus: Nurse retention rates in those units improved dramatically.

Our pilot project was successful because we were able to work together with our hospital administrators to find a commonsense solution to a chronic problem. Hospital administrators and staff nurses shared the same commitment to support the safety and well-being of nursing professionals, just as we would expect for our own patients. We need to consider similar collaborative approaches that keep nurses at the bedside and nursing as a career choice that we want for our daughters and sons to pursue. The future of nursing depends on it.

Vanessa Patricelli is an orthopedics nurse at Harborview Medical Center in Seattle and a member of SEIU Healthcare 1199NW.

Leave a Comment

Please enter your name.
Please enter a comment.

  • Hello. I am desperate for your tips on how you collected your data. I’m a Resource RN and I cover 39 minute lunch breaks in the ICU but I want to take it to the next level and fight for our 12 hourRNs to get their 15 minute breaks (something that has never happened in the 18 years I’ve been there). I would also welcome any data you collected. Thank you!

  • It so important that we take care of ourselves so that we can provide great care to our patients. Thanks for sharing this study.

  • This also applies to
    Surgical Techs who work in Operating rooms as well. Pleasing doctors to get all of their cases done and no time for techs to get a break or lunch , especially when their are cases added on. First if you schedule back to back cases then make sure you have appropriate staff to handle the cases. Second you could hire a tech for lunch relief. You can’t expect your staff to run on empty and do a good job. Morale will soon decline and people look for jobs elsewhere

  • This also applies to s
    Surgical Techs who work in Operating rooms as well. Pleasing doctors to get all of their cases done and no time for techs to get a break or lunch , especially when their are cases added on. First if you schedule back to back cases then make sure you have appropriate staff to handle the cases. Second you could hire a tech for lunch relief. You can’t expect your staff to run on empty and do a good job. Morale will soon decline and people look for jobs elsewhere

  • this is the reason why I am leaving my profession, in my case, I am 61, the younger nurses seem to sit at the desk on their cell phones and I cant get a break..voicing it many times to deaf ears…

  • I’ve nursed for 30 years. Most of my experience has been in hospital. Nursing is a dirty, back-stabbing, stressful, abusive profession for the nurse. That about sums it up.

  • This was one of the biggest reasons I decided to leave hospital nursing after 8 years. If we are not able to care for ourselves, we cannot be expected to care for others. I wish nursing was different, but federal cuts have caused the healthcare situation we now find ourselves in. One day I hope caring for the sick and dying will be seen as a valued career. Only then will those who choose to take on this difficult career be seen as a value.

  • California nurses are lucky.. Most states do not even consider breaks.
    Enjoy what you have. It’s awesome to be a Ca RN. I agree, we are the slaves, but, we don’t have to do it. Make a choice.

  • I dont think Hospitals are at all interested in assisting nurses EXCEPT to give them any NON human assist device that one could think of. They simply do NOT want to pay benefits, or even salary. I have even heard the place I had been employed, is getting rid of the older/ more experienced RNs as they are expensive? A tiny more hourly wage, and I dont know, lets see Im not having babies but had a knee replacement, (I think the 12 or more hours standing at an ICU bed had something to do with that replacement) but that wont happen 3-4 times….Ha, do they even know their value, how many mistakes were stopped because of a seasoned nurse…how much education and nurturing they provide a unit. I know cause I have been nurturing other nurses since I was 32, and now working at 56 starting to feel less valued. I KNOW I am less valued. I have seen healthcare go up and down with staff. During a nursing shortage, they give us what we need to provide good patient care, and now that we arent as short, they are pulling away from the bedside, even more or less asking family to come care for their loved one. They stopped providing shampoo, went back to providing body cleansers as the patients skin is healthier and less complications. But over all the years, I think a patient would tell you they want to see their nurse, they want us, NOT their family to HAVE to care for them. It is one thing that hospitals just DO NOT want to provide, is the nursing care. They go out of their way buying programs to reduce the number of RNs needed. Even now cameras are babysitting multiple patients, their Vitals, seeing if they are behaving, but had to pay for it, so pulled the RN. Patients WANT, and need human care, period. I never really got a lunch for 30 minutes, unless census was down on a rare shift. Forget a break…we had to find time to safely leave a seriously ill patient to empty our bladder…I dont see it changing, unless we have another nursing shortage, there is that brief time, when we start to have the right number, then the hospital realizes its staffed, and down they go again. Another PROGRAM do decrease the number of humans needed. They will NEVER learn…the people making decisions are WAY too far removed from the bedside period!!! AND CHEAP…The less they pay us, the more he gets you see!!!!!

    • Insurance wants your patient to be at deaths door before they admit to hospital for any reason besides surgery and if your over 65, watch out they hope you die in less than 6 months.

  • My unit pushes us to take breaks but breaks are a joke. In order to take one, I have to take on someone else’s patient load while they take theirs. That means twice the patient load for her break times….hand off alone takes up another hunk of time that could be used taking care of my own patients. And being night shift, the cafeteria is closed, the atrium is closed, the break room is full of sleeping people and they just chopped it in half anyway. Quiet is king…so there aren’t tvs or chitchatting allowed anywhere on the unit. What exactly am I supposed to DO on my break? Also, taking a break usually means I stay over finishing documentations so I’d rather work through my break and get home sooner, especially if I am coming back for another shift the next night.

Recommended Stories

Sign up for our Biotech newsletter — The Readout

Your daily guide to what’s new in biotech.

X