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  • Writer's picturePatrick Neumann

The health-care crisis won’t be solved without addressing the elephant in the room: Staff workload

Do you really want your loved one’s nurse or caregiver rushing through their required care?

By Patrick Neumann and Sue Bookey-Bassett
Friday, May 17, 2024

Resiliency training and other popular staff retention approaches will not solve the problem of desperately overworked staff, Patrick Neumann and Sue Bookey-Bassett write. Dreamstime

Excess workload has been identified as a root cause of the current health-care crisis in report, after report, after report. Excess workload for front-line staff like nurses contributes to fatigue, burnout, medical error and staff quitting.


After heroically working under decades of austerity policies, nurses are burned out and the health-care system is in collapse. If automakers took the same approach to workload management, not a single car would roll off the line with all five wheels properly connected (did you forget the steering wheel?). Excess workload lies at the root of the health-care crisis in Canada today and the wheels are flying off the cart.


So why then does our health-care system have no systematic approach to measuring workload? There is no objective measure of workload in use that can ensure staff have no more than eight hours of care work to complete in an eight-hour shift. There is a saying: “If you can’t measure it you can’t manage it” and by this standard, the Canadian health-care system is flying blind with regards to staff workloads.


It is no wonder our health-care system is in trouble: How can we set “safe staffing levels” with no measure of workload? Without evidence-based workload management, efforts to stave off the shortfall of nurses with increased hiring and “resiliency” training and other staff retention efforts are doomed to fail.


14 hours of work in a 12-hour shift


While the variability in care work can make measuring workload a challenge, new tools using computer simulation technologies are opening the door to objective workload measurement. Our computer modelling approaches have shown that nurses can have over 14 hours of work to complete in a 12-hour shift.


How are staff supposed to keep up with these demands? By rushing? By skipping non-essential tasks? All too often nurses are working overtime or skipping breaks in an effort to deliver the quality of care they were trained for. No wonder nurses are quitting in droves.


These modelling tools allow us to create virtual care units based on actual unit conditions. These models have shown the impact on nurse workload goes well beyond nurse-patient ratios as is currently being discussed.




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