Complexity Compression: Nurses Under Fire

Abstract

It has been documented that up to 40% of the workday of nurses is taken up by meeting the ever-increasing demands of the systems of healthcare delivery in which nurses are employed. These demands include the need for increasing documentation, for learning new and seemingly ever-changing procedures, and for adapting to turnover in management and administration. Attention to these issues also means that 40% of that workday is not available to patients. Believing that these increasing demands are affecting nurses' decisions to remain in nursing or to leave, a group of Minnesota nurses and nurse educators examined the work environments of nurses and the issues related to those environments. The result of this examination was discovery of a phenomenon affecting all nurses that may be central to the projected shortage of nurses. The phenomenon is complexity compression-what nurses experience when expected to assume additional, unplanned responsibilities while simultaneously conducting their multiple responsibilities in a condensed time frame. The phenomenon was validated by a group of 58 nurses who participated in focus groups that led to the identification of factors influencing the experience of complexity compression. These factors were clustered into six major themes: personal, environmental, practice, systems and technology, administration/management, and autonomy/control. Further validation studies are planned with the population of practicing professional nurses in the state of Minnesota.

Perceptions of Teaching, Research, and Service Expertise, Workload, Organizational Support, and Satisfaction among U.S. Faculty Members’ Intent to Stay in Tier 1 or Tier 2 Organizations: A Structural Equation Model

“…Breault (2011) wrote about the demands on today's college faculty as the "intensification of the professoriate". This is like the workplace complexity compression phenomenon described by Krichbaum et al (2007) in which nurses are expected to take on more duties without the benefit of more time.…”

Compliance of Nurses to National Core Competency Standards

“…This is supported by the study of Ahmadi (2011) which referred the effects of workload and stated that most nurses suffer from heavy workload and do not have the opportunity to consider patients' various needs and provide holistic care. Krichbaum et al (2007) also identified this nurse caredelivery experience and termed it as complexity compression that occurs when nurses are expected to assume, in a condensed time frame, additional, unplanned responsibilities while simultaneously conducting their other multiple responsibilities.…”

“…According to the works of many authors (Kalisch, (2006);Krichbaum, et al, (2007); Potter et al, (2005) and Tucker and Spear (2006)) compliance of nurses to competency regarding Quality Improvement relates to how nurses perform their tasks in their respective units. The findings that there were no significant differences between Patient Care Competency -Safe and Quality Nursing Care, Communication, Collaboration and Teamwork, Empowering…”

Complexity of Care Is Associated With Distressing Environmental Factors

“…1 When task or work complexity increases, there is a corresponding increase in complexity of systems and clients and an increase in demands from both. 3 Through research, patterns of complexity included both work activities (also known as work complexity) related to physical tasks of caregiving and cognitive processes (also known as cognitive complexity) related to goal setting, knowledge, and managing care that affected work performance and decision making. 4 Nursing care is not always clearly defined.…”