Exploring the relation between modelled and perceived workload of nurses and related job demands, job resources and personal resources; a longitudinal study

Abstract

Aim Calculating a modelled workload based on objective measures. Exploring the relation between this modelled workload and workload as perceived by nurses, including the effects of specific job demands, job resources and personal resources on the relation. Design Academic hospital in the Netherlands. Six surgical wards, capacity 15–30 beds. Data collected over 15 consecutive day shifts. Methods Modelled workload is calculated as a ratio of required care time, based on patient characteristics, baseline care time and time for non-patient related activities, and allocated care time, based on the amount of available nurses. Both required and allocated care time are corrected for nurse proficiency. Five dimensions of perceived workload were determined by questionnaires. Both the modelled and the perceived workloads were measured on a daily basis. Linear mixed effects models study the longitudinal relation between this modelled and workload as perceived by nurses and the effects of personal resources, job resources and job demands. ANOVA and post-hoc tests were used to identify differences in modelled workload between wards. Results Modelled workload varies roughly between 70 and 170%. Significant differences in modelled workload between wards were found but confidence intervals were wide. Modelled workload is positively associated with all five perceived workload measures (work pace, amount of work, mental load, emotional load, physical load). In addition to modelled workload, the job resource support of colleagues and job demands time spent on direct patient care and time spent on registration had the biggest significant effects on perceived workload. Conclusions The modelled workload does not exactly predict perceived workload, however there is a correlation between the two. The modelled workload can be used to detect differences in workload between wards, which may be useful in distributing workload more evenly in order prevent issues of over- and understaffing and organizational justice. Extra effort to promote team work is likely to have a positive effect on perceived workload. Nurse management can stimulate team cohesion, especially when workload is high. Registered nurses perceive a higher workload than other nurses. When the proportion of direct patient care in a workday is higher, the perceived workload is also higher. Further research is recommended. The findings of this research can help nursing management in allocating resources and directing their attention to the most relevant factors for balancing workload.

Nursing Home, Ward and Worker Level Determinants of Perceived Quantitative Work Demands: A Multi-Level Cross-Sectional Analysis in Eldercare

“…Two Danish studies (one in eldercare) showed that evening shifts were associated with reduced quantitative demands compared to day shifts ( Bøggild et al , 2001 ; Nabe-Nielsen et al , 2009 ). Other studies support our finding of a relationship between psychosocial aspects of the work environment and perceived quantitative demands ( Rugulies et al , 2010 ; Hansen et al , 2015 ; Elfering et al , 2017 ; Mette et al , 2018 ; Burr et al , 2019 ; Berthelsen et al , 2020 ; Van Den Oetelaar et al , 2021 ). For example, one study in hospital nurses showed that increased social support from colleagues was associated with a decrease in quantitative demands ( Van Den Oetelaar et al , 2021 ).…”

“…Other studies support our finding of a relationship between psychosocial aspects of the work environment and perceived quantitative demands ( Rugulies et al , 2010 ; Hansen et al , 2015 ; Elfering et al , 2017 ; Mette et al , 2018 ; Burr et al , 2019 ; Berthelsen et al , 2020 ; Van Den Oetelaar et al , 2021 ). For example, one study in hospital nurses showed that increased social support from colleagues was associated with a decrease in quantitative demands ( Van Den Oetelaar et al , 2021 ). Another example is a controlled trial in eldercare that found that self-rostering (i.e.…”

Defining adequacy of staffing in general hospital wards: a Delphi study

“…49 Consensus was also not reached on the level of work pace. In contrast, van den Oetelaar et al 50 found that an increase in workload had a strong impact on work pace; however, their objective measure of workload is validated by the subjective workload measure existing of other aspects such as physical, mental or emotional workload as well. Adequate staffing can contribute to acceptable workload, but this relation differs between workload aspects.…”

What determines physical, mental and emotional workloads on nurses? A cross‐sectional study

“…Nevertheless, there is limited evidence on which scale performs best. The Questionnaire on Experience and Evaluation of Work (QEEW) (van Veldhoven et al, 2015) measures job demands as physical, emotional and mental loads and was used to measure perceived workload on nurses (Van den Oetelaar et al, 2021). We aimed to identify determinants of nursing workload by studying specific impact factors on each dimension: physical, mental and emotional.…”

“…loads(Oppel & Mohr, 2021) or no effects at all(Wang et al, 2021), whereas the present study enriches current knowledge by indicating that inadequate staffing resources in the shift will entail not only physical but also mental consequences. Factors like personal processing capacity, activity complexity, working memory, time shortage or other indirect demands were considered important in determiningWang et al, 2021), and one study evaluating the percentage of registered nurses in the shift and the perceived workloads found effects only on emotional workload and not on physical or mental loads (Van denOetelaar et al, 2021). We deduce that nursing physical and emotional workloads will improve in shifts with better skill-mix due to a better distribution of activities among nurses and other health careT A B L E 1 (Continued)Note: Adjusted R 2 , coefficient of determination; physical workload R 2 = .414; mental workload R 2 = .097; emotional workload R 2 = .113; all R 2 scores were significant, p < .005.…”