Study Of Time Taken By Nurses On Hospital Work

Press, Volume XCIV, Issue 28160, 26 December 1956, Page 3

Study Of Time Taken By Nurses On Hospital Work

"The Press'- Special Service

AUCKLAND, December 25. Stop-watches are not a normal gdjunct of hospital routine, but for the last si x months two Auckland supervising sisters have been using them, day and night. They have, been “shadowing” 80 nurses and sisters, timing them on ward work in their every minute of duty.

Their survey—a job analysis in a >ard of each of four hospital board Institutions— has just ended. Well overdue. as board officers readily admit, it is the most minute investigation attempted in New Zealand. It has a twofold aim—to help the nurse and give better service to the patient. A few sample results obtained were: £ general-duties charge sister at National Women’s Hospital spent onlv 31 per cent, of her day on actual patient care; a hospital aid, only 50 per cent. pother charge sister had to spend 156 minutes in clerical duties- a

general-duties sister, 130. A sample 8 a.m.-5 p.m. day of a gen-eral-duties sister (the charge sister was off) went like this: basic nursing, 12 per cent.; technical nursing. 18 per cent.; administration and organisation, 53| per cent.; other jobs, including meal. 161 per cent. A registered maternity trainee working a night shift at the same hospital: basic nursing, 14J per cent.; technical nursing, 47 per cent.; administration and organisation, 27 per cent.; domestic duties, 6| per cent.; others. 5 per cent. This nurse, due off duty at 6 a.m., did not finish until 7 a.m. Comprehensive Observations

About the only thing the “timekeepers"—Sisters M. F. McKean and A. M. Ryan—did not clock- was the nurse's pulse. On basic nursing they tagged her doing everything from giving fruit juices and removing hot water bottles to caring for patients’ nails and changing napkins. On technical nursing, everything was covered from checking drugs to stockmaking; and on administrative matters, from the sending of telephone calls to ruling lines in ward books, from private study in the ward to preparing the ward for church services. They even timed a nurse’s frantic search for a broom when she found the cupboard locked. The housemaid had locked it before going off duty to prevent anyone making off with the ward vacuum cleaner.

At each hospital they wanted to know who does the ward flowers? How long does it take? What washing is done in the ward? By whom? And a host of other things requiring, from any one analysis of a nurse’s working day. no fewer than 82 separate answers.

They estimated that at the National Women’s Hospital there were 15 established practices which were cumbersome or time-consuming and which could be simplified without affecting

service or training. Some ol these were:— Distributing meals, washing soiled linen, maixng glucose, drinks, seriiismg equipment, collecting dishes, sluicing toilet gear, recording ternperatures. borrowing medicine from other departments, distributing and removing flowers, putting away clean linen, dispensing iron pills. They concluded that the first five techniques cou’d be carried out by non-nursing staff. Much the same story results from the other hospitals. And always the same hoary chestnuts,” some of them ia™ Sub]ect of re P o rts dating back to 1»27, crop up over and again—the time-consuming rewriting, meal-serv-ped-moving, drug-collecting and sterilising.

Often the nurse’s biggest problem is the smallest thing—matches, for instance. Much time is wasted looking for them or borrowing from patients. Flmt-guns were tried, but the flints always ran out.

The cumbersome job of constantly shifting heavy bed-screens from end to end of the wards, a lack of teaspoons. an absence of hand basins on a ward verandah—these are other, apparently inconsequential, matters which are significant when the minutes are tallied.

Many of the items listed have been remedied already. Others, concerning policy, will be subject to f -rther investigation before a change is made. The survey includes not only nurses trained and in training, but also household staff and orderlies. It will be both continued and intensified. It was touched off by the results of a trip to the Royal Newcastle Hospital.' near Sydney, made by- the secretary of the Auckland Hospital Board (Mr R. F. Galbraith) last year. ‘‘These initial results are highly pleasing,” he said. “Far more has come to light than we estimated and the further good which will slowly yet undoubtedly follow is incalculable. The reaction of nurses generally has been most favourable and where, as the survey has progressed, we have been able to make immediate improvements, they are very happy indeed..” The ultimate analysis would probably fill two volumes, Mr Galbraith said.