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Nurses practice in a wide range of settings, from hospitals to visiting people in their homes and caring for them in schools to research in pharmaceutical companies. Nurses work in occupational health settings[45] (also called industrial health settings), free-standing clinics and physician offices, nurse-led clinics, long-term care facilities and camps. They also work on cruise ships and in military service. Nurses act as advisers and consultants to the health care and insurance industries. Many nurses also work in the health advocacy and patient advocacy fields at companies such as Health Advocate, Inc. helping in a variety of clinical and administrative issues.[46] Some are attorneys and others work with attorneys as legal nurse consultants, reviewing patient records to assure that adequate care was provided and testifying in court. Nurses can work on a temporary basis, which involves doing shifts without a contract in a variety of settings, sometimes known as per diem nursing, agency nursing or travel nursing. Nurses work as researchers in laboratories, universities, and research institutions. Nurses have also been delving into the world of informatics, acting as consultants to the creation of computerized charting programs and other software. Work environment__ Internationally, there is a serious shortage of nurses.[47] One reason for this shortage is due to the work environment in which nurses practice. In a recent review of the empirical human factors and ergonomic literature specific to nursing performance, nurses were found to work in generally poor environmental conditions. De Lucia, Otto, & Palmier (2009)[48] concluded, "the profession of nursing as a whole is overloaded because there is a nursing shortage. Individual nurses are overloaded. They are overloaded by the number of patients they oversee. They are overloaded by the number of tasks they perform. They work under cognitive overload, engaging in multitasking and encountering frequent interruptions. They work under perceptual overload due to medical devices that do not meet perceptual requirements (Morrow et al., 2005), insufficient lighting, illegible handwriting, and poor labeling designs. They work under physical overload due to long work hours and patient handling demands which leads to a high incidence of MSDs. In short, the nursing work system often exceeds the limits and capabilities of human performance. HF/E research should be conducted to determine how these overloads can be reduced and how the limits and capabilities of performance can be accommodated. Ironically, the literature shows that there are studies to determine whether nurses can effectively perform tasks ordinarily performed by physicians. Results indicate that nurses can perform such tasks effectively. Nevertheless, already overloaded nurses should not be given more tasks to perform. When reducing the overload, it should be kept in mind that under loads also can be detrimental to performance (Mack worth, 1948). Both overloads and under loads are important to consider for improving performance."[48] Some countries and states have passed legislation regarding acceptable nurse-to-patient ratios. |
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