Balancing nurse workload to improve care
Claudia Kambonde has a big job. A soft-spoken, resilient woman with a gentle smile, Kambonde is the Nurse Matron at the Windhoek Central Hospital where she coordinates the work of some 700 nurses across several operational units of the hospital.“My work is interesting. I enjoy my work, even though sometimes it’s hard when there are too many patients in some operational units and not enough nurses to care for them,” Kambonde says. On those days, the Matron has to make tough decisions. It is her job to work with the managers of the operational units to shift nurses around to cover each unit and, if necessary, call in off-duty nurses to provide surge support. Her job requires a level-headed leader who can successfully negotiate with managers to convince them to share their human resources with patients across the hospital.
“It is not a simple numbers game with an easy nurse-to-patient ratio,” Kambonde explains. “Sometimes, the kind of care needed is intensive, and the impact of delayed care is severe. For example, eye patients may be few, but they need to have their eye drops administered on time for it to be effective,” she says. Delays and distractions in the administration of healthcare can be detrimental.
Overload protection
To protect her nurses from overload that can impact the quality of care they provide, Kambonde recently participated in a series of workshops by the Ministry of Health and Social Services (MoHSS). These workshops were designed to determine the standard tasks required for all types of patient care and the staff time required to perform those tasks.
At the workshops, supported by the U.S. government through the United States Agency for International Development (USAID), participants analysed the workloads of medical officers, nurses, radiographers, psychologists, and other cadres of public health workers.
These analyses will assist the Government of Namibia to appropriately allocate resources to meet the health needs of the population and achieve universal healthcare coverage - a situation in which everyone has access to basic, affordable healthcare as prioritised by the government.
“This workload analysis will make my work easier,” Kambonde says. “It helps you make use of your statistics to determine your staffing needs.” The detailed results will impact health facilities across the country. They will provide managers like Kambonde, as well as the MoHSS, with the data they need to recruit and deploy medical staff.
For Kambonde, the workload analysis will reduce the amount of time she has to spend negotiating with operation unit leads and nurses about staff allocations. “When nurses are not distracted, overworked, and overwhelmed, they are better at their jobs and can provide skilled, quality healthcare efficiently and effectively. This means patients have shorter wait times, more positive experiences in the hospital, and leave with better health outcomes.”