Intensity of nursing work in public hospitals

cross-sectional, quantitative study, carried out in 22 public hospitals. The sample was composed of 265 nurses and 810 nursing technicians and assistants. Data were collected through a questionnaire and analyzed with Exploratory Factor Analysis. The calculation of the distribution of the work intensity by category was done using a score ranging from -1 to +1 standard deviation of the data. Fisher’s exact test (0.05 <p≤0.10) was used to observe the significance between groups according to the employment bond.

Results:

work intensity contributed to the explanation of precarization of work, with a value of 13% for nurses and 51.2% for technicians and assistants. For the technicians and assistants, the variables with the highest factor loadings were ‘work requires more than she can do’ (0.6696) and ‘takes on multiple tasks due to staff shortages’ (0.6156). Among nurses, the highest factor loadings were observed in the variables ‘time pressure at work (0.6779) and ‘Work pace’ (0.6651).

Conclusion:

the variables analyzed indicate that work intensity occurs differently among nursing workers, and is revealed by the versatility, understaffing and flexibility of work.

Descriptors:
Work; Nursing; Nurses; Nurses’ Aides; Licensed Practical Nurses; Hospitals, Public

Work intensity variables	Factor loading	Permanent			Outsourced
Work intensity variables	Factor loading	Q1^* * Q1= Quartile 1;	Median	Q3^† † Q3 = Quartile 3	Q1^* * Q1= Quartile 1;	Median	Q3^† † Q3 = Quartile 3
Work requires more than she can do	0.6696	2	3	4	2	3	4
Takes on multiple tasks due to staff shortages	0.6156	2	3	5	2	3	4
Cares for more patients than she is capable of	0.5844	2	3	4	2	3	5
Time pressure at work	0.5518	3	3	4	3	3	4
Work pace	0.5251	3	4	5	3	4	5
Does activities that are not her responsibility	0.4804	2	3	4	2	3	4
Does many things she doesn't agree with	0.4551	2	3	3	2	3	3
Feels pressured by her boss to complete tasks	0.4542	1	2	3	1	2	3
Does activities for which she was not trained	0.4328	1	2	3	1	2	3
Tasks are interrupted before she can complete them	0.4323	1	2	3	1	2	3
Rest breaks during the workday	-0.4510	2	3	4	2	3	4
Work allows the development of activities and the achievement of goals in a calm manner	-0.4863	2	3	4	2	3	4
Eats calmly during the workday	-0.5046	2	3	4	2	3	4

Work intensity variables	Factor Loading	Permanent			Outsourced
Work intensity variables	Factor Loading	Q1^* * Q1= Quartile 1;	Median	Q3^† † Q3 = Quartile 3	Q1^* * Q1= Quartile 1;	Median	Q3^† † Q3 = Quartile 3
Time pressure at work	0.6779	3	3	4	3	3	4
Work pace	0.6651	4	5	5	4	4	5
Work requires more than she can do	0.6052	2	3	4	3	3	4
Cares for more patients than she is capable of	0.5700	3	4	5	3	4	5
Takes on multiple tasks due to staff shortages	0.5494	2	4	4	3	4	4
Supervises more workers than she is capable	0.4307	1	3	4	2	2	4
Tasks are interrupted before she can complete them	0.4140	2	3	4	2	3	3
Repetitive gestures	0.4039	3	4	5	3	4	5
Rest breaks during the workday	-0.4589	1	2	3	1	3	3
Work allows the development of activities and the achievement of goals in a calm manner	-0.4946	2	3	3	2	3	3
Eats calmly during the workday	-0.5517	2	3	4	2	3	4

Work intensity score	Permanent		Outsourced		p-value
Work intensity score	N	%	n	%
<=-1SD^* * SD = Standard deviation low	121	20.3	35	16.4	0.431
>-1SD^* * SD = Standard deviation and <=+1SD^* * SD = Standard deviation intermediate	361	60.5	132	62.0
>+1SD^* * SD = Standard deviation high	115	19.3	46	21.6
Total	597	100.0	213	100.0

Work intensity score	Permanent		Outsourced		p-value
Work intensity score	N	%	n	%
<=-1SD^* * SD = Standard deviation low	28	17.4	19	18.3	0.449
>-1SD^* * SD = Standard deviation and <=+1SD^* * SD = Standard deviation intermediate	98	60.9	69	66.3
>+1SD^* * SD = Standard deviation high	35	21.7	16	15.4
Total	161	100.0	104	100.0

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Tatiane Araújo dos Santos E-mail: tatianearaujosantos@yahoo.com.br https://orcid.org/0000-0003-0747-0649