Changes in Nursing Practice: The Perceptions of Nurses Working with Reduced Workloads in Acute Care Hospitals under the Re-Employment System

Abstract

This study aimed to identify changes in nursing practice perceived by nurses working under the re-employment system in acute care hospitals with workloads reduced through exemption from night shifts or shorter working hours. The participants were nine nurses (including assistant nurses) who were re-employed with reduced workloads after retirement at four acute care hospitals in the Kinki region. All nurses were assigned to departments in which they had previous experience. This study was a qualitative inductive analysis using semi-structured interviews. Because the workload after re-employment was reduced through measures including exemption from night shifts and shorter working hours, the participants felt that they had more time and were more relaxed, allowing them to "respond to the needs of patients and colleagues when necessary" and to "explain things more carefully". Participants also felt that working in a fixed department allowed them to better understand the details of their work and to "proactively improve their practice". Participants also reported that "awareness of their own ageing gave them a deeper understanding of older patients", and "awareness of their own ageing led them to perform tasks one by one with extra care".

These findings suggest that reduced workloads in re-employment after retirement lead to provision of careful care and proactive improvement in nursing practice. We therefore believe that re-employed nurses continuing to work with reduced workloads will contribute to improving the quality of nursing care in today's healthcare settings, where it is said that there is not enough time to spend on nursing care.