Nurses experiences of "being swamped" in the clinical setting and association with adherence to AWHONN nurse staffing guidelines

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MCN The American Journal of Maternal/Child Nursing


Purpose: Being swamped is defi ned as "when you are so overwhelmed with what is occurring that you are unable to focus on the most important thing."The purpose of this study was to explore the experience of being swamped in the clinical setting among nurses who are members of the Association of Women s Health, Obstetric and Neonatal Nurses (AWHONN) and the relationship of the level of being swamped to adherence to the AWHONN (2010) nurse staffi ng guidelines. Study Design and Methods: A 25-item survey was sent to ~21,000 AWHONN members by email in the Fall of 2018. It was completed by 1,198 members, representing 49 states and the District of Columbia. Questions explored timing and causes of being swamped, its effect on health care team members and patients, what helps when a nurse feels swamped, and nurses reports of their hospital following the AWHONN nurse staffi ng guidelines. Results: Twenty-eight percent of nurses reported being swamped daily or multiple times per day. Situations that contribute to being swamped include assignments that are too heavy, interruptions, critical patient situations, and mistakes made by others that nurses are expected to catch and fi x. Teamwork and someone stepping in to help without being asked were identifi ed as most helpful when a nurse feels swamped. Nu rses practicing in hospitals following the AWHONN nurse staffi ng guidelines always or most of the time reported less frequency of being swamped as compared with those in hospitals that followed the guidelines some of the time, or rarely (p < 0.001). Clinical Implications: Being swamped is a common phenomenon among AWHONN members responding to the survey. The reported incidence of being swamped daily is signifi cantly associated with the extent to which hospitals follow the AWHONN nurse staffi ng guidelines. Nurse leaders, hospital administrators, and staff nurses must work together to identify and initiate timely, feasible nurse staffi ng solutions that support the safety of patients and nurses.

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