When you’re there in body, but not in mind

Greetings WSNA members! My name is Jessica Rainbow, and I wanted to thank the many WSNA members who answered the call to participate in my dissertation study on nurse presenteeism in the fall of 2017. Presenteeism is when someone is physically at work, but not fully engaged or performing. I became interested in presenteeism due to my own experiences with burned out and sick coworkers as an ICU nurse and after interviewing nurses about their fatigue while a nursing PhD student. As nurses, we have a lot going on both at work and outside of work, and these things (like our work environment and our own health and well-being) can affect our ability to be fully present at work.

Presenteeism in nursing has been linked to negative outcomes for patients, nurses and health care organizations. Missed patient care, falls and medication errors have all been linked to presenteeism in prior studies (Cassie, 2014; Dhaini et al., 2016; Letvak, Ruhm, & Gupta, 2012). In studies that have looked at presenteeism across professions, nurses have been found to have the highest rates. However, there are limited studies on what leads to presenteeism among nurses, and we don’t know what the best way is to measure presenteeism. So, for my dissertation study, I did a survey that compared different existing presenteeism measures and assessed what leads to presenteeism and what the consequences of presenteeism are.

I recruited nurses from around the country through social media, nursing organizations like WSNA and hospitals. Specifically, I recruited nurses who worked in hospitals providing direct patient care. A total of 447 nurses from 40 different states participated in the survey. On average, nurses had 11.3 years of experience, worked 34 hours per week and were 39 years old. Presenteeism rates on our survey were higher across measures that looked at presenteeism due to sickness, job-stress and workplace violence than in previous studies. We found that there was a connection between negative work environment, lower professional values as described in the ANA’s Code of Ethics, higher perceived stress and work-life imbalance and higher presenteeism. Presenteeism was linked to lower professional quality of life, higher turnover intention and more missed patient care.

These findings indicate that presenteeism is a more prevalent problem than previously thought, that multiple factors can contribute to presenteeism, and that there are consequences for nurses, health care organizations and patients. Nurses should be aware of their own potential presenteeism during a shift and think about presenteeism and its consequences when deciding to attend work when not at their best. Nurse leaders should consider presenteeism and its associated consequences when making decisions about employee policies (e.g. mandatory overtime.) As a researcher, I am working to learn more about how to measure presenteeism and how to intervene to address the issues leading to presenteeism (like work environment and stress) and presenteeism itself.

Thank you again to all those who participated in my survey — your responses provide a baseline from which we can build going forward and future directions for my research. If you are interested in learning more about nurse presenteeism and my research, you can contact me via email at jrainbow@email.arizona.edu or follow me on Twitter @JessicaGRainbow.