Less is more

Last monday the district nurses in the Netherlands decided to protest against the heavy workload they are experiencing. The workload is rising due to administrative tasks that are contributed in theorie work. Furthermore there is political talk about a budget decrease for district nurses.
 
In The Netherlands the healthcare system is based on self-management and informal care. District nurses help patients to stay in their environment as long as possible. Many people think that district nurses only help with several tasks in the house, but this is not true. District nurses also help with medical care like administering an infusion. Some political parties like the PVDA are talking about a budget decrease on district nurses, but this is not legally documented. This may be found a strange measure, because the focus is letting people stay in their own environment as long as possible. Problem is that this decision will lead to protest from the district nurses.
 
District nurses are complaining about the stressful workload because of the shortage in staff, while more people are in need of care from the district nurses. The shortage is around ten thousand nurses, but there is no exact number for the district nurses. Problem is that most people who are educated to be a nurse have a preference for working in the hospital. Furthermore, the working hours of the district nurses are very flexible. Most of the time the working hours are in the morning and afternoon but they are subjected to change. The hospital has fixed working hours, which is an advantage over the district nurses.
 
Another problem is the administrative workload. Many district nurses spend a lot of time on the administrative tasks, instead of taking care of patients. Almost 75% of the district nurses spend about a quarter of their time on the administrative tasks. Around 10% of the administrative tasks are not even patient-related.
 
A solution for the workload will be less administrative work and more nurses that want to work in the district sector. Starting next year Hugo de Jonge, the new minister of public health, welfare and sport, wants to start making arrangements between the district nurses, insurers and health suppliers. This has been decided on 22 November 2017.
 
So we will see if these arrangements will lead to a reduce of workload for the district nurses. We hope that the quality of care will increase with these agreements. We will keep you updated on this matter!
 
 
 
Written by: Marit Segaar & Anne de Pender
Published: 27 of November 2018

SHARE is the Faculty Association of the study ‘Health Policy and Management’ at the Erasmus University Rotterdam.

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