Nursing workload: An unquantifiable entity

Background: In the increasingly prominent drives towards cost containment and efficiency nursing is under pressure to justify its value to healthcare. On the surface nursing workload assessment methods would appear to offer a means to quantify the nursing input to patient care. Aims: To examine the validity of nursing workload methods with respect to nursing practice and nursing knowledge. Findings: Previous studies and the conclusions of subject reviews have cast doubt on the reliability and validity of most methods and indicate that they have no clear theoretical base. Conclusion: It appears that nursing is more concerned with knowledge processing and nurses' intentions than just with the activities of caring. It is suggested that patients control the time element of nursing care. The need for nursing workload information, despite its validity problems, is discussed and a pragmatic solution is suggested