Presenteeism in nursing: A mixed methods study of its relationship with nurse fatigue and patient safety

The hospital-based registered nurse has a primary role and responsibility for oversight of patient safety within the hospital setting. It is therefore critical for hospital-based nurses to be functioning at an optimal level to provide quality patient care. Nurse fatigue has been implicated as a factor in health care-related errors. Presenteeism results when an individual attends work while experiencing a health alteration. Nurses often experience fatigue which, to date, has not been studied as it relates to presenteeism. The purpose of this study was to explore relationships among nurse fatigue, presenteeism, nurse work function, and patient safety among hospital-based registered professional nurses.;Using a convergent parallel mixed methods design, a convenience sample of 272 hospital-based nurses from seven hospitals was recruited via email invitations sent through hospital-based listservs. Quantitative date were collected with reliable and valid instruments using web-based methods. Qualitative date were collected with a single item open-ended question. Quantitative data were analyzed using descriptive and multiple linear regression. Qualitative date were analyzed using procedural steps outlined by Creswell and Plano Clark (2011 and coding techniques recommended by Saldana (2003).;The sample was predominantly female (93.7%) with a mean age of 41.4 (SD 12.3) years. On average, the sample had worked as a nurse for 14.5 ( SD 12.6) years. The majority held a baccalaureate degree in nursing (55.9%). Multiple linear regression analyses were used to predict nurse work function in three areas. The linear regression model explained the least amount of variance in causing incidents at work (19%), with greater amounts of variance explained for impaired contact with patients and families (34%), and cognitive aspects of work performance (40.9%). All models were statistically significant. In all three models, lower presenteeism predicted greater difficulty in nursing work function. Greater chronic fatigue and lower accountability to patients predicted impaired contact with patients and their families. Three themes emerged from the qualitative data: (a) causes of fatigue; (b) effects and outcomes: subtheme 1 compromising patient safety and care, subtheme 2 compromising the health and welfare of nurse; and (c) never been a time.;Results demonstrated nurses were making efforts to overcome fatigue in the hospital setting. However, nurse fatigue impacted the health and safety of the patients and the nurses themselves. Future research is recommended utilizing a longitudinal study to examine the effects of nurse fatigue and presenteeism over time and its impact on the long-term health of the nurse as well as patient safety outcomes.