A 14-year investigation into the workload of oncology nurses in the Netherlands Cancer Institute

In the Netherlands Cancer Institute, the daily workload of nurses has been measured since 1976. Each day the head nurse ranks the patients into one of the seven categories of care requirements. It can be inferred from the data that the percentage of patients who need intensive nursing care has doubled from 30% in 1976 to more than 60% in 1989. The increase in the nursing staff has only partially kept abreast of the increase in the workload. In addition to this simple technique, a more refined "factor evaluation system" has been developed. On the basis of this method, a more detailed check can be made as to what connection there is between the characteristics of the patient, the particular disease and treatment on the one hand, and the nursing workload on the other. Because of this it is possible to assess and to predict the consequences for nursing care when a new therapy is introduced. The correlation between both assessment methods is good: 0.72. A plea is made to use both methods of assessment in conjunction: the simple method for assessing the daily workload, and the refined and thus more laborious method to analyze the factors responsible for changes in the workload. In view of the rapid dissemination of new oncological therapies, it is essential that international consensus be reached with regard to a method for measuring the workload of nurses. In this way the consequences of these new therapies for the workload of nurses might be known more rapidly and proper measures could be taken.