Why call it nonproductive time? : Nursing2023

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Department: EDITORIAL

Why call it nonproductive time?

Laskowski-Jones, Linda MS, APRN, ACNS-BC, CEN, NEA-BC, FAWM, FAAN

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Nursing 53(3):p 6, March 2023. | DOI: 10.1097/01.NURSE.0000919004.62269.9c
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In response to my January Nursing2023 editorial entitled, “Classifying nurses as expenses comes at a high price” that I shared on social media, a reader added her own nursing bug-a-boo to the comments: having her nurse educator role categorized as nonproductive by her hospital instead of productive.

For those unfamiliar with these common healthcare finance terms, paid time for nurses in direct patient care is often designated productive; paid time for attending educational sessions or meetings and working on projects, such as to improve patient-care quality, is often considered nonproductive. This terminology applies even when nurses perform “nonproductive” activities as part of their role requirements or job responsibilities. The problem is that most budgets do not adequately support nursing hours outside of direct patient care.

These terms are insulting for their implications and can carry genuine budget challenges for nurse leaders. From a high-level perspective, budget dollars are allocated for nursing productive time in relation to a specific workload. For example, on an inpatient unit, the nursing budget is typically based on the number of patient days and hours of care established for that area; in the ED, it is calculated by considering the number of patient visits.

Aside from the flaws inherent in calculating nursing workload this way, budgeted nonproductive time may be completely disconnected from the needs of the nursing unit to support safe staffing. The nurse leader then has the dilemma of scheduling nurses to attend required education and other essential non-direct care activities with a budget that does not concurrently enable assigning the necessary number of nurses to care for patients without exceeding the budget. The choice becomes working short of nurses on the unit or canceling education and other essential professional functions that take nurses away from direct care.

Offering no budget provision for nursing professional development and activities that support high standards of excellence undervalues the contributions of nurses and does not promote workplace engagement. These environments are ripe for turnover and care quality issues. When frontline nurses are not granted time to learn or address improvement opportunities, desired outcomes decline. Words and actions matter: productive and nonproductive terms must be replaced with inoffensive language such as direct and indirect. Budgets need to support nurses to attend essential professional development and outcome improvement activities without negatively impacting direct-care staffing. Recruiting and retaining nurses requires new thinking.

Until next time,



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