The nurse, located at the center of the health system, is expected to constantly enrich his/her cognitive background, the professional proficiency and the possessed communication and cooperation skills. Moreover he/she has to manage all issues pertaining to the health progress of the patients, handle emergencies, cooperate efficiently with other medical and paramedical staff and update and encourage the patient’s relatives. To serve these functions, the nurse is expected to work hard under adverse conditions mainly due to the ongoing economic crisis that strikes the Greek society. The hospital staff in Greece was notably reduced by 15% in the years between 2010- 2017, whereas the proportion between the nursing staff and the general population is by far the worst in the EU (3.2 nurses against an average of 8.4 nurses in the EU per 1000 inhabitants), as stated in the EU “Greece’s Health Profile in 2017”. An average nurse is overwhelmed by emotions of tension, alertness, joy, satisfaction alternated with disappointment, fatigue, fear and sadness. This is the main reason why the nurses sometimes leave a bad impression of being distant and indifferent professionals and most of the times they are treated likewise; That’s happening due to their internal striving to balance all the aforementioned contrasting feelings created through the interaction with the working environment. The nurse’s qualifications are not only confined to the typical ones. The latter are those that will secure him/her with a steady job after his/her studies and the internship. It is imperative that he/she will give a daily struggle to produce the best outcome. Sometimes - most of the times, thankfully - the nurse will succeed, some other times, he won’t. What is happening then in those cases? Did he/she overestimate own potentials, was there any mistake, did the team cooperate in a wrong way? It is needed to find an educated answer to these questions. This entire quest for the truth, the demand for a validated search with supporting evidence, the concern for the healthcare of the suffering person and the health promotion in general place the Nurse Science in the spectrum of the applied sciences.

Data set from the article Van Bulck L, Goossens E, Luyckx K, Apers S, Oechslin E, Thomet C, Budts W, Enomoto J, Sluman MA, Lu CW, Jackson JL, Khairy P, Cook SC, Chidambarathanu S, Alday L, Eriksen K, Dellborg M, Berghammer M, Johansson B, Mackie AS, Menahem S, Caruana M, Veldtman G, Soufi A, Fernandes SM, White K, Callus E, Kutty S, Moons P; APPROACH-IS consortium and the International Society for Adult Congenital Heart Disease (ISACHD). Healthcare system inputs and patient-reported outcomes: a study in adults with congenital heart defect from 15 countries. BMC Health Serv Res. 2020 Jun 3;20(1):496. doi: 10.1186/s12913-020-05361-9. PMID: 32493367; PMCID: PMC7268498.

This is the abstract:

Background: The relationship between healthcare system inputs (e.g., human resources and infrastructure) and mortality has been extensively studied. However, the association between healthcare system inputs and patient-reported outcomes remains unclear. Hence, we explored the predictive value of human resources and infrastructures of the countries' healthcare system on patient-reported outcomes in adults with congenital heart disease.

Methods: This cross-sectional study included 3588 patients with congenital heart disease (median age = 31y; IQR = 16.0; 52% women; 26% simple, 49% moderate, and 25% complex defects) from 15 countries. The following patient-reported outcomes were measured: perceived physical and mental health, psychological distress, health behaviors, and quality of life. The assessed inputs of the healthcare system were: (i) human resources (i.e., density of physicians and nurses, both per 1000 people) and (ii) infrastructure (i.e., density of hospital beds per 10,000 people). Univariable, multivariable, and sensitivity analyses using general linear mixed models were conducted, adjusting for patient-specific variables and unmeasured country differences.

Results: Sensitivity analyses showed that higher density of physicians was significantly associated with better self-reported physical and mental health, less psychological distress, and better quality of life. A greater number of nurses was significantly associated with better self-reported physical health, less psychological distress, and less risky health behavior. No associations between a higher density of hospital beds and patient-reported outcomes were observed.

Conclusions: This explorative study suggests that density of human resources for health, measured on country level, are associated with patient-reported outcomes in adults with congenital heart disease. More research needs to be conducted before firm conclusions about the relationships observed can be drawn.