Scientific Online Resource System

Scripta Scientifica Salutis Publicae

Work overload of nurses and midwives in Bulgarian hospitals and the need for provision of supporting care by health assistants

Krasimira Laleva, Lora Georgieva


INTRODUCTION: Medical professionals face big problems in providing supporting care. Currently it is delivered by nurses and midwives, a huge challenge in terms of the constant work overload this kind of med­ical professionals face in Bulgaria.

AIM: The aim is to explore the work overload among nurses and midwives in Bulgarian hospitals and the need for the recruitment of a separate group of additional staff - health assistants for the delivery of sup­porting care.

MATERIALS AND METHODS: The study was conducted among the medical staff in nine hospitals in five cities of Northeastern Bulgaria. The total number of respondents was 463 including physicians, nurses and midwives. Data about the work overload of nurses and midwives, as well as the need for additional per­sonnel for supporting care was collected by a semi-structured questionnaire. Data was analyzed with IBM SPSS v. 19 - descriptive statistics and non-parametric tests (the Chi-square test was used for analyzing the independence of two categorical data).

RESULTS: Results show that according to the medical staff, nurses and midwives are `permanently` and `frequently` overloaded with work due to the provision of supporting care for patients. There was no statistically significant relationship between `profession` and `work overload` (χ2=9.188, p=0.163), i.e. - both nurses and midwives are considered as overloaded with work. Almost all respondents notify that med­ical orderlies also take part in delivering supporting care. Two thirds of the respondents acknowledge the need for hiring health assistants.

CONCLUSION: There is an essential need for health assistants in Bulgarian health care. The new health professionals would be fully involved in providing supporting care which would improve quality of care and reduce the work overload of nurses and midwives.


work overload, nurses, midwives, supporting care, health assistant

Full Text


Supporting Care 2012 [Internet]. London [cited 2017 Feb 28] (

United Hospital Fund- Next Step in Care [Internet]. New York: Next step in care; 2013, [cited 2017, Feb 28]. UHF Family Caregivers and health Care professionals Working Together (http://www.

Holland JL, Rowe FB, Roath FL, Stone BG. Hospital attendant selection. Nursing Research. 1960; 9(2): 104.

McConvey MM. A study of Some Characteristics of Mental Hospital Attendants. A Thesis Submitted to the faculty of the Graduate School of Loyola University in Partial Fulfillment of the Requirements for the Degree Master of Arts, 1960. (

Kentucky Community & Technical College System [Internet]; Kentucky, USA: Online Nurce Aide Certificate, Learn on Demand [cited 2017, Feb 28] ( Offer/NAAProgram.aspx).

Groupe Hospitalier Saint-Augustin [Internet] Malestroit, France: Training and research [cited 2017, Feb 28] ( training-search).

Hospital Attendant. Classification Standard. [Internet]. [cited 2017 Feb 28] ( hrh/statistics/Health_workers_classification)

Bailey S, Scales K, Lloyd J. The emotional labour of health-care assistants in inpatient dementia care. Ageing and Society. 2015; 35(02): 246-69. doi: 10.1017/S0144686X13000573

Gresham T. Attendant Vs. Orderly 2015. [Internet]. [cited 2017 Feb 28] ( attendant-vs-orderly-23097.html).



About The Authors

Krasimira Laleva
Medical University of Varna

Department of Social Medicine and Health Care Organization, Faculty of Public Health

Lora Georgieva
Medical University of Varna

Department of Social Medicine and Health Care Organization, Faculty of Public Health

Font Size