...will provide the foundation for developing the nursing organization as a "health-promoting organization." The background and significance, theoretical framework, study findings, and executive strategies are discussed. The results and implications are intended to guide executive strategies, including organizational interventions, to build the nursing organization for quality patient care and positive working environments. Background and Significance The glue that holds the hospital together are the first-line managers. However, these managers are caught in a crossfire. Torn between multiple needs — patient, the staff, and the administration — nurse managers have been downsized and stretched over multiple units (Curtin, 2001). Nurse managers responsible for multiple units are severely challenged to maintain the needed blend and balance of clinical and business management, which is essential to staff nurse retention. Report after report identifies the importance of the nurse manager in retaining nursing staff (Boyle, Bott, Hansen, Woods, & Taunton, 1999; Corser, 1998; Cullen, 1999; Flannery & Grace, 1999; Fletcher, 2001; Kerfoot, 2000; Leveck & Jones, 1996; Slaughter, 2002; Taunton, Boyle, Woods, Hansen, & Bott, 1997). Further, staff nurses report burnout and dissatisfaction with their jobs and a concern about decreasing quality of care (Aiken et al., 2001; First Consulting Group, 2002). The data on the nursing shortage portends a health care delivery system in severe...
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...Business Case Analysis - Nursing Second Shift Staffing Business Case Analysis - Second Shift Staffing Monarch General Hospital has recently experienced short staffing of the nursing workforce for the second shift (15:30 to 23:30). This report was commissioned to examine options for the Healthcare Chief Officers involved, which will provide valuable guidance toward a reliable business solution based on currently available evidence. Background Monarch is currently experiencing a deficit in the supply of nurses. In particular, the deficit is on the second shift. But, overall, the actual problem to address is a less than optimal supply of nurses. The plan to remedy the problem for the actual shift involved will be addressed in the strategy and implementation. This deficit of nurses will cause delayed delivery of care to patients and/or adverse events. This will likely lead to patient dissatisfaction, lawsuits and the hospital absorbing unnecessary and unplanned for costs. These factors will ultimately lead to a reduced number of hospital admissions. Monarch must achieve the ability to control the shortage instead of surrendering to it. This report will examine two of the four currently considered options. The first option is hiring additional permanent personnel and the second is hiring short-term, temporary personnel to be used on an as needed basis. Business and Operational Impacts The factors leading to a reduced numbers of hospital admissions will affect...
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...5. The consequences of nursing turnover 6.1. Loss of patients * Healthcare organizations have reported having to turn away patients to other healthcare facilities due to lack of available staff resulting from high level turnover. This is a particularly significant concern for healthcare organization operating in states that mandate minimum nurse to patient staffing ratio (xxx). 6.2. Decreased quality of patient care * Staff shortages caused by nursing turnover are associated with significant decreases in the general quality of patient care, increases in the length of patients stays within hospital and greater number of hospital acquired infection (xxx). 6.3. Increased contingent staff costs * Many healthcare organizations are forced to rely on contract nurses to overcome staff shortages caused by high level of nurse turnover. Such contract nurses can cost twice as much to employ as nurses employed directly by the company (xxx). 6.4. Increase nurse turnover * Nurse turnover creates staffing shortages that increase the work demands placed on the organizations remaining nurses. This heightens the risk of the remaining nurses quitting due to excess workload and constantly increasing nurse turnover within organization (xxx). 6.5. Increased turnover of medical support staff * High level of nurse turnover creates disruptive, unstable work environments that negatively impact the retention of other medical service providers that...
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...Nursing Shortage and Nursing Turnover Nursing shortage is a phenomenon that is affecting nurses and the provision of adequate patient care in today’s health care industry. Nursing shortage is said to occur when the demand for employment of nurses is far greater than the number of nurses willing to be employed at that time (Huber, 2010). According to the American Association of Colleges of Nursing (A.A.C.N.), “the nursing shortage is expected to increase as baby boomers age, and the need for health care increases” (A.A.C.N., 2013, Para 1). In the United States, Registered Nurses (R.N.) make up the largest recorded working population of the health care profession, and the Bureau of Labor Statistics estimates that 2.7 percent of the workforce comprises of nurses compared to 3.6 percent in the last 6 years (A.A.C.N., 2013). This decrease is attributed to the current shortage and high turnover of nurses. This current trend in the nursing profession has a great effect on the provision of health care because it has reduced the quality of care of patients, increased accidents amongst patients, absenteeism rates and staffing among others. The purpose of this paper is to discuss the causes of nurse turnover and shortage, find out ways nurse leaders and managers may resolve this problem, and also to discuss the writer’s own personal and professional philosophy of nursing regarding this issue. Nursing shortage is also evident by the reduction in the availability of new nurses, inadequate...
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...Literature Review One nursing issue that I am passionate about is the shortage of nurses. This has been a long standing problem, even in the days of Ms. Florence Nightingale, when she and her nurses "used limited resources to address unlimited wants for healthcare (Cherry & Jacob, 2014)". They did the best they could and were able to improve the soldiers' condition dramatically. Agreeably, the situation is far better today. This topic is of great importance because, a shortage of nurses means that the ratio of patient to nurse increases and this can result in nurses being overwhelmed. It also affects the every aspect of patients’ care and it increases the risk of negative patients’ outcomes. It makes nurses apprehensive when they are going to work and that is not a good way to feel on a regular basis. Some of the reasons listed as causes of shortage of nurses include lack of good role models and early professional socialization, unrealistic workload, an aging workforce, negative work environment, retention problem, and insufficient nursing faculty staff. I chose the first article "Becoming a nurse: a meta-study of early professional socialization and career choice in nursing," because it attempts to deal with the issue of nursing shortage by investigating what motivates young people to choose nursing as a career and early professional socialization (Price, 2009). It highlighted the need to have good mentors, peers and role models, especially as new nurses are transitioning...
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...Registered Nurse to Patient Ratio LLM Various participants in different states across the nation has lobbied the state legislatures and the United States Congress to proclaim laws that will recuperate the overall working conditions of hospital and clinical staffing. Proposed nurse to patient staffing ratios has become a huge discussion in the healthcare field. It has developed a huge concern that patients and nursing staffs are being harmed related to the inadequate nurse to patient ratio staff. This issue alone has caused an increase in severity of illness, fatigue, hospital stay, and harm to patients. With the increase in complexity of care per patients, nurses grow weary thus increase the negative impact of the inability to improve the quality of hospitalization outcomes for the patients. It is prominent that we identify and maintain the appropriate number of the nurse to patient staffing ratio, as it is critical key of delivering the optimal quality patient care. In the pass few years and even up until now, there has been a massive growth in need for more registered nurses in hospitals and clinics due to the rising acuity of patients and shorter lengths of stay. More and more patients appear looking for healthcare assistance. The safety and quality of the care patients are looking for are becoming difficult to find as registered nurses grow exhausted and drained out of energy. Inpatient working conditions has weakened in various facilities, as hospitals cannot fulfill...
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...list' in the category of fastest growing companies in the United • Mr. Stagen was awarded Ernst & Young's Entrepreneur Of The Year award in the Greater Los Angeles region in 2007 • Founded the National Association of Travel Healthcare Organizations (NATHO) in 2008 2 Today’s Agenda • A Look at Today’s Healthcare Workforce • Reviewing the KPMG U.S. Hospital Nursing Labor Costs Study Results • Strategies for Optimizing the Nursing Workforce 3 Learning Objectives • Understand how to successfully blend full-time and contingent labor to achieve financial and patient care goals. • Develop proactive contingent staffing strategy to attract highest quality nurses. • Leverage new research to understand the impact of contingent staffing on quality and patient outcomes. 4 State of the Healthcare Workforce • Healthcare employment up 360,000 in last 12 months1 • The average age of a Registered Nurse is 472 • Nurses looking at job changes3 – 42% are not satisfied with their current job – 24% plan to seek new employment if economic recovery continues – 32% plan to take steps to leave nursing in the next 1-3 years 1 Bureau of Labor Statistics, 2 & 3 AMN Healthcare 2011 Survey of Registered Nurses 5 Proactive Planning Hospital executives need to be asking: How do I control my workforce expense budget most efficiently? 6 Equation for utilization of Permanent RNs vs. Temporary RNs has changed dramatically •...
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...caring or protecting themselves, they should start off by practicing in the environment and at home, it will be easier for them to protect themselves when in the hospital. The skills and knowledge will gain while practicing at home and in the environment. Sometimes the nurses forgot to look for the complex and dangerous threats that facing them in the working environment. Work place violence, define as the behavior involving physical force intended to hurt, damage, or kill someone or something in the workplace. Work place violence is one major threat that is facing the nurse’s safety in the environment. Nurses might get into trouble if they do not prevent themselves from the violence. Work place violence can result from lacking of nurses or shortage of nurses that works in one ward with plenty of patient. Working with plenty of patient may cause loose of concentration with the patient. This can cause the nurse to accidently poke herself or himself. That’s why it’s better for nurses to get enough sleep before going for their shifts. Nurse...
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...Self-Assessment I am Karen Franklin BSN, I have been a nurse for 4 years. I am applying for Clinical II, I have grown as a person and as a nurse. I have had the priviledge to work in several different areas of nursing and truly enjoy being a nurse. My first position was on a telemetry unit where I got to learn of how to care for and manage critical care patients. In addition to learning how care for my patient, I learned how to initiate care plans, comply with core measures and do bedside teaching with patients and families. I received ACLS certification, critical care certificates and basic arrhythmia certificates. As experienced nurse, I have learned how to effectively time manage, prioritize patient care and work independently, as well as, team member. My experience has allowed me to grow as nurse, using the skills I was taught can allow me to share my knowledge with others. I feel some of strenghts are having good clinical skills and a good of understanding of how to best care my patient’s. My peers can attest that I am willing to go the extra mile to help; I don’t mind answering other’s call bells, take patienys pain medication and assist with bathroom needs or repositioning. I volunteer once a month at a senior living facility in my area, also at church functions. In the future I would like to volunteer more and possibly do missionary work. In the past eight months I have taken on the role of charge nurse. I received a brief introductory on how to do the patient assignment...
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...Nursing Shortages and Solutions Seketha Silas Walden University Nurs 3001-6, Issues & Trends in Nursing September 8, 2013 This assignment is about the concerns of the nursing shortage locally, nationally and globally. It will address some of the reasons and solutions for the nursing shortages. The purpose of this paper is to understand the nursing shortages and discuss some implementations that may help to resolve the shortages. Although, the country is experiencing an economic recession, think about January 2014 when millions of Americans will be able to get health insurance. Nursing may be the answer to some of the key healthcare and employment problems the US is struggling with right now. Lindsey (2013) states “with the graying of America has come a shortage of healthcare professionals, especially nurses. From 2009 to 2011, 85 percent of Associate Degree Nursing programs turned away qualified applicants.” (para 1) Nursing programs at some schools are closed due to funding cuts. There is lack of faculty at schools to train nurses. The lack of faculty to train new nurses definitely can cause concern for nursing shortages. Applicants are being turned away. Nurse educators have to endure lower salaries along with unrealistic expectations about their academic roles. Some nursing faculty is expected to balance their academic roles along with advancing their expertise and managing clinical practice. The lower salaries are sometimes lower than their colleagues working in...
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...Educational Preparation: Competencies, Associates Degree V’s Baccalaureate Nursing The History of the Associates Degree in Nursing Does an Associates degree in Nursing (ADN) or a Baccalaureate degree (BSN) in Nursing better prepare a nurse to function at a level required to remain autonomous in both general and critical care? At the end of World War II there was a shortage of nurses working in the hospital setting. The Baccalaureate degree required a four-year education, and the shortage could not wait for this completion. It was recognized that there would need to be two-tier’s of nursing, both a professional BSN and a technical ADN nurse (Matthias 2010). Mildred Montag completed her research on The Education of Technical Nurses (Matthias 2010) and developed the Associates Degree nurse, or technical nurse, who would complete routine or intermediate nursing care under the supervision of a Baccalaureate degree nurse. However, the ADN’s technical only skill set dissolved and they were functioning at no different level than their counterparts the BSN, working side by side with only their education differentiating them from each other in the work place. Course Variation There is a year in difference between a diploma and Associates prepared nurse v’s Baccalaureate prepared nurse. However, there are courses that researchers have placed an emphasis on to act autonomous and outside the original restrictions of a technical nurse. These courses include critical thinking, social...
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...the Nursing Workforce Shortage After researching the current and future state of the nursing workforce, there are many issues regarding the nursing workforce that should be addressed at the upcoming retreat. To begin, the reason for emphasis on the nursing workforce is that nurses constitute the largest group among the health service providers (Barton, 2010), as you very well may be aware. Without considering implications that affect the largest group of the workforce, the organization will not be able to strategically plan for the shift of the nursing shortage currently at-hand. First, we must consider the current workforce distribution of nurses. A national survey by the National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers in 2013, indicates roughly 55% of the RN workforce being at the age of 50 years old or older (American Association of Colleges of Nursing, 2014). With the current demographic makeup of this group, it is inevitable that a majority of the nursing population will be retiring soon from practice and teaching. While the Affordable Care Act tries to address the projected shortage by increasing the supply of workforce, increase the support of training, and establishing loan and grant payments, the shortage of nurses may very well be still be an issue. If issues regarding the lack of faculty and training continue, similar to the rate as reported in 2010 with 80,000 qualified applicants being denied entry to nursing schools...
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...There were many things that I observed during the Capstone experience. The first thing was that many of the nurses were severely fatigued throughout the night shift. Some nurses relied heavily on caffeine throughout the night and others would get multiple items from the vending machine. A couple nurses had a hard time keeping their eyes open, while other nurses were wide awake throughout the entire shift. I also observed nurses taking breaks and walking the stairs to help themselves gain more energy. I found it most shocking that one of the individuals having a very hard time coping with the night shift had over 10 years of permanent night shift experience. This individual often mentioned how he would only sleep a few hours in between shifts...
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...Dynamics NSG-430 1 Tricia Aud February 04, Competency differences between BSN and ADN are many, the BSN is more prepared than ADN to be a nurse, as they are more efficient and effective. Although the ADN can do many of the same jobs, access patients, pass medications and start intravenous lines, the BSN is more academically well rounded thus making them more qualified to be leaders, educators and managers in the work environment. The argument is weather the educational level of a nurse affects their decision making and leadership skills. In an article my Marcia Masters (1989) she explains that decision making is an inherent task to the role of today’s nurse. The nursing environment is both demanding and complex. After the development of the technical nurse by Margret Montag (1951), due to the shortage of nurses after WWII, there has been an ongoing controversy. She believed in a new kind of nurse, one that would be prepared to start after a two year program. Although good intentioned, some believe the ADN not to be as adept at decisions making and critical thinking as the BSN. Some ADN programs do have curriculum for leadership/ management as part of their courses or incorporated in another course. De Chow (1977) points out, “when the ADN programs were conceived, they were not meant to prepare graduates for administrative tasks and positions.” Along with taking the same educational board exam the ADN also takes on the same legal responsibilities the BSN nurse. There...
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...organization, also bringing the same binder to the same class it belongs to would help tremendously. This is an important goal because being organized would make studying and fallowing along with most teachers much easier. This goal of mine should be accomplished by the second week of school. I will know it is achieved when I am more confident in class because I am on track if not ahead of my teacher. Improving studying skills is a very important goal of mine. You don’t pass tests with luck or good attendance, good grades are accomplished by good studying. I will reach this goal by reaching my first goal of being more organized, also by putting more time into my school work rather than outside distractions. My mother always says that nursing school is like putting yourself in prison, only the school work matters not you friends or social life. This goal must be reached very early on into my college career, without it...
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