...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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...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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...NURSE SHORTAGE STRATEGIES The nursing shortage has been around for the greater part of the 20th century, and now into the 21st century, and has placed the healthcare system under some significant strain The number of patients with age-related health needs are exploding, just as a large number of health professionals are retiring. Unmet health care needs are fast approaching. There simply are not enough health professional students "in the pipeline" to meet the oncoming demand for care. The result? An impending health workforce shortage of unprecedented proportions. Nurse leaders are challenged to identify creative solutions to the issue of nursing shortage. There are many contributions to the nursing shortage. In a sense, the nursing shortage is simply from the spread of nurses that lack skills that are needed for the growing population and individual patient care. The work that nurses are hired to do is not that well understood, even by educators that are members of today’s nursing society. There is a vast gap in what the public thinks skilled nurses actually do. This reason alone is one of the causes of the nursing shortage that is happening. The nursing shortage also includes: (1) poor working conditions, (2) inadequate resources for nursing research and education, (3) nursing workforce aging, (4) women having expanded career options, (5) nursing...
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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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...approximately thirty seven thousand jobs were added in March 2011 alone (AACN). The staffing of registered nurses has been a long time concern due to the fact the shortage greatly affects patient safety as well as quality of care (nysna.org). Studies have shown that adverse patient outcomes have been related to the ineffective nurse staffing as patients have had longer hospital stays, increased infections, and higher mortality rates (Needleman, et al, 2002). To relieve the pressures put on an organization with the shortage many have begun to substitute people who are not as prepared to care for patients. This has been done by hiring temporary nursing services or recruiting foreign nurses who are not familiar with the facility, policies and procedures or the patients ( nysna.org). The ineffective nurse staffing also leads to retaining issues as nurses experience decreased morale, increased stress and anxiety, increased physical ailments, and burnout. DEFINE THE PROBLEM The problem is that hospitals cannot recruit and/or retain healthcare professionals such as nurses and physicians fast enough in the ever growing healthcare field. With the baby boomers reaching retirement age and becoming eligible for Medicare hospitals need to not only recruit but retain nurses. Nurses are hard to recruit based on low enrollment in nursing school due to low numbers of nurse...
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...Strategic Action Budget Having adequate staffing is a continual problem in nursing. Having the right quantity of nurses to care for the patients without going over the budget is difficult. According to Roussel, strategic staffing is an approach to analyze the problem. Strategic staffing analyzes the staffing needs based on long-term objectives for the unit and tries to find a combination of permanent and temporary employees with the best skills to meet these needs. Strategic staffing also requires an understanding of the different types of staffing. The purpose of this request is to obtain qualified nurses utilizing in-house or temporary staffing services to fill short-term nursing needs. Finding qualified individuals for interim placement is necessary because of the increased census of this facility as a result of the current hiring freeze. Leaving the facility understaffed is having a negative effect on the staff morale and quality of patient care, and must be addressed. According to Roussel, each patient care unit should have a master staffing plan that includes the basic staff needed to cover the unit for each shift. Basic staff is the minimum number of personnel needed to staff the unit and they need to be fully oriented full and part time employees (Roussel, 2013). Options are a) the staff already in place, b) using a short-term contingency staff or a temporary agency, or c) long term temporary nurses or travel nurses. With limited resources...
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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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...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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...situations in her life. To Jada Pinkett Smith in the television series ‘Hawthorn’ where she took on the role of Chief Nursing Officer and showed her passion for her job although being faced with challenges in her personal life . All these characters are fictitious and none of them accurately portrayed the true challenges that nurses face every day in their daily roles. It is important that with Healthcare becoming more and more complex and health insurance mandating care educating the public is crucial. Implementing new and creative ways to educate the public is also important. As a Case manager my colleagues and I realized the importance of education of the public and we used Case Management week (from October 11-17 2015) to increase the publics knowledge in the role of case manager. We found effective ways and tools to stimulate and educate the public we used the hospital’s intranet, had fairs with the use of poster boards with bold direct literature about the topic in hand, and found ways to keep it exciting and engaging for the public. Now in the in the day and age of the “super highway’ we are fortunate to have this great easy and accessible tool and this is a great source of educating the public, with applications such as Facebook Twitter, Instagram and television are all means of promoting and educating the public and put forth the message about nursing and our ever changing roles....
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...“A growing body of research shows that nurses working 12-hour shifts are more fatigued and at greater risk for making errors” - Roxanne Nelson. Nurses are our primary caregivers and have a duty to perform. If a nurse is exhausted and can not meet his or her full potential then that can intrude into the patient's safety. Therefore, nurses should be limited to 4 days a week with 8-hour shifts. The connection between extended work hours and worker fatigue, decreased productivity, and increased patient and personal safety is well documented in nurses undergoing their home. Researchers studied data that show over five thousand work shifts and found that hospital nurses worked longer than their scheduled shift and more than 40-hours a week. Studies...
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