Impact Report to Senior Leadership
The Nursing Challenge
A prominent nursing center in the mid-size East South Central city in the South has come under the fire due to a major challenge of shortage in the nursing staff. An increase in the health care expenses led to a temporary reduction in the staff’s earning that led them to decrease in the number of nurses. Decreasing the nursing staff is the only logical way to combat the increased health costs, however, it partly kills the working enthusiasm of the staff. But, the decreased staff is birthing more problems, as there is an array of patients that come to this center for care and cure and the decreased number of nurses cannot put up with all of them.
From the prospect of the nurses, the decreased staff is only burdening the available nurses with more patients. Dealing with more patients, burdens an individual nurse with more work load that leads to stress. Also, working more shifts can lead to fatigue and sleep deprivation. Fatigue and sleepiness often compromises with patient safety. According to Jha, Duncan and Bates (2010) Fatigue, Sleepiness, and Medical Errors nurses need to give thorough attention to patients, make sound judgments, and sometimes quick reactions and decisions need to be made in emergency cases. (July 2001) All this is affected when nurses do not get proper sleep and work more hours.
The center facing the staff shortage nursing challenge is a teaching hospital. The hospital envisions enhancing the lives of people by serving them with patient-centered care. Innovation, tradition, experiences, and optimism are some of its key areas of growth, based on which the hospital stands proud. The mission statement is dedicated to excellence and innovation in teaching, patient care, research and delivery of services. The hospital holds dear the values of integrity, respect, accountability, compassion, and primary concentration on patients. It aims to deliver excellence in teaching, patient care, research and innovation.
The shortage of staff leaves a negative impact on each of the key features along with the mission, vision, and values of the teaching staff.
Firstly, the vision is disrupted as quality care in patient service is hindered with the lack of staff. At times, some patients may be neglected as all the available nurses could be engaged with other patients. With a higher nurse-to-patient ratio, more patients are prone to neglect leading to infections, injuries and inadequate knowledge regarding how to look after and take care of their injury or illness. (“What happens to patients when nurses are shortstaffed?”, 2017) Lives are not enhanced as patients return often sicker than before.
Secondly, the key features that led to the growth of the organization are also not honored. With over burden, there is little for a nurse to learn and gain experience from. Nurses in training would also only get confused as they receive poor training and less instructions from their senior nurses who would also be occupied with increased work flow.
Furthermore, according to Carayon and Gurses (2008) Patient Safety and Quality: An Evidence-Based Handbook for Nurses, an increased workload will result in increased job dissatisfaction and burnout contributing to high nurse turnover. Excellence would also not be delivered, as with the decreased staff the nurses would also be expected to do unprofessional works such as picking up food trays for instance. Innovation cannot be achieved with inexperienced and occupied staff. Thirdly, and ultimately it would be difficult to maintain the tradition and mission of quality care for patients and imparting skill in teaching and training nurses as well as research. Lastly, the challenge arising due to nursing staff shortage will also leave an impact on the hospital’s values as well. Firstly, integrity centers around doing the right thing but a shortage of staff will not do so. This is because it does lead to more burden to the working nurses. Respect is another value that is interconnected and the respect of all the nurses, patients, and the organization is at stake here. Similarly, the value of accountability of the action also lies on the hospital. With less nurses, patient care gets poor so any accidents or unawareness regarding any individual patients can occur. Accountability as a value is, therefore, questioned. Tired nurses will, as an effect of the workload, not be able to practice with compassion, another value of the hospital that will not be honored.
Since the organization is a teaching hospital, it sets an example for the younger, learning generation who will pick each and everything from the situation and the impact of the nurse shortage will also have an impact on the students. Since the hospital embeds teaching as in its mission statement, calling themselves educators. Therefore, this nursing challenge creates a gap in accomplishing the mission of the hospital, fulfilling its vision, and outlining its values.
A Strength, Weakness, Operation, and Threat (SWOT) analysis on the understaffed nurses reveals a better picture of the whole situation. Below is a table that explains the analysis.
|Strengths Higher quality care Better treatments leading to improved patient health outcomes and decreased mortality Thorough patient assessments Support from the American Nurses Association Recent research and innovation Latest medical technology with skilled and fully trained staff.
|Weaknesses Understaffed nurses Recent budget cuts to promote further research and meet increased health care costs. Patient care at risk Training levels go down
|Opportunities Encourage more research about effective nursing methods Grant scholarship programs for student nurses More intensive to experienced nurses Request for a budget increase.
|Threats Cost of legistion Fixing shortage of nurses and aging workforce Opposition from cooperate bodies Conflicting research related to nurse to patient ratio Hospital reputation at risk
A nurse leader is the need of the hour. The position would call for an individual who can deal with the current challenge. Evidence shows that nurse leaders have a positive impact on the work environment, improved patient outcomes, and organizational performance. (Sherman, Edwards, Giovengo, & Hilton, 2009). An experienced, well- trained leader is one whom its staff looks up to and follows the targets set by him. He chalks out a plan to combat the challenge and the steps towards the achievement of that goal are encouraged, regulated, and inspected by him. Nurses with different education and competences yield varying skills to patient care. A lead nurse ensures that all the nurses must be able to practice to the optimum of their individual capabilities. To that end, the nurse leader promotes a professional environment, recognizes and rewards these differences by assigning nurses’ roles. (“Strategies to Reverse The New Nursing Shortage”, 2017) The nurse leader can plan strategies to eliminate the threat emanating from the understaff nurses challenge such as recruiting students and appointing healthy nurses over aging nurses who cannot meet the demand of the agile profession of nursing. Patients outcome is great as studies have shown transformational leadership was associated with reduced medicinal errors. (“How Nursing
Leadership Styles Can Impact Patient Outcomes and Organizational Performance | Bradley University Online”, 2017). Effective nurse leaders assign appropriate staffing and resources to achieve care and optimal patient outcomes. Moreover, at the organizational level they sketch strategic direction by participation in the decision-making tier and with their ability to effect nursing practices and values. Good qualities of a nurse leader include dedication, clear vision, strategic focus, empathy, and commitment to develop the staff. Overall, the position of the nurse leader will align strategies and achieve goals to face the challenge and maintain the strengths of the organization.
Carayon, P., & Gurses, A. (2017). Nursing Workload and Patient Safety—A Human Factors Engineering Perspective. Ncbi.nlm.nih.gov. Retrieved 12 April 2017, from https://www.ncbi.nlm.nih.gov/books/NBK2657/#_ch30_rl1_
How Nursing Leadership Styles Can Impact Patient Outcomes and Organizational
Performance | Bradley University Online. (2017). Onlinedegrees.bradley.edu. Retrieved 12 April 2017, from http://onlinedegrees.bradley.edu/resources/infographics/how-nursing-leadershipstyles-can-impact-patient-outcomes-and-organizational-performance/
Jha, A., Duncan, B., & Bates, W. (2017). Chapter 46. Fatigue, Sleepiness, and Medical Errors | AHRQ Archive. Archive.ahrq.gov. Retrieved 12 April 2017, from https://archive.ahrq.gov/research/findings/evidence-basedreports/services/quality/er43/ptsafety/chapter46a.html
Sherman, R., Edwards, B., Giovengo, K., & Hilton, N. (2009). The Role of the Clinical Nurse
Leader in Promoting a Healthy Work Environment at the Unit Level. Critical Care
Nursing Quarterly, 32(4), 264-271. http://dx.doi.org/10.1097/cnq.0b013e3181bad5a8
Strategies to Reverse The New Nursing Shortage. (2017). Nursingworld.org. Retrieved 12 April 2017, from http://nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/wor kforce/NursingShortage/LegislationStrategies/NursingShortage.html
What happens to patients when nurses are short-staffed? (2017). Truthaboutnursing.org. Retrieved 12 April 2017, from http://www.truthaboutnursing.org/faq/shortstaffed.html
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