Bottlenecks and Statistics

Nurse staffing and how it relates to the quality of patient care has been an important issue in the field of nursing for quite some time. This topic has been particularly popular recently due to the fact that there is an increasing age among those who make up the Baby Boomer era in the United States. There will be a greater need for nurse staffing to increase to help accommodate the higher demand of care. Although nursing is “the top occupation in terms of job growth,” there are still nursing shortages among various hospitals across America today. The shortage in nurses heavily weighs on the overall quality of care that each individual patient receives during their hospital stay (Rosseter, 2014).

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

everyone has different style when it comes to management. Because it is not an easy task it may be very demanding on anyone having to fulfill his responsibilities correctly. Considering that the manager doesn’t only have to make sure policies are followed correctly but also ensuring that the staff does the job correctly. Because nursing staff ratios can have an influence on managers as nursing lacks can intensify the chance of error. As a result Patients care may suffer and that can cause nurses to get

A. Nurse sensitive indicators are factors that are directly impacted by nursing.  There indicators fall into three categories; structure, process and outcomes of nursing care.  The structure indicators are the organizational piece of nursing care. These relates to the amount of staff on duty at a given time, how many RN's are on duty and experience level of the staff. For example, evidence indicates institutions with a higher number of RN’s possessing a Bachelor Degree in nursing result in improved patient outcomes. The process indicators measure nursing care such as patient assessment, patient care and intervention. These are the organizational policies and procedures of nursing.   The patient outcomes are indicators directly related to

Shared governance empowers nurses by recognizing that nurses, as front line staff, are in a position to have a unique understanding of the complexities of daily patient care. Utilization of unit-based councils made up of staff nurses to solve problems and evaluate procedures ensures that evidence-based best practices are implemented (Fray, 2011). Shared decision making in nursing units increases the use of best practices through process development, sharing of successes across multi-unit areas and in the development of new nurse leaders. Unit-based councils are often chaired by younger nursing staff and nursing leaders act more as facilitators allowing these young new nurses to be

There are many challenges facing today’s nursing leaders and managers. From staffing and scheduling, to budget cuts and reduced reimbursements, today’s nursing leaders must evolve to meet the ever changing health care environment. Constance Schmidt, Chief Nursing Officer at Cheyenne Regional Medical Center (CRMC), identified retaining experienced registered nurses (RN) as one of the biggest problems she faces as a nursing leader. She went on to state “Nationally, most hospitals have more than 60% of their nurses with at least 5 years of experience. At CRMC, it’s the reverse. We have more than 60% of our nurses with less than 5 years of experience” (personal communication, March 28, 2014). The two largest factors affecting those numbers are the nursing shortage and nursing retention. The first, the nursing shortage, was identified years ago and has been researched countless times. Some projections indicate the number representing the gap between available registered nurses, and the positions needing to be filled, could be over a million before the end of the current decade. The latter, retention of nurses, is a problem in every health care facility in the nation. Nursing turnover results in both a significant financial cost to hospitals, and a significant impact on the community through its effects on patient outcome.

staff, the skill level of the nursing staff, and the education/certification of nursing staff” (ANA, 2015). These

Nursing-sensitive indicators reflect the structure, process and outcomes of nursing care. The structure of nursing care is indicated by the supply of nursing staff, the skill level of the nursing staff, and the education/certification of nursing staff. Process indicators measure aspects of nursing care such as assessment, intervention, and RN job satisfaction. Patient outcomes that are determined to be nursing sensitive are those that improve if there is a greater quantity or quality of nursing care (e.g.,

Nursing-sensitive indicators reflect the structure, process, and outcomes of nursing care. (Nursing-Sensitive, 2014.) The skill level of the nursing staff, the supply of nursing staff, and the education or certifications of the staff are all used to measure the structure of nursing care given to any given patient. Patient outcomes, which are improved by a greater quality of care, are said to be nursing sensitive. Some examples of

In healthcare it is very important to have strong leaders, especially in the nursing profession. A nurse leader typically uses several styles of leadership depending on the situation presented; this is known as situational leadership. It is important that the professional nurse choose the right style of leadership for any given situation to ensure their employees are performing at their highest potential. Depending on which leadership style a nurse leader uses, it can affect staff retention and the morale of the employees as well as nurse job satisfaction (Azaare & Gross, 2011.) “Nursing leaders have the responsibility to create and maintain a work environment which not only promotes positive patient outcomes but also

Once these qualities are achieved that organization’s outcomes are superior. The intended audience is for nurse managers and those in leadership positions to help them identify their particular skill set and enhance their management qualities for most effective outcomes. This article is relevant because it allows for accurate public perceptions of people’s skill sets as leaders in nursing. The strength of the article is the clear and concise language used as well as the incorporation of figure 1 chart. The chart allows the reader to differentiate between the styles of leading and it’s effect on organizational outcomes.

The current and growing shortage of nurses is posing a real threat to the ability of hospitals, long-term care facilities, and others to provide timely access to quality care. Nurse staffing shortages and nurse turn-over contributes to the growing reduction in the number of staffed patient beds available for services, increasing costs, and rising concerns about the quality of care. Health care organizations highly depend on nurse managers and leaders to reverse this trend. This paper discusses the reasons for nursing shortage and turn-over, different approaches to solve this issue, and my personal philosophy about this issue.

Nurse leaders are faced with issues or problems on a daily basis that are often expected and sometimes unexpected. It “comes with the territory” so to speak. If there were no issues to solve or hurdles to overcome the necessity of designating a leader would not seem quite as important. Nurse leaders can tackle issues that occur in their work environment using nursing theory to guide them. Nursing theory provides a framework that nurse leaders can use to implement interventions or changes to positively impact the staff they lead. This framework of the theory will set the standards for achieving the desired outcomes and is based on knowledge that is gleaned from practice and/or research.

Nursing care delivery is defined as the way task allocation, responsibility, and authority are organized to achieve patient care. Tiedeman and Lookinland (2004) suggested that systems of nursing care delivery are a reflection of social values, management ideology, and economic considerations. (Tiedeman&Lookinland, 2004) According to Fewer (2006), the quality of nursing care delivery systems affects continuity of care, the relationship between nurse and patient, morale, nurse job satisfaction and educational preparation.(Fewer, 2006) Nurses are essential human resources to provide medical services with professional knowledge and skills in the healthcare setting. However, the registered nurse turnover rate has increased in recent years resulting

“Nurse sensitive indicators reflect the structure, process, and outcomes of nursing care. The structure of nursing care is indicated by the supply of