Evaluation Of A Nurse Manager Of The Palliative / Hospice Care Unit At A Veteran's Hospital

Arrange for staff to accompany resident when she ambulates, frequent reminders, her cognitive and physical status will have to be fully evaluated to determine her level of alertness and what functions she is capable of performing by herself.

As a manager for a large department her job duties are quite extensive. She manages over forty employees. She reinforces compliance of staff with hospital policies, gives informal/formal feedback regarding performance throughout the year, promotes staff development, and uses effective listening, writing, and verbal skills. She promotes satisfaction targets related to patients, employees, and physicians, actively participates in, and leads interdisciplinary teams. Alicia also assist the director in maintain departmental budget, monitors supply utilization and maintains budgeted targets, and responsible for an efficient and accurate payroll.

My second clinical day took place on September 24th, 2015 at Saint Barnabas Hospital in Livingston, New Jersey. My preceptor Maria Brilhante, MSN, RN, allowed me to observe the morning huddle that took place with all the nurse managers that are in the hospital. The purpose of this huddle was to keep the director of nursing informed about the census on each unit. I found this processed to be very uniformed and professional because the DON was engaged. The day went on with me attending meetings on how managers could implement plans to contain cost for the hospital. Maria did her daily rounds on her patients and her nursing staff. She has a folder that contains papers on how each nurse is progressing from the time they get off orientation. Her motto to the nurses is, “You are good at what you do, so when I coach don’t take offense. I am only trying to get you to be great”. This boost their confidence which I thought to be important.

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.

The most challenging area Mrs. Dukes faces is staffing. For a well- developed health care system, sufficient, highly motivated and skillful employees are essential components (Saleem, 2015). It is important that we remember people are the most important and valuable asset of an organization. Every position is an important position and it takes skillful and effective people to fill those spots. “Staffing is the managerial function concerned with the procurement and maintenance of human resources” (Dunn, 2010). Having the right staff members is key in running an organization. If you hire individuals who are

In addition, nurse managers must make skilled staffing and scheduling decisions to ensure that safe and cost-effective care is provided by caregivers (Yoder-Wise, 2015, p. 256). However, as a nurse manager I would select “to require hospitals to have a nurse driven staffing committee which create staffing plans that reflect the needs of the patient population and match the skills and experience of the staff.” In addition, as a nurse manager, I would also select “for legislators to mandate specific nurse to patient ratios in legislation or regulation” since during the TJC accreditation process, the surveyor reviews the staffing plans developed by the nurse manager for any obvious staffing deficiencies, such as, a shift or series of shifts in which the unit staffing plan is not met (Yoder-Wise, 2015, p.

Learning experiences influencing her personal development into leadership include the years worked as a clinical nurse on the stroke unit. Recognizing the leadership skills of her unit director inspired her to consider pursuing management

All services are delivered with sensitivity to the clinical, emotional and spiritual needs of the individual” (mission, n.d.). We can also state Jefferson Hospital's vision here “Our communities will have confidence that Jefferson Hospital will be available for them in times of need, providing superior care and service, and working to improve the health of the region.” (Vision, n.d.) The hospital as a whole try to live by this mission statement and the vision statement, however, the manager of the oncology unit tends to forget how to partner with their employees to develop health needs. He also forgets superior service comes from happy staff members. As a manager, he should provide resources to the staff, have an open-door policy, and treat everyone as an individual. Instead, he micromanages resulting in employees losing their sense of autonomy and having a hostile

These highlight the system’s dedication toward providing culturally competent care, professional development, advancement in technology and research, etc. Memorial Hermann Southwest does work towards these system-wide goals however, its primary focus is on the value of “providing superior quality and cost efficient, innovative, and compassionate care.” (See Appendix G) In order to do this, leadership within the facility constantly stresses the importance of cooperation, initiative, innovation, culture, and flexibility among their staff. Teamwork is highly valued within the organization and seen within each department as well as interdepartmentally and between numerous disciplines including nursing, pharmacy, human resources, financial services, physicians, and case management. Staff members collaborate to ensure that quality care in multiple facets is provided including patient satisfaction, infection control, and potential acquisition of Magnet Status. The staff is motivated to look at the “bigger picture” and adjust work accordingly. There is a realization amongst the staff that there will always be an opportunity for improvement and that flexibility and adaptability will be necessary for these improvements to occur. There is no evidence of working in a department silo. The staff works collectively towards the common goal of betterment of the organization in all aspects to provide the best care

I appreciate you all mentioning that there is a high turnover rate for hospice organizations. From my personal experience with hospice, it is a very difficult and rewarding field of work that takes a special person. Due to the high turnover rate, this can also impact the quality of care for patients. If an employee is not happy with their position or is feeling burnt out, then the patient and the family can be negatively impacted. While it is a waste of resources for the organization, it can also impact the organizational success on whether or not a patient and/or family members will refer to that particular facility.

Providing the highest level of quality healthcare to our patient is our number one priority as nurses in this profession. However, for this goal to be met, we need the collaborative support from management to correctly staff our nursing units. Our staffing needs should not just been based on the legal minimum requirement, management needs to go beyond the traditional methodology of staffing and calculate the staffing needs from a different approach in order for us, nurses to meet that goal.

For decades, nurses created theories as a framework for practice. Theorists made observations based on experiences, then sought to describe, predict outcomes and solve problems. One such problem, recently identified by the American Association of Critical Care Nurses or AACN, is maintaining a healthy work environment to decrease high turnover rates, nurse burn out, and adverse patient outcomes. By illuminating factors that create a healthy work environment, nurse leaders can improve retention, enhance job satisfaction, and provide better patient centered care (Blake, Leach, Robbins, Pike & Needleman,2013). The aim of this paper is to explore the relationship of Jean Watson’s Theory of Human Caring and creating a healthy work environment.

Oversees a team of 9 staff memebers while ensuring consistent and quality service for residents

Through your help staff must be allowed to find self-confidence within them, not only will they work more efficiently but they will probably end up enjoying their jobs a lot more, this is the beginning of efficient and welcomed service. A nurse manager’s goals would therefore largely be based on their staff, ensuring that they are happy and cared for. A successful institution is only triumphant when everyone is working in an enjoyable environment and this all starts with you. Patient care will immediately show improvement and the institution will be remembered for the caring service that they received. People always tend to respond well to a kind and gentle attitude above that of an aggressive and forceful nature. Nurse manager goals are not achievable overnight, but they are reachable, with a lot of hard work, dedication, a vision and enthusiasm for what you do.

As nurse manager Barbara is responsible for managing the staff, scheduling and budgeting for the unit. Her staff includes twenty-five registered nurses and eight patient care assistants (PCA’s). The unit is known for its culture of confrontation, blaming, and favoritism. The staff is dissatisfied, unmotivated, and not functioning as a team to deliver quality patient care. In Barbara’s first month she has lost two RN’s and due to a hiring freeze at EMU Barbara was not able to replace the positions. The unit is short staffed, stress levels are high and employee morale is low. Barbara meets individually with twenty or so staff members and comes to the conclusion that no one is happy and she has a lot of work to do. There are multiple groups that Barbara has identified issues with and she must come up with an action plan to manage the discrepancies. She has found issues in downward management which involves senior nurses, newer nurses, and patient care assistants, and in upward management including administrators and physicians,