The department of respiratory therapy at Hershey Medical Center has 90 full-time respiratory therapists in addition to the management team. The management team includes a manager, an assistant manager, an outpatient manager, three supervisors, two educators, and two clinical specialists. The department also has 20 per Diem, 15 part-time respiratory therapists, and ten equipment technicians. Currently, the departmental vacancy rate is 10 % which includes maternity leave and chronic conditions, and the rest are open positions within the department. The shift supervisor utilizes a spreadsheet for each patient care areas to determine the number of respiratory therapists needed to staff that particular area. Attached is an example of staff worksheet.
Appropriate nurse staffing is a complex topic that has arisen as a nationwide healthcare issue within the profession of Registered Nurses (RN). To truly understand the concept of staffing one must understand that staffing and scheduling are often at times used interchangeably although Mensik (2014) noted a distinct difference between the two (p. 2). The American Nurse Association [ANA] (2012) has defined appropriate nurse staffing “as a match of registered nurse expertise with the needs of the recipient of nursing care services in the context of the practice setting and situation” (p. 6). Scheduling, in contrast, involves taking into account factors such as a unit’s historical census numbers along with anticipated surgical volumes
One of the major strategic issues, in this case, is the total lack of corporate communication. Viewing internal and external communication as connected functions shifts the focus of corporate communication to answering questions about how an organization can communicate consistently with its many audiences in a way that represents a coherent sense of self pg. 235. During the acquisition period, Sister Mary Theresa had failed to communicate her objectives both internally and externally as she failed to inform the Mt. Mercy board members of her tentative offer. Thus, Auston Transcript article about the acceptance of the verbal offer to MEDICO for the purchase of Abbott Hospital surprised several board members. Immediately following the article,
As a healthcare provider we have to ensure we have the correct amount of staff as well as staff with the right skill set and qualifications on shift which meets the needs of the people we are supporting.
I am very fortunate to be serving as a Registered Nurse (RN) in our community for the past 17 years. For years, my RN colleagues here in Michigan have expressed frustration and concern when working chronically understaffed shifts and the when using mandated overtime to cover staffing shortages. Safe staffing levels
Providing the best care to each patient starts with providing the proper amount of staff members to each unit. Looking at the needs of different units not only allows administration to see areas for improvement, but also areas that are being handled correctly. Utilizing the indicators provided by The Joint Commission, 4 East, a pediatric medical/surgical floor, has a high rate of falls and nosocomial pressure ulcers that appears to be related to the increase overtime nurses have been working for that floor (Nightingale, 2010). Research has shown increases in adverse events have been related to nurses working over 40 hours a week (Bae, 2012).
Dr. Linda Aiken is the leading researcher in nursing staffing rates within the United States (Kerfoot & Douglas, 2013). She suggests that each state follows California’s example of conducting research to determine a minimum staffing ratio and making it a law (Kerfoot & Douglas, 2013). The California legislation enhanced nurse staffing in hospitals across the state and improved the patient care results of millions of patients (Kerfoot & Douglas, 2013). After the bill went into effect, job satisfaction increased, and the nursing shortage ended (Kerfoot & Douglas, 2013).
The ethical committee should intervene to determine the ethical responsibilities of the medical and administrative staff. The people involved should be held accountable and give them the opportunity to communicate the patients about the medical
Respiratory Therapist or Technicians can work many location such as hospitals, nursing facilities, emergency transport centers, neonatal or pediatric intensive care, physician’s offices, home health agencies, surgical intensive care, specialized care hospitals, medical equipment supply companies, and patients at homes. Working as a Respiratory Therapist they perform a variety type of functions to maintain a patient airway. Under the direction of a physician, respiratory therapists have primary responsibility for all respiratory care diagnostic procedures and therapeutic medication & treatments. Respiratory therapists also supervise the work of respiratory technicians. When technicians implement
regulate RN staffing based on patients ' needs by reducing amount of patients assigned for those who need more arduous care.
This nurse is interested in the affects administrative decisions surrounding nurse staffing in regards to patient outcomes and nurses work satisfaction. This nurse began her research with a question in mind; “How do RN to patient ratios affect patient outcomes?” The search returned greater than 2000 articles related to Nurse Staffing and patient outcomes. Although, many of the abstracts supported the relevance of the topic the amount of material was excessive and the subject too broad. In an effort to create a list that would be more manageable, this nurse concluded her topic needed to be refined and constructed a much more concise and limited search until finally she constructed a PICOT question which yielded less results within a limited topic.
One of the major functions of a nurse manager is managing a budget and allocating resources necessary to manage the unit or facility effectively. “Major steps in the budgeting process include gathering information and planning, developing unit budgets, developing cash budgets, negotiating and revising, and using feedback to control budget results and improve future plans”(Yoder-Wise, 2012, p. 244). The nurse manager must be able to accommodate variances and acclimate the budget in both the projections and up-to-date expenditures. Proficiency in managing a unit level budget is essential for both a favorable variance and optimal patient outcomes. Budgeting entails reviewing revenues and expenses, staffing costs, supplies, and capital equipment costs (Contino, 2001). This case study examines personnel, overtime (OT), supplies, travel, equipment, and staff education and the manner in which management can address these factors.
The American Nurses Association supports a legislative model in which nurses are encouraged to create staffing plans specific to each unit. This approach will aide in establishing staffing levels that are flexible and can be changed based on the patients needs, number of admissions to the unit, discharges and transfers during each shift (“Nurse staffing plans,” 2013). This model will assist in keeping the unit staffed appropriately and organized in need of a change during each shift. Without an organized plan like this, a nurse may be required to take on a new admission and already have too big of a workload.
Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses (Jooste, 2013). The nurse manager has to explain to the management of the benefits of change in providing adequate staffing all the time. Adequate staffing helps staff retention. Staff retention saves a lot of money in terms of orienting new people to the unit. Safe staffing always helps in the reduction of falls, infection rates, pressure ulcers, decrease hospital stays and death. Flexible and creative scheduling is essential for retaining staff and promoting a positive work climate (Grohar-Murray & Langan, 2011). Adequate staffing with good staffing ratio will help nurses to concentrate on their patient care which may help in a reduction in medical errors and lawsuits to the hospital.
The determination of the sufficient number of nurses is complicated and requires proper coordination between the management and nursing. Patient acuity and turnover and skill mix are among the factors that are considered in the process (“Nursing and Patient Safety,” 2017). MacPhee, Dahinten, and Havaei (2017) note that workloads for nurses are measured at three levels, these are unit, job, and task. Concerning the unit-level, the assessment of workload is usually based on staffing and skill mix considerations. The perception of RNs, concerning the quantity of work they
A continuous concern that continues to present itself within the healthcare environment is adequate staffing on nursing units. Most hospital organizations try their very best to accommodate staffing needs, though many units remain understaffed for an unspecified amount of time. Inadequate staffing can negatively affect patient outcomes, lead to nurse burnout, and decrease patient satisfaction scores. Combating this issue will require a great deal of effort, as many geographical face nursing shortages when seeking new graduates and qualified candidates. Employees may begin to feel that they are unable to pursue personal goals within a healthcare organization, due to inability to transfer as a result of staffing shortages. This often results in nursing seeking employment or career advancement outside of the organization or geographical area, which further intensifies ramification associated with inadequate staffing.