Position Description Project : Critical Care Nursing

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).

The purpose of this paper is to discuss the problems related to inappropriate nurse-patient ratios and provide suggestions that may improve the problem. The American Nurses Association advocates for proper number of nursing staff for delivery of quality patient care. However, hospitals are faced with problems related to decreasing staff levels. The Registered Nurse Safe Staffing Act of 2015 provides for patient protection by establishing safe staffing levels. This bill requires the staff nurse to be actively involved on committees and in the development of unit-based staffing plans. The formation of the Protest of Assignment allows nurses to advocate for change to ensure proper patient care. Nurse recruitment is another challenge that is

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.

The American Association of Critical-Care Nursing (AACN) is the largest nursing organization of a non-profit character in the world. It represents 500,000 nurses and their interests. The responsibility of these nurses is to provide health care services to the critically and acutely ill patients. Thus, the duty of the AACN organization is to give its members all the possible resources and knowledge, so that they could help critically ill clients become healthier. Therefore, I would like to join the AACN organization. To become a member of this particular organization I need to learn more about it by researching some questions.

The nursing shortage has been influenced by the aging workforce, shortage of nursing faculty, professional alternatives, poor working conditions and poor nursing image. By 2020, there will be an increase in demand for registered nurses (RNs) due to the increase need for healthcare services to meet the needs of the baby boom generation (Keenan & Kennedy, 2003). It is estimated that the nursing shortage will range from 400,000 to 808,000 full-time equivalents (FTE) RNs. The nursing shortage has impacted the intensive care units (ICU), medical surgical units and operating rooms (Keenan & Kennedy).

Adequate nurse staffing is clearly a crucial element in safe, effective hospital care. A 2011 study by nurse researchers concluded that adding more nurses to a unit markedly improves patient outcomes and safety in hospitals (Griffith, Ball, Murrel, Jons & Rufferty,

Safe nursing ratios provide better outcomes for patients and provide better working conditions for nursing staff. Unsafe nursing to patient ratios have detrimental and negative outcomes in the nursing care that patients can receive in the hospital. For example, medications that are administered to patients late can alter their drug administration schedule. The late administration of cardiac drugs can be detrimental to patients’ well-being because this can cause a failure in maintaining the drugs therapeutic serum levels and consequently increasing the likelihood of arrhythmias. High patient to nurse ratios can also cause nurse burnout. Nurse burnout is precipitated by the increased physical and emotional exhaustion from being assigned too many patients depending on the type of floor that one is working. This causes nursing staff to leaves the nursing field due to the undue stress and look for positions that aren’t as stressful. This will only contribute to the nursing shortage. Patient hospital stays can also be effected due to the number of days that a patient stays in the hospital. This leads to an extended number of days in the hospital which can cause a loss of money that insurances would not agree to pay. The safety of the patients need to be a nurse’s priority and this can be a great cause of concern with an unsafe number of patients being cared for by the nurse. As nurse timing becomes a priority, it becomes important to be able to take care of each patient that is

The reasons for this national crisis are multifactorial, but 1 important component is the accelerated departure of nurses from their profession. Turnover, or lack of retention of qualified personnel in the job environment, occurs frequently in critical care nursing, with reported annual rates exceeding 25% to 60%. Accordingly, reducing the ICU nurse turnover rate is a high priority for nursing and health care leaders.

As a new graduate registered nurse, I know that when I begin my first job the reality shock will occur. I will be overwhelmed at times by anxiety, fear, failure, and disappointment. Burnout is higher for new nurses, and it is my responsibility to help combat it for my fellow graduates and for myself. For years nurses have felt the increased impact of compassion fatigue, with patient safety and satisfaction rates plummeting. Nurses are faced with sicker patients with shorter hospital stays everyday. The pressure to treat the patients, but get them out of the hospital as soon as possible; without making any mistakes is a huge burden most nurses will feel at some point in their career. There have been countless studies, thousands of hours, and billions of dollars for research spent on finding a solution to the problem. In order to find a solution one must first understand the problem. These are three separate issues with one common problem, high nurse-patient ratios.

Safe nurse-patient ratio is a complex issue debated on for many years. Due to inadequate staffing registered Nurses are faced with high patient ratios, and nurse burn out everyday. According to the American Nurses Association, “Massive Reductions in nursing budgets combined with, the challenges presented by a growing nursing shortage have resulted in fewer nurses working longer hours for sicker patients. This situation compromises care and contributes to the nursing shortage by creating an environment that drives nurses from the bedside”. (2012) Through the nurse’s process, the essential role of the Registered Nurse is to assess, diagnose, and plan based on outcomes, implement and evaluate the effectiveness of nursing care. However, it is not realistic to thoroughly implement these core guidelines in a safe and effective way, when you are responsible for an inadequate patient load.

Over the last year I have been a nurse intern at MetroHealth on the Medical Intensive Care Unit; I started with them in the old unit and have transitioned with them to the new unit in the Critical Care Pavilion (CCP). The old unit has thirteen rooms and was in the shape of a circle with a central nursing station so you could have visibility to all patient rooms. The new unit, which has a total of forty-eight rooms, half for the Medical Intensive Care Unit (MICU) and half for Critical Care Step-down; consists of long spread out halls with no central nursing station. For my Collaborative clinical I am working on the Step-down side of the new CCP; I have the unique experience of seeing and working with two nursing units that once were separated by five floor and are now sharing one floor and ancillary staff. This paper will address the barriers of transitioning to an isolated nursing unit and my clinical experiences at MetroHealth’s Critical Care Step Down unit. The four topics that will bed discussed include working climates, nursing care delivery model, staffing, and leadership style.

The American Association of Critical Care Nurses (AACN) is the world’s largest specialty nursing organization (“American Association of Critical Care Nurses,” n.d.). There are more than 100,000 practicing nurses that are members of the AACN (“American Association of Critical Care Nurses,” n.d.). The purpose of the AACN is to provide expert knowledge to critical care nurses to create a healthcare system that is driven by the needs of patients and their families (“American Association of Critical Care Nurses,” n.d.). Their mission is to promote and enhance consumer health and safety by establishing and maintaining high standards of professional practice (“American Association of Critical Care Nurses,” n.d.). The headquarters for the organization

The economic impact on healthcare has taken its toll on the reduced number of registered nurses providing direct bedside care to patients compromising patient safety and dramatically increasing the potential for negative outcomes. Studies reveal that several other factors have also played a key role concerning nursing shortages over the years, such as healthcare organizations downsizing, reduced reimbursements, increased workloads, inadequate staffing plans and job dissatisfaction. Currently, mandated minimum nurse-to-patient staffing ratios have been implemented in several states with many more trying to pass some type of legislation (Chapman et al.331). In other states hospitals opted to form safe staffing committees that include the

I would like to express my sincere gratitude for giving me the opportunity to work as a Critical Care Nurse at NYC Health + Hospitals / Queens. I am writing to inform you of my resignation from the position of Staff Nurse- Critical Care. My last day of work will be July 14, 2017.

Close your eyes and imagine a world without nurses, scary right. Nurses have a crucial role in the healthcare system today. Health care is forever changing and our nurses are now on the frontline more than ever before. Nurses, are in demand. However, even though there are many vacant nursing spots, and many nurses, no applications are being filled. Why? The shortage of nurses is directly related to the increase in patient workloads, patient and nurse safety, job dissatisfaction and burnout. Our patients, as well as our nurses are suffering more than ever before. State-mandated staffing ratios are necessary to ensure the safety of patients and nurses. Each day we are losing nurses to other professions and causing more harm than good to our patients. Nurses are overworked; they are burn out and are dissatisfied with their job. Adequate nurse staffing is key to patient care and nurse retention. I am concerned that the nurse to patient ratios are increasing within the State of Indiana, endangering our patients, as well as driving nurses from their profession.