The Code Of Ethics For Nurses With Interpretive

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).

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.

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

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.

Mandatory staffing ratios have been suggested as a way to meet nursing staffs’ concerns of high nurse to patient ratios. Mandatory staffing ratios are used as a way to reduce workload and patient mortality and are aimed at addressing the perceived imbalance between patient needs and nursing resources. (American Nursing Association, 2014). However, issues have been raised on applicability of staffing ratios since it could lead to increased costs without the guarantee of improvement in the quality of health care and could also lead to unintended consequences including unit closures, limited infrastructural development and limited access by patients (American Nursing Association, 2014).

Neither nurse managers nor hospital administration will comprise of that 55%. This makes good sense. Nurses providing direct care will implement and assist in design of plan. In designating the appropriate number of registered nurses to each unit for each shift will greatly improve services rendered, thus, maximizing patient care and increasing positive patient satisfaction

In the first medical surgical unit, it is forecasted there will be 14,007 patient days in 2015 with the 5:1 ratio, there needs to be 2,802 staff members in this unit. In the second medical surgical unit, there will be 14,086 patient days in 2015 and will need 2,817 staff members. The third unit will have 10,846 patient days and will need 2,170 staff members to meet the standard ratio. The final unit will have 9,936 patient days in 2016 and will need 1,987 staff members.

Truth-telling is an important issue within the nurse-patient relationship. Nurses make decisions on a daily basis regarding what information to tell patients. The specific issue in question is whether a nurse should abide by the Code of Ethics for Nurses by revealing the truth to the patient or refrain from telling the truth to the patient because they are respecting the wishes of the patient’s family. Nurses and health care professionals should always tell the truth to their patients unless the patient forgoes their rights to autonomy or cannot think for themselves. By providing the patient with the truth, they allow the patient to come to terms with their conditions and give them the options for further treatment.

Nurse managers should consider patient needs, level of education, expertise and work satisfaction before dictating the number of nurses-to-patient ration (Murray, 2017). Reported by Martin (2015), the risk of mortality can be decreased by 50%. Starting with the nurses, a large amount of workload can bring fatigue, inadequate sleep, employment and increase in calls-out which leaves nurse managers to make changes to assignments. This takes times out of the resource nurse shift to focus on redistributing patient, in turn, causes a delay in starting their plan of care. As an aide, there have been times at Meritus where a nurse calls out and the resource nurse at least spends an hour with the outgoing nurse communicating with the staffing office to ask for a float pool nurse. On the other hand, outcomes such as “pneumonia, shock, cardiac arrest, and urinary tract infections are directly related to low nurse staffing” (Martin, 2015). On the stroke medical-surgical unit, sometimes there is one aide for 28 patients. Some of these patients need turning every two hours, incontinent or bedrest, but it is difficult to attend to all of them on an hourly rounding base and provide adequate care to each of them. At one point, a new graduate nurse was given seven patients to care for. According to Meritus nurse residency program, new grads can have up to six patients on a medical-surgical floor. One can only imagine how overwhelming that can be for a new nurse. To help prevent these poor outcomes from occurring, strategies to improve nurse staffing can be utilized by

The clinic I currently work at is adequately staffed in my opinion. There are two doctors, four full time physician assistance, three full time nurses, and five full time administrative/ clerical staff. We also have approximately ten part time or as needed nurses and three part time or as needed physician assistance. I would first determine my staffing mix by reviewing the numbers from the last six to twelve months. Then I would compare the number of patients seen to the number of providers working each day. I would then look for any correlation in the two. Next, I would use the positive correlation to assist me in determining the appropriate staffing ratios and needs. When a department is well staffed it provides better outcomes for the

However, is shortsighted as appropriate nurse staffing levels are essential to optimizing quality of care and patient outcomes in this era of value-based health care. The greater benefits can be derived from staffing models that count the number of nurses and/or the nurse-to-patient ratios and can be adjusted to account for unit and shift level factors.

I plan to have 4 patients per Registered Nurse, one Unlicensed Assistive Personnel, one secretary, two Licensed Vocational Nurses, two Registered Nurses, and me as Charge Nurse/Manager.

The goal is to get the most out of the fewest staff members and still provide high level quality care. The staffing may differ from unit to units depending on the acuity of the patients and the volume of the patients that require care. The number of staff required to perform day to day operations can change due to illness or vacations, so there must be plans in place to factors for this. The use of pool nurses or offering overtime can be an option, but both have some drawbacks. The use of a pool nurse that may not be as familiar with the unit or the equipment can limit either the number of patients care for or the level of care provided. The nurse that is in an overtime situation can become fatigued and the risk for errors increases, as well as, the financial burden it places on the facility. “Professional nurses are responsible and accountable for individual practice and understanding the consequences of fatigue in preserving integrity and safety” (Dent, 2015, p. 44). Many facilities that have staffing issues utilize particular staffing patterns that allow for the most available staff when the volume is at its pinnacle and the reduce staff during slower periods. The nurse manager also must take into account breaks and lunches to keep their staff nourished and elevate moral. The relief for a lunch or break can be a deciding factor in the retention of a seasoned professional nurse. The manager also must maintain productivity on the unit, it is an ongoing balancing-act to keep staff and patients happy, as well as, administration related to the

Critical care nursing is a roller coaster ride. It has a lot of surprises throughout the day and you never know what is around the corner. Our Critical Care Step-Down Unit here at Davenport Hospital has a capacity of 30 beds (6 private and 12 semi-private rooms). 2 West accommodates a variety of patients such as adult postsurgical, trauma, seizures, renal failure, and myocardial infraction patients. This unit provides care for patient that have been discharged from an Intensive Care unit, but they are not stable and require a high level of monitoring before they return in a general medical surgical floor. Lately our unit has been struggled with staff shortage. It has been weeks that in the day shift there are only 3 register nurses and each of them provide care to 6 or 7 patients. Based on the hospital protocol policy nurse-to-patient ratio in a step-down unit must be 1:4 or fewer at all times. In addition, I am designing this written proposal to seek approval of hiring a new critical care nurse in 2 west step-down unit. The above proposed nursing position will definitely benefit both the unit staff and patient population. The nursing shortage can easily lead to nursing burnout such as fatigue, injuries, and dissatisfaction. Also, nurses that work in such conditions are more predisposed on making mistakes and medical errors. This proposal will definitely benefit the patient who are being treated on this unit as well. According to Huber (2014), “effective staffing has been

As a nurse manager, Sam is responsible for staffing his unit. Nurse managers are challenged with the task of managing scheduling and staffing within their particular budget (Yoder-Wise, 2015). Sam must staff his unit, which includes planning for hiring and positioning qualified human resources to meet the needs of a unique group of patients (Yoder-Wise, 2015). Sam must consider several aspects of the unit in order to staff the appropriate amount of employees. He must consider the type of floor (range of patient conditions), number of patients, patient satisfaction, stage of illness, observations with interventions required, family situation and treatment needs (Yoder-Wise, 2015). He then must select the appropriate applicant, the individual must be qualified, fit the culture of the unit, and ultimately “the goal is to match the person with the