The Specialty Nurse Company : Evaluating Human Resources

The institutions began redesigning staffing schedules and care plans for clients to accommodate the decreased need (Institute of Medicine Staff, Davis, Sloan, & Wunderlich, 1996, p. 94). Most institutions restructured trying to reduce operating costs by changing work methods and roles of the staff. Between 1981 and 1993, full-time-equivalent (FTE) nursing staff declined by more than 7 percent nationally after adjusting for client days and case-mix complexity (Aiken, Sochalski, & Anderson, 1996, pp. 88-92). These changes were done without regard to better client outcomes, thus producing the current need for change.

Nursing shortages have always occurred in cycles. Recently, the shortage has become worse due to the implications of managed care as a way of controlling escalating health care costs. While the shortage did ease some during the recession of 2009, there is still a shortage in some areas of the country (Cherry & Jacob, 2014). Increased student enrollments and government policies have helped with the shortage, but the occupational outlook for nursing jobs is expected to grow faster than any other occupation through 2018. So it is essential that the supply of nurses increases to keep up with the demand. The current shortage is due to several factors. First, new nurses are needed to replace “baby boomers” who will be retiring in the near future. Second, as the population ages, there will be a demand for more healthcare, leading to a demand for more nurses. Third, new advances in patient care will lead to more people in the healthcare system needing more specialized care, and lastly, the affordable care act places a large emphasis on preventive care, leading to more people desiring wellness visits (Cherry & Jacob, 2014). Finally, according to Dall’Ora, Chiara, Griffiths, Peter, Ball, Jane, Simon, Michael Aiken, Linda H. (2015), “shifts lasting 12 hours or longer were associated with a 40 percent greater level of job dissatisfaction and a 31 percent higher risk of planning to quit. Job satisfaction and burnout in the nursing workforce are global

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.

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).

Does the issue of nurse staffing have an effect on quality of patient care? This study addresses the topic of nurse staffing, which includes nurses (RN and LPN) and nurse’s aides. Research in Action: Agency for Healthcare Research and Quality (AHRQ) presents the study “Hospital Nurse Staffing and Quality of Care”. Nurse staffing is measured in one of two ways: nursing hours per patient day and nurse to patent ratio (Stanton, 2004). The article looks at periods of high vacancy rates, assesses the patients needs, the development of care

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.

Being hired as the Director of Human Resource Management for a large health care organization, my company has an overall shortage of registered nurses. Using the concepts learned in this course, construct a five-year plan for recruiting new RNs into the organization while retaining the RNs already employed. Specific questions to address include:

Nurse retention is a recurring problem for healthcare facilities, and can be prevented with changes in structural empowerment with management, improvements and changes with the pay and benefits, and finding ways to help increase job satisfaction.

Tammie, to combat the shortage of nurse’s health care organizations utilizes the services of staffing organizations. In the healthcare workforce costs continue to rise for traditional options for filling shifts, such as overtime, float pools, contract travelers, and agency personnel ((Kulma & Springer, 2006). High turnover rates increase the need for agency and contract personnel use. The use of agency and contract personnel creates dissatisfaction among employees who have to work a long side individual that are being paid more to perform the same job

The NDST is based on the idea that in order to perform effectively and produce quality outcomes, an organization must structure its nursing units to complement the environment (organizational size, skill mix) and the technology (stability of patient acuity, diversity of patient conditions) (Meyer & O'Brien-Pallas, 2010). Although patient satisfaction and positive patient outcomes are important indicators of competent care in a healthcare organization, it is also necessary to consider financial considerations; at the end of the day the organization is a business. Often times, providing adequate staffing in order to achieve optimal staff ratios is just not feasible due to cost effectiveness. Decreased employee satisfaction related to staffing shortages, lack of increased wages, increased patient loads, and stressful work environments must also be taken into consideration as dissatisfaction often leads to absenteeism and turnover, further complicating staffing issues (Borkowski,

Eric Hoskins suggests that the revenue from medical tourism could be used to hire more nurses (Jones, 2014). This is just one small yet important aspect that may affect me; as a nurse I could advocate that if the facility agrees to support medical tourism a set amount of revenue should go towards hiring more nurses. The hospital nurse workforce is experiencing greater workloads resulting in part from a national nurse shortage (Vahey, Aiken, Sloane, Clarke & Vargas, 2004). Higher nurse workloads are associated with burnout and job dissatisfaction, which is something that I am concerned about for my future career as I hear so often about the hospital staffing cutbacks (Vahey, Aiken, Sloane, Clarke & Vargas, 2004). Nursing fatigue causes decreased

Another important concept is the relationship between nursing care hours and staffing mix. In order to cut costs, staffing models have reduced RN representation in the staffing mix and increased the use of unlicensed assistive personnel. Reviews of current literature suggests that as RN hours decrease and UAP increase, adverse patient outcomes

Understanding the origins of the Human Capital Theory begins by understanding the worth of an individual. As we move through our career in the nursing profession, we reflect on our education and experiences and how they have contributed to our wealth of knowledge. We understand that an individual who has not been trained as a nurse cannot simply walk off the street and start practicing as a nurse. There is a fundamental knowledge base, which has been accredited by the school/institution we attend, that certifies we have successfully attained a level of education that establishes us as nurses. Gary Becker's book entitled Human Capital, published in 1964, stated that, “human capital is similar to ‘physical means of production’: one can invest in human capital and one's outputs depend partly on the rate of return on the human capital one owns. Thus, human capital is a means of production, into which additional investment yields additional output (Kiker, 1966). The concept of the Human Capital Theory can be traced back to the 17th century, when Sir William Petty placed a value on laborers to demonstrate the power of England (Kiker, 1966). Additionally, in 1853 William Farr proposed that net future earnings (potential to earn a living based on skillset) represented wealth in the same way property and assets determine wealth and should thus be taxed. Becker was influenced by these and many other individuals that contributed to the idea of

To maintain the number of nurse and adjust various monthly demand with financial condition, she should consider both laying-off and hiring at the same time. For this reason, she needs to calculate the cost for reorganizing staffing levels. For full-time nurses, when they work overtime, they can receive $6/hour more. However, they should work 2 hours more. In addition, the maximum workday would be 5 days. In order to avoid this problem, hospital would hire part time nurses. They can receive $3/hour more than the regular work time of full-time nurse, but the number of part time nurse is limited; it should be maximum 15% of total nurse. Now, except for 20 surgical nurses, 110 nurses can be changed. In this state,