Description
Directions
In a minimum of 300 words please discuss how these concerns impact morale, patient care, nursing autonomy etc. Use at least 1-2 references and proper APA format. After, made a response to the two posts.
Discussion Prompt(s)
Jonathan Kirkpatrick recently was hired as a nursing manager in an acute care hospital for orthopedics, neurology, and two medical-surgical units for a for-profit corporation. Nurse Kirkpatrick is responsible for quality, cost, and morale for the units that he manages. As part of his employment package, he is rewarded with a bonus based on the amount of money that he is able to save the hospital.
One of the first things Nurse Kirkpatrick is asked to do in his new position is to cut the fat out of staff numbers. The corporation that owns the hospital believes there are too many nurses on the payroll. Personally, although he does not say so upfront, Nurse Kirkpatrick disagrees. He believes the nurses currently on staff are all needed for quality of care. As he looks for ways to cut these numbers, what concerns might he raise to make administrative staff aware of the risks? Identify both ethical concerns and potential legal concerns
Remember that part of being in leadership is to advocate for employees and balance the requirements of the job.
Post 1
I believe that Nurse Kirkpatrick needs to explain to upper management the importance of having enough staff on payroll to fulfill the needs of the unit. If they start getting rid of nurses they could run into the issue of being short staffed and having nurses go into overtime or having to pay bonuses to get nurses to pick up shifts. This can put nursing leaders in a very difficult position because they are feeling pressure from upper management to lower costs while they also must advocate for their nurses by not leaving them understaffed. “Nurses were working more than 6 hours overtime per week.” (Berney, B., Needleman, J., & Kovner, C. 2005). All of this overtime comes when you want to limit the number of nurses that you have on the schedule. Days are short staffed so people are forced to have to pick up overtime shifts to allow for the unit to run fully staffed. While it is very important to keep the hospital on budget, upper management doesn’t always look at the big picture or how it effects patient care, they often times just look at how much money they can save when in the end, it ends up costing them more money anyway.
Reference:
Berney, B., Needleman, J., & Kovner, C. (2005). Factors Influencing the Use of Registered Nurse Overtime in Hospitals, 1995-2000. Journal of Nursing Scholarship, 37(2), 165-72. http://dx.doi.org/10.1111/j.1547-5069.2005.00032.x
Post 2
What concerns might he raise to make administrative staff aware of the risks? Identify both ethical concerns and potential legal concerns.
- Nurse Kirkpatrick should raise to make administrative staff aware the risks of short staffed. Though this can cause stressed and pressure from the corporation towards Nurse Kirkpatrick, it is important to advocate the nurse shortage that can also cause going over budget that cause nurses to go overtime or picking up more shifts. The concern about short staffed not only affect remaining staff but the patients as well. One of the study by Aiken and colleagues was that nurses with the highest nurse-to-patient ratios (fewer nurses for the number of patients) were more likely to describe feelings of burnout, emotional exhaustion, and job dissatisfaction than nurses with lower ratios (more RNs for the number of patients) (Huber, p. 347, 2013). If there is more patients add onto understaff on a unit, it can cause medical errors and simple mistakes. With the concerns on being short staffed, this can also cause burnout within the nursing staff with exhaustion. This can also cause an increase rate of turnover and decrease the level of job satisfaction which would like cost more to pay nurses to work overtime.
- The ethical concerns and potential legal concerns in this case scenario is short staffing. The important role of Nurse Kirkpatrick is advocating for the employees and addressed his concern and make it aware to the administrative staff. Consequences of this can result in deterioration of patient outcomes in terms of increased mortality and failure-to-rescue rates (Huber, p. 107, 2013). Along with decrease of quality patient care, outcomes of nurses in exhaustion and job dissatisfaction, increases cost from results in increasing nurse turnovers, and legal liability (Huber, p. 107, 2013). Nurse Kirkpatrick can hopefully explain and discuss the concerns of cutting the staff numbers that can impact huge on the quality of patient care, nursing outcomes, and the cost to the organization.
Reference:
Huber, D. (2013). Leadership and Nursing Care Management. [Bookshelf Ambassadored]. Retrieved from https://ambassadored.vitalsource.com/#/books/97814…