The Nursing Challenge
The nursing challenge, in this case, is a shortage of nursing staff. Dispensation of healthcare to hospitalized patients is multifarious. Therefore, it needs the cooperation and coordinated effort of many health professionals. Doctors, advanced practice nurses, registered nurses, and other related health professionals provide specialized health care services. Hospital administrators come up with strategic plans to continually manage, build, and implement systems and facilities of care and administer resource allocation. Model of problem identification, teamwork, communication, and problem-solving within these cadres contribute to the hospital’s ability to operate efficiently.
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An insufficient supply of registered nurses is a major stressor for a healthcare institution. The shortage of nurses came as a result of a combination of factors; lack of motivation, low wages, decreased the supply of working nurses, and a stressful work environment. As a result of nursing staff shortage, there has been an increased risk of bad patient outcomes, increased labor costs, increased operational costs, reduced number of patients seeking medical services from the facility, decreased effectiveness, and efficiency of care (Buerhaus, Donelan, Ulrich, Norman, DesRoches, & Dittus, 2007).
The System/Organization
The organization is a teaching hospital with a divisional organizational structure with separate health departments and sections that are semi-autonomous. These departments are self-managed and concentrate on a narrow aspect of healthcare service and hospital management.
The gaps in healthcare as a result of the nursing staff shortage include a lack of motivation, system obstacles that limits teamwork, and a lack of resources (Harrison, 2010). There are gaps in patients’ expectation of quality health care delivery and the circumstance in which they get low-quality care (Harrison, 2010). Features of low-quality healthcare include unreliability, unresponsiveness, minimal competence, and poor communication (Harrison, 2010). Performance differences emerge from compromises in the allocation of healthcare resources (Harrison, 2010). For instance, the organization may have insufficient resources to hire additional nursing staff because they have committed their resources for other purposes; leading to patients having to wait longer to access services. The complicated nature of healthcare does not need a segregated, but a unified, systems approach to performance improvement (Harrison, 2010). For example, patients only receive intervallic medical attention when they become acutely sick because there is no primary care physician. A system that includes a primary caregiver would ensure the continuity of patient services without interruption (Harrison, 2010).
A system is a repeated interaction of an interdependent group of things that constitute a unified whole (Cordon, 2013). Systems thinking is a method of solving problems that adhere to two basic premises including; perceiving reality in regards to wholes and appreciating that the environment is a crucial part of the system because it interacts with the system (Cordon, 2013). According to integral theory, all things are interconnected in a grander scale of things (Cordon, 2013). One element in systems is reality which has an element of time happens in a continuum and is a part of a greater whole (Cordon, 2013). Reality must always be considered according to context, as co-occurring or complete parts called holons (Cordon, 2013). Holons are systems within a system or whole parts (Cordon, 2013).
The nursing practice environment level of needs match with Maslow’s theory of needs, including the need for nurses to feel safe in the work environment and in turn, provide safe healthcare to their patients, to identify with the organization by having a sense of belonging, and to feel capacitated to do the best they can given their knowledge and experience (Paris, 2011). According to Maslow’s theory, if the nurses’ basic needs are met by the hospital administration, their focus will move to achieving greater level needs such as self-actualization (Paris, 2011). Insufficient staffing and day-to-day workplace demands increase the stress levels of nurses and may lead many nurses to quit the organization or the profession altogether (Paris, 2011). Disrespect and disrupting behavior from doctors is linked with nurses’ job dissatisfaction, and daily activities such as looking for medication or patient records prevent nurses from conducting meaningful patient care (Paris, 2011). Such stressors are linked with the lower practice environment levels of needs (Paris, 2011). A nurse leader should be able to first address the basic needs of nurses of sufficient staffing and competency to provide safe nursing care (Paris, 2011).
Organization structure, vision, mission, philosophy statement
The organization’s vision is to be the leader in professional nursing practice in the state. It will be the best professional nursing center and among the best academic health institutions in the country in nursing education, research, and practice distinction in patient care.
Nursing is a combination of science and art founded on skills, knowledge, integrity, and excellence. The organization’s mission is to ensure that the patient goes back to the community with the greatest potential for productivity and health or sustain the patient’s reassurance and dignity until they die.
The philosophy is to commit to maintaining and persistently enhance the safety and quality of nursing care by constant monitoring and evaluation of results and resolution of recognized problems. The facility takes its role in educating seriously and is committed to the mentoring and educating medical, nursing, and associated health students of the future.
SWOT Analysis
SWOT analysis perceives strength as the present factors that have facilitated exceptional organizational performance (Harrison, 2010).
Strengths
The strengths of the organization include high-tech medical equipment and activities geared towards community health care improvement initiatives. Additionally, the employees have a clear understanding of the organization’s objectives on quality improvement. Quality improvement entails a rigorous work schedule, intense training projects, and collaborative work. But with understaffed nursing personnel, nurses find the quality improvement to involving and exhausting that they decide to leave the organization.
Weaknesses
Weaknesses are organizational aspects that will increase the cost of healthcare or decrease the quality of care (Harrison, 2010). The weaknesses, in this case, are an organizational structure that limits collaboration with other departments and the autonomy of health care professionals, a lack of motivation, and financial problems. The organization has a huge group of uninsured patients that negatively affects the organization’s financial standing.
Opportunity
The organization introduced clinical protocols to improve the efficiency and quality of healthcare and it partners with communities to establish new healthcare programs.
Threats
Threats are elements that could negatively affect organizational performance (Harrison, 2010). These include an increasing number of uninsured patients, the demand to reduce healthcare costs, nursing staff shortage, and an organizational structure that is divisional.
One solution for the problem of nursing staff shortage would be to replace the divisional organization structure with a clinically-based structure that puts nurses, physicians, and other health professionals, and managers at the helm of a decision-making threesome
The Position
The organization should set up a team of healthcare executives comprising a nurse leader, physician, and manager. The executives would learn new skills needed to value employees (Nevidjon, 2001). The lead nursing executive will partner with the Head of Human Resources to enable the team’s discussion of how they value nursing staff and how this is demonstrated in the organization (Nevidjon, 2001). Human resources in the form of nurses can make or damage the organization’s impression and competitive leverage (Nevidjon, 2001). Organizations that maintain a substantial competitive advantage are those that are capable of attracting and retaining talent (Nevidjon, 2001).
The position would entail identifying the benefits that will keep nurses in the organization to prevent a high turnover and perpetual shortage. The best source of information on the causes of nursing staff shortage and to alleviate it is the nurses. The areas that would require long-term and short-term solutions include schedules, reliability gap, autonomy, and respect for the profession (Nevidjon, 2001).
- Buerhaus, P. I., Donelan, K., Ulrich, B. T., Norman, L., DesRoches, C., & Dittus, R. (2007). Impact of the nurse shortage on hospital patient care: comparative perspectives. Health Affairs, 26(3), 853-862.
- Cordon, C. P. (2013). System Theories: An Overview of Various System Theories and Its Application in Healthcare. American Journal of Systems Science, 2(1), 13-22.
- Harrison, J. P., & Association of University Programs in Health Administration. (2010). Essentials of strategic planning in health care (p. 92). Chicago, IL: Health Administration Press.
- Nevidjon, B., & Erickson, J. I. (2000). The nursing shortage: solutions for the short and long term. Online Journal of Issues in Nursing, 6(1), 4-4.
- Paris, L. G., & Terhaar, M. (2010). Using Maslow’s Pyramid and the National Database of Nursing Quality Indicators (TM) to Attain a Healthier Work Environment. Online Journal of Issues in Nursing, 16(1), A1.
