Methods of obtaining necessary approvals and support
The initial step is to obtain approvals and buy-in from hospital leadership and support from fellow staff. Through leadership approval, resources would be provided to support the efforts to combat nurse shortage and secure possible changes in procedures and policies on nurse staffing. Buy-in will assist with obtaining support from key hospital administrators.
First, it would be imperative to meet with leaders and key staff in advance to discuss possibility of their formal approval. Second, the idea or proposed solutions would be positioned with regard to benefits to the hospital, patients and nurses. Finally, all issues relating to the proposed solutions and changes will be answered precisely and confidently.
It will be necessary to determine the hospital administration expectation on nursing shortage and patient outcomes, as well as understanding policy guidelines on staffing and decision-making processes and authority.
An administrator with authority to approve policies, guidelines and allocate resources will also be included in the process. Any resistance to the solution will be noted, and a link will be determined between the concerns such as improved patient outcomes, low burnout among nurses and favorable working environments among others.
For fellow staff, it is imperative that they have the necessary information to understand the proposed solutions against nurse shortage. This method would ensure that they comprehend and support the process. Thus, information need of the staff will be considered to address their specific needs.
Description of the current problem
It has been observed that the hospital experiences an extremely high nurse turnover, despite the high number of incoming nurses every year. Many training nurses do not stay after completing their training. At the same time, the hospital has a difficult time attracting qualified registered nurses and has to rely on state directives for employees. The hospital operates mostly with a vacant position for a resident nurse; sometimes the number increases to three. The institution has been forced to try to reallocate its funding to entice new nurses to stay longer.
This situation affects the hospital’s ability to meet its service obligations. As a result, it is likely to miss any performance-based funding assistance. Such outcomes end up causing additional harm through reduced service quality and availability, which lead to a cyclic relationship of low funds and low service quality and availability.
A lack of dedicated nurses leads to difficulties in running hospital improvement programs, undertaking monitoring and evaluation programs that can help in sustaining its operations. Reliance on temporary nurses causes the hospital to focus on short-term medical issues and is unable to implement systematic solutions to its problems. Thus, the provision of health care is seriously curtailed.
Detailed explanation of the proposed solution
An effective solution to nursing shortage will also eliminate inadequate patient care.
The hospital should review and change its policies on short-term registered nurses to meet its current needs adequately.
The facility should develop appropriate transition mechanisms to ensure that nurse-related duties are easily transferable. For instance, it will require creating a repository communication, decisions, management activities, patient care data, and human relations to facilitate easier transfer of patients from one nurse to another. Consequently, the hospital will be able to manage its workload under its current resources.
Focusing on a value and institutional culture system that promotes sharing of resources, including staff resources, can help in the long-term.
Causes of nurse shortage due to lack of funds will be addressed by additional lobbying to respective state departments on health care.
The creation of a suitable working environment with appropriate balancing of patient duties and overall nursing workload can make the hospital attractive and cause many short-term nurses to consider becoming residents on a permanent basis.
Rationale for selecting the proposed solution
The review and change to policies on short-term registered nurses are necessary because the hospital receives significantly high number of new nurse practitioners every year from nurse training institutions. These nurses come to the hospital for further training. A policy that promotes retention of a specific number of short-term registered nurses can help the hospital to avert nurse shortage.
The facility should develop appropriate transition mechanisms to ensure that nurse-related duties are easily transferable. This proposed solution would streamline operations, enhance efficiency in management of patient records, prevent data loss and promote collaboration and communication between multidisciplinary teams. In addition, it would assist nurse to manage their duties effectively.
For a facility with few staff, sharing of nursing roles, knowledge and available resources would result in efficient utilization of such resources to reduce nurse load and enhance patient outcomes.
It would be prudent for the hospital to lobby for additional funding for staffing. This solution would ensure that nurses have better remuneration and improved working conditions. Financial support would ensure that the hospital has adequate resources to facilitate provision of care.
With improved working environment, the hospital will reduce high attrition rate and retain short-term registered nurses. Thus, it would be able to control nurse shortage and improve nurse staffing and patient quality of care.
Evidence from literature review
Intellectual capital theory was applied in this case. Intellectual capital is a theory that focuses on the collective knowledge of individuals and the structures that are present in a given organization (Stewart, 2001). The aim of this theory is to ensure that knowledge and information are integrated and used effectively to achieve competitive advantage (Thompson, 2006). This theory is effective in implementing the proposed solution since it takes into consideration the input of employees (nurses) and the overall organizational structure and management of the health facility.
Hospitals are the largest providers of managed care and the largest employers of registered nurses (Byrne & Martin, 2015). They have to accomplish care provision and administrative duties and meet the rising demand by relying on resources that increase at a very slow rate. The hospital can be able to manage its workload under its current resources (Byrne & Martin, 2014).
Structural capital is the information that is present within the structures, databases and systems that are present in a given entity (Thomka, 2007). This includes the overall organizational structure and management of the health facility.
Causes of nurse shortage due to lack of funds could be addressed by additional lobbying to respective state departments on health care (Byrne & Martin, 2015).
All these proposed solutions would effective management human capital and structural capital within the healthcare facility and result in the improvement of the health services offered and nurse recruitment and retention.
Description of implementation logistics
After the approval and acquisition of the necessary resources for the proposed solution, the implementation solution will be implemented systematically.
The organizational structure will be adjusted to accommodate new nurses, and if possible be given administrative roles. At the same time, the hospital must introduce a new culture of recruiting short-term registered nurses, review workflow, and define roles for additional nurses.
In every department, the unit head will drive change, educate nurses and oversee the implementation process.
It is also expected that senior leaders at the facility will be responsible for driving the overall change in process, organizational structure and solution implementation.
Educating staff would be conducted on specific areas of human capital management, motivation, workflow management and reinforcing new culture through seminars and workshops.
The implementation process would also be reviewed six months after implementation using pre-tests and post-tests to determine improvements in nurse retention and patient outcomes. Feedback will be used for improving processes.
Resources required for implementation
The following resources are required to implement the proposed solution effectively.
Staff: although all members of the staff are expected to support the implementation process, senior nurse leaders and unit heads are expected to educate staff and lead change across their respective departments.
Educational materials: PowerPoint materials will be prepared for seminars and workshops. In addition, handouts will be availed after training to nurses.
Assessment tools: pre-tests, post-tests and surveys will be used to assess progress of the implemented solution.
Technology: reliable computers fitted with analytical tools such as Excel or SPSS will be used during training, data management and analysis. In addition, a projector will be used for presentation.
Funds: funds will be required to implementation certain aspects of the proposed solutions. These include cost of educating nurses, developing and printing handouts, data collection and analysis. In addition, funds will also be required to hire new staff and enhance working environments.
Byrne, D. M., & Martin, B. N. (2014). A solution to the shortage of nursing faculty: Awareness and understanding of the leadership style of nursing department head. Nurse Educator, 39(3), 107-112.
Byrne, D. M., & Martin, B. N. (2015). Nursing shortages in the OR: Solutions for new models of education. AORN Journal, 101(1), 115-136.
Stewart, T. (2001). Wealth of Knowledge: Intellectual Capital Theory in 21st Century Organizations. New York: Currency Double Bay.
Thomka, L. (2007). Mentoring and its Impacts on Intellectual Capacity. Nursing Administration Quartely, 31(1), 22-26.
Thompson, G. (2006). Classifying the Concepts of Knowledge Transfer: A Literature Review. Journal of Advanced Nursing, 5(6), 691-701.