The author of this report is asked to lay out a master plan for a nursing/medical organization spoken and enumerated from the standpoint of a new nursing executive. The plan given in this report will have six major sections. In the same order in which they will be covered in this report, these facets include contextual information, nursing strategic planning, culture and image, physical setting and technology, nursing's role in inter-disciplinary care and quality/success metrics. While crafting and expressing such a plan is a complex and daunting task, there are a few core principles that should guide anything and everything pertaining to the plan.
The mission statement, vision statement and organizational assessments of the organization will all center on three basic ideals, those being integrity, quality of care and the utilization/realization of human capital. In short, the nursing wing of the organization in question will be run with the utmost ethics and integrity, will be run as efficiently and neatly as possible with compromising quality of care and the people working for and developing within the organization will be allowed to blossom and grow in their careers, in their culture/society and in the way they treat patients.
The hospital's nursing staff needs to be equipped with the latest and greatest standard equipment that exists and it needs to come from top-shelf health equipment suppliers and vendors like McKesson, Cerner and GE Health. Best and non-optional practices must be drilled into the heads of all nurses so that things are done the right way the first time, every time. Immediately disposal and absolutely no re-use of sharps, never allowing harm to come to a patient if preventable and so forth are just the tip of the iceberg as far as that goes. That said, nurses should not be intimidated into compliance and/or micromanaged. Instead, they should be empowered and allowed to thrive and flourish but if they stray out of the required practices, they need to be corrected swiftly and forcefully. In terms of organizational charts, the firm needs to follow a chain of command but the organizational chat needs to be as short as possible from top to bottom. The organizational chart should be much more horizontal and vertical. Even so, the lines of responsibility should be crystal clear and it should never be mistake or compromised who is responsible to do what and by when. Checklists and best practices should be followed to the letter and without fail. However, in the inevitable event that something does not fit neatly into a certain procedure or best practice, it should be assessed why there is not a fit and whether a revamp of a policy or procedure is called for. However, the normal order of things is to follow the prescribed procedures to the letter every single time.
As far as strategic planning goes, this is very crucial when speaking of the nursing profession. The nursing population is starting to age and many industry experts peg the average age of a nurse in the 50's and that is rather high ("Average age of nurses," 2010). New generations of nurses need to be encouraged, cultivated and brought up through the ranks but there should never be a failure to uphold the standards and quality of education that is required to get the proper certifications and degrees because unleashing unqualified and ill-prepared nurses into the world is only going to end badly for a lot of people involved including the nurses themselves and the patients they serve.
Parallel to that is the importance of choosing and grooming the right people to lead and direct the nurses. Nursing managers and executives should be, without exception, registered nurses themselves and should never simply be someone who is supposedly good managing people. There are industries that lend themselves to having non-industry experts managing people that are but the medical/nursing field is a field that should never manifest or behave in this way. All nurses and executives need to know in fine detail how to deal with crises, what their personnel are facing every day and what they need to do their job well. Nurses that are under such managers and executives will respect such managers a lot more than a non-nurse or novice nurse as there will be more trust in the idea that the nursing manager/executive knows the intricacies of the job rather than the public relations game and/or the dollars and cents of things (Germain & Cummings, 2010)(George & Haag-Heitman, 2011).
Regardless of rank, all people in the nursing staff should be treated with respect, should be given the options and resources to realize their career goals and should be allowed the opportunity to use the best and most advanced (but trusted) technological and computer options. For example, relying on clipboards and paper records should be eschewed in favor of using tablet technology like offerings made available by Apple and Samsung and electronic medical records are the wave of the future irrespective of what some naysayers may want you to think (Angst & Agarwal, 2009)(Gillum, 2013). It is true that a profit needs to be made but this can be achieved through tactics that do not affect quality of care like private rooms (as an option), gift shops and cafeterias in the building and so forth. Every patient in the building, paying or not and affluent or not, should get the same care no matter what unless it is not life-threatening AND is purely discretionary.
As far as culture and image goes, nurses obviously have their own niche and place in the culture of society and even within the hospital itself. This can be seen in other departments like information technology and such. What should be avoided, is cliquish behavior whereby nurses break into cadres of a couple people and thus behave like the high school-age groups that they resemble and mimic. Obviously, some people will be friends with some or many coworkers while others put up a wall between their work and home lives. Either is acceptable and this is completely up to each person, but the use of bullying, sabotage/subterfuge and such should end up with the hammer being brought down on any nurse or group of nurses that behaves in an obtuse or childish way. Managers or executives engaging in this or allowing it to fester should be removed from their post if they do not immediately rectify the situation (Katrilini, Atabay, Gunay & Guneri, 2010).
As far as physical settings and technology, the aforementioned electronic medical records and the use of tablet technology is just a start but all-encompassing training and configuration so that information flows as quickly as it can and needs to from one person to another or from one team to another. Information flows into and out of the hospital should also happen when they need to but in a secure and HIPAA-compliant way. Speaking of, information technology security should not remotely be an afterthought and this includes training nurses in how to use the technology and how to never use the technology. Of course, this should include following rules of "need to know" as far as accessing records such as those of friends, family and celebrities (Sawyer, 2007). Anyone consistently or egregiously violating those ethical standards should be summarily dismissed.
In terms of inter-disciplinary care, there is definitely a set of ethics and politics that come to light when looking at the nursing profession. This is often a necessary part of the job and should not be shut down just because it's present. It's impossible to stop and can actually be harnessed in a good way. For example, some people who are not management can show themselves to be subject-matter experts (SME's) and this will tend to lead people to lean on them harder for questions and advice that should generally come from managers, executives and trainers. While allowing this to happen to excess is not a good thing, it can be used as a barometer of what needs to be done more, less or differently and allowing people to learn from each other as they work should not be shot down if/when it occurs. Even so, some people will want to throw their weight around or they will make assertions and/or demands that they should not be engaging in and/or they are not qualified to execute. Since patient safety and experiences in the hospital are something that should never be toyed with, this should be brought into check as needed. For example, if there is an action item on a checklist that a certain senior nurse thinks is pointless or wrong, they should bring that concern to management and not unilaterally decide to change or omit the checklist item.
Lastly, there has to be a huge focus on measurement of success and compliance with an important part of that being the use of the proper metrics and proverbial yardsticks, and so on. At a bare minimum, nurses…