Leadership Nursing Question 2 Response:

Leadership Nursing

Question 2 Response:

Given the fact that these nurses lost their positions due to budgetary constraints, it seems unlikely that other units within the same hospital would have adequate funds to retain these nurses unless there had been a major program shift -- i.e. one department was increased in size and another unit's budget was decreased as a result. This would lead to the creation of more permanent positions and a need for nurses within the expanded unit, and certainly the hospital ought to look to its own staff for reorganization rather than terminating and hiring. This is not really the case, however, and it is hoped that administration is efficient and effective enough to allocate funds to units as befits their needs; if nurses are being cut from one unit for budgetary reasons, there should not be extra room in other units' budgets to hire nurses, and thus there is little likelihood that these nurses will be able to find short-term employment in the hospital after being let go form their own departments.

This does not mean that other short-term employment opportunities are not available while the nurses wait for or engage in longer-term solutions. A number of businesses and institutions hire nurses on a short-term basis for rotating care to patients, many of whom require short-term in-home care due to a recent injury, surgery, or other impermanent debilitation (Simnoazzi 2009). Nurses can also attempt to seek such short-term positions on their own, and if there are not other contractual obligations barring the hospital from recommending their former nurses to patients in need of such care, this could be the basis of an effective limited partnership. Nurses that are able to relocate have even more opportunities in this regard, and will also be able to locate suitable long-term employment sooner.

Day 1

On my first day in the medical-surgical unit, the importance of establishing a clear communications network in high-paced nursing situations quickly became apparent. At times it was very difficult to determine precisely what was necessary to be done, and at other times the same information was communicated by several individuals in a time-consuming and somewhat frustrating manner. While it is of course necessary to ensure that all necessary and relative information is made available to all nurses in the unit on an ongoing basis, to ensure current knowledge and appropriate action, the inefficiencies of this process within the unit seemed to make for a great deal of extra work in communicating that was not entirely necessary. Research has shown that such communication problems can contribute significantly to work stress and burnout among nurses, and it was certainly easy to see why (Heaven & Maguire 2008). Because this was my first day, I did not feel it was appropriate to comment on this situation, but as I begin to feel more comfortable and to have a stronger idea of what is necessary, I definitely plan on approaching the lead nurse.

Day 2

Despite the hectic pace that is kept up day in and day out in the medical-surgical unit, the importance of getting to know patients and truly provide personal and quality care to them was emphasized to new nurses today. I got the experience to meet and connect with several pre- and post-op patients and their families, and it was a very rewarding and uplifting experience. Despite the poor health that a few of the patients were obviously in, I was able to make them more comfortable and to certainly improve the quality of their time in the unit through a few friendly and brief conversations, shared experiences, and simple shows of compassion. This really helped me to remember why it was I became a nurse, and demonstrates the true needs of patients that I was helping to care for and not simply trying to cure. These moments also made the more mundane and laborious elements of the job seem more worthwhile, and I was definitely feeling less stress and more satisfaction upon the completion of my shift than I had the previous day, when such patient connections has not seemed possible.

Day 3

Though falls from hospital beds are more common than might be expected, a fall that occurred in the medical-surgical unit was deemed worthy of calling a meeting of available nursing staff to review fall prevention procedures and stress the importance of maintaining regular and frequent rounds as well as sitting with fall-prone patients whenever possible, even in short and frequently rotating shifts, to ensure that movement can be facilitated when desired. One nurse actually brought up the use of restraints, which were acknowledged to be available as a measure of last resort but which were not to be used except in extreme cases and with the permission of the lead nurse. This is in keeping with current research on the subject, which was actually referenced by the point nurse in this instance, especially when stressing the preferred techniques for mitigating risks of falls and the lack of desirability of the use of physical restraints (Shever et al. 2010). This experience was highly educational both in its specifics and in seeing the dynamics of practice and the influence of research in a practical setting.

Day 4