Nursing administration staffing models and practices

Nursing Administration-Staffing

A strategy for recruiting nurses for the acute care units

The effect of the nursing shortage crisis combined with higher patient acuity has become a crucial concern for the nursing management team. This relates largely to the balancing patient needs with staffing needs. Nurse executives at hospitals contribute to the shortage of women having numerous opportunities outside the health care industry and to inadequate compensation for work done. However, diverse recruitment strategies can be employed to help in reversing this pattern. Local initiatives may include collaborating with nursing schools as primary sites for clinical rotations, offering referral bonuses, and establishing residency programs. It also includes hiring new graduate nurses, encouraging the nurses to visit high schools to boost students' interest in the field, and encouraging more males to join the field. Internal strategies include paying acute care nurse premium dollars for working additional hours, giving annual bonuses associated with employment longevity, providing scholarship programs for nurses and tuition reimbursement (Hamlin, Davie, & Richardson-Tench, 2009).

Job description for a staff nurses in the acute care units

Area of Focus: Clinical Care

Competencies Responsibilities in an Acute Care:

-Critical thinking skills

-Clinical competence in caring for patients, knowledgeable about disease processes and can identify symptoms of complications.

-Skilled in the psycho-social evaluation of patients and their families

-Effective in identification of the need for consultation services of Advanced Practices Nurses and other allied health providers

-Knowledgeable about pharmacological therapies and drug interactions

-Able to integrate care of multiple disciplines to achieve highest outcomes

Environment:

Oversees and performs the gathering of holistic evaluation and the implementation and development of a care plan

Oversees patient care management

Conduct daily evaluation of the patient population

Rounds with clinicians frequently to discuss the progress of patients

Offer direct care to complex patients when necessary

Conducts patients' follow up through unit settings and care needs of nurses

Directs or calls clinical staff to call specialists or consultants

Troubleshooting complex issues in patient care, documenting findings, and progress in patient's medical records

Offers briefings to new staff members and conducts reviews of the pertinent data for care provision

Ensures family and patient preparation for care across the continuum

Open-ended questions for interviewing candidates to work as staff nurses

Standard Nursing Interview Questions

1. How would you describe your skills as a team player?

2. How will you deal with difficult doctors?

3. How will you deal with difficult patients and/or their families?

4. How will you handle unexpected circumstances, such as being short staffed and having to perform a treatment you have not done previously?

5. What are nurses' biggest challenges?

6. What are your plans for future growth?

Behavioral Questions

1. Provide an illustration of a situation where you were required to resolve a conflict with an uncooperative patient while providing care. What did you do?

2. Give an example of when you had to address a problem arising while there was so other medical staff

3. Have you ever been in a situation where you had to demonstrate a solid ethical attitude at work, regardless of the pressure to do the reverse, weaken your ethics and integrity stance?

4. Illustrate a stressful situation whereby you were required to stay calm while managing to calm families and their patients

5. Have you ever had to explain any medical issues to an individual who never spoke your language or did not understand medical terms? Explain

6. Have you ever been in a situation where you did not get along with one of your colleagues? How did you address sit and what were the results?

7. Have you ever been in a situation where your shift had ended and while winding up, a new patient arrived and needed your critical care? How did you address it?

8. What will you do in a case where a patient severely needs some medical care, under stress, or intense pain, and you have to offer care? What steps will you take to relax the patient?

Retention strategy

The hospital will implement magnet features to help in retaining nurses presently practicing in the acute care department. For example, the work environment will be fashioned in accordance with magnet features, which offer access to supporting infrastructures to empower the role of nurses. Eliminating stringent rules, fostering a work environment that supports professional accountability, and allowing nurses the flexibility to make a professional judgment in solving patient issues will encourage an autonomous practice atmosphere. Shared governance and participatory management models are two strategies of constructive ways to ensure formal power is spread to support the autonomous work teams and enable nurses to have control over their work environments (Hamlin, Davie, & Richardson-Tench, 2009).

In addition, organizational efforts that enhance access to information, opportunity, and resources can also empower staff and increase the level of job fulfillment around nurses. Giving access to opportunity structures could be achieved by offering progression positions for nurses, providing nurses with additional responsibilities, which challenge their creative energies and implementing clinical ladders. The practice of incorporating nurses into unit committees and the wide task force within the hospital covering all the managerial levels and other departments is important. It gives them the extra obligations and opportunities for acquiring new skills. An alternative way that nurse mentors can reward acute care nurses is by encouraging relationships outside the hospital. This is possible by financially supporting for them to participate in community organizations and attending professional conferences (Brown, 2012).

Access to better and more information for nurses will be achieved through informal and formal communication channels among the management team and the nurses. Intermittent staff meetings scheduled with the nursing managerial teams will guarantee a regular exchange of information; supervisors who offer information build a foundation of trust and collaboration. In addition, participatory management strategies have the possibility to expand correspondence between nurses and managers. Guaranteeing access to resources is a critical point in expanding job satisfaction and empowering nurses. This can take the manifestation of participatory management, in which acute care nurses can affect the decision making process of action of securing both equipment and supplies and extra support services (Brown, 2012).

Maintaining the supremacy of the nurse-patient relationship is an essential method in the effort to retain nurses in the acute care hospital setting. Although it is challenging to implement because of today's cost conscious healthcare atmosphere, sufficient staffing of nurses is important in determining the esteem and determination. The quality care they give to patients has an effect in organizational results (Dickson & Flynn, 2008). In any case, this system requires the business astuteness of the nurse manager for it to be executed viably. Moreover, getting satisfactory supplies for acute care nurses for them to do their job competently is an alternative essential aspect of the retention strategy. With financial limitations confining the available for resources and supplies, nurse managers must adopt their practical and innovative strategies.

Mentoring program for newly employed nurses

The aim of mentoring programs is to facilitate the transition of a new nurse to professional practice. Mentoring plays a crucial role in the orientation of a new nurse in the acute care department. Graduate nurses are always placed a mentor in the clinical setting. Mentoring is a source of additional resource for nursing graduates in the clinical environment.

In most cases, when nurses enter the workforce, they will be individually paired with a senior nurse (preceptor) in the department. The role of the preceptor will be to teach procedures and policies, act as a teacher, and oversee skills. The new nurse will depend on the preceptor for instruction and guidance and goes to the preceptor with concerns and questions. Therefore, this is a great asset for the new nurse. New nurses experience difficulties as it is not easy to communicate to the preceptor about complaints or a co-worker in the department; such little things can result in frustration forcing the new nurse to leave (Dickson & Flynn, 2008).

The goal of the nurse-mentoring program will be to maintain the new graduate nurses at the hospital a long time and provide them the necessary support to achieve this goal. The first thing the hospital will do is define mentorship based on the program. In this case, a mentor will be defined as a collaborative partner who will be a motivator and role model, providing support, inspiration, enthusiasm, and nurturing in a non-structured learning setting. The mentor will offer a safe, friendly, non-judgmental and a creative environment for the new nurse (Huston, 2014). The hospital will conduct surveys from which it will select the appropriate nurse mentors. In the surveys, the nurses will be chosen based on how they reflect with the definition of a mentor.

The mentoring program will supplement the clinical orientation. It provides an approach to help the new nurses as they transition and adjust from the graduate nurse to the Acute Care Nurse (ACN) role. The clinical educator will assign a preceptor for a one-on-one orientation on the employee's unit. The new employee will participate in the selection of their nursing mentor. All ACNs will be required to participate in the mentoring program: they are licensed staff working in full-time operations but with less than one year of experience (Dickson & Flynn, 2008). This program is seen optional for the experienced nurses in acute care department. The newly hired graduate nurses will have the chance to choose their nursing mentor in the course of the orientation week. After completing the mentor match, the preceptor will meet with the new nurse employee monthly during the first eight months of employment. The mentoring program will offer the new employee the opportunity to:

I. Seek guidance and advice for the mentor about professional development

II. Strive for progressive learning

III. Actively listen to mentors and ask questions to obtain clarification on various issues

IV. Obtain knowledge of various hospital programs to help the new employee with professional development

V. Help the new employee integrate into the hospital culture through social skills and knowledge

VI. Commit to the values, goals and vision of the hospital

Eligible requirements for nurses to become mentors include:

I. Must be actively practice the mission, vision and standards of excellence necessary for all the hospital employees

II. Must be an employee of the hospital at least, for a period of twelve months; excluding the probation period. Issues of attendance will not be applicable.

Orientation guide for newly employed nurses

Being in an unfamiliar environment and assuming new duties might cause a little anxiety and stress for new employees. This guide is to help hospitals help their new employees' transition into the organization. Managers have the most direct impact on establishing a positive work environment and employee's initial experience (Huston, 2014). Offering the necessary, basic information, making new employees feel welcomed and responding to concerns and questions are achieved through a well-organized orientation. This section offers a guide and comprises of the basics required by the new employee.

Before the arrival of the new employee

Orientation is a process beginning at the interview and continues across the probation period. The hospital should utilize the period between acceptance of offer and actual reporting date to establish contact with the new employee. This will create a positive impression while reinforcing the employee's decision that he made the right decision in accepting the offer. The following are some ideas to make sure the first day kicks off as expected and that the new employee feels welcomed (Marquis & Huston, 2009).

The hospital should send the new employee a welcome letter indicating:

I. Reporting date, time and place

II. The person to report to on the first day

III. Title, position and salary

IV. Job description

V. Length of probation period

VI. Directions to the department

VII. Organizational chart for worker's division or function

VIII. Parking area and IX. Suggested office attire

The management must announce to the appropriate employees and to the department the new employee's name, date of arrival and job responsibilities. They should be encouraged to offer support in welcoming the new employee.

Finalize departmental welcome and logistics: This involves selecting an individual from the department to be available during the first week of the employee to answer any questions, give a tour of the organization and the departments. The individual must be willing to do this, must be able to make the new employee feel welcomed, and their attitude and performance reflect positively on the department and the organization (Huston, 2014).

Office/work station and desk: The manager must order appropriate supplies including business cards. Appropriate office resources must be assembled. They include dictionaries, directories, computer program manuals, and staff listing. The supervisor must prepare interesting and meaningful tasks for the first day and first week. Additionally, prepare a first week schedule of meetings, tasks for the employee and on-the-job trainings.

Training and technology needs: The information technology department must assist the new employees and ensure the new employee has the requisite training and technology to use. The hospital should review the employee's technology training and needs by arranging one-one-one technology training for the new employee. Technology training and needs might include making sure that appropriate software and computer equipment is in working condition (Hamlin, Davie, & Richardson-Tench, 2009).

Overview of business ethics, confidentiality and security: The new employee must receive the appropriate details about security credentials like personal identification number, user name and password. The supervisor must assess knowledge about and comfort with computer software and hardware (Hamlin, Davie, & Richardson-Tench, 2009).

I. VoiceMail and Telephone

II. Internet use and navigating the company's website

III. Email

IV. Information on calendaring

V. Employee's First Day

The top priority of the hospital should be to make the new employee feel welcomed. The hospital will provide information to meet the needs of the new employee and avoid information overload. The new employee must be introduced to the other members of the immediate organization and other key members in every department (Marquis & Huston, 2009). The hospital should give general orientation to departmental and office policies and procedures. The topics should include:

I. Dress code

II. Company mail

III. Punctuality

IV. Security

V. Attendance

VI. Work hours

VII. Issuing required keys

VIII. Breaks, lunch and coffee hours

IX. Department and organizational culture

X. Personal safety

XI. Smoking policy

XII. Customer service tenets

Provide organizational overview through:

Discussing the goals, culture, objectives and functions of the department

Presentation of the organizational chart to the employee

An explanation of the interrelationship between departments

Describing main functions of each departmental member

Introducing the employee to assigned staff members responsible for taking the employee to lunch

Plan a tour to encompass the following locations:

I. Conference room

II. Work area

III. Lounge area

IV. Vending machines

V. Copy machine

VI. Fax machine

VII. Bulletin boards

VIII. Supply room

IX. Dining hall

X. Assigned parking lots and staff parking lots

First-Day Work Assignments

It is important for the new employee to complete a meaningful assignment on the first day at work. The employee will have a feeling of being needed and useful hence reduce any anxiety the employee might have. The supervisor will identify all the tasks to be done by the new employee after a little training. The list below contains fast day activities for the new employee. These activities can be scheduled throughout the week as part of the departmental orientation (Huston, 2014). This will involve: