Evidence Based Nursing Coaching Style Management - Essay Example

Evidence based nursing coaching style management NHS- Shortfall in nursing; evidence based study and management Any assessment of nursing coachingneeds to focus on the present and near future staffing requirements for health services in the country. First among considerations of the probable pattern of future demand for health care is whether the demand for nurses which is presently on the rise would show the same trend over the next decade. It is admittedly difficult to make such predictions but there is some evidence in the literature which is indicative of some definitive trends. The key determinant of the market demand for nursing professionals is age. Nursing in most countries has an 'ageing' profile with a sizeable proportion of the nurses being considerably experienced. This inadvertently has a number of employment policy implications. Replacing and recruiting people to make up for the older nurses who are near retirement age is infact a very significant problem for the health sector. Nursing itself is comprised of several smaller sub-divisons and there is much evidence to reveal that the ratio of the nursing work force is not equally divided within these sub groups. Careful analysis reveals that prison services, the armed forces, local authorities, occupational health nursing and emergency health services are some of the divisons that do not suffer from a shortfall with respect to the workforce number. Interestingly nursing homes for the elderly are increasingly being seen as having fewer and fewer trained nurse practitioners and in many cases even trained personnel. The reason for this anomalous distribution remains largely unclear and it is a problem the health sector is now grappling with. The UK nursing work force in particular provides a very complete picture in this respect. (Buchan 1999). It is a problem which infact has become the subject of much research and study over the last decade. Demographics reveal that the UK population in general is ageing, and the nursing workforce in the region is no exception. It is a growing population with a greater number of elderly people, which is ensured by advances in medical practice and technology which has resulted in increased life span of the population. Consequently a growing challenge for the National Health Service (NHS) in the UK is providing adequate nursing facility for its population. The key element of effective nursing coaching in the present scenario is to develop appropriate workforce planning mechanisms that take into account the supply and demand for nursing staff. Quite evidently these should take into account the demographics (i.e the age and type) of the client population and the workforce, and aim to reach a balance of demand and supply as may be the requirement of the market. Infact it can be safely said that the continued prevalence of the shortage of nursing workforce over the past decade could be considered a result of some shortcoming the coaching style for nurses. Both as educators or as nurse practitioners we need to look at the plausible shortcoming of the present coaching style since it is obviously unable to adequately address this problem! Some of the major reasons for people taking up nursing as a career option are because of the opportunities to care for people, to gain some autonomy at the work place and also to be fairly rewarded both financially and emotionally (Irvine and Evans 1995). This has to be taken into account for future training strategies in nursing if the present shortage particularly in geriatric (old age) wards is to be addressed. Coaching styles have to focus on increasing motivation for and clearly elucidating the potential incentives of nursing in general and geriatric nursing in particular. Intervention strategies Nursing and midwifery have traditionally relied on a fairly narrow defined group of school leavers (predominantly female) for recruitment purposes. This population in general is less inclined to work with the elderly population to begin with. In addition geriatric nursing does not provide as challenging a face as some other aspects of nursing like emergency or military nursing divisions may do, neither is it as financially compensatory as occupational health nursing may be. A review of the literature reveals that there are indeed several prevention and intervention strategies which have been well researched and advocated to resolve the problem. Various initiatives are however now underway in the NHS in order to provide admission routes into nursing education for a broader range of applicants. These would include mature candidates, entrants from ethnic minorities, and entrants with vocational or work-based experience. These initiatives include nurse cadet schemes and career bridges between the roles of auxiliary/health care assistant and nurse. Also candidates from such backgrounds are more likely to be inclined to the option of geriatric nursing. In addition an increasing number of the workforce is now being recruited from other countries. Approximately 3.5% of nurses in England and about 1% in Scotland now are not of British origin. (UKCC 2001) It is thought that an influx of non native population may serve to counter the shortage of the nursing workforce. The second problem that has been identified in terms of the nursing work force is the excessive work load on the nurses which lead to much deployment. The hours of overtime work in this field appears to be far in excess of other workforces with similar pay scales. Intervention strategies in this respect look at enabling nurses to combine work and non-work commitments. Evidence-based approaches which look at the kind of flexible employment practices which would ensure this are indeed becoming the focus for the NHS now. One intervention strategy that is now being widely employed to address the shortfall of nurses that is however associated with a limited evidence base is the issue of 'Qualified/unqualified' mix in nursing. Most of the evidence in this respect are from regions in the USA ( reviewed in Siehoff 1998). The UK workforce seems to be more cautious in implementing this work plan. The several disadvantages of this plan however as has becoming increasing evident over time suggests that it may perhaps be a well informed decidion on the part of NHS and geriatric homes to avoid this strategy. It has been reported that the quality of health care suffered and the work load for the qualified nurse increased considerably in the 'mix' nursing practice. The NHS hence may have done well to avoid the trap based on the limited evidence that is available on this area. However all intervention strategies inadvertently require the education sector to be proactive in training and responding to resolve this problem. The way ahead As can be seen from the above mentioned intervention strategies, there is much focus on introduction of new workers from a wide range of backgrounds to counter the shortfall in the nursing population. This would evidently need an extensive training programme and there is hence a need for the education sector to gear up to meet these needs. It is infact widely acknowledged that the limiting factor for the scope of the intervention strategies would be the response of the educators and trainers to cooperate and design courses and curricula which would meet the needs of the new work force. The challenge for the education providers for nursing would be to generate a clear picture of the roles for nursing/midwifery staff in addition to that of doctors in the new scheme of health care. This new scheme does indeed require a positive and active contribution from all health workers and not just doctors (Brown and Grimes 1995). This gives more chance of continued self and professional development for nursing professionals but it is up to the educators to inform the prospective(in training) nurses of such changes in the work environment and job descriptions. Training of entrants from other countries and different back grounds also will depend on the capacity of the education sector to integrate the needs of health services in the country with the special training that the new entrants may require. Overall promoting nursing as a career would be considered another role that educators may need to think about with respect to long term intervention strategies that may serve to address the problem of shortfall in nursing workfall. Once again, the role of evidence based research can be studied in this respect. Some countries have witnessed previously a 'disconnect' (or time lag) between the identified need for new workers or new roles, and the capacity of education providers to meet this need. With this in mind educators now would need to ascertain that the NHS intervention strategies are not compromised due to similar problems once again. It is indeed the responsibility of educators to identify the need of the hour and aim to fulfil the market demands in nursing. Such an evidence based integrated approach is perhaps the ideal way to go to resolve the current problem faced by the healthcare sector. Conclusion The novel evidence based approach now increasingly being used by nursing coaching practiceis well justified in terms of sound validation based upon widespread methodical clinical and industry research. This enables the utilisation ofstate of art systematic research findings to support decisions and training about future practice of the newly trained members (nurses) of the health care sector. It provides for a holistic and integrative health perspective for the patients and is indeed thekey to creating work environments with good staff retention, high levels of work satisfaction, and a long term solution for the NHS staffing problem. Sources Brown,S.A. & Grimes,D.E. (1995) A Meta-Analysis of Nurse Practitioners and Nurse Midwives in Primary Care. Nursing Research, 44 (6), 332-339. Buchan,J. (1999) The Greying of the UK Nursing Workforce: Implications for Employment Policy and Practice. Journal of Advanced Nursing, 33 (9), 818-826. Irvine,D. & Evans,M. (1995) Job Satisfaction and Turnover Amongst Nurses: Integrating Research Findings Across Studies. Nursing Research, 44 (4), 246-253 Siehoff,A.M. (1998) Impact of Unlicensed Assistive Personnel on Patient Satisfaction: an Integrative Review of the Literature. Journal of Nursing Care Quality, 13 (2), 1-10. UKCC (2000) Statistical Analysis of the UKCC Professional Register 1 April 1999-31 March 2000. UKCC, London UKCC (2001) Big Rise in Overseas Applications. UKCC News website, dated 4 May 2001, (http://http://www.ukcc.org.uk/cms/content/home/search. asp). UKCC, London Read More