Nursing Management - Essay Example

?Nursing Management Discuss why absenteeism and turnover in nursing are costly to the organization. High turnover rates may lead to poor patient outcomes because the institution could loose employees who have gained some levels of expertise, familiarity with the work environment and patient trust. This has the potential of making the hospital to loose customers leading to reduce profit margins or reduced economies of scale. The institution also incurs expenses in the process of recruiting new staff. At times, the new workforce needs to be trained on certain skills that are important for quality patient outcomes. This means the higher the turn over rates, the higher the rate at which the institution incurs these expenses. Castle and Engberg (2004) explain that when the levels of absenteeism are high, the nurses who are available are forced to take mandatory overtime and this presents extra costs to the healthcare institution. This could also affect the efficiency of the available nurses because of working under strenuous conditions. Because of this, the healthcare institution may become limited in its capacity to handle normal number of patients. Absenteeism also leads to inconsistency in managing patient cases because teams handling patients have to be changed frequently and this may lead to poor patient outcomes and reduced trust by customers. 2) Providing privacy for patients is an important consideration for health service planners and providers. What factors should be considered in regard to privacy when providing nursing care? In regard to patient privacy, nurses should consider the effects of breaching privacy on the patient such as withdrawal and lack of cooperation. There are also circumstances which require that nurses weigh the importance of revealing the patient information to some relevant information verses the risks of maintaining privacy. An example is where the parents of a youngsters have to be notified of their child’s condition so that they can support in paying for their treatment. If the youngster’s condition is serious and the parents are not notified, the patient could die. Nurses should also consider the relevance of the third parties for example insurance companies or employers paying for a patient’s medical bills have the right to access the patient’s medical records or else they might not pay. Others could include people who could be potentially harmed by the patient’s condition. In the case of married couples, nurses should not withhold the medical records of their partners from them. 3) Discuss the importance of policy, protocol and procedure manuals in hospital wards. In hospital wards, policies are important in justifying some of the interventions taken by nurses that the patients could question for example referral of all patients suspected to be victims of physical abuse or rape to the most appropriate external medical provider. They also spell out permission granted to nurses in regard to some emergency cases for example administration of epinephrine to a anaphylaxis patient without an order from registered nurse or physician. Protocols guide nurses on the right thing to do in regard to their various roles for example what to include when making orders for the treatment of a patient. These could include patient’s full names, frequency and route of administration, date and time ordered among others. Procedure manuals on the other hand ensure that right from reception, admission and henceforth, the correct medical examinations and procedures are conducted on all patients and they are given the right medications. 4) Define the term ‘skill mix’, and explain why ‘team nursing’ is ‘skill mix’. The term skill mix simply means a mix of staff in the workforce or the pooling of professionals from various fields to accomplish a given task. Roles and activities are demarcated among various categories of staff. Team nursing can be described as skill mix because it involves the working together of professionals from different but related professions. These professions come together to identify, evaluate, plan and implement a comprehensive patient-centered care. In both cases, professionals required for the meeting the nursing needs of a group of patient are brought together. 5) Discuss the important avenues of government in relation to health services. One important avenue of the government in relation to health services is public health. Through this avenue, the government is able to partake in disease prevention, promotion of health and prolonging of the lives of its citizens. These include the running of vaccination programs, emergency response programs, and ensuring the safety of food and drugs. The government can also work to respond to threats to public health and promote healthy living behaviors through the department of health and health education. 6) Explain how industrial instruments support the nursing profession. According to Daly et al, (2004), industrial instruments can to facilitate the career paths of nurses because they cover all classifications of nursing and nurses working in various sectors. These instruments can be organised in a manner that they reflect the existing career structure in the nursing profession hence they help to maintain relevance and currency in the nursing profession. Some industrial instruments are designed in such a way that they are responsive to the emerging initiatives in the nursing profession. Where the other various models of nursing practice like midwifery are supported by industrial instruments, they ensure that nurses are remunerated appropriately and their nursing practice is supported by unambiguous and clear conditions of employment. 7) Discuss the meaning and implications of information technology for nursing care. Information technology (IT) refers to the acquisition, storage, processing, transmission, dissemination and retrieve of information through the use of software programming computers and other equipment, and networking. Health information technology (HIT) provides the framework for the management of health information across an institution’s computerized systems and its safe exchange between providers, consumers and other quality entities. Broad and consistent utilization of IT by nurses will prevent medical errors and expand access to affordable care. The use of IT by nurses will also result improved management of patient records, early detection of the outbreaks of infectious disease within the institution and around the country, and improved tracking of the management of chronic diseases. Electronic ordering of medications will improve efficiency of nurses and lead to on-time patient attendance. Clinical decisions will also be improved due to the use of internet-based IT systems that support this. 8) Explain what constitutes a Registered Nurse’s scope of practice. Discuss the role of the Registered Nurse in an environment of varying skill mix. The scope of practice of Registered nurses (RNs) ranges from diagnosing and assessing patients, providing interventions and treatment and making referrals. They treat or prevent injury, assist communities, individuals and families to achieve optimal total health and well-being, and advocate, teach and counsel to enhance well-being and health. They evaluate, monitor, coordinate and supervise the provision of health services, teach nursing practice and theory, engage in research related to the practice of nursing and health, and allocate, manage and administer resources related to health care (College and Association of Registered Nurses of Alberta 2005). In an environment of varying skill mix, the role of RNs is to give directions to other members of the team who are less skilled such as assistants in nursing (AINs), ward assistants (WAs) and/or personal care assistants (PCAs). The RNs will spend most of their time providing direct patient care while the less skilled workers perform basic tasks and even responsive and complex tasks as directed by the RN. 9) Describe key strategies for managing nursing workload and time management practices Two important workload and time management strategies for nurses are routinization and prioritizing. Prioritizing enables nurses to identify those tasks that are more important and urgent and thus focus on them at the expense of less valuable activities. Routinisation of tasks improves the speed of attending to such tasks. Other important strategies include planning one’s workday ahead of time, organizing oneself and one’s workspace, minimizing and managing interruptions in the workplace and delegating tasks both at work and at home (Waterworth 2003). Organizing oneself and one’s workspace will reduce confusion arising from misplaced items or misidentified tasks which could lead to wasting of time and role confusion. Nurses should adopt stress coping techniques. This will enable them cope with equal usual amounts of tasks with lesser stress or efforts 10) Discuss the advantages of an intranet clinical information system into the hospital. One of the advantages of an intranet clinical information system into an hospital is that it provides a more flexible access general medical knowledge and particular patient information. It provides a central data repository and improved ways of displaying individual patient information in multimedia, graphical and summary forms (Dudeck et al 1997). Intranet also improves communication between staff and administration because information communicated reaches everyone instantly. 11) Identify how an individual can cope with the processes of change. In order to cope with change, an individual should begin by taking change as a means and not a barrier to their goals. This will help them to avoid an attitude of fighting or wanting to flee from the change. They should also realize the capacity in them to adapt to change. One should analyze the opportunities for personal growth presented to them by the change. This is seeing the big picture to avoid missing the chance because of fear. This will help to them to quickly transit into the acceptance stage. It will replace despair with acceptance and anticipation of the potentially brighter future presented by the change. In the process of maintaining an optimistic outlook, one should keep one’s expectations realistic so that any negative outcomes will not look so overwhelming. 12) It is said that within organizations resistance to change can be positive. Explain how resistance to change can be positive. Resistance to change is based on important truths and viewpoints that are valid that should heard, taken in and considered if change is to succeed. This is to say that resistance to change reveals to the management areas to be reflected on and to be considered henceforth for smooth running and success of the organization. Resistance to change can weed out ideas that are not good because they have not been vetted thoroughly. Resistance also delays the pace of change and this buys time for the organization and people to adjust more and put in place the infrastructure and systems required to support the post-change reality. To the people, resistance provides an outlet for their energy and emotions during a time of intense pressure. This is useful and convenient because if this outlet is closed, it allows unnecessary build up of pressure and this could reach explosive levels. Organised resistance forms, exposes and shapes the organization’s informal leaders. Support and commitment to these leaders is important for the success of change efforts in the future. 13) Briefly describe key features of Kurt Lewin’s ‘Force Field’ model for change. The key features of Kurt Lewin’s ‘Force Field’ model for change are driving forces and restraining forces. The driving forces are reasonable, conscious, positive and economic whereas the restraining forces are emotional, illogical, negative, social/psychological and unconscious. The two sets of forces are real and should be taken into account when managing, reacting o or dealing with change. The model has 3 stages namely unfreezing, moving and refreezing. In the freezing stage, the strength of the forces that maintain the existing equilibrium is reduced. It involves reaching the point of understanding that change is required and getting prepared to move from our current zone of comfort. Unfreezing therefore prepares people and creates a situation that change is needed. The moving stage occurs as we make the necessary changes. In this stage, new organizational values are developed and behaviours and attitudes to help move the organisation on. In the freezing or refreezing stage, the changes that have been made are stabilised in order to obtain a new equilibrium. The changes are accepted and become the new routine or norm. 14) What is ‘Reality Shock’ and how can it be prevented. Reality Shock refers to jarring or unsettling experience resulting from a great difference between what was expected and the actual situation has turned out to be. In nursing, it refers to the conflict of expectations experienced by a nursing student who is transitioning to a registered nurse. One method of preventing reality shock is preceptorship. This transitional program presents the reality that new graduates will find in the workplace. Thrall (2007) explains that hospital residency programs should be designed by all hospitals. These programs help nursing students transit smoothly from school to the hectic hospital environment and prevents them from escaping the profession. Voluntary services during holidays help students familiarize more with their future roles in a practical setting. 15) Explain a process of organizational evaluation. Organizational evaluation analyses, compares and measures the coherence specific objectives and results and between general and specific objectives of the organization. Various variables important for the efficiency of the organization and those related to the organization’s patterns of behavior and effectiveness are measured. The three elements in the assessment process are the organization, the assessment team and the people. The steps to be followed in the process of organizational evaluation begin by identification of the objectives of the exercise, nature and size of the organization, areas to be covered and potential users of the results and recommendations. Framework for conducting the exercise, methodology for conducting the exercise, data collection, and evaluation methods should also be identified. The finality of this is displaying and analysis the results and making recommendations. References Castle Nicholas and Engberg John. (2006). Organizational characteristics associated with staff turnover in nursing homes. Gerontologist. (1) pp 62–73. College and Association of Registered Nurses of Alberta (2005). Scope of Practice for Registered Nurses. Edmonton, AB. Author. Daly John, Speedy Sandra and Jackson Debra (2004). Nursing Leadership. Elsevier. Australia Dudeck Joachim et al. (1997). New technologies in hospital information systems Thrall Terese (2007). “Shock absorbers. Hospital residency programs smooth the bumps for new nurses.” Hospitals health networks AHA. (6) pp 60, 62, 64. Waterworth Susan (2003). Time management strategies in nursing practice. Journal of Advanced Nursing. (5) pp 432–440. Read More