Nursing and Leadership, Genesis Health Care - Assignment Example

? Nursing and Leadership Lecturer: Genesis Health Care is a facility that offers the following patient care services: Transitional Care: This is care that offers easy accommodation of the patient while they are in hospital and once the patient has fully recovered, they are returned back to the comfort of their home; Progression orthopaedic rehab: This is patient care that is focussed on all forms complex diseases and diagnosis, injury and/ or surgery; Short stay: This is immediate patient care that once completed, the patient is returned back home; Alzheimer’s care: This is care that is focussed on patients with Alzheimer’s disease as well as other forms of dementia and Long Term Care (LTC): This is a 24-hour non-medical patient care that focuses on elderly individuals as well as those with chronic or prolonged illnesses. The nursing department offers the above care services, more so the rehabilitation services for patients who are in need. Despite that, there are a few challenges which are faced in the department. The interviewed Director of Nursing (DON) stated that the lack of LTC taught courses/classes to new graduate students is one of the challenges that they do face and that has to be resolved with immediate effect. This is due to the fact that the ratio of individuals at the centre who need LTC is higher than the staffs that are available to offer it. As a result, some inconveniences and hitches do occur while propagating for effective LTC. In a bid to counter the LTC problem, the leadership that is prevalent in the nursing department matters a lot. If the leadership is based on morale and productivity, then that will yield success in offering LTC to patients else more challenges are prone to be faced on a daily basis. With that, there are a number of leadership styles that can be practiced in the nursing department. However, these depend entirely on variables such as people and the environment. Some of the leadership styles include: Democratic: This is one of the best leadership styles that a nursing department can incorporate. It advocates for the inclusion of the nurses in the decision making process. This makes them feel motivated as well as part and parcel of the health care facility committee. However, the senior nurse makes the final decisions; Authoritative: This style of leadership is stricter as compared to the democratic leadership style. The senior nurse makes all the decisions without the inclusion of the other nurses. Additionally, the senior nurse gives orders to be done and there is very close supervision of the nurses in the department. This is not the best approach to implement in a nursing environment. The nurses may feel de-motivated, neglected and they may lack innovation in their line of work; Affiliative: This leadership style is focussed on people (nurses). It ensures that the nurses have a satisfactory working environment so that they can deliver superior care services to patients. This style is best to boost morale in the nurses. However, the senior nurse may lack their authoritative figure. Based on the response of the DON, the most effective and efficient leadership styles that ought to be incorporated are the democratic and affiliative leadership styles. In a bid to support this, Goleman (2000) suggested that leaders should incorporate a variety of leadership styles and focus on those that are fruitful. Some of the leadership skills that go hand in hand with good leadership styles include: Interpersonal skills - Which incorporate the aspects of managing the different and unique cultural diversities in the department. It is important for a leader to have the right knowledge while dealing with different cultures since a health care centre is a home to all types of people regardless of their ethnicity background; Democratic skills; Listening skills, Problem solving skills – Which help to solve problems without encountering big risks, Time management skills and Motivational skills. If a leader has a number of the mentioned skills, then that environment is indeed healthy to work in. When it comes to hiring of staff at Genesis Health Care Centre, experience and competency are a critical concern. As a result, a number of channels are used to recruit the best practitioners. These include: The corporate clinical recruiter: This is a healthcare organization whose core aim is to provide health care facilities with the best and talented health care practitioners based on their previous works. They work by gathering information about the practitioner as well as performing background checks on their eligibility. Other additional measures that are normally put in place include; ensuring that the nurse or staff member is licensed. One of the benefits of getting qualified and competent nursing practitioners is that they will always ensure that all departmental tasks have been carried out efficiently. In addition to that, any nursing research that needs to be carried out will be done with superior quality. As a result, the most influential nursing research that was conducted was based on the impact of developing better and healthier workplace cultures for nursing practitioners worldwide. Nurse influence is also a major concern at Genesis. According to the DON at Genesis Health Care Centre, nurses are required to have minimal influence with regard to managing their work environment. However, this influence should be optimally professional and as directed by corporate. Change is inevitable in all the departments in a health care facility. As a result, Genesis is a Health Care facility that ensures that only appropriate and planned change is adopted for the better aid in current and future operations. According to the DON at Genesis, the only current and planned change that is nursing related involves the optimization of the existing clinical operations – Clinical capabilities as well as IV push medications. As cited from Genesis Health Care (2012), clinical capabilities cater for the following groups: 24/7 Direct Admission – that incorporates IV Antibiotics and medications , pain management, end of life care, infusion therapy, nutrition management; Advanced Capabilities that cater to – cardiac management, pulmonary management and bariatrics; Specialties that cater to – assisted / senior living, transitional care, dementia care and orthopaedic rehab. Improving on clinical capabilities also calls for the improvement of nursing performance. As a result; at Genesis Health Care Centre, the performance improvement process that has been implemented is as a result of the COR data collection. The benefits that ought to be reaped from the implementation of this strategy include an optimized service delivery to patients as well as patient safety. These elements also happen to be the main goals to achieve for any nursing department. Despite the incorporation of the COR data collection technique, there are several pull and push forces that are prone to be encountered during this process. Therefore, they could have a major influence on the quality of care and service that will be delivered at the health care facility. According to the DON, these influential forces on the delivery of nursing care and service include: changes in settlements – compensation; changes in the Minimum Data Set (MDS) 3.0 and the Medicaid case mix index in New Jersey. Financial compensation: It is without doubt that financial compensation is a very influential factor while seeking to retain health care practitioners. The lack of an adequate financial compensation model could lead to adverse challenges – Lack of nurses or staff – at the health care facility. Therefore, compensation is very influential to nursing care and delivery. Changes in MDS 3.0: The MDS assessment tool is used to measure clinical, psychological, life care etc. The benefit of MDS 3.0 is that it offers optimal accuracy, reliability and it is very resourceful with regard to providing a resident’s assessment on their health status. These assessment results have an influence on the choice and facilitation of Nursing Homes (NH), Swing beds (SB) and so on. Changes to the MDS 3.0 could have an impact on the results that it produces for residents based on their care management. As cited from the Centre for Medicare and Medicaid Services (2013), the MDS 2.0 faces challenges related to its incapability to include information on direct resident interviews. Additionally, it also disenfranchises them from the assessment procedure. Based on that, any changes in the current MDS 3.0 could influence the delivery of nursing care and services. Medicaid case mix index in New Jersey: A case mix state occurs during the conversion of the normal Medicaid reimbursement system to the use of the new MDS/ RUG's based system. A number of US states have already incorporated the new system; New Jersey being one of them. Due to that, the Genesis Health Care facility in New Jersey could be affected by this conversion and this could cause an impact and/ or an influence on the delivery of nursing care and services at. It is with no doubt that challenges are prone to be faced in every Health Care facility. However, a key would be to always anticipate for possible problems and strategise on their corresponding solutions that will aim at reducing the impacts to be encountered. According to the DON, some of the anticipated nursing service and delivery challenges in future – 5 years - include re-hospitalization of the LTC patient. This is due to the reason that LTC focuses on providing long term care to the patient while they are at the centre. Therefore, when the patient is released based on their health status improvement after a period of time they may get ill again; therefore, needing LTC again. With that, they get re-hospitalized or re-admitted to the health care facility. Neuman and Fawcett (2002) suggested that an environment consists of, “all internal and external factors or influences surrounding the identified client or client system” (p.18). In addition to that, the external environment is made up of stressors. Stressors have the capability to affect a client’s “usual stability level, or normal line of defence” (p. 14). Neuman model depicts the client or the client system as the individual who has distinct personal attributes. In a bid to get acquainted and/ or familiar to the environment, the client or client system (individual) has to develop defences; which in turn act as a form of protection from the unknown environment. The lines of defence on the other hand are attributes that are tagged to each client. They consist of variables such as: psychological, physiological, socio cultural, spiritual and lastly developmental which co- relate with each other. Based on the fact that each client has their own characteristics these variables will differ from one person to another. As a result, the lines of defence can be related to the overall wellness of a person (client); that is they protect the client from stressors which can attack the client. The key concepts in this model include: The client or client system (individual) that is characterised by their personal variables, a flexible line of defence and a line of resistance; the environment that is either internal or external and has stressors; health of the individual that could be either good health or faced with illness; nursing that offers the solution and/ or prevention to stressors. To the DON, stressors affect the disbursement of optimal health care services due to the fact that the ratio of individuals who need LTC is higher than that of the staffs. To the organisation, the first impact of stressors is that they affect the overall care delivery due to the re- hospitalization of LTC patients. Secondly, stressors have an impact on the financial bit that regards to paying the staff in time as well as their compensation for over time while delivering care to the patients. For the staff, stressors have the capability to affect their overall service delivery due to the reason that they are few. As a result, there is increased work load as well as less break times. How can these stressors be prevented with regard to the Betty Neuman Model? First, the DON should seek to recruit more staffs that are conversant with LTC care so that they can be attached to the health care centre. An alternative would be to advocate that new graduates should be taught on how to deliver LTC care. Secondly, the organisation could incorporate a centre that would fully accommodate LTC patients; thereby, they would offer them constant care and avoid re-hospitalization. Another aspect would be to better compensate staff that offer LTC. Additionally, overtime should be paid accordingly. This will eliminate workplace burnout, absenteeism and employee turnover. Further on that, high management positions have their advantages such as: better pay, better resource allocation, decision making and policy implementation. Their disadvantages include: they are the first individuals to be pinned down by the top chair when operations lag behind or they do not follow protocol, they may have to work longer hours to prove their worth to the top chair and they will be the ones handling complains and resolving them when mid management cannot handle them. According to the DON, the advantages of having nurses in the mid level and high-management positions in the health care facility include: the work load will be shared equally among the two levels and all responsibilities will not be geared to the high level management only. It can be concluded that, one of the opportunities in the application of this model is that it helps the health care facility to realize what client variables need to be achieved so as to ensure that the environmental factors – Internal and external are stable. References Centre for Medicare and Medicaid Services. (2013). MDS 3.0 for Nursing Homes and Swing Bed Providers Web. Retrieved from: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30.html Genesis Health Care. (2012). Our Services. Web. Retrieved from: http://www.genesishcc.com/ Goleman, D. (2000). Leadership That Gets Results [Harvard Business Review]. Web. Retrieved from: http://www.internationalbusinesscoaching.com/content_common/pg-article-summary.seo Neuman, B. and Fawcett J. (2002). The Neuman Systems Model. New Jersey: Prentice Hall PTR Read More