Question

Misty Bailey was recently hired as nurse manager for a 30-bed medical-surgical unit with the mandate to “turn the unit around.” After several weeks in the new position, Misty introduced a new staffing protocol to require nurses to have an increased number of patients assigned per shift and to sign up for additional shifts to avoid the use of agency nurses. The staff nurses were upset with Misty's new staffing protocol and appointed a colleague, Jonathan Mathews, to discuss their concerns with Misty. Jonathan approached Misty with the staff nurses' concerns and attempted to discuss how the new staffing protocol would negatively affect patient care and unit morale. Jonathan requested that he and the staff be provided with an explanation regarding the basis for the new protocol and that the staff be included in identifying solutions to the staffing problems to ensure patient safety is protected. Misty was not receptive to Jonathan's concerns, stating that management of the unit was strictly up to her. The meeting concluded with both parties feeling a sense of frustration. Over the next several days, unit morale declined significantly and Misty encountered a great deal of resistance regarding implementation of the staffing protocol. Unsure as to how to best manage the growing resentment among the staff, Misty solicits the advice of her director of nursing, Brigitte Johnson. Ms. Johnson encourages Misty to conduct a meeting with nursing staff representatives, including Jonathan Mathews, to resolve the issue.

Questions

1. Which of the following should have been Misty’s first step in regarding implementation of a new staffing protocol that ensures patient safety and promoted nurse satisfaction?
   1. including the staff in decision-making process
   2. gaining support from the facility’s chief nursing officer
   3. presenting the staff with management’s concerns
   4. enforcing her policy no matter what for the good of the floor

Answer 1

Which of the following should have been Misty’s first step in regarding implementation of a new staffing protocol that ensures patient safety and promoted nurse satisfaction?

1. including the staff in decision-making process
2. gaining support from the facility’s chief nursing officer
3. presenting the staff with management’s concerns
4. enforcing her policy no matter what for the good of the floor

Answer is a.including the staff in decision-making process

According to ANA 5 principles of staffing are

• Health care Consumer: Nursing staffing decisions are based on the number of the patients , and populations served
• Interprofessional Teams: Optimal care is achieved through individual actions and collabration with other health care team members. Nurses are full partners in the delivery of safe quality health care
• Workplace culture: Organizational leaders must create a workplace enviornment that values nurses as critical members of health care team
• Practice Enviornment : All nursing care delivery systems must provide the necessary resources to meet each health care consumers individual needs and demands of the unit
• Evalution : Organizations must have appropriate nurse staffing plans . All settings need well- developed staffing guidelines with measurable nurse- sensitive outcomes.

So in the above case we can plan for flexible Nursing staffs. you can include following steps for flexible staffing

• A focus on flexibility and team work to effectivily meet the ever chhanging needs of the patients.
• follow a work place culture
• follow currect staff patient ratio except in special occations like Diaster managment
• Nurses at all level having role in staffing decision
• Provide leaves according to the staffs needs
• include staff in making monthly working schedule
• Staffing needs and assignments taking in to account factors such as patient status and nurse competencies.
• Nurse driven staffing guidelines with measurable outcomes

Leadership quality to be created . In all the shifts there must to be a team leader to help each nursing staff in the surgical ward. Include Jonathan Mathews as part of representing nursing staffs for their work schedule. Avoid unnessary leaves. Timely inservice education to boost the staffs knowledge. If possible appoint more nursing assistents to help nursing staffs.