Introduction
It's bad enough that County Healthcare Centre, our home, doesn't have enough nurses to care for all of the 500+ patients we supervise on a daily basis. There is now a nursing shortage in both the county and the state. Efforts to recruit nurses from other states have been unsuccessful due to the little revenues we have received throughout the years. Revenue declines have also forced us to lay off some of our few nurses. Our decision to offer some of the long-serving nurses early retirement has negatively affected our staff and the quality of service we offer. Many nurses today work in fear of being laid off next. I have written this proposal to explain to you the two issues affecting our department and to outline the method in which we can promote communication, collaboration and teamwork so that we can improve the conditions in our department.
Impact of Layoffs on Ancillary Services
When other employees are being laid off, the remaining ones live in fear. Majority do not even understand why the layoff is really necessary, and strongly oppose the move in their hearts (Rosin, 2014). With the opposition, it is not possible for physicians to continue to deliver high-quality ancillary services. Many readmitted patients who were under the care of the laid-off nurses do not receive the quality of care they expected because the nurses they find are either too busy with other patients, or do not understand the specific needs of the patient. Some of the nurses may even learn new abnormalities in the patient's condition but may fail to report them, feeling they may be blamed for letting the patient's condition get worse. Some ancillary service providers even fail to ask for clarifications from peers or even the manager if there are cases they do not understand because they fear they may also be sent away due to incompetence (Streeton, 2016).
Impact of Nurse Shortage on Quality of Care
As a result of the shortage of nurses in the healthcare center, individual nurses are assigned to too many patients. The nurses have to work for long hours without resting in order to help all the patients. This in turn leads to a reduction in the quality of service offered, which we have been registering in our facility. When a nurse has to attend to more than 10 patients in a day, it is not possible to give personalized care to such patients. It is possible, therefore, to miss out on some of the key elements of the patient's recovery. Many instances of drug overdose, under-dose and wrong prescriptions have been reported recently, which has increased the rates of readmissions. The pharmacists are outnumbered by the many patients thereby increasing the pressure and the workload. Due to fatigue and work monotony, it is very easy for the pharmacists to prescribe the wrong drug to a patient or confuse prescription units leading to overdose or under-dose. The increasing workload without any salary increase has made many nurses feel less motivated, which in turn affects the quality of care they provide (O'Daniel, Rosenstein, 2008).
Solution: Communication, Collaboration, and Teamwork
No salary increments can be promised considering the reduction in revenues we are experiencing currently. I cannot even promise you a reduction in the workload or that new nurses will be hired. It is even highly likely that some more of our members might have to leave us owing to the poor revenues. The only solution to our dilemma is therefore, to accept the facts and find ways to work around them. Communication, collaboration, and teamwork are what can help us improve the quality of care we provide (Stephen, 2015).
Inclusion and Flexibility
All of us have to feel included in every decision made in terms of patient care. To ensure the desired sense of inclusion is achieved, we will hold periodic staff meetings to discuss the issues we meet in our daily duties and deliberate on the best ways forward. Through training, all staff members will be educated on how to be flexible in the duties they perform (Treadwell, Binder, Symes, & Krepper, 2015). A nurse responsible for lab tests will not be limited in the lab but will be flexible enough to help patients with their physical activities. Dietary nurses will also be able to assist in other areas like pharmacy. The flexibility will assist in making us competent enough to take care of all the patients we have, without putting too much pressure on any one of us. Our duties will be balanced so that no person will be struggling with all the work while others are free (O'Daniel, Rosenstein, 2008).
Training and Knowledge Transfer
The training that will be offered will be conducted by the senior nurses to junior ones. This strategy will ensure that, in case the healthcare center has to let go of some of the senior nurses, the younger ones will still have the right knowledge and skills to continue providing high-quality care. The flexibility of all staff members will also help in ensuring that there will always be someone to fit into the gap left when other employees are laid off.
Effective Communication, Collaboration, and Teamwork
All staff members should learn to communicate and collaborate with each other. When one does not feel well or is overburdened with workload, he/she should feel free to reach out to others and ask for assistance. Whenever a staff member does not understand some condition or patient status, he/she should be able to ask for clarifications from other staff members. In case problems are noticed in the process of providing care, nurses should be able to report such cases to the office so that corrective measures can be taken. Collecting information from staff members can be through feedback boxes and suggestion boxes. This will be favorable to the staffs who wish to report a problem but remain anonymous (O'Daniel, Rosenstein, 2008).
Working as a Team
Working in teams will be very important where workload is too much for just a few people. It won't mean that all nurses will have to crowd a single workplace to help one another. Teamwork means that each individual will be responsible for the other. No single duty will be for a particular nurse. This implies that staff members will perform each other's duties whenever his or her workload goes lower. This can help in minimizing the pressure on nurses and making them feel that they are not being overburdened with work (Jones, 2005).
Conclusion
There is no need to panic over the laying off of nurses that have been going on. There is no ill motive fuelling the laying off. The revenues received by the healthcare center have declined tremendously and we cannot afford to pay all employees and still fund administrative and health-related activities. Staff members should also understand that the heavy workload does not stem from any reason other than the shortage of nurses. To ease the heavy workload stemming from the shortage of nurses and the laying off, staffs need to learn to communicate effectively, collaborate with one another, and work as a team.
References
Jones, D. (2005). California nurse leaders address the state's nurse shortage. Nurse Leader, 3(1), 46-49. http://dx.doi.org/10.1016/j.mnl.2004.11.011
O’Daniel, M., Rosenstein, A.H. (2008). Professional Communication and Team Collaboration. In: Hughes, R.G., editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Chapter 33.
Rosin, T. (2014). 31 hospital, health system layoffs affecting 100+ employees in 2014. Leadership & Management. Hospital Review.
Stephen, A. (2015). Fostering Interprofessional Collaboration in Healthcare. Campaign for Action. New Jersey.
Streeton, A. (2016). Improving Nurse-Physician Teamwork: A Multidisciplinary Collaboration. MEDSURG Nursing, 25(1), 31-66.
Treadwell, J., Binder, B., Symes, L., & Krepper, R. (2015). Delivering Team Training to Medical Home Staff to Impact Perceptions of Collaboration. Professional Case Management, 20(2), 81-88. doi:10.1097/ncm.0000000000000066
