There is a dynamic relationship between the healthcare system, health promotion practices in organizations, and the quality of care offered. The complexities of a healthcare system can undermine the responsibilities of the people providing care to patients. High-quality service in healthcare facilities is commonly evident in organizations where the relationship and interrelationships between the leaders and the rest of the employees are effective. System thinking promotes proper coordination between different departments in an organization. In healthcare facilities, collaboration through interdisciplinary relationships is likely to improve the outcomes and decrease cases of morbidity and mortality.
The main problem affecting the emergency department is the issue of nursing staff shortages. The growing population and changes in the demographic characteristics of diseases have increased the need for healthcare services. The rate of patients in the emergency department has increased thereby augmenting the demand for more nurses in the unit. These professionals play a significant role in the management of patients in this unit. Hence there is a need to have enough nurses and reduce the ratio of patients to nurses in the unit. One of the major reasons for the need to balance the ration of nurses to patients is that inadequate staff increases the risk of cross infections and mortality rates.
Some of the negative effects associated with nursing staff shortage include the inability of the nurses to provide the patients with proper care and attention, the likelihood of turning away patients due to the low number of staff to meet patient demands, and treatment or medication errors due to nurse burnouts (Lee et al., 2017). A study conducted on the effect of the nursing shortage showed that every additional patient on nurses’ caseload increased the risks of patient mortality by seven percent (Bean, 2017). High workloads for nurses working in emergency departments or intensive units have also been associated with decreased patient survival rates.
The System Organization
The selected organization was a healthcare facility with a focus on the emergency department. The organization structure of the facility is based on the division of units based on the type of services provided, such as the administrative, renal, intensive care, and maternal and infant care units, cardiovascular center, and medical and surgical wards. The mission of the facility is to deliver quality healthcare services to its patients, pace the needs of the patients first, and utilize the highest quality of medical technology in healthcare provision. The vision of the facility is to be a leading facility in healthcare provision and caring for people using advances in the medical field. The philosophy statement of the healthcare facility is based on treating each patient with dignity and providing them with the best treatment options available. The organization aims at being recognized as a national model for excellent healthcare services and providers of individualized-based services to patients.
Nursing staff shortage affects the ability of nurses to provide quality care to their patients. It also impacts the relationship between nurses and other healthcare practitioners in the department due to the inability of the nurses to complete the available tasks within the specified time. The flow of activities in the organization have been affected by these shortages as nurses have been constantly accused of lagging in their work and neglecting some of their roles. Aside from that, the nursing shortage has also affected healthcare institutions due to reduced quality of the care offered to patients, which has affected the reputation of the facilities and increased the risks of lawsuits associated with patient treatment errors.
The nursing shortage contributes to the development of a poor interpersonal relationship between nurses and their patients, which in turn, limits the effectiveness of the services provided by these experts and their abilities to meet all the needs of their patients. The increased workload placed on the limited number of nurses in the healthcare facility contributes to increased rates of harassment of nurses by leaders and other healthcare providers as the available nurses are forced to perform all the duties related to their profession. Aside from that, the relationship between nurse leaders and their subordinates can also be affected by a poor implementation of the organization’s working standards and desired quality of work in the units. Research has proven that healthcare facilities with better nurse staffing, appropriate nurse-patient ratios, and suitable working environments have a reduced likelihood of dealing with nurse burnouts and nurses dissatisfaction with their work (Mchugh & Ma, 2014). Nursing shortages have also been associated with an increased likelihood of nurses’ intention to leave their job and reduced quality of work, which would affect the ability of the healthcare organization to care for their patients.
The nursing shortage challenge affects staff’s competency, shared decision-making capabilities of interprofessional teams, and patient involvement in their treatment plan. Consequently, the interprofessional teams’ ability to make evidence-based decisions and other management, collaborative practices, and the quality of patients’ outcome is hampered (Anderson, 2016). These factors affect the ability of the organization to perform well and meet its healthcare delivery objectives.
· Highly trained nurses
· Quality facility
· Availability of advanced medical technology
· The facility can hold a large capacity of patients
· Nurse shortage
· Nursing burnouts due to shortages
· Increased risk for medical errors due to nurse burnouts and shortages
· Poor collaboration between healthcare practitioners
· Poor retention of new nurses due to workload
· Providing workshops and advanced education to nurses, which increases their ability to handle duties in the healthcare facility
· Offering newly hired and available nurses study breaks to promote the advancement of their skills to promote investment in long-term professional development for the nurses
· Increasing the number of nurses working in the emergency department
· Providing efficient nursing schedules for reducing nursing burnouts and shortages in the emergency department
· Training more nurses to work in the emergency unit
· Cutting the budget for other sectors to promote the hiring of new nurses
· Offering nursing residency programs to give graduates the opportunity to increase their experience in the different environments in the hospital (Mtega, Kibona, Dhamani, & Petrucka, 2017; Mchugh & Ma, 2014). The residents can also be hired to cater to the nursing shortage
· Increased risk for nurses to leave their jobs
· The retirement of older nurses, which increases nursing shortages
· Poor mentorship between expert older nurses and novice nurses thereby losing the ability to transfer skills and expertise among the nurses
The new nurse leader will take an administrative role and work with the human resource department, other nurse leaders in the organization, and the current nursing workforce in addressing the needs of the nurses. The expert will have the power to organize nursing training sessions that will equip existing nurses with adequate skills to cater for patients and provide additional workforce in the emergency department through implementation of a residency program that would help graduate nurses to increase their experience. Moreover, the leader can also introduce programs that promote the hiring of graduate nurses after completion of their residency programs. The nurse leader will also involve the existing nurses in professional collaboration with other healthcare providers to promote the quality of services offered to patients.
This position will improve the coordination between nurses and other healthcare providers. It will also reduce nursing shortage through the residency program, promote a reduction of expenditure in other sectors to support the hiring of new nurses, and promote nursing training and continuous education programs to equip nurses with adequate skills. Some of the key leadership skills, knowledge, and abilities required for the nursing position include motivation, responsible, ability to delegate roles effectively, interpersonal communication skills, dedication to excellence, mentorship, advanced nursing training, and critical thinking (Joseph & Huber, 2015). The nurse leader should also have adequate experiencing and training related to leadership roles.
The nursing shortage is a common problem among healthcare facilities across the country. This program stems from the increased demand for healthcare services associated with increased population and rates of diseases. There is a need to address the nursing shortage problem affecting healthcare facilities as a way of promoting patient care and their outcomes. Addressing this problem would also resolve other challenges related to nursing shortage such as burnouts, medication errors, and poor retention of nurses in the workforce.
Anderson, B. R. (2016). Improving Healthcare by Embracing Systems Theory. Journal of Thoracic and Cardiovascular Surgery, 152(2), 593-594. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4947551/.
Bean, M. (2017, August 24). Study: Every Extra Patient on a Nurse’s Caseload Increases Mortality Risk by 7%. Becker’s Clinical Leadership & Infection Control Retrieved from https://www.beckershospitalreview.com/quality/study-every-extra-patient-on-a-nurse-s-caseload-increases-mortality-rate-7.html
Joseph, M. L., & Huber, D. L. (2015). Clinical Leadership Development and Education for Nurses: Prospects and Opportunities. Dovepress, 7: 55-64. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5740995/.
Lee, A., Cheung, Y. S., Joynt, G. M., Leung, C. C., Wong, W.-T., & Gomersall, C. D. (2017). Are High Nurse Workload/Staffing Ratios Associated with Decreased Survival in Critically Ill Patients? A Cohort Study. Annals of Intensive Care, 7: 46. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413463/. Retrieved from Annals of Intensive Care.
Mchugh, M. D., & Ma, C. (2014). Wage, Work Environment, and Staffing: Effects on Nurse Outcomes. Policy Politics, and Nursing Practice, 15(0), 72-80. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4667784/.
Mtega, B., Kibona, L., Dhamani, K., & Petrucka, P. (2017). Perceptions of Nurses on Patient Outcomes Related to Nursing Shortage and Retention Strategies at a Public Hospital in the Coastal Region of Tanzania. Open Journal of Nursing, 7, 1044-1057. Retrieved from https://pdfs.semanticscholar.org/7e15/dc800f62798b79f914ff664eff0ba918772d.pdf.