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Have a great nursing unit
By Jeff on Oct 05, 2010 in Hospital Staffing
To make your nursing unit run at its best find leaders among your staff and empower them. http://ht.ly/2N0ML
Tag: "nurse managers"
Nurse leaders are making due and getting better for it
By Jeff on Apr 16, 2010 in Featured, Hospital Economics, Hospital Staff Retention, Hospital Staffing, Nursing Staff Management
A recent benchmarking survey discussed at The Leaders’ Lounge looked at impact that the economy’s downturn had on nursing units, with some not all too surprising results, but some that do have a direct impact on healthcare staffing, including nurse managers:
- Cutting back on educational travel
- Delaying filling open positions
- Renegotiating supply costs and contracts
- Cutting back on overtime
They even had to do things like:
- Implement mandatory paid time off a couple days through the year
- Decrease employee’s pension contributions
- Eliminate bonuses for management
- Stop matching retirement fund (401k) contributions
Actions like this had the not surprising effect apparently of reducing the nursing staff’s morale, which led the nurse managers surveyed to rely on actions like:
On the upside though the survey showed that nurse managers are expecting to see spending in hiring and travel increase in the next year, with 74% saying their facility is hiring right now, and 65% planning to travel to a couple of conferences in 2010.
Based on these findings it looks like that despite the negative effects of the economy over the last year, there were also improvements in employee engagement, efficiency and retention efforts. Which coupled with smart hiring practices and smart use of temporary staff as the recession ends should help improve patient care and reduce nurse burnout over the next year.
What are your thoughts and experiences over this last year?
Demystifying healthcare staffing: How can hospitals make sure they are staffed appropriately in a nursing shortage?
When it comes to staffing your hospital it important that you have a plan in place. You want to make sure that you have enough nurses in place to deal with things like seasonal fluctuations, the opening of new units or wings, unexpected and expected staff vacancies and illnesses just to name a few. That part you already know, the hard part is how you develop that plan.
For starters it needs to be a plan that takes of long-term and short-term staffing shortages. Like anything in life it is easier to plan for something if you know what to expect, which is why being able to look at some historical factors to predict just what your staffing needs are going to be is an important first step of creating a plan to make sure your unit always has a safe level of nurses for the number of patients you are going to have. Some factors to include in this are:
- Your hospitals past census levels
- Your staffing budget
- Your accepted nurse to patient ratios
Conversely one thing you want to avoid is being overstaffed because it can be very costly to a hospital on a tight budget. Ultimately you want a plan that at least helps your unit break even, but even better you want it to help your hospital make money.
So when you look at staffing your hospital or unit, temporary staffing can be a good part of your staffing plan. You will often hear from the C-Level when money gets tight that temporary staff is one of the most costly budget items and easiest to get rid of, but if the use of travel nurses is part of a plan, not a quick reaction to unexpected census changes then they should not be seen as an expense, but as a revenue generator. A few factors to keep in mind when looking at the cost of temporary nurse staff as part of your staffing plan are:
- How many patients are you not seeing because your nurse numbers are too low?
- What is your average revenue per patient?
- What percent of your FTEs are being covered by internal float pools and how long will that last?
- What are average nurse turnover rates?
- How much are your recruiting cost for a full-time staff?
- What is your annual salary for a full-time nurse?
When you put together your staffing plan don’t just look at the immediate weigh what your nurse needs will be through the course of the year and determine the times when you will need both full-time staff and temporary (travel or per diem) staff. Not only will you be able to ease the burden on your full-time staff, plan for the temporary staff’s orientation better, help your hospital make more money and most importantly, treat more patients.
Nurses on television. Helpful or harmful?
With all the new shows based around nurses that came out this televesion season I wondered about your take on them now that a lot of the hoopla has died down. I actually haven’t seen them myself, but I have read a lot of negative opinions about them. And from what I have seen and read they just seem to be playing off of exisiting stereotypes and creating false expectations for young nurses or those looking into the career.
But, what about you? Do you feel they are good or bad for the profession? Why? Is one worse or better than the others?
Solve the nursing shortage by caring for patients?
I just read an article about an initiative in New Jersey led by the New Jersey Hospital Association’s Institute for Quality and Patient Safety, in partnership with the Robert Wood Johnson Foundation aimed at educating and supporting nurses so they can increase the amount of time they spend at with patients and in the process improving their job satisfaction. In turn this should help address the nursing shortage by stopping or at least slowing down the leaving of nurses from the profession.
The hope is that by giving nurses, particularly more experienced ones, a chance to stay connected to patient care they will stay passionate about caring for others and stay in the profession. The program is receiving a substantial funding of a $732,000 grant and will focus on three goals:
I must admit I had never thought about this connection before, that of nurse satisfaction improving the closer a nurse can get back to delivering patient care. This is very understandable. The extra duties that that get added to nurses’ jobs are most often not what motivated them to get into nursing in the first place. So why not address the burnout problem by letting them do what drew them to the profession in the first place.
What about your state or hospital for that matter? Are there any initiatives underway to help nurses get closer to the patient? What about on a more micro-level? What are you doing in your nursing units?
What can you learn about the patient experience from dolls?
A lot apparently.
In an article about the patient experience from HealthLeaders Media, Gar Crispell, general manager for American Girl, talked about the ways that the American Girl Doll Hospital works to provide a great patient experience for the dolls that visit it and their owners. One thing that the article mentions is their consistency and how they strive to delight with each interaction. If you want to see what that kind of patient experience brings just go to YouTube and look at all the “American Girl Doll back from the hospital videos” are out there. These are little girls who love their dolls and take the time to film and upload a video about it when they get them back.
Here is a video of a little girl as she gets one of her dolls back from the hospital. Imagine if your patients and their family’s got that excited about their stay with you.
And here is a blog post from the mom of a little girl whose doll visited the American Girl Doll Hospital, read it and the comments and you will see what their focus on patient experience can do.
The people at the American Girl Doll Hospital are able to do this without knowing a lot about their patients. But as nurses and nurse managers who have the ability to talk to and learn about your patients your job should be much easier. Great patient experience only comes from one place. The hospital staff and most often those on the front line of providing that experience are nurses. And the happier the nurses the better the patient experience. So as a nurse manager what are you doing to help make your nurses happy and teach them to pass that on to your hospital’s patients?
Gel (Good Experience Live) Conference Promotes the Patient Experience
I posted about this over at TravelNursingBlogs.com too, but thought it would also be worth mentioning here too.
The Gel (Good Experience Live) Conference is on Thursday, October 22, 2009 (and optional 2nd day: Fri, Oct 23) in New York City. It brings experts on the patient experience together to put on a series of talks on the patient experience, focusing especially on:
- Who’s improving it?
- How are they improving it?
- What approaches are being taken in various healthcare disciplines?
This is the conference’s seventh year. It looks like a great list of speakers will be there, so if you’re in the New York City area you should check it out.
Here is a video made available from last years conference.
Bridget Duffy at Gel 2008 from Gel Conference on Vimeo.
Can special talents of your nurses improve patient care?
I came across an article on HealthLeadersMedia.com the other day about nurses at Arundel Medical Center using their artistic touch to liven up patients rooms that were undergoing renovations, by painting uplifting scenes on the windows that were covered top protect patients from viewing the bright lights from the welders. Staff, patients and visitors all said the paintings help improve the atmosphere of the floor.
But it made me wonder what other ways could nurse managers give the nurses a chance to use the talents of the nurses in their unit to help improve patient care and the atmosphere of their unit. Making crafts? Writing stories? Being a clown?
Is there anything you have done or our doing? Let’s hear ‘em.
Nursing management and the economy
I just wanted to quickly point you to a good post at The Leaders’ Lounge about strategies to help your maximize your staff during this tough economy. But really this is good advice all the time.
The author Bonnie Clair, MSN, RN lays out some simple steps like how to assess your talent, improve employee engagement, listen to your staff’s ideas and suggestions, build closer relationships with your customers, improve your department’s culture, build trust among your staff and retain your superstars. Give it a read.
What have you been doing to help your nursing staff perform better during this tough time? Anything else you would add?
How do you orient travel nurses?
One of the big concerns of nurse managers and hospital staffing managers is the length of time it takes to truly orient a new travel nurse into their hospital and unit. This is an understandable concern, if you consider you only have a temporary nurse for basically three months at your unit and if they are there, then most likely the hospital has an immediate need and getting them working as quickly as possible is crucial. The norm seems to be anywhere from a half-day to three days of orientation, whereas a permanent nurse may receive anywhere from a week to two weeks of orientation.
Because they are travel nurses coming to you through a travel nursing company you should be able to trust that the agency has qualified their skills and competency as a nurse, but there are still going to be still simple things like where are your supplies, where is the cafeteria, how is the floor organized, etc. that need ingrained quickly.
Obviously the orientation of a nurse is something that needs a delicate balance of speed and thoroughness, but there are not a lot of resources out there to help you build a quick, but effective orientation plan. At least that I could find. But, maybe we can help each other.
I would love to be able to provide some simple advice for our hospital clients (hopefully that is some of you) on how to make their orientation the most effective for them and for our travelers and I think you should be able to share with others hospital staffing and HR professionals the things that have worked for you. Handbooks? Quizzes? Mentors? Tour Guides? Puppet shows?
So if you have a second please share. If you want to be anonymous just send me an email at Jeff.Long@MedicalSolutions.com.
