The General Surgery Unit: Nursing Deficit

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Introduction

One of Eastern Massachusetts University Hospital’s (EMU) divisions, the General Surgery Unit (GSU), is infamous for having the lowest employee satisfaction levels and the greatest personnel turnover rate. In addition to having average patient satisfaction ratings that have been progressively dropping over the past few years, this facility is known for its adversarial, finger-pointing, and favoritism-based practices (Groysberg et al., 2009). When Barbara Norris took over as the nurse manager of the unit at GSU, there was tension among the nursing staff and many of the attending physicians. She was in charge of organizing the unit’s schedule and budget and overseeing a team consisting of registered nurses (RNs) and patient care assistants (PCAs).

Issues Facing the Organization

At GSU, there were various issues, including a staffing shortage, high levels of stress, and low employee morale. Additionally, overtime was not provided because of other cost-cutting measures that the GSU administration had implemented. Therefore, the nurse manager could not give overtime to other employees to replace sick leave for one of the nurses. Another major issue at GSU was the lack of performance review procedures since leaders before Barbara did not maintain thorough and accurate records of the staff’s annual performance reviews (Groysberg et al., 2009). The senior nurses were another issue for the unit because rather than supporting and mentoring the younger nursing staff, they were frequently very critical of them and voiced their complaints behind their backs. Additionally, leaders prioritized financial gain over patient care and failed to encourage worker cooperation and coordination.

Recommendations

Any decision the managing nurse makes regarding staffing, such as recruiting a nurse or a secretarial assistant, should be discussed with the staff. To address the nursing deficit at GSU, she can minimize spending or use a small portion of the nursing fund to hire additional employees. For every issue that GSU is dealing with, the nursing manager needs to create reasonable, doable goals. To get around the employment moratorium and provide more employees for GSU, Barbara should speak with the director of nurses. Regular unit meetings will aid in creating a sense of community and a more positive work atmosphere. The managing nurse could implement a fair and open evaluation procedure but might not have any influence on whether annual salary raises are proportionate to review results or use alternative acknowledgment methods.

Indicators of Success

The ability to positively affect the needs and high expectations of patients, their families, the community, and even GSU workers is made possible by the strategic plan’s objectives, initiatives, and tactics aligned with operation and performance goals. Establishing benchmarks and connecting each strategy’s key performance indicator metrics results in transparent accountability throughout the whole GSU, promotes strategic planning through metrics management, and concentrates efforts on patient-centered care. The leading key indicators of success at GSU include improved patient experiences and results for every patient, improved interaction and dialogue with senior nurses, practitioners of advanced practices, and employees, improved patient health equity, enterprise-wide diversity, equity, and inclusion, a streamlined, assertive hiring process, lower turnover thanks to development and retention initiatives, and improving the patient access to primary care, specialty care, and core services.

Conclusion

An environment where the junior nurses learn from the seniors and the seniors don’t feel like they have to shoulder the weight of aiding their senior colleagues will help alleviate tension at GSU. The organization can identify the nurses who have performed the best overall so they may be rewarded with a bonus or a raise by keeping thorough and accurate records of the staff members’ annual performance reports. Regularly conducting informal check-ins and a more formal yearly review as essential management tools will promote open communication and a transparent evaluation process for the unit.

Reference

Groysberg, B., Nohria, N., & Bell, D. (2009). Barbara Norris. Leading Change in the General Surgery Unit, 1–5.

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