Shortages of nurses are getting worse and is also occurring outside of the USA. Recruitment of foreign nurses may not be an option for the US healthcare system in the future. Conditions are materializing in a way that healthcare organizations will probably increase their efforts to replace nurses with less qualified and less expensive personnel, in part because of the shortage, and the shortage will be used as a legitimate reason for "de-skilling" the direct patient care staff.
I am a fervent advocate of advancing the nursing profession to a true professional status. The issues facing nursing are many and there is no quick fix. To advance our profession will take time, commitment, and must start at a "grass roots" level in the local hospitals and other organizations that employ nurses.
THIS POST IS PRIMARILY DIRECTED TOWARD NURSE MANAGERS.
Here are some facts, like them or not. Administrators, corporate executives, and doctors have the power in healthcare. For nursing to advance and conditions to improve, these are the people we will have to convince, primarily healthcare executives. As you should be aware, the primary motivator for executives is making money. This is not necessarily a bad thing, it is what they are hired to do.
When the hospital is performing well financially, administrators are happy, when it is not, administrators are not happy and begin to look for ways to cut costs. Since nurses are the most visible employee to the hospital's customers, nurses are in position to GREATLY INFLUENCE the success of the hospital. As a matter of fact, NURSES ARE PROBABLY THE GREATEST SINGLE INFLUENCE ON THE SUCCESS OF THE HOSPITAL.
Make no mistake, DOCTORS ARE THE PRIMARY CUSTOMER, NOT THE PATIENT. Doctors are the only ones that can order things that make money for the hospital, so administration holds them in high esteem and bends over backwards to accommodate them. Doctors judge a hospital, to a large degree, on the quality of the nursing staff. They look for professionalism, skill, knowledge, assistance in getting their diagnostic information, they want reports on how their patients are doing. These are their primary interests so they can GET IN, MAKE ROUNDS, AND GET OUT QUICKLY.
We know that employees are more productive and perform best when they are satisfied with their jobs. IT IS A PRIMARY RESPONSIBILITY OF THE NURSE MANAGER TO SHAPE AND INFLUENCE THE SATISFACTION AND MORALE OF THEIR NURSING STAFF. There are many ways to do this. One primary way is to "screen out" the negativity from upper level management. Not saying to hide or withhold information, but how you relay negative information will greatly influence your staff's morale. The nurse manager should work hard to keep things positive for their staff. Some suggestions:
-be visible, available, a resource, willing to pitch in and help
-stay out of your office as much as possible
-stand up for your staff, defend them, bragg on them
-point out to your staff good things they are doing
-look for reasons to praise your staff
-honor requests for days off, go out of your way to do this
-show up and take report early in the morning along with staff
-if things are bad on the unit, don't leave early
Remember this: YOUR SUCCESS DEPENDS ON THE SUCCESS OF EACH OF YOUR STAFF NURSES. IF THEY ARE NOT SUCCESSFUL, YOU WILL NOT BE SUCCESSFUL. Therefore, your number one job is to find ways to make your staff successful, so, support them, help them, nurture them.
-give your staff room to be themselves
-recognize their professional autonomy
-do not create an oppressive, hostile atmosphere where everyone is afraid of getting reprimanded
-give them freedom to take educated risks, and if their ideas don't work, do not reprimand them.
Doctors, administrators, patients, and your co-workers all prefer a positive, upbeat, motivated atmosphere to one of negativity and complaining--you are the first line in helping create this, it is your responsibility.
