Recognizing the major advantage of having ancillary staff as part of the team in any healthcare setting. The assistance they provide to both patients and nursing staff can improve patient satisfaction, decrease rate of nursing burnout and increase overall unit efficiency.
NursesGeneral NursingArticle
Having worked in multiple healthcare settings, many of us have seen how differently each unit can function. While no two units will be the same naturally, differences can be attributed to many factors, including patient acuity, management style, staffing plan/ratios, and much more. While several issues noted are frequently discussed and improved to better the performance of the unit, there is one topic that is somewhat avoided - the massive benefit of employing ancillary staff.
Years ago, I worked on a high acuity, high volume, outpatient Oncology unit. While we frequently treated around 100 patient per day (with limited nursing staff), we certainly didn't do it alone. Yes, it was busy - but always eventually manageable, mainly due to the assistance the nursing staff received from other members of the team. For example, we had a unit assistant to help answer the eternally ringing phone and direct calls to nursing staff only when necessary. They were available to help make phone calls on our behalf to track down patient transport, security, etc. The unit assistant cleaned the patient area after each patient, freeing up valuable time for us to prepare for the next patient. We also were fortunate enough to have a patient care assistant to help with vitals and comfort measures. (While nurses are always happy to get apple juice, magazines and warm blankets, we don't always have the time. Having a patient care assistant was not only a major benefit to nurses, but also to the patient's overall experience and comfort level - crucial.) Having a team of phlebotomists also made the patient volume possible. Without them being the first to lay eyes on the patient (calling nursing when something seems off), drawing labs, taking baseline vitals and weight - we never could have treated that many patients in a day.
After leaving that position, I experienced a very different setting on multiple occasions. One where there is very limited, to no staff - other than nursing. This leaves the nurse with so many non-nursing tasks on top of her regular duties that the patient is ultimately the one who pays the price, time for bedside care is extremely limited. Aside from the expected nursing duties (monitoring, medication admin, charting, etc, etc, etc, etc - so many tasks!), without ancillary staff, he/she is now additionally required now to allot time for answering the phone, making charts/copies, sending faxes, cleaning beds, restocking, running to the blood bank and pharmacy, and more.
Nurses are expensive. Is their time best spent performing non-nursing tasks? Certainly not when it is taking away from patient care, making it difficult to attend to patient needs and spend much needed time at the bedside. It can take up so much time on a busy unit that it in fact prevents nurses from taking more patients, limiting the unit capacity. This becomes a slippery slope in terms of hospital revenue, as well. When all of the budget is spent on employing only nursing and no ancillary staff - the hospital is not maximizing their return on investment. Units who do not employ any assisting staff members typically will not be able to treat and discharge patients as quickly and efficiently as one with a fully diverse staff could. When beds aren't filled or turned over as quickly, money is ultimately being lost. Nurses are burnt out faster, being asked to perform multiple roles with limited resources and time.
Is it possible to have a busy outpatient unit run only by nursing staff and management? Yes, but does it really make the most sense? I don't believe so. The benefits to having a robust and diverse staff are many. This can most certainly improve efficiency but more importantly, it can allow us all, as a team to provide the best possible care to our patients - while still holding on to our own sanity.
What are your experiences? What positions have I left out that have been most helpful to you as a nurse? How are your units run? Do you have helpful tips to share?
