Comparison of Leadership and Manager Approach to the Issue

Write an essay on Nurse to Patient Ratios.

In the medical field, “Nurse to patient ratios” is increasingly becoming a topic of concern, as much as many people are demanding for government intervention. Presently, “minimum staffing laws” is enacted only in California, while other states are yet to implement in their workplaces. According to Laschinger et al., (2014) similar laws were purposed in other countries but in vain as its implementation are refused by the hospitals. Several hospitals consider that such laws will be an extra financial burden depriving them of their flexibility to make necessary staff related decisions (Bernabeo & Holmboe, 2013).

 In this essay, the author will discuss the issues related to nurse staffing ratios. The author will compare and contrast the expected behavior of nursing leaders and managers, about the issue. Further, the author will discuss the roles of the leader versus manager. Lastly, the author will present the personal approach that best fits to solve the selected issue. The arguments in the essay will be supported by the literature review.

Nursing unions argue that hospitals recruit less number of nurses but admit a higher number of patients (Shekelle, 2013). Consequently, job burnout and stress are increasing among nurses, also, hampering patient safety (Aiken et al., 2012). According to the president of “Michigan Nurses Association”, Hospitals tend to be business as they focus more on the “short-term bottom line” (Naylor, 2012). It is not known whether legal intervention to tackle a shortage of nurses is the right approach or not. However, the leadership and management approaches to resolving the issue of inadequate nurse-to-patient ratios may be helpful in improving the consequences.

Nursing management is a complicated task. Mangers need to monitor the hospital operations and at the same time ensure that the nurses play their role in such operations (Bernabeo & Holmboe, 2013). It is the duty of the managers to make sure that the nurses are accurate in delivering their services and perform well in their job (Aiken et al., 2012).

Shortage of nurses increases the chance of errors, which affects the hospital management (Shekelle, 2013). Increase in death rate is the major outcome of medical errors (Laschinger et al., 2014). Shortage of nurses reduces the care services for patients. The reports of Shekelle, (2013) reveal that approximately 1.6 million “preventable healthcare errors” occurs each year in the US, signifying one medical error per day per patient. Also, shortage of nurses also leads to ineffective communication with patients and their families in decision-making (Pham et al., 2012). Naylor, (2012) believes that it leads to failure in maintaining the patient’s dignity and respect. Several incidences were reported where nurses administered medication at the wrong time, sometimes gave the overdose of medicines, failed to assist patients in managing pain and were unavailable in the emergency wards (Shekelle, 2013). Increasing the severity of illness and death is associated with inadequate nurses for patients (You et al., 2013). Such incidences discourage nurses, as they are highly responsible for patient’s safety (Pham et al., 2012). 

My Personal Approach

Therefore, it is imperative for the hospital management to develop strategies to ensure both “quality and safety of healthcare services.” There are some approaches to tackle low nurse-to-patient ratios. Managers need to be strategic in determining the work environment and tactfully assign nurses for their work (You et al., 2013). Working schedule should be modified to decrease nurse’s burnout. Shekelle, (2013) recommends that to maintain the work efficiency; nurses must be provided with sufficient recovery time after attending a large number of patients and working longer shifts. It will ensure that the nurses are in a correct frame of mind before they enter into next shift.

Leadership differs from management, and it plays a different role in health care setting. Any medical professional may have this quality irrespective of their position. Efficient leaders motivate people to accomplish both personal and organization’s goals (Simons & Leroy, 2013). They inspire others to stimulate them to work with full potential and bring out the best in them (Sherwood & Zomorodi, 2014). Qualitative analysis was performed by Wong et al., (2013) and her associates, to determine the patient outcomes and its relation to nurses’ motivation and nursing leadership models. To obtain reliable and valid results the researcher has performed the quality assessment of their methods also. Research findings showed a positive correlation between “relational leadership style model and patient outcomes” (Wong et al., 2013).

Relational leadership is one of the approaches that can help leaders to resolve the issue of nurse staffing ratios (Naylor, 2012). This leadership is defined as “process of people together attempting to accomplish change or make a difference to benefit the common good” (Laschinger et al., 2014). This type of leadership is also called as “inclusive type of leadership” that has an additional quality to accept all viewpoints and backgrounds (Hutchinson & Jackson, 2013). Nursing leaders can obtain feedback from nurses regarding their experiences due to nursing staff ratios using this approach. It can also include the involvement of nursing staff for better ideas to change the environment. Consequently, all the health personals are empowered to participate in a possible solution to obtain the common goal.

Given an opportunity, I would personally opt for “Relational approach” to solve this issue. As a leader, I would collaborate with everyone for decision making. In my past leadership experience, I had received successful results when I included other people’s ideas and opinions. I have always asked for feedback for self-evaluation. It encouraged me to correct my leadership direction. I never favored “authoritative leadership or micromanaging”. In my approach to handling the issue of lower nursing staff, I will collect information about the areas that nurses enjoy in the organization. Based on the feedback, I would ensure that more patients and longer shifts in those areas are assigned to the nurses. On the other hand, less number of patients will be assigned to nurses in the areas they are uncomfortable with. To make the workplace more interesting for nurses, I will shuffle the schedules every alternate week.  In any case, a nurse works for the longer shift due to an emergency, I will ensure that he or she has sufficient recovery time before the start of next shift time. I am sure this will minimize and prevent the nurse’s burnout. I believe that frustration in any work will never fetch positive results. The ultimate goal will be to maintain the work setting fun and joyous and keep up the nurses motivated and their spirit high up as “motivated nurse makes a productive nurse.”

Conclusion

Conclusion

When a large number of patients is assigned to the single nurse, it turns hectic for the nurses. Hospital environment with low nurse-to-patient ratios makes nurses more stressed. Also, patient’s safety is highly compromised in a quest to fulfill the needs and demands of every patient. Therefore, managers and leaders in health care organizations often develop several strategies and approaches to ensure the quality and safety of care provided. However, the approaches vary from different management strategies and leadership styles. However, the best method to maintain working efficiency of nurses is by “keeping the environment interesting and motivating.” It is necessary to involve nurses in decision-making because they are the ones who have a valuable perspective on the problem. Unfortunately, most hospitals fail to realize this aspect. 

References

Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Jama, 288(16), 1987-1993.

Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M., … & Tishelman, C. (2012). Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. Bmj, 344, e1717.

Bernabeo, E., & Holmboe, E. S. (2013). Patients, providers, and systems need to acquire a specific set of competencies to achieve truly patient-centered care. Health Affairs, 32(2), 250-258.                                                                                                                           

Hutchinson, M., & Jackson, D. (2013). Relational leadership in nursing: towards a more critical interpretation. Nursing Inquiry, 20(1), 11-22.

Hutchinson, M., & Jackson, D. (2013). Transformational leadership in nursing: towards a more critical interpretation. Nursing Inquiry, 20(1), 11-22.

Laschinger, H. K. S., Wong, C. A., Cummings, G. G., & Grau, A. L. (2014). Resonant leadership and workplace empowerment: The value of positive organizational cultures in reducing workplace incivility. Nursing economics,32(1), 5.

Naylor, M. D. (2012). Advancing high value transitional care: the central role of nursing and its leadership. Nursing administration quarterly, 36(2), 115-126.    

Pham, J. C., Aswani, M. S., Rosen, M., Lee, H., Huddle, M., Weeks, K., & Pronovost, P. J. (2012). Reducing medical errors and adverse events.Annual review of medicine, 63, 447-463.

Shekelle, P. G. (2013). Nurse–patient ratios as a patient safety strategy: a systematic review. Annals of internal medicine, 158(5_Part_2), 404-409.

Sherwood, G., & Zomorodi, M. (2014). A new mindset for quality and safety: The QSEN competencies redefine nurses’ roles in practice. Nephrology Nursing Journal, 41(1), 15-22.

Simons, T., & Leroy, H. (2013). Issues in researching leadership in health care organizations. Leading in Health Care Organizations: Improving Safety, Satisfaction and Financial Performance (Advances in Health Care Management, Volume 14) Emerald Group Publishing Limited, 14, 221-234.

Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: a systematic review update. Journal of nursing management, 21(5), 709-724.

You, L. M., Aiken, L. H., Sloane, D. M., Liu, K., He, G. P., Hu, Y., … & Shang, S. M. (2013). Hospital nursing, care quality, and patient satisfaction: cross-sectional surveys of nurses and patients in hospitals in China and Europe. International journal of nursing studies, 50(2), 154-161.