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1Tiffany YoungC157: Essentials of Advanced Nursing Practice Field ExperienceWGU
2A1. Purpose and OverviewNurse staffing is a major concern as it affects both patient safety and quality of patient care (CHIN How, 2003). With heightened attention to costs, hospitals have opted to decrease nursing staff levels as well as auxiliary staff. This raises concern as the quality of care in hospitals may be adversely affected (CHIN How, 2003). The purpose of the consultation is to identify the weaknesses within the unit and develop a plan to correct the concern. The consultation began with an interview from the nurse leader of the Clinical Transition Unit. The nurse leader discussed the staffing ratio used on the unit. According to the nurse manager, staffing is dependent upon the productivity reports generated every pay period by the Tableau graph, in addition to the shift management tool that looks at the current census, and the number of patients that are in the Emergency Department (ED). If there are more staff scheduled for a shift that are needed, staff members will be “pushed back (PB), floated (F), or cancelled (C).” Push backon this unit means staff will come in to work at a later time than scheduled, dependingon census. If census is still low, the staff member may then be placed on call (OC) and later cancelled. Floatedmeans the staff member will be sent to a specific unit to fulfill staffing shortages. Cancelled means the staff member does not have to work their scheduled shift. There is an excel spreadsheet that is used to document which staff members were pushed back, floated, and cancelled to ensure fairness. On dayshift, the individual that makes staffing decisions include the nurse manager, assistant nurse manager, and charge nurse. On nightshift, the individual that makes staffing decisions include the assistant nurse manager and charge nurse. As a result of staff members being pushed back, floated, and cancelled, staff members have become unpleased, resulting in a number of staff members finding other employment. Staff members are upset due to not
3receiving their full hours, resulting in receiving a reduced paycheck. They are also upset because of having to use their paid days off (PDO), resulting in not having enough PDO to go on vacation. Another reason for being upset is that some shifts begin with nurses having 5 patients each without having a patient care technician available to provide assistance, putting patient safety at risk. The plan is to develop a system that ensures staff is receiving their hours and ensure staff members are not functioning with limited staff available. A2. Description of OrganizationFlorida Hospital is one of the country’s largest not-for-profit health care providers with 22 campuses serving communities throughout Florida. Florida Hospital, located in Central Florida, is a 2,247-bed acute-care medical facility and is a member of Adventist Health System.