Week 6-Leadership and Professional Identity-Scheduling and Staffing

 

Staffing Available

 	
5 RN 2 LPN 2 NA
 	
30 patients

Acuity Level 1 – 6 Patients

 	
Room 2301 Susan is a 93-year-old who fell at home and is waiting for nursing home placement who uses a walker and requires assistance to the bathroom and ADLs
 	
Room 2312 Fredrick is a 57-year-old who is recovering from a knee replacement who needs educational reinforcement and is going home today.
 	
Room 2319 Joshua is a 63-year-old who was in for cardioversion and is going home today.
 	
Room 2329 Brian is a 49-year-old who has been diagnosed with hypertension and Alzheimer’s Disease who wanders off the unit and needs assistance with ADLs.
 	
Room 2304 James is a 95-year-old who has osteoarthritis and needs help getting out of bed, bathing, and dressing.
 	
Room 2307 Francis is a 39-year-old who will be discharged today. She received discharge teaching yesterday about her ruptured appendix wound and wants to review the care instructions before she leaves.

Acuity Level 2 – 8 Patients

 	
Room 2302 Brooke is a 33-year-old who was admitted with new-onset DM with uncontrolled blood sugars. She has started on new medications, including insulin, and needs additional patient and family education.
 	
Room 2311 Mark is an 83-year-old who is in isolation for MRSA and is on IV antibiotics and ten other medications.
 	
Room 2320 Jeffrey is a 63-year-old who is non-compliant with his medications and came in with hypertension and crackles in his lungs. He has daily labs and has a wound on his left foot.
 	
Room 2330 Leslie is a 46-year-old who had unstable angina and had a cardiac catheterization yesterday late afternoon and stayed over for observation.
 	
Room 2305 Traci is a 72-year-old who has a history of heart disease, a history of myocardial infarction, and mild dementia.
 	
Room 2308 Alecia is a 33-year-old who was experiencing chest pain and is scheduled for a stress test later today.
 	
Room 2303 Theodore is a 22-year-old who has had DM since he was a 10-years-old who requires medication adjustments.
 	
Room 2318 Bruce is a 45-year-old who was placed on isolation for C-Diff and is on several IV medications.

Acuity Level 3 – 9 Patients

 	
Room 2306 Amelia is an 83-year-old after a stroke and requires total care.
 	
Room 2313 Audrey is a 78-year-old with newly diagnosed COPD.
 	
Room 2317 Abigail is a 90-year-old who is a diabetic with a chronic leg infection.
 	
Room 2328 Roxanne is an 82-year-old with newly diagnosed lung cancer.
 	
Room 2322 Nancy is a 56-year-old with chronic kidney disease and on peritoneal dialysis.
 	
Room 2323 Dennis is a 35-year-old who was admitted with right upper quadrant pain that radiates to the right shoulder.
 	
Room 2314 Roger is a 46-year-old who is wasted and malnourished. She has severe diarrhea.
 	
Room 2309 Terry is a 59-year-old who has bladder cancer with painless hematuria.
 	
Room 2310 Barry is a 54-year-old who has a history of mitral valve regurgitation.

Acuity Level 4 – 7 Patients

 	
Room 2315 Karen is a 45-year-old who had an acute myocardial infarction with percutaneous coronary intervention.
 	
Room 2321 Fredrick is a 43-year-old who was admitted after an overdose and required close monitoring.
 	
Room 2327, Samantha is a 57-year-old with severe abdominal pain with no bowel sounds.
 	
Room 2324 Robbie is a 62-year-old who has been vomiting and pain in the abdomen.
 	
Room 2325 Jenny is a 58-year-old MVA who has a tracheostomy.
 	
Room 2326 Annette is a 68-year-old who had a bowel resection and colostomy.
 	
Room 2316, David is a 54-year-old with weakness and a decreased level of consciousness.

 

 

 



RN 1
RN 2
RN 3
RN 4
RN 5


Room #
Acuity
Room #
Acuity
Room #
Acuity
Room #
Acuity
Room #
Acuity


2327
4
2321
4
2326
4
2327
4
2325
4


2322
3
2326
4
2328
3
2330
3
2306
4


2310
3
2313
3
2317
3
2310
3
2323
3






































LPN 1
LPN 2
CNA 1
CNA 2
Staff 

·  5 RN

·  2 LPN

·  2 CNA

30 patients

·  6 acuity level 1

·  8 acuity level 2

·  9 acuity level 3

·  7 acuity level 4


Room #
Acuity
Room #
Acuity
Room #
Acuity
Room #
Acuity


2311
2
2308
2
2307
1
2301
1


2305
2
2309
2
2329
1
2312
1


2320
2
2307
2
2304
1
2319
1


2307
2
2324
2















































 

Directing the Staff to their Assigned Roles

As managers, nurses will handle staff shortages frequently. They must utilize the staff to ensure their patients receive the essential healthcare services they may require. Nurse managers must direct their staff members to their respective units. Due to issues with staff shortages, a new staffing assignment has been made depending on patient’s needs in our unit. These assignments have been completed based on the competence and scope of practice of the available staff members. This was done to ensure that all our clients receive the best quality nursing care services. RNs and LPNs should be in the same shift to ensure that RNs provide effective supervision for CNAs and LPNs. The patient-nurse ratio should also be 3:1 to minimize exhaustion and to ensure the patients receive the best care.

Nurse managers must consider the skills of the staff when assigning them to different patients. RNs, LPs, and CNAs all have different scopes of practice. They must thus be assigned to patients who match their scope of practice and skill set. Registered nurses can check patients’ vital signs, administer drugs, coordinate care, and provide counseling to the patient (American Nurses Association, 2021). LPNs can check patients’ vital signs, change bandages and dress wounds, ensure patients are comfortable, and administer drugs in some healthcare organizations (American Nurses Association, n.d.). On the other hand, CNAs can move patients, bathe patients, feed patients, groom patients, document information, transport patients, stock supplies, and answer patient calls (Nurse.org, n.d.). The roles were distributed based on the skill sets.

There are six patients in acuity one. They will be managed by CNAs. The patient in acuity either requires assistance with daily living activities or discharge instructions. These duties are within the scope of practice of CNAs. The patients in acuity level 2 require medication administration, wound care, and monitoring. They can be managed by LPNs. The patient in acuity 3 and 4 have complex medical needs. They will be managed by registered nurses who have the skills to manage patients with respiratory and cardiac conditions. The RN can also be able to coordinate care and ensure the patients receive quality care.

Communication with Staff

Effective communication in the healthcare delivery industry ensures that high-quality patient care services are delivered to patients (HIPAA Journal, 2020). In addition to this, it will meet employer expectations. Before beginning the shift, the nurse manager should communicate the new assignments with clarity and openness. This will ensure that the staff members will understand their new assignments and what is expected of them. The nurse manager must also foster dialogue and answer any questions that the staff members may have. The nurse manager must emphasize the benefit of attending to patient needs to improve patient outcomes. The nurse manager must promote honest communication among the staff members. The LPN and CNAs will be assigned to RNs who can inquire from in case of any issue.

Another meeting will also be held at the end of every shift. In this meeting, the staff members will communicate any challenges they experienced during the previous shift to the nurse manager. This feedback will enable the nurse manager and the staff members to develop solutions and new strategies that will help them overcome any challenges they experienced during the previous shift. They will also communicate to the nurse manager on patient progress and any supplies that may be required.

Client Equity

Equity ensures that all individuals have equal opportunities of receiving healthcare services. I will implement strategies that ensure my staff is competent to promote equitable healthcare services. The staff members will be advised to handle patients based on their acuity and needs. Patients with more complex and critical healthcare needs will be prioritized before stable patients. The staff members will also be assigned to patients based on their skills. Registered nurses will be assigned to patients with more complex healthcare needs, such as respiratory and cardiology issues, while LPN and CNAs will be assigned to stable patients. This will ensure that the patients receive the healthcare services they need.

In addition to this, I will train my staff on cultural competency. Cultural competency will ensure that my staff considers the patients’ values, needs, and cultural inclinations when providing service (Nair & Adetayo, 2019). Cultural competence will eliminate bias among my staff members. They will deliver healthcare services without considering gender, race, and political inclination. In addition to this, the RNs will supervise the LPNs and CNAs to ensure that they offer care to all patients as required.

In summary, nurse managers must direct their staff members to ensure that patients receive the care they need. Duties assigned to the staff members must match their scope of practice and skill levels. They must also foster open and honest communication between staff members to ensure efficient coordination of care. Finally, they must ensure equity by promoting cultural competence in their units. Even though staff shortages are a menace in the healthcare delivery industry, nurse managers must utilize the available staff members to deliver nursing care that improves patient outcomes.
References
American Nurses Association. (2021). Nursing scope and standards of practice (4th ed.).

American Nurses Association. (n.d.). What is nursing & what do nurses do? | ANA enterprise. https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/

HIPAA Journal. (2020, March 30). Communication strategies in healthcare. https://www.hipaajournal.com/communication-strategies-in-healthcare/

Nair, L., & Adetayo, O. A. (2019). Cultural competence and ethnic diversity in healthcare. Plastic and Reconstructive Surgery – Global Open, 7(5), e2219. https://doi.org/10.1097/gox.0000000000002219