NLM100 Leadership Theories in Nursing

Introduction

One of the major factors that leads to attrition of skilled healthcare service providers is high workload. Nurses are often stipulated to work for prolonged hours after their shift time for multiple number of days. This not only enhances their physical stress, resulting in various illness like back pain, spondylitis and others, but also results in major mental illness like anxiety and depression. As per Holland et al. (2019), high workload leads to emotional exhaustion, anger and burnout. Lack of work life balance along with mental and physical illness leads to job dissatisfaction and eventually attrition. Considering the fact that attrition of skilled nurses possess the potential to deteriorate the quality of health service provided, it is highly crucial for mangers to ensure effective work life balance of the nurses.

Analysis And Tool Selection

In order to effectively deal with a critical issue, it is highly crucial for mangers to select a specific approach and follow the approach step by step so that the issue can be resolved. In the given scenario,   the aim of the manager is to solve a specific issue, which is enhanced amount of workload leading to employee dissatisfaction. Given the fact that in order to resolve the issue, the manager has to understand the root cause behind the issue and evaluate the potential solutions available, the problem solving tool is considered to be appropriate to resolve this problem. The 5 steps of the problem solving tool that has been followed to solve the problem includes definition of the problem,  gathering and analyzing data, generating a series of potential solution and implementing the best action and evaluating the action.

Defining The Problem

The key problem that I have to resolve in this scenario includes excessive workload on the employees resulting in physical and mental stress. A significant number of workers are found to be dissatisfied due to the huge workload. Also, it can be understood that there exists unequal distribution of workload within teams. Employee dissatisfaction is persisting from a prolonged period of time which is evident from the information that the previous unit manager had to resign due to lack of support from the employees. Also, a significant number of employees are of the perception that they are being aid less than what they should be given the huge workload. My aim as the new nit anger is to reduce the workload by ensuring equal distribution of work and effective work life balance of the employees

Gathering And Analyzing Data

As per Islam, Ahmed and Ali (2019), gathering adequate information to identify the root cause behind an issue, is a crucial step to solve an identified issue. As a newly appointed unit manager, I lack work experience and knowledge about the exiting problems in the unit. Considering the fact that one of the key reasons behind high workload won the employees of an organization includes ineffective recruitment procedure, I will gather adequate information about how nurses are hired currently in the organization. For instance, in critical care, the nurse to patient ratio mist be 1:2 and for the emergency department it should be 1:4. In case, a single nurse is stipulated to take care of multiple number of patients, it automatically enhances his or her workload. Hence, in order to ensure the work life balance of the healthcare service providers, an effective nurse to patient ration needs to be maintained.

Apart from gathering information about the current recruitment strategy, it is crucial for me to understand the work strength of each of the nursing team. Given the fact that I have heard one of the LPNs complaining about higher amount of workload in team 2 compared to team 1, it is quite evident that the work load between teams is not equally distributed. As per Ross, Roger and King (2019), unequal distribution of workload within an organization is a major reason behind job dissatisfaction and employee resentment. As per Kim et al. (2019), managers of healthcare home should implemented effective strategies to ensure that the total workload is equally distributed amongst the employees. This will not only prevent employee resentment but will also reduce the workload.

Finally, considering the fact that I have gathered information that employees are dissatisfied with their current remuneration, I need to assess the total number of hours an employee is stipulated to work within the organization, the number of hours they are working over shift and their monthly remuneration. Also, I need to evaluate whether, the RNs and LPNs are compensated for working more than their shift hours. As per the Canadian employment regulation, a healthcare service provider is stipulated to work a minimum of 8 hours per day and 48 hours a week. Also, high amount of effort given on daily basis, if not appreciated and compensated results in demotivation. Nurses feels less valued and losses loyalty towards the organization.

Generating Possible Solutions

Given the fact that on the basis of the gathered information and analysis, it can be understood that the potential key areas to be addressed includes:

1. Lower number of staffs than required, resulting in unhealthy nurse to patient ratio.
2. Lack of effective task distribution amongst the teams
3. Lack of  effective compensation policy

As per Blay et al. (2017), the Canadian healthcare industry is evidencing lack of skilled workforce majorly due to lack of interest of students to participate in the industry. The high workload and lower remuneration, compared to other industries can be considered to be the key reason behind this. Hence, in order to attract a huge number of potential candidates, the management can enhance the salary of the candidates a little higher than its competitors.

In order to ensure recruitment of skilled staffs, the organization can opt for multiple number of exams. For instance, majority of the healthcare homes recruit employees on the basis of two sets of exams, namely theoretical exam, followed by a verbal interview. Alternatively, employees can be recruited on the basis of their basic skills and then effective on job training and education sessions can be provided to enhance their skills.

In order to ensure effective task distribution, an open door meeting can be held with the team leaders of each team and on the basis of roster, shift timings as well as patient to nurse ratio, roles and responsibilities of each team can be developed. Additionally, the manager should ensure that each of the team possess equal number of staffs for ensuring equal task distribution. Alternately, a meeting with all the employees can be conducted and employees can be assigned teams based on their preferences and skills.

Thirdly, a meeting with the HR management and operational manager of the organization can be conducted where the requirement of enhancing the basic remuneration of the employees given the high competition between the organization within the healthcare industry of Canada and the risk of losing employee can be highlighted. Alternately, the management can ensure that no employees are made to work over time by keeping track of their total working hours.

Implementation The Optimum Action

First of all, in order to deal enhance the number of healthcare serve workers in the organization through recruitment, the management should opt posting a detailed job recruitment advertisement both in popular job portals as well as in social media platforms. Secondly, in order to enhance the skills off the staffs, the organization should invest on training and education session. As per Di Muzio et al. (2019), enhanced skills of the nurses lower their workload stress since it enhances their efficiency to complete tasks within a shorter period of time and thus maintain a healthy work life balance. Thirdly, for equal distribution of tasks, the team leaders should be instructed to ensure equal number of tasks in each team (Van Bogaert et al., 2017). Finally, no employees should be pressurized to work overtime. In case a staff does it on their own wish, they should be compensated through incentives.

Evaluation Of The Action

In order to evaluate the impact of the action on the organization, I will conduct a periodic survey, in order to find out the degree of satisfaction of the employees. Additionally, I will check the records in order to find out the degree of enhancement in quality of care provision and patient satisfaction rate.

Conclusion

From the above discussion, it can be concluded that it is high time for the organization to develop strategies for reducing workload on the healthcare service providers since it may result in attrition of nurses if not addressed on an emergency basis. The strategies discussed above if implemented effectively, can not only reduce the workload but will also enhance the loyalty of the employees towards the healthcare home in near future.

References

Blay, N., Roche, M. A., Duffield, C., & Gallagher, R. (2017). Intrahospital transfers and the impact on nursing workload. Journal of clinical nursing, 26(23-24), 4822-4829.

Di Muzio, M., Dionisi, S., Di Simone, E., Cianfrocca, C., Di Muzio, F., Fabbian, F., ... & Giannetta, N. (2019). Can nurses’ shift work jeopardize the patient safety? A systematic review. Eur Rev Med Pharmacol Sci, 23(10), 4507-19.

Havaei, F., & MacPhee, M. (2020). The impact of heavy nurse workload and patient/family complaints on workplace violence: An application of human factors framework. Nursing open, 7(3), 731-741.

Holland, P., Tham, T. L., Sheehan, C., & Cooper, B. (2019). The impact of perceived workload on nurse satisfaction with work-life balance and intention to leave the occupation. Applied nursing research, 49, 70-76.

Holland, P., Tham, T. L., Sheehan, C., & Cooper, B. (2019). The impact of perceived workload on nurse satisfaction with work-life balance and intention to leave the occupation. Applied nursing research, 49, 70-76.

Islam, T., Ahmed, I., & Ali, G. (2019). Effects of ethical leadership on bullying and voice behavior among nurses: mediating role of organizational identification, poor working condition and workload. Leadership in Health Services, 32(1), 2-17.

Kim, J. H., Parameshwara, N., Guo, W., & Pasupathy, K. S. (2019). The impact of interrupting nurses on mental workload in emergency departments. International Journal of Human–Computer Interaction, 35(3), 206-217.

Qureshi, S. M., Purdy, N., Mohani, A., & Neumann, W. P. (2019). Predicting the effect of nurse–patient ratio on nurse workload and care quality using discrete event simulation. Journal of nursing management, 27(5), 971-980.

Ross, C., Rogers, C., & King, C. (2019). Safety culture and an invisible nursing workload. Collegian, 26(1), 1-7.

Van Bogaert, P., Peremans, L., Van Heusden, D., Verspuy, M., Kureckova, V., Van de Cruys, Z., & Franck, E. (2017). Predictors of burnout, work engagement and nurse reported job outcomes and quality of care: a mixed method study. BMC nursing, 16(1), 1-14.

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