Question

Case Study 4

In reviewing available hospital employment, you identify three potential positions as a staff nurse in orthopedics. Because orthopedics is where you would like to work, you evaluate each of the positions:

• Position 1: A regional medical center, with a nurse-to-patient ratio of 5:1. Total patient care is expected of all nurses, and there is only one nursing assistant assigned to each unit. The hospital recently purchased safe handling equipment for every unit.

• Position 2: An urban hospital with a nurse-to-patient ratio of 9:1. There is one nursing assistant assigned to every nurse. The hospital has new patient handling equipment, although it is shared between two units.

• Position 3: A local hospital with a nurse-to-patient ratio of 7:1. There is one nursing assistant for every nine patients. The hospital is working toward Magnet status and uses a shared governance model.

A. Explore each position in relation to your safety as a nurse. What are the benefits and detriments of each position?

B. Which position provides the safest working environment? Explain your response?

C. What additional questions should be asked in relation to staffing?
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D. The hospital in position 3 is described as working towards Magnet status. What impact might this have on your decision to accept or turn down an employment offer? For help, review the implications of Magnet status

Answer 1

it isn’t just about making sure health care settings are free from potential threats to a practitioner’s physical welfare – the World Health Organization (WHO) defines a healthy environment as a place of “physical, mental, and social well-being,” supporting optimal health and safety.

Q.A

Position 1: A regional medical center, with a nurse-to-patient ratio of 5:1. Total patient care is expected of all nurses, and there is only one nursing assistant assigned to each unit. The hospital recently purchased safe handling equipment for every unit.here the nurse patient ratio is very less.work load and quality practice will be compromised.equipment related risk is beneficial.

Position 2: An urban hospital with a nurse-to-patient ratio of 9:1. There is one nursing assistant assigned to every nurse. The hospital has new patient handling equipment, although it is shared between two units.in this case the workload of nurses is not a problem as the nurse patient ratio is sufficient.equipments are shared between the unit is a risk for safe practicing.

Position 3: A local hospital with a nurse-to-patient ratio of 7:1. There is one nursing assistant for every nine patients. The hospital is working toward Magnet status and uses a shared governance model.it is a better hospital to work as the hospital is trying to attain a magnet satatus which is beneficial for developing a quality practice culture and organisational culture.

Q.B Which position provides the safest working environment? Explain your response?

position 1 is a better option as it is an institution with nurse patient ratio of 5:1 and each unit has one nursing assistant.the hospital recenly purchased safe handling equipments and is not shared between units.so it is a safe place to work.

Q.C Additon questions in related to staffing

• Who is the chief nursing officer, to whom does she or he report, and does she or he have -authority over staffing?
• Who controls the staffing budget?
• Is the level of staffing an active and ongoing discussion in the organization, and do staff nurses have input?
• Does the organization have a shared governance model?
• When, where, and how is staffing input obtained from staff nurses?
• How do ratios in the organization compare with recommendations of national and regional -organizations, such as the American Organization of Nurse Executives and the Association of Critical Care Nurses?
• What is the content and length of orientation for new nurses?
• What is the philosophy regarding staff mix designations?
• What is the frequency of floating to other nursing units?
• What are the criteria used by the organization in determining competency of cross-trained staff?
• What resources does the organization use to supplement staff during peak census?
• If concerns arise about the adequacy of staffing, where and to whom is it appropriate to voice those concerns?
• How are overtime, on-call time, and cancellation of regularly scheduled shifts handled?
• Does the organization mandate overtime?
• If so can the staff nurse refuse to participate without repercussions?
• What is the turnover rate, and what is the average longevity of staff nurses?What opportunities for advancement exist in the organization, such as clinical ladders or other systems of recognition?
• Where does the organization expect discussions about staffing or practice issues to take place?

Q.D

Magnet status:

award given by the American Nurses' Credentialing Center (ANCC), an affiliate of the American Nurses Association, to hospitals that satisfy a set of criteria designed to measure the strength and quality of their nursing. A Magnet hospital is stated to be one where nursing delivers excellent patient outcomes, where nurses have a high level of job satisfaction, and where there is a low staff nurse turnover rate and appropriate grievance resolution. Magnet status is also said to indicate nursing involvement in data collection and decision-making in patient care delivery. The idea is that Magnet nursing leaders value staff nurses, involve them in shaping research-based nursing practice, and encourage and reward them for advancing in nursing practice. Magnet hospitals are supposed to have open communication between nurses and other members of the health care team, and an appropriate personnel mix to attain the best patient outcomes and staff work environment.

MAGNET designation appears to enhance organisational culture for nurses and the framework used to introduce MAGNET helps to empower nurses to direct organisational culture in their facility. Conclusion and Implications for Nursing and Health Policy: MAGNET appears to have a positive impact on organisational culture, particularly for nurses. However, lack of standardised evaluation tools used to assess organisational culture associated with MAGNET designation limits comparability of the studies. Generally, the quality of evidence used to develop recommendations was poor to very poor.so working in a hospital with magnet status is good for the growth of skills and culture in nursing