Question

Which of the five problems affecting the nursing empowerment project (considered in our PinO Workshop) should hospital managers prioritise for immediate action to improve staff morale and enhance the service to patients? Give reasons for your choice and then explain what you think the managers should do to resolve the particular problems you identify.

Case Exercise MANAGING EMPOWERMENT AND WORKPLACE INNOVATION Preliminary Briefing Senior executives within a Glasgow-based NHS Trust have been advised of recurring problems with the provision of nursing care in a paediatric surgical ward. Given existing resource constraints, a gro nursing autonomy as a cost-effective solution Independently, hospital managers have responded to the difficulties by introducing pilot measures that prepare the ground for a more ambitious empowerment programme. However, these initial steps are proving controversial, and the merit of continuing along this route has yet to be established. und-swell of opinion favours an expansion of You have been seconded to an independent review committee charged with evaluating the practical viability of nursing empowerment and devising a package of proposals and positive recommendations that can be applied to improve the quality of care within the paediatric unit. An interim assessment is expected in the first instance to inform decision-makers of your initial reactions to the core difficulties and pilot solutions. Local quality assurance managers are currently compiling additional information on the progress of the pilot project and the immediate reactions of staff. This material will be available on completion of your first report and should inform your final deliberations.

Answer 1

1. Sectionalism and elitism are important countervailing tendencies

The sectionalizing of primary care nursing can be a threat to primary care nursing. The concept of sectionalism and elitism must be neutralized. Job descriptions and neutralizing salaries can be done to achieve it. Horizontal and vertical elitism is seen in nursing profession.

2. Renegotiating the boundary lines between nursing, medicine and professional management

The primary nursing model needs the support from other disciplines. Clearly defining the role can help in this situation.

3. Vehement opposition from some sections of medical opinion

The awareness programmes and amendments can help in managing the opposition from other sections.

Ward managers have to redirect all the patient enquiries to primary care nurse and they have responsibility for individualized care from admission to discharge

4. Divisions and status hierarchies within nursing itself have been further out of focus imposing a challenge to the published vision of beneficial outcomes

5. Difficulties with reform initiatives and practical experiences.

By improving worker commitment and responsiveness

Coaching their staff

Encouraging them to achieve the necessary skills to ensure client satisfaction

Quality management approach

Improve care levels under resource constraints by applying principles of quality management and primary nursing

Worker commitment and responsiveness

Coaching the staff

Encouraging them to achieve sufficient skills to achieve closeness with customers

Changing basic patterns of care can improve patient satisfaction and develop a successful model of care.

In primary nursing concept, the particular nurse is in charge for the care of a patient and the nurse managers involve in activities traditionally done by junior doctors like admission and discharge of a patient, medication administration, Iv drips, administration of toxic chemotherapy drugs, obtaining cervical smears. Primary care nursing improves the accountability, autonomy, comprehension and coordination in nursing practice.

In this model the primary care nurse will be responsible for the patient and family, assessing needs at the bedside. The develop care plans and reacting to events as they develop immediately. The cooperation with managers and doctors are necessary for the success of this model. This can improve job satisfaction, reduces turn over rates and lower stress levels.