Temporary vacancy

Please respond to this discussion: 

When a unit is short-handed, it might be easy to try and work with the staff that is available but unfortunately, this can lead to unsafe practices and staff dissatisfaction.  When utilizing per diem nurses, the disadvantages would include an increased risk of patient harm.

Per diem nurses are not familiar with the facility’s policies and procedures, which could lead to patient incidents.  The hourly rate for these nurses is more than the staff nurses’ overtime pay so it would be a higher out-of-pocket expense but on the other hand, they enjoy the money and are more willing to pick up multiple shifts.

This could lead to staff dissatisfaction due to per diem nurses being paid more.  When your current staff isn’t happy, they are less likely to perform to the best of their ability.  Paying your regular staff overtime to help fill in the vacancies again would be an increased expense, but it would at least be for nurses that are familiar with the facility, staff, and patients.

Temporary vacancy

Implementing a process like the Happy2Help program provides a “proactive, voluntary, incentivized program for regular staff that provides an addition layer of systemwide staffing and minimizes need for competing mechanisms such as on-call and vacancy rate bonus pay” (Woltz et al, 2021, p.579).

This increases staff satisfaction, and patient safety leading to improved patient satisfaction scores, and increased cost savings.  When utilizing your staff for additional shifts, it is not necessarily needed to ask them to cover a 12-hour shift.

Analyzing the busiest times during the shifts, like med pass and meals, would provide the times needed for additional staff. This means that maybe the nurses would be asked to pick up a 4-, 6-, or 8-hour shift.

Temporary vacancy

As a nurse manager, I would try to avoid the option of leaving the spot vacant for the six weeks and only working with the available staff.  “Decreased staffing and increased workload are major contributors to stress and burnout” (Schneider et al, 2022, p. 47).

Again, this would lead to poor patient outcomes and staff unhappiness, possibly leading to staff leaving and causing an increased shortage.  Overall, being in the role of nurse manager, it is imperative to take into consideration patient safety, staff satisfaction and cost savings.

As the manager, emotional intelligence is necessary to carry out expectations of leading, managing, and following, exhibiting self-awareness, self-regulation, empathy, and social skills (Yoder-wise, 2019).  Setting this example for the staff can become contagious and flow over to them, building leaders out of followers.

Temporary vacancy

ORIGINAL QUESTION

As Nurse Manager at City Medical Center, you are budgeted to staff your 30 bed unit with four RNs, three LVNs, and two CNAs for the day shift. You learn that one of your RNs is going out on medical leave of absence for six weeks.

Your options to fill the temporary vacancy include use of per diem nurses, use of overtime for your current staff, or just work with the available staff during this time. What would be the pros and cons of each option? Include discussion of salary expense, staff satisfaction, patient safety, and characteristics of an emotional intelligent nurse manager; using the Salary Schedule below.

 SALARY SCHEDULE – Base Salary Schedule at City Medical Center:

RNs:   Staff                        $26/hr

Charge                     $28/hr

Team Leader            $ 26/hr

Per Diem                  $ 35/hr

LVN:   Staff                        $ 18/hr

CNA:                                  $ 11/hr

Overtime Pay for all staff is 1 ½ time base salary per hour

Also check: Discussion of the case scenario using the cellular process

Solution