Speculations on High Turnover Rates
The feeling of powerlessness is a common condition among nurses. There are numerous factors, which might foster its emergence. However, the outcome is always the same: nurses fail to provide the patients with high-quality medical treatment and care and ensure their safety, the level of their professionalism decreases, and, finally, they choose to quit because of burnout and moral dilemmas (Andrews, Burr, & Bushy, 2011).
Generally speaking, causes of this feeling can be divided into four categories: frustration, inadequacy, vulnerability, and apprehension (Kornhaber & Wilson, 2011). They derive from both organizational issues and working with people. Speaking of nurses employed by the emergency department, frustration may come from long working hours and stressful working environment. Sometimes, patients require special care, but nurses do not have enough time for it.
Similar situations might become a potential source of frustration. As for inadequacy, it refers to repetitive influxes of patients as well as witnessing their pain and emotions. Apprehension is a common result of seeing deaths and pain. The same can be said about vulnerability. However, it is a consequence of witnessing helplessness and realizing the inability to help some patients and cope with work-related stress.
That said, there are numerous issues, which might result in the feeling of powerlessness. Nevertheless, it is still possible to find some sources of power. First of all, there is the power of knowledge and experience. It means that nurses should remember that they possess enough competence to overcome difficulties and can use their knowledge as the primary tool for handling them. Another source of power is communication.
It implies the connection with other team members and trusting that they will help if necessary. Finally, there is the power coming from the information. Nurses are recommended to keep in mind that they work with people and every detail shared by the patients might be used to help them and save their lives minimizing, as the result, the risk of feeling powerlessness (Kelly & Tazbir, 2013).
Nancy could use these sources of power to encourage the staff to become empowered. She could provide them with some examples proving that knowledge, information, and communication are effective in decreasing the severity of powerlessness. Moreover, Nancy might demonstrate that she is concerned and open so that nurses experiencing emotional problems and work-related stress are free to share their stress with her. These steps might be beneficial for defusing similar behaviors and empowering emergency unit staff.
Returning to 8-Hour Shifts
Changing a working day is a vital policy change. That is why it requires gathering additional information, especially in cases of promoting shared responsibility model in healthcare units. Before representing a unit on a policy-making meeting, it is paramount to find out the staff’s position on returning to 8-hour shifts.
Because the primary motivation of policymakers is to increase patient satisfaction by decreasing medication errors after a nurse has worked more than 8 hours, it is critical to ask nurses if they believe in the effectiveness of similar changes for achieving this objective. It means that knowing whether nurses support this idea and recognize the fact that they make errors because of tiredness would be useful. Finally, it might be beneficial to think about other options they might want to offer to the unit’s senior management.
In addition to information from the staff, it is also recommended to gather some overall information about the operation of the unit. For example, it is vital to analyze the statistics of making medication errors to find out whether the claimed trend is consistent with real facts. Also, it is even more critical to determine which alterations in the schedule will be necessary once the proposed change is adopted and whether hiring new nurses will be required.
The motivation for gathering this information is identifying the changes, which will entail decreasing a working day. Finally, it might be beneficial to investigate the performance of other departments of the healthcare unit to conclude whether 8-hour shifts correspond with higher levels of productivity and patient satisfaction.
Regardless of the findings of investigations, it is paramount to keep in mind the postulates of the shared governance model. It implies the division of roles in a team between practicing and managing nurses. Practicing nurses are responsible for high levels of professionalism and patient satisfaction while managing nurses’ focus on distributing available resources and controlling practical issues (Cherry & Jacob, 2014).
It means that all team members acknowledge shared responsibility for the wellbeing of patients (Kearney-Nunnery, 2016). Understanding the significance of shared governance will make bringing about policy changes easier because one person represents the interests of the whole group. Moreover, it might help accept the adoption of changes because shared customer satisfaction is the primary priority. It means that if team members believe in shared responsibility, they will be willing to shorten the duration of their shifts if it is the only way to treat their patients better.
References
Andrews, D. R., Burr, J., & Bushy, A. (2011). Nurses’ self-concept and perceived quality of care: A narrative analysis. Journal of Nursing Care Quality, 26(1), 69-77. Web.
Cherry, B., & Jacob, S. R. (2014). Contemporary nursing: Issues, trends, and management. St. Louis, MO: Elsevier.
Kearney-Nunnery, R. (2016). Advancing your career: Concepts of professional nursing. Philadelphia, PA: F. A. Davis Company.
Kelly, P., & Tazbir, J. (2013). Essentials of nursing leadership and management. Boston, MA: Cengage Learning.
Kornhaber, R. A., & Wilson, A. (2011). Enduring feelings of powerlessness as a burns nurse: a descriptive phenomenological inquiry. Contemporary Nurse, 39(2), 172-179. Web.