One of the most burning issues at Intermediate Care Unit (IMC) of Kendall Regional Medical Center is the turnover of nurses especially novice professionals. Brewer, Kovner, Greene, Tukov-Shuser and Djukic (2012) stress that the turnover of new nursing professionals is especially alarming as it negatively affects both the employees and the healthcare unit. One of the basic reasons for the turnover is the workload and unhealthy working conditions, which is mainly a result of the lack of patient care technicians. Jones and Gates (2007) stress that the cost of nurse turnover ranges between $22,000 and $64,000 per nurse, which makes it urgent since healthcare units have rather limited funds.
The most appropriate solution to the problem is the development of the healthy working environment through empowerment of nurses and decrease of the workload. The decreased workload will positively affect nurses’ job satisfaction and the quality of services provided. The nursing staff empowerment will also be beneficial for the increase of job satisfaction as nurses will be able to participate in the decision-making process and develop the most efficient working conditions.
The introduction of participatory management can be an effective strategy to implement the change (Tironi, Silva, Dellarosa, Haddad & Vannuchi, 2014). This approach is instrumental in empowering nurses who will be able to make decisions related to the scope of their work. They will be more motivated and committed (Tironi et al., 2014). To implement the change, it is possible to employ the model of change that consists of three stages: unfreezing, moving and refreezing (Mitchell, 2013). This method will help make sure that the change will be effective and lasting. During the unfreezing stage, the key players involved will acknowledge the need for change and will get acquainted with the change plan. The second stage is the change proper. During this period, the key players will carry out the change plan. The final stage is crucial as its successful implementation will create the corresponding culture at IMC.
During the first stage, it is important to carry out research concerning the needs and expectations of the key players. It is essential to understand concerns of nursing professionals as well as the nurse manager, administrator, and supervisors. This can be done with the help of a survey. Evidence-based nursing provides the necessary theoretical as well as practical paradigm for implementation of the research (Stetler, Ritchie, Rycroft-Malone & Charns, 2014). The nurse manager can be responsible for collecting and analyzing the data. This professional should come up with a brief report including major needs and expectations of the key players. This will help develop efficient policies. The report should also have the background information on the costs of nurse turnover. The manager will provide the report to the administrator, and some data may also be reported to the rest of the key players. It can be a good idea to implement the discussion of the results of the survey. This will be the beginning of nurses’ empowerment. The discussion may unveil some important insights into the problem. The report and results of the discussion will be the basis of the change plan.
The second stage of the change is concerned with the implementation of the plan. One of the steps will be hiring more patient care technicians. It is clear that this step will be more cost-effective than the turnover (Jones & Gates, 2007). Nursing professionals will have more freedom in decision-making processes, which is crucial for the development of favorable working environment (Sherman & Pross, 2010). As far as the problem of the workload is concerned, it is important to hire more patient care technicians. These can be medical school students or nurses with lower qualifications. The empowerment of nurses will be manifested through their power to delegate some of their responsibilities to the patient care technicians.
As has been mentioned above, the third stage of the change process is refreezing. It is essential to make sure that the developed policies will be effective and lasting. Nurses should be encouraged to remain active in decision-making while the key players should not try to restrict the power of nursing professionals. Training and discussions should be held on a regular basis. Nurses should share their experiences and ideas on their daily activities. It is also important to introduce the corresponding changes in the job description and other important documents. Institutionalization of the change will bring the real change to the healthcare facility.
On balance, it is possible to note that the nurse turnover at Intermediate Care Unit (IMC) of Kendall Regional Medical Center is the most urgent. Workload and unhealthy working environment are central factors that have a negative impact on nurses’ job satisfaction and performance. The solution to this problem is the empowerment of nursing professionals as well as the decrease in the workload. The implementation of the change should be divided into three stages. This will ensure effectiveness and lasting effects of the new policies and practices.
Reference List
Brewer C. S., Kovner, C. T., Greene, W., Tukov-Shuser, M. & Djukic, M. (2012). Predictors of actual turnover in a national sample of newly licensed registered nurses employed in hospitals. Journal of Advanced Nursing, 68(3), 521–538.
Jones, C., & Gates, M. (2007). The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention. OJIN, 12(3).
Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1), 32-37.
Sherman, R., & Pross, E. (2010) Growing future nurse leaders to build and sustain healthy work environments at the unit level. The Online Journal of Issues in Nursing, 15(1), 112-121.
Stetler, C. B., Ritchie, J. A., Rycroft-Malone, J., & Charns, M. P. (2014). Leadership for Evidence-Based Practice: Strategic and functional behaviors for institutionalizing EBP. Worldviews on Evidence-Based Nursing, 11(4), 219–226.
Tironi, N. M., Silva L. G. C., Dellaroza, M. S. G., Haddad, M. C. L., & Vannuchi, M. T. O. (2014). Management impact of staff turnover in the view of nurses: an exploratory study. Online Brazilian Journal of Nurses, 13(4), 549-558.