Lori Lioce and Kristen Herrin
Jennifer Broadwater is the director of women’s health of a regional nonprofit healthcare system. She has doctoral preparation in executive leadership. Prior to her current appointment, Broadwater served as a nurse manager at a small private hospital for 2 years after graduation.
Historically, Broadwater’s department has run smoothly and efficiently and was one of the premier departments within the organization. Over the past 3 months, some of the nurses began requesting transfers to other departments, and some resigned to seek employment outside the organization. The CNO is concerned and would like Broadwater to make this her first priority.
The department consists of 175 full- and part-time employees: 88 BSN RNs, 61 ADN RNs, 24 patient care technicians, and 2 unit secretaries. In the past, staff members have worked well together. Recently, nonproductive turnover has increased and has resulted in additional stress among the staff members, creating a negative, distrusting culture. Due to many seasoned nurses leaving and new nurses coming on board, staff members report being overwhelmed with orienting new nurses and dealing with nursing students. In addition, staff members feel that the patients may not be getting the proper care.
Staffing and Resource Management
An in-depth staff analysis reveals certain nurses with a pattern of callouts. Broadwater reports to her CNO that she will need to address productivity, accountability, and productive turnover versus nonproductive turnover. Broadwater considers the best use of her staffing mix to maximize efficiency and productivity. The hospital has Magnet designation and a shared governance model, using relationship-based care as its professional practice model. Broadwater is concerned that the shared governance model and the relationship-based care model may not be translating to the day-to-day operations of patient care delivery. Broadwater is considering an alternative nursing care delivery model that might be used with the current staffing mix to enhance productivity and better meet the needs of staff members and patients.
Case Study Questions
1. Broadwater’s department uses a decentralized budgeting process. Using the eight steps identified earlier in this chapter in the procedures for decentralized budgeting, identify how Broadwater would use her understanding of her staffing mix, patient care needs, and shared governance model to best address department problems.
2. Using the staffing mix, how might Broadwater maximize her professional nursing capacity, considering the need to increase her BSN RN pool?
1. Locate and read five recent articles in nursing journals about pay for performance. Summarize the implications for the nursing profession.
2. You are having lunch with a nurse colleague who asks you about your current courses. She asks you what you think are the three most important financial concerns facing the nursing profession. Offer your three concerns and review the literature to find supportive evidence.