Method of obtaining approval(s) and securing support
Any new project or proposed plan requires a careful implementation plan in the light of specific risks and requirements which may emerge during this phase. While the program may be viable from a planning and designing point of view, the implementation process is characterized by putting up of structures and resources to see to it the workability of the proposed plan or solution. Thus, as a designer is critical that you engage with the leadership within the organization as well as fellow staff so as to minimize the chances of resistance to the proposed solution. Resistance is always inevitable. However, careful consideration of the views of organizational leaders and fellow staff will always propel the solution to completion (Saunders, Evans & Joshi, 2005). This could mean involving them from the initial phases of designing and deliberation of requirements. On the other hand, organizational leaders play a critical role in supporting the funding of required infrastructure as well as approving the safety and viability of the solution.
The important aspect is to have a well-versed background of the issue, the solution and the requirements, as well as its viability into the future. Nursing retention is a factor that directly affects the quality of care and thus, the proposed policies at organizational and governmental level should take the issue or patient safety into account. The ability to convince the leaders and fellow staff that the new policies will be applicable to solving the current nurse shortage as well as resolving the shortage in the long term will be the key. This should be supported with evidence from statistics and literature especially where such policies have been proved effective upon implementation (Saunders, Evans & Joshi, 2005).
Description of current problem description
Nursing shortage has historically been a persistent issue on nursing and healthcare. The nurse-patient ratio and the nurse-working hours have shown a trend that signifies a strained workforce amidst an increasing population. This has not only compromised the quality of care but has continually caused a lack of interest from aspiring young people to join the workforce. This has been more to do with the lack of proper channels that can offer career advancement for nurses, as well as the unsatisfactory workplace environment associated with nursing.
Similarly, the enrollment rates in colleges have dwindled in recent years. This is attributed to the lack of platforms for nurturing leadership skills for new nurse practitioners and the continued neglect of nursing students in colleges in terms of lack of sufficient funds to enable them pursue their education to the higher levels. In cases where this funding has been done, the salary and wages for nurses have not been at a level where the new nurse practitioners can adequately repay the loans while sustaining a livelihood. This is particularly in comparison with other professions. All in all, these situations cumulatively lead to a point where nursing can be described as a career that does not offer its human resource networks the adequate support. Visibly, the infrastructure, a satisfactory work environment, career advancement strategies or sustainable pay packages or performance incentives for motivational purposes are not well structured to facilitate a positive work environment (Tillot et al., 2013).
Description of the proposed solution
One key aspect of ensuring nursing retention and minimizing the cost of replacing the quitting nurses is to develop a strategy through policy making that can enable nursing as a profession compete for the top cream in the job market and education sector. On a similar note, the idea is to make nursing a profession where the welfare of the nurses is taken into account as an influencing factor in the quality of care provided. Today’s nurses are holistic and are indeed expected to serve more than just the instructions provided by the physician. They are expected to act as advocates for quality care, patient education, as well as act as leaders in their roles (Wieck et al., 2010). However, organizational cultures and the work environment have been seen as an impending factor in ensuring that the nurses perform these roles adequately.
Rationale for selecting proposed solution
The decision to adopt new policies as solutions to the ever persistent nursing shortage was based on the review of different literatures that have majored on the causes of the nursing shortage. On the other hand, interaction with the current, retired and nurses who have quit the workforce unearthed that the work environment has not been essentially supportive for the nurses. As such, the solutions lay on the need to work out the policies that can effectively provide a satisfactory work environment. Similarly, a review of the costs and benefits of implementing this solution proved that it would ultimately be viable to retain the current workforce as opposed to replacing the quitting workforce (SPENCE LASCHINGER et al., 2009). This would also act to attract new entrant into the profession especially the young people who have always had the aspirations to join nursing. The key has been to bring nursing to a level where as a profession it can compete in the job market with other professions especially in terms of pay packages and satisfactory work environments.
Review of Literature
An aging workforce, job dissatisfaction, changing patient demographics and lack of satisfactory work environments are the primary causes of the nursing shortage today (Tillot et al., 2013). This then underlines that while the resources may be continually available, the appropriate management and distribution of these resources to key aspects of nursing has not been entrenched. This is more in line with what Renter et al. (2014) identifies as magnet designed organizations that focus on positive work environments defined by emerging needs within the professions. Continued education and attractive pay packages are the major aspects that can be adopted from the magnet designed organizations that would go a long way in facilitating the workplace that motivates the workforce.
On the other hand, an organizational culture defines how well the policies will be implemented and adopted to completion. This brings to the fore the critical role of the Nurse Manager in ensuring full adoption of the policies that will create an enabling environment for nurses across all diversity in demographics and ideologies. According to Wieck et al. (2010), the Nurse Manager must provide channels that link the new nurses to the experienced workforce in such a way that they are nurtured in skill and leadership. This, Wieck et al. (2010) notes would be one of the intrinsic sources of motivation of the young nurses by placing more responsibility on them and giving them a platform where they can be involved in decision-making and policy reviewing.
In Dunn (2012), the relationship between the nurse and the patient plays a crucial role in the outcome. However, the relationship can only work well when the nurse is provided with an environment that alleviates fatigue and psychological stress. Such an environment should give the nurse the freedom to make decisions that suit the patient without necessarily relying on the instructions provided by nurse leaders or physicians. This autonomy can however impact negatively especially when the welfare of the nurse is sidelined SPENCE LASCHINGER et al. (2009). Nurses may potentially use the autonomy to make decisions that compromise on the quality of care especially by omitting procedures when under pressure to serve more than one patient. As such, Dunn (2012) calls for collaborative cultures within the workforce. The author also notes that if nurses have to work collaboratively with other specialties in healthcare, the utmost aspect is providing them with sustainable pay packages that are at par with other professionals within healthcare. Along this view, then all indications point to a particular weakness in policies as opposed to availability of resources. Restructuring the nurse’s education system, the salary and pay package system and the work environment will essentially provide the short-term and long-term solution to the nursing shortage.
Description of implementation logistics
Nurturing leadership, open up avenues for continued education and sustainable pay packages that can match other professions are three major strategies that need to be considered when thinking about the welfare of the nurse. This begins with creating organizational cultures that support independent decision-making and collaborative approaches in delivering care. Nurses need to be appreciated not as assistants to the physicians but equal partners. When this is achieved, motivation is gained, and the work environment supports nurturing leadership for nurses. On the other hand, emerging technological changes require that nurses and physicians be allowed to gain continued education so as to remain relevant in the care they provide (Dunn, 2012). This implies that governments and organizations should be in a position to provide funding for such programs collaboratively and thus begins with efforts to legislate such allocations at federal and state levels.
In another perspective, wages and salaries as well as performance pays based on merits should be implemented. The level and quality of service delivery in any organization is proportional to the salaries and wages provided as well as other intrinsic motivational factors such as the performance payments. These should be retained and documented within the organizational policies through a collaborative deliberation of such payments (Dunn, 2012). At federal level, legislation should provide for such motivational payments as well as ensure that there are strict regulations that govern how these payments are awarded through merit. The full implementation at federal and organizational level will take up to 12 months considering the lobbying involved in adoption of proposed legislation. At organizational level whoever, the proposed solution should kick-off as soon as approval is granted by the leadership since current policies can still provide a significant solution for the short term. On the other hand, issues such as organizational culture that will need to be reviewed across all healthcare institutions do not require any demanding resources for adoption.
Resources required for implementation
The proposed solution is based on the adoption of policies as opposed to restructuring of any major physical infrastructure. As such, a multidisciplinary approach is required between organizational staff as well as key stakeholders on the health sector and legislative or political leadership. Through the nurse leaders and professional organizations, it will be less demanding to formulate and deliver the proposed legislative agendas that will support the proposed solution. Similarly, with the level of influence that the professional organizations and in particular the American Nurses Association wields, the lobbying of support for the legislative recommendations will be done within the proposed timeframe (Saunders, Evans & Joshi, 2005). Evaluation for this program will be based on the assessment of nurse quitting rates upon a year’s full implementation of the proposed solution. This will also provide a reflection of the positive work environment as achieved through the proposed policies.
On the other hand, evaluation will also be accessed on the enrolment trends in nursing colleges which will reflect a new passion for the course as instigated by friendlier funding and career advancement programs in the nursing curriculum. At organizational level, the evaluation will be based on the how new nurses adapt seamlessly to the organization and their ability to demonstrate good-decision making and practice autonomy. This will reflect a new found ideology for nurturing informal leadership skills within the workforce.
References
Dunn, D. (2012). What Keeps Nurses in Nursing? International Journal for Human Caring, 16(3), 34-41.
Saunders, R. P., Evans, M. H., & Joshi, P. (2005). Developing a process-evaluation plan for assessing health promotion program implementation: a how-to guide. Health Promotion Practice, 6(2), 134-147.
SPENCE LASCHINGER, H. K., Leiter, M., Day, A., & Gilin, D. (2009). Workplace empowerment, incivility, and burnout: Impact on staff nurse recruitment and retention outcomes. Journal of nursing management, 17(3), 302-311.
Tillot, S., Walsh, K., & Moxham, L. (2013). Encouraging engagement at work to improve retention. NURSING MANAGEMENT, 19(10), 27-31.
Wieck, K. L., Dols, J., & Landrum, P. (2010, January). Retention priorities for the intergenerational nurse workforce. In Nursing Forum (Vol. 45, No. 1, pp. 7-17). Blackwell Publishing Inc.
