Three Things I Would Change

The three most important areas that I would address if I were nurse manager on our unit would be staffing requirements, opportunites for nurses, and nursing leadership and management roles. At the present time our nurse to patient staffing ratio is not good. In the beginning we had adequate staffing and if acuity on our floor increased we were able to increase staff as needed. The reason for this is because we had an adequate amount of PRN nurses. Now that has decreased to almost half. We are constantly begging nurses from other floors to come to our floor whenever we are short staffed but our acuity remains high. One problem is that the hosptial does not have a floating requirement. By this I mean that if you work on the caridac floor and your acuity is low, you have the option of going home early but there is not mandantory requirement that you must float to another floor that your are skilled to float to if that floor is experiencing an increase in acuity and a decrease in staffing. This would be the first thing I would push to get changed. As a manager I would include the analytical ability to identify this problem and effectively manage my staff by advocating for this change which is stated in Leadership and Management in nursing as something I must do to see change (citation).

The next thing I would address would be oppotuniites for nurses. At the presetn I know of at least three nurses on our floor that have put in transfer request to different areas of the hospital. I know one nurse that has been a nurse for about three years and all but one year she has worked on our med-surg floor. She has a strong desire to become a labor and delivery nurse. She ahs applied to that floor, but the nursing manager told her she cannot hire her without any experience. This makes me so mad. I feel like that when we become nurses we have the foundation to work in any area we choose. I do agree there are specialtiy areas where we need additional traingin, but without opportunities to do so many nures like the one I mentioned above feels that her dream will never come true. If I were nurse manager I would try and make my voice heard to someone and try and advocate for intern training programs for someone like this nurse that would love to be in a specialtiey area. Currently the only program we have at the hospital I work for like this is in the Operating Room. Changes like these must be made or the nursing shortage will only get worse. (citation).

The hospital I work for currently has a manager for every unit/floor. Sometimes there is one manager for two floors. My nursing manager has to manage two floors. She does have an assistant manager. I see the assistant manager fairly often, but hardly ever see my nursing manager. If I need to see her she is always in her office. The nurses on the floor below ours that my nursing manager also manages complain that they never see her and if they need something she is suddenly out