A Crisis in Nursing case study Hi, here are the instructions, and a pic of the case is attached.Case Summary: you have to hand in a one-page summary (type
A Crisis in Nursing case study Hi, here are the instructions, and a pic of the case is attached.Case Summary: you have to hand in a one-page summary (typed with12-point Times Roman, and double-spaced on standard white paper) describing the problems in the case and possible solutions. CASE STUDY 4.1: A Crisis in Nursing
Eight years ago, Los Rayos cut the annual
employee picnic and Christmas party in order
to save money.
Five years ago, Los Rayos expanded nurses’
jobs to engage in activities like cost cutting and
Dis
1.
Los Rayos del Sol Medical Center is a hospital and sur-
gery center located in Florida. Its main facility has 500
beds and several outpatient centers, it employees 2,600
people, and has recently partnered with the Mayo Clinic.
Despite this seeming success, Los Rayos is experiencing
high turnover amidst its nursing staff. The nurse average
turnover rate is 14% for hospitals, a while Los Rayos has
a turnover rate of 21%. New graduate nurses turn over
at a rate of 27% within their first year, with an additional
37% of those new nurses wanting to leave, according to
a survey conducted nationwide.84 At Los Rayos, new-
nurse turnover is 40%. The hospital spends an average
of 13 weeks85 to fill a vacant position and thousands of
dollars
per
hire.86 Turnover often leaves units under-
staffed, which creates poor patient experiences, nurse
burnout, and lower quality of care. It also cuts into the
firm’s bottom line.
Why are the nurses leaving? Los Rayos strives to
provide the highest quality in patient care, but it also
has to manage costs and comply with the new govern-
ment regulations from the Affordable Care Act. Thus,
over the last 10 years, Los Rayos has made a number of
changes.
quality control. It required nurses to provide
three to five cost saving
ideas
per year or
they would be negatively evaluated on their
performance appraisals. The next year, the
firm put a cap on each position’s wage brackets
,
which resulted in nurses with greater than 12
years
of service not receiving raises.
2.
SE
Three years ago, Los Rayos removed the intake
coordinator position from all units except the
ER and laboratory. This means that unless
a patient is admitted to the hospital in the
ER or immediately after laboratory testing,
the nurse(s) on the unit has to complete the
admission paperwork when the patient is
brought to the unit.
Pa
Di
SO
th
• Two years ago, Los Rayos began using tablets
for patients’ charts and tracking and dispensing
medicine. To prevent drug theft
, medicine
carts were equipped with a new security system
that requires nurses to scan a patient’s hospital
bracelet with the tablet, select the medication,
and confirm the order before the tablet will
send the information to the cart and unlock
the needed medicine. The
process often
Ten years ago, Los Rayos changed the
staffing model. All units had two licensed
nurses and a housekeeper. Housekeepers
were minimum-wage staff that helped the
nurses do things like wash linens and stock
the nurses’ station with basics. These tasks
can take a lot of time away from the normal
nurses’ job duties of doing rounds, required
charting, administering doctors’ orders, and
helping patients. Los Rayos promoted the
housekeepers to health techs, which were
supposed to do more patient care tasks,
but most were not equipped with the skills
needed to do these advanced tasks and were
not given training by the hospital. At the
same time, Los Rayos reduced the number
of nurses per unit by one. This raised staffing
ratios from 12 patients to one nurse to 24
patients to one nurse.
has technical problems or delays and causes
frustration to both nurse and patient.
A year ago, Los Rayos began requiring all its
presenting continuing education courses to
reduce training costs. Nurses are required to
complete 60 hours of continuing education
annually for license renewal. The nurses did
given any nonmonetary rewards.
not receive any additional compensation for
the training they developed, nor were they
90
SECTION II . UNDERSTANDING INDIVIDUALS IN ORGANIZATIONS
Six months
ago,
Los Rayos changed from
8- to 12-hour shifts to reduce costs and to
allow patients to be closer to their caretakers.
However, patients from the maternity and
geriatrics wards have complained about only
seeing nurses at the start and end of shift and
have negatively rated their hospital experience
on surveys. Some employees like 12-hour shifts;
however, most employees agree these shifts are
exhausting, and the nurses often state they don’t
have the time and energy to “go the extra mile”
for colleagues and patients.
Discussion Questions
may
1. How do you think the changes Los Rayos made affected
nurses’ attitudes? What problems to the business
poor nurse attitudes cause in addition to turnover?
2. Which of the job attitudes from the chapter do y
3. How might leadership and personality of managers
and administrators be affecting the situation?
4. If you were the director of a hospital and going to do
a survey of employee attitudes, which attitudes would
you want to know?
you
feel is the biggest contributor to nurse turnover? The
smallest contributor? Why do you think so?
SELF-ASSESSMENT 4.1: How Much Career Adaptability Do You Have?
Part I. Taking the Assessment
Different people use different strengths to build their careers. No one is good at everything; each of us emphasizes
some strengths more than others. Please rate how strongly you have developed each of the following abilities using
the scale below each question.
Strongly
Disagree Disagree Neutral Agree
Strongly
Agree
Statements
I think about what my future will be like.
1
2
3
4
5
1
2 lam aware of the educational and career choices that I must
make.
2.
3
4
01
1
3
2
4
3. I prepare for the future.
5
2
3
1
4
5
Iplan how to achieve my goals.
1
N.
()
4
5
5. I make decisions by myself.
2
1
3
4
5
6 take responsibility for my actions.
3
4
2.
5
1. I do what’s right for me.
3
4
2
5
& Icount on myself.
3
4
5
2
9. I look for opportunities to grow as a person
(Continued)
CHAPTER 4 . ATTITUDES AND JOE SATISFACTION 91
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