Nursing Shortage: A Case Study

Financial Impact
The nursing shortage in the healthcare setting, can result in decreased quality of care with the patient and this can have a significant impact on the financial aspect of the organization. As time changes, there are more acute illnesses being presented in the hospital as a result of the patient prolonging to seek medical treatment. The delay in seeking medical treatment often stems from the patient not having health insurance and seeking home remedies as an alternate method of treatment. When the patient present to the hospital with multiple acute illnesses, the staff should be skilled, ready and available to render the necessary treatment for the patient. The idea of nursing shortage, poses the risk and outcome of poor

quality care. As the quality of care rendered to the patient declines, the patient becomes at risk for hospital acquired pneumonia, decubitus and urinary tract infections. This paper will include an interview with two co-workers, who are actively involved in the financial management of the organization, Mr. J.G. and Mrs. D.J. Second, the interviewer will discuss the measures used to resolve the issues and the future plans of nursing shortage within the organization. Finally, a statistical information will be discussed regarding the financial issues within the organization. The purpose of this paper is to conduct an interview with two co-workers who are involved with the problem of financial management of the organization and to formulate a conclusion with this current issue.
Interview
Working at a modern hospital located in the midlands region of South Carolina, and being the number one busiest emergency room in the area can becoming very challenging and overwhelming for the medical staff. The challenge comes in place for the organization Lexington Medical Center, when the patient acuity rises and there is a greater demand with the availability of nursing staff. The shortage of nursing staff affects the quality of care and the overall outcome of the patient health. When the quality of care of the patient health is affected, this can have a negative effect on the financial aspect of the organization.
A interview was conducted on two co-workers, whom have a better understanding on the financial aspect of the organization Lexington Medical Center. Mr. J.G. is the nurse manager for the medical surgical unit and he has to deal with the financial management and budget control of his unit on daily basis. Every Monday, he has to give a report to his boss concerning the number of agency staff usage, overtime report, and census count for the unit. There continues to be an issues with staff shortage and the use of agency nurse to fill in the needs on the schedule.
Mrs. D.J. is the clinical coordinator for the medical surgical unit and she is a part of the center for best practice. She works with Mr. J.G. on the unit concerning staffing education on problems identified with patient care such as falls, hospital acquired pneumonia and urinary tract infection. The problems identified on the unit are as a result of the issue of staffing and nursing shortage.
A phone interview was conducted with Mr.

J.G. and Mrs. D.J. with the following questions concerning the issues of staffing and nursing shortage. How long has the organization tried to address the issue of staffing and nursing shortage? “Nursing shortage has always been an issue for the Lexington Medical Center. I have been employed here for almost five years and there continues to be a struggle with staffing the unit. We have to utilize agency nurses to fill in the needs on the unit” (J. Gudvangen, personal communication, April 30, 2016). What measures have been taken to address the issue of staffing shortage? “There are incentives being offered to attract new employees to work at the facility. A sign on bonus is offered to the nursing staff for up to fifteen thousand dollars, depending on what area of nursing you specialize in. Also during the peak season when the census is really high in the hospital, a bonus incentive program is offered for medical staff in a twelve weeks span. If the employee works a certain amount of extra hours, in addition to their regular schedule, at the end of the twelve weeks a bonus is paid to the employee. The bonus can range from twenty-five hundred dollars to twelve thousand dollars. This is used a method to attract the staff to work extra hours during the busiest time of the season" (J. Gudvangen, personal communication, April 30, 2016). What future steps have been planned to address the issue of staffing shortage? “The hospital is

planning on expanding the units and constructing new building to service the needs with the community. We are currently looking at some of the incentives some of the local hospitals are utilizing to attract people to come and work at their organization. We are seeking to offer more attractive options such as one hundred percent continuing education assistance, relocation packages, salary increases, and retirement packages. Our goal for hospital is to obtain magnet status by the year thousand and twenty. So whatever it takes to attract people to work at this organization and carry on the culture we present with providing superior service to the patient’s and our community” (D. Jakes, personal communication, April 29, 2016). What problems does Lexington Medical Center foresees as a block to address the issue with nursing and medical staffing shortage? “As the hospital continues to grow, there continues to be an issue with having enough staff and resources to fill the needs. Some days when we are down on the unit, we have to utilize the clinical care coordinator nurses as floor nurses. This takes away from the valuable resources or asset for the nurses to utilize, when there is help needed or guidance to care for the patient’s. The nurse to patient ratio is one to six and for the nurse tech one to twelve or sometimes one to sixteen. This places a lot of stress and burden on the nurses and techs involved in direct patient care. There becomes a problem with providing quality care and this places the patient at risk for decubitus, hospital acquired urinary tract infections and pneumonia. The average cost for hospital acquired decubitus can cost the organization around one-hundred and thirty eighty thousands of dollars per patient. There are times when the staff becomes overwhelmed and they may feel burden by the demands of the job. God forbid if a mayday occurs on the unit, this really throws the schedule off. The patient has to be revived and sent to a higher level of care. The organization is finding themselves utilizing agency nurses more to fill in the needs of the schedule. This is causing a lot of problems with our budget system and around March and September of each month, we have to cut back on the usage of agency nurses on the schedule. It cost the organization eighty-seven dollars a day to utilize a registered agency nurse on the schedule, with no benefits. We usually start our nurses out at twenty three dollars an hour and with the cost of providing benefits comes up to around one hundred and twenty eight dollars per nurse. Even though it cost the organization more to have a permanent staff nurse, we are constantly utilizing agency nurses more and going over our budget limit per quarterly for agency staffing. There are times in which we may go over budget spending limit for agency staffing by as much as thirty five percent” (D. Jakes, personal communication, April 29, 2016).
Conclusions
“Adequate nurse staffing and organizational/managerial support for nursing are key to improving the quality of patient care, to diminishing nurse job dissatisfaction and burnout and, ultimately, to improving the nurse retention problem in hospital settings” (Aiken, Clarke, & Sloane, 2002, p. 187). At Lexington Medical Center, their goal is to obtain the magnet status by thousand and twenty and the need for adequate permanent would be required to fulfill this mission. After conducting an interview with Mr. J.G. and Mrs. D.J, I was able to obtain a better understanding of financial management of this organization. Attracting the staff for this hospital becomes a top priority while trying to service the patients and needs of the local community. When this problem is resolved, there will become an improvement with the quality of care rendered to the patient’s and their family members involved in patient’s care.