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Cost Effective Plan

How to Improve the Fiscal Health of the Department

Nursing Shortage in the Pre-Op Area

It is evident that there are critical nursing shortages in many hospitals, which affect patients, nurses, physicians, as well as hospital administrators (Buerhaus, 2000). After conducting a random survey to determine the impact of the shortage of nurses in my department, I concluded that it is something critical due to increase in the number of preventable deaths. The situation has affected nurse-patient relationships, communication, quality of care and overall efficiency. Often nursing shortages have effects on patient safety, as it impacts on early detection of their complications (Buerhaus, 2000). I realized that there was an urgent need to develop team collaboration so as to improve patient care, as well as their safety. However, it has not been easy to increase the number of nurses to the required level due to many other factors, including financial constraints.

Hospital administrators and nurses need to work as a team and come up with ways of dealing with the shortage as they work more closely than before. Generally, patient care should be a shared goal that needs discipline and teamwork (Buerhaus, 2000). Since we cannot reverse the shortage of nurses immediately, there should be communication to help strengthen the relationship between the existing nurses and improve the quality of patient care.

The Effects of the Nursing Shortage

Nursing shortage is currently a big problem caused by a lack of new students joining the nursing career, an aging workforce, and rapid population growth, thereby resulting in an increased need for better healthcare (Buerhaus, 2000). It is evident from several other reports that a significant percentage of patient death or injury is as a result of inadequate nurse staffing. It is a problem that also affects the nurses; they are overworked due to increased workloads, working for longer hours, and most importantly, there are limited resources needed to provide a high quality of healthcare to the patients. This takes its toll on the assessment of patients, diagnosis as well as treatment.

The number of nurses required in a hospital depends on its size and number of patient beds present. This means that on a daily basis the patients to nurse ratio depends on the number of patients that each department has. My department has lots of patients daily, which results in understaffing as the hospital does not have the required finances to hire new nurses. A nurse has lot of work, when to consider patient history, the time and attention a single patient requires and medications. So, if there are many patients in a department like ours, there will be lots of work required and patients will end up receiving less attention and care. Getting more nurses has become a problem because of inadequate nursing programs as well as insufficient amount of instructors to guide them. Addressing the shortage of nurses will go a long way to addressing the current weaknesses seen in patient care.

Inadequate staffing levels impact on both nurses and patients, but most importantly on the finances. Many deaths are caused by increase in costs of treating some diseases. The cost of care that goes into treating these patients will increase. Notably, nursing shortages affect the hospital in terms of fiscal management; not many patients will get the quality care they deserve, hence a rise in the cost needed to treat them.

Solutions to the Nursing Shortage

Hospitals are under a lot of pressure to come up with an environment that promotes quality care and guarantee safety, while at the same time controlling costs. To improve the hospital’s financial health, I propose a number of customized solutions that are flexible and scalable as well. Notably, the solutions have to work within the hospital’s budget so as to maximize investments and savings.

For many years, nursing shortages have been solved by hiring or recruiting nurses from other states or countries such as Canada, India, and English-speaking African countries, as well as increasing their wages (Clifford, 1988). However, after conducting a survey, the current shortage of nurses in the hospital requires long term planning and solutions, since short term solutions have little impact (Clifford, 1988).

Short term and long term solutions to the current shortages need recruiting of new nurses, retaining the current ones, and increasing the capability of nursing schools. I suggest that the hospital invests in supplying various educational facilities and funding or financial aid to specific students as scholarships in nursing, which will encourage them to work in the institution in the future. Other strategies should include retaining the current nurses in the hospital by providing a suitable working environment. The management should also encourage those who had left the nursing career by promising them even better working conditions. In general, the hospital should improve its working conditions as well as improve professional development of the nurses in the hospital.

I also propose the following provisions: scholarships for a number of nursing students; public service announcements and community education programs aimed at encouraging more students to pursue careers in nursing; career ladder programs; a fast-track faculty loan repayment program for those who wish and agree to join the hospital’s workforce; practice grants for the administration; and long term training grants to those joining the nursing program within the hospital.

The hospital should also strive to improve the current working conditions for nurses by banning compulsory overtime practices and improving the staff ratios. In general, there should be a structural and cultural change within the hospital. Notably, there is a huge gap between the supply of nurses and their demand in hospitals, which will even worsen in future. However, in trying to deal with this problem, the hospital needs to be concerned about the impact it would have on its finances.

Importantly, all hospitals should form a team to help in training of students in the nursing professions and encourage nursing orientation as well (Hodgman, 1999). I propose to the hospital that they should come up with an in-service and continuing education, besides setting internal staff levels, which are based on nurse proficiency and skill mix. It is important that all health care organizations invest in nursing services.

Hospitals face a lot of pressure when it comes to controlling their finances, and the nurses are the ones who receive large parts of the hospital budget. I propose hiring more nurses as a short term solution, because it could actually save the hospital some money. A large number of patient deaths and wasting of valuable time could actually be avoided if the number of nurses is increased. However, it is impossible to get new nurses because of the lack of professors to teach them. Patients nowadays require even more nursing care, but the situation is bad, since there are fewer nurses to give them the necessary care.

Implementing the above mentioned measures will go a long way into improving the current situation. An increase in staff will take care of shortages, as the other proposals act for the long term. It is important that we take care of the future. The current workforce will eventually retire and hence leave a gap which may not be easily solved (Hodgman, 1999).

Specific Strategies to Solve the Nursing Shortage

I propose: the development of educational partnerships with other relevant institutions, promotion of bedside nurse retention programs, training of current staff and new and emerging leaders, initiation of various scholarship programs and clinical academies as well, reduction of costs such as registry and traveler costs, initiating programs that support creativity, and also developing a plan that will redesign the patient care delivery model.

Proposed Budget

Developing educational partnerships (Education)..

Reduced--$ 300,000 per year

The grant that provides the hospital with funding for education programs will be consolidated to generate savings. Partnerships in the education department will reduce the money used for training and retraining of nurses.

Slashing registry and traveler costs (Transport).

Reduced--$ 500,000 per year

The budget reduce guarantee funding for overseas travel expenses for the hospital executive officers, as well as reducing the number of the officers who travel out of the country for conferences and other official functions. The budget envisions give saving the greater priority.

Forming a Frontline Leadership initiative that fosters creativity (Leadership).

Frontline leadership development initiatives will reduce funds, which were traditionally spent by the hospital due to poor leadership and misappropriation of funds

Promoting bedside nurse retention.

Increased—$ 1,000,000

The budget should be increased in order to save the amount used to care for very sick patients, who will be left to go home and return afterwards when the sickness deteriorate.

Training staff and molding leaders (Education).

Reduced--$ 2 million

Training of staff on the modern equipments will help reduce cost caused by mishandling and destruction of these equipments. Some of them are quite expensive and training of the employees will be important in reducing the cost of repair and maintenance.


These are all short and long term goals, which will take up to ten years. In evaluating the effectiveness of the proposals, it is important that the management evaluates every single plan I have discussed after every year. They should be able to note that there is a reduction in the overall cost of treating patients.

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