Ashford General Hospital Proposal

Introduction

For decades, the United States of America has experienced a nursing deficit, and a lot of hospitals have suffered the problem as it continues to increase over the years. The challenge has become a global issue and has increased at an alarming stage, and many stakeholders have been affected, such as nurses, the community, patients, learning institutions, doctors, and the administrators. According to statistics, it is expected that more than 300,000 nurses would be required by the year 2020 in America (Cox, Willis & Coustasse, 2014). Therefore, there would be more job positions from the growing demand for registered nurses between 2017 and 2020.The primary driving force is the recent surge of the baby-boomer generation that has increased significantly. Moreover, the aging population does not show signs of reducing, in fact, it is expected to continue rising over the years. The need for more health care professionals has intensified, and the country has expanded its capacity to take care of the rising demand for human services change.

Current Issues at Ashford Hospital

As the CEO of the organization, I have decided to address the issue of nursing shortage with the assistant of other team members. The institution has currently been struggling with the nursing shortage and has opted to look for alternatives and guidance from other organizations that have been faced with the same problem. The problem has to be examined thoroughly and efforts made to find the best measures to find solutions and alternatives. Indeed, all departments would be analyzed, and their current positions would help in the search for the best strategic measures to be taken. The team members and the CEO should come up with a number of questions that would guide them in identifying the appropriate changes that should occur at the hospital. 

Solutions Implemented at Other Hospitals

A lot of hospitals do not have enough nurses to provide efficient care to patients in the health care industry. Team members that were chosen by the CEO of Ashford Hospital to carry out research on institutions that have been faced with the same problem found several with the same issue. The team found different strategies that were used to resolve the issues from five different hospitals that included John Muir Medical Center, Minnesota VA Healthcare, John Hopkins Hospital in Baltimore, Mayo Clinic in Rochester, UCLA Medical Center in Los Angeles, and Washington Hospital. The hospitals experience a nursing shortage, inadequate staff, high rate of retiring nurses and heavy workloads.

Partnership with Nursing Schools

Hospitals in the United States should partner with educational institutions and assist them in ways that would enhance continuing education in the nursing career. The partnership should aim at having a competent nurse workforce that would enable to minimize the current situation of nursing shortage. Hospitals like the Minnesota VA Healthcare and Mayo Clinic partnered with the University of Minnesota to help expand their student capacity by enrolling more students. The health center supported the university financially so it could place more students on the institution with the aim of hiring them upon graduation (Rosseter, 2014). With the shortage of experienced professionals, the health centers were able to use their resources and change the working status of their organizations. Furthermore, more staff was recruited at the University and was retained at the health centers, thus allowing them to grow and resolve the nursing shortage crisis. The strategy helped in decreasing the ratio between the patient and the nurse as well as providing the graduates with support and improving their skills (Dolan, 2011). Furthermore, the hospitals shared their physical resources in an effort to overcome the barrier of research space and classrooms.

Employment Opportunities

Hospitals such as the UCLA Medical Center in Los Angeles used the opportunity to employ licensed RNs who were working in non-nursing fields as well as those who did not have jobs. Recruiting and rehiring trained nurses is an important resource in the health care industry. The nurses are experienced and mature and would take their job seriously, reducing job turnovers. The nurses should be provided with refresher courses to enhance their skills and knowledge. Besides, the organizations used the training opportunities to advertise for vacant positions across the globe and even hired immigrant workers. Nurses from other countries help significantly in the problem of shortage as they run in the emergency and inpatient units. Besides, they improve the health outcomes due to the large numbers of the unemployed skilled workforce. Hiring experienced workers, for instance from the Philippines could balance the ratio of nurse-patient in the US hospitals (Littlejohn, et al., 2012). 

Employee Development

Most health cares have realized the benefits of an adequate number of staff in their institutions. Hospitals develop private education programs that help in developing the skills and knowledge of their nurse employees and trainees. The programs assist the nurses to gain experience with speed, and the proficient ones are retained with more knowledge. Furthermore, their standards are raised for an increasingly complex health care environment. They are motivated and encouraged to seek a faculty career with a purpose of creating more workforces in future. Hospitals like Minnesota VA Healthcare use volunteer programs that help develop nurses as well as patient care (U.S. Department of Veterans Affairs, 2017).

Salary and Financial Benefits

Low wages and salaries could catalyze the high turnover rate. Hospitals that have a competitive salary for their employee would experience low turnover rates. For this reason, John Muir Medical Center uses this strategy to retain its employees and recruit many others who find the offer impressive. In addition, the hospital provides nurse residency program to new nurses who are a benefit as it gives the nurses confidence in their work. The nurses at the local schools are given some few days wages to help them in offsetting their living costs (Childers, 2017). Others like the Washington hospital uses flexible schedules that allow nurses to have short breaks in between their busy schedule, thus balancing between work and leisure time. The work schedule helps workers meet other obligations as well as enhance their tight working hours to an exciting one.

Work Environment

Nurses require a conducive environment to work from; therefore, hospitals should provide efficient places to work with improved facilities. Management should create dynamic working environments to help the employees work in a healthy environment and improve the outcomes (Baernholdt & Mark, 2013). Communication should be sufficient, and all employees should cooperate to lessen the impact of the nursing crisis. Furthermore, there should be adequate resources and managerial support for workers for the proficient outcome. Hospitals like John Hopkins and Mayo Clinic use the strategy to enhance their employees work environment by including the conditions necessary to provide safe patient care. Besides, a conducive working environment would help in improving the daily nursing practice that would result in a positive patient experience. Nurses and the rest of the staff members would work in an environment that is free from stress that may arise due to various reasons. Moreover, factors that inhibit the quality care should be eliminated, and the management should comprehend positive influences that lead to job satisfaction.

Two Strategies to Be Used By Ashford Hospital

Due to the increasing stress of lack of enough nurses at the health care industry, Ashford General Hospital has felt the pressure and is in dire need to improve their retention and recruitment techniques. The staffing crisis has affected patients in various ways as well as the community. However, there have been some barriers that have continued to affect the health care industries, and ways to eliminate are known, and proposals to solve the situations are underway in most organizations. Ashford General Hospital has identified two most convenient strategies that would help in solving their problem both in short-term and long-term.

Nurse Education Partnership

Nurse education should be aligned to a clinical as it helps in developing competent practitioners equipped to face health care difficulties (Bvumbwe, 2016).Ashford General Hospital should invest in the strategy that involves in nurse education and should devise methods that would help in training graduates as well as provide them with the opportunity to further their careers. The hospital should liaise with learning institutions to open new vacant seats for nurse students. Furthermore, it should provide scholarships, and in return, nurses should work at the hospital during their free time and after graduation. The hospital should also have orientation programs for new nurses to promote satisfaction and efficient patient care. During orientation, managers should pair new nurses with the experienced ones for better results (Beal, 2012). 

Besides, new nurses who are students would gain better experience that would help in advancing their confidence to the next level. The nurses would be committed to the organization and would bridge the gap of the nursing shortage. The administrators and leaders at the Hospital would ensure that adequate funds to support the program are provided by the finance department to improve the continued support of the partnership between the nursing schools and the hospital. 

Nurse Refresher courses should be available to all nurses working at the hospital to enhance their contribution to health care delivery. The opportunity to enroll in these programs would motivate the employees to remain at the hospital since they continue to develop professionally while still at work. Furthermore, gaining more knowledge helps to improve patient care as nurses gain more autonomy and are given the chances of solving difficult situations under the supervision of a professional. Leaders would ensure that patients are given effective care, and support and their needs are met at top notch levels. Moreover, services provided would be better and continue to improve in future.

Employment Opportunities

Most people living in the developing countries migrate to the United States and other developed countries in search of greener pastures. Most immigrants are educated and pose vocational qualifications (Littlejohn et al., 2012). Individuals from other countries who are looking for job opportunities and have the necessary skills should be offered employment in hospitals on the basis that they enroll for further education at nursing schools to improve their efficiency. They should be recruited for better productivity and employed at general hospitals, thus reducing the problem of nursing shortage. Ashford General Hospital would utilize the method to hire more nurses in their institution, thus enhancing professional development, patient safety, and reducing nurse shortage. 

According to Roxanne (2014), graduates and experienced nurses are currently seeking for an open position in hospitals. Ashford General Hospital should use this opportunity to employ the RNs to work in their institution. Employing more nurses would ensure patient satisfaction and nurses would not be faced with the challenge of overload. More nurses would mean better working conditions, and in turn, this would result in high performance due to the balancing of nurse-to-patient ratios. Employment opportunities would attract more young people to enroll in the nursing profession as their career option. Furthermore, it would motivate individuals including men to choose nursing as a priority career choice. The job opportunities should offer good and competitive salaries as a major motivation. (Christopher, Chiarella & Waters, 2017)

Stakeholder Analysis

The principal aim of having a stakeholder analysis is to help Ashford hospital identify the departments that need improvement and the actions that need to be taken to help in solving the current issues. The stakeholder analysis would include the internal and external stakeholders who would be part of the proposed plan in generating knowledge in the decision-making process. Furthermore, they facilitate the implementation of the proposed strategies and their future directions. Most organizations depend on their stakeholders for growth and success (Schiller, et al., 2013). Internal stakeholders include the management, leaders, professional and non-professional staff. They operate within the bounds of the institution and provide sufficient inducements. External Stakeholders are the people that put input to the organization. Others compete with it while others have a particular interest in its function methods. They are compromised of the government regulatory systems, finance department, suppliers, patients, human resource, and community organizations like local education institutions.

The nursing shortage at Ashford Hospital is currently impacting the nurses and patients at the institution. The nurses are faced with the challenge of job division, and they end up working for more hours with a heavier workload. Too much work for fewer employees might cause job dissatisfaction as parent’s needs, and care is not entirely met. The patients, on the other hand, suffer at the hands of the hospital staff since they receive inadequate care, negligence and other possible fatalities that would put the institution at risk. The hospital should find ways to add more nurses to their organization in order to minimize the current situation.

The education assistance program requires all the stakeholders to come together and find the best strategic methods to use to initiate the proposal of partnership at local nursing institutions. The proposed strategy has a great impact on the external stakeholders such as the finance department since more funds are needed to cater for the scholarships and tuition fees for nurse students. The local education institutes are given the opportunity to enroll more students in their schools. Therefore, they are required to add more classes and premises to accommodate a high number of learners. Leaders should prove their efficiency through their commitment and servant leadership. They should guide the other staff members through a culture of high trust and responsibility to oversee quality and safety of patient care. Managers should be well informed about the changes in their surroundings to enable them to address the concerns appropriately (Schiller et al., 2013).

Creating employment opportunities at Ashford would have a significant impact on the Human resource, government regulatory systems, patients, nurses, and finance departments. Hospitals should provide sufficient attention to quality and safety of patients. Furthermore, government policies should ensure that governing procedures are followed. Employing more people from other countries would result in an ethnic issue that would encourage the growth of a minority group in the country. Employing immigrants means that the government has issued work permits to foreigners who might overstay in the country and become citizens of America. 

Change Process

The change process should begin by a review of the literature about the nursing shortage. The strategies formulated are on the basis of job satisfaction and efficient patient care in health centers. The proposed changes should highlight the importance of reducing nursing shortage in America. There should be alternatives and change process to ensure better patient care and to employ skilled and experienced nurses at Ashford. Staffing decision should reflect various factors that would lead to higher satisfaction levels of all the stakeholders in the organization. The stakeholders could look for programs that would help in offering online tuition in the nursing field for new and experienced students looking to advance their careers. In addition, technological support, such as the use of automated procedures, electronic medical reports, and computerized order entry would reduce the workload and allow nurses to spend more time with the patients and provide adequate care. Stakeholders should learn how to create the right nurse mix for every unit since different workers have different ways of performing.

Fiscal Impact, Ethical, Legal and Diversity Risk Factors

The nursing profession is guided by various values, such as dignity, integrity, accountability and social justice. The values are of significant value since they help the nursing fraternity to address disparities at the health centers in an appropriate manner. Lack of nurses in health centers has resulted in a significant fiscal impact due to the increased costs of management. Ashford Hospital has opted to employ nurses from other countries that have created ethical concerns to patient care. Students from local institutions are an added advantage to the organization since they reduce the nursing shortage. However, the students need a lot of supervision, and they should be extra careful while taking care of patients and should deliver best quality care. Nursing schools could be a barrier in nurse education since they have limited capacity for enrolments. Furthermore, they have few financial resources and are not able to raise salaries for the student nurses.

The population of the United States of America is projected to increase in the next decade. Therefore, the need to have a larger workforce in the health care industry is important as this would enable the health care industry to deliver a cost-effective quality care to the growing population. The diversity in the nursing workforce, would provide more opportunities for better patient satisfaction and positive health outcomes. The recruitment of minority students should be prioritized in order to have equally diverse medical practitioners across the country and in turn, this would initiate a positive perspective to student learning.

Conclusion

The health needs of people in the community require the availability of an effective, productive and sustainable health workforce. The current situation of the nursing shortage is a major global issue that is being addressed by various organizations. There is a vision to secure the future, and some factors addressing the problem are known, and solutions are being implemented at all levels. The recruitment and retention process could provide better insights and job satisfaction. Ashford General Hospital is aimed at bridging the gap of the nursing shortage, thus turning to various hospitals to seek for advice and guidance. The hospital copied some strategies, such as creating vacant positions for more nurses and liaising with local universities to enroll more student nurses. The two strategies are the most important and could help the hospital provide professional development in their institution as well as provide efficient patient care and satisfaction.

References

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Bvumbwe, T. (2016). Enhancing nursing education via academic–clinical partnership: An integrative review. International Journal of Nursing Sciences, 3 (3), 314-322.

Childers, L. (2017). Bay Area hospitals, colleges join forces to address nursing shortage . Retrieved from https://www.samuelmerritt.edu/president/news_room/aug_2008/bay-area-hospitals-colleges-join-forces.

Schiller, M. W. (2013). A framework for stakeholder identification in concept mapping and health research: a novel process and its application to older adult mobility and the built environment. BMC Public Health, 13, 428.

Dolan, T. B. (2011). Has the Nursing Shortage Come to an End?  ONS Connect, 26 (8), 8-12.

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Rosseter, R. J. (2014, April 24). Nursing Shortage Fact Sheet. American Association of College of Nurses , pp. 1-7.

Roxanne, N. (2014). Revisiting the Nursing Job Market. American Journal of Nursing, 114 (1), 17-18.

Christopher, S. A. Chiarella, E. M., Waters, D. (2017). Can generation Y nurses supply areas of shortage? New graduate challenges in today’s job market. Australian Journal of Advanced Nursing, 33 (2), 35-44.

U.S. Department of Veterans Affairs. (2017, April 5). Minneapolis VA Health Care System . Retrieved from https://www.minneapolis.va.gov/about/.