Analysis Of Nursing Home Understaffing Case Study
Almost all organizations operate with the sole aim of thriving and exceeding their competitors. It is therefore right to say that conflicts of any source are not welcome to avoid decline in ratings or quality of service. Lillian had waited so long for the perfect opportunity to present itself, so she can secure a job with AART Care a local nursing home in her hometown. Not long after she had interviewed for a position at the nursing home, she got an offer with a full-time position as a Registered Nurse. The job began the following week and she was so excited to go to work.
Lillian loved her job and she put in every effort to impress her colleagues and superiors. Sometimes she would go out of her way to ensure that the safety of her patients is always taken seriously and come first. Her coworker Sandra also a registered nurse worked a par-time schedule and only came in to work on certain days of the week. Everyone but Sandra seemed to admire Lillian’s hard work and zeal for the work. Lillian had noticed Sandra’s Hostility towards her but chose to ignore any form of confrontation to avoid conflicts. Secondly, she did not feel the need to argue with and be disrespected by a girl young enough to be her child. Her main concern however, was having to orient with Sandra for the next few weeks knowing fully well how hostile she is towards her. On one occasion, Sandra told Lillian that the company is always understaffed and does not perform internal audits of any sort therefore, she could cheat on her documentation and not administer eye drops to her patients if she feels that the night was too stressful, and she couldn’t get to it.
Lillian realized that Sandra only acts busy at work when anyone is watching but always finds loopholes to do the least amount of work when the opportunity presented itself. As a RN, Lillian understood what it meant to write false documentation on a patient. She also noticed that Sandra took longer breaks than usual. Sometimes almost abandoning the floor and the patients for close to an hour and half expecting her to perform her job duties for her. On one occasion, one of Sandra’s patients fell in her absence and suffered a skin tear. The facility’s policy was that in the account of a fall, the patient should be left in the position they fell, kept comfortable, and a supervisor must be called to the unit to assess the patient before lifting them of the floor.
On this night Lillian broke all protocol to cover for Sandra even though she knew it was not the right thing to do. One a unit with about 40 patients, there was only one nurse to provide care and so patient falls were a regular problem in the facility. That evening When Sandra returned from her break, she told Lilian that she should have called the supervisor’s attention instead of doing what she did. Lilian saw this as Sandra’s way of trying to have her fired from the job.
Nevertheless, Lillian continued to focus on her patients and channeling her energy toward their wellbeing and safety and went about her work ignoring anything she was told to do by Sandra. Things however, didn’t seem to work well between the two coworkers and Sandra would report Lillian to her supervisor for the least mistakes she made. The silent war continued between the coworkers continued for a few more weeks but Lillian did not see the need to report what was going on to her supervisors. She continued to her work and that of Sandra whenever Sandra takes her long undocumented breaks. Out of concern, Lillian decided to advise Sandra and remind her of the policy and cautioned her to shun her poor working habits. She stressed that if Sandra sees that she isn’t doing something right, she would like for her to help her make the right decisions instead to finding ways to report her to her superiors. Sandra got upset and stated that she wasn’t in the right position to tell her how to do her job since she’s been there longer.
Finally, Lillian had enough and decided to voice out her concern to her supervisors that day. MaryAnn, one of the supervisors stated that the complains were becoming too much and advised Lillian to take up the matter to the director of nursing and report her case. According to MaryAnn, Sandra always felt threated when there’s a new full-time nurse. The company’s policy was that, a par timer would have to float to another unit to help when there’s need for it. Full timers are to remain on their assigned units and only floats when necessary.
The following day, Lillian took her case to the director of nursing as advised by the supervisor, at the office, she narrated everything that has been happening to the DON. She apologized for any wrong doing by confronting Sandra and asked for her unit to be changed. After she left the office, the director of nursing had a meeting with Sandra where she was warned of her behavior towards new hires that come to her unit. The DON, told her that she was aware of her rude behavior and how she constantly keeps driving people away from the facility. Her unit was then switch so that she went on another unit and Lillian got to stay on her unit as always.
Negligence on the part of management
David Goguen defined Negligence as an act or omission (failure to act) by a medical professional that deviates from the accepted medical standard of care. In the scenario above, the two ladies both suffered from the negligence of management to properly address the issue of possible employee to employee abuse. From what we know, MaryAnn the supervisor state that the complains had become too much that’s why she advised Lillian to take up her case to the director of nursing. There must have been several complains prior to Lilian’s that have been over looked. If the facility had issued a warning to Sandra after one or two complains the previous times it happened, may be that could have calmed things long before Lillian was hired. It appears they waited till somebody had enough before a disciplinary action was taken. Such negligence has the power to cost an organization a lot. As an organization, you may be found liable under health and safety laws for the actions of your workers and so you must take precautions to prevent misconduct and abuse of workers in your organization. For instance, if Lillian had made what she was going through affect her work, the impact would have been felt in the quality of care and service to her patients.
Internal Audits
Audits are one way an organization can measure their progress adequately. According to Sara Morris, Internal audits are beneficial to an organization because, they improve and controls the environment of the organization by assessing efficiency and operating effectiveness. She also stated four more ways in which internal audits can be of great importance to an organization. They are; provide objective insight, improves efficiency of operations, evaluates risks and protects assets, assess controls, and ensures compliance with laws and regulations. In the scenario, Sandra mentioned the lack of internal audits to monitor activities in the facility. It makes you wonder how their annual or semiannual survey by the State department of health were like. Maybe if audits were being conducted, the director of nursing would have notice discrepancies in the care given to the patients and addressed the issue. Because of the facility manager’s ignorance of ongoing employee bulling and abuse, many employees would not last with the organization and leave to seek a pleasant working environment somewhere else. Failure # 3. Lack of concern for understaffing issues.
Employees must motivate themselves at the work place. Really no external source can motivate an employee in the work place. However, employers must work on how to influence the motivators in their employees. According to an article by NIBusinessinfo, to gain your employees' loyalty and commitment you need to do more than just pay them well. The article further explained that in a competitive job market, you also need to consider people's social and psychological needs - and this means leading and motivating your workforce properly.
In the scenario we can clearly see a case of an undermotivated staff. If she understood her role correctly and understand that she is not inferior, and maybe she might behave differently towards her colleague Lillian. Bryan Barajas, author of the article 6 Ways to Create a Highly Motivated Healthcare Workforce explained that Employees like to be recognized, and healthcare employees are no exception. He suggested that doing certain things like establishing a “feedback loop” that provides ongoing feedback to people to reinforce positive behaviors is a good way the facility could create a channel for the employees to feel appreciated motivated and recognized for the work they do. In the scenario, the facility kept a vital information that could help them to themselves and this could have done a lot of damages to their organization. When a person is not satisfied with an organization and decides to leave, their anger can fuel a lot of things that could bring a company’s ratings down and make them open to various attacks from their competitors.
In the last couple of years, it seemed that more nursing homes are experiencing an issue with understaffing. While most nursing homes are adapting to the change and finding ways to handle the situation, it seems like the clear majority are still bent on using their old outdated system that’s not working. This is serious for a business because, if you don’t put the thriving of your business into consideration, you are bound to fail at the quality of services you provide for your clients/patients. Nursing home understaffing may also contribute to psychological disorders among staff members, as stress escalates.
Solution
Many systems in place at the facility was not working out. To address and solve the situation, Mary the Director of Nursing at AART took the matter to the Nursing Home Administrator and a leadership meeting was called to officially discuss the problems facing the facility. At the meeting, the staffing coordinator gave a brief rundown of what the staffing of the facility had been like in the last two years. Few keys points that were mentioned included the increase in call outs for the past year and how it had become such a difficult task to get staff to come in to work on some days. At the meeting it was concluded that the lack of staff to help with the work had taken a toll on the few loyal staff and made them lose interest in coming to work. Everyone agreed that there was no channel of communication for employees to freely voice out their opinions and problems.
There was also no form of internal audits to assess the progress of the facility, thirdly Lack of proper incentive to motivate employees into staying with the organization and the employees did not feel like their performance at work was being acknowledged. With these ideas on the table, it was now time to brainstorm and find ideas on what could be done to rectify the problem. First, they decided to have a meeting with all staff in the facility the following week. The meeting would to be an open forum where the employees would freely speak out and bring forth their demands and ideas to management. It was because of the ignorance on the part of the leadership that’s why the few people who felt bullied by Sandra did not bother reporting the incident but rather left the organization. To solve this issue, Mary developed a new habit.
Every morning, before the management morning meeting, she would visit all nine units on the three floors familiarizing herself with the staff and chatting with a few that she met in the halls. The Nursing home administrator concluded that moving forward there will be internal audits every 4 months of the year to assess the progress of the facility. To motivate staff to put in their best work, an award will be given to the unit that complies the most and has less citations or deficiencies. Management also concluded that the quality of care is the topmost priority of the facility so therefore, they would start considering any one who is able to work half shifts and substitute the remainder of the half shift to those that need to pick up extra time. Even though that was going to mean overtime cost for the facility, everyone agreed that it is the best idea since it will motivate the new hires and retain them in the facility. Within a few weeks the facility began to notice minor changes with staff turn out.
Conclusion
The conflict situation that aroused between the collogues of AART nursing home was an interpersonal conflict. Interpersonal conflict occurs when two or more individuals who must work together fail to share the same view. In today’s workplace, Interpersonal conflicts are very common and can start when people feel threatened at their place of work and begin to feel that their work are not being recognized. The least attention given to a fellow colleague is enough to arouse jealousy and hatred between staffers. Creating a safe and pleasant working environment play a vital role in retaining employees in an organization. When employees feel safe in their working environment, it increases their productivity and increases the quality of service provided. More importantly an employee will be roused and express a sense of fulfillment at their job if by chance they feel that they are viable at their place of work and feel that they are performing admirably.
