Nursing Staffing

Nursing Staffing





Question One

Nurses aid normally take care of patients by bathing them, feeding them and toilet them. Every day, the nursing staff, ensures that they get the patients up and take them to the dining room. The nursing staff usually works alone because they have little or no assistance available. Despite the fact that the limit to nursing staff is 16 nurses’ aide, just about 13 perform direct care. The nursing staff, therefore, is often loaded with heavy duties and rarely completes their cores. Nursing entrepreneurs are the true change agents in nursing (Sullivan, 2000). Entrepreneurs have the virtue of persistence in work, and they capture enthusiasm, imaginations and creativity necessary to adapt to new ventures. When nursing becomes a business, it means the nurses practice on a freelance basis and are self-employed. Nursing practice can be done in research, clinical or education as a business. For any healthcare business success, it must have quality services; it must be cost efficient and easily accessible.

Question Two

Nurse’s scope of study and practice is based on experiences, professionalism, educational qualifications. These subjects determine the level of autonomy practice. Strategies for enhancing are based on the provision of support for accelerating the professionalism in nursing and a clear expectation for the nursing decision (Melnyk & Overholt, 2011).

Clarification of the Expectation on the Autonomy

When nurses clearly communicate and organize their work, then they can enhance autonomy. This means they will have the freedom to decide on the clinical judgment. For a nurse to describe expected behavior, he has to understand the clinical patient, science, and art of nursing. This may involve, support of independent decision-making and expectation of the nursing action. The nurse’s decision involves interdependent and independent actions. Incorporating the expertise in nursing facilitates autonomous practice into the care of patients. For instance, the organization of patients care units to be judged by nurses based on the recommendation of the treatment plan. If nurses were given an opportunity to make their judgment in the clinical rounds, then this would maximize the contribution of their unique understanding of the care of patients. Investing in an input means the care of patients will be improved more solutions will be explored communication improved to supplement the plans.

If autonomous practice is recognized, then this can enhance communicated expectations. Suppose you if you acknowledge excellent performance, you will provide a venue for displaying autonomous practice. Role modeling, rewarding and recognizing exemplary performance by nurses encourages the autonomous actions. Nurse leaders and specialists should also be involved in behaviors reflective of autonomy. They can also serve as role models and mentoring excellence in performance. A sample of coaching autonomy may include addressing an unexpected behavior. For example, coachers can compare the expected action and the actual action of nurses and illustrate how to make expected autonomy more explicit. There can always be feed back if nurses do not meet their expectations. In recent studies, it has been confirmed that favorable environment will facilitate excellent autonomy.

Enhance Competitive Practice

A competitive nursing expertise will establish a sound clinical judgment. Nursing expertise constitutes skill, knowledge and extensive experience. Autonomy can be foster by creating a learning environment and implementing strategies to enhance competence. If confidence and competence are enhanced, then autonomy will be fostered. In meetings, clinicians can share patient scenarios that can that challenged them. By doing this, they get feedback and advice on how to tackle such complicated patient scenarios. Nurses should be encouraged to participate in continuous examinations that assess the degree of autonomy that they present in their judgment. Enhancement of autonomy can also be through the establishment of an evidence based practice approach.

Strategies that enhance Control over the Practice of Nursing

Nurses, being employees, must work within the imposed regulations and rules of hospitals. This has a profound effect in the work they practice. If nurses sincerely wanted to exercise their practice, they must possess the power to make decisions based on their profession.

Decision-Making Requires Practice

Authorities in power have often dictated Participationory and empowerment management. Representatives in an organization are known, and all nurses are expected to put some input. Staff nurses are responsible and accountable for solutions and issues discussed in the structure. The accountability and responsibility of nurses for nurses cannot be stressed adequately. This is where many shared governments get awry.

Question Three

Growth of Knowledge

The growth of knowledge in nursing is centered in the creation of culture and systems whereby nurses collaborate with other healthcare professionals, increasing nursing education and supporting nurses in practicing to the extent of their training and education. In a report, Steven Wartman, the chief executive officer of the Association of Academic Health Centre, said that the future of nursing recommendations is “not surprising”. In that boardroom, Wartman’s speech brought a wider perspective to the discussion. For example, it is advisable to increase the percentage of baccalaureate degree to 80 percent in the next 10 years. In the United States, only 50 percent of nurses meet this target. Wartman suggests that while it is necessary to increase nurses’ education, it has always been considered as a fractured career. The fracture is known to take place between baccalaureate and the two-year programs.

An issue in this report is the consensus model about certification and education requirements. “The nursing organizations have signed to it” Haller, the vice president of Patient care and Nursing services. The report also suggested doubling the number of nurses with a doctorate in the next 10 years.

Fulfilling individual Potential

If the nurses can fully utilize their knowledge in the profession, then increased education would be useful. However, nurses usually confront the institutional policies and government regulations that prevent them from performing to the best of the ability. The laws that are for or against the practice of advanced nursing to examine patients independently, prescribe drugs, and interpret lab tests vary from state to state. How then can we move to a national framework? In the near future, the need for implementation of consistent practice of advanced nursing laws will be higher. Hill mentioned that they would need professionals to lead in that sector.

Not everyone is with the agreement that advanced practice nurses should take the role of primary care providers. The Dean of the School of medicine, Edward Miller, said that if the report’s recommendation were taken to the ultimate level, the nurses would practice independently.

Working with Our Colleagues

These are changes that penetrate across various disciplines and affect the entire healthcare team. They need an enormous amount of collaboration, communication, and respect. Wartman pointed out challenge. “Healthcare professions should practice within guided the framework, and this mentality prohibits the changes that we’d like to see taken place. Perhaps there are Hopkins’s steps taken within the environment that can stop it.” The question involves moving that interdisciplinary environment from the research lab and to the classroom and hospital. What would be the main obstacle? “We have schools for medicine, nursing and public health with three calendars,” Hill said. Planning joint classes, interdisciplinary lectures, and or student organizations while on various schedules “presents a huge problem and those are what challenges us.” Jim Yager, PhD, said, “I think we are comfortable working together between the schools of nursing public and health,” The Senior Associate added “Perhaps we could share some best practices. Nevertheless, our different academic calendars do create difficulties. “If we want to do something good, we must have a single schedule for the three schools. That would eliminate a couple of barriers,” Miller agreed, while he spoke for the School of Medicine.  They paused while they imagined the possibilities.

Specific Recommendations

Scope-of-Practice Obstacles ought to be removed

Highly accomplished practice registered nurses ought to capable of practicing to the full degree of their learning and schooling. The following actions are proposed; the congress must expand the Medicare course to take in coverage of the services of highly accomplished practice registered nurse, which are inside the range of practice under appropriate state decree, just like the way physician services are presently covered.

The congress should adjust the Medicare plan to sanction highly accomplished practice registered nurses to carry out admission evaluations, in addition to, official recognition of residence Health Care Services (HCS) patients and for admittance to hospital and trained nursing facilities. There should be an expansion of chances for nurses to direct and circulate collaborative development endeavors. Private, as well as public funders, health care associations, nursing education courses, and nursing organizations should increase chances for nurses to direct and deal with collaborative endeavors with general practitioners. Moreover, the extra associates of the health care panel to carry out research and to revamp and develop practice surroundings, as well as health systems. These units should as well provide opportunities chances (Helton et al., 2012). The Center for Medicare along with Medicaid Innovation ought to sustain the growth and valuation of payment models and care delivery, which utilizes nurses in an extended and leadership capability to develop health results and decrease costs. Performance measures are supposed to be expanded and executed speedily. This should be enhanced in places where top practices are apparent to mirror the nurses’ contributions, as well as, guarantee better-quality care.

Execution of Nurse Citizenship Programs

Nursing State boards, certifying entities, the federal administration, as well as health care associations must implement methods to support nurses’ achievement of a transition-to-practice course (nurse citizenship). This is after their completion of a pre licensure or highly accomplished and superior practice degree course in the event they are changing into new medical practice areas (Massachusetts Nurse Advocate, 2007). The following deeds and actions ought to be implemented to execute and support nurse citizenship courses. Nursing State boards, in partnership with certifying bodies, for instance, the Joint Commission ought to support nurses’ attainment of a citizenship program subsequent to their completion of a pre licensure or highly accomplished practice degree course. This should also be the case in aspects of changing into new medical practice areas.

Increasing the Nurses’ Percentage having a Baccalaureate Degree

Academic nurse directors across all nursing institutions should work jointly to boost the percentage of nurses having a baccalaureate degree. This figure should be improved from 50 to above 80 percent by the year 2020. These directors should collaborate with education certifying bodies, private along with public funders, as well as employers to guarantee funding, check growth, and amplify the diversity of scholars to produce a personnel set to meet the stipulations of various populations across the existence of people.

Doubling the Figure of Nurses Who Have Attained a Doctorate by the Year 2020

Nursing Schools, with the support of private along with civic funders, educational officers with university trustees, and certifying bodies are supposed to double the nurses having a doctorate by the year 2020. This is for the intention of adding to the nurse staff cadre and investigators, with concentration to heightening diversity.

Ensuring that Nurses Participate in Lifelong Learning

Certifying institutions, nursing institutions, health care associations, and long-lasting proficiency educators from manifold health professions are supposed to work together to guarantee that nurses, as well as, nursing scholars and faculty carry on their edification and participate in lifelong learning for the reason of gaining the knowledge required to give care for varied peoples across the existence of people.

Exemplar of a Nursing Leader

This paper reviews Jamie Ellis who is a RN Category I Personnel Nurse in 8 South. She says that, in the perspective of a nurse who is involved in pediatric cardiology, the truth is that nature is not all the time just. Daily, children are delivered with different congenital anomalies. These babies deserve an opportunity to share life’s experiences normally. In partnership with a panel of specialists, Jamie Ellis totally changes infants’ lives and the unprivileged families. From atrial failings to transposition, Ellis has had the accountability to campaign for eminence of unprivileged persons with heart problems. Ellis assists and supports needy patients. Moreover, she educates the victims on the subject of healthy livelihood. Jamie Ellis depicts that there is never a career that requires such faith and selflessness.

Every nurse usually has a tale or remembrance of a child that psychologically, morally and professionally has influenced their life. She depicts her encounter with Lexis on her arrival to the hospital. She looked magnificent although she had heart disorders. She had an extensive cardiac history and was brought to the hospital for cardiac biopsy (Fricano, 2011). Jamie Ellis depicts that Lexi merely wanted a person to share the small girl stuff like dolls and cosmetics. For an infant who has exhausted more than fifty days on ECMO following a heart transfer, Lexi is evidence that infancy resiliency overshadows no risk taking. Lexi has taught her how imperative disruption is for hurting procedures. Even though, she negotiated for no IV Jamie coped with the difficulty to string the catheter whilst holding her in discussion about Lexi’s February holiday to Disney. She as well educated Jamie on how imperative “play” is to an infant, particularly in the sickbay. Jamie took her sister and monitored all the aspects while she was in bed. Jamie is comforted realizing that her nursing involvements made Lexi, as well as, her mother remain less distressing. Jamie realizes that she has encountered frequent sufferings in her short life. Moreover, there are many other patients having heart problems similar to Lexi’s situation.


Fricano, J. E. (2011). Skilled Healthcare: The Impact of Statutory Nursing Staffing Standards.

(Cover story). Health Law Litigation, 9(1), 1-19.

Helton, J., Langabeer, J., DelliFraine, J., & Chiehwen, H. (2012). do EHR investments lead to

lower staffing levels?. Hfm (Healthcare Financial Management), 66(2), 54-60. Retrieved

June 9, 2012

Massachusetts Nurse Advocate. (2007, October). A Special Message For ED Nurses Why

H.2059, The Patient Safety Act, Will Improve both Patient Care and your Working Conditions. Massachusetts Nurse Advocate, pp. 6-7. Retrieved June 9, 2012

Melnyk, B.M. Overholt, E. (2011). Evidence-Based Practice In Nursing & Healthcare: A Guide To Best Practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Sullivan, E.J. (2000). Creating Nursing’s Future: Issues, Opportunities, and Challenges St.

Louis: Mosby.

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