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The Nursing Crisis: Improving Job Satisfaction and Quality of Care

The Nursing Crisis: Improving Job Satisfaction and Quality of Care. Linda Searle Leach, Ph.D., R.N., C.N.A.A. Assistant Professor California State University, Fullerton. Current Conditions. Turnover Unstable Workforce Few Incentives for Experienced RNs Increased Cost of RN staff

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The Nursing Crisis: Improving Job Satisfaction and Quality of Care

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  1. The Nursing Crisis: Improving Job Satisfaction and Quality of Care Linda Searle Leach, Ph.D., R.N., C.N.A.A. Assistant Professor California State University, Fullerton

  2. Current Conditions Turnover Unstable Workforce Few Incentives for Experienced RNs Increased Cost of RN staff Declining Morale Quality Concerns Unionizing/Labor Activity Higher Census Aging Patient Population Shorter Lengths of Stay Increased Patient Load Lack of Collaboration Increase Overtime Stressful Work Environment Aggressive Recruitment Image Campaigns Registry/Traveler Staffing Hiring Bonuses Higher Wage Rates Salary Compression

  3. Expand educational capacity and opportunity Increase state and federal support for nursing education Do not cut budgets that currently fund nursing education Provide incentives for and access to degree-granting education programs Fund workforce data collection and planning Systematically compile workforce data Forecasting models of supply and demand Promote partnerships between service and education More effective recruitment Recruit future generations Enhance diversity American Organization of Nurse Executives(AONE) Legislative Priorities 2003 Health Care's Human Crisis: The American Nursing Shortage. The Robert Wood Johnson Foundation. 2002. Increase the Supply of RNs

  4. View RNs as strategic assets Satisfying work relationships Improve compensation Make positive changes in work environments Support integration and development of new nurses Labor saving technology Ergonomic technology Adopt characteristics of Magnet hospitals Health Care's Human Crisis: The American Nursing Shortage. The Robert Wood Johnson Foundation. 2002. Increase Retention

  5. Increase Retention • Expand career options • Paid opportunities • Strengthen nursing leadership • Support education for managers and administrators • Nurse executives must be key decision-makers • Nurse involvement in decisions • Increase visibility of RNs contributions to quality of health care • Decrease individual workloads Health Care's Human Crisis: The American Nursing Shortage. The Robert Wood Johnson Foundation. 2002.

  6. State Strategies to Address Workforce Issues • Increase Supply • Registered Nurses • Master’s Prepared Nurses • Faculty • Protect Workforce, Ensure Safety • Obtain Data for Workforce Planning

  7. Assembly Bill 394 (2002) Directs the California Department of Health Services (CDHS) to establish “minimum, specific, and numerical licensed nurse-to-patient ratios by licensed nurse classification and by hospital unit.” Little data to drive decision-making process, even less agreement Increased costs Expected implementation date: July ‘03 Enforcement challenges California’s Nurse Staffing Legislation

  8. Hospital Unit Nurse to Patient Ratios General Medical-Surgical 1:6 (1:5 after 12-18 months) Labor & Delivery 1:2 Postpartum 1:6 (Mothers Only) Couplets (moms & babies) 1:4 Behavioral Health & Psychiatric Units 1:6 Telemetry Unit 1:5 Step-Down Unit 1:4 Emergency Departments 1:4 Trauma 1:1 Critical Care 1:2 Pediatrics 1:4 Specialty Care (Oncology) 1:5 Post-Anesthesia Care Unit 1:2 Mixed Units 1:6 (1:5 after 12-18 months) Operating Room 1:1* - Current law/regulation Neonatal ICU 1:2* - Current law/regulation ICU/CCU 1:2* - Current law/regulation Burn Unit 1:2 Well-Baby Nursery 1:8* - Current law/regulation Intermediate Care Nursery 1:4* - Current law/regulation CDHS Nurse Staffing Ratios • Nurse means • Licensed Nurse = • RN • LVN • LPT

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