Dynamics Involved in the Nursing Manager and Nursing Informatics Career - Essay Example

Interview Paper

Leadership refers to a way of influencing people to achieve certain goals. According to Hostetter and Klein (1), it can be learned if someone chooses to. Good nursing leaders can empower or influence others to produce good outcomes in a lot of situations. A leader refers to anyone who motivates or influences people to complete certain tasks while a manager refers to someone hired by firms to aid their workers in achieving the organizational goals (Hostetter and Klein 1). In a health care setting, one of the leaders is a nurse manager; they have numerous roles, which will be discussed in this paper, but for summary, their main role is managing nurses who look after patients in a healthcare setting.

With the fast growth and application of technology, especially in the healthcare setting, a lot of attention has been put into how the professional world is adapting to its use. Today, the nursing world is more diversified; there are normal nurses, nurse managers and nurse informatics among others. All these require different level of skills training to carry out their duties effectively. They also came with their unique challenges. This paper sought to interview a nurse manager and a nurse informatics in order to understand the dynamics of their field, which appear the same, but are totally different.

A nurse manager oversees a nursing unit in a healthcare setting; they give direction to nursing staff and oversee patient care, budget allocation and management decisions. A nurse informatics, on the other hand, is on the forefront of the changing tech in medicine; they manage communication data, as well as information to clients and provide health care provision to patients. The nurse manager confirmed that some of their workloads include: making of the duty roster, budgeting, dealing with clinical issues, managing conflicts, training staff and keeping up with the organizational behavior. For the nurse informatics, her major workloads included doing a lot of troubleshooting, attending a lot of meetings with similar agendas, a lot of system development and upkeeps, dealing with countless nursing issues, training and educating nurses and filling forms at the bedside. During periods of high seasons, nurse managers tend to call some of the nurses who are of duty back to work in order to manage the high number of patients and during low seasons, they tend to grant some nurses some off time from work. When a nurse is called during their off period, they are paid for the extra hours they put in. For the nurse informatics, during high periods, they seek assistance to manage the records from other nurses, but during low periods, they normally deal with all of the records themselves.

When it comes to how the volume of work flows in their organizations, both are assigned to specific duties by the hospital’s administration. After this, it is the work of the nurse manager to assign specific duties to her subordinates. The nurse manager confirmed that if she feels a specific duty can be conducted by a particular nurse, then she will assign it to her. Such duties include looking after patients and writing records or overseeing the handing over of the patient. The nurse informatics, on the other hand, carries out most of the IT related tasks by herself. However, things such as updating records and recording current records she designates it to other nurses. For instance, for the nurse informatics, she confirmed that her subordinates normally examine patients using computed tomography (CT) to determine whether they should be admitted or not. The CT scan is done in an inpatient setting even if it is done in some of the outpatients it increases their workloads.

Some of the common inefficiencies stated by the nurse manager and the nurse informatics are the shortages of clinicians, prolonged hospital stays and incompetently managed patient flow in terms of admitting and discharging of the patients. The nurse manager also stated that in their hospital they experience poor communication between staff members and high readmission rates. Both organizations depend on a greater use of nurse practitioners and physician assistants to handle lower-level care decisions. This is with an aim of dealing with shortage of clinicians. When it comes to dealing with inadequately managed patient flow, the nurse manager confirmed that they are constantly forced to redesign their system-wide processes, which impacts the flow. A number of strategies that they use comprise of assessing patient flow through reviewing occupancy and 'parking' of patients, allocating separate ORs for unscheduled and scheduled surgeries and offering a process for scheduling both the date and time of discharge a patient at least one day earlier. For prolonged hospital stays, the nurse manager claimed that their hospital offers practitioners with a list of resources, for instance, nursing homes, social workers, skilled nursing centers, behavioral healthcare centers, rehabilitation services, to help eliminate or reduce the issue of prolonged stays. For poor communication, the nurse manager claimed that their organization has set up some protocols of communicating issues involving patients or staff. For instance, when there is conflict among nursing teams, they are required to solve their issues through the mediation of the nurse manager. Also, they use IT assisted tools to relate their messages. For example, when they want to assign different tasks to different nurses, they send messages to them are they are obliged to reply so that the administration knows that certain assigned tasks are being dealt with. When it comes to hospital readmissions, the nurse manager claimed that avoidable readmissions normally take place since inpatient care coordination and quality care is inappropriate. She claimed that they have put in more efforts to ensure patient is put at the center of care in order to avoid readmissions as much as possible.

The nurse manager claimed that she feels that people, particularly the hospital’s administrations feel their work is to engage with patients only. Nevertheless, she feels that offering proper care to their patients involves a complex set of communication starting from the front desk workers to assisting personnel to pharmacists to doctors to nurses to the checkout department. She believes that even though there are protocols set by the administration, her personal responsibility lies in making sure that each and every worker comprehends the objectives of their work and that care provision is their main target. But from her say, she says she is personally liable of ensuring that the nursing unit functions as a community; this means that all members understand all tasks that are happening around instead of each member having their own specialty. She claimed that this is the basis of all conflicts in a health care setting – varying opinions. Once people are taught to do the same duties, she believes that then, conflicts will reduce. She believes that these people need to be taught the importance of punctuality when it comes to fulfilling duties, but the importance of the duty itself perhaps is the care of the patient or hospital.

The nurse informatics claimed the status quo of working in an informatics clinical setting is built behind computers and technology. Nevertheless, she believes that this should not be the case; according to her, the most important thing to teach nursing informatics and even nurse mangers and their nursing units is change management. She believes that by cultivating change management to nursing units, the entire organization can be able to comprehend how individual or organizational change or behavior can influence the effectiveness of the hospital. She believes that change management is the vital element of what all nursing informatics carry out on a day to day basis. The informatics nurse lamented that hospital administrations hardly ever give them credit of what they know. She claims that nurses, for instance, comprehend all clinical processes better than all other professionals in a healthcare setting simply because that is what they are taught. They are also change experts judging by the amount of new equipment, medication, practice and patients they have to look after day in day out. Therefore, simply basing the status quo on computers and technology does not help, but change management is more significant.

How to Maximize these Efficiencies

Some of the efficiencies discussed by these two professionals include: shortage of clinicians, prolonged hospital stays, inadequately managed patient flow, poor communication between staff members and high readmission rates. When it comes to dealing with poor communication in the hospital, Buchan and Aiken (3262) claims that each and every person in the unit should be considered as a member and not a case. This is particularly true when it comes to patients. Poor communication arises when people are treated differently in a team (Buchan and Aiken 3262). Hutchinson et al. (3021) advise that this has been the goal of patient-centered care. The authors claim that hospitals studies have found out that hospitals that have gone to place patients at the center of their care normally communicate very well in terms of achieve certain tasks. Nevertheless, hospitals that have not placed patients at the center of their care normally lag behind in communication. A healthcare unit should communicate each and every step to avoid any mishaps. For instance, in the start of the ER, Hutchinson et al. (3021) advices that it would be important to have someone assigned to provide the patient and his/her family with updates concerning what is taking place.

A lot of authors believe that prolonged hospital stays and high readmission rates in hospitals goes hand in hand (Hostetter and Klein 1; Buchan and Aiken 3263; Hutchinson et al. 3022). They believe that quality of the care is what will determine the outcome, whether they will have prolonged stay or be readmitted. Hostetter and Klein (1), in particular, establish that hospitals need to establish regular discharges of patients. This can be done by making planned inspections around wards to check which patients can be discharged. They can also implement nurse-led discharges. This is because nurses work with patients daily and are at the best position to say whether the patient can be discharged or not. Some hospitals have implemented predictive discharge models to help them decrease the amount of time patients stay at their hospitals and also eliminate delays. Also, others apply visual triggers, for instance, visible anticipated date of discharge.

The issue of nursing shortages Buchan and Aiken (3264) believe is HR related. The authors claim that HR is not doing enough to attract or keep nurses in the practice. According to the authors, the shortages can be shun through fresh models of team-based care, which depend on non-physician clinicians—for instance, physician assistants and nurse practitioners—for primary care. Clinical settings are also advised to use managed service programs (MSPs) so as to cut costs and enhance efficiency. This is a management innovation, which is common in other sectors of the economy apart from healthcare. MSPs grant one source of management and billing for many healthcare staffing providers. A lot of hospitals have numerous providers for clinical practitioners. Buchan and Aiken (3264) showed that using MSPs in a hospital setting gives positive outcomes even if you have a limited number of clinicians.

Finally, managing patient flow in hospitals plus other clinical settings can aid in decreasing overcrowding, preventing inadequate handoffs and avoiding delays, all of which are situations that worsen the situation of patients as others trying to receive care (Hostetter and Klein 1). A number of methods ensuring that there is a smooth flow of patients in hospitals include orchestrating their arrival and discharge through elective procedures, as well as transferring oversight of a patient who is awaiting admission from ER to other units. Eventually, enhancing patient flow might mean putting more effort to accommodate patients’ schedules plus reevaluating how and when these ought to be delivered. Hostetter and Klein (1) claim that this is already taking place in primary care setting, with a rising number of retail clinics especially those embedded in convenience locations such as schools. Therefore, hospitals should also look to implement this in order to ensure there is a proper flow of patients in order to avoid unnecessary confusion.

In conclusion, this paper has discussed some of the dynamics involved in the nursing manager and nursing informatics career. The paper has also discussed some of the challenges and inefficiencies that they face in their respective organizations plus how they can be mitigated. Perhaps as a recommendation to policymakers, they should erect laws that will make this profession more lucrative maybe but increasing their income and also reducing the academic requirements for those who are willing to join the discipline.