Involving Nurses in Hospital Staffing Decision-Making

A qualitative study that looks at the experiences of nurses who have served on staffing committees.

When I am faced with challenging situations and issues that involve multiple stakeholders, I seek guidance or information from others to make the most informed decisions. This is a practice many health professionals and researchers emulate, and it makes sense to do this, yet when it comes to the topic of nurse staffing in hospital settings, nurses are not usually involved in the process. If they are involved to some degree, it is likely because of a hospital’s pursuit for nursing excellence recognition through shared governance and/or the external pressure of state laws, like mandated nurse staffing committees.

Nurse autonomy and engagement means better care.

Over the years, research has shown how increases in nurse autonomy and engagement can positively benefit patient care and support nurse retention, yet how do these concepts apply to nurse staffing? In what ways are those concepts translated into practice or policy efforts? These were the questions that initially guided me.

Seeking a real voice in nurse staffing policymaking.

In a survey exploring the concept of staff nurse involvement in hospital staffing policymaking, most nurses described feeling powerless. with […]

2024-03-20T10:15:39-04:00March 20th, 2024|nurse staffing, Nursing, nursing research, patient safety|0 Comments
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Why Nurses Assist Falling Patients Despite the Risk

A too-common scenario.

Joe opens his eyes and looks through the window of his hospital room. He has always been early to rise. Even at age 82, he can’t shake the habits he learned when he was young.

“I’m woozy again,” Joe thinks as he sits up in bed. His medication sometimes makes him feel that way. Joe presses the call light so a nurse can help him to the bathroom. The nurses have been reminding him to do that so he won’t fall.

Then he reconsiders. “I can make it on my own. I don’t want to bother the nurses. They need to help the patients who really need it.” Joe moves to the edge of his bed. His walker isn’t nearby, but he urgently needs to reach the bathroom. Still dizzy, Joe holds onto the bed for a moment to keep from falling forward. After a moment, he manages to stand up and walk to the bathroom. As he enters the room, his dizziness returns, and his legs suddenly feel weak.  A feeling of dread washes over Joe as he begins to fall…

Nurse Smith starts her rounds and is looking forward to seeing Joe. He is always up early to greet her with a smile and a joke. As she opens the door to his room, she sees him entering his bathroom without his walker. She moves quickly toward him, but he suddenly sways forward. She knows he is going to fall. Reacting immediately, she grabs him by the torso […]

2024-02-20T10:44:39-05:00February 20th, 2024|Nursing, nursing research, patient safety, Quality improvement|1 Comment
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The Face of Burnout in Nursing: My Personal Story and Lessons Learned

Woman looking at ocean at sunset Photo by Artem Kovalev on Unsplash

Two-and-a-half years ago, I experienced severe burnout in my role as a night shift charge nurse in a cardiovascular ICU. This blog post shares my personal story, highlighting the common ingredients of burnout and the challenges I faced. Through this experience, I learned valuable lessons that can benefit both nurses and the health care industry as a whole.

Where it All Began

Transitioning from a clinical nurse educator to a night shift charge nurse in a new cardiovascular ICU was an exciting opportunity for me. However, it soon became overwhelming due to various factors. These included a surgeon I didn’t see eye-to-eye with, moral and ethical dilemmas in patient care, staffing challenges, and a hostile work environment created by lateral violence from coworkers.

Strained to the Breaking Point

As my anxiety grew, I struggled to meet expectations each night. While prioritizing patient care and my night shift team, I feared for our patients’ well-being. Frequently, we were overloaded with acute post-cardiothoracic surgery patients. Despite my efforts to manage admissions responsibly, I faced constant pressure. Doubts crept in, and I lost trust in myself and my ability to provide safe care.

The emotional toll […]

2023-07-13T11:32:42-04:00July 13th, 2023|career, Nursing, nursing career, nursing stories, patient safety|3 Comments
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Black Boxes in the Operating Room: Improving Quality of Care and Patient Safety

What’s covered in this post?

  • Black boxes record video, audio, and data from multiple sources in the operating room (OR), such as cameras, microphones, patient monitoring equipment, and medical devices.
  • By offering transparency on the multiple simultaneous processes in the OR, black box data can be used to improve safety and efficiency, train staff, and onboard new nurses.
  • The data can be used for retrospective analysis of specific events or aggregate analysis to detect patterns and variations in practice over time.
  • Black box data has been used to improve and standardize OR processes such as handling tissue samples, handoff communication during shift changes, and pre-surgical patient positioning.
  • The data is de-identified and is normally deleted within 30 days.
  • Finding what went right and learning from it is the goal, not pointing fingers.

Figures in the OR as recorded and de-identified by an OR Black Box. Image courtesy Surgical Safety Technologies.

Rebecca McKenzie, DNP, MBA, MSN, RN, assistant vice president of perioperative services at Duke University Hospital, recently spoke with AJN about her hospital’s use of black boxes in operating rooms (ORs) to standardize key processes to improve safety and efficiency, train […]

2023-05-26T15:01:50-04:00May 5th, 2023|Nursing, patient safety, Quality improvement, Technology|1 Comment
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Pediatric Mental Health Tops ECRI’s 2023 Top 10 Patient Safety Concerns

Photo by Eric Ward on Unsplash

Each year, the ECRI Institute creates a list of top 10 patient safety concerns along with actionable recommendations for institutions to reduce these risks.

Some years, the list includes repeat offenders such as medication errors and concerns surrounding staffing. In the past few years, the list has reflected the reality of living during a global pandemic, with 2022’s top 10 concerns including clinician’s mental health, supply chain disruptions, and vaccine coverage gaps. This year’s list moves away from the pandemic somewhat, but still includes some fallout from COVID-19, with the number one concern reflecting a crisis among our youth: pediatric mental health.

According to the report:

“Concern for pediatric mental health was already high during the 2010s due to the growing use of social media, limited access to pediatric behavioral health providers, drug and alcohol use, gun violence, and socioeconomic impact, among other stressors. However, pediatric mental health issues have been exacerbated by the COVID-19 pandemic, with a 29% increase in children age 3 to 17 experiencing anxiety and a 27% increase in depression in 2020 compared with 2016.”

The report lists some recommendations to confront this issue, including securing leadership support and resources to evaluate the organization’s pediatric […]

2023-04-05T12:25:54-04:00April 5th, 2023|patient safety|0 Comments
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Content disclaimer

Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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