Q1:
What is the underlying problem in this case from the perspective of a hospital administration?
Extracted text: caregivins fore Management in Action understanding of job demands going in.216 Many quickly recognize that good pay isn't enough to offset other job factors. As one nurse put it, "Nursing ain't for sissies, and if you choose nursing for the monetary ben- efits and not because you love the profession or love Difficulties Attracting and Retaining Human Capital in the Nursing Profession Imagine a job that pays well above national averages and provides many opportunities for continuing edu- cation, specialization, and career advancement. It al- lows you to be active every day and to make a real difference in scheduling flexibility some describe as "fantastic!"208 Would you sign up? Strong salaries, lifelong learning opportunities, three-day workweeks, and meaningful work are common facets of a nursing career. And yet, people, you will not stay."217 The gender pay gap is another compensation issue in the nursing profession. Although women account for 91 percent of nurses, female RNs earn between $4,000 and $17,000 less per year than their male colleagues. 218 Male RNs also enjoy significant career advancement and mobility advantages over female RNs, an effect de- scribed as a "glass escalator" that takes males in female- dominated professions "straight to the top" of the career ladder while their female counterparts spend their careers climbing lower rungs.219 lives, along with the kind of hospitals consistently report nursing shortages stem- ming from both a lack of applicants and extremely high turnover rates. Turnover seems particularly high newly minted registered nurses (RNS), with among data suggesting approximately 18 percent-30 percent of new nurses quit their first job within a year.209 With all the positives associated with the career, why do hospitals have such a hard time attracting and retain- ing nurses? INTERPERSONAL TREATMENT It's not uncommon for nurses to experience verbal and physical abuse on the job. The mistreatment stems from three primary sources: doctors, other nurses, and patients. The American Medical Association says doctors and nurses have an ethical obligation to ensure their working relationships with one another reflect a "common commitment to well-being" and are "based on mutual respect and trust."220 In spite of this advice COMPENSATION Nursing is one of the college majors with the highest starting salaries,210 with new RNs earning an average of almost $60,000 annually. This salary is competitive when compared to the $49,000 overall average starting salary for new college graduatesl and the U.S. median annual income of around $57,500.212 RNs can earn six- they take night or overtime and the extensive training, skills, and knowledge they operate in an environment where figure annual incomes if shifts But many RNs feel their salaries do not compensate them for the level of responsibility and the physical and emotional demands of the job.21s One of the primary nurses possess, doctors repeatedly question their competence. In a so- cial media rant that went viral, Florida anesthesiolo- gist Dr. David Glener said nurse practitioners were or work as traveling nurses.213.214 "useful but only as minions."221 physically assault nurses. A Virginia nurse recalls surgeon calling him "stupid" and throwing a bloody scalpel at him in the operating room because the Physicians sometimes a reasons cited for high nurse turnover, particularly in early careers, is that new nurses don't have a realistic Human Resource Management CHAPTER 9 371 nurse "didn't have a rare piece of equipment that he needed."222 Bullying is a problem among peers. Studies suggest that 45 percent of nurses. Nurse-on-nurse bullying isn't harmful just to the toward nurse safety. Says Collins, "They've tried to per- suade their bosses to launch major campaigns to pre- vent nurses from getting hurt lifting patients, but their pitch goes nowhere."230 Some hospitals hav cused of trying to minimize or even hide data on inju- ries in response to questions about nurse safety. 231 have been bullied been nurses who experience it-it's also detrimental to pa- tient tient care. Said Renee Thompson (DNP, RN, CMSRN), "when you're being treated in a way that is making you feel badly, When we're not freely communicating with of the healthcare team, it ultimately affects out- comes "223 In an interview with Nurse.com, Cole RESPONSES stons the flow of information. Both patient outcomes and the bottom line suffer when nursing departments are understaffed.32 Still, nurses continue to feel that hospital administrators undervalue them and treat them as disposable labor.23 In response, members comes. Edmonson (RN) added, "it's known that nurse bullying ultimately impacts the quality and safety of patient care being provided, as 75% of nurses state they are aware of errors in patient care or issues created when nurse bul- lying occurs." Patients are a third source of nurse mistreatment. some are resorting to collective action. In March 2018. the California Nurses Association announced that its 18,000 member RNs associated with the Kaiser Permanente whelming majority" to authorize negotiators to call a strike. Members of the union cited severe concerns ealth system had voted by an "over- Heimericks, executive director of the Missouri Nurses Association, says, "I suspect that if Says. nurses if they've been harassed by patients, a with the low standards of care for patients and hospi- tals' "refusal to support a series of RN proposals that would enhance safe staffing and general patient care standards. "234 ask majority would say yes."225 The reason? According to American Nurses Association President Pam Cipirano, nurses' roles often create the illusion, for patients, FOR DISCUSSION that nurses will comply with their demands. Cipriano says "the health care worker is expected to make a good situation out of a bad one," and patients some- times assume nurses "should be able to tolerate what- ever another human being dishes out at them" merely because those patients are under stress.226 Abuse can also turn physical, with survey data suggesting that tween 25 percent and 75 percent of nurses have suf- fered violence from patients, their visitors, or their families. with dien prhano Problem-Solving Perspective 1. What is the underlying problem in this case from the perspective of a hospital administrator? 2. What role do you believe hospital administrators have played in contributing to nursing shortages and high be- nurse turnover? 3. What can hospitals do to increase nurse supply and retention rates? Application of Chapter Content INJURIES ON THE JOB 1. What could hospitals do to create a realistic job pre- Nurses experience frequent and serious work-related injuries. The Bureau of Labor Statistics (BLS) indi- cates more than 35,000 injuries are reported annually among nursing employees, with most stemming from the daily work of moving and lifting patients.228 In spite of a long-held tradition of teaching safe lifting techniques to nursing students, decades of data now show there is no safe technique for manually lifting view before new nurses accept a position? How do you think this might help with nurse retention? 2. What type of training or development might hospitals offer to help reduce nurse turnover? 3. What steps could hospitals take to ensure male and female nurses are given equal opportunities in com- pensation and promotion decisions? how there patients. 229 tents. Some hospitals have invested in nursing staff's phys- 4. Do hospitals have a legal and/or ethical responsibility to invest more money in equipment to prevent work- related nursing injuries? Why or why not? 5. What do you think are the primary reasons nurses ical safety by purchasing specialized lifting equipment similar to that used to lift heavy parts in manufacturing facilities. Hospitals in Florida's Baptist Health System and the Department of Veterans Affairs have reduced nurses' lifting injuries by up to 80 porating these machines, but industry experts say the majority of hospitals have not followed suit. According to James Collins, a research manager at the National Institute for Occupational Safety and Health, hospital workers feel frustrated with the progress being made experience so much mistreatment on the job, and what can hospitals and nurses do to decrease these incidents? percent since incor- 6. Why do you think some nurses are resorting to collec- tive action, and what do you think hospitals might do to proactively advance nurses' interests and avoid nursing strikes? 372 PART 4 Organizing