II.

Strategic planning is a management tool that helps organizations set long term
goals. It assures that the individu working for the organization together to accomplish
set goal and objective. Discuss your strategic planning based on the management
problems in your workplace that you have identified.

You ara required to use SWOT analysis as a situatinal audit in your strategic planning.

Using the FIVE steps in strategic planning , discuss the steps you would take to solve
your management problems.

Was the planning effective ? Critically discuss your views of the outcome

Give recommendations or suggestion to improve the effectiveness of the strategic

planning process.

Outline of the assignment

 Introduction – the senario of the management problem

We hear many reasons for nurse turnover, the most frequent of these being lower
wages than can be earned in other areas of health care or in other industries. There
are, however, other issues that cause nurses to leave one facility for another or, in
some cases, to leave the field completely. Some of the issues include the burdens of
administrative tasks, a lack of respect from senior management, difficulties dealing with
unhappy physicians, lack of confidence in leadership, poor communication, and lack of
career advancement opportunities. If we address many of these issues and look for
ways to be more flexible in scheduling, we can have a positive impact on nursing staff
retention.

While we in healthcare finance struggle to fill vacant positions within our own
department, we may have lost sight of a looming crisis in a critical sector of our
organizations' workforce--nursing.

.
Obstetrics and gynecology Hospital serdang is having problem of shortage of nursing
staff. The total number staffs in Labour Room is( U29 ) eight staff with midwifery course
and ( U19 ) is eighteen.

Two Staff nurses U29 on each shift , with the assignment one in charged and one
runner. Both of the staff nurse (U29 ) have to supervise the four of U19 . The
assignment of the four U19 is two staff is taking care of five deliveries room each, one
is a potter sending postnatal mother to the post natal ward and the last one receiving
baby in the maternity operation theather when there is lower segment cesarean
section(LSCS ) needed. Hospital Serdang had eighteen deliveries room but operational
ten room only due to shortage of staff. .Maximum deliveries thirty per day and is about
ten deliveries per shift.

Increased workloads, mandatory overtime, high turnover of patient ,the staff burn out
because they have to do double duty in order to let the members taking leave or night
duty off. This scenario become worsen when the particular staff on duty taking medical
leave or on emergency leave.

As a staff of the Labour Room we do understand the work stress, in order to performed
well , we do follow the standards of practice but sometime in lacking of staff we thence
to make mistakes . We cannot function effectively.
  Identification of S.W.O.T analysis as a situational audit in organization

In this situational using the S.W.O.T

Strength

The management do provide us knowledge through attending course . Management

particular is offering degree in nursing to motivated individuals interested in the
nursing/healthcare arena. They also provide continuous nursing education , continuous
medical education to be more knowledgeable s and killful performance They also
offering promotion and increase in salary to a degree holder . The management do
provide advanced equipment to emphasize nurses efficiency.

Opportunities

Department do recruit staff and doctors for further studies , this will provide better
care and knowledge .Better performance in work wise and better paid.

Staff is encouraged to go for several short courses , so that staff have gain knowledge
and skill. Example Infection control course, with this will bring down infection to the
department.

Hospital Serdang is an information technology (IT) hospital it provide new facilities

,high technology and modern equipment and most antenatal mothers choose Hospital
Serdang.

Weakness.

Shortage of staff midwife in Labour Room . Staff wants to go for midwife course but ,
management cannot effort to allowed them

Over flow of patient because modern and new hospital encourage patient to come. We
cannot admit patient more than the bed provided by the system .( IT Hospital )
Threats

Shortage of nuses and this is proven by

According to a report by the Health Resources and Services Administration, 30 states

currently have shortages of registered nurses (RNs). The shortage is expected to
intensify over the next two decades, with 44 states expected to have RN shortages by
the year 2020. Furthermore, the demand for nurses in 2012 is expected to be 2.9
million, up from the 2.3 million that were needed in 2003.

There has never been a more appropriate time to pursue a career in nursing in the
United States. The total job openings, including new jobs and replacing nurses who no
longer are practicing, will be more than 1.1 million from 2002 to 2012.

Shortage of nurses is a serious problem. This problem will make disability of nurses to
provide safe and effective nursing care to patient.

Nurses have to communicate to patient in order to make them understand , but

sometimes we really cannot effort to do so because we don’t have enough time. This
will make decrease on patients satisfaction.

Increased workloads, mandatory overtime, high turnover and lack of time for patient
care have all been cited in numerous studies as major problems impacting work
conditions. Budget cuts have resulted in cuts in support staff/service, increase in
“floating” off-unit, increase in patient loads and having to do more with less. At the
same time, the ability to complete nursing tasks is declining.

Acording to Kristie K. Nakamoto 2004 A Closer Look at the Nursing Shortage in Hawaii
University of Hawaii at Manoa 20% of nurses reported that necessary oral hygiene was
left undone, 31% reported that skin care was left undone, 27.9% reported that teaching
patients was left undone, 39.5% reported that comforting or talking to patients was
necessary but left undone, 40.9% stated that developing or updating care plans was left
undone and 12.7% said that preparing patients and families for discharge was left
undone

* Discussion – the five steps in strategic planning.

 Steps to be taken
 View of the out come.

According to Case, Mowry & Welebob (2002), technology systems installed by hospitals
as part of quality improvement efforts were found to provide significant benefits for
nurses and may provide some solutions to relieving the nursing shortage. Many of the
changes that nurses advocate for are technology systems that decrease the likelihood
of making a medical error. Such technology include nurse scheduling, mobile
communication, messaging functionality, medication administration, clinical decision
support functionality, computerized physician order entry (CPOE), automated nursing
documentation, and computerized patient record (CPR)/clinical data repository (CDR).
These types of technology approaches can be implemented as part of a plan to
increase patient safety and foster a supportive work environment for nurses. The other
benefits that have been noted are nurses spending less time documenting and more
time spent with the patient at the bedside, less overtime, more effective use of allied
health care referrals, better documentation of patient education, less charting of
redundant data and safer patient care due to the ability to chart in real-time.
Although technology systems that increase patient safety may not always
increase nurse efficiency, they can relieve anxiety and enable nurses to provide safer
and higher quality care, which have a positive impact on job satisfaction and potentially
on nurse recruitment and retention (Case, et al. (2002).
To Recommendations

address the nursing shortage for the State of Hawaii we must first start by recruiting and
retaining qualified nursing faculty. Expanding the nursing faculty will in turn increase the
number of qualified nursing students accepted into each nursing program. The increase
in competent, prepared nurses will address the nursing shortage and improve quality
nursing and healthcare in Hawaii. Increasing nursing faculty salaries will attract masters
prepared, doctoral candidates and clinical experienced individuals into the educational
system while retaining present faculty members. In addition, increased nursing
education dollars are needed to increase the capacity of the UH system schools of
nursing.

The shortage can be further addressed by increasing the supply of nurses

through expanded educational capacity and opportunity (Kimball & O’Neil, 2002). Such
ways to accomplish this include increasing scholarships and loans available to nursing
students, increasing partnerships between local hospitals and schools of nursing to
adequately educate our future nurses and by providing future nurses a realistic
expectation of the profession.

Local hospitals must implement and develop ways to make positive changes in
the work environment. Hospital administration must recognize nurses as a valued
member of the health care team and treat nurses as such. Recommendations include
addressing staffing levels, offering flexible scheduling, mentor roles and
ergonomic/safety improvements, promoting professional autonomy in clinical decision-
making, building expertise in specialty nursing care and leadership, developing and
testing new care delivery models, adopt modern information technologies and creating
work options for aging nurses (Kimball & O’Neil, 2002).

The Hawaii State Center for Nursing and the Nurse Shortage Task Force are two
solid programs that promise to address the nursing shortage while exploring ways to
recruit and retain nurses. Registered nurses, hospital administration, other health care
providers, health system planners and consumers must come together in a meaningful
way to create a health care system that supports quality patient care and all health care
providers. Surely solutions to successfully recruiting and retaining competent health
professionals can be sought; the health of our State depends on it.

There is clear evidence that reducing nurse-to-patient ratios leads to safer workplaces,
less stress and higher job satisfactions for nurses. In addition, the ratio of RNs to
patients has a direct impact on nurse burnout, job satisfaction and quality of patient
care.

Technology and the Nursing Shortage

References

Altonn, H. (2002). Nursing shortage worsens with little relief on the horizon.
Honolulu Star Bulletin. [on-line] http://starbulletin.com/2002/05/09/news/story7.html

American Association of Colleges of Nursing. (2002). Strategies to reverse the

new nursing shortage. [on-line]
http://www.aacn.nche.edu/Publications/positions/tricshortage.htm

American Nurses Association. (2001). Analysis of American nurses association

staffing survey. [on-line] http://www.nursingworld.org/staffing/

Buerhaus, P., Staiger, D.O., & Auerback, D.I. (2000). Implications of an aging
registered nurse workforce. JAMA, 283 (22), 2948-2954.

Bureau of Labor Statistics. (2002). U.S. Department of Labor. [on-line]

http://www.bls.gov/

Case, J., Mowry, M., & Welebob, E. (2002). The nursing shortage: Can
technology help? First Consulting Group. [on-line]
http://www.chcf.org/documents/hospitals/NursingShortageTechnology.pdf

Creamer, B. (2003). UH regents entice nursing faculty. The Honolulu Advertiser.

[on-line] http://the.honoluluadvertiser.com/article/2003/Apr/18/ln/ln06a.html
 Creamer, B. (2002). UH offers fast-track nursing program. The Honolulu
Advertiser. [on-line] http://the.honoluluadvertiser.com/article/2002/Sep/06/ln/ln34a.html

Dela Cruz, L. (2002). Not enough caring. Hawaii Business Magazine. [on-line]
http://www.hawaiibusiness.cc/hb102002/default.cfm?articleid=30

Kimball, B & O’Neil, E. (2002). Health care’s human crisis: The American nursing
shortage. [on-line] http://www.rwjf.org/research/researchByArea.jsp?title=Nursing:
%20Transforming%20Care%20at%20the%20Bedside&detailID=1108

Meiers, R. (2004). Health priority issues. Healthcare Association of Hawaii. [on-

line] http://www.hah.org/

Nelson, R. (2002). US nursing shortage a “national security concern.” The

Lancet, 360(9336), 855.

Sawada, K. (2003). New UH center addresses nursing shortage. Pacific

Business News. [on-line]
http://www.bizjournals.com/pacific/stories/2003/07/28/story5.html

State of Hawai‘i Employment Outlook for Industries and Occupations, 2000-2010,

State of Hawai‘i, Department of Labor and Industrial Relations, Research and Statistics
Office.

The Chronicle of Higher Education. (2003). Average faculty salaries public

doctoral/research extensive universities 2002-2003. [on-line]

http://www.ir.fsu.edu/Performance_Indicators/Comparisons/C27.pdf
 lving the Nursing Shortage

05.29.2007

Solving the Nursing Shortage

For years, hospitals all over the United States have experienced a shortage in nurses,
nurse administrators, nurse managers and nurse practitioners. Unfortunately, the
shortage doesn’t appear to be getting any better.

According to a report by the Health Resources and Services Administration, 30 states

currently have shortages of registered nurses (RNs). The shortage is expected to
intensify over the next two decades, with 44 states expected to have RN shortages by
the year 2020. Furthermore, the demand for nurses in 2012 is expected to be 2.9
million, up from the 2.3 million that were needed in 2003.

There has never been a more appropriate time to pursue a career in nursing in the
United States. The total job openings, including new jobs and replacing nurses who no
longer are practicing, will be more than 1.1 million from 2002 to 2012.

The main reasons for the high demand of nurses in this country include an 18 percent
growth in population, an aging, health-obsessed baby boomer population, and extended
life spans. According to a report released in May of 2001 by the Nursing Institute at the
University of Illinois College of Nursing, the ratio of potential caregivers to the people
most likely to need care—the elderly population—will decrease by 40 percent between
2010 and 2030.

The problem is one of simple supply and demand. Demand for nurses will grow by 40
percent by the year 2020, while the supply of nurses will increase by only 6 percent over
the same period. The aging population of nurses in this country is another factor. The
median age of nurses continues to increase, and a large wave of retirements is
unavoidable.

In August of 2002, the Nursing Reinvestment Act of 2002 was signed by President Bush
to address the problem of our nation’s nursing shortage. It was intended to promote
people to enter and remain in nursing careers, thus helping to lighten the growing
nursing shortage. The law establishes scholarships, loan repayments, public service
announcements, retention grants, career ladders, geriatric training grants and loan
cancellation for nursing faculty. Funding for these programs is provided through 2007 by
law.

To address the growing needs of today’s population, at least one college in particular is
offering both undergraduate and graduate degrees to motivated individuals interested in
the nursing/healthcare arena. Founded in 1976, University of Phoenix is one of the
original accredited universities to offer online college education with complete degree
programs by use of the Internet. It is the nation’s largest accredited university, with over
17,000 highly qualified instructors, 170 campuses and Internet delivery worldwide.

University of Phoenix offers two Nursing/Health Care undergraduate degrees: Bachelor

of Science in Nursing (RN license required) and Bachelor of Science in Health Care
Services (BCHCS). The graduate degrees in the same field are: Master of Science in
Nursing (RN license required), Master of Science in Nursing/Family Nurse Practitioner
(RN license required) and Master of Science in Nursing/MBA/Health Care Management
(RN license required).

“The nursing shortage in this country is a major problem, but there are some pluses to
the dilemma,” said Barbara Sanner, the Arizona Marketing Manager for University of
Phoenix. “One of the benefits to the shortage is that you can virtually write your own
ticket, meaning that you can work anywhere in the country, in any environment and the
job pays well.” Typically, starting registered nurses earn salaries in the $40,000+ range.
University of Phoenix’s nursing program has been accredited by the National League for
Nursing Accrediting Commission (NLNAC) since 1989. It is currently seeking nursing
program accreditation by the Commission on Collegiate Nursing Education (CCNE). It is
changing its accreditation from NLNAC to CCNE because most baccalaureate and
higher degree programs in nursing are now accredited by CCNE. Currently in the U.S.,
about 70 percent of baccalaureate nursing programs and 79 percent of master’s nursing
programs are accredited by CCNE.

The BSN program is designed to develop the professional knowledge and skills of
working RNs. One must have a minimum of 30 nursing credits to become eligible for
this program. However, a valid RN license satisfies this requirement. There are 13
courses offered in this program, and three of them have a clinical component. Most of
the courses are online, but students have the opportunity to do some of the class work
in-person in residency programs, for example. Students also have several opportunities
to interact with fellow students.

The curriculum consists of biological, physical and social sciences, which contribute to
the science of nursing and focus on the development of the nurse’s role as caregiver,
teacher and manager of care. All three of the clinical components require spending 20-
45 hours of practicum in five weeks.

“One of the key areas that distinguish us from others is that you can take classes at
night,” Sanner said. “That is a big plus for nurses, and our local campuses try to fit
courses that work for the tough schedule demands that nurses have.”

“We also have a strong foundation in the bio and physical sciences,” Sanner added.
“There is probably a perception in the market place that we don’t have it, but that is not
true. We’re also not just offering courses strictly for nurses going into hospital care. We
have courses that prepare you to become nurse supervisors, managers of small-care
facilities, geriatric wards, etc. We offer a broad basis for different kinds of nursing
opportunities, not just hospital nurses.”
The MSN/MBA/HCM program is intended to provide nurses with the blend of advanced
nursing and business management skills necessary to manage today’s health care
delivery systems. The MBA/HCM curriculum emphasizes the identification, analysis and
solution of multifaceted management problems that require technical understanding and
balanced decision making.
If you are the type of person who is driven by a desire to help people and to make a
difference in people’s lives , pursing a career in nursing might be the perfect career
option. Enrolling in a nursing program such as University of Phoenix’s gives students the
opportunity to aid people and make a very good living while helping to eliminate this country’s alarming shortage in nurses.

About the Author - Que Schafer is a writer for http://www.searchforclasses.com/ To read more of his articles and to learn
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