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The Staffing Mindset
I originally delivered this speech in July, 2000 at a national conference presented by The Forum on Health Care Leadership. A version of it is featured in Creative Health Care Management's Staffing: Changing the Way We Think, a collection of essays, interviews and speeches examining the staffing problem in hospitals.
A few excerpts:
I can't remember a time, ever, when a staff nurse said, "We had enough help for the work to do today." We have a scarcity mind set in this profession. As a result, every staff nurse every day drives to work saying to herself: "There's not going to be enough help today. I know there's not going to be enough help today and I'm not going to be able to get everything done today. I hope I don't screw up too badly today." Every day, when that shift is over and that nurse is driving home she's saying, "Oh, I didn't do this. Oh, I forgot to do that. I didn't do everything I should have done. My patients didn't get the kind of care they should have gotten and I'm angry about it." We have a population of staff nurses going to work fearful and coming home angry. Every study on nursing satisfaction ends up with the same conclusion: Nurses love to take care of patients; they hate their jobs…
I want to change the way you think about patient care. The mindset we got when we went to school was based on assessment of patient care needs: our grade was linked to the number of needs we were able to find. "What, you only got three needs? That's a 'C'.” "Fifteen needs? That's an 'A'.” Find the needs, find the needs, find the needs. The more needs, the better the grade. At no point was the issue of resources to meet the needs attached to the assessment of needs. We could assess the needs, but decision making about which needs would be met and which ones would not be met was not ever part of the process. . .
I want to talk about workload and staffing and bring some realism into what I consider to be unrealistic and unhealthy mind sets. A unit is not four walls, a med room, a utility room, a desk area, lounge and so on. It's really two groups of people: patients and staff. Patients have needs; staff have abilities, skills, licenses, and job descriptions. The care delivery system is how you get these two together….
We've got a mind set that says when the workload goes up we've got to have more resources. And in point of fact we don't always "got to have more resources". Now nursing is a very busy profession. There's always more work to do than time available. When things go bad that becomes even worse. But even on the best day, when everything was perfect, nurses will say there was more work to do than time available.
© Copyright 2007 Marie Manthey.
Last update: 6/18/2007; 9:51:51 AM.
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