Nursing Leadership Project
In this project, the chosen study area is Latifa Hospital, a women, and children hospital that serves the UAE region. Central to this project was a data collection exercise that aimed at establishing the detailed information about the organization including the problems its facing and a proposal of the possible solutions to the identified challenges. The researchers utilized observation and interview of the Nurse-In-Charge as the methods of data collection in the one-week duration that the study took. In essence, a summary of all the activities undertaken and their results forms the basis of this discussion.
PART 1: DATA COLLECTION FINDINGS
Origin and Type of the Organization
Latifa Hospital is a public maternity and children hospital that serves the UAE community as a whole. Its origin dates back to the year 1987 when its name was Al Wasl hospital. In 2012, its name changed to Latifa Hospital, in honor of the mother of the then Vice-President and Prime Minister of UAE, Sheikh Mohammed bin Rashid Al Maktoum.
Mission Statement and Vision
Its mission statement as an institution is to offer consumer-centered, best quality health care services to both mothers and children in a professional manner, serving all UAE and Dubai residents as well as referrals from other parts of the world.
Latifa Hospital’s vision is to become a leading example of an institution excelling in the provision of specialized health care services to women and children.
System Design
The hospital utilizes a functional organizational structure that points out the primary functions undertaken and the managers assigned to those functions. Characteristic of this system is the nature of the chain of command, which in this case is apparent since the managers of low and middle management levels report to the top level managers of the same functionality as theirs. The rationale of this organizational structure is the wide range of services provided by the hospital and the concurrent administrative roles that are essential for its running.
Nursing Delivery System
Latifa Hospital utilizes a total nursing care delivery system in which one nurse is responsible for one patient’s care from the beginning of a shift up to the end of it. Such a care delivery system according to her is useful in this organization due to the sensitive nature of the maternity and pediatrics wards.
Typical Day of the Nurse Leader
According to nurse manager, the typical day’s activities include but not limited to the following:
- receiving hand-over report from the night staff
- conducting a nursing round
- supervise the support staffs responsible for cleaning the maternity ward
- ensuring that all patients
- reporting to the Director of Nursing Services so that he can be up-to-date with the unit’s progress
- updating the inventory
- participate in daily ward round
Key Players of the Organization
The nurse in-charge asserted that they have a range of health care professionals that have been useful in the attainment of the hospital’s objectives. They include the nurses, midwives, medical doctors, pharmacists, nutritionists, clinical officers, physiotherapists, and non-health staff such as secretaries.
Organizational Challenges
From the interview, it was clear that the organization was facing various challenges. One familiar problem to the institution is the large number of documents that a nurse must fill despite the heavy workload. Besides, the issue of nurses taking up non-nursing jobs such as wheeling patients to the ultrasound department was also apparent in the study area. Lastly, the interviewee also reported a significant shortage of nurse specialists within the hospital.
Current Quality Improvement Projects
At the time of the study, the observation was that the organization was helping its employees to adapt to the electronic documentation system. The aim of this project according to the interviewee was to offset the challenge posed by documentation.
Additionally, the organization had the plan of reducing the incidence of mortality due to postpartum hemorrhage. In this project, they encouraged mothers to remain in the postnatal ward for at least a day so that the nurses can monitor for signs of postpartum hemorrhage.
Finally, the organization also had a program of improving exclusive breastfeeding practice among mothers. In this initiative, they encouraged breastfeeding immediately after birth and throughout the stay in the postnatal unit.
PART 2: IDENTIFICATION OF PROBLEM AND SOLUTIONS
From the data collected, it was apparent that Latifa was not devoid of challenges. Of the interest, however, on the hospital’s list of problems is the shortage of specialized nurses. A problem of this kind is ironic to the vision of Latifa Hospital. Such is the case due to its aim of becoming a leading center of providing specialized care to mother and children, which as per now is in jeopardy given the lack of skilled nurses.
That said, the problem is not easy to assume given the impact it has had on the hospital. For instance, it has resulted in a scenario of delayed decision-making, which would have been non-existent with the presence of specialized nursing staff. To worsen the situation further is the fact that it increases nurses’ dependence on medical doctors, who have such busy schedules that they cannot come in time to help rescue the situation. Consequently, there are poor outcomes on the part of the hospital, which negatively affects the reputation of the hospital. In light of such impacts, assessing the problem in practical details and coming up with solutions to this challenge is of the essence.
Literature Review
In the contemporary world, an outcry about the shortage of specialist nurses exists. The same is evident in the prediction made by the World Health Organization of the need for above 1.8 million new nurses worldwide by the year 2020. The situation is even worse, especially in the developing countries. A case in point is the worrying trend that shows the nurse specialists in these countries fleeing to developed countries for better pay and appreciation concerning recognition and salary. In the UAE, the ratio of nurses to the patients in 2012 was 26 nurses for every 1000 patients (Bell, 2014). The problem is significant, as such, that it requires a look at its causes and ways to rectify it. Failure to do so, the health care sector is at risk of struggle with this issue for unforeseeable future.
Firstly, identifying the causes of this problem is of the essence in establishing the plan of solving it. An actual cause of this issue is the low payment that nurse specialists are getting. According to Lam, Fong, and Yuan, (2012), many experts have decided to search for ‘greener pastures’ thereby causing attrition in developing countries. Besides, an aging population is also to blame since the senior nurses are retiring and thus leaving a gap that is not easy to fill. Nevertheless, scholars also cite brain drain as a reason for the shortage of nurses in the developing countries. Lastly, in the UAE, for instance, Bell, (2014) observes that the small number of medical institutions devoted to teaching specialist courses as another possible explanation for this challenge in the region.
That said, one thing that is consistent with all studies tackling this matter is that there are solutions for such problems. For example, Lam, Fong, and Yuan, (2012) are of the opinion that there is an urgent need for investing in nursing education to handle this problem for good. According to her, post-basic courses in specialty areas such as midwifery, pediatrics, newborn intensive care unit and diabetic nursing are some of the course that can be good additions in solving this challenge. Also, bettering the work conditions and the pay given to current specialist nurses is another way that this problem can come to an end. Such an action will motivate the nurse practitioners to remain in their countries other than fleeing from them in search of better-working conditions (Seo&Spetz, 2014). Finally, training sessions for the nursing staffs at the various hospitals can also assist in correcting the situation. A strategy of this kind will ensure that the local capacity to handle the issues is on the increase (Fitzgerald, Kantrowitz-Gordon, Katz, & Hirsch, 2012). Apparently, with such evidence-based practices in place, the problem will be long gone before many realize it.
PART 3: PRESENTATION (POSTER)
Problem
Shortage of specialized nurses is a significant challenge in Latifa Hospital.
Impacts of the Problem Identified
- Delayed decision-making
- Overdependence on medical doctor
- Poor healthcare outcomes
Solutions
- Introduction of post-basic courses in areas such as midwifery and pediatrics nursing
- Improving working conditions, for instance through incentives
- Introduction of on-job training sessions in specialty nursing areas
Steps of Solving the Problem
- Assessing the problem
- Coming up with all alternative solutions
- Analyzing all solutions by weighing their strengths and weaknesses
- Choosing the best option (education/ training the nurses)
- Implementation of the solution
- Evaluation of the whole process
Evaluation of the Progress
- Monitoring for the increase or decrease of the problem indicators (health care outcomes, decision-making practice, and dependence on medical doctors)
Follow-up Plan
- Opening a post-basic nursing training school for specialized courses
- Raise the amount earned by the specialists to encourage more to enroll for such courses.
Conclusion
In closure, the study went according to plan, since the researchers were able to get all the necessary information that they required. However, in future, their expectation is to come up with a more accurate and detailed information concerning the cause and effect of the various phenomena by use of other data collection methods.
References
Bell, J. (2014). More nurses and better education needed to cope with UAE shortage. The National UAE.
Fitzgerald, C., Kantrowitz-Gordon, I., Katz, J., & Hirsch, A. (2012). Advanced Practice Nursing Education: Challenges and Strategies. Nursing Research And Practice, 2012, 1-8. http://dx.doi.org/10.1155/2012/854918
Lam, B., Fong, P., & Yuan, H. (2012). Nursing Shortage: The Facts and Strategies in Macao Society. OJIN: The Online Journal Of Issues In Nursing, 18(1).
Seo, S. &Spetz, J. (2014). Demand for Temporary Agency Nurses and Nursing Shortages. INQUIRY: The Journal Of Health Care Organization, Provision, And Financing. http://dx.doi.org/10.1177/0046958013516583
