Reference no: EM132217372

A Crisis in Nursing Los Rayos del Sol Medical Center is a hospital and surgery center located in Florida. A facility with 500 beds, it has recently partnered with the Mayo Clinic. Los Rayos is experiencing high turnover. The nurse average turnover rate is 14% for hospitals, while Los Rayos has a turnover rate of 21%. New graduate nurses turnover at a rate of 27% within their first year, with an additional 37% of those new nurses wanting to leave. At Los Rayos, new nurse turnover is 40%. The hospital spends an average of 13 weeks to fill a vacant position and thousands of dollars per hire. Turnover often leaves units understaffed and having poor morale and lower quality of patient care. Why are the nurses leaving? Los Rayos strives to provide the highest quality patient care, but it also has to manage costs to comply with government regulations. Thus, over the past 10 years, Los Rayos has made a number of changes. Ten years ago, Los Rayos changed the staffing model. All units had two licensed nurses and a housekeeper. Housekeepers were minimum wage staff that helped nurses do things like washing linens and stocking the nurses’ station with basics. These tasks can take a lot of time away from nurses’ normal job duties of doing rounds, charting, administering doctor’s orders, and helping patients. Los Rayos promoted the housekeepers to health techs, who were supposed to do more patient care tasks, but most were not equipped with the skills. At the same time, Los Rayos reduced the number of nurses by one. This raised staffing ratios from 12 patients to one nurse to 22 patients to one nurse. Other changes included the following: • Eight years ago, Los Rayos cut the annual employee picnic and Christmas party in order to save costs. • Five years ago, Los Rayos expanded nurses’ jobs to engage in activities like cost cutting and quality control. It required nurses to provide three to five cost-saving ideas per year or they would be negatively evaluated on their performance appraisals. • Two years ago, Los Rayos began using tablets for patients’ charts and dispensing medicine. To prevent drug theft, medicine carts were equipped with a new security system that requires nurses to scan the patient’s hospital bracelet with the tablet, select the medication, and confirm the order before the tablet sent the information to the cart and unlocked the needed medicine. While it prevents theft, the process caused frustration to both the nurse and the patient. • A year ago, Los Rayos began requiring all its nurses to take turns developing, planning, and presenting continuing education courses. Nurses are required to complete 60 hours of continuing education annually for license renewal. • Six months ago, Los Rayos changed from 8-hour to 12-hour shifts to reduce costs and allow patients to be closer to their caretakers. However, patients from the maternity and geriatric wards have complained about only seeing nurses at the start and end of shift. Some employees like 12-hour shifts; however, most agree that these shifts are exhausting, and the nurses often state they don’t have the time and energy to “go the extra mile” for colleagues and patients. Discussion Questions 1. How might the changes Los Rayos made affect nurses’ attitudes? What problems to the hospital outcomes might poor nurse attitudes cause? 2. Which of the job attitudes from the chapter do you feel is the biggest contributor to nurse turnover and why? The smallest contributor and why? 3. How might leadership and the personality of nurse managers and administrators be affecting the situation? Be specific. 4. If you were the director of a hospital and going to do a survey of employee attitudes, which attitudes would you include on the survey? Why?