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Eliminating Healthcare Martyrs

Carrie Vaughan, for HealthLeaders Media, March 26, 2008
I am sure that most of you have heard or even uttered the phrase, "This will go faster, if I just do it myself." While that may be true, it is not always the best option.

Work force shortages are impacting hospitals nationwide, and it is imperative that senior leaders make sure that their staff members are being used appropriately. For example, care extenders like physician assistants and nursing aides can help offset the workload of physicians and nurses. The Bureau of Labor Statistics projects the number of PAs to increase 27% (from 66,000 to 83,000) between 2006 to 2016. And the number of nursing aides will increase 18% during the same time period.

Obviously, these positions are not new to healthcare; physicians and nurses work with these individuals on a daily basis. But are they using them to their full potential? Well, that depends.

State regulations vary on what services these individuals can provide. For instance, some states allow advanced practice nurses to admit patients to the emergency room or prescribe medications while others do not. In addition, nurse practitioners operating solo practices in remote parts of the country work under the supervision of physicians. Some states may require the collaborating doc to conduct regular chart reviews, whereas, the supervision in other states is more relaxed.

The relationship with the supervising doc or nurse also plays a huge role in what services these individuals perform, industry experts say. How much help a nurse or doc is willing to accept from support staff often boils down to time and trust. Let's face it. Training someone new can be a pain. Everything takes longer. You have to answer countless questions. Someone is watching your every move. So, you may forgo training support staff on certain job duties. There is also the trust factor. This is an industry where lives are at stake, so it can be difficult to let someone else care for your patients or handle administrative duties and trust that their work will meet your specifications and standards.

Just about every hospital has a healthcare martyr on staff. You know the one. The person who is bogged down by too many responsibilities (either by choice or necessity), but has a hard time asking for or accepting the help that is offered. They may even be one of your best employees.

One way to help foster a more collaborative atmosphere, however, is through care teams. Experts that I have spoken with advise hospital leaders to schedule the same docs, nurses, and aides to the same shifts. The thinking is that after working day in and day out together they will build trust over time, and physicians and nurses will let these care extenders handle more and more responsibilities. This will not only enable docs and nurses to focus their efforts where they are needed the most, but it can also keep your star employees from burning out.

Editor's note: Tomorrow is the last day to submit your entry for HealthLeaders Top Leadership Team award. So if you think that your senior leadership team is outstanding, submit your entry in either the small (fewer than 100 licensed beds) or community (100 to 499 licensed beds) hospital category. For more details or to submit an entry, visit the TLT Web site.


Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at cvaughan@healthleadersmedia.com.

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