The best place to start when planning leadership training courses for your charge nurses.
Leadership training is an essential component to training a charge nurse. Orienting charge nurses to the role means investing time in planning for leadership courses.
This is purely dependent on the organizational role expectations. If your organization decides to train charge nurses to assume managerial responsibilities as well, then you may want to invest the time in planning leadership training courses.
Your best starting point is to summarize the list of duties and responsibilities that you have outlined in your charge nurse job description or charter.
Review this with the nursing leadership team and then categorize them into similar themes, for example, communication, delegation, and conflict resolution, to name a few. After you have done this, you will be able to assess the kinds of leadership training you want to offer your charge nurses.
Of course, leadership training is intensive and ongoing, and your orientation program will cover only the highlights.
But if you really want to sustain leadership development, then you will need to offer additional courses for your charge nurses to attend during their orientation period.
Do not wait to ask your charge nurses to attend these courses too far out of their orientation. Ensure charge nurses attend all the leadership courses at least within the first 180 days of their new role.
At a minimum, provide training courses in:
Editor's note: This was a book excerpt adapted from Charge Nurse Program Builder: Tools for Developing Unit Leaders.
Review the skill sets that are critical for case managers to possess that go beyond those of the traditional staff nurse role.
This article first appeared in HCPro's Nurse Leader Insider, a sibling publication of HealthLeaders.
Not all nurses can be successful case managers. Case managers must possess many skill sets in addition to those needed in a traditional staff nurse role, and might be considered “advanced practice” for that reason. Let’s take a look at the skills believed to be critical to the success of the hospital case manager. The skills needed include:
Decision-making and problem-solving
It is difficult to prioritize these skills, and they may all come into play at various times for effective case managers. Case managers must consider that on any given day they may need to call on many of these skills in order to effectively accomplish their job. It is the combination of these skills and the flexibility of the individual carrying them out that will make the difference. For example, case managers have to be able to work autonomously and make quick decisions. However, those decisions must be communicated to the rest of the case team on an ongoing basis.
Editor's note: This was a book excerpt adapted from Core Skills for Hospital Case Managers: A Training Toolkit for Effective Outcomes by Toni Cesta, PhD, RN, FAAN, and Beverly Cunningham, MS, RN.
Understanding the calculation for a full-time equivalent will help you know how many staff are required to meet the needs of your department.
This article first appeared in HCPro's Nurse Leader Insider, a sibling publication of HealthLeaders.
Developing and monitoring the staffing budget is one of the most, if not the most, difficult responsibilities of the nurse leader. Labor consumes the majority of the financial resources of the organization. Therefore, everyone must act responsibly in order to ensure the financial health of the organization. But how do you know how many staff you need on your position control in order to meet the needs of the department (not too many, and not too few)? That is a $100,000 question!
As a nurse leader, you are expected to know what your average daily census is for your department and staff. Flexing your staffing levels to the volume that you have is key to your department being productive. You may be asking yourself, where does patient safety and quality care come into consideration, instead of just dollars? There are also several evidence-based leadership studies that prove the higher the RN ratio to patient, the lower the adverse outcomes for the patients. The successful nurse leader learns to find the right balance between quality, safety, staff satisfaction, and fiscal responsibility in providing the most effective staffing plan.
What's a Full-Time Equivalent?
The first step to understanding the staffing budget is to understand the calculation for an FTE. An FTE is an employee, or a combination of employees, who work full time, which would be 80 hours per 14-day pay period or for a total of 2,080 hours per year. You can calculate how much any one person consumes of your budgeted FTE allocation by using the following equation:
Hours per day the employee works × Days per pay period the employee works / 80 hours (number of hours an FTE works in a 14-day pay period)
8 hours per day × 6 days per pay period = 48 hours per pay period divided by 80 hours/FTE = 0.6 FTE
12 hours/day × 6 days/pay period = 72 hours/pay period divided by 80 hours/FTE = 0.9 FTE
Hospitals around the country are always looking for new ways to recruit nurses, and some are offering more and more expensive perks to attract and keep nurses.
We hear all the time about nursing shortages, especially in rural healthcare settings. CNNreported this week on some of the more outlandish strategies hospitals are using to recruit and retain nurses. Here are a few examples:
UCHealth operates nine hospitals and over 100 clinics in Colorado, Nebraska, and Wyoming, and they have a staggering 330 openings for RNs. Because the local nursing pool is limited in those areas, they are offering relocation bonuses up to $10,000, and an additional $4000 a year for continuing education. They are offering a Traveler RN program as well, which would allow nurses to do 13-week rotations at different facilities operated by UCHealth.
Inova Health System operates six Washington, D.C.-area hospitals, and they are offering a $20,000 sign-on bonus and up to $20,000 in relocation reimbursement for nurses who live more than 50 miles from one of their hospitals. Nurses that live within 50 miles of their hospital also receive a $10,000 signing bonus.
West Virginia University (WVU) Medicine runs eight hospitals in the state, and they are offering a few different incentives to attract nurses. For nurses that stay with WVU Medicine for more than five years, they receive full college tuition to WVU for both themselves and their children, and partial tuition if they go elsewhere. They also offer a commuter lodging program, which gives nurses that live 60 miles away from their facility a free place to stay in the area.
For more information about how you can recruit and retain nurses in your department, check out these selections from the Strategies for Nurse Managers Reading Room:
Ever since the Harvey Weinstein scandal broke in 2017, there’s been new (and well-deserved) attention placed on sexual harassment, and healthcare organizations are no exception. The industry is rife with examples.
A surgeon cornered a colleague in a cloakroom after a professional society dinner and insisted he was going to walk her to her hotel room. There was a $168 million lawsuit against a California hospital after a surgeon slapped a nurse’s rear daily while saying “I’m horny.” A Denver nurse was sent to prison for fondling female patients while they were sedated. A nurse was pinned to a bed by a patient and had her clothes ripped off and back clawed.
Ideally, everyone could go to work without having to worry about harassment. But since this isn’t an ideal world, healthcare organizations must get proactive about preventing, investigating, and resolving sexual harassment claims and violations.
Kate Fenner, PhD, RN, managing director of Compass Clinical Consulting, specializes in organizational optimization, performance improvement, and regulatory compliance. Anyone who has worked in a healthcare organization can recount a harassment story or allegation, she says. And some organizations are more prone to these problems than others.
“The very public attention currently being paid makes it even more imperative that executives lead their organizations on this pressing issue,” Fenner says. “Prevention, detection, and remediation are the key components of a successful approach. Thoughtful leaders use all three to assure a safe and productive care environment.”
And it’s not just the public and newspapers watching. Government agencies and surveyors are also taking notice.
“Regulators and surveyors (CMS and The Joint Commission) pay careful attention to the news and trends in public interest,” Fenner says. “Allegations of improper conduct, such as that recently lodged against a physician then practicing at a highly regarded medical center, pique regulator interest and focus attention.”
Types of harassment
The U.S. Supreme Court has ruled that there are two types of sexual harassment covered by the Civil Rights Act, which recognizes sexual harassment as an infringement on employee’s civil rights:
Quid pro quo: “Job security, advancement, or benefits are tied to sexual favors. This type includes unwelcome sexual advances, requests for sexual favors, or physical or verbal conduct of a sexual nature that are tied directly or implicitly to employment.”
This type of harassment is fairly straightforward (“Come to my hotel room and we’ll talk about your promotion.”). It also applies to retribution/punishment for rejecting a person’s advances (“Since you won’t go out with me, I’m demoting you.”).
Hostile work environment: “Inappropriate behavior is so pervasive and severe that it permeates the workplace and interferes with the individual’s ability to carry out the duties of the job.”
This type is more subjective and covers a variety of bad behaviors: unwelcome jokes, graphic images, insults, threats, gestures, and touching of a sexual nature. Typically, most quid pro quo cases also include hostile work environments.