The Nursing Crisis: Improving Job Satisfaction and Quality of Care

Slide Presentation by Linda Searle Leach, Ph.D., R.N., C.N.A.A.

On April 23, 2003, Linda Searle Leach, Ph.D., R.N., C.N.A.A., made a presentation in the Web-Assisted Audioconference entitled The Nursing Crisis: Improving Job Satisfaction and Quality of Care.

This is the text version of Dr. Leach's slide presentation. Select to access the PowerPoint® slides (194 KB).

The Nursing Crisis: Improving Job Satisfaction and Quality of Care

Linda Searle Leach, Ph.D., R.N., C.N.A.A.
Assistant Professor
California State University, Fullerton

Slide 1

The Nursing Crisis: Improving Job Satisfaction and Quality of Care

Linda Searle Leach, Ph.D., R.N., C.N.A.A.
Assistant Professor
California State University, Fullerton

Slide contains a picture of Linda Searle Leach.

Slide 2

Current Conditions

Slide contains a diagram of a repetitive cycle.

• Higher Census.
• Aging Patient Population.
• Shorter Lengths of Stay.
• Increased Patient Load.
• Lack of Collaboration.
• Increase Overtime.
• Stressful Work Environment.

Leads to . . .

• Turnover.
• Unstable Workforce.
• Few Incentives for Experienced RNs.
• Increased Cost of RN staff.
• Declining Morale.
• Quality Concerns.
• Unionizing/Labor Activity.

Leads to . . .

• Aggressive Recruitment.
• Image Campaigns.
• Registry/Traveler Staffing.
• Hiring Bonuses.
• Higher Wage Rates.
• Salary Compression.

Leads back to . . .

• Higher Census, etc.

Slide 3

Increase the Supply of RNs

• Expand educational capacity and opportunity.
  • Increase state and federal support for nursing education.
  • Do not cut budgets that currently fund nursing education.
  • Provide incentives for and access to degree-granting education programs.
• Fund workforce data collection and planning.
  • Systematically compile workforce data.
  • Forecasting models of supply and demand.
• Promote partnerships between service and education.
• More effective recruitment.
  • Recruit future generations.
  • Enhance diversity.

Source: American Organization of Nurse Executives(AONE) Legislative Priorities 2003. Health Care's Human Crisis: The American Nursing Shortage. The Robert Wood Johnson Foundation. 2002.

Slide 4

Increase Retention

• View RNs as strategic assets.
  • Satisfying work relationships.
  • Improve compensation.
• Make positive changes in work environments.
  • Support integration and development of new nurses.
  • Labor saving technology.
  • Ergonomic technology.
  • Adopt characteristics of Magnet hospitals.

Source: Health Care's Human Crisis: The American Nursing Shortage. The Robert Wood Johnson Foundation. 2002.

Slide 5

Increase Retention

• Expand career options.
  • Paid opportunities.
• Strengthen nursing leadership.
  • Support education for managers and administrators.
  • Nurse executives must be key decision-makers.
  • Nurse involvement in decisions.
• Increase visibility of RNs contributions to quality of health care.
  • Decrease individual workloads.

Source: Health Care's Human Crisis: The American Nursing Shortage. The Robert Wood Johnson Foundation. 2002.

Slide 6

State Strategies to Address Workforce Issues

• Increase Supply.
  • Registered Nurses.
  • Master's Prepared Nurses.
  • Faculty.
• Protect Workforce, Ensure Safety.
• Obtain Data for Workforce Planning.

Slide 7

California's Nurse Staffing Legislation

• Assembly Bill 394 (2002).
  • Directs the California Department of Health Services (CDHS) to establish "minimum, specific, and numerical licensed nurse-to-patient ratios by licensed nurse classification and by hospital unit."
  • Little data to drive decision-making process, even less agreement.
  • Increased costs.
  • Expected implementation date: July 2003.
  • Enforcement challenges.

Slide 8

CDHS Nurse Staffing Ratios

Slide contains a table of Nurse to Patient Ratios by Hospital Unit. Nurse means licensed nurse, including RN, LVN, and LPT. For example, General Medical-Surgical unit needs 1:6 nurse to patient ratios; Labor & Delivery needs 1:2; Operating Room needs 1:1, by current law/registration.

Current as of July 2003

Internet Citation

The Nursing Crisis: Improving Job Satisfaction and Quality of Care. Text Version of a Slide Presentation at a Web-assisted Audioconference. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/workforctel/sess1/leachtxt.htm

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