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1. As a nurse leader working as a hospitalist nurse practitioner (NP) having a lack of support from top leadership is a current operational challenge my colleagues and I are currently challenged by. Unit nursing directors often look to us to help educate and raise up floor nurses to help increase their bedside and critical thinking skills simply because has nurse practitioners, we have a strong understanding of the potential nurses can rise to and how they function overall. However, nurse practitioners in my current place of employment are not employed or led by nursing leadership or entities. Instead, we work under the Department of Medicine (DOM) which is directed and governed by physicians. The DOM dictates our current workflow and list of expectations to perform while on duty and spending excess amounts of time to dedicate to nursing education is not overtly supported by the current department budget. They view us as physician partners and less like nurses. It puts NPs in a challenging position. We are trained as nurses and want to support the nursing society as much as possible, but we are overwhelmed with our current workloads directed by the DOM, especially in the post-covid era of high patient volume, high patient acuity, diminished work place morale and staffing.
The hospital currently uses team nursing delivery care model which is a new transition for this organization. Prior to COVID, they utilized a primary care nursing model where a single nurse was the primary point of contact and caregiver for a set of patients during their specific shift (Healthstream, 2021). To overcome staffing and paitent acuity challenges that presented during the COVID-19 pandemic, team nursing was initiated and primarily using two nurses and a clinical technician to care for up to eight patients in a pod. In team nursing, nurses typically plan and share the nursing care with the assistance of clinical technicians of all eight patients during their 12 hour shift (Beckett et al., 2021). The clinical technician would be delegated tasks by the nurses to include taking vital signs and assisting with activities of daily living.
2. As a leader to improve the situation, I have been having ongoing discussions with unit nursing directors to go to their leadership to request funding for dedicated nursing educators first and foremost. Sharing an official copy of the job description and taking time to explain that the role of the hired NP within the organizaiton does not provide current opportunities for paid education to floor nurses. As an alternative, I have requested they approve compensation for my personal time to develop education platforms and presentations. Investing in nurisng development programs is key to increasing the education of nurses to improve patient care and outcomes (AONL, 2022). It is improtant for everyone to understand the roles of all team members to improve the efficiency of the organization and individual employee experience (Rose, 2021). Additionally, it is essential to take a team approach to sharing the burdeon of improving the education of the unit. Empowering the nurses to create an education committee, developing a list of topics to learn and teach, and presenting series of topics may help improve the workplace by facilitateing nurses’s autonomy and angency by creating an empowering environment. This idea may have a multitude of benefits to include improving the education of the whole overall unit but also providing opportunities to increase nurse autonomy which has been shown to increase job satisfaction and staff retention (Gotttlieb et al., 2021).
