Employees first

Posted on April 16, 2013 by in Job Stories

MIGHTYtEAMThe following is just an opinion and should be judged as such.

This opinion is based on past work experience in a different field. During my time as a restaurant manager, I learned a couple of things.

One thing I learned was that if you decrease your focus on the customer and increase the focus on the employees, all aspects of the business improve.

Restaurants and Hospitals aren’t the same but I think the principal can be applied.

The long-term benefit

In the beginning, it requires a little investment with staffing and time but the long term payoff is good.

The focus became more of how can we HELP YOU take care of the customer instead of how can we take care of the customer.

When we focused on the customer, we always put the employees on a line between us and them.

One example of this was staffing for meal rushes. We always based staffing on historical sales.

This was fine if you did not want growth.

When we started staffing for historical sales plus 10% growth, it was a struggle at first but began to pay off and we started beating previous years sales on a regular basis.

The way I see it working is that, when you put your employees first, they have a greater satisfaction in their job and this effects many other areas.

Let’s apply this to what I have seen in 11 years of nursing in the hospitals, specifically ICU’s since that is what I am most familiar with.

The impression we get is that staffing is based on census and “acuity” (note quotes).

The staffing purse strings are usually so tight in most ICU’s that I have worked in that the strict 2:1 and occasional 3:1 ratios are used based on “acuity”.

If there is too much staff, they are often called off or floated and given assignments on other units.

If there is adequate staff and discharges occur, staff is sent home quickly usually with no contingency for afternoon admissions.

The staffing equation

My belief is that the onsite staff should always have the ability to admit 1 without overloading the ratio and there should be a contingency to admit at least 2 more.

This would mean that a census of 3 would call for 2 onsite and one contingency, whereas a census of 4 would call for 3 onsite and one contingency.

This allows for admission without overloading the nurses and would allow the nurses to give the patients the type of care that we all want to give them anyway but often can’t.

“The hospital would start killing the HCAHPS scores.”

If no admissions occur, this allows the nurses to do the extras that often get left out such at medication education.

After this standard has been in active for awhile, the hospital will begin to see the benefits in multiple areas.

First, burnout will be reduced and employee satisfaction will increase.

This will show a great savings in education and training because turnover will drop drastically.

Census will continue to climb as word of mouth gets out as to how well the loved ones were taken care of in the facility.

The hospital would start killing the HCAHPS scores.

If reimbursements are going to be tied to the HCAHPS as we have been told, this becomes very important.

This is just one area of adjustment but focusing on employee satisfaction really would increase all aspects of the business.

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8 Responses to “Employees first”

  1. Profile photo of John Jackson
    John Jackson
    21 April 2013 at 8:05 PM #

    i agree 100%, most hospitals are going towards, patient satisfaction and leaving the nursing staff in the dust!

  2. Profile photo of LaRissa Tidwell
    LaRissa Tidwell
    22 April 2013 at 11:49 AM #

    As nurses, we need to educate the public about who is taking care of them. Most patients can’t tell the difference between a CNA and an RN unless we tell them. It has been proven that more nurses=better outcomes. The public needs to be taught this in a way that applies to them so that they in turn will demand more nurses. Unfortunately, “the public” also includes insurance companies I’m surprised that the insurance companies don’t demand more nurses, because it would make their costs in the long run go down as well.

    • Profile photo of Greg Meisinger
      Greg Meisinger
      25 April 2013 at 4:08 PM #

      I started out working at a hospital that everyone wore the same color….EVERYONE. My current facility has just gone from wear whatever to color coding by discipline and department. The concept is to make the patient aware of who is coming into the room. Light blue is respiratory, dark gray is nursing, etc. CNO is basing this on best practice studies but there has been a lot of push back by employees.

  3. Profile photo of LisaRN
    LisaRN 25 April 2013 at 10:23 AM #

    I agree whole heartily! I do not understand how management does not get that better staffing guidelines equal better outcomes for facilities and patients alike for all the reasons you listed in this article. We sometimes wonder if our matrix is designed to line some upper managements pockets with bonuses for using less staff yet they ask why our HCAHPS are so low and our turn over rate so high. They ask more and more for less and less and it is not only frustrating but at times becomes unsafe for the patient and nurse alike.

  4. Profile photo of Robin Barry
    Robin Barry
    9 July 2013 at 9:57 PM #

    no telling how much would be gained from error preventions. When you work “short” based on ‘acuity’, census or other measures, how many times did the staff present get paid extra for the staff person shorted? Somebody is making Money in healthcare, but is sure isn’t the nurses or front line staff.

  5. Profile photo of DebyRN
    DebyRN 23 December 2013 at 12:17 PM #

    Please tell me where to get hired in new jersey as a new grad RN?? I am going crazy trying to find a job to get my ” 1 year staffing experience” !! :-(

  6. Profile photo of Chrbui
    Chrbui 24 June 2014 at 7:02 AM #

    It’s crazy that hospitals are so focused on these HCAHPS scores but at the same time we are so understaffed on nurses and techs! How are we supposed to tend to them in a timely manner when we have 6 patients and sometimes no tech. It’s hard enough when we have a tech. And then were not supposed to tell the patients that were short staffed so instead of thinking that we got to them as fast as possible they think we just took our time because we don’t care!

  7. Profile photo of gsmeisinger
    gsmeisinger 29 July 2014 at 6:10 AM #

    I just read an post on Linkedin about grocery store workers fighting to get their CEO reinstated after he was removed by the board that backs up my stance. To see the post, copy the following link into your address bar https://www.linkedin.com/today/post/article/20140728151045-7668018-would-you-fight-to-keep-your-ceo-supermarket-workers-offer-leadership-lesson?trk=eml-ced-b-art-M-3-7742147323952197605&midToken=AQFkUdtHQjbySg&fromEmail=fromEmail&ut=2r57Ta2CY1KCk1.

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