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Improve nursing culture amid an economic crisis

by Denise Danna, DNS, RN, NEA-BC, FACHE

There are no quick fixes for cutting costs within a facility. System issues and problems often exist that, if resolved, could improve the overall budget. These system improvements take a great deal of time to implement for successful change, however there are some key points for developing a culture of accountability and engaging staff when facing economic perils: [more]

Budgeting for orientation, education, and training

Do you get a little stressed out when it comes time to budget for orientation, education, and training? You might find it helpful running through these questions beforehand:

1. How many orientees does the hospital expect this year?
2. How long is orientation for experienced hires? For new graduates?
3. How many education days does the hospital provide for each staff member?
4. How many mandatory classes does the hospital require each employee take?
5. How many outside training classes does the hospital pay for per employee each year?
6. Does your hospital pay for staff meeting attendance for days the employee is out?

How do you plan your budgets?

Who is accountable to the cost and use of patient supplies?

Are you finding yourself spending more time with a budget sheet, calculator and bottle of Tylenol these days? If you answer yes, that makes you normal as a Nurse Manager. With all your fiscal responsibilities do you ever wonder how much accountability staff should have?

Of course, their first response will be, “you make the big bucks you should take care of the money stuff. I’m here to take care of sick people and be a nurse, not an accountant”. Sound familiar to anyone? You might be wondering, where is Shelley going with this? Think about your role as a manager as it relates to sound fiscal practices in your department. With that in mind, how do you see your role as it relates to holding staff accountable from a fiscal perspective?

Have you wondered what goes on in the mind of the staff nurse when he/she reaches for supplies? You may be hoping they are calculating the cost to purchase the item vs the amount you are actually reimbursed. But, let’s be real here, after all a good professional blog prides itself on reality. When I work my prn shifts as a staff nurse and I am in need of a supply for a patient, my thoughts are (in order of priority);

Do I remember where this item is stored?

  • Will the item actually be there on the shelf?
  • What is going on with my other patients while I am in the supply closet?
  • When can I finally get to the bathroom (ok, maybe this is a number 2 priority)?
  • What time is lunch?

Can you put yourself in the position of your staff as they make selection decisions related to supply use? How can the manager educate and coach staff to lead to a more fiscally realized use of supplies? If the nurse needs one sterile 4×4 for a procedure and they have the following to choose between, how do they make their decision?

Option 1 package with 2 4×4’s
Option 2 package with 4 4×4’s

Some staff will select the item based on which one they see first. Another staff person may consider/rationalize the following;

If a liter of irrigating solution costs the same as a 250cc bottle, maybe the same applies to other supplies.

What do you think your staff consider as they make decisions about selecting supplies for their patients? How have you educated staff to details regarding costs vs reimbursement? If you had the opportunity, what would you implement that would hold staff more accountable to areas related to the costs of providing health care?

National Nurse

A New York Times editorial by Teri Mills, RN, MS, ANP, CNE, that called for a national nurse position, resonated with the public, sparked a federal bill, and galvanized opposition from established nursing organizations.

What do you think of Mills’ proposal to create a National Nurse?

For more interesting reading on the subject check out

Holiday gifts for staff

by Shelley Cohen, RN, BS, CEN

Where does the time go?

Thanksgiving is around the corner and holiday shopping will soon be on everyone’s mind. What are you planning to do for your staff this year to show your appreciation? Some of you have a small group, while others may have more than 100 staff members, which can be very costly for the manager.

What gift ideas have worked well? And what ideas, well let’s just say, didn’t get the reception you were hoping for?