case study: you are a nurse manager in a busy emergency department. you have been working in this department for almost 10 years now and have been in your leadership role for the previous five years. recently, the hospital you work for has undergone major policy changes in regards to rn staffing

Q.1. How a Nurse Manager or Leader Can Impact a Struggling Unit’s Culture when Changes Cause Staff Unrest and Distress

 Staff unrest and distress can undermine their well-being and health.  It can also undermine their critical thinking because high-stress levels deplete their energy. However, the nurse manager in the case study can impact a struggling unit culture that causes staff unrest and distress by identifying and tracking personal stressors. The strategy will help the nurse manager identify mitigation or avoidance strategy. Another strategy for the nurse manager is communicating clearly and concisely and determining what can and cannot be controlled.  Staff engagement will help find a mutually acceptable solution to changes causing staff unrest and distress. Per the case study, experienced nurses feel fatigued because of the constant flow of novice nurses requiring preceptors. In this case, the nurse manager should engage these nurses to identify solutions to preceptor burnout and reduce high turnover rates among experienced nurses.

Q.2. Overview of the first thing that the Nurse Manager of the Unit should do to Address Current Issue

According to the case study, the major problem in the unit is preceptor burnout, which results in high turnover rates of experienced staff. The high turnover rates are attributable to the constant flow of graduate nurses that require preceptors. As a result, staff morale has declined and workplace incivility has increased.  Therefore, the first step is addressing preceptor burnout by engaging them and investing in their continuous development and onboarding process.  Engagement of the preceptors is vital because it will help the nurse manager collaborate with them to identify appropriate interventions. The interventions may range from balancing teaching and practitioner roles, designing well-structured preceptor guidelines, tackling time constraints, and providing peer or organizational support (Bodine, 2018). Other interventions include investing in preceptors’ onboarding process to prevent their burnout and investing in the continuous development of preceptors to equip them with skills to address the unique challenges they encounter in their practice.  Therefore, preceptor engagement will help identify interventions to tackle their burnout and loss of morale.

Q.3. Effects of a Unit’s Culture on Patient Care Delivery

The case study’s organizational culture is not favorable because of the high turnover rates of experienced healthcare workers, reduced workplace morale, and incivility in the workplace. Such a culture undermines patients care delivery and staff morale and satisfaction with their jobs.  Therefore, the Unit Manager should engage the Unit Staff in addressing the Unit’s challenges and designing a culture that promotes effective working relationships. Staff engagement will help create a culture that supports professional growth and sustained performance. Additionally, preceptor burnout will no longer be a problem because individual staff will contribute to addressing the issue using their skills and knowledge. Therefore, a unit culture determines patient outcomes and staff satisfaction.

 A unit culture determines the quality and safety of care accessed by the patient population. Curry et al. (2018) note that an influential organizational culture reduces mortality rates and enhances an organization’s survival in dynamic and complex environments because of the shared behavior, patterns, values, and beliefs. An organizational culture also accelerates improvements and learning and facilitates staff adoption of evidence-based practices. Thus, an organizational culture influences staff performance and patient healthcare outcomes. Equally, organizational culture improves coordination and teamwork.

A positive organizational culture boosts staff satisfaction and organizational performance. The culture creates a perfect environment for staff to innovate and solve problems they may encounter in their practice. An effective organizational culture promotes work balance, internal communication, reward system, employee satisfaction, professional growth, and leadership style. Organization’s productivity will be undermined if a leader compromises these factors.  Therefore, a positive organizational culture ensures that staff with different behaviors, abilities, backgrounds, and personalities collaborates to improve patient care outcomes.

The management ability to satisfy patients and manage human resources influences organizational culture.  Therefore, organizations with constructive cultures promote positive relationships, are achievement-oriented and encourage self-actualization. However, with the rapidly evolving healthcare sector, healthcare providers f