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Consider the questions below. If you have personal experiences or stories related to nursing shortages, staff retention, and the inclusion of CNAs and LPNs in healthcare teams, share examples to support your perspective.a. What are the ethical considerations and implications of using CNAs and LPNs to address nursing shortages, and how do these relate to patient safety, quality of care, and the healthcare workforce?b. In this episode, what ethical principles or values are at stake for hospital administrators, the nurse educator, the nursing team, and the patients?c. Imagine you are a nurse educator or part of the hospital administration team. How would you approach the integration of CNAs and LPNs into your nursing staff to combat the nursing shortage? What ethical principles would guide your decision-making process?
Down towards one point, or maybe having dietary pastries instead of greens.0:33
We need more nursing assistance to more. That’s what we’re proposing here, LaDonna.0:41
We need the support. Dedicating a lift team is doable, but with every department short on staff, it’s going to take maneuvering.0:45
As my nurse leader, Megan has her finger on the pulse of our team’s needs, all while balancing quality of care and hospital policy.0:53
Our bonus is an option. The medical system is hundreds of thousands of nurses, short as it is.1:01
I want to keep the ones that we do have. This hospital is already operating at a deficit.1:08
You’re asking for money that we don’t have. It might be a short term solution, but at least it tells them that they’re valued.1:12
We appreciate them. One reason why I asked Terrence to join us is because he can help us with that.1:19
As a nursing educator, I think he’d have some good insight to contribute.1:26
Well, I know hiring bonus staff for extra work seems like a trend that’s happening around hospitals right now,1:30
but honestly, it’s just going to create more burnout. It’s a salve, not a fix.1:36
Tell me what you have in mind.1:41
Well, I think St Mary’s should consider facilitating a plan for certified and licensed nurses who want to up their skills.1:43
Career planning for nurses who want to move beyond bedside tuition reimbursement or loan forgiveness.1:50
Anything to support them when they’re committed to this hospital.1:56
Another possible route could be to upscale LV ends and utilize seniors to provide support.2:00
What do you think? You want us to retrain nurses to work with unqualified workers with the amount of patients we have at the moment, do we not?2:07
This is way beyond their scope.2:17
It requires a level of critical thinking they’re not trained for, and I don’t have the capacity to train them without taking away from our patients.2:18
Megan Maybe it’s not what you want to hear right now, but you asked me to weigh in on this.2:26
And so this is my suggestion. Well, find a better suggestion.2:29
Okay, let’s take a recess here and think about it.2:32
We also need to take a look at our scope of practice and find a way to manage the delegation in supervision of our LV,2:35
NS and CNAS within legal limits. I think that’s wise.2:40
Let’s regroup in five and come back and find some common ground we can all agree on.2:46
Okay. Have you been down this road before?2:52
It’s not going to work. We’d have to rip all this wiring out, try a different angle.3:00
The fix, I suggest, works. If you could make it work for you.3:05
I’ll give it a go. I’ll try to make it work for me before ruling it out.3:12
Oh. We were waiting for you to discuss seniors and aliens.3:22
Your reservations weren’t wrong. Maybe I could try. Your suggestion wasn’t wrong either.3:27
I was only looking at the use of Libyans. And CNN is one way.3:31
The way it’ll put more strain on my shoulders. And I am sorry. And I want to try to make it work before ruling it out.3:36
We just need to figure out how to implement it in a way that doesn’t place more burden on our ends.3:42
Then we approach the strategy from a patient’s first type of thinking.3:48
I like that putting our patients first means utilizing the resources we have and ones we can attain.3:52
In a way I hope can complement what our friends are capable of and taking a bit of the strain off their backs.3:59
And what are the trade offs that we’re willing to make? Should we go this route?4:05
What are the risks that we incur in this process? Our situation with nurse to patient ratio isn’t sustainable.4:09
We’ve got to at least try something.4:15
Right now, let’s look at where policies are failing the current system that we have and figure out a way that our bedside nurses can compensate.4:17
Now, there’s two ways to tackle this retention and recruitment.4:28
Megan, you’re the closest leader to them in the department.4:32
We rely on you to keep up day to day morale.4:36
The cost of labor and contracting new nurses beyond our budget is a challenge, and it would have to be approved by the CFO and it may not go anywhere.4:39
So let’s touch base in a few weeks and see where we are with retention, and then we will take a look at the recruitment if necessary.4:47
Then patients first, patients first.4:55
Okay, Terrence, if we’re going to do this, we got to do it right.5:01
Okay. Well, as the nursing educator, here’s what I can do. Hey.5:05
I’m so sorry, but we need you on the floor. It’s an emergency, and we got multiple high acuity patients and not enough hands.5:16
We’re doing our best to keep up with two patients of coded. One is died.5:22
Our LV ends have a limited scope of practice with assessment and I need help with all the things I can’t ask the aliens to do.5:27
So I’m sorry. It’s okay. You do? I can. I’ll jump in, provide support until you and the other arms can catch up to your patients.5:35
Go. And right behind you. I’m still here.5:41
Come on in. I just want you to know that all the friends are caught out.5:49
I feel for Mario. The patient that died today was his.5:55
He takes all his patients to heart. If you need me to talk to him or any of the staff, I’m happy to take any heat, if that helps.6:00
Well, thank you, Cleo. Reintroducing LV ends is helping, but I don’t know.6:08
It’s just not enough. Was it really the best solution?6:18
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