This unit my team has been discussing exam 3. This has helped me reflect on how to increase morale of my unit by implementing different activities, perks, recognition, and for coworkers to get to know one another in hopes that it will enhance teamwork/morale. We discussed how each of us would deal with conflict which tends to be to avoid it but deal with conflict at the lowest levels before going up the chain of command. This sounds well on paper, but when emotions get the best of us it can be hard to maintain professionalism. For me I tend to need a little time to process everything that was said or done to determine how I would like to deal with conflict especially in the workplace where we are to work as a team to provide care to patients. Through modernhealthcare’s website I found that healthcare cost has increased with pharmaceuticals being the biggest factor as to why, even though cost has increased in nearly all categories of health care. I find it sad that pharmaceutical companies are gouging at the American people’s pocket especially when a lot of research that is done is funded through government grants, or donations.
This week we discussed risk management and the legal responsibilities of the nurse leader. During the discussion of the emergency department incident it was apparent that many people may point and say there is neglect of the patient when left in four point restraints and not thoroughly inspected for contraband as he had a lighter and caused further injury to himself by burning the restraints.
The importance of this scenario was to not point fingers at everyone but to gather information to paint the larger picture and to see what may need to change; whether that be protocol or retraining of staff. If this behavior trends with any given staff member it may be an indicator that the staff member is not following protocol and is more likely to become a liability for the hospital to keep staffed.
This scenario alone hits home the idea that we should be very knowledgeable on the policies in place so that when something like this does come up not only are we covering ourselves but may point out change that needs to occur in our workplace. Patient safety is our number one priority and incidences like this are avoidable if we do our due diligence.
This unit we discussed what motivational factors we would put into place to create an environment that staff would want to be part of and not leave for a competing position. Sometimes it is the simple things that create a place for people to come and enjoy the work they do. Unrealistic expectations that set us up for failure creates an environment that is toxic as we tend to look to our left and our right to place blame as to why something may have happened. Praise for a good deed or act would help employees realize their hard work doesn’t go unnoticed, and to treat those for their hard work with gifts and public praise. When discussing this with our group it only solidified the similarities that would help increase morale for floor nurses/staff.
Using this in my career I can take these ideas to help implement them in my workplace. Many of these items just needs the initiation and convincing to higher management. The ball has got to start somewhere and if we want that change we may have to be the ones to push the ball. As we progress in our career we need to consider changes that occur in our workplace and how they may affect the units morale and what we can do to maintain a level of morale that keeps our patients safe by having/utilizing proper teamwork.
This week we learned/discussed conflict in the workplace. Many in our group discussions came to the same conclusion when creating steps to address the issue in the workplace. The first step should always be to recognize that there is conflict in the workplace between individuals or groups within. The next step is to if necessary intervene by separating individuals, mediating, or get security involved, and knowing when to get management involved. We also did a bargaining assignment that helped us realize when bargaining pay raises for employees may cause conflict and have financial repercussions to the employer and employees if not done with care as strikes/layoffs, and loss of production could occur.
The movie The Guardian helped us recognize conflict and the use of effective conflict management can create a better environment for both parties involved. It also portrayed poor conflict management skills that not only didn’t resolve issues but made them worse as the film progressed. The take away from for me was that when in a leadership position it behooves us to be respectful, do not public shame, and provide an environment where both parties are safe to discuss problems, concerns, or conflict in the workplace. My hope is that I can recognize when I recognize conflict within myself or others that I will be able to effectively use conflict management that can create a positive outcome.
This week I learned that strategic planning has changed as healthcare leadership changes as well with a focus to look at a large goal and set benchmarks or time frames that are shorter to be more achievable with 6/12/18/24 month time frames that make goals more realistic to reach as CEO’s are able to create the change in this time frame. As a group we discussed strategic planning for what programs could be offered at UVU and how they may be implemented focusing on MSN/FNP programs that could be offered to help alleviate the disparity in Utah as the research has shown that there is a growing need for NP’s in the state of Utah. To implement a strategy as a University it would be quite time consuming to get all the pieces together to implement a new program. From obtaining the staff, budget, physical resources (building, office supplies, technology or programs), clinical sites, accreditation and creating a process to accept applicants into the program that share the same values to support the communities they will likely serve.
Utilizing this information will help me understand that when implementing goals for a large corporation such as many healthcare corporations it takes much more thought and planning to implement the change as it can be much more costly and should take proper steps to minimize negative effects of ideas that may be implemented poorly.
This unit I learned more about myself and how I deal with change by watching Who moved my cheese. This short clip had me connect with each character in different ways. At times I’m like sniff and scurry where I utilize my intuition and instincts to act promptly. In ways I’m like Hem and resist any change and will think of the worst-case scenario, and like Haw I learn to adapt to the change and learn that at times change is necessary to better myself and those I am around. Ultimately, I would say I am like Haw and I’ve been working on looking inward of what I can do to better myself through self-reflection.
The discussion for this week I found that many people were similar in that they felt as if they connected with the character Haw with Hem being a close second in that change can be hard to accept but are capable of recognizing change is necessary to better yourself.
To utilize this information in my nursing practice I will need to be open to the idea of change being a positive movement in my career even though it may be nerve wrecking at times. Another way I can be proactive in knowing that change is inevitable is to be on the forefront of seeking positive change within my career and work environment. It is also beneficial to help others understand the change and help provide guidance so that the change can be more readily accepted and implemented in their career.
- How do you create a monthly budget and how do you decide how much to allot for something?
I create a budget on previous sales within that month to predict the current month expenses for any given product or service provided. Any excess revenue is placed into a saving fund for unpredicted expenses or short comings within the company.
- When you create a budget how do you stick to it?
Making specific budget allotments for each category within the business such as payroll, products, maintenance (building, cleaning supplies, office supplies ect.). When there is a need for going over budget such as employees going in overtime, increased expenses in general excess expenses are pulled from the savings fund for such expenses.
- When you overspend on your monthly budget how do you go about fixing this?
In terms of staffing, utilizing previous years staffing needs we staff to prevent overtime by ensuring that there is no need for specific employees to go into overtime. Some times overspending is required but this is taken into account for next years or month budget and budgeting in the future may require cuts in certain areas.
- What different categories are included in your budget.
Staffing, maintenance/supplies, products
- Do you do monthly budgets, yearly budgets, budgets that extend beyond those time lines, or all the above?
A little of each, the company goes year to year to get a trend of sales throughout the year and what we may expect. Then we go from month to month based off of sales, holidays, and any other events that may require additional staffing or expenses.
- Do you utilize software to make and customize your budget? If so, what software do you use?
For the software that I utilize we use excel to help customize our budgeting needs.
- When creating a budget what your process of approval?
Our process of approval depends on the extent of the needs, for example if we need more staffing a few people will be involved. Outer department managers make the call if extra staff is needed however they are given an allotment of hours for each week which needs to be maintained. If they need to go over the hours allotted then there needs to be higher management such as my self.
- Budgeting helps a company track where a company is investing to increase profits or cut unnecessary spending. When creating a budget are you looking for expected or projected returns from the allocated budget?
Projected returns from an allotted budget is what is expected. We provide a service and that service doesn’t guarantee a profit. We can however track trends within the company to predict a projected profit for the given month.
- At what point will you not fund a project/employee due to loss in profits? (specific percentage or trending loss?)
The point we stop funding a project or employee due to loss in profits is more along the lines of a trending loss. There are bad days/months/years but doesn’t necessarily mean the project or employee is not effective but may be other outlying factors that affect the loss. However each scenario is different and needs to be looked at individually to make the call.
- What are your priorities when creating your budget?
When creating my budget is to be profitable as a business so that we can keep our doors open to the services we provide. We try and create a realistic goal to maintain our budget to profit ratio. The goal is to build the business up and expand to communities in need of our services as a corporation.
- When creating a projected budget, are you utilizing last years budget to income as a reference? And if you do what other factors do you consider that would influence budget to income? (ie holidays or events)
Yes, we utilize last years budget as stated before, and holidays are always considered as the line of business we provide caters toward holidays or events. And each of these holidays/events are taken into consideration utilizing last years holidays/events budget.
- If you have budgeted appropriately, and there is a surplus at the end of a year, what do you do with the extra income?
The extra income is saved into a high yield business savings account which will help fund future budgeting needs, projects, or expansion within the business.
- How do you help your employees work through potential challenges that may arise from budgeting cuts?
We try to keep our employees in the loop of our budgeting cuts or needs. This is done through transparency throughout our team by providing profitable or nonprofitable weeks/months/year. This helps the employees understand the company needs.
- Who all has an input into the allocation of the budget?
This depends on level of which the needs are. If it is simple supplies then we have a designated employee that maintains the budget for supplies. Each department manager makes the call when extra staff is needed within a given percentage over allotted budget, then upper management is consulted.
Retail Store Manager
During my interview I learned that there are many different factors that go into account when creating a budget and as a business grows, they create their own data to give reference to future budgeting needs. This is important to track as it can be easy to let the cost of the business make it non-profitable. It is also important to look at other outliers that may affect a given project/employee from being profitable and not jump to conclusions by not funding a project/employee. Each budgeting cost needs to be considered as it will add up quickly by the end of the week/month/year to ensure the projected income will be greater than the projected budget.
This week we discussed career development, staffing, and reviewed a modern healthcare article. Career development was a reminder that there are different stages when developing our career. Education, experience, leadership opportunities, goals for further development (higher education/ administration), and work with people who will help you grow in your career. Staffing is important as we progress in our career as we may have to help create a staffing schedule for a unit/clinic/hospital. The most important aspect to staffing is to ensure that the unit is taken care of, experienced to new healthcare provider ratio’s to provide a safe environment for the staff/patients.
Our group discussed our goals in our personal career development, and the way our unit staffs. This helped provide perspective of what others long term goals are within the nursing profession, and realistic time frames to achieve them. This makes me think that many others have put some time and effort into planning their career choices to meet their goals. We also discussed the differences in our units staffing needs and realized that many not every unit will staff the same way which makes sense as every unit adapts and changes over time to meet the needs of the specific unit.
This information helps provide a path of knowledge that can be taken into consideration when making long term goals for my nursing career and the insight to what may be required to staff the unit.
This unit I really began to understand where the future of nursing is leading and requires us nurses and future nurses to rely invest into our education because the government body that oversees the funding that is offered for providing services and medicare and Medicaid funding would be withheld from the hospital if the RN who is taking care of the patient does not have their bachelors. Which makes sense why hospitals/corporations are shying away from hiring ADN’s forcing students to pay more for an education that has no increase in pay. APRN’s are also pushing to become sole providers without having to consult or work under a medical doctor as they are advocating that APRN’s provide equitable high quality care with no increase in medical errors/discrepancies.
The team activities provide an opportunity to see another classmates perspective which help me reflect on the different dynamics of the information ultimately playing a role in how I shape or reshape my opinions/beliefs/thoughts. I would say that it didn’t necessarily change my opinion on the subject but that it helped me see different perspectives which I may or may not agree with.
The information will help me understand where nursing is going in the future. The potential for growth in the future of nursing will help me rethink and shape my future goals of education and specializations that are available.
I believe that the current push that is happening for APRN’s is going to effect how healthcare is provided to communities and will over time shape the interactions and co-operations between healthcare providers mainly between medical doctors and APRN’s.
This week I learned much more of the nitty gritty of the financial realm of what it may take to run a unit/hospital. Every penny spent toward a unit is money taken away from profits, or the ability for a hospital to stay open to provide care to patients/community. It would be interesting to see more people go through a budget of a hospital unit to really understand what it cost, and what types of things can not be billed for in the medical profession such as a failed attempt of placing a catheter. I’m interested in performing my interview questions next week for a company that deals with outdoor retail. My brother works for the company and they have really made it a focus to treat their employees well. The Interview for this week was interesting as I talked with my mother in law who helps manage a team at Cadence. I found that some companies are very lenient toward their employees. In a state such as Utah I thought you would see more companies that would be quick to fire when they deal with poor performing employees.
This week I’ve learned that there is much more to running a hospital unit than meets the eye. There is a lot of moving parts within the financial realm. This aspect has opened my eyes to the materials we utilize at work, the work codes we use to show where the funding is going such as continuing education, and orientation. It’s important to get these right as it may take away from potential hours going to the unit for floor nurses/techs.