Instructions

How could you make a case to the vice president of nursing for an increase in the number of RNs to staff the pediatric unit? You are a nurse manager for a 30-bed pediatric unit in a large urban hospital. According to the patient classification system used by the hospital, the level of acuity of pediatric patients on your unit is consistently very high and the patient census averages 26. The only pediatric oncologist in town practices at your hospital and has told you in the past that he preferred to have his patients admitted to your unit because of the quality of nursing care provided; thus the unit always has a high number of pediatric patients with cancer. Additionally, two pediatric surgeons have told you that they prefer the care provided on your unit to that provided by the other hospital in town. However, recently, there has been an increase in the number of complaints from families–twice in the past week-and one of the physicians has come to your office to talk about patient care problems. You also sense increased tension and dissatisfaction among the RNs because of increased patient-to-staff ratios and increased workloads. As you analyze the problem, you note the following facts: Although the average patient census for the year is 26, there has been an increased patient census over the last 2 months with up to 32 patients with higher acuity. Quality management studies indicate that the length of stay (LOS) for your unit has increased and is now 3 days longer than the DRG allowable, and readmissions have increased over the past 6 months. The common theme of family member complaints is that “no one seems to know what is going on with my child’s case.” The common theme of recent physician comments is that “I can never find a nurse who knows what is going on.” The nurse manager already has some information from families and physicians about their perception of the quality of care, but it would be important to further verify that the complaints/concerns represent a significant pattern. An important pattern to note would be that both family and physician comments indicate that nursing team members are not communicating effectively with one another. The final piece of information needed by the nurse manager is the staff’s perception of how patient care is being managed on the unit. With the complete picture the nurse manager can make a case to the RNs on the unit that they need to begin to look at their current nursing care delivery model and to determine how it can be improved with currently available resources

Why is a positive parent-school partnership especially important to establish when a child has special needs?

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