Scenario #1

The medical-surgical unit's typical nurse-to-patient ratio is one staff nurse to 5 patients. We also have one charge nurse for each shift who participates in staff, patient, and daily huddle rounds. The charge nurse also helps staff with things they may need help with, such as admissions, discharges, drawing labs, or starting IVs. The charge nurse can take up to 2 patients, but they must be low-acuity patients due to the charge nurse's many other responsibilities. On one day shift, there were 14 patients on the unit with three staff nurses and one fairly new charge nurse, Betty, scheduled to work. Staff anticipated one discharge for the day and informed of one pending admission from the emergency room downstairs and one around 2 pm from another facility. Being new in her charge role, Betty was already nervous about what seemed like a busy day. When putting together patient assignments that morning, the off-going charge nurse told Betty that one of her day shift nurses, Amanda, had just called in. Betty became teary-eyed and overwhelmed, as she had not experienced this staffing challenge before. As the nurse manager walked onto the unit, she overheard Betty say, "The staff nurses are angry that they may take six patients each, but how am I supposed to take care of extra patients, attend my meetings, and help them with their tasks? This is too overwhelming. I do not know what to do".

Skill Application #1

Opportunity Statement

The current undesirable situation is that Amanda called in, leaving the unit understaffed. Betty is not sure how to navigate this situation effectively, and she and her team are feeling overwhelmed. Failure to manage this situation effectively could result in increased stress and burnout among the nursing staff, compromised patient care due to the high nurse-to-patient ratio, and potential mistakes or oversights in patient treatment. Ideally, Betty would remain calm and focused, prioritize tasks effectively, and manage her emotions to lead her team efficiently.

Social and Emotional Power Skill

Self-management skills would be appropriate for this scenario because they empower nurses to take control to overcome obstacles regardless of discomfort or ambiguity. As a nurse leader in this situation, I would use the SEI skills of self-management to help Betty prioritize tasks, delegate effectively, and ensure that the team is not overworked. I would offer Betty tips on how to organize her day. For example, I could assist Betty in finding a replacement for Amanda while suggesting that Betty ask someone not involved in direct patient care to perform the daily patient rounding, and the daily nursing huddle could be shortened or eliminated. This would free up the charge nurse's time to help the rest of the staff so that each patient gets the needed attention and the staff can handle the situation.

Strength

As a nurse leader in this situation, I would leverage my strength of empathy to provide emotional support and guidance to Betty and the other nurses. This would foster a sense of unity and resilience during this challenging time.

Communication Strategy

I would use active listening as the appropriate communication strategy to build consensus in this situation. I would speak with each nurse one-on-one in private so they could freely voice their frustrations and concerns. I would be nonjudgemental, ensure no distractions, and provide my full attention to each staff member. Active listening would help Betty and the other nurses feel supported and understood.

Based on the above scenario, describe lessons learned while determining the appropriate social and emotional power skill to address the scenario