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Registered Nurses

The shortage of RNs is really hurting the sector

by Leigh Kelly

It’s an ongoing problem that was difficult to deal with before Covid 19 hit but has been exacerbated now with the lockdowns and mass vaccination programme that is currently underway. It appears that no health care organisation is immune from being affected, albeit to a lesser degree in some places.  As you see, I’ve also been affected with having to cancel all Clinical Updates due to lack of participants. While it is not as dire for me as for facilities, it’s having an impact across the board.

While no one can blame nurses from leaving lower paid jobs for those that are paying more, it’s till disheartening to see. I’m left wondering how this could be avoided because a lot of research around why employees leave their jobs is rarely because of money. You’ll see in this video, that no one mentioned low pay as a reason to leave their job. 

While many do leave for higher wages, there’s still enough evidence to suggest that if a person is happy in their work, they like the culture, and their colleagues, are supported by management, receive recognition for the work they do are better motivators for a person to accept lower pay than leave to chase the mighty dollar.

While receiving higher wages does give short term gain, it may not offer the same amount of satisfaction as their previous workplace. There is still multiple reasons for this but sometimes more money does not necessarily help the person in their day to day life.  

So, what is the cost of choosing more money over happiness and job satisfaction? 

Well, to the individual it may increase their stress levels. Their inner critic may also be reminding them that you left a job they loved for money which has not actually compensated them for that loss. It could make the person sad, regret the decision they made and often as a consequence end up spending the extra money they earned on other ways to try and make them happy.

If you are thinking of leaving your current job, that you love, then take a look at this video.

The new job, with extra money, may not be all it makes out to be. While your current employer may not be able to pay your money, there may be other ways in which your employer can reward you. So, if you get a job offer for more money, before you just jump ship and take the offer, have a talk to your employer. See what they can come up with for you to stay because if you are a valuable employee, they would rather keep you than lose you. Any employer knows that to lose a good employee will cost them up to 3 times your wage/salary to replace you up to 12 months to get the new person up to the level you are at now.

So, my question to you is what are the real benefit to you to leave your current job, apart from money? Do this exercise and you may well change your mind about the extra dollars. 

The art of delegation and direction

by Leigh Kelly

I’ve recently been contacted by a company who is reviewing their RN understanding of delegation and direction especially when working with unregulated staff. I thought I would discuss this topic today because it is something, Registered Nurses need to be mindful of and our responsibilities around this. I wonder how many of us have been on to the NZNC to review what our responsibilities are around delegation and direction?

The NZ Nursing Council describes delegation and direction as follows:

  • Delegation is the transfer of responsibility for the performance of an activity from one person to another with the former retaining accountability for the outcome.
  • Direction is the active process of guiding, monitoring and evaluating the nursing activities performed by another.

While it might be easy to delegate a responsibility, how do you really know the level of knowledge of the person you are delegating to? We are all good at assuming that a person knows, BUT how do we know? Have you monitored or evaluated the person to ensure they have the knowledge and skill to do the job because ultimately you are responsible for the care being delivered? This 3 min video explains it really well

The problem I see is with the amount of paperwork and the physical workload that is now the responsibility of the Registered Nurse. It can become very easy to delegate a job assuming the person knows what to do but lacking the time to monitor and evaluate the caregiver/support worker. 

I can see how easily this can happen as I constantly see on the ‘Facebook platform New Zealand Please Hear Our Voice’, the stress that nurses are under with their workload. Many people work long hours, do not take breaks and get burnt out, so how are you going to give direction to the person you are delegating the task too? It can be tricky.

Even if a person has a Level 2, 3 or 4 qualification, can you be assured they are competent at carrying out the delegated task? Unfortunately, you can’t. So how are you going to ensure the person has the specific training?

One way to get them to do targeted training for the task or tasks they are going to do, online. For instance, if you are dealing with someone in the community who has a tracheostomy, get them to show proof of understanding tracheostomies online. The same goes for any ostomy, including PEG feeding. I know for instance, that on Care Training Online, I have a training module that comprehensively covers these topics. It’s not an NZQA Unit Standard, it’s practical training and understanding of the topic.

So, targeted training is one thing but how are you going to monitor and evaluate their competence so that you are assured they know what they are doing. So here lies the problem. Unfortunately, there’s no other way but to actively assess them doing the job because ultimately, you, the Registered Nurse, is responsible for the care they are delivering.

It’s a very tricky situation but the one thing you must do at all costs, is protect not only your good name but your Practicing Certificate as well. You must not compromise yourself in any way. While I cannot tell you how to do this, as each organisation is different, I can tell you that you have to be proactive and find a suitable way for you to delegate and direct safely so you can be confident the person delegated is delivering safe care.

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