Statement of the problem:

In recent years John Peter Smith has had the problem of patients not having enough nurses to
treat them. Even after John Peter Smith has received a new CEO that started to make changes
to the hospital the nurses are still working long hours and not enough extra nurse staff.

Objective:
This proposal examines John Peter Smith Hospital issue with nurses working long hours and
nurse short staffing. We then offer a plan to reduce long working hours and reduce the shortage
of nurses.
Sources:
Our data comes from hospital reviews, management resource for hospitals and healthcare
systems, American Nurse Association, library, nurse short staffing/nurse working long hours
graphics and chart.
Details of the problems:
The subsection examines the effects of nurse short staffing and working long hours.

Severity:
In 1998, at Wesley Medical Center in Kansas, with 42 sick patients on the seventh floor, where
five nurses should have been on duty that night, but instead there were only three, Shirley Keck,
61, staff shortage was proven fatal of pneumonia. When Keck was struggling in gasping for air,
her daughter, Becky Hartman, was not able to find a nurse, according to an investigation by the
Chicago Tribune. I kept running out to the nurse station for help, but there was no one around,
Hartman said. I was raising my voice and getting angry. I was so frustrated.
A nurse eventually arrived, but by then Keck had already stopped breathing and suffered
permanent brain damage as result, losing all ability to speak and to care for herself. She passed
away earlier this year.
Hartman believes her mother would still be alive if the hospital had not cut back its nursing staff
in an effort to save money. When nurses are overworked and have no time to do their jobs
correctly, patients like my mother pay the price. Hartman told the Tribune.
Hartman sued the medical center, in one of the first suits ever brought against a hospital for
wrongful death due to understaffing. Hartman recently agreed to drop the lawsuit for a $2.7
million cash settlement. The hospital did not have to admit accountability for Kecks death, and
Hartman was not restricted from discussing the case, as it is often required to do so in medical
settlements.
Causes:
Patients complained about the long wait and quality care.
1) More and more nurses retiring
2) Not enough nursing students being hired

3) Inadequate pay/ benefits

4) Lack of rules being enforced
5) Unorganized staffing units
6) Excessive workload
Needs:
Nurses working excessive long hours and being short staffed is intervening with the patient's
health/care and is giving John Peter Smith a bad reputation which is keeping patients away. By
addressing this problem as soon as possible, we can help assure patients health and care at
the hospital, also restore the hospital's reputation. We must eliminate long working hours and
short staffing for nurses in order for this to happen.
Scope:
The proposed plan will include a thorough assessment of methods, cost and materials,
personnel requirements, feasibility, and expected results.
Phase of the plan:
We can overcome these issues by these three ideas: (1) Prioritize assignments. (2)
Improvement of delegated skill and using unlicensed staff wisely. (3) Involve the family in patient
care.
Prioritize Assignments:
Nurses need to handle the most important task first while preparing a patient for surgery is a top
priority, on the other hand doing paperwork could wait.
Improvement of delegation skills and using unlicensed staff wisely:
When in a tight situation and being understaffed we need to have effective time management
skills. By utilizing the unlicensed staff the nurses can handle the bigger issues. The unlicensed
staff can do paperwork, readings, weigh ins, and measurements. This will improve our patient
care and taking some of the workload off of the nurses.
Involve family in patient care:
You can reduce the workload and increase family involvement. After our loved ones get out the
hospital we have to take of them on our own. We tend to question if we are providing them with
the best care possible. Involving family can increase the comfort level by have practicing proper
care in a safe environment.

Cost of hiring new nurses:

The true cost of hiring a nurse is much more than salary and benefits. According to the U.S.
Bureau Labor of Statistics, the average benefits package costs an employer 30% of the annual
payroll cost. The benefit package, which generally includes health care coverage and paid time
off,(vacations days, sick days, and personal days) costs a hospital approximately $20,000 per
year for each nurse. The average cost of losing a single nurse is equal to about twice the

nurse's annual salary of about $65,000. The hospitals on average loses about 4.9M-7.6M
dollars due to nurse turnover. With help with turnovers hospitals can save an additional
$378,500 for each percentage changed.
Personnel:
The American Nurse Association is determined to maintain the highest professionalism in
increasing the nurse to patient ratio in the hospital. The staff can look forward to planned job
fairs and nurse students up to front recruitment of more students to the nursing field. The staff
can a better benefits to help current staff like wellness gyms,or areas to reduce stress and
fatigue. The cost of so of the improvements to hospital can be prioritize to what is need now and
increase the nurses pay by getting more funding. Get the community more involved with the
hospital increase funding by having community benefits to change the community point view of
the hospital has changed.
Feasibility:
After evaluating your need at the hospital; we feel that the feasibility of this proposal can be life
changing to patients but also cost effect for the hospital. Compared to other County hospitals,
depends on how well does JPS uses it funding?
In the DFW area the American Nurse Association have found from newspapers in the area like
Star- Telegram that JPS uses it money on changes to the hospital instead of improving staffing
issues, patients outview and community outreach. Other hospitals in the area have improved
their standards putting in place our plan so increasing their percentage of low standards to 90%
overall experience of the hospital. The willingness to spread the great new about the hosptial
new standards. Nurses have a more flexibility short shift decreasing the stress and burn -out
rate. The enrollment count of nursing students and new hiree of RNs increased to decrease the
patient to nurse ratio improve the patients experience at the hospital.
Benefits:
Although it may seem counterintuitive to hire more nurses when a healthcare provider is already
struggling with tight budgets in a bad economy, some experts claim that increased staffing can
yield a significant amount of patient safety improvements which will more than pay for the
personnel costs. The key is to look beyond the expenditure versus the expenditure of a
downstream due to the ratio of nurses to patients. The expenses of hiring new nurses should be
viewed as a long-term investment towards avoiding nurse shortages and gain a better quality of
taking care of patients and at a quicker pace.

Conclusion:
Nurses working long hours and nurse shortage has become a threat to the patient's healthcare
and started a bad reputation for the hospital. An assertive plan is needed to ensure the patient's
health care and stay at the hospital, as well as its reputation.
A close look into the proposed plan will show that it will work if the steps of the plan are taken.