Health world
Attracting and retaining excellent nurses is a common challenge faced by the nursing departments of many hospitals. In the current situation of shortage of nurse resources in the country and even around the world, this problem is even more difficult.
What can be done to solve the hospital nursing staff problem? The Nursing Department of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology (hereinafter referred to as "Tongji Hospital") has innovatively constructed the "Tongji Nursing Magnetic Management" method with six dimensions, maximizing the value of human resources, and becoming the "heartbeat hospital" for many nurses!
"Magnetic hospitals", that is, in the case of a severe shortage of nurses, hospitals can still attract professional nurses like magnets. What is responsible for this "swimming against the current" success?
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01 Wise Leaders: Transformational Nurse Managers
The Nursing Department of Tongji Hospital has implemented the "Transformation Trilogy" in multiple ways and methods to help the head nurse smoothly transform from a traditional nursing manager to a transformational nursing manager.
By learning new knowledge, you can clarify the direction of your goals. The hospital holds 2-3 standardized management training courses for head nurses and nursing backbones every year to help managers understand the development and management trends of nursing at home and abroad; Organize practical sharing of excellent nursing management cases to enhance the awareness and ability of scientific application of management tools; Provide further study opportunities at home and abroad to help head nurses open their minds and broaden their horizons; Carry out "benchmarking learning" and share excellent management experience.
Through management practice, the learning effect is tested. The director of the nursing department and the chief nurse implement "ambulation" management, go deep into the clinical frontline, listen to the opinions and suggestions of nurses extensively, and help find weak links in clinical practice; Arrange the head nurse to provide services, guidance and assistance during high-risk nursing periods; For typical diseases, nursing experts are organized to implement the overall nursing rounds of the responsibility system, understand the problems existing in specialized nursing, and continuously improve the quality of specialized nursing through the establishment of specialist quality indicators, case analysis, workshops and other forms.
Through comprehensive evaluation, reflect on management effectiveness. Through multi-form, multi-time and multi-dimensional standard evaluation, the head nurse is guided to discover the advantages and strengths in management, develop strengths and avoid weaknesses, and seek further improvement.
02 "Bottom-up" management model
In 2014, the Nursing Department of Tongji Hospital proposed to implement the "shared governance" model, advocating the transformation of the "bottom-up" management model and promoting the direct participation of nurses in nursing management decision-making.
The nursing department selects a nursing team with clear professional development planning ideas and strong execution, and the head nurse and nurses in the ward independently manage the nursing quality, and the nursing department provides corresponding resource guarantee and guidance. Nurses give full play to the autonomy and self-discipline of professional practice, find problems in nursing management and nursing quality improvement in the ward and put forward suggestions for improvement, participate in and monitor the improvement process throughout the process, and evaluate the improvement results.
As of 2017, the hospital has carried out 686 quality control improvements, and developed 56 medical technology nursing innovation projects. Tongji Hospital receives more than 400 proposals from nurses every year through various channels, such as the "HEART" communication mode, the "fragmented" training method, the "online self-appointment" training system, and the "important information morning meeting" recitation system.
03 "Supportive" working atmosphere
A good, healthy and supportive working environment can best stimulate employees' subjective initiative and enhance internal motivation. Tongji Hospital actively creates a supportive working environment and provides a good working atmosphere and strong backing for nurses.
Reasonable allocation of nursing human resources to reduce the work pressure of clinical responsible nurses. Establish a resource nurse database as the most powerful human resource emergency guarantee in clinical practice; Set up a support center to provide 24-hour services such as patient escort examination, specimen pick-up and delivery, and drug transfer, which is greatly convenient for patients; Establish a team of assistant nurses to provide daily care for critically ill patients and ensure patient safety.
Humanized flexible scheduling mode to enhance the professional feeling of nurses. According to the needs of patients and the work feelings of nurses, the nursing department scientifically and reasonably adjusts the nurse scheduling mode to ensure the quality of patient nursing care, and at the same time effectively reduce the frequency of shift handover between nurses, shorten the working hours of nurses per shift, and ensure the physical and mental health of nurses.
Smooth communication channels and care for the physical and mental health of nurses. Set up an angel QQ group to build an online communication platform to encourage nurses to pour out their hearts; Set up a psychological home for nurses, arrange psychological counselors to sit in the clinic, and provide professional psychological counseling and counseling for nurses; Set up "Nurses' Sleep Day" and "Birthday Gifts", and carry out activities such as "Walking into the Rental House" and "Do Not Disturb Tongji" to ensure that nurses have enough sleep, care about nurses' lives, marriage and love, and improve nurses' happiness index.
Develop a nursing performance appraisal network platform to enhance nurses' sense of belonging. The evaluation index of nurse title promotion is linked to the workload, work quality and work effect of clinical nursing, and the 360° all-round performance appraisal completely breaks the identity system and realizes equal pay for equal work.
04 Democratic flat management
The Nursing Department has set up four committees: "Nursing Quality and Safety Management Committee", "Nursing Teaching and Research Committee", "Nursing Training and Happiness Committee" and "Nursing Innovation and Development Committee" to attract nurse representatives and nursing backbones.
Clinical nurses can directly participate in every aspect of nursing management, such as the formulation or revision of nursing systems, process plans, quality standards, etc., giving nurses more opportunities to participate in decision-making to improve clinical nursing practices and working environments, and achieve democratic flat management.
05 Healthy competition: the superior is up, the average is let go, and the mediocre is down
The Nursing Department fully implements post management (see Figure 1), clarifies the career advancement and planning of nurses (see Figure 2), promotes the career development of nurses, formulates job descriptions in detail, clarifies qualification requirements, job responsibilities, training content, assessment indicators and advanced standards, so that people have standards in their hearts, and realizes the benign competition mechanism of "the best are up, the average is let go, and the mediocre is down".
In addition, Tongji Hospital has innovatively set up "teaching supervision posts" to increase the sense of ownership and responsibility of nurses. Since the establishment of this position in 2017, the hospital has 104 teaching supervisors and completed the pre-service training of 713 new nurses.
06 An open platform to enhance professional autonomy
The Nursing Department of Tongji Hospital has continuously optimized the nursing management system to improve the professional practice ability and quality management ability of nurses, so that nurses can gain more professional autonomy.
In terms of improving the clinical decision-making ability of nurses, on the one hand, we should fully create various opportunities to provide nurses with training and education platforms to improve their own quality, such as online classes, distance learning, mobile APP, micro-courses, and continuing education, refresher training, and international exchanges outside the hospital. On the other hand, the patient-centered implementation of the whole process, comprehensive and seamless nursing from patient admission to post-discharge rehabilitation guidance, from PDA bedside care risk assessment, implementation of personalized nursing plan, formulation of care plan for critically ill patients, provision of specialized nursing health education, participation in nursing quality index monitoring, implementation of patient discharge follow-up, etc., the responsible nurse exerts professional autonomy to provide patients with the most appropriate nursing decisions.
The Nursing Department has also set up 12 professional teams such as diabetes, wound/stoma, rapid recovery, pain management, geriatric care, and humanistic care, and the nursing backbone of all departments of the hospital participates in related work. Each team member provides professional, high-quality, and high-quality nursing services for patients, and also breaks down barriers, implements multidisciplinary teamwork, conducts hospital-wide consultations for difficult and critically ill patients, puts forward nursing suggestions, and continuously tracks nursing results. The hospital encourages evidence-based nursing, and all staff actively innovate and practice, and regularly provide guidance and assistance to clinical innovation ideas.
The magnetic nursing culture of Tongji Hospital mainly plays a role in the above six aspects, which are constantly transformed, promoted synchronously, overlapped with each other, and jointly promoted, and finally achieved the "attraction" and "motivation" of nursing staff.
With such an excellent "hard configuration", which nurse is not impressed?
To learn more about selected management cases, welcome to read the health book "In Search of Excellence in Medical Practice" ~ Click on the title to quickly purchase the book