Patient Safety and the Chain of Command in Nursing
The organizational structure of the medical staff in the relevant institutions has been created over many years and has long been tested for all sorts of models and alternatives. However, the patients themselves are not always protected from all possible disadvantages of this system. The chain of command is often too long in the nursing hierarchy, and some vital decisions that require a response from senior officials must be made without delay. However, this is one of the most apparent problems; other equally important ones are considered below in this work.
Clinical practice is a serious and responsible business that requires the attention and high concentration of the employee throughout the shift. In this regard, there is a practice of burnout, the prevention of which is a national imperative (Hellyar et al., 2019). In this situation, if the signs of burnout are not discovered in time by the administration, management, or supervisors, the consequences of a deterioration in their professional qualities or concentration can harm the patient. As a result, research is now being conducted on introducing additional programs that can monitor the emotions of the medical staff within the team. Programs are usually based on interprofessional peer review, one of the main goals of which is to optimize patient outcomes (Hellyar et al., 2019). Another benefit of such research is the identification of skills that prevent burnout. For example, these include an open statement about their problems within the team and the presence of open, trusting communication between employees.
Therefore, as an obstacle to the chain of command, poor communication can also determine the patient’s condition and lead to sentinel events. In a rapidly changing world environment, the importance of effective communication can hardly be overestimated, especially during a pandemic. While each employee has their responsibilities and roles, the process of communicating information to the relevant authorities is equally essential. As the execution of orders occurs vertically from the ruling body to medical institutions, any claims and proposals must go through the entire chain without detours. Since the direct management of the institution is better aware of the specifics of its work than government bodies, it will be able to offer a better solution (Sauer et al., 2019). Patient care can suffer from various disagreements in the structure of the nursing staff when for example, nurses ask for more expensive equipment from the institution’s management due to depreciation, the influx of patients, or other essential reasons.
Various unique features of organizational processes within an institution can act as an obstacle. If a student had an internship in another medical institution with a different internal charter, then in the new place, more time is needed for restructuring. Regardless of possible obstacles, in any case, the most significant attention should be paid to the processes to ensure timely treatment of patients so that their health is not compromised. As a solution, it is proposed to standardize communication using effective communication methods (McDougall, 2017). This approach promotes discipline and teamwork that can prevent a lot of the above personnel mistakes, contributing to more reliable delivery of messages to all structural levels of the medical staff.
The chain of command, and in particular some of its aspects, directly impacts patients’ health. From the apparent explanations for the human factor to the deeper issues of teamwork, burnout, and communication quality, the aspects are studied by researchers to propose new promising tools. Techniques and methods are tested first on small groups of medical personnel to then test the implementation for entire medical institutions. In all such innovations, the most important thing is to maintain a fundamental goal of improving the quality of patient care and their health.
References
Hellyar, M., Madani, C., Yeaman, S., O’Connor, K., Kerr, K. M., & Davidson, J. E. (2019). Case study investigation decreases burnout while improving interprofessional teamwork, nurse satisfaction, and patient safety. Critical Care Nursing Quarterly, 42(1), 96-105.
McDougall, L. (2017). Standardized communication to improve patient safety in the PACU. Journal of PeriAnesthesia Nursing, 32(4), e18-e19.
Sauer, L. M., Romig, M., Andonian, J., Flinn, J. B., Hynes, N., Maloney, R. & Johns Hopkins Biocontainment Unit Publishing Group. (2019). Application of the incident command system to the hospital biocontainment unit setting. Health Security, 17(1), 27-34.