A registered nurse (RN) is responsible for treating patients, providing advice, and emotional support to them and their relatives. Depending on the specialty, nurses can operate in various settings, such as pediatrics or critical care. Some RNs can work in multiple specialties or provide both primary and specialty care to their patients.
There is a basic framework of duties and responsibilities that RNs have to perform. RNs implement the orders of physicians, administer medication to a patient, perform treatments, and special tests. They are also responsible for documenting the progress of treatment as required by the policy of their healthcare facility as well as state or federal regulations. RNs will also contribute to ordering, interpreting, and evaluating patients’ diagnostic tests for assessing their condition.
Unlicensed assistive personnel (UAP) can offer an essential contribution to the healthcare team under the direction of professional RNs responsible for care coordination. Unlicensed assistive personnel includes nurse aides, assistants, technicians, attendants, and other members of support staff that can operate under the guidance of nurses.
Examples of tasks that UAPs can do in a healthcare setting include simple dressing changes, clean catheterization, or establishing gastrostomy feeding. It is essential to note that UAPs may not re-delegate the tasks that have been assigned to them. The activities of workers operating under the job title of UAP will be inevitably guided by registered nurses who are required to have the education and training on how to delegate the responsibilities to other staff members. Moreover, nurses should have an opportunity to conduct periodic assessments on the effectiveness of UAPs in performing specialized tasks.
Nurses will delegate some tasks and activities to UAPs that do not require specialized knowledge, judgment, or skill. Therefore, UAPs will not conduct initial patient assessments to identify appropriate plans for treatment. Nor will they evaluate the progress of patients or the lack of progress in the plan of care developed for a particular patient. The tasks that will be assigned to UAPs by nurses are likely the ones that do not imply using professional judgment.
Such tasks are usually considered routine for patients, pose little potential risks, do not involve any substantial modification in care from one patient to another, and can be carried out with a fixed outcome. Also, UAPs will perform the tasks that do not involve ongoing assessments, interpretations, or significant decision-making that cannot be logically isolated from the task itself.
While nurses and other healthcare personnel care for their patients on a regular basis, it is essential to ensure that they are also cared for to boost their motivation and workplace satisfaction. A supportive and healthy work environment is a crucial factor in developing positive recruitment and retention practices of the nursing faculty. Stressful work conditions have shown to contribute to shortages in nursing staff. At the same time, supportive environments represent a place where workers feel supported, valued, and encouraged to develop both personally and professionally (Walls, Hockberger, & Gausche-Hill, 2017). Because of this, it is imperative to have a cohesive plan for establishing a positive work environment that will facilitate the effectiveness of nurses in the workplace.
The first step in the plan is concerned with the fair distribution of salaries and benefits to personnel. The value-based purchasing approach can become a new payment model that offers financial incentives to healthcare providers for meeting specific performance measures. The model supports the provision of quality care and underlines the importance of positive clinical outcomes such as good blood pressure, patient counseling, measures to help patients to stop smoking, as well as other aspects targeted at the general improvement of health. Value-based purchasing can be integrated into the plan of sustainable healthcare environments because it makes providers accountable for both the cost and the quality of care they offer in the attempt to reduce the implementation of inappropriate care and rewarding providers who show positive outcomes in care.
The second step is to distribute the workload among healthcare providers fairly. This point is explained by the research findings showing that healthcare personnel who works more than fifty hours per week and during night shifts is more likely to experience workplace stress and show poor performance in terms of care quality (Birhanu, Gebrekidan, Tesefa, & Tareke, 2018). Nursing managers who are usually responsible for developing schedules should collaborate with the nurses and distribute the workload accordingly. It is also necessary to ensure that nurses who can take more shifts are given more opportunities to work and earn more according to the value-based purchasing approach.
A management system can also be integrated to align nurses’ activities with the different levels of diagnosis intensity and the time necessary to care for each patient (van den Oetelaar, van Stel, van Rhenen, Stellato, & Grolman, 2016).
The third step is ensuring the ongoing professional development of nurses to ensure that they can adapt to the new developments in care and can meet the continuously changing demands of the modern healthcare system. Nursing professional development specialists can be hired to help the facility in order to establish a framework for outlining the critical steps in personnel development. It is imperative to remove scope-of-practice barriers to ensure that the developed policies expand the scope of practice as related to the competencies aligned with the level of nurses’ preparation.