Staffing, optimized

Thank you for publishing "Maintain Optimal Staffing with Position Control" by Michelle Hampton, PhD, RN, CCRN (January 2017). I appreciate tools, such as the position control management tool (PCMT) discussed in the article, that can assist with staffing optimization given the challenges and complexity of productivity management in healthcare today. I applaud the cross-functional utilization ability of the PCMT for nurse executives, departmental leaders, and human resources personnel supporting the team in effective and informed decision making. The innovative design described by the author includes areas of data incorporating staffing grids, optimal pattern reports, position control, position variance, skill mix summary, and full-time equivalent projections. The results noted with the use of sophisticated tools show phenomenal progress, including accuracy of staff need predictions, rapid filling of open shifts, reduction in labor spending, and increases in nurse satisfaction.

One recommendation for improvement is additional information gathering regarding the impact of acuity on workload. With this detail, evidence-based workload levels can be assessed to promote a skill mix appropriately based on identified acuity patterns, as well as education levels. It's been noted in the literature that staffing grids based solely on nurse-to-patient ratios can impact financial and quality outcomes due to wasteful skill mix. The author notes that matching competency and acuity promotes balanced workloads of appropriate skill mix that reduce labor cost while improving productivity and hours per patient day. I wonder if incorporating this additional detail into a PCMT would offer greater transparency and significance to strategic staffing and planning to support optimal workforce management?

Again, thank you for publishing articles that relate to nursing leadership concerns in the current state of the healthcare industry.

-Lorrie Kirby, BSN, RN, CMSRN

Mentoring for the win

I recently read the article "Peer Mentoring: A Grass Roots Approach to High-Quality Care" by Kathryn Fleming, PhD, RN, CPHQ, NEA-BC (January 2017). I'm an experienced RN who's anticipating a future transition into the role of a novice manager. I found this article to be well written and very informative on the bedside approach to mentorship. Many years ago as a new graduate, I received a 6-week internship in critical care. I was mentored by a seasoned fellow nurse, and I had a positive experience. However, enthusiasm for mentoring was low. The mentoring program proposed in the article would seem to increase excitement about mentoring by recruiting those with a passion and developing an organized team with a mission for success. An important aspect of continued quality care is establishing peer mentors who are excited about the role.

I would like to add the need for a quality mentoring approach regarding entry-level management. It's been documented that novice managers are often expected to hit the ground running. This is a far cry from the 6-week orientation we experienced as new bedside caregivers. I appreciate this article and its contribution to building successful peer mentoring programs. As I transition from an expert caregiver to a novice manager, I hope to see more evidence-based guidance for mentoring at the mid-level of patient care.

-Jennifer Harris, BSN, RN

The positive impact of transformational leadership

I'm writing to let you know how impressed I was with "Transforming Leadership for Patient Satisfaction" by Sheri Leonard McRae, DNP, RN, CPHQ, NEA-BC (February 2017). I agree that "leaders who see their staff members as partners and gain their respect will experience better patient outcomes than those who merely direct and reward" as the author states. Although I've worked primarily at the same hospital, I've moved within it to various units and had the invaluable experience to work with leaders who displayed both transactional and transformational styles. I found that working for someone with a transformational style who's charismatic, inspirational, and motivational instead of a transactional leader who just tells you what to do had a big impact on my performance. Who wants to go to work and be "bossed" around? Certainly, not nurses with our varied styles and independent natures. Certainly, not me.

What keeps me at my current job is my leader who sees me as a partner. I can feel the respect. This inspires me to do better, work harder and safer, and keep a positive attitude, even on the busiest days. I believe his leadership style has a ripple effect overall and the patients recognize the difference because we treat them in the same light.

I'm hoping that nurse leaders read this article and make the necessary changes to educate themselves and others on the transformational leadership style. It will have a huge impact on patient satisfaction and the overall success of the hospital. We can modify the adage here that says "a happy wife equals a happy life" to be "a happy nurse equals safe practice equals better patient outcomes equals maximum reimbursement."

-Karen Rock, RN

The article "Transforming Leadership for Patient Satisfaction" by Sheri Leonard McRae, DNP, RN, CPHQ, NEA-BC (February 2017) is informative and relevant to the transformation of the nursing profession. As an experienced bedside RN seeking to take on new leadership roles, I appreciated reading this article. The concept of transformational leadership is well defined, and this article shows its positive effects on patient care. Effective nursing leadership is a medium through which healthcare delivery and consumer demands can be accomplished.

As an ED nurse, I encounter various leadership styles throughout the disciplines. Transformational leadership is used by my director and its effectiveness is deeply valued. My director isn't afraid to put on gloves and remove an I.V line or give a patient a bed pan. She constantly motivates her staff and promotes staff development. As a result, she influences many, inspiring her staff to go beyond the norm. Staff members, patients, and even guests appreciate her presence. Reading this article reinforced to me what I see on a daily basis and the importance of an effective leader. Thank you for sharing this information on leadership transformation for patient satisfaction. Many will benefit from this article.

-Clark Elpenord, RN