QUESTION:

Complete a Force Field Analysis regarding this shift schedule pattern for RNs and LPNs. Identify driving and restraining forces, assign valences, and indicate whether (and why) you believe this is a good / bad idea.

Please note :A Forcefield analysis is generally portrayed graphically, with the driving and restraining forces in bullets, with arrows pointing towards the idea in the middle.

Thank you.

Case Study: Developing a Nursing Schedule at a Private Long Term Care Facility You represent a family that owns and operates 7 homes for seniors, offering a mix of independent living suites with long term care beds. Currently, you have 6 locations on Vancouver Island and one location in Kamloops. You have decided to open an 8th location in Prince George, based on the existing waitlists for long-term care beds, the stable economy, the position of Prince George as a regional service centre for health care, education, and government, the presence of the university and college. City Council is very supportive as your proposed development fits with their Community Plan. You had initially considered a residence that would contain 68 Independent Living apartments in addition to 50 assisted living /long term care beds. As a result of the Environmental Scan, you have decided to change the mix to 45 Long Term Care beds and 72 Independent Living apartments, as this will reduce the number of nurses you will need to have on shift at any given time. You will need to have one Registered Nurse (RN) on shift at all times - 7 days per week, 24 hours per day, in the Long-Term Care unit. You will also need to have either a 2nd Registered Nurse, or a Licensed Practical Nurse on shift at all times. LPNs are paid less, but are still able to deliver medications and change wound dressings, and other nursing duties as needed. The RN would be responsible for the development of care plans, meetings with family members, etc. Health Care Assistants would be employed to assist with bathing, dressing, and feeding the residents. RNs and LPNs are in short supply. There are virtually no unemployed nurses in the community. Even though the college and university graduate LPNs and RNs every year, they are quickly snapped up by Northern Health. The college and university both partner with Northern Health, and nurses complete their unpaid practical hours at Northern Health Facilities. RNs must complete 1150 practical clinical hours under the supervision of an RN to graduate; LPNs must complete 500 hours. As a result, Northern Health gets the first opportunity to meet and assess the future graduates; students are often given job offers before their practical ends. Nurses who have not chosen a specialty will generally end up working in General Medicine at the hospital. The ratio of nurses to patients is generally 1:11; the patients have a much higher level of acuity than in private long term care facility. At the hospital, it would not be uncommon for up to 8 of those 11 high acuity patients to have concurrent disorders (mental health and addictions, violent dementia). As a result, nurses are now statistically more likely to sustain a violent injury at work than police or security officers. According to Kathy Rush, "Within the first two years, 33 to 61 per cent of new nurses change their place of employment or leave the profession entirely." This is a concerning statistic, which, given the low unemployment level of nurses, Northern Health getting "first pick of the graduating students, and the fact that the average age of a nurse is 45, you must prepare for a significant recruitment challenge. You could engage in international recruitment, but that would be an expensive and lengthy process, as foreign-trained nurses would need to go through a credentialing process in order to be licensed to practice in B.C. Northern Health nurses (not specialists) generally work a modified schedule which, over the course of a year, averages out to 37.5 hours per week. A typical nursing rotation would be work 2, twelve-hour day shifts (7am-7pm), followed by 2 twelve-hour night shifts (7pm-7am), followed by four days off. This schedule has been voted for by the nurses, who prefer longer shifts with more days off, but isn't without its problems. Shifts are busy, and nurses commonly complain that they don't get time to drink a coffee, nevermind take a lunch break. The schedule can result in fatigue, which can increase errors and lower productivity, and on the personal front, creates challenges for childcare, child rearing, and spousal relationships. When asked why they maintain this work schedule, one nurse commented, "You need to get away from the hospital for a couple of days to recover - otherwise you just wouldn't be able to go back." When a nurse is asked for overtime (if another nurse isn't available for shift), this "pulling a double" results in a nurse working for 24 consecutive hours. At your Long Term Care facility, you're considering a different shift schedule, believing it may help you recruit. You want to implement a straight, 37.5 hour work day for your RNs and LPNs, which consists of an 8 hour shift with a half hour unpaid lunch. Shifts would typically rotate as follows: 5 day shifts (7am- 3pm), followed by 2 days off, then 5 evening shifts (3pm-11pm), followed by 2 days off, then 5 night shifts (11pm-7am). Health Care Assistants would also have 8 hour shifts with a half hour unpaid lunch. Shifts would typically rotate as follows: 5 day shifts (7am-3pm), followed by 2 days off, then 5 evening shifts (3pm- 11pm); there are no Health Care Assistants on the night shift