Introduction
Hospitals are important because we all depend on them for our survival, since we are prone to illnesses at any given time. The hospitals are comprised of individuals who are there to achieve one common goal towards the provision of healthcare services. Currently, the employees who work in hospitals have filed cases in courts because their respective hospitals have denied them work breaks. They feel that their respective hospitals have denied them their rights. This paper will focus on what causes this problem in US hospitals and possible solutions.
Problem Definition
Registered nurses (RN) in the United States are responsible for delivering healthcare services to patients such as administration of medicine and washing the wounds of the patients. In most hospitals, the nurses work on an hourly basis whereby they work under defined work schedules. However, at times, they have to work extra hours due to the increase in workloads (Williams, 2007). For instance, when natural disasters strike, such as earthquakes, there are many casualties, and thus the nurses have to work round the clock in a bid to save as many lives as possible.
During circumstances similar to the ones mentioned above, the nurses are very cooperative, but the problem here is that the nurses no longer get their breaks as stipulated in their work ethics. The nurses had certainly tried to solve the problem with their administrators and when their efforts did not bear any fruits, they resorted to taking legal action against their employers.
Additionally, there were no established channels of communication in hospitals for employees to file lawsuits. Effective human resource management is possible when the administrators can interact with their employees. This is because it is the surest way of understanding the needs of the employees (Brester, 2007).
Causes of Industrial Disputes
The administrators should identify the exact cause of the legal action because politicians to gain political mileage can perpetuate the lawsuits. Brewster (2007) explains that there are several causes of industrial action and this is because there are other underlying issues that might have influenced the nurses to seek the intervention of the judicial system. The first cause of industrial action revolves the wages and salaries. This is the most obvious reason because the cost of living has hiked and the nurses must have plotted to use the argument of overworking as the platform to demand better pay.
The second cause of industrial dispute includes layoffs, which makes employees use the strikes to amend their terms of employment. The nurses who filed the lawsuits in Washington were certainly working on a contract basis and by suing their employers, they hoped to secure their jobs through permanent employment (Williams, 2007).
Consequences of Denying Nurses a Break
Medical practitioners are always busy, but this does not justify their reason for overwhelming their junior staff. In other fields, employees are entitled to one annual leave, but for RNs, they can only get short and frequent breaks. The breaks are important because they allow employees to focus on their individual needs. The nurses spend most of their time with the patients at their own will and therefore it is important to give them their regular breaks as a sign of appreciation for their contribution towards the achievement of their hospital’s goals. For instance, most nurses have families like everyone else and some do not live with them, which means they can only interact with their families during the breaks (Williams, 2007).
Nursing is a reserved career, meaning that one can only pursue it if he/she is passionate about it. However, when hospitals deny nurses regular breaks, they lose their pride and thus, hate their job because they view it as an obstacle to their individual goals (TMB RN (allnurses.com), personal communication, July 26, 2011). This suggests that they will not have any enthusiasm as they discharge their duties. In the end, this negativity will affect their performance and could make them unfriendly to patients; no nurse will work diligently when his/her family is close to being broken.
Thus, hospital administrators should understand that RNs have individual goals that are parallel to those of their respective hospitals. If at any given time those goals are not met, the nurses would not want to be associated with the hospital, and in the end, they will look for work elsewhere. The regular breaks allow nurses to relax and refresh their minds. Besides, the breaks allow them to evaluate their performance and identify specific areas that they need to improve on.
Hospitals’ human resource managers should understand that the quantity of employees’ output is useless if the quality does not meet the required standards. In fact, overworking employees does not increase productivity in any way. This is because it makes the nurses feel confused, and thus they cannot make commendable decisions. Similarly, nurses who work under pressure can make many mistakes, which could result in deaths. For instance, an overwhelmed nurse may administer certain medications to the wrong patient simply because he/she is working to impress the manager.
Boxall and Purcell (2008) argue that breaks are important because they enhance the performance of employees and this is because they are able to come up with creative approaches to improving the quality of output. Interacting with the outside world through social networks and other mediums of interactions earns this creativity. Nurses encounter new challenges in their work, and by interacting with people in other areas and other fields they are able to learn new techniques of handling challenges in their workplaces. Keeping nurses glued to work implies that their knowledge will soon be exhausted once it is not updated, and thus the approaches that they once used to solve problems may not be valid.
Nurses who work on an hourly basis expect to be paid for every extra hour they have worked and if this is not done then they feel that their rights have been violated because their terms of service dictate that they be paid according to the number of hours they have worked. It is also evident that the nurses have not been receiving payment for the extra hours of work (TMB RN (allnurses.com), personal communication, July 26, 2011).
Possible Solutions
Responding to Nurses’ Complains
Before nurses resort to filing lawsuits, they must have tried presenting complaints to the hospitals’ administrators. The administrators should listen to the complaints and thereafter launch investigations. During the briefing sessions, the administrators should listen more and talk less. Listening would help the administrators to understand the situation at hand. The administrators should respond in a very friendly tone to make the nurses feel appreciated and respected and thus, open up.
The human resource department should document nurses’ grievances instead of presenting them verbally. This is because there is a high chance of manipulating oral statements. Moreover, the administrators should inform the nurses about the approaches that they intend to employ towards solving the problem. They should also include the timeframe within which to solve the matter. This would instill a sense of trust in the nurses and thus, they would not consult another party.
Hiring More Nurses
The hospitals should analyze the situation before it gets out of hand and this is because the decline in the nurses’ performance could cause the concerned hospitals to lose their clients to their competitors. The commendable quality of service that has impressed the clients has influenced the need to work for long hours, which has caused patients to flood the health facilities (Williams, 2007). This suggests that hospitals should hire more nurses to reduce congestion in service delivery. Once the nurses have been absorbed into the system, the administrators should seek to establish unique work schedules for each nurse. This will go a long way towards enhancing the performance of the nurses.
Similarly, the nurses have been working for more hours because there is a vacuum in the workforce, and hiring more nurses will help fill the existing gaps. Therefore, the tasks can take less time to complete because the tasks will be broken into manageable sub-tasks. In this light, hospitals should assign nurses to tasks within their capabilities. Guest (2001) agrees that this will help in eliminating errors because individual nurses will handle the tasks that are best suited to them.
Flexible Work Schedules
The hospitals should consider setting up flexible working schedules. This implies that there should be day and night shifts so that the nurses can adjust themselves to cope with their work schedule. There are several benefits of having flexible work schedules. First, the nurses have their obligations in their respective families and private lives. According to Paauwe (2004), some nurses have roles that are more demanding back at their homes, such as being a mother and/or wife, which means they have to create a balance between their careers and family life. With these hard economic times, one job is never enough for a freelance nurse and thus, a defined work schedule will help them to program themselves.
Having flexible working hours can also help the nurses to determine the right time for leaving their house. This will help the nurses to avoid heavy traffic and thus, help them save the money they would have spent to fuel their vehicles. Hospitals should arrange to accommodate nurses who cover long distances to get to work: the hospitals can establish houses for such nurses. Nurses who encounter heavy traffic are stressed before they get to their workstations. When this is added to the stress they get from dealing with patients with different needs, the situation becomes worse.
Human beings are not like robots and thus, when a nurse works for extra hours, his/her body will become exhausted, and his/her lifespan in the organization will decline. For instance, if a nurse were to work for more than eight hours, that nurse would hardly work for more than ten years. Besides, having a clearly defined work schedule eliminates work conflicts that could arise due to clashing schedules. Moreover, the nurses will feel liberated because they are the ones who dictate when they should be working.
Similarly, work schedules are a source of encouragement to the nurses, and in fact, most employees prefer to be their bosses, thus they require minimal supervision. This makes them feel responsible, and hence they know their duties, which make them work hard at their own will because they feel like they own the health facility. Making the nurses their supervisors makes them feel contented about working with the organization and therefore the organization will not lose its reliable nurses to its competitors.
Flexible working hours also reduce instances of absenteeism because the nurses will adjust themselves to fit in the hospitals’ programs, which will eventually improve their performance and concentration. In the past decades, the public has blamed nurses for causing the deaths of patients who were under their care, but studies have shown that the hospital administrators are to blame (Williams, 2007). From another perspective, some nurses opt to work for long hours because they are determined to make ends meet.
The hospital administrators should therefore carry out routine checkups to ensure that every nurse takes the regular breaks as required. Concerning the issue of nurses who overwork to earn more money, the hospital administrators should identify ways of meeting the financial needs of nurses by giving them soft loans. In addition, the hospitals should conduct training seminars for the nurses regarding the significance of taking breaks. The administrators should also review work schedules to meet the nurses’ changing needs. For instance, if a female nurse has an infant, her schedule should be revised so that she can spend the whole day with her baby.
There have been instances where nurses use their work as a scapegoat to evade the challenges they are facing back at home. Such nurses need to be enrolled in counseling programs because ignoring them can unleash their anger on the patients. The problems that arise in most hospitals should be viewed as opportunities of growing towards the hospitals’ destiny.
By engaging in dialogue, the hospital impacts positively on the parties that are involved, thus understanding the problem and the solutions that need to be implemented. In addition, it increases the awareness of the problem, which is difficult to identify without grievances. Solving the problems, which nurses and the entire workforce in the medical field face would strengthen the bond between employees and their administrators. Ignorance would further disintegrate the bond and it would be difficult to realize the goals of each entity. At the end of the conflict, the parties would command respect from each other. In essence, Boxall and Purcell (2008) note that problems in human resource management induce people to review their goals and prioritize them according to their urgency.
Furthermore, the hospitals should consider automating some of the tasks such that there is minimal involvement in the tasks. For instance, the departments that handle health records require efficient automation to retrieve records faster compared to hard copies. Alternatively, Hammonds (2005) advises that hospitals can outsource other no-core services like drug delivery to other companies. Outsourcing some services is generally cheap compared to hiring professionals.
Approaches of Solving Conflicts
In the light of issues arising from denial of breaks to nurses, the first approach to solving conflicts is called competitive stand, where the afflicted party sticks to its position, and thus cannot accept anything less (Paauwe, 2004). This approach is best suited for the nurses because they are a very influential element in Medicare services provision. However, the nurses and the administrators cannot be sure that the solutions would solve entirely the problem because there is a possibility of speeding the decision-making process; a nurses’ strike would have ensured, and the consequences would be fatal.
The second option for nurses would be to collaborate with the administrators because they reckon that everyone is important, and thus they cannot prioritize their needs while ignoring those of others. In this case, involving the nurses in a collaborative approach would serve the purpose because a firm stand would result in boycotts, which in return would result in casualties.
The third option is called compromise, which involves setting the minimum requirements that must be addressed. The idea here is to reach a consensus such that none of the parties will get everything. In this approach, the promises are fulfilled gradually in a uniform manner. For instance, if reforms are introduced in the nursing fraternity they should also be introduced in other areas that are linked with healthcare services.
Accommodative is the fourth approach, which entails omitting one’s needs for the sake of another person’s wellness. The hospital administrators would have to ignore their needs because the challenges are more urgent and can have a great impact on the hospitals and the administrators would eventually bear all the blame. It is important to grant a nurse his/her regular breaks than denying him/her and risk losing a patient’s life.
The last approach is known as ignorance: most hospital administrators in the US are currently using this. This is probably because they knew that the nurses had a higher bargaining power than they did. By being ignorant, they thought the nurses would get tired of airing their grievances, but little did they know that they only fuel their desire to get what they are entitled to.
The nurses would not have sued the hospitals they work for if they had been given an audience in the first place. If they had done this earlier, they would have collectively participated in solving the problem, but since they were ignorant, the nurses decided to look for a lasting solution without the administrator’s consent. The administrators needed to put themselves into the shoes of the nurses because that is the only way they could get a clear picture of what was going on behind the scenes.
It would have been good if the administrators had accepted that the argument presented by the nurses was real. They chose to ignore the nurses because they did not understand the problem. Therefore, hospital administrators should be keen and refer to indicators such as health records, which would have implied the need to hire more nurses to meet the increasing demand for healthcare services. This means that situations do not strike abruptly.
Conclusion
Upon listening to the pleas of nurses, the administrators should not give statements justifying their moves. They should instead sit in round table meetings with the nurses, identify the possible solutions, and consult relevant bodies on matters that seem to be difficult. One expects the administrators to focus on the consequences that would follow if they continue ignoring the reports that nurses present. There, both the administrators and the nurses should analyze the possible solutions discussed in this paper: responding to nurses’ demands, flexible working schedules, and hiring more nurses. The solutions should then be allocated priorities depending on their practicability. This suggests that the most practical option should come first. The parties should also consider the time and the resources that are required to implement each solution. Priority should be given to the solution that is cheap and requires less time to implement.
References
Boxall, P. & Purcell, J. (2008). Strategy and Human Resource Management 2nd ed.). Basingstoke: Palgrave MacMillan.
Brewster, C. (2007). Human Resource Management: European Views and Perspectives. International Journal of Human Resource Management, 18, 769-787.
Guest, D.E. (2001). Human Resource Management and the American Dream. Journal of Management Studies, 27, 977-87.
Hammonds, K.H. (2005). Why We Hate HR. Fast Company, 97, 40-47.
Paauwe, J. (2004). HRM and Performance: Achieving Long Term Validity. Oxford: Oxford University Press.
Williams, J. S. (2007). Introduction to Health Services (7th ed.). Clinton Park, NY: Delmar Thomson Learning.