Interdisciplinary Plan Proposal

9

Solving Staffing Shortages in Critical Care: An Interdisciplinary Approach

Student Name

Capella University

Course Number: Name of Course

Prof. Name

Date

Solving Staffing Shortages in Critical Care: An Interdisciplinary Approach

Staffing shortages in critical care units, especially during night shifts, pose significant challenges to patient care and nurse well-being. Nurses are often required to manage excessive patient loads, leading to burnout and compromised care quality (Alzoubi et al., 2024). The complexity of this issue necessitates the involvement of multiple disciplines to develop comprehensive and sustainable solutions. This paper explores the staffing shortages in a critical care unit, identifies the need for interdisciplinary solutions, and discusses relevant change theories and leadership strategies to improve staffing and patient outcomes.

Interview Summary

The healthcare organization discussed in this interview is a critical care unit within a large hospital system, which faces significant staffing shortages, particularly during night shifts. These shortages hinder the unit’s ability to function efficiently and affect patient care quality. The interviewee, a Nurse Supervisor, manages the unit’s operations and nursing staff, while also taking on the role of Resource Nurse during understaffed periods to ensure proper nurse-patient ratios.

The primary issue identified is the chronic shortage of nursing staff, especially at night, when nurses are often assigned more patients than recommended—up to four instead of three. This creates a high-risk environment for both patients and staff. Additionally, the absence of APRNs during night shifts further complicates care, as APRNs typically assist with complex patient care and provide oversight for nursing staff. Since they are not available, processing patient orders becomes delayed operationally.

Measures such as float pool nurses, agency nurses, and bonus pay for extra shifts have not solved the staffing problem. While these temporary fixes help fill immediate needs, they don’t solve the underlying problems, like high turnover rates and strained staff. However, according to the interviewee, these solutions do not solve the deeper organizational challenges.

The critical care unit fosters interdisciplinary collaboration regarding organizational culture. For example, we have the ‘Glint’ survey that staff can raise concerns through. In accordance with feedback made regarding the shortage of APRNs to work on evening shifts, management has escalated the APRNs number to work in the shift, proving the organization is one that listens to the staff and creates a spirit of collaboration.

Issue Identification

The critical care unit staffing shortage, especially on night shifts, is a problem that is multifactorial and requires an interdisciplinary solution. What often arises from this is that nurses are expected to care for more patients than they should, and, ultimately, burnout and, at times, patient safety are compromised. In addition, the lack of APRNs on night shifts creates operational inefficiencies and makes the care process complex, leading to nurses having difficulty approaching APRNs to place the patient’s orders.

A staffing shortage is not just a nursing issue; it is an issue for physicians, administrators, and support teams—and an interdisciplinary approach is necessary. The complexity of the issue necessitates input from many different disciplines to design solutions that work to address both the short-term operational challenges and the longer-term staffing concerns. An interdisciplinary approach can do the following: resource allocation is optimized, communication is improved, and the environment is set up to allow each professional to bring his or her expertise to bear on the problem (Igbinenikaro et al., 2024).

Together, these disciplines must work in concert to identify appropriate staffing solutions, such as employing part-time and per diem professionals or indeed better matching nursing shifts and physician scheduling (Igbinenikaro et al., 2024). The organization will be able to develop long-term solutions that meet care quality and operational needs by bringing all the stakeholders to the table.

Change Theories that Could Lead to an Interdisciplinary Solution

Several change theories can guide an interdisciplinary solution to the staffing shortage. According to Cone & Unni (2020), Lewin’s Change Management Model is a structured way of dealing with organizational change. It consists of three stages: unfreezing, change, and refreezing. The first ''stage—'unfreeze'—necessitates the organization's acknowledgment that a change is required and that staffing practices need to change. The "change" stage involves putting the new practices in place, including APRNs on night shifts and better nurse-patient ratios. Last is the "refreeze" stage, which embeds these changes and solidifies them into the organizational culture. Widely used in the healthcare organizations to manage complicated issues like staffing shortages and to increase operational efficiency, Lewin’s model is applied (Paul, 2024).

Kotter’s 8-Step Change Model is centered on leadership in leading the change. The steps are creating urgency, forming a coalition, and communicating a vision for change (Kang et al., 2022). Kotter’s model is especially applicable to building a sense of urgency for the staffing shortage and rallying the key stakeholders—nurses, physicians, and administrators—to align on a common vision for a more sustainable staffing model. Kotter (1996) also states that the model’s focus on communication and empowerment will allow for all staff to participate in the change process.

The complexity theory is concerned with organizations as complex, adaptive systems. This implies that staffing shortages are not easy problems but rather complex, dynamic challenges that must be continuously adapted and worked together to solve. Complexity Theory emphasizes continuous feedback and flexibility in problem solving, which is highly suitable for dealing with the multifaceted nature of staffing shortages (Shi et al., 2021). Interdisciplinary teams are incorporated into the organization to help adapt and refine solutions to staffing challenges as they develop.

Transformational Leadership Theory focuses on inspiring and motivating staff to reach greater levels of performance and collaboration. Transformational leaders create a shared vision, promote teamwork, and encourage professional development (Murage, 2022). When it comes to staffing shortages, transformational leadership can motivate the team to work together to solve problems in new and creative ways while also making the team feel valued and supported.

Leadership Strategies that Could Lead to an Interdisciplinary Solution

Leadership strategies are effective in creating an environment that promotes collaboration and addresses staffing shortages in an interdisciplinary manner. Distributed leadership shares the leadership responsibilities among many individuals in the organization (Jakobsen et al., 2023). The advantage of this strategy is that it gives nurses, physicians, and administrators the opportunity to contribute to decision-making and problem-solving. Distributed leadership can ease the pressure on any one person, and all staff members are involved in solving staffing problems. This collaborative method can help the unit as a whole function better and guarantee that the solutions are rounded and sustainable.

Another key leadership strategy is collaborative decision-making, which encourages input from all levels of the organization. The organization involves nurses, physicians, and administrators in decision-making to ensure that a staffing solution is informed by multiple perspectives. Additionally, collaborative decision-making promotes a sense of ownership and accountability among staff that may improve the effectiveness of the solutions and increase staff buy-in (El Amin et al., 2021).

Fostering a supportive work environment requires mentorship and peer support programs. Newly hired nurses are mentored into the team and supported with the demands of the unit through mentorship and peer support programs that offer emotional and professional support to staff members who are experiencing burnout or stress (Hookmani et al., 2021). These programs make up a culture of collaboration where staff members can count on one another for support during hard times. When staffing shortages cause high levels of stress, peer support and mentorship also help keep morale up.

Conclusion

Staffing shortages in critical care units demand interdisciplinary solutions that meet both short-term and long-term sustainability. Change theories and leadership strategies, such as distributed leadership and collaborative decision-making, can be utilized by healthcare organizations to improve staffing, enhance patient care, and decrease burnout. Ultimately, the best way to address staffing challenges is with a coordinated, team-based approach that will resolve issues in a way that is both effective and sustainable and that supports both patient outcomes and staff well-being.

References

Alzoubi, M. M., Al-Mugheed, K., Oweidat, I., Alrahbeni, T., Alnaeem, M. M., Alabdullah, A. A. S., ... & Hendy, A. (2024). Moderating role of relationships between workloads, job burnout, turnover intention, and healthcare quality among nurses.  BMC psychology,  12(1), 1-9. https://link.springer.com/article/10.1186/s40359-024-01891-7

Cone, C., & Unni, E. (2020). Achieving consensus using a modified Delphi Technique embedded in Lewin's change management model designed to improve faculty satisfaction in a pharmacy school.  Research in social and administrative pharmacy,  16(12), 1711-1717. https://www.sciencedirect.com/science/article/abs/pii/S1551741119310484

El-Amin, A., Hill, J. M., Austin, S. J., & Marks, Q. L. (2021). The way forward: collaborative organisational decision-making.  International Journal of Innovation in Education,  7(1), 17-26. https://www.inderscienceonline.com/doi/abs/10.1504/IJIIE.2021.114907

Hookmani, A. A., Lalani, N., Sultan, N., Zubairi, A., Hussain, A., Hasan, B. S., & Rasheed, M. A. (2021). Development of an on-job mentorship programme to improve nursing experience for enhanced patient experience of compassionate care.  BMC nursing,  20, 1-18. https://link.springer.com/article/10.1186/s12912-021-00682-4

Igbinenikaro, O. P., Adekoya, O. O., & Etukudoh, E. A. (2024). Fostering cross-disciplinary collaboration in offshore projects: strategies and best practices.  International Journal of Management & Entrepreneurship Research,  6(4), 1176-1189. https://www.fepbl.com/index.php/ijmer/article/view/1006

Jakobsen, M. L., Kjeldsen, A. M., & Pallesen, T. (2023). Distributed leadership and performance‐related employee outcomes in public sector organizations.  Public Administration,  101(2), 500-521. https://onlinelibrary.wiley.com/doi/abs/10.1111/padm.12801

Kang, S. P., Chen, Y., Svihla, V., Gallup, A., Ferris, K., & Datye, A. K. (2022). Guiding change in higher education: An emergent, iterative application of Kotter’s change model.  Studies in Higher Education,  47(2), 270-289. https://www.tandfonline.com/doi/abs/10.1080/03075079.2020.1741540

Murage, S. W. (2022). Transformational leadership and performance of public universities in Kenya.  American Journal of Humanities and Social Sciences Research,  6(2), 160-168. https://www.ajhssr.com/wp-content/uploads/2022/02/P22602160168.pdf

Paul, J. (2024). Navigating Strategic Change Process in Healthcare Organizations During Unexpected Crisis.  Medical Research Archives,  12(3). https://esmed.org/MRA/mra/article/view/5213

Shi, Y., Zhai, G., Xu, L., Zhou, S., Lu, Y., Liu, H., & Huang, W. (2021). Assessment methods of urban system resilience: From the perspective of complex adaptive system theory.  Cities,  112, 103141. https://www.sciencedirect.com/science/article/abs/pii/S0264275121000391