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The Nursing Shortage

Thinking Outside the Box: RESCUE NURSES LEND A HAND

MCCOLLUM, JONI

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Journal of Christian Nursing: October 2004 - Volume 21 - Issue 4 - p 22-25
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In Brief

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Do you struggle to find the resources needed in facing daily work challenges that can leave you frustrated, drained and feeling helpless? Are you familiar with the sacrifice God asked of Abraham regarding his only son, Isaac, offering him back to God (Gen. 22:1–18)? Has God asked you to do something that made no sense to your finite mind? If you answered yes to any of those questions, you can relate to my story.

I have been face-to-face with God, wondering why he would ask me to choose between obedience to him and what was important to me. Little did I realize that obedience to God would open the door to unlimited resources. In my quest for obedience, God taught me to look to him for the resources I would need.

God was leading me to an excellent place, but to get there I had to learn to be obedient. Several years ago, I felt God asking me to give up my career as a nurse manager, something I had worked for years to attain. After prayer and hesitation, but sensing God's leading, I made a big career move—back to bedside nursing. Following nineteen years of nursing, and ten years in management, I started back at the beginning of the career ladder. My colleagues were confused by my decision. I appeared to be slipping backwards, not moving forward, in my career. I couldn't make sense of it—I only knew that I was being obedient. Later I discovered that God led me to an obscure place to teach me what I could not learn anywhere else.

In the past I took great pride in the fact that I was independent, self-sufficient, competitive and tenacious. What I had not learned was how to be dependent on God or on others. The first lesson God taught me in my quest for obedience was humility. I suddenly found myself doubting my nursing abilities. Was I too old to care for patients? I felt physically and emotionally drained at the end of each shift. I needed to be alert to make split-second decisions that could mean the difference between life and death. I recall thinking that there must be a better way to care for patients, but I couldn't see how. The burden was overwhelming.

Questioning why God had brought me to this place, I assumed a constant state of prayer. I began my days early with prayer and Bible reading. I pleaded with God throughout the day for the resources I needed to care for my patients. Over and over again God reminded me, “In all these things we are more than conquerors through him who loved us” (Rom 8:37). I was learning to depend on God, although I didn't feel much like a conqueror. I began to gain a new respect and admiration for the nurses and others who worked side-by-side with me. I watched in amazement as God answered my prayers with unexpected and tangible help when a coworker lent a helping hand at just the right moment. God used those months to set me apart and teach me how much I needed others, at that time a foreign concept. Long days of obedience and dependence would open many future doors.

Five months later, God again opened the door to management. Unlike the past, this time I was not the one seeking the position; the position came to me. My manager, Cheryl Rice, had been running a unit and a half for several years. When the hospital decided to expand the beds to two complete units, she accepted an offer to manage one of the units. I was approached to consider managing the other unit and expanding the services from twenty-one beds to forty The units would be sister-units and primarily offer services for cardiac medicine patients. I accepted the challenge, and God used this opportunity to change my world.

My lessons in dependence began to pay off. Cheryl and I entered into a partnership and decided to run the units as one big unit instead of independent operations. We combined our staff resources and divided up the day-to-day operations of the units. Neither of us had functioned in this capacity as managers before, nor did we know anyone who had. We became pioneers in an endeavor that became so rewarding we vowed we would never work independently again.1

Our first challenge was opening twenty additional beds. We discovered that hiring ancillary staff was no problem, but the nationwide nursing shortage was. When we could no longer stall for time, we pressed forward, opening a few beds at a time, without additional resources. Opening the first section of beds went smoothly. The next section, however, was more challenging, as the nurses carried a patient load that exceeded the norm by two or three patients. Soon we had tenured nurses threatening to leave because of the workload. We had to do something soon to relieve the staff. We desperately needed more nurses.

I called out to God for the resources I knew only he could provide. We asked overworked staff nurses to work more hours. We pleaded with PRN and part-time staff to accept more hours. We met with recruiters routinely and supplemented our staffing needs with agency whenever possible. We tried everything we could to get more help to the staff. Yet all our efforts were not enough.

As I asked God for more nurses, he impressed upon my heart this thought: Open your eyes of faith. You have all you need at your fingertips. Just tap into the resources you have. I mulled that over and over and could not comprehend the answer. I prayed Ephesians 1:18, “That God would open the eyes of my heart that I might know the hope to which he has called me.”

TO THE RESCUE

One day Cheryl and I remembered a voice mail from a PRN nurse who months before had said, “I would love my job more and work more often if I could work around my family's schedule, and if I didn't have to take a patient assignment. I could help the nurses down the hall rotate IV sites, admit patients, discharge patients, etc.” Initially we laughed at this message, but when we were desperate we called and said, “Let's try your proposal.” She worked non-traditional hours in a role in which she did not have a designated patient assignment. Rather, she allocated time to each nurse at the bedside to rescue her colleagues. She became the nurse's nurse. This worked so well, we were able to keep beds open and retain nurses. We successfully opened the last section of beds in October 2001 and have been operating at full capacity since.

We call this program The Rescue Nurse.2 Several nurses offer extra hours in which they rescue coworkers with the daily care of patients. It brings relief to the nurse who, like me at the bedside, struggled with the responsibility of caring for very ill patients. The Rescue Nurse concept, which started as a last-ditch effort, eventually became one of the most successful retention and recruitment efforts we have ever used. In the two years since its implementation, we've watched our staff vacancy rate drop from 38% down to 6%. In addition, our nurse turnover rate has dropped to 3%. It worked so well that we presented our ideas to hospital management, who in turn asked us to share it with our peers. We eventually offered several of our rescue nurses to other units to teach the concept. As a result, the Rescue Nurse program was included as one of the nursing retention and recruitment efforts on our hospital's strategic plan this year.

Once the beds were open, our focus turned to developing staff. God continued to remind me, through his Word and through the encouragement of friends, that we have the resources we need within our reach. God taught me to see beyond the visible—to see with eyes of faith. I learned that resources are more than numbers. God taught me to dig deeper and to discover the natural talents and gifts that others possess and to tap into those talents.

A nurse who had a meticulous eye for detail and great time-management skills became the perfect performance improvement organizer. Another nurse who was a natural-born teacher and mentor became the unit's orientation instructor. A creative nurse took on the responsibility of developing a bulletin board with pictures of new staff and a board for recognizing tenured staff on their hospital anniversary dates. The list grows as we build our team of leaders.

God continues to bless our work as we look to him, the God of all our resources. He knows what we need. He taught me to look to him but also to look to others. God never intended for me to function as an island. We, as nurses, need each other. I realized that when I turned to others for help, I was able to accomplish more than I could have alone. Synergy is gained when people work together toward a common goal. Failures are divided, and joys are multiplied. Others provide encouragement when I am discouraged, and they offer a depth of perception to challenges that I cannot see. Victory is certain as we focus together on God as the source of all we need (2 Cor 2:14).

1 Joni McCollum and Cheryl Rice, “Manager Satisfaction and Retention: Partner Pairing,” Nursing Management, September 2003.
    2 Joni McCollum and Cheryl Rice, “The Rescue Nurse,” Nursing Management.
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