ICU is an integral part of any health care facility. Therefore, a safe and positive work environment is imperative to ensure proper delivery of care by all of its member as a team. However, we have somehow failed to achieve that desired state here at the ICU. Lack of team morale, leadership, and a sense of role deprivation have created a disgruntled state among the nursing staff. After much analysis, I have come to the following conclusion and recommendation that I believe will be proven helpful to identify and address the immediate issues at hand:
• ICU is significantly understaffed; immediate staffing should be our priority.
• Collaborative participation and planning by all members towards the common and shared goal so that ICU ward can become successful as a true team.
• Restriction of visiting hours to enable the nursing staff to perform their duties properly.
• Improvement and enforcement of security in the ICU ward to ensure a safe working environment.
• Proper recognition and motivation of the nursing staff by various incentive programs.
The recent cutback in ICU staffing has proven detrimental to the work environment. The pool nurses, even though are getting paid more than the regular nurses, are less skillful and inexperienced. This issue of inadequate staffing has resulted in a higher workload which put the nursing staff in a stressful environment. In order for the ICU team to succeed as a team, it requires right members matched to their goal . Therefore, the management should consider hiring more seasoned ICU nurses rather than inexperienced pool nurses. This measure is both efficient and cost effective.
Team Building Measures:
In a clinical setting, effective patient care and management are solely dependent on teamwork .However, the ICU staff has failed horribly to come together and perform as a team. The team morale is at an all-time low. Lack of leadership, communication, clearly defined roles and responsibility, and respect among its member are the root causes of the current situation. In order for ICU ward to function as a true team all of its members need to accept the fact that they all share a common goal .
They need to realize that despite of their differences in professional title, their role has an equal importance in achieving that common goal. I recommend and expect a strong participating style leadership from the management where all members of ICU ward will be treated equally, they will have a clear idea about their roles and responsibilities, they all will be encouraged to participate in the decision making process, and their opinion will be valued with appropriate feedback . I also recommend a monthly meeting where all the staff will get together and share their thoughts and ideas. These steps will definitely help to develop a sense of respect and cohesion among the ICU staff. Only then the ICU ward can be a true team .
Restricted Visiting Hour:
Hospital should strongly consider changing its current policy regarding the ICU visiting hour. ICU is a home for patients who need critical care. A 24/7 visiting hour policy not only increases a patient’s risk of infection, but also impedes the doctors’ and the nurses’ ability to provide the appropriate care. Without any doubt, the continuous interference by the patients’ attendance contributes to a health care personnel’s stress level and demotivates them to perform their duties at an optimum level .So, I propose that the visiting hours should be restricted to 8 am-10pm. This will enable the ICU staff to do their job properly, and also the patients will get appropriate amount of time to be with their loved one and get the holistic care they need.
Safety and Security Measures:
Unsafe work environment is another pressing issue that the authority needs to deal with as soon as possible. The ICU ward is gradually becoming risky and hazardous due to increasing number of violent patients and patients with infectious diseases. This poor work environment creates a sense of insecurity which is a major impediment to motivation. It ultimately results in poor performance of the nursing staff . Therefore, the management should enhance the security measures in the ICU ward to ensure everyone’s safety. There also should be a specific protocol to control the increasing cases of communicable diseases.
Proper Recognition and Motivation:
Lack of recognition is an apparent issue which is hindering the success of ICU ward as a team. Nursing staff, despite of their hard work, are being ignored. They are not getting the proper recognition that they deserve which is instilling in them with a sense of role deprivation . In order to motivate them the management should initiate various incentive programs with a balanced tangible and nontangible reward system .Individual programs such as pay-for-performance (where desired outcomes are financially rewarded)  and group program such as Hybrid compensation program (where an individual in a group is rewarded according to his/her performance, when the group reaches a goal)  could be useful in this case.
In addition to these recommendation, management should also consider the following alternatives:
• Pay raise for the ICU nurses and continue hiring pool nurses.
• More comfortable scheduling for seasoned ICU nurses and night shift for pool nurses.
• Increased accountability for all ICU staff by implementing a rating system.
I strongly recommend that management adopt the above mentioned measures as soon as possible to resolve the current conflict and job insecurity among the nursing staff. Although there are some drawbacks of the proposal, they are outweighed by the end result that the recommended measures will inevitably provide: “A true team, working together to achieve a common goal with a sense of respect and cohesion among each other.”