 GBMC Post Partum Unit: Every Nurse a
Charge Nurse
When the permanent night charge nurse on Greater Baltimore
Medical Center's (GBMC) busy Post Partum unit took an extended personal leave,
clinical manager Etna Weinhold was faced with an opportunity for staff
development. She wanted to keep the position open for her colleague, but still
needed to have a nurse in charge of the unit at all times. Weinhold discussed
the situation with her staff and found they all were willing to take a turn at
being in charge to cover the need.
The nurse did not return to work. Today, almost two years
later, the staff continues to cover the charge role. The practice also has been
extended to the day and evening shifts. All 38 RNs on the staff participate.
Until recently, the only permanent administrative role in
addition to Weinhold's position as clinical manager has been a two-day a week
position of clinical partner on the day shift. The clinical partner position is
filled by a full-time nurse who devotes approximately 16 hours to
administrative duties, spending the remaining time in direct patient care and
charge responsibilities.
Weinhold's longtime clinical partner recently left to take a
part-time staff position. When the position was posted, she was delighted to
find that two of her own staff nurses applied. And, because of the charge nurse
experience, both were highly qualified and felt confident they could fill the
position. On the recommendation of her staff, who participated in the
interviews, Weinhold hired one nurse for the clinical partner slot and promoted
the other to permanent charge nurse on the night shift. (Other nurses who work
on the unit still cover their time off.)
Weinhold describes herself as an advocate for the
professional development of nurses. Sharing the charge nurse position is "a
leadership opportunity for every RN who's in post partum," Weinhold says. The
opportunity enhances the nurse "in terms of professional development and in
terms of thinking globally."
Having two qualified internal applicants for the clinical
partner "is the ultimate success," according to Weinhold.
Another benefit Weinhold says is that the strategy has led
to development of a team that works closely together in a variety of other
ways. First and foremost, she says that the nurses respect the role of charge
nurse and are very willing to collaborate and support decisions because they
know the responsibility of the role firsthand. There's "no grumbling," Weinhold
says. Because of the way everyone works together, the unit is able to manage
its budget more closely and minimize call in of extra staff for peak periods.
They also are able to "wow" the patients with family-centered care.
Staff turnover is low, too — nurse departures are
limited mostly to relocation or retirement.
The hospital's record of implementing innovative ideas that
improve workplace efficiency and employee satisfaction are also factors. In
fact, the Post Partum unit was the first unit at GBMC to do
self-scheduling—beginning in 1988, rotating a three-person committee each
month. The Post Partum staff then introduced the concept to nursing units
throughout the hospital.
Clearly stated staffing guidelines and other staffing and
scheduling policies—including self-scheduling—further contribute to
the unit's success with staff and patients. All nurses are aware of the
policies and of GBMC's "core values" and how to apply them to daily practice.
These principles form the basis for orientation to the charge role. Peer
mentoring and Weinhold's coaching provide opportunities for observing,
demonstrating, and reviewing each nurse's performance as a charge nurse.
"Each nurse learns in his/her own way," Weinhold says. Her
method is to help them determine what they need to know and access the
appropriate resources, many of which are available right on the unit. Weinhold
calls this approach, "Partners in Practice"—the model is based on
developing from novice to expert nurse with the aid of continuous constructive
feedback from peers and supervisors.
The postpartum staff is focused on creating an atmosphere
that is best for the patient.
"The patient is the pulse center of everything," Weinhold
says. She's convinced the professional development of nurses is key to
addressing the nursing shortage. "Nurses need to feel valued in the workplace
and hospitals need to have systems in place that support patient care." At
GBMC's Post Partum unit it's been a formula for success!
Contact:
Etna A. Weinhold
Clinical Manager,
Post Partum Unit
Phone: 443-849-2593
E-mail: eweinhol@gmbc.org
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