组织的物理结构看上去像一个旧建筑与开放的排水系统包括医院、护理学院、医学院和旅馆。混合的完全医院有1185个床位的病人护理专业仍占领了几乎所有的时间和每个病房都包含50个病人床位。人力资源而言,医院只有425名护士,护士和230名学生护士40头。显然,护士病人比率将50分,每个病房都有一个容量为50床意味着50个病人。根据护理代表,旷工是为他们的主要挑战之一,以满足病人的需求和分配护士当任何灾难发生。他们保持7护理人员在早班,晚班只有2中3被分配在夜班。此外,在灾难或危机情况下他们把学生护士作为“劳动”克服人员不足(Safrunnissa、个人通信,2012年11月14日)。它给人的印象护理短缺和缺乏卫生保健设施最终导致受损的病人护理的质量。然而,在我的假设如果学生护士没有监督下独立工作,然后临床错误的可能性,患者安全仍然是一个问题。巴基斯坦是一个发展中国家,疾病和人口的双重负担。通常在上面该被政府医院有病人在这种稀缺资源的大量涌入和护理人员。护士短缺问题总是最重要的挑战大多数国内外卫生保健组织。另一方面,Khowaja(2009)指出,“巴基斯坦医疗体系既不是主管,也不是全面为不断增长的人口提供足够的服务”(p.263)。
组织与高效领导人总是培养,推进和强有力的管理。的指挥系统和管理层次扮演的基本角色为了支持组织训练有素的和结构良好。组织结构在古代主要由高层管理者有能力带来任何改变是否在员工的支持。然而,对我来说他们是一个组织的杆可以用民主的方法,提高干预的影响需要保护其员工成功的质量改进的工具。在该情况比较类似的如上所述。根据Safrunnissa(个人沟通,2012年11月14日)“它有一个垂直层次结构在高层管理的位置首席护理管理者是谁最有经验和有权力在护理部门,比副首席护理管理者,护理管理者,主管护士,护士,注册护士、助产士和助理助产士。然而,医学主任及其委员会的椅子都是医生主要决策者。在护理部门的一些职位空缺等政府设置的文化是他们年级护士在多年的临床经验而不是资格。“不过,在我看来,将改变卫生保健组织都很困难当它缺乏有经验的和合格的领导人因为职业发展的要求与时间的需求增加。因此,它是理想的教育,使护士,让他们可分享的治理和加强护理形象护士仍努力奋斗实现体面的社会地位。我们探讨了多数为如该诉讼所面临的挑战。、人力资源缺乏、缺乏动力,稀缺的资源和管理信息系统等。此外,在与领导和管理的概念,本文将主要强调权力的指挥链的概念,政治在卫生保健、护理和挑战的形象有着毁灭性的影响卫生保健组织和护理专业。
英国护理论文代写:护理人员
The physical structure of the organization appears like an old building with open drainage systems including hospital, school of nursing, medical college and hostels. The hospital has altogether 1185 beds with mixed specialty of patient care which remain occupied almost all the time and each ward contains 50 patient beds. As far as the human resource is concerned, hospital has 425 nurses only, 40 head nurses and 230 student nurses. Apparently, the nurse patient ratio would be 3:50, as each ward has a capacity of 50 beds means 50 patients. According to the nursing representative, absenteeism is one of the major challenges for them to accommodate patient's requirement and assigns nurses when any disaster in the city occurs. They keep 7 nursing staff in morning shift, 3 in evening shift whereas only 2 are assigned in night shift. Additionally, in disaster or crises situations they assign student nurses as 'Labor' to overcome staffing shortage (Safrunnissa, personal communication, November 14, 2012). It gives the impression of nursing shortage and deficient health care facility which ultimately leads to compromised quality of patient care. However, in my assumption if student nurses are working independently without under supervision, then the possibilities of clinical errors and patient safety remain a question. Pakistan is a developing country that bears the double burden of diseases and its population. On top of it JPMC being a government hospital usually have the abundant influx of patients in such scarce resources and nursing staff. Nursing shortage always remains the foremost challenge for majority of the health care organizations nationally and internationally both. On the other hand, Khowaja (2009) stated that "the Pakistani health care system is neither competent nor comprehensive to provide adequate services for the growing population" (p.263).
Organizations always foster and advance with efficient leaders and strong management. Chain of command and management hierarchy plays the fundamental role in order to support organization well-disciplined and well-structured. Organizational structure in ancient times mainly consists of top managers who have all the power to bring any change whether it is in the favor of employees or not. However, for me they are the lever of an organization which can increase the impact of interventions with democratic approach and need to guard its employee for successful quality improvement of the facility. In JPMC somehow the situation is relatively similar as mentioned above. According Safrunnissa (personal communication, November 14, 2012) "It has a vertical hierarchy having top management on the position of chief nursing superintendent who is most experienced and has the authority power in nursing division, than comes deputy chief nursing superintendent, nursing superintendent, head nurses, charge nurses, registered nurses, midwives and assistant midwives. However, medical director and their committee's chairs all are physicians who are mainly the decision makers. Some of the positions in nursing division are vacant as the culture of the government setup is such that they grade their nurses on years of clinical experience rather than qualification." Nevertheless, in my point of view, to bring change in any health care organization gets difficult when it lacks well experienced as well as qualified leaders since the requirement of the professional advancement increase with the demand of time. Therefore, it is desired to educate and empower nurses so that they can share the governance and enhance nursing image for which nurses are still striving hard to achieve respectable position in society. We have explored on majority of the challenges that are faced by JPMC for e.g., lack of HR, lack of motivation, scarce recourses and management information system etc. Furthermore, in relation to leadership and management concept, the paper will mainly highlight the concept of chain of command of power, politics in health care, image of nursing and challenges that is having a devastating effect on health care organization and nursing profession.
