Critical Analysis of Governance and Leadership Practices in a Long Term Nursing Unit

Running Head: Critical Analysis
Assessment
Critical Analysis Essay
Word Count:...
Student Name:......
Submitted to:........
Griffith University

Critical Analysis 2
Introduction
The assessment critically evaluates the given clinical scenario to analyze the potential issues
associated with governance and leadership practices of the Organization. The aim of the essay is
to specifically examine the factors affecting the delay in recruitment process, unfilled posts,
difficult work culture, high rate of staff turnover, and overtime practices in the long term nursing
unit. The essay concisely describes the scenario and context which affect the delivery of quality
care at the work place. It evaluates the different issues faced by the unit which affect the patients,
and staff. Finally on the basis of evaluations, it recommends the strategies which can be
implemented to assist the delivery of professional quality care. The discussion only focuses on
the given clinical scenario. It will be argued that inefficient management, leadership and
governance at the workplace (as shown in the scenario) can lower down the productivity of the
unit and may worsen the quality of care.
The Context
The most important factors affecting the long term nursing unit are: lack of experienced
leadership (Manager), delayed recruitment process and many unfilled posts, difficult work
culture, high rate of staff turnover, high rate of sick leaves among employees, and overtime
pressure to fill roster deficits. Hiring the inexperienced graduates has resulted into increased
incidents of consumer falls and medication errors since last 6 months. There are several
problems in recruiting the senior and experienced registered nurses in the unit so the
management started hiring young graduates at respective vacant posts for minimizing the
overtime load on the existing staff. Hiring the young inexperienced graduates resulted into

Critical Analysis 3
increased consumer falls and medication errors. None of the nurse already working at the
manager’s post has shown keen interest in continuing her job at the same post. Around 25% of
the fulltime jobs at the unit are vacant. Hiring the inexperienced candidates further increased the
incidents of aggression among the patients and the staff members. Moreover, the lack of
permanent experienced and professionally qualified nurse educator and clinical facilitator has
lowered the quality of staff training and education at the unit.
The most important factor influencing the quality of care is ‘unfilled posts’. The management is
careless about completing the annual recruitments on time. Most of the posts like that of manager
are vacant since two years.
Critical Evaluation
The clinical scenario reflects several issues related to filling leadership roles at the unit, lack of
quality training of nurses, shortage of experienced staff, inadequate compensation and salary,
improper behavioral management of nurses and increasing complaints from the patients.
Inadequate Staffing- Lack of experienced staff threatens the patient safety and health in the unit.
It also increases the rate of injury and fatigue in the staff and compels the existing clinicians to
work for longer hours under stressful work conditions. Inadequate staffing may impede the
efforts of the nurses at work to perform the care processes. According to the Hospital
Readmission Reduction Program by Affordable Care Act, the hospitals having higher nurse
staffs are penalized to 25% lesser extent than the hospitals having lower staff (Gooch, 2015).
According to the reviews of Minnesota Department of Health, the lower levels of nursing staff is
linked to higher patients mortality, falls and failure to rescue during hospitalization (Gooch,