Discuss the responsibilities that a nurse leader has when it comes to development of the budget. What do you feel is the most important of these responsibilities? Explain your rationale.
As the healthcare sector becomes increasingly complex and cost-conscious, nurse leaders play a critical role in budgeting. Here are some of the key responsibilities they typically have in the budget development process:
Needs Assessment: Nurse leaders are responsible for identifying and articulating the financial requirements of their department or unit. This includes everything from salaries and equipment to supplies and training costs.
Data Analysis: They must collect and analyze data to forecast future needs accurately. This includes understanding trends in patient population, analyzing the usage of resources, and anticipating changes in healthcare regulations or technologies.
Budget Preparation: Nurse leaders usually contribute to the creation of the budget. They must be able to make informed decisions about where funds should be allocated based on both current needs and strategic objectives.
Budget Implementation: Once the budget has been approved, nurse leaders are responsible for managing their unit’s finances in accordance with the outlined budget. This may involve making day-to-day spending decisions, monitoring expenditures, and adjusting plans as necessary.
Communication and Collaboration: Nurse leaders are the link between the nursing staff and higher management. They must effectively communicate the budgetary constraints and priorities to their team, and also advocate for their team’s needs to upper management.
Performance Evaluation: Nurse leaders must assess how well the budget is being adhered to and whether the financial objectives are being met. This may involve reviewing financial reports, identifying areas of overspending, and recommending corrective action.
Education and Training: Nurse leaders have the responsibility to promote financial literacy among nursing staff. By teaching their team about the importance of cost-effective care, they can help to instill a culture of fiscal responsibility.
Out of these responsibilities, I would argue that perhaps the most important is the ability to effectively communicate and collaborate. A nurse leader should not only be adept at managing resources but also at advocating for their team’s needs and effectively conveying budgetary constraints to their staff.
The rationale for this is that budgets aren’t just about numbers, but about people. It’s important that all members of a nursing team understand why certain financial decisions are made and feel that their needs are being taken into consideration. Effective communication ensures that everyone is working towards the same goals, and it helps to build trust and collaboration within the team. Furthermore, by understanding and advocating for their team’s needs, nurse leaders can contribute to a budget that not only makes financial sense, but also supports high-quality patient care.
Reference
Brown, P., & Leger, J. M. (2021). Chapter 5, Budgeting. Jones & Barlett (Eds.) Financial management for nurse managers: Merging the heart with the dollar (5th ed). Retrieved from https://bibliu.com/app/#/view/books/B1BPN02BMBJH1/epub/EPUB/xhtml/033_Ch04_02.html#page_73
Nurse leaders have an important role when it comes to developing the budget for the unit or the organization. Their responsibilities will directly impact budget planning and management (Penner, 2017). Depending on the organization, nurse leaders’ roles may be restricted but also will depend on the position they hold in the organization. However, nurse leaders with their knowledge, can provide subject matter expertise that can improve the accuracy of the budget (Leger, 2021, p.84). Nurse leaders often focus on projecting the expenses for the unit for the future period, usually, it is the upcoming year. It is common to use the prior year’s performance to project the budget, but evaluation is recommended to determine if adjustments are needed to meet the estimated upcoming needs. Nurse leaders hold knowledge that allows them to determine the salary and expenses necessary for planning adequate and efficient staffing levels (Leger, 2021, p.86). Another important duty of the nurse leader is to manage expenses and staffing for the unit. The goal is to meet the department’s needs with an appropriate skill mix of staff while remaining productive and within the planned budget. I learned from the textbook that nurse leaders can project the percentage of total overtime hours, but often organizations limit the planned use of overtime (Leger, 2021). For example, our organization’s OT usage is set at 2.5%. Therefore, I think it should be an opportunity for nurse leaders to request additional FTEs when the OT percentage remains high throughout the year. We often use a traveling agency to fulfill the staffing needs, but in some cases, having regular short-hour staff is a better choice. Nurse leaders may also be responsible for determining the nonproductive hours for each job class. These will be the hours that will be used for orientation, education, and meetings throughout the year. The development of the department’s budget is a complex process, and I am very glad to learn more about budgeting now while I am still at the beginning of my management career.
References:
Leger, M. (2021). Financial management for nurse managers: Merging the heart of the dollar (5th ed.). Jones and Bartlett. ISBN-13: 9781284230932
Penner, S. (2017). Economics and Financial Management for Nurses and Nurse Leaders (3rd ed.) https://bibliu.com/app/#/view/books/9780826160027/epub/OEBPS/text/9780826160027_Copyright.html#page_iv
The most important consideration in the development of a budget is the workload. In the hierarchy of service needs one must consider nursing workloads, patient to nurse ratios, and mixture of skill sets to meet patient needs (Leger 2021). The responsibility of a nurse leader is to balance all these factors in a manner that is in sync with operational budgets. Therefore, I cannot objectively say that of the three factors discussed by Leger (2021), one is more important than the other, however what can be inferred is that the amount of work needed to be done can determine operational budgets. I believe workload can determine patient ratio and skills necessary for care. Workload is independent of nurse-to-patient ratio and skill set, as when there is no workload (i.e. Patients) there is no need for a patient ratio or skill set. However, in the event there is workload the other two factors become relevant. Intensive care units commit 60% of their operating budget to staffing, thus using tools like the nursing activities score NAS allows nurses workload to be visible and help with planning and budgeting (Stafseth et al., 2018). Thus, there are a lot of tools available for nurse leaders to be able to evaluate workloads and determine budgetary boundaries. Staffing is often the most contentious topic within budgets as there always seems to be a call for more nurses from front line leaders and constraint from senior leadership.
References
Leger, J. M. (2021). Financial management for nurse managers: Merging the heart with the dollar (5th ed.). Jones & Bartlett Learning.
Stafseth, S. K., Tønnessen, T. I., & Fagerström, L. (2018). Association between patient classification systems and nurse staffing costs in intensive care units: An exploratory study. Intensive & Critical Care Nursing, 45, 78–84. https://doi-org.lopes.idm.oclc.org/10.1016/j.iccn.2018.01.007
