solved You are a nurse manager at a local post-acute care

You are a nurse manager at a local post-acute care nursing facility. Today is April 1, and you have received the budget printout (above) for your department. Your charge nurses are requesting an additional RN on day and evening shifts since acuity has increased dramatically over the last 2 years. (The average annual salary without benefits would be $65,000). Dr. Richardson has requested two new continuous passive motion (CPM) machines ($3000 each) for post-operative orthopedic patients. In addition, you would like to attend a national orthopedics conference in New York in August (projected cost $1500). The $650 conference registration fee is due now.
Two Response Posts (min 250 words): Provide feedback to agree or disagree with your classmate’s budget decisions. What responsibilities do the staff nurses have (if any) for staying within the unit’s budget? Give specific examples.  

Post # 1

Kate BassMondayJul 5 at 8:34pmManage Discussion EntryAfter reviewing the budget report for April 1st, I would conclude that we would not hire another registered nurse to help out with the increasing acuity on the unit this fiscal year. I came to this conclusion by looking at the budget and projecting it to be about $100,000 over our current budget. Instead, I would extend overtime to nurses currently working until we make it into the next fiscal year in three months, in which I would reevaluate our need for more RN’s and plan accordingly. I would address this first and bring it to the person in charge over me to make sure they agree with that decision. I would then notify the charge nurse of our decision and explain why this is not feasible as of yet. My next obstacle to tackle would be the physician who was requesting two new continuous passive motion machines for post-op orthopedic patients. This is a situation I would also assess and gather more information on to see if all of our patients would benefit from these machines or only a certain amount of patients or a specific population. If all the patients can not benefit from these devices, I would have to decline the physician’s request due to no more funding in our equipment department and ask the physician to follow up on the idea in the next fiscal year. If all of our patients benefited from those machines and our budget was based on the improvement of our performance, I would consider it and possibly move some funds around because that would give us more funding. The time frame that I would speak to the physician would depend on how long it took to investigate the situation. Once I came to a conclusion, I would then talk with the physician as to why I could or could not provide funding for the physician equipment he requested. To address the national orthopedics conference, I would say this could be made possible. I say this because we could use what is left in the budget to pay the registration fee. We could either pull from another part of the budget for the rest of the registration payment since the amount needed would not send the budget into a crisis. Or we could pay out of pocket depending on how much I feel this conference would advance our knowledge and help our team out. Then the rest of the money I believe, would be due in August, which is the next fiscal year when our budget renews, and we could pay the remainder with that. The most accurate budgeting area was travel because we spent $0 in March and still have $500 left to help with expenses. The most inaccurate projections were the personnel in which come the end of the fiscal year, we will have been over budget by at least $100,000. The significant steps in planning a budget include gathering information and planning, developing budgets for each unit, developing a cash budget, negotiating and revising that said budget, and using feedback to control your budget results and improve your plans. Therefore, learning to defend and negotiate budgets is an essential skill for a nursing manager (Trepanier, 2019, pp. 371–372). It seems like the organization set this budget, and then there were few attempts to follow said budget. I believe nursing management could have controlled these inaccuracies had the nursing manager paid more close attention to the budget. Another factor that would have helped was if variance analysis were done periodically. Cherry (2019) states that variance analysis is a process in which deviations from budgeted amounts are examined by comparing actual financial performance results against the expected or budgeted performance. If this is something we had practiced throughout the fiscal year, we would’ve known the minute we were heading towards going over budget and corrected it right away. These factors influenced my decision because I wanted to try and stay as within budget as possible, which was very difficult. I also wanted to ensure that everything that needs to be taken care of was, even if we had to pull from other budgets to make it happen. The decision I arrived at was what I felt best would suit the budget and the unit’s needs until we start a new fiscal year in July, where I can reevaluate where we can cut costs and where the budgeting money needs to go.ReferencesCherry, B. (2019). Budgeting basics for nurses. In B. Cherry & S. R. Jacob (Eds.), Contemporary nursing issues, trends and management (8th ed., pp. 309–321). Elsevier.Trepanier, S. (2019). Managing cost and budgets. In P. S. Yoder-Wise (Ed.), Leading and managing in nursing (7th ed., pp. 358–376). Elsevier . ReplyReply to Comment

Post # 2
Linette Suttles6:16pmJul 8 at 6:16pm
Manage Discussion Entry
This week’s assignment proves to be a challenge that I believe managers face all the time. A budget is the basic financial document in most healthcare organizations. This helps organize and carry-outs activities for the organization during a certain time frame (Trepanier, 2019). In the example, the first portion to discuss would be the operating budget. The operating budget is the financial plan for the day-to-day activities (Trepanier, 2019). In the example, they are asking for two extra full-time nurses. One for days shift and one for night shift. Trepanier (2019) states that the costs do not change as the increased volume of patients changes. I would keep the requests for the nurses to benefit the unit. I also feel that just having these extra nurses would help the unit and the patient care. I work in an ICU, and I know we have been short lately and if we can hire and maintain these extra nurses, we may not feel overworked as we are now. The other-than-personnel services expense budget would be for the travel budget for the conference that was discussed in the example. I think that once the newly hired nurses are maintained that perhaps we can hold off on the conference for another time frame. The capital budget funds major equipment purchases (Cherry, 2019). In the example, the doctor would like to order two CPM machines. Cherry (2019) suggests that the budget for these capital expenditures should be between $500-$2,000. Since I have already cut the travel conference, I would suggest purchasing one new CPM machine and if proves to be beneficial for the unit then next year we can purchase another CPM machine. I feel like if the unit shows improvement with these budgetary changes, that if we need the extra CPM machine we could speak to the organization and see if we can have an increase in our budget. I also think that due to reimbursements from healthcare that we can also utilize this for our extra needs and not have to ask for more money from the organization. The focus is to provide better care to the unit but still maintain a budget. Nurses need to advocate for the patients, provide quality evidence-based practice, provide efficient operations staffing budget, and utilize cost-effective supplies (Cherry, 2019).
References
Cherry, B. (2019) Budgeting basics for nurses. In B. Cherry & S.R. Jacob (Eds), Contemporary
nursing: Issues, trends & management. (8th ed. pp. 309-321). Elsevier
Trepanier, S. (2019) Managing costs and budgets. In P.S. Yoder-Wise (Ed.), Leading and Managing in Nursing.
(7th ed. pp.358-376). Elsevier