Magazine article American Nurse Today

Size Matters-Or Does It?

Magazine article American Nurse Today

Size Matters-Or Does It?

Article excerpt

IN SPORTS, we often hear the saying "Size matters." Usually, it means the bigger and stronger athlete triumphs. But sometimes, the smaller and seemingly weaker one may have the advantage and ultimately prevail to win the game or race.

Does "Size matters" mean anything in nursing? In every hospital, nursing is the largest department--often representing more than 50% of staff. But does that mean nursing is the biggest and strongest department? Does nursing have more influence than other departments in creating policies, enforcing professional behavior, or setting guidelines that ensure adequate time at the bedside to care for patients? If you're smiling or just shaking your head right now, it's because you know nursing certainly does not have more influence.

Why not? In the average hospital, the medical staff, despite its much smaller numbers, has the lion's share of power, However, its influence is somewhat mitigated by the power and influence of the C-suite (CEO, COO, CFO), a group even smaller than the medical staff. Physicians' influence stems from their ability to admit patients, perform surgeries, order tests, prescribe drugs, and direct the care provided to patients. The medical staff generates revenue; the C-suite essentially manages expenses.

So where does nursing fit into this power structure? It's a complex question to answer, especially considering that nurses are mistakenly viewed as a non-revenue generating expense. And in terms of educational degrees, nursing differs significantly from the C-suite and medical staff. …

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