NRBS4360 Medgar Evers College Managing Costs and Budgets Case Discussion

Read the following case studies then read the following chapters answering the questions while referencing to the chapters. I WILL UPLOAD THE CASE STUDIES ALONG WITH THE CHAPTERS.

(Textbook-Yoder-Wise, 6th edition)


Read assigned Chapters 12, 14, & 15.Answer all the questions below related to each chapter assigned. Submit your response in a designated “drop box” in Blackboard on Friday, July 26, 2019 at 11:59 pm

Chapter 12: Managing Costs and Budgets

Case Study 1

Andrew RN, MSN, is the new nurse manager for a long-term care unit in a rural community hospital. The deadline for the next year’s budget proposal is 6 weeks from now. Andrew is aware of the current reimbursement schema and performance requirements by the Center for Medicare and Medicaid Services (CMS), research about concerns of staff nurses having a voice in decisions, research about the differences between Magnet facilities and facilities without that designation, and the organizational “politics” of submitting a budget request.As is true of the other units within the hospital, this unit experiences staffing problems. Andrew decides that the staff should be involved in creating the budget request.


What typical reports would it be useful for him to share with the staff so that they have a clear perspective on the current financial situation?

1.What documents will be needed to support a request for additional staff positions?

Case Study 2

Myra, RN, BSN, has been the evening charge nurse on 3 South, a general medical-surgical unit at the Medical Center Hospital, for 3 years. The nurse manager has suddenly experienced a long-term illness, and Myra is asked to serve as the temporary manager of the unit. The first financial report Myra receives is the expendable supplies report. This report reveals that the projected unit expenditures were $30,000, but the unit was charged for actual expenses of $57,460. Myra notes that this is the second month for which the expendable supplies expenses have been dramatically over the budget. She wants to revise the projected budget to reflect the actual expenses more accurately.


1.Describe the various factors that she must consider when revising the budget and the multiple approaches that might be used.

Chapter 14: Staffing and Scheduling

Case Study 1

During the budget preparation cycle, Jack, RN, BSN, the nurse manager of the cardiac telemetry unit, is asked to forecast the total anticipated patient days. Jack reviews past reports and finds that the total varies between 5740 and 5940. Based on this finding, Jack decides to forecast the total patient days at 5840. The telemetry unit uses a decentralized staffing approach and almost never uses nurses from other units or from staffing agencies or the hospital’s float pool to cover staffing needs. Six months into the year, Jack finds that the actual total patient days to date are 3094. In reviewing the past 6 months, Jack realizes that a new cardiac specialist began a practice associated with the hospital.


  • How should Jack project the staffing for the remainder of the year?
  • What are the possible approaches to staffing the unit?

Case Study 2

Melina, RN, MSN, is the director of a long-term care facility. Last year Melina created the staffing schedules for the entire facility, which consists of four distinct units. One of the units is an intensive service for residents with Alzheimer’s disease. When the staffing was centralized, Melina typically provided additional staffing to this unit by reassigning staff from one of the other three units. Now, the long-term care facility has been purchased by a corporation. As a result, there are many corporate policies that each newly purchased facility is expected to implement. One of those policies relates to decentralized staffing. In addition, there is a strong financial productivity expectation for each facility and for the various units within each facility. Clearly, a plan must be devised to ensure appropriate staffing that meets patient care needs, accreditation standards, and staff satisfaction in addition to the corporate expectations.


1.How can a transition be planned to create the best possible outcomes?

Chapter 15: Selecting, Developing, and Evaluating Staff

Case Study

Hope, RN, BSN, is a new graduate and has joined the staff of a busy multiservice surgical unit. She is frustrated and has difficulty performing the numerous psychomotor skills necessary to provide care to her clients. The equipment is very different from the equipment she has experienced, and the procedures differ from those that she learned in her nursing program. Hope’s orientation has been fragmented because of several changes of the nurse designated as her preceptor. Hope is nearing her initial 3-month evaluation and is worried.


  1. What should Hope do to prepare for the evaluation?
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