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Introduction
The management of the healthcare sector requires using not only adequate leadership practices and approaches to monitoring employee performance but also appropriate funding for innovation and industry development. In the work process, medical specialists of various fields, including physicians and nurses, face various problems and issues that need to be overcome in order to maintain a high level of public services. Certain practices and methodologies designed to help managers select personnel efficiently serve as supporting HR tools. At the same time, the management system itself depends on different factors, including a set of objective solutions to control the work of personnel and assistance from higher authorities. This work addresses two significant topics: the features of selection and recruitment in the medical industry and financing of this sector by using the example of the Irish healthcare system. The analysis can help assess the existing challenges and ways to overcome them.
HRM in Healthcare: Selection and Recruitment
Hiring professional and highly qualified medical staff is a responsible task for a number of reasons. According to Abdollahi, Tabibi, and Komeili (2018), healthcare specialists should be highly skilled and prepared for ongoing training since continuous education is an integral part of both physician and nursing practices. In this regard, most modern medical facilities approach the selection and recruitment procedures responsibly. The evaluation of these concepts can provide an opportunity to identify the key trends in the existing principles of human resource management and determine specific tools utilized for this work.
Theories and Concepts
Some modern approaches to the recruitment and selection of medical staff replace obsolete practices due to the emergence of more advanced assessment and testing systems for future healthcare employees. For instance, LaMartina, Zamierowski, and Dewan (2018) note that the traditional principle of assessing nursing students based on admission ranks cannot predict the outcomes of upcoming activities accurately. In this regard, more advanced tools are utilized, which can improve the quality of testing. The authors mention strategic simulations as mechanisms that create the most natural working environment and determine the degree of preparedness of future medical staff objectively (LaMartina, Zamierowski, and Dewan, 2018). Certain practices are designed to determine whether a particular specialist is suitable for a particular position. As Cogin, Ng, and Lee (2016) note, this practice is called a commitment-based approach and is based on evaluating the personal skills of medical staff in the context of the required range of upcoming activities. Such approaches to selection and recruitment are of practical importance and allow for a comprehensive assessment of applicants’ achievements.
Individual practices are designed to determine how objectively medical staff assess individual skills. Mazhindu et al. (2016) mention the Action Research approach as a tool that involves the voluntary involvement of employees in order to familiarize themselves with the upcoming range of activities and assess personal potential. However, more often, selection and recruitment methods imply evaluating job seekers by professional HR specialists. In particular, according to Cogin, Ng, and Lee (2016), the role theory is one of the main concepts utilized in the healthcare environment. The authors note that this mechanism consists in the possibility for HRs to influence job seekers’ work attitudes and determine the level of professionalism of the target audience (Cogin, Ng, and Lee, 2016). Such a model is convenient and suitable for both senior medical personnel and nurses. As a relevant example of workplace practice, the position of a nurse manager will be examined in order to determine appropriate selection and recruitment practices used for this post.
Workplace Example
Any leadership position requires commitment and increased responsibility, and the post of a nurse manager is no exception. As Haaland, Olsen, and Mikkelsen (2019, p. 2509) argue, employees of this profile “are exposed to organisational, economical, scientific and political demands”. These factors justify the need to develop objective recruitment and selection strategies. The authors note that the traditional principles of hiring nurse managers are characterized by an emphasis on high professionalism but the lack of support and proper training (Haaland, Olsen, and Mikkelsen, 2019). This means that outdated theories and concepts of HR activities in relation to hiring nurse managers can be ineffective in the context of professional growth. In this regard, Haaland, Olsen, and Mikkelsen (2019) offer employees responsible for the development and implementation of selection and recruitment strategies to pay attention to personalized job promotion techniques. In particular, the individual characteristics of nurse managers, for instance, their age, cultural background, professional experience, and some other factors can be evaluated as criteria that influence working interests and attitudes. In case such an HR practice is applied, healthcare institutions may employ motivated and talented nurse managers with high potential.
Challenges and Ways to Overcome Them
In different positions, healthcare employees have specific obligations that they have to fulfill for the stable operation of the entire medical institution. However, work practices may be accompanied by challenges and barriers caused not only by poor training but also by underdeveloped selection and recruitment strategies. For instance, according to Adatara et al. (2018), nurse managers should assist the HR department in hiring nursing staff and conducting training with subordinates. However, due to an insufficiently high educational and practical base, those in charge cannot create such a selection environment that would allow hiring suitable employees. Another significant challenge that Saifman and Sherman (2019) highlight is a high turnover rate caused by the insufficiently productive work of HR specialists and preventing the implementation of highly effective selection and recruitment practices. Addressing these gaps is a significant aspect of skilled leadership.
In order to overcome the aforementioned challenges, managers and HR specialists should promote appropriate workflow optimization strategies. For instance, as Adatara et al. (2018) note, productive leadership training is one of the mechanisms that allow educating decision-makers on the necessary selection and recruitment principles and filling the gap of insufficient competency. Addressing the issue associated with high turnover can be achieved by organizing a flexible workflow. According to Haaland, Olsen, and Mikkelsen (2019), the work-family balance is a criterion that is crucial to consider when promoting relevant HR practices. The healthcare sector requires high commitment, and creating a supportive environment is an important aspect.
Healthcare Funding in Ireland
The Irish healthcare system is a public sector that is largely funded by government grants and sponsorship of research projects. As an example, Smith et al. (2019) cite the results cited by the Economic Research Institute and note that financial management is provided by the responsible respective boards. As target projects for which budgetary funds are allocated, assistance to the older population of the country is considered, as well as to vulnerable groups, in particular, children. In general, the Irish healthcare sector has enough resources to provide good health services, but optimizing the financial management system is a significant task to improve the quality of medical care. The example of nurse managers’ activities in healthcare settings can provide insights into the success of the current program to support this public sector.
Nurse Manager’s Role
The workplace initiative to discuss can relate to the activities of nurse managers as important specialists coordinating both human resource issues and the nuances of budget allocation. Ryan et al. (2019) analyze this post in the context of the position promoted by the state public fund due to the age characteristics of these employees. As the authors argue, about one-third of all nurse managers in Ireland is over fifty, which, in accordance with the state financial assistance program, is a condition for additional financial payments (Ryan et al., 2019). This initiative is justified by significant losses for the medical sector due to the early retirement of highly qualified nurse managers. Therefore, the state allocates funds, which corresponds to the officially accepted program.
The duties and responsibilities of nurse managers are extensive in order to count on financial assistance. Wilson and Devkota (2018) consider projects that specialists in this profile should coordinate and note that their work initiatives, for instance, the implementation of advanced staffing practices, are prerequisites for material benefits. In addition, nurse managers are the senior link in junior medical teams and often carry out supervising functions that require high concentration and unconditional professionalism. According to Wilson and Devkota (2018), after the World Health Organization made recommendations to Ireland in 2014 to improve the quality of care by delegating greater powers to nurse managers, these employees obtained more opportunities. As a result, the range of responsibilities that this post assumes is an objective reason for additional funding from the budget.
Principles of Financial Management in the Irish Healthcare System
The Irish healthcare system differs from many others in that the insurance model is not key in shaping its financial base. Burke et al. (2018) analyze this industry and note that in 2011, there were attempts to restructure the budget in accordance with the insurance policy. Nevertheless, as the authors note, later, the inappropriateness of this strategy became apparent, and by 2016, none of the original proponents of this reform were ready to refuse the tax system (Burke et al., 2018). Money from the national fund, which is replenished by tax payments, goes to the development of the healthcare industry. Moreover, in addition to public funds, private sponsorship is also provided. However, according to Burke et al. (2018, p. 1281), its share is significantly less important: the amount of financial resources coming from public sources is 81%. Such a correlation indicates the strong dependence of the healthcare industry on the country’s budget and the dominance of the tax system as the main funding resource for medicine in Ireland. Therefore, the concept of health insurance funding is atypical for the state.
Challenges Faced by Nurse Managers and Ways to Overcome Them
In the Irish healthcare system, some outdated approaches to organizing financing and identifying responsibilities for specific sectors may cause challenges for certain categories of employees involved. In particular, nurse managers, as professionals who carry out a wide range of duties and participate in the planning of the work process, can face high workloads. As Wren and Connolly (2016) state, reduced funding can cause increased working hours to meet the performance requirements of medical personnel. As a result, due to a decrease in funds that could be spent on attracting additional junior employees, nurse managers are forced to conduct many operational tasks on their own, which is fraught with working fatigue. Another potential challenge that Power (2017) mentions and that is a consequence of the aforementioned gaps is increased expectations. Under high workload conditions, nurse managers are not obliged to weaken performance and worsen patient outcomes. Nonetheless, with a shortage of workforce and insufficient resources for urgent interventions, it is challenging to achieve high operating outcomes. As a result, fatigue and overly high expectations from both senior managers and patients are potential problems.
Overcoming these challenges should take place with the participation of various stakeholders, including senior managers and government agencies. In individual healthcare settings, department heads can coordinate workload based on the current workforce rather than optimal indicators, which can reduce fatigue. In relation to increased expectations, a reporting system is a convenient way to determine the range of tasks in which they are performed by nurse managers. Employees of this profile are not required to perform duties that are outside the scope of their authority. As a result, due to reports, nurse managers will be able to justify their activities and protect labor rights.
Conclusion
The principles of selection and recruitment in the medical field and the peculiarities of healthcare funding in Ireland are the topics addressed. In relation to HRM, several theories and concepts are applied, and the commitment-based approach is one of the valuable strategies. By using the example of a nurse manager’s position, challenges and ways to overcome them are identified. For the healthcare sector in Ireland, the tax system is the main financing platform, and the insurance principle is not the dominant concept. The role of a nurse manager is significant, and the existing gaps define high obligations and requirements.
Reference List
Abdollahi, A., Tabibi, J. and Komeili, A. (2018) ‘Selection, recruitment and training of nursing managers in hospitals: a comparative study’, Modern Care Journal, 15(3), p. e81682.
Adatara, P. et al. (2018) ‘Challenges of being a hospital nurse manager in the Volta region of Ghana: a qualitative study’, Nursing Management, 25(5), p. e1773.
Burke, S. et al. (2018) ‘Sláintecare – a ten-year plan to achieve universal healthcare in Ireland’, Health Policy, 122(12), pp. 1278-1282.
Cogin, J. A., Ng, J. L. and Lee, I. (2016) ‘Controlling healthcare professionals: how human resource management influences job attitudes and operational efficiency’, Human Resources for Health, 14(1), p. 55.
Haaland, G. H., Olsen, E. and Mikkelsen, A. (2019) ‘Making a career in hospitals: determinants of registered nurses’ aspirations to become a manager’, Journal of Advanced Nursing, 75(11), pp. 2506-2515.
LaMartina, K., Zamierowski, D. and Dewan, M. (2018) ‘A method to improve the selection of nursing students’, Journal of Nursing Education and Practice, 8(12).
Mazhindu, D. M. et al. (2016) ‘The nurse match instrument: exploring professional nursing identity and professional nursing values for future nurse recruitment’, Nurse Education in Practice, 18, pp. 36-45.
Power, M. (2017) ‘Commissioning of human and social services in Ireland: potential, opportunities and challenges’, European Journal of Social Education, 28/29, pp. 83-91.
Ryan, C. et al. (2019) ‘Ageing in the nursing workforce – a global challenge in an Irish context’, International Nursing Review, 66(2), pp. 157-164.
Saifman, H. and Sherman, R. O. (2019) ‘The experience of being a millennial nurse manager’, JONA: The Journal of Nursing Administration, 49(7/8), pp. 366-371.
Smith, S. et al. (2019) Geographic profile of healthcare needs and non-acute healthcare supply in Ireland. Dublin: ESRI.
Wilson, D. M. and Devkota, R. (2018) ‘A study of nurse‐based Injury Units in Ireland: an emergency care development for consideration worldwide’, The International Journal of Health Planning and Management, 34(1), pp. e72-e84.
Wren, M. A. and Connolly, S. (2016) Challenges in achieving universal healthcare in Ireland. Dublin: ESRI.
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