Budget ProcessBudgetis a financial proposal that includes projected expenditures as well as incomefor the duration of time (Marquis &Huston, 2017, p.
236). In my facility the budget process is usually a jointpower between the Director of Nursing (DON) and the facilities financedepartment. Budgets are required in anorganization because it would increase and improve the quality of care in thefacility. WhenI did my interview, I spoke with the DON. Finding financial information was abit challenging. The answers were vague and not straight to the point.
I wasunable to find relevant reading materials regarding financial management, andthere were scarce reference managerial tools to look up the information.However, what I learned during the interview was that there is an issuesurrounding the development of resources allocation, which I assumed relates tothe complexity of the relationship between the existing budgets. Inthe facility, we have a permanent ongoing budget that is routinely approved (unableto find who approve this budget), and a temporary budget, which is set out eachyear in the schedule of new expenditures. For example, change in staffing accordingto the facilities census.
Overall, I noticed that there is lack of informationsystem to provide appropriate information for allocating resources.Relationship of Budget to Organizational Goals AtWhitney Oaks Care Center (WOCC), our mission and vision is to provideoutstanding and innovative healthcare in an environment that remembers theimportance of the individual and family. A budget needs to be centered oninformation that includes health needs of the patients, service patternsprovided, and costs involved.
One thing I noticed is that we do not have aprofessional accountant, without accountant to manage the finance there can bea constraint on the system and a reflection of dominance in the departmentwhich can result in reduced care. In my opinion, the facility needs to be provided withadequate resources to allow effective and efficient operation. Additionally,the DON needs to review staff position and note any recommended changes in thestaffing pattern. I also spoke to someof my co-workers, and as expected, we all are clueless when it comes to thefacility finance and budget.Fiduciary Challenges Eventhough the DON in the facility is aware of the budgeting and financial process,she acknowledged that there have been a little training in budgeting, and thiscombined with the complexity of the process is a significant problem. Marquisand Huston (2017) argued that many nurses including the managers find thefiscal planning because there is lack of education and training on the budgetpreparation.
Another reason for the challenge the DON verbalized wasthat there is not enough time for department heads and nurses to attendtraining and education programs. She said, ” We already have many managementtraining. However, no accessible course concentrated on fiscal management.” Another challenge we discussed was the fact that most ofus nurses at the facility do not know the facility financial managementperformance because communication among the department heads is lacking. The financial books are not in reach for thenurses as well. Professional Nurse’s Fiscal Role The role of the decision maker on the facility or in anyhealthcare organization can increase the inherent capacity if the head nurse tocritically think and make independent and informed decision regarding theimprovement of their financial management competency. For example, at WOCC Ibelieve providing the nurses with budgeting information or keeping thebudgeting resources at reach can improve our awareness on how money is beingspent in the facility. Department heads should use a variety of empowermentstrategies that are important to the intrinsic motivation of head nurses.
Weas professional nurses and members of an organization should make sure weattend a few in-service training on financial management to learn and gain moreknowledge on how facility budget works and operates. Overall, preparing nursesto influence the financial performance of the facility on a regular basis is necessary,because financial management not only promotes department benefit but also successfullyreduces medical cost and improves the deficiency of medical resources. Finally,after the interview, I realized that the budget interconnects information aboutthe facility to other parties who have an interest in the facilities status. Inmy facility’s case, the DON must often be able to justify proposed expenses andrevenues to the interested parties.