Critical Analysis
Loyola University New Orleans
Abstract
Nursing leadership within the healthcare organization has brought to the forefront of problem that nurses complain of when it comes to job satisfaction. It is this lack of satisfaction with their current leadership and position that plays a direct role in theior retainability and The San Antonio Military Medical Center (SAMMC) 2-South Surgical-Trauma Intensive Care Unit (STICU), is one of two such STICUs within SAMMC. There are six ICUs and one Burn ICU operating in the largest Level I trauma center in San Antonio, Texas. This paper will examine and compare two separate nursing theories and their applicability to nursing leadership within healthcare organizations.

Critical Analysis
Intensive Care Units within any health care facility have long been proven to employ the highest quality nurses with the most nursing experience and knowledge base. Staffing units such as these is probably one of the most challenging experiences for a unit manager of any health care facility. The types of patients that require admission to the ICU are the highest acuity patients within the hospital setting. These patients are critically injured and or terminally ill. The nurses that care for these patients work under the most stressful circumstances. The Human Resources department for SAMMC must maintain adequate personnel to staff the medical center in a manner that is both safe for the patient and the staff members alike. The SAMMC Human Resources Department was assessed in relation to the medical center’s operations by assessing the major; strengths, weaknesses, threats, and opportunities (SWOT ANALYSIS).
The San Antonio Military Medical Center functions as one of only thirty one hospitals within the United States that holds both Level I trauma certification and American Burn Association certification. SAMMC is also accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). There are also numerous certifications and accreditations throughout SAMMC, within the individual departments of the hospital that are listed by Fried & Fottler (2008). SAMMC is a government owned health care facility that is operated by a military joint base, currently led by the United States Air Force. Being a military healthcare facility requires that SAMMC remain compliant within all aspects of federal employment and healthcare law, or face financial penalties for such deficiencies and noncompliance.
U.S. Army medical centers staff their facilities differently than the rest of the U.S. Army. Medical facilities are considered non-deployable and therefore staff according to the health care mission of the military installation that they are attached to. Deployable units within the U.S. Army are referred to as TO&E units, which stands for Table of Organization and Equipment. Hospitals and other non-deployable units within the U.S. Army are considered TDA, which stands for Table of Distribution and Allowances. All units within SAMMC are allocated staff members based on what their respective TDA calls for. Available beds, unit mission, and past census help determine what the TDA calls for staffing. There is a somewhat high turnover rate of military staff RNs due to military Permanent Change of Station (PCS), where the military member receives orders to move to another military base. Due to the excellent retirement benefits available to the GS RNs and the lower staff-to-patient ratios, their staffing historically remains higher than most civilian healthcare facilities. In the 2-South setting, I would focus on maintaining the GS employee staffing at optimum capacity by utilizing bonuses and scheduling flexibility to offset the possible staffing shortage that arises due to deployed military staff members.
This paper focuses on 2-South Surgical-Trauma Intensive Care Unit, one of two Surgical-Trauma Intensive Care Units in SAMMC. The difficulty associated with staffing a military