Character, honor, will, self-control, respect – can be read on a piece of paper hanging on the wall of Géza Nagy’s office, and when asked about it, he answers: these are basic values in his life, and he conveys them to his colleagues as well. The first thought of the nursing director of the Szabolcs-Szatmár-Bereg County Teaching Hospital was that there had been a mistake. The fact that he would receive such a significant recognition, the civilian section of the Hungarian Golden Cross of Merit, did not even cross his mind.
Predictability, planability
Photo: Péter Sipeki
“It’s an uplifting feeling, it was an honor to take it over, and it’s also a responsibility, you shouldn’t let go of what I was given for, according to the award,” he says. And the laudation reads as follows: in recognition of the work done in order to establish and successfully operate the objective profession-specific human resources planning system for healthcare professionals. And if this seems like an unsolvable puzzle, the nursing director will introduce you to the details.
– In simpler terms, this is the human volume framework (hvk), which is a management professional topic and is about the management of skilled workers. I started dealing with this in 2005, when I was transferred to the 614-bed hospital with several active wards on Sóstói út. I investigated how the schedule and overtime of the skilled workers developed, and I came to a quite surprising conclusion: there was no system, it was random how many people were on duty day and night in the inpatient ward, and it was also impossible to track who worked overtime, when and why.
It was a motivation to be able to limit this, make it transparent, predictable and planable. I thought that if the number of beds, including the number of patients, is given, then there should always be the same number of nurses during the day and at night. This is also good for the patient, as he knows when and how many people work in the department. Leave can be granted, and overtime has a visible and real reason – he recalls the beginning of the process. The system was fully matured in 2011, when he was appointed director of nursing at the András Jósa Teaching Hospital, and they were able to increase the number of beds to 1,800 beds, reduce overtime by 85 percent, give them time off, and the wards functioned well. Later, it was introduced to the full integrated institution in five institutions with 2,700 beds. The argument in favor of hvk is that it provides a stable nursing presence at the patient’s bedside, and predictability and planability for the professional, so they can work stably and safely.
He saw all the wonders of the profession
– There is no doubt – he admits – that this narrowed the room for maneuver of the department heads, but taking into account the needs of patient care, we jointly agreed on the optimal staff numbers and the nursing professional content. We have 130 nursing units in inpatient care, and each head nurse knows the hvk that applies to him, which must be followed. If you want to deviate from this, you must consult with the deputy director of nursing, and if it is really justified, you can change it, but this is the compass, the yardstick in nursing. The human resources planning system for skilled workers is today a model and an example, many hospitals in the country come to Nyíregyháza to learn about its basics, which they can use successfully in their own institutions.
– My sister was a midwife, but I chose the nursing career not because of her example, but because of parental motivation – Géza Nagy recalls the beginnings, and adds: as a boy from Szatmárcsek, he saw a very small slice of healthcare at home. At that time, it was possible to enter the health vocational high school department of Kölcsey Ferenc High School after a very serious admission. He already completed his internship at the county hospital, so it is no coincidence that he started working here in 1986, the first in the country to start at that time, dr. Károly Pikó in the emergency department, or as it was called at the time, admission department. In addition to obstetrics, gynecology and children’s care, he met all cases, 80-100 patients were treated daily.
She worked her way through the ranks, studied, trained herself, first became a graduate nurse, completed the health management course, completed the patient rights representative training, and in 2012 she also obtained a university certified nurse qualification. Yes, he admits, his desire for learning and knowledge also contributed to the organization of professional worker training within the institution.
Internal trainings have started
– If we have the right to teach, we are an accredited training place, then let’s use it. This is good for the hospital and our employees, as they can study locally, so they don’t have to travel, they lose less time, they can advance professionally, and we benefit from their knowledge, and this is of prime importance in patient care, he explains. – Everything points to the need for internal training, and it feels good that many people have the desire to learn. Perhaps few people know, but they also organized training for patient attendants.
– The patient is monitored in the ward by doctors and nurses, however, when they have to be transferred from there for an examination, it is the responsibility of the patient attendant to notice if there is a problem, to understand the signs and changes in condition, that is why their training was necessary, their knowledge can even save lives – Géza Nagy shows that every moment of patient care is important. He won the position of Deputy Director of Nursing in 1995 at the end of a very serious selection process.
Photo: Péter Sipeki
He tried to perform both nursing and management work in parallel, but maximum performance could not be provided in two places at the same time – he refers to the high human and professional demands placed on himself. As a professional group leader nurse, he learned and experienced everything, except for a few specialties, which of course also benefits him greatly as a leader. He saw all the beauty, difficulties, troubles and wonders of the profession.
The patient’s interest is the most important
As a nursing director, you have to keep in mind and take into account the performance of institutional tasks, which does not always coincide with the interests of individual employees.
– If we can make a managerial decision that is good for seven out of ten people, then it is a good managerial decision. There is no such thing as everyone is always satisfied, so you have to try to make it good for as many people as possible. It is important for the interests of the employees to feel good, to create a good working environment, but the care of the patients and the interests of the patient must come before these. Nothing can precede this, nothing can be more important than this. Anyone who works in a hospital knows this exactly, and somewhere a certain self-sacrifice is also necessary, emphasizes Géza Nagy. As an example, he cites the period of Covid, where the interests of the patient overrode everything, when there was no end to working hours, and an amazing burden was placed on the skilled workers as well.
– My management professional principle did not change even when we became an integrated institution in 2015, and Mátészalka, Fehérgyarmat, Vásárosnamény and Nagykálló already belonged to us. My values remained the same. Eight years have passed, and that management professional thought and spirit has taken root there as well.
It’s a team effort
– I have an excellent relationship with the assistant directors of nursing, the team is very good, everyone works with the care expected of them, and this is true for the professional group head nurses, department head nurses and nurses. Nursing management is complete in this way and with them, he adds, since it is teamwork. Not only as a nursing director, but also as the regional leader of the Hungarian Chamber of Professional Health Workers (MESZK), he considers the supply of supplies to be the biggest challenge.
– In 1982, there was an eight-fold over-subscription, now there is an eight-fold shortage. And unfortunately, those who graduate don’t imagine their future here either, they don’t come to work at the hospital. There are not enough skilled workers, we can see it at the national and local level, the field is no longer attractive to young people, even despite the wage increase. It is a big responsibility to make some kind of positive change in this.
She admits that she misses nursing work in her life, but she knows her limitations, she would be the same beginner today as she was in 1986. “I still stab everyone in the family,” he says with a smile.
