NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

            Working in health care is not an easy task. There are always competing needs and ethical dilemmas that need to be addressed. Nurses are frequently understaffed and overworked, leading to burnout and an increase in medical errors. Resources are often limited. Throughout COVID-19, personal protective equipment (PPE) has been limited, providing unsafe work environments for all medical personnel. Additionally, cleaning materials, gloves, and other important equipment have been unavailable. Nurses are placing themselves and their patients in danger working with limited resources and decreased staffing. Patients are waiting to seek care until it is dire, increasing morbidity and mortality while also increasing the workload of current nurses. Currently, health care in the United States is facing competing needs and stressors that greatly impact the quality of care provided. Through this discussion post, I have decided to focus on the increased stress load of patients related to understaffing and greater workloads, as I experience this on a daily basis in my current workplace.

Nurses are constantly being challenged in their workplace. They are under great pressure of providing quality nursing care with an evidence-based background while being limited in resources, taking much of their energy, pride, and their ability to provide family-based, holistic health care (Kelly & Porr, 2018). Several incentives for longevity of nurses have been identified and implemented into policy, whether at a facility, state, or national level. For instance, facilities that have policies surrounding higher rates of pay and benefits experience a decrease in nursing shortages (Combes et al., 2018). This exemplifies one of the many ways competition can improve the quality of care clients receive. In states such as Minnesota, nursing unions advocate for wage increases and improvements in benefits and salary. Being a part of the union allows nurses to advocate for changes in policy that promote safer work environments for patients and nurses alike.

In 2017, the Minnesota Nurses Association (MNA) received 3,048 reports regarding dangerously low staffing (Minnesota Nurses Association, n.d.). This has resulted in patients not receiving medication on time, patients not receiving adequate assessments, and discharge education being neglected. Additionally, short staffing leads to risk of patient harm, longer hospital stays, medication errors, preventable injury, increases in infection rates, and possibly even death (Minnesota Nurses Association, n.d.). As a member of the nursing union, Minnesota nurses have the opportunity to file short staffing reports when they feel safety is being compromised. The MNA sends these reports to the facility, nursing leaders, and state officials, yet 2,372 of the reports filed had no response (Minnesota Nurses Association, n.d.). It is frustrating for nurses and patients to see that nothing is being done to fix the issues surrounding short staffing. However, by filing these reports to your local union, they bring these concerns to the bargaining table and to Legislation, promoting the creation of policy surrounding safe staffing levels.

Additionally, issues surrounding understaffed hospitals have led to greater problems in controlling the cost of health care. Minnesota has seen large reductions in access to care with hospitals and insurance companies making higher profits than ever seen before (Minnesota Nurses Association, n.d.). The Minnesota Nurses Association has recognized the problems surrounding cost of care and is working towards policy solutions. It has been suggested by the MNA that policy require transparency surrounding the closing of health care facilities, ensuring that advance notice is provided to legislature, municipal officials, and communities in order to prepare for changes (Minnesota Nurses Association, n.d.). By providing this advanced notice, it would allow the legislature to review the community impacts of closure and how it would affect quality and cost of care for clients served.

The Minnesota Nurses Association has also proposed that hospitals benefit from a tax break, exempting them from state income tax, sales tax, and property tax (Minnesota Nurses Association, n.d.). By providing this relief, it would enable hospitals to provide greater community benefits surrounding patient care, research, education, and preventative measures. By allowing for these tax breaks, hospitals could work to combat the cost of care and provide quality improvements for communities. As I have discussed in recent weeks, the rising cost of health care has caused astronomically problems for patients, families, and health care providers. Increases in numbers of morbidity and mortality have led to nurses being overworked and understaffed. This is promoting an environment of unsafe care. Additionally, the continued rising cost of care is preventing individuals from seeking the care that they need.

In order to combat the fight against rising health care related costs we must advocation on a legislative level. Policy must be established to prevent hospitals and insurance companies from creating a business out of the health care industry. Policies proposed above by the Minnesota Nurses Association are great examples of things our communities could do to decrease the rising cost of care. This would benefit our communities and our health care workers tremendously. As we are aware, hospitals are focusing primarily on preventative health measures. Unfortunately, if the cost of care remains this high, it will be nearly impossible to reach entire populations before chronic disease ensues. As professional nurses, we must continue to work with our facility and union leaders to promote a voice for change on a political level. Policy implementation may be our final chance at evolving health care to be affordable to all, making it a right rather than a privilege.

References

Combes, J.B., Elliot, R.F., & Skatun, D. (2018). Hospital staff shortage: The role of the

competitiveness of pay of different groups of nursing staff on staff shortage. Applied Economics, 50(60), 6547-6552. doi: 10.1080/00036846.2018.1490000.

Kelly, P. & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to

enhance RN practice. The Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06.

Minnesota Nurses Association. (n.d.). Press release: MNA nurses report short staffing pervasive

in Minnesota hospitals. https://mnnurses.org/press-release-mna-nurses-report-short-staffing-pervasive-in-minnesota-hospitals/.

The World Health Organization (WHO) has declared the year 2020 as the Year of Nurse and Midwife, where nurses play a pivotal role in the fight against the COVID-19 pandemic. Nurses and other healthcare professionals (HCP) were touted as the new heroes of this generation. We have seen scenarios where HCPs are being applauded as they walk to or from the hospitals. Law enforcement and fire trucks even line the streets, blaring their sirens and lights in homage to the service of HCPs being in the frontline in the fight against the pandemic. But despite the credits the HCP are getting, they are still humans that succumb to stress, exhaustion, and burnout in the line of their profession.

            Burnout of healthcare workers are a top priority issue for healthcare organizations. Competing issues that may affect policies that will mitigate health worker burnout is short staffing for nurses, and an increase in workload. Shortage of nurses means the narrow supply in the setting of increasing demand for nursing services (Gennaro, 2020). The increasing number of hospitalized, critically ill patients due to the pandemic and the growing number of the elderly population is increasing the demand for nursing care. The danger nurses are facing in this time of pandemic might also lead future generations to shun away from nursing because of the risk involved in the profession and further worsen the shortage (Gennaro, 2020). Inadequate supply of protective personal equipment (PPE) could also have a big impact on the stress level of HCWs. Healthcare organizations (HO) are always thinking of the longevity of the crisis and PPE conservation and thus there is some concern that HO is too stingy in distributing PPEs which causes some of the HCW to feel stressed with issues pertaining to the protection of their well being. The feeling of helplessness of employees pervades organizations that did not properly address their PPE distribution issue (Moore et al., 2021).

            Nursing shortage increases the workload of nurses. When the workload is increased, nurses are then exposed to physical and mental stresses that lead to burnout (Liu et al., 2020). Burnout is associated with feelings of cynicism and nurses’ intention to leave their profession. A high turnover rate impacts the organization negatively as it is very expensive and time-consuming to replace and train a new nurse (Diehl et al., 2021).

            Inadequate or mismanagement of PPE supply likewise is detrimental to the organization. It is important to conserve resources but not at the expense of the safety of the HCWs. Rationing of PPEs is a sensitive issue for the HCWs as a failure by the organization to provide adequate PPEs could risk exposure of the HCW and jeopardize their safety and cause the HCW undue stress and feeling of helplessness and anger towards the organization (Moore et al., 2021).

References

Diehl, E., Rieger, S., Letzel, S., Schablon, A., Nienhaus, A., Escobar Pinzon, L., & Dietz, P. (2021). The relationship between workload and burnout among nurses: The buffering role of personal, social and organisational resources. PLOS ONE, 16(1), e0245798. https://doi.org/10.1371/journal.pone.0245798

Gennaro, S. (2020). 2020: The year of the nurse as seen through a coronavirus lens. Journal of Nursing Scholarship, 52(3), 231–232. https://doi.org/10.1111/jnu.12556

Moore, K. S., Hemmer, C. R., Taylor, J. M., & Malcom, A. R. (2021). Nursing professionals’ stress level during covid-19: A looming workforce issue. The Journal for Nurse Practitioners. https://doi.org/10.1016/j.nurpra.2021.02.024

. In every organization, there are always competing ought to be addressed to ensure efficiency in the operational processes. Specifically, in healthcare institutions that involve the development and implementation of different policies, there are always competing needs be fully addressed by the management or policymakers. Competing needs arise within any organization as healthcare workers seek to meet their targets and leaders seek to meet hospital goals (Minvielle, 2018). In every healthcare organization, leaders and workers often have their specific goals. The differences in their objectives or goals may lead to competing needs. As leaders and workers set their targets, there are always priorities; besides, there is always the need to consider the available resources that may facilitate processes and procedures towards meeting these goals. A policy addressing adequate nurse staffing is essential to meet the patient and workforce needs while minimizing hospital costs. However, utilization of more nursing staff might result in economic inefficiencies along with misallocated resources (Wicks & St Clair, 2017).

Before embarking on allocating resources, there is always the need for healthcare management to consider their priorities to address the competing needs. In most cases, healthcare institutions consider their priorities before distributing resources to different processes. To effectively formulate policies that would ensure incorporation of the best practices as well as the efficiency in the general operational processes, the management needs to involve nurses and other healthcare professional teams (Park & Yu, 2019). In other words, making a decision on where to allocate resources should involve the entire workforce. A policy might address these competing needs by ensuring an optimal nurse-to-patient ratio, improving care outcomes for patients, and ensuring patient safety. Besides, a policy may be formulated and enough resources allocated to ensure a significant reduction in the number of healthcare-acquired infections and the improvement in patient outcomes.

References

Minvielle, E. (2018). Toward Customized Care: Comment on”(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”. International journal of health policy and management, 7(3), 272. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890073/

Park, H., & Yu, S. (2019). Effective policies for eliminating nursing workforce shortages: A systematic review. In Health Policy and Technology, 8(3), 296-303. https://doi.org/10.1016/j.hlpt.2019.08.003

Wicks, A. M., & St Clair, L. (2017). Competing values in healthcare: balancing the (un) balanced scorecard. Journal of Healthcare Management, 52(5). https://web.a.ebscohost.com/abstract?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=10969012&AN=27028943&h=xt8qw%2fV9vHxEXGym8bL66d4PtA2v%2f%2bjudnSM4Nhe6H