NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

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Competing needs arise within any organization as healthcare workers strive to meet their goals and hospital leaders strive to meet hospital objectives. Setting priorities and allocating resources are required for either targets or goals. A policy addressing adequate nurse staffing, for example, is critical to meeting patient and workforce needs while minimizing hospital costs. Using more nursing staff, on the other hand, may result in economic inefficiencies as well as misallocated resources.

Staff shortages have negative consequences, such as lower quality and quantity of care because there are fewer resources to offer. Work overload causes burnout among existing nurses, compromising patient safety. Current literature consistently supports nursing shortage policies, which vary by country. However, there is a continuous effort to improve the working environment for nurses by changing certain aspects such as pay agreements, emergency hiring plans, and RN residency programs (Park & Yu, 2019). Nurses should also express their views on how to reconcile competing needs; the culture of silence fosters acceptance and continues to suppress nursing professional knowledge (Kelly & Porr, 2018).

The aging population, with baby boomers entering the age of increased need for health services, is one competing need that may impact nursing shortage. This would necessitate more students enrolling in nursing programs today, as well as the hiring of more educators to provide students with proper training. Another factor is nurse burnout; statistics show that national turnover rates range from 8.8% to 37%. (Lisa et al., 2020). Nurses are experiencing burnout on a daily basis and are leaving the profession in search of better opportunities or advancement. Maintain optimal nurse-to-patient ratios in order to improve nurse staffing and the quality of care provided. Finally, hospitals have been forced to reduce staffing and implement mandatory overtime policies in order to ensure nurses are available to work when the number of patients admitted unexpectedly increases. Additionally, increase the workload to reduce health-care costs.

A policy might address these competing needs by ensuring an optimal nurse to patient ratio which can improve care outcomes for patients and ensure patient safety. Healthcare policymakers’ involvement in developing a staffing policy in every organization to improve working conditions (such as working hours, violence in workplace, managing workload) for the nurses staff to improve competencies and better job satisfaction. Ensure adequate government funding to allocate resources for training and clinical skills without causing strains on the government and organization budget. Also, devote resources toward increasing nurses wages; a token of appreciation for their dedicated and hard work.

The COVID-19 pandemic has revealed many critical issues in the national healthcare system in the United States. The nursing shortage is among the top priorities because the whole system relies on nursing practitioners as the backbone. The statistics emphasize the urgent measures taken at each level of the government. As of March 2022, almost every state had taken executive actions to address the shortage, such as issuing temporary licenses to put nursing students to work (Zhavoronkova et al., 2022). The problem is significant enough to disregard the impact of competing needs in healthcare delivery.

Nursing shortage results from the impact of various external forces on the healthcare system. These include but are not limited to the aging population, aging workforce, nurse burnout, and population growth (Haddad et al., 2022). Therefore, the demand for registered nurses will be the highest among all professions. The reported growth will be at a faster rate (9%) than all other occupations, with more than 275,000 additional nurses being needed until 2030 (Haddad et al., 2022). The government actively invests in the development of nursing education and encourages more people to enter the profession and address the shortage. Nevertheless, the impact of competing needs in healthcare delivery persists. The available nurse workforce does not have sufficient resources to address all primary care needs. Alternative approaches such as preventative and chronic disease interventions and outpatient care models help close the gap, but they do not suffice (Korownyk et al., 2017). The nursing shortage is inextricably linked to diversity, aging, and education accessibility. For instance, the number of nurses has not kept up with the aging US population (Zhavoronkova et al., 2022). It implies that the new policies need to be comprehensive, addressing the factors and aspects of the healthcare issue.

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

Your post and observation on this issue is important and I would say I did witness the stress that Covid-19 brought to my job, community, and the country. The World Health Organization (WHO) declared COVID-19 as a pandemic on March 11, 2020, when infections and deaths began to increase exponentially worldwide. The first cases were reported during December 2019 in Wuhan, China (WHO, 2020). I worked at my local hospital here in Tampa, Florida and when covid came, the hospital did not know how to handle it, surgeries were limited to emergencies only, we lost hours at work and sometimes we were forced to work on covid floors against our will. It was frustrating! I had to get another job as I wasn’t making enough to support the family and eventually after a few months decided to finally face the devil (Covid-19) and took a travelling nurse job.

The stress and inconvenience brought by Covid-19 was tasking on both healthcare workers and patients. It was sad for health care workers to see their colleagues get the virus, suffer health consequences and die. The rapid spread of the disease created challenges for healthcare systems and forced healthcare workers to grapple with clinical and nonclinical stressors, including shortages of personal protective equipment, mortality and morbidity associated with COVID-19, fear of bringing the virus home to family members, and the reality of losing colleagues to the disease (Hall, 2020).

The burnout from the adverse effect of covid-19 combined with nursing shortage heightened the stress in the healthcare industry mostly with nurses bearing the brunt of it all. Colleagues at my job were constantly complaining, reluctant to work, at times I would hear nurses crying in the bathroom and break room. There were no early organizational strategies in place to assist employees with stressors related to Covid-19. Early detection of psychological distress and supportive intervention should be taken according to the associated factors to prevent more serious psychological impact on frontline nurses (Nie et al., 2020).

Thank you.

References

Hall, H. (2020). The effect of the COVID-19 pandemic on Healthcare Workers’ Mental Health. Journal of the American Academy of Physician Assistants, 33(7), 45–48. https://doi.org/10.1097/01.jaa.0000669772.78848.8c

Nie, A., Su, X., Zhang, S., Guan, W., & Li, J. (2020). Psychological impact of Covid‐19 outbreak on Frontline Nurses: A cross‐sectional survey study. Journal of Clinical Nursing, 29(21-22), 4217–4226. https://doi.org/10.1111/jocn.15454

WHO (2020). Coronavirus disease 2019 (COVID-19). Available online at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 (Accessed: September 14th, 2022).

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.

To Prepare:

Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

By Day 3 of Week 3

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the

NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

By Day 6 of Week 3

Respond to at least two of your colleagues on two different days by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.

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The healthcare environment is significantly growing and improving the quality of clinical services is essential. Healthcare policies and

practices provide regulation in daily operation and ensure uniformity for all employees so that there are no discrepancies (Rosa et al., 2020). For a policy to be developed in nursing, the competing needs must align with the agenda the strategy is advocating for. Competing needs arise when the healthcare workers want to meet the set goals and objectives. For example, the workforce needs may be adequately addressed but the resources required are not sufficient enough to facilitate policy development (Anderson et al., 2020).

NURS 6053 DQ Organizational Policies and Practices to Support Healthcare Issues

The competing needs that may impact the national healthcare issue/stressor under study in this discussion is the multi-morbidity. Multi-morbidity is steadily increasing across the world and poses a major challenge to healthcare systems around the world (Franklin et al., 2017). According to the healthcare providers, the reasons for the rise in multi-morbidity is lifestyle choices in which most Americans live a sedentary life, leading to obesity, cardiovascular disease, and diabetes. In Medicare population, 65% of patients have two or more chronic illnesses, therefore, Multi-morbidity is related to ageing and it is also socially patterned being common and occurring at an early age in areas of high socio-economic deficiency (Sacha et al., 2020).

To address the competing needs, the healthcare organization has to implement major changes in the workforce issue, managing patients, and distribution of resources (Figueroa et al., 2019). Managing chronic illnesses reduces the cost of healthcare because the rate of chronic diseases is higher especially in the US compared to other nations. The population affected by chronic illnesses requires special attention, therefore, the government should get sufficient nurses to help the people. Through the process of expansion of the affordable treatment programs, discouraging sedentary lifestyle, improving the medication adherence, and providing grants and funds to support healthcare, the health organization in America can play its role in the reduction health care cost (Crowley et al., 2020).

In conclusion, managing chronic illnesses, increasing resources, and advising people to live a healthy lifestyle leads to achieving the set goals in healthcare. Reduction in workforce can be achieved through gathering enough resources. Managing the competing needs have impacted before setting organizations policies and practices.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 3 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 3

To participate in this Discussion:

Week 3 Discussion

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RE: Discussion – Week 3

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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

NURS_6053_Module02_Week03_Discussion_Rubric

	Excellent	Good	Fair	Poor
Main Posting	Points Range: 45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	Points Range: 40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	Points Range: 35 (35%) – 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.	Points Range: 0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness	Points Range: 10 (10%) – 10 (10%) Posts main post by day 3.	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%) Does not post by day 3.
First Response	Points Range: 17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	Points Range: 15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	Points Range: 0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response	Points Range: 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	Points Range: 14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	Points Range: 0 (0%) – 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation	Points Range: 5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days.

Total Points: 100

Name: NURS_6053_Module02_Week03_Discussion_Rubric

response #1

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Hi Alexis

References

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