Assignment: Developing Organizational Policies And Practices on Nursing Shortage

Assignment: Developing Organizational Policies And Practices on Nursing Shortage

Assignment: Developing Organizational Policies And Practices on Nursing Shortage

As nurses we’re faced with ethical dilemmas daily. We must not confuse ethics and the actual laws surrounding this profession. Although ethics and the law are very similar and paths overlap, they are not the same. Ethical dilemmas occur quite frequently in the healthcare field, which makes healthcare professionals more aware of how to respond to such events. Ethical issues put all healthcare professionals in the mindset of doing what is best for the patient. A national healthcare issue that is currently on a higher trend seems to be the nursing shortage in the work field. Overwhelming patient assignments ultimately lead to disgruntled staff affecting the overall working environment. The shortage in nursing many organizations are facing seem to have multiple effects on quality improvement or indicators such as customer service scores, increased amount of workloads and a decrease in the quality of care rendered (Buerhaus, Skinner, Auerbach, & Staiger, 2017).

As safety is the number one goal inpatient care, polices over time have been revamped to ensure safer working environments for the shortage of nurses ultimately reducing medication errors as well as nurse burnout. Moreover, whereas patient needs dictate that hospitals shpuld hire more nurses, the financial performances of these hospitals is also a factor. Thus, nurisng shorateg is being affected by the need to provide quality healtt care services vis-à-vis the need to maintain heallty financial performances by health care facilities. Evidence suggests that hospitals have chosen the latter need hence the existence of nursing shortage.

Policies and Practices to Address Nursing Shortage

At a leadership level, leaders must find the common balance to retain nurses by any means necessary while also understanding the demands placed on staff with unbearable patient acuities. Finding such balances demand strict policies to be put in place even if they are state-regulated. Within my organizations, we have strict policies for the different levels of care to determine the patient/nurse ratio (Abhicharttibutra et al., 2017). With the higher demands of needs for the care the patient may require they are put on different units, which also sets the bar for the nurse-patient ratio. A patient at a medical-surgical level of care does not and may not require the same care as a patient at an intensive care unit.

For each level, there are guidelines our hospital follows, which will tell providers, managers, and patient flow coordinators the needs of the patient and the appropriate floors. This is done to ensure the acuity levels are not too intense for that unit, especially for the nurse-patient ratio on that unit. Along with setting limits regarding the units and patient level of care, there are also patient acuity tools utilized. Patient acuity tools have been proven useful with the formulation of proper nurse to patient ratios as well dispersing workloads. The purposes for nursing tools as such “increase nurse satisfaction with their patient assignment.”

Composing policies is done at many organizations and is forever changing. With established policies, the healthcare field is able to have standards in place to protect staff. Furrther, by enforcing these policies, nurses are protected from things such as assuming care of patients in what may be unsafe working environments. The American Nurses Association (ANA) is the safeguard for nurses and guides the policymakers within organizations for safe conditions. According to the ANA, federal regulations have been in placed to support nursing staff for safer working environments implying that facilities have an adequate amount of staff for patient care. The goal of policies and laws as such are necessary for the ensuring safety of the patient as well as safe workloads (Ferrer et al., 2014).

Currently, there are a few states with staffing laws which is remarkable because by law that nurse is protected. The main strengths of staffing laws are that they help in enhancing the number of nurses employed annually in the healthcare sector, hence reducing patient-nurse ration in addition to protecting the rights of nurses for better healthcare (Yang, Hung, & Chen, 2015). However, the main obstacle towards this policy is that some states have failed to implement staffing laws, which makes it very hard to track down the hiring frequency and the total number of nurses in that state. As a result, the quality of healthcare tends to be affected negatively. Within such states, items such as patient acuity tools are used to help with facilitating fair-shared assignments amongst staff.

Response I

Hello Ayeshia, Great post! Thank you for your insight into this discussion; very informative. The first case of Covid-19 was reported in Wuhan, China. As of April 4th, 2020, more than 1 million infected patients were reported, and the disease spread over more than 60 countries worldwide (Talaee et al., 2022). According to Huang et al. (2020), COVID-19 is an acutely fatal disease that causes millions worldwide due to progressive respiratory complications.

At the beginning of the pandemic, a lack of available treatment forced healthcare professionals to optimize only symptomatic treatments, isolate patients and provide supportive care. It was a stressful experience for many healthcare workers. The authors state that gender or age can influence the stress level at work and thus represent a risk factor; among nurses, women are more stressed than men (Couarraze et al., 2021). Covid was a pandemic that affected the whole healthcare system.

During the COVID-19 pandemic, the working conditions were overwhelming; healthcare professionals experienced high work-related stress. I worked as a progressive care unit (PCU) and Intensive care unit charge nurse. This pandemic was the most challenging experience I have been through in my life. There were days that I witnessed nurses and doctors crying, frustrated because there was no chance to save the patient despite performing all the possible interventions and following all the policies. Sometimes, doctors and nurses coded patients for as long as an hour because we refused to lose the battle; calling families to notify them that we lost their 20-year-old child, husband, wife, mother, father, siblings, or loved one was hard to do.

References

Couarraze, S., Delamarre, L., Marhar, F., Quach, B., Jiao, J., Avilés Dorlhiac, R., … & Dutheil, F. (2021). The major worldwide stress of healthcare professionals during the first wave of the COVID-19 pandemic–the international COVISTRESS survey. PloS one, 16(10), e0257840.

Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., … & Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet, 395(10223), 497-506.

Talaee, N., Varahram, M., Jamaati, H., Salimi, A., Attarchi, M., Sadr, M., … & Seyedmehdi, S. M. (2020). Stress and burnout in health care workers during COVID-19 pandemic: validation of a questionnaire. Journal of Public Health, 1-6.

Ethical Considerations

One ethical issue when dealing with policies aimed at solving nursing shortage the laws on aging nurses and retirement. Healthcare facilities are faced with the hard decision of how to reduce the nursing shortage when the majority of nurses will be retiring in a few years. Many healthcare organizations have come up with strategies to work with nursing schools in the country where students will get absorbed after studying. It is however difficult for health institutions as they want to retain experienced nurses (Ferrer et al., 2014). Some of the policies that should address the nursing shortage should look at how the nurses are hired and the intervals of hiring to prevent the massive exit of nurses due to retirement such as the staffing laws. Aging nurses have the experience and expertise to provide quality health services. Experience in nursing will help in observing the principle of doing no harm. Experienced nurses will do little or no harm to patients. It is therefore important to consider the nursing principle of nonmaleficence when addressing the issue of nursing shortage in the country. Additionally, offering subsidized funds for students and nursing faculties will also help in solving the nursing shortage (Abhicharttibutra et al., 2017). This will help in increasing the enrollment of more students into nursing. Loan programs with no interest will also be initiated in nursing schools for registered nurses who want to enroll in advanced nursing courses. Consequently, increasing using wages will also attract more students to nursing school, which will, in turn, increase the number of nurses in the entire state

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Given the community gap in understanding the nursing profession, improving the image of nursing in the country, by encouraging nurses to frequently communicate with the press on positive nursing aspects will help to attract more students to take up nursing courses hence curbing the nursing shortage. Consequently, nurses should be encouraged to mentor students and lure the younger generation into taking up nurses courses. It is also necessary to launch nursing professionals’ advertising campaigns through social media platform, which will support the profession. It is also important for the supervisors in health care facilities to be encouraged to offer physical and psychological support to the workers. The supervisors should also be trained frequently to improve their supervisory skills. The knowledge imparted to them during the training will include treatment of the staff favorably, being friendly to the staff and encouraging team building (Nantsupawat et al., 2017).

Positive impacts of nurses will be acknowledged through recognition. A chance for the nurses to voice their view and take part in policy-making activity will be in cooperated in all healthcare facilities. As such, the nursing working environment will be friendly hence retaining most nurses in their jobs and attracting young students towards joining the profession in future. A good example is a work that has been accomplished by the America Nursing Association in protecting the rights of nurses and enhancing ethical observation in the nursing profession which has greatly led to an increase in the number of nurses in the country (Abhicharttibutra et al., 2017). The organization has also initiated several training programs and scholarships which has attracted more young generation to study nursing which will completely abolish the issue of nursing shortage in future.

Assignment: Developing Organizational Policies And Practices on Nursing Shortage

Assignment: Developing Organizational Policies and Practices

By Day 7 of Week 3

Submission and Grading Information

Cost of medication determines whether the patients will be willing to seek healthcare services from an institution or not. The goal of the quadruple Aim is to reduce the cost of education and increase the access to healthcare services by the population. The cost of medication depends on various factors including the changing economic times and the need to increase the number of healthcare providers in an organization. From the business perspective, institutions operate with the aim of making profits. Therefore, in the call for improving the quality of the healthcare services the patients receive, the healthcare institutions may require to increase their staffs and other equipment necessary for efficient operations. Addition of the resources result in the increased cost which must be transferred to the patients who are the consumers. Therefore, the current study explores the conflicting perspective of the mandatory overtime as a way of meeting the needs of the patients without increasing the cost of medication.

Competing Needs

The increasing number of patients in the healthcare institution requires an additional human resource. However, conventionally, the ratio of healthcare providers to the patients have remained low because of the limited resources. Healthcare providers are forced to attend to many patients beyond the standard requirements. Alternatively, the healthcare institution may opt to recruit more staff and this will result in additional costs which may be transferred to what patients pay. Some leaders may opt make full of their current staffing in responding to the rising costs and change in the payment policies by the federal government.

The introduction of the pay-for-value compensation method meant that healthcare institution would improve the quality of healthcare services to the patients (Kominski et al., 2017). Besides, the policy aimed at eliminating all the unnecessary health interventions that could otherwise increase the cost of medication. Furthermore, the hospital institutions are forced to utilize their existing staff accordingly to improve both the quality of care and minimize the treatment costs. Nurses and other healthcare providers may be forced to work for long hours since they have to spend lots of time understanding the need of their patients to meet the quality threshold (Bernstrøm et al., 2019). On the other hand, the increasing number of patients also force them to work overtime. Therefore, the need to lower the cost of medication and at the same time maintain the quality.

Relevant Policy Practice

The healthcare organization introduced the mandatory overtime as a way of dealing with increasing demand for the quality healthcare services as well as maintain the cost low. Eliminating the mandatory overtime means that the institution may have to employ more staff and this will result in additional cost of medication. The nursing staffs are expected to work for about 2 hours extra per day to meet the demand for healthcare delivery. The policy was introduced after recognizing that the nurses and clinicians spent little time with the patients and so did not identify all their needs. As a result, the healthcare providers were required to spend enough time and so they would have to work overtime depending on the patients’ flow. Therefore, all the employees recruited in the organization were made aware of the mandatory overtime requirement whenever requested.

Critique of the Policy

The policy was developed to respond to the need to improve the quality of healthcare services to the patients. The introduction of the pay-for-performance means that the healthcare institutions would be compensated based on the patients outcome and not the services offered. As a result, the institution had to develop an approach of responding to the need without increasing the costs of medication to the patients. Nurses and clinicians would spend more time with their patients and understand all understand the underlying factors that could impact their treatment outcomes and this would lead to better outcomes.

However, exposing the healthcare providers to long-working hours could leads to injuries and emotional exhaustion. Studies have indicated that burnout among the employees in healthcare sector is attributed to the long working hours (Kowalczuk et al., 2020). It is ethically wrong to expose the healthcare providers to health risks with the intention of reducing the medication costs (Moon et al., 2020). The quadruple Aim advocate for both the better outcomes for the patients and improved quality of life for the healthcare providers. Mandatory overtime for the healthcare providers does not improve their quality of life but instead increases their risk of developing burnout.

Furthermore, studies show that fatigued employees are prone of making errors and this means that the patients could suffer more from the medication errors (Salen & Norman, 2018). The policy in the institution is only suitable for short-term goal but destructive in the long-run. All healthcare providers must be treated with dignity and be given enough time for rest. Therefore, while the goal of the policy was to address the issue of rising costs, it could increase the costs because of the frequent recruitment requirement due to high employees’ turnover in the organization. High turnover rates could compromise the quality of the healthcare delivery to the patients farther.

Recommendation

The healthcare organization can use other policies to improve the quality of healthcare services in the organization other than the mandatory overtime. The healthcare institution can introduce the electronic health system that will allow the healthcare providers to interact with their patients virtually and so reduce their need to go to the hospitals. The electronic health system will increase interaction between the healthcare providers and their patients as well as improve the level of patients’ commitment in managing their health (Sprivulis, 2020). Eventually, the pressure to attend to many patients in the hospital will reduce as the quality of treatment improves. In addition, the cost of medication ill improve significantly (Sanyal et al., 2018).

The healthcare providers will work with the community health volunteers in offering the healthcare services to the patients at home. The policy will promote better treatment outcomes which will improve the quality of life for the healthcare providers. Furthermore, the healthcare providers will be motivated to offer their best in interacting with the patients.

Conclusion

The rising cost of medication following the Medicaid and Medicare programs present a significant challenge to the healthcare delivery process. The introduction of pay-for-value compensation aimed at making the medication costs affordable. However, the increase in the number of patients seeking healthcare services exerts a significant pressure on the limited number of healthcare staff. The introduction of the mandatory overtime is one of the ways of ensuring the healthcare providers offer quality services to all patients. However, the policy presents more harm to the healthcare providers’ health. The electronic health systems can be deployed by healthcare institutions to minimize the need for the patients to visit the hospital and improve the treatment outcomes.

References

Bernstrøm, V. H., Alves, D. E., Ellingsen, D., & Ingelsrud, M. H. (2019). Healthy working time arrangements for healthcare personnel and patients: A systematic literature review. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-3993-5

Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38(1), 489-505. https://doi.org/10.1146/annurev-publhealth-031816-044555

Kowalczuk, K., Krajewska-Kułak, E., & Sobolewski, M. (2020). Working excessively and burnout among nurses in the context of sick leaves. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.00285

Moon, S., Mariat, S., Kamae, I., & Pedersen, H. B. (2020). Defining the concept of fair pricing for medicines. BMJ, l4726. https://doi.org/10.1136/bmj.l4726

Salen, P., & Norman, K. (2018). The impact of fatigue on medical error and clinician wellness: A vignette-based discussion. Vignettes in Patient Safety – Volume 2. https://doi.org/10.5772/intechopen.70712

Sanyal, C., Stolee, P., Juzwishin, D., & Husereau, D. (2018). Economic evaluations of eHealth technologies: A systematic review. PLOS ONE, 13(6), e0198112. https://doi.org/10.1371/journal.pone.0198112

Sprivulis, P. (2020). Connecting health care through information technology. Patient Safety First, 299-317. https://doi.org/10.4324/9781003116677-14

A rubric lists grading criteria that instructors use to evaluate student work. Your instructor linked a rubric to this item and made it available to you. Select Grid View or List View to change the rubric\’s layout.

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Name: NURS_6053_Module02_Week03_Assignment_Rubric
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Excellent Good Fair Poor
Add a section to the paper you submitted in Module 1. In 4–5 pages, address the following:

· Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
Points Range:23 (23.00%) – 25 (25.00%)
The response accurately and clearly identifies at least two competing needs impacting the healthcare issue/stressor selected.
Points Range:20 (20.00%) – 22 (22.00%)
The response identifies at least two competing needs impacting the healthcare issue/stressor selected.
Points Range:18 (18.00%) – 19 (19.00%)
The response identifies at least two competing needs impacting the healthcare issue/stressor selected that is vague or inaccurate.
Points Range:0 (0.00%) – 17 (17.00%)
The response describes at least two competing needs impacting the healthcare issue/stressor selected that is vague and inaccurate, or is missing.
· Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.

· Critique the policy for ethical considerations and explain the policy\’s strengths and challenges in promoting ethics.
Points Range:27 (27.00%) – 30 (30.00%)
The response accurately and thoroughly describes in detail a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected.

The response accurately and thoroughly critiques in detail the policy for ethical considerations and explains in detail the policy\’s strengths and challenges in promoting ethics.
Points Range:24 (24.00%) – 26 (26.00%)
The response accurately describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected.

The response accurately critiques the policy for ethical considerations and explains the policy\’s strengths and challenges in promoting ethics.
Points Range:21 (21.00%) – 23 (23.00%)
The response describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected that is vague or inaccurate.

The response critiques the policy for ethical considerations and explains the policy\’s strengths and challenges in promoting ethics that is vague or inaccurate.
Points Range:0 (0.00%) – 20 (20.00%)
The response describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected that is vague and inaccurate, or is missing.

The response critiques the policy for ethical considerations and explains the policy\’s strengths and challenges in promoting ethics that is vague and inaccurate, or is missing.
· Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.

· Cite evidence that informs the healthcare issue/stressor and/or the policies and provide two scholarly resources in support of your policy or practice recommendations.
Points Range:27 (27.00%) – 30 (30.00%)
The response provide one or more accurate, clear, and thorough recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies.

Specific and accurate examples are provided.

Accurate and detailed evidence is cited that informs the healthcare issue/stressor selected and a specific synthesis of at least two outside scholarly resources in full support of the policy or practice recommendations is provided. The response integrates at least 2 outside resources and 2 or 3 course-specific resources that fully support the healthcare issue/stressor selected.
Points Range:24 (24.00%) – 26 (26.00%)
The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies.

Specific examples may be provided.

Evidence is cited that informs the healthcare issue/stressor selected and a synthesis of at least one outside scholarly resource that may support the policy or practice recommendations is provided. The response integrates at least 1 outside resource and 2 or 3 course-specific resources that may support the healthcare issue/stressor selected.
Points Range:21 (21.00%) – 23 (23.00%)
The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies that is vague or inaccurate.

Examples may be provided.

Vague or inaccurate evidence is cited from 2 or 3 resources that informs the healthcare issue/stressor selected and may support the policy or practice recommendations provided.
Points Range:0 (0.00%) – 20 (20.00%)
The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies that is vague and inaccurate, or is missing.

Examples are missing.

Vague and inaccurate evidence is cited that informs the healthcare issue/stressor and may include at least 1 scholarly resource that vaguely and inaccurately supports the policy practice recommendations is provided, or is missing.
Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
Points Range:5 (5.00%) – 5 (5.00%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
Points Range:4 (4.00%) – 4 (4.00%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.
Points Range:3.5 (3.50%) – 3.5 (3.50%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.
Points Range:0 (0.00%) – 3 (3.00%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion was provided.
Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation
Points Range:5 (5.00%) – 5 (5.00%)
Uses correct grammar, spelling, and punctuation with no errors.
Points Range:4 (4.00%) – 4 (4.00%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
Points Range:3.5 (3.50%) – 3.5 (3.50%)
Contains several (3 or 4) grammar, spelling, and punctuation errors.
Points Range:0 (0.00%) – 3 (3.00%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
Points Range:5 (5.00%) – 5 (5.00%)

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