NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices
Walden University NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices
Whether one passes or fails an academic assignment such as the Walden University NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices
The introduction for the Walden University NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
Struggling to Meet Your Deadline?
Get your assignment on NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices done on time by medical experts. Don’t wait – ORDER NOW!
How to Write the Body for NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices
After the introduction, move into the main part of the NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
Stuck? Let Us Help You
Completing assignments can sometimes be overwhelming, especially with the multitude of academic and personal responsibilities you may have. If you find yourself stuck or unsure at any point in the process, don’t hesitate to reach out for professional assistance. Our assignment writing services are designed to help you achieve your academic goals with ease.
Our team of experienced writers is well-versed in academic writing and familiar with the specific requirements of the NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices assignment. We can provide you with personalized support, ensuring your assignment is well-researched, properly formatted, and thoroughly edited. Get a feel of the quality we guarantee – ORDER NOW.
NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices
NURS 6053 Week 3 Assignment Developing Organizational Policies and Practices
Competing needs in healthcare organizations affect their abilities to deal with national health issues or stressors that compromise the quality of care delivery. Employees and leaders compete in healthcare settings based on the need to attain better quality provision and ensure that patients get value for their money, particularly through implementing evidence-based models like value-based care. Nurse burnout is a national health issue because of the adverse effects on nurses, patients, and the entire health care system (Chen et al., 2021). As such, healthcare organizations should evaluate their policies and practices to address nurse burnout while maintaining quality care and ethical standards. The purpose of this assignment is to discuss nurse burnout as a national health issue and the competing needs that hinder organizations from overcoming it. The paper critiques organizational policies on tackling the issue and recommends strategies to balance the competing needs while addressing ethical weaknesses of the current policy.
Competing Needs Leading to Nurse Burnout
Nurses encounter demanding workloads because of low nurse-to-patient ratios, high patient acuity, limited resources and time that reduces charting shorts or breaks, and increased patient needs and assignments. The two critical competing needs identified in this situation include the attainment of proper or appropriate staffing ratios and the need to offer quality care (Chen et al., 2021). Staffing ratios allow organizations to increase their bottom line since private health facilities focus on profit maximization. However, meeting these needs is a challenge for the health care organization that I work for because of the existing nursing shortage. Nurse turnover contributes to a substantial shortage, with figures showing that it will reach close to 400,000 by 2025 (Brown, 2018). Due to the shortage, burnout is bound to surge, exacerbated by the increasing demand for care and the emergence of infectious diseases like the current COVID-19 pandemic. As such, the organization’s leadership needs to develop interventions to address and manage these competing needs of adequate staffing ratio and patient quality care.
Policies/ Practices to Impact Nurse Burnout
The organization has not instituted sufficient policies to address the current issue. However, practices like innovative approaches through staff scheduling exist, but these are standard interventions that do not substantially affect the issue. Having sufficient staffing numbers can reduce stress among employees, lower the prevalence of burnout associated with overburdened working, and create a better work-life balance for nurses. In their study, Kelly and Poor (2018) observed that enhancing employee well-being and ensuring improved patient care requires organizations to have an effective work-life balance. Through this approach, nurses become more engaged, compassionate, healthier, and well-positioned to offer quality care since they are well-rested.
Lowering the nurse-to-patient ratios is one of the most effective ways to address the problem of nurse burnout. The approach allows nurses to have more time for patients and provide holistic care. The organization also implements hourly rounding, enhancing the patient perception of nurses’ responsiveness in units where such may be a challenge. Hourly rounding also reduces patient falls, uses call lights, and enhances patient satisfaction levels and scores (Garcia; Brosinski & Riddell, 2020). Implementing an hourly rounding program is essential for identifying the “most cost-effectiv eapproach.” The implication is that if a facility integrates these strategies and enhances the quality of care without necessarily raising the cost of care or doing budget cuts, it can address the issue of nurse burnout.
Policy Critique
Ethical considerations are essential for effective care delivery, especially in healthcare organizations when dealing with employee issues like nurse burnout. Leaders in organizations need to balance profits and welfare of healthcare workers to alleviate other issues like nursing shortage which increases the susceptibility to adverse conditions like medication errors (Melnyk & Fineout-Overholt, 2018). Ethical awareness implores organizational leaders to consider the overall good of these practices to nurses and their welfare against profits (Milliken, 2018). Purposeful and systematic hourly rounding offers several benefits that include improved patient satisfaction, patient safety, and quality of care. Nurses can recognize any adverse patient event fast and employ corrective interventions (Hutchinson et al., 2018). Patient safety is a core aspect of human dignity, and providers should take all measures to protect patients. Implementation of hourly rounding is based on ethical principles related to the professional code of conduct as advanced by the American Nurses Association (ANA). Ethical considerations implore nurses and the facility administration to embed hourly rounding to enhance patient dignity through harm reduction and attending to all their needs timely.
Recommendation
The need to address nurse burnout and the competing aspects of quality and appropriate nursing ratios implores the organization to adopt evidence-based practice policies. Among these is the Quadruple Aim framework. The model focuses on enhancing patient experience, lowering the cost of care, improving the health of populations, and enhancing the welfare of healthcare workers, especially nurses. The framework allows organizations to focus on patients, nurses, and even the management (Jacobs et al., 2018). Therefore, implementing this approach would offer a host of benefits to tackling the issue of nurse burnout in the facility by addressing nursing ratios and quality of care.
The facility can implement the model through a systematic approach by focusing on current operations and processes to ascertain that they lead to enhanced efficiency. The approach entails evaluating areas where the organization is not performing well (Melnyk & Fineout-Overholt, 2018). The facility can use change models like Lewin’s change process to identify salient aspects to transform in the current practice of hourly rounding. The facility should integrate these components by identifying and using employees as change agents to make the case of enhanced effectiveness. The Quadruple Aim will help the organization enhance quality, address nurse burnout and improve nurses’ welfare.
Conclusion
Competing needs impact the ability of organizations to deliver quality care. Needs like the quality of care and attainment of appropriate patient ratios compete. They require healthcare facilities and their leadership to use effective interventions that result in quality care provision. The use of hourly rounding has ethical considerations based on its benefits and rationale. Implementing the Quadruple Aim framework will enable the facility to address the issue of nurse burnout while tackling the two competing needs of nurse staffing ratios and quality of care.
References
Brown, S. (2018). The Impact of Resiliency on Nurse Burnout: An Integrative Literature
Review. MEDSURG Nursing, 27(6), 349–378.doi:10.1097/JTN.000000
Brosinski, C., & Riddell, A. (2020). Incorporating hourly rounding to increase emergency
department patient satisfaction: A quality improvement approach. Journal of emergency nursing, 46(4), 511-517.DOI: 10.1016/j.jen.2019.08.004.
Chen, R., Sun, C., Chen, J. J., Jen, H. J., Kang, X. L., Kao, C. C., & Chou, K. R. (2021). A
large‐scale survey on trauma, burnout, and posttraumatic growth among nurses during the COVID‐19 pandemic. International Journal of Mental Health Nursing, 30(1), 102-116.DOI: 10.1111/inm.12796.
Garcia, M. G., Dutton, H., Samuel, K., & Marusich, J. (2021). Purposeful hourly rounding to
decrease peripheral intravenous infiltrations and extravasations in pediatrics. Journal of Pediatric Nursing, 61, 59-66.DOI: 10.1016/j.pedn.2021.03.009.
Hutchinson, M., Jackson, D., & Wilson, S. (2018). Technical rationality and the decentering of
patients and care delivery: A critique of ‘unavoidable’ in the context of patient harm. Nursing Inquiry, 25(2), e12225.DOI: 10.1111/nin.12225.
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging Employees in Well-
Being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly,(3), 231.DOI: 10.1097/NAQ.0000000000000303.
Kadivar, M., Manookian, A., Asghari, F., Niknafs, N., Okazi, A., & Zarvani, A. (2017). Ethical
and legal aspects of patient’s safety: a clinical case report. Journal of Medical Ethics & Historyof Medicine, 10(15), 1–5.
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to
enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6.
doi:10.3912/OJIN.Vol23No01-Man06
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing &healthcare:
A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 1, “Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry”(pp. 7–32).
Milliken, A. (2018). Ethical Awareness: What it is and why it matters. OJIN: Online Journal of
Issues in Nursing, 23(1), Manuscript 1. doi: 10.3912/OJIN.Vol23No01Man0
Healthcare Policies and Practices for Clinical Change
Healthcare policies and procedures help provide standardization and clarity in addressing challenges as well as activities that are crucial for health and safety, legal liabilities, and regulatory needs within every day clinical practice. Two competing needs that affect organizational nursing shortage are workforce satisfaction and customer satisfaction. Healthcare institutions are mostly fixated on patient satisfaction and at times fail to acknowledge the set workforce that provides care to the clients. When the workforce feels unmotivated through aspects such as lack of recognition by the management, then this reflects the probability of provision of low-quality healthcare that leads to patients’ dissatisfaction (Anand & Dwivedi, 2019). When patients are not satisfied, the management may opt to relieve some workers of their duties, others may also leave due to dissatisfaction, and this increases nursing shortage within the organization. The purpose of this paper is to examine relevant policies that may be used in addressing the two competing needs that are related to the issue of nursing shortage as a stressor- NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices.
Click here to ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT on NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices
Relevant Organizational Policy or Practice Impacting Nursing Shortage
Healthcare organizations are required to be innovative in attaining the needs of the workforce, while at the same time ensuring the provision of safe and quality care to the patients. An effective practice to address the issue of nursing shortage as adopted by my organization is the use of the Magnet Certification for assessing the effectiveness and quality of nursing within it (Haddad & Toney-Butler, 2020). My organization can use the policy to remove issues related to competition between the needs of the nurses and patients’ satisfaction (Rodriguez-Garcia et al., 2020). This is because the policy encompasses involvement of nurses in decision-making processes for effective clinical outcomes as well as effective grievance resolution measures. This in turn ensures nurses’ job satisfaction with low rates of turnovers as well as their delivery of top patient outcomes
The Magnet Recognition Program for adoption by the organization has sound ethical considerations, and no noteworthy ethical concerns or challenges. The strength of the policy in promoting ethics is founded on the rigorous approach that involves several months of evaluations for evidence of excellence in terms of nurse satisfaction, patient satisfaction, and care outcomes within the given institution (Haller et al.). The documentation strategy for the Magnet Certification Strategy involves transformational leadership, structural empowerment, exemplary professional practice, and new knowledge, innovation as well as enhancements. This is done for purposes of compliance of certification together with ethical considerations
Magnet Program certification necessitates the need for describing the healthcare institution,
practice settings for the nurses, and undertakings for upholding patient-centered care, sound ethical considerations, continued EBP research projects, and the Chief Nursing Officer’s (CNO) work description as well as their resume. In NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices, the aspect of ethics is incorporated within various courses in the program that necessitates addressing social conducts via continued educational research on core cultural behaviors. Every year, mandatory, updated computer-tests are carried out on social conduct alongside ethical content and education is given by leaders to the clinical staff who fail to attain competent scores (Van Bogaert et al., 2018). The program’s robustness in engagement and commitment of the clinical staff in inspiring excellent patient outcomes within every day interdisciplinary practice is overseen through clear frameworks, methodologies as well as resources upheld by governance and policy contexts that attains visible and accountable outcomes.
Recommendation of Policy or Practice Changes for Addressing Competing Needs of Resources, Workers, and Patients
A practice change may be fixated on a change of governance for transparency, accountability, and putting in place effective mechanisms for tackling the challenges. These may include the need for the conflicts arising from the competing needs to be encompassed as a key item within the agendas of relevant committees. This is then followed by making reports on the set needs for attaining the desired outcomes (Harris et al., 2017; NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices). There should also be the aspect of quality improvement initiatives within decision-making structures for ensuring a process of review for pinpointing where the issues lie and coming up with effective strategies for addressing them.
Ethical shortcomings that can be tackled within the present policies include autonomy that necessitates
for patients to be involved in the decision-making process of healthcare that they receive. Another ethical concern is nonmaleficence that aids in the evaluation of probable harms within the existing clinical systems. The principle of beneficence can also be addressed to ensure the attainment of the objectives of offering as well as inspiring positivity in the realization of the best healthcare outcomes and satisfaction (Ramsom & Olsson, 2017). The ethical consideration of justice can be fulfilled by ensuring a full analysis of the limits of the available healthcare resources within the set healthcare organization.
Conclusion
Policies within healthcare are crucial as they help devise the overall plans of action utilized in leading required results, and are also key for helping in decision-making. They help create clear communication to the workforce the intended outcomes within the institution. The healthcare personnel is in turn able to comprehend their set roles combined with responsibilities within the settings. They help set the foundation for the provision of safe, and cost-effective care to patients.
References
Anand, S., & Dwivedi, R. (2019). Interrelating employee satisfaction and customer satisfaction in the healthcare Industry. UNNAYAN: International Bulletin of Management and Economics. https://www.researchgate.net/publication/331312483_Interrelating_employee_satisfaction_and_customer_satisfaction_in_the_healthcare_Industry
Haddad, L. M., & Toney-Butler, T. J. (2020). Nursing Shortage. Treasure Island, FL: Statepearls Publishing.
Haller, K., Berends, W., & Skillin, P. (2018). Organizational culture and nursing practice: the magnet recognition program® as a framework for positive change. Revista Médica Clínica Las Condes, 29(3), 328-335. https://doi.org/10.1016/j.rmclc.2018.03.005
Harris, C., Allen, K., Waller, C., & Brooke, V. (2017). Sustainability in health care by allocating resources effectively (SHARE) 3: Examining how resource allocation decisions are made, implemented and evaluated in a local healthcare setting. BMC Health Services Research. https://doi.org/https://doi.org/10.1186/s12913-017-2207-2
Ramsom, H., & Olsson, J. M. (2017). Allocation of health care resources: Principles for decision-making. Pediatrics in Review, 38(7), 320–329. https://doi.org/https://doi.org/10.1542/pir.2016-0012
Rodriguez-Garcia, Carmen, M., Marquez-Hernandez, Veronica, V., Belmonte-Garcia, Teresa, … Genoveva. (2020). Original research: How magnet hospital status affects nurses, patients, and organizations: a systematic review. American Journal of Nursing, 120(7), 28–38. https://doi.org/10.1097/01.NAJ.0000681648.48249.16
Van Bogaert, P., Van heusden, D., Slootsman, S., Roosen, I., Van Aken, P., Hans, G. H., & Franck, E. (2018). Staff empowerment and engagement in a magnet® recognized and joint commission international accredited academic centre in Belgium: a cross-sectional survey. BMC Health Services Research. https://doi.org/https://doi.org/10.1186/s12913-018-3562-3
Week 3 Assignment: Developing Organizational Policies and Practices
Healthcare organizations have competing needs because of the limited resources and reforms. The Quadruple Aim framework as well as innovative delivery models like value-based care implore providers to develop effective interventions to address these competing needs. Nursing shortage is a health care stressor or issue that implores organizations to develop policies and practices to tackle it and guarantee quality care outcomes (Koopmans et al., 2018). This paper focuses on the competing needs emanating from nursing shortage and development of relevant policies or practices. The paper also critiques the policy for ethical considerations, explains its strengths and challenges in ethics promotion.
Review of Nursing Shortage as Healthcare Stressor
Nursing shortage has significant implications on the quality of care that providers offer. Nurses are frontline care providers and first point of contact between patients and the healthcare system (Mattioni & Wilson, 2018). The first competing need that can impact nurse shortage are the financial needs of nurses in these organizations which contradicts the institution’s focus on profits or return on investment. The second need is patients attaining bet healthcare services as they pay for them and are entitled to quality. The need contradicts the one for nurses as it means that they must be willing to serve patients but are not well compensated. Further, their workload becomes more because of the shortage. They do not feel well remunerated for the efforts and are demotivated yet patients want quality care irrespective of their situation.
Relevant Policy Influencing the Stressor
The current organizational policy and practices of hiring new-graduated nurses is one of the issues contributing to the nurse shortage in the facility. The organization adopted this policy as a means of reducing the overall cost of running the facility because new-graduated nurses want experience and getting their first job is a significant anticipation as they want to gain experience as providers (Perry et al., 2018). However, as they get new and greener opportunities in other organizations, they leave leading to a significant workload for the remaining care providers who experience burnout. Eventually, they also leave and the problem is does not get a solution.
Policy Critique
The current policy does not promote ethical values and principles of healthcare, especially the biomedical principles of beneficence, non-maleficence, and justice as well as autonomy. The policy fails to consider these ethical values for patients and even providers. The policy should ensure that the hired nurses are compensated well instead of giving them low wages leading to high turnover rates. The policy does not promote any ethical values as it exposes patient to low quality due high turnover rate.
Recommendations
The current policy can be effective if it focuses on hiring newly-graduated nurses and training them sufficiently so that they do not leave the organization. These new nurses should be motivated and inspired through good compensation, incentives, and leadership support to retain them. The competing needs should not be the ultimate determiners but quality of care and the retention of best and well-trained providers (Milliken, 2018). The change will ensure that nurses and patients interact and have quality services for mutual benefit and respect.
Conclusion
Nurse shortage is a critical healthcare stressor that needs effective strategies and approaches to address. Low nurse staffing levels threaten the quality of care and patient safety. Therefore, organizations, like ours, should develop effective interventions to ensure patient safety and quality of care.
References
Koopmans, L., Damen, N. & Wagner, C. (2018). Does diverse staff and skill mix of the team’s
impact quality of care in long-term elderly health care? An exploratory case study. BMC Health Service Research, 18(988). https://doi.org/10.1186/s12913-018-3812-4.
Mattioni, C. & Wilson, L. (2018). A collaborative approach to creating a perioperative nursing
recruitment and retention strategy: The official voice of perioperative nursing the official
voice of perioperative nursing. AORN Journal, 108(6), 675-678.
DOI: http://dx.doi.org.ezp.waldenulibrary.org/10.1002/aom.1243
Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: Online Journal of
Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01
Perry, S.J., Richter, J.P. & Beauvais, B. (2018). The effects of nursing satisfaction and turnover
cognitions on patient attitudes and outcomes: A three-level multisource study. Health
Services Research. DOI: 10.1111/1475-6773.12997
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.
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
Recommendations
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.
References
Abhicharttibutra, K., Kunaviktikul, W., Turale, S., Wichaikhum, O.-A., & Srisuphan, W. (2017). Analysis of a government policy to address nursing shortage and nursing education quality. International Nursing Review, 64(1), 22-32.
Buerhaus, P. I., Skinner, L. E., Auerbach, D. I., & Staiger, D. O. (2017). Four Challenges Facing the Nursing Workforce in the United States. Journal of Nursing Regulation, 8(2), 40-46.
Ferrer, J., Boelle, P. Y., Salomon, J., Miliani, K., L’Hériteau, F., Astagneau, P., & Temime, L. (2014). Management of nurse shortage and its impact on pathogen dissemination in the intensive care unit. Epidemics, 9, 62-9.
Nantsupawat, A., Kunaviktikul, W., Nantsupawat, R., Wichaikhum, O.-A., Thienthong, H., & Poghosyan, L. (2017). Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. International Nursing Review, 64(1), 91-98.
Yang, P.-H., Hung, C.-H., & Chen, Y.-C. (2015). The impact of three nursing staffing models on nursing outcomes. Journal of Advanced Nursing
Section 1: Analysis of a Pertinent Healthcare Issue
The healthcare system encounters a host of pertinent issues that require interventions to improve the quality of care offered to patients and reduce costs. The Quadruple Aim framework focuses on ensuring quality access to care that leads to better patient experience, improvement of population health, reduced costs and enhancing the work life of healthcare providers (Arnetz et al., 2020). However, a pertinent healthcare issue that can impact this framework and public health in general as well as care delivery is personnel shortages, especially nursing shortage. The purpose of this paper is to discuss nursing shortage as a pertinent health issue and its impact on the organization.
Nursing Shortage and Impact on the Organization
Nurse staffing shortage is a critical issue that requires interventions because of its effects. Organizations and evidence from federal agencies like the Bureau of Labor Statistics and the American Nurses Association assert that there will be a significant increase in nursing jobs over the next five years compared to any occupation or profession. The Bureau of Labor Statistics indicates that over 176,000 openings will be available for nurses in healthcare due to newly created roles as a result of advanced education and the need to address physician shortage, nurses leaving the profession and those retiring because of their age (Broome et al., 2022). The BLS assert that the nursing shortage will continue to bite the healthcare delivery as more Americans with diverse needs get access to care due to reforms through legislations at both state and federal levels.
Nursing shortage has serious implications on the organizations, especially in critical care situations and the need to deliver quality patient-centered interventions. The increased number of patients per nurse means poor quality of care due to strain and associated fatigue. Nurse shortage is a leading cause of burnout and nurse turnover. For instance, figures from the organization’s leaders show that over ten nurses left the facility in the last two years due to working on long shifts. Data also indicates a rise trend of missed nursing care in the facility due to the shortage (Tamata et al., 2023). The implication is that nursing shortage in any facility leads to increased cost of care and high turnover rates. Having limited nurse of nurses also leads to increased risk of patients to adverse events like medication errors and falls which the organization cannot get reimbursed by the Centers for Medicare and Medicaid Services (CMS). As such, the entity loses funds when patients miss care or experience adverse events that preventable like falls, healthcare associated infections, and medication errors.
Recently, I analyzed some of the challenges we face regarding the shortage of nursing staff. Nurses and healthcare organizations encounter many issues that affect their delivery of care to patients and health populations. Frameworks like the Quadruple Aim offer a host of goals for individuals to pursue to maintain and enhance healthcare. The changes and reforms in the healthcare sector mean that healthcare providers and organizations will always encounter challenges like the nurse staffing shortage amidst rising demand for care and the need to reduce costs (Broome & Marshall, 2021). This letter aims to analyze nurse staffing or personnel shortage in the healthcare sector and how organizations are navigating the issue to meet rising patient needs, reduce costs, and offer high-quality care.
Nursing shortage entails the lack of sufficient levels of staff to meet the legal requirements or ratios for effective care delivery. Different sources and organizations, including federal agencies like the Bureau of Labor Statistics, estimate that the number of available nursing jobs would increase compared to all professions (ANA, 2022). The BLS attributes this rise to newly created roles, nurses leaving the profession for other areas, and those retiring due to age. The implication is that these factors will lead to the creation of over 175,000 openings for registered nurses every year until 2029 (Department of Labor, 2022). The agency opines that more openings will occur simultaneously within this period among other advanced practice roles like nurse practitioners, nurse midwives, and even anesthetists.
In our organization, nurse shortage is a critical issue, as evidenced by the need for nurses to work for long hours and have few of them per shift. These working conditions mean that nurses experience stress, burnout, and fatigue and are susceptible to events like medication errors. Nurses also have to endure an increased workload that makes them experience mental exhaustion since they cannot undertake their duties effectively. Again, nurses in the organization do not get leadership support since the reporting procedure and policy for medication errors lack sufficient safeguards to protect them from litigations. For instance, two nurses left the organization last month because of these issues and the lack of effective mechanisms to solve the ever-rising shortage of personnel, especially when handling emergencies in the emergency room.
According to two professional journal articles that I read, the nursing shortage is not just a national healthcare issue but also a global one affecting the health industry in many countries, especially developing nations. However, developed nations like the United States also face increased shortages of nurses, including specialty nurses, to meet the rising care needs due to reforms in the industry. The first article by Aiken et al. (2022) explores the nursing shortage issue before and during the COVID-19 pandemic. The study notes that before and during the pandemic, many healthcare organizations experience nurse shortages leading to high levels of nurse burnout. The authors note the need for healthcare facilities to improve their nurse ratios to attain better outcomes and prevent chronic hospital understaffing.
The second article by Shah et al. (2021) explores the prevalence and factors leading to nursing burnout in the U.S. The authors are categorical that one of the factors causing burnout among nurses is nurse shortage, as the remaining nurses carry on the workload of others to offer patient care. The implication is that nurses leave their profession and organizations because of burnout and fatigue since they face a myriad of patients with diverse health conditions. Again, the study by Bourgault et al. (2022) emphasizes the effects of burnout associated with the current nursing shortage problem. While addressing this issue requires being data-informed and using a country or setting-unique approach, it is no doubt that nurse shortage is a serious healthcare stressor for nurses and healthcare organizations.
Organizations vary in their approach to nursing shortage based on the interventions they initiate and implement. Most organizations address the issue through innovative care models that reduce the demand for in-person interactions between nurses and patients. These include telehealth and telemedicine as evidence-based practice approaches to address the issue. The implication is that they are investing in health technologies to allow them to offer better patient care to diverse patient populations. Organizations seek better ways to retain their nurses and reduce nurse turnover through incentives like professional development opportunities and better working conditions (Spurlock Jr., 2020). They ensure that they have a satisfied nursing staff dedicated to offering quality care.
In summary, according to the two articles, addressing the issue of nurse staffing shortage requires a collaborative effort and leveraging technology as well as promoting primary care interventions to reduce demand for care in facilities. Primary health promotion ensures that individuals reduce their susceptibility and vulnerability to diverse conditions while leveraging technologies means that organizations can integrate better and innovative ways to meet care demands.
These strategies may impact the organization positively and negatively if it implements them. positively, it will mean that the organization will address shortages and improve its care delivery. It will mean that the entity can attain the Quadruple Aim goals (Drennan et al., 2019). However, it requires investment in these technologies and what they portend for diverse patients, especially in improving their outcomes and access to care services. The organization should also invest in better conditions and terms of service for its staff. These solutions include things such as subsidized funding or an increase in wages.
A range of solutions needs to be offered to solve the nursing shortage in our health care organization., from subsidized funding to an increase in wages. Additionally, offering tuition for nurses seeking to advance their degrees could possibly be helpful. Resources could be allocated towards increasing wages, which would affect the recruitment and retention of registered nurses already in the facility. Another important strategy to further address the nursing shortage, is allowing our nurses, scheduling flexibility and coverage. This will help nurses to juggle their busy work schedule with their home life and provide room for decompressing between stressful and demanding shifts.
Competing Needs Impacting Nursing Staff Shortage
Competing needs in healthcare provision implore stakeholders, especially organizational managers and leaders to prioritize what they consider as essential at the expense of another component. Nursing staff shortage is a national health concern that arises due to diverse competing needs; these include the need to reduce operational costs and help facilities make profits based on financial returns and the need to invest in more personnel to improve quality of care and patient outcomes that requires additional resources (Haegdorens et al., 2019). These added resources imply that the organization spends more on expenses at the expense of making profits and investment. Therefore, the need for better profits means that these entities will not hire sufficient levels of nurses to meet the care demand because of cost-cutting measures. However, this means that nurses will not be motivated to work better and improve the quality of care offered to patients in their settings.
Competing need for nurse welfare as dictated by the Quadruple Aim framework cannot be attained as nurses have to work long hours and with increased workload to meet patient needs. Nurses work optimally when they are not strained and overloaded as these conditions make them susceptible to committing errors. These errors, considered by the Centers for Medicare and Medicaid Services (CMS) as never events, lead to loss of revenue as facilities are never compensated or incentivized through financial resource allocation. As such, it is essential for health care entities to consider a raft of measures which will ensure that all competing needs do not affect their efforts to have recommended nurse-to-patient ratios in their facilities.
Relevant Policy or Practice to Address Nursing Staff Shortage
The organization employs different policies and practices aimed at reducing nursing staff shortage. Key among them include having a retention initiative that focuses on improving the overall professional development of nurses. Under this policy, nurses get reimbursed for their tuition once they commit themselves to the facility for at least three years. The initiative funds their training, workshop sessions, and even attending nursing conferences across the country. This policy has positive influence on mitigating the nursing staff shortage as nurses feel that the organization is keen on enhancing their professional growth and development, especially through the acquisition of new knowledge and research evidence (Haegdorens et al., 2019). Through the approach, nurses get to learn about new practices that they can implement to improve patient care delivery.
A core practice in the organization that encourages nurse retention is participative leadership model as adopted by nurse leaders and managers. Through this practice, leaders and managers in the organization engage nurses to solicit their views on changes and other structural issues that the organization wishes to implement to improve overall working conditions that translate to better care delivery and patient satisfaction.
Critiquing the Policy for Ethical Considerations & Policy’s Strengths and Challenges to Promote Ethics
The policy and practice in the organization are essential and help promote the welfare of nurses. However, from an ethical perspective, the policy does not consider nurses’ safety levels as it fails to address the high nurse turnover. The policy also ties one since evaluation of who qualifies to benefit from the reimbursement entails an elaborate process and need for one to commit at least three years in the facility. This is not ethical and may make one not keen on pursuing the benefits since it ties them to the organization.
Positively, the policy and practice are essential to retaining nurses who are more committed to serving the organization. The practice also ensures that both leaders and managers engage nurses to get their input on a raft of measures that they intend to implement in their organizational setting (Drennan et al., 2019). However, the practice should be more focused on helping nurses remain as opposed to leaving the organization to reduce the underlying nursing shortage issue. Due to the workload, many nurses in the facility cannot find time to attend such seminars, and if they do, those remaining must carry out their duties and obligations. The implication is that such these practice and policy are important but should lead to better results as the organization continues to experience increased levels of staffing shortage with devastating effects on overall patient care.
Recommendations
A policy as well as practice that can address the competing needs of resources, workers, and patients and create a balance is having a robust retention policy based on increasing quality leadership and resources to cater to different needs of the organization and nurses. A retention policy whose main focus is improving the welfare of nurses meets the requirements of the Quadruple Aim framework and implores providers to focus on better ways to deliver care since they are well catered to and their needs addressed. Such a policy must ensure that nurses do not leave the facility and when they leave, the have competent replacements since it is also costly to orient a nurse (Kelly et al., 2018). Incentivizing nurses to report about medication errors and other safety issues will also increase the retention rates as opposed to blanket condemnation when a mistake happens. The current policies may have ethical challenges or shortcomings which should be addressed through the implementation of new approaches and use of novel ideas that are nurse-driven and patient-centered.
Conclusion
Nursing shortage requires interventions that will help to reduce its prevalence and allow organizations to attain better nurse-to-patient ratios. The effects of the nurse shortage are profound, and having technologies may help improve the current situation. More fundamentally, the engagement of all stakeholders is necessary to improve quality outcomes. Together, we must work to make our workplace a success in achieving the quadruple aim of increasing access, decreasing cost, increasing quality, and finding meaning in the work of healthcare and now this must include a safer, less stressful workplace.
References
Aiken, L. H., Sloane, D. M., McHugh, M. D., Pogue, C. A., & Lasater, K. B. (2022). A repeated
cross-sectional study of nurses immediately before and during the Covid-19 pandemic: Implications for action. Nursing Outlook, 101903. DOI: 10.1016/j.outlook.2022.11.007
American Nurses Association (ANA). (2022). Nurses in the Workforce.
Bourgault, A. M. (2022). The nursing shortage and work expectations are in critical condition: is
anyone listening? Critical Care Nurse, 42(2), 8-11. https://doi.org/10.4037/ccn2022909
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert
clinician to influential leader (3rd ed.). New York, NY: Springer.
Department of Labor (2022). US Department of Labor announces $80M funding opportunity to
help train, expand, diversify nursing workforce; address shortage of nurses. https://www.dol.gov/newsroom/releases/eta/eta20221003
Drennan, V. M., & Ross, F. (2019). Global nurse shortages: the facts, the impact and action for
change. British medical bulletin, 130(1), 25-37. https://doi.org/10.1093/bmb/ldz014
Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of
nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multicenter study. BMC Health Services Research, 19(1), 864. DOI: https://doi.org/10.1186/s12913-019-4688-7
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to
enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1),
Manuscript 6. https://doi.org/10.3912/OJIN.Vol23No01Man06.
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021).
Prevalence of and factors associated with nurse burnout in the US. JAMA network open, 4(2), e2036469-e2036469. DOI:10.1001/jamanetworkopen.2020.36469
Spurlock Jr, D. (2020). The nursing shortage and the future of nursing education is in our hands.
Journal of Nursing Education, 59(6), 303-304. DOI: 10.3928/01484834-20200520-01.
Yang, Y. T., & Mason, D. J. (2022). COVID-19’s impact on nursing shortages, the rise of travel
nurses, and price gouging. Health Affairs Forefront.
DOI: 10.1377/forefront.20220125.695159
Analysis of a Pertinent Healthcare Issue
Healthcare organizations and nurses face increased number of complex issues that must be addressed to enhance care delivery and meet patient needs. These issues range from nursing shortage, rising cost of care, changes in government policies and emerging infectious diseases leading declaration of pandemics like the COVID-19 pandemic. The shortage of nurses in healthcare facilities and the entire health system is a serious health issue that requires interventions at organizational and government level, both state and federal governments (Haddad et al., 2022). The purpose of this paper is to discuss nurse staffing shortage as a pertinent health issue and offer strategies at organizational levels to address it.
Nurse Staffing Shortage and Impact on the Organization
The American Nurses Association (ANA) asserts that more registered nurse jobs would be available through 2026 than any other profession. The Bureau of Labor Statistics also projects that over 275,000 more nurses will be required within the health care sector to meet the rising needs till 2030 (Haddad et al., 2022). The implication is that nurse staffing shortage is a serious issue that affects nurses and healthcare organizations in different care settings, from inpatient facilities to nursing homes and long-term care facilities. Further, Blouin and Podjasek (2019) assert that the rising demand for care emanates from healthcare reforms that include the positive effects of increased government-sponsored health insurance coverage through the Affordable Care Act 2010 and innovative care models like the value-based purchase (EBP) by the Centers for Medicare and Medicaid Services (CMS). While investment in healthcare has increased, the staffing levels have not increased to meet the need. Furthermore, an aging population is also rising with many qualifying for both Medicare and Medicaid benefits.
In my organization, the available data shows that the rise in patient numbers has led to increased stress levels among nurses. The facility has considered using floating nurses in more than one unit. However, the intervention is not sustainable as these nurses are only there for a short while before they leave. Data also shows that while there have been no major patient safety events reported like serious medication errors, this situation is still precarious and requires better interventions. The data also show a number of missing nursing care which can have overall negative effects on patients and their overall outcomes.
Summary of Reviewed Articles on Nurse Staffing Shortage
Studies show evidence of the prevalence of nurse staffing shortage and its effects on patient care. In their study, Griffiths et al. (2018) explore the association between nurse staffing and adverse patient outcomes, especially mortality in inpatient facilities. The study indicates that nurses missed care and this leads to poor patient outcomes. The study is emphatic that having sufficient nurse levels is key to improving overall staff motivation and morale as well as reducing the nurse turnover rates.
Again, a study by Zhang et al. (2018) exposes the level of nursing shortage as well as its forecast and the associated negative effects. The authors forecast the South and the West regions of the country to have the most intense shortage leading to 2030. The study observes that nursing shortage will have significant effects on the nursing workforce, especially registered nurses who are considered the frontline care providers. These effects include increased burnout and stress as highlighted by Shah et al. (2021), high nurse turnover rates, and poor patient safety and quality outcomes. Wrong medication administration, missed care and compromised patient quality levels are also other outcomes of nurse staffing shortage.
Nurse Shortage Approach by Other Organizations
Existing evidence suggests that organizations are deploying innovative ways to address the nurse staffing shortage. These entities are leveraging technology to improve access to care and reduce possible burnout arising from increased demands. The use of informatics and electronic medical records (EMRs) as well as the deployment of telemedicine and telehealth are considered as effective ways of removing nurses from direct care areas (Haddad et al., 2022). Secondly, organizations are also striving to have better retention rates for their different cadres of nurses while they leverage innovative approaches like better scheduling and shifts for nurses.
Strategies to Address the Organizational Impact of Nursing Staff Shortage
Addressing the issue of turnover through effective and good leadership enhances retention levels and help organizations deal with nurse staffing shortage. According to Zhang et al. (2018), continuing education and leadership development are significant incentives for organizations and the healthcare sector to retain nurses and encourage others to join nursing schools. Having residency programs can help the organization deal with the nursing shortage as they will have a training initiative that helps them get nurses who are familiar and comfortable with the hospital and its culture. Griffiths et al. (2018) opine that organizational incentives and partnering with nursing schools can help providers deal with nurse staffing shortage. More fundamentally, organizations must motivate their staff and ensure that they can develop innovative ways to retain them by offering an organizational culture which values their efforts and recognizes them through rewards and other incentives.
These strategies may impact our organization positively in different ways. These include increased motivation and retention rates, quality patient outcomes for patients and better safety levels. The organization will also enhance its ability to get reimbursement from CMS (Auerbach et al., 2018) However, these strategies require the facility to allocate more resources for staff development and incentives. The organization may have to seek additional sources of revenue to meet the costs associated with implementing the interventions. However, the positive aspects are more than the negative outcomes for the organization. For instance, the number of medication errors will reduce and nurses may be willing to report such errors because they won’t be afraid of victimization and reprimand from nurse leaders and managers.
Two Competing Needs Impacting Nursing Shortage
The two competing needs in the organization that have a direct influence on nurse staffing shortage include nurse seeking ways to meet their financial obligations, take care of their families and have a comfortable life which implore them to demand for better working conditions, including an attractive compensation package (Antwi & Bowblis, 2018). This need is contrary to the organization’s management’s focus on return on investment because of their business operations. The second competing need is patients’ need for quality and best care as well as nursing services. Patients demand for this so that they can get value for their money through quality care. The need is a direct competing one for both nurses and the owners of the healthcare facilities who seek ways to enhance revenues and meet financial obligations while also attaining return on investment. The lack of motivation and incentives on nurses will be explicit as patients would encounter nurses who are not committed or dedicated to their duties and adhere to professional practice standards.
Relevant Policy on Nursing Shortage
One of the organizational policies on this issue is the use of floating nurses where nurses are pulled from one unit to another and reassigned to different areas of practice based on patient census, acuities and demand. Floating is difficult and many consider it a problem for nurseswho may be specialists in other areas yet they are taken to new units where they are not familiar. Floating creates an imbalance in the ability of nurses to care for patients based on their level of acuity. While many argue that floating doe nit compromise quality of care and safety, it can be difficult as it may entail nurses working for long hours which leads to fatigue. The policy helps the organization to reduce its overall costs but does not offer a permanent solution to the nurse staffing shortage.
Ethical Critique of the Floating Nurse Policy
The floating nurse policy affects fundamental ethical considerations in nursing which may be violation of the expected professional conduct of nurses as expected by the provisions of the American Nurses Association (ANA). The ANA implores nurses to practice with respect and ethical perspective through the provision of care based on the nursing processes. However, this policy violates ethical aspects like personal values and job satisfaction and leads to increased moral distress for providers in diverse healthcare settings (Antwi & Bowblis, 2018). The implication is that nurses want to practice in units and specialties that respect their values and do not lead to increased moral distress emanating from more workload and associated fatigue. Constant burnout leads to reduced level of nurse satisfaction and participation in quality care improvement interventions. The policy’s strengths in promoting ethics include its focus on enhancing quality and safe patient care but not for the nurses’ benefits. The policy provides more benefits to organizations and not nurses who encounter challenges in navigating different units and who may not be sure of their areas of assignment or duty in their organizations.
Recommended Policy and Practice Changes
Based on evidence, it is apparent that the most effective policy and changes in the organization entail the development and enactment of a competitive and attractive recruitment and retention model. The organization needs to develop a policy that incentivizes nurses to join it and remain committed to it for at least five years. The retention policy should offer incentives like higher training and education for one to improve their skills, better remuneration package, and increased taping of top talent. The organization should create more partnerships with diverse entities to leverage their expertise and link nurses as well as have an intensive recruitment pool for new staff. The organization can also leverage nurses on temporary basis under the concept of locum tenens which means that they can work for a while and consider if they can be recruited and employed to address the shortfall (Thy, 2018). This approach will address the ethical aspects of care and allow nurses to attain a balance of their work and the expectations as well as financial obligations. They will feel valued when they have sufficient workload and their issues are well addressed through effective staff motivation.
Conclusion
Nurse staffing shortage is a serious national health care stressor that affects not just organizations but the entire healthcare system. The issue raises serious concerns because of its negative effects on patient care and quality services as well as outcomes. Organizations must find evidence-based practice strategies to tackle the issue and improve the quality of care as proposed in this paper. They must also develop policies that entail ethical considerations and focus on the development of nurses through increased opportunities for advanced education and training.
References
Antwi, Y.A. & Bowblis, J.R. (2018). The impact of nurse turnover on quality of care and
mortality in nursing homes: Evidence from the great recession. American Journal of Health Economics, 4(2), 131–163. https://doi.org/10.17848/wp15-249
Auerbach, D. I., Buerhaus, P. I., & Staiger, D. O. (2018). Better late than never: Workforce
supply implications of later entry into nursing. Health Affairs, 26(1), 178-185.
DOI: 10.1177/1062860617738328.
Blouin, A. S., & Podjasek, K. (2019). The continuing saga of nurse staffing: Historical and
emerging challenges. JONA: The Journal of Nursing Administration, 49(4), 221-227.
DOI: 10.1097/NNA.0000000000000741.
Griffiths, P., Ball, J., Bloor, K., Böhning, D., Briggs, J., Dall’Ora, C., … & Smith, G. (2018).
Nurse staffing levels, missed vital signs and mortality in hospitals: Retrospective longitudinal observational study. Health Services and Delivery Research, 6(38).
DOI: 10.1111/jan.13564.
Haddad, L. M., Annamaraju, P. & Toney-Butler, T. J. (2022). Nursing shortage. StatPearls
[Internet].
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021).
Prevalence of and factors associated with nurse burnout in the US. JAMA network open, 4(2), e2036469-e2036469. DOI: 10.1001/jamanetworkopen.2020.36469
Thy, M., Bardon, J. & Carbonne, H. (2018). Evaluation of locum tenens activity by young
anaesthesiologists and intensivists: A national survey. Anaesthesia, Critical Care & Pain Medication, https://doi.org/10.1016/j.accpm.2018.04.005
Zhang, X., Tai, D., Pforsich, H., & Lin, V. W. (2018). United States registered nurse workforce
report card and shortage forecast: A revisit. American Journal of Medical Quality, 33(3),
229-236. DOI: 10.1177/1062860617738328.
Recently, I analyzed some of the challenges we face regarding the shortage of nursing staff. Nurses and healthcare organizations encounter many issues that affect their delivery of care to patients and health populations. Frameworks like the Quadruple Aim offer a host of goals for individuals to pursue to maintain and enhance healthcare. The changes and reforms in the healthcare sector mean that healthcare providers and organizations will always encounter challenges like the nurse staffing shortage amidst rising demand for care and the need to reduce costs (Broome & Marshall, 2021). This letter aims to analyze nurse staffing or personnel shortage in the healthcare sector and how organizations are navigating the issue to meet rising patient needs, reduce costs, and offer high-quality care.
Nursing shortage entails the lack of sufficient levels of staff to meet the legal requirements or ratios for effective care delivery. Different sources and organizations, including federal agencies like the Bureau of Labor Statistics, estimate that the number of available nursing jobs would increase compared to all professions (ANA, 2022). The BLS attributes this rise to newly created roles, nurses leaving the profession for other areas, and those retiring due to age. The implication is that these factors will lead to the creation of over 175,000 openings for registered nurses every year until 2029 (Department of Labor, 2022). The agency opines that more openings will occur simultaneously within this period among other advanced practice roles like nurse practitioners, nurse midwives, and even anesthetists.
In our organization, nurse shortage is a critical issue, as evidenced by the need for nurses to work for long hours and have few of them per shift. These working conditions mean that nurses experience stress, burnout, and fatigue and are susceptible to events like medication errors. Nurses also have to endure an increased workload that makes them experience mental exhaustion since they cannot undertake their duties effectively. Again, nurses in the organization do not get leadership support since the reporting procedure and policy for medication errors lack sufficient safeguards to protect them from litigations. For instance, two nurses left the organization last month because of these issues and the lack of effective mechanisms to solve the ever-rising shortage of personnel, especially when handling emergencies in the emergency room.
According to two professional journal articles that I read, the nursing shortage is not just a national healthcare issue but also a global one affecting the health industry in many countries, especially developing nations. However, developed nations like the United States also face increased shortages of nurses, including specialty nurses, to meet the rising care needs due to reforms in the industry. The first article by Aiken et al. (2022) explores the nursing shortage issue before and during the COVID-19 pandemic. The study notes that before and during the pandemic, many healthcare organizations experience nurse shortages leading to high levels of nurse burnout. The authors note the need for healthcare facilities to improve their nurse ratios to attain better outcomes and prevent chronic hospital understaffing.
The second article by Shah et al. (2021) explores the prevalence and factors leading to nursing burnout in the U.S. The authors are categorical that one of the factors causing burnout among nurses is nurse shortage, as the remaining nurses carry on the workload of others to offer patient care. The implication is that nurses leave their profession and organizations because of burnout and fatigue since they face a myriad of patients with diverse health conditions. Again, the study by Bourgault et al. (2022) emphasizes the effects of burnout associated with the current nursing shortage problem. While addressing this issue requires being data-informed and using a country or setting-unique approach, it is no doubt that nurse shortage is a serious healthcare stressor for nurses and healthcare organizations.
Organizations vary in their approach to nursing shortage based on the interventions they initiate and implement. Most organizations address the issue through innovative care models that reduce the demand for in-person interactions between nurses and patients. These include telehealth and telemedicine as evidence-based practice approaches to address the issue. The implication is that they are investing in health technologies to allow them to offer better patient care to diverse patient populations. Organizations seek better ways to retain their nurses and reduce nurse turnover through incentives like professional development opportunities and better working conditions (Spurlock Jr., 2020). They ensure that they have a satisfied nursing staff dedicated to offering quality care.
In summary, according to the two articles, addressing the issue of nurse staffing shortage requires a collaborative effort and leveraging technology as well as promoting primary care interventions to reduce demand for care in facilities. Primary health promotion ensures that individuals reduce their susceptibility and vulnerability to diverse conditions while leveraging technologies means that organizations can integrate better and innovative ways to meet care demands.
These strategies may impact the organization positively and negatively if it implements them. positively, it will mean that the organization will address shortages and improve its care delivery. It will mean that the entity can attain the Quadruple Aim goals (Drennan et al., 2019). However, it requires investment in these technologies and what they portend for diverse patients, especially in improving their outcomes and access to care services. The organization should also invest in better conditions and terms of service for its staff. These solutions include things such as subsidized funding or an increase in wages. A range of solutions needs to be offered to solve the nursing shortage in our health care organization., from subsidized funding to an increase in wages. Additionally, offering tuition for nurses seeking to advance their degrees could possibly be helpful. Resources could be allocated towards increasing wages, which would affect the recruitment and retention of registered nurses already in the facility. Another important strategy to further address the nursing shortage, is allowing our nurses, scheduling flexibility and coverage. This will help nurses to juggle their busy work schedule with their home life and provide room for decompressing between stressful and demanding shifts.
Competing Needs Impacting Nursing Staff Shortage
Competing needs in healthcare provision implore stakeholders, especially organizational managers and leaders to prioritize what they consider as essential at the expense of another component. Nursing staff shortage is a national health concern that arises due to diverse competing needs; these include the need to reduce operational costs and help facilities make profits based on financial returns and the need to invest in more personnel to improve quality of care and patient outcomes that requires additional resources (Haegdorens et al., 2019). These added resources imply that the organization spends more on expenses at the expense of making profits and investment. Therefore, the need for better profits means that these entities will not hire sufficient levels of nurses to meet the care demand because of cost-cutting measures. However, this means that nurses will not be motivated to work better and improve the quality of care offered to patients in their settings.
Competing need for nurse welfare as dictated by the Quadruple Aim framework cannot be attained as nurses have to work long hours and with increased workload to meet patient needs. Nurses work optimally when they are not strained and overloaded as these conditions make them susceptible to committing errors. These errors, considered by the Centers for Medicare and Medicaid Services (CMS) as never events, lead to loss of revenue as facilities are never compensated or incentivized through financial resource allocation. As such, it is essential for health care entities to consider a raft of measures which will ensure that all competing needs do not affect their efforts to have recommended nurse-to-patient ratios in their facilities.
Relevant Policy or Practice to Address Nursing Staff Shortage
The organization employs different policies and practices aimed at reducing nursing staff shortage. Key among them include having a retention initiative that focuses on improving the overall professional development of nurses. Under this policy, nurses get reimbursed for their tuition once they commit themselves to the facility for at least three years. The initiative funds their training, workshop sessions, and even attending nursing conferences across the country. This policy has positive influence on mitigating the nursing staff shortage as nurses feel that the organization is keen on enhancing their professional growth and development, especially through the acquisition of new knowledge and research evidence (Haegdorens et al., 2019). Through the approach, nurses get to learn about new practices that they can implement to improve patient care delivery.
A core practice in the organization that encourages nurse retention is participative leadership model as adopted by nurse leaders and managers. Through this practice, leaders and managers in the organization engage nurses to solicit their views on changes and other structural issues that the organization wishes to implement to improve overall working conditions that translate to better care delivery and patient satisfaction.
Critiquing the Policy for Ethical Considerations & Policy’s Strengths and Challenges to Promote Ethics
The policy and practice in the organization are essential and help promote the welfare of nurses. However, from an ethical perspective, the policy does not consider nurses’ safety levels as it fails to address the high nurse turnover. The policy also ties one since evaluation of who qualifies to benefit from the reimbursement entails an elaborate process and need for one to commit at least three years in the facility. This is not ethical and may make one not keen on pursuing the benefits since it ties them to the organization.
Positively, the policy and practice are essential to retaining nurses who are more committed to serving the organization. The practice also ensures that both leaders and managers engage nurses to get their input on a raft of measures that they intend to implement in their organizational setting (Drennan et al., 2019). However, the practice should be more focused on helping nurses remain as opposed to leaving the organization to reduce the underlying nursing shortage issue. Due to the workload, many nurses in the facility cannot find time to attend such seminars, and if they do, those remaining must carry out their duties and obligations. The implication is that such these practice and policy are important but should lead to better results as the organization continues to experience increased levels of staffing shortage with devastating effects on overall patient care.
Recommendations
A policy as well as practice that can address the competing needs of resources, workers, and patients and create a balance is having a robust retention policy based on increasing quality leadership and resources to cater to different needs of the organization and nurses. A retention policy whose main focus is improving the welfare of nurses meets the requirements of the Quadruple Aim framework and implores providers to focus on better ways to deliver care since they are well catered to and their needs addressed. Such a policy must ensure that nurses do not leave the facility and when they leave, the have competent replacements since it is also costly to orient a nurse (Kelly et al., 2018). Incentivizing nurses to report about medication errors and other safety issues will also increase the retention rates as opposed to blanket condemnation when a mistake happens. The current policies may have ethical challenges or shortcomings which should be addressed through the implementation of new approaches and use of novel ideas that are nurse-driven and patient-centered.
Conclusion
Nursing shortage requires interventions that will help to reduce its prevalence and allow organizations to attain better nurse-to-patient ratios. The effects of the nurse shortage are profound, and having technologies may help improve the current situation. More fundamentally, the engagement of all stakeholders is necessary to improve quality outcomes. Together, we must work to make our workplace a success in achieving the quadruple aim of increasing access, decreasing cost, increasing quality, and finding meaning in the work of healthcare and now this must include a safer, less stressful workplace.
References
Aiken, L. H., Sloane, D. M., McHugh, M. D., Pogue, C. A., & Lasater, K. B. (2022). A repeated
cross-sectional study of nurses immediately before and during the Covid-19 pandemic: Implications for action. Nursing Outlook, 101903. DOI: 10.1016/j.outlook.2022.11.007
American Nurses Association (ANA). (2022). Nurses in the Workforce.
Bourgault, A. M. (2022). The nursing shortage and work expectations are in critical condition: is
anyone listening? Critical Care Nurse, 42(2), 8-11. https://doi.org/10.4037/ccn2022909
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert
clinician to influential leader (3rd ed.). New York, NY: Springer.
Department of Labor (2022). US Department of Labor announces $80M funding opportunity to
help train, expand, diversify nursing workforce; address shortage of nurses. https://www.dol.gov/newsroom/releases/eta/eta20221003
Drennan, V. M., & Ross, F. (2019). Global nurse shortages: the facts, the impact and action for
change. British medical bulletin, 130(1), 25-37. https://doi.org/10.1093/bmb/ldz014
Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of
nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multicenter study. BMC Health Services Research, 19(1), 864. DOI: https://doi.org/10.1186/s12913-019-4688-7
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to
enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1),
Manuscript 6. https://doi.org/10.3912/OJIN.Vol23No01Man06.
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021).
Prevalence of and factors associated with nurse burnout in the US. JAMA network open, 4(2), e2036469-e2036469. DOI:10.1001/jamanetworkopen.2020.36469
Spurlock Jr, D. (2020). The nursing shortage and the future of nursing education is in our hands.
Journal of Nursing Education, 59(6), 303-304. DOI: 10.3928/01484834-20200520-01.
Yang, Y. T., & Mason, D. J. (2022). COVID-19’s impact on nursing shortages, the rise of travel
nurses, and price gouging. Health Affairs Forefront.
DOI: 10.1377/forefront.20220125.695159
Thank you for your post. Regarding the Opioid crisis, the Biden-Harris administration released a Whitehouse Statement and Release on September 24, 2022, awarded $1.5 billion for both States and Tribes to help address drug overdoses and recovery. This funding supports increased access to treatment for substance use disorders, removing barriers for the public to access Naloxone and expanding public access to recovery support services. According to Smith, Salisbury-Afshar, & Zaza (2020), there are 3 priorities for future research for finding effective strategies for population-based programs and improving prevention methods for Opioid misuse. These 3 areas include: “understanding the roles of social determinants in opioid misuse, opioid use disorder, and other opioid-related harms, improving prevention policy and program implementation, and investigating and implementing risk mitigation and harm reduction approaches” (Smith, Salisbury-Afshar, & Zaza, 2020). Ideas suggested include funding for housing and job training for incarcerated individuals and increased research efforts in understanding the correlation between social determinants of health and Opioid misuse. Other suggestions include reductions in Opioid prescriptions, family strengthening programs, Assisted housing programs, job training & placement programs, and improved mental health services. The authors suggested looking at Opioid misuse prevention strategies used internationally, which include: providing safe syringes for Opioid use to prevent transmission of blood-borne diseases in addicts, overdose prevention sites, and efforts to provide a safer drug supply. The authors state that even these interventions are inefficient and more research should be taken to understand better the complexities of Opioid misuse to facilitate evidence-based prevention strategies geared towards all aspects of the public’s well-being.
References
The White House (2022). What They Are Reading in the States: Biden-Harris Administration Awards $1.5 Billion to States and Tribes to Combat Overdose Epidemic. https://www.whitehouse.gov/briefing-room/statements-releases/2022/09/24/what-they-are-reading-in-the-states-biden-harris-administration-awards-1-5-billion-to-states-and-tribes-to-combat-overdose-epidemic/
Smith, H.J., Salisbury- Afshar, E., & Zaza, S. (2020). American College of Preventive Medicine Statement on Prioritizing Prevention in Opioid Research. AMA J Ethics, 22(8):E687-694. doi: 10.1001/amajethics.2020.687
Don’t wait until the last minute
Fill in your requirements and let our experts deliver your work asap.