NURS 6053 Assignment: Developing Organizational Policies and Practices Essay

NURS 6053 Assignment: Developing Organizational Policies and Practices Essay

Dear Chris Delanune,

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.

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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.

Sincerely,

Beverly Jennings, RN

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.

https://www.nursingworld.org/practice-policy/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

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Add a section to the 2-3 page paper you submitted in Module 1. The new section should address the following in 1-2 pages:

• Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
• 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.
• 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.
• I HAVE INCLUDED MY FIRST PAPER IN MY DOWLOADS.