Review of current Healthcare Issues

NURS 6053 Review of current Healthcare Issues

Staffing shortages in the health care industry has become a significant issue and stressor all over the nation. Nurses work extremely hard and that is not a secret. With imminent staffing shortages in the health care profession and an increase in the volume of patients seeking care services, patient loads are increasing rapidly, thus making it difficult for nurses already short staff to manage all patient care needs effectively and efficiently (Bakhamis et al.,2019). The United States has a massive nursing shortage, and the problem is only set to grow. Due to an influx of patients into our health system, the retirement of baby boomers, and educational bottlenecks, nursing positions are not being filled fast enough to keep up with demand (Xue et al., 2016). Nurses overworked and understaffed on the front lines. There are millions of registered and licensed practical nurses in the United States. Most of these nurses, however, are not happy and comfortable in their work, they are stress, overworked, underappreciated, and underutilized leading to significant impact on the delivery of care.
Impact on Work Setting
Staffing shortages can have a significant impact on the quality of work, on productivity, creativity, competitiveness, nursing care outcomes, and on ensuring patients’ safety (Norful et al., 2018). At my health care organization due to staffing shortage, nurses sometimes work long hours because other nurses calling in sick, running one to four hours late from working under very stressful conditions resulting in burnout, injury, fatigue, and job dissatisfaction. Nurses suffering in my health care facility delay treatments and make other mistakes due to the relationship of the nurse-to-patient ratio (Xue et al., 2016). An unfortunate outcome is that patient quality of care suffers, resulting in a variety of complications including emergency room overcrowding and delay of treatment.
Organizational Response and Changes Implemented
A range of solutions has been offered as a way to solve the nursing shortage in my health care organization from subsidized funding, hiring new nurses, wage increases, and contracting with nursing agencies for nurses to fill in periodically. My health care organization provides tuition for nurses seeking to advance their degree. In addition, resources have been allocated towards increasing wages which has affected recruitment as well as retention of Registered Nurses already in the facility.
Another important strategy to further address the nursing shortage is that, nurses are allowed scheduling flexibility and coverage. This has help nurses to juggle their busy work schedule with home life and educational opportunities, and also allows room for decompressing between stressful, emotionally demanding shifts and days of work.
Health care of the nation, and patients, in particular will benefit the most from adequate staffing and a healthy and well rested nurse because efficiency and productivity will increase, the number of work-related mistakes at the same time will reduce, sick leaves are going to be rare, shorter, and burnout will not occur often (Norful et al., 2018). By introducing said strategies, we would not only increase staffing in health care but equally, reduce the stress-related illness rate among nurses and would also significantly raise the quality of healthcare and patient outcomes.
References
Bakhamis, L., Paul, D.P., Smith, H., & Coustasse, A. (2019). Still an Epidemic: The Burnout
Syndrome in Hospital Registered Nurses. Health Care Manag (Frederick); 38(1):3-10
Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner-physician
comanagement: A theoretical model to alleviate primary care strain. Annals of Family
Xue, Y., Ye, Z., Brewer, C., & Spetz, J. (2016). Impact of state nurse practitioner scope-of-
practice regulation on health care delivery: a systematic review. Nurs Outlook;
64(1):71-85.

Review of current Healthcare Issues

Discussion: Review of Current Healthcare Issues
If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?
These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.
In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.
To Prepare:
• Review the Resources and select one current national healthcare issue/stressor to focus on.
• Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

Review of current Healthcare Issues
By Day 3 of Week 1
Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

Review of current Healthcare Issues
By Day 6 of Week 1
Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.
Submission and Grading Information
Grading Criteria

Review of current Healthcare Issues

To access your rubric:
Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 1

To participate in this Discussion:
Week 1 Discussion

________________________________________

Review of current Healthcare Issues

Review of current Healthcare Issues
Leadership Week 1 Peer Response 1
Kinner,
Staffing shortages are unfortunate and a problem across the nation. Research has shown again and again the negative impact of inadequate
staff on patient care. Nursing shortages result in increased serious patient safety events impacting hospital reimbursement (Blouin & Podjasek,
2019). In the intensive care unit I currently work, it is not uncommon to have a 3-1 patient ratio and the charge nurse having to take patients as
well as many nurses working overtime hours to try to alleviate the patient load. However, nurse burnout is imminent when there is not enough
staff leading to high nurse turnovers which can result in a financial loss to the hospital up to 7.86 million annually (Blouin & Podjasek, 2019). The
COVID-19 pandemic has brought to light the need for sufficient staff and the dire impact of nursing shortages (Bell & Sheridan, 2020). The
intensive care units are overflowing with high acuity patients without the proper staff to care for them. The pandemic has also decreased the
number of staff available because of having nurses frequently out sick and quarantined with the Covid-19 virus. The organization I work for are
trying to alleviate the problem by utilizing emergency relief nurses funded by the government as well as offering financial incentives for full staff
employees to work extra. Historically, organizations have utilized outside agencies when staff was inadequate within the organization.
Unfortunately, when outside staff is used, critical components and elements of patient care tend to be left out (Blouin & Podjasek, 2019). The
COVID 19 pandemic has also exposed many other ongoing challenges that nurses face long-term including lack of child care and risks to
themselves and their families of contracting illnesses (Bell & Sheridan, 2020). Nurses face many challenges that ultimately lead to high turnover
rates for hospitals. Combatting the nursing shortage will take strategic planning and policy to keep nurses in healthcare and prevent short-term
burnout and high turnover rates for hospitals.
References
Bell, M., & Sheridan, A. (2020). How organizational commitment influences nurses’ intention to stay in nursing throughout their career.
International Journal of Nursing Studies Advances, 2, 100007. https://doi.org/10.1016/j.ijnsa.2020.100007
Blouin, A., & Podjasek, K. (2019). The continuing saga of nurse staffing. JONA: The Journal of Nursing Administration, 49(4), 221–227.
https://doi.org/10.1097/nna.0000000000000741

Review of current Healthcare Issues

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11 months ago
lorraine garacia
RE: Discussion – Week 1- Main Post
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Kinner
I enjoyed reading your post. Staffing shortages seems to be an ongoing problem. This is a huge problem when it comes to patient and staff safety. It should be obvious to health care that when there is a nursing shortage, there is an increase in medical errors our negative outcomes. In 2006 California mandated that nurses will have no more than 5 patients on the medical floor. According to Patient Safety Network (PSNET), “The causal relationship between nurse-to-patient ratios and patient outcomes likely is accounted for by both increased workload and increased stress and risk of burnout for nurses” (PSNET, 2019).
On one of the hospital units where I work, we have a floor dedicated to older adults. At times we feel short staffed even though our numbers don’t look high but our acuity is really high. Some weeks we have older adults that are walkie talkies and then the next week we can hall all very high fall risks patients that are using walkers and wheelchairs. These are the days we feel short staffed and wish management would staff us according to acuity and not by a grid. During these stressful high acuity weeks, if a patient falls, we are called into a post fall meeting to meet with the CEO. One questions that is always asked is “what could you have done to prevent this fall”. This question to me is a bit passive aggressive. I have not been to this meeting but this is what my peers have told me. I believe that the question should be “what should we have done to prevent this fall”, talking as a team not as an individual. In the older adult units, these patients usually have a longer length of stay compared to our other behavioral floors. Longer lengths of stay usually can lead to a higher risks of falls especially on older adults that are on anti psychotic medications that may cause drowsiness. According to a study, there was an increased risks of falls for elderly people on anti psychotics, or benzodiazipines, leading to a more unsteady gait and balance instability (Jong, Elst, & Hartholt, 2013).

Jong, M. R., Elst, M. V., & Hartholt, K. A. (2013). Drug-related falls in older patients: Implicated drugs, consequences, and possible prevention strategies. Therapeutic Advances in Drug Safety, 4(4), 147-154. doi:10.1177/2042098613486829
Pape, T. (n.d.). Nursing and Patient Safety. Retrieved December 4, 2020, from https://psnet.ahrq.gov/primer/nursing-and-patient-safety
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11 months ago
MORENIKE OLUKOYA
RE: Discussion – Week 1- Main Post
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Response 1
Hello Kinner,
This is a very interesting post you have here. I totally agree with you that hiring new nurses or bringing in travel nurses to relief nurses in the organization will be helpful to decrease nursing burnout and alleviate the stress of the nursing shortage. Nurse educators and leaders should also encourage the development and deployment of nursing personnel with skills appropriate to the health care system, the public, policy makers and the profession must engage in ongoing long-term workforce planning, regardless of the perceived or real pressures related to the short-term demand for nursing services (A.A.C.N, n.d.) When nurses are able to work regular hours with adequate rest and break, their productivity will be optimal and this will positively reflect on patient outcome.
I also believe that organizations can review their policies to utilize medical assistants for some non-technical nursing duties to help reduce the workload on nurses. Additional measures could also include introduction of financial incentive such as increase in wages to help encourage nurses in the face of additional work responsibilities. Other solutions suggested include encouraging efforts aimed at improving the public image of nursing through education and the use of the media to ensure increase in nursing education (Aboshaiqah, A, 2016).
In order to ensure good quality of care and uphold nursing working standards, nurse administrators should ensure that they take all necessary steps to avoid nursing shortages in their respective organizations.

Review of current Healthcare Issues

References
(A.A.C. N, n.d.) Strategies to Reverse the New Nursing Shortage. Retrieved from https://www.aacnnursing.org/News-Information/Position-Statements-White-Papers/Reverse-Shortage.
Aboshaiqah, A, (2016). Strategies to address the nursing shortage in Saudi Arabia. International Nursing Review. Volume63, Issue 3. https://doi.org/10.1111/inr.12271

Morenike Olukoya.

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11 months ago
Pamela Frances Yanos
Response to Kinner
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Response #1 The Nursing Shortage
Great post Kinner. I cannot agree more. Nurses form the backbone of the healthcare system and according to recent a study by Rosenberg (2019), lower levels of RN staffing increase the risk of death during a hospital stay and increasing the number of nursing assistants cannot compensate for RN shortages.
We are currently very short-staffed at our facility, and management has tackled this issue by offering time and a half plus $30 to RNs willing to work overtime, bonuses to employees who are able to successfully refer a new hire RN to our hospital, and lastly by bringing in travel and agency RNs. Sadly, I cannot say that it has been fully effective as we still find ourselves struggling with an incomplete amount of staff on some days. With the continued spikes of COVID-19 infections has continued to stress and overwhelm hospitals and health systems nationally, we are at an exceptionally risky period for patient care and safety. The nursing shortage and the future of nursing education is in our hands and nurses should not miss the chance to serve as educators and inspire young people to foster a passion for the nursing profession which may be through shadowing programs or presentations at career fairs (Fisher et al., 2020).

References
Fisher, M., Walter, L., & Slade, J. (2020). A helping hand to promote nursing. Nursing, 50(8), 67–69. https://doi.org/10.1097/01.nurse.0000684248.99237.a4
Rosenberg, K. (2019). Rn shortages negatively impact patient safety. AJN, American Journal of Nursing, 119(3), 51. https://doi.org/10.1097/01.naj.0000554040.98991.23

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11 months ago
AFOLAKE OYINLOLA
RE: Discussion – Week 1- Main Post
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Kinner Atekwane,
One of the most critical issues that health care is facing today is nursing shortages where the estimated shortage of nurses would be increased to 340,000 in 2020” (Force, 2005). The shortage of nurses has been a major problem in the health care system globally and has become worse during this pandemic period. The majority of the nurses quit their positions because of the mortality rate of the frontliner and also because they are easily infected with the virus while transmitting it to their family members who stay at home. This has affected the number of nurses in the facility and has been a serious burden on the available nurses because they have to cover the open shifts which lead to constant mental and physical fatigue. The mental and physical fatigue will reduce the patient’s care outcome due to clinical errors that are committed as a result of fatigue. These errors would have been avoidable if not for the shortage of nurses that lead to the stress of working overtime on the available nurses. The recommendations will be for the government to review health care policies as regards the shortage of nurses so that there can be adequate nurse staffing that will reduce “burnout syndrome” in the health care system, review the policies as regards nursing school admissions, grant loans, grants, the scholarship for students and improve the wages for nurses.
References
Force, M. (2005). The Relationship Between Effective Nurse Managers and Nursing
Retention. JONA: The Journal Of Nursing Administration, 35(7), 336???341. doi: 10.1097/00005110-200507000-00005
S Kleinman, C. (2004). Leadership: A Key Strategy in Staff Nurse Retention. The Journal Of
Continuing Education In Nursing, 35(3), 128-132. doi: 10.3928/0022-0124-20040501-09

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11 months ago
William Boyle
Peer Response #1 Week 1
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Hello Kinner,

Staffing is such an important aspect of patient care. Having higher ratios of nurses to other providers has been shown to result in positive patient outcomes (Broome & Marshall, 2021). I find this true after observing how some situations unfold at work. Psych patients need to be observed for safety purposes when they display dangerous behaviors. I have seen many times where a sitter will be assigned to watch two patients in neighboring rooms because there is a staffing shortage. In these situations, the nurse and the sitter use teamwork to keep all parties safe. Even with the best plans in place situations can go awry. Psych patients have been known to leave their rooms unnoticed when nurses and sitters are distracted. Had there been another sitter this situation could have been avoided. Understaffing is also a vicious cycle. The understaffed nurses work harder making up for lack of staff and eventually call out themselves. I have seen nurses quit because they are overworked. Having high turnover also creates a safety issue because having experienced staff decreases negative patient outcomes (Wang et.al., 2020). I feel this is true because experienced nurses are excellent sources of knowledge. I frequently ask them questions and find them more informative than textbooks.

Thanks,
Will

Broome, M., & Marshall, E.S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer
Wang, L., Lu, H., Dong, X., Huang, X., Li, B., Wan, Q., & Shang, S. (2020). The effect of nurse staffing on patient‐safety outcomes: A cross‐sectional survey. Journal of Nursing Management (John Wiley & Sons, Inc.), 28(7), 1758–1766. https://doi-org.ezp.waldenulibrary.org/10.1111/jonm.13138

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11 months ago
Margaret Frazier
RE: Discussion – Week 1- Main Post
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Hi Kinner,

Staffing shortages are a serious concern in multiple regions. Intensive care unit nurses, who typically oversee no more then two patients at a time, are now being pushed to care for six to eight patients to make up for the shortfall in parts of Texas said Robert Hancock, president of the Texas College of Emergency Physicians (“Hospitals in half the states are facing a massive staffing shortage- STAT,” 2020)
I see that several hospitals in this area are offering sign-on bonuses up to 20,000.00 because they are so short-staffed. Nurses are becoming so burnt out with their patient loads, and patients are paying for it. We aren’t able to care for the whole patient when we have an 8-10 patient load. As you mentioned” due to staffing shortage, nurses sometimes work long hours because other nurses calling in sick, running one to four hours late from working under very stressful conditions resulting in burnout, injury, fatigue, and job dissatisfaction”.
With the need for so many nurses in all areas around the world, colleges need to make educational programs more available and more affordable so that we can get more nurses trained. The American Association of Colleges of Nursing (AACN) is working with schools, policymakers, nursing organizations, and the media to bring attention to this healthcare concern (“AACN fact sheet – Nursing shortage,” n.d.).

References

AACN fact sheet – Nursing shortage. (n.d.). The American Association of Colleges of Nursing (AACN). https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage

Hospitals in half the states are facing a massive staffing shortage- STAT. (2020, November 19). STAT. https://www.statnews.com/2020/11/19/covid19-hospitals-in-half-the-states-facing-massive-staffing-shortage/

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11 months ago
Abimbola Junaid
RE: Discussion – Week 1- Main Post
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Hello Kinner
I enjoyed reading your post, the staffing shortage in the healthcare department is a serious issue as the decrease in the rate of healthcare professional is a problem due to the high demand for healthcare. The shortage is due to many factors that are causing staff shortage in many cases. The most common factor that is seen in this global problem is that the young generation wants to gain financially equivalent amount to what they will be spending to gain that position. This has led to a decrease in the rate of new professionals joining the healthcare department. Another major factor that is seen in the most cases is the burnout due to high workload. Since there is a low amount of healthcare professional, the existing personnel have to work more which leads to workload stress (Tawfik et al., 2017). Since they are responsible to do more work and develops workload stress causing the quality of the service to go down making this more devastating for the institutes. The aging population is also a factor that has a proper impact on the staffing shortage as the most nursing staff is affected by this. The new nurses get agitated from the behavior of the elderly and leave the profession. This attitude towards the profession is also a factor that affects the staffing shortage. However, the most affected corner is the quality of the service that healthcare professionals are providing (Kotala, & West, 2018). Due to lack of numbers in the institute, the professionals are not able to spend appropriate time with the patient, thus they are not able to provide satisfactory service. Short staffing develops lack of time as there are a low number of professionals available to provide healthcare. Staffing shortage also gives rise to deprofessionalization, because the professionals of healthcare institute have to cover for more than one part of the healthcare institute.

References
Tawfik, D. S., Sexton, J. B., Kan, P., Sharek, P. J., Nisbet, C. C., Rigdon, J., … & Profit, J. (2017). Burnout in the neonatal intensive care unit and its relation to healthcare-associated infections. Journal of Perinatology, 37(3), 315.
Kotala, R., & West, D. J. (2018). Performance of hospitalists and inpatient clinical outcomes. Hospital topics, 96(4), 102-107.

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11 months ago
Cole Rehburg
RE: Discussion – Week 1- Main Post
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Response 1
Kinner,
It is interesting that you chose staffing as your healthcare issue. Currently, our facility is having trouble with staffing. When staff is low, safety is not prioritized. Suprisingly, the evidence base around staffing in the psychiatric setting is limited (McKeown et al., 2019). Subjectively speaking, I feel when staff is low the risk for patients being placed in seclusion or restraint are increased. According to Zolot, staffing appeared to have a statistically insignificant effect on restraint use (2016). Regardless of the lack of evidence, I believe staffing affects staff morale the most. When staff is feeling overworked, quality of care decreases. In order to address the lack of staff, our facility has begun offering monetary incentives for picking up shifts. I think this will help, but I think more needs to be done to address the root of the problem.

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Resources
McKeown, M., Thomson, G., Scholes, A., Jones, F., Baker, J., Downe, S., Price, O., Greenwood, P., Whittington, R., & Duxbury, J. (2019). “Catching your tail and firefighting”: The impact of staffing levels on restraint minimization efforts. Psychiatric and Mental Health Nursing. https://doi-org.ezp.waldenulibrary.org/10.1111/jpm.12532
Zolot, J. (2016). Physical restraint use associated with rn staffing. American Journal of Nursing, 116(12). DOI: 10.1097/01.NAJ.0000508649.33070.e1
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11 months ago
Uju Okwesili
RE: Discussion – Week 1- Main Post
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Response
Hello Kinner,
Your discussion was extensive and informative. Staffing shortage has been a long historical problem in the health care industry. Many things like offering shift differentials, bonuses, loan forgiveness programs, recruiting nurses from other countries have been put in place to help curve this issue, but still, the challenge exists. Staffing shortage hinders patients’ and caregivers’ safety, poses a threat to one’s license, and affects organizational budgeting and overall facility quality measures rating.
For example, a family looking for a good quality long-term health care facility will look into quality measures, and staffing is one of the measures. The family will prefer to go to a facility with five-star staffing than one with one or two stars.
Staffing shortages result in mandatory extra shifts that one is not mentally and physically prepared for. This most often results in medication error and injury to patients, and even up to staff injury. Staffing shortage poses lots of threats to the patients and the staff and the health care organization in general.

References

Bakhamis, L., Paul, D.P., Smith, H., & Coustasse, A. (2019). Still an Epidemic: The Burnout
Syndrome in Hospital Registered Nurses. Health Care Manag (Frederick); 38(1):3-10

Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner-physician
comanagement: A theoretical model to alleviate primary care strain. Annals of Family

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11 months ago
Betty Joubert Walden Instructor Manager
RE: Discussion – Week 1- Main Post
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Thanks Kinner, great thoughts expressed and you offered great information regarding to burnout. As healthcare leaders, it is very important to ensure that nurses are adequately protected against undue arm. Class, please explain a time when you addressed specific challenges with Administator.
Dr, Joubert
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11 months ago
Omowunmi Adeoti
RE: Discussion – Week 1- Main Post
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Great Post Kinner, The issue of staffing shortages especially in nursing has been an ongoing one and unfortunately there hasn’t been any concrete resolution to this problem. There have been strategies and incentive that have been put in place by various organizations to essentially combat this problem or at least prevent it from escalating even more. Most hospitals and facilities have implored specialized efforts by establishing a Retention and Recruitment committee to ultimately ensure job satisfaction is prevalent among Nurses that are being hired in an Organization which facilitates retention. This helps to slow down the high turnover rate in a clinical setting. The committee is also responsible for keeping the line of communication open with nurses that have been newly hired, to ascertain and address any challenges in scope of practice they might be faced with. heir new role and ways the Organization can help them.

There must be certain protocols set in place for staffing to be adjusted according to level of patient acuity as opposed to basing it on mere numbers so as to avoid Nurses burnout which in turn leads to high turnover. Evidence based practice as revealed that clinical settings with inadequate and disproportionate staffing ratios are positively correlated with higher readmission rates (Gnerre et al, 2017). This is an expense that can be avoided as it costs the Center for Medicare & Medicaid Services approximately $26 billion annually which is very unnecessary. When there is a high patient-to nurse ratio, it often leads to an increased urinary tract and surgical site infections in patients in the clinical setting, according to Wei et al (2017). The negative impact of nursing shortage is extensive and has continued to ravage several healthcare organizations throughout the United States. Essentially, the long-term consequences of staffing shortages will lead to devastating consequences on local, regional, and national levels of healthcare. According to the Bureau of Labor statistics Employment Projections 2012-2022, the nursing profession is projected to grow from 2.71 million in 2012 to 3.24 million in 2022, a growth of approximately 20% (American Association of Colleges of Nursing, 2014). In addition, the Bureau suggests that there will be a need for 525,000 nursing replacements in the nearest future, which in turn will open up and create nursing roles to nearly 1 million as a result of the growth and replacements (American Association of Colleges of Nursing, 2014). The issue of nursing shortages needs to be addressed by healthcare organizations as the insufficiency of staff nurses would become detrimentally costly to the healthcare sector.

References

American Association of Colleges of Nursing. (2014). Nursing Shortage. Retrieved from www.aacn.nche. edu/media-relations/factsheets/nursing-shortage

Gnerre, P., Rivetti, C., Rossi, A., Tesei, L., Montemurro, D., & Nardi R. (2017). Work stress and burnout among physicians and nurses in internal and emergency departments. Italian Journal of Medicine, 11(2), 151-158.

Wei, R., Ji, H., Li, J., & Zhang, L. (2017). Active intervention can decrease burnout in ED nurses. Journal of Emergency Nursing, 43(2), 145-149. https://doi.org/10.1016/j.jen.2016.07.011
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1 year ago
AFOLAKE OYINLOLA
RE: Discussion – Week 1
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Over the past years even before I started practicing nursing science, some of the problems that the health care system has been facing include affordable healthcare coverage and services, access to quality healthcare, and the evolution of information technology. Moreover, the Triple Aim which is a framework that is established by the Institute of Healthcare Improvement is innovated for addressing the concerns and issues in the health care system. to address these concerns and issues. “The goal was to improve the healthcare issues by improving access to healthcare, improving health outcomes, and decreasing the cost of healthcare delivery” (Laureate Education, 2018). The national healthcare issue/stressor that is selected for analysis and explanation of how the healthcare issue/stressor may impact my work setting is understaffing/shortage of nurses and medical burnout.
Describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.
I have worked in various facilities where there is understaffing and a shortage of nurses. The shortage of nurses in the health care system has been a huge problem in the health care system which still remains a major problem today. There should be an equilibrium between nurse staffing and the number of patients. One of the priorities of the health care providers is to have a well-trained nurse to provide adequate quality care. If there is a shortage of nurses, the available ones will be prone to mental and physical fatigue which can also lead to fatigue syndrome. Moreover, nurses that have “burnout syndrome” can make clinical errors. Medication error for example can cause permanent damage to the health of the patient of eventually leads to death. In addition, nurses are prone to “burnout syndrome” which is described “as a feeling of failure and exhaustion resulting from excessive demands on the energy, personal resources or spiritual strength of workers that prevent them from providing care and assistance to users of organizations in different fields whose primary objective is to help others”( Ruiz-Fernández et al.,2020).
My facility reacts to this issue by writing the American Nursing Association (ANA) on how to identify major elements to achieve optimal staffing which includes: the consumer, interprofessional teams, workplace culture, practice environment, and evaluation (American Nursing Association, n.d). Unfortunately, this has been an ongoing problem of health care systems for years which is still a problem till today. The immediate response was sent to the facility; however, the promises and solutions have not been implemented till today as the facility still suffers a shortage of nurses. However, since there were no forthcoming solutions from the government despite that the American Nursing Association (ANA) promised to get across to the legislators on the issue of shortage of nurses especially in the remote areas, the facilities had to implement an increase of overtime from “ a time and a half to a time and three-quarter” to nurses who are ready to work overtime. Moreover, the available nurses in urban centers were trained with the use of telemedicine so that they can see patients through this information technology in case the number of patients supersedes the available nurses in the remote areas.
References
American Nursing Association. (n.d.). Principles for nurse staffing. Retrieved from American Nursing Association. (n.d.). Principles for nurse staffing. Retrieved from https://www.nursingworld.org/practice-policy/nurse-staffing/staffing-principles/
Griffiths, D. (2017). How low staffing levels intensify risk stressors for nurses. Ohio Nurses Review, 92(2), 11.
Laureate Education (Producer). (2018). The Healthcare Environment [Video file]. Baltimore, MD: Author.
Ruiz-Fernández, M. D., Pérez-García, E., & Ortega-Galán, Á. M. (2020). Quality of Life in Nursing Professionals: Burnout, Fatigue, and Compassion Satisfaction. International Journal of Environmental Research and Public Health, 17(4).

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1 year ago
Betty Joubert Walden Instructor Manager
RE: Discussion – Week 1
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Thank Afolake for your thoughts and how you would assist in designing specific interventions that are evidence based. At one time, nurses followed orders and did not use critical thinking. Describe what change? Dr. Joubert

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11 months ago
AFOLAKE OYINLOLA
RE: Discussion – Week 1
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Thank you Dr. Joubert.
The reason why some Nurses follow order and not using critical thinking in service delivery might be due to overworking because of shortage of staff. The use of critical thinking is a key for every nurses to solve problems of patient by making a good decision in their nursing intervention. Thinking of patient safety in every decision making takes time. A Nurse that has a lots of patient might not be able to take time to think well in decision making. Therefore persistent nursing staff recruitment to keep compliment for staff shortage can be of a huge help to improve nurse to patient ratio. Staff training may also help to improve adequate care delivery. Good salary or overtime compensation will also encourage nurses doing good job. Lastly Nurses continuous education is also a major key to improve their skill knowledge in order to meet up with the evolution in nursing practices.
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11 months ago
Laura McLoughlin
RE: Discussion; Response #1 – Week 1
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National Healthcare Issue/Stressor
Hi Afolake! I enjoyed reading your discussion post on the nursing shortage and how it has become a national healthcare issue/stressor. Nursing shortages have been an issue for sometime and continue to be due to many factors. One factor that effects the nursing shortage in rural areas and primary care settings is due to most nursing schools are located in metropolitan areas and those acute care hospitals tend to attract the newer graduates (Haryanto, 2019). In urban areas, rehabilitation hospitals and skilled nursing facilities tend to have a shortage due to salary expectations. There is also a demand problem with the number of inpatient, critical and labor-intensive patients that have increased due to the aging population and the advancement of keeping ill patients alive longer (Upenieks, 2003). These patients require increased work hours by nurses to care for them. Lastly, retention of nurses has been an issue. Many hospitals have incentive programs and have increased pay, but money is not the only problem, nurses want to be appreciated and respected. According to Upenieks,2003, nurses want to be recognized for their expertise and be a part of the decision-making when it comes to patient care. There are many more issues that have contributed to the nursing shortage, these are just a few.
Impact on my Healthcare Organization and Their Solution
When my hospital found itself in a nursing shortage, the first thing they did was to offer incentive sign-on bonuses and retention bonuses. At first, this strategy worked, and we were almost fully staffed. However, the nurses weren’t feeling appreciated and still felt overwhelmed by the acuity of the patients. The hospital never has fully figured out how to fix the acuity issue, but they did come up with an appreciation strategy that has seemed to help some on the retention factor. The “Yeti Yell” is the name of the appreciation program. Anyone can nominate a nurse for this program. There are forms all over the hospital that you fill out on why you are giving a “Yeti Yell”. These forms are duplicate so once you fill it out, one copy goes to the person you are appreciating, and the other goes to administration. The forms that administration receive are then compiled and put out in an email newsletter for all to read and one person is drawn every month to receive a Yeti Tumbler of their choice. Nurses have felt more appreciated since this program started almost two years ago and many who were thinking of moving on before the program started, have stayed. You can hear them talk about how someone gave them a “Yeti Yell” and how it makes their day and makes them feel like what they are doing matters and is appreciated. This program is not a complete solution to retention, however it is a start in the right direction.

References

Haryanto, Mickey & RN-BC, MBA. (2019). Nursing Shortage: Myth or Fact?. Orthopedic
Nursing, 38, 1-2. https://doi.org/10.1097/NOR.0000000000000535
Upenieks V. (2003). Recruitment and retention strategies: a magnet hospital prevention
model. Nursing Economic$, 21(1), 7–23.
https://search-ebscohost-
com.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=106823835&site=ehos
t-live&scope=site

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11 months ago
Kinner Atekwane
RE: Discussion – Week 1- Response 2
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Response #2 to Afolake
Great post Afolake! The ANA is a great association that your facility had presented the nursing shortage/ nurse’s burnt out syndrome. The Registered Nurse Safe Staffing Act of 2013 (H.R. 1821) has been introduced by the ANA to Congress since May 8, 2013, which empowers registered nurses (RNs) to drive staffing and scheduling decisions in hospitals and, consequently, protect patients and improve the quality of care. (GovTrack.us.2020). As you stated, staffing has a direct impact on patient safety. If staff are burnout, it can cause medication errors. Research has shown that inadequate nurse-patient ratios are linked to higher rates of patient falls, injuries, infections, medications, and even death. Determining the appropriate number and mix of nursing staff is critical to the delivery of quality patient care and positive outcomes (Marc`et al.,2019). In addition, poor management could result in rapid turn-over of staff and contributory to the rapid turnover of staff are pay and benefits, workload and poor relationship with other staff due to burnout of staff.

References
GovTrack.us. (2020). H.R. 1821 — 113th Congress: Registered Nurse Safe Staffing Act of 2013. Retrieved from https://www.govtrack.us/congress/bills/113/hr1821
Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., Januszewicz, P. (2019). A nursing
shortage – a prospect of global and local policies. Int Nurs Rev; 66(1):9-16.

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11 months ago
MARTHA CHIMHASHU
RE: Discussion – Week 1
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Response 2 to Afolake
Nurse Burnout
Hi Afolake,
I enjoyed reading your post regarding nurse burnout as one of the reasons contributing to the current nursing shortage. According to Mudallal et al., burnout is a “reduction in nurses’ energy” resulting in “emotional exhaustion, low motivation, and reduced work efficiency” (2017). Nurse leaders can influence nurse burnout and affect work outcomes (Mudallal et al., 2017). Jacobs et al. suggests engaging in employees’ well being as a way to mitigate burnout (2018, p. 234). Strategies to reduce burnout include forming committees that are focused on increasing employee engagement and reducing turnover (Jacobs et al., 2018, p. 243). Burnout is associated with lower patient satisfaction and poor patient outcomes. Any organization hoping to achieve the quadruple aim needs to focus on its employees because doing so will reduce burnout and allow an organization to quickly reach its goals.
Regards,
Martha Chimhashu

References
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging Employees in Well-Being. Nursing Administration Quarterly, 42(3), 231–245. https://doi.org/10.1097/naq.0000000000000303
Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017). Nurses’ Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 004695801772494. https://doi.org/10.1177/0046958017724944

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11 months ago
William Boyle
Peer Response #2 Week 1
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Hello Afolake,

I hope researchers are gathering large amounts of burnout data through this pandemic situation. Burnout is a popular topic in nursing and seems that everyone gets it at some point. It makes nurses lose compassion and lose interest in what they are doing (Wei et. al., 2020). Nursing leadership can decrease burnout by creating an environment of teamwork and trust (Wei et. al., 2020). I feel this true because I get stressed if I am unsupported at work. One of my first nursing mentors told me nursing is a team sport. I shrugged the advice off at first but now I understand it. Nursing leaders using team building exercises create a better work environment (Broome & Marshall 2021).
When I feel like a team member, I am happier, more productive, and less stressed. There are times when I work with other people and the teamwork vibe is noticeably off. Feels like a rough day when this happens. Nursing leadership can improve these relationships by monitoring staff and improving communication between them. This could be as simple as pairing nurses that work well together often. The sticky wicket with this method is it may convey favoritism. This is why we need nurse leadership to guide us towards togetherness and away from burnout.

Broome, M., & Marshall, E.S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer

Wei, H., King, A., Jiang, Y., Sewell, K. A., & Lake, D. M. (2020). The impact of nurse leadership styles on nurse burnout: A systematic literature review. Nurse Leader, 18(5), 439–450. https://doi-org.ezp.waldenulibrary.org/10.1016/j.mnl.2020.04.002

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1 year ago
Betty Joubert Walden Instructor Manager
RE: Discussion – Week 1
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Class, sometimes, hospitals expects each employee to apply its mission in order to provide quality service to each patient and family member. Even with certain recognitions through its lifetime, the organization continues to strive on the base of providing quality holistic care to each person that steps into their halls. How are the employees reminded of the mission and vision statements. For example, my employees would have these items attached to the name badge?
Dr. Joubert

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1 year ago
Laura McLoughlin
RE: Discussion – Week 1
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Dr. Joubert:
To remind employees of the mission and vision statements, first the administration must lead by example to show that these statements are truly important for all to follow. Secondly, I would have these statements displayed all over the organization as a reminder and reward those employees who practice these statements.
Laura
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11 months ago
Shola Owoyemi
RE: Discussion – Week 1
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Dr. Joubert Employees should be reminded of the mission and vision statement through engagement by building a philosophy of engagement and every employee can name the hospital’s mission and discuss how his or her role contributes to that mission, staff members will be more engaged in-hospital initiatives and they are more likely to achieve their goals. Also, making sure the statement is short and memorable, and employees should find it relatively easy to employ in their everyday work. And lastly, the employee should talk about the mission, vision statement, they should come up in meetings on a regular basis.

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11 months ago
MARTHA CHIMHASHU
RE: Discussion – Week 1
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Response 3 to Dr. Joubert
Dr. Joubert,
At my organization we recite the mission statement at the beginning of each shift during huddle. Our mission statement is, “Above all else, we are committed to the care and improvement of the human life” (Medical City Healthcare, 2020). Reciting the mission statement daily results in better patient-centered care because the mission statement is embedded in the work we do. We have a value of the month. This month’s value is “you first” (Medical City Healthcare, 2020). This is a reminder for us, the employees, to put ourselves first. In order to take care of others, we must ensure we are well taken care of physically, mentally, emotionally, and financially. Focusing on the clinician is the fourth pillar of the quadruple aim (Boller, 2017, p. 707). By allowing the employee to put themselves first, we can help improve their work-life and reduce burnout (Richey & Waite, 2019, p. 39). This allows the staff to provide safe and effective care resulting in better patient outcomes (Boller, 2017, p. 708).
Regards,
Martha Chimhashu

References
Boller, J. (2017). Nurse Educators: Leading Health Care to the Quadruple Aim Sweet Spot. Journal of Nursing Education, 56(12), 707–708. https://doi.org/10.3928/01484834-20171120-01
Medical City Healthcare. (2020, November 23). Medical City Healthcare. https://www.medicalcity.com
Richey, K., & Waite, S. (2019). Leadership Development for Frontline Nurse Managers Promotes Innovation and Engagement. Nurse Leader, 17(1), 37–42. https://doi.org/10.1016/j.mnl.2018.11.005

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1 year ago
lorraine garacia
RE: Discussion – Week 1
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Description of the National Healthcare Issue
I currently work in a mental health unit where we have patients that with mental illnesses and substance abuse. In my unit, I see a big turnover with patients struggling with alcohol abuse. Unfortunately, we have been seeing more patients admitted for substance abuse due to the Pandemic. These are very stressful times, and our staffing department has been struggling to keep our mental health units staffed safely by using a grid for each unit. Sometimes the grid doesn’t make sense to me because the acuity is high most times in mental health and we need extra staff so we can deliver the best care.
Our patients that are admitted due to alcohol abuse are most times on a CIWA protocol. A CIWA protocol is a tool used to determine what level of severity of detox the patient is in according to their symptoms. With the CIWA protocol, we also medicate the patient according to a score used measured by the patients symptoms. According to the World Health Organization (2018), “Worldwide, 3 million deaths every year result from harmful use of alcohol, this represents 5.3 % of all deaths”. Alcoholism can be triggered by so many factors in people’s lives. Unfortunately, alcohol can be the only coping skill for some people to get through their daily struggles. I have seen very sick patients who struggle with alcoholism, one being liver disease. In 2018 there were 83,517 deaths due to liver disease starting with the age of 12 and older, this included 42.8 % that involved alcohol (National Institute of Alcohol NIH, 2019).
Impact of Registered Nurse Shortage in high acuity settings
Since alcoholism comes with many factors which not only included physical illnesses but also mental illnesses, we as nurses not only have to care for the patient physically but also mentally. Since these patients are most times very ill, our acuity on the mental health unit is very high. These patients require a lot of attention and most times are suicidal as well. Most times we are short staffed due to a grid that was made according to census. For example, if we have 12 patients one mental health unit (hall), then the grid states we only need 2 nurses and one tech. To some people this may sound accurate, but unless you have worked on a mental health unit and detox unit, this is short. We deal with patients yelling, cursing, and threatening us which we have to call security and medicate the patient, then we have the detox patients that we also have to care for and make sure they are not regressing. In between all these we have to do not hour rounds but Q15 minute rounds for each patient. Because the treatment for alcoholism and mental illness is different, we as nurses have to know the signs of regression for alcoholism and the signs of escalation for mental illness. Although alcoholism is considered a mental illness, the protocol of care is very different. Our units can become very hectic and challenging and sometimes may leave us with tears, but my peers are very skilled, and we never leave anyone drowning in work. If we can only have one more nurse or tech to help out on the floor, it would make a positive and significant difference on the attention and care we give our patients. According to the Journal of the American Psychiatric Nurse Association (APNA), 2016, “Acuity. Aligning staffing based on patient needs and acuity is an important consideration for risk mitigation and safety on the unit (Delaney & Johnson, 2006)”.

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References
Alcohol Facts and Statistics. (n.d.). Retrieved December 1, 2020, from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
Alcohol. (n.d.). Retrieved December 1, 2020, from https://www.who.int/news-room/fact-sheets/detail/alcohol
APNA Position Statement: Staffing Inpatient Psychiatric Units, 2012. (n.d.). Retrieved December 1, 2020, from https://journals.sagepub.com/doi/10.1177/1078390311432133

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Review of current Healthcare Issues

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