Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example
Nursing shortages are a national healthcare stressor associated with increased incidences of errors, higher morbidity, and mortality rates. Nurse shortage leads to high patient-to-nurse ratios, and nurses often experience fatigue, dissatisfaction, and frustration. On the other hand, patients experience higher morbidity, mortality, and failure-to-rescue rates. Nurse shortage prompts longer shifts that increase fatigue, injury, and stress, undermining patient care quality. Fewer nurses than required increases the workload for the remaining nurses, a significant challenge for the American healthcare system (Pastores et al., 2019). Heavier workloads result from increased nurse demand, inadequate nurse supply, reduced staffing and increased over time, and patient length of stay reduction.(Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
As the US aging population increases, the demand for nurses and other healthcare practitioners increases. The current nurse supply is insufficient to meet the increasing health needs adequately, and the shortage is expected to grow in the future. Nursing schools are also struggling to keep up with the rising educational needs. Numerous policies have been implemented to address the increasing demand for nursing practice and short supply. However, most organizations are aware that hiring more nurses increases healthcare costs. These are competing health care needs that impact policy development. It is imperative to explore the measures and strategies nursing leaders can use to find a balance between the staffing needs of the organization and the needs of ensuring quality, effective, and safe patient care.(Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
Many interconnected factors affect the demand for nursing practice. They include cost-containment needs within healthcare organizations stemming from managed care and high competition in the healthcare environment, organization consolidation, reengineering, downsizing, inpatient hospitalization rates reduction, hospital patients’ increased acuity, and a shift from hospital-based to ambulatory community-based settings. Nursing shortages are linked to responses to the rising health care costs since the early 1990s. Some hospitals are forced to reduce nursing staff and impose mandatory overtime policies for the remaining nurses to meet the increasing health demands (Pastores et al., 2019). Cost pressures also force hospitals to lower patient lengths of stay. (Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)The remaining patients have poor outcomes and require more intensive attention from nurses. It becomes challenging for hospitals to develop policies that ensure a conducive working environment for nurses, high quality of patient care, and cost-containment. Cost-containment policies seem to counter nurses’ and patients’ well-being policies. For instance, reducing the nursing workforce to reduce costs increases the workload for the remaining workforce, undermining their well-being. Also, policies that require an organization to downsize increase patient-to-nurse ratios, undermining the quality of patient care.(Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
Healthcare organizations aim to provide high-quality health care while managing costs consistently. These goals counter one another, making it difficult to achieve them simultaneously. Hospitals that are forced to reduce staff members and introduce mandatory overtime lead to heavy nursing workloads that adversely impact patient safety. Higher workloads lead to nursing job dissatisfaction, which increases nurse turnover, further escalating nursing shortages (Pastores et al., 2019). Policies that require organizations to reduce the length of hospital stay to reduce costs also counter nurse well-being policies. Nurses are needed to care for sicker patients with higher acuity. Their roles extend to nonprofessional tasks like delivering food, retrieving food trays, housekeeping, patient transportation, ordering, coordinating, and ancillary services. The job demands become too much, and hospitals struggle to retain the already burned-out nurses.(Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
Ethically, nurses should demonstrate moral virtue, ethical obligation, and responsibility for the work environment. They are expected to do what is right and act with integrity, respect, industry, and moderation. They should demonstrate knowledge, skill, wisdom, compassion, courage, altruism, honesty, and patience. Nurses should be moral persons or agents with an obligation to beneficence, nonmaleficence, justice and fairness, and fidelity. They are required to develop and maintain a culture of excellence and support other nurses to meet their ethical obligations. They should support and conduct respectful interactions with colleagues, offer mutual peer support, and identify healthcare environment challenges (American Nurses Association, 2015). However, these obligations and ethical requirements are almost impossible among a demoralized, dissatisfied, burned out, and frustrated workforce due to nursing shortage and heavier workloads. They force nurses to surpass their well-being to fulfill them. Promoting ethical practice and improving nurses’ well-being are competing needs that should be addressed simultaneously.(Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
Policies should focus on the factors influencing the supply of nurses, especially APRNs, including work environment, recruitment, retention, education, and compensation for nursing to survive and thrive. The work environment is the most significant motivator for nurses making employment decisions. The current and anticipated shortage is linked to an insufficient supply of experienced staff and qualified managers. Strategies to increase the supply of nurses successfully should begin with policies that focus on the care environment and nurse well-being, including those that eliminate mandatory overtime, reduce nursing workload, increase workplace interdisciplinary collaboration and teamwork, and support nurses’ self-care.(Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
Improving staff well-being results in increased employee engagement, crucial in helping the system meet its goals (Jacobs et al., 2018). Policies that enhance employee well-being should be elevated and those that support high-quality, low-cost care in patient-centered settings. Policy efforts should also address recruitment issues by increasing student recruitment into nursing programs. Organizations such as the National Student Nurses’ Association and American Nurses Association that influence policy development should focus on media campaigns designed to encourage junior and senior high school students to apply to nursing programs and encourage existing nurses to remain in the profession. They should also consider the recruitment of foreign nurses. Policies that shorten work hours, especially for older nurses, to 32 to 36 hours a week, have proven effective in increasing staff retention.(Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
Education also contributes to the nursing shortage, considering that many organizations are currently hiring highly educated and qualified APRNs and encouraging existing ones to pursue higher degrees and certifications. However, nurse educators are also limited and seen as a nursing shortfall. Educators are more limited for the doctoral level. Policies should support doctoral programs enrollment to produce more educators to enhance nursing schools’ capacity to educate sufficient nurses to meet the increasing demands (Gerardi et al., 2018). Increased nursing school capacity can also help increase the proportion of nurses with higher degrees to ensure a highly educated workforce.
Compensation and wage increases can increase health care costs but prove effective in retaining nurses and increasing job satisfaction. Wage increases are a reality for healthcare organizations, and policies should support negotiated nursing contracts for sustainable and reasonable annual wage increase percentages. Policies should also promote nurses’ ethical awareness to help nurses recognize the implications of decisions and actions. Promoting patient safety means that nurses can effectively identify and address ethical problems as they occur (Milliken, 2018). Ethical dilemmas can be frustrating for nurses, and organizations should promote policies that enhance ethical awareness to support practice, promote patient safety, and ensure a satisfied and informed workforce. (Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. Retrieved from https://www.nursingworld.org/coe-view-only(Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving Closer to the 2020 BSN-Prepared Workforce Goal. The American journal of nursing, 118(2), 43–45. https://doi.org/10.1097/01.NAJ.0000530244.15217.aa(Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
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, 42(3), 231-245. https://doi.org/10.1097/naq.0000000000000303(Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
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. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html(Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
Pastores, S. M., Kvetan, V., Coopersmith, C. M., Farmer, J. C., Sessler, C., Christman, J. W., … & Price, K. (2019). Workforce, workload, and burnout among intensivists and advanced practice providers: a narrative review. Critical care medicine, 47(4), 550-557.(Organizational Policies and Practices to Support Healthcare Issues Comprehensive Nursing Essay Example)
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