Sample Answer for NURS 6052 Week 1 Discussion Review of Current Healthcare Issues Included After Question
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.
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.
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.
A Sample Answer For the Assignment: NURS 6052 Week 1 Discussion Review of Current Healthcare Issues
Title: NURS 6052 Week 1 Discussion Review of Current Healthcare Issues
In one of the hospitals I work in, there has been a shortage in hospitalist physicians. At times, the organization was paying a huge sum to fill this shortage with locum physicians. In Washington State, Nurse Practitioners (NPs) are allowed to practice unrestricted, therefore, the organization hired 5 NPs to work as hospitalists. This not only was a cost-effective solution but was also an employee retention solution, as many physicians were leaving the organization due to burn out. However, there are 16 states and 3 U.S. Territories that have reduced practice regulations and 12 states that have restricted practice (State Practice Environment, n.d.). These restrictions limit access to care. When I worked in Texas, the clinic that I worked in had a waiting list for primary care appointments that went out 45-60 days due to a shortage in physicians and the limitations put upon NPs scope of practice. If Texas had full practice authority for their NPs, they could have done like my current organization did and hired more NPs to fill the void, therefore increasing the access to care.
Description of the National Healthcare Issue
Physician supply has been impacted due to the long training times, the capacity of medical schools, and the lack of residency positions (Auerback et. al., 2018). Due to the reduced number of physicians treating patients, we have seen an increase in the number of advanced practice registered nurses (APRN), especially NPs and physician assistants (PAs) that have overlapped with the care that physicians provide. Although this has helped address the shortage of primary care providers and specialists, the restrictions put on NPs in certain states has become a barrier for them to practice fully and fill the need for more care providers. For instance, in New York, there are written practice agreements between NPs and physicians (Poghosyan et. al., 2018). In 2015, New York adopted the Nurse Practitioner Modernization Act that would remove these practice agreements for NPs that had at least 3,600 practice hours, however sadly it has not been fully adopted and NPs are still limited in their scope of practice. Texas is another state that limits NPs practice by requiring that they practice under the supervision of a physician within a 75-mile radius (Wofford, 2019). These regulations affect patient’s access to care and do not assist in achieving the nation’s goal of efficient and cost-effective care for all when limiting the skill set of less costly providers (Poghosyan et. al,. 2018).
In order to provide better access to care and more cost-effective care, we must adopt the same full practice authority for NPs in all U.S. states and territories. Giving NPs the right to practice their skills fully would alleviate the shortage of not only primary care provides but also specialists, where the access to care is often long.
References
Auerbach, D. I., PhD., Staiger, D. O., PhD., & Buerhaus, Peter I,PhD., R.N. (2018). Growing
ranks of advanced practice clinicians — implications for the physician workforce. The
New England Journal of Medicine, 378(25), 2358-2360.
doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1056/NEJMp1801869
Poghosyan, Lusine, PhD, RN, Norful, Allison, PhD, RN & Laugesen, Miriam. (2018). Removing
restrictions on nurse practitioners’ scope of practice in New York State: Physicians’ and
nurse practitioners’ perspectives. Journal of the American Association of Nurse
Practitioners, 30, 354-360. https://doi.org/10.1097/JXX.0000000000000040
Pohl JM, Hanson C, Newland JA, Cronenwett L. Analysis & commentary. Unleashing nurse
practitioners’ potential to deliver primary care and lead teams. Health Affairs.
2010;29(5):900-905. doi:10.1377/hlthaff.2010.0374
State practice environment. (n.d.). American Association of Nurse Practitioners.
https://www.aanp.org/advocacy/state/state-practice-environment
Wofford, P. (2019, July 8). Texas nurse practitioners fight for full practice authority. Nurse.org.
https://nurse.org/articles/texas-nurse-practitioners-fight-for-practice/
A Sample Answer 2 For the Assignment: NURS 6052 Week 1 Discussion Review of Current Healthcare Issues
Title: NURS 6052 Week 1 Discussion Review of Current Healthcare Issues
I agree with you that shortages in physicians impacts healthcare. The enactment of the Affordable Care Act and the growing population has contributed to physician shortages in the United States (Zhang et al., 2020). With more people having access to healthcare it has become a harder task to find enough physicians to provide care to patients. I agree with you that lack of physicians can negatively impact health organizations because it causes a barrier in access to healthcare.
In my work setting we have been impacted with physician shortages. We only have one child psychiatrist available to our patients. Though our organization utilizes many psychiatric nurse practitioners at times the care that they can provide is limited. For example, when a child needs to be committed to our unit, the child needs to be assessed by two psychiatrists. Since we only have one psychiatrist available in the hospital, to complete the commitment the patient is assessed via tele-psyche. At times the patient refuses to speak with provider via tele-psyche and we then must wait for another provider to come in from another hospital. This at times causes a delay in care.
Though my facility like your facility utilizes psychiatric nurse practitioners to provide better access to healthcare, in certain situations there are still barriers met due to the limitations on what the nurse practitioner can do in NJ. In Massachusetts nurse mental health clinical specialist can file to commit a patient (Johnson and Stern, 2014). I agree with you that giving nurse practitioners full practice authority across the state can help with the impact that physician shortages can have on access to healthcare. Great Post!
References
Johnson, J. M., & Stern, T. A. (2014). Involuntary hospitalization of primary care patients. The primary care companion for CNS disorders, 16(3), PCC.13f01613. https://doi.org/10.4088/PCC.13f01613
Zhang, X., Lin, D., Pforsich, H., & Lin, V. W. (2020). Physician workforce in the United States of America: forecasting nationwide shortages. Human resources for health, 18(1), 8. https://doi.org/10.1186/s12960-020-0448-3
A Sample Answer 3 For the Assignment: NURS 6052 Week 1 Discussion Review of Current Healthcare Issues
Title: NURS 6052 Week 1 Discussion Review of Current Healthcare Issues
One of the biggest issues in healthcare today is substance abuse. I work on a dual diagnosis inpatient psychiatric unit. If I have 10 patients, at least 5 of them will have problems with substance abuse. If a patient requires treatment, we will deal with that while taking care of their psychiatric crisis. This can be extremely difficult and frustrating at times. It seems as though we have a revolving door, many repeat patients. A patient that continues to be in active addiction is very hard to treat no matter how much medication or therapy we provide.
Work Setting
The facility I work for is very small, and the culture is close-minded and reluctant to change. I find myself very frustrated with this. A facility needs to not only survive, but thrive. A facility should have strategic planning with long term goals/visions for the whole organization to be successful (Broome & Marshall, 2020). We seem to do the same things over and over for our patients, even though with many it’s not working. There is minimal planning for patients, the doctor rarely shows up for treatment team and there are no consequences for him. When he does attend, he is often condescending and disrespectful to staff and patients.Work environments are very important to our well-being and job satisfaction. Employees with a hostile workplace will have a negative attitude and poor performance. So in this situation, everyone suffers (Jacobs et al., 2018), Our provider will not continue a patient’s medication assisted treatment (MAT) at times, just solely based on past behavior. If a patient is admitted on our unit and has a valid prescription for Suboxone, it should be continued just as any home medication would.
I have often advocated for patients and complained to management about this issue.It always falls on deaf ears. We are not helping the patient by doing this, we are actually hurting them. The patient will be with us for a week or so, the Suboxone will be out of their system on discharge. So you can guess what happens when they leave the hospital, they will use drugs. It is just a matter of time until we see the patient again. This is just one example of bad decisions that cost the hospital and insurance company money. Substance abuse costs around $13 billion dollars per year. Hospitals have opportunities to engage and help high risk patients with proper treatment (Peterson et al., 2021).
Social Determinants of Health
In my area low socioeconomic status is a driver for substance abuse. This area is very rural with limited opportunities for employment and growth.Residents often have to travel far distances to find adequate employment, I drive 45 minutes to my job. There are no activities for kids, with the nearest movie theater an hour away, or bowling alley 30 minutes. Teenagers often end up drinking and doing drugs on the weekends. I often see people that come from generations of substance abuse. The patients I care for have grown up in households where the parents, and even grandparents use drugs.
Response
My workplace has not done anything to help combat this healthcare issue. The social workers will usually only make referrals to one substance abuse treatment company, even though it does not have a good reputation.Patients often come back to us with their horror stories. We also have a provider who does not seem to care about the patients and will “punish” them based on past behavior during prior admissions. Substance abuse is a serious problem world-wide, but my team should do their very best to make a difference even if only one patient succeeds.
References
Broome, M. E., & Marshall, E. (Eds.). (2020). Transformational leadership in nursing (M. E. Broome & E. Marshall, Eds.). Springer Publishing Company. https://doi.org/10.1891/9780826135056Links to an external site.
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.0000000000000303Links to an external site.
Peterson, C., Li, M., Xu, L., Mikosz, C. A., & Luo, F. (2021). Assessment of annual cost of substance use disorder in us hospitals. JAMA Network Open, 4(3), e210242. https://doi.org/10.1001/jamanetworkopen.2021.0242Links to an external site.
A Sample Answer 4 For the Assignment: NURS 6052 Week 1 Discussion Review of Current Healthcare Issues
Title: NURS 6052 Week 1 Discussion Review of Current Healthcare Issues
Nursing Shortages and Nurse Burnout as a National Healthcare Issue
Staffing shortages in the healthcare industry have become a significant issue and stressor nationwide. It is no secret that nurses work extremely hard to meet patient needs. 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, who are already short-staffed, 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 need to be filled faster to keep up with demand. Nurses need to be more staff on the front lines. There are millions of registered and licensed practice nurses in the United States. Most of these nurses, however, are not happy and comfortable in their work; they are stressed, overworked, and underappreciated. Their skills need to be utilized, leading to a significant negative impact on care delivery.
Impact on Work Setting
Staffing shortages can significantly impact the quality of work, productivity, creativity, competitiveness, nursing care outcomes, and patient safety. At my health care organization, due to staffing shortage, nurses sometimes work long hours because other nurses call in sick, running one to four hours late from working under very stressful conditions resulting in burnout, injury, fatigue, and job dissatisfaction. Nurses suffering from job dissatisfaction and burnout delay treatments and make other mistakes due to the relationship of the nurse-to-patient ratio (Xue et al., 2020).
An unfortunate outcome is that patient quality of care suffers, resulting in various complications, including emergency room overcrowding and treatment delay—understaffing results in burnout and stress among healthcare workers primarily. The healthcare challenges can be attributed to multiple factors. Although health care is inherently high-stress due to witnessing patients’ agony and loss of life, there is a worsening rate of stress and burnout. Studies show that nearly half of the U.S. healthcare workers report at least one symptom of burnout, such as emotional and physical exhaustion, low job satisfaction, and depersonalization. These impair the ability of health workers to connect with patients in meaningful ways and fully concentrate on patient care, resulting in reduced productivity, increased nurse turnover, and risk of suicide among caregivers. This can compromise the quality and safety of care. It can also increase the risk of medical errors and hospital-acquired infections (Jacobs et al., 2018).
The most significant factor is the rising pressure to produce better outcomes in the U.S. healthcare system at lower costs. As a result, care providers take the most crucial role in implementing the value-based care system. Due to the Centre of Medicare Services pressure, healthcare organizations are putting pressure on their employees to change their practice methods. Although the shift is suitable for patients, health workers bear the most significant burden.
Organizational Response and Changes Implemented
A range of solutions has been offered to solve the nursing shortage in my healthcare organization, from subsidized funding, hiring new nurses, wage increases, and contracting with nursing agencies for nurses to fill in periodically. My healthcare organization provides tuition for nurses seeking to advance their degrees. In addition, resources have been allocated towards increasing wages which has affected the recruitment and 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 helped nurses to juggle their busy work schedule with home life and educational opportunities and provides room for decompressing between stressful, emotionally demanding shifts and days of work. Implementing an electronic health record system and employing administrators to handle clerical duties has reduced the care providers’ workload (Shanafelt & Noseworthy, 2019). To improve job satisfaction, participatory decision-making, where health workers’ views are considered, has been adopted.
Additionally, counseling and stress management programs are offered to healthcare workers in the work environment. By introducing said strategies, we would not only increase staffing in health care but equally, reduce the stress-related illness rate among nurses and significantly raise the quality of healthcare and patient outcomes. Patients 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 and shorter, and burnout will not often occur (Norful et al., 2018).
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
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: moving from the triple to the quadruple aim. Nursing administration quarterly, 42(3), 231-245.
Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner[1]physician comanagement: A theoretical model to alleviate primary care strain. Annals of Family
Shanafelt, T. D., & Noseworthy, J. H. (2019). Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. In Mayo Clinic Proceedings (Vol. 92, No. 1, pp. 129-146). Elsevier.
Xue, Y., Ye, Z., Brewer, C., & Spetz, J. (2020). Impact of state nurse practitioner scope[1]of-practice regulation on health care delivery: a systematic review. Nurs Outlook; 64(1):71-85.