NURS 6053 Assignment Developing Organizational Policies and Practices

Sample Answer for NURS 6053 Assignment Developing Organizational Policies and Practices Included After Question

Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.

Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.

Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.

RESOURCES

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WEEKLY RESOURCES

To Prepare:

Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (1-2 pages):

Developing Organizational Policies and Practices

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.
Due to the nature of this assignment, your instructor may require more than 7days to provide you with quality feedback.
NURS 6053 Assignment Developing Organizational Policies and Practices

BY DAY 7 OF WEEK 3

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A Sample Answer For the Assignment: NURS 6053 Assignment Developing Organizational Policies and Practices

Title: NURS 6053 Assignment Developing Organizational Policies and Practices

Burnout among nurses compromises the quality of health-care services patients receive. The evidence-based practices require that nurses engage with their patients and create a friendly environment to identify their needs and develop better treatment measures. Besides, they have to take an adequate history of the patients and make accurate diagnoses. On the other hand, nurses experiencing burnout will not have the urgency to interact with the patients because they feel undervalued and insignificance. Various factors contribute to the burnout experiences among the nurses. Some of the factors include a poor working environment and relationship with the leaders. Alternatively, the increasing number of patients with chronic illnesses increases the demand for nursing services. Also, patients with terminal illnesses require palliative care which is dependent on the holistic care approach. Such environments cannot be achieved with the high incidence of burnouts among the nurses. Therefore, addressing the health issue will be important progress to improving the quality of life of the nurses and the quality of healthcare services patients receive.

Two Competing Needs Impacting Your Selected Healthcare Issue/Stressor

The previous analysis focused on improving the healthcare worker’s work-life in the University Of Florida Shands Hospital. The competing needs that could impact the burnout issues in the hospital include the need to improve leadership and management in the organization, the need to develop a collaborative culture that allows healthcare providers to share ideas widely and improve the patients’ management. Also, there is a need to promote nursing informatics in the institution, which will significantly improve the quality of healthcare services the patients receive. The healthcare system is dynamic and this means that the needs will also change from time to time. However, the ability of the healthcare institution to handle the needs as they arise depends on the leadership practices.

Furthermore, poor leadership contributes to a poor working environment, which ultimately contributes to high burnout among the nurses. As a result, there is an urgent need to embrace transformational leadership and a culture of collaboration in the institution. The leadership and cultural system will create a sense of belonging and so reduce the turnout rate as well as burnout incidences among the nurses. Furthermore, nursing informatics needs to aim at linking the patients to the healthcare providers and utilizing the available data to improve the quality of healthcare services the patients receive. It may appear futile to increase the number of nurses or even offer counsel when their working environment is unconducive. Integration of an automated data management system will allow the nurses to access the patients’ data and link with other departments easily and so minimize the time taken to attend to a patient.

Relevant Policy or Practice in Your Organization That May Influence Your Selected Healthcare Issue/Stressor

The policies for addressing the healthcare issue in the organization include the increased use of an outside agency to supply the nurses, offering of counseling programs, shifting the 12 hours of work to 8 hours in a day, and offering preceptors for each new employee during the training. The policies aim to improve the nursing experiences and making them more productive in the duties. The policy on increasing the nurse supply and reducing the ratio of patients to nurses will prevent overload and so allow the nurses to spend adequate time with their patients (Boamah et al., 2016). Inadequate supply of the nurses results in overload and prolonged working hours because of the ever ballooning number of patients.

On the other hand, the counseling programs seek to deal with the psychological concerns of the patients. Burnout is characterized by emotional and psychological exhaustion with the victims having low energies to deliver in their areas of responsibilities. Therefore, offering counseling services will help in identifying other factors likely to be contributing to burnout and how to address them. Furthermore, reducing the working hours from 12 to 8 hours means that the nurses will have time to rest and engage in social activities. Also, their levels of fatigue will reduce significantly (Liu et al., 2019).

Critique The Policy for Ethical Considerations

The policies and practices support the ethical principles guiding the healthcare practice. The goal of healthcare delivery is to promote healthy living and reduce suffering among patients. On the other hand, it may be impossible to reduce suffering among patients when the healthcare providers are suffering. Therefore, the practices aimed at improving the quality of life for the nurses and giving them the freshness to handle patients’ needs accordingly. Also, the policies support the ethics of justice. On the other hand, some of the policies regarding the promotion of ethics include discrimination in recruitment by external agencies. Furthermore, the counsellors could provide bias information or rather use the nurses’ data against them. The effectiveness of the counselling sessions depends on the transparency and openness between the nurses and their counsellors. There are cases where nurses may outline specific relating to the organization’s management. Lack of confidentiality from the counsellor could lead to exposing the nurses and affecting their working relationships further.

Policy or Practice Changes Designed To Balance The Competing Needs Of Resources, Workers, And Patients

The organization should embrace open forums where both the leaders and nurses can share their ideas and opinions on the work process. The policy will help in balancing the need to address nurse burnout and the leadership approaches in the organization. The forums will promote the transformational relationship between the nurses and the leaders and so facilitate quality healthcare delivery. Recruiting transformation leaders or rather offering training may require additional resources. Similarly, adding the number of nurses in the organization will require more financial input. However, creating open forums and regular meetings will help in devising collaborative methods to address the nurses working conditions and improve leadership experiences. Burnout is not always about inadequate staffing; however, employees’ experiences and interactions with the organization plays an important role.

According to Asif et al. (2019), transformational leaders seek to understand the experiences of the nurses and work with them to overcome the challenges. The regular interaction between the leaders and the nurses allows frequent communication and sharing of ideas that alleviate the burnout experiences among the nurses (Wu et al., 2020).

Conclusion

Finally, burnout is a serious concern in healthcare delivery. Proper policies should be developed to improve the working experiences of the nurses and allow them to offer quality healthcare services to the patients. There is a need to increasing the nursing staff, reduce the working hours and offer counselling services; however, the hallmark approach to burnout incidences is improving the leadership practice and working environment which stimulates passion for work among the nurses.

References

Asif, M., Jameel, A., Hussain, A., Hwang, J., & Sahito, N. (2019). Linking transformational leadership with nurse-assessed adverse patient outcomes and the quality of care: Assessing the role of job satisfaction and structural empowerment. International Journal of Environmental Research and Public Health, 16(13), 2381. https://doi.org/10.3390/ijerph16132381

Boamah, S. A., Read, E. A., & Spence Laschinger, H. K. (2016). Factors influencing new graduate nurse burnout development, job satisfaction, and patient care quality: A time-lagged study. Journal of Advanced Nursing, 73(5), 1182-1195. https://doi.org/10.1111/jan.13215

Liu, C., Liu, S., Yang, S., & Wu, H. (2019). Association between transformational leadership and occupational burnout and the mediating effects of psychological empowerment in this relationship among CDC employees: A cross-sectional study. Psychology Research and Behavior Management, 12, 437-446. https://doi.org/10.2147/prbm.s206636

Wu, X., Hayter, M., Lee, A. J., Yuan, Y., Li, S., Bi, Y., Zhang, L., Cao, C., Gong, W., & Zhang, Y. (2020). A positive spiritual climate supports transformational leadership as means to reduce nursing burnout and intent to leave. Journal of Nursing Management, 28(4), 804-813. https://doi.org/10.1111/jonm.12994

A Sample Answer 2 For the Assignment: NURS 6053 Assignment Developing Organizational Policies and Practices

Title: NURS 6053 Assignment Developing Organizational Policies and Practices

The delivery of hospital care to patients is complex and involves the intervention of many health care practitioners, including licensed nurses, specialized nurses, doctors, and other specialists. In these groups, hospital administrators are responsible for developing patterns for troubleshooting, identification, and communication in order to ensure the efficiency of the hospital (Marc, Bartosiewicz, & Burzyńska, 2018). Inferior treatment shortages contribute to overwork by certain patients. An overworked nurse is endangering care quality. The lack of sufficient staff, such as nurses, is a key factor in health facilities. The scarcity of nurses in hospitals is known as a regional concern, and since 1998, many medical services have struggled from a scarcity of nurses. Medical practitioners also already have heavier workloads, a significant issue in the health sector. The problem can be tied up with four major causes, rising nursing demand, inadequate availability of staff, under personality and excessive overtime, and patient reduction.

The backbone of healthcare is patient safety. Forgiveness, but true: medical mistakes are reported to be the third leading cause of death. For more patients seeking medical services under the “Affordable Care Act” and a growing pressure on the program from the ageing population, patient protection is a key competency pursued by workers across a variety of health care organizations. Patients receiving wrong medications, the wrong dose or a mixture of drugs interacting poorly include drug errors. Slips in documentation or other types of human error could cause these mistakes (Gaffney, Hatcher, & Milligan, 2016). The “Food and Drug Administration” reports that since 1992, it has received over 30,000 reporting medication errors, which is voluntary, so that the actual number of medication errors is probably much larger. Work in a hospital can be dangerous. Provider was frequently met with accidents as bulky objects was removed, medical tools are trapped, slipped or dropped or broken by patients or guests out of sight. There is a growing chance of contamination.

Relevant policy

From a country-level policy perspective, a lack of nurses is normally identified and measured against the historical levels of staffing, resources and estimates of health services demand in that country. It is the difference between the reality that the healthcare practitioners are accessible at present and the demand for higher supplies but this is described as “shortage.” It is also not readily quantifiable and a term that is utilized by various groups, even sometimes in the same county sense, with specific meanings. One

important point to be taken into consideration is that no ‘magic bullet’ policy will address nursing deficiencies. Two critical considerations are highlighted from research on the performance of human resources management behaviour. First of all, “contingency” needs to be taken into account – that the implemented HR policies must “fit” the features, contexts and priorities of the organization or system in which these are being implemented. Second, the so-called ‘bundles’ of related and coordinated HR policy interventions are more likely than single or uncoordinated interventions to achieve lasting improvement in organizational performance. This is a significant message for the sometimes politically-politicized health sector, which sometimes focuses on short-term policymaking and in which cycles of scarcity can endanger program stability. It can also be remembered that one point is to recognize the ‘best standards’ in proof on the basis in shortcomings, yet to render the correct set of HR policy measures a broad and consistent implementation. Evidence suggests that HR’s good practice is somewhat lacking: even as checked through empirical reports, it is not often visible in everyday action of many organizations. NURS 6053 Assignment Developing Organizational Policies and Practices

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Policy for ethical considerations

As part of health system efforts strengthening globally, Health policy and system research (HPSR) are increasingly funded and undertaken. The philosophy of HPSR is still a fairly new area in research with several theoretical and concise problems that still have not been taken into account. The guiding principles and values of HPSR are included in the normative questions. What ethical concerns arise in the conduct of HPSR are descriptive issues. The various ethical issues in HPSR are characterized by a small but growing number of academic work. Ethics HPSR is also an evolving and fairly new area. Ethics, too, has components for software and hardware that are articulated at various rates (international, regional, local, and institutional). Ethical rules and procedures, ethical boards, ethical staff, ethics preparation programs, etc. can be part of the equipment. Equipment Includes the ethical principles and values and processes agreed on in order to respect and maintain those values, such as informed consent and community participation (Pratt & Ali, 2017).

Ideally, the elements of ethics applications would be expressed in their hardware. Through meaningful extract analysis of formal and informal literature, ethical issues in four main categories were identified: free support, risks and advantages identified and balanced, justice, and the identification and evaluation of ethical requirements. There is a lack of clarity regarding the risks and benefits of which in the HPSR risk/benefit evaluations should be assessed (Marc, Bartosiewicz, & Burzyńska, 2018). HPSR experiments also include multiple ‘participants’ stages of study, several of whom are not persons per se. Because HPSR may generate costs and benefits for people, communities or organizations, and health systems and ethics analysis will need to consider these potential dangers and profit levels into consideration.

Recommended Policy

In the majority of the services proposed, financial assistance will be related to the ability of nursing students to operate in regions of regional and professional issues. Ideally, the federal government and nurse unions must have support for these services. Leaders of the committee were rightly concerned by the current downward decline in nursing school enrolments, but it might be early for the committee to call for supply-side subsidies. As mentioned above, historical data show that any reactions in wages appear to lead to increases in the supply of new nurses. Although tuition subsidies are a market-friendly gesture for school students, they may be wasteful and even harmful in certain cases — particularly if the government finances the grant. If employers finance the subsidy (e.g., through back pay loans for services), the direct flow of funds from the supplier’s request shall remain intact.

Evidence that informs the healthcare issue

The first evidence is this (Marć, Bartosiewicz, & Burzyńska, 2018) article that presenting much information about the selected healthcare issue. Nursing and nurses still face major obstacles related to global structural trends and the aging of the nation. In the world, the number of people aged 60 and over will rise to 1.3 billion by 2031 from 900 million in 2015, an increase of 55 percent, whereas the number of older people worldwide will more than double to almost 2.0 billion by 2050. The unfinished health care examination, the poor economic condition of most hospitals and medical facilities, poor accessibility to medical care services, disproportionate site position of specialist clinics, dissolution of school medical care system, increasing costs of and restricting modern medical procedure are additional factors which contribute to Poland’s poor performance amongst other countries.

The other evidence is the article composed by Christian M. Rochefort, David L. Buckeridge, and Michal Abrahamowicz. According to this evidence, in general, in a particular hospital, infants’ level varies shift by shift from one unit to one unit and within a given Unit, depending on the fluctuations of the patient’s care requirements and unforeseen absenteeism (Rochefort, Buckeridge, & Abrahamowicz, 2015). Many characteristics for nursing workers, including levels of expertise and qualifications, can theoretically be correlated with EA incidence. For each transition in a specified hospitalization, time-variable access to healthcare workers may be assessed.

References

Gaffney, T. A., Hatcher, B. J., & Milligan, R. (2016). Enhancing Patient Safety: Factors Influencing Medical Error Recovery Among Medical-Surgical Nurses. OJIN: The Online Journal of Issues in Nursing.

Marc, M., Bartosiewicz, A., & Burzyńska, J. (2018). A nursing shortage – a prospect of global and local policies. International Nursing Review.

Marć, M., Bartosiewicz, A., & Burzyńska, J. (2018). A nursing shortage – a prospect of global and local policies. International Journal Review.

Pratt, B., & Ali, J. (2017). Ethics of health policy and systems research: a scoping review of the literature. Health Policy and Planning.

Rochefort, C. M., Buckeridge, D. L., & Abrahamowicz, M. (2015). Improving patient safety by optimizing the use of nursing human resources. Implementation Science.

A Sample Answer 3 For the Assignment: NURS 6053 Assignment Developing Organizational Policies and Practices

Title: NURS 6053 Assignment Developing Organizational Policies and Practices

First I want to touch on two subjects, one being the example that is given about nurse’s working 12 hour shifts. I was always told that this policy came about for the continuity of care and that’s patients actually feel better when they know their nurses and when they feel their nurse’s know them better because having them for several hours and for several days. I know my family always jokes around that I “only work three days a week” but not many people understand the physical and mental struggles that come with working twelve hour days. As nurses we are at work for more than 12 hours, sometimes report runs over, sometimes something happens at shift change that requires someone to stay over and help; for the most part a nurse is away from their home and family way longer than the 12 hours of work. I know there’s sometimes at work when it gets to be 5pm or 5am (depending on which shift I am on for that week) when I am mentally done and feel that I can not keep giving my patients the care they need and deserve and I still have another two hours of the shift left, its scary to think of any mistakes that could possibly happen due to a nurse’s tiredness or mentality decline. NURS 6053 Assignment Developing Organizational Policies and Practices

The next topic, which also touches on competing needs is the use of rotating shifts for staffing the hospital. I have been a bedside nurse for almost six years now and I have been rotating from night shift to day shift and vice versa, depending on the needs of my unit. There’s been a multitude of times when I have had to work a Friday day shift and work night shift that Saturday, being exhausted from working all day I have to try and force myself to stay awake so that I can sleep in, or sleep most of the day so I can work and provide good quality care to my patients during night shift, it is extremely difficult but that is not even the worst of it. There has been many times that I have to work a night shift, go home that day and be back on days the next day, there have also been times when I have got as little as 1.5 hours of sleep due to trying to get myself off of night shift back to days, and no one can provide good quality care working on 1.5 hours of sleep. When I bring this up to my manager it’s always the needs of the floor outweighs the needs of the nurse and that it is policy to rotate. Nurses who work rotating shifts tend to experience work‐related stress, but their stress levels improved if they had at least 2 days off after their most recent night shift (Lin, et al., 2015). Last thing, one of my coworkers had to call off because she was unable to sleep at all prior to her shift (due to having to rotate between nights and days) and in calling off she was not able to be paid “sick time” because she was in fact not sick, she expressed her disappointment that had she come in to work with no sleep she was putting the lives of her patients at risk, but that did not matter to the nursing supervisors, because the competing needs outweighed the needs of the individual nurse and it was policy, to call off sick you have to say “I’m sick”.

The healthcare issue/stressor that I chose was the health insurance; that being the affordability and lack of and the need for universal health insurance. When health insurance is provided by an employer, it comes out of the employees pay, decreasing their oveerall pay and potentially causing financial heardship on the employee and their family. The costs of healthcare are affecting the federal budget deficit; and because health insurance for working Americans is mainly provided by employers, the increased costs are contributing to stagnating wages. (Buchan, et al., 2015). My healthcare institution will take any person, regardless of their health insurance, or lack of and treat them all the same. MetroHealth is a federally-funded medical institution and is also a level 1 trauma center. Metro is not the only health care institution located in northeast Ohio, there is also University Hospitals and The Cleveland Clinic; the difference of these three is the other two institutions do not accept patients with no health insurance. Metro, being constantly in a competition with these two other healthcare institutions created a policy that no patient would ever be turned away, for any reason, even when the hospital is at max capacity. Metro being the only number 1 trauma center of the three main healthcare institutions and accepting all patients regardless of their health insurance is already providing care to large amount of patients, but our CEO wanted to compete more; so he created the “no patient gets turned away” policy.

Due to no patient being turned away there has been times when we have had patient’s in the Emergency Room sleeping in the hallways, because there are no more rooms available, and sleeping on gurneys, because there are no more beds available. With that many patients it creates stressful situations for all healthcare workers working in that area, patients get upset when they are just out in the open and do not get their privacy in their own room, and they get highly irritable when they do not have a “comfy” hospital mattress to sleep on. Being on the floor it is always our first job to apologize for their stay in the ER and to listen to their complaints and attempt to calm them down; patient satisfaction is usually measured by the waiting time (Dellaert, Cayiroglu, Jeunet, 2016). With this many patients, and family members for each patient, there comes a point where HIPAA is unable to be enforced, as patients, and their family members, are overhearing doctors and nurses treat other patients and discuss their care either to the patient or each other. It always seems like those that create and enforce the policies are so far removed from the bedside that they truly do not understand how this impacts the quality of care. NURS 6053 Assignment Developing Organizational Policies and Practices

Buchan, J., Twigg, D., Dussault, G., Duffield, C., & Stone, P. W. (2015). Policies to sustain the nursing workforce: an international perspective.International Nursing Review,62(2), 162-170.

Dellaert, N., Cayiroglu, E., & Jeunet, J. (2016). Assessing and controlling the impact of hospital capacity planning on the waiting time.International Journal of Production Research,54(8), 2203-2214.

Lin, P. C., Chen, C. H., Pan, S. M., Chen, Y. M., Pan, C. H., Hung, H. C., & Wu, M. T. (2015). The association between rotating shift work and increased occupational stress in nurses.Journal of occupational health,57(4), 307-315.

A Sample Answer 4 For the Assignment: NURS 6053 Assignment Developing Organizational Policies and Practices

Title: NURS 6053 Assignment Developing Organizational Policies and Practices

Healthcare organizations focused on delivering high-quality patient care usually have various ongoing activities at any occasion of different project lengths that require different investments of human and financial resources. The activities often conflict, potentially hindering the organization’s success due to competing needs. However, health organizations can balance the competing needs by planning strategically, setting goals, constant communication, and utilizing supportive tools (Gaim et al., 2018). Nursing shortage is the identified national healthcare stressor. The purpose of this paper is to explore the competing needs that impact nursing shortage, discuss practice in the organization that impacts nursing shortage, and recommend a practice change that can balance the competing needs.

Competing Needs Impacting Nursing Shortage

Nursing shortage is measured in connection with a healthcare organization’s staffing levels, available resources, and approximates of health care demand. The gap between the currently available workforce and the target for a higher level of workforce provision is defined as a shortage (Marć et al., 2018). The competing needs affecting the nursing shortage in the organization include patients’ healthcare needs and financial needs for the organization’s projects. There is an increasing need for high-quality healthcare among patients, which creates a high workload for nurses. With the increased aging population characterized by a high prevalence of chronic illnesses, patients need nurses to provide high-quality care (Marć et al., 2018). The patients’ healthcare demands have significantly created the nursing shortage in healthcare organizations. Furthermore, the increasing healthcare needs cause fatigue and burnout among the current workforce resulting in high turnover, which results in further nursing shortage.

The financial needs for an organization’s ongoing projects are another competing need impacting nursing shortage in organizations. Limited financial resources significantly contribute to the nursing shortage since healthcare leaders are required to allocate resources based on priority needs (Marć et al., 2018). Competing needs occur when leaders are forced to choose if to prioritize financial resources to hire more nurses or to use the resources for projects such as infrastructure and purchasing medical commodities. Besides, competing needs arise when leaders have to choose whether to use the limited financial resources as financial incentives for nurses or utilize the resources in other projects (Marć et al., 2018). Choosing the latter option results in inadequate motivation from the organization causing low job satisfaction, high turnover, and eventually nursing shortage.

A Practice in My Organization That May Influence Nursing Shortage

Mandatory overtime is a practice in my organization that may influence nursing shortages. The organization has seen a dramatic increase in leaders using mandatory overtime as a staffing tool. Mandatory overtime is an unsafe staffing practice that is commonly used to address the nursing shortage. Nurses are forced to work extra shifts because of inadequate staffing resulting in high burnout levels and job turnover, further worsening the shortage issue (Son et al., 2019). Besides, mandatory overtime negatively affects patient care since it is attributed to increased cases of medical errors and missed nursing care, resulting in poor patient outcomes and high healthcare costs. Nurses are involved in numerous activities during a single shift, including admitting patients, administering medication, conducting patient assessments, implementing nursing care interventions, and discharges. The duties cause physical and psychological fatigue such as muscle, joint, and back pains, high anxiety levels, depression, and sleep disturbances (Santana et al., 2020). The fatigue and negative health effects of long working hours from mandatory overtime shifts have been associated with a high nursing turnover rate secondary to low job morale. Furthermore, the negative effect on nurses’ health has caused a high rate of sick offs, which further causes a nursing shortage.

Ethical Considerations of the Practice

Mandatory overtime practice aims to meet the nursing staffing needs necessary to meet patient healthcare needs, thus promoting the best health outcomes. Mandatory overtime ensures that adequate nurses attend to patients at every shift, which ensures all interventions are implemented and promotes patient satisfaction. Therefore, the strength of the practice in promoting ethics is seen in ensuring patients receive the needed nursing care to promote better health outcomes (Son et al., 2019). The practice upholds beneficence by ensuring that there are enough nurses to meet patients’ needs at any shift and thus promote the best patient outcomes.

Nevertheless, the mandatory overtime practice is faced with ethical challenges since it puts patients’ and nurses’ health at risk, thus failing to uphold nonmaleficence. Extended shifts have been linked with increased risks for injury, such as musculoskeletal injuries, cardiovascular symptoms, development of high blood pressure, and high-stress levels due to fatigue and inadequate rest (Santana et al., 2020). The practice makes nurses work extended hours without having sufficient sleep, which is detrimental to their mental health. Inadequate rest and sleep and the ensuing fatigue affect a nurse’s ability to provide optimal patient care, thus affecting the quality and safety of patient care. Therefore, the practice puts patients’ safety at risk and increases the risk of hospital-acquired complications from poor or missed nursing care (Son et al., 2019). Furthermore, mandatory overtime violates the nurses’ right to make independent decisions on when to work overtime. Although some nurses do not mind working overtime, mandatory overtime is often an intrusion into nurses’ free time. It takes away their opportunity to engage in social life and have a healthy work-life balance (Santana et al., 2020). Besides, nurses hardly ever assess their fatigue levels correctly until they are at a point of being impaired.

Policy or Practice Changes Designed To Balance the Competing Needs

Task shifting is a practice change tailored to balance the competing needs in relation to the nursing shortage. Task shifting refers to a practice in which trained cadres without competencies for specific tasks implement the tasks, thus increasing levels of health care access (Afolabi et al., 2019). Task shifting seeks to offer cost-effective healthcare services by a new cadre of workers when a nursing shortage puts irrational demands on the existing nurses who cannot meet patients’ health needs. For instance, some trained nurses from other countries may not have the credentials to work as registered nurses in the US due to training differences. Task shifting can be applied by employing these nurses as health care technicians or nurses’ aides. It shifts their roles and responsibilities to diverse practices, especially in areas of long-term care (Leong et al., 2021). Besides, the registered nurses can delegate simple tasks to the nurses, thus reducing the workload.

Conclusion

Nursing shortage is a persistent health issue that affects nurses’ ability to provide high-quality care to patients, thus, compromising the safety of care and patient outcomes. It is not only an organizational challenge but also a healthcare challenge since it adversely affects healthcare outcomes. The competing needs affecting the nursing shortage in the organization are patients’ healthcare needs and financial needs for the organization’s projects. Mandatory overtime shifts have adverse health effects on nurses and patients. Task shifting can be introduced in the organization to lower nurses’ workload, thus reducing the associated nursing shortage.

References

Afolabi, O., Abboah-Offei, M., Nkhoma, K., & Evans, C. (2019). Task-shifting must recognize the professional role of nurses. The Lancet Global Health, 7(10), e1328-e1329. https://doi.org/10.1016/S2214-109X(19)30358-4

Gaim, M., Wåhlin, N., e Cunha, M. P., & Clegg, S. (2018). Analyzing competing demands in organizations: a systematic comparison. Journal of Organization Design, 7(1), 1-16. https://doi.org/10.1186/s41469-018-0030-9

Leong, S. L., Teoh, S. L., Fun, W. H., & Lee, S. W. H. (2021). Task shifting in primary care to tackle healthcare worker shortages: An umbrella review. European Journal of General Practice, 27(1), 198-210. https://doi.org/10.1080/13814788.2021.1954616

Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2018). A nursing shortage – a prospect of global and local policies. International Nursing Review. https://doi.org/10.1111/inr.12473

Santana, I. R., Montes, M. A., Chalkley, M., Jacobs, R., Kowalski, T., & Suter, J. (2020). The impact of extending nurse working hours on staff sickness absence: Evidence from a large mental health hospital in England. International journal of nursing studies, 112, 103611. https://doi.org/10.1016/j.ijnurstu.2020.103611

Son, Y. J., Lee, E. K., & Ko, Y. (2019). Association of Working Hours and Patient Safety Competencies with Adverse Nurse Outcomes: A Cross-Sectional Study. International journal of environmental research and public health, 16(21), 4083. https://doi.org/10.3390/ijerph16214083

A Sample Answer 5 For the Assignment: NURS 6053 Assignment Developing Organizational Policies and Practices

Title: NURS 6053 Assignment Developing Organizational Policies and Practices

Cost of medication determines whether the patients will be willing to seek healthcare services from an institution or not. The goal of the quadruple Aim is to reduce the cost of education and increase the access to healthcare services by the population. The cost of medication depends on various factors including the changing economic times and the need to increase the number of healthcare providers in an organization. From the business perspective, institutions operate with the aim of making profits. Therefore, in the call for improving the quality of the healthcare services the patients receive, the healthcare institutions may require to increase their staffs and other equipment necessary for efficient operations. Addition of the resources result in the increased cost which must be transferred to the patients who are the consumers. Therefore, the current study explores the conflicting perspective of the mandatory overtime as a way of meeting the needs of the patients without increasing the cost of medication.

Competing Needs

The increasing number of patients in the healthcare institution requires an additional human resource. However, conventionally, the ratio of healthcare providers to the patients have remained low because of the limited resources. Healthcare providers are forced to attend to many patients beyond the standard requirements. Alternatively, the healthcare institution may opt to recruit more staff and this will result in additional costs which may be transferred to what patients pay. Some leaders may opt make full of their current staffing in responding to the rising costs and change in the payment policies by the federal government.

The introduction of the pay-for-value compensation method meant that healthcare institution would improve the quality of healthcare services to the patients (Kominski et al., 2017). Besides, the policy aimed at eliminating all the unnecessary health interventions that could otherwise increase the cost of medication. Furthermore, the hospital institutions are forced to utilize their existing staff accordingly to improve both the quality of care and minimize the treatment costs. Nurses and other healthcare providers may be forced to work for long hours since they have to spend lots of time understanding the need of their patients to meet the quality threshold (Bernstrøm et al., 2019). On the other hand, the increasing number of patients also force them to work overtime. Therefore, the need to lower the cost of medication and at the same time maintain the quality.

Relevant Policy Practice

The healthcare organization introduced the mandatory overtime as a way of dealing with increasing demand for the quality healthcare services as well as maintain the cost low. Eliminating the mandatory overtime means that the institution may have to employ more staff and this will result in additional cost of medication. The nursing staffs are expected to work for about 2 hours extra per day to meet the demand for healthcare delivery. The policy was introduced after recognizing that the nurses and clinicians spent little time with the patients and so did not identify all their needs. As a result, the healthcare providers were required to spend enough time and so they would have to work overtime depending on the patients’ flow. Therefore, all the employees recruited in the organization were made aware of the mandatory overtime requirement whenever requested.

Critique of the Policy

The policy was developed to respond to the need to improve the quality of healthcare services to the patients. The introduction of the pay-for-performance means that the healthcare institutions would be compensated based on the patients outcome and not the services offered. As a result, the institution had to develop an approach of responding to the need without increasing the costs of medication to the patients. Nurses and clinicians would spend more time with their patients and understand all understand the underlying factors that could impact their treatment outcomes and this would lead to better outcomes.

However, exposing the healthcare providers to long-working hours could leads to injuries and emotional exhaustion. Studies have indicated that burnout among the employees in healthcare sector is attributed to the long working hours (Kowalczuk et al., 2020). It is ethically wrong to expose the healthcare providers to health risks with the intention of reducing the medication costs (Moon et al., 2020). The quadruple Aim advocate for both the better outcomes for the patients and improved quality of life for the healthcare providers. Mandatory overtime for the healthcare providers does not improve their quality of life but instead increases their risk of developing burnout.

Furthermore, studies show that fatigued employees are prone of making errors and this means that the patients could suffer more from the medication errors (Salen & Norman, 2018). The policy in the institution is only suitable for short-term goal but destructive in the long-run. All healthcare providers must be treated with dignity and be given enough time for rest. Therefore, while the goal of the policy was to address the issue of rising costs, it could increase the costs because of the frequent recruitment requirement due to high employees’ turnover in the organization. High turnover rates could compromise the quality of the healthcare delivery to the patients farther.

Recommendation

The healthcare organization can use other policies to improve the quality of healthcare services in the organization other than the mandatory overtime. The healthcare institution can introduce the electronic health system that will allow the healthcare providers to interact with their patients virtually and so reduce their need to go to the hospitals. The electronic health system will increase interaction between the healthcare providers and their patients as well as improve the level of patients’ commitment in managing their health (Sprivulis, 2020). Eventually, the pressure to attend to many patients in the hospital will reduce as the quality of treatment improves. In addition, the cost of medication ill improve significantly (Sanyal et al., 2018).

The healthcare providers will work with the community health volunteers in offering the healthcare services to the patients at home. The policy will promote better treatment outcomes which will improve the quality of life for the healthcare providers. Furthermore, the healthcare providers will be motivated to offer their best in interacting with the patients.

Conclusion

The rising cost of medication following the Medicaid and Medicare programs present a significant challenge to the healthcare delivery process. The introduction of pay-for-value compensation aimed at making the medication costs affordable. However, the increase in the number of patients seeking healthcare services exerts a significant pressure on the limited number of healthcare staff. The introduction of the mandatory overtime is one of the ways of ensuring the healthcare providers offer quality services to all patients. However, the policy presents more harm to the healthcare providers’ health. The electronic health systems can be deployed by healthcare institutions to minimize the need for the patients to visit the hospital and improve the treatment outcomes.

References

Bernstrøm, V. H., Alves, D. E., Ellingsen, D., & Ingelsrud, M. H. (2019). Healthy working time arrangements for healthcare personnel and patients: A systematic literature review. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-3993-5

Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38(1), 489-505. https://doi.org/10.1146/annurev-publhealth-031816-044555

Kowalczuk, K., Krajewska-Kułak, E., & Sobolewski, M. (2020). Working excessively and burnout among nurses in the context of sick leaves. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.00285

Moon, S., Mariat, S., Kamae, I., & Pedersen, H. B. (2020). Defining the concept of fair pricing for medicines. BMJ, l4726. https://doi.org/10.1136/bmj.l4726

Salen, P., & Norman, K. (2018). The impact of fatigue on medical error and clinician wellness: A vignette-based discussion. Vignettes in Patient Safety – Volume 2. https://doi.org/10.5772/intechopen.70712

Sanyal, C., Stolee, P., Juzwishin, D., & Husereau, D. (2018). Economic evaluations of eHealth technologies: A systematic review. PLOS ONE, 13(6), e0198112. https://doi.org/10.1371/journal.pone.0198112

Sprivulis, P. (2020). Connecting health care through information technology. Patient Safety First, 299-317. https://doi.org/10.4324/9781003116677-14

A Sample Answer 6 For the Assignment: NURS 6053 Assignment Developing Organizational Policies and Practices

Title: NURS 6053 Assignment Developing Organizational Policies and Practices

You made very good points. There are policies that state that they will provide safe working conditions; however, some places do not follow through with what they say. Kelly and Porr (2018) share how some nurses have had to, unfortunately, accept conditions that are unsafe and told to just accept it, but then it just causes ethical distress. Their well-being was compromised. As you wrote, assigning too many patients to a patient is unsafe. Though hospitals are trying to offset costs and deal with scarce resources, nurses do not need to be overwhelmed and overworked. It will only result in more nurses leaving, causing a loss in costs and fewer patients will be served. I agree with you that care will get missed and harm can be done that a nurse will not intend to happen. I used to work at a hospital during my first year as an RN that gave us seven and eight patients and I do recall accidentally not seeing things or not having the time to get the medications they needed in a prompt manner. Fortunately, no one suffered any harm from it, but I left after one year. The Director was more concerned about making more money and would receive accolades for it, yet the staff was overwhelmed and burnout and morale were very low. I had to take care of myself and resign.

You also made a good point regarding all nurse practitioners being allowed to work in their scope of practice without the limitations that some states have. This is cost-saving because in some cases, patients are not billed as high when a nurse practitioner tends to them versus a physician. The point that you discovered about an increase of death in the ED by 34% due to overcrowding. A few times a year, I work in the ED at my PRN job in the holding area, giving reports to floor nurses when a bed is available. There is always such as demand and rush to get them out due to overcrowding but sometimes things are not getting taken care of, like starting potassium replacement or patients being hurried to my pod from another pod in the ED and report being given up to an hour later. I complained to the Charge Nurse and when that was not corrected the next time, I notified my Supervisor who addressed it. The patient must come first.

We must have the emotional intelligence to know our values, understand others’ values, and notice our feelings, others’ feelings, and how it is affecting things (Walden University, 2009b). It is also important to allocate resources in a healthy way so that a cultural change can form (Walden University, 2009b).