NURS 6053 Week 1 Discussion Review of Current Healthcare Issues SAMPLE
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.
In NURS 6053 Week 1 Discussion: Review of Current Healthcare Issues SAMPLE, 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 – NURS 6053 Week 1 Discussion: Review of Current Healthcare Issues SAMPLE.
NURS 6053 Week 1 Discussion: Review of Current Healthcare Issues SAMPLE References
American Nursing Association. (n.d.). Principles for nurse staffing. Retrieved from American Nursing Association. (n.d.). Principles for nurse staffing. Retrieved from
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).
National Healthcare Issue/Stressor
Hi A! 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 as required by NURS 6053 Week 1 Discussion: Review of Current Healthcare Issues SAMPLE.
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- NURS 6053 Week 1 Discussion: Review of Current Healthcare Issues SAMPLE. 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.
NURS 6053 Week 1 Discussion: Review of Current Healthcare Issues SAMPLE References
Haryanto, Mickey & RN-BC, MBA. (2019). Nursing Shortage: Myth or Fact?. Orthopedic
Nursing, 38, 1-2.
Upenieks V. (2003). Recruitment and retention strategies: a magnet hospital prevention
model. Nursing Economic$, 21(1), 7–23.
com.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=106823835&site=ehos
t-live&scope=site
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)”.
NURS 6053 Week 1 Discussion: Review of Current Healthcare Issues SAMPLE 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
Great post Brittany. During the pandemic, one challenge faced was the inability to plan accurately. Since news of the outbreak in China in December 2019, the hospital had designed the potential conversion of wards to isolation units and the nursing workforce required should those changes occur. However, they did not near follow those plans (Fan et al., 2021). The reason was that there were too many uncertainties resulting from the novelty of the disease. The mode of transmission, its contagiousness, the morbidity, and mortality rates of the disease, etc., was unknown. Therefore, this resulted in a day‐to‐day reaction to the number of isolation admissions. Despite the massive increase in isolation bed capacity, the occupancy rates did not reach the hospital’s isolation capacity from January to May 2020 (Fan et al., 2021). Reasons for low occupancy rates could be due to efforts to minimize admissions to acute hospitals. Sent medical teams to foreign worker dormitories to triage workers who were tested positive for COVID‐19.
When it comes to staffing, it is known that nurse staffing, and nursing skill mix are “directly linked” to quality of care and patient outcomes. More recently, the focus of concern has been on the cost‐effectiveness and safety of nurse staffing. In the UK, identified nine indicators of safe nurse staffing (Butler et al., 2019). Four of these indicators relate to patient outcomes: falls, pressure ulcers, medication administration errors, and the adequacy of meeting patients’ nursing care needs. Two hands describe to nursing staff: missed breaks and compliance with any mandatory training; and three indicators relate to staffing outcomes: nursing overtime; planned, required, and available nurses for each shift; and high levels or ongoing reliance on temporary nursing staff, or both (Butler et al., 2019). It has been reported that having an adequate number of registered nurses decreases patient deaths, injury, and permanent damage; reduces rates of falls, missed care, and pressure ulcers; and is associated with the prevention of healthcare‐acquired infections and associated costs (Butler et al., 2019).
References
Butler, M., Schultz, T. J., Halligan, P., Sheridan, A., Kinsman, L., Rotter, T., … Drennan, J. (2019). Hospital nurse-staffing models and patient- and staff-related outcomes. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd007019.pub3
Fan, E. M. P., Nguyen, N. H. L., Ang, S. Y., Aloweni, F., Goh, H. Q. I., Quek, L. T., … Ong, E. H. M. (2021). Impact of COVID‐19 on acute isolation bed capacity and nursing workforce requirements: A retrospective review. Journal of Nursing Management.
Response 1
Alexis, I agree completely that the rising costs of healthcare is a huge stressor to many individuals and facilities. The facility that I work at personally works with each patient to make sure no struggle, financially, is present in order for them to receive the proper treatment and care that they need. To effectively pay for primary care, future payment models should invest in a primary care infrastructure, one that supports team-based, community-oriented care, and measures the delivery of the functions of primary care (Park, B., Gold, S.B., Bazemore, A., & Liaw, W. (2018).
Nurses have a personal connection with patients. As you mentioned you really see how patients do not receive the ultimate treatment they deserve because you patients rely a lot on funding from state taxpayers. Being a nurse, we are a leader: we must acquire the ability to understand and function effectively within realities of the environment and context where you work (Broome, M., & Marshall, E. S. (2021). As nurses we must continue to advocate for our patients and stand up for adequate healthcare coverage!
References
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert
clinician to influential leader (3rd ed.). New York, NY: Springer.
Park, B., Gold, S.B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment
models influence primary care and its impact on the quadruple aim. The Journal of the American Board of Family Medicine, 31(4), 588-604. https://doi.org/10.3122/jabfm.2018.04.170388.
NURS_6053_Module01_Week01_Discussion_Rubric
| Excellent | Good | Fair | Poor | |
|---|---|---|---|---|
| Main Posting |
Points Range: 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
Points Range: 40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
Points Range: 35 (35%) – 39 (39%)
Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
Points Range: 0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
| Main Post: Timeliness |
Points Range: 10 (10%) – 10 (10%)
Posts main post by day 3.
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Points Range: 0 (0%) – 0 (0%)
|
Points Range: 0 (0%) – 0 (0%)
|
Points Range: 0 (0%) – 0 (0%)
Does not post by day 3.
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| First Response |
Points Range: 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
Points Range: 15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 13 (13%) – 14 (14%)
Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
Points Range: 0 (0%) – 12 (12%)
Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. |
| Second Response |
Points Range: 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
Points Range: 14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 12 (12%) – 13 (13%)
Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
Points Range: 0 (0%) – 11 (11%)
Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. |
| Participation |
Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
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Points Range: 0 (0%) – 0 (0%)
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Points Range: 0 (0%) – 0 (0%)
|
Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
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| Total Points: 100 |
|---|
Nursing education is a lifetime commitment. The need to advance to the next level of professional and career development for all nurses cannot be ignored. In fact, continuing education has come to be associated with career and professional satisfaction (Price & Reichert, 2017). However, it is necessary to consider the fact that the demanding nature of nurse education as everyone is experiencing at the moment strains many nurses, especially those that are also working full time. This requires resilience, commitment, and perseverance. If nurses find it hard to balance their education and work, this may affect not only their health but also the health of their patients. This calls for the need to balance and streamline nursing practice and nursing education. Programs such as the ones offered by Walden provide flexibility for nurses. Employers should also offer flexible time for nurses in order to allow them to focus on continuing education as well. Some organizations have mentors who focus on the novice nurses that are just transitioning from education to practice (Jangland, Gunningberg & Nyholm, 2021). These mentors make the process easy and they give new nurses the opportunity to learn in a healthy workplace environment while getting prepared for future challenges.
References
Jangland, E., Gunningberg, L., & Nyholm, L. (2021). A mentoring programme to meet newly graduated nurses’ needs and give senior nurses a new career opportunity: A multiple-case study. Nurse Education in Practice, 57, 103233
Price, S., & Reichert, C. (2017). The importance of continuing professional development to career satisfaction and patient care: Meeting the needs of novice to mid-to late-career nurses throughout their career span. Administrative Sciences, 7(2), 17
