NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues

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NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.

To Prepare:

  • Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
  • Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

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By Day 3 of Week 3

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

By Day 6 of Week 3

Respond to at least two of your colleagues on two different days by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 3 Discussion Rubric

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

To participate in this Discussion:

Week 3 Discussion

RE: Discussion – Week 3
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Week 3, Initial post

The competing needs of healthcare delivery as they pertain to Burnout and general workload of healthcare workers.

Working in the healthcare industry can be both gratifying and challenging. The unrelenting chronic stress of being exposed to life and death issues, long hours and loads of

work can progressively evolve into burnout. If fact, the odds are pretty high that burnout will affect every healthcare professional at some point in their career.

Burnout is defined as the consequence of mental and physical exhaustion that is caused by stress resulting in depersonalization and a profound decrease in personal

accomplishment. Burnout is a major safety issue,” said Lisa DiBlasi Moorhead, EdD, MSN, RN, CENP, associate nurse executive with The Joint Commission.

“Nurses who experience burnout leave an organization and perhaps even leave the nursing profession.”

My hospital is a profit organization where cost efficiency and profit maximization is their focus. Lots of cost reduction efforts have been in place prior

to covid-19 and more noticed during the peak of covid-19 pandemic. The other focus of my hospital is to supply us with the materials and

equipment’s necessary to do our jobs and to focus on patient’s satisfaction, neglecting the general working conditions of healthcare workers, especially the

nurses.Major competing needs in healthcare delivery U.S, hospitals operate within highly decentralized, competitive insurance and delivery systems in which revenues depend on volume and patients mix. U.S. hospitals stand out

for high costs, low rate of hospital admissions, and short length of stay. Reimbursement incentives have encouraged a migration of care freestanding

centers and emergence of niche hospitals. National health spending has risen sharply over the past several years, fueled by rapid increase in

hospital costs. (Robert J. Blendon & co.’ Health affairs’’ May,2004) In a few years, hospital performance has become a matter of popular concern

within the healthcare industry. Tighter budgets and widespread restructuring have led to higher expectations from many stakeholders such as

patients, the public, health professionals and payers. (Etienne Minvielle, & Co. Hospital performance, 2007). Operating cost and patient’s’ satisfaction,

modern equipment,IT, PPEs, staffing, supplies, among others contribute to the competing needs of my hospital.

Burnout and general workload of healthcare workers as a concern

My hospital is a relatively small compare to some bigger ones around. It has been struggling financially which affect all other area of  operations before the

covid-19 pandemic but more intense during he peak of the pandemic. The leaderships kept changing policies that favors the organization and negatively

impacted the nursing staff as an example which eventually affect patient’s outcome. Most of this period whenever we were short staffed, extra patients are added

to the assignments making it more overloaded with in coming admissions. The vitals and fingerstick being taken by the PCTs were added to our workload,

just to save money without considering the welfare of he nurses or how we are faring. One mask per nurse per week, PPEs, such as gowns are being

reused throughout the entire shift. Patients constantly complains about the level of care, call lights not being answered promptly, and care is being delayed,

because we were busying attending to other patients. No incentive to stay extra time completing the charting or pick up extra shifts like

their counterparts. I will expatiate more on this in the assignment. All of these contributed to the burnout and workload of many us

which transient to poor or negative patients’ hospital experience.

 

                                                                                                                       References

Blendon, R. J., Schoen, C., Desroches, C. M., Osborn, R., Zapert, K., & Raleigh, E. (2004). Confronting Competing Demands To Improve Quality: A Five-Country Hospital Survey. Health Affairs, 23(3), 119–135.

Minvielle, E., Sicotte, C., Champagne, F., Contandriopoulos, A.-P., Jeantet, M., Préaubert, N., … Richard, C. (2008). Hospital performance: Competing or shared values? Health Policy, 87(1), 8–19.

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Nursebooks.org.

RE: Discussion – Week 3
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T, I agree that this pandemic has made nursing shifts remarkably busy. In my opinion, nursing has changed forever. One thing that has been hard for me to adjust to is wearing a mask for 12 plus hours. Some nurses have voiced concern about wearing a mask, specifically N95 masks, for several hours. One study showed that nurses tolerated wearing respiratory protection for two 12-hour shifts. CO(2) levels increased significantly compared with baseline measures, especially when comparing an N95 with a surgical mask to only an N95, but changes were not clinically relevant. Perceived exertion, perceived shortness of air, and complaints of headache, lightheadedness, and difficulty communicating also increased over time.  In conclusion, Long-term use of respiratory protection did not result in any clinically relevant physiologic burden for health care personnel, although many subjective symptoms were reported (Rebmann, Carrico & Wang, 2013). Although necessary, it can also be very time consuming to communicate with family members via facetime during this pandemic. It is crucial to make the patient as relaxed as possible. In most cases, hospitals across the nation are not allowing visitors, including family members, to be with patients. Relaxation content on patient room televisions can provide a needed distraction and ease stress for patients. TeleHealth Services is the nation’s leading provider of interactive patient experience solutions that integrates patient televisions, audiovisual systems, entertainment and relaxation content for hospitals and clinics throughout the nation (TeleHealth Services, 2020)

References:

Rebmann T, Carrico R, Wang J. Physiologic and other effects and compliance with long-term respirator use among medical intensive care unit nurses. Am J Infect Control. 2013;41(12):1218-1223. doi:10.1016/j.ajic.2013.02.017

TeleHealth Services. (5 C.E., July 2020). TeleHealth Services Provides No Cost Relaxation Videos for Hospitals to Ease Patient Stress During COVID-19 Crisis. Business Wire (English).

Rubric Detail

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Name: NURS_6053_Module02_Week03_Discussion_Rubric
Grid View
List View
Excellent Good Fair Poor
Main Posting
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.
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.
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.
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
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
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.
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.
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.
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
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.
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.
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.
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
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Name: NURS_6053_Module02_Week03_Discussion_Rubric

RE: Discussion – Week 3 (Main Discussion Post)

Nursing resources are vastly diminished. I can share from personal experience how my unit is suffering. I work on a psych unit, and when rounding we are taken off the floor to round with the doctor, a telehealth one. Yes, this is snot new for us, but currently our newer doctors are taking a very long time to round and this keeps a nurse off the floor and delays discharges and medication changes, interrupts groups and basically causes added stress to the unit. To add salt to a wound, a new policy came into effect where a psych nurse must do an assessment on any emergency room patient that scores moderate or high on the Columbia Suicide scale and work with the staff there to treat the patient. This can also pull a nurse from the unit for hours. While my unit is not dealing with limited resources such as PPE, it is struggling to provide cares to their patients because they are off the floor dealing with other issues, some not even associated with our unit.

Financially I am allotted so many nursing hours, and while patient centered care is a little different for a unit where patients are mobile and provide self-cares, it does little to have an extra aid on the unit who can’t pass medications or do discharge or medication teaching. Patient centered care can be beneficial in this area as patients have a higher level of satisfaction, so by cutting nursing staff from the floor it decreases patient satisfaction and employee satisfaction scores (Bachnick et al., 2018). It is sad because in nursing school, at least when I attended years ago, very little was ever discussed as nursing being a business model. I came out of school ready to provide care to those that needed it, and while we still do so we are responsible for adhering to policies that are mandated by corporate and other organizations. This can lead to tension between nurses and other units which can lead to poor patient care (Kelly & Porr, 2018), something I am seeing almost everyday currently. Only by speaking up can our leaders understand the frustration occurring, and because of this policy in place I have lost two nurses from day shift leading to the already short staffing the unit is dealing with.

References

Bachnick, S., Ausserhofer, D., Baernholdt, M., & Simon, M. (2018). Patient-centered care, nurse work environment and implicit rationing of nursing care in swiss acute care hospitals: A cross-sectional multi-center study. International Journal of Nursing Studies81, 98–106. https://doi.org/10.1016/j.ijnurstu.2017.11.007

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN23(1). https://doi.org/10.3912/OJIN.Vol23No01Man06

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