NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

Developing Organizational Policies and Practices on Mental health stigmatization

 The U.S. healthcare system has improved over the years. Technology has dramatically helped improve healthcare systems in many ways. However, the quality of care delivered to patients is still largely dependent on the ability of healthcare professionals to provide adequate care by employing critical thinking, problem-solving skills, and evidence-based approaches. Therefore, when healthcare workers are overwhelmed by the increased workload, increased hours, and mandatory overtime, the ability to provide safe care is depreciated and leads to nurse burnout and a potential danger to patients (Cuff & Forstrag 2019). Burnout among healthcare professionals is now recognized as a problem by many in the healthcare system, hence the addition of a fourth agenda to the “Triple Aim,” which promotes the positive mental health of healthcare providers in the work environment (Fitzpatrick, Bloore, & Blake 2019) NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment. However, not enough research has been done to find evidence-based solutions to address the problem. The lack of sufficient healthcare personnel including nurses, physicians, and other caregivers, as well as the increased workload, hours, and physical, emotional and psychological demands has placed a significant burden on the sparsely available healthcare professionals left caring for a growing number of patients (Costa & Moss, 2018). This paper aims to address the issue of burnout in healthcare systems, identify the competing needs impacting burnout, and evaluate policies that influence staffing and prevent burnout

Competing Needs Impacting Nurse Burnout

One approach by which healthcare organizations can address burnout is by creating policies that support work-life balance of their staff, promote job satisfaction, improve staffing, and increase nurse retention. However, competing needs and limited resources can potentially create a substantial barrier to implementing any effective policies in decreasing nurse burnout. One of these competing needs is cost. The cost of healthcare delivery for both human and material resources in the United States is a major hindrance to addressing the issue of burnout among healthcare workers and is a major factor contributing to the common practice of understaffing healthcare facilities across the nation (Costa & Moss, 2018). The perceived cost of implementing policies such as mental health time off, appropriate staffing ratios, and employee compensation and appreciation may prevent some organizations from implementing these policies. Therefore, policy proponents need to educate stakeholders on using a cost-benefit analysis of how the implementation of these policies affect cost and revenue in relation to how burnout and high turnover rates also affect cost and revenue. According to Rivas (2018), the estimated cost of nurse burnout related turnover is $14 billion in the U.S. this is money that can be spent in improving the health care delivery system.

The nursing shortage is another competing need that may restrict institutional efforts to address nurse burnout. The introduction of the Affordable Care Act (ACA) has provided millions of Americans with access to healthcare, thus increasing the number of Americans seeking care (Glied, Ma, & Borja, 2017). There has also been an increase in the average life expectancy in the U.S., leaving a growing aged population with chronic conditions needing care (World Health Organization (2020). These are some of the factors that have created a gap between the number of patients needing care and the number of healthcare professionals available to care for them, thus enhancing the nursing shortage. The lack of a standardized staffing ratio is detrimental to the health care system because it leaves organizations to decide policies regarding nurse-patient ratios (Blitchok, 2018).  Unbalanced staffing ratios increase nurse burnout, which further worsens the unsafe staffing ratios by increasing turnover rates and absenteeism devolving into a repetitive toxic cycle. Organizations in these cycles may want to implement policies to address understaffing but find it difficult due to the shortage of nurses to replace nurses who quit or retire.

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Policy influencing Nurse Burnout in my Organization

The organization where I work has policies in place to help address nurse burnout. An example of such a policy includes a mandatory break with other nurses as “buddies” to help cover a nurse’s assignments during breaks. This practice helps ensure that nurses can take a 30-minute lunch break and two 15 minutes breaks that can be taken if the unit is not busy. Another policy that could prevent nurse burnout is the use of a matrix for staffing. The matrix helps determine the maximum number of patients that can be assigned to nurses and nursing assistants.

Policy Critique and Ethical Considerations of the Policy

Research has shown that Safe staffing ratios improve patient outcomes and increase patient and staff satisfaction (American Nurses Association, 2019). The use of a staffing matrix at my organization is a policy that guides the nurse-patient matrix. However, there are loopholes that prevent strict adherence to staffing ratios; the matrix is based on the number of patients in the units, and acuity is not considered. Also, the organizational policy allows for a maximum of eight patients to one nurse; however, the matrix only allows for four nurses when the census is 32-35, meaning some nurses end up with nine patients without consideration for new admits that may arrive in the middle of the shift. The matrix also does not account for lack of nursing assistants, so sometimes nurses may end up with eight patients, four of which do not have a nursing assistant assigned to them thereby. Increasing the workload. This policy is lacking ethical standards due to another policy that prevents nursing managers from making discretional decisions based on a given situation. The policy also prevents nurses from questioning their patient assignments, thereby making it difficult for nurses to refuse an unsafe assignment.

Strength of the Policy and Challenges in Promoting Ethic

The strength of this policy is its ability to ensure adequate staffing for this organization, appropriate staffing is one of the most challenging tasks in a healthcare organization, this matrix helps the staffing coordinator plan ahead to ensure a safe staffing ratio. Although policies and procedures are essential and implemented to provide guidance and structure in an organization, the policies should have ongoing evaluation to ensure they do not have adverse effects and that they continue to produce positive outcomes. One challenge in promoting ethical consideration of this policy is the use of a nonclinical staffing coordinator who is unable to make appropriate clinical and ethical decisions relating to staffing problems. Nurses are directly affected by staffing decisions, and their inability to be involved in the decision making regarding staffing and patient care can lead to negative outcomes. Nurses should be involved in making staffing decisions as they have the knowledge to determine ethical issues that may affect staff and patients (Registerednursing.org, 2020).

Policy or Practice Suggestions to Balance Competing Needs of Resources, Workers, and Patients

The healthcare system holds healthcare professionals accountable for the delivery of quality and safe care. Accountability in healthcare is essential to ensure the quality and safety of care and prevent adverse outcomes to patients and the community at large. However, this accountability needs to be inclusive of all aspects of healthcare. In addition to holding healthcare professionals accountable, healthcare organizations and healthcare leaders need to be held to a higher standard of accountability for how healthcare organizations are run. Healthcare organizations need to employ a safety-first culture in how policies are drafted and implemented.

Developing and adhering to safe staffing ratios is an example of employing a safety-first culture. A study by Driscoll et al. (2017), found that safer nurse staffing ratios are associated with a decreased mortality rate in an in-patient hospital.

The ability to balance competing needs and still provide safe care is crucial in health care, healthcare organizations can utilize a policy review committee that involves all stakeholders. For example, staffing decisions should not be made by managers and employers alone. Nurses should also be allowed to voice their concerns and hold their employers accountable for a safe working environment as well as participate in decision making. A study by Kutney-Lee et al. (2016) indicated that engaging nurses in shared decision-making promote positive patient and nursing outcomes; it also improves nurse performance and nurse retention and increases the organization’s profit.

Conclusion

The United States is a nation that values healthcare outcomes and public health, must continue to create an awareness of the emerging trends regarding healthcare personnel shortage and its effect on care delivery and burnout. We must continue to advance our strategies to achieve balanced staffing ratios to prevent burnout in the workforce, decrease the occurrence of adverse events to patients due to this burnout, and promote continuity in the delivery of quality care.

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References

American Nurses Association. (2019). Staffing ratios. Retrieved from https://www.nursingworld.org/practice-policy/nurse-staffing/

Blitchok, A. (2018). Proposed federal RN ratios- What you can do about it. Retrieved from

https://nurse.org/articles/federal-staffing-ratios/

Costa, D. K. & Moss, M. (2018). The Cost of Caring: Emotion, Burnout, and Psychological Distress in Critical Care Clinicians. AnnalsATS Journal 15(7). 787-790. Retrieved from https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201804-269PS

Cuff, P. & Forstag, E. H. (2019). A Design Thinking, Systems Approach to Well-Being Within Education and Practice: The Importance of Well-Being in the Health Care Workforce. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK540859/

Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyoombwe, T., & Astin, F. (2017). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European Journal of Cardiovascular nursing. Retrieved from

Glied, S. A., Ma, S., & Borja, A. (2017). Effect of the affordable care act on health care access. Retrieved from https://www.commonwealthfund.org/publications/issue-briefs/2017/may/effect-affordable-care-act-health-care-access

Kutney-Lee, A., Germack, H., Hatfield, L., Kelly, S., Maguire, P., Dierkes, A., Guidice, D. M., &Aiken. (2016). Nurse Engagement in Shared Governance and Patient and Nurse Outcomes. The journal of nursing administration 46(11). 605-612. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5117656/

Registerednurisnig.org. (2020). Ethical Practice: NCLEX-RN. Retrieved from https://www.registerednursing.org/nclex/ethical-practice/

Rivas, R. (2018). Turning the Lever Down on Burnout and Turning up Resilience, Well-being, and Joy (Part 3). Retrieved from https://www.healthcareexcellence.org/2018/05/18/turning-lever-down-on-physician-burnout-cost-turnover-burnout/

World Health Organization. (2020). Global Health Observatory (GHO) data. Life expectancy. Retrieved from https://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends_text/en/

Assignment: Developing Organizational Policies and Practices

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.

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. NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment
• Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (4-5 pages):

Developing Organizational Policies and Practices

Add a section to the paper you submitted in Module 1. The new section should address the following:

• 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. NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

By Day 7 of Week 3

Submit your revised paper.

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