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.
Due to the nature of this assignment, your instructor may require more than 7 days to provide you with quality feedback.

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Solution

Developing Organizational Policies and Practices

Two Competing Needs Impacting Stress and Burnout in The Workplace

Nursing has been reported to have the highest risk of staff “burnout” among the numerous jobs people pursue in the United States, resulting in a nurse turnover problem in medical clinics and institutions across the country (Blanchfield, 2021). Burnout is characterized by a combination of exhaustion, pessimism, and inefficacy due to long-term job pressure. The factors that are legitimately associated with nurse “burnout” include: Mental and physical fatigue, tumultuous environment, stressful jobs and hours nurses are expected to maintain up, lack of trust in work accomplishment, and lack of time to complete documented plans (Reith, 2018).

Working long hours and being understaffed are two competing needs that lead to stress and burnout. This study aims to look at the analysis of nursing shortages and burnout in the healthcare sector. Nursing shortages are a global problem that affects all nurses in the country. Nursing groups and unions are collaborating to address the issue of nursing burnout and have taken many steps to achieve an acceptable nurse-to-patient ratio (Nuamah & Mehta, 2020). The same stressor affects nurses in various ways. Some nurses cannot cope effectively with workplace stress, which directly impacts their healthcare delivery competence. Burnout has a detrimental influence on nurses’ health and directly affects the patient. Spending long hours, overtime, and a rising patient load contribute to medication errors, which can be catastrophic when dealing with high-risk drugs like insulin or heparin.

Nurses confront a variety of stressors daily, including disagreements among healthcare professionals, bullying, verbal or sexual abuse from superiors and coworkers, problems with providers, and so on. These variables can result in high amounts of stress, leading to emotional dissatisfaction, depression, anxiety, and poor physical health (Bautista et al., 2020). The idea of developing a happy working environment influences the issue of work-related stress. Workplace social ties are very crucial. Conflicts have a detrimental impact, leading to more mistakes and poor performance. As a result, the nurses’ mental and physical health and patient safety would be threatened.

Relevant Policy Influencing Selected Healthcare Issue/Stressor

There is no protocol in place to handle nurse burnout. Furthermore, no policy establishes a nurse-to-patient ratio. Dependent on the unit, the physicians’ patient load ranges between 15 and 37. The ensemble is made up of four structures. An institution with 37 patients should have two registered nurses and at least one licensed practical nurse on duty to handle medicine delivery (Clark & Lake, 2020). Due to a nursing shortage, a nurse practitioner may be in charge of 37 patients and accountable for administering drugs to 20 or more of them. This causes an increase in job stress, leading to burnout and compassion fatigue. Lincoln Rehabilitation Center is continuously looking for new orders to recruit nurses. The facility I currently work in uses outside nursing organizations to overcome nurse deficiencies. They are employed as temporary external contractors. Arrangements for agency nurses range from three to twelve months. At the moment, the LRC operates a substantial proportion of agency nurses. This technique benefits meeting the demand for nurses and providing fresh ideas to the boards. Travel nurses have broader experience and are more eager to attempt different experiences than regular nurses.

They may exchange their insights and lessons gained with other nurses to enhance health outcomes. Another strategy used by the hospital to address the nurse shortage is obligatory overtime for regular personnel. Another method for filling nursing demands is to work forced overtime. Maintaining Professional Ties is an institution-wide policy that addresses workplace issues (Recuero & Segovia, 2021). The policy prohibits verbal or physical abuse, racial or ethical discrimination, sexual assault, antagonism, arrogance, profanity, violence, intimidation, and harsh criticism that intimidates or trivializes others. The legislation promotes these actions to be reported in an incident report, which documents the event. The director will take the necessary steps to correct the conduct.

Ethical Considerations

Continuously teaching new staff needs enough financial resources. One of the primary issues with contractor nurses is that they are prone to medication mistakes due to a lack of knowledge in that hospital (Harry et al., 2021). It takes some time to become acquainted with all of the patients. Furthermore, the contractor nurses are bouncing throughout all wards, making it even more challenging to understand the patients. The nurse’s job becomes more complex, unpleasant, and error-prone when unfamiliar with the patients, their diagnoses, health histories, treatment plans, and statuses (Koirala et al., 2021). Contracts for travel nurses are constantly shifting, and there are gaps amongst them. Making nurses spend long shifts makes them unhappy and escalates their stress. Because of the nurse shortage, they are forced to work double shifts for 16 hours away from the family. This causes an uncomfortable emotion, which will affect their performance at work. They will exhibit a lack of desire and fatigue, which will impact patient care and safety. Handling mentally sick patients will be complex for a mentally strained nurse because she will have less tolerance to regulate behavior, be quickly irritated, and not be rehabilitative (Roth et al., 2021).

Psychologically unwell individuals require the services of a self-confident nurse. A stressed nurse may use more seclusion and shackles, which are only used as a last option to control an upset patient. The nurse promotes wellness and safeguards patient safety, as per the Code of ethics for nurses (Zhang et al., 2020). While nurses are anxious and burned out, patients’ safety and health might be jeopardized. As a result, management and organizational processes must assist nurses in carrying out their responsibilities and adhering to their code of ethics.

The institution does not have to tolerate inappropriate behavior at work and promotes a safe workplace, which benefits the policy linked to the code of conduct (Nuamah & Mehta, 2020). The human resources department has strengthened the implementation process. They have replied to the allegations promptly and efficiently. They have not permitted a toxic workplace and have urged all nurses to seek early assistance in this regard.

Recommendations

Hospital management should establish systems and procedures to address the issues mentioned above. The institution should recruit additional nurses and implement a policy requiring a low nurse-to-patient ratio to decrease nursing burnout. More nurse positions should be listed on the facility’s homepage (Torlak et al., 2021). Travel expenses, pay packages, and sign-on bonuses should be given and compensated to attract and recruit nurses from distant locations. The hospital should offer new residency programs for newly graduated nurses. These precautions may be costly, but they can save the organization money in the long term by avoiding litigation. To assist nurses in reducing stress, the hospital should give counseling and assistance (Dean et al., 2021). A psychiatric faculty should provide these possibilities to their staff in the same manner as other hospitals. Participation of nurses in hobbies, social gatherings, parties, and other functions may bring healthcare practitioners closer and foster healthier connections.

Adopting the Healthcare Improvement’s Triple Aim Model is a therapeutic modality that can help to balance the need to minimize costs while still providing excellent patient-centered care. According Al Jasser et al. (2020), the triple objective framework aims to enhance patients’ experience, lower healthcare costs, and improve the quality of life of selected populations. UBH Medical Center will need to take a structured change approach to execute this framework properly. This adjustment would concentrate on strengthening existing operations and measures to ensure that they are designed for maximum efficiency while pinpointing the many areas where the organization is failing. To do this, UBH Medical Center will need to identify the persons and families targeted by care services, the health preventive and promotional programs in place, the adaptive cost reduction approach, and how improvements may be incorporated entirely into hospital curative systems. The triple goal strategy would help the hospital provide excellent treatment while lowering costs and enhancing patient experiences. Process reengineering may also assist in examining a process to discover areas linked with large wastes and design effective methods oriented toward simplifying.

References

Al Jasser, B., & Almoajel, A. (2020). Adopting the Triple Aim Framework in the Saudi Healthcare System: A Delphi Study. Risk Management and Healthcare Policy, 13, 2189.

Bautista, J. R., Lauria, P. A. S., Contreras, M. C. S., Maranion, M. M. G., Villanueva, H. H., Sumaguingsing, R. C., & Abeleda, R. D. (2020). Specific stressors relate to nurses’ job satisfaction, perceived quality of care, and turnover intention. International journal of nursing practice, 26(1), e12774.

Blanchfield, M. A. (2021). Job Stressors and Burnout among Immigrant Nurses Caring for the Elderly in the United States of America: The Role of Working Environment Conditions. Journal of Human Resource & Leadership, 5(2), 1-13.

Clark, R. R., & Lake, E. (2020). Burnout, job dissatisfaction and missed care among maternity nurses. Journal of nursing management, 28(8), 2001-2006.

Dean, S., Al Sayah, F., & Johnson, J. A. (2021). Measuring value in healthcare from a patients’ perspective.

Harry, E., Sinsky, C., Dyrbye, L. N., Makowski, M. S., Trockel, M., Tutty, M., … & Shanafelt, T. D. (2021). Physician task load and the risk of burnout among US physicians in a national survey. The Joint Commission Journal on Quality and Patient Safety, 47(2), 76-85.

Koirala, B., Davidson, P. M., & Rushton, C. H. (2021). Ethics in nursing: Progress on National Nursing Ethics Summit. Nursing outlook.

Nuamah, J. K., & Mehta, R. K. (2020). Design for stress, fatigue, and workload management. In Design for health (pp. 201-226). Academic Press.

Recuero, L. H., & Segovia, A. O. (2021). Work-Family Conflict, Coping Strategies and Burnout: A Gender and Couple Analysis. Journal of Work and Organizational Psychology, 37(1), 21-28.

Reith, T. P. (2018). Burnout in United States healthcare professionals: a narrative review. Cureus, 10(12).

Roth, C., Berger, S., Krug, K., Mahler, C., & Wensing, M. (2021). Internationally trained nurses and host nurses’ perceptions of safety culture, work-life-balance, burnout, and job demand during workplace integration: a cross-sectional study. BMC nursing, 20(1), 1-15.

Torlak, N. G., Kuzey, C., Sait Dinç, M., & Budur, T. (2021). Links connecting nurses’ planned behavior, burnout, job satisfaction, and organizational citizenship behavior. Journal of Workplace Behavioral Health, 36(1), 77-103.

Zhang, W., Miao, R., Tang, J., Su, Q., Aung, L. H. H., Pi, H., & Sai, X. (2020). Burnout in nurses working in China: A national questionnaire survey. International Journal of Nursing Practice, e12908.