NURS 6053 Wk 2-3 Response To Discussion: Organizational Policies And Practices To Support Healthcare Issues

NURS 6053 Wk 2-3 Response To Discussion: Organizational Policies And Practices To Support Healthcare Issues

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NURS 6053 wk 2-3 response : INTERPROFESSIONAL ORGANIZATIONAL AND SYSTEMS LEADERSHIP Please respond to Golda Trompeta and half a page eachCarolyn Cheatham
RE: Discussion – Week 3
COLLAPSE

The pressures on a nurse in a single shift are tremendous. Workplace stressors that include lack of resources, increased patient ratios, management expectations, and constant demands from patients and their families are a part of a nurses’ daily work. Add in long hours and the lack of self-care, and a nurse has the potential to suffer compassion fatigue. Compassion fatigue is a healthcare stressor that can adversely affect patient care. A healthcare organization’s needs and systems in place may not agree with a nurse’s values, and this disconnect can add to the stressors a nurse is required to manage.

According to the American Nurses Association (ANA), compassion is one of the central values of nursing. Compassion fatigue is characterized as the stress that stems from a nurse’s “involvement of relationships with patients and families in which the nurse witnesses the trauma or suffering of patients” (Lachman, July-August 2016, p. 275). Compassion fatigue has been described as the cost of caring and the loss of the ability of nurture (Boyle, 2015). The ANA Code of Ethics for Nurses with Interpretative Statements states that the “nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth” (p. 19). Section 5.2 also mentions methods nurses must do to combat compassion fatigue. These activities include exercise, getting enough rest, eating healthily, engaging in leisure activities, maintaining family and personal relationships, and attending to spiritual and religious needs (Association, n.d., p. 19).

Patient safety and satisfaction are negatively affected when nurses have compassion fatigue; therefore, healthcare organizations must see this stressor as a priority. Nurses have an ethical duty to practice self-care to care for others, but healthcare facilities must also change work practice environments and culture to assist nurses. Oncology nurses work in an environment that includes the management of complex diseases, poor prognoses, repeated exposure to death, dying, pain, and suffering. Oncology nurses experience compassion fatigue because of the work that they do and the ethical dilemmas they face regularly. Nurses experience death so often that they feel desensitized to death. Workloads make it challenging to spend more time at the bedside with family members of those that are dying. The demands of taking care of a dying patient are exhausting, and nurses may feel themselves growing tired of taking care of the patient because they are “running on empty.” Often, there is a lack of interventions such as ethics training or ethics rounds. Healthcare organizations should provide end-of-life educational programs, forums where nurses can express their concerns, and where their contributions are acknowledged (Kim et al., 2016). Other strategies include rotating assignments.

The work of a nurse requires doing so much with so little. Ethically a nurse must practice self-care to provide the quality care patients deserve. Healthcare organizations must have systems in place that support nurses who suffer from compassion fatigue. Without proper attention, compassion fatigue compromises patient safety and outcomes.

References

Association, A. N. (n.d.). Code of ethics for nurses with interpretive statements (2nd ed.). American Nurses Association.

Boyle, D. A. (2015). Compassion fatigue. Nursing, 45(7), 48–51. https://doi.org/10.1097/01.nurse.0000461857.48809.a1

Kelly, P., & Porr, C. (January 2018). Ethical nursing care versus cost containment: considerations to enhance RN practice. The Online Journal of Issues in Nursing, 23(1). https://doi.org/10.3912/OJIN.Vol23No01Man06

Kim, S., Seo, M., & Kim, D. (2016). Unmet needs for clinical ethics support services in nurse: Based on focus group interviews. Nursing Ethics, 25(4), 505–519. https://doi.org/10.1177/0969733016654312

Lachman, V. D., (July-August, 2016). Compassion fatigue as a threat to ethical practice: identification, personal, and workplace prevention/management strategies. Medsurg Nursing, 25(4), 275–278.

Milliken, A. (2018, January). Ethical awareness: what it is and why It matters. The Online Journal of Issues In Nursing, 23(1). https://doi.org/10.3912/OJIN.Vol23No01Man01

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Carolyn Cheatham
RE: Discussion – Week 3
COLLAPSE
WK3 Main Discussion Post

If asked to rate the needs of the workforce, health care resources, and patients in descending order of importance, most nurses would probably list patients first. After all, most nurses got into the profession to help people. Nurses are keenly aware of the need to stretch resources and to be as efficient as possible. Frequently, to accommodate this, the needs of the workforce are shuffled to the bottom. Nurses sometimes get a bit of a martyr complex in this, with “taking one for the team” being seen as a badge of honor. It is hard not to turn around if you hear a code blue being called as you walk out after your shift has ended. And when there is a crisis, such as the current pandemic, we see nurses across the country volunteering to go to hot spots like New York City to work in extremely difficult situations.

And that’s okay, now and then. But to be subjected to that feeling of crisis, that need to “take one for the team” day after day, shift after shift, leads to burn out. When the policies of a health care organization conflict with the nurse’s ability to provide appropriate care, nurses may become apathetic or disengaged, decreasing the quality of care they provide (Kelly & Porr, 2018).

One area in which nurses have been experiencing this is in staffing. Even before the Covid-19 crisis, many facilities had been struggling to provide appropriate staffing levels for nurses. Just establishing what “appropriate” staffing levels means is a challenge. Creating a policy on minimum nurse to patient ratios, when done correctly, can have a direct positive impact on patient outcomes and employee satisfaction (Carlisle et al., 2020).

However, policies on staffing should be based on data gathered locally. Simply saying that all med-surg units, for example, have to have a minimum nurse to patient ratio of 1:4 may not work. It fails to take into account such issues as patient acuity and nurse experience. But just establishing a policy that states what minimum staffing should look like only addresses one aspect of the issue. Competing requirements also play a part in workforce recruitment and retention.

Budget is always a consideration in health care. Staying competitive with salaries is vital to hiring well-trained nurses. Another issue is simply having an adequate supply of qualified applicants. As the population ages, their need for health care resources increases. Nurses are aging, too, and many will be approaching retirement soon. Add those factors to the number of students being turned away from nursing programs due to a lack of faculty or preceptors, and one can see why a national shortfall of nurses is only expected to grow (American Association of Colleges of Nursing, 2019).

While considering a policy to improve workforce recruitment and retention, it is important to address all aspects of the issue. Minimum staffing requirements may reduce some concerns of nurses. Still, it may lead to mandatory overtime and floating to units they are not familiar with to meet staffing requirements. Additionally, efforts should be made to increase the availability of qualified nurses, such as partnering with nursing schools. Allowing nurses more flexible schedules so that they may teach part-time and continue to work in the clinical environment may enable schools to increase acceptance rates. Investing in workforce development upfront may pay off by reducing turn over and improving patient satisfaction and safety outcomes in the long run.

References

American Association of Colleges of Nursing. (2019). News & Information. Retrieved June 16, 2020, from https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage

Carlisle, B., Perera, A., Stutzman, S. E., Brown-Cleere, S., Parwaiz, A., & Olson, D. M. (2020). Efficacy of using available data to examine nurse staffing ratios and quality of care metrics. Journal of Neuroscience Nursing, 52(2), 78–83. https://doi-org.ezp.waldenulibrary.org/10.1097/JNN.0000000000000499

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. Online Journal of Issues in Nursing, 23(1), 3. https://doi-org.ezp.waldenulibrary.org/10.3912/OJIN.Vol23No01Man06

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