Importance of Leadership Essay Paper
Importance of Leadership Essay Paper
The importance of nurse staffing to the delivery of safe and high quality health care cannot be overestimated. That is because nurse personnel are a critical factor in determining the nature of care outcomes for patients and quality of care in medical facilities. To be more precise, the structure of nurse staffing (such as skill mix and hours of care) determines the available skills, competencies and knowledge that determines the specific care approaches applied as well as availability when intervention is required, such as preventing pressure ulcers and fall incidences. Although there is an awareness that nurse staffing is a source of concern, economic and financial realities limit efforts to address this concern. Currently, restructuring in medical facilities, spurred in part by market competition among medical facilities and shift towards managed care payment structures, have led to aggressive cost containment measures. Historically, human resources and particularly nurse staffing has been a point of focus on cost containment measures, with the attention being on redesigning work structures and reducing the workforce. These measures have led to heavier workloads for the available nurses, which has heightened concerns about staffing adequacies in medical facilities (Mason et al., 2020). Concurrently, there are professional and public concerns that safety and quality are being compromised in care delivery since the low staff levels result in increased opportunities for errors and mistakes. Importance of Leadership Essay Paper The expected deepening of nurse staffing shortage in the coming years has increased the urgency of developing a solution that is acceptable to public and professional policy forces, labor market and health care finance (Huston, 2014). The present paper discusses some of the competing needs impacting nursing staffing, policies that affect this issue, and policy solutions that balance the needs of stakeholders.
Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
Two competing needs have been identified as impacting nurse staffing as a health care stressor. The first competing need is finances, an issue of great concern in profit-making medical facilities that must manage their costs in order to report profit margins that are more acceptable to their investors. The health care industry is confronted by intense financial pressure due to environmental uncertainties that include the continued penetration of managed care and payment reductions in the public sector. This set of circumstances have resulted in a considerable number of medical facilities facing declining financial performance. The declining financial performance has forced medical facilities to re-engineer and restructure their internal operations. A key strategy that has been applied is reducing the size of nurse staffing with the intention of reducing costs even as they try to maintain care quality and safety (Mason et al., 2020). The second issue is the need to maintain nursing presence. Medical facilities recognizing that maintaining the presence of nurses is critical for identifying and addressing preventable causes of errors that compromise care quality and safety. As medical facilities seek to reduce nurse payroll costs while maintaining nurse presence, some of them have adopted the strategy of replacing the more knowledgeable and experience nurses who cost more on payroll with assisting nurse personnel who are usually not well trained in the nursing discipline prior to being employed. Even as medical facilities seek to address the issue of nurse staffing, they are faced with the real concern of how to balance nurse skills mix with the presence of nurses and patient acuity (Hickey & Brosnan, 2013).
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Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
A relevant policy that affects the issue of nurse staffing in the organization is patient acuity. the medical facility recognizes that too much nursing care would result in higher costs and greater financial burden, while too little nursing care would result in poor clinical outcomes. Given this awareness, the facility determines its nursing staffing needs based on the acuity of each patient and the overall acuity mix in the inpatient units. This is linked to the overall need and demand for nursing care services as well as the burden of patient care for each nurse personnel during a shift. The acuity system is based on classifications of nursing outcomes and standardized nursing language as well as nurse assessment and other relevant medical data. The system offers timely information about the condition of each patient and overall acuity mix, with the information used to make decisions about staffing. The strategy adopted by the facility has seen patients’ lengths of stay in the facility being shorter as care is compressed and more intense. Patients newly arrived at the facility receive more attention and require greater nursing attention since they are considered to be at a higher risk for experiencing clinical instability within the first few hours of arriving at the facility, and would require more frequent care coordination, treatments and assessments in order to better understand their medical condition.
Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
The patient acuity policy that is used to determine nurse staffing at the facility has ethical implications. As far as ethics is concerned, nurses have a responsibility not to do harm. In addition, medical personnel and facilities must act in the best interest of patients and protect them from being exploited. In medical ethics, the patient receives greater attention than other things to include the bottom line (financial implications). Losing money, or saving money or making money should not be an excuse that justifies harm to patient (Dunham & Pinczuk, 2014). If medical facilities cannot present adequate numbers of nurses to ensure the delivery of safe and high quality care, then the medical facility should not put forth to the public that it will deliver safe and high quality nursing care. Doing others would be considered fraud. However, there are exceptions to this, especially in times of emergencies such as war or natural disasters when normal operational plans no longer apply and emergency plans are required. This makes it clear that safe staffing is an ethical imperative of medical facilities. There is no acceptable ethical reason that would justify a medical facility failing to provide safe nurse staffing for its patients, except for times of emergencies (Westrick, 2015).
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.
A recommended policy change is ensuring that nurse staffing is dictated by the characteristics of the patients (such as cooperative, confused, conscious, aged, deaf, incontinent, blind and so on). This would ensure that patients receive the nursing care that they require in order to achieve the desired care outcomes while addressing safety and quality concerns. Also, it would improve the patients’ opinions about the medical care received (Bridges et al., 2019). In addition, nursing staffing should depend on the experience, education, number and fatigue of nurses as well as the extent to which they are supported by ancillary staff. This would ensure that the right skill mix is available to meet the needs of patients. Besides that, nurses should be allowed to contribute to the decisions about how they should be distributed since they are responsible for assessing the needs of patient. Inclusion of nurses allows them to engage in advocacy activities that represent the best interest of the patients while avoiding the ethical issues (Wynendaele, Willems & Trybou, 2019).
References
Bridges, J., Griffiths, P., Oliver, E., & Pickering, R. (2019). Hospital nurse staffing and staff–patient interactions: an observational study. BMJ Quality & Safety, 28(9), 706-713. http://orcid.org/0000-0001-6776-736X
Dunham, J., & Pinczuk, J. (Eds.) (2014). Financial Management for Nurse Managers: Merging the Heart with the Dollar (3rd ed.). Jones & Bartlett Learning, LLC.
Hickey, J. V., & Brosnan, C. A. (2013). Evaluation of Health Care Quality in Advanced Practice Nursing. Springer Publishing Company, LLC.
Huston, C. J. (2014). Professional Issues in Nursing: Challenges and Opportunities (3rd ed.). Lippincott Williams & Wilkins/Wolters Kluwer.
Mason, D. J., Gardner, D. B., Outlaw, F. H., O’Grady, E. T. (2020). Policy & Politics in Nursing and Health Care (8th ed.). Elsevier Health Sciences.
Westrick, S. J. (2015). Essentials of Nursing Law and Ethics (2nd ed.). Jones & Bartlett Learning, LLC.
Wynendaele, H., Willems, R., & Trybou, J. (2019). Systematic review: Association between the patient–nurse ratio and nurse outcomes in acute care hospitals. Journal of Nursing Management, 27(5), 896-917. https://doi.org/10.1111/jonm.12764 . Importance of Leadership Essay Paper
