NURS 6053 DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES

Nurse practitioners serve as fundamental assets to healthcare service. They serve as the largest section of the health profession (Haddad et al., 2023). However, nurses face many obstacles within the healthcare setting. A major issue faced by nurse practitioners today is the shortage of nurses within the field of healthcare. Nurse-to-patient ratios are versatile based on staff and facility requirements, accommodations, and even coverage. Due to increased demand for nurse practitioners, nurses have had to adapt to unsafe ratios, responsibilities, and practices. This is due to the immediate impact that the past three years have had on the healthcare setting.

Nursing shortages have been a pertinent issue throughout the history of healthcare. However, 2020 exacerbated the issue of nursing shortages due to the advent of the coronavirus pandemic. COVID-19 resulted in a severe impact on the healthcare setting. It demonstrated that without enough registered nurses, physicians, respiratory therapists, pharmacists, and other clinicians, the U.S. healthcare system cannot function (Costa & Friese, 2022). The pandemic exposed major weaknesses in the healthcare setting and unnerved countless nurse practitioners and other clinicians.

While the pandemic resulted in an increased demand for nurse practitioners and other clinicians, the stressors of the pandemic also resulted in decreased motivation, safety, and job satisfaction for nurses. According to a national survey by the American Association of Critical-Care Nurses, “66% of respondents reported having considered leaving the profession, a percentage much higher than previously reported rates” (Costa & Friese, 2022). In fact, the literature of nursing shortages has seen a recent increase in scholarly attention since the pandemic began.

Summary of Literature

Nursing shortages are an unprecedented issue within the healthcare sector both nationally and internationally. In the examination of nursing shortages in the United States, it has been made evident that nurse practitioners have been more concerned with their responsibilities and duties in the past three years than other points in history not including natural disasters. Aside from the textbook, two articles on nursing shortages have been reviewed from outside resources. These articles address the issue of nursing shortages in different healthcare organizations. The following is a summary of the two articles from New England Journal of Medicine and the National Library of Medicine.

“Nursing Shortage” by Haddad et al. (2023) describes the advent of nursing shortages in the United States. This article from the National Library of Medicine also provides recent statistics on the prevalence of nurse practitioners in the United States. According to the article, there are approximately 29 million nurses and midwives globally, with 3.9 million nurses and midwives in the United States (Haddad et al., 2023). The article emphasizes the need for more nurses within the next decade, which has been influenced in large part by the discouraged nurses who served as essential personnel during the COVID-19 pandemic.

Costa & Friese’s “Policy Strategies for Addressing Current Threats to the U.S. Nursing Workforce” (2022) explains how the COVID-19 pandemic resulted in decreased motivation for nurses to return to work. Studies in this article have shown that a range of stressors and traumatic experiences, including furloughs, a lack of adequate personal protective equipment (PPE), increased violence, excessive workloads, and reduced support services have influence nurses’ apprehension to return to the healthcare setting (Costa & Friese, 2022). This article also emphasizes the increasing demand for nurse practitioners over the next decade.

Summary of Strategies

These articles highlight both the issues inherent with nursing shortages as well as potential strategies for addressing the organizational impact of national nursing shortages. Haddad et al. (2023) address technology and personal empowerment as vital strategies for decreasing the issue of nursing shortages. Costa and Friese (2022) describe state legislation as a necessary strategy for providing nurses with adequate resources and support tools which will encourage nurse practitioners to return to work. The following is a summary of the strategies highlighted respectively in the provided articles.

One of the main resources that has helped nurses navigate challenges throughout the healthcare setting in the past few years are digital databases. These help with data storage and recall of patient information. The introduction of the Electronic Medical Record (EMR) and other technological advances improve the likelihood of nurses’ willingness to stay in the profession (Haddad et al., 2023). However, these can also impact the nurse practitioner in a negative way. Some seasoned nurses struggle with the technology and remove themselves from the profession at an earlier rate (Haddad et al., 2023).

Another option is increasing employee motivation. Ensuring that nurses feel inspired, empowered, and appreciated for their work is essential to promoting confidence in the workplace. According to Haddad et al. (2023), an environment that empowers and motivates nurses is necessary to rejuvenate and sustain the nursing workforce. However, these methods can only be implemented appropriately through proper political procedure. State legislation that eliminates onerous scope-of-practice regulations for advanced practice providers would enable nurse practitioners, including midwives, to practice independently and could increase access to healthcare (Costa & Friese, 2022).

Developing Organizational Policies & Practices

Two competing needs impacting the nursing shortage issue in healthcare are economic interest and quality of patient care. Economic interest is an issue because the current trends in the healthcare setting have been primarily corporate-minded, leaning away from quality of care and more toward expenses and accommodations being utilized within the healthcare setting. This competes with the need of quality patient care, as nurses are now being forced to contend with these corporate-based prioritization of healthcare versus giving patients the best quality of care they deserve (Goldfarb et al., 2008). The nursing shortage persists because there are countless nurses who refuse to put up with such a work environment, especially those who became nurse practitioners to help patients in need rather than the overarching healthcare corporations.

A relevant practice that is influencing and mitigating nursing shortages is the focus on personal wellness and mindfulness for nurse practitioners in the healthcare setting. The practice has been developed over the past few years from multiple peer-reviewed studies, tailoring to the healthcare environment to successfully improve nursing staff supply (Park & Yu, 2019). Nurse practitioners can benefit from mindfulness training within the healthcare setting by reaffirming their sense of purpose and motivation despite the corporate trends in healthcare seen today.

It is important to consider the ethics of mindfulness and mental health and wellness training for nurse practitioners. Ethically, the corporate trends that are focusing on the costs of healthcare technologies and tools being used are unsound because they do not focus enough on the quality of patient care. This creates an ethical dilemma for many nurses who decided to join the occupation in order to improve the quality of patient care and help people. Many nurses leaving the healthcare setting are doing so because they do not feel ethically or morally obligated to meet corporate quotas over personalized care.

Policy changes that should be designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of existing policies include the reallocation of stakeholder agency and prioritization of needs within the healthcare setting. The need for a steady supply and maintenance of health personnel is a major issue worldwide, only exacerbated by the nursing shortage trend (Park & Yu, 2019). Therefore, it is imperative that the nurse practitioners being hired within the healthcare setting are given the proper resources and support tools so they can be competent in practice to the best of their abilities. A change in practice that can begin within the healthcare setting includes the shift from corporate quotas back to personalized care.

The needs of resources, workers, and patients can be balanced by simply focusing on quality of patient care. This is the biggest reason why nurses have decided to leave the healthcare system in search of other professions. Without the ability to provide adequate care due to limitations set by corporate stakeholders of pharmaceutical or healthcare technologies, nurses begin to lose their personal motivation to do what they have been trained to (Haddad et al., 2023). Mindfulness and personal wellness training is a certain way to maintain work motivation.

The nursing shortage is a major crisis that is faced across the globe. In the United States, “most nursing leaders agreed that the quality of the U.S. healthcare system depends on improvements in effectively managed, highly educated nursing personnel, both quantitatively and qualitatively (Park & Yu, 2019). This implies that the organizational culture of the healthcare system needs to be radically reformed in order to accommodate the needs of all stakeholders. However, the biggest stakeholders within the functionality of healthcare are nurse practitioners. Their satisfaction and sense of purpose is integral to healthcare operations.

References

Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3^rd ed.). New York, NY: Springer.

Costa, D. K., & Friese, C. R. (2022). Policy Strategies for Addressing Current Threats to the U.S. Nursing Workforce. The New England Journal of Medicine, 386(26), 2454–2456.

Goldfarb, M. G., Goldfarb, R. S., & Long, M. C. (2008). Making Sense of Competing Nursing Shortage Concepts. Policy, Politics, & Nursing Practice.

Haddad, L. M., Annamaraju, P., & Toney-Butler., T. J. (2023). Nursing Shortage. National Library of Medicine.

Park, H., & Yu, S. (2019). Effective policies for eliminating nursing workforce shortages: A systematic review. Health Policy and Technology, 8(3), 296–303.