Main Discussion Post- Week 1
Nurse staffing is a national healthcare stressor that impacts the health care system. Safe nurse staffing is essential to both the nursing profession and the overall health care system as it ensures nurses deliver safe, quality care in all practice settings (ANA, n.d.). Proper nurse staffing helps improve outcomes in several areas, including patient satisfaction, procedural and medication errors, patient mortality, hospital readmissions, and length of stay (ENA, 2018). Facilities need to develop a multi-faceted nurse staffing plan that should decrease cost without compromising patient safety, patient satisfaction, or staff satisfaction (ENA, 2018). Finding the correct balance between patients’ needs and the number of nurses to have on shift at a specific time is essential for facilities to be profitable and ensure both patient and employee satisfaction (Bazazan et al., 2019; Wynendaele et al., 2019).
COVID-19 caused drastic changes in bed capacity and nursing workforce requirements worldwide, with the hospital I am currently employed being no exception (Fan et al., 2021). I am presently employed at an Alaskan for-profit hospital in the Emergency Department (ED), as one of the charge nurses. In the ED before COVID-19, the RN to patient ratio in my facility was 3:1 with stable patients and 1:1 with any critical patient, including patients with an Emergency Severity Index (ESI) of 1 or sometimes 2 depending on specific situations. Currently, the RN to patient ratio is 5:1 with the remaining 1:1 with ESI 1’s.
Patient census in the ED has been down in the past two to three months at my organization. Nurses are forced to flex home if nurse to patient ratios drop below 3:1. Nurses who are flexed home are required to use his or her personal PTO to cover missed hours to maintain full-time or part-time status. For example, imagine it is two in the afternoon and the nurse to patient ratio in the ED is currently 2:1. A day shift nurse (7 am-7 pm) is forced to flex home and use five hours of personal PTO to pay their wages to maintain full-time status.
In addition to increasing the nurse to patient ratio, we are now required to take two 12 hour on-call shifts each month in addition to our full-time or part-time hour requirements to help cover department staffing needs. When a nurse is on-call, he or she makes four dollars an hour. This wage is not even minimum wage, yet it ruins two entire days for the nurse if they are not called into work. The on-call nurse is utilized if a nurse is flexed home and then there is an influx of patients who check-in, helps cover holes in the schedule, and covers if a nurse calls off sick.
As I understand an organization needs to be profitable to survive and thrive in the healthcare system, my current organization has increased stress related to nursing staffing. Lowering the number of ED patients cared for by emergency nurses is the single best solution to improve patient flow and minimize ED overcrowding (ENA, 2018). Patient care, nurse satisfaction, and nurse intention to leave are all impacted by nurse staffing (ENA, 2018). Hospital management needs to pursue the access and use of reliable data so that the validity and generalizability of evidence-based research can be assessed, which in turn can be converted into policy guidelines (Wynendaele et al., 2019, p. 896). Even though several charge nurses have brought evidence-based research to our leadership, my facility continues to implement these changes and is losing skilled nurses because of it.
References
American Nurses Association. (n.d.). Nurse staffing. Retrieved February 28, 2021, from
https://www.nursingworld.org/practice-policy/nurse-staffing/
Bazazan, A., Dianat, I., Bahrampour, S., Talebian, A., Zandi, H., Sharafkhaneh, A., & Maleki-Ghahfarokhi, A. (2019, May). Association of musculoskeletal disorders and workload with work schedule and job satisfaction among emergency nurses. International Emergency Nursing, 44, 8-13. http://dx.doi.org.ezp.waldenulibrary.org/10.1016/j.ienj.2019.02.004
Emergency Nurses Association. (2018). Position statement: Staffing and productivity in the Emergency Department. Retrieved February 28, 2021, from https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/staffingandproductivityemergencydepartment
Fan, E. M. P., Nguyen, N. H. L., Ang, S. Y., Aloweni, F., Goh, H. Q. I., Quek, L. T., Ayre, T. C., Pourghaderi, A. R., Lam, S. W., & Ong, E. H. M. (2021, January). Impact of COVID-19 on acute isolation bed capacity and nursing workforce requirements: A retrospective review. Journal of Nursing Management. Retrieved February 28, 2021, from https://onlinelibrary-wiley-com.ezp.waldenulibrary.org/doi/full/10.1111/jonm.13260
Wynendaele, H., Willems, R., Tryou, J. (2019, July). Systemic review: Association between the patient-nurse ratio and nurse outcomes in acute care hospitals. Journal of Nursing Management, (27)5, 896-917. http://dx.doi.org.ezp.waldenulibrary.org/10.1111/jonm.12764
Post a description of the national healthcare issue
Important information for writing discussion questions and participation
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Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
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Important information on Writing a Discussion Question
- Your response needs to be a minimum of 150 words (not including your list of references)
- There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
- Include in-text citations in your response
- Do not include quotes—instead summarize and paraphrase the information
- Follow APA-7th edition
- Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
- A minimum of 6 responses per week, on at least 3 days of the week.
- Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
- Each response needs to be at least 75 words in length (does not include your list of references)
- Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
- Follow APA 7th edition
- Points will be deducted if the above is not followed
- Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
- Here are some helpful links
- The is a great resource
