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It is imperative that if the health care system is to overcome these health care stressors then a fourth aim should be expanded and implemented

Responses

Initial Post 1

One of the national healthcare issues facing the country is the nurse shortage.  The healthcare system is advancing and the need for adequate nursing staffing is essential to meet the demand of healthcare institutions. Nurses are a critical part of healthcare and make up the largest section of the health profession. According to the World Health Statistics Report, there are approximately 29 million nurses and midwives in the world, with 3.9 million in the United States. According to the American Nurses Association, due to the increased access to health care services for more individuals by the Affordable Care Act, there is an estimate that one million additional nurses will be needed by the year 2028 (American Nurses Association, 2019).

Vari & Ross (2019), confirmed that data indicates that 16.5 percent of all nurses employed in hospitals quit their jobs within the first year. Further, recruiting a replacement nurse is a time-consuming affair with average recruitment time ranging between two and three months per nurse, depending on the specialty.  Apart from the growing demand for nurses due to people living longer and suffering from ailments, another factor contributing to the shortage is the high turnover seen in the nursing industry. The causes related to the nursing shortage are numerous and pose issues of concern as the nursing profession continues to face shortages due to lack of potential educators, high turnover, and inequitable distribution of the workforce (ANA, 2019).

The reasons for the nursing shortage as identified by Gandi et al., (2016) are

  • Aging workforce
  • Aging population
  • Workplace violence in the healthcare setting
  • Nurse burnout
  • Career and family

 

Despite the financial costs, the nursing shortage have an inevitable negative impact on the quality of care received by the patients.  Haddad et al., (2020), supported that there is a direct connection between patient mortality and shortage of nurses as, hospitals with fewer nurses witnessed a 2–7 percent increase in mortality.

This issue of nursing shortage has been tackled by my institution by the employment of new graduate nurses and a decrease in the nurse-patient ratio. The graduate nurse residency programs have greatly decreased the workload as the new graduate are been trained for a period of 3 months in the unit setting while being enrolled in a one-year program in the education department. The nurse-patient ration of 4:1 has also increased.  Appropriate staffing levels had led to a decrease in medical errors, increased patient satisfaction, nurse retention, and improved nurse retention rates.

In conclusion, nursing shortage results in heavy patient assignments and workloads, which have been shown a decline in patient care and safety, as well as on nurses’ dissatisfaction with their ability to do their jobs effectively.

References

RE: Week 1 Discussion – Initial Post.

The triple aim was introduced in 2008 close to when the Patient Protection and Affordable Care Act (ACA) was passed into policy (Marshall & Broome, 2017).  The triple aim according to Feely, 2017 who writes for the Institute for Healthcare (IHI) states it was instated to help give health care institutions a clear set of goals to work toward that focus on the improvement of health, making sure that the care of individuals is enhanced, and reducing the cost of health care. There are some organizations who have instated a fourth aim which is enjoyment for health care providers in their work (Feely, 2017).  With this structured implementation of the triple aim there are factors which lead to its success or adds to the health care facilities issue/stressor.  One of these stressors that interest me and not only facing the health care facility that I work at but also the national health care system is Primary care strain and or burnout.  There has been an increase in staff shortages in the health care professions with an ever growing volume of patients who are seeking services with increased complex comorbidities which makes it very difficult according to Norful, de Jacq, Carlino, and Poghosyan (2018), to manage all of the needs of patients effectively and efficiently.  The basis for the growing interest in adding the fourth aim according to Coidakis-Barss and Patchell (2019), is to care for the caregiver and address the increased occurrence of provider burnout.

 

Provider burnout will continue unless sound measures are developed to help combat the health care provider shortage against the increasing demands for care.  This issue has impacted the work setting at the hospital that I am working in as several of our NP’s and nursing team have expressed severe burnout and work 60-80 hours per week.  My brother in-law was working as an Acute Care NP for a rehabilitation facility and I felt like we never saw him as he easily was working around 80 hours per week and still taking calls on the weekend which would disrupt his sleep.  He became so run down and felt that sadly he was missing out on our church’s activities, so he decided to change jobs.  There is also at my hospital a severe nursing shortage which they are choosing to fill with new grads and agency nurses but because it is labor intensive so many of the new grads are easily overwhelmed.  To help alleviate some of this strain and nursing burn out they have allowed some travel nurse contracts to be filled and have hired over 60 new nurses but many of the units are still short staffed and new grads take a lot of training to be safe and competent and are getting burn out as well.

 

It is imperative that if the health care system is to overcome these health care stressors then a fourth aim should be expanded and implemented so that the working environment for health care providers is improved and the risk of burnout is diminished.  By committing to this aim health care facilities should see an improvement in the retention of staff and improved patient satisfaction scores as they will not feel the stress that can so often get passed on from nurse to patient.

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