Respond to the following post by providing additional thoughts about competing needs that may impact your colleagues’ selected issues (nursing burnout) or additional ideas for applying policy to address the impacts described.
Competing needs within the healthcare industry are an important topic of discussion. The American Nurses Association (2015) discusses how “registered nurses (RNs) are constantly challenged to provide quality nursing care while resources are chipped away” (p. 1). Healthcare organizations and nurse leaders must continually balance the needs of patients, staff, the organization, and finite resources. This post will discuss how competing healthcare needs impact policy development and specific competing needs related to nurse burnout, including how policy might address those competing desires.
How Competing Needs Impact Policy Development
Competing needs have a significant impact on healthcare policy development. Healthcare leaders have a responsibility to develop and implement policies that meet both the organization’s needs and important stakeholders. Stakeholders are individuals or groups that have a significant interest in a policy or project and are critically impacted, negatively or positively, by the policy outcomes (Melnyk & Fineout-Overholt, 2019). Strategic policy development involves identifying competing needs, brainstorming solutions, developing policies to address the competing needs, policy implementation, and policy evaluation (Broome & Marshall, 2021). Often, the needs of one stakeholder will be in direct conflict with the needs of another. In healthcare, important stakeholders include patients, clinicians, and health organizations. So, for example, an organization may be experiencing a nursing shortage but unable to fill open positions due to a lack of qualified applicants. Developing a policy aimed at hiring and training new graduate nurses would be an ethical policy that meets the organization’s needs while also facing challenges in the workforce supply.
Competing Needs Related to Nurse Burnout
Nurse burnout has become a significant industry crisis. Burnout before the COVID-19 pandemic was estimated to occur in around 35 to 45 percent of nurses and is now estimated to be closer to sixty percent (Kelly et al., 2021). Nurse burnout is equated to unsuccessfully managed stress in the workplace. Common examples of competing needs that contribute to nurse burnout include:
Shortage of nurses leads to higher nurse-to-patient ratios and unsafe staffing, but quality patient care and optional outcomes depend on safe assignments and staffing ratios. In addition, premature departures from the profession and a lack of nursing school faculty members have led to a lack of qualified applicants (Broome & Marshall, 2021).
Increasing demand for care like five-star hotels, which impacts the mental wellness of nurses, versus the needs of hospital to have high Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores for reimbursement.
Budget restraints, which restricts the hiring of additional nurses. According to Milliken (2018), many hospitals have replaced individualized care models with more budget conscious models that focus on efficiency over individualized patient care and outcomes, which has created displaced anger and suffering among nurses and worsened burnout symptoms.
Expansion of technology in the workplace has led to constantly changing workflows. Technology has the ability to improve and streamline care to promote optimal patient outcomes, but this has resulted in constant changes in policies and technology.
Impacts and How Policy Addresses These Competing Needs
Competing needs weigh heavily on the nurse. As point-of-care clinicians and chief caregivers, nurses are responsible for providing safe and compassionate care. Nurses are constantly told to achieve the same or even higher levels of care with less staff, less resources, ever evolving workflows, and poor scheduling. As a result, nurses experience fatigue, compassion, depression, and cynicism, jeopardize patient safety, and increase their risk of personal injury (Kelly et al., 2021). Eventually, some nurses leave their unit or the profession altogether, worsening the nursing shortage.
Policies should address the competing needs of the institution and it’s employees. I will use my own work as an example. Before the coronavirus pandemic, our triage nurses worked in a call center located in the back room of our office building. Unfortunately, the pandemic caused constant sick calls due to illness, virus exposure, and loss of childcare when schools moved to remote learning. The short staffing and increased stress from the pandemic worsened burnout symptoms among staff members. Budgetary restraints and lack of qualified applicants present barriers to improving staffing. As a result, clinic administrators created a new policy that allowed triage nurses to work from home. This policy improved the work-life balance of nurses by decreasing commute time and allowing a break from the clinic setting. It also gave nurses the ability to pick up extra or partial shifts from the comfort of their own home; this positively impacted staffing and boosted morale.
