Discussion: How Competing Needs Impact Development

Discussion 1how Competing Needs May Impact The Development Of A Policy

Discussion 1 how Competing Needs May Impact The Development Of A Policy For my previous discussion post, I discussed how staffing shortages can lead to burnout due to increased workloads and longer hours. Burnout has been shown to significantly increase medication errors, reduce patient outcomes, and reduce productivity which decreases the quality of patient care overall (Bakhamis et al., 2019). Nurses will also become overwhelmed working in stressful environments, creating lower job satisfaction scores and lower nurse retention (Bakhamis et al., 2019). Because of this need to prevent burnout in nurses, the policy would need to be developed to address having an adequate nurse-to-patient ratio while also balancing budget costs.

Despite attempts to develop policies to help healthcare organizations, competing needs related to the workforce and lack of resources make it difficult to address the shortage. Nursing leaders would need to develop a policy that can create a supportive environment for nurses to care for patients safely. The goal would be to improve patient outcomes and improve retention, decreasing burnout. For example, developing a policy to establish set nurse-to-patient ratios depending on the unit. Adequate staffed units have been shown to result in lower mortality rates, shorter hospital stays, and less risk for adverse risks like medication errors (Saville et al., 2019).

Specific Competing Needs that May Impact Nurse Shortages For adequate staffing, there needs to be a balance between the funds available and the organization’s available budget so that it is sustainable while also providing the best patient outcomes. In other words, there needs to be staff and funding available for this to happen. Within my healthcare organization, we have used travelers to fill in shifts to help supplement staffing. There have been times when the number of travel nurses outnumbers staff nurses on a given shift. While these travelers provide much-needed help, they also have expensive contracts and will work a few months per their contracts.

When discussing this dilemma with hospital leadership, we have been told this process is not sustainable in the long run. Instead, the hospital risks losing more money in paying travelers than losing staff nurses. According to Kelly and Porr (2018), this is an example of how the business model of healthcare can negatively impact nurses and their ability to provide safe, high-quality patient care. Over time this can increase nursing stress due to ethical dilemmas, increase burnout, and ultimately worsen staffing anyway (Kelly & Porr, 2018). Nurses should recognize these issues as serious ethical dilemmas as patients risk subpar care due to increasing healthcare costs.

Milliken (2018) suggests nurses develop ethical awareness, by challenging situations and understanding the outcomes of these actions. For example, in my healthcare organization, we have discussed how the lack of staffing can lead to increased medication errors and our CLABSI/CAUTI rates due to nurses being in a ratio that's fifty percent or even double what their normal ratio is. For example, in my ICU unit, the standard nurse-patient ratio is 2:1. However, there have been times we are 3:1 or even 4:1 while being expected to provide the same care with more strain on time and resources. Nurses must speak up when they feel they are in an unsafe patient assignment, further developing ethical competence (Milliken, 2018).

By speaking up, nurses can be advocates for changes in policy, improving on the current process. Conclusion Overall, staffing shortages have created challenges in the healthcare field, leading to increased nurse burnout and poor patient outcomes. Attempting to develop policy to support nurses has been difficult as the organization must also care for its own interests including available funding and budget costs. In other words, the organization must provide funding to staffing, as well as the resources needed to care for patients like the building costs, technology, and other miscellaneous costs. It is recommended that nurses become ethically competent so that they can address moral dilemmas when there is concern that patient care is subpar due to available resources.

Paper For Above instruction

The development of effective healthcare policies is inherently complex, often influenced by competing needs that must be balanced to achieve optimal patient outcomes while maintaining organizational sustainability. One prominent example of such a competing need is addressing nurse staffing shortages, which directly impact patient safety, nurse well-being, and overall healthcare quality. The interplay between resource allocation, workforce management, and financial constraints creates a delicate environment where policy decisions must accommodate multiple, sometimes conflicting, priorities.

Staffing shortages are a significant source of nurse burnout, as increased workloads and extended hours contribute to physical and emotional exhaustion among nurses. Burnout not only diminishes job satisfaction but also compromises patient safety by increasing the likelihood of medication errors and adverse events. Research by Bakhamis et al. (2019) underscores the adverse effects of nurse burnout, linking it to reduced productivity, lower quality of care, and higher turnover rates. Consequently, developing policies that establish appropriate nurse-to-patient ratios becomes a strategic priority to promote a supportive work environment, improve patient outcomes, and retain qualified nursing staff.

However, establishing optimal staffing ratios is subject to financial and resource constraints. Healthcare organizations operate within budgets that limit the extent to which staffing levels can be increased, especially when considering the high costs associated with travel nurses or temporary staffing agencies. For instance, in many hospitals, the reliance on travel nurses can temporarily alleviate staffing gaps but incurs significantly higher costs. Kelly and Porr (2018) critique this model, emphasizing that while it provides short-term relief, it is unsustainable in the long run due to financial strain and potential ethical dilemmas. Over-reliance on costly staffing solutions can divert funds from other critical areas, such as technology upgrades or infrastructure improvements.

Ethical considerations are central to managing this dilemma. Nurses frequently face moral distress when forced to work under unsafe staffing conditions, which can lead to compromised patient care. Milliken (2018) advocates for cultivating ethical awareness among nurses, enabling them to recognize and challenge situations where patient safety is at risk. For example, when nurses in a ICU are asked to care for four or more patients instead of the standard two or three, they face increased pressure to provide quality care with limited resources. Speaking up and advocating for safe staffing levels is essential to fostering ethical practice and policy change.

Furthermore, leadership must play a proactive role in creating healthy work environments that support staff retention and job satisfaction. Components such as effective communication, shared decision-making, transformational leadership, and recognition contribute to a positive organizational climate (ANA, 2021). Implementing policies that promote collaboration and support nurses’ professional development can mitigate burnout and improve patient outcomes. Leaders should also engage frontline nurses in policy development to ensure that staffing models are practical and responsive to the realities of clinical practice.

In addition to staffing, other competing needs influence policy development, including financial sustainability and technological advancements. Healthcare organizations must balance investments in infrastructure, staffing, and technology to deliver high-quality care within limited budgets. These choices are often shaped by external pressures such as government regulations, reimbursement models, and public expectations (Perkins, 2021). Recognizing and addressing these competing needs requires a comprehensive, ethically informed approach that aligns organizational goals with workforce well-being.

In conclusion, balancing competing needs in policy development is crucial for sustainable healthcare delivery. Addressing nurse staffing shortages involves navigating financial constraints, ethical considerations, and organizational priorities. Effective policies must be rooted in ethical awareness, supported by leadership, and responsive to the realities of clinical practice. By doing so, healthcare organizations can foster a safe, supportive environment that promotes both patient safety and nurse well-being, ultimately enhancing the quality of care delivered.

References

• American Nurses Association (ANA). (2021). ANA’s proposed policy solutions to address the nurse staffing shortage crisis. South Carolina Nurse, 28(4), 10–11.
• Bakhamis, L., Paul III, D. P., Smith, H., & Coustasse, A. (2019). Still an epidemic: the burnout syndrome in hospital registered nurses. The Healthcare Manager, 38(1), 3-10.
• Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. https://doi.org/10.3912/OJIN. Vol23No01Man06
• Milliken, A. (2018). Ethical Awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. https://doi.org/10.3912/OJIN.Vol23No01Man01
• Perkins, A. (2021). Nursing shortage: Consequences and solutions. Nursing Made Incredibly Easy!, 19(5), 49–54.
• Saville, C. E., Griffiths, P., Ball, J. E., & Monks, T. (2019). How many nurses do we need? A review and discussion of operational research techniques applied to nurse staffing. International Journal of Nursing Studies, 97, 7-13.