Developing Organizational Policies and Practices

Full Answer Section

1. Hospital Financial Sustainability: Hospitals operate in a competitive healthcare environment with financial pressures. Staffing cuts are often seen as a cost-saving measure, despite potential long-term consequences.

Existing Policy/Practice:

Mandatory Overtime: Many hospitals allow or require mandatory overtime for nurses when staffing shortages occur. This policy aims to ensure adequate staffing levels to meet patient needs, but it can contribute to nurse burnout.

Critique of Policy:

• Ethical Concerns: Mandatory overtime raises ethical concerns because it disregards nurses' well-being and autonomy. Excessively fatigued nurses may be more prone to errors, posing risks to patient safety. ([Ref 2]: The Joint Commission. (2019). Sentinel Event Alert #59: Promoting a Culture of Safety to Prevent Nurse Burnout and Its Patient Safety Consequences. Joint Commission, https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/sea-59-workplace-violence-final2.pdf)
• Strengths: This policy can ensure adequate staffing levels during unexpected surges in patient volume or emergencies.
• Challenges: Regular reliance on mandatory overtime contributes to nurse burnout, reduces job satisfaction, and increases turnover rates. This creates a vicious cycle that can ultimately lead to a less qualified nursing workforce and potentially compromise patient care.

Recommendations:

1. Implement Safe Staffing Ratios: Hospitals should establish and enforce safe nurse-to-patient ratios based on patient acuity levels. This ensures adequate care while preventing nurse overload. ([Ref 3]: American Nurses Association. (2018). Position statement: Nurse staffing and patient safety. American Nurses Association. https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/)
2. Invest in Staff Retention Programs: Develop programs that promote job satisfaction and well-being, such as flexible scheduling options, tuition reimbursement for advanced degrees, and mental health support services. This not only reduces burnout and turnover but also fosters a culture of employee investment. ([Ref 4]: Laschinger, H. K., Leiter, M. P., & Day, D. V. (2009). The sustainable work environment in healthcare: A critical issue for employee well-being and patient safety. American Psychologist, 64(8), 698-704.)
3. Explore Alternative Staffing Models: Hospitals can explore alternative staffing models like per diem nurses or travel nurses to fill temporary staffing gaps, potentially reducing reliance on mandatory overtime.

Conclusion:

By balancing the need for financial sustainability with the well-being of nurses and patient safety, hospitals can create a more ethical and sustainable work environment. Investing in safe staffing ratios, employee retention programs, and exploring alternative staffing models can achieve this balance and ultimately improve the quality of care for patients.

Sample Answer

Healthcare Issue/Stressor: Nurse Burnout and Retention

Competing Needs:

1. Patient Care Quality: Hospitals strive to deliver high-quality care, requiring a well-staffed and engaged nursing workforce. Nurse burnout, characterized by emotional exhaustion, depersonalization, and reduced sense of accomplishment, can negatively impact patient safety, satisfaction, and outcomes. ([Ref 1]: Aiken, L. H., Sloane, D. M., Luckhaupt, L. L., & Choi, W. Y. (2018). Nurse staffing and patient mortality in hospitals with magnet designation. Nursing Economics, 36(2), 85-90.)