Competing Needs Impacting Nursing Shortages

Competing Needs Impacting Nursing Shortages For the healthcare organization, to be able to serve the community better and to maintain safety of patients and the entire workforce, a healthy work environment, safe staffing, and more educated nurses are needed. However, with the nursing shortage happening globally due to different factors affecting in retaining and hiring nurses, balancing between resources such as tight unit budget, improving patient's health and well-being of the workforce is difficult to attain. These are the competing needs that the administration has to look at very closely in making policy. Adopting Efficient Staffing Practices to Address Nursing Shortages of Resources To fill the gaps in the staffing problem, WakeMed management hired more nursing travelers and implemented mandatory on-call for its staff. Further, all full-time, part-time, and supplementals nurses have been required to sign up for a 2-12-hour shifts every six weeks scheduled. Additionally, nurses from telemetry units were shadowing with ICU nurses for a few days in order to train them to take care of low acuity patients from ICU in the event the hospital reaches the peak of the pandemic. Implemented Policy and Ethical Considerations Hiring more travel agency nurses is more appealing nowadays in many health care organizations. The most popular reason for this is that agency nurses can fill short-term staffing shortages and reduce staffing costs. Although traveling nurses get higher rates compared to permanent nurses, they are more cost-effective for the hospital. The hospitals can maximize their tight budgets by not paying travelers health benefits, retirement, and paid time offs. The use of travel nurses also reduces recruiting, training, overtime, and payroll costs. Moreover, agency nurses are easy to relocate from one unit to another, where nurses are needed the most. On the other hand, mandatory on-calls can ease the nursing shortage by requiring all nurses to sign up extra hours to fill in the gaps. Nevertheless, fatigue and burnout from long hours of work in stressful environments, and inadequate sleep between shifts can affect nurses' performance, impacting patient care. These symptoms were associated with a high incidence of a medication error, a high percentage of serious preventable adverse events, and also contributed to the elevated rates of workplace injuries (American Association of Nurse Anesthetists, 2015). Patient safety is one of the main challenges in quality of care, especially if the allocated resources were limited. Hiring an agency nurse may fill in the gaps for nursing shortages in the unit. However, with less familiarity with the hospital policies and procedures, it raises concerns about disruptions of care, which puts the patient at risk. On the other hand, using mandatory on-calls may prevent nurses from delivering excellent quality and error-free care due to sleep deprivation and burnout. Lastly, using nurses who are not adequately equipped to fulfill their duties, such as non-ICU nurses taking care of low acuity ICU patients, is a major ethical dilemma that can occur in healthcare facilities. Any actions that conflict with nursing goals of protecting, promoting, and restoring the health and well-being of individuals are at risk of acting unethically (Milliken, 2018). Recommended Policy Changes "Nurse satisfaction is one indicator of the quality of health services in the hospital" (Rizany et al., 2019, para. 2). Nurses might offer their loyalty and commitment and improve their work performance if they were satisfied with their job and working conditions. An excellent example of making the employees more satisfied with their job is self-scheduling, whereby departments manage their schedule according to their own unique staffing needs. Through self-scheduling, employees increase job satisfaction and retention and reduce no show at work that may contribute to nursing shortages. Self-scheduling improves nurse's performance and would lead to patient’s satisfaction. References American Association of Nurse Anesthetists. (2015). Patient safety: Fatigue, sleep, and work