Policy Paper Part 1 Assignment

Current health care issue and impacts of the issues

The current health care issue has been identified as nurse shortage. It is undeniable that nurses work hard within the health care environment even as they take on long shifts. They continuously work in inter-professional health care teas, advocate for patients, check in with families, and administer medication for the best results within an intricate and complicated medical system. It is not uncommon for nurses to jump from unit to unit to make up for the shortages, have patients waiting, and missing their lunchbreaks. The bottom line is that the USA is experiencing a nursing shortage with the problem only set to grow. Due to the educational bottlenecks, retirement of baby boomers, and influx of patients into the health care system, the nurse positions are not being filled fast enough to meet the existing and projected demand. Although this might appear as a simple equation of supply and demand, the actual cause and impact of the issue calls for an intervention at multiple levels (Schulte, 2014).Policy Paper Part 1 Assignment

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The nursing profession is listed as one of the fastest job growth occupations in the USA. It is estimated that the USA currently has a demand for 3 million registered nurses and this demand will grow to 3.3 million by 2030, a 7% increase. In addition, it is estimated that the USA will have 175,900 openings for registered nurses annually over the next ten years, with the openings factoring in workforce exists and retirements. The current nursing workforce falls short of the demand by about 36.8%. The existing nursing shortage has had a profound effect on patient care. It has increased the workload of the available nurses while increasing the likelihood of patients dying within 30 days of admission by 7%. It is estimated that increasing the number of nurses by 10% would reduce patient mortality by 7%. In addition, the high patient-to-nurse ratios has been linked to high nurse burnout that results in increased negative outcomes for patients, such as surgical site and urinary tract infections. Overall, nursing shortage is associated with longer hospital stays, lower rates of infection, and lower failure-to-rescue incidents (Rosseter, 2020).Policy Paper Part 1 Assignment

Background information on the issue

Nurses are a critical health care resource and comprise the single largest medical profession. The nursing profession in the USA continues to report shortages due to inequitable distribution of the workforce, high turnover, and lack of potential educators. The issue is caused by a range of factors. Firstly, it is caused by violence in the health care setting with the ever-present threat of physical and emotional abuse that nurses face adding to their stress while negatively affecting work effort and job satisfaction. The risk of violence to nurses can be as high as 38%. Secondly nursing is a fast growing profession and the current supply is unable to meet the existing demand. Thirdly, the clash between family and career has an impact on the shortage. Although males have been encouraged to join the nursing profession, it still remains a mainly female dominated profession. During the childbearing years, female nurses will leave the profession or cut back on their responsibilities to attend to their family responsibilities. Some of the female nurses may eventually rejoin the profession, while others may decide not to work or join other professions (Schulte, 2014). Fourthly, nurse burnout presents a concern. Some of the nurses who are working in the profession are faced with the reality of shortages and high workloads that cause them to experience burnout and decide to leave the profession. The turnover rate from burnout is as low as 8.8% in some areas and as high as 37.0% in other areas. Fifthly, the nursing workforce is aging. One third of the nursing workforce is older than 50 years of age and expected to retire over the next ten years. This number includes nurse faculty, and expected to cause reduced enrollment in nursing schools. Finally, the population is aging and has increasing need for health care services. 71 million Americans are expected to reach the retirement age by 2019 (Young & Kroth, 2018). Policy Paper Part 1 Assignment

Social, economic, ethical and political factors that impact the issue

Undoubtedly, there is a need for nurses to address the existing shortage. However, efforts to address this need has been negatively affected by three factors. Firstly, there are workplace obstacles. Although there is a shortage of nurse personnel, the positions are not optimized to attract and retain nurses. Fewer nurse personnel implies that those who are working have a high workload and must work overtime and cover shifts to keep the patients covered. The high pressure and mot time works leads to nurse burnout, both physically and emotionally. Secondly, there are financial obstacles. Qualifying to practice as a nurse is financially costly. The cost is significantly higher for those pursuing specialties. This means that those seeking to gain nursing education may be unable to do so because of inability to pay for the education. Finally, there are educational obstacles. Nursing has a high level of interest as there is high job security. However, attending nursing school requires high educational attainments. In addition, there are low faculty numbers. This means that only a small number of people can attend nursing school so that only a small number graduate as nurses (Young & Kroth, 2018).

Issue statement expressing personal position on the issue

The issue of nursing shortage is a source of concern that would only worsen unless addressed. The issue is caused by unfavorable working conditions, and low numbers of qualified nurses. This issue should be addressed from two perspectives. Firstly, presenting favorable working conditions and setting up independent committees to determine the appropriate number of nurses required by each department and facility. Secondly, presenting education opportunities so that more people have an opportunity to train as nurses.

Key stakeholders impacted by the issue

The burden of nurse shortage impacts a range of stakeholders. Firstly, it impacts nurses as they are faced with larger workloads. The shorthanded nurses are under greater pressure and at higher risk of making mistakes.  Secondly, it impacts the patients as they receive lower quality care with mistakes. Thirdly, it affects other medical personnel. They are similarly being strained in care provision as they are forced to support nurses by taking on some of their roles and responsibilities (Young & Kroth, 2018). Policy Paper Part 1 Assignment

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Two policies/bills that impact the issue

There are two bills that impact the issue. Firstly, the Registered Nurse Staffing Act of 2014 (HR 1821) that supports the long-term growth and sustainability of nurses in the health care industry. The bill is intended to have medical facilities enact standardized staffing models to reduce nurse fatigue during shifts and reduce nurse burnout (Supplemental Health Care, 2014). Secondly, the Nursing Workforce Reauthorization Act the offers financial grants and loans to support nursing education thus enabling more people to qualify as nurses (Congress.gov, 2020).

References

Congress.gov (2020). H.R.959 – Title VIII Nursing Workforce Reauthorization Act of 2018. https://www.congress.gov/bill/115th-congress/house-bill/959

Rosseter, R. (2020). Nursing Shortage. https://www.aacnnursing.org/news-information/fact-sheets/nursing-shortage

Schulte, M. (2014). Healthcare Delivery in the U.S.A.: An Introduction (2nd ed.). CRC Press.

Supplemental Health Care (2014). Nurse Staffing Legislation: What You Need to Know. https://www.shccares.com/blog/nurse-staffing-legislation-what-you-need-to-know

Young, K., & Kroth, P. (2018). Sultz & Young’s Health Care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett Learning, LLC. Policy Paper Part 1 Assignment