NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices

Analysis of a Pertinent Healthcare Issue: The Great Resignation

NURS 6501: Interprofessional Organizational and Systems Leadership

Analysis of a Pertinent Healthcare Issue: The Great Resignation

Information from the U.S. Bureau of Labor Statistics suggests that nearly 50 million Americans willingly resigned from their jobs in 2021 in the ongoing Great Resignation phenomenon (Fuller & Kerr, 2022). While the major exodus of employees is partly attributed to the COVID-19 pandemic, experts warn that the Great Resignation had started way before the SARS-CoV-2 outbreak in Beijing China in early 2019 with the average monthly resignation frequency rising by 0.10% annually from 2009 – 2019 (Fuller & Kerr, 2022). In the healthcare field, it is recognized that an engaged, qualified, diverse, and talented labor force is fundamental to the optimal functioning of America’s healthcare system. However, there are critical staffing shortages that threaten access to care by communities (American Hospital Association, 2022). Vacancies for various nursing positions amplified by 30% between 2019 and 2030, and the deficiency is anticipated to persist  (American Hospital Association, 2022).

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Nurses were at the frontline of the pandemic, and a large share suffered burnout, trauma, stress, and elevated behavioral health difficulties that pushed them to resign (Fuller & Kerr, 2022). As stated previously, however, the major challenge of preserving talented, qualified medical professionals preludes the COVID-19 outbreak. It is projected that the U.S. will face a deficiency of >125 000 clinicians by 2023 and there is a necessity for >200,000 RNs annually to replace retiring RNs and fulfill the demand for nursing care (Jiskrova, 2022). In our hospital, the Great Resignation worsened an already dire situation. Five experienced nurse-midwives and six RNs aged >50 years quit working instead of earning additional wages at the end of their careers. The extreme nurse shortage threatened patient safety in the organization at the height of the pandemic, with increased patient mortality attributed to COVID-19 and other treatable illnesses, since more nurses missed work due to the pandemic-associated stress and burnout (Buchan et al., 2022) NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices.

Summary of Two Articles on the National Stressor

I selected a topical article published by McKinsey that highlights strategies that can be adopted to develop a U.S. public-health workforce of the future (Kumar et al., 2022). The authors recognize the impact of the COVID-19 pandemic and the associated workforce exodus on the delivery of health services across the country. Six interventions are proposed in the article for developing and retaining a healthy workforce (Kumar et al., 2022). The first strategy is to re-evaluate the capabilities and roles of public-health staff by investing in systematic intervention to map out the requisite competencies necessary for the future and design customized, role-specific workforce expansion plans. The second is leveraging momentum attained via collaborations established in response to the SARS-CoV-2 outburst and the third is investing in employees by supporting clear avenues for professional advancement and development (Kumar et al., 2022). The fourth strategy is establishing innovating enlistment processes that expand talent pipelines to mitigate the Great Resignation, and the fifth proposal is prioritizing health equity to guarantee that the health staff mirror the community they serve via refreshed employment classifications and training focused on diversity, equity, and inclusion (Kumar et al., 2022). Lastly, the above authors propose the need for cultivating strong leaders by redesigning the orders of leadership in public health via external recruitment and upskilling.

The second article I selected also reveals the unprecedented staffing difficulties that have braced nurse leaders in the past two years. The authors attribute the challenges to the upsurge of COVID-19-positive patients, which overwhelmed the country’s health system (Molle & Allegra, 2021). The authors assessed nurses’ views on the benefits of a buddy-staffing framework. The findings of the evaluation of the buddy staffing model revealed that it can potentially improve nurse retention and reduce the mass exodus of RNs by promoting teamwork, efficiency, patient safety, and staff enablement (Molle & Allegra, 2021). All the above benefits positively influence organizational culture and alleviate stress and burnout attributed to the readiness to quit the nursing profession completely or quit specific organizations.

Strategies to Reduce Nursing Shortages

From the reviewed articles so far, it is apparent that the nursing shortage is a major challenge to the U.S. healthcare industry. At our hospital, nursing scarcity was resolved by collaborating with international nursing recruitment agencies to recruit foreign-trained RNs, mainly from the Caribbean, Asia, and African countries (Buchan et al., 2022). The hospital has also developed stress management and coping interventions to empower medical staff to develop resilience to burnout. Based on the findings of the two scholarly articles, the hospital can also work on upskilling the direct care workforce to have RNs who are optimally enabled to manage the care of individuals and reduce the pressure placed on the hospital (Kumar et al., 2022). Besides, the hospital should also seek to highlight health equity to ensure that the employees’ community they serve via refreshed employment classifications and training focused on diversity, equity, and inclusion (Kumar et al., 2022).

Developing Organizational Policies and Practices

The outburst of the COVID-19 pandemic posed significant pressure on the country’s healthcare system, placing our hospital on the brink of closure (Kurnat-Thoma et al., 2017). The management of our hospital was compelled to focus on not only lifting personnel morale during extraordinary times but also on striving to keep the hospital from constraining financially. In particular, the indefinite postponement of elective surgical procedures placed the hospital leaders in a catch-22 situation of managing nurse staffing costs and guaranteeing optimal quality care at the height of the Great Resignation. As outlined previously, five experienced nurse-midwives and six RNs aged >50 years resigned from our hospital at the beginning of the pandemic citing stressful workplace settings and fear of contracting the virus. The hospital leaders approximated the cost per attrition event to be >$90,000, including recruitment fees, training and onboarding, and tackling the declined productivity in the initial six months (Avant Healthcare Professionals, 2020). The Great Resignation, therefore, made the hospital leaders consider the logic of working with understaffed nurses when the revenues began dropping. However, available evidence shows strong correlations between understaffing and prolonged hospital stay, nurse and patient dissatisfaction, elevated readmission rates, complication rates, patient mortality, and occurrence of adverse events (Rhendren, 2020). In sum, the occurrence of the viral pandemic exacerbated the Great Resignation, which placed hospital leaders in a dilemma of whether to avoid hiring new nurses and avoid the extreme associated costs or hire new nurses to ensure patient safety even when the hospital is in financial ruin.

It is standard practice at our hospital that all RNs should be cross-trained to care for all types of patient assignments during nurse staffing crises (American Nurses Association, n.d.). The policy has allowed the hospital to have a ‘float pool’ of nurses capable of moving from unit to unit especially when patient acuity increases and patient census surges beyond the unit staffing supply. The strengths of cross-training allow the nurses in the float pools to be well-rounded in their expertise and have numerous years of nursing experience, and their comprehension and independence facilitate streamlined workflow (American Nurses Association, n.d.) NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices. However, nurses are inclined to reject floating, thereby resulting in a conflict between nurses and nurse managers. Besides, in our hospital, floating pools raises ethical concerns regarding patient safety since reassigning of RNs from their typical assignments to inadequately staffed units is not a proactive process that can result in compromised patient care (Bitanga, 2019). A practice that hospital managers can embrace to address the impacts of nursing shortage partly due to the Great Resignation and avoid the shortcomings of float assignments while balancing the competing needs of the hospital finances, patients, and staff is leveraging the resources of international recruitment of RNs through agency enlistment (Avant Healthcare Professionals, 2020). Working with foreign-trained RNs can be substantially lower in cost than per diem and travel fees, and the reliance on international RNs can safeguard the hospital’s labor budget from hiring costs, which almost doubled following the outburst of the viral pandemic(McHugh & Ma, 2017; Straw, 2018).

References

American Hospital Association. (2022). Fact sheet: Strengthening the health care workforce. https://www.aha.org/fact-sheets/2021-05-26-fact-sheet-strengthening-health-care-workforce

American Nurses Association. (n.d.). Questions to ask in the decision to accept assignments. https://www.nursingworld.org/practice-policy/nurse-staffing/questions-to-ask-in-making-the-decision-to-accept-a-staffing-assignment-for-nurses/

Avant Healthcare Professionals. (2020, June 17). Managing nurse staffing costs post COVID-19. https://avanthealthcare.com/blog/articles/managing-nurse-staffing-costs-post-covid-19.stml

Bitanga, M. (2019). What are the effects of floating on nurses and patient care? RN Journal. https://rn-journal.com/journal-of-nursing/effects-of-floating-to-nurses-and-patient-care

Buchan, J., Catton, H., & Schaffer, F. A. (2022). Sustain and Retain in 2022 and beyond: The global nursing workforce and the Covid-19 pandemic. International Council of Nurses. https://www.icn.ch/system/files/2022-01/Sustain and Retain in 2022 and Beyond- The global nursing workforce and the COVID-19 pandemic.pdf

Fuller, J., & Kerr, W. (2022, March 23). The Great Resignation Didn’t Start with the Pandemic. Harvard Business Review. https://hbr.org/2022/03/the-great-resignation-didnt-start-with-the-pandemic

Jiskrova, G. (2022). Impact of COVID-19 pandemic on the workforce: From psychological distress to the Great Resignation. Journal of Epidemiology and Community Health, 76(6), 2021–2022. https://doi.org/10.1136/jech-2022-218826

Kumar, P., Lurie, E., & Parthasarathy, R. (2022). Building the US public-health workforce of the future. McKinsey & Company, February. https://www.mckinsey.com/industries/public-and-social-sector/our-insights/building-the-us-public-health-workforce-of-the-future

Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover—A 10-element onboarding program intervention. SAGE Open Nursing, 3, 237796081769771. https://doi.org/10.1177/2377960817697712

McHugh, M., & Ma, C. (2017). Wage, work environment, and staffing: effects on nurse outcomes. Policy Political Nursing Practice, 176(3), 139–148. https://doi.org/10.1177/1527154414546868.Wage

Molle, E., & Allegra, M. (2021). Nurses’ perceptions of the buddy staffing model: Implications for nurse leaders. Nurse Leader, 19(6), 625–629. https://doi.org/10.1016/j.mnl.2021.08.008

Rhendren, R. (2020, August 30). Nurse staffing costs must be weighed against the cost of errors. Health Leaders. https://www.healthleadersmedia.com/nursing/nurse-staffing-costs-must-be-weighed-against-cost-errors

Straw, C. N. (2018). Engagement and retention in float pools: Keeping the team above water. Nursing Management, 49(10), 30–36. https://doi.org/10.1097/01.NUMA.0000546201.01962.0D NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices

To Prepare:

• Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
• NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices
• Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
• Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (1-2 pages):

Developing Organizational Policies and Practices

Add a section to the 2-3 page paper you submitted in Module 1. The new section should address the following in 1-2 pages:

• Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
• Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
• Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
• Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
• Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.
• Due to the nature of this assignment, your instructor may require more than 7 days to provide you with quality feedback NURS 6053 Week 3 Assignment: Developing Organizational Policies and Practices.