Professional Nursing: Concepts & Challenges Essay

In the face of the COVID-19 pandemic, adequate staff, burnout, and fatigue have become major barriers in the healthcare setting (Jacobs, McGovern, & Heinmiller, 2018). The negativity associated with such stressors as fatigue and burnout prove to be very contagious among workers, and spreads quickly throughout the workplace (Jacobs et al, 2018). In turn the negativity greatly impacts the well-being of staff and consumers alike (Jacobs et al., 2018). Job performance, health, and resiliency are affected as nurses suffer from work-related stress, fatigue, and burnout (Jacobs et al., 2018). Medical professionals cite long hours, bureaucratic tasks such as charting, excessive paperwork requirements, and lack of adequate staffing as significant sources of stress and burnout (Reith, 2018). Members of leadership are tasked with improving the conditions that negatively impact workers and breed negative environments experienced with burnout and feeling overworked (Jacobs et al., 2018). I currently serve as the lead nurse for a school system comprised of twelve schools, that have an enrollment of approximately 7,000 students, and nine nurses. We do not have the luxury of having substitute nurses that are readily available at any time. We do however, employ five contract nurses that are available on a limited basis at times. The lack of staff availability has indeed impacted the district nurses causing fatigue, and resulting in difficulty requesting time off. Professional Nursing: Concepts & Challenges Essay.  As an administrative professional for the system, I work closely with my superintendent to continue to secure positions of full-time and contract nurses every year when the budget is discussed (Reith, 2018). As lead nurse, I also work with the nurses that I supervise to network together in an effort to identify and address concerns and issues that arise, and may lead to stress, burnout, and fatigue (Reith, 2018). With the recent struggles and uncertainty of the COVID-19 pandemic, I have made a concerted effort to keep myself and the nurses abreast of the latest guidelines provided by the Centers for Disease Control (CDC), provide opportunities for round-table discussions together in a social setting to foster a less stressful environment, and most importantly, I have approached the Board of Education about hiring more contract nurses on an emergency basis and having those nurses in place the first few days of school to help with re-entry (de Oliveira, de Alcantara Sousa, Vieira Gadelha, & do Nascimento, 2019). Also, whenever possible, I help with paperwork, and covering field trips that are long in duration, or overnight so that the nurses with young families are not away from family overnight or for an extended day (De Oliveira et al., 2019). On the surface, school nursing may not seem as though there would be a great deal of stress in the workplace, however, in there are several students attending school that require intermittent urinary catheterization, enteral tube feedings, diabetics, and seizure students requiring Diastat administration. The smallest school in the district has a ratio of one nurse to approximately 450 students, while the largest school has a ratio of one nurse to approximately 1200 students. With the acuity, the potential for long hours, the lack of employment resources, we as school nurses do tend to suffer from fatigue, and burnout. References de Oliveira, S. M., de Alcantara Sousa, L. V., Vieira Gadelha, M., & do Nascimento, V. B. (2019). Prevention actions of burnout syndrome in nurses: An integrating literature review. Clinical Practice and Epidemiology in Mental Health : CP & EMH, 15, 64–73. https://doi.org/10.2174/1745017901915010064 Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3), 231–245. doi:10.1097/NAQ.0000000000000303 Reith T. P. (2018). Burnout in United States Healthcare Professionals: A Narrative Review. Cureus, 10(12), e3681. https://doi.org/10.7759/cureus.3681 2 post The national healthcare issue/stressor I chose to discuss is the staffing issue. This is not a new issue but continues to plague our system and was really brought to light during the Coronavirus Pandemic. From 2003 to 2013, the number of nurses entering the workforce doubled. (Marshall & Broome, 2017) The Institute of Medicine determined that there is a need to increase the nursing forces’ education to BSN degree or higher to 80% by 2020. (Gerardi, Farmer, & Hoffman, 2018) With ill prepared nurses in healthcare, this can cause harm to the patient and the healthcare industry. When the COVID-19 virus hit in Georgia in March 2020, we did not and still do not have adequate staff to care for critically ill patients. This would mean the staff was being continuously tripled and patients were suffering because the nurses could not give the proper care to these patients. There were patients that died because we could not hear alarms, pumps, and notice issues leading to decompensation. My healthcare system has sat down with us multiple times and leadership rounds weekly to make sure we have what we need to care for our patients and what they can do for us. We recently were helped with Georgia Emergency Management Agency (GEMA) nurses to help decrease the number of patients the staff nurses were taking and additionally contracted with 5 dayshift and 5 nightshift agency nurses to help as well. This has significantly helped reduced the number of patients that staff nurses were taking and therefore allowing better care and outcomes for our patients. Professional Nursing: Concepts & Challenges Essay. We were being capped from taking any overtime since June and they opened overtime and implemented a bonus program to pick up shifts. We as healthcare providers are going to oversee finding new ways to have patient care organized and develop ways to keep providers accountable for quality, cost and patient experience. (Ricketts & Fraher, 2013) References Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving Closer to the 2020 BSN-Prepared Workforce Goal. American Journal of Nursing, 118(2), 43-45. Marshall, E. S., & Broome, M. E. (2017). Transformational Leadership in Nursing. New York: Springer Publishing Company. Ricketts, T. C., & Fraher, E. P. (2013). Reconfiguring Health Workforce Policy So That Education, Training, And Actual Delivery Of Care Are Closely Connected. Health Affairs, 32(11), 1874-1880. doi:10.1377/hlthaff.2013.0531

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Response 2: Post 2.

The discussion post identifies staffing as a health care stressor. It acknowledges that although this is not a new concern, the Covid-19 pandemic has highlighted the issue and given it greater attention as the need for medical personnel increased at all levels. It specifically mentions the State of Georgia as facing a medical staff shortage that has become more acute in the face of Covid-19 pandemic. The author mentions that getting additional nurses from other sources such as Georgia Emergency Management Agency has helped to reduce the shortage. In addition, the available nurses were assigned more responsibilities. Other than the mentioned interventions, the issue of staff shortage can be addressed by having nurse students who are close to graduation being assigned responsibilities as part of an internship program. Another strategy is to assign nurses based on patient acuity so that nurses are available where they are needed most (Black, 2020). Another suggestion is to recruit nurses with lower qualifications who demand lower wages and can complete the routine tasks such as registering patients so that the work pressure on nurses is reduced without significantly increasing wage costs (Ellis & Bach, 2015). Overall, the post presents an informative analysis of staffing as a health care stressor.

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References

Black, B. (2020). Professional Nursing: Concepts & Challenges (9^th ed.). Elsevier.

Ellis, P., & Bach, S. (2015). Leadership, Management and Team Working in Nursing (2^nd ed.). SAGE Publications.

Response 1: Post 1.

The discussion post identifies the Covid-19 pandemic, adequate staff, burnout, and fatigue as health care stressors. They are identified as such because they hinder efforts to provide care by stressing the available resources. In addition, the post notes the positon that nurse leaders play in addressing the stressors. The author specifically mentions how nurse staff shortages act as a stressor through increasing the workload of the available nurses so that they experience fatigue that has a negative impact on their work. The author further mentions that the uncertainty of Covid-19 pandemic has added to the stressor. To address this concern, the author recommends that additional nurses be hired to reduce the pressure on the available nurses. Still, there is a need to mention other strategies for addressing the issue, such as recruiting nurses with lower qualifications who demand lower remunerations, and assigning the available nurses based on acuity so that they are available where they are needed most (Ellis & Bach, 2015). Also, the suggestion can be made that nurse students close to graduation can be offered an opportunity to practice with routine nursing tasks in order to reduce some of the pressure practicing nurses experience in the work environment (Black, 2020). Overall the post offers an informative analysis of inadequate nurse staffing in the school system as a health care stressor. Professional Nursing: Concepts & Challenges Essay.

References

Black, B. (2020). Professional Nursing: Concepts & Challenges (9^th ed.). Elsevier.

Ellis, P., & Bach, S. (2015). Leadership, Management and Team Working in Nursing (2^nd ed.). SAGE Publications. Professional Nursing: Concepts & Challenges Essay.