Discussion: Organizational Policies and Practices to Support Healthcare Issues
Healthcare organizations are changing their focus. Instead of just looking at how well patients do, they are now more interested in saving money and being efficient (Kelly & Porr, 2018). This change can be tough for nurses. It might mean fewer staff and less stuff needed to take good care of patients. Even though we know that nurses with a Bachelor of Science in Nursing (BSN) degree are better at helping patients and making sure they stay alive, hospitals aren’t making it a priority to hire them. The Institute of Medicine (IOM) asked if nurses are getting the right training. They said schools should teach students about things like taking care of patients first, using the best methods we know work, making things better, and using technology (Giddens et al., 2015). They teach these things in BSN programs, not in Associate Degree in Nursing (ADN) programs.
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One reason hospitals don’t want to hire nurses with BSN degrees is because there aren’t enough nurses already, and this problem will get worse as more older people need care (American Association of Colleges of Nursing [AACN], 2020). If hospitals only hired nurses with BSN degrees, they wouldn’t have enough staff. Spetz (2018) said the IOM thinks nurses should have at least a BSN to do better at their jobs and help patients more. But hospitals care more about saving money, and most nurses don’t have a BSN degree (Angel, 2020). So, even though BSN nurses do better with patients, hospitals think having enough nurses is more important.
But there are things hospitals could do to get more BSN nurses. This would make patients do better and save money in the long run. Hospitals could make rules to hire more BSN nurses. This would mean better results for patients and less cost. They could also help ADN nurses go back to school to get their BSN. They could pay for their classes and give them more money when they finish. If hospitals did these things over five or ten years, they could have more nurses with BSN degrees. This would mean better care for patients, which is what everyone wants.
References
American Association of Colleges of Nursing. (2020). Nursing shortage. Retrieved December 14, 2020, from https://www.aacnnursing.org/Portals/42/News/Factsheets/Nursing-Shortage-Factsheet.pdf
Angel, L. (2020). Best practices and lessons learned in academic progression in nursing: A scoping review. Journal of Professional Nursing, 1–7. https://doi.org/10.1016/j.profnurs.2020.08.017
Giddens, J., Keller, T., & Liesveld, J. (2015). Answering the call for a bachelors-prepared nursing workforce: An innovative model for academic progression. Journal of Professional Nursing, 31(6), 445–451. https://doi.org/10.1016/j.profnurs.2015.05.002
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1). https://doi.org/10.3912/OJIN.Vol23No01Man06
Spetz, J. (2018). Projections of progress toward the 80% bachelor of science in nursing recommendation and strategies to accelerate change. Nursing Outlook, 66(4), 394–400. https://doi.org/10.1016/j.outlook.2018.04.012
Discussion: Ways to Help with Health Problems
Nurse leaders often face tough choices, like deciding how to use limited resources fairly. Resources are limited, and every organization has to decide how to use them best.
For example, some places have nurses work 12-hour shifts to keep them from leaving. But research shows that when nurses work longer, they make more mistakes. So, how can leaders make sure they do what’s best for the organization and patients?
In this Discussion, think about a big health problem in the country. Think about how different needs might affect making rules about that problem.
To Get Ready:
Look at the Resources and think about the big health problem you picked before.
Think about how different needs in healthcare might affect your health problem.
By Day 3 of Week 3
Put up an explanation of how different needs, like those of workers, money, and patients, might affect making rules. Then, talk about how these needs might affect the health problem you picked. What are the good and bad effects, and how could rules help? Be clear and give examples.
By Day 6 of Week 3
Answer at least two of your classmates on two different days. Say more about how different needs might affect their problems, or give more ideas for making rules to help with the problems they talked about.
Response
Great post. It’s been proven that nurses with BSN degrees help hospitals and other healthcare places in many ways. For example, patients are 10% less likely to die overall, and they have a 5% better chance of surviving when something goes wrong (O’brien, Knowlton, & Whichello 2018). Hospitals also save money when they have more BSN nurses because fewer patients have to come back, and they get better ratings from patients, which can mean more money for the hospital (O’Brien, Knowlton, & Whichello). Even though we know these good things, most hospitals haven’t reached the goal of having 80% BSN nurses by 2020. There are a lot of reasons why nurses don’t go back to school, like not having enough money, having to take care of family, or not seeing how it helps their careers. Hospital bosses need to think about these things, like paying for classes or helping nurses find better jobs after they finish (Sarver, Seabold & Kline 2020). At my job, they help pay for classes, but they don’t offer better jobs for BSN nurses or more money. Do you think more nurses would go back to school if hospitals were clearer about how it helps?
References:
O’Brien, D., Knowlton, M., & Whichello, R. (2018). Attention Health Care Leaders: Literature Review Deems Baccalaureate Nurses Improve Patient Outcomes. Nursing Education Perspectives, 4, 2. https://doi-org.ezp.waldenulibrary.org/10.1097/01.NEP.0000000000000303
Wendy L., S., Kelly, S., & Melissa, K. (2020). Building a Foundation of Evidence to Support Nurses Returning to School: The Role of Empowerment. Nursing Education Perspectives, 41(5), 285–290. https://doi-org.ezp.waldenulibrary.org/10.1097/01.NEP.0000000000000704
Discussion: Organizational Policies and Practices to Support Healthcare Issues
Healthcare organizations have moved away from prioritizing patient outcomes to a focus on efficiency and decreasing costs (Kelly & Porr, 2018). This shift in principle can be hard on the nursing staff because it can cut staffing and resources needed to provide proper patient care. Even though there is clear evidence showing that bachelor-prepared nurses are linked with better patient outcomes and decreased mortality, hospitals do not prioritize hiring nurses with a Bachelor of Science in Nursing (BSN) degree. An Institute of Medicine report (IOM) questioned the proper preparation of nurses. It encouraged education programs to make sure students were taught the importance of patient-centered care, evidence-based practice, quality improvement, and information technology (Giddens et al., 2015). These areas are addressed in BSN programs, not in an Associate Degree in Nursing (ADN) program.
One reason that healthcare organizations are not embracing the push for BSN-prepared nurses is the current shortage of Registered Nurses (RNs) that is expected to only increase due to the Baby Boomers aging (American Association of Colleges of Nursing [AACN], 2020). If healthcare organizations required a BSN degree as a hiring requirement, there would be no way they could staff their facilities. Spetz (2018) reports that the IOM recommendation for nurses to improve care and patient outcomes is to hold a BSN degree or higher. Healthcare policy is written for efficiency, and trying to hire only BSN-prepared nurses is not efficient due to the low percentage of RNs holding their BSN (Angel, 2020). The needs of staffing seem to outweigh the evidence that nurses that hold BSN degrees have better patient outcomes.
Healthcare organizations could change their policies to encourage hiring a higher percentage of BSN-prepared nurses, which would improve patient outcomes, which would ultimately decrease costs. The policy could also be changed to encourage nurses that hold an ADN degree to go back to school for their BSN with tuition reimbursement and increased wages upon graduation. Over a five to ten-year span, an organization could dramatically increase the percentage of nursing staff with a BSN degree integrating these policies, with the outcome all healthcare providers want, superior patient outcomes.
References
American Association of Colleges of Nursing. (2020). Nursing shortage. Retrieved December 14, 2020, from https://www.aacnnursing.org/Portals/42/News/Factsheets/Nursing-Shortage-Factsheet.pdf
Angel, L. (2020). Best practices and lessons learned in academic progression in nursing: A scoping review. Journal of Professional Nursing, 1–7. https://doi.org/10.1016/j.profnurs.2020.08.017
Giddens, J., Keller, T., & Liesveld, J. (2015). Answering the call for a bachelors-prepared nursing workforce: An innovative model for academic progression. Journal of Professional Nursing, 31(6), 445–451. https://doi.org/10.1016/j.profnurs.2015.05.002
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1). https://doi.org/10.3912/OJIN.Vol23No01Man06
Spetz, J. (2018). Projections of progress toward the 80% bachelor of science in nursing recommendation and strategies to accelerate change. Nursing Outlook, 66(4), 394–400. https://doi.org/10.1016/j.outlook.2018.04.012
Discussion: Organizational Policies and Practices to Support Healthcare Issues
Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.
For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?
In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.
To Prepare:
- Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
- Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.
By Day 3 of Week 3
Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.
By Day 6 of Week 3
Respond to at least two of your colleagues on two different days by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.
response
great discussion post. It is proven that bachelorette nurses (BSN) bring economic and professional benefits to hospitals and other health care institutions. Among the many benefits of BSN nurses is a 10% decrease in overall mortality rates, and patients have a 5% greater risk to survive near misses or high-risk complications (O’brien, Knowlton, & Whichello 2018). There are also financial benefits for hospitals to staff with BSN nurses such as decreased readmission rates and higher patient satisfaction ratings which directly correspond with compensation (O’Brien, Knowlton, & Whichello).
Even though there are clearly proven benefits of staffing with BSN nurses most hospitals have not obtained the 80% BSN ratio by the year 2020. There are many barriers to nurses returning to school the ones that I debated myself were financial affordability, family obligations, and career advancement. hospital leaders and administrators need to be cognizant of limitations such as but not limited to tuition reimbursement, age of nursing staff, and formulate a list of professional opportunities for post-bachelor graduation (Sarver, Seabold & Kline 2020). With my current employer, there are tuition reimbursement opportunities however, there is no list of potential professional opportunities that would be exclusive to BSN nurses and there is currently no financial benefit for having a BSN over an ADN degree. Do you feel hospitals and other health care institutions would have a greater success rate of nurses returning to school if they were more transparent?
References:
O’Brien, D., Knowlton, M., & Whichello, R. (2018). Attention Health Care Leaders: Literature Review Deems Baccalaureate Nurses Improve Patient Outcomes. Nursing Education Perspectives, 4, 2. https://doi-org.ezp.waldenulibrary.org/10.1097/01.NEP.0000000000000303
Wendy L., S., Kelly, S., & Melissa, K. (2020). Building a Foundation of Evidence to Support Nurses Returning to School: The Role of Empowerment. Nursing Education Perspectives, 41(5), 285–290. https://doi-org.ezp.waldenulibrary.org/10.1097/01.NEP.0000000000000704
