Discussion: Review of Current Healthcare Issues

Instructions:

Respond to your colleague who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

**minimum of three (3) scholarly references are required for each reply cited within the body of the reply & at the end**

Reply # 2

Stephanie Hedden 

RE: Week 1: Review of Current Healthcare Issues (Main Post)

COLLAPSE

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Identified Healthcare Issue: Turnover

            The Patient Protection and Affordable Care Act (ACA) introduced the nation to the concept of the “Triple Aim,” which addressed “population health, management of healthcare costs,” and concepts related to quality of care and patient satisfaction (Broome & Marshall, 2021, p. 69). Perhaps as an unintended consequence of that defined resolution, healthcare organizations nearly immediately recognized that the Triple Aim failed to acknowledge the resolution’s impact upon those responsible for addressing the aims, the healthcare workers themselves. The Quadruple Aim’s unique addition to the model seeks to emphasize “work life” including a “focus on the provider experience” (Broome & Marshall, 2021, p. 69). As a profession, the work life experience of nurses as healthcare providers is widely acknowledged to be highly stressful, especially in acute care environments which newly licensed nurses are expected to begin careers. Staff turnover, a nationwide healthcare concern, contributes to more stress on the nurses who remain within organizations experiencing high turnover.

Effect of Turnover upon Work Environment

            In acute care, nurses make up a substantial percentage of staff population, which means that high turnover can create perceptions of instability or inconsistency among both staff and patients. Also, as Ricketts and Fraher (2013) noted, the “team-based” environment of care, forcing nurses, dieticians, physicians, therapists, and others to collaborate, presents unique challenges when it comes to providing sufficient clinical training. For example, some newly licensed nurses may be overwhelmed or bewildered by the expectation that they work in interdisciplinary teams, if not prepared for this in the school of nursing. Lastly, turnover is closely related to staff “fatigue” and “burnout” according to Jacobs et al. (2018). “Stressors at work” and home contributed to health care providers including nurses leaving the acute care environment for workplaces perceived as less detrimental to well-being (Jacobs et al., 2018). Therefore, turnover can be a self-perpetuating problem, especially when associated with staff feelings of overwhelmed burnout.

Responses of Health System to Turnover

Broome and Marshall (2021) recognized both “recruitment and retention” as proactive contributors addressing the problem of nursing turnover (p. 69). Nurse “residency” programs meet these criteria because they exist in part to safeguard against newly licensed nurses departing soon after achieving initial competence. My hospital, as one facility within a three-facility organization, attempted to participate in our organization’s residency program for three cohorts over one calendar year. The residency program did not ultimately meet our facility’s needs because, as the program was started by the flagship facility, it was not flexible enough to account for conflicting policies between the satellite facilities. Therefore, we Clinical Educators eventually adapted the organization’s residency model and created a facility-specific program called “New Graduate Nurse Orientation.” Since retention does not merely concern new graduate nurses, but all facility nurses, another layer of staff support was needed. We implemented a dedicated space called the “Code Lavender” room, a private staff break area dedicated to wellness, stress reduction, and respite for nurses facing overwhelming pressure on shifts (Gregory, 2021). Consistent with the reports of Gregory (2021), our nurses’ feedback regarding the room’s massage chairs, oil diffuser, music, and lighting has been positive. While touring new nurses around the facility, I have had the opportunity to describe the Code Lavender room’s benefits. These new recruits cannot fully appreciate the unique “work life” stressors they are about to encounter in their new careers. As a nurse leader, I have approached the realities of nursing-related stressors honestly with new hires, and I am glad to demonstrate for them that the leadership values the promotion of their well-being (Gregory, 2021).

References

Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.

Gregory, D. (2021). Code Lavender: Designing Healthcare Spaces to Enhance Caregiver Wellness. HERD, 14(2), 13–15. https://doi-org.ezp.waldenulibrary.org/10.1177/1937586721993785

Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administraiton Quarterly, 42(3), 231-245.

Ricketts, T., & Fraher, E. (2013). Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected. Health Affairs, 32(11), 1874-1880.

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