Organizational Policies and Practices to Support Healthcare Issues

            In my experience, my healthcare organization has placed their priority and focus on saving money.  Last week, I wrote about nursing shortage and how my unit is often short-staffed and overworked.  I questioned my manager as to why the administrators refuse to do anything about it since it has been going on for years.  I’ve also written a formal letter to my hospital administrator stating the unsafe assignments, burnout of staff members, not getting breaks, and being forced to take more admissions without the staff to support it placing patient safety at risk.  Eventually, I learned that “it was up to the financial department to approve more positions”.  My manager told me that our unit had to prove we needed more positions by the average number of daily patient census and level of acuity.  This response completely disregards the health and well-being of nurses, quality care, and patient safety. 

            Ideally, if my healthcare organization cannot provide the workforce and resources needed to accommodate the influx of patients then the policies should support nurses at the very least.  For example, the policy to divert patients from the Emergency Room if there are not enough nurses on staff.  Unfortunately, my healthcare organizations views diverting patients, as refusing patients and thereby losing business/money.  Furthermore, the inability to address the needs of competing workforce, resources, and increased patients should directly influence policies to reflect the working environment and prioritize patient safety. 

            “RNs are constantly challenged to provide quality care, while resources are chipped away, in addition to their energy, pride and ultimately their capacity to fulfill patient and family healthcare needs” (Kelly & Porr, 2018, para. 1).  The number one competing need with nursing shortage is the drive to reduce costs.  Positions are difficult to get approved due to the high costs of training a new nurse.  “According to the Journal of Nursing Administration, it can cost $82,000 to replace a nurse” (The University of New Mexico, 2016, para. 7).  Policy can address these needs by implementing daily mandatory on-call for nurses.  Policy can provide additional incentives to nurses working overtime.  Lastly, policy should reinforce appropriate ICU staffing ratios 1:2 with possible admitting assignments.  For instance, on days that PICU is appropriately staffed, one nurse is then floated to accommodate another unit, once again leaving the unit short-staffed.

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