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Mandy Johnson  (She/Her)

Jun 10 10:56pm| Last reply Jun 13 3:18am

Reply from Mandy Johnson

Expanding on my last discussion, one national healthcare issue is the limited access to healthcare within rural areas. Patients living in rural areas face higher rates of poverty, have an increased risk of chronic disease, and often have a poorer health status than those living in more urban areas (Centers for Disease Control and Prevention (CDC), 2024). These patients face numerous barriers, including provider shortages, limited or no specialists in the area, transportation issues, and financial limitations.  Furthermore, patients residing in rural areas are more likely to be uninsured, underinsured, and have a hardship in paying out-of-pocket costs for medical treatment. Therefore, these patients are more likely to either postpone medical treatment, enhancing disease progression, or use the emergency room for non-emergent conditions. No matter the circumstance, we must practice “with compassion and respect for inherent dignity, worth, and unique attributes of every person (American Nurses Association, 2015), and we, as healthcare providers, must provide the most comprehensive care to each individual.

When focusing on the latter example, patients using the emergency room for non-emergent conditions creates a domino effect of dilemmas. This crowds our emergency rooms, pulls care away from more critical patients, increases the patient-to-provider and patient-to-nurse ratios, and increases the risk of nursing burnout. During high-volume times, it will remain crucial to maintain ethical awareness, recognizing any negative impact or risk when nursing actions could potentially fail to align with nursing goals (Kelly & Porr, 2018).

Limited access to healthcare, nursing shortages, and financial limitations for patients and facilities are competing needs within our healthcare system. Policy can balance these needs. For instance, an enhanced telehealth policy for rural residents could increase healthcare access for those in need. This could reduce the number of emergency room visits, lower the patient-to-nurse ratio and workload, and reduce the risk of nursing burnout. This would also be more cost-efficient for the patient and facility. Deerain (2022) emphasizes that telehealth will definitely play a supporting role in future access to care. However, lawmakers will need to thoroughly evaluate the competing needs of healthcare within rural areas before initiating change.

References

American Nurses Association. (2015).  Code of ethics for nurses with interpretive statementsLinks to an external site.Links to an external site.. Silver Spring, MD: Author. Retrieved from:  https://www.nursingworld.org/coe-view-onlyLinks to an external site.

Centers for Disease Control and Prevention. 2024. About Rural Health.  https://www.cdc.gov/rural-health/php/about/index.htmlLinks to an external site.

Deerain, M. (2022). National Rural Health Journal - Where to with telehealth?  The Australian Journal of Rural Health,  30(5), 702–704.  https://doi.org/10.1111/ajr.12927Links to an external site.

Kelly, P., & Porr, C. (2018).  Ethical nursing care versus cost containment: Considerations to enhance RN practiceLinks to an external site.Links to an external site..  OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from:  http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.htmlLinks to an external site.

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Courtnie Oliver

Jun 10 10:42pm| Last reply Jun 14 9:36am

Reply from Courtnie Oliver

Mental health among healthcare workers continues to be a significant national healthcare issue that affects employee well-being, patient outcomes, and organizational performance. Developing policies to address this issue can be challenging because healthcare leaders must balance competing needs related to the workforce, available resources, and patient care demands. While organizations have an ethical responsibility to support employee well-being, they must also maintain adequate staffing levels, control costs, and ensure safe, high-quality patient care.

One competing need involves workforce well-being versus staffing demands. As a nurse who spent most of my career in the ICU before transitioning to an ICU step-down unit, I have experienced the mental and emotional strain associated with caring for high-acuity patients. Many nurses benefit from mental health resources, wellness initiatives, and adequate time off to recover from workplace stress. However, staffing shortages often make it difficult for organizations to provide additional time away from work without increasing the burden on remaining staff. As a result, leaders must balance employee wellness with operational needs.

Another competing need involves financial resources. Implementing employee assistance programs, resilience training, counseling services, and wellness initiatives requires organizational funding. Although these programs may improve retention and reduce burnout, leaders may struggle to justify the upfront costs when faced with competing budget priorities. However, failing to address healthcare worker mental health can contribute to turnover, absenteeism, and recruitment expenses that may ultimately cost organizations more in the long term (Kelly & Porr, 2018).

Patient care needs also compete with workforce well-being initiatives. Patients deserve safe, effective, and compassionate care, yet burnout can negatively affect nurses’ ability to provide optimal care. Research has shown that emotional exhaustion is associated with decreased job satisfaction and increased risk of errors (Greco et al., 2022). Therefore, policies that support employee mental health may also improve patient outcomes. For example, organizations may implement policies that encourage the use of mental health resources, provide debriefing sessions after traumatic events, and promote safe staffing practices.

The American Nurses Association (2015) Code of Ethics emphasizes that healthcare organizations have a responsibility to create ethical work environments that support the health and well-being of nurses. Effective policies should balance employee needs with organizational and patient care priorities. One example would be implementing structured peer-support programs and mental health services while also utilizing staffing strategies that minimize excessive workloads. Such policies can help reduce burnout while maintaining safe patient care.

Addressing mental health among healthcare workers requires leaders to recognize that workforce well-being, resource allocation, and patient outcomes are interconnected. By developing policies that support nurses while maintaining organizational effectiveness, healthcare leaders can promote both employee wellness and quality patient care.

References

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Author.

Greco, E., Graziano, E. A., Stella, G. P., Mastrodascio, M., & Cedrone, F. (2022). The impact of leadership on perceived work-related stress in healthcare facilities organisations.  Journal of Organizational Change Management, 35(4–5), 734–748.

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN:  The Online Journal of Issues in Nursing, 23(1).

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