ANALYSIS OF A PERTINENT HEALTHCARE ISSUE

First discussion

          The national healthcare issue/stressor I have chosen is healthcare staffing shortages and burnout. Healthcare staffing shortages can be directly related to nursing burnout.  (Shah, M. K., et.al 2021)  “Healthcare professionals are generally considered to be in one of the highest-risk groups for the experience of burnout, given the emotional strain and stressful work environment of providing care to sick or dying patients.” (R. G. Bangani, et.al 2021) “Especially healthcare workers like the nurses work in an intense stressful dynamic environment with utmost priority for patient-care which allows no margin of error.” Demanding work schedules, high acuity patients, and multiple responsibilities can contribute to stress which can cause mental fatigue and manifest in physical illness such as high blood pressure, diabetes, obesity along with anxiety and depression. All these factors make nurses and healthcare professionals miss work shifts and become unhappy with their jobs, resulting in burnout and staffing shortages.

          Nursing shortages affect my unit nearly every shift I work. Pulling nurses and nursing technicians from their normal work unit and shuffling staff is constant, even mid-shift after work has begun for the shift. All of this shuffling makes for unhappy staff. Although travel nurses are being employed the needs still need to be met. (Levine, D. 2021) “The nation will need an additional 1.2 million nurses by the next year to meet growing demand for their services and to replace those leaving.” The main goal of health care is patient satisfaction, which cannot be maintained with shortages in staff. The constant rotation of staff resulting from nurse burnout can and should be addressed. Happy nurses will result in retention and quality care.

          The social determinant most affected by healthcare staffing shortages and burnout is access to quality healthcare. If there isn’t enough healthcare staff there are fewer appointments available in outpatient settings and patients have longer waits in the ER for inpatient beds, which in turn causes longer waits to be seen in the ER due to ER beds being used for inpatients. Burnout and staffing shortages affect all aspects of care, if hospital staff are unhappy the quality of care is diminished. Longer wait times for call bells to be answered, late medication passes, and less personalized interactions with patients. (Levine, D. 2021) “The situation has deteriorated further since the start of the pandemic with some 60% to 75% of clinicians reporting symptoms of exhaustion, depression, sleep disorders, and PTSD, while nurses are equally if not more stressed.” All of these problems result in less satisfaction for the patient. The nursing shortage has become a national crisis.  

          In my healthcare organization travel nurses, pay incentives for working extra shifts, and higher-paid float nurses have been utilized to help combat the issues of staff shortages and burnout. This has addressed the problem but is not a fix to the problem. My organization as well as others need to address the cause of the shortages and burnout and not use quick fixes. Many hospitals I have worked in address the nursing shortage issue by hiring new nurse graduates, which is great but they need to remember it takes experienced nurses to train them. Retention of nurses is a problem that needs to be addressed.  Things such as improved work environments such as lower acuity assignments, and employing sufficient numbers of nurse technicians and sitters which are essential for safe patient care can relieve stress and burnout for healthcare professionals, especially nurses. The big issue that my organization and many others have not addressed is equality of pay. Yearly raises and cost of living raises need to be consistent. Healthcare professionals are constantly exposed to serious diseases and experience stress daily and should be compensated for the risk. If these issues are not addressed, it will be easier and less stressful to work in a factory, where you are not exposed to diseases such as TB, CDIFF, MRSA, and many others.

Reference

Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and Factors Associated With Nurse Burnout in the US.  https://doi.org/10.1001/jamanetworkopen.2020.36469Links to an external site.

Links to an external site. G. Bangani, V. Menon and E. Jovanov, (2021) "Personalized Stress Monitoring AI System For Healthcare Workers,  https://doi.org/10.1001/jamanetworkopen.2020.36469Links to an external site.

Levine, D. (2021) U.S. Faces Crisis of Burned-Out Health Care Workers. found at  https://www.usnews.com/news/health-news/articles/2021-11-15/us-faces-crisis-of-burned-out-health-care-workersLinks to an external site.

 Reply

2nd discussion

National Healthcare Issue

            Millions of people globally suffer from a substance use disorder (SUD). The increased use of prescription opioids for chronic pain and extremely potent opioids on the illegal drug market have both contributed to the rise in the abuse of these drugs. Opioid overdose is often an outcome of abuse and has become an international healthcare concern around the world. In 2019, 125,000 deaths occurred due to opioid abuse. One risk factor contributing to the increase in this health crisis is incarceration (World Health Organization: WHO, 2023).

Impact on the Work Setting

            Working in correctional medicine, substance abuse is a common problem for individuals entering the justice system. With 2.1 million individuals being held in jails and prisons, the United States has the highest rate of incarceration in the world. Of those incarcerated individuals, 85% are convicted of a drug charge and have an SUD. Inmates are often forced to go through withdrawal due to a lack of Medication-assisted treatment (MAT) programs in use in correctional facilities (Cates & Brown, 2023). This is inclusive of those who are receiving treatment in the community before incarceration. This lack of treatment contributes to the opioid overdose crisis upon release of these individuals into the community. Because of the abstinence from the drug while in prison, their tolerance to higher doses of the drug is lost. When they relapse and go back to using the same amount as pre-incarceration the respiratory system cannot tolerate it and overdose occurs (Joudrey et al., 2019).

Social Determinants

            Individuals with SUD often come from toxic and impoverished environments in communities with high crime rates. Lack of stability with housing and economic means exposes individuals to increased stressors daily (Amaro et al., 2021). Many turn to substance abuse to relieve the burdening impact of these situations in their lives leading to the development of a SUD. Individuals are then at a higher risk of becoming involved in the justice system, which itself increases the risk of Opioid overdose (Incarceration, n.d.). The lack of treatment that is the current norm within most correctional settings does not offer a positive impact on the local communities. 

Response to the Healthcare Issue

         MAT programs are more effective in increasing the percentage of individuals who continue treatment post-incarceration than those who are forced to withdraw (Cates & Brown, 2023). The prison system in which I work is starting a MAT program to offer treatment to incarcerated individuals. They will be treated with either methadone or suboxone depending on the provider’s recommendation. In addition to the medication, patients will receive education about addiction and substance abuse counseling. Any underlying mental health and medical issues that the patient is diagnosed with will also be treated with their consent. Not only is this program necessary to decrease the number of overdose deaths after release, but it also offers a better plan of care for their overall healthcare outcomes.

References

Amaro, H., Sánchez, M., Bautista, T. G., & Cox, R. (2021). Social vulnerabilities for substance use: Stressors, socially toxic environments, and discrimination and racism. Neuropharmacology, 188, 108518.  https://doi.org/10.1016/j.neuropharm.2021.108518 Links to an external site.

Cates, L., & Brown, A. (2023). Medications for opioid use disorder during incarceration and post-release outcomes. Health & Justice, 11(1).  https://doi.org/10.1186/s40352-023-00209-w Links to an external site.

Incarceration. (n.d.). Healthy People 2030. Retrieved November 26, 2023, from  https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/incarceration Links to an external site.

Joudrey, P. J., Khan, M. R., Wang, E. A., Scheidell, J. D., Edelman, E. J., McInnes, D. K., & Fox, A. D. (2019). A conceptual model for understanding post-release opioid-related overdose risk. Addiction Science & Clinical Practice, 14(1).  https://doi.org/10.1186/s13722-019-0145-5 Links to an external site.

World Health Organization: WHO. (2023, August 29). Opioid overdose.  https://www.who.int/news-room/fact-sheets/detail/opioid-overdose Links to an external site.