DEVELOPING ORGANIZATIONAL POLICIES AND PRACTICES
Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.
Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.
Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.
RESOURCES:
· American Nurses Association. (2015). Code of ethics for nurses with interpretive statements Links to an external site. . Silver Spring, MD: Author. Retrieved from
https://www.nursingworld.org/coe-view-only
Note: Review all, with special attention to “Provision 6” (pp. 23–26).
· Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice 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.html
· Milliken, A. (2018). Ethical awareness: What it is and why it matters Links to an external site. . OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved from
http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html
To Prepare:
Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.
The Assignment (1-2 pages):
Developing Organizational Policies and Practices
Add a section to the 2-3 page paper you submitted in Module 1. The new section should address the following in 1-2 pages:
Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.
Due to the nature of this assignment, your instructor may require more than 7 days to provide you with quality feedback.
Note:
The Week 3 Assignment (1-2 pages):
Developing Organizational Policies and Practices
Write a new section related to the paper you wrote in week 2. The new section should address the following in 1-2 pages:
1. Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
1. Describe a r elevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
1. Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
1. Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
1. Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.
### Developing Organizational Policies and Practices
#### Competing Needs Impacting Mandatory Overtime
In the previous module, the national healthcare issue/stressor of mandatory overtime was examined. Mandatory overtime often arises from the need to address staffing shortages and ensure continuous patient care. However, it can lead to several competing needs:
- **Workforce Well-being vs. Patient Care**:
– **Workforce Well-being**: Nurses working extended hours are at a higher risk of burnout, fatigue, and job dissatisfaction, negatively impacting their physical and mental health.
– **Patient Care**: While mandatory overtime ensures that patient care is not interrupted, it can compromise care quality if overworked nurses make errors or provide suboptimal care due to fatigue.
- **Cost Containment vs. Quality Care**:
– **Cost Containment**: Hospitals may rely on mandatory overtime to avoid hiring additional staff, thus saving on recruitment and training costs.
– **Quality Care**: Prolonged working hours can impair nurses’ decision-making abilities and increase the likelihood of medical errors, thereby compromising patient safety and care quality.
#### Relevant Policy: Mandatory Overtime Practice
In many healthcare organizations, including the one under review, mandatory overtime is a practice used to manage staffing shortages. This policy requires nurses to work beyond their scheduled hours to meet patient care demands.
#### Ethical Considerations
**Strengths**:
– **Immediate Staffing Solution**: Ensures that patient care is maintained without interruption during staff shortages.
– **Flexibility in Staffing**: Allows the organization to manage unexpected increases in patient volume without the delay of hiring additional staff.
**Challenges**:
– **Nurse Burnout and Fatigue**: Prolonged working hours can lead to nurse burnout, negatively impacting their health and job satisfaction (Kelly & Porr, 2018).
– **Compromised Patient Safety**: Fatigued nurses are more likely to make errors, which can jeopardize patient safety (Milliken, 2018).
#### Policy Recommendations
To balance the competing needs of resources, workers, and patients while addressing ethical shortcomings, the following policy changes are recommended:
- **Flexible Staffing Models**:
– **Example**: Implementing a float pool of nurses who can be called in to cover shifts during high demand periods. This reduces reliance on mandatory overtime.
– **Evidence**: Studies have shown that flexible staffing models can effectively reduce nurse burnout and improve patient care quality (Bae, 2012).
- **Increased Use of Part-Time or Per Diem Staff**:
– **Example**: Hiring more part-time or per diem nurses to fill staffing gaps can reduce the need for mandatory overtime.
– **Evidence**: Research indicates that utilizing part-time and per diem staff can provide flexibility in scheduling and improve workforce satisfaction (Dall’Ora et al., 2015).
- **Enhanced Support for Nurse Well-being**:
– **Example**: Providing wellness programs, mental health support, and adequate rest periods between shifts to help nurses manage stress and avoid burnout.
– **Evidence**: Programs focused on nurse well-being have been shown to improve job satisfaction and reduce turnover rates (Adams et al., 2019).
### Conclusion
Balancing the competing needs of resources, workers, and patients requires thoughtful policy changes that promote both ethical considerations and practical solutions. Implementing flexible staffing models, increasing part-time or per diem staff, and supporting nurse well-being are viable strategies to address the challenges associated with mandatory overtime. These changes not only improve nurse satisfaction and health but also enhance patient care quality and safety.
### References
Adams, J. M., Durkin, M., & Arora, M. (2019). Preventing burnout in nurses: A systematic review. *Journal of Nursing Management, 27*(1), 165-178. https://doi.org/10.1111/jonm.12651
Bae, S. H. (2012). Nursing overtime: Why, how much, and under what working conditions? *Nursing Economics, 30*(2), 60-71.
Dall’Ora, C., Griffiths, P., Ball, J., Simon, M., & Aiken, L. H. (2015). Association of 12-hour shifts and nurses’ job satisfaction, burnout and intention to leave: Findings from a cross-sectional study of 12 European countries. *BMJ Open, 5*(9), e008331. https://doi.org/10.1136/bmjopen-2015-008331
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), Manuscript 6. https://doi.org/10.3912/OJIN.Vol23No01Man06
Milliken, A. (2018). Ethical awareness: What it is and why it matters. *OJIN: Online Journal of Issues in Nursing, 23*(1), Manuscript 1. https://doi.org/10.3912/OJIN.Vol23No01Man01
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