One the most important issues facing nursing these days is the changing healthcare insurance industry. I saw how these changes affected staff firsthand. I worked at Quincy Medical Center for three years until it closed in December of 2014. The Affordable Care Act led to cuts to Medicaid supplemental payments for the uninsured and has forced many hospitals to reduce staff or close like Quincy Medical Center. This is a concern for nurses because under current federal regulations there are no specific requirements for nurse to patient ratios. Multiple research studies demonstrate that lower nurse-patient ratios save both lives and money long term. For example, hospitals that routinely staff with 1-to-8 nurse-to-patient ratios experience five additional deaths per 1,000 patients than those staffing with 1-to-4 ratios, according to the Journal of the American Medical Association. Higher nurse to patient traditions lead to higher burnout …show more content…
When the hospitals and other health care facilities were adequately staffed with nurses, the facilities saved more money. When nurses are out for 7 to 8 days from work related injuries, temporary nurse from agencies would come in to fill their spot. This process cost the health care facilities even more money, because temporary nurse agencies are paid more than regular staff nurses. Also when nurses are required to work overtime to cover shifts, nurses reported feeling burned out from work related stress. Nurses working overtime, also reported feeling depressed and stressed from the demand placed on their jobs. As a result of this demand, nurses often would leave their place of employment after a year. This resulted in high overturn rates of nurses. Facilities would then spend more money on new hires and temporary nurses. When ratio of nurse to patient is low facilities spend more on covering for nurses out on leave and patient care
The purpose of this paper is to conduct an in depth exploration of the nursing care considerations of patients in a specific clinical area. Through the synthesis of prior knowledge, clinical experiences and skills, evidence based best practices, and care of patients a comprehensive care and teaching plan will be composed. Integration of critical thinking and clinical reasoning skills, combined with evidence-based research will provide confirmation of nursing process comprehension. The inclusion of reviewed literature will further support knowledge and understanding.
be hung. First off for electrolytes we check results to ensure what the numbers were, everything
Question 2: I provide almost all of the care for assigned patients throughout the shift but may not have the same patients from their admission to discharge
Inconsistent nurse-patient ratios are a concern in hospitals across the nation because they limit nurse’s ability to provide safe patient care. Healthcare professionals such as nurses and physicians agree that current nurse staffing systems are inadequate and unreliable and not only affect patient health outcomes, but also create job dissatisfaction among medical staff (Avalere Health, 2015). A 2002 study led by RN and PhD Linda Aiken suggests that "forty percent of hospitals nurses have burnout levels that exceed the norms for healthcare workers" (Aiken, Clarke, Sloane, Sochalski & Silber, 2002). These data represents the constant struggle of nurses when trying to provide high quality care in a hospital setting.
In the health care industry, nurse to patient ratios is often a controversial issue related to the cost involved to maintain a safe staffing level. Registered nurses know and continue to reiterate the importance of safe staffing levels in health care facilities. However, reductions in nursing budgets, coupled with the expanding nursing shortage, have resulted in a reduction of available nursing staff. As a result, the nursing staff at most health care facilities are forced to work longer hours with more acutely ill patients. Consequently, patient care is compromised and this ultimately perpetuates the nursing shortage because of this negative work environment.
For over a decade researchers have been performing studies examining the effects patient-to-nurse ratios have on adverse outcomes, mortality rates, and failure-to-rescue rates of patients and on job dissatisfaction and burnout experiences of nurses. Aiken, Sloane, Sochalski, and Silber (2002) performed a study which showed that each additional patient per nurse increased patient mortality within 30 days of admission by 7% and increased failure-to-rescue by 7% as well. This same study also showed that each additional patient per nurse resulted in a 23% increase in nurse burnout and a 15% increase in job dissatisfaction. Additionally, Rafferty et al. (2007) performed a study in which the results showed that patients in hospitals with higher patient-to-nurse ratios had a 26% higher mortality rate and nurses were twice as likely to have job dissatisfaction and experience burnout. Blegen, Goode, Spetz, Vaughn, and Park (2011) performed a study where results showed that more staffing hours for nurses resulted in lower rates of congestive heart failure morality, infection, and prolonged hospital stays. The same study also showed that increased nursing care from registered nurses resulted in lower infection and failure to rescue rates and fewer cases of sepsis.
Nursing, as the largest health care profession in the United States, plays a tremendous role in health promotion and delivery of care. From the 2.7 million employed registered nurses to the current Deputy Surgeon General of the United States, nursing infiltrates all aspects of healthcare (Bureau of Statistics, 2015). Therefore, as a profession, nursing must understand the intricacies of the Patient Protection and Affordable Care Act (ACA) and within its framework develop strategies to “advance nursing, health, and healthcare through education, clinical practice and research,” (Young et al, 2017). This paper aims to review portions of the ACA as it pertains to nursing, and offer an example of nurse practitioner innovation in practice.
The study by Aiken et al in 2002 revealed that there was a higher chance of nurses experiencing job related burnout in hospitals with high Patient nurse ratios. Further, nurses in institutions which had the highest rates of patient to nurse ratios were twice likely to suffer from dissatisfaction from their jobs. These influenced the decisions of nurses to leave their current jobs and thus creating more staffing problems that would lead to more negative patient outcomes.
The debate to find the perfect balance of nurse to patient ratio continues between healthcare workers and legislators. According to an article in Modern Healthcare magazine, “Got enough nurses?” Nurse groups cite a Kentucky case to support push for staffing ratio laws,” nurses attending to a dozen or more patients at a time is “physically impossible” (Rice, 2015). Rice reports statements made by Gerard Brogan, lead nursing practice representative for the California Nurses Association, Pamela Cipriano, president of the American Nurses Association, American Organization of Nurse Executives, a subsidiary of the American Hospital Association, Jan Emerson-Shea, vice president of external affairs for the California Hospital Association, Peter Buerhaus, director of the Center for Interdisciplinary Health Workforce Studies at Vanderbilt University Medical Center in Nashville, Doctor Christine Cassel, CEO of the National Quality Forum, Bonnie Castillo, director of the Registered Nurse Response Network for National Nurses United union, Linda Aiken, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania, discussing research and other insights into the hardships of large nurse to patient ratios. As nurses continue to research and present data to contest the high patient to nurse ratios, hospitals push back with confronting data and research; both unable to reach an agreement.
The health care industry is experiencing a surge in the number of baby-boomers needing health care and increased demands on the physicians providing the care. This trend has made the role of Advanced practice providers more important (cite). It is imperative to understand the differences and similarities in the advanced practice provider roles as it pertains to healthcare. This paper will identify specialty nursing roles including advanced practice registered nurses (APRN). It will further compare and contrast the advanced practice nurse (APN) and physician assistant (PA) roles in practice.
Reflecting on the time spent working in the Neuroscience Department at Sinai Hospital, I am grateful that I could be a part of this program. I am proud to say that I have evolved from the student nurse that applied for this position three months back. Working on the unit has given me the confidence needed to propel me into the next phase of the nursing program. As I prepare to go back to school, I will utilize the skills that I have learned to provide quality and safety to my patients.
Heather, I agree that education for the family and advocacy for the patient is a key to our nursing practice of the aging population. As the nurse, we need to have the skills and knowledge about key concepts of gerontology and gerontological nursing to teach patients and their families effectively (Tabloski, 2014). Applying the nursing process by using nursing care plans allows the nurse to assess, diagnose, identify expected outcomes, implement interventions, and evaluate outcomes. This framework helps us to follow through with education and advocacy for our patients. Supporting patients and their families will only strengthen the relationship with the nurse establishing trust, which is important for positive
The nursing profession has been around for a very long time. Through many changes and reforms, it has drastically evolved into the nursing profession we have today. Nurses have an important role within the healthcare industry in the treatment and medical care of the sick. These trusted healthcare professionals continue to make up the largest majority of the healthcare field, as well as the fastest growing occupation. Nursing is a job that allows people to not only care for the sick but also to experience, learn and further their interest in the human body. This course has definitely provided me an insight to the roots of the profession I would like to pursue. I think it is important to know the history of nursing to understand fully on the problems that are affecting the profession. I believe that we cannot effectively address important issues without a foundation of historical knowledge. In other words, by examining the nursing history, I will be able to appreciate my important role as a nurse in the healthcare system. The topics I will be including in my reflection are the works of Florence Nightingale, the affects of World War II, the challenges of Filipinos aspiring to be nurses, and excerpts in Chapter 10 of “A History of American Nursing.”
Now that we have made it half way through CPE, I have switched from the medical floor, down to the maternity floor. The pace of this floor has been very much slower than on the medical floor during my three shifts. The lack of due dates has left the nurses with a little to do. Although, this has been slightly frustrating due to only having a few shifts to get the feel of the floor. I have had the opportunity to work along side the nurses with mothers who are coming in with concerns such as pelvic pain or bleeding. I have taken this slow period to ask many questions about all the care that is provided on this floor. In addition, I have used the many resources in the nursing station to take notes on newborn assessments and postpartum assessment.
Home health care nursing is a growing industry, with a large number of patients and their families opting for home-based health care. Today there are specific academic programs to train nurses in home care. There are also a number of agencies that place home health care nurses in the appropriate environment with ailing individuals and their families. These agencies match criteria such as the nurse's experience and qualifications, the patient's care requirements, budget and the location of the patient and the nurse.