Peer answers: Review of Current Healthcare Issues

 Respond to  two of your colleagues who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor. 

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Peer 1

Melissa Jackson

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National Healthcare Issue

 

           The National healthcare issues I chose is the Primary Care Provider shortage. According to the American Association of Nurse Practitioners (AANP) (2019) there are over 270,000 Nurse Practitioners licensed to practice in the United States. This is a big leap up from 248,000 in 2018, and 120,000 in 2007. The AANP states “current provider shortages, especially in primary care, are a growing concern, yet the growth of the NP role is addressing that concern head-on.” NPs and PAs can help lessen the physician/PCP shortage and provide an influx of patients with access to quality care. In order for this to happen there has to be a care delivery model that works for both the patient and the provider. Norful et al. (2018) stated “successful co-management can alleviate individual workload, prevent burnout, improve patient care quality, and lead to increased patient access to care.” Improved patient outcomes are the desired end result for all healthcare professionals. So, finding the happy balance among different levels of providers is a must to reach those goals.

Impact on the Work Setting

The current provider shortage is having a major impact in the work setting. Patents are having difficulty finding providers, waiting longer to be seen, utilizing emergency services unnecessarily, paying high costs for services and, (I fear) overall losing faith in the healthcare system.  Since the ACA was put into effect and more people had access to healthcare, there has been a strain on the system. There just aren’t enough physicians to go around. The healthcare system is being overloaded. Utilizing NP’s is one obvious solution to the issue. A downside is that some states severely limit the scope of NP’s and don’t utilize them to their full potential and education Only 50% of states allow for NPs to have Full Proactive Authority. During the pandemic some of these restrictions were lifted and it allowed for more access to care. I believe this has shown how much of an impact the Advanced Practice Nurse can have on the issues we are currently facing.  

Health System Response

            I currently reside in Georgia, and will be moving to Alabama in the spring.  Neither of these states grants NP’s Full Practice Authority (FPA). It is my hope that these states soon adopt FPA to allow NPs to provide a greater reach of healthcare, especially in the more rural and underserved parts of GA and AL. Allowing for full FPA will “improve access to care, streamline care and make it more efficient, decrease cost, and protect patient choice” (Issues at a Glance: Full Practice Authority, 2022). With a healthcare system that is currently overloaded, it is in the best interest of the patient population to improve access to care.

References

American Association of Nurse Practitioners. (2019, March 29). Nurse Practitioner Role Grows to More Than 270,000. Retrieved August 29, 2022, from https://www.aanp.org/news-feed/nurse-practitioner-role-continues-to-grow-to-meet-primary-care-provider-shortages-and-patient-demands

Issues at a Glance: Full Practice Authority. (2022, April). American Association of Nurse Practitioners. Retrieved August 29, 2022, from https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-bri

Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse Practitioner–Physician Comanagement: A Theoretical Model to Alleviate Primary Care Strain. The Annals of Family Medicine, 16(3), 250–256. https://doi.org/10.1370/afm.2230

Peer #2

Christina Bradford 

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National Healthcare Issues: Nursing Shortages

Nursing makes up one of the largest areas of healthcare. The United States has experienced nursing shortages for years. According to the Bureau of Labor Statistics, “registered nurses are listed among the top occupations as job growth; however, it projects there will be 175,000 job openings for registered nurses each year through 2029” (American Association of Colleges of Nursing, 2022). Over the years, the nursing shortage has become a national healthcare issue, above many other problems. Many factors evolve around the current nursing shortages in healthcare. “The nursing profession continues to face shortages due to a lack of potential educators, high turnover, and inequitable workforce distribution that stems from an aging population, nurse burnout, and population growth in the United States” (Haddad et al., 2022).

I have worked in the emergency department for 20 years, and the nursing shortages have increased tremendously. “Organizations face increased pressures to improve outcomes, keeping employees from being burned out and disengaged becomes an increasing concern” (Jacobs et al., 2018). Organizations focus on patient satisfaction and meeting hospital productivity numbers instead of nursing job satisfaction and less employee turnover. “The quadruple aim includes principles of population health, management of healthcare costs, and enhancement of the patient care experience, including quality and satisfaction, and a proposed fourth aim to include strategies to improve work life with a focus on the provider experience” (Marshall & Broome, 2021, p. 69). For an organization to be successful, leaders must identify and prioritize healthcare delivery, all while improving the work life of the healthcare workers.

Over the years, I have seen first-hand the problems with limited nursing staff in the emergency department. Understaffed days have led to staff taking more than the 1:4 ratio and, at times, a high acuity assignment involving multiple intubated patients. During the peak of Covid, this became an everyday responsibility of the emergency room nursing staff. This expectation became not only overwhelming and increased nursing burnout but became a huge safety concern on many levels. During this time, our leadership created a staff-led team for our department that would meet monthly. This monthly meeting with staff was very beneficial for staff to voice concerns and come up with solutions to the staffing matrix while still providing patient care. The leadership team and staff created a matrix for adequate daily staffing based on current trends in the department. The department can put in a request before the shift for how many additional nurses are needed to care for the patients that are held in the department, and these nurses are sent to take on the admissions. This has helped tremendously so that the emergency department nurses can care for ER patients instead of admitted patients. This incentive also gave the nurses a feeling that the leadership team listened to the department’s request. “A strategic leader continually thinks of the organization with a perspective from higher levels, taking a large perspective of analysis, and looking into the future and must think conceptually and creatively” (Marshall & Broome, 2021, p. 56). This type of thinking helps the department move forward for the better.

 

 

 
 
 
 
 

References

American Association of Colleges of Nursing. (2022). Nursing Shortage. 

www.aacnnursing.org

Haddad, L., Annamaraju, P., & Toney-Butler, T. (2022). Nursing Shortage. StatPearls Publishing. 

www.ncbi.nlm.nih.gov

Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the triple aim to the quadruple aim. Nursing Administration Quarterly, 43(3), 231–245.

Marshall, E., & Broome, M. E. (2021). Transformational leadership in nursing (3rd ed.). Springer Publishing Company. 

https://doi.org/10.1891/9780826193995

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Christina Bradford 

RE: Discussion – Week 1

COLLAPSE

Top of Form

National Healthcare Issues: Nursing Shortages

Nursing makes up one of the largest areas of healthcare. The United States has experienced nursing shortages for years. According to the Bureau of Labor Statistics, “registered nurses are listed among the top occupations as job growth; however, it projects there will be 175,000 job openings for registered nurses each year through 2029” (American Association of Colleges of Nursing, 2022). Over the years, the nursing shortage has become a national healthcare issue, above many other problems. Many factors evolve around the current nursing shortages in healthcare. “The nursing profession continues to face shortages due to a lack of potential educators, high turnover, and inequitable workforce distribution that stems from an aging population, nurse burnout, and population growth in the United States” (Haddad et al., 2022).

I have worked in the emergency department for 20 years, and the nursing shortages have increased tremendously. “Organizations face increased pressures to improve outcomes, keeping employees from being burned out and disengaged becomes an increasing concern” (Jacobs et al., 2018). Organizations focus on patient satisfaction and meeting hospital productivity numbers instead of nursing job satisfaction and less employee turnover. “The quadruple aim includes principles of population health, management of healthcare costs, and enhancement of the patient care experience, including quality and satisfaction, and a proposed fourth aim to include strategies to improve work life with a focus on the provider experience” (Marshall & Broome, 2021, p. 69). For an organization to be successful, leaders must identify and prioritize healthcare delivery, all while improving the work life of the healthcare workers.

Over the years, I have seen first-hand the problems with limited nursing staff in the emergency department. Understaffed days have led to staff taking more than the 1:4 ratio and, at times, a high acuity assignment involving multiple intubated patients. During the peak of Covid, this became an everyday responsibility of the emergency room nursing staff. This expectation became not only overwhelming and increased nursing burnout but became a huge safety concern on many levels. During this time, our leadership created a staff-led team for our department that would meet monthly. This monthly meeting with staff was very beneficial for staff to voice concerns and come up with solutions to the staffing matrix while still providing patient care. The leadership team and staff created a matrix for adequate daily staffing based on current trends in the department. The department can put in a request before the shift for how many additional nurses are needed to care for the patients that are held in the department, and these nurses are sent to take on the admissions. This has helped tremendously so that the emergency department nurses can care for ER patients instead of admitted patients. This incentive also gave the nurses a feeling that the leadership team listened to the department’s request. “A strategic leader continually thinks of the organization with a perspective from higher levels, taking a large perspective of analysis, and looking into the future and must think conceptually and creatively” (Marshall & Broome, 2021, p. 56). This type of thinking helps the department move forward for the better.

 

 

 

 

 

 

 

References

American Association of Colleges of Nursing. (2022). Nursing Shortage. 
www.aacnnursing.org

Haddad, L., Annamaraju, P., & Toney-Butler, T. (2022). Nursing Shortage. StatPearls Publishing. 
www.ncbi.nlm.nih.gov

Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the triple aim to the quadruple aim. Nursing Administration Quarterly, 43(3), 231–245.

Marshall, E., & Broome, M. E. (2021). Transformational leadership in nursing (3rd ed.). Springer Publishing Company. 
https://doi.org/10.1891/9780826193995

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