Staffing Issues Case Study Reflection

Staffing issues interactive case study with journal entry
Click on this link to view the Staffing Issues Interactive Case Study.
After you view the case study, reflect upon what you have learned and how it is related to the learning materials. Compare the case study to your nursing practice and give a similar example from your experience in which you might have run into an ethical situation.
Submit your entry by Sunday, 11:59 p.m. (Pacific time). Your reflection content should be a minimum of 500 words, equal to five to six paragraphs, and is worth 50 points.
Over staffing issues

• Complete the staffing issues. Associate what you have studied in your weekly materials with what is presented in this case study.
  -After you complete the case study, use the journal tool in blackboard to reflect upon what you’ve learned from the case study and related learning material this week.
  Compare this case study to your nursing practice and give a similar example from your nursing experience in which you might have run into on staffing or a similar situation.
  Scenario:
  It is high census season for the hospital. The nurses are concerned because they have
  been working extra shifts for a month and they are tired. Click on the nurse schedule to
  view their current schedule
  Nurse schedule:
  Grace: Just look at this schedule. The Lead Nurse has placed mandatory overtime for this month
  again! I just can’t do it again. I’m so tired, and I made a medication error last month. I’m afraid
  that I may hurt a patient and could never forgive myself
  Nancy: Oh no! I have a wedding of already RSVP two on that Saturday. That’s three Saturdays in
  a row! And each weekend I work, I’m always the senior nurse, with all new grads or nurses with
  less than a years experience.
  Narrator: Uh oh it looks like the nurses are unhappy with their schedule
  Susie: What’s going on?
  Nancy: We were all scheduled an extra day each week.
  Susie: Oh great, an extra day each week! What are you frustrated about? I’ll take an extra one
  from one of you ladies, or I’ll let the Lead know I can work another day
  Nancy: Susie, are you sure you want to do that? I think that’s unsafe. We are already on notice
  from the infection control nurse about the increase of central line infections on the unit. And
  you would just complaining earlier about having to work short most of the time.
  Grace: I can’t work her mandatory extra shifts. Besides is it legal for her to do that? Isn’t it
  against the law to schedule overtime? I’m going to have to see our union representative. And
  let’s not forget about mandatory staffing ratios.
  Susie: Ladies stop whining. I’m saving up for a car, so what if I’m a little tired. I get the job done.
  They just want a warm body here and I provide that
  Nancy: I just read this article earlier, and it points out that nurse understaffing and nurse
  fatigue other two prominent issues that negatively impact the quality of care delivered to
  patients
  According to the article in JAMA Pediatrics —a national study found that very few neonatal
  intensive care units provide sufficient numbers of nurses to meet national guidelines and that
  units caring for the most vulnerable babies are also the most understaffed, putting the health
  of critically ill newborns at risk.
  We need more nurses.
  ARTICLE: (to be attached)
  Grace: You know I don’t even know the staffing ration requirements for this unit. Yesterday I
  cared for five babies, one who was really sick and required transferring to County General
  Nancy: Grace, the ratio was 1:4 on this unit for lower risk babies and 1:1 in the NICU (neonatal
  ICU).
  Susie: You know, there’s a nursing shortage at the bedside and with the implementation of the
  new computer charting and the implementation of the Affordable Care Act, health care costs
  are soaring. Let’s check out the guidelines for mandatory staffing again and speak with the
  director. I know that nurse fatigue is a factor when mistakes are made, and we’re taking care of
  very sick babies. The hospital does not actually use acuity guidelines in real time.
  Nancy: There are reclassification tools that measure the requirement needed for each patient.
  Sometimes the stated mandatory ratio does not always meet the requirement for staffing or
  mean that we are unsafe. I think this might be something we could bring to management
  during the next staff meeting. You know, become part of the solution.
  Susie: We need to get together at the next union meeting and talk about this mandatory
  staffing issue. I can’t work five days a week anymore. I could really hurt my patients.
  Nancy: I do believe an employer can ask us to work as much overtime as needed to cover shifts.
  But we might want to check our union contract again and always put patient safety.
  first for more information click the link on the
  article:
  Nurse Staffing
  Our health care system faces immense challenges. Staff shortages brought about by
  cost-cutting decisions, an aging population, increased patient complexity and need, and
  an aging workforce places stress on working conditions for nurses and affects patient
  care and overall outcomes. An increasing body of evidence shows appropriate nurse
  staffing contributes to improved patient outcomes and greater satisfaction for both
  patients and staff. However, the need remains for appropriate staffing in all health care
  settings. For more than two decades, ANA has continued working to address unsafe
  nurse staffing levels to improve working conditions for nurses and achieve optimal
  patient outcomes.
  Safe nurse staffing is essential to both the nursing profession and to the overall health
  care system. Staffing affects the ability of all nurses to deliver safe, quality care in all
  practice settings. By eliminating unsafe nurse staffing practices and policies, we can
  provide better health care for all.
  The American Nurses Association is committed to providing the best in evidence-based
  policy, practice, products, advocacy and professional development to ensure safe
  staffing and transform health and health care delivery.
  Read on to find out more about how ANA is working to improve nurse staffing and how
  you.
  Narrator: Yes, understaffing does impact the quality of care and may lead to increased rates of infection. As registered professional nurses, we must ensure that we are all practicing safely and are not fatigued, because understaffing goes hand in hand with nurse fatigue. According to the Nursing Staffing Strategy, 69% of health care professionals surveyed said that fatigue caused them to feel concern over their ability to perform during work hours. Additionally, nearly 65% of participants reported they had almost made an error at work because of fatigue.
  The aging nurse population and nursing work shifts that are longer than eight hours can also have an impact on errors and fatigue. When discussing the aging nurse, according to Reese, the director of Kronos (K. Brimmer 2013) in “2008 the average age of nurses was 45.5. The average
  age is probably closer to 52 now and we’ve found that the aging workforce tires easily and
  working extra shifts doesn’t help. These highly skilled workers have to make critical decisions
  related to patient care and is doing it in a fatigued state, will only increase the risk for errors
  and injuries”, said Reese. We can only hope that we continue to discuss these sensitive issues
  including mandatory staffing

SAMPLE SOLUTION

Nursing shortage is a serious challenge facing the US healthcare system. Nursing shortage necessitates available nurses to work extended shifts of twelve hours or longer. This in turn affects the quality and safety of patient care offered by the nurses. From the case study, I have learned that the problem of nursing shortage is exacerbated by several factors including implementation of cost-cutting measures by hospitals, an aging nursing workforce, increased patient complexity and need, and an aging population. According to Haddad et al., (2020), when shifts are extended beyond the normal eight hours and combined with overtime, or shifts rotating between day and night, and consecutive shifts, there is a high probability of nurses becoming fatigued and burnt out and this may compromise patient care.
From the case study, the adverse impact of long working hours and shiftwork is evident. For instance, Grace admits to having committed a medication error the previous month due to fatigue resulting from mandatory overtime. Although healthcare organizations have a duty to provide patient care around the clock, this often comes at a heavy price when patient safety is compromised. One of the ways that healthcare organizations attempt to overcome the nursing shortage and provide around-the-clock….