Nurses Impact Policy Essay

The Need for Nurses to Engage in Political Involvement There has been a pandemic apathy towards political activism among the nursing fraternity, despite the fact that politics to a greater extent affects the way these medical practitioners carry out their duty of providing care. Nurses have not seen any reason for political involvement citing that no direct relationship exists between nursing and political activism (Boswell, Canon and Miller 5). They claim that nursing is about application and service, demonstration by involvement and more of ‘walking the walk’ rather than the political ‘talking the talk’ (Rains and Barton-Kriese 219). Political activism to them is a waste of the precious time that could be used to provide healthcare Nurses Impact Policy Essay

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Apart from the Affordable Care Act, there has been increased government and court involvement in the determination of how healthcare issues are run, like the recent denial of the nonprofit tax exemption status to some hospitals in Chicago (Bergen 2). These hospitals, which include the Northwestern Memorial Hospital and the Prentice Women’s Hospital, are known to provide important healthcare services to patients who cannot afford to pay the expensive costs in private hospitals (Bergen 2). These unfavorable healthcare policies among others are bound to be more frequent and the resultant problems may promote the emergence of other bigger ones unless immediate action is taken. The nurse today can be compared to a person who busies himself/herself with process of rescuing a situation to the extent that he/she finds no time to investigate the real cause of the problem. If a nurse could know the real cause of the problem, then he/she would be capable of eradicating it once and for all. This act of finding the real cause of the problem is what entails political activism and this is what should be running in the blood of every nurse. Political Activism in Nursing Politics in itself is a means to an end, in which case the end is the formation of a public policy. It is the process of trying to influence the decision makers in order to implement changes that will improve the lives of communities, populations and clients (Godfrey 84). Nurses Impact Policy Essay

United States is transforming its health care sector in order to give affordable and quality healthcare to its people. This system is envisioned to be accessible to every patient centered and evidence based care facility that will improve the health care. In order to realize this dream, the system requires drastic remodeling in various aspects (Domino, 2005). One of the major aspects that shall be considered is the nursing profession that represents the largest part of the system.

By looking into various aspects of the nursing profession, nursing organizations as well as the state bodies can develop measures that will see futures developments within this sector. Of importance are the major issues in nursing like evidence based practice, education and training, staffing, research and leadership. This vision aims at addressing these aspects in the hope of recommending the best approaches to the development of nurses. It is envisioned that not only will they impact todays’ nurse but provide a platform on which future policy makers and leaders can direct nursing. The Vision of Nursing Nurses Impact Policy Essay

Following the signing into law the healthcare reform, United States took on the responsibility of transforming its healthcare system. The vision of this nation is to have affordable, quality, safe, and more accessible healthcare. This represents the largest transformation in the healthcare sector since 1965 during the creation of the Medicare and Medicaid program. Such changes not only affect the patient but also the healthcare provider. According to Domino (2005) nurses are the primary sources of primary healthcare, transformations of the healthcare system cannot ignore this organ.

Furthermore improved healthcare system, accessibility and affordability, translate to an increase to an increase in the number of patients in the healthcare system. The realization is that already the nursing profession faces various challenges. These are seen in the provision of reformed healthcare and the meeting of the increased health needs. Nursing staffing is not only a present issue but that has been a center of discussion over the years especially in the last decade. As we try to grapple with the health care reforms, we cannot ignore the ongoing staffing in the nursing sector.Nurses Impact Policy Essay

Nursing has continually faced increased differences in demand and supply that the system has showed sign of insufficient number of nurses. According to Kany (2004) this is due to the problems that exist between the value and image associated with nursing. In addition to this, this deficiency has been associated to the limited role nurses have had in the identification of the priorities in the delivery of healthcare. Therefore as we make steps towards a future marked by improved healthcare, there is a need to address this issue.

It is important that we realize that efforts to increase the number of nurses are not emerging but an ongoing process (Cicatiello, 2000). Key holders within the healthcare system have realized the need for nurses to play an important role in the advancement of the future agenda of nurses. This advancement is seen as a means of changing policies that affect healthcare delivery, work environment and the diversity of the profession. Hence, as we embark on a new era of improved healthcare delivery, we should involve the participation of the nursing sector.

The major reason that was identified for the deteriorating number of nursing enrolment and the increase nursing shortage was image and value. Back in 2000 the American Nursing Association realized that the image of nurses and nursing was skewed (Kany, 2001). The association revealed that at that time there was lack of awareness and value for the nursing profession. Therefore this translated to reduced enrolment into nursing education and training programs. This then led to the creation of nursing organization that would steer the future of the nursing profession.Nurses Impact Policy Essay

Various changes ever since have been put into effect to improve the number of enrolments into the profession. With efforts under way in the matching of the demand and supply of nurses, there exist a realization that the community of nurses can only realize change through effective leadership and planning. Kany (2004) argues that the American Nursing Association created a plan that would see the future development of the nursing program. This plan incorporated various steps that were seen as vital towards the increase in the number of nursing staff.

Their plan realized that the first step was the creation of nursing leadership that creates comprehensive strategies that can direct the future of nursing (Cicatiello, 2000). These strategies will be realized through the assistance of nursing organizations and stakeholders within the healthcare system. Stakeholders in this care are the respective nursing educators, nursing bodies that are associated with the welfare of nurses. Therefore nurse’s role should move beyond patient care and recovery but to leadership and planning.

Hence the future of nurses will have a base that is characterized by collaborative efforts of their own actions in order to support healthcare administration in the implementation of healthcare plans. Hence the future will be one where the nurses will be actively involved in the planning, implementation and exeution of any policy and plans that are related to their job description. Another important role we envision in our nurses is the ability to increase the economic value of the nursing organ. Cicatiello (2000) implies that nurses should contribute more towards the improvement of the quality of the healthcare patients receive.

This care must be matched to the proper utilization and the saving of money set aside for healthcare. In order to realize this role, the nurse must be one who can economically utilize healthcare facilities that are assigned to them. This is seen as an important factor since they have direct access to the pharmaceutical products, medical tools and even energy sources that are utilized by healthcare facilities. Hence by being indirect control of these resources, they are obligated to use them wisely as they provide healthcare to patients. In addition to this vision, we can further advance the goal of the American Nursing Association.Nurses Impact Policy Essay

This organization had seen a need for nurses to integrate nursing delivery systems or models. This implies that any nursing model or delivery system that is used cab be integrated in order to improve the services of nurses. According to Kany (2004) the ANA saw this as one of the decisive factors towards the development of the nursing sector. On the other hand, nurses play an important role to the public relations of the healthcare sector. This is because by being the largest sector in the delivery sector of the healthcare department, they have the greatest influence over the image of this sector.

According to Kany (2004) the values the sector holds towards healthcare delivery, creates an image of nurses. Furthermore it also affects the quality of the delivery of the healthcare services. In order to improve the image, value and quality of the healthcare system, the nursing sector must promote this field. It is without a doubt that patients are known to respond well to treatment and the healthcare system depending of the care of their nurses. How well the new reforms in the healthcare sector will take effect will be greatly influenced by the nurses.

Hence, not only will they be responsible for public relations but this role will be furthered by how well the nurses uphold the nursing culture. They need to realize that not only is service delivery important, but they need to uphold a professional culture that will define the nursing profession. They can best create a nursing culture, by acquiring the necessary education, training, image, satisfaction and standards that will define this institution. By embracing the values of nurses they will have changed the image the society holds about them.Nurses Impact Policy Essay

They will also possess in them the power to establish them as a vital part of the healthcare system. Nurses should realize that they have the power to make and promote their profession. Only have they presented themselves as a force to recon with will they be able to make-to-make impact on their profession as contributors to policy making. Not only will they have an impact on policy and decision-making, but they will also attract the number of registered nurses. In the end the vision is a nurse who will be able to be able effective leader who upholds the values of their profession.

The development of this nurse will be realized through the partnership of all the stakeholders within the nursing sector. This vision is also supported by (Tornabeni & Miller, 2008), who describe the evolution of the nurse to a nursing leader. This nursing leader is able to connect academic and practice in order to design the role of the nurse. It is without a doubt that the reforms have the potential to create gaps within the system. These gaps will be realizes through the missing steps in the passing into law the implementation of the changes.

This is because apart form the changes that the law has brought, there exists changes within the healthcare insurance system that directly affects the system. According to the Tornabeni and Miller (2008) this is couples with the changes in the modalities of treatment and increased education of healthcare providers creates loop holes. Such loopholes in the system can only be effectively handles by professionals and effective leadership. The nurse as the primary healthcare giver has the power to provide a consistent environment to the patient.Nurses Impact Policy Essay

They are at the core of the healthcare system and therefore possess the power to effect the changes required smoothly. Towards this effort our vision is of a nurse leader who utilizes evidence based practice in the professional field. Current nursing theories require nurses to incorporate research, practice and nursing theories in their profession (Squires, Moralejo, & LeFort, 2007). We have established that the traditional roles like care giving, public relations, professional etiquette, education and training are vital to the future of nurses.

However, we cannot ignore current trends within the nursing profession, these are research and evidence based practice (Adamsen et al. , 2003). These approaches are used to create nursing theories that will improve the quality of nursing care. For a nurse to achieve evidence-based practice, they need to link the findings of their researched to their practices. This forms a benchmarked towards increased education and learning of nurses within the profession. To improve the nursing profession nurses are encouraged to actively participate in solid research.Nurses Impact Policy Essay

Such research covers nursing areas like, assessment, prognosis, treatment, prevention, causation, clinical prediction and even qualitative studies (Squire, Moralejo, LeFort, 2007). During research nurses also learn important aspects like team participation, data collection and the conception and leading of a project. The data obtained from these researches will provide them with most needed information on the healthcare giving. Nursing research will help develop the professional competence of the nurses in the field. This is because they will able to use the academic knowledge and research in the advancement of their skills.

The hope is that more nurses realize the power of nursing research in the development of skills and knowledge. The wealth of knowledge that can be created and realized from research and analysis will not only help the nurse but will also assist in healthcare reforms. Nurses are encouraged to utilize available, cause studies, opinions of experts and clinical trials in order to further their research. The research findings from these analyses if well evaluated and utilized, they will go a long way in evidenced based practice.

According to Squires, Moralejo and LeFort (2007), evidence based practice and researched are being taught in the current nursing education and training programs, it is only through application in the field that actualization can be realized. The health sector is endowed with a wealth of knowledge, from qualitative and qualitative researches. The nurse can utilize this background information to create a pool of knowledge that can be applied to their skills. This will be a viable means for them to improve their profession will creating the solid basis for the future.Nurses Impact Policy Essay

According to Houser (2007), evidence based research is best achieved through, the matching of the problem to a research method. This method is one that will best provide reliable data, factors, and outcomes on patient, intervention measures, and predictors. It is without a doubt that for evidence based research to be effective the nurse must also evaluate their personal experience and abilities. A self-evaluation can be most applicable if the nurse joins a research team that will provide feedback on their assessment. Since self-tests can be biased, only through colleagues can a nurse realize their competence.

Houser (2007) believes that such test provide the best results if the participants or audience are made aware of the outcome. Participants in this care being the administrators, other nurses, or team members, this is because the truth discovered in this research can go along way in assisting the entire healthcare system address areas for concern. They also assist in decision policy making and implementation. A well-informed healthcare nurse is able to assist the healthcare system meet its goals. Therefore not only does the nurse assist the patient in improved quality care but the administration too benefits from responsible nurses.Nurses Impact Policy Essay

The vision is that the healthcare nurse becomes an effective leader in their field. Such a leader will be able to meet the demands of an ever changing system but more so assist with the current reforms. This nurse wills also posses the dynamics required towards the steering of the nursing profession in the right direction. It is without a doubt that the nurse of the future is expected to decisive factor in the development and growth in the nursing profession. The dream of this nation is that the healthcare system will cater for the needs of the nation as well as provide quality healthcare.Nurses Impact Policy Essay

The nurse in this case holds the key towards the achievement of this dream. The vision is that the nurse of the future will evolve from not only providing care to the patient but will be actively involved in decision making. The nurse therefore should fully practice the education and training they acquired. Through this practice there will be able to improve their career, profession and ultimately healthcare services. Furthermore, by improving this profession, they will have to power to improve nursing education. Therefore nursing organizations and stakeholders need to create nurse leaders.

This will give them the power to participate fully in design and development of the healthcare sector. They will also be able to assist and contribute to decision and policy making that affects the nursing sector. Such support will be realized from the wealth of date they will posses from the evidence based practice and research. Hence, for the reforms to be effective it is envisioned that the nursing community will take these factors into practice. The establishment of long-term goals will be seen as an added advantage towards the realization of this dream.Nurses Impact Policy Essay

The nursing career is among the most important professions in the world. There have been changes in the health care profession, which has an impact on the workload of the nurses, patient safety and the quality of care accorded. It is for this purpose that the chosen study topic is “Nurses Perception of Patient Workload on Nursing Effectiveness.” Whenever there is staff burnout in the vocation, it develops a critical problem as it is a human service profession. It leads to debilitation of workers, becomes expensive to agencies, and it is detrimental to the clients. Understanding the perception that nurses have towards patient workload is essential in identifying other factors affecting their effectiveness such as job stress. Therefore, the topic focuses on the nurses and their perception of the current situation on workload. If they consider that it is heavy, it may be affecting their output, which may be detrimental to the patients.

JUSTIFICATION FOR TOPIC CHOICE
As earlier stated, nursing is one of the most stressful professions. Job stress entails a psychological syndrome that an individual has in response to chronic exposure to interpersonal and emotional stressors while on the job. The psychological markers of stress sometimes may occur without an individual’s awareness of the demands of the environment. They include increased cardiovascular activity and heightened psychological arousal (Warner, 2014). Often, the environment at the healthcare facilities lacks adequate support staff, which may further contribute to the job’s stressful nature. The profession is also facing shortage of nurses. Analysis indicates that there may be a shortage in the workforce of the nurses in the future. As the baby boomers age, there will be increased demand for nurses due to the augmented need for healthcare. The current supply of nurses is from the registered nurses and the licensed practical nurses. There are various issues contributing to the nursing shortage. First, there is a shortage in the nursing school faculty, which is restricting the enrollment into the nursing profession (AACN, 2014). In 2012, the U.S. nursing schools turned away almost 80,000 qualified applicants who were interested in pursuing baccalaureate and graduate programs in nursing. The main reasons were insufficient faculty, classroom space, clinical sites, budget constraints, and clinical preceptors (AACN, 2014).Nurses Impact Policy Essay

Second, there is a notable section of the nursing workforce that is nearing retirement. According to a 2013 survey, about fifty-five percent of registered nurses are aged 50 or older (AACN, 2013). In the next decade, more than one million nurses will retire. Third, there are changes in the demographic composition that is signaling the need for additional nurses. It is mainly due to the increasing aging population. The birthrate is reducing, which means that there will be fewer people to work as nurses as the current lot retires. Moreover, as the aged population increases, the demand for healthcare will increase. Fourth, studies have indicated that there is high-stress level in the profession due to insufficient staffing, which is affecting their satisfaction. As a result, many nurses are leaving the profession. It is also characteristic for nurses to change professions after a short period of service (AACN, 2014). The safety of patients and quality of the services that they receive is reliant on the satisfaction of the nurses. It is also reliant on the nurses’ ability to handle their workload efficiently.
When the number of nurses is not sufficient, the care and safety of patients may be compromised. At the same time, the nurses may be dissatisfied, overwhelmed and distressed. Increased nurse-patient ratio lead to frustration and job burnout, which is the key cause of turnover in the profession. When there is a shortage in the nurses’ workforces, it becomes necessary to develop strategies that will enable the rectification of the issue (AACN, 2014). It is also evident that the nurses’ shortage problem is not only an American problem, but also a global problem. Numerous countries are affected by the same problem, and finding the current situation is a step towards getting the solution. It is essential for the nurses operating in all institutional specialties, as well as, those in leadership and administrative positions to examine the factors contributing to the current shortage. In addition, there should be familiarization of the nurses to the situation and make a determination of what ought to be implemented in order to influence improvement strategies. Therefore, the choice of the topic will guide the study into identifying the situation in the nursing profession, and the perception that the nurses have towards their roles. Additionally, there will be an investigation of the patients’ situation due to the prevailing situation. In addition, the findings can be applied in the findings of a solution.Nurses Impact Policy Essay

IMPORTANCE OF THE PROJECT TO NURSING
Nursing course requires understanding the practical and theoretical issues relating to the profession. In addition, it is necessary to understand the actual environment. As the research indicates, a considerable number of nurses do not pursue the profession for more than two years after they start practicing (AACN, 2014). It means that they are usually unprepared for the actual work experience. Understanding how to become a nurse or the medical issues associated with it is important, but practicing is the ultimate goal. Therefore, loses its purpose to have a large number of qualified nurses who are not willing to practice. The project will assist in analyzing the situation from the nurses’ perspective. They will provide information that will assist students to understand the situation in the actual field and prepare for it. As the discipline entails different aspects of training, an additional reinforcement to the training can assist develop high-quality nurses who are prepared for the actual work is necessary. As a nurse, the main target is to become useful in the field. In addition, the discipline may not be highlighting different issues affecting the profession. For instance, there should be preparation for the students to work under pressure. The study will make recommendations to relevant authorities on the factors affecting the profession.Nurses Impact Policy Essay

The recommendations will include actions that need to be taken in the teaching. The current procedures used for teaching in health related fields are mainly student based. Most of the courses evaluate the teachers based on the evaluations made by students. The students have no field experience to understand whether whatever they learn is useful or important. The perspectives offered by the nurses will be useful in the development of curricula, which means that the students who go through it will be better prepared for their professional role. The recommendations will also provide the plight of the nurses, and through the nursing discipline, it can be possible to get relevant authorities responding to the problem. Therefore, the project is relevant to the nursing discipline as a whole.Nurses Impact Policy Essay
PROBLEM STATEMENT
PROBLEM OUTLINE
In the recent years, there has been an increase in the demand for healthcare and nursing services. It has also attracted increased demand. It has become important to understand the workload that health providers have, and its impact on their delivery of service. Consequently, the closer examination of the issues has led to the need to examine the characteristics of the caregivers, as well as, the care provided. Increased pressure on the nurses due to their workload translates to low output or lower quality of service. As the current population of people ages, the demand for healthcare services will increase. It means that it would be necessary to have more nurses attending to the patients. Additionally, the general population in America, which is a developed country, is increasing at a slow pace. Therefore, there will be fewer people to take the current positions as nurses. The pressure is increasing as time moves, and it has become necessary to gather information regarding the perception of the nurses. While studying, nurses are trained to work under pressure. However, it is uncertain whether they can handle the pressure they get due to increased workload.Nurses Impact Policy Essay

When working under pressure, human beings tend to produce low-quality results. When the nurses have to work extra hours, or attend to a larger number of patients, it means that there are getting immense pressure both physically and psychologically. Studying the human factors relating to nursing workload is vital, rather than considering the simple factors, such as, task performance, time needed for the accomplishment of roles, and skill competency. In addition, although other researchers have focused on the matter, it is essential to recognize the nurses’ perspective. If the workload increases, the nurses suffer from stress. The occupational stress will lead to decreased efficiency and increased hazardous within and without the hospitals. Among the different factors leading to absenteeism, job stress is ranked high. It also leads to absenteeism (Adib-Hajbagheri, Khamechian & Alavi, 2012). With the influence of other factors, having a large workload can affect the nurses negatively when at the place of work, besides, their private lives. Consequently, the services given to the patients are of lower quality. The problem relates to the identification of the perception that the nurses have towards patient workload, as well as, its effect on delivery of service. It is essential to understand these aspects in order to develop recommendations and suggestions that would promote the improvement of the situation.

As a result of the increased workload, there is a lack of sufficient time for a nurse to tackle various tasks. It has a direct impact on the patients. It can also impact negatively on the nurses’ decisions on the performance of various procedures. Nurse-patient communication is also affected by the time insufficiency. Increased workload has also led to decreased motivation for the nurses. Thus, the nurses’ turnover and absenteeism increase. There is also poor performance and reduced morale. It also leads to stress in the workplace, violation of rules and errors.Nurses Impact Policy Essay

BACKGROUND
Over the past two decades, there have been numerous changes in the health service delivery. Different parties have made changes in relation to new sets of regulations by the government (Scott, Matthews & Kirwan, 2014). Consequently, the approach through which the nursing care is provided has changed. Earlier studies have focused on the concern of patient workload focusing on different variables. Such variables include staffing patterns, perception of patients, pattern of communication between different professions, and demands from the environment (Scott, Matthews & Kirwan, 2014). Such demands include the availability of supplies, which contribute the outcomes of the patients and quality of services. However, other aspects, such as, intellectual capital, contribution of nursing knowledge, and psychological workload should also be considered. Although it has been identified that the measures of nursing workload does not assure efficiency, and they lack to capture the complexity of the nursing workload, it is necessary to conduct such studies. The work environment variables have received little focus from studies relating to nursing workload (Scott, Matthews & Kirwan, 2014). However, that has been focus on factors such as the relationships of between employees and colleagues, as well as, their managers. It has been identified that work relationships have higher impact on the satisfaction of the nurses than economic variables. The effects of the workload on nurses have been witnessed not only in USA, but also in other countries throughout the globe.Nurses Impact Policy Essay
OUR BENEFITS

The present trepidations regarding the effect of nurse staffing on the quality and safety of the patient services emanate from the merging of different factors. They include recurring shortages in the nurses’ workforce, measures to contain the costs in the 1990s, and increased concern by the public regarding the safety of the patients (AACN, 2014). Fewer patients per nurse increase the quality of care and safety of the patients. The presence of medical as a cause of deaths in the hospitals has also elicited pressure to understand whether staffing has an impact of the safety of the patients. It could be attributed to the nurses’ pressure or lack of concentration while offering services due to burnout. Nurses have also aired their perceptions regarding the re-engineering and redesign of their work. The concern of nurses relates to the increasing ratios of the patients to nurses, its impact on the welfare of the patients, and the substitution of unlicensed personnel.
POSSIBLE CAUSES OF THE PROBLEM
The working population is aging at a high rate than the general population. Consequently, when nurses retire, there are no replacements available. A significant part of the current nurses in the workforce are nearing the retirement age, whereas few nurses are being employed. There is also a decrease in the nursing school faculty, which restricts the enrollment of nurses. It is mainly due to classroom space, clinical preceptors, and clinical sites. As the general population increases, there is an increased demand for the nursing services. Consequently, the pressure increases on the current workforce. The increased pressure and stress in the workforce have led to job dissatisfaction, and most of the nurses leave the vocation. As a result, the remaining nurses have to attend to a higher number of patients.Nurses Impact Policy Essay

RESEARCH QUESTIONS
Is there an increased workload in the profession according to the nurses?
What is the impact of the current workload on the ability of nurses to offer services?
What is the effect of the workload on the patients?
LITERATURE REVIEW
IMPACT OF THE WORKLOAD
There are different aspects relating to the dissatisfaction of patients due to the high workload on the nurses. Aalto, Karhe, Koivisto, & Valimaki (2009) study the connection between the nurse’s workload and the dissatisfaction of the patients. They found that the workload of the nurses varies depending on the flow and condition of the patients. They found a connection between high workload and dissatisfaction of the patient. Blay, Duffield & Gallagher (2012) focus on the transfer of patients due to workload on the nurses. When the patients have short stays, there is increased work to be done by the nurses. Additionally, there is increased risk of health-care acquired infections and incidents of medication. Bogossian, Winters-Chang, & Tuckett (2014) focus on the perception of nurses in relation to its contribution to abrasion in the nursing vocation. They found out that various factors including workload affect the perception of the practicing nurses towards the profession. Duffield et al. (2010) conduct a study on the different factors relating to the workforce and workload of the nurses. It became evident that the models of care are varied according to the circumstances in each of the wards, as well as, the levels of staffing.Nurses Impact Policy Essay

Myny et al. (2011) conduct research and identify that there are different causes and effects of the impact level of workload pressure. They suggested that nursing workload has a multi-causal etiology, and the influencing factors can be integrated to for a workload measurement tool. A study conducted by Palese (2013) sought to conceptualize the impact of the daily intervention by nurses for the Italian patients. They found out that the nursing system has positive impacts on the safety of the patients, as well as, other multidisciplinary outcomes. The impact is in different levels including national and international. Donovan, Doody & Lyons (2013) focusing on stress as an important factor in the nursing profession. It has adverse impacts on both physical and emotional aspects of the nurses. Consequently, it reduces individuals’ ability to work as required. In the nursing profession, it has adversarial effects on the patients.

MEASUREMENT OF THE WORKLOAD
The assessment of the nursing workload requires the use of electronic sources of information. Baumberger & Hunstein (2009) focus on the use of data available in the electronic sources so as to assess the link between the nursing workload and the outcomes. They state that it increases the explanatory power of nursing data. Brito & Guirardello (2011) conducted a study relating to the workload on nurses relating to inpatients. They found out that the use of Nursing Activities Score (NAS) can assist in the evaluation of the workload of the nurses. Debergh et al. (2012) conduct a study on the measurement of workload in the intensive care unit. They found that the nursing activities score had been influenced by the characteristics of patients and shift type. Therefore, it is possible to measure the workload per shift. Fasoli & Haddock (2010) discuss the issues relating to systems of patient classification. They suggest that approaches used to predict staffing should be parsimonious and should minimize workload. They should also include the indicators used to measure the complexity of patients, resources available and organizational features. Hoi et al. (2010) suggested that in a rapidly changing nursing working environment, it is necessary to have frequent reviews of the workload measurement systems.Nurses Impact Policy Essay

Jenkins & Welton (2014) indicate the importance of the standard measurement of the nursing cost for each patient. It could be benchmarked in all the hospitals so as to pass the information to all nursing administrators regarding the care delivery decisions. Kirby & Hurst (2014) indicated the importance of using a complex audit tool during the measuring of the workload, staffing, and quality of services in nursing facilities. It is a measure enable comparison of the factors, and their impact. Kohr, Hickey & Curley (2012) conduct research on different aspects of the synergy model during the making of nurse-patient assignments. They concluded that the synergy model is a prospective conceptual framework for a nursing productivity system. It may capture the researchers’ capacity to quantify the allocated resources. Kwiecien, Wujtewicz & Medrzycka-Dabrowska (2012) discuss the importance of the measurement of the workload. As one of the most frequently quoted factor in customer dissatisfaction, it is vital to measure it and respond accordingly. Mueller et al. (2010) conduct a study on the functioning of the patients as a predictor of the workload of the nurses. They found out that the in patients who suffered from cardiovascular and cardiopulmonary conditions selected similar responses, while those with muscular skeletal conditions gave different response. Therefore, they concluded that selected categories of scores could be used to measure workload in relation to different rehabilitative needs of patients.Nurses Impact Policy Essay

Rossetti, Gaidzinski & Bracco (2014), conduct a study to identify the different indicators of the needed nursing workload in the emergency department for pediatric patients. They found a nurse – patient ratio of 1:2.6. They concluded that the application of a standard classification instrument was satisfactory. Sawatzky-Dickson & Bodnaryk (2009) studied the dependability and legitimacy of the Winnipeg Assessment of Neonatal Nursing Needs Tool. They concluded that it provided a reliable estimation regarding the number of nurses needed for a certain collection of patients so as to provide quality care. They recommended that nurse managers should incorporate it to determine the extra drivers that ought to be considered for the nurses in regard to time.

SOLUTIONS TO THE WORKLOAD PROBLEM
Brann & Gustavson (2013) conduct a study on the issues relating to the problem of workload in the nursing profession. They suggest that controlling the workload will depend on maintenance of fiscal responsibility. It also requires the analysis of the work environment to ensure that nurses receive adequate support from other staff and they have a good relationship. Ellis (2013) conducted a study relating to the policies relating to the workload in the nursing faculty. The results indicated that about 12 credit hours are given to the concept of the workload per semester. They suggested that an increase on the time and components should be considered. Garcia (2013), suggest some features that should be included in the acuity system. The features include reliability and objectivity, validity, patient-centered, inclusive, efficiency, alignment, predictive, informative, actionable, and outcome driven. Keleher et al. (2009) focus on the importance of focusing on issues affecting the nurses. They state that nurses are effective in care giving in different roles. Therefore, their condition ought to be considered and improved.Nurses Impact Policy Essay

Sundaramoorthi et al. (2010) suggest the use of two policies to make the nurse – patient assignments during the admission of new patients. They are the heuristic (HEU) policy and the partially-optimized (OPT) policy. The HEU policy assigns a new patient to a nurse who has performed least direct care among available nurses. The OPT policy seeks to lessen the variation among nurses for an entire shift through the estimation of assigned direct care. Welton (2014) suggest issues relating to the importance of the development of an advanced nursing care delivery system. He suggests the application of information acquired in the management of businesses. Therefore, hospitals should use electronic approaches in scheduling, staffing and setting of assignments. It will assist in the minimization of the heavy workloads and pressure on nurses; hence, improving their output. Measures that will lead to a minimization in the number of patients that each nurse should serve ought to be applied. In a study conducted by Magalhaes, Dall’Agnol & Marck (2013), they found a link between the safety of patients and the workload on nurses. Fewer patients per nurse ought to be the target as it improves restorative thinking. It also allows communication and personal relationships between the nurses and the patients.Nurses Impact Policy Essay

LITERATURE CONCLUSION
The literature has provided essential information relating to previous studies on the research topic. The topic relates to the identification of the perspective of nurses on pressure emanating from the heavy workload, and its impact on patients. The literature review has provided possible impacts of the problem, measurement procedures and possible solutions. All the information is essential in the conduction of the research. It sets the foundation of what to be expected during the study. The measurements suggested by different authors will be essential in the collection of information for the project. In addition, the literature will assist in the analysis of the findings. It will act as a basis for comparison between the current issues and what is available in literature.

The United States Department of Labor identifies the current trends of employment that affect the nursing world. “Registered Nurses (RN) at this time represent the largest occupation in health care, with 2.5 million jobs” (Vallano, 2008, p.169). Vallano (2008) proceeds to summarize the employment trends in nursing by giving percentages of the present nursing rate in the hospital setting and the employment rate for the future of nursing. The percentage of nurses in the hospital setting is standing at 59 percent and the employment rate for nursing is expected to reach 23 percent from the year 2006 to the future year of 2016, this rate is said to be faster than the average for all occupations (Vallano, 2008, p.169).
With the positive statistics mentioned above, how is it that a steady rise of employment for nurses can last for decades and then suddenly decline for years? Researchers have discovered some of the factors that are found to be the cause for the trends of employment in nursing. These include: nursing shortages, wages, and location of employment, gender, marital status and differences between novice and expert nurses. These factors have been researched and explained on how they affect nursing employment and also helps give an idea of the future employment trends in the nursing world.Nurses Impact Policy Essay
Discussion of Pertinent Professional Literature
It is important for new graduates, present nurses, foreign nurses, and nurses who may no longer work in a health care atmosphere to understand the current and future employment trends in nursing. In the book, Your Career in Nursing: Manage Your Future in the changing world of Healthcare, Vallano (2008) identifies six criteria that any of the nurses that were mentioned above should observe

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The first part is that one (part A). It includes a practice circumstance which I have been discovering in classroom classes, to be mentioned in terms how a insurance policy like’our health our health care our say”, which influences service user engagement and integration of services; and how this relates to interprofessional working.

For the next part (part B), a self-assessment of my degree of development is necessary, using the provided self-assessment document which relates to the Interprofessional Functionality Platform through reflections.Nurses Impact Policy Essay

”Our health our good care our say” is the National Policy that I am going to study in this task, showing how it influences interprofessional dealing with service users. It had been released in January 2006 which is aiming for more effective health and interpersonal care and attention services outside medical center. Its custom logo is ‘This insurance policy is a new way for community services’. It pieces out the government authorities perspective for ‘high quality support meeting people’s aspirations for self-reliance and greater control over their lives, making service flexible and responsive to individual needs. ” That means that it focuses on for a person-centred environment in the health and health care area.

The scenario that I select concerns Jane, a single young mom of two children, who was identified as having locally advanced carcinoma of the cervix. She underwent a radical hysterectomy with pelvic lymph node sampling and she is currently having radiotherapy and chemotherapy. Jane habitually smokes and wines. In the next part, the results of this patient’s behaviour are going to be analysed, since it very seriously influences the results of her healthcare.Nurses Impact Policy Essay

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MAIN PART

As it once was stated, this task is approximately the service consumer engagement and integration of services. A service user is essentially any individual who obtains the impeccable, selfless and person-oriented service from the health and social attention coverage; if that insurance policy is really as perfect and person centred as they declare it to be, is a topic which will be analysed further along in this project. The amount of the user’s engagement is seriously fluctuated. People should be urged to be engaged in healthcare at levels they are comfortable with, but at the same time be empowered through information, training and other support to access the amount of involvement to which they may aspire. (period) ‘the service end user can make alternatives from a variety of options. They cannot do this if they do not really know what is available and whether they are entitled to it”.Nurses Impact Policy Essay

For effectively delivering health and communal care services, it is vital that professionals must work collaborative and the service end user to be involved in their care. Relating to Hippocrates in the 5th BC; the role in the individual care and attention is not only part of medical doctors’ work, but patients must also take part in order for a smoother and less problematic cure to take place. This discussion can be explicitly justified when watching a patient that presents non-compliance behavior, since it makes the work for the cure of this patient almost impossible. In this case, Jane is the service individual since she’s been through a variety of services (assessed and treated by a physiotherapist, join an area smoking cessation group which is run by a small team of nurses and physiotherapists to support her in giving up smoking on a permanent basis, begin radiotherapy treatment and chemotherapy with cisplatin). Though, she actually is not active at all. With her attitude like lacking her consultations in the radiotherapy treatment, stop attending in the local cessation group for giving up smoking, she implies that she doesn’t want to comprehend the value of her treatment and how much is going to help her the cessation group to become well, in order to raise her children.Nurses Impact Policy Essay

Through interprofessional and collaborative working, experts may take on a number of roles to promote this involvement.

Collaborative working is about engaging in partnership with other specialists and the ones we care for (Whittington, 2003). Furthermore it can be argued that no job by its own can meet all the needs of its service users. Nevertheless, by using the skills and know-how of all participants of the multiisciplinary team in an integrated way, it could be ensured that all the needs of these people using the services are met. The importance of mutual value in an operating environment, as well as understanding and co-operation, with the combination of good communication and collaborative working is very important. It undoubtedly offers a person-centred environment, in which users of services experience high quality care that minimises risk and prohibits as far as possible serious mishaps and service break down.

Wittington state governments in his work that, if there is no collaborative working between your health care professionals ‘service isolation and fragmentation can result in insufficient co-ordination, poor communication with service users, users spending longer intervals away from home and increased service costs’. (Wittington, 2003)Nurses Impact Policy Essay

Subsequently, for the Government authorities’ drive to change the ideology from certain requirements of the service to needs of the user, various key plan breakthroughs have been established during the last couple of years, that changed the structure of medical and social treatment. Each development has greatly impact the way in which that health insurance and social care experts conduct their service, the way the provision of services is provided and the experience of the service for the service user  Nurses Impact Policy Essay

‘Our health our health care our say’ is looking to achieve four main goals. Firstly, it is aiming to provide better reduction services with prior intervention in medical and social attention services. This is going to be performed by collaborative practice between the GP and Major and Attention Trusts (PCTs) with municipality services, by having a personalised service which is going to advice and support the general public (Makely, 2005). For instance, cancer tumor support services are providing advice and support, not only in the cancer tumor patients but also to their families. Within the malignancy support services, there must be work specialist who can offer individual support. Secondly, it aims to provide to people more choice and a louder tone by providing them the capability to choose and affect social and main care. Quickly, one of the suggestions is to provide a GP practice list to the public, thus giving them the choice to get the info they want and know very well what services can be purchased in their area. For the individuals who are not so positive applying this list there will be GP practices to offer in person communication in opening times. According to the NHS website (NHS The National Centre for Engagement, 2008), on Apr 2008 the LINks (Local Engagement Systems) was setup. These are sites that are run by residents and categories, who inquire people’s impression, whilst monitoring the delivery of attention and utilizing their authority to oblige service to account on their activities. This is helpful in the better understanding of what the city necessitated from the commissioners and the managers of health insurance and attention services. The other goal is to try to do more on tackling inequalities and increasing usage of community services. Which means that local health insurance and social good care  Nurses Impact Policy Essay commissioners will continue to work together to understand and solve local inequalities. Again, discussion boards, websites and networks like the LINks will help these care and attention providers, allow councils to access an array of views, assisting to develop care and attention pathways and with this way is going to enhance the services and help people who need specific treatment and support such as people who have particular needs like moms, cultural minorities, people at the end of the lives among others to obtain the service that they might need (NHS The National Centre for Participation, 2008). And the ultimate aim is to aid more the people who have long-term needs like people with disabilities. Because they need to have a specific knowledge of their condition and what they can do, so they will manage their lives. This goal is likely to be achieved by creating a programme which is going to give the information that the people who have long’term health insurance and social care needs and by developing assistive technologies to support these folks in their own homes. Because of this purpose, collaborative working will be necessary, given that they have to deal with not only with health issues of the people who have long-term needs but also with sociable problems. (Makely, 2005) A variety of professionals like psychologists, health professionals, social supporters, counsellors will add in the best support of these people.Nurses Impact Policy Essay

‘Our health our care and attention our say’ insurance plan explores a number of aspects on Jane’s storyline. It mostly addresses health and wellness and public issues. For example, the fact that Jane is a single mum and she does not work, the above plan is looking to help these kind of people, by assisting them and finding them the appropriate service to help them. Even though Jane is convinced that she does not need any help from any support worker, I think a guidance and some financial support, will allow her to trust the machine and make her willing in listening the experts. Moreover, Jane smokes and refreshments which aggravates her health problems considerably. It’s been advised to her, to go to local cessation group which was working by small team of nurses and physiotherapists, but she discontinued attending to that consultations. Collaborative working between the services is necessary since they advise the other person that Jane does not attend to that local group and in the radiotherapy treatment she misses a whole lot of appointments. The professionals that have caused Jane, seen that changes mood and she sometimes would go to treatment drunk and she has an non- compliance behaviour. All this information is most likely heading to be talked about in MDT meetings, so they find some ways to help this mother so that she can appreciate the importance of her treatment. From Jane’s storyline, it is noticeable that even the radiotherapists want to help her, nonetheless they cannot, because as a free-will person she shows her unwillingness to not follow the instructions of the experts and not listening whatsoever what the professionals are informing her.

It is evident therefore that, for effectively providing health and communal treatment services, is vital that professionals must work collaboratively and the service users to be actively involved with their own personal good care. This position has been empirically accepted as an improved method for conducting health and communal care. The abovementioned, can be observed in the progress made during recent years, therefore of carefully influenced policies which have a tendency to support public awareness of their medical condition, and encourages patient involvement in the process of their care and attention.Nurses Impact Policy Essay  These procedures also maintain that local inequalities should be eradicated, mainly through supplying a stronger voice to patients; in this way enforcing patient participation in their personal health care. Nonetheless, even though these reform guidelines have introduced a significant degree of improvement towards an improved health and interpersonal policy, the thought of a service customer getting the impeccable and ideal health care (talked about in the begging of the project) continues to be quite a distance to go. This is proven by genuine circumstance studies like Jane’s, which is a great exemplory case of the ineffectiveness that some parts of the communal and healthcare currently screen. But one must take into account the progress of these policies, and assume even more improvement in the health good care plan with the advantages of new plans, so that individuals like Jane can enjoy a powerful health care.

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PART B

REFLECTION ON MY DEVELOPEMENT NEEDS

DOMAIN: Collaborative Working

Description: Within my placement, I have been asked to consider an old female in the transfer services, because the support workers were busy. In the manner to the transport services, the old sweetheart said that she was feeling sick, and she threw up. At the same time a radiotherapist came and she asked me to help her with the health care of the patient. I helped bring her some medication from the pharmacy. The radiotherapist then allocated me the responsibility to remain with her and manage her, because she was needed to work back the procedure machine. ONCE I was sure that the individual could be left alone for a couple of minutes, I went to the reception and up to date them on what occurred and ensured that these were going to contact the travel services. The transfer services set up it so when the patient believed better, they got her home.Nurses Impact Policy Essay

Feelings: I experienced pleased for myself since I acted responsibly. I used my interpersonal skills and communicated successfully with the reception, therefore the transport services would be familiar with the situation in time and arrange move for the individual.

Evaluation and examination: Feeling the need to take the duty and take care the old woman, demonstrates I am well informed about myself and my skills. Also, the actual fact that the radiotherapist allocated me the care of the patient, shows that she understood my skills and she thought in me. By accomplishing successfully this task I showed that we develop my social skills by communicate reception and ensure that the lady will go home safely without triggering any trouble to other patients. Now I am able to say that I satisfied the capability CW2 L1 Recognises the need for effective interpersonal skills to enhance person centered service. Within the action plan (appendix) I unveiled a series of actions to perform the particular level 3 of the capability.Nurses Impact Policy Essay

DOMAIN: Reflection

Description & Emotions: I was watching, a radiotherapist performing a first day patient talk when the radiotherapist realised that the patient was not up to date about the side effects of the treatment since the doctor never talked about it. I had been annoyed, as i realised that the patient agreed upon the consent form but he did not know about the medial side effects since it is a big impact in patient life during and after radiotherapy, therefore i asked the radiotherapist after the patient kept, why the physician did not inform the patient in case that was appropriate. The radiotherapist told me that the precise doctor will it, because he is aware of that the radiotherapists will repeat the medial side effects. But it continues to be not appropriate since the patient must be up to date and fully aware before signing anything.

Evaluation and research: I was alert to what the patient should know about his treatment when he is coming for the first day chat, is because I’ve seen a variety of first day chats and I had been in the clinics for some time with the physician and the patients will these were putting your signature on the consent forms. It is demonstrated that the knowledge I had fashioned help me to critical appraise the situation and have for main reasons why the patient was not aware properly. Following this incident, I can establish that I am able to say that I satisfied the ability R2 L1 Knows evidence-based practice in service delivery.Nurses Impact Policy Essay

DOMAIN: Cultural Recognition & Ethical Practice

Description: An individual needed a translator to talk to us in the division. It was the first time I was in that situation and I detected what everybody does for that. These were using body gestures while they were speaking slowly. I had been the one who brought the patient in the room. I had not been aware of the problem of the patient and when I realised that he didn’t know any British I was surprised, however I did so not show it and I waited to observe how that situation would continue and the way the personnel and doctors would react. I escorted the patient into the room and identified him (Name, particular date of beginning and first type of his address).

Feelings: Initially, I did not know how to react in this kind of situation. WHENEVER I was identifying the patient, I did so not know where I should look at when I was making the questions, the patient or the translator? So I thought carefully what was appropriate and I tried to view both of them while I was figuring out the patient, but mostly I had been looking the individual since he was the service end user.Nurses Impact Policy Essay

Evaluation and research: I came across it a significant nice experience, due to the fact it was amazed me the complete situation. In clinic room I used to be observing carefully what’s going around me and exactly how everybody was reacting so by the end of the reaching between the patient and the physician, I would know how to react properly, too. I liked just how I reacted after i realised that the individual was not speaking British. I stayed relaxed and I reacted the way I would react with every other patient. I checked out his ID and asked how he was sensing. I just noticed a little unpleasant while i didn’t know where to look, the patient or the interpreter, so I was trying to look both of them. From just how that the doctor was reacting I learned that I will look immediately at the individual and speak to him. Nevertheless, there’s a need to speak slower with more pauses so the interpreter can convert correctly. Now I am in a position to say that I attained the ability CAEP2 L1 Recognises samples where involvement and educated decision are critical in promoting the physical condition of individuals who use services and I’ve made an action arrange for further development.

DOMAIN: Organisational Competence

Description & Emotions: This past year, in the IIP component we performed through some activities. One of the activities was to get a scenario of an individual story and from there to conclude which services the patient should visit. With this activity, every member of the team was figuring out his role in the situation and after that we understand each other’s role in order to treat the individual. I was astonished by the data that I gained recover activity. I learned about the other professions’ role in medical and care community.Nurses Impact Policy Essay

Evaluation and analysis: It was gratifying gaining knowledge through activities. Now I am able to suggest to an individual which of the assistance to use to get the appropriate care for his/her problem. Furthermore for even more development of my skills I made an action plan. (appendix). I fulfilled the ability OC2 L1 Knows team structures within the community of practice. Nurses Impact Policy Essay

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