While it is important to find balance between safe patient care and the needs of an organization, it can be a challenge. Competing needs, such as the needs of patients, workforce, and resources may impact the development of a policy because the competing needs should coincide and be in agreement with what the policy is advocating for. There may be conflicting aspects, for example, what is best for the patient may not be best for resources or costs, and what may be best for resources and costs, may not be what’s best for the workforce and healthcare staff. When a new policy is being considered, it’s satisfactory to find a “happy medium” of what will benefit all parties. This takes a lot of time, planning, and input from different stakeholders including patients, healthcare workers, management, the financial and planning department, etc.
It’s vital for nursing staff to reach out and not only advocate for patients, but also themselves, when pushing for an agenda and/or creation of new policy. Many nurses voice frustration due to a sense of powerlessness of inability to change their current situation and work encouragement. Working in a restructured healthcare system often leads to nurses’ professional knowledge being undermined, leading to internal conflict and tension. Nurses staying silent about their current circumstances may lead to pent-up frustration, which is harmful for themselves, and also the nursing professional as a whole, as this can further lead to outbursts of displaced aggression (Kelly & Porr, 2018). Ways that nurses can get involved with policy include participating in state and national nursing association, such as the American Nurses Association, attending legislative sessions, participating on national boards, building relationships with state lawmakers, collaborating with lobbyists, subscribing to legislative notifications, contributing to evidence-based data, running for office, educating the general public about policies and processes, and lastly, supporting a local candidate whose views best align with the needs of the healthcare system (Morris, 2023).
The healthcare issue I have chosen to discuss throughout this course is lack of mental health resources. Two competing needs for this topic include safe nurse to patient ratios and nurses’ mental health and well-being. As mentioned, there is a shortage of mental health resources, which means that there are patients that are not getting the care they need for their mental health issues. Patients are even turned away for admission to inpatient mental health units due to the unit being understaffed. An individual that doesn’t work in healthcare, may think, “Why don’t we just admit patients that need mental health to the inpatient mental health unit, and the nurse will just have a busy day and have to take on more patients than usual”. Some facilities have done this, and nursing staff will have nine to ten patients to take care of on their own. One may initially see this as a beneficial idea, as more patients are getting access to care which may address the lack of mental health resources, but this is incorrect. The safe nurse to patient ratio for psychiatric care is one nurse for four patients (National Nurses United, 2023). Overloading one nurse with too many patients, also referred to as unsafe staffing ratios, is so dangerous, as it leads to an increase in medication errors, changes in patient condition are more likely to be missed, and safety checks can be delayed, resulting in increased risk of patient suicide on the unit (Phillips et al., 2021). The Code of Ethics for Nurses, code 3.4, discusses that nurses have a responsibility in promoting a culture of safety, and nurses should use the chain of authority when an issue has grown beyond their control, such as unsafe nurse-to-patient ratios (American Nurses Association, 2015)
In hopes of combating the issue of lack of mental health resources, nurses are often required to work long shifts, which include overtime. Patients struggling with mental health issues can also be verbally and physically abusive to healthcare staff. The combination of working in stressful conditions along with extended hours can result in an increase in anxiety and depression in nursing staff. In 2021, 22% of healthcare workers reported experienced moderate depression, anxiety, and post-traumatic stress disorder in a collective analysis of 65 studies, 69% of physicians reported experiencing depression and 13% had thoughts of suicide, and nurses and frontline workers reported more severe psychological symptoms than other health workers (Centers for Disease Control and Prevention, 2022).
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