Organizational Policies And Practices To Support Healthcare Issues

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.
For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?
In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.
To Prepare:

Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

By Day 3 of Week 3
Postan explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.
By Day 6 of Week 3
Respondto at leasttwoof your colleagueson two different daysby providing additional thoughts about competing needs that may impact your colleagues selected issues, or additional ideas for applying policy to address the impacts described.
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The main discussion will need at least 3 references and also in APA 7 format
The two discussions below will need at least three references all in APA 7 format each
Thomas discussion
Competing needs in the world of healthcare exist on a number of levels including the national level and also at the most local levels. I normally work on a COVID free orthopedic unit that focuses mostly on diabetic amputations, elective joint replacements and surgeries following orthopedic trauma. Initially during the pandemic, we halted our elective surgeries which was consistent with national guidelines (Diaz et al., 2020). As numbers stabilized, we began elective surgeries again, but recently we have seen numbers of COVID cases increase locally. In the past few weeks, we have started taking on more medical/surgical patients in order to make room for COVID patients on other medical surgical floors. The competing needs in this situation include the needs of the hospital in terms of freeing up beds for COVID patients, staffing needs on my unit as we are taking on more patients, and also resources that we need in order to care for this new group of patients. The competing needs of the hospital in this case with regard to caring for COVID patients and also caring for other medical surgical patients resulted in a policy change on my unit. The policy change in this case was our switch from a unit that cared for orthopedic patients only to one that was more inclusive of other medical/surgical patients.
The stressor that I selected for the previous discussion was care of the elderly. One area of conflict that I constantly see is the desire of family members to provide care for patients in the home when they are unable to fully meet the needs of the patient. Some patients require 24 hour care and unfortunately many families are not able to fully provide that care. Caring for the frail elderly in the home is often preferred. However, informal care providers are often presented with the challenges of self-care, educating themselves about how to provide care, finding additional support, and a lack of societal recognition for the role that they play in healthcare (Plthner et al., 2019). Despite the best efforts of family members and assistance from home care services, the level of care is still lacking, which places the patient at risk for declining health status. The competing need in this instance is the medical needs of the patient, competing with the ability of the family to provide those services or at least set up home care. A review by Hirschman and Hodgson (2018) identified several evidence-based approaches that may help to delay transition of care to skilled nursing facilities among patients with dementia. Programs such as the New York University Care Giver Intervention, Goals of Care intervention, MIND at home and Partners in Dementia Care help families to obtain the skills and resources required to provide adequate care to the dementia population in the home setting. The overarching theme is that while competing needs do exist in this area, education can help to reduce the burden on families and possibly help them to achieve the goal of home care for their loved ones.