Nurses: The Patient's Greatest Advocates in Healthcare Delivery - Research Paper

Introduction

The effectiveness of the healthcare system heavily relies on the efficacy of the nursing fraternity. The services offered by nurses are needed in almost all health facilities be it in the private sector or in the public sector. Some of the roles and duties carried by nurses in the aim of ensuring quality delivery of health services are centered on patient welfare hence an important link between patients and their doctors. They could perhaps be referred to the patient's greatest advocates. They are the first people that meet and welcome a patient in a health facility, assist in administering of prescribed medication in case a patient is incapacitated in any way.

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Nurses also monitors patients progress at a personal level because they spend a lot of time interacting with patients to ascertain effectives of the treatment given by the doctors for proper action to be taken. Besides assisting and administering medication, they also have to provide emotional support needed to patients and their family members or close relations because they have a greater understanding of situations surrounding illnesses. The act as counselors in difficult situations such as when death of a loved one occurs hence help them cope with the situation thus creating the much needed stability and comfort.

Nursing is undeniably a very demanding profession that requires a lot of sacrifice and true passion.it is both physically and emotionally demanding as nurses have to work for as long as 12-hour shifts. During the shifts they are required to be on the lookout and alert monitoring their patients closely and with all due diligence. The job involves making countless rounds in designated wards in case they work in larger and busier facilities which is normally the case. During their rounds they have to attend to each and every patient and providing any necessary assistance needed by the patients. Most of this tasks involve a lot of physical activities meaning that they have to be on their feet throughout the duration of their shifts. The profession also demands a lot of emotional strength and selflessness because being able to handle emotionally drained people or patients with life threatening conditions is not an easy thing to handle. Holidays for nurses is another rare thing to come across. This is because patients are always in health facilities and require assistance therefore nurses have to give up such privileges and give up on family time just to be service to their patients and institutions.

Discussion of Area

It is therefore important to note that services offered by nurses are crucial hence the need to put in place enabling conditions to work more effectively. The main issue affecting the nursing profession currently hence hindering productivity is lack of an enabling environment majorly fueled by inadequate patient-Staff ratios. Currently the healthcare sector including acute care hospitals have low staffing levels in comparison to the large volumes of patients admitted. Low staff ratio to patient ratio is the main contributor and a hindrance for nurses to provide adequate and quality services to their patients. Low absorption of nurses in health facilities also means that the few available nurses have to deal with increased workloads than they can handle. The excessive workloads results in the nurses fatigue hence a risk to their mental and physical health. In addition the nurses can't have sufficient time to attend to attend to each patient assigned effectively. This in itself means that patients are at a high risk of being victims of negligence.

Impact of Area on Nursing Care

A study by Coffman, Seago & Spetz (2020) on healthcare workforce more specifically on the issue of nursing ratios included collected opinions on nurses about the subject matter. The study revealed that most registered nurses were of the opinion that number of employed nurses in acute care hospitals is inadequate hence affecting the quality of patient care in those facilities. Besides inadequate quality services to patients, low staffing ratio is the main cause of increased turnover in the nursing profession. When the number of hired nurses happens to be extremely low in certain facilities, workloads increase and when the situations goes beyond optimum levels, the experience becomes unbearable to many registered nurses who then opt to resign or move to other professions. A good case study would be the 2019 corona virus pandemic that plagued the world. The virus saw health institutions receive record number of patients than most health facilities could handle because of low staffing ratio against the number of patients who needed absolute attention and care. The resulting affects were unprecedented number deaths of which most could have been saved with sufficient care and close monitoring.

Furthermore, patient's expectations have tremendously increased over time which his could be attributed to higher level of knowledge on patients' rights. The modern patients unlike the traditional patients who perceived the services of a nurse perhaps as a favor and a show of concern of care from the health facilities have a totally different perspective on the services offered by nurses. Modern patients are extremely knowledgeable and have unique demands and expectations that need to be met by the few available nurses, this eventually becomes too much for nurses because their numbers can't meet all the demands adequately hence causing unfavorable conditions that results in increased stress levels to nurses.

A study by Jordan as cited by Girmay et al (2018), indicate that modern patients associate quality nursing experience to enough time spent between patient and their caregiver and a show of respect to patients. However that is not enough, apart from time spent and being accorded respect, patients also expect to be informed adequately concerning their health status including treatment and their progress. Nurses are also supposed to exhibit other factors such as being cheerful, showing kindness and all attributes associated to care givers (Negash, 2014). Going contrary to such demands and expectations is considered incompetency and highly unethical in the modern setting. However for this to be achieved the nursing- patient ratio needs to be harmonized. Harmonization of nursing patient ratio would ensure that patients get the maximum attention needed as the number of nurses would be evenly distributed against a specified minimum number of patients. Workloads would also be contained hence nurses would most likely be a stable state of mind and be able to exhibit intangible qualities like being cheerful , show kindness to their patients and show respect.

Current Practices to Address the Issue of Nursing -Patient Ratio

As shown through various sources and personal experiences, the nursing profession is very demanding hence all stakeholders respond effectively to issue affecting the nurses to ensure quality service delivery and personal welfare of nurses is put into consideration. The main solution to the problem of low staffing in the nursing profession is the implementation of the minimum nurse to patient ratios in hospitals and other institutions offering medical services. This would definitely go a long way in improving the quality of services offer to patients and at the same time improve patient's nurses working conditions. Implementation of minimum nurse to patient ratios would also help solve the increased turnover amongst registered nurses. According to Dawson et al (2014), the main issues leading to increased turnover in the nursing profession revolve around poor working environment characterized by incompatibility of some nurses in terms of skills poses and unfavorable patient to Staff ratios.

One of the earliest states to begin the process of addressing the nurse to patient ratios was the state of California in 2002. The state through it legal mandate gave directives to the California Department of Health Services to come up with "a minimum, specific and numerical licensed nurse to patient ratios by Licence nurse classification and by hospital unit" (Coffman, 2020). The passage of the minimum nurse-patient ratio act denoted as A.B. 394 was passed in 1999 after many years of intense advocating by the unions representing nurses in California. In the California Minimum nurse to patient ratios act the following propositions were established; in operating rooms the minimum ratio was one nurse per patient while in nurseries where new born babies were kept the ratio being at one nurse per eight infants. For medical and surgical rehabilitation divisions the proposed ratio was one nurse per six patients. Up to date Caronia remains the only state that has an official laws pertaining nurse to patient staffing ratio (King, 2019). However other states and health facilities are gradually coming up their own minimum staffing standards

Recommendations

It is important for stakeholders in the healthcare sector to realize the importance of setting conditions and standards that ensure both safety and quality service delivery. Therefore all states should consider passing laws and regulations that ensure staffing minimum staffing standards are enacted and implemented accordingly. Apart from regulations for the federal governments individual health providers both from the public and private sector should also set standards that ensure balanced nurse to ratios for quality service delivery.

To conclude, the nursing profession is indeed a very sensitive division in the healthcare provision sector and to that effect an enabling working environment needs to be provided to the nurses for effective service delivery. One way of providing an enabling working environment to ensuring balanced patient to staff ratios by the federal governments and individual health providers. This would accrue benefits to both patients as they would receive quality service and to the nurses in ensuring a healthy working condition.

References

Coffman,M.J.,Seago,A.J.,&Spetz,J. (2020) Minimum Nurse to patient ratios in acute Hospitals In California. Health Affairs- Vol 21.5. https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.21.5.53

Dawson, A.J., Stasa, H., Roche, M.A. et al. Nursing churn and turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies. BMC Nurs 13, 11 (2014). https://doi.org/10.1186/1472-6955-13-11

Girmay, A. Marye,T & Gerensia, H. 2018. Patients expectations strongly associated with patients perception to nursing care: Hospitals based cross sectional study. doi: 10.1186/s13104-018-3447-x

King University Online, 2019 Nurse to patient Ratio: How is too Many? www.nursingcenter.com/ncblog/

Negash AK, Negussie D, Demissie AF. Patients' satisfaction and associated factors with nursing care services in selected hospitals, Northwest Ethiopia. Am J Nurs Sci. 2014;3(3):34-42. doi: 10.11648/j.ajns.20140303.12. [CrossRef] [Google Scholar]