NRS 493 GCU The Pandemic Has Led to A Complex Situation in Nursing Response
During your practicum, determine what clinical problem or issue the organization is facing. Discuss two implications for nursing.1 – Jocelyn PerezI am doing my practicum in a community health clinic. The current clinical issue that the clinic is facing is providing services that are safe for both the workers and patients. Finding alternative ways to help people gain access to care has become a priority during this pandemic. People are still suffering from health conditions that need monitoring to prevent further deterioration. The restricted access to care makes it difficult for people to schedule an appointment and receive care. This is due to the unwanted high volume of traffic in the waiting room to prevent the virus's spread. The first implications for nursing include nurses directly exposed to the virus, which results in being at high risk of developing the disease. This scares nurses for transmitting it to their loved ones causing them to leave their job. This has significant implications for the workforce and the ability of health systems to deliver care at a time of heightened need. The second one is the psychological implication of the stress associated with separation from family, sleep deprivation, and heavy workloads created by health system demand and staff shortages. These psychological impacts are likely to have both short- and long-term consequences for nurses (Fernandez et al., 2020).ReferenceFernandez, R., Lord, H., Halcomb, E., Moxham, L., Middleton, R., Alananzeh, I., & Ellwood, L. (2020). Implications for COVID-19: A systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. International Journal of Nursing Studies, 111, 103637. https://doi.org/10.1016/j.ijnurstu.2020.1036372 – tamara GuiterrezMental Health care and resources for treatment continues to be problematic in our organization and community. Our rural area is limited to mental health care and close to obsolete for mental health care and resources available to our youth. Although resources are available in surrounding nearby cities, transportation and acceptance remains a concern. Mental health is a crucial part of one’s life and well-being. Individuals need mental health resources to continue to be productive in their lives, personal and professional. Nurses play an imperative role in caring for mental health patients and providing the services needed for successful compliance. They are the largest group of individuals providing this care. Nursing professionals need the equal amount of training and education in psychological studies as received in primary health problems. More organizations that are educational are ensuring these trainings implemented and provided to prepare nurses for the care of mental health treatment as well as preventative practice. Nurses implement the mental health care included in the patient’s primary health care. History of the patient helps the nurse learn more about the patient’s mental well-being and needs expected to arise from their evaluations to provide proper intervention for positive patient outcomes.WHO | Developing Nursing Resources for Mental Health.https://www.who.int/mental_health/policy/mnh_nursing/en3 – Nathanaelle JosephI am doing my practicum in a clinic during the pandemic and many people are afraid of catching the virus, running out of PPEs, and closing down the clinic due to the pandemic. we have adopted new protocols such as social distancing, temperature screening, Covid screening questions, wearing shield and mask, and washing hands. We encourage staff to spend less than 15 minutes with the patients and for patients to spend less than 30 minutes in the clinic. we also encourage them to get tested as often as they can, stay home if they have any symptomsThe major problems are lack of staff and fear of catching COVID-19 for both the patient and the staff.1- Many staff has tested positive for COVID-19. once staff has tested positive for COVID, they must be quarantined for 14 days and re-tested on day 15. We have lost a lot of staff who are on sick leave. On average the clinic would have 50-60 staff, today we have 22 staffs that have tested negative for COVID. We have encouraged all of our staff to get vaccinated with either Pfizer or Moderna and continue to practice social distancing in the cafeteria. We encourage them to know the signs and symptoms of COVID-19 and if they feel any abnormality, get treatment right away.2- Many of the patients that come to our clinic have preexisting health conditions such as HIV, diabetes, asthma, and many others. We encourage them to sign up for mychart where they can video chat with their providers to request a medication refill, and share other concerns. We give hand sanitizers, face mask, gloves, and antibacterial wipes. we encourage the patient to stay home if they don't feel well, come 30 minutes before their appointments, social distancing, come alone, they can only bring one person with them, if necessary. We want the clinic to be open and continue to cater to the needs of the community. We can achieve this by following the CDC guidelines.ReferencesCOVID-19 symptoms. Center for Disease Control and Prevention4 – Sonia MendezI am doing my practicum in a inpatient setting and the main problem that this hospital is having is retention. Their are many nurses that are leaving because they are being pay more for traveling assignment, even when they are just going 30 to 40 miles away when it was known to be 50 miles or more to be consider a travel assignment. The hospital have been losing very good nurses because they can't compete with their wages. The hospital is trying to retain the nurses by giving them different bonuses, but it hasn't really been completely successful at the moment. One of the implications that the nurses are facing is that they are working short staff, they feel more tired and the chance of them making mistakes are higher. They are constantly floating to other units and working in different environments and with different population of patients then what they are used to. The second implication that the nurses face with this situation is stress, they feel stress just to think that they have to come to work and that they know that they are going to be short staff. They are worry that they are going to have a bad day or that they are going to finish late and they have to be back the next day and do it again. They worry because they are exposed to the virus and they don't know when they can take it home. ReferencesOverwhelmed hospitals rush to hire travel nurses: "We're getting hit pretty hard". (2020, December 29). Retrieved from https://www.cbsnews.com/news/overwhelmed-hospitals...What is the main issue for your organization in addressing a solution to evidence-based nursing practice? Discuss what might be the first step in addressing and resolving this issue.5 – cara harrisThe main issue for my organization in addressing a solution to evidence-based nursing is the fact that the organization is driven on policy and procedures that have been in place to focus on episodic care versus the ability to take advantage of evidence-based nursing practices. This is due in part to the lack of education and knowledge of the medical practitioner and the focus on common procedural episodic care management. In spite of its benefits adoption of evidence-based practice in healthcare system remains low. (The Nursing Ace, 2019) This attributed to various factors, which include cost implications, ethical issues, shortage of relevant professionals and lack of a harmonized curriculum in nurse education to promote adoption of evidence-based practice in the workplace. (The Nursing Ace, 2019) Because of these issues, evidence-based nursing is a real challenge to adopt and implement as a best practice to the health and care needs for the patient. Education and training is the first step in empowering nurses to begin to utilize and practice evidence-based nursing for patient care. It is also important for the advanced nurse through additional education and achieving BSN and MSN credentials to assist with the evidence-based practice. And in most cases the organization will need to revisit and update their issues with practice policies. To address the issue, it is important for the organization to modify its policy to ensure that nurses feel empowered to apply evidence-based practice in their clinical duties. (The Nursing Ace, 2019) Allowing the educated and trained nurse to utilize and manage care with evidence-based nursing will assist with patient care and create a holistic approach to the care and needs of the patient. This will set the pace for better overall education and prevention to adequately educate patients for the ability to manage their health needs.ReferencesGoodman, K. W. (2013). Ethics and Evidence-Based Medicine: Fallibility and Responsibility in Clinical Science. New York: Cambridge University Press.Nursing Ace. (2019). Organizational issues and solutions to evidence based nursing practice. Retrieved from https://thenursingace.com/organizational-issues-and-solutions-to-evidence-based-nursing-practice/6 - Shannon bolinFor a healthcare system to be beneficial to the community they serve, they must always continue to evaluate their current policies and procedures and make efforts to implement new interventions that are supported by evidence-based practices (EBP). As discussed in the Alatawi et al. paper about barriers in implementing EBP, limited resources are an issue that this as well as many healthcare systems fail to correct promptly (Alatawi et al., 2020). As hospital systems continue to improve their standards and expect better outcomes, they do not always provide the means for the nurses to implement EBP. One issue that the hospital system has made a top priority is the reduction and prevention of falls and falls with injury. While some falls may not be avoidable, the hospital system has dedicated itself to identifying issues and implementing steps to reduce the yearly average of falls. Through conferences, post-fall huddles, and scenario simulations, there are several suggestions the leadership level has identified that will help nursing staff. The early implementation of a companion care partner or “sitter” for those who have a high fall risk, however, there is often not enough nursing or CAN staff to cover these needs. They implemented a hourly rounding and bathroom checks for each patient as a way of reducing risks of a patient attempting to get up on their own but have increased the number of patient to nurse/cna staffing, leaving the floors without the proper staffing levels to offer quality rounding. One last intervention they have recently suggested is the immediate discontinuing of all chair alarms, which had been a standard tool used on the floors and offered the chair alarm as a better alternative, but have not provided an adequate amount to the floors for use. As with many hospital systems, good intentions often come ahead of adequate funding, equipment or implementation. The hospital system where my practicum is taking place has a lot of great ideas of how to reduce and prevent falls, however, I would suggest if they are willing to take the time and manpower to identifying the problems associated with the fall they must also at the same time be willing to offer the departments support in implementing these intervention and not leave it to the budgeting job of the unit manager to find ways to acquire the necessary tools to implement these suggested changes.Alatawi, M., Aljuhani, E., Alsufiany, F., Aleid, K., Rawah, R., Aljanabi, S. & Banakhar, M., (2020). Barriers of implementing evidence-based practice in nursing profession: A literature review. American Journal of Nursing Science. Retrieved from http://www.nursingscience.net/article/152/10.11648.j.ajns.20200901.16