Ethical Issues In Nursing: Nurse-Patient Ratios

American Nurses Association (ANA) Code of Ethics with Interpretive Statements, provision 1 states, “the nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by consideration of social or economic status, personal attributes, or the nature of health problems” "(About Code of Ethics," 2017). In order to provide quality care to the homeless population, the community health nurse is challenged to put aside her own preconceived opinions about drug addiction, alcohol abuse, mental illness and the assumed unwillingness to care for oneself. “While trying to help clients negotiate ‘the system’ the professionals may face a client’s noncompliance with medical regimes, drug abuse, and even stealing or selling medical resources” (Hunter, 1993, p. 139).

This chapter provides a background of nurse burnout and their effect on quality of care

State-mandated nurse-to-patient ratios remains a controversial topic in healthcare. Sufficient nurse staffing is key to ensure adequate patient care, while scarce staffing effects patients’ safety and puts nurses at risk for burnout. Determining nurse-to-patient ratios in nursing facilities remains a challenge for the nursing profession. There are many factors to consider when determining staffing methods, such as cost, nurses’ satisfaction, patient outcomes and safety. Mandating ratios is one attempt at ensuring nurses’ workloads do not exceed what is needed for adequate patient care and safety. Throughout this paper, I will explore both the pros and cons of mandated nurse-to-patient ratios in order to resolve the question, does nurse to

Burnout is classified viewed in three phases. The first phase of burnout is the arousal phase. The nurse shows anxiety, insomnia, forgetfulness, inability to concentrate, feelings of beings overwhelmed, frustration, sadness, and new physical symptoms, such as headaches and stomach problems. If the nurse does not recognize that these symptoms require intervention, the second phase is energy conservation. In this phase, the nurse starts to call in sick to work; o she may be chronically late getting to duty. Deadlines are not met, a cynical or resentful attitude develops, a persistent sense of fatigue pervades both are the nurse’s personal and professional’s life.

Nurse staffing is a significant region of worry because it can place a strain on patient safety as well as quality of patient care. With cost effectiveness in mind, hospital administrations have elected to reduce nursing staffing ratios and substitute licensed nurses using cheaper unlicensed personnel. This increases uneasiness as the quality of care in hospitals might be undesirably reduced. The necessity to evaluate nurse staffing is essential.

A healthcare system should include an interprofessional team that works well together. If everyone in the interprofessional team is not cooperative or passionate about building the group, this may impact a patient’s outcome. The goal of an interprofessional team within a healthcare system is to provide the finest quality of care for their patients. If one or multiple cannot put the effort to work with others, the intended result may be corrupt. It is vital for healthcare interprofessional teams to function as a whole to provide the greatest result.

Due to hospital care reaching an all-time high in America, we need nurses now more than ever before. Currently in America, we have an issue with nurses having too many paperwork to fill out. In the article “We Need More Nurses” by Alexandra Robbins argues we need more nurses in the hospital. Nursing shortage has been a common issue throughout the world. Because of this issue others are being affected in many different ways. This issue is not only affecting the hospital, but also the patients. In the article “When Hospital Paperwork Crowds Out Hospital Care” by Theresa Brown argues that nurses have too much paperwork to fill out about their patients. Having too many paperwork takes away from the nurses getting involved with their patients. In my opinion, neither of the arguments are valid because they lacks supporting details .Even though Robbins and Brown are passion about their topic, they both did a great job using pathos

Large patient loads combined with a stressful work environment affects nurses’ abilities to provide quality healthcare. Patient safety should never be compromised. It is our responsibility to learn from research and improve our current nurse staffing ratios. Nurse staffing is key and affects all other outcomes. Without nurses administering the right treatment at the right time to the right patients, all other healthcare interventions are not effective. Improvement of nurse staffing levels will improve the quality of care our patients receive.

With a nurse shortage, patients are not getting the best quality care they should be getting. Archive stated that hospital nurse staffing, is a matter of major concern because of the effects it can have on patient safety and the quality care patients deserve. Nursing-sensitive outcomes is an indicator of the quality care and can be defined as variable patient or family caregiver state, condition, or perception responsive to nursing intervention. Some unfortunate patient outcomes potentially sensitive to nursing care are shock, urinary tract infections (UTIs), pneumonia, longer hospital stays, upper gastrointestinal bleeding, failure to rescue, and 30-day mortality. Research has focused on negative rather than the positive patient outcomes for the simple reason that adverse outcomes are more likely to be documented in the medical record. This is important evidence because it gives us conditions and results of what can happen if patients get lower quality care. Patients’ are not having enough time getting checked up by a nurse, and nurses would miss some diagnostics. Patients are getting sick because of the poor care they are receiving from nurses. The care patients can get is affected by a nurse shortage, “Nursing workload definitely affects the time that a nurse can allot to various tasks. Under a heavy workload, nurses may not have sufficient time to perform tasks that can have a direct effect on patient safety. A heavy nursing workload can influence the care provider’s decision to perform various procedures. A heavy workload may also reduce the time spent by nurses collaborating and communicating with physicians, therefore affecting the quality of nurse-physician collaboration” (ncbi). This is important because it tells us that nurses wouldn 't have enough time to perform tasks that can affect the patients’ care. If nurses are being overworked because of a nurse shortage, then patients’ would not have the best quality care they would need, which can be a

Moreover, several studies have been conducted to examine the effects of low nurse staffing on patients hospitalization experiences, as well as its effect on nurse careers in the long run. A recent study by Frith, Anderson, Tseng, and Fong (2012) to explore the relationship between nurse staffing and medication errors, demonstrated that medication errors were higher in a cardiac care unit and non-cardiac care unit when staffing levels were lower. In addition, Frith et al. (2012) pointed out that medication errors increase by 18% for every 20% decrease in nurse staffing below the average due to failure to follow medication administration protocol As mentioned earlier, nurses perform the last and the most important step of medication administration. Thus, having adequate time to assess each patient efficiently and following the medication rights is critical to provide safe patient care and prevent errors.

One ethical obligation nurses are required to fulfil during their shift is to ensure no harm is done to their patient. Due to nursing shortages and too many patient’s, nurses are finding this hard to do. Ethics help nurses make the right decisions with the guidance of their morals, but due to shortages and overworked nurses they tend to feel dissatisfied with their jobs. This results from unsafe work environments, lack of time for communication and quality care of patients. “Understaffing and overtime hours have been associated with increases in patient mortality, hospital-acquired infections, shock, and bloodstream infections” (Kane et al., 2007b). Ethical conflicts are work can lead to physical and mental burnout for nurses. According to the Nurse Code of Ethics nurses are morally obligated to

Neff, Cimiotti, Heusinger, & Aiken (2011) carried out the largest survey of registered nurses ever conducted in a large southeastern state to see what the nurses have to say about providing safe and effective care and how satisfied nurses are with their current nursing position. A survey was sent out to a random sample of 49,385 registered nurses who were working and residing in this southeastern state using a modified Dillman’s methodology. Neff et al. (2011) mailed a cover letter explaining the purpose of the survey. Then a postcard was sent out a week after the first mailing to encourage participation. All the nonrespondents were sent a second mailing, and a voice message was sent to all nurses 2 days after the initial mailing and 2 days

The problem description in this article identified is that when there are too many patients assigned to a nurse there will not be an effective and well done job by the nurses and the patient will not be save. According to (Christian Duffin (2012). The Safe Staffing for Older People’s Wards report argues that if a nurse is overseeing more than seven patients, care will not be safe. And also the this will also have a serious impact on the health of the nursing staff, it was stated that because nurses’ heavy workload is an issue practically everywhere,

that while nurses plays a very important role in improving the health care system of the country,

Nurses play an essential role in the healthcare industry. The nurse workforce is made up of licensed nurses: registered nurses (RNs), licensed vocational nurses (LVNs) and licensed practical nurses (LPNs), along with nurse aides. Registered nurses are responsible for assessments of patients’ needs, development of care plans, medication administration, and treatments, while licensed vocational nurses perform specific care under the delegation of the registered nurses and supervisions. Nursing aides perform activities of daily living (unskilled attention) to the patient. Adequate nursing staffing is essential to both patient care and outcomes, also to the retention of nurses while inadequate staffing creates problems for both the patients and