COVID-19 infection is one of the most current global healthcare issues. The United States is one of the worst-hit countries globally, with over 152,000 new cases and a total of more than 13 million cases currently leading to the death of over 263,000 Americans (Center for Disease Control and Prevention [CDC], 2020). Due to the increase in the infection rate of COVID-19 during the 2020 winter season, schools, businesses, and public activities are being shut down or scaled-down to the barest minimum to curb the transmission rates. The COVID-19 shutdown has enormous adverse economic and psychosocial effects on the American population while the government struggles to provide relief for individuals and businesses to survive the resultant hardship (Hughes, 2020).
Besides, the recent upsurge in the COVID-19 infection rate in the United States has occasioned many challenges on the country’s healthcare system due to an increase in hospitalizations across the country. Hospitals are running out of available bed spaces, personal protective equipment, and medical staff (McKinsey Insights, N.PAG., 2020). Most importantly, there is an increasing demand for healthcare workers all over the country following the COVID-19 crisis. Hence, in this period, more than ever before, the frontline workers’ well-being is paramount to sustaining the workforce needed in this pandemic era. Adopting the quadruple aim approach for patient care will improve patient care outcomes and experience and reduce hospital stay and cost (Jacobs et al., 2018). The quadruple aim takes cognizances of healthcare workers’ well-being by actively engaging them while improving the work environment. Healthcare workers, especially the nursing staff, are more productive and resilient when their welfare and work environmental stressors, are eliminated (Gallup, 2017).
Furthermore, the healthcare system is passing through a lot of transformation since the inception of the Affordable Care Act (ACA) which is currently compounded by the emergence of the Coronavirus pandemic (Pittman & Scully-Russ, 2016). It is essential to enhance healthcare workers’ skills and capabilities, especially the nursing staff, to deal with the current challenges occasioned by the pandemic. The inclusion of worker-friendly policies and development plans by healthcare employers and the government will ensure the healthcare workforce’s sustenance through the Coronavirus pandemic’s difficulties (Pittman & Scully-Russ, 2016). The education/training of staff and the adequate supply of PPEs and deliveries needed for caring for hospitalized patients are essential to ensure healthcare staff’s safety (Ricketts & Fraher, 2013). Increasing free testing sites and providing safe vaccines to vulnerable populations and frontline workers is the government and policymakers’ fundamental responsibility in combating the incidence of the COVID-19 virus.
In conclusion, the COVID-19 pandemic has imposed enormous challenges on the healthcare system of the United States. The frontline workers experience stress and burnout by the increased hospitalization and infection rate in the country. Adopting the quadruple aim will go a long way to alleviating the stress and burnout of healthcare workers, especially the nursing staff. The healthcare administrators and the government should adopt plans and policies that address the healthcare workforce’s demands and needs in this current era of the COVID-19 pandemic through staff training, education, and career advancement programs.
Center for Disease Control and Prevention. (2020). CDC COVID Data Tracker. Retrieved on December 2, 2020, from https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days.
Gallup. (2017). State of the American Workplace Report. Retrieved on December 2, 2020, from https://www.gallup.com/workplace/238085/state-american-workplace-report-2017.aspx
Hughes, J. S. (2020). The Coronavirus Aid, Relief, and Economic Security (CARES) Act–Tax Relief for Individuals and Businesses. Congressional Research Service: Report, 1–17.
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3), 231–245.
McKinsey Insights, N.PAG. (2020). Challenges Emerge for the US Healthcare System as COVID-19 Cases Rise.
Pittman, P., & Scully-Russ, E. (2016). Workforce Planning and Development in Times of Delivery System Transformation. Human Resources for Health, 14(56), 1–15. doi:10.1186/s12960-016-0154-3. Retrieved from https://human-resources-health.biomedcentral.com/track/pdf/10.1186/s12960-016-0154-3
Ricketts, T., & Fraher, E. (2013). Reconfiguring Health Workforce Policy So That Education, Training and Actual Delivery of Care are Closely Connected. Health Affairs, 32(11), 1874–1880.
I enjoyed your thoughts on the current state of the healthcare arena. You expertly touched on many current issues that we are experiencing. I agree with your thoughts on the importance of the adoption of the Quadruple Aim. The more I learn about the Quadruple Aim, the more I wonder why the well-being of healthcare providers has not been on the priority list for healthcare organizations sooner. According to Epperson et al., (2019), The Triple Aim addresses payers, organizations, and payments in its ideology; I cannot help but wonder how the providers of the healthcare services were left out of the equation, given that any of the other three would not exist without those individuals providing the services.
COVID-19 has given us a big reason to regret not adopting Quadruple Aim sooner. The psychological toll is arguably comparable to what is experienced by military personnel in battlefield conditions (Albott et al, 2020). We are now at a point where it is critical organizations provide resiliency training and opportunities that promote debriefing of stressed-out staff all while continuing to provide for the care of the huge numbers of critically ill COVID-19 patients. The stress is palpable to those of us on the outside as well; much of my time now is spent educating about inaccuracies of ineffectiveness of masks and social distancing on social media. Most of the exchanges are friendly, or at least, I try to keep them that way (you get more flies with honey than you do with vinegar, right?). Unfortunately, these exchanges continue to occur, and I expect they will increase as discussions about the safety and efficacy of the vaccine become more frequent. Still, I will continue to try, as I recognize that as a nurse, I am perceived as a credible and reliable source of information, and I feel it is my responsibility to do what I can to assist in the fight against this deadly virus.
Albott, C. S., Wozniak, J. R., McGlinch, B. P., Wall, M. H., Gold, B. S., & Vinogradov, S. (2020). Battle buddies. Anesthesia & Analgesia, Publish Ahead of Print. https://doi.org/10.1213/ane.0000000000004912
Epperson, W. J., Childs, S. F., S., & Wilhoit, G. (2019). Provider burnout and patient engagement: The quadruple and quintuple aims. Www.Physicianleaders.org. https://www.physicianleaders.org/news/provider-burnout-patient-engagement
Discussion: Review of Current Healthcare Issues
If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?
These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.
In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.
Review the Resources and select one current national healthcare issue/stressor to focus on.
Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.
By Day 3 of Week 1
Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.
By Day 6 of Week 1
Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.
It goes without saying—this has been a rough year—arguably, the roughest many of us will face in our entire career. Most, if not all, of us were blindsided by the arrival of the COVID-19 pandemic. In a complex occupation that has inherent risks to our own balance and personal well-being, many of us have inadvertently been responding reactively to stress rather than proactively preparing for it (Abram & Jacobowitz, 2020). This style of coping, when combined with the arrival of the COVID-19 pandemic, is a recipe for disaster; a true sink or swim situation where we find ourselves on our own grasping for a lifeline to safety, yet feeling like it is out of reach . But there is a quality within all of us that when properly maintained can be our own lifeline—resilience—the ability to thrive despite adversity. Healthcare organizations that prioritize resiliency training and maintenance benefit in many ways from their investment, including quality of the care provided and retention of highly skilled staff.
We all possess the capacity for resilience, but many of us have not nurtured it within ourselves enough along the way to feel we can depend on it to be our lifeline. Resilience is the ability to adapt to and persevere through stressful and challenging situations and achieving personal growth in the process (American Psychological Association, 2012). I personally experienced a glitch in my resilience early on in the pandemic and found that my organization was not prepared to help me determine ways that I could cope more effectively. This situation led me to quit my prn clinic job at a clinic that I loved, and although my position was not critical in the organization, it was something that meant a lot to me and was extremely distressing to me that I found myself floundering.
Through my studies, I have learned that the transformation in healthcare we have known as the Triple Aim was inherently lacking in an area that was key to the success of such an initiative—the well-being of the healthcare workers themselves (Broome & Marshall, 2021). The Triple Aim focuses on quality and cost as they relate to the patient and the payor, but it does not address they quality of the experience of the healthcare worker or the cost that the healthcare worker will pay in the process. Enter the Quadruple Aim—the addition of the idea that the well-being of those providing the care is directly related to the success of the components of the Triple Aim (Broome & Marshall, 2021).
I worked for my former employer for over 30 years, and I was described as a “team player” and one who “embraces change” on more than one occasion. Yet when the real stress arrived with the COVID-19 pandemic, I felt as if I had been left to fend for myself, and it was then that I considered that perhaps my organization was less concerned about the resiliency of the employees, and that being the case, I was not willing to allow myself to go down with the ship. In light of my experience, I have chosen to focus on resiliency development and maintenance in the healthcare occupational settings. Our patients look to us for strength and guidance, which as healthcare workers, we are more than willing to share; however, we must also recognize that it is crucial that we identify and nurture our own coping strategies, and learn how to employ them in the context of our own situations.
Abram, M. D., & Jacobowitz, W. (2020). Resilience and burnout in healthcare students and inpatient psychiatric nurses: a between-groups study of two populations. Archives of Psychiatric Nursing. https://doi.org/10.1016/j.apnu.2020.10.008
American Psychological Association. (2012). Building your resilience. https://www.Apa.org. https://www.apa.org/topics/resilience
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.
sample post 3
Week 1 Discussion
Burnout in healthcare has long been an issue many nurses face as they give their all when caring for patients. Burnout is described as a long-term outcome related to excessive exposure demands of the job and results when the employee can no longer endure the stress (Algunmeeyn et al., 2020). The recent COVID-19 Pandemic has exacerbated this long-held state of burnout, causing nurses to walk off the job or not show up for work. Previously dedicated employees are now no-call no-shows because they are physically and mentally exhausted fighting both a Pandemic and misinformation. The World Health Organization Director declared that the COVID-19 pandemic is going through an ‘infodemic’ (information epidemic) of misinformation (Barua et al., 2020). Fighting both a pandemic and infodemic increases the stress nurses already face.
Not only are nurses dealing with normal burnout, we are now having to fight misinformation. Facebook reported warning labels were placed on about 90 million pieces of content related to covid-19 misinformation in two months at the beginning like false cures, anti-vaccination propaganda, and conspiracy theories (Barua et al., 2020). This can be a daunting task to keep the public educated on science-based theory and approaches to COVID-19. Misinformation about the global health crisis COVID-19 pandemic generates a severe risk to public health (Barua et al., 2020). It is our job as nurses to continue to educate our patients and the population on fact and science-based evidence.
The most significant resources to explain burnout include autonomy, social support at work, and available resources (Manzano García & Ayala Calvo, 2020). Short staffing contributes to increased burnout. Burnout in hand leads to increased sick days, decreased job satisfaction, and a decrease in health and well-being. In the workplace, this may mean mandatory overtime may need to take place, making it more difficult to balance family and work. At the state of MN, mandatory overtime occurs frequently and is used for routine staffing. What is seen is a higher call-in rate with those caring for the most mentally ill in the state.
Trying to plan to avoid burnout is key. Managers need to make an effort to reduce stress in the job, reinforce resources for covid-19 treatment, and promote support from upper management (Algunmeeyn et al., 2020). Scheduling extra staff members is a great solution, but only happens on a rare occasion. Implementing 10-hour shifts at my facility allowed for an overlap of nurses mid-day. It felt as though the staffing ratio had increased, though it had not. The mere hours the nurses worked changed so more were present during the busiest times of the day. This is a good solution to reduce burnout. A lot of hospitals are moving towards 12 hour shifts. The addition of 12- hour shifts would allow for less travel time and transitions from work and home life, increasing employee satisfaction. Self-care is another area that employers need to focus on and encourage to avoid burnout.
Burnout in healthcare has been seen everywhere over the years. It is important for management to listen and support its staff, encourage self-care, and offering additional staffing when able. Involvement of upper management will allow for the additional support staff that is needed to decrease stress in the nursing force that is dealing with not only a pandemic, but an infodemic as well.
Algunmeeyn, A., El-Dahiyat, F., Altakhineh, M., Azab, M., & Babar, Z.-U. (2020). Understanding the factors influencing healthcare providers’ burnout during the outbreak of covid-19 in jordanian hospitals. Journal of Pharmaceutical Policy and Practice, 13(1). Retrieved December 2, 2020, from https://doi.org/10.1186/s40545-020-00262-y
Barua, Z., Barua, S., Aktar, S., Kabir, N., & Li, M. (2020). Effects of misinformation on covid-19 individual responses and recommendations for resilience of disastrous consequences of misinformation. Progress in Disaster Science, 8, 100119. Retrieved December 2, 2020, from https://doi.org/10.1016/j.pdisas.2020.100119
Broome, M. E., & Marshall, E. S. (2020). Transformational leadership in nursing (3rd ed.) [E-book]. Springer. https://doi.org/https://mbsdirect.vitalsource.com/#/books/9780826135056/
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being. Nursing Administration Quarterly, 42(3), 231–245. Retrieved December 2, 2020, from https://doi.org/10.1097/naq.0000000000000303
Laureate Education (Producer). (2015). Leading in Healthcare Organizations of the Future [Video]. https://class.content.laureate.net/bff323eadbbca206b96404db9ab32968.html
Manzano García, G., & Ayala Calvo, J. (2020). The threat of covid‐19 and its influence on nursing staff burnout. Journal of Advanced Nursing. Retrieved December 2, 2020, from https://doi.org/10.1111/jan.14642
Excellent post. Certainly, burnout is a real issue that faces nurses in the workforce today. I also, as you already know, work with the State of MN and have experienced the burnout issues that you described. It would seem that an inability to keep consistent staffing which leads to significant mandatory overtime is a major problem at the state hospital. And as you mentioned, when the issue begins to peak at any given time, it certainly significantly effects a nurse’s job satisfaction. This decreased satisfaction and mandatory overtime leads to more sick calls, which only worsens the problem. It’s a bit of a vicious cycle.
Chang et al. notes that there is evidence decreased job satisfaction caused by burnout directly lessens a nursing professional’s professional commitment (2017). The authors go on to define this professional commitment as in effect professional integrity, meaning a nurse’s desire and ability to follow best practices even in the face of adversity or increased stress (Chang et al., 2017). I have witnessed this firsthand, in where burnout is so significant, good and capable nurses feel forced to make less than ideal choices in order to lessen the burden they feel on themselves through the shift and the workweek.
Jones suggests that nurses develop a regimen at least weekly of devoting a minimum of 15 minutes to the practices of mindfulness of the situation and relaxing the mind from it’s stress (2019). Certainly, this is good advice for nurses to take time to relax and focus their mind on their own time, I believe another component is a commitment from the health care organization to addressing the underlying issues that contribute to or may be the primary cause of the increased burnout.
Chang, H., Shyu, Y. L., Wong, M., Chu, T., Lo, Y., & Teng, C. (2017). How does burnout impact the three components of nursing professional commitment? Scandinavian Journal of Caring Sciences, 31(4), 1003–1011. https://doi-org.ezp.waldenulibrary.org/10.1111/scs.12425
Jones, B. (2019). Fifteen minutes may decrease nursing burnout: A discussion paper. International Journal of Nursing Sciences, 7(1), 121–123. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ijnss.2019.11.004
Nurse burnout seems to be a problem that nurses have faced for many years. During the COVID-19 pandemic, burnout has become an even bigger problem. Prolonged stress at work can lead to burnout (Soto-Rubio et al., 2020). Increased stress at healthcare facilities was inevitable. Like you said, the amount of misinformation, conspiracy theories, and the changing protocols created stress among providers and all other healthcare workers. The prevalence of burnout among RN’s in the US ranges from 35-45%, where nurses had twice the rate of depression compared to other healthcare professionals (Janeway, 2020). Those statistics are alarming, especially with the unknown of how long the pandemic will continue. It would be interesting to see what hospitals across the country are doing for their nurses to help reduce burnout. Our hospital provides stress management tips and peer support. However, burnout is high as staffing is often low resulting in nurses being asked to pick up multiple shifts.
Great post Joy, I enjoyed reading your discussion.
Janeway, D. (2020). The Role of Psychiatry in Treating Burnout Among Nurses During the Covid-19 Pandemic. Journal of Radiology Nursing, 39(3), 176–178. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jradnu.2020.06.004
Soto-Rubio, A., Giménez-Espert, M. D. C., & Prado-Gascó, V. (2020). Effect of Emotional Intelligence and Psychosocial Risks on Burnout, Job Satisfaction, and Nurses’ Health during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 17(21). https://doi-org.ezp.waldenulibrary.org/10.3390/ijerph17217998
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