Instructions: Reply to the threads of at least 2 classmates.

Instructions: Reply to the threads of at least 2 classmates. 

Trend 1

“Nurses play a critical role in the delivery of safe, quality care within the U.S health care system” (Snavely, 2016).  For years the U.S has faced several bouts of nursing shortages.  “Throughout the history of the health care workforce in the United States, a cyclical pattern of nursing shortages and surpluses has occurred” (Snavely, 2016).  There are a number of elements that have caused nursing shortages over the years.  Some of the causes for nursing shortages are stressful work environments, aging baby boomers, not enough nursing graduates, and the increased number of people who have health insurance due to the Affordable Care Act.  One of the main reasons for nursing shortages is the stressful work environment.  “Nurses have reported feeling “physically exhausted and emotionally drained” due to conditions in their workplace, such as an increased patient load in a high performance, high stakes environment” (Dotson, Dave, & Crazier, 2012).  Nurses deal with high stress working in hospitals. The nurse to patient ratio is sometimes too much for the nurse.  A nurse may have too many patients to take care of during a single shift with little to no help.  This leads to the nurse being physically and emotionally drained.  Many nurses, after working in the hospital for a length of time, tend to try and find a less stressful clinic position.  This leads to significant nursing shortages within the hospitals.  Nurses are having to work long hours and required to work mandatory overtime because of the patient load and the shortage of nurses.  “Long work hours can lead to exhaustion, restlessness, inadequate sleep patterns, and deficits in performance and reaction time” (Bae, 2012). “Nursing is highly rewarding, yet incredibly stressful and demanding both for the caregiver and family members” (Snavely, 2016).

Nurses working in a high stress environment get burnt out.  Nurses are overworked and underpaid. “Burnout, fatigue, and stress cause many nurses to leave the vocation only a few years after entering into it” (Snavely, 2016).   Nurses are expected to work in stressful work environments and work over time but they do not get the pay they deserve.  “Consistently stressful work environments with little monetary or prestige incentives for nurses have been a mainstay in nursing history” (West, Griffith, & Iphofen, 2007).  Nurses sometimes have to work through their lunch because of their patient load.  They also have to work long hours with little to no breaks at all.  This leads to burn out in the nursing field.

Some things that can be done to help with the nursing shortage are to allow flexibility with schedules and try not to make nurses work long hours without breaks, allow for incentives and advancements, and lessen the stress in the work environment.  A team approach can help decrease stress levels in the work environment.

 

 

Trend 2

It is estimated that certain physician specialties will be in shortage over the next several years, in part due to the continuing aging of the general population with more medical services needed.  Family practice physicians and intensivists, those that treat critically ill patients in the ICU, are two that might be lacking in future years.  The shortages are more apparent in rural areas across the country.  “Published estimates indicate that intensivists currently provide care to only 37% of all ICU patients in the United States and that they are located primarily in large hospitals and teaching institutions” (Lois, 2014 p.1121).  The majority of doctors are not choosing these fields to go in but other more lucrative specialties like orthopedics or urology.  Family practice, internal medicine and pediatrics make the least amount of money coming out of medical school so not as many doctors want to go into those fields but those are the doctors we need to for prevention and treatment of routine medical conditions.

One of the options to provide a solution to the shortage of family practice or internal medicine physicians is to incorporate either nurse practitioners or physician assistants into physician practices.  It takes less school and post school training for these fields and they are able under a doctor’s supervision, to treat some of the same medical conditions.

In the years ahead, it is reasonable to expect that the primary care workforce will evolve to increase the number and enlarge the scope of practice of PCNPs and Pas, alter the role of PCMDs to focus more on medically complex patients, promote the collaborative relationships, include other professionals and nonprofessionals as part of the primary care team, and use technology more effectively to increase the capacity and reach of clinicians. (Buerhaus, DesRoches, Dittus & Donelan, 2015 p.152).

Many practices and clinics are already incorporating nurse practitioners and physician assistants in addition to their physicians.  The employee clinic at my hospital uses two nurse practitioners to treat things like sore throats or urinary tract infections and give routine vaccines.

Training time was also an issue regarding the shortage of intensivists.  One solution that was presented in the article by Lois was to create a one year expedited critical care training program that would allow hospitalists (physicians who practice internal medication in an inpatient hospital setting) with 3 years of practice to complete and obtain a certificate for critical care (2014).  Several groups have expressed concerns about doing fast track training such as the American College of Chest Physicians and the American Association of Critical Care Nurses (Lois, 2014).   More studies will need to be done to determine if a shorter training period would be sufficient to give physicians the needed knowledge to be proficient in critical care.

For either solution to work collaboration and teamwork is going to be needed among clinicians and professional groups with the end goal being to provide a more efficient and productive health care workforce (Buerhaus et al, 2015).  In addition some state policies and regulations may need to be revised to accommodate these changes.  Nurse practitioners and physician assistants can do various things depending on the state where they are licensed.

Ephesians 4:16 states, “From whom the whole body, joined and held together by every joint with which it is equipped, when each part is working properly, makes the body grow so that it builds itself up in love”.  In the articles I read for this discussion fear of competition was mentioned where a physician might feel threatened by other professions like nurse practitioners taking over their jobs.  A new way of thinking may be needed by some where an atmosphere of working together is fostered and not looking at it as competition.  In the end I think there is plenty of work to go around and we need to use all our resources wisely and in love in health care to provide quality patient care in any setting. (words 657).