Response to Jessica Miller
Competing Needs and Policy Development
Policymaking in healthcare is about standardizing safe practices and creating solutions. When there is a significant or persistent conflict in healthcare, policies can address the issues. During the Covid-19 pandemic, there have been many conflicting needs. One of the most predominant conflicts has been the needs of healthcare workers versus the needs of the patients.
Competing Needs of Healthcare Workers and Patient Care
When healthcare workers are tasked with unsafe assignments, they suffer mentally and physically (Rolin et al., 2021). Nurses are working long hours and extra shifts to compensate for the staffing shortages while also dealing with these heavy assignments. The result is that the nurses will be tired, overwrought, and less safe.
These situations are causing moral distress among the healthcare employees because they are not capable of providing adequate care and are forced into making decisions that can cost lives (American Association of Critical-Care Nurses [AACN], n.d.). However, despite staffing shortages and higher acuity assignments, patients still require care, and it is part of the Code of Ethics for Nurses to provide that care and maintain accountability (American Nurses Association, 2015). This dilemma drives nurses away from the bedside and even out of the profession (AACN, n.d.).
Policies to Address the Conflicting Needs
Policy implementation that directly affects the influx of Covid-19 patients to the hospital includes the mandate for non-essential workers to stay home. By isolating at home, the number of people infected by Covid decreases, and so does the strain on the healthcare workers. Other policies that are significant to preventing the spread of Coronavirus include mandatory masks when indoors and staying home if febrile or experiencing Covid-like symptoms (Center for Disease Control and Prevention [CDC], 2021).
American Association of Critical-Care Nurses (AACN). (n.d.). Moral Distress in Nursing: What
You Need to Know. https://www.aacn.org/clinical-resources/moral-distress
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements.
Centers for Disease Control and Prevention (CDC). (2021). Interim infection prevention and
control recommendations for healthcare personnel during the Coronavirus disease
2019 (COVID-19) pandemic. U.S. Department of Health and Human Services.
Rolin, S. N., Flis, A., & Davis, J. J. (2021). Work coping, stress appraisal, and psychological
resilience: Reaction to the COVID-19 pandemic among health care providers. Psychology & Neuroscience. https://doi.org/10.1037/pne0000257
Testing and providing care to patients with suspected or confirmed COVID-19 infection and keeping healthcare workers (HCWs) are the most competing needs for organizations. The pandemic has placed an extreme strain on HCWs. According to Billings et al.(2021), HCWs are facing threats to their own physical safety and indirectly the physical safety of their families. These workers are managing many patients with high rates of mortality within a high-pressing work environment. They are dealing with challenges in providing care with strict measures on infection control in place and with inadequate personal protective equipment (PPE).
Employers have the responsibility of providing all HCWs with training and PPE. According to employers are obligated to ensure a safe working environment for staff and have adequate resources to deliver quality nursing care. As workers at the forefront in the battle against the pandemic, nurses have the right to safe working environments; nevertheless, this is not usually the reality. Nurses around the world have concerns over inadequate PPE. Employers have failed to comply with the standards of care and protection recommended by the WHO leading to exposure of frontline workers to infection (Malaudzi et al., 2021).
To ensure minimal risk of infection when delivering care to COVID-19 patients, the CDC recommends the utilization of PPE including gloves, a gown, an N95 respirator, and goggles/ face shield. Nevertheless, airborne precautions are not utilized in everyday, routine care of patients suffering from general respiratory illness. The widespread utilization of barrier precautions in the care of every patient with respiratory symptoms should be of the greatest priority. In outpatient offices, emergency departments, and other settings, there are infected but undiagnosed patients, the majority with atypical presentations or mild cases. There is limited availability of respiratory isolation rooms, and N95 masks especially in outpatient offices, to feasibly assess each patient with respiratory illness (Adams & Walls, 2020)
Many HCWS have conditions that increase the risk for infection and even death if they contract COVID- 19 disease, so health care organizations will be required to decide whether such workers, including nurses and physicians, need to be redistributed away from sites with the highest risk. Recognizing the risk of HCW deficits, institutions are canceling conferences, prohibiting travel to medical meetings, recommending curtailing of personal travel, and limiting nonessential travel. These travel restrictions are to affected areas and also to international and domestic sites to keep HCWs close and available. Avoiding crowds and travels is likely to lessen t risk of infection (Adams & Walls, 2020).
Adams, J. G, & Walls, R. M. (2020). Supporting the Health Care Workforce During the COVID-19 Global Epidemic. JAMA, 323(15), 1439-1440. doi:10.1001/jama.2020.3972
Billings, J., Fung, B. C., Gkofa, V., Greene, T., & Bloomfield, M. (2021). Experiences of frontline healthcare workers and their views about support during COVID-19 and previous pandemics: a systematic review and qualitative meta-synthesis. BMC Health Services Research, 21, 923. https://doi.org/10.1186/s12913-021-06917-z
Malaudzi, F. M., Malaudzi, M., Anokwuru, R. A., & Davhana-Maselesele, M. (2020) Between a rock and a hard place: Ethics, nurses’ safety, and the right to protest during the COVID-19 pandemic. International Nursing Review, 68(3), 270-278. https://doi.org/10.1111/inr.12703