Effective nurse leaders are frequently faced with ethical dilemmas that arise from the inherent tension between competing needs and limited resources within the healthcare system. These dilemmas require leaders to carefully balance the needs of the organization with the imperative of ensuring quality, effective, and safe patient care. One example of such a dilemma is the use of 12-hour shifts as a strategy for nurse retention.
It has been observed that as nurses work longer hours in a single shift, they are more likely to commit errors. This raises concerns about patient safety and the quality of care provided. On the other hand, 12-hour shifts have been implemented as a method to address workforce needs, particularly in the context of nursing shortages. Nurses often prefer longer shifts as it allows them to have more consecutive days off, which can lead to better work-life balance and job satisfaction.
In order to find a balance between the needs of the organization and ensuring quality care, nurse leaders must carefully consider the impact of competing needs. Competing needs can include the needs of the workforce, the availability of resources, and the needs of patients. Each of these factors can significantly influence the development of policy in healthcare organizations.
For instance, the needs of the workforce can impact policy development by influencing decisions related to scheduling, workload, and nurse retention strategies. In the case of 12-hour shifts, nurse leaders must weigh the preference of nurses for longer shifts against the potential negative impacts on patient safety. This requires a thoughtful consideration of evidence-based practices and the implementation of policies that strike a balance between the needs of the workforce and patient care.
Furthermore, the availability of resources, such as financial and staffing resources, also plays a crucial role in policy development. Limited resources can create competition among various departments or units within an organization. Nurse leaders must allocate these resources efficiently, ensuring that patient needs are met while also addressing the needs of the workforce. For example, if a healthcare organization is facing a shortage of nurses, nurse leaders may need to allocate resources to recruitment and retention initiatives in order to address the staffing needs.
Finally, the needs of patients are a paramount consideration in policy development. Policies must be designed to prioritize patient safety, quality care, and positive outcomes. Nurse leaders must carefully consider how competing needs may impact patient care and develop policies that address these needs while ensuring the delivery of high-quality care. For example, in the case of 12-hour shifts, nurse leaders may need to implement policies that limit consecutive shifts without compromising patient safety.
In the context of a national healthcare issue or stressor, there may be specific competing needs that impact policy development. One such issue could be the allocation of scarce resources during a public health crisis, such as a pandemic. During such crises, healthcare organizations face the challenge of balancing the needs of both infected and non-infected patients, while also ensuring the safety and well-being of healthcare workers.
The competing needs in this situation include the need to allocate resources for testing, treatment, and prevention measures for infected patients, as well as the need to provide ongoing care for non-infected patients. Additionally, there is a need to protect healthcare workers by providing them with adequate personal protective equipment and ensuring their well-being amidst the rapidly evolving situation. Policy development in this context would require careful consideration of these competing needs and the development of strategies that optimize resource allocation, patient care, and workforce safety. For example, policies may prioritize the allocation of testing kits and resources to areas with high infection rates while also ensuring the availability of essential healthcare services for non-infected patients.
In conclusion, nurse leaders face ethical dilemmas resulting from competing needs and limited resources within the healthcare system. The needs of the workforce, resources, and patients all impact the development of policies. Nurse leaders must carefully and ethically balance these competing needs, considering evidence-based practices and implementing policies that prioritize patient safety, quality care, and the well-being of the healthcare workforce.
