Discussion: Organizational Policies and Practices to Support Healthcare Issues

Posted: November 9th, 2022

Competing needs, such as the workforce, resources, and patients’ needs, impact policy development. In developing nursing policies, competing needs must align with the proposed agenda that the policy seeks to advocate. For example, a policy addressing adequate nurse staffing should meet the patient and workforce needs while minimizing financial costs.  Nurses are frontline caregivers who provide care to patients in a cost-effective manner. The quality of care provided to a large extent is dependent on various factors, one of which is the care delivery model and care environment. The needs of the workforce/nursing need to be addressed adequately. However, sometimes the required resources to meet those needs are not enough to enable policy development, and therein lies the problem.

According to Clarke and Donaldson (2008), Nursing is a critical factor in determining the quality of care in hospitals and the nature of patient outcomes. Policies developed can positively impact patients while negatively impacting the workforce; hence, all stakeholders must be actively engaged in the policy development process to address needs. Stakeholders can influence system change initiatives (O’Rourke, Higuchi, and Hogg, 2016).

Specific competing needs that may impact the national nursing shortage are the failure to organize and utilize the workforce effectively; this inability or failure may lead to a shortage or excess supply of clinical staff. An oversupply of nurses leads to increased costs to the healthcare organization and economic inefficiencies coupled with misallocated and mismanaged resources under the pretext of adequate staffing. The shortage of staff in healthcare organizations has adverse effects, including low quality of care, unsafe care, possible adverse effects, and negative outcomes.

Furthermore, nurses are overloaded and overworked because there are fewer resources, leading to burnout, call-offs, and eventually compromising patient safety due to inadequate staffing/nursing shortage. According to Scruth et al. (2018), it is critical to maintaining a balanced workload to ensure that nurses do not experience fatigue and stress.

A policy can address these competing needs by providing an ideal nurse to patient ratio that can improve nurse staffing in healthcare organizations and improve care and positive patient outcomes, putting the patient as the central focus of care. According to Jarrar et al. (2018), patient‐centeredness helps mitigate the nursing shortage’s negative impact on care outcomes. A policy can create a framework that ensures an excellent nurse to patient ratio depending on the healthcare organization’s care setting. For example, the nurse to patient ratio for an acute surgical unit or acute psych ward can be 5: 1, meaning one nurse will be assigned to five patients at the most, which is the practice at current employment.


Clarke, S. P., & Donaldson, N. E. (2008). Nurse staffing and patient care quality and safety. In Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality (US).

Jarrar, M. T., Rahman, H. A., Minai, M. S., AbuMadini, M. S., & Larbi, M. (2018). The function of patient‐centered care in mitigating the effect of nursing shortage on the outcomes of care. The International journal of health planning and management33(2), e464-e473.


O’Rourke, T., Higuchi, K. S., & Hogg, W. (2016). Stakeholder participation in system change: A new conceptual model. Worldviews on Evidence‐Based Nursing13(4), 261-269.

Scruth, A. E., Sabrina , G., & Liesel , B. (2018). Work Life Quality, Healthy Work Environments, and Nurse Retention. Clinical Nurse Specialist, 32(3), 111-113. doi:10.1097/NUR.0000000000000376

Discussion: Organizational Policies and Practices to Support Healthcare Issues

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.

To Prepare:

  • Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
  • Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

By Day 3 of Week 3

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

By Day 6 of Week 3

Respond to at least two of your colleagues on two different days by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.


Your post is quite informative of the nature of the work environment and the policies negatively impacting nursing practice. These policies facilitating competing needs such as workforce can be seen in the denial of the full authority to practice for the Nurse Practitioners (NPs) in some states. Full authority to practice is State practice and licensure law that allows all nurse practitioners to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments, including prescribe medications, under the exclusive licensure authority of the state board of nursing (American Nurses Association, AANP, 2016).

Currently, 22 states and the District of Columbia, or 44%, have adopted full practice authority licensure and practice laws for NPs (AANP, 2016). The move to grant full practice authourity to NPs cushions the effect of lack of primary healthcare providers and reduces the healthcare burden for remote and underserved populations. However, the cost of healthcare is also made affordable by allowing NPs full practice authourity. Most states still have policies and regulations that restrict NPs from practicing, hence increasing the workload burden for the few available providers



American Association of Nurse Practitioners (AANP). State practice environment. 2016 Retrieved from https://www.aanp.org/legislation-regulation/state-legislation/state-practice-environment

Peterson M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology, 8(1), 74–81.

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