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An alternative framework that conceptually applies to the issue of mandated nursing patient ratios is Neumann’s Systems Model. This theory, “… focuses on the wellness of the patient system in relation to environmental stress and reactions to stress,” (Kearney-Nunnery, 2016). The patient system is comprised of five variables; the physiological, the psychological, the sociocultural, the developmental, and the spiritual. “Nursing practice is directed toward facilitating optimal wellness through retention, attainment, or maintenance of client system stability,” (Kearney-Nunnery, 2016). In order for the patient to have a positive created environment, it is the nurse’s responsibility to ensure the internal and external environmental stressors are working in a cohesive manner for the patient to reach optimal wellness. The nursingprofession as a whole naturally comes with its accepted share of stress. When patients’ lives are held in the balance of life or death decisions stress is expected, however unacceptable levels of stress are reached when nurses have to take on a greater patient work load. Heightened levels of stress and unmet patient expectations lead to a break in the interpersonal relationship between thenurse and patient which ultimately impedes the patient’s achievement of optimal wellness. By utilizing the primary, secondary, and tertiary preventions listed in Neuman’s nursing outcomes,
PATIENT SAFETY AND LEGAL ISSUES SAFE STAFFING 11nurses are able to attain and reformulate patient goals. Ultimately it is the nurse’s responsibility to ensure patient short term and long term goals are attained through the nurse-patient system. This is not feasible when a nurse is overwhelmed with too many patients and there is an increase potential for patient harm. As nurses it is imperative that we leave stress at the door and focus on the patient and tasks in front of us, regardless of our patient assignments. With mandated nurse patient ratios, nurses and patients will experience less stress and patients will have a better chance of achieving the optimal level of wellness.Concluding ReflectionsAs a new graduate nurse, my first employment was at a long term care facility in which patients had multiple comorbidities and required not only treatment interventions but medical supervision. It was not uncommon for my patient care assignment to include anywhere from 20 to 33 patients. While the challenges of acute care versus long term care nursing are different, there are still challenges, time management issues, and the overwhelming insecurity that because you have so many patients, at times you’re doing more harm than good. I eventuallybegan working in a hospital in the acute care setting and quickly realized that when it comes to overwhelming patient assignments the issue affects all facets of the nursing profession. If mandated nursing patient ratios were granted, I feel that my nursing practice would greatly improve. I feel that I would be more confident in my nursing skills and patient care. Walking into
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Nursing, Patient safety, Hospital Nurse Staffing, national nurse, The Registered Nurse Safe Staffing Act