sign machines, may also need to be purchased to support an expanding workforce. According to the American Nurses Association and Avalere (2015), adding more registered nurses to the staffing mix can yield a cost savings of $3 billion dollars annually nationwide, which is a result of four million avoided hospital stays for adverse events. Adding more licensed providers to staffing protocols also helps to reduce costly readmissions. By meeting the goals of the nurse-sensitive indicators, reimbursement monies would be greater. Martin (2015) suggests that while hospitals who increase their nurse ratios may initially feel a slight change in operating expenses, the benefit is a decrease in the amount spent on adverse patient outcomes. Personal Values My days as a travel nurse and then as a director on a med/surg unit have drastically affected my view regarding a standardized nurse/patient ratio. I have seen, many times, a nurse become so overwhelmed with the needs of their patients that they become incapacitated in their ability to critically think and serious outcomes have happened. One example is a time that a fellow nurse had six patients on a very heavy nephrology floor. She was so busy passing pain medications and tending to patients’ needs that she missed a patient having an active heart attack and the patient died. I had the experience of working in California, the first state to mandate a nurse to patient ratio. I worked on a medical oncology floor and had no more than four patients at a time. I was able to take care of my patients in a timely manner, review their charts and become familiar with
POLICY, POLITICS, & GLOBAL HEATLH 6 their cases, and actually had time to connect with them. As a travel nurse, I received recognition from the management at that hospital, all because I had time to take care of my patients. Ethical Principal or Theory The ethical principal that could apply to this bill is that of nonmaleficence. The definition of nonmaleficence is the avoidance of harm or hurt, which is core to nursing ethics. In order to not harm patients, nurses need a firm foundation. Short staffing a unit undermines this foundation by introducing a workload that can fatigue a nurse quickly, mentally and physically, to the point that they are not able to critically think when making decisions that have the potential to be a threat or harm their patients. As staffing becomes more inadequate, the principal of nonmaleficence is harder to cling to. Top-Down Approach to Policy Advocacy By using the top-down approach effort to effect policy change, a person of influence is approached with the idea. A person of influence is anyone that has the power to effect change, such as a congressman, state governor, or chief nursing officer of a local healthcare facility. By gaining their support, policies are often implemented by their persuasive actions.
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