In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting.

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

·      Review the Resources and select one current national healthcare issue/stressor to focus on.

·      Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.


Sample paper

A national healthcare issue I have selected is one that I have experienced since I began working as a nurse 12 years ago: nursing shortage.  “According to the World Health Organization (WHO), there is a shortage of 7.2 million healthcare workers with regard to health needs, whereas the report by the ‘Third Global Forum on Human Resources for Health’ estimates that by 2035, the nursing deficit will reach 12.9 million (Marc, Bartosiewicz, Burzynska, Chmiel, & Januszewicz, 2018, p. 10).  Working in Pediatric Intensive Care Unit (PICU), nursing shortage creates unsafe nurse to patient staffing ratios.  Unlike California, New Jersey does not have mandated staffing ratios.  I have worked shifts with three patients; two of those were intubated on full ventilator support.  An appropriate PICU assignment is one nurse for one invasively ventilated patient due to the close monitoring required to adequately care for the patient.  Nursing shortage has negatively impacted my work setting in several ways.

Nursing shortage produced poor patient experience of care, low staff retention, and increased hospital acquired infections.   When patient load exceeds available nurses, patient experience is compromised.  Patients become aware that their nurses were difficult to call at bedside or spent their time tasking, instead of showing care and compassion.  Also, unsafe staffing ratios increases burnout and nurses tend to leave for higher education or a different career entirely.  Patient care is also compromised with nursing shortage.  Studies have found increased length of stay for patients when higher nurse-to-patient ratios result in more complications (Heinz, 2004).  For example, one PICU nurse with three patients (all requiring total care) will not be able to turn patients every two hours for pressure ulcer prevention and provide mouth care every two hours for ventilator associated pneumonia prevention.  Hence, increase in hospital acquired injuries or infections.

My health care work setting is still struggling to respond to nursing shortage n.  At first, when my unit was short staffed and nurses were not getting their morning or lunch breaks, the administrators would send the unit boxes of pizza.  After awhile nurses began submitting incident reports for unsafe nurse to patient ratios.   Nurses were now scared of losing their license if a patient was seriously harmed because they could not get into their patient room in time.  Finally, administrators and finance department agreed to open positions for the PICU.  Last year, we hired 10 nurses onto the unit.  However, we are still short staffed!  Positions remain open and posted but hardly anyone is applying or qualified.  Nevertheless, according to Marshall & Broome (2017), “the nursing supply between 2013 and 2025 is expected to exceed demand, within a projected 3,849,000 nurses available for 3,509,000 positions –an excess of 340,000 nurses” (p. 72).


Heinz, D. (2004, January 1). Hospital nurse staffing and patient outcomes: a review of current literature. Dimensions of Critical Care Nursing23(1), 44-50. Retrieved from

Marc, M., Bartosiewicz, A., Burzynska, J., Chmiel, Z., & Januszewicz, P. (2018, July 24). A nursing shortage – a prospect of global and local policies. International Nursing Review66(1), 9-16.

Marshall, E. S., & Broome, M. E. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer