The Office of Personnel Management (OPM) approved a request from the
Department of Veterans Affairs (VA) on March 19 to waive a section of
federal law that governs retired VA workers.
The waiver makes it
easier for the department to rehire retired VA health care workers
and will help VA health care facilities bolster their medical staffs
during the COVID-19 pandemic.
VA is implementing
the authority and could begin hiring actions as soon as this week.
As a result, VA is
inviting interested retired physicians, nurses, pharmacists,
laboratory technicians, respiratory therapists and other medical
professionals to register online.
VA is especially looking for health care providers with interest and expertise in:
care/support (at a VA medical center and/or outpatient clinic)
As a re-employed annuitant, you receive your Civil Service Retirement System (CSRS) or Federal Employee Retirement System (FERS) annuities, as well as a paycheck as a federal employee. The waiver is in effect until March 31, 2021, according to OPM.
A large European study linked hospital nurses who work 12-hour shifts to adverse outcomes like burnout and job dissatisfaction. The survey published in BMJ Open involved more than 31,000 nurses in 488 hospitals across 12 countries.
One of the major
results was that nurses working 12 hours or more in a shift
experienced high burnout. Most notably, nursing shifts of at least 12
hours increased the odds of high emotional exhaustion by 26%,
compared with nurses working shifts of eight hours or less. Nurses
who worked longer shifts were also more likely to experience high
depersonalization (a dreamlike or detached state of mind) and low
finding was the connection with job dissatisfaction. Nurses who
worked shifts of 12 hours or more were 40% more likely to report
being dissatisfied with their job — and 31% were more likely to
plan to leave their job — compared with nurses working shifts of
eight hours or less.
noted a paradox. Nurses prefer longer shifts because of the
perception that they improve job satisfaction, but longer shifts may
have the opposite effect. “Nurses may be choosing to sacrifice work
satisfaction for benefits in other spheres of life,” they said.
“However, this type of choice is likely to compromise nurses’
recovery sleep, physical and psychological well-being: the stress of
those long workdays and the recovery time needed may counterbalance
any perceived benefit.”
Similar findings were seen in an American study of more than 22,000 nurses in four states. According to researchers in Health Affairs, longer nursing shifts “were associated with significant increases in the odds of burnout, job dissatisfaction, and intention to leave the job.” In particular, the odds of burnout and job dissatisfaction were up to two and a half times higher than nurses working eight- to nine-hour shifts.
Perhaps most striking was the study’s conclusion that the longer the shift for hospital nurses, the higher the levels of patient dissatisfaction. In fact, both studies warned how nurse burnout and job dissatisfaction could adversely affect patient safety.
Evaluating Job Performance for Nurses Working Longer Shifts
If longer nursing shifts contribute to burnout and job dissatisfaction, the consequences fall across two general spheres. One is the impact that issues like turnover and absenteeism can have on an organization’s culture and finances. The other area encompasses issues, according to BMJ Open, like higher risks of medical error, lower quality of care, and reduced well-being (for nurses and patients).
While there’s no
consensus that 12-hour shifts are a health risk, it’s not hard to
find sources that support the affirmative. That’s the case for the
two major studies mentioned so far, and researchers in Health Affairs
were much bolder with their results. “Our findings contribute to a
growing body of research associating nurses’ shift length with
patient safety issues,” they said while noting four additional
studies. “The results also highlight an area of health care ripe
for policy development at both national and institutional levels.”
The other side of the debate is well-represented. A separate study in BMJ Open was the first to bring in an objective measure of missed care, in the form of missed or delayed vital signs observations, to gauge any impact on the quality of care. Healthcare assistants who worked long shifts at the large hospital in England had a significant increase in delayed vital signs observations, but the same wasn’t true for RNs. According to those nurses, time constraints result in less interpersonal care (such as comforting patients and planning their care) instead of clinical care.
Another study published in the Journal of the Intensive Care Society compared eight- and 12-hour shifts during a two-year period at a large intensive care unit in Wales. The first year everyone worked the traditional shift, and the second year, the longer shift was introduced for those who opted in. The results showed no significant differences between the two groups across multiple outcomes, including clinical incidents, sickness rates, personal injuries, and staff training. An improvement was found in emotional exhaustion and depersonalization for those working 12-hour shifts.
Perspective on the Debate Over Nursing Shift Length
It’s important to remember the complexity surrounding research on
extended nursing shifts.
“It is difficult to control extraneous variables, including shift sequence, overtime and break patterns,” according to authors in the Journal of the Intensive Care Society, when discussing their perception about the research varying in quality. “Age, grade, and experience of the nurse may also influence study findings.”
Another thing to
keep in mind is whether shift length is the most critical issue in
the broader discussion. “This is a topic in nursing that has been
debated for many years,” said Leeann Denning, assistant professor
and chair of the nursing department at Shawnee State University. “I
know nurses who prefer and do well with 8-hour shifts and those who
prefer and perform well with 12-hour shifts. Research is clear on the
effects of fatigue, but I think the conversation needs to move from
the hours worked to what level of care is required of that nurse
during the shift.”
From shift length to
the level of care, research on those types of topics can help raise
more awareness and ultimately improve the quality of care. Engage in
these conversations while you earn your online RN to BSN — a
designation that research has linked to improved patient care. You’ll
gain the knowledge and skills to prepare for leadership or
specialized roles to make a positive impact in your career.
The nurse-founded company Soothing Scents had a free giveaway contest for DailyNurse readers earlier this month, and three lucky entrants won special kits containing a sampler of Soothing Scents products:
Soothing Scents creates evidence-based, drug-free nursing interventions to manage patient nausea and anxiety. Delivered via on-the-go inhalers, Soothing Scents products such as QueaseEASE (which manages nausea experienced during and after surgery) are used in over 2,000 hospitals across the US.
High ethical standards are essential in healthcare. Four fundamental principles lay the foundation for healthcare ethics.
Autonomy honors patients’ right to make their own decisions.
Beneficence helps patients advance their own good.
Nonmaleficence does no harm to patients.
Justice ensures that patients are treated equally, fairly and impartially.
Current ethical issues in healthcare center on these guiding principles. Healthcare professionals must be prepared to navigate the following issues.
5 Ethical Issues in Healthcare
1. Improving Access to Care
The Department of Health and Human Services identified access to healthcare as an objective for its Healthy People 2010 and Healthy People 2020 initiatives. In 2012, only 83.1 percent of people had medical insurance. The latest figures from the National Health Interview Survey show that 12.5 percent of adults under age 65 are uninsured. Improving access to care has been a central issue in healthcare for many years. This includes not just private insurance but also Medicare, Medicaid, military and other government health insurance plans.
2. Protecting Patient Privacy and Confidentiality
Violating a patient’s privacy and confidentiality can have legal and ethical consequences for healthcare providers and professionals. Patients’ medical information is protected by the Health Insurance Portability and Accountability Act. Topics like increases in data breaches and smartphone usage highlight the ongoing need to understand this ethical issue.
3. Building and Maintaining a Strong Healthcare Workforce
“The U.S. has been dealing with a nursing deficit of varying degrees for decades, but today … this shortage is on the cusp of becoming a crisis, one with worrying implications for patients and health-care providers alike,” according to The Atlantic. An aging population, the rising prevalence of chronic disease and an aging nursing workforce are contributing to the shortage.
If healthcare providers are unable to develop and sustain a strong workforce, patient care will suffer, as the American Association of Colleges of Nursing notes. Yet, accomplishing this in the midst of a nursing shortage is difficult. Nurse retention strategies should become a central focus for all hospitals and healthcare institutions.
4. Marketing Practices
As of 2016, the U.S. healthcare industry was spending almost $30 billion per year in marketing and advertising to consumers, according to The Journal of the American Medical Association. Yet some question the ethics of a healthcare provider spending so much to promote its services or even a specific medicine or technology (whether or not the maker is named). Examples of hospitals getting involved in commercial endorsements for pay have highlighted this issue even more.
An institution can have ethics committees review the facility’s marketing practices to help prevent any missteps. Healthcare professionals should consult with their employer before making testimonials.
5. Care Quality vs. Efficiency
Balancing quality and safety with efficiency is a difficult challenge, which is amplified given the increasing pressure hospitals face to lower the cost of healthcare while improving quality. “It raises a real question about whether the right values are driving our focus in our healthcare system,” Cynda Hylton Rushton, PhD, RN, told AMN Healthcare Briefings. “Should efficiency be the driver?”
The Role of Nursing Leaders
Skilled and knowledgeable nursing leaders can oversee nursing staff members, helping and mentoring them along the way. More leadership in nursing is needed to achieve a higher quality of care and properly respond to major ethical issues.
Alvernia University’s online RN to BSN Completion Program helps nurses enhance their careers and pursue leadership positions. In a flexible and convenient online environment, the programs allow nurses to reach their goals while maintaining their current work and personal schedules.
Only one group of Americans has more than doubled in size over the past twenty years: the elderly. They’ve experienced more than most in their lifetimes, from world wars to the first man on the moon. Thanks to lengthening life spans, they have much more to experience; over 41.4 million Americans are 65 and older – that’s more than 13.3 percent of the total U.S. population.1
As this golden group ages, how can we serve and love the elders that hold such a special place in our communities and families?
The role of geriatric social workers includes:
Helping senior citizens cope with common problems experienced by the elderly
Ensuring the needs of their clients are met from day-to-day
Providing aid with financial issues, medical care, mental disorders and social problems
Geriatric care manager
Care managers help the elderly and their loved ones develop a long-term care plan and connect with necessary services.
Healthcare business manager
These managers make sure healthcare facilities provide the most effective patient care. This includes planning and coordinating services in hospitals and clinics.
Art therapy uses the visual and auditory arts to help restore function and general wellbeing. Benefits can include:
Increased cognitive skills
Improved motor skills
78 percent of art therapists report working with older adults on a regular basis.2
Grief counselors help seniors process bereavement and loss, as well as cope with thoughts of their own death.
Assisted living administrator
Administrators manage assisted living facilities or services, which provide care to adults who need help with daily tasks like bathing, eating and dressing.
These educators provide the elderly with lessons that inform them about health concerns.
Physical therapists help aging adults strengthen their muscles, increase mobility and improve endurance. They also help with recovery from an injury or illness.
HELPING AND HEALING
The elderly are likely to face hardships, but with our help, they don’t have to go through them alone.
Bereavement and loss
A natural part of the aging process is experiencing the loss of loved ones as well as coping with one’s own progressing age. Seniors often experience bereavement and loss differently than younger adults, which puts them at risk for depression, anxiety and PTSD. Grieving seniors can benefit from the support others as they work through difficult times.
75 percent of adults 50 and older reported finding humor and laughter in their daily lives.3
Family caregivers play a crucial role in keeping the elderly comfortable at home by providing support like:
Loving relationships and companionship
Minimal health and wellness assistance
Support with day-to-day needs
More than 10 percent of the U.S. population have served as unpaid caregivers for older adults.4
Health promotion and self-care
Age can prevent seniors from properly taking care of their bodies, but we can help our loved ones stay beautiful and healthy. Helping the elderly groom themselves, receive regular medical attention and stay active can go a long way in promoting general wellbeing.
In more extreme cases, seniors may experience disabilities or other chronic health conditions. You can support older adults by ensuring they can access the healthcare professionals and resources they need. This might involve assistance with transportation and attending to business, legal and medical concerns.
75 percent of seniors have at least one chronic health condition, and most have two or more.5
End-of-life and palliative care
As our loved ones enter their final days, specialized care can help provide relief from the symptoms and stress. End-of-life and palliative care makes their last days as pain-free and comfortable as possible.
Quality of long-term care
Fortunately, there are a number of geriatric professionals trained to provide excellent care for aging adults in all of these areas. A growing population of the elderly means the demand for these practitioners is greater than ever – and there are more opportunities for you to bring wellness and care into the lives of the elderly than ever.
The rising reliance on big data to help make decisions in healthcare means the need for analysts is rising steadily. Combine this reliance with our growing use of cloud computing – the practice of using a network of remote servers hosted online to store, manage, and process data – and the increasing population of elderly patients, and healthcare analytics is a career that could see an overall 14 percent rise in jobs by 2026, according to the Bureau of Labor Statistics.
Insurance companies are major employers in the U.S. According to Statista, a statistics clearinghouse, there are around 2.6 million people employed in insurance. Medical actuaries analyze the financial costs of risk and uncertainty of clients and business decisions for insurance companies. They use math and statistics to assess the risk of medical and life events. The 2017 median pay for an actuary is $101,560 and according to the BLS, the field is expected to grow by 22 percent by 2026.
PHARMACEUTICAL AND RESEARCH AND DEVELOPMENT DATA
Medical scientists conduct research aimed at improving overall human health by researching diseases, cures, pharmaceuticals and medical best practices. They often use clinical trials and other investigative methods to produce data that they can then use to reach their findings. New medications require careful analysis of the data collected by researchers. Most people who work in research labs have at least a master’s level of education or are actively pursuing an M.S. in analytics. According to the BLS, in 2017, the median pay for a medical scientist was $82,090 and the field is expected to expand 13 percent by 2026.
Healthcare analysts can work with government or nonprofit agencies to improve healthcare outcomes for various communities, which can be based on locale or demographic. Some of the tasks healthcare analysts may perform include; providing solutions to community health and social problems by conducting and analyzing research, conducting site visits to assess operations and costs of healthcare programs and preparing policy briefs based on their research. The BLS doesn’t offer statistics for healthcare analysts, but Payscale puts the median salary at $62,121. Payscale also reports most people in the field have a master’s degree and, “for the first five to 10 years in this position, pay increases steeply, but any additional experience does not have a big effect on pay,” most likely due to competition for these types of jobs.
PATIENT BEHAVIOR AND SENTIMENT DATA
According to the BLS, medical and health services managers, also called healthcare executives or healthcare administrators, coordinate medical and health services. For these jobs, analyzing patient behavior and sentiment data is critical to make good treatment choices that benefit the patients. They might manage an entire facility, a specific clinical area or department. Health services managers maintain policies that conform to changes in healthcare laws, regulations and technology. In 2017, the median pay for these positions was $98,350 a year.
GET STARTED TODAY
A master’s degree in analytics will prepare you for a well-paying, in-demand job in healthcare analytics, and Notre Dame of Maryland University can help you.
The University offers a fully online Master of Science in Analytics that can help you become an asset in your current role or prepare you for the jobs of the future. NDMU has strong networks with regional businesses and 75 percent of graduates are directly applying their research projects to their jobs.