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Question to posts below: (During your practicum, determine what clinical problem or issue the organization is facing. Discuss two implications for nursing).


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comment #1:

There are several clinical issues that should be addressed however, the biggest concern facing the organization is nurse retention. Certainly, my organization is not the only one facing this growing problem, this concern is across the spectrum of health care. There are many nurses that express “burnout” as the biggest reason for leaving an organization, at least for my facility. Not enough focus was placed on adequate staffing and management visibility. In order to safely care for patients, there should be appropriate staffing of nurses and active visibility of management.


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Twigg, D., & McCullough, K. (2014). Review: Nurse retention: A review of strategies to create and enhance positive practice environments in clinical settings. International Journal Of Nursing Studies, 5185-92. doi:10.1016/j.ijnurstu.2013.05.015


#2: Critical care is a high-stress setting that has many ethical and emotional components that can be taxing to nursing. As the one constant in a patient’s day and the coordinator of care, the nurse faces unique challenges in the healthcare realm. As a result, nurses and other members of the interdisciplinary team can experience the effects of moral distress and the accompanying symptoms of burnout. Moral distress is defined as “when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action”(Jameton, 1984). It is estimated that one in three healthcare providers will experience burnout syndrome in their career. The long-term consequences can lead to depression, maladaptive coping mechanisms, disengagement at the bedside, and leaving the position or professional altogether. There are strategies that can be used to combat the origin and the sequelae of clinical situations that lead to burnout and the resulting turnover.

The caring professions cannot function optimally if members are experiencing burnout. The key to safety and patient engagement that leads to better patient outcomes and experiences is to have fully functioning and engaged staff members. The issue of employee turnover creates a revolving door of staff members leaving little opportunity for growth as significant time, energy, and resources are being used in the hiring and training of replacement staff.

Austin, C. L., Saylor, R., & Finley, P. J. (2017). Moral distress in physicians and nurses: Impact on professional quality of life and turnover. Psychological Trauma: Theory, Research, Practice, and Policy, 9(4), 399–406. (Supplemental)

Jameton, A. (1984). Nursing practice: The ethical issues. Englewood Cliffs, NJ: Prentice-Hall.


Question to posts below (What is the main issue for your organization in addressing a solution to evidence-based nursing practice? Discuss what might be the first step in addressing and resolving this issue).



Currently, sadly enough as described earlier, lack of nurse staff and retention is hindering the unit from researching, developing and enacting EBPs. Clearly this requires a mass hire of new nursing staff in order to, not only to accommodate the census, but to also create opportunity to make some much needed changes. In order to make an impact in retaining the seasoned nurses and hiring appropriately, management must create an environment worth working for. Things such as functioning equipment, shared governance and autonomous opportunities, and a leadership style that communicates openly with their staff at any level. Another huge opportunity would be career advancement with incentive. So many institutions advertise the “preference” of a baccalaureate degree or higher, which should mean a higher wage for the advanced education. There are some facilities that offer this in addition to student loan repayment, which is always an attractive offer.


Twigg, D., & McCullough, K. (2014). Review: Nurse retention: A review of strategies to create and enhance positive practice environments in clinical settings. International Journal Of Nursing Studies, 5185-92. doi:10.1016/j.ijnurstu.2013.05.015



In a fast-paced and often hectic environment, it is hard to find the time during working hours to provide education on evidence-based practices. Commitment is required by staff to make time on days they are not working to attend in-services and education that is essential for the adoption of evidence-based practices. Development of a culture that supports nursing education and recognizes the need for continuing education is the foundation for this process. Organizational buy-in requires that they be willing to provide and pay for the costs of this education and strong nursing leadership is needed to ensure that staff understands the importance of this knowledge and is supported when developing new practices. I would say that making time for these important events is an issue to facilitating change in nursing practice, it needs to be made a priority.

In an article in Journal of the Medical Library Association (JMLA) the authors conclude that the barriers to implementation of evidence-based practice include lack of time, inability to understand statistical interpretation and language used in research data (Majid, Foo, Luyt, Zhang, Theng, Chang, & Mokhtar, 2011). Lack of confidence in the interpretation of research data is a problem that can be addressed in the education of staff, this can be accomplished with continuing nursing education. Making the time for education, providing education, and implementation of evidence-based practice requires effective leadership and a commitment from nursing as well as the healthcare organization to make these practices reality.

Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y. L., Chang, Y. K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association : JMLA, 99(3), 229–236. doi:10.3163/1536-5050.99.3.010


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