Discussion: Organizational Policies and Practices to Support Healthcare Issues

Healthcare organizations have moved away from prioritizing patient outcomes to a focus on efficiency and decreasing costs (Kelly & Porr, 2018). This shift in principle can be hard on the nursing staff because it can cut staffing and resources needed to provide proper patient care. Even though there is clear evidence showing that bachelor-prepared nurses are linked with better patient outcomes and decreased mortality, hospitals do not prioritize hiring nurses with a Bachelor of Science in Nursing (BSN) degree. An Institute of Medicine report (IOM) questioned the proper preparation of nurses. It encouraged education programs to make sure students were taught the importance of patient-centered care, evidence-based practice, quality improvement, and information technology (Giddens et al., 2015). These areas are addressed in BSN programs, not in an Associate Degree in Nursing (ADN) program.

          One reason that healthcare organizations are not embracing the push for BSN-prepared nurses is the current shortage of Registered Nurses (RNs) that is expected to only increase due to the Baby Boomers aging (American Association of Colleges of Nursing [AACN], 2020). If healthcare organizations required a BSN degree as a hiring requirement, there would be no way they could staff their facilities. Spetz (2018) reports that the IOM recommendation for nurses to improve care and patient outcomes is to hold a BSN degree or higher. Healthcare policy is written for efficiency, and trying to hire only BSN-prepared nurses is not efficient due to the low percentage of RNs holding their BSN (Angel, 2020). The needs of staffing seem to outweigh the evidence that nurses that hold BSN degrees have better patient outcomes.

          Healthcare organizations could change their policies to encourage hiring a higher percentage of BSN-prepared nurses, which would improve patient outcomes, which would ultimately decrease costs. The policy could also be changed to encourage nurses that hold an ADN degree to go back to school for their BSN with tuition reimbursement and increased wages upon graduation. Over a five to ten-year span, an organization could dramatically increase the percentage of nursing staff with a BSN degree integrating these policies, with the outcome all healthcare providers want, superior patient outcomes.


American Association of Colleges of Nursing. (2020). Nursing shortage. Retrieved December 14, 2020, from https://www.aacnnursing.org/Portals/42/News/Factsheets/Nursing-Shortage-Factsheet.pdf

Angel, L. (2020). Best practices and lessons learned in academic progression in nursing: A scoping review. Journal of Professional Nursing, 1–7. https://doi.org/10.1016/j.profnurs.2020.08.017

Giddens, J., Keller, T., & Liesveld, J. (2015). Answering the call for a bachelors-prepared nursing workforce: An innovative model for academic progression. Journal of Professional Nursing31(6), 445–451. https://doi.org/10.1016/j.profnurs.2015.05.002

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing23(1). https://doi.org/10.3912/OJIN.Vol23No01Man06

Spetz, J. (2018). Projections of progress toward the 80% bachelor of science in nursing recommendation and strategies to accelerate change. Nursing Outlook66(4), 394–400. https://doi.org/10.1016/j.outlook.2018.04.012

Discussion: Organizational Policies and Practices to Support Healthcare Issues

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.

To Prepare:

  • Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
  • Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

By Day 3 of Week 3

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

By Day 6 of Week 3

Respond to at least two of your colleagues on two different days by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.


great discussion post. It is proven that bachelorette nurses (BSN) bring economic and professional benefits to hospitals and other health care institutions. Among the many benefits of BSN nurses is a 10% decrease in overall mortality rates, and patients have a 5% greater risk to survive near misses or high-risk complications (O’brien, Knowlton, & Whichello 2018). There are also financial benefits for hospitals to staff with BSN nurses such as decreased readmission rates and higher patient satisfaction ratings which directly correspond with compensation (O’Brien, Knowlton, & Whichello). Even though there are clearly proven benefits of staffing with BSN nurses most hospitals have not obtained the 80% BSN ratio by the year 2020. There are many barriers to nurses returning to school the ones that I debated myself were financial affordability, family obligations, and career advancement. hospital leaders and administrators need to be cognizant of limitations such as but not limited to tuition reimbursement, age of nursing staff, and formulate a list of professional opportunities for post-bachelor graduation (Sarver, Seabold & Kline 2020). With my current employer, there are tuition reimbursement opportunities however, there is no list of potential professional opportunities that would be exclusive to BSN nurses and there is currently no financial benefit for having a BSN over an ADN degree. Do you feel hospitals and other health care institutions would have a greater success rate of nurses returning to school if they were more transparent?



O’Brien, D., Knowlton, M., & Whichello, R. (2018). Attention Health Care Leaders: Literature Review Deems Baccalaureate Nurses Improve Patient Outcomes. Nursing Education Perspectives4, 2. https://doi-org.ezp.waldenulibrary.org/10.1097/01.NEP.0000000000000303


Wendy L., S., Kelly, S., & Melissa, K. (2020). Building a Foundation of Evidence to Support Nurses Returning to School: The Role of Empowerment. Nursing Education Perspectives41(5), 285–290. https://doi-org.ezp.waldenulibrary.org/10.1097/01.NEP.0000000000000704