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Ronny Berkovitz

and Barak Shapiraa was published on 4th May 2020. The research centers a study on illegal performance-enhancing substances which are mainly used by bodybuilders and athletes in sports to gain body mass and muscle. Anabolic-androgenic steroids are the most common drugs and have been associated with a variety of both long-term and short-term psychiatric and medical effects. The purpose of this text is to critique the article through the description of research questions

The Impact of Shortage of Nurses on Quality of Care among CCU patients

The Impact of Shortage of Nurses on Quality of Care among CCU patients

Name of student

Institution

Introduction

The current nursing shortage is an alarming situation in most of the hospitals. Registered nurses are the most affected, as many of them have reached the retirement age and left the profession. Delivery of quality care in the clinical area is greatly affected by the number of nurses, in relation to the population of patients (Stechmiller, 2002). The situation is worse in the critical care settings due to understaffing. According to Stechmiller (2002), the shortage of critical care nurses results from a shortage of skilled nurses who may attend the patients in the critical care setting, as well as, the other areas of clinical practice. The shortage leads to compromised delivery of care in the Critical Care Unit. Also, there are not enough nurses to conduct research, which can be used to improve patient outcomes. According to Petterson (2010), many of the nurses in the clinical setting are under-educated; as they have been requested to provide their services, as a measure of addressing the shortage. Since the critical care set-up requires specialized professionals, it remains the most hit department in the provision of quality nursing care. As a result of the shortage, Petterson (2010) asserts that, nurses in the critical care unit are overworked, fatigued and work for long hours. This leads to undesirable patient outcomes in the critical care settings. Addressin,g this area of clinical practice will lead to an improvement in the quality of critical care, and eventually patient outcomes.

Research Problem and Purpose Statement

Nurse-patient ratios are a critical part of nursing practice. This is extremely important in areas that are very demanding, in regard to nursing care, like the critical care unit. The number of nurses in a hospital unit, in relation to patient population, affects the quality of care provided to the patients. According to Stechmiller (2002), the nurse-patient ratio directly affects the quality of care that is provided in the CCU. In addition, the delivery of care in the CCU has been compromised as a result of the shortage of skilled staff, which is affecting the whole world. Critically ill patients, who make the highest population of the patients in ICU, require total nursing care. If this care is not provided, the results will not be desirable (Stechmiller, 2002). Ewart et al. (2004) agree that the shortage of qualified nurses in the US is posing a great challenge to the availability of quality care for the critically ill patients. According to Ewart et al. (2007) critical care delivered by nurses who are trained in critical care delivery has been effective in realizing patient outcomes than care delivered by unskilled nurses. Addressing this issue is a matter of utmost importance in clinical practice. The stakeholders need appreciate the effects that shortage of skilled nurses has on the delivery of patient care. This can be accomplished through research. In lieu of this, the current study aims at looking at the effects of the shortage of nurses on the delivery of critical care services, at the critical care setting.

Research Questions

What is are the effects of shortage of nurses on the quality of care among CCU patients

What is the impact of improved quality of care?

Does shortage of nurses affect quality of care?

In what ways does the shortage of nurses affect quality of care?

What are the outcomes of improved quality of care?

While analyzing the feasibility of the five questions, the elements of a satisfactory research question were considered. The aim was to identify the question that could be empirically tested. Questions 2, 3, 4 and 5 were found not to be empirically testable, because they lacked some variables that would be necessary for the study. For example, question 2 does not indicate to whom the impact of improved quality of care applies. This also applies to questions 3, 4 and 5. They do not identify the population under study. However, question 1 indicates the problem under study, the variables under study, and the expected outcomes. Looking at the questions through the PICO perspective, question 1 meets the criteria.

Preliminary PICO question

What are the effects of the shortage of nurses on the quality of care among CCU patients?

The PICO variables relevant to this question are explained as follows:

P in the question (the population or patient) is represented by ‘critically ill patients’. The study’s population is the critically ill patients in the Critical Care Unit. The intervention is represented by ‘quality care’, which is realized through having enough number of skilled staff. To accomplish the ‘C’ part of PICO, the study compares the outcomes of care provided by few nurses in relation to high patient population, and the care provided by enough number of nurses in relation to patient population. In regard to ‘O (outcome),’ the study will consider the effects that shortage of nurses has on the delivery of quality care in the CCU.

Keywords

Critical care nursing

Shortage of nursing

Nurses shortage in acute care settings

Under-staffing in Critical Care Unit

Under-staffing in Intensive Care Unit

Quality of care in Critical Care Unit.

Impact of Shortage of nurses on quality of care

Effect of shortage of nurses on critical care delivery

Acute care settings crisis

Quality of care in acute settings

While developing the key-words, the rationale focused on the variables. Some of them are “shortage of nurses”, “quality of care’ and “Critical Care Unit”. In order to develop many keywords for effective literature search, the synonyms of the variables were considered. For example, ‘acute’ was substituted with ‘critical’. Additionally, alternative terminologies were used. For example, ‘Critical Care Unit” was substituted with ‘Intensive Care Unit’. Finally, related words were used. For example, ‘effects’ was used in place of ‘impact’.

References

Petterson, J. (2010). The effect of high patient-nurse ratios. Nursing Times, 107(2), 1-4.

Stechmiller, K. J. (2002). The nursing shortage in acute and critical care settings. AACN Clinical Issues, 13(4), 577-584.

Ewart, W. G., Marcus, L., Gaba, M. M., Bradner, H. R., Medina, L., & Chandler, B. E. (2004). The critical care medicine crisis, a call for federal action: A white paper from the critical care professional society. CHEST, 125(4), 1518-1521.

Racial discrimination is an issue that has affected African (3)

Racial discrimination is an issue that has affected African American people for decades now. It traces its origin back to the era where black people were forced to work on farms as slaves for white people. They were considered inferior and worthless hence being bought and sold like commodities and as slaves. It manifests itself in many ways and places in the current world, from workplaces, shopping centers, schools, hospitals, and even neighborhoods. Racial discrimination affects black people both physically and mentally, and it needs to be eliminated.

Racial discrimination is an issue that affects people worldwide, and our efforts to stop it may seem little with no impact on society. Usually, the government is the body to make a meaningful impact in society concerning racial discrimination. They, however, choose to be quiet and not support the matter. If it’s anything, the law enforcers are the ones who contribute to racial discrimination by using excessive force when handling black people. This characteristic of the government prompts me to take the initiative and support the black community despite knowing my efforts are negligible. It still counts for something, and I believe the little we offer for the course goes a long way. It may seem meaningless since efforts don’t match the many cases of racial discrimination. Regardless, it should not stop us from doing the right thing.

I am applying the Broome argument in favor of climate change. I will argue that we have a moral obligation to end Racial discrimination in our society. I believe the principles of equality and human rights go hand in hand. Therefore, it is a requirement that one adheres to the laws established for the sake of the country and its people as a law-abiding citizen. Human rights are part of the law, and they are meant to protect citizens from any kind of discrimination either by other citizens or by the state itself. I find it interesting how individuals in society choose to give a blind eye to racial discrimination issues and still claim to be state law abiders. The laws are quite clear concerning the definition of racial discrimination and how it may be practiced in society. The roles of other society members are also laid out. It comes down to our willingness to take part in the racial eradication stoppage initiative.

Freiman, on Why It’s Okay to Ignore Politics, argues that instead of voting, one should focus on other charitable activities because the chances are that one vote will not change the outcome of the elections. Racial discrimination is an issue experienced in nearly all states in America and all over the world. This fact can explain why people would not want to participate and contribute to eliminating racial discrimination. The fact that it is happening worldwide belittles the efforts of an individual who wishes to be part of the initiative. It discourages them by making their contribution look inferior. I find his style of the argument relevant in this case because individuals fail to rebuke racial discrimination because they feel their efforts will not amount to a tangible outcome.

Broome’s argument in Climate matters talks about how many minuscule imperceptible harms lead to serious harm. According to Broome, individuals fail to recognize emissions they release into the air because it is small compared to the size of the world. He warns that small emissions made by individuals daily amount to large harmful emissions that cause global warming. As much as we feel our efforts don’t count, we should also think about doing the right thing as individuals, following our conscience, and living free from its guilt. The thought that many people can share in this thought and that the number of supporters can grow is motivation enough. People should derive their motivation to stop racial discrimination from their own conscience. What does your heart tell you to do? Are you at peace knowing you have done nothing concerning the issue? These are some of the questions individuals should ask themselves to evaluate where they stand. Despite knowing that my efforts are negligible, I still advocate for the black community whenever possible. People should choose to do the same because there is nothing to lose if you look at it. Creating awareness as one of the initiatives also brings more people to the initiative, and we know there is power in numbers. I use Broome’s style of argument that small efforts put together amount to something substantial and impactful. An individual effort may not prove substantial, but large masses can easily lead to a change anticipated.

Maskivker argues that citizens are not obliged to vote, and if they do, it is very strict. He states that many citizens choose not to vote for this reason. The argument style in this context relates well with Dominant races views. Dominant races might argue that the issue doesn’t concern them as they are not directly affected and refuse to participate. However, this might not be the case because we have long-term effects of racial discrimination that affect the community at large. When African American people are denied jobs in the country, it means that they have no source of income hence reduced purchasing power. As a result, there will be a surplus in the market now that consumers have no money to spend. There is, therefore, an economic imbalance that hinders economic growth. Economic growth is a matter that affects all citizens regardless of their race. It becomes a cycle that impacts society negatively. We need to take the initiative and support the black community because their contribution to the economy and community matters.

In the Immorality of Having Children, Rachel argues that it is okay to take an action if it contributes positively to the world and does not interfere with another person’s personal space. Her argument style proves relevant because I feel choosing not to do something about racial discrimination is far worse. It will be a constant bother to know that one has the capacity and capability to do something about racial discrimination but still choose to be silent. It is better to contribute to the issue, however little it may be. I might not reach all the black people facing discrimination worldwide but might change people around me, my neighbors, friends, or even classmates. That meaningful impact on an individual is very important and cannot be compared to not taking the initiative to spearhead racial discrimination in society.