1st discussion The national healthcare issue being proposed is the Covid-19 vaccine mandate. “The OSHA COVID-19 Emergency Temporary Standard (ETS) on Vaccination and Testing generally requires employers to establish, implement, and enforce a written mandatory vaccination policy” (OSHA, 2021). My hospital is enforcing the vaccine mandate as are many companies. There are consequences from this as many staff members are refusing. In an interview with an OSF hospital representative, MSN states this policy will “effect nearly 24,000 employees at 150 locations throughout Illinois and Michigan, including its hospitals in Peoria, Rockford, Galesburg, Monmouth, Kewanee, and Pontiac (Renken, L., 2021).
My organization has had many get the vaccine because they demanded it, but many have refused. In New York, the largest healthcare organization stated, “we are pleased to report that most team members are opting to be vaccinated so as to avoid being terminated” (Lenthang, M., 2021). This is a different way to provide medical care than anything else we do. The vaccines work. I have received a vaccination. But having companies demand it or termination has not been a public health tactic frequently used.
Lenthang, M., (2021). Hundreds of hospital staffers fired or suspended for refusing COVID-19 vaccine mandate. ABC News. id=80303408
Occupational Safety and Health Association (OSHA). (2021). Mandatory Vaccination Policy Template. 2Fdefault%2Ffiles%2Fcovid-19-ets2-sample-mandatory-vaccination-policy.docx
Renken, L. (2021). OSF HealthCare mandating COVID vaccine for all employees by the end of September. MSN. oyees-by-the-end-of-september/ar-AAMpuhU
2nd discussion. The national healthcare workforce is currently threatened due to a shortage of nurses. The reasons behind the nursing shortage are complex and layered. One significant contributor to the current nursing-exodus is a lack of job satisfaction. As we develop strategies to contend with this existing and worsening healthcare crisis, especially in these pressured times due to the current global pandemic, it is important to analyze the contributing issues carefully to mitigate

the harm they cause. By looking at some of the underlying issues that are causing nurses to retire early or completely change professions, we can intentionally design programs to help retain the nursing workforce.
It is obvious that nursing shortages affect the quality of patient care delivered; when there is more work to be done than staff to do the work, the work suffers. In healthcare the “work” is people. The people that suffer are patients and the nurses that are tasked to care for them. This becomes a cycle, as it becomes more difficult to care for patients, less nurses are willing to make the sacrifices needed to deliver care. In a recent survey conducted by the American Nurses Foundation surrounding nurses’ mental health and well-being, over 50% of nurse-responders stated that they experienced exhaustion in the last two weeks, 28% stated that they wanted to quit their job, 18% reported that their intention was to leave within then next six months and an alarming 47% reported that their work was negatively affecting their health and well-being (AHC, 2021).
The question then becomes: What is the root cause of this burnout? A qualitative study out of Vanuatu attempted to identify themes surrounding this subject by interviewing beside RNs. The themes that emerged from the study included heavy workload, lack of workforce, unusual working hours, lack of support and opportunity, and the stress associated with physical, mental, medical, social and family risks of the job (Tamata et al, 2021). These concepts are familiar, as they have been the traditional challenges to healthcare workers. However, with the exacerbation of the healthcare industry due to the pandemic, these factors are heightened. Workload expands as patient census and acuity of illness has increased without a matching response of the nursing workforce. Even nurses without mandatory on-call hours have worked more out of a sense of obligation and urgency as we see our units filling beyond capacity and lacking safe nurse-to-patient ratios. Nurses have felt abandoned by administrations because of working conditions without the proper equipment. The medical risks associated with the work is significant, especially before Covid-19 vaccines were available to medical workers. The U.S. has lost over 3600 healthcare workers to Covid-19, with bedside caregivers being impacted the greatest (AHC, 2021).
Last month the ANA recommended six strategies for stakeholders to implement to combat the current nursing shortage crisis. Of these recommendations, the first item on the list was to address the current fatigue and mental well-being of nurses (ANA, 2021). As a population, nurses are determined, resourceful and resilient, however the pressures of the work and the environment have caused many nurses to seek other employment options. To help mitigate this loss of workforce, hospitals and medical organizations have been exploring efforts to help nursing staff achieve the resilience necessary to maintain work-life balance and avoidburnout in the current complex healthcare environment.
The concepts of velocity and vitality are key components for a nurse to have the self-awareness necessary to continue performing effectively. The ability to balance the demands of the workday can be enhanced by a health system that encourages workers to invest time and resources into their own well-being (AHC, 2021). The hospital I work for has implemented an employee
wellness program that not only offers many options but also incentivizes self-care. They also opened a 24-hour gym with special times that offer classes. Most recently after realizing that the last surge caused significant trauma to many staff members, free personalized counseling sessions have been available to any staff that is interested. I believe that these interventions, when used effectively, have to potential to greatly impact the resilience of the nursing workforce, I have seen and experienced it personally. The counseling sessions have provided an outlet and a way to process some of the traumas we have experienced. Our unit has changed the format of our staff meetings quite significantly, for the first 15 minutes we discuss housekeeping items, then the conversation shifts to recent events and what went right, what we could have improved and what we learned from the experience. These interventions seem somewhat insignificant when considering the overwhelmingness of the last two years, and even though this is just one layer of the greater issues contributing to the nursing shortage, it is a great place to start.
AHC MEDIA. (2021). International Nursing Group Sounds Alarm Over Interrupted Nursing Pipeline: Retirements and burnout are increasing. Hospital Case Management, 29(7), 1–3.
ANA’s proposed policy solutions to address the nurse staffing shortage crisis. (2021). South Carolina Nurse, 28(4), 10–11.
Laureate Education (Producer). (2015). Leading in Healthcare Organizations of the Future [Video file]. Baltimore, MD: Author.
Tamata, A. T., Mohammadnezhad, M., & Tamani, L. (2021). Registered nurses’ perceptions on the factors affecting nursing shortage in the Republic of Vanuatu Hospitals: A qualitative study. PloS one, 16(5), e0251890.