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Health Care Policy:Effects of Recession on Nursing Care and Medical Emergency Services

Essay should consist of 50 percent theory and 50% research

Author: Sana UllahStudent ID: 0524681Prof.: Andrew GoodmanCourse: Public PolicyLife and, to some extent, disease are unpredictable. You will never know when and how you will die? You will never know in whom hands you will die; nurses or emergency staff at the hospital? The focus of this essay will be on nursing care and medical emergency services during recession. Will these services experience the effects of recession as the auto and other industries are experiencing during the 2009 recession period. This paper will take into consideration previous recessions of 1980 and 1990 to prove the hypothesis that nursing care and medical emergency services will be reduced during 2009 recession period. Before proceeding ahead, lets take a look at the definition of nursing care, medical emergency and recession. Nursing is a process in which nurses process, assess, plan, implement and evaluate patient care. In short, they are responsible for taking care of the patients in the absence of a doctor. On the other hand, medical emergency is an injury or illness that is acute and poses an immediate risk to a persons life or long term health. Lastly, recession refers to a significant drop in economic activity (Economic Concepts, 2009) resulting in high unemployment rate and low gross domestic product (GDP). In the past, recessions lasted from few months to years during which, many service providers had to declare bankruptcy or cut back on employees to fight the effects of recession. The 2009 recession has seen many service providers declare bankruptcies and/or cut back on their employees to stay in business. Most of these service providers were private such as the automotive industry. Nursing care and medical emergency services are provided by the government and thus are believed to be recession proof as the funding to provide these services comes from the government. In the past recessions, government put a freeze on new hiring and pay increases (Kines & Shaw, 2008) in the public sector so save money during the recession. Nursing care is usually done in hospitals (course book), senior homes and if necessary at private homes of patients. Nursing care is a profession which is thought to be recession proof. As long as there are patients there will be nurses. This may be true to some extent but when we look at nurse patient ratio, it becomes evident that nurses profession is at risk during 2009 recession period. Carecor, who provides qualified licensed nurses to hospitals, said that Ontario government is decreasing funding for hospitals during the 2009/2010 fiscal year. (Yeo, 2008) Carecor further said that the cut in funding postponed additional 9,000 nurses in Ontario. Everyone who works in the hospital knows that the nursing shortage is very real. (Yeo, 2008) The cut backs in health care budget are due to financial difficulty. Ontario governments revenues will be going down from taxes because business is not going well. People are laid off and the pressure of the government to spend to stimulate revenues is going up and there will be significant pressure on the health care budget. (Lem, 2009) The shortage in health care budget is causing shortage in nursing which in return will affect how perform their duties. Todays nursing shortage is very real and very different from any experienced in the past. As a huge segment of the population, the baby boomers, enters their senior adult years, the demand for health care is expected to grow in response. (Rosseter, 2009) The need for care comes at a time when nursing schools are struggling to maintain enrolment levels and a large percentage of the RN [Registered Nursing] workforce is close to retirement. (Rosseter, 2009) According to health Canada 2009, during the 1990/92 recession period, the nursing patient ratio was 1:119 patients, in a 12 hour shift, but it increased significantly to 1:133 in 2001, a 12 percent increase. This increase in nursing patient ratio has hindered nursing care negatively as many nurses are now forced to work long stressful hours and attend more patients. Furthermore, in a recent study it was concluded that hospital sector(s)... have seen cuts in nurses [and] are seeing a reduction in the number of nursing hours in hospitals by 2,000 hours due to budget constraints." (Lem, 2009) In addition there are "fewer and fewer new recruits able to enter nursing... and more and more nurses (are) leaving the profession or the country, an even more critical shortage is inevitable unless action is taken." (Health Canada, 2009) Statistics show that during the 1990 recession period, there was an increase of 11% in Canadian population and a decrease of registered nursing seats by 26%. Statistics also show that there was 46% decrease in nursing graduates which is leading to shortage in nursing. The decrease in nursing seats during the 1990 was due to the effects of recession. Hospitals were not hiring nurses due to lack of funding from the government and nurses currently hired are overloaded with patients thus dramatically decreasing nursing patient interaction time and quality of nursing. Medical Emergency Services is another recession proof service because it receives funding from the government. Even though it is a recession proof service, it is also true that doctors, nurses and other staff working in the medical emergency department will have to operate with the shortage of staff and increased number of patients. During recession, hiring of more staff including nurses and doctors freezes, thus increasing burden on staff already working in the medical emergency department. In Ontario, the nursing shortage isnt just affecting home care for seniors, but also hospital surgeries... There is a labour crisis, it has already begun. (AIMS, 2009) Furthermore, there are many surgeons who are unable to operate on patients due to shortage of nursing and other staff. They have no other option but to cut back on surgical dates. (AIMS, 2009) Many of the patients who arrive at medical emergency for treatment come with minor injuries which can wait or treated by family doctors or walk-in clinics. Theory/Policy ModelThere are many theories which help us understand how to improve on current policies in place. For instance, nursing care is a profession which is responsible for patient care in hospitals, senior homes and other institutions where they may be required. According to one study, nurses spend approximately three quarters of their time on work that does not contribute to patient care... this not only destroys productivity; it also destroys motivation and pride. (Health Canada, 2009) The misuse of nurses is costing government a lot more and the quality of work has decreased greatly. A policy model which if applied during recession period will help save government a lot of money and increase the quality of work done by the nurses. The policy model is called, Public health nursing intervention model. (Medscape, 2009) PHNI model helps define more clearly the duties of nurses and creates a better work environment for them in which they will be able to increase their productivity, motivation and pride. The work not related to nursing care is taking away interest, pride and motivation of nurses as they are not being given the chance to do what they were hired for, which is to take care of the patients. Furthermore, clerical work is leading to diminished knowledge of nurses thus they are unable to take care of their patients effectively. Public health nursing intervention model will help reshape how nurses care for patients in Canadian health system. It will allow them to give more attention to their patients which would increase their self confidence and motivation which in return will result in patient satisfaction.Similarly, doctors in medical emergency services cannot operate on patients effectively if there is a shortage in nursing staff that deal with minor cases and assist doctors or surgeons during operations and other assistance. PHNI model applies to medical emergency services as there are nurses who assist doctors and surgeons during their operations. ImplementationIn order to reduce burden on nurses and improve their quality of work, clerks will be hired who will work along with nurses and take care of necessary paper work. This would help reduce cost and will allow nurses to care for more patients. To reduce medical emergency wait time and extra load, people will be educated through media such as news papers, TV and pamphlets which will inform people about when to go to emergency and when not to. People will be educated about the difference between emergency and non emergency cases and if they are in doubt, they should go to walk-in clinics first and let them refer you to emergency services. Furthermore, hiring new graduates during with a less wage will further assist in medical emergency department and in nursing care for the baby boomers. As there are many nurses who are retiring, hospitals can hire two nurses for the same pay during recession. The hired nurses will be able to care for more patients thus reducing nursing patient ratio from 1:133 currently.

ConclusionServices which run privately are greatly affected during recessions as compared to services which are funded by the government. Nursing care and medical emergency services are funded by the government, thus recession has a least effect on these services. There is a shortage in nursing in nursing due increased patients and lack of budget to hire more nurses during recession period. This shortage is causing decrease in quality of care provided by the nurses to their patients. By implementing policies which will hire new graduates with less pay and hiring clerks to deal with paper work will further help increase patient care at hospitals and other departments where nurses provide care services. Similarly, medical emergency services will not be affected by the recession as they receive the funding from the government. Medical emergency department will not be able to hire new staff due to reduced budget from the government. By opening new walk-in clinics, extended their working hours and educating public on what is emergency and what is not will further help reduce burden on medical emergency department, thus helping them focus on more serious cases. The hypothesis that nursing care and medical emergency services will be reduced is true even though these services receive funding from the government, the shortage of staff in medical emergency department, shortage in nursing care staff and increase in patients clearly support the hypothesis.

ReferencesAIMS. (2009). Despite recession, looming labour shortage big threat, Retrieved March 29, 2009, fromhttp://www.aims.ca/socialprograms.asp?typeID=4&id=2480

Economic Concepts. (2007). Recession, Retrieved March 25, 2009, from http://www.canadianeconomy.gc.ca/English/economy/recession.html

Health Canada. (2009). The Problem- What is Causing the Shortage of Nursing Care?, Retrieved March 29, 2009, from http://www.hc-sc.gc.ca/hcs-sss/pubs/nurs-infirm/2002-cnac-cccsi-final/cnac-cccsi5-eng.php#2

Kines, L. & Shaw R. (2008). Government freezes public sector wages, Retrieved April 08, 2009, fromhttp://communities.canada.com/victoriatimescolonist/blogs/soundoff/archive/2009/02/18/257747.aspx

Lem, S. (2009). Think the worst of the recession is over?, Retrieved March 29, 2009, fromhttp://www.torontosun.com/news/canada/2009/03/30/8934701-sun.html

Medscape. (2009). Theoretical Framework for Health Case Management Role, Retrieved April 08, 2009,from http://www.medscape.com/viewarticle/543725_4

Rosseter, R. (2009). Nursing Shortage at a Glance, Retrieved March 29, 2009, fromhttp://www.campusrn.com/students/article.asp?news_id=919

Yeo, R. (2008). Nursing Agency Use During Economic Downturn, Retrieved March 29, 2009, fromhttp://www.carecor.com/content/nursing-agency-use-during-economic-downturn