Policy Change Essay

Published: 2021/12/02
Number of words: 4724


Safe State Nursing Ratio is a public health policy that advocates for the minimum patient allocation to the health care providers. The United States is one of the countries faced with the challenges of the Safe States Nursing Ratio violation due to the need of the medical facilities and organizations to cut down the costs of staffing. These medical facilities and organizations cut down the staffing costs by having a few nurses within the health care setting. This strategy translates to the nurses’ overworking as they are subjected to more workload and insufficient time allocation to attend to each of the patients accordingly. The rates of violation on the Safe State Nursing Ratio are very high, a move that has greatly contributed to the provision of quality health care for all the patients. This argument is based on the fact that for the achievement of quality health care, there is a need for the health care providers to have enough time with the patients. This is achieved by attending to the tiny patient details, engaging the patient’s family, and most significantly educating both the patients and their families on the various health care concerns. Arguably, all patients have the right to have access to standard and quality health care. Therefore, there is a need to enhance the Safe State Nursing Ratio to accomplish better health care by enhancing the capacity of the health care providers to deliver their service to the patients as required by the mission of the nurses and the standards of nursing practice.

The Policy Choice

The choice of the Safe State Nursing Ratio as public health that requires subjection to policy changes is due to its impact on the health of the patients and the position it places the nurses. Based on the arguments of Senek et al. (2020), the power of advocacy lies in the voice that seeks to ensure the protection of the patients and advocate for the patients’ well-being. Senek et al., (2020) further argue that all the patients have the right to quality health care, and the nurses have the right to a work environment that caters to their well-being, and most significantly, has value for the mission of the patients. In this case, my choice to present the policy for change is because quality health care is achieved with the development of a functioning Safe State Nursing Ratio. This is because the nurses will have adequate time to monitor a particular patient, educate them, and interact with the family to give them hope and educate them as well on various health care concerns. Looking back at the state of the medical facilities in modern society, they are characterized by patient over-crowding and insufficient nurses and health care providers. Therefore, there is a need for the development and advocacy towards change on the Safe State Nursing Ratio to achieve better health care for all the people.

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The enhancement of the Safe State Nursing Ratio is essential in boosting the general public health care and the nursing practice as a profession. According to Harrington et al., (2020), every state has a benchmark for maintaining the appropriate nurses’ patients’ ratios. The choice for the maintenance of the appropriate nurse-patient ratio is due to the positive influence in the achievement of health care and the nursing profession. In this case, the enhancement and adherence to the policy are essential. The policy of the Safe State Nursing Ratio boosts health care since it allows for the patients to receive quality care as they are accorded more attention (Harrington et al., 2020). Additionally, with an adequate allocation of nurses to the patients, there is sufficient time to educate the patients, reduce the number of medical errors, and attend to their families for support and assurance (Senek et al., 2020). On the other hand, the policy of Safe State Nursing Ratio promotes the nursing profession since the allocation to a reasonable number of patients allows them an opportunity to deliver quality care to each of the patients. In this case, the nurses achieve job satisfaction.

Safe State Nursing Ratio has a negative influence on the financial aspects of medical organizations. The organization’s financial implication is based on the need to increase the number of nurses to serve the patients. In this case, the organizations will be required to invest more finances to cater to a higher labor force’s salaries and maintenance. According to the arguments of Senek et al., (2020), most medical organizations have embarked on the reduction of the staffing of personnel due to the increasing financial uncertainties. The organization’s strategy to cut down the staffing is to ensure the maintenance of the organizational profitability with lower staffing. This is because with a lower labor force they are required to commit little finances to the management of employee salaries. However, Meyer et al. (2020) support that the maintenance of the required Nurse-Patient ratio positively influences medical organizations’ financial productivity. This argument is based on the fact that maintains the nurse-patient ratio ensures that the organizations achieve a competitive advantage due to the delivery of high-quality care against the other medical organizations.

Actions are a reflection of the values that people hold. In this case, I strongly believe that my value for humanity reflects on my actions of advocacy towards the state staff ratio. It is unethical for the organizations to prioritize the enhancement of the quality of care instead of organizational profits. On the other hand, I believe that I am an individual that believes in the value of ethical standards, norms, and good habits in influencing public policies. State Staff Ratio is essential indicating that every organization should prioritize the value for human life and the delivery of quality care for all the patients. According to Harrington et al., (2020), the promotion of the value systems is essential in achieving cultures that support the advocacy for public policies. In this case, the governments must ensure that there is the promotion of a culture that supports values through learning and positive changes by encouraging people to embrace what is desirable for all the people and not just a section of the society.

The ethical principle of autonomy influences my perspective on policy change on the concern of the State Staff Nursing Ratio. Autonomy as a principle is guided by the concept of individualism, individual actualizations, and the achievement of personal happiness. In this case, personal happiness emerges concerning regard for people’s rights. Armijo-Olivo et al., (2020) argue that the theory of autonomy is a concept that works towards the creation of liberation. The liberation is achieved through the capacity of the people to move from the oppression imposed by others. This autonomy theory applies in the context of advocacy for the patients’ rights that emerge by their entitlement to quality health care. However, the strategy of the right to good health care is a concept oppressed by the institutions that give priority to the amassment of profits compared to the health of the patients, and also the nurse’s right to a work environment that gives them a chance to accomplish the mission of a nurse.

Policy Brief

The policy brief is presented to the state representative in the health care program. The primary reason for the brief presentation to the state representative in the health care program is to ensure access to the policy’s presentation for the legislatorial amendments and enhancement of the policy. The policy needs the state representative’s attention due to the deterioration rates of the health care system for the public. In recent years, there has been a failure in delivering quality patient care since the medical facilities have embarked on maximizing profitability compared to the health of the patients and the productivity of the nurses (Senek et al., 2020). Based on the arguments of Meyer et al., (2020), there is an intense connection between the state staff ratios and the provision of quality patient care. The connection between the delivery of patient care and the policy depicts that well-established patient to nurse ratios enhance the nurses’ judgment as they provide care to patients with different needs within medical care facilities.

Armijo-Olivo et al., (2020) further argue that fatigued nurses have higher chances of committing medical errors, thus jeopardizing patient safety. In this case, there is a need for the policy of patient-nurse ratios to be enhanced and voiced. This ensures that the nurses are allocated to a reasonable number of patients who do not subject them to stress and fatigue in their performance of duties as nurses. Winter et al. (2020) indicate that due to the violation of the State Staff Nursing policy, the nurses lack sufficient time to offer moral and emotional support to their patients and the patient’s family members. In this case, nursing education ideals are entirely neglected, provoking the need for the policy of State Staff Ratio in Nursing practice to receive the desired attention to ensure its applicability in all the health care settings.

Based on a critical analysis of the existing literature, the nurses have been on the front line for a long time as they advocate for the safety of the patients (Meyer et al., 2020). Therefore, I believe that the time has come for the policy to be presented to the right people to enhance its amendments to ensure compliance from the entire sphere of nursing practice. Through a critical analysis of the existing literature, the nurses’ vigilance in the dispensation of their duties is determined by the capacity to unleash potential without hindrances (Meyer et al., 2020). However, vigilance is not achieved in a setting where the nurses are overcrowded with patients assigned to them since it compromises their capabilities to give care to their full potential.

Advocacy for change and enhancement of the State Staff Nursing Ratios is difficult due to the various challenges encompassing advocacy for the policy. Based on the arguments of Bridges et al., (2019), the advocacy for the State Staff Nursing Ratios is challenged due to the existence of various nuances among the people. The nuances of the State Staff Nursing policies are explained in the journal article authored by Bridges et al. (2019) as they contend that other influential elements impact patient outcomes. The factor mentioned by Bridges et al., (2019) in the journal article as other factors that influence the patient outcomes include the environmental aspects, patient acuity, and the allocation of shifts to the nurses.

On the other hand, the advocacy and address of the staffing ratios face other challenges from the people who firmly believe that the achievement of quality care within the medical settings does not entirely require the mobilization of staffing ratios. Rather, the hospitals’ capacity to have efficient analytics of the patient needs and the aspect of the times when there is much traffic from the patients (Meyer et al., 2020). The aspect of costs further worsens the challenge of addressing the staffing ratios policies. This is because most people firmly believe that addressing staffing ratios requires medical organizations to spend more on recruiting thus the need for adequate funding to cater to more nurses. This strategy could impact other programs such as the opioid medical program and the patients’ mental health care services.

According to Carlisle et al., (2020), it is costly for most clinical organizations to embrace the staffing ratios that could, to some extent, lead to the closure of the medical organizations. In this case, it is crucial for the State Staff Ratio in nursing practice to be amended to ensure that all of the social determinants of its applicability are focused upon to ensure for its implementation without creating financial burdens for the medical organizations and communities (Meyer et al., 2020). Even though there is massive acceptance of the State Staffing Ratio in health care, there is the existence of a huge number of people who firmly believe that State Staffing policy in health care is a challenge to the implementation of quality health care for all the people (Meyer et al., 2020). This argument is supported by the fact that the State Staffing Ratio leads to the development of obstacles that would lead to inadequate accessibility to better health care for all the people. This is due to the limitation on the number of patients assigned to each of the nurses.

Through a critical analysis of the various challenges and the need to address the state staffing ratios, various intervention measures can be considered in addressing the policy. First, there is a need to establish a well-defined strategy to implement the Staffing Ratio in Nursing Practice. An amendment to the policy should be made with a clear determination and specification of each nursing role and responsibility (Carlisle et al., 2020). Through the state staffing ratios, there should be a clear definition and establishment of the maximum number of patients assigned to each nurse.

Financial implications on the health care organization are some of the challenges hindering the staff ratio strategy’s addressing. In this case, there should be an establishment of strategies that will ensure each of the medical organizations is provided with various state funds to avoid the indulgence in the staffing shortages in each medical facility (Armijo-Olivo et al., 2020). Through a critical analysis of the existing literature, nurses’ shortage is influenced by the huge financial burdens imposed on the organizations by the staffing ratio strategy (Carlisle et al., 2020). This argument is based on the fact that most medical organizations focus on ensuring profitability. Therefore, through the sharing of state funds to the health care facilities, they will acquire more staff and retain their profitability.

Addressing the State Staffing Ratio concern in the Nursing practice, there should be the development of other measures that ensure the patient-nurse ratio is reduced. In this case, creating more medical facilities would assist in reducing the number of patients. Enough medical facilities will ensure that patients don’t crowd in hospitals (Carlisle et al., 2020). However, it is worth noting that establishing more medical facilities is also a challenge. Even though the establishment of more medical facilities is challenging, adequate funding from the state and federal governments will reduce the increasing number of patients against a nurse.

The most effective course of action in addressing the State Staffing Ratio’s concern is for the decision-maker to present a motion that would facilitate the amendment of the policy in a design that will enhance the implementation of the policy. Based on a critical analysis of the existing literature, the policy’s presentation for motion amendments will ensure that each of the changes made adequately satisfies the provision of quality care through the assignment of a reasonable number of patients to each nurse (Armijo-Olivo et al., 2020). According to Delhy et al., (2020), the existence of nuances on the staffing ratio’s applicability is a hindrance to the implementation and addressing of the concerns attached to State Staffing Ratio in nursing practice. Delhy et al., (2020) further argue that an essential strategy that can be embraced is for all people to understand that quality health care depends on the nursing practice. Therefore, all decision-makers need to establish a civic education program where the people are enlightened of the various advantages of embracing the nursing practice’s State Staffing Ratio.

The achievement of a common ground for the concerns of State Staffing Ratio is crucial, especially through the development of a consensus on the most appropriate directions of the policy that will ensure the safety of the patients and improved health care (Delhy et al., 2020). According to Carlisle et al., (2020), science is also an effective strategy in countering the challenges impending implementing the State Staffing Ratio in nursing practice. The application of science in this context depicts through the development of measures that undermine the efficiency of the limitations attached to the mode of design on the current methods attached to the establishment of various approaches for the achievement of neutral ground for the State Staffing Ratio in Nursing Practice (Winter et al., 2020). An example of the scientific nursing strategy crucial in implementing the State Staffing Ratio in nursing practice is the validation of the indicators influencing the quality of care from the perspective of the State Staffing Ratio.

The top-down approach is defined by the use of comprehensive factors in the decision-making processes. In this case, the top-down approach is used in the establishment of the bigger picture. The primary components used in determining the end goal of the decision are defined by the same comprehensive elements used as the critical driving forces (Omar et al., 2020). In this case, the comprehensive element to consider for the efficiency of State Staffing Ratio in nursing practice using the top-down approach is enhancing the well-being of the nurses in the delivery of patient care (Winter et al., 2020). This argument is based on the fact that there has been an increase in the nurses’ claims in recent years. They have insufficient time with their patients and, most significantly, the education sessions with their family members. This element has lost its ideals due to the rising numbers of patients assigned to each of the nurses, depriving them of ample time with patients (Winter et al., 2020). Therefore, the policy’s effectiveness will be determined by the achievement of quality health care for all the people and job satisfaction of the nurses.

Community Organization Plan

Hope nursing home is a community organization for patients with terminal illnesses. The community organization’s interest in the Staff Ratio public health policy is to ensure that all of the nursing patients are provided with adequate and quality health care. The primary concern attracting the community organization’s advocacy is due to the rising professional shortages at the organization. At the same time, an increase in the number of patients admitted at the facility. According to Delhy et al., (2020), nurse shortages leads to increased cases of morbidity due to the lack of adequate health care, and also due to the high chances of jeopardy on the patient safety as a result of medical errors and negligence due to the cases of stressed and fatigued nurses at the facility. Therefore, the community organization’s primary interest in addressing the concerns of State Staffing Ratio in nursing practice is to assist in advocacy for the community organization to be assigned more nurse personnel and for more financial allocation by the local government for the sustainability of the workforce.

The CBPR principles collaboratively work in the establishment of the community as a sense of unity. The CBPR principles apply under the influence of the community resources and strengths of the entire community. According to Afifi et al., (2020), Community Based Participatory Research (CBPR) is an approach that involves the participation of the people directly affected by the issue at hand. In this case, the policy’s advocacy will involve the Hope Nursing home community organization since it is directly affected by the State Staffing Ratio’s concerns in nursing practice (Afifi et al., 2020). The collaboration with the community organization will entail an engagement of the three primary CBPR principles that include the focus on the local significance of the public health problems, and the ecological point of view, the acknowledgment of the community as a unified entity, and the building of resources, and the strengths of the community.

Based on the arguments of Brush et al., (2020), the CBPR principles are beneficial as they assist the community organizations in the achievement of its needs faster since they focus on the determination and addressing of the concerns affecting the community at large. Involving the community organization to participate in the advocacy for the amendment of the public health policy will be achieved by presenting a proposal that will spell out the benefits of addressing all the concerns attached to State Staff Ratio in nursing practice. Through the proposal, I will involve a request for the community organization to join with an indication of the benefits they stand to gain by participating.

The collaboration will be achieved through the community organization’s involvement, which indicates the challenges encountered due to nurse shortages amid patient traffic. The goals of the community organization align with mine towards the selected public policy. I look forward to achieving improved health care for all the people, and the community desires the same by overcoming their problems of workforce shortages. The organizational goals of achieving a stable and sufficient workforce are one of the strategies for improving health care since the nurses will be assigned to a reasonable number of patients. They will also have enough time to revive the dying ideals of nurse’s education to the patients and create connections with the family members of the patient to offer them assurance and moral support (Bridges et al., 2019). In this case, the community organization and I have the same motive for enhancing the Staff Ratio public health policy.

The most important step to take in achieving the goals begins with the development of an objective. After establishing an objective, the next step is to create awareness of the Staff Ratio practice policy to all the relevant and influential organizations and the general members of the public. The next step is to mobilize the stakeholders within the health care setting to ensure the development and implementation of various comprehensive components and control plans to facilitate the achievement of the public policy’s developed goals.

The next step will be to expand the available advocacy groups, such as the patient organizations and other community volunteers. Then, there will be the promotion of values needed to develop programs and policies for the enhancement of the initiative for the Staff Ratio policy in nursing practice. Next, there will be the simplification of the plan on the public policy and the use of media messages to enlighten the people on the significance of policy change for the Staff Ratio in the nursing practice to achieve quality health care. The final step will be to mobilize support resources for the implementation of the intervention measures and ensure the maintenance of the decision-makers in addressing the concerns attached to the enhancement of the State Staff Ratio in nursing practice.

The community organization members’ primary role includes capacity building and problem-solving roles through the development of the social and political systems. This is because the community organization members’ goals and objectives include engagement in the policy’s briefing. Developing a collaborative evaluation plan using the CBPR principles requires critical elements such as the stakeholders’ involvement. The involvement of the stakeholders is essential as it assists in the combination of numerous perspectives. According to Afifi et al., (2020), applying the CBPR principles in developing a collaborative evaluation plan uses the rookie evaluators, which are the primary influencers of the various tools to be used in the evaluation procedure. On the other hand, an element to consider in the development of the evaluation plan is the involvement of community organization unique concepts essential in the enhancement of adaptability, which is an element of consideration since unique evaluation processes enhance the validity of the data and also builds the sustainability of the collaboration initiative.

The evaluation of the community organization plan will be achieved through the engagement of the top-down approach. Through the top-down approach’s involvement, there will be an identification of the most critical elements that define the entire community organization plan (Dhaini et al., 2020). In this case, the evaluation will take place by determining the common goals of public policy. Additionally, the evaluation will be done by determining the dispensation or roles and responsibilities of all the participating members. On the other hand, the evaluation takes place by determining a critique of the various steps staged to develop the community organization plan. Notably, all the mentioned elements have a positive influence on the community organization development plan. Therefore, it can be deduced that the community organization plan is viable.

Change is imperative and exists in all the spheres of life. However, the greatest challenge lies in the various strategies of dealing with change. It is worth noting that the implementation of change is different from the management of change. The study focuses on the implementation, and the most identifiable approach is advocacy through the involvement of the decision-makers. Through a critical analysis of the existing literature, this strategy has its strengths since the advocators deal directly with the state representative on public health care (Meyer et al., 2020). Additionally, there is the implementation of change through a collaborative strategy with the community organization.

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The strategy implementation approach has its strength in that it contains various personnel who play a significant role in advocacy. Additionally, involving the community organization is crucial as it attracts the intense attention of the decision-maker. On the other hand, the two approaches have their limitations (Meyer et al., 2020). The decision-makers’ direct involvement is flawed. It takes a longer period to have access to the decision-maker and has longer processes involved in implementing change due to the legislative regulation of policy change. The collaborative approach is also flawed in that it is prone to manipulations and only works when there is a common goal with the involved parties in the collaboration. Through a critical analysis of the two approaches, I would recommend the collaborative approach since it attracts various influential groups in society.


Notably, the State Staff Ratio in nursing practice is an essential policy for enhancing public health care. However, recent years have been met by violating the policy due to the greed for profit maximization and hard economic times. Therefore, it is essential to advocate for the policy’s enhancement to ensure its adherence to improved health care achievement. However, the implementation of policy change is not easy. Therefore, for the implementation of policy change, collaborative practice from a community organization is essential.


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