Nursing Issues and Policy Development: A Critical Analysis

This report delves into the multifaceted issues affecting the nursing profession, primarily within the context of New Zealand, highlighting the need for policy development to address these challenges. It examines critical problems such as workforce supply shortages, workplace hazards and violence, inadequate compensation, long working hours, and the difficulties nurses face in meeting patient expectations. The paper explores the link between these issues and existing policies, using the Nurse Practitioner Role in New Zealand as an example, and offers a rebuttal to contradictory statements. The report underscores the persistent nature of these challenges, despite ongoing efforts to mitigate them, emphasizing the need for continuous evaluation and adaptation of nursing practices and policies to improve the working conditions and professional satisfaction of nurses. The analysis emphasizes the importance of addressing these issues to retain nurses and ensure high-quality patient care.

Running head: NURSING 1
Nursing
Student Name
Institution
Author’s Note

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Abstract
Nursing issues require deeper understanding and changes are hanging on policy
development. The paper examines various issues and problems that are facing the nursing
profession. Some of the analyzed problems or issues within the report are workforce supply,
workplace hazards, workplace violence, compensation, meeting patient expectations, long
working hours, personal health, Poor work-life balance, and nursing education pathway. These
issues show a clear picture of reasons why many nurses are willing to leave the profession for
other career. This is due to discouragement, emotional stress and lack of confidence or inability
to meet client’s expectations. The paper tries to show the connection between nursing problems
and policies that have been developed. An example of policies document that is already available
is Nurse Practitioner Role in New Zealand. Some of the principles that is foundation of the
policy can be traced back to nursing problems. This report also gives a short rebuttal argument
on some contradictory statement of nursing problems. This report concludes by indicating that
some challenges have been affecting nurses for many years despite the effort to contain nursing
challenges.
Table of Contents

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Introduction.................................................................................................................................................3
Nursing Problems and Issues.......................................................................................................................4
1. Work dissatisfaction........................................................................................................................5
2. Workforce supply............................................................................................................................5
3. Compensation..................................................................................................................................6
4. Long working hours.........................................................................................................................7
5. Workplace Hazard...........................................................................................................................8
6. Workplace violence.........................................................................................................................9
7. Meeting patient’s expectation..........................................................................................................9
8. Personal health...............................................................................................................................10
9. Poor work life balance...................................................................................................................11
10. Nursing education path..............................................................................................................12
Policy development...................................................................................................................................12
Nurse Practitioners Role in New Zealand..............................................................................................13
Principles of the policy..........................................................................................................................13
Rebuttal.....................................................................................................................................................13
Reference...................................................................................................................................................15

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Introduction
Nursing as a professional area of concern has many issues and problems that have been
affected the department for many years though some of these issues are contemporary. Nursing
professionals remains an important medical profession not only within the country but also
globally. Nursing professionals holds a key role especially in caring for patients makes it one of
the core element of medical health. There are many different studies that have been conducted in
order to establish various issues that affect nursing professionals. These issues or problems have
resulted in the development of policies while some issues have never been resolved. Some of the
problems that have been affecting nurses within New Zealand have resulted in numerous strikes
and work boycott that is seen in the recent past. In a bid to tackle nurse issues, the minister of
health has form many task forces and have recommended some policies changes. An example of
the policy document that resulted in the task force appointed by the Minister of Health was the
Nursing Role of New Zealand. Some of the most common nursing problems or issues include
workforce supply, workplace hazards, workplace violence, compensation, meeting patient
expectations, long working hours, personal health, Poor work-life balance, and nursing education
pathway. The following paper explores various nursing problems and issue that necessitate the
need for policy.

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Nursing Problems and Issues
Nursing as professional area of concern faces many problems or issues that have resulted
in the development of policies within New Zealand. Despite the important position of the nursing
practice within the health system, a number of challenges highly affects the nursing profession.
Some of these challenges have been resolved while others still persist until today and are the
leading cause of nurses strikes witnessed in country in the past few weeks. The overall result of
these challenges is the development of a nursing policy that reduces some of the challenges.
Some of the discussed problems are workforce supply, workplace hazards, workplace violence,
compensation, meeting patient expectations, long working hours, personal health, Poor work-life
balance, and nursing education pathway.
1. Work dissatisfaction
Work dissatisfaction is an issue that is facing nursing professional with many nurses
indicating that their job does not match their expectations. As cited by Chhugani and James
(2017), many nursing practitioners are struggling with emotional challenge especially accepting
their professional carrier payment. Different studies has proven the issue of emotional challenge
and identified that nursing practitioners more so those nurses that are of 30 years and below are
finding it difficult to accept current payment and work environment. In addition, a study by
Baraz-Pordanjani, Memarian, and Vanaki (2014) shows that more than 40% of nursing
professionals within New Zealand has lost confidence in their profession due to harassment and
bullying in the course of practice. This is also true with the cases of unsafe care that nurses offer
due to emotional stress leading to dissatisfaction by clients. To make it worst, many nurses has
changed their career over the past 12 months due to workplace problems leading to
dissatisfaction. Another research by Tsuruwaka (2015) also shows a survey conducted within

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New Zealand among nurses that indicate workplace dissatisfaction is the main reason that makes
some nurses travel overseas looking for jobs. Several studies have suggested that there is a need
for a mechanism to encourage nursing practitioners and reduce the job dissatisfaction that has
been experiencing.
2. Workforce supply
Workforce supply is another problem or issue that has affected the nursing practitioners
in the country over the past years. Firstly, there is a high demand for the nursing workforce as
compared to the current workforce available within the country and this has resulted in huge
demand. Increasing specialized care such as aged care and community health care is putting
pressure on the available nursing professional within the country and point to future increase
(Mari, 2017). Secondly, the workload that nurses are exposed is making the nursing profession
difficult and unattractive. The number of them, when compared to the number of nurses, point to
a worrying figure and this has resulted in the high nursing workload. Thirdly, the aging of many
nursing professionals is high when compared to the current supply indicating the possibility of
future workforce shortage. The population characteristic of the New Zealanders shows that the
population is aging at a faster rate and this also true with the nursing professionals that is also
losing many aged professional. This could result in a shortage in the future within the country
and regionally. The nursing low workforce issues have been reported for many years this has
necessitated the need for policy that will consider staffing to ensure that the low workforce is not
experiencing in the future (Ramos, Brehmer, Vargas, Trombetta, Silveira and Drago, 2015).

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3. Compensation
Remuneration is another issue that highly affects nurses not only within New Zealand but
globally. Nursing compensation has been argued as not comparable to the workload that nurses
are exposed to in health care facilities. According to Lisa (2015), nurses within the Pacific region
are generally paid the low salary of average $ 18000 annually and this is high when compared to
another nurse from other regions such as Mid-Atlantic region where nurses are paid $ 14800. In
addition, these payment disparities have made many nursing practitioners to seek employment in
other regions outside the country hence reducing the nursing population within the country. The
compensation is also tied to the emotional and job dissatisfaction that is normally linked to low
confidence among nurses. Cannaerts, Gastmans and De Casterle (2014) indicate that the pay
does not consider the number of hours that nurses take caring for patients and this has resulted in
poor living standards of nursing professionals. Many nursing practitioners have cited their
expectation is totally different from what they are going through as professionals and this is
worsening in some health care facilities where work conditions are poor. Many nurses, therefore,
have suggested a new way of compensation that will ensure better pay. This prompted the need
for the development of some compensation mechanisms to better the need for nurses.
Progressive payment is one way that nurses have suggested for ensuring that nurses are paid in a
better way (Rogers & Wattis, 2015).
4. Long working hours
Long working hours is another area of concern as nurse work for many hours before shift
and the condition depend on the facility where nurse is on duty. Sometimes nurses are forced to
work for many hours due to the care they are providing to patients. There are often cases of
fatigue resulting from extended shifts or nurses working back to back and this may bring medical

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mistakes from nurses. According to a study conducted by Hakojärvi, Salminen, and Suhonen
(2014), longer working hours that nurses are subjected to result in burnout and patient
dissatisfaction and are experienced by many healthcare facilities within the country and globally.
Another survey conducted the Nursing Council of New Zealand (2014), also shows 80% of
nurses in America are experiencing similar longer working hours as compared to those within
New Zealand. Moreover, the on average most nurses work for more than 13 hours shift leading
to the patient’s dissatisfaction. This is completely making many nursing professionals to
experience emotional challenges leading to the option of leaving a job for another profession.
Negative cognitive and regret characterizes the life of most of the nurses that have experienced
longer shifts in the course of the profession. Conclusively, many nurses are feeling that longer
working hours is due to a low nursing workforce that is currently experienced in New Zealand.
The overall result of nursing long working hours was that many nurses are leaving the career for
other jobs and there is a need for the development of regulations that will be beneficial to all
workforces (Yousefy, Yazdannik & Mohammadi, 2015).
5. Workplace Hazard
There are many different workplace hazards that are affecting nursing professionals in the
course of their duty. Firstly, many nurses are reportedly exposed to blood borne pathogens that
put their lives at risk of getting ill. According to Salminen, Stolt, Metsämäki, Rinne, Kasen, and
Leino-Kilpi (2016), more than 5.6 million health workers are exposed to the risk of pathogens
that are dangerous to their life. Secondly, nurses sometimes experience injuries that result from
equipment or machines that are sued within the hospital to treat patients. Thirdly, many hospitals
and health facilities have a huge number of germs that nurses are either directly or indirectly
exposed and this put their life at risk. This makes many workers that are working within this

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hospital to risk their lives. In addition, the nursing practitioners are always working in many
different departments and this has made them risk contacting diseases from many patients
(Ganesh, Fiona, Wilma and Hugh, 2014).
Studies indicate that there is a need to reduce the risk that nurses are exposed as this can
result in injuries, illness and event mortality among these nursing professionals. According to
Mari (2017), there is a need to come up with risk mitigating factors especially a policy that will
ensure that nurses are not at risk in the course of duty. In addition, there is a need to train nurses
on ways to protect themselves from risk associated factors when in practice. This necessitates the
need for a policy document that outlines the procedures that are carried out to prevent the risk
that nurses are exposed.
6. Workplace violence
Workplace violence is another issue that is affecting the nursing profession in New
Zealand. The origin of the violence nursing professionals experience is mainly from co-workers
and patients. Patients reportedly harass nurses who turn out to be violent and this has highly
contributed to injuries and other work-related complications. Moreover, many nurses are
exposed to abuse from patients who sometimes have a mental related illness that makes them
violence (Hutchinson, Shedlin, Gallo, Krainovich-Miller and Fulmer, 2014). In addition, co-
workers are also a source of violence that is also reported according to the data from
occupational health hazards. Over the past few years, the number of cases that are due to
violence from abuses has increased. Workplace violence that nurses experience is normally seen
as a key factor that makes nurse have a negative attitude from collaborative duty especially when
the violence results from co-workers. Research by Arslan and Dinc (2016) shows the need to

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come up with a strategy to reduce or control violence and one of the suggested areas that can
help the nursing practitioners is the development of policy to reduce this violence. Furthermore,
the development of a policy point to the possibility of doing away with the issue of violence for
many years to come.
7. Meeting patient’s expectation
Meeting the patient’s expectation is an issue that is reported affects many nurses since
patients have high expectations that may not be met. According to Beaver (2015), nurses see
meeting the patient's expectation as an important area of concern due to challenges that nurses
face making it difficult to meet these challenges. For instance, one of the reasons that have been
advanced for not meeting patient's expectation is based on the short staffing making nurse to be
overworked. This has resulted in poor quality of care offered by these nurses and the condition is
worst in some health care facilities where the number of caregivers is even smaller than the
standard. In addition, the dissatisfaction of patients reduces the morale of the nurse and increase
the stress leading to poor quality of service. Patients in many health facilities have reported poor
quality of services resulting from a low number of nurses attending to these patients. There is a
need for the development of control measures that will ensure that the nurse population
correspond to the patient number as this will ensure that patients receive the service worth their
expectation. One of the ways to meet patient expectation is to develop policies that will ensure
certain care are offered to patients (Jamieson, 2012).
8. Personal health
Personal health has been cited as one of major causes of low morale among nursing
practitioners. It is worth noting that nursing practice is a risky and health hazard career that may

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result in poor personal health. This is even worst in cases where nurses are experiencing
workplace challenges and the overall result is the poor quality of service that is a medical risk
(Chhugani & James 2017). The stress these practitioners are exposed to leads to emotional
problems such as depression. Increase stress is related to health complications that have been
experienced in many health care facilities across New Zealand. For instance, those nurses
working within the Maori people have been experiencing low career morale due to the work
condition that they are exposed. Moreover, the female gender has been exposed to more risk
emanating from workplace violence from male counterpart or patients. Discrimination is even
getting worst with some nurses reportedly abused or injured in the course of duty. Another
source of personal stress and health is long working hours or shifts that make nurses work
through feeling tired and burnout. This has complicated the health leading to more health-related
issues. The stress and personal health issues make it needful to have some policies that can
determine the number of hours that nurses should work and other stress-related causes for
ensuring that there is an improvement in nurse personal health (Beaver, 2015).
9. Poor work life balance
Poor duty-life balance is a nurse issue that is based on other challenges that have already
affecting nurses. Firstly, long working hours and shifts leave little for nursing practitioners to
take time and relax with their families. Secondly, any numbers of commitments within the nurse
profession make it difficult to balance between their personal life and work. Thirdly, emotional
and stress that nurses are subjected is the reason many nurses can’t take care of personal issues
that they face. Low remuneration and individual’s need have also made it difficult to balance
between personal life and duty leading to more challenges than solutions. A survey by Sinclair,
Papps, and Marshall (2016) indicates that many nurses have reported that they do not know how

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to balance their personal issues and work due to long commitments. Studies further suggest the
need to help the nurse plan for their personal issues and necessitate the need for personal
development training on how to balance personal life and work. Moreover, the development of
policy to train nurses on the need to balance work and life is important for future service quality
improvement. This will also ensure that nurses are not exposed to challenges that may result in
stress (World Health Organization, 2015).
10.Nursing education path
Nursing learning path, especially in the educational path, remains a challenge within the
nursing profession as many practitioners are unable to advance their education. According to
Gooch (2015), many nurses argue that there are many factors that make it difficult to advance
their training and education. Firstly, a tight working environment makes it difficult to pursue
advanced education in New Zealand and this has increased over the past years. Secondly, as
indicated by Nahid, Zahra, Farkhondeh, Camellia and Majid (2016), many nurses find it difficult
to further their education to master’s degree level due to the low compensation they receive from
employers. In addition, the insufficient salary has been shown to be not enough for family use
making it difficult to do other developmental issues. Thirdly, the inability of nursing
professionals to balance personal life and work has also contributed to low advance educational
trainees within institutions. As identified by Jamieson (2012), nursing education path has been
marked with challenges making many nurses to opt out of training before being registered as
nurses. This is due to challenges that these nurses face in the course of duty and is also connected
to nursing emotional stress leading to the loss of confidence.