Summary of the Problem
The US healthcare system is now undergoing many changes and is facing numerous challenges. Nurse staffing is one of the most urgent issues to be solved in view of the contemporary challenges of the system. It has been acknowledged that inappropriate staffing leads to a slower healing process in patients and an even higher rate of mortality. Cimiotti, Aiken, Sloane and Wu (2012) state that burnout and inefficient leadership (as well as management) result in nurses’ emotional detachment from their work. Nurses have rather an excessive workload and they often make medical errors due to their fatigue.
It is also necessary to add that nurse staffing is associated with issues concerning inefficient education or experience. Thus, nurses with degrees and more experienced nursing professionals have proved to be more effective in coping with the workload and providing proper healthcare services, which leads to lower rates of mortality, improved healing process, and increased patients’ satisfaction. Of course, it is also important to take into account cultural issues and issues concerning diversity. Nursing professionals often experience additional emotional (as well as professional) load due to inappropriate diversity policies utilized in a healthcare facility.
The Most Applicable Middle-Range Theory
Clearly, a number of nursing theories can be applied to come up with the necessary solutions to the problem. However, it is possible to note that middle-range theories are most applicable in this case as they provide the bridge between the theory and practice, between frameworks and actual situations (Brown, 2005). Nurse staffing is an issue that needs a very practical approach. Therefore, practical inquiry theory can be the most applicable in this case as it is associated with close collaboration between researchers and practitioners (Stevenson, 2005).
When using the practical inquiry theory, the inquirer looks into the problem and he/she is in close contact with practitioners. Discussions can be seen as some of the most common tools in this approach. It is noteworthy that practitioners share their ideas and the causes and effects of the problem become vivid. More so, practitioners (as well as the inquirer who is an objective observant) come up with possible solutions to the issue. It is also important to note that this approach enables the researcher to consider each case in detail and develop the necessary strategy suitable for a particular situation. The developed strategy can be utilized in many other settings if adjusted accordingly.
Practical Inquiry Theory’s Origin
Practitioners started talking about the gap between theory and practice as far back as the first half of the twentieth century (Stevenson, 2005). Many researchers, as well as practitioners, noted that universities do not provide future nurses with all the necessary skills to cope with daily issues. It was also acknowledged that many theories were rather too generalized and they could hardly be applicable in real-life settings.
At the end of the twentieth century, researchers started working on the theories that could be utilized in particular cases. Thus, researchers tried to concentrate on “creating meaning in relation to a phenomenon, rather than capturing some pre-existing reality” (Stevenson, 2005, p. 196). It is necessary to note that there has been a lot of progress in this sphere as numerous new approaches have been developed.
Previous Applications of the Practical Inquiry Theory
The practical inquiry theory has been widely used to address a variety of issues. It is possible to provide an example of the use of this approach in psychiatry. Stevenson (2005) describes a case that can be seen as exemplary since it provides insights into the essence of the approach and its benefits. Stevenson (2005) notes that practitioners are often stuck due to the rigidity of certain theories. This is especially true when it comes to such mental disorders as schizophrenia. A practitioner could not achieve any progress with a patient suffering from this disorder. At a certain point, the practitioner decided to put aside all the theories (that had been unsuccessfully applied earlier) and have a deeper collaboration with the patient. The patient shared her views of herself (with the help of images from the famous book Alice in Wonderland). The practitioner put aside existing frameworks on identity and applied a new approach developed with the help of the patient’s ideas on herself. It is noteworthy that the nurse did not agree with the practitioner. The nurse concentrated on the use of frameworks developed earlier. At the same time, the practitioner achieved significant progress with the patient, which shows the effectiveness of the use of practical inquiry theory.
The Use of the Theory to Address Issues Concerning Nurse Staffing
As has been mentioned above, the practical inquiry theory can (and should) be employed to address issues associated with nurse staffing. First of all, researchers have to make discussions their major tools. During these discussions, nursing professionals should share their ideas and concerns. This will enable the researcher to identify reasons for excessive workload and nurses’ fatigue (lack of professionalism and so on). Importantly, the researcher will identify issues the particular facility has. Of course, it is important to pay attention to such issues as the complexity of tasks, workload, education, experience background, diversity, and so on.
The data obtained during inquiries should be carefully analyzed. At that, discussions cannot stop, as the second phase will start with a new set of inquiries. Nursing professionals will be able to share their ideas on possible solutions of the existing problems. Thus, the inquirer will provide a list of major issues existing in the facility and nursing professionals will discuss these problems. They will come up with particular steps to solve this or that issue. Of course, it is important to invite managerial staff to participate in some of these discussions. Again, the inquirer should draw practitioners’ attention to the aspects mentioned above (education, competence, diversity and so on). It is important to encourage people to put aside old frameworks or, at least, provide a totally new perspective on the use of these theories.
Finally, it is necessary to add that the strategy can be developed on the basis of the data obtained and results of the discussions. However, prior to the discussions, the researcher has to make sure that practitioners understand the need of change and are ready to implement it. Otherwise, the practitioners can see the discussion as worthless mandatory meetings where they can remain passive. Practitioners have to understand that they are able to change the situation and make a difference. Collaboration during inquiries can be effective only when all participants are active, sincere and committed to implement the change. Finally, it is possible to add that the strategies developed in the particular case can be applicable in similar settings and, hence, the frameworks can be (at least, partially) employed in other healthcare facilities.
Reference List
Brown, S.J. (2005). Direct clinical practice. In A.B. Hamric, J.A. Spross, C.M. Hanson (Eds.), Advanced practice nursing: An integrative approach (pp. 143-185). Philadelphia, PA: Elsevier Saunders.
Cimiotti, J.P., Aiken, L.H., Sloane, D.M., Wu, E.S. (2012). Nurse staffing, burnout, and healthcare–associated infection. American Journal of Infection Control, 40, 486-490.
Stevenson, C. (2005). Practical inquiry/theory in nursing. Journal of Advanced Nursing, 50(2), 196-203.