Dilemma is the word I have chosen to describe this situation. Unfortunately, I think this is a very common occurrence within this setting for nurse practitioners. The practitioner in this scenario is faced with having integrity in treating the patient properly and seeing other patients and maintaining volume in order to be compensated financially. When it comes to nurse staffing to patient ratio, one article says that it is important to have a balance in order to provide the best patient outcomes (Clarke & Donaldson, 2008). Another article talked about how healthcare has incongruent goals. These goals include improving patient outcomes while providing patient-centered care and keeping costs down (Judge-Ellis & Wilson, 2017). This is exactly what this scenario shows.
My Experience with this Situation
I have felt in a similar situation on a smaller scale. When our unit became increasingly busy and our staffing was down I had to take on an additional patient and,at the time, I was not comfortable with the load. I felt that I was not equipped to give the patients the best care and safety required. Unfortunately, our unit was not in a position to get additional help, especially so quickly, and I had to figure it out. I was able to care for the patients as needed and got some help. The amount of stress and even fear this added to my work was worrisome. This is not a position that was comfortable and I would think being in this given scenario would be worse. I would hate to have my work integrity and my finances go head to head. I would like to think I would care for the patients and I am sure at times I would and at others the financial aspect would guide my decision making.
Clarke, S. & Donaldson, N. (2008). Nurse staffing and patient care quality and safety. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2676/ (Links to an external site.)Links to an external site.
Judge-Ellis, T. & Wilson, T. (2017). Time and NP practice: naming, claiming, and explaining the role of nurse practitioners. Retrieved from https://www.npjournal.org/article/S1555-4155(17)30602-5/pdf