Denetrius Banks 
     The national healthcare stressor that I selected is burnout.  Burnout is a stressor that we all, at one time in our health career, have faced.  For me, I can honestly say that I have experienced burnout.  I currently work six days a week working at Fresenius Kidney Care Dialysis Clinic.  Burnout is an emotional condition marked by tiredness, loss of interest, or frustration that interferes with job performance (Dyrbye et al., 2017)
     Being a nurse is not easy and nurses are facing increasingly difficulty working conditions and are burning out.  My experience during this COVID 19 pandemic has caused me to experience being burnt out.  Dealing with the stressor of being burnout has an impact or my work setting at the dialysis clinic.  At times, I dreaded going to work. Many days I felt mentally and physically exhausted.  My sleep patterns was unpleasant.  I would sleep four or five hours and awake and was unable to go back to sleep. 
     General nursing is a profession that requires working in a variety of things and situations with continuous and regular delivery of physical and emotional care.  It is a situation where the nursing staff can be under continuous exposure to a wide range of occupational stressors (Fraga, 2019).  Dealing with COVID 19, our administrator decided to give mandatory days off per week to help decrease the feeling of being burnt out. Extra nurses have been hired at the dialysis clinic, so instead of one nurse caring for twelve to fourteen patients, we are now caring for eight patients per shift.  The has been a decrease in exhaustion among the staff since another nurse has been added to the pool.
References
Dyrbye, L. N., Shanafelt, T. D., Sinsky, C. A., Cipriano, P. F., Bhatt, J., Ommaya, A., West, C. P., & Meyers, D. (2017). Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care. NAM Perspectives, 7(7). https://doi.org/10.31478/201707b
Fraga, J. (2019, June 5). Why the WHOs Decision to Redefine Burnout Is Important. Healthline; Healthline Media. https://www.healthline.com/health/mental-health/burnout-definition-world-health-organization
Nursing Burnout: Why It Happens and How to Avoid It | Rasmussen College. (2018). Rasmussen.Edu. https://www.rasmussen.edu/degrees/nursing/blog/nursing-burnout-why-it-happens-and-what-to-do-about-it/

Henrietta Mosoke 
Health Insurance Coverage and impact on work setting
 Healthcare affects everyone as well as politics and businesses, Laureate Education (Producer). (2018). Healthcare coverage has always been one of the challenging issues facing the United States and a compromise on how to provide health insurance to all Americans is yet to be attained. In his discussion, Brunton (2018), expresses his concerns about most Americans not being able to purchase health insurance coverage. The author lamented the fact that most Americans are forced to make difficult decisions on whether to get their medications or buy food. Statistically, the average American family spent $9,996 in healthcare insurance during 2017 while about 27 million Americans are still uninsured. President Obama instituted the Patient Protection and Affordable Care Act are also known as ACA or Obamacare in 2010. The main aim was to reduce health insurance cost and make it available to most Americans.The president intended for no American to be denied health coverage based on pre-existing conditions. Preventive care to be free with no out of pocket premiums. For adult children up to 26 years to stay on their parent’s health insurance plan, Woolhandler & Himmelstein (2017). Still Many Americans are without health insurance coverage despite the growing need for health concerns. Disparities in care amongst low socio-economic groups and vulnerable populations especially children and the elderly, and those with specific health concerns present enormous challenges.
            I work with Medstar health and I have noticed that the lack of healthcare coverage by some patients has a huge impact on the finances of the organization. There are patients brought to the emergency room of the hospital from shelters, others homeless, or those found in the streets. In addition, there are still other patients who get admitted and treated with no insurance nor accommodation. The hospital is left with the burden of absorbing the healthcare cost and also to get accommodation for these patients. For example in 2019 alone, the hospital had a bad debt of $61.2 million, charity care of $32.8 million and a total of $94.0 million unsponsored care, medstarwashington.org.
In a bid to improve the health of its employees, Medstar provides affordable health insurance coverage to all employees as well as their families. This coverage includes medical, dental, and vision care. Just like Pittman & Scully-Russ(2016) mentioned in their study, Kaiser Permanente started by providing care just to employees and their families and later expanded to providing care to the public. Health insurance coverage continues to be a challenge as still a lot of patients are admitted without insurance coverage and the hospital still has to absorb the cost of treatment through voluntary programs and other available healthcare grants. In a bid to cut down on losses, I have observed shorter hospital stays with treatments being compressed into fewer days. For example, patients who come in with alcohol withdrawal are mostly treated for a maximum of three days except they have other underlining conditions.
References
Brunton, S. (2018). Can We Afford to Be Healthy, Wealthy, and Wise? Clinical Diabetes, 36(4), 281“282. https://doi-org.ezp.waldenulibrary.org/10.2337/cd18-0069
Laureate Education (Producer). (2018). The Healthcare Environment [Video file]. Baltimore, MD: Author.
Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.
Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human Resources for Health, 14(56), 1-15. doi:10.1186/s12960-016-0154-3.https://human-resources-health.biomedcentral.com/track/pdf/10.1186/s12960-016-0154-3
Woolhandler, S., & Himmelstein, D. U. (2017). The Affordable Care Act: How Nixons Health Reform Proposal Became Democrats Albatross. International Journal of Health Services¯: Planning, Administration, Evaluation, 47(4), 612“620. https://doi-org.ezp.waldenulibrary.org/10.1177/0020731417729661

USE 3 SOURCES ON EACH DISCUSSION