Open-Ended Question Essay On Pain Modulation Sample Assignment

History of placebo analgesia

Many medical historians believe that the placebo effect has played a significant role in the development of medicine throughout time. Placebos didn’t become a staple of contemporary medicine until they were utilized as controls in clinical studies. In 1784, Louis XVI commissioned Benjamin Franklin and Antoine Lavoisier to examine Franz Mesmer’s claim that he had discovered “animal magnetism,” an alleged invisible force Mesmer thought held curative capabilities (Muller et al., 2016). Franklin and Lavoisier used placebos as controls in this study. Without notifying the patients, Franklin and Lavoisier exposed patients to “mesmerized” items or placebos (i.e., untreated objects). As a result of the researchers’ findings, they concluded that animal magnetism does not have any scientific foundation.

However, despite being widely employed in clinical studies, the placebo effect has been demoted to being regarded as just a nuisance variable to be controlled for since the development of the double-blind placebo-controlled study. This has been an unpleasant side consequence. There was little attention to placebo effects before the twentieth century. Beecher’s meta-analysis was perhaps the most important in this regard. A 35 percent average improvement in symptoms was found when Beecher merged the data from placebo groups from 15 separate trials on ailments like pain, seasickness, coughing, and anxiety, arguing for the potency and merit of the placebo effect (Annoni, 2020). There has been a lot of discussion about the placebo effect’s capacity to activate endogenous modulatory systems involved in self-healing procedures, despite Beecher’s technique being questioned later on.

Psychobiology and biochemistry of placebo and nocebo effects

Psychobiology and biochemistry of placebo effects; The placebo effect is typically explained using classical conditioning, a learning technique. Additionally, Pavlov (1927) found that a bell paired with the administration of morphine, which promotes restlessness in dogs, caused the dogs to become agitated when the bell was heard alone, giving the first indication that drug-like (placebo) effects may be conditioned. When it comes to the placebo effect, contextual cues (e.g., syringe, treatment room) are considered conditioned stimuli that may cause conditioned placebo effects when paired with an active therapy (e.g., morphine) (e.g., pain relief; the conditioned response) (Petrie & Rief, 2019). Social learning, also known as vicarious learning or modeling, may be used to produce placebo effects. It’s possible that the participants’ knowledge of placebo analgesia came from seeing the impact of the drug on others rather than through firsthand experience. Socially produced placebo analgesia is equivalent to conditioned responses and much more significant than vocally induced analgesia.

Psychobiology and biochemistry of nocebo effects; pain may be induced as a nocebo effect by anticipating its worsening by verbal disclosures or earlier exposure to unpleasant sensations (e.g., classical conditioning). Nocebo effects are equivalent in size to those generated by genuine experiences of increased somatosensory perception, discomfort, itching, and deterioration of motor function(Petrie & Rief, 2019). Because nocebo effects may also be generated by seeing other people suffer, social learning is essential in developing nocebo effects.

Negative expectations might have a counterintuitive effect on therapeutic effects. Bronchoconstrictors were characterized as bronchodilators by asthmatic patients, and the opposite was true when they were classified as bronchoconstriction by non-asthmatics. Furthermore, healthy patients who were given a stimulant, but were instead given a muscle relaxant drug, increased muscular tension (Požgain et al., 2014). In patients, nocebo effects may lead to psychological anguish, medication nonadherence, and the need for additional medications to alleviate the nocebo side effects.

How placebo and nocebo effects are formed

While “sugar” tablets are frequently linked with the placebo effect, many popular medications, such as analgesics and antidepressants, also include a placebo effect that contributes to their effectiveness. This is due to the belief that therapy would alleviate the patient’s discomfort (Palese et al., 2019). Positive treatment expectations (i.e., being informed the opioid will considerably lessen their pain) doubled the analgesic effect in a group of individuals administered a potent opioid and then exposed to painful stimuli.

On the other hand, the nocebo effect refers to a decrease in treatment effectiveness, an aggravation of symptoms, or the emergence of new side effects that do not occur due to the active therapy. 2 Since the treatment is seen to inflict damage, and this is why many are afraid of it (Klinger et al., 2017). The research found that when patients were informed that the opioid would make them more sensitive to pain after the first impact wore off, it entirely abolished the opioid’s analgesic benefit. The nocebo effect may be responsible for a large percentage of the side effects of drugs.

Nocebo-induced effects may be explained by the patient’s increased awareness or sensitivity to regular day-to-day symptoms, such as aches, pains, exhaustion, mood swings, and sensory alterations, due to their expectation that their therapy would have unfavorable consequences (Klinger et al., 2017). An undesirable impact is then linked to the treatment, and these symptoms are taken into account in the diagnosis (Petrie & Rief, 2019). Treatment-related side effects are changes in the course of an illness or its symptoms, which may be linked to the use of a new drug or treatment strategy.

Ways to communicate for reducing pain perception and nocebo hyperalgesia in daily clinical practice

The use of framing tactics may help reduce the occurrence of nocebo-related occurrences. It’s possible to provide the same information to reduce stress, worry, tension, and pain. In recent research, pregnant women who requested epidural analgesia were asked to disclose their health information and verbally propose ways to alleviate their pain. When a woman was told about the epidural procedure, she was told either a typical depiction of the pain or a soft one that included some excellent features. “You are going to feel a giant bee sting; this is the worst part of the treatment” and “We are going to give you a local anesthetic that will numb the region, and you will be comfortable throughout the process” were the two disclosures made by the authors when executing the epidural analgesic process.

In the same manner, we all agree that the first disclaimer stated above is a standard approach to explaining the effects of the process. In contrast, the second description discusses the procedure expecting the anesthetic medication’s benefit. A blinded evaluation of the patient’s pain experience followed. Nocebo group women in labor reported much more pain during the local anesthetic injection than those who had the treatment coupled with calm and pleasant remarks and were warned to anticipate it to hurt like a bee sting. According to this research, the manner presented information may significantly influence results, underlining the need for thorough disclosures. Information may be presented in a way that minimizes the nocebo’s impact while respecting patients’ rights to be informed. An empathetic communication compatible with professional ethics should be included in every clinician’s practice.

Reliving one’s emotional trauma throughout therapy is essential. The patient’s mental health may be assessed and treated through psychological treatment. Taking the drug while the patient is in a happy state of mind can also assist them in having better expectations for the future. When discussing the therapy with the patient, be careful not to use any negative language. The patient should be allowed to ask questions about the drug. The nocebo effect may be reduced by addressing patients’ worries, diminishing their worry, and increasing their optimistic expectations and minimum anxiety. With good information, patients may change their impressions of a medicine. Adverse nocebo effects may be reduced by switching from pessimism to optimism regarding medicine.

When working with clients regularly, it’s critical to prevent unfavorable results from being unintentionally linked to the environment. To help patients who’ve had a bad encounter with medicine, you must assist them in their efforts to reassess their unfavorable recollections of a particular drug. Changing their perception of the medicine and reducing nocebo hyperalgesia can help. Instead, if the patient has unfavorable recollections of a prescription, it will be critical to alter the surrounding circumstances to achieve therapeutic efficacy. It may be performed by switching to a generic version of a drug. It will lessen the nocebo effect by lowering patients’ unfavorable perceptions of a specific medicine. Drug wrapping or packaging may also be used to alleviate unwanted memories. As a result, it will lessen the patient’s unpleasant reaction to it.

Three critical ethical issues related to placebo and nocebo effects and four potential solutions

The present understanding of the placebo and nocebo effect gives us the information needed to begin an ethical dialogue. To do so, three fundamental ethical problems should be addressed. First is consequentialism. a concept of ethics in which the effects of one’s actions determine the morality of that action. The optimum outcomes of a specific action might vary based on the context and the value theory being considered. The second is informed consent. Ethics requires informed consent for medical treatment. To make well-informed choices regarding treatment, patients have the right to be informed and to ask questions. The patient-physician connection may be strengthened through effective communication. Lastly is autonomy, the right to control one’s destiny. It is within the purview of everyone who is morally capable of making decisions about their own lives.

First is the involvement of patients and the public in research planning. While some deceit will be included in the research, it will not hurt the people. A team of public members may participate in this stage to serve as witnesses. The second is authorized deception. According to this method, participants are informed they would be deprived of information that is not detrimental to them but critical to their participation in the study. If necessary, it may be given to them as soon as the data gathering is finished. The third is debriefing participants. Participants may be debriefed as early as practicable during the data collecting phase. Informing participants that deception was utilized because it was necessary to the exam but that the test was not damaging should be included. It will assist in resolving the ethical dilemma of individual agencies. Lastly is the participant-nominated informed consent. Nominated informed consent may be achieved by designating a trusted third party to receive and agree on their behalf to disclose personal information.


Webster, R. K., Weinman, J., & Rubin, G. J. (2018). Ethical issues surrounding the study of nocebo effects: Recommendations for deceptive research. British journal of health psychology, 23(4), 775. (Webster et al., 2018)

Petrie, K. J., & Rief, W. (2019). Psychobiological mechanisms of placebo and nocebo effects: pathways to improve treatments and reduce side effects. Annual Review of Psychology, 70, 599-625.

Klinger, R., Blasini, M., Schmitz, J., & Colloca, L. (2017). Nocebo effects in clinical studies: hints for pain therapy. Pain reports, 2(2).

Palese, A., Rossettini, G., Colloca, L., & Testa, M. (2019). The impact of contextual factors on nursing outcomes and the role of placebo/nocebo effects: a discussion paper. Pain Reports4(3).

Požgain, I., Požgain, Z., & Degmečić, D. (2014). Placebo and nocebo effect: a mini-review. Psychiatria Danubina26(2), 0-107.

Annoni, M. (2020). Better than nothing: a historical account of placebos and placebo effects from modern to contemporary medicine. International Review of Neurobiology153, 3-26.

Müller, M., Kamping, S., Benrath, J., Skowronek, H., Schmitz, J., Klinger, R., & Flor, H. (2016). Treatment history and placebo responses to experimental and clinical pain in chronic pain patients. European Journal of Pain20(9), 1530-1541.

Opioid Addiction Epidemic Essay Example For College

Opioids were the go-to prescription medicine for everyone who experienced any pain in their bodies. People relied on opioids a lot to the point it became a major problem in the United States. Addiction rates among people of all ages have become higher because people did not think that opioids were anything else rather than quality medications that help them with their pain. People believed in the pharmaceutical companies’ assurances that claimed that opioids would not cause any addictions. Opioids were legal drugs which doctors encouraged patients to use until the negative side effects began affecting the patients. The accurate results of the opioids became known when the first wave of the opioid epidemic began in 1990. Opioid addiction is a serious matter that should be dealt with because the lives of many people are at stake.

The first wave of the opioid pandemic was caused by the many prescriptions people got from their doctors. At that time, the drug was used as a pain medication for all people without knowing its dangers to addiction. Many people found themselves dependent on drugs that they could not function without two or more pills a day. Doctors did not realize the damage the pain medications they were prescribing to their patients were causing until it was too late. According to Liu et al. (n.d.), communities, where opioids were readily available and easily prescribed were among the first places to experience opioid abuse. Some people even began sharing their opioid prescriptions with other people, which is illegal. Sharing prescribed drugs is illegal and dangerous because people have different needs, and only doctors should prescribe medications. Many of the people who initially used opioids such as codeine, methadone, and oxycodone were cancer patients who experienced immense pain due to their cancer treatment. The pharmaceutical companies led to the first wave of an opioid epidemic because they encouraged non-cancer patients to use opioids for any pain. The second wave of the opioid epidemic started in 2010 when deaths involving heroin overdose increased. Heroin is a drug made from morphine, which is in the class of an opioid. When opioid prescriptions started to have limitations because of the high addiction rates experienced in the first wave epidemic, people switched to heroin. People who were dependent on opioids and no longer had access to prescriptions found a way to get heroin in their system. During this time, heroin addiction brought in new diseases such as HIV and Hepatitis, because heroin is mostly injected (Severance-Medaris, 2021). People shared heroin injections, which gave way to new diseases, making the opioid epidemic a more dangerous health threat. During this wave, many children born from women with an opioid addiction who used heroin were born addicted to the drug. Innocent infants suffered due to their mother’s addiction, which brought back concern for ways to help people beat their opioid dependency. People who have a dependence on opioids are more vulnerable to heroin addiction than those who have no prior use of any opioid drugs. The second wave claimed many lives because most of the people who used heroin had a dependency on an opioid drug which increased their risk. The third wave of the opioid epidemic was seen in 2013 when deaths due to the consumption of illegally manufactured fentanyl increased. The two waves of the opioid epidemic caused several opioids to be removed from the market due to their high addictive rates. People in the black market started to manufacture synthetic opioids to help meet the needs of many people who wanted access to opioids due to their addiction. Some of the synthetic opioids manufactured in the black market were not safe for consumption, leading to many deaths during the third wave. The three waves of the opioid epidemic led to the deaths of thousands of people. According to CDC (n.d), in 2019 alone, over 70% of the 70,630 deaths involved an opioid.

Once taken, opioids enter the body, and a person feels a sense of relief and pleasure. The opioids dull pain in the body, giving a person temporary relief. Opioids can be safe for use if people follow their doctor’s prescription and avoid taking more than they should. Cancer patients and people who have undergone surgeries need pain medication for them to cope with their day-to-day activities before they heal or recover. Small doses of opioids in the body can cause sleepiness, while higher doses can slow the breathing and heart rate, which may cause death (Krieger, 2018). People become addicted to opioids because they want the relief and pleasure the drugs offer them when in pain. Once they become addicted, they continue using the drugs even when they are not in pain, making them vulnerable to overdose. Opioid supplements can also lead to health complications if the doctor has not allowed their use. Heroin use has several adverse effects on the body, and once people inject themselves, they become high and experience ecstasy. Heroin is used by many people who are addicted to pain medication because it has the same effects. Opioids were encouraged mainly in the past because pharmaceutical problems did not advertise that they are addictive and may cause death. The complications that come with using opioids were ignored until it was too late, which contributed to many deaths in the country due to an opioid overdose. People also die from opioid withdrawal once they decide to stop the abuse without medical assistance. As much as it is advisable to stop abusing opioids, an addicted person should seek medical help for them to handle the withdrawal period without succumbing to death or giving up and relapsing. Some withdrawal symptoms include vomiting, diarrhea, muscle pain, anxiety, and severe headaches. Withdrawal weakens the body, and without medical care, one might not survive the ordeal.

The number of pregnant women who abuse opioids or use heroin has increased, which is evident from the number of infants born with withdrawal symptoms. Many women addicted to opioids do not seek treatment, and they continue taking pills or injecting themselves with heroin which affects the health of their babies. Regarding the opioid epidemic, pregnant women contribute significantly to the increase of people dependent on opioids because they introduce their babies to the drugs before they are born. Babies born with the addiction suffer once they experience withdrawal symptoms because they are dependent on the drug. Many of the children born with drugs in their system do not survive because of the pain and discomfort they feel when undergoing withdrawals. Future generations are being affected by the opioid epidemic, and if nothing is done to control the use of opioids and heroin, future generations will continue to suffer. Innocent children should not have to suffer from withdrawal symptoms caused by the mother’s actions. The issue of opioid misuse among adults in the United States should be addressed to avoid more waves of the opioid epidemic that may cost more lives.

The start of the Covid pandemic brought up another alarming surge of opioid abuse and overdose. According to Erica Ernst, the country is experiencing not an opioid epidemic but an overdose epidemic (Caine, 2021). Many people died as a result of opioid or heroin overdose during the first year of the pandemic. The increase in overdoses was attributed to the stress levels people were experiencing and the fact that most physical doctor visits were prohibited. People ended up self-medicating, increasing their addiction which left them vulnerable to an overdose. Researchers have found out that most drugs that people abuse have been combined with the synthetic form of opioid, fentanyl. Heroin was the number one drug that was found to have the most amount of fentanyl than heroin components. During the pandemic, people opted for drugs laced with opioids, increasing the number of overdoses reported in the country. Drugs laced with fentanyl are more deadly than when used by themselves. Every state in the country experienced an increase in overdose deaths in 2020, which was the pandemic year. The increase in opioid overdose death during the pandemic has been attributed to social isolation and mental illness. People were asked to stay in their homes, which may have created an opportunity for people to develop drug habits that led to their overdose. Mental illness needs constant care because it often clouds people’s judgment from knowing what is right or wrong. People with mental illness already using prescribed opioids may have changed their drug habits which increased their risk of an overdose. People do not have to be addicted to overdose using opioids. Taking more than is required at one time can lead to a severe overdose that can cause death if medical assistance is not administered.

The opioid epidemic needs a permanent solution that will help save the lives of people who have become dependent on pain medication because of the pain they experience from health issues like surgery. Many people addicted to opioids or heroin did not willingly want to be dependent on those drugs, but their lack of knowledge of the dangers of the drugs made them vulnerable. Private and public health organizations should come up with strategies to help people overcome opioid and heroin addiction. The government should also take measures to ensure opioid drugs, heroin, and other drugs laced with fentanyl are not readily available for people to buy and consume. The government can help deal with the opioid epidemic by ensuring the Food and Drugs Association (FDA) is strict on its tests and medicine approvals. Many of the opioids that have claimed the lives of countless American citizens were approved by the FDA. The FDA also allowed pharmaceuticals companies to market the drugs without adequate tests to know for sure whether they were dangerous or not. The United States will remain vulnerable to opioid addiction and overdose if such mistakes by the FDA are not addressed and corrected (Center for Drug Evaluation and Research, 2021). Before approving any drug and allowing companies in the pharmaceutical industry to promote it, the FDA should be sure of its effects to help develop the proper doses to avoid patients’ addiction.

The other measure that should be taken to help solve the opioid epidemic is for health care providers to develop pain treatment therapies for patients experiencing chronic pain instead of prescribing pain medication. People who constantly take pain medications can quickly become dependent on them, even if that is not the intention. To avoid accidental addictions through prescribed pain medications, doctors should develop ways for the patients to deal with the pain instead of using the pain medicines. Some of the pain treatment therapies that doctors should recommend to their patients are constant exercise and yoga sessions. Exercise and yoga help keep the patient occupied, and it helps they gain control of their body’s feelings (Harvard Health, 2017). The other treatment therapy that can be used as a substitute for pain medications is music therapy. Patients should find their favorite genre in music and use it to ease their pain after surgeries, chemotherapy, or any other health situation that may cause pain. Patients who can swim are encouraged to engage in the activity because it helps strengthen the body and fight the pain they feel. Therapeutic body massage can also help patients relax and learn to deal with pain without using pain medications. Patients who use pain treatment plans instead of pain medications have a good chance of recovering without the risk of opioids addiction.

Creating awareness of the effects of prescription drugs and how they can affect one’s health is essential in the fight against the opioid epidemic. People should know how opioids affect their lives and how they can resist the urge to consume them. Creating awareness and educating people on opioids will help people understand the actions to take once they become dependent on a drug their doctor prescribed. The government and other private health care facilities should partner up with hospitals and other health facilities for the campaign on creating awareness to work. Funds should also be designated to create awareness regarding the opioid epidemic. A campaign for pregnant women with opioid addiction should be held because the lives of innocent infants are at risk. Treatment plans for such women should be laid out for them to help themselves and their babies live a drug-free life. The government should ensure that drugs such as heroin are not on the market. Heroin makes an excellent substitute for opioid medications, and its availability will derail the efforts of reducing the opioid pandemic in the country. The Drug Enforcement Agency (DEA) in the country should conduct a raid on all drug distributors in the black market who enable drug users to continue with their dangerous habits. The eradication of opioid drugs and heroin in the black market will reduce their availability and reduce the spread of the epidemic. The government should allocate funds to the DEA to ensure they perform their duties efficiently and effectively. Most of the cases of an opioid overdose will reduce once such measures are taken by all the relevant people in the health sector. Rehabilitation centers for people who wish to get treatment and rehabilitate from opioids should be cheap to ensure everybody in the country can afford treatment. Counseling sessions should be given to all patients who need to learn how to deal with pain without using painkillers.

In conclusion, the opioid epidemic occurred in three waves; the first one in 1990, the second in 2010, and the third in 2013. The three waves saw an increase in opioid-related deaths at different levels and due to various factors. Thousands of people in the United States have an opioid use disorder, and many others have died of an opioid overdose. Pregnant women addicted to opioids and heroin are at risk of giving birth to babies suffering from withdrawal. During the covid pandemic, opioid overdoses increased drastically. Many people opted to self-medicate because of the fear of visiting hospitals and the loneliness caused by social isolation. Pain treatment plans such as yoga, therapeutic massage, and music therapy can be substitutes for pain medications for patients experiencing pain. The FDA is responsible for ensuring all the medicines prescribed to people are well researched, and all the side effects are known. The opioid epidemic is claiming many people’s lives in the United States, and its increase is alarming. Everybody in the country should be aware of the opioid epidemic and work towards ending it for the benefit of all people.


Caine, P. (2021, October 25). US Overdose Deaths Surge to an All-Time High. WTTW News.

CDC. (n.d.). Understanding the Opioid Overdose Epidemic | CDC’s Response to the Opioid Overdose Epidemic | CDC. Centers for Disease Control and Prevention.

Center for Drug Evaluation and Research. (2021, March 29). Opioid Medications. U.S. Food and Drug Administration.

Harvard Health. (2017, July 28). 8 non-invasive pain relief techniques that really work.

Krieger, C. (2018, March 21). What are opioids and why are they dangerous? Mayo Clinic.

Liu, L., Pei, D., & Soto, P. (n.d.). History of the Opioid Epidemic. Poison Control.

Severance-Medaris, C. (2021). The Other Epidemic: COVID-19 and Opioid Overdose. NCSL.

Discuss What Relevant Theories Of Organization Behavior Suggested, Such As Teamwork And Motivation, Evident In The Selected Organization Sample College Essay


National Health Service (NHS) is a government-funded healthcare facility based in the UK that offers medical services to communities at subsidized costs. Teamwork and motivation are essential in enhancing effectiveness in service delivery to enhance the welfare of patients in the Covid 19 pandemic. Teamwork entails the capability of individuals to work together and communicate effectively to inspire confidence and unity while performing their roles. Motivation involves enhancing the cognitive, emotional, and social forces to activate and initiate behavior that is goal-oriented. Patients visiting such facilities access urgent care services in case of severe medical conditions. During the Covid 19 pandemic, healthcare professionals at NHS have been actively involved in identifying the symptoms of the disease, testing the patients, isolation, and vaccinating. The health facility maximizes its workforce to ensure that patients access value-adding services for improved health. It is a facility with approximately 1.3 million experienced and motivated employees. The research question aims at discussing the appropriate ways of resolving workplace challenges through motivation and teamwork will be discussed to enhance effective healthcare activities. NHS employees have been overwhelmed in response to the Covid 19 pandemic and therefore, teamwork, and motivation levels are essential in handling the pressures that are associated with supporting patients and saving lives. This study aims at addressing the challenges faced by NHS during the Covid 19 pandemic through enhancing organization behavior theories: such as teamwork and motivation to positively impact the health of communities through improved healthcare.

Case Study

Background Analysis

NHS has been supporting patients during the Covid 19 pandemic to enhance their health and well-being. Due to the increase in the number of infections, health care workers have experiences contagion fear, family health concerns, stigma, interpersonal isolation, and quarantine which have resulted in mental health issues (Wilson 2018). Healthcare professionals have also gone through stress, anxiety, and fear when offering direct patient care, especially in instances where the protective resources are inadequate (Wilson 2018). Workers have had to work for long hours with minimum rest to meet the increasing demand for healthcare services (Wu et al. 2021). As a result, they get overwhelmed, demotivated, exhausted and stand a risk of providing substandard services (Wu et al. 2021). Healthcare professionals are committed to offering exceptional care services and, in the process, risk their health and well-being (Wu et al. 2021). Generally, the Covid 19 pandemic places significant pressure on the capability of the NHS to offer high-quality and safe care services (Wu et al. 2021). Coping under an overwhelming working environment inhibits the ability to provide exceptional services hence the need for addressing the challenges experienced by healthcare professionals in their courses of duty during the Covid 19 pandemic.

Despite the challenges experienced by NHS and healthcare professionals, the facility is still committed to offering exceptional healthcare services during the Covid 19 pandemic, which seems interesting (Grey 2008). The facility ensures that healthcare professionals are well versed with the recent information regarding the Covid 19 pandemic through knowledge improvement programs (Grey 2008). In such sessions, knowledge regarding diagnosis, treatment, and prevention measures is imparted for proper coordination among staffs and patients (Valenza 2022). With a clear understanding of the processes and procedures to be followed for effective healthcare services, patients have better experiences while accessing healthcare services (Valenza 2022). With such pieces of training, healthcare workers learn to appreciate each other’s skills and consider them as their strengths in the profession (Valenza 2022). As such, an organizational culture that makes people to feel like they belong is enhanced (Valenza 2022). Also, teamwork and motivation are enhanced hence improved treatment options.

Major Organizational Behavior Challenge

The major organizational behavior challenge experienced by NHS is the inadequacy in the number of staff that has resulted in overwhelming workloads, moral distress, burnout, and unrealistic expectations during the Covid 19 pandemic. This challenge has been caused by an increase in the demand for healthcare services, especially for Covid 19 patients (Buchanan and Huczynski 2003). Without sufficient healthcare workers, effective care services are limited, putting the health of patients at risk. NHS has also experienced challenges in workforce recruitment, planning, and retention (Buchanan and Huczynski 2003). As a result, during the Covid 19 pandemic, a backlog of care was created. More attention has been given to the Covid 19 patients, and patients with non-Covid needs have regularly found healthcare services unavailable for them. The overwhelming experiences of the healthcare workers have made them to shift attention to Covid 19 patients with routine care, and planned operations have been suspended to free up resources such as hospital beds (Buchanan and Huczynski 2003). Recently, approximately more than 300,000 patients have been waiting for their non-Covid needs to be met during the Covid 19 pandemic (Buchanan and Huczynski 2003). The morale of the frontline workers has deteriorated as Covid 19 has put workers at NHS under significant strain. Doctors and nurses are exhausted and, in most cases, are nearing burnout (Buchanan and Huczynski 2003). Such instances have been caused by insufficient healthcare professionals in the NHS to meet the increasing demand. Approximately one in ten nursing posts are currently vacant at NHS, resulting in approximately 40,000 vacancies (Buchanan and Huczynski 2003). These healthcare professionals have demonstrated commitment in their roles during the pandemic, but all this has been to their personal detriment, as they sometimes lack adequate protection (Buchanan and Huczynski 2003). In the long run, these healthcare experts could develop severe mental health challenges such as post-traumatic stress disorder during and after dealing with Covid 19 at the frontline.

Cause of the Challenge

Such health consequences have been caused by the UK government’s reluctance attitude to investing in medical knowledge improvement programs. The training costs of doctors and nurses are usually high, which is evident in a publicly funded system (Thompson and McHugh 2009). During the Covid 19 pandemic, reducing training costs has not been an effective move as it makes staffing a major challenge (Thompson and McHugh 2009). Healthcare professionals can not officially assume their roles without the necessary knowledge having been imparted to them, as service delivery could be compromised (Thompson and McHugh 2009). Healthcare workers should be seen as an asset at NHS rather than a liability to ensure adequate care services (Thompson and McHugh 2009). Cost-cutting initiatives at NHS have therefore placed barriers on recruitment at a time when such experts are needed most.

Theory Discussion

Teamwork and Motivation Theories

Teamwork Theory

Teamwork refers to the process of working with people collaboratively to achieve a specific goal. The teamwork theory aims at reducing burnout issues as one person is no longer responsible for handling patients (Somani 2021). A team of health care professionals come together and exchange ideas on how best they can offer reliable services to enhance the well-being of patients (Knights et al. 2006). A collaborative effort gives healthcare professionals an opportunity to work together and offer assistance and guidance in their areas of strengths and weaknesses (Knights et al. 2006). Healthcare workers work as a team to enhance their confidence levels in their roles and provide relief in overwhelming cases (Somani 2021). Teamwork theory will therefore address the challenges associated with overwhelming workloads, moral distress, burnout, and unrealistic expectations that NHS has been experiencing during the Covid 19 pandemic (Knights et al. 2006). Through teamwork, employees and managers can communicate effectively to address pressing issues that hinder effective services (Knights et al. 2006). When all clinical and non-clinical workers work collaboratively, improved patient outcomes are experienced. Medical errors will also be prevented, improving efficiency and enhancing patient satisfaction. Workloads make healthcare professionals unproductive and are likely to offer substantial services (Knights et al. 2006). The teamwork theory makes it possible for workers to assist one another appropriately for patients’ well-being. Staff relationships are also improved through teamwork, making assistance when handling challenging healthcare roles possible (Knights et al. 2006). Teamwork also improves job satisfaction, and employees become passionate about their roles (Knights et al. 2006). Motivation levels increase as well, encouraging development and career growth among healthcare professionals.

Motivation Theory

Motivation theories provide insights to organizations regarding what makes workers perform better. Such theories offer managers with tools to motivate employees by understanding how staff can be supervised better (Flodgren et al. 2011). Through motivation, organizations initiate, guide, and maintain behaviors that are goal-oriented (Flodgren et al. 2011). Motivation is what drives people to act the way they do and is influenced by emotional, social, and cognitive forces (Flodgren et al. 2011). Considering the staffing challenges that NHS has been experiencing, the goal-setting theory is applicable in addressing the issue.

The goal-setting approach is a motivation theory that was introduced by Edwin Locke. The methodology holds that health workers get motivated when specific goals are set to direct their roles and responsibilities (Willan et al. 2020). It is a methodology that will boost the morale of frontline workers at NHS, which has been deteriorating due to the overwhelming experiences (Flodgren et al. 2011). In this theory, commitment to goals and self-efficiency are critical in promoting effective operations (Flodgren et al. 2011). By defining the goals of providing exceptional healthcare services and incorporating measures to impact positively the well-being of communities NHS will enhance effectiveness and efficiency (Flodgren et al. 2011). Awareness regarding the proposed goals should be created for healthcare workers to enhance consistency in care services (Flodgren et al. 2011). The means to achieving the proposed goals, such as the provision of adequate resources, should also be communicated clearly by NHS for systematic operations (Flodgren et al. 2011). Through the goal-setting approach, NHS will also enhance self-efficiency by executing healthcare behaviors that will enhance confidence in attaining specific performance goals (Flodgren et al. 2011). Initiatives such as hiring, retention, and motivation are supported by this theory and will address the issue of inadequate staffing in NHS. Staff retention resolves inadequacy in healthcare workers, and the costs of hiring will also be cut (Flodgren et al. 2011). Training costs associated with orientation and recruitment will also be managed through staff retention (Flodgren et al. 2011). Motivation, therefore, plays a critical role in enhancing a conducive working environment for healthcare experts (Flodgren et al. 2011). When they are motivated, they are influenced to perform their roles to the expected standards for efficiency in service delivery. When healthcare workers are motivated to work, they express commitment, and in the long run, patients will have better health experiences.

Empirical Work

The NHS Leadership Academy advises that effective teamwork and motivation make healthcare facilities able to overcome the challenges they experience in a short time. Evidence from the academy has indicated that staff working as a team is a process overseen by the managers and supervisors, who should be role models in enhancing collaboration (Azizi et al. 2021). Staffs should also be aware of the importance of collaboration in enhancing the welfare of patients so that they are cooperative in the process (Chung et al. 2021). Also, when healthcare workers are motivated in their roles, they acquire the drive to perform their roles without having to be closely monitored or pushed (Azizi et al. 2021). They understand their roles and have the initiative to execute them.


Organizations providing healthcare services should embrace teamwork and motivation theories for quality services. These are methodologies that appropriately resolve the challenges experienced in their daily operations (Collings et al. 2021). NHS will appropriately resolve the issues surrounding them by applying these theories hence the need to embrace them (Collings et al. 2021). To effectively incorporate these theories, healthcare facilities should evaluate their challenges and identify appropriate areas where these theories apply for exceptional services.


I think, to effectively address the challenges that NHS has been facing during the Covid 19 pandemic, the teamwork and motivation theories should be applied. These theories are broad and provide realistic solutions to the challenges that NHS has been experiencing (Faupel and Süß 2019). NHS has been facing staffing issues where the healthcare workers available are inadequate to meet the increasing demand for healthcare services (Faupel and Süß 2019). Such challenges have made the entire workforce overwhelmed, risking the health of patients. The teamwork theory offers solutions to such challenges since, through teamwork, employees can communicate with ease and assist one another in areas of challenge for improved patient health (Faupel and Süß 2019). When teamwork is enhanced, staff workload will be adequately handled, reducing the patient traffic that has resulted due to fatigue and lack of enough rest. I also think that the morale of frontline workers can be effectively boosted through the motivation theory. The motivation theory provides room for enhancing commitment and self-efficiency when offering healthcare services, hence addressing the deteriorating staff morale that has resulted from the overwhelming experiences (Faupel and Süß 2019). When staffs are motivated to work, they are self-driven (Islam et al. 2021). They do not have to be closely supervised to enhance productivity. They are aware of their job description and are committed to their roles and responsibilities (Faupel and Süß 2019). I believe that NHS will resolve the issue of deteriorating morale of healthcare workers through applying the motivation theory that enhances self-drive and commitment amongst workers (Islam et al. 2021). NHS will also learn about the importance of providing the necessary resources for the appropriate protection of workers when handling Covid 19 patients (Islam et al. 2021). When staffs are appropriately protected, they develop confidence in service delivery, impacting positively the lives and well-being of patients.


The National Health Service (NHS) is a healthcare facility that offers medical services to communities at reduced prices. It is a government-funded institution that aims to positively impact communities through providing reliable healthcare services to patients. During the Covid 19 pandemic, NHS has been overwhelmed due to the rise in demand for healthcare services. The available workers have been inadequate, resulting in burnout, mental issues, and general fatigue making them not productive to the expected standards. Such challenges that the facility encounters in its daily activities which hinder seamless operations. Teamwork and motivation theories provide appropriate solutions to these challenges, especially during the Covid 19 pandemic. Healthcare workers at NHS have also had concerns such as contagion fear, stigma, and interpersonal isolation that has made it challenging for them to meet the expectations of their patients. When serving clients, these professionals are sometimes not appropriately protected as the available resources are overstretched. These challenges have been caused by the United Kingdom government being reluctant to invest in knowledge improvement programs for healthcare workers. Considering that the training costs are relatively high, the government has considered cutting on such costs, which is not a wise move either. Such programs should be given priority so that doctors and nurses are equipped with the appropriate skills to work effectively. Staffs that are inappropriately trained are likely to offer substandard services hence the need for a comprehensive training program. These inefficiencies have made recruitment and hiring processes challenging, resulting in staffing issues at NHS during the Covid 19 pandemic.


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