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The media can negatively influence the public’s image of nursing. Most television shows that have a medical theme, often focus on the sex driven story lines. Nurses are often seen having relationships with work colleagues, cheating on their spouses with someone at work, or having some sort of other personal drama that has nothing to do with medicine. It certainly makes for interesting television in the interest of ratings, but fails to produce a sense of professionalism in the women acting in the show. Examples of these shows are ER, Scrubs, Grey’s Anatomy, and Nurse Jackie.

People are highly influenced by the media. Media platforms are how opinions are formed and people believe them if they are not experiencing them first hand. Nurses are always seen as female. The nurse should be very attractive, wearing makeup, slim figure, and perfect hair. Their scrubs are always form fitting. What I’ve seen in some of these shows is when a woman, in any medical role, says or does something highly intelligent, people always seem surprised. Why should this be surprising? Often times the show portrays the man as the surgeon, the doctor, and the go-to know it all. The impression of the man is generally not very nice, has poor bedside manner, and no one likes them. Then somewhere, along the series, a strong willed female puts the grumpy doctor into place. Then, by some miracle, she has gained his respect and the respect of the rest of the unit. If there is a male nurse in a show or movie, they are seen as a lesser man. It continues the false idea that a nurse is a woman’s role (Creasia, 2011).

There are ways in which the general public can be better educated on the role and scope of nursing. One of the simplest ways is to be confident, educated, and proud. When a nurse knows what they are talking about and can explain it to a patient confidently, that nurse is portraying a competency, educated rationale, and body language that they are a professional and should be respected. Taking pride in one’s self, wearing your nametag, shaking a patient’s hand, and addressing them formally, are all ways that a nurse can make an impact on the false portrayal of the media’s nurse representation (Summers, 2016).

References:

Creasia, J. L. (2011). Conceptual Foundations: The Bridge to Professional Nursing Practice. St. Louis: Elsevier.

Summers, S. (2016). American Nurse Today. Retrieved from https://www.americannursetoday.com/lets-take-lea

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If I was going to adopt a new procedure for my hospital, the first thing I would do, is check to make sure it was going to be within my scope of practice. It is important to make sure we are not practicing under or over our scope. Every nurse should know the Nursing Practice Act (NPA) and be aware of other laws and rules that govern nursing practice. The NPA is the most important legislation affecting nursing. It defines the scope of practice for specific nursing roles and gives nurses the legal authority to practice within their scope (McDaniel, 2014). Another excellent source for nurses to use, is their local Board of Nursing. The Board of Nursing is specific to each state and goes into more detail as to what we can and can’t do within our practice. Some BONs publish periodic newsletters that are available on their websites and contain information about changes to their statutes. Whenever a BON makes a change to rules and regulations, public hearing notices must be posted. (Hartigan, 2016). According to Hartigan, is imperative we ask ourselves a few questions before embarking on new procedures or adopting new polices at our place of work. Do you possess the requisite knowledge, clinical skills, abilities, and judgments to safely and effectively perform this activity/role/ task/procedure/intervention based on your prelicensure educational program, postgraduate program, or continuing education program? Is this education documented? (2016). Once I was sure this procedure was appropriate to my scope of practice, I would take the idea to leadership and collaborate on how to bring the idea forward to physicians and other disciplines. In summary, nurses must work smart we have gone through too much to get our license to lose it for practicing outside of our scope.

References:

Hartigan, C. (2016). Scope of Practice. Critical Care Nurse, 36(5), 70-72. doi:10.4037/ccn2016325McDaniel, R. (2014). Know Your Nursing Practice Act. Missouri State Board Of Nursing Newsletter, 16(1), 1-6.

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The transition from dependence to autonomy can be a very stressful event for adolescents. As with other major life changes, this transition can trigger depression. It is imperative for nurses and caregivers to have a clear understanding of the signs and symptoms of depression. The signs and symptoms can be generally classified into a broad range of emotional and behavioral changes such as loss of energy, loss of interest in usual activities, loss of appetite, extreme lethargy, sudden outbursts, self-harm or drug use, and change in grades or social status (Teen Depression, 2018).

Both heredity and environment play a role in contributing to depression, so it is crucial to discuss these factors with the patient and family whenever it is permissible to do so. There is no sure way to prevent depression, but primary methods of prevention include exercise, maintaining good nutrition, and boosting self-esteem (Teen Depression, 2018). Secondary prevention methods include seeking early treatment, counseling, and medication (Teen Depression, 2018). Tertiary methods include the continued use of medication, and establishing support networks (Teen Depression, 2018).

Local Southern California resources include the McMillen program at Torrance Memorial Hospital, which offers counseling and treatment options, and the Del Amo Hospital, which offers a variety of emergency and routine treatment options for mental health. Aside from merely referring the adolescent to a community resource, nurses can perform effective intervention by educating patients regarding secondary and tertiary prevention methods, so that the patient can begin to manage the condition. In doing so, nurses can give patients the tools they need to continue healing outside of the healthcare setting.

Reference

Teen depression (2018). The Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/teen-depression/symptoms-causes/syc-20350985

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When conducting a health assessment screening on individuals, it is the health care provider’s responsibility to realize that not everyone understands and follows the most current healthcare recommendations. These recommendations often include prevention, having a regular primary physician, annual health checkups, and understanding what health maintenance means for long term healthy lifestyle. As the county experiences a large influx in cultural diversity, it is important to identify barriers that can cause important factors to be overlooked (Grand Canyon University, 2012). One of these barriers his language. Nurses must assess a patient’s ideas of proper health. Nurses must also consider the patient’s access to medical insurance and resources.

In Sue Li’s case, a healthcare provider should pay close attention to the patient’s support network, also considering if her living conditions are safe and free of harm. Every patient should be screened for abuse. The abuse assessment screening tool can be an effective resource to help reveal abuse in a safe and non-threating environment. This kind of environment allows a patient to feel as though they can trust the health care system and confide in the nurse.

In the event that the patient answers yes to any of the abuse assessment screening questions, follow-up questions should be asked regarding type of abuse, who is involved, and how long has it been going on (Jarvis, 2016). This screening tool was created because violence is very common in society. Abuse affects all levels of socioeconomic status. Abuse has no preference for race, gender, age, or financial status. Nurses are responsible to make sure the patient is not in any life-threatening danger. By law, findings must be reported to the social services and local law enforcement within 24 hours. It would also be in the patient’s best interest to provide direct resources and access to temporary placement if the patient feels their life could be in danger.

References

Jarvis, C. (2016). Evolve Resources for Physical Examination and Health Assessment (7th ed.). St. Louis, MO: Elsevier

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A comprehensive health assessment in a geriatric patient is conducted to help identify potential abnormal findings (Grand Canyon University, 2012). The assessment should include a physical examination, family history, evaluation of cognition, sensory loss, nutrition, mental health, and a determination of any advance care plan for end of life.

When the nurse first encounters the patient, there are clinical signs that can be observed by paying close attention to the client’s general appearance and behavior. Close observation is important in conducting a thorough assessment, and observation begins from the first moment of contact with the client. Important factors to notice include the steadiness of the patient’s gait and balance, and the general appearance of self-care and hygiene. Also, it is important to note if the elderly client is wearing corrective lenses or hearing aids. These findings are indications of a sensory deficit, and they should trigger the nurse to speak slowly and clearly, making direct interactions in close proximity.

Assessment of family history is important in assessing risk factors and heritable disease, and, especially with the elderly, it has the added benefit of helping the nurse address living conditions and the existence of a support system, which might be beneficial when evaluating a patient’s ability to manage care. Cognition is a critical factor in determining patient’s ability to manage care. A patient with a neurodegenerative disorder, such as dementia, may have a severely diminished capacity to comply with medical recommendations, follow-up care, self-care, and nutrition.

Assessment of nutrition should include examination of the hair, nails, and teeth. This can provide important clues about the state of a patient’s nutrition. Patient’s with diminished nutrition may not be as resilient after sickness or injury, and they are more vulnerable to pathogens and hospital-acquired infections.

The assessment of advanced directives and end-of-life plans is another crucial element in providing care for the elderly. This portion of the assessment is important because many of these directives are legally binding, and they can provide a large amount of information and direction to healthcare providers in the event of death or incapacitation.

References

Health assessment of the older adult (2012). Grand Canyon University. Retrieved from https://lc-ugrad3.gcu.edu/learningPlatform/user/users.html?

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A comprehensive health assessment in a geriatric patient is conducted to help identify potential abnormal findings (Grand Canyon University, 2012). The assessment should include a physical examination, family history, evaluation of cognition, sensory loss, nutrition, mental health, and a determination of any advance care plan for end of life.

When the nurse first encounters the patient, there are clinical signs that can be observed by paying close attention to the client’s general appearance and behavior. Close observation is important in conducting a thorough assessment, and observation begins from the first moment of contact with the client. Important factors to notice include the steadiness of the patient’s gait and balance, and the general appearance of self-care and hygiene. Also, it is important to note if the elderly client is wearing corrective lenses or hearing aids. These findings are indications of a sensory deficit, and they should trigger the nurse to speak slowly and clearly, making direct interactions in close proximity.

Assessment of family history is important in assessing risk factors and heritable disease, and, especially with the elderly, it has the added benefit of helping the nurse address living conditions and the existence of a support system, which might be beneficial when evaluating a patient’s ability to manage care. Cognition is a critical factor in determining patient’s ability to manage care. A patient with a neurodegenerative disorder, such as dementia, may have a severely diminished capacity to comply with medical recommendations, follow-up care, self-care, and nutrition.

Assessment of nutrition should include examination of the hair, nails, and teeth. This can provide important clues about the state of a patient’s nutrition. Patient’s with diminished nutrition may not be as resilient after sickness or injury, and they are more vulnerable to pathogens and hospital-acquired infections.

The assessment of advanced directives and end-of-life plans is another crucial element in providing care for the elderly. This portion of the assessment is important because many of these directives are legally binding, and they can provide a large amount of information and direction to healthcare providers in the event of death or incapacitation.

References

Health assessment of the older adult (2012). Grand Canyon University. Retrieved from https://lc-ugrad3.gcu.edu/learningPlatform/user/users.html?

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Social determinants are the circumstances in which people are born, grown, live, work, and age (World Health Organization, 2018a). Social and economic factors influence behaviors as well as predict outcomes (Senterfitt, Long, Shih, & Teutsch, 2013). Individuals are unlikely to be able to directly control many of the determinants of health (World Health Organization, 2018b).

If the community is financially or socially struggling, there are more harmful behaviors, causing added challenges when attempting to establish positive practices (Senterfitt et al., 2013). Therefore, the better the social environment, the more likely it is to embrace and maintain wellness behaviors (Senterfitt et al., 2013). Such things that encourage active communities include access to health care services, adequate public safety, accessible social support, as well as safe housing and local food markets (HealthyPeople.gov, 2014).

When the following six specific conditions are present, an infectious disorder can be spread from person to person; creating the chain of infection. By breaking this chain at any of the links, the spread of illness is stopped (The Government of Nunavut, n.d.).

Disease agent- pathogens that cause sickness
Reservoir- the carrier of the pathogen; humans, animals, or the environment.
Mode of escape- coughing or sneezing.
Mode of transfer- direct or indirect contact.
Mode of entry- inhalation, absorption, or needle sticks.
Susceptible host- the person next exposed; usually with a compromised immune system (The Government of Nunavut, n.d.).
Transmission of the pathogen can be interrupted at any point in the chain:

Eliminate or inactivate the agent.
Contain and prevent the transmission of germs at the exit portals by using sufficient infection control.
Protect any portals of entry and susceptible new hosts from transference (The Government of Nunavut, n.d.).
The bottom line is to break the chain at any opportunity. As nurses, we can help break the chain of sickness, primarily by using exceptional hand hygiene and knowing how to use and apply personal protective equipment correctly.

References

The Government of Nunavut. (n.d.). Chain of Infection. Retrieved from https://www.gov.nu.ca/sites/default/files/files/3_…

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Although many people are considered both ‘at risk’ and ‘vulnerable,’ there is a difference between the two. ‘At risk’ describes the level that someone could be exposed to an illness. A risk for sickness can be contributed to factors that include age, race, gender, and also how common specific diseases are within the community. In comparison, being vulnerable is the state at which people are unable to ‘anticipate, cope with, resist and recover’ from an impact (WHO, 2018). For example, there are many factors to consider why there are fewer influenza vaccinations received by Hispanics and African Americans than other groups; however, this places their community ‘at risk’ of contracting the virus (Rangel, Shoenbach, Weigle, Hogan, Strauss, & Bangdiwala, 2005).

When discussing vulnerable groups, children, the elderly, the poor, and minority groups are typically included. There are many reasons these people are susceptible: the poor population may be homeless, and among other causes, lack the finances to obtain health insurance; children are without the knowledge and voice; women may prefer and be unable to find female physicians; and minorities experience racism in healthcare as well as poverty because of inadequate education and economic opportunities (WHO, 2018).

These groups experience challenges in advocating for themselves due to the lack of either wisdom or fiscal resources; which are necessary to fight such vulnerabilities. Discrimination is the main ethical issue at hand. Although, some of the other fundamental concerns when advocating for these groups would include obtaining adequate access to health care and insurance coverage, in addition to helping them improve their literacy rates and financial positions for longevity.

As of 2016, the population of the U.S. was estimated at 326 million; of the reported, 12% live in poverty, 51% are female, 23% are children, and 41% are minorities (U.S. Census Bureau, n.d.). Proving that it is everyone’s responsibility to help make a difference in promoting wellness efforts in our communities.

References

Rangel, M. C., Shoenbach, V. J., Weigle, K. A., Hogan, V. K., Strauss, R. P., & Bangdiwala, S. I. (2005). Racial and Ethnic Disparities in Influenza Vaccination Among Elderly Adults. Journal of General Internal Medicine, 20(5), 426–431. http://doi.org/10.1111/j.1525-1497.2005.0097.x

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Understandably, there are mixed opinions in regard to the effectiveness of the current healthcare system; because it

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has worked well for some, but not all. It may not be perfect, but it is’t a total loss. Unfortunately,the cost of healthcare does not equal the quality, and with or without health insurance, it is creating financial hardships for common society (Dudek, 2017); thus leading to sustainability concerns. With the cost of healthcare continuing to rise and without equal increases in the average American income, many individuals are at risk of losing coverage, and therefore not having access to needed care.

Secondary to the financial evaluation, is the concern in the quality of care provided (Rice, et.al, 2014), one way the quality of care is measured, is by life expectancy (Etehad & Kim, 2017). In 2016, the life span in the U.S. was 78.5 years, whereas the longest is 84.2 years, representing the people of Japan (World Health Organization, 2018). The number of people that die from complications or conditions that could have been avoided with timely and effective care, is referred to as mortality amenable to healthcare (Nolte & McKee, 2012). In 2007, the rate was the highest in the United States and doubled that of France, which was the lowest of the four countries researched (Nolte & McKee, 2012).

However, despite these drawbacks, there have been advancements made as well. For instance, increasing the availability of electronic medical records so that multiple providers have the capability to always have current information to safely care for their patients, as well as implementing evidence-based policies to prevent hospital admissions and readmissions.

That being said, this shows that our healthcare system posses both positive and negative elements, proving a fair score when compared globally. Nevertheless, we still have mountains to climb in order to improve issues such as the economics and quality of care.

References

Dudek, A. (2017, October 14). U.S. Health Care System: American Taxpayers Paying A Lot, Getting Little In Return–A German-American Perspective. Retrieved from https://www.huffingtonpost.com/alev-dudek/us-health-care-system-ame_b_12431960.html.

Etehad, M., & Kim, K. (2017, July 18). The U.S. Spends More on Healthcare Than Any Other Country — But Not With Better Health Outcomes. LA Times. Retrieved from http://www.latimes.com/nation/la-na-healthcare-comparison-20170715-htmlstory.html#

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Within primary prevention, prevention of illness takes place (Magruder et al., 2016), including avoidance of the development of disease even if exposure happens (Bissell, 2006). It includes preparedness activities, and reducing exposure to environmental risk factors, in addition to improving resilience to them (Rose, 1992). For example, efforts exist in the form of promoting proper nutrition or utilizing vaccines to prevent disease (Rose, 1992). During the Haiti earthquake, the simple existence of the disaster team in preparation for the disaster was a primary prevention measure.

Resources were significantly limited in Haiti; most primary prevention efforts would have needed to take place in the initial preparation phase, before starting the mission. There could have been things that would have better prepared the volunteers, that also would constitute as primary prevention, that wasn’t observed in the video journal, but that doesn’t necessarily mean that it didn’t happen. For example, in addition to providing immunizations and prevention for the Haitian people, it is also important to also have good health protection practices for the volunteers. Education would’ve been helpful to address environmental conditions, sanitation, food preparation, and infection control practices. Learning about Haiti’s health and culture practices to help avoid and prevent the spread of disease. For example, better options to replace the bucket used for handwashing, how to safely prepare cultural food choices, and how to prevent contraindicated practices that could cause barriers to infection control or promote complications.

secondary prevention

Secondary prevention occurs after a disease has originated but before it becomes symptomatic (Howlett & Stein, 2016). It involves using disease control tools to reduce the spread of an epidemic and minimizing the harm that occurs once a disease or injury affects an individual or population (Bissell, 2006). Therefore, early interventions offer more optimal outcomes (Magruder et al., 2016).

The monitoring of minimum standards for water safety security, sanitation, shelter, and personal hygiene is critical for health promotion after disasters. Awareness of the emergence of water and foodborne disease is of importance to the health of the victims (Jafari, Shahsanai, Memarzadeh, & Loghmani, 2011). Antibiotics can often be considered a primary intervention to prevent disease, but in this case, many people were already ill and were treated to avoid further complications; making it become a secondary intervention.The empathetic conversation and Bible reading with the grieving man in the hospital; showing support and stating the fact that someone cared was in some ways, important as medical tasks. This secondary prevention is addressing the needs of the man who has already endured the emotional distress of the disaster and is helping to prevent his anguish from developing into a long-term psychological diagnosis.

tertiary prevention

The tertiary prevention phase is characteristically long in duration, and often an opportune time to initiate new aspects of primary prevention as the society attempts to “build back better” and reduce future risk (Keim, 2016).Disaster recovery actions promote the goal of decreasing the damage caused by a disaster and rebuilding communities to recover post-impact. Efforts would involve establishing interventions that are geared towards meeting the long-term needs of the victims and the community (Howlett & Stein, 2016). Steps are taken to help individuals who have been injured or ill to learn life skills and focus on regaining the full capacity to live normal lives (Bissell, 2006). Such needs are determined by the nature and extent of damage that had occurred to individuals or the community as a whole. An excellent example would include the provision of a place where individuals could have the opportunity of sharing with others about their experiences during the disaster thereby contributing to a positive healing process.Efforts would entail working in collaboration with other rescue teams such as the local police, fire department, and the Red Cross.

References

Bissell, R. (2006). Public Health and Medicine in Emergency Management. In Disciplines, Disasters a