NURS 6050 Essay Assignment
Agenda Comparison Grid Template
Use this document to complete the Module 1 Assessment Agenda Comparison Grid and Fact Sheets/Talking Points Brief.
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Opioid Crisis in the United States
Description In 2017, the number of overdose deaths involving opioids (including prescription opioids and illegal opioids like heroin and illicitly manufactured fentanyl) was 6 times higher than in 1999. (CDC, 2017).nurs 6050 Essay Assignments
Administration (President Name) Pres. Donald Trump Pres. Barack Obama Pres. George W. Bush
Describe the administrative agenda focus related to this issue President Trumps administration has an agenda to get behind the driving forces that are causing drugs to be accessible to people. They will also provide education, awareness, and prevention measures, cut off the flow of drugs into the US by border patrol, and creating and providing evidence-based treatment for opioid addiction.
Former President Barack Obama set many different motions into play. His administration was responsible for setting restrictions on the MD’s that were prescribing the narcotics and opioids to their patients. He placed strict laws on what and when MD’s can give prescriptions for certain medications. The Bush administration focused on managing United States borders to prevent drugs and illegal substances from entering the country.
George Bush’s administration was also focused on providing treatments, treatment centers, and therapy for citizens.
Allocation of financial and other resources to this issue On September 19, 2018, the Administration awarded more than $1 billion in funding to State and local entities to address the opioid crisis.nurs 6050 Essay Assignments
Substance Abuse and Mental Health Services Administration awarded $930 million in grants to support prevention, treatment, and recovery activities.
Health Resources and Services Administration awarded more than $396 million to 1,232 community health centers, over 120 rural community organizations, and academic institutions.
Centers for Disease Control and Prevention awarded States, territories, tribes, and partners more than $194 million to bolster prevention and data collection efforts battling this crisis.
“$1 billion in new mandatory funding over two years to expand access to treatment for prescription drug abuse and heroin use.
$920 million to support cooperative agreements with States to expand access to medication-assisted treatment for opioid use disorders.
$50 million in National Health Service Corps funding to expand access to substance use treatment providers.
$30 million to evaluate the effectiveness of treatment programs employing medication-assisted treatment under real-world conditions and help identify opportunities to improve treatment for patients with opioid use disorders.” (Obama Whitehouse, n.d.)
Over $3 million for drug treatment and research
Notes on Administration’s approach to the issue President trump is securing borders, using more advanced mail flagging for international packages.
President trumps administration is also ensuring that medical personnel are carrying Narcan to prevent/treat overdoses.
The Obama Administration was much slower to respond and acknowledge the opioid crisis versus other administrations.
The Bush administration wanted to reform the Medicare system and make it easier for seniors.nurs 6050 Essay Assignments
I do not feel like there was as much focus on the opioid crisis with the bush administration as there has been with the Trump and Obama administrations.
This Administration has nearly doubled funding for opioid and pain research from $600 million to $1.1 billion and is supporting research for a vaccine to prevent opioid addiction.
The administration has implemented a “safer prescriber plan.” Under the Obama administration, drug overdose deaths nearly doubled, going from 36,450 in 2008 to more than 63,600 in 2016.
The Obama administration enacted the affordable care act which in turn expanded Medicaid and helped many people struggling with addiction
Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
I think after examining all the information regarding the different administrations and comparing and contrasting them I would finalize that the Trump administration has the biggest of the helping hands in fighting the opioid crisis in this country. The Trump Administration is the one who is going all out with “the wall” for preventing all illegal immigrants into the country which includes drug rings and traffickers. They are also the administration who seems to be allocating the most money for the opioid crisis when compared to the other administrations.
How does the healthcare issue get on the agenda and how does it stay there?
I think that the opioid crisis, like any other healthcare issue just needs to be talked openly about to be able to stay on the agenda. The media and social media are a great way to do that. Speaking out about the issues and voicing issues constantly is one very good way to keep the topics in people’s eyes and also keeps them on the agenda for resolving.nurs 6050 Essay Assignments
Who was the entrepreneur/champion/sponsor of the healthcare issue you selected?
I think that it takes congress and legislators throughout all the different states to be the entrepreneurs for any healthcare issues but especially the opioid crisis. This is an issue that may be different throughout each state. Some states are worse than others. The President himself is also a good champion or sponsor for speaking of the drug crisis and finding ways to help or eliminate the issue all together. I feel like we, as a country are headed in the right direction regarding the opioid crisis.
The issue that I chose that is a HUGE issue throughout the country would be the opioid crisis. This is an issue that can be dealt with on a state and local level. Opioid overdoses are on the rise throughout the country, some areas of the country worse than others. This issue should be included in the agenda for legislation for that reason. This is one of the highest death incidences in the country and also something that can easily be prevented. This issue can start by being looked at a local and individual level. Healthcare providers, healthcare centers, hospitals, clinics, MD offices, and health departments can all come together to provide not only regulation and monitoring of opioid prescriptions but also other beneficial attributes such as education.nurs 6050 Essay Assignments The citizens that are being prescribed these medications need education on what can happen if they are not taken properly or the signs and symptoms of dependence. They also need education on nonpharmalogical interventions for the reasons behind needing these pain medications. These are all simple things that any nurse working in ANY area of the healthcare field can provide. People love listening and talking to nurses about their health and well-being. We, as nurses, are more often than not more well liked over even the doctor. Sometimes we can even get through to patients better than the physician themselves. We all need to come together and use these strong voices and talents to help this opioid crisis throughout our country!
FACT SHEET: President Obama Proposes $1.1 Billion in New Funding to Address the Prescription Opioid Abuse and Heroin Use Epidemic. (n.d.). Retrieved February 26, 2019, from https://obamawhitehouse.archives.gov/the-press-office/2016/02/02/president-obama-proposes-11-billion-new-funding-address-prescription
Opioid Overdose. (2018, December 19). Retrieved February 25, 2019, from https://www.cdc.gov/drugoverdose/epidemic/index.html
President Donald J. Trump’s Initiative to Stop Opioid Abuse and Reduce Drug Supply and Demand. (2018, October 24). Retrieved February 25, 2019, from https://www.whitehouse.gov/briefings-statements/president-donald-j-trumps-initiative-stop-opioid-abuse-reduce-drug-supply-demand-2/nurs 6050 Essay Assignments
Www.facebook.com/jerry.mitchell.5872. (2018, February 10). Obama gets D-minus, Trump an F for work on opioid epidemic, expert says. Retrieved February 26, 2019, from https://www.clarionledger.com/story/news/2018/02/09/obama-gets-d-trump-f-work-opioid-epidemic-expert-says/1043205001/
NURS6050 – Week 2 Discussion
Nurses as Leaders in the Health Care Reform
With so many changes occurring within the health care system today, I believe nurses play a huge part in the decisions that are made within all aspects of the system. Many nurses may not see themselves as “leaders” per say but their voice is what we need to hear to see the positive changes in the ongoing reform to the health care system. It does not matter whether you are bedside nurse or you are always attending meetings in the boardroom, leadership is needed in all areas in order for us to provide out patients with the most adequate care possible.nurs 6050 Essay Assignments
Influence of Nursing on Health Care Decisions at all Levels
The style of leadership that is needed comes from all directions at all levels. Every member of the healthcare team must work together to adapt to the continuous changes of the health care system (The Future of Nursing: Leading Change, Advancing Health, 2011 pg. 223). Nurses in particular at all levels need strong leadership skills. These skills are pertinent in order for patient safety and quality of care to be delivered. We must engage with physicians and other health care professionals in order to ensure that the healthcare we deliver is efficient and effective. It is important for them to assume leadership roles within the healthcare system and its redesign (The Furture of Nursing: Leading Change, Advancing Health, 2011 pg. 12).
Nurses understanding that their leadership is important will lead to many changes within the health care system. These changes include but are not limited to integrating new practice models, leading curriculum changes to prepare workforce for patient needs and applying research findings to practice (The Future of Nursing: Leading Change, Advancing Health, 2011 pg. 225). Why not speak up and lead the way for these changes? nurs 6050 Essay Assignments
According to Steele (2017), Florence Nightingale’s contributions to the nursing profession were based on her belief that nurses should uphold a leadership role during health care reform and that they should not accept the status quo. Nightingale stood behind her belief by taking on various administrative roles in an array of settings. She was a very successful leader and was shrewd when implementing change in conjunction with its affiliation to leadership and management.
Nurses are leaders in a variety of settings. These settings include public health, hospitals and the community (National League of Nursing 2017). Leading and serving in these areas can bring change to the health care system as well. The nurses bring great decision making-skills, diverse perspectives, critical thinking and knowledge of health care and are great communicators. Why not lead the way in the community and bring forth change for those in need?nurs 6050 Essay Assignments
As expected, nurses play a very big part as leaders in health care reform. Further research on this area is very important for the current health care reform. For our efforts to be successful, nurses from all areas need to implement strong leadership skills. From floor nurses serving in partners with physicians to educators and managers to researchers, etc, we all must stand strong in our competencies and lead with determination and the drive for adequate health care for individuals in our communities, state and the country.
Nursing 6050 Week 3: Nursing Policy and Advocacy for Population Health
Week 3: Initial Post
While the cost of healthcare in the United States is rising, the quality of care is not improving. The higher cost of healthcare does not mean a better quality of care. The high cost of healthcare is related to the waste and overconsumption of test, procedures, and referrals to specialists that are not necessary. Healthcare services are primarily paid by the government, through Medicaid and Medicare.nurs 6050 Essay Assignments The government is attempting to decrease the cost of healthcare by decreasing the use of defensive medicine, choosing less costly treatments, paying fixed amounts for procedures, using electronic health records, value-based purchasing, reducing the cost of end-of-life care, and changing individual’s behavior (Knickman & Kovner, 2016, pp. 265-267).
Decisions made by the government or health insurance companies whether to pay for certain health care services or not can lead to ethical and economical challenges. For example, in “Review of prostate cancer Provenge renews medical cost-benefit debate”, the decision on whether the first vaccine for prostate cancer, Provenge, should be covered by the government is under debate due to its high cost (Stein, 2010). It is unethical for Medicare’s decision to be affected by cost because “Medicare is not supposed to take cost into consideration, when making such rulings” (Stein, 2010). Provenge, in this case, cost $93,000 per patient and prolongs life for about four months (Stein, 2010). Paying for Provenge would not be economical for Medicare. Some believe that Provenge should be covered because it prolongs life, while others believe that the treatment is too costly and can be used elsewhere. “At some point, if we keep paying these very high prices for treatments that provide very limited benefit, we’re going to reach the point where we can no longer afford health care,” said Alan Garber (Stein, 2010). Public and private health insurance companies cover the cost of health services they believe will increase the quality of life of the patient and would be cost-effective in the long run.
“The four goals of good healthcare are to relieve symptoms, cure disease, prolong life and improve quality of life” (Maharaj & Paul, 2011). For a patient to receive medical services recommended by the physician, the government or health insurance company must agree to pay for the services. It is done to reduce the cost of healthcare and prevent waste and overconsumption of medical services.nurs 6050 Essay Assignments “The denial by payers of requests for newer drugs or for diagnostic or surgical procedures, although quite often justified on legitimate medical grounds, can create the impression that financial considerations outrank optimal patient care” (Ethics in forefront of move to control medical costs, 2013). The policy decision making-process that determines what type of care is covered by public and private insurers is not an easy one. There are ethical and economical challenges that must be balanced. A policy may be ethical, but not economical, and vice versa. To meet the goal of increasing quality of care, we must all work together, including patients and healthcare workers. We must work to decrease the cost of healthcare while providing necessary care. Patients and physicians play a major role in decreasing the cost of healthcare. Patients must work towards changing their health behaviors and, providers need to reduce the number of unnecessary services.
NURS 6050 Week 4 Discussion
“Population health is defined as the health outcomes of a group of individuals, including the distribution of such outcomes within the group” (What is Population Health?, n.d). Individual health is dependent on many factors within the life of that person. These factors include such things as education, income, ethnic groups and quality of environments where the individual lives, learns, works and plays. (Knickman, J.R., Kovner, A.R., & Jonas, S., 2015). For this discussion, I chose to address prescription drug abuse/misuse and how it is currently affecting our community. nurs 6050 Essay Assignments “These determinants are conceptualized as the result of exposure to different patterns of these multiple determinants” (Knickman, J. R., Kovner, A. R., & Jonas, S., 2015. p 80). The following paragraphs will discuss how the five population health determinants affect prescription drug abuse/misuse among young adults and how we as a community need to be a social advocate for this increasingly prevalent issue.
Access to health care
Prescription drug abuse is the misuse of a medication for nonmedical purposes whether it be in amounts not recommended by a physician or the use of another individuals medication (National Institute of Drug Abuse. February 2016). Prescription drug abuse/misuse among young adults is significant and is currently affecting many communities. Access to health care is an ongoing issue in the community with regard to prescription drug abuse/misuse. Many people live with this disease daily and do not understand that is an issue that at some point will lead them to the point of needing immediate medical attention. Statics show that in 2015, approximately 97 million people received prescription pain killers for use. Of the 97 million individuals, 12.5 million abused/misused the medication in the past year with approximately 3.8 million of those individuals abusing/misusing them in the past few months. (Health Reform and the Substance Use Disorder Treatment System: A Time of Change, 2017). In 2013, it was recorded that treatment for prescription drug abuse/misuse burdened the economy by costing us $78.5 billion. Of that total, $28.9 billion was due to treatment costs and the increase health care needed. (The Economic Burden of Prescription Opioid Overdose, Abuse and Dependence in the United States, 2017).nurs 6050 Essay Assignments
As stated above, many individuals with prescription drug abuse/misuse do not even realize that they have a health issue to begin with and that it involves a serious psychological issue that requires treatment and counseling. There are many behaviors that are linked to prescription drug abuse/misuse some of which include: aggressive behavior in childhood, lack of parental supervision, poor social skills, experimentation, drugs available within schools and poverty within their community.
One’s social environment is probably the most important determinant with regard to prescription drug abuse/misuse. Temptation is all around us. The push from peers or social groups to try drugs automatically engrains those thoughts of the need to fit in. Individuals who begin to abuse drugs early on in their life have an increased risk of developing an out of control addiction as they age. Movie stars and musicians are also the role models for this age group and therefore its seen as “if they are doing it, I should too.” Prescription drug abuse/misuse “has become a medical dilemma in the recent times. Many people including famous celebrities and well-known people have died due to the drug overdose.” (Siddiqui, A., Ali, R., & Tohid, H., 2017, February 17).nurs 6050 Essay Assignments
Family life plays a direct role in this issue. Having a family member or members of an individual’s household portraying the negative behavior increases the risk of children within that home developing the same addiction later in life. (Prescription Drug Abuse & Addiction Effect, Signs & Symptoms, 2017). On the other hand, having a support system around you are so pertinent. When someone is struggling with addiction, it is always important to remember that they should never accuse someone of being addicted. According to Dr. Michael Frost, “This almost always results in the person becoming defensive and can create a situation where they become resistant to help.” (How to Support Someone Addicted to Pain Pills, 2015). I may not have suffered from prescription drug abuse but I did suffer from illicit drug abuse for many years. Having went through that addiction myself at one point in my life, having my family support me and give me the power to change was what got me through the most difficult times.
Scientists have been unsuccessful in the identification of just one single gene that causes addiction. The vulnerability to drug addiction is a very complex and it contains many determinate factors. Pinpointing one particular biologic gene is very tricky. Addicts do not carry the same genes and those carriers may not portray a particular trait but research has shown that addiction is influenced by genes. (Genes and Addictions, n.d.).
There are many things that contribute to the development of prescription drug abuse. No matter where the factor originates from, it is a problem none the less. Identification of addiction is key with successful treatment outcomes that follow. If you know someone or yourself have an addiction, be that support for them or find someone positive to support you. Life is too precious to throw it away on addiction.
NURS 6050 Week 5 Discussion Addressing Behavioral Risk Factors
Behavioral Risk Factor
The behavioral risk factor I chose to address in regard to this week’s discussion post is cigarette smoking and how prominent it is in our society. It is reported that “more than 300,000 children and teens become new smokers and 30% become addicted to tobacco.” (Knickman, J. R., & Kovner, A. R., (2015), p. 122). Healthy People 2020 goals were to decrease tobacco use in adults from 20% to 12% and adolescents from 35% to 16% (Knickman, J. R., & Kovner, A. R., 2015). Another riveting statistic is how many women continue to smoke while pregnant. This behavior “accounts for 20% of low birth weight deliveries.” Furthermore, parents who choose to smoke in their household where children are present SIDS, respiratory middle ear infections and a decrease in lung function is more common. (Knickman, J. R., & Kovner, A. R., 2015). According to the Center for Disease Control and Prevention, 10% of women smoke during the last 3 months of pregnancy. (Tobacco Use and Pregnancy. (2016, July 20).
I come from a long line of smokers and I did try tobacco at one point in my life. My maternal grandmother smoked during her pregnancy with my mother which resulted in her low birth weight of 5lbs. My grandmother continued to smoke throughout the rest of her life and passed away 26 years ago from lung cancer. Since that time, my mother began smoking and has ultimately quit.
There are many reasons why smoking is so prevalent most of which is environmental. Such reasons include low income and mood control. However, there are interventions we can incorporate to help change take place with smoking cessation according to the Population-Based Intervention Model. Change does tend to take time and it can be challenging but a few steps can make a great impact and go a long way. nurs 6050 Essay Assignments
Downstream interventions are focused on helping the struggling individual one on one. I believe that this is the best way to help and individual. With one on one attention, a person feels important and sees that there are ones committed to helping the succeed. Sometimes getting into a treatment group or self-help counseling can be difficult but it’s possible. If that is not the route for them then maybe the pharmaceutical route is best.
Education is so important today in the health care setting. Probably 80% of the people that I have taken care of in my day to day job are smokers or know someone who smokes. The midstream intervention level intervention used at every discharge home that we do at work automatically incorporates education on smoking cessation and risk factors related to smoking. I believe that this part of our required discharge paperwork could potentially help someone make the first step in attempting to quit.
The downstream and midstream interventions seem quite easier to achieve. Upstream interventions require “state and national public policy” (Knickman, J. R., & Kovner, A. R., 2015). Due to this requirement, the interventions could take a significant amount of time to take effect.nurs 6050 Essay Assignments Economic incentives are what caught my eye. Everyone loves money that is an incentive to change. Within the health system that I work for, they incorporate and program called HealthyU when employees are able to receive “free” money for being healthy. Another incentive for being healthy for us employees is by receiving a decrease in insurance premium particularly for not smoking. Our hospital has also put into place a “no smoking campus” policy. No one is allowed to smoke on hospital grounds in hopes that this will reduce the risky behavior around the health care facility.
NURS 6050 Week 6 Discussion Improving Quality
According to the Institute of Medicine (IOM), health care quality is “the degree to which health care services for individuals and populations increase likelihood of desired health outcomes and are consistent with current professional knowledge.” (The National Academics of Sciences Engineering Medicine, 2013). In this discussion, I will consider the six aims for improvement presented by the IOM and address my health care organization’s challenges and improvements in regard to a quality or safety issue.
Quality of care is the main focus not only within my entire organization of employment but also within my specific unit. We are strongly focused on the quality of care provided to our patients and the outcomes of that care. We believe that providing safe, effective, patient-centered care will increase positive outcomes and decrease the overall hospital stay of each individual.
Safety is “an essential and vital component of quality nursing care.” (American Nurses Association, 2003). This aim can sometimes be challenging within a health care organization because it contains many flaws and it is prone to errors. These errors more times than not will be detrimental and cause harm to patients.
One particular quality care issue that affects my area of work is the rate of Catheter Acquired Urinary Tract Infections (CAUTIs). As I have stated previously in other discussions, my care is directed to a wide variety of individuals on a Medical/Surgical unit. At any given time, I may be giving care to 2 or 3 patients with a urinary catheter out of the 5 individuals I am assigned to. The reasons for these catheters can range from the healing process of a decubitus ulcer to acute urinary retention due to intraoperative medications. No matter what the reason, a patient should not suffer a urinary tract infection (UTI) from a urinary catheter that is meant to assist in the “healing” process. nurs 6050 Essay Assignments
“Concerns about costs, lengths of stay, and patient safety would be good enough reasons to establish protocols to reduce the incidence of CAUTIs, but now there’s a financial concern as well.” (American Sentinel University, 2013). Due to the preventable nature of this issue, many insurance companies refuse to cover the cost of care associated with the CAUTIs. “Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter. Between 15-25% of hospitalized patients receive urinary catheters during their hospital stay” (Centers for Disease Control and Prevention, 2017, July 19). Since this quality care issue can be prevented, the CDC and other organizations have developed a guideline for prevention. These guidelines include but are not limited to appropriate catheter use, alternatives to catheter use, proper techniques for insertion and maintenance, and quality improvement programs. “Each CAUTI is associated with the medical cost of $758. And, a total of over $340 million spent in health care is attributable to the incident of CAUTI in the U.S. each year.” (National Healthcare Safety Network, n.d.)
There are many things that nurses can do with managing catheters that can reduce the risk for infection by using strategies/steps given by the Center for Disease Control (CDC). The unit that I work on has adopted a nurse driven protocol that allows removal of unnecessary catheters. We do also have some physicians who place standing orders for removal of a catheter after a certain time period. Since the implementation of these two things, we have seen a drop in out CAUTIs since last year. These infections can be prevented and nurses need to advocate for the removal if not necessary. The preventive measures could potentially save one’s life and money
NURS 6050Week 7 Discussion Health Care Policy
There are many health care issues that medical staff face on a daily basis. The one health care issue that I currently am directly affected by and that needs addressed is in regard to the nurse to patient ratio. On my unit of work, this is an ongoing safety issue and increases the risk for sentinel events to occur. Currently, the American Nurses Association is working feverishly to develop a law advocating for all over the United States to be able to give safe and effective care to patients. nurs 6050 Essay Assignments “The ANA and Constituent & State Nurses Associations (C/SNAs) in the states are promoting legislation to hold hospitals accountable for the development and implementation of valid, reliable, unit-by-unit nurse staffing plans.” (Safe Staffing – American Nurses Association, n.d.)
The current federal regulation which is 42 of Federal Regulations (42CFR 482.23 (b) requires all hospitals to have the safe number of patients assigned to one nurse for all the hospitals to participate in Medicaid. This law was based on ensuring that quality care be given to all participants of Medicaid. This law states that “A nursing facility must have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental and psychosocial well-being of each resident in accordance with a written plan of care.” (The National Consumer Voice for Quality Long-Term Care (formerly NCCNHR), n.d.).
Many times, then not, this policy seems to be ineffective in hospital settings as there have been continual nurse to staff ratio issues with those that are insured by Medicaid. Over the past 6 years, I have noticed that most hospitals assign teams by acuity of the unit when considering the daily staffing. I honestly don’t think that many are even aware of this federal regulation. nurs 6050 Essay Assignments The current effects of this policy in relation to cost have been positive due to the fact that all ensured by Medicaid are in the hospital, and have easy access. However, the main adverse effect is going to be the quality due to the fact that no one takes into account appropriate nurse to staff ratio. This policy is in no way affecting my nursing practice other than the fact that almost every nurse I talk to that works on my unit is overwhelmed and exhausted with the unfair staffing. We have a high turn-over rate due to this issue. “Enforcement of the federal staffing standard is extremely rare. The lack of decisions means either that facilities cited with staffing deficiencies did not appeal or that the deficiencies were cited at such a low scope and severity that no remedy was imposed (and therefore no appeal was possible under the federal enforcement system, which allows appeals only when remedies are actually imposed), or both” (Nurse Staffing: Requirements of Federal Law CMA, n.d)
The Kingdon’s Model is an effective way to help influence a federal change with regard to the issues of nurse to staff ratios. There are four ways according to this model. These include policy, problem, political and window opportunity. The problem stream “can be marked by systematic indicators of problem, by a sudden crisis” in which feedback is given. (Milstead, J. A., 2016, p. 51).
The first way to help this issue to be resolved according to this model is in relation to policy. This current policy discussed earlier is not really taken in to account so that is requires us to act and make our voice heard. How are we going to do that? By taking our problems to officials and those capable of charge to better out hospital setting. Congress has continued to fail to make a federal law requiring that there is always safe patient to staff ratios regardless of insurance coverage and in reference to individual hospital acuity level. Managers and the “powers to be” say that we always look at the overall statistics of each hospital and staff based on what they find. Each unit should be unique.nurs 6050 Essay Assignments This would not enable the “powers that be” to do that and would require legally for them to staff each unit based on the true acuity and not on a statistic.
Currently, the ANA (American Nurses Association) is working on the Registered Nurse Staffing Act that will hopefully be passed one day to help reduce the incidence of sentinel events and the burn out of nurses.nurs 6050 Essay Assignments
NURS 6050 Week 8: Policy & Advocacy for Population Health
Discussion Post: Week 8
Needs of Veterans and their families
Two types of health needs for returning veterans and their families are support for individuals with traumatic brain injuries and post-traumatic stress disorder. According to Seal, Bertenthal, Samuelson, Maguen, Kumar and Vasterling (2016), a large number of American people have been injured overseas due to explosions and other war-related issues. PTSD is also very prevalent due to being in the high-stress environment of combat. According to Seamone, McGuire, Sreenivasan, Clark, Smee and Dow (2014), “PTSD and traumatic brain injuries are the invisible wounds of war” (pg. 2). It has been noted that veterans have a high prevalence of homelessness along with issues of getting the appropriate health insurance to take care of their needs. Veterans also struggle with easing back into civilian life and often struggle with psychiatric problems coupled with drug and alcohol addiction. (Jackonis, Deyton and Hess, 2008). It is imperative that veterans receive the mental health and medical care they need to thrive in society.
Ways to Advocate for Veterans
There are numerous ways to advocate for the veteran population. According to The International Council of Nurses (2008), nurses can use their voice to represent individuals who are suffering. An advocate can also empower veterans to speak up for themselves. Nurses can also play the part of an interceder, encouraging dialogue between individuals.nurs 6050 Essay Assignments Advocates can bring the concerns of veterans to policymakers to initiate public policy. “It is imperative for nurses to be involved in hospital or community-based groups, professional associations for veterans and special interest groups”(p.12). Just being involved and showing that you care can also serve as advocating. Providing a listening ear can speak volumes to someone who just needs someone to talk to. These are all ways that nurses can be advocates to the veteran population.
Positive Advocacy Skills
According to Tomajan (2012), to be an effective advocate, it is required that you have strong verbal and leadership skills, critical thinking abilities and the capability to work with others. According to Begley (2010), “autonomy, advocacy, assertiveness, and accountability are also good qualities for advocates to have”(p.3). From my experiences as a nurse, I believe it takes time and experience to develop these skills. As nursing experience grows, it becomes common to advocate for patients on a daily basis. Advocacy almost becomes second nature in this profession and the more that it is done, the easier it will become. According to Milstead (2013), to enhance “advocacy skills consider taking an advocacy workshop or doing an internship to help educate yourself in advocacy and the legislative process”(p. 179,182). This type of formal education will help strengthen advocacy skills as well.nurs 6050 Essay Assignments
Nurses Responsibilities as Advocates
The responsibility of the nurse in advocacy is to take the lead in fighting for what’s right for you patients. “It is the nurse’s job to act and react when you see unfair, unjust, unhealthy environments, practices and funding decisions”(International Council of Nurses, 2008,p.11). “Good nurses, therefore, perform their functions well, and they maintain high standards in all areas of practice and governance”(Begley,2010, p.3). As nurses, we are on the front lines in regards to patient care which is why advocating is so important. It is the nurse that will see a problem that needs to be addressed first. As nurses, we have a responsibility that patients receive the best care possible. Being a good advocate is a way to ensure that this objective is being met.
Begley, A. M. (2010, 12). On being a good nurse: Reflections on the past and preparing for the future. International Journal of Nursing Practice, 16(6), 525-532. doi:10.1111/j.1440-172x.2010.01878.x
International Council of Nurses. (2008). Promoting health: Advocacy for health professional. Retrieved from http://www.whpa.org/PPE_Advocacy_Guide.pdf
Jackonis, M. J., Deyton, L., & Hess, W. J. (2008, 12). War, Its Aftermath, and U.S. Health Policy: Toward a Comprehensive Health Program for America’s Military Personnel, Veterans, and Their Families. The Journal of Law, Medicine & Ethics, 36(4), 677-689. doi:10.1111/j.1748-720x.2008.00322.x
Milstead, J. A. (2013). Health policy and politics: A nurse’s guide. Burlington, MA: Jones & Bartlett Learning.
Seal, K. H., Bertenthal, D., Samuelson, K., Maguen, S., Kumar, S., & Vasterling, J. J. (2016). Association between mild traumatic brain injury and mental health problems and self-reported cognitive dysfunction in Iraq and Afghanistan Veterans. Journal of Rehabilitation Research and Development J Rehabil Res Dev, 53(2), 185-198. doi:10.1682/jrrd.2014.12.0301
Seamone, E. R., Mcguire, J., Sreenivasan, S., Clark, S., Smee, D., & Dow, D. (2014, 10). Moving Upstream: Why Rehabilitative Justice in Military Discharge Proceedings Serves a Public Health Interest. American Journal of Public Health, 104(10), 1805-1811. doi:10.2105/ajph.2014.302117 nurs 6050 Essay Assignments
“Patients have the right to expect that information regarding their care and treatment will be kept confidential” Nursing: scope and standards of practice (2010). As a nurse, it is my duty to keep all patient information confidential. When keeping confidentiality, it establishes trust with my patients and their families.
When reading this scenario, I immediately think, “Oh great!” My initial response would be to inform my sister right away about her significant other, however, legally I am not allowed to disclose this information. In this situation, I would attempt to speak with the patient’s physician because this would be “averting a serious threat to public safety and health” (Pozgar, G. (2013), p. 450). Being my sisters significant other, his conditions could be threatening not only to himself but her as well. I would speak with him, considering this would be within my practice, and inform him that it is very important that he seek out all previous partners and ensure they are aware and tested. He would be informed of the severity of the disease and how deadly it is, potentially scaring him into doing what is right for my sister. nurs 6050 Essay Assignments
I did encounter a similar situation to this one. I took care of a patient that was HIV positive and the wife knew however the family did not. His hospitalization was due to the HIV disease process but we were not permitted to speak of the diagnosis or why this person was hospitalized. At least in this scenario the wife knew. Even though I have a few ideas, I believe that all of them are ethical. I was shocked to see that disclosure is permitted in an event that there is a serious threat to public health and safety. HIV/AIDS is just that! “Despite the ethical obligation of doctors and other healthcare professionals to maintain confidentiality, legal mechanisms such as search warrants and court orders can allow for confidentiality to be breached in order to disclose HIV-related risk behaviors” (Impact – The negative impact on public health, n.d).
Nursing: Scope and standards of practice. (2010). Silver Spring, MD: American Nurses
Pozgar, G. (2013). Legal and Ethical Issues for Health Professionals (3rd ed.). Burlington, MA:
Jones & Bartlett Learning.
Impact – The negative impact on public health. (n.d). Retrieved from
NURS 6050 Week 10 Assignments
There are many ethical standards that I believe should be used to advocate for the aging population and with regards to end-of-life care. Utilitarian ethical theory “involves the concept that the moral of an action is determined solely by its contribution to overall usefulness” (Pozgar, 2013, p. 12). In other words, it means doing the greatest good for the most people and that the end justifies the means (Pozgar, 2013).
The elderly has such a special place in my heart as I work with this population every day in the hospital. The specific population that sticks out to me the most is the dementia patients because they tend to be the ones that do not receive the best care. There are many ethical principles that I live by as a nurse. The most important to me are beneficence, autonomy, and justice especially when it comes to end of life care. Beneficence is “doing good, being kind, showing compassion and helping others” and providing equal benefits to all (Pozgar, 2013). Autonomy is “the right of a person to make one’s own decision”. Justice is “being fair in the distribution of benefits and risks and demands that all be treated the same” (Pozgar, (2013), p. 15). Every health care professional can make a difference in the elderly population. nurs 6050 Essay Assignments
Analysis of Ethical Challenges
As I mentioned above the determinants to help this aging population, there are challenges that come along with what was mentioned. Not everyone feels that the Utilitarian approach would be useful for the aging population. “Both the prevalence and the costs of chronic illness care will continue to rise” (Knickman, J. R., & Kovner, A. R., (2015), p. 112). Unfortunately, access to health care for some of the elderly is not available. That simply is because some live in such drastic areas and do not have any help. In addition, insurance requires many stipulations to get the appropriate care needed and many elderlies just go without it. “Data from the United States suggest that health care spending at the end of life is not increasing any more rapidly than health care spending in general” (Changing Role of the Family, n.d). It would be nice if all insurance companies had this ethical determinant in mind but of course it is all about money. nurs 6050 Essay Assignments
In regard to end-of-life care, the ethical principles of autonomy, beneficence and justice is a must. I know that in my practice, regardless of whether I agree with the situation or not, the patient is my priority and I respect their decision. When families want their loved one who has metastatic disease to keep going through treatments but the patient says no, it is my job to advocate for the patient and uphold their wishes.
How can we help the change take place??
There is an easy solution: YOU! Be that voice that the aging population needs. We are all equal and our constitution spells that out. We all have rights. Regardless of someone’s background, or if they do not have insurance they all should be treated the same. The aging population is the easiest to mistreat, especially those with dementia. I once observed this really neat picture of an elderly woman with dementia looking in the mirror and her reflection was a young nurse. Remember who they once were! Even though they are physically and mentally aging, they still deserve the same care and treatment as any other member of society.nurs 6050 Essay Assignments
NURS 6050 Week 11 Assignments
The US Institute of Health (IOM) defines the mission of public health as, “fulfilling society’s interest in assuring conditions in which people can be healthy”. Additionally, in the Dictionary of epidemiology (2001) public health is defined as, “one of the efforts to protect, promote and restore the people’s health. It is the combination of sciences, skills, and beliefs that is directed to the maintenance and improvement of the health of all people through collective or social actions” (Koplan, Bond, Merson, Reddy, Rodriquez, Sewankambo, & Wasserheit., 2009)
Providing adequate healthcare in underdeveloped countries is a very difficult task faced with almost overwhelming obstacles. The ability to reach those in poverty, ill health and distrust takes a lot of labor. This day in age, as in the past, there are many hurdles constraining the reach of care to underdeveloped countries. The first hurdle to overcome the inadequacies is financial assistance. The World’s Bank estimates the cost to reach the Millennium Development Goals by 2015 is going to cost $40-$60 billion a year (Devarajan, Miller, & Swanson). The question is; who is going to pay this huge debt? Devarajan et al., explains that by reducing poverty we can achieve multiple goals. Poverty is associated with multiple public health disparities, such as infant mortality and poor public health as a collective. Reducing the poverty level will not only reduce infant mortality rates, as parents will be able to afford better pre and post birth care, but also reduce dependency expenses of other nations.
Reducing poverty in underdeveloped countries requires a huge economic plan. Devarajan et al., states in order for countries to benefit fully from multilateral trade they need to take advantage of market access. They will require large investments to create infrastructure that will boost transportation, telecommunications, customs, tax administration and better management of overall public investments. Devarajan et al., explains that these key elements are vital to reducing trade barriers, stimulating growth and reducing global poverty in underdeveloped countries.
A second hurdle to reducing diseases in the poor is to gain pharmaceutical support. Gaining the cooperation and support of large pharmaceutical agencies is vital to reducing health disparities. Pharmaceutical companies are notaries for not sharing their gross profit with the public, the according the 1999 edition of The Nation the Pharmaceutical Research and Manufactures of America (PhRMA) claimed to have set a goal of $24 billion of research to “set every last disease of the path to extinction”. nurs 6050 Essay Assignments Obviously $24 billion is a huge loss of investment, and in turn, most businesses would not toss away $24 billion in earnings if they did not have at least double that much to lose, and if they did not have a plan to earn it back in a short amount of time. To put it further into perspective, $24 billion is approximately half the cost the World’s Bank estimates it would take to reach the Millennium Development Goals yearly. Unfortunately, pharmaceutical companies have adopted a less humanistic approach when it comes to saving lives. The New York Times addresses this concern rather abruptly by saying “drug companies can’t seem to roll out fast enough. They have absolutely nothing to do with matters of life and death. They are what have come to be called lifestyle drugs—remedies that may one day free the world from the scourge of toenail fungus, obesity, baldness, face wrinkles and impotence. The market for such drugs is worth billions of dollars per year.” On the down side, a recent survey of the 24 largest drug companies found that not even one maintains a research program for malaria.
Increasing pharmaceutical cooperation support comes down to one main hurdle, and that is finances. It is without doubt very expensive to research new, and existing, medications for market. Forbes.com reports that in now costs five billion dollars to create a new drug. A company hoping to market one single drug can expect to spend $350 million before the drug is even available for commercial sale (Desmond-Hellmann, 2013). nurs 6050 Essay Assignments
So the question remains, who is going to pay? One such way to reduce costs for research is to persuade pharmaceutical companies to combine efforts. Companies now a days are worried for their bottom dollar. As mentioned before, it is very expensive to develop new drugs, but persuading companies to work cooperatively can help to reduce costs and combine research to have quicker delivery of drugs with minimal research and development debt. Additionally, subsidizing expensive cost with government grants to those companies working on drugs to reduce worldwide disparities, especially those in underdeveloped countries would help to relive the burden of cost for pharmaceutical companies, large and small.
Advocating at the Global Level
The International Council of Nurses (ICN) believe that nurses are key to improving access to quality and cost-effective care and enhancing the health of populations. Every year the ICN celebrates International Nurses Day and provides resource kits to share with nurses and the general public (2012). The ICN is a federation of national nursing associations that enables nurses to speak as one to influence health policy. Using the ICN nurses from all countries can coordinate actions and interact closely with patients, families and populations in a variety of environments. Supporting and joining the ICN is an excellent way to advocate at the global level. One nurse can collaborate with millions of members from across the world sponsor concerns as a collective. Every year the ICN presents a strong delegation at the annual World Health Assembly in Geneva Switzerland. This assembly allows nursing concerns to be heard and addressed in an open forum. These voices subsequently are the “seeds of the policies that will be developed and implemented in various countries” (Benton, 2012). Nurses make excellent advocates as they are skilled in various expertise from policy development, cost constraints and health delivery. They are in positions to offer advice on polices to improve the health of underdeveloped, as well as developed, nations. nurs 6050 Essay Assignments
NURS 6050 Essay Assignment