The nursing profession is a subset of the general healthcare profession aimed at providing care within the ordering scope of physicians. For the past decade the profession has been in a general state of change as patient care evolves from hospitals to outpatient and primary care environments. Registered nurses (RN) are health care professional who work closely with physicians in the provision of care, education and support to patients as well as their family members (Bureau of Labor Statistics, 2014). Their job description and responsibilities are partly determined by their specific employers.
RNs are entrusted with an assortment of responsibilities in the course of their shifts, generally they care for and educate patients on their conditions and are required to establish trust and build good rapport with patients and their family members. The scope of practice for registered nurses is outlined in the Nursing Practice Act, Business and Professions Code Section 2725 (Board Of Registered Nursing, 2011). In this article, the roles and functions of registered nurses are categorized into three: Independent Functions; here nurse roles are restricted to direct and indirect care services that guarantee safety, comfort, personal sanitation and safeguarding of patients as well as undertaking disease prevention and recuperative measures. Conduction of skin tests, immunization methods and handling of blood samples is also outlined in this sect.
Depended functions involve administering of medications therapies whereas Interdependent functions are those that authorize nurses to alter treatments in case of abnormal characteristics. The code of ethics for registered nurses encompass the ethical values expected of nurses and their obligation to individuals with health care needs and those getting care (Canadian Nurses Association, 2008). The code is aimed at helping nurses in ethical practices and guiding them whenever challenges related to ethics arise in their interactions with patients, families, communities and public health systems.
For eligibility to a career in nursing, an individual is required to have attained the age of 18 years and have a high school diploma. To qualify as a registered nurse, one is required to have undergone at least one of the following educational programs; Diploma programs, Associate Degree in Nursing or a Bachelor’s of Science Degree in Nursing (Registered Nurse (RN), 2014). All these programs cover courses in physiology, anatomy, chemistry, microbiology, nutrition, psychology, liberal arts, and social and behavioral science, these programs can be obtained from any the following institutions; Alabama Southern Community College and Villanova University (Fulche).
The duration of studying these programs ranges from 2 to 4 years depending on the certificate taken and the institution offering the program. It takes one an average of 2 to 3 years to earn an Associate degree in Nursing from a Community college such as Alabama Southern Community College. A Bachelor’s Degree in Nursing from the University of Villanova takes 4 years to complete while an accredited Diploma in nursing takes 3 years and is usually offered from accredited hospitals. The cost of undertaking a nursing program takes an annual average cost of $2,272 for a community college and a total of $5,836 for a four-year program in a university (Fulche).
Before one can start practicing as a registered nurse, licensure is required. One is required to sit and pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) (Bureau of Labor Statistics, 2014). Once one has passed the test, they are required to graduate from an accredited nursing school and posses clinical work exposure. Once this is achieved, they are issued with a license by the Board of Registered Nursing.
Currently the job availability for Registered nurses is low, according to the American society of nurses, over 40% of registered nurses who obtained licensure between Jan. 1 2009 to March 31, 2010 failed to get employed within 18 months of graduation (Biolchini, 2013). The growth trends of the profession are however encouraging, according data published by the United States Bureau of Labor Statistics, the employment of registered nurses was projected to increase by 19% between 2012 and 2022 with those having Bachelor of Science degrees in nursing option expected to have the greatest opportunities (Bureau of Labor Statistics, 2014).
There are limited job advertisements for Registered nurses in publications such as the Sunday Herald, however as employment in the career is expected to grow significantly come 2022, it is expected that the number of job advertisements for registered nurses in daily publications will increase significantly. Experience is not required for employment of registered nurses since they graduate with a significant level of clinical exposure.
Their salaries and compensation vary depending on their levels of education, work experience, location and institutional affiliation. The starting salary for an average registered nurse is estimated at an average of $64,690 per year, experienced registered nurses who posses advanced educational level may earn over $80,000 per year (Bureau of Labor Statistics, 2014). Majority of registered nurses begin their careers as staff nurses, with experience and advanced education, they get promotion to higher ranks such as vice president and chief of nursing. Increased managerial-level positions however require advanced education level such as a graduate degree in nursing or health services administration (Bureau of Labor Statistics, 2014).
There are a number of professional organizations both at state and national level that registered nurses can align to. The American Nurses association (ANA) is one such organization that operates at a national level. This organization is responsible for advancing and protecting the nursing profession. Students can join ANA at a cost of $10 (ANA, 2014). The National Student Nurses Association provides mentorship towards development of future professional as well as facilitation of their entry into the job market. Nursing students can join NSNA at an annual fee of $30 (NSNA, 2013). There exist several professional organizations for registered nurses at state levels, these include; North Alabama Nurse practitioner association, Alaska Nurse Practitioner Association, Iowa Association of Nurse practitioners and many more in each of the 50 states. The admission fee for student registered nurse is usually subsidized mostly it is below $10.
Several journals on registered nurses and nursing activities exist, a few example include; The Journal of Law, Medicine & Ethics which is available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1748-720X at an annual cost of $616 for an online or print copy and $710 for both copies. The Association of periOperative Registered Nurses journal is available online at http://www.aorn.org/ce/ at a cost of $370. Continuing education units is a necessary requirement for this profession. Competency in practice and lifelong learning are considered significant elements of the profession. Registered nurses are required to undertake 30 hours of CUE after every two years as a way of keeping their licenses active (Department of Consumer Affairs, 2013). Professional nurse organizations provide avenues such as conferences, webinars and continuing education programs to their members at discounted rates (ANA, 2014). Majority of the professional organizations provide their members with units approved by the national Credentialing Center’s Commission.
Reflection / Personal Career Plan
As an undergraduate student pursuing a course leading to a Bachelor of Science Degree in Nursing, I see myself fitting in the career path of a registered nurse. Having undertaken most of the required courses for a registered nurse practitioner there are only a few steps that I need to cover before I fit into the profession. As part of my career plan, I intent to through the full course of four years of university education from which I will obtain a Bachelor of Science Degree in Nursing. Once this is accomplished, I intent to apply and sit for the NCLEX-RN exam through which I will be eligible for licensure. Since the profession requires a significant amount of clinical exposure, I have intentions of enrolling in an accredited nursing school, from which I will gain the experience and graduate as a qualified registered nurse.
My career objective is to provide healthcare to my community members and contribute positively in the wellbeing of ill persons and their families. This I intent to achieve by becoming a qualified registered nurse. My career goal is to have positive contribution to the nursing fraternity and help in reshaping and improving the profession. This I intent to achieve by joining professional registered nurse organization and seek scholarship opportunities to further my education level. Advancing my education is a strategy towards qualification for higher managerial levels in the profession as well as becoming a significant stakeholder. With advanced managerial roles as well as critical decision making abilities in the profession, I will be in a position to transform the profession with positive ideas.
ANA. (2014). Continuing Professional Development. Retrieved April 5, 2014, from American Nurses Association (ANA): http://www.nursingworld.org/MainMenuCategories/CertificationandAccreditation/Continuing-Professional-Development
Biolchini, A. (2013, January 14). 43 percent of newly licensed registered nurses can’t find jobs. The Ann Arbor News .
BOARD OF REGISTERED NURSING. (2011). AN EXPLANATION OF THE SCOPE OF RN PRACTICE. Sacramento: State of California: Department of Consumer Affairs.
Bureau of Labor Statistics. (2014, January 8). Occupational Outlook Handbook: Registered Nurses. Retrieved April 5, 2014, from United States Department of Labor: Bureau of Labor Statistics : http://www.bls.gov/ooh/healthcare/registered-nurses.htm
Canadian Nurses Association. (2008). Ethical Practise: The Code of Practice for Registered Nurses. Ottawa: Canadian Nurses Association.
Department of Consumer Affairs. (2013). Continuing Education for License Renewal. Retrieved April 5, 2014, from California Board of registered Nursing: http://www.rn.ca.gov/licensees/ce-renewal.shtml
Fulche, R. Community Colleges. Washington, DC: American Association of Community Colleges.
NSNA. (2013). Membership. Retrieved April 5, 2014, from National Student Nurse Association (NSNA): http://www.nsna.org/default.aspx
Registered Nurse (RN). (2014, April 4). Retrieved April 5, 2014, from Explore Health Careers.org: http://explorehealthcareers.org/en/Career/21/Registered_Nurse_RN#Tab=Requirements
My Nursing Philosophy
Nursing is a noble profession that requires high-level commitment to exercising vital values related to patient care. I deeply believe that it is a calling because of the fact that I feel closely drawn to persons in need. Generally, the primary goal of nursing is to ensure patient safety, empowerment, attend to the entire needs of the patient, and finally attain healing. Besides being caring, nurses require knowledge regarding clinical practice and integrity in order to achieve both personal and professional goals. Nurses assume the sole responsibility of providing holistic and safe patient centered care at all times. At this point, it is worth appreciating that patients have varied conditions and require different forms of help. Individualized attention enables nurses to respond effectively to the needs of all patients. In order to attain this desirable state of affairs, nurses uphold important values and virtues pertaining to patience, love, care, commitment, hard work, persistence, and kindness amongst others.
In order to perform optimally at all times, education is of paramount importance. Nurses are responsible for keeping themselves knowledgeable about their clinical practice, patient expectations, and the changing trends in this field of specification. This is attained through perpetual learning. Education equips them with sufficient and relevant skills, knowledge, and competencies to make informed decisions regarding the wellbeing of patients. Self-enhancement through education enables nurses to evolve professionally and become conversant with important technological advances. It empowers them to exercise evidence-based practice at all times as well as educate the patients about their conditions and how best they can manage them in order to hasten recovery. Educating patients’ families about health behaviors and available treatments enables them to attain quality lifestyles. Effective nursing practice recognizes the importance of continued knowledge acquisition.
Successful nursing practice appreciates the role of legal and ethical provisions. As much as personal beliefs and values are imperative aspects that guide behavior, nurses should acknowledge professional ethics too. In case of any form of conflicts that have adverse effects on the wellbeing of the patients, they seek for guidance. Direction from reliable mentors enables them to meet patient needs without compromising their personal beliefs as well as value systems. Professional practice requires nurses to assume accountability for the decisions that they make at all times. This implies the need to exercise critical thinking and base their actions on objective thought. In order to attain favorable outcomes, nurses appreciate the contributions of their colleagues as well as other medical professionals to the wellbeing of the patient. Fundamentally, nurses are resourceful individuals who have vast knowledge in the field of healthcare. They assist other health professionals, fellow nurses, and nursing students during the execution of their duties. The strong mutual relationships enable them to maximize patients’ health and enhance the reputation of the profession.
From an individual point of view, nursing is a satisfying profession whose goal and objectives are consistent with my mission. In this respect, it is rewarding because it enables me to meet both individual and career objectives. I derive immense satisfaction from helping those in need and giving them hope. Currently, I contribute significantly to this practice though effective pain management and emphasis on holistic care. Besides being a leader and mentor, I focus on inspiring willing individuals to enter the profession and contribute positively to the health and wellbeing of populations.
Module 2 Discussion
Medication errors are known to be preventable events that can cause or result into patient harm or wrong medication use while in the process of controlling medical care professional, consumer or patient. These errors are as follows:
A research shows that over 60 percent of hospitalized patients miss their expected medication while in the hospitals. This amounts to an average of 6.8 medications that are left out for every patient. According to the Institute of Medicine report projected that medication errors injure about 1.5 millions of patients every year in America. Medication mistakes result from doctor despair and fatigue, poor support, insufficient working resources as well as inadequate job security. Such errors can be avoided by providing improved education and working conditions as well as including better training processes to doctors and nurses.
This medication error results from failure to adhere to the recommend or appropriate drug, or using too low dose of a suitable drug. Other causes of under prescribing are because of fear of unfavourable interactions or effects, failure to identify the suitability of treatment and ignorance or doubts regarding possible effectiveness. Sometimes there is tendency of avoiding treatment in elderly people, which can result to bad effects including what is known as risk treatment mismatch whereby those that are less aggressive to treatment are at higher risk. This medication error can be avoided by an inter-professional approach that can help in ensuring appropriate administration of the correct medication to the patients. Health providers should also be provided with appropriate training as well as resources needed to fulfil their functions. Doctors and nurses should also adhere to the prescribed guidelines and recommendations as indicated on the drugs labels.
Using theories to improve patient care and outcomes
Nursing theory present a different form of outlook that describes the experience of nursing, describe the patient, when nursing is required, and to recognize the limitations and objectives of nursing’s curative actions. a number of nursing theorists concentrate on care models that, partly or wholly, replicate and have an impact on nursing beliefs and practice. Some theories are controlled by philosophy such as Sister Caliista Roy’s adaptation model, sciences and clinical practice in which she familiarized the flexibility of an individual body and soul. Roy views the objective of nursing as encouraging adjustment to add to a person’s wellbeing, value of existence and failing with pride (Miles et al, 2010, pg 73). This theory is significant, because the body and spirit are matchless and until these constituents are dealt with as a whole, there is no expectation of cure, wellness or approval.
Joyce Travelbee founded her theory upon the interpersonal practices amid two persons, one who calls for help due to poor health and the other who is capable of providing that support (Chinn, 2011, pg. 83). The objective of the practice is to help a patient deal with a sickness, gain knowledge from it, find connotation in and develop from that incident. The capability of the nurse to comprehend and deal with pain and distress are vital in this theory. An individual’s outlook towards pain eventually verifies how well that someone will deal with sickness. Similarly, Ida Jean Orlando Pelletier centers her theory on the nurse-patient interpersonal practice (Chinn, 2011, pg. 85). Orlando hypothesizes that the nurse upholds closely controlled procedures and a trained response, which calls for constant self-reflection whilst investigating the implication of a patient’s conduct and opinion. The nurse could then investigate and confirm the significance of his/her opinions with the client. Through the practice, mix-ups and misconceptions are reduced. Consequently, patient satisfaction, ease and actions pick up, resulting in an enhanced sense of health. Thriving nurses use nursing theory and pursue essential principles, whether knowingly or unknowingly, daily during patient care to improve patient care and outcomes.
Chinn, P. L., & Kramer, M. K. ( 2011 ). Integrated knowledge development in nursing (8th ed .). St. Louis : Elsevier-Mosby .
Miles, K. S., & Vallish, R. (2010). Creating a personalized professional practice framework for nursing. Nursing Economics, 28(3), 171-80, 189. Retrieved from http://search.proquest.com/docview/577373442?accountid=1611
Health Initiative in Prevention of Child Maltreatment
This essay is about a health initiative that
can be applied to help children experiencing or who experienced maltreatment
and abuse. The focus is on child sexual abuse. Concerning health initiatives in
maltreatment of children, this essay discusses the Suspected Child Abuse and Neglect (SCAN) initiative and the Healthy Families America (HFA). SCAN is
all about networking with various stakeholders to identify and rehabilitate all
victims of maltreatment while HFA is about reaching out into the homesteads to
identify cases inhabited with agoraphobia due to abuse related stigma.
Background and Introduction
This section provides information about history of maltreatment and emerging concepts when it comes to children and their families in a general perspective. Statistics have also been compiled to aid understanding of the threat of child maltreatment. Although health and research institutions report a decline in child maltreatment activities for the period 1990-2010, children still have no peace. Despite a CPS report showing that sexual violence among children has gone down by 62%, neglect reduced by 10% and physical abuse by 56% in 1990 through 2010, children have no way they can cry out their maltreatments to get assistance, hence the figures could be higher. According to The Centres for Disease Control and Prevention (CDC) (2011), child maltreatment is defined as an act of commission or omission by a caregiver or parents towards a child resulting into real or potential harm or threat. In Public health, child maltreatment is a serious problem with serious negative impacts. In fact, children who are victims of abuse and maltreatment often have injuries physically and psychologically. Physically, they may suffer from cuts, serious wounds, burns, bruises or broken bones (Gilbert, Parton, Skivenes, 2011). Psychologically, injuries among the children could lead to stress that eventually affect the emotional development of children by disrupting the activities of the brain.
Arguing with facts, in 2011 alone, the US and its child protective services (CPS) recorded an approximate 3.7 million referrals of children living under maltreatment or neglect 680,000 of whom were children subjected to maltreatment (Leventhal Martin and Gaither, 2012). More than 79% of the children in consolidated US at that time were living as victims of neglect while 18% were being subjected to physical abuse, 9% to sexual abuse while 10% were accorded other forms of maltreatment that were recorded as drug/alcohol addiction by parents, abuse threats and lack of supervision. However, other sources other than CPS feel the statistics are underestimated. For instance, a report by Theodore, et al (2005) showed that about 15% of all the children in the US experience some type of abuse in their lifetime.
Effects of maltreatment in children
The main effects include health challenges say drug abuse, obesity, emotional trauma and risky behaviours e.g. prostitution. Scientifically, stress has been found to affect the development and growth of the immune and nervous systems (Finkelhor, 2009). Based on this understanding, children surviving child maltreatment or neglect are prone to serious problems of health when they become adults. The main problems that the affected children are likely to experience later in life as a result of neglect and abuse include drug abuse, depression, smoking, eating disorders such as obesity, risky sexual behaviours, suffer from chronic diseases, addiction to alcohol and drunkenness, thinking suicide among other public health risks (Finkelhor et al, 2005). These issues could eventually be a big burden to the government now that it is reported that new cases of child abuse in the US cost about $124 billion annually and the cost is still rising. Besides, in 2011 alone, more than 1750 children died of maltreatment in the US 71% of whom had experienced neglect and 48% physical abuse or a combination.
Development of health initiatives in maltreatment
Analysis in this part of the essay is about numerous efforts taking by state and civil society to contain attempts of maltreatment and rehabilitating the affected children (people). As a result, a number of health initiatives have been started in the US to take child abuse. These initiatives have focussed in one or more of the following kinds of abuses among children. The first according to US Department of Health and human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2012) is physical abuse where the aim of the interventions is on reducing or eliminating the use of physical force against a child such as kicking, shaking, hitting or burning. The second one is an aim to do away with child sexual abuse with more than three quarters of initiatives aiming here. Initiatives target child-fondling, exposure to sexual orientations, pornography, rape or defilement. Emotional abuse initiatives in child health mainly focus on reclaiming a child’s self-efficacy through rehabilitation programs. Children are extracted from emotional impacts such as name-calling, rejection, shame, threats and withholding love. Other initiatives focus on neglect. Neglect refers to the failure by a parent to meet the basic needs of the child i.e. housing, food, clothing, medical care and education (Helfer and Kempe, 1976). One program, an initiative in child maltreatment is the suspected child abuse and neglectsa program shortened as SCAN initiative.
The SCAN and HFA program initiative
The SCAN program focuses on rehabilitation of victims of past sexual abuse and other forms of maltreatment. HFA concentrates on going out to reach for children fearing to get out after maltreatment by visiting homesteads.The SCAN program was started in 1999 with an aim to support children suspected to have been victims of maltreatment and abuse (especially sexual abuse) by providing mainly an access to complete healthcare (Durham, 2011).
The initiator of the program observed a lot of child molestation in schools and increased numbers of children being diagnosed of sexual abuse before making a proposal to the ministry of public health. The initiative works in close contact with children, adolescents and their members of family in order to identify causes of abuse and prevent them before they spread. The initiative actually works by networking with police forensics, CIDs, child protective services, education stakeholders, NGOs and the accident and emergency services among other partners (Bahamas Ministry of Health, 2011). Other than handling current problems, the initiative was meant to impart support, care and skills so that future abuses to children and adolescents already abused would be non-existent.
Among others, SCAN has managed to develop, pilot and evaluate protocols for management of children earlier abused. About 70% of children subjected to various types of abuses have been effectively rehabilitated and can fit into the society without fear of victimization. The SCAN initiative has also been able to arrange for prompt legal, psychological and medical services for children and their families after suspected abuse. There is much effort that has been directed towards the coordination of the society to help children abused as a strategy to rehabilitate abused children. Community programs in education are many, an aspect developed by the SCAN program (Fang et al, 2012). The community is taught on the importance of respecting children and the penalties for culprits so that at least, children can be free of abuse.
However, SCAN does not perform exceptionally well when it comes to society sensitization. For this reason, another model of home visiting was developed by the US department of health to reinforce child protection and elimination of abuse (Prevent child abuse America, 2013). The initiative was named Healthy Families America established in 1992 to provide a rapid response system to the US advisory board on child abuse and neglect. Through this program, a group of specialists visit families occasionally not just to collect data but sensitize people at a personal and family level because many crimes occur in the family. On average, 75000 families are visited and served annually with the program in more than 40 states in the US.
Analytically, child maltreatment initiatives
are a wise thought in managing child abuse. However, there is need for
sustainable abuse prevention programs that can support the Healthy families
America initiative. Managing child abuse, Gil (1970), will
be the best weapon to prevent public health issues in the future such as
alcoholism, mental sickness etc. causing public security and health problems.
Bahamas Ministry of Health (2011). Suspected Child Abuse and Neglect (SCAN) Programme. [Online] Available at <http://www.bahamas.gov.bs/wps/portal/public/Health%20Initiatives/SCAN/!ut/p/b1/> [Accessed 29 Mar. 14]
Durham, NH. 2011 Crimes against Children Research Centre, [Online] Available at <www.unh.edu/ccrc/pdf/CV203_Updated%20trends%202010%20FINAL_12-19-11.pdf>[Accessed 29 Mar. 14]
Fang, X., Brown, D. S., Florence, C. S., & Mercy, J. A. (2012). The economic burden of child maltreatment in the United States and implications for prevention. Child Abuse & Neglect, 36(2), 156-165.
Finkelhor D, Turner H, Ormond R, Hamby SL. (2009) Violence, abuse, and crime exposure in a national sample of children and youth. Paediatrics, 124:1411-1423.
Finkelhor D. et al (2005). The victimization of children and youth: a comprehensive national survey. Child Maltreatment 10:5-25.
Gil, D. G. (1970). Violence against children: Physical child abuse in the United States. Cambridge, MA: Harvard University Press.
Gilbert, N., Parton, N., & Skivenes, M. (Eds.). (2011). Child protection systems: International trends and orientations. Oxford University Press.
Helfer, R. E., & Kempe, C. H. (Eds.). (1976). Child abuse and neglect: The family and the community. Cambridge, MA: Ballinger Publishing Company.
Leventhal, J. M., Martin, K. D., & Gaither, J. R. (2012). Using US data to estimate the incidence of serious physical abuse in children. Paediatrics, 129(3), 458-464.
Prevent child abuse America (2013). Healthy Families America Program. [Online] Available at <http://www.preventchildabuse.org/index.php/about-us/about-hfa> [Accessed 29 Mar. 14]
The Centres for Disease Control and Prevention (CDC) (2011). Preventing Child Maltreatment Program activities guide. Department of Health and Human Services: USA [Online] Available at http://www.cdc.gov/violenceprevention/pdf/cm_prog_activities_guide-a.pdf [Accessed 29 Mar. 14]
Theodore, A.D., Chang, J.J., Runyan, D.K., Hunter, W.M, Bangdewala SI, Agans R. (2005). Epidemiologic features of the physical and sexual maltreatment of children in the Carolinas. Paediatrics 2005; 115:e331-e337.
U.S. Department of Health and human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2012). Child Maltreatment 2011. [Online] Available at <http://www.acf.hhs.gov/programs/cb/research-data-technology/statistics-research/child-maltreatment> [Accessed 29 Mar. 14]
Roy’s Adaptation Model (RAM)
RAM is considered amongst some of the greatest models of the nursing metaparadigms and has in many ways influenced the practice. The nature of RAM makes it practical, generalizable and testable, which makes it a frequently used model in education and guiding nursing research (Shosha & Kalaldeh, 2012). RAM has provided nursing practice with a conceptual pathway for studying and understanding human behavior. The model is structured in terms of adaptive behaviors and a set of processes through which an individual adapts to diverse internal and external environmental stimuli. An individual’s response to the environmental stimulus may be in one of the four adaptive modes, which are, psychosomatic, self-concept, role function, and interrelationship (Shosha & Kalaldeh, 2012). For instance, if a patient is suffering from a skin condition, the nurse will have to figure out what the causes might be through examination of the patient’s psychological state and their adaptation to stress. However, it is common that the skin condition could have developed due to newly acquired allergies, poor nutrition or dwelling conditions. While they adapt to the environment, the skin conditions are expected to gradually decrease. The nursing practitioners have a unique responsibility of promoting health in the aforementioned adaptive modes through environmental management and the promotion of patient adaptation.
The model has separated the different ways in which individuals cope with situations, that is, individual or group coping mechanisms. RAM’s concepts of the environment, in terms of conditions or influences that are in contact with an individual are likely to affect the development of their behavior, and also their health (Clarke et al., 2011). For instance, when new individuals are brought into contact with a strange environment, they discover that the coping mechanisms they had previously used may no longer be effective, and must therefore, develop new coping mechanisms through counseling sessions or new support groups. By the time they get back to their usual environments, the fond memories they shall have developed through the interactions will overshadow any of the difficulties they endured.
Clarke, P. N., Barone, S. H., Hanna, D., & Senesac, P. M. (2011). Roy’s Adaptation model. Nursing Science Quarterly, 24(4), 337-344. doi: 10.1177/0894318411419223
Shosha, G., & Kalaldeh, M. (2012). A Critical Analysis of Nursing Using Roy’s Adaptation Model in Nursing Research. International Journal of Academic Research, 4(4), 26-31. doi: 10.7813/2075-4124.2012/4-4/B.3
Death is among the most devastating experiences for the family and friends of the departed. It brings with it the feeling of loneliness and despair, as well as loss of hope. There are terms that can be used regarding death and the period before and after the loss of a beloved. These terms include bereavement, grief, traumatic grief, disenfranchised grief, primary loss, secondary loss, ambiguous loss and mourning. The following is an overview of these terms.
This is an experience undergone by friends and family of a loved one in the period before death, at the time of death and the adjustments made after the loss (Wimpenny, 2006). Bereavement therefore refers to the state of living with a loss.
This refers to the affective reaction of an individual after the death of a kin or friend. Grief is therefore the entire experience of losing someone close to us through the person’s demise, and the subsequent emotional condition of the bereaved following the loss (Wimpenny, 2006).
While death may be shocking to the loved ones, it may affect others differently. When the experience of grief goes on for a long time, and is extreme, this can be referred to as traumatic grief (Wimpenny, 2006). This is particularly accurate when the death of a beloved was unexpected, and occurred through either violence or an accident. It may also be as a result of the individual’s inability to adapt normally to the loss of the loved one. Traumatic grief usually has substantial effect on an individual, and affects the person’s life.
This is the feeling caused by a loss and subsequent downplaying of the loss by society. According to Attig (2004), the society denies such individuals the right to grief, therefore causing disenfranchisement of their grief. The loss may not be acknowledged by the society, for instance the loss of a pet, home, or in some cultures, a miscarriage.
This refers to the immediate loss that one feel at the demise of a beloved. The very absence of the person, pet or the relationship as a result of death refers to primary loss (Wimpenny, 2006).
The passing on of a beloved sets a chain reaction and therefore a number of other losses. While the initial death of the loved one is the primary loss, what one loses as a consequence of the death of the loved one is the secondary loss. Secondary losses therefore include things such as companionship for a couple or friend, lifestyle especially if the departed was the sole breadwinner, social status and support system.
This is demise of a beloved that does not offer closure for the individuals that remain behind. The loss is therefore clouded with a lot of confusion, and in case of death, while the person may be physically absent; they remain emotionally and psychologically present (Attig, 2004). This can also occur to individuals whose loved ones are not dead, but are away for a number of reasons, such as an adopted child longing for his/her birth parents.
This refers to the visible act of grieving (Wimpenny, 2006). It is the external expression of bereavement and may include private or public display of such actions. In other cases, mourning may involve cultural rituals according to societal customs and traditions for the process.
Attig, T. (2004). Disenfrachised Grief Revisited: Discounting Hope and Love. OMEGA, 49(3):197-215
Wimpenny, P. (2006). Literature Review on Bereavement and Bereavement Care. Aberdeen: Robert Gordon University
Cultural Aspects in Pain Management among Hispanics
Cultural and ethnic aspects play vital roles in managing pain and analgesia. Hispanic patients go through pain due to adverse cultural and ethnic perceptions, expectations, and dynamics. However, Hispanic populations express pain differently and adversely. More so, people from minority Hispanic communities are regarded as poor with regards to pain management. They also experience reduced prescriptions with regards to analgesia based on the doses of pain administered (Larry, 2012). This thesis will focus on pain management while discussing cultural and ethnic roles on pain perceptions, expectations, dynamics and management. The framework will consist of the patients and a team of healthcare givers. For the purpose of this article, Bates Bio-Cultural Model of pain will be utilized. It integrates social learning theory and physiologic explanations on pain development, interpretation and management (Epps ET AL., 2008).
Hispanic population located and living in United States has been on the rise since 1950. In 1950, the population was estimated as four million persons from Hispanic community. In 2008, the estimated number of Hispanic persons was recorded at forty seven million. This is attributed to high birth rates and increasing immigration cases. Although they come from different and diverse backgrounds, they share similar values, languages and religious beliefs. However, they also differ on country of origin, income levels, degree of acculturation, levels of education and the length they have resided in United States (Larry, 2012). It is important to study cultural and ethnic aspects affecting and/or influencing care and treatment. Some persons feel neglected especially when they regard their quality of life is adversely affected. They feel pain which they find difficulties in managing and controlling in order to derive more satisfaction from their current situations in life (Donahue, Piazza, Griffin, Dykes & Fitzpatrick, 2008).
Race has played a vital role in developing and implementing policies aimed at reducing, managing and controlling pain. For the past two decades, pain management within Hispanic populations has been on the rise. Scientific literature materials coupled with curricula development and clinical practices are utilized to manage pain. The Joint
Commission on Accreditation of Hospitals and Healthcare Organizations (JCAHOs) implemented new guidelines aimed at helping persons and organizations providing care and treatment to manage pain. Thus, JCAHOs aims at providing appropriate care to Hispanic populations. It also aims at improving and increasing qualities of life through provision of pain relievers as well as educational interventions and standards to optimize pain management. These forms of treatment are mainly provided to Hispanic persons from racial, cultural and ethnic minority communities (Mario & Knox, 2013).
An assessment was conducted among persons living in minority communities. The findings highlighted several issues and challenges affecting people’s lives thus, increasing pain and lowering quality of life. It was therefore important for JCAHO to formulate and implement pain management standards in United States to serve Hispanic persons residing in the country. In order to care, treat and control persons unable to manage their pain, JCAHO provides the following guidelines. Firstly, recognize the right of patients to appropriate assessment and management. This ensures they are enrolled in an appropriate program tasked at assisting people to manage their pain (Green, Anderson & Baker, 2008).
Secondly, identify patients with pain in an initial screening assessment. Different persons suffer from diverse forms of pain. As a result, people from minority communities cannot be enrolled in a similar pain management program. Thirdly, perform a more comprehensive pain assessment when pain is identified in a person’s life. This helps in identifying unique factors attributing an increasing pain (Mario & Knox, 2013). Consequently, record the results of the assessment in a way that health care facilitates are able to conduct regular assessments and follow-ups. This measures recovery plans as it identifies factors either contributing or reducing pain. Thus, it assists in listing a number of factors that can be applied to achieve full recovery within a short period of time. This further ensures patients learn to manage their pain outside the health care facilities, improving and achieving high qualities and standards of life (Mario & Knox, 2013).
thesis has studied, examined and discussed ethnic and cultural aspects on pain
management and control. However, it has also asserted cultural, ethnic and
racial perceptions can increase pain among persons from minority communities. It
is therefore important to ensure persons from minority communities are able to
access health care facilities. They ensure Hispanic populations admitted as
patients in the health care facilities are provided with sufficient pain
management assistance. It is provided in form of programs facilitated by a
group of highly qualified, trained, experienced and willing health care givers
and professionals. However, it is also vital and convenient to build Hispanic
and Non-Hispanic ED health care facilities in rural areas to cater for patients
located in the regions. Thus, pain management is a health care issue that can
adversely affect a person’s quality of life, psychological status, emotional
balance and strength. Seeing treatment can play an important role in reducing
the adverse effects and eliminating the possibilities a person is likely to
suffer from the same in the future.
Donahue, M., Piazza, I., Griffin, M., Dykes, P., & Fitzpatrick, J. (2008). The Relationship Between Nurses‟ Perception of Empowerment and Patient Satisfaction, Applied Nursing Research, 21, 2-7
Epps, C., Ware, L., & Packard, A. (2008). Ethnic Wait Time Differences in Analgesic Administration in the Emergency Department, Pain Management Nursing, 9, 26-32.
Green, C., Anderson, K., & Baker, T. (2008). The Unequal Burden of Pain: Confronting Racial and Ethnic Disparities in Pain, Pain Medicine, 4, 277- 294.
Larry, P. D. (2012). Trans-cultural Health Care: A Culturally Competent Approach, F. A. Davis Publishers.
Mario, I., & Knox, H. T. (2013). Culture, Brain, and Analgesia: Understanding and Managing Pain in Diverse Populations, Oxford University Press.
Usefulness of Benner’s work
Patricia Benner’s work has contributed significantly to the roles of nurses. Her theory creates the impression that patients can recover and grow in a healthy and creative way as they rely on the works and care done by the nurses. Whether a nurse is a beginner (novice) and has no experience or an expert who has the mastery of the nursing principles in terms of rules, guidelines and principles, care can be accorded to the patient in a systematic and professional way without role conflicts. Benner’s contribution helps nurses to utilize the resources available with passion as they offer services to the patients. These contributions are important in my present role as a nurse supervisor in a home care agency, as they help to apply past experiences as the foundation guide to the daily problems in a nursing environment.
As Benner indicated, caring is the central focal point of a nurse as it gives the opportunity to connect with others while at the same time give help to those in need (Judith 141). This entails personal concerns for others in events, projects and other aspects that may concern the patients or the nurses. Benner’s theory helps me in my role as nurse supervisor in a home care agency. The theory guides me in supervising all the affairs of the patients ranging from their needs, activities that ought to be carried out regarding the patients as well as giving due care to patients who are in the facility. This is important because it helps in coordinating activities that other nurses ought to be performing in order to ensure smooth flow of activities.
Using Benner’s stages in clinical competence stages, from novice to expert, I am able to know how to allocate duties in the facility without creating conflict or distributing work to those who are unable to fulfill their duties because of their level of expertise. Since I know the qualifications of a novice nurse, I am able to allocate them work that relates to their experience and exposure to the job, the same case applies to the advanced beginners, the competent nurse, the proficient and the expert nurse. This helps me in work delegation within the facility. As an expert in nursing, I am able to improve the communication issues in the facility, deal effectively with interruptions that may arise as well as anticipate the various needs of the patients. This helps me to create harmony in the facility between the other nurses, the patients, and their families. This is vital as it helps in creating and maintaining ethical relationships with all stakeholders in the facility.
Benner’s contributions have therefore helped the facility to maintain a healthy work environment while promoting learning and caring culture. This is observed when the expert nurses help the beginners and the advanced beginners learn how proper care is given the patients. Because the nurses in the facility are able to work as per their experiences, there is increased self-confidence in them and this improves patients’ safety while reducing conflicts. The works of Benner are vital in any facility and nursing situation since they help in the promotion of the existing nurses, when orienting new nurses and when increasing clinical knowledge in the care of hospitalized patients and other outpatients (Alligood 131). The theories and concepts brought about by Benner help nurses to support each other and appreciate the framework for lifelong learning through practice, research as well as education.
Alligood, Martha R. Nursing theorists and their work, 8th Ed. 2014. St. Louis, Missouri: Elsevier. Print.
Judith, M, and Leslie S. Treas. Fundamentals of Nursing. Philadelphia: F.A. Davis Co, 2011. Internet resource.
Family nurse practitioners must have various competencies to ensure that they provide quality healthcare to patients under their direct care. Family nurses are supposed to initiate suitable and well-timed consultation as well as referral or transfer when a problem that they are handling exceeds their capacity of practice or level of expertise (Derengowski et al., 2000; Kinnersley et al, 2000). Similarly, such a nurse should weigh and get involved to help a patient with an urgent and complex situation. As such, they should diagnose unsteady and multifaceted health care issues using collaboration (teamwork) and discussion with the multi-disciplinary health care team as determined by the situation, specialty, and personal experience and knowledge, for instance, family and patient possibility of aggression, mistreatment, and addictive manners (Ferrell et al., 2003; Lindeke & Sieckert, 2005).
Continuing education, certification, and evaluation, describe the level of competency, official recognition, and appraisal of family nurse practitioners to ensure that they offer quality health care (American Nurses Association, 2010; Towle, 1998). Family nurse practitioners are challenged under these competencies to further their level of education in order to improve their capacity to handle complex medical issues, sit for examinations in regard to their training and become recognized by professional bodies such as the American Academy of Nurse Practitioners Certification Program (AANPCP), the American Association of Colleges of Nursing (AACN), the American Nurses Credentialing Centre (ANCC), and the Association of Faculties of Paediatric Nurse Practitioners (AFPNP) amongst others (Cronenwett et al., 2007). After recognition, the nurses can then be appraised to varied levels of professionalism based on their levels of education and experience, as indicated by the professional examinations and certificates or accreditations that they have (Story et al., 2002). As such, well-educated and professional nurses are able to offer patients better health care.
American Nurses Association (Ed.). (2010). Nursing’s social policy statement: The essence of the profession. Nursesbooks. org.
Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., & Warren, J. (2007). Quality and safety education for nurses. Nursing outlook, 55(3), 122-131.
Derengowski, S. L., Irving, S. Y., Koogle, P. V., & Englander, R. M. (2000). Defining the role of the pediatric critical care nurse practitioner in a tertiary care center. Critical care medicine, 28(7), 2626-2630.
Ferrell, B. R., Virani, R., Smith, S., & Juarez, G. (2003, January). The role of oncology nursing to ensure quality care for cancer survivors: a report commissioned by the National Cancer Policy Board and Institute of Medicine. In Oncology Nursing Forum (Vol. 30, No. 1, pp. E1-E11). Oncology Nursing Society.
Kinnersley, P., Anderson, E., Parry, K., Clement, J., Archard, L., Turton, P., & Rogers, C. (2000). Randomised controlled trial of nurse practitioner versus general practitioner care for patients requesting “same day” consultations in primary care. Bmj, 320(7241), 1043-1048.
Lindeke, L. L., & Sieckert, A. M. (2005). Nurse-physician workplace collaboration. Online Journal of Issues in Nursing, 10(1).
Story, M. T., Neumark-Stzainer, D. R., Sherwood, N. E., Holt, K., Sofka, D., Trowbridge, F. L., & Barlow, S. E. (2002). Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics, 110(Supplement 1), 210-214.
Towle, A. (1998). Continuing medical education: Changes in health care and continuing medical education for the 21st century. Bmj, 316(7127), 301-304.
Outcome Indicators of Global Childhood Obesity
For about three decades now, the incidence of obesity and overweight has substantially increased among children aged below 18 years. The highest number of children affected has been evidenced in upper middle income states, whereas countries with low income have the least prevalence rate. Nevertheless, obesity in children is increasing in almost every country with popularity rates growing highest in lower middle income nations. The following are some of the developed and utilized outcome indicators used to measure progress of global childhood obesity.
Child Health Indicators of Life and Development (CHILD)
This indicator was commissioned by the Directorate General for Health and Consumer Protection like a component of health screening project. This project engaged representatives of about fifteen EU member States together with other two European Economic Area (EEA) nations, that is, Norway and Iceland. After investigation of child health in literature review and its broadest sense, initial potential lists indicators were spotted and examined for realism and definitional transparency, including pan-European and data availability comparability. The outcome of about 38 sets of indicator provided a broad child health image in Europe as well as suggested productive and other ways to increase knowledge (World Health Organization, 2012).
Peristat and Perisat II
This was an associate as well as parallel to the CHILD project in the EU health monitoring programme. This indicator dealt with the pregnancy period, labor, maternal post-partum health as well as child health during the period of prenatal. The indicator mostly covers the initial weeks of life and reinforces measures of congenital anomalies, low birth weight, early infant mortality and health determinants throughout pregnancy (Leonardi, 2010).
Child Safety Action Plans
The importance of this indicator is the distribution of the populated sets of infant wellbeing indicators through the EU member states. Additionally, it produces assessment indicators of strategic preparedness dimensions of the member states so as to address the childhood safety agenda regarding leadership, infrastructure as well as capacity.
This is a demography and socioeconomic indicator that takes social and cultural position as well as characteristics of parents and family to describe the children’s background. First, an outline of both social and cultural measures and indicators, which are significant for analysis on equity regarding health of children are provided. Strengths and weaknesses of cultural and social indicators are described and finally, recommendations for improving and using cultural and social indicators are made in studies on childhood health (World Health Organization, 2007).
Leonardi, M. (2010). Measuring disability and health supporting policy development. The European project. Disability and Rehabilitation, 31(1): 50-58.
World Health Organization. (2012). Childhood obesity control. Web. 11 Mar 2014. Retrieved from http://www.who.int/dietphysicalactivity/childhood/WHO_new_childhoodobesity_PREVENTION_27nov_HR_PRINT_OK.pdf
World Health Organization. (2007). WHO Classification, Functioning,
Health and Disability. Childhood and Youth Version. Geneva, 24-45.
Social Exchange Theory and Nurse-Patient Relation
The first assumption of the Social Exchange Theory (SET) is an exchange activity involving rewards and costs. The second assumption states that individuals usually seek to maximize benefits, while attempting to lessen the costs. Finally, human beings are self-centered, and will often strive to satisfy their needs first. The core components of this theory include outcome and comparison level of possible worthy alternatives. This implies that individuals tend to establish and continue their social relations based on their expectations that it will be mutually rewarding (Neufeld and Harrison 10-11).
These assumptions can significantly affect the nurse-patient relations. A patient who appreciates the efforts of his/her nurse will possibly receive better health care services as a form of reciprocity. This will improve the nurse-patient relation to higher levels as the expectation of each continues to rise. Lack of appropriate rewards will trigger a reverse effect where their relationship will continue to deteriorate. However, it has been practically established that the patient’s expectation is normally more demanding compared with those of nurses, thereby introducing an imbalance in rewards. The exchange imbalance that causes burnout in nurses mainly results from the patient’s difficult patient problems, and their higher emotional demands. The nurse may also experience burnout as they dedicate most of their time providing direct care to patients, some of whom have very poor prognosis. Consequential ethics and the ethical principles of deontology are largely ethical if they can contribute to the well-being of the patient who is experiencing more suffering. SET is not quite compatible with the values of the nursing profession since the patients are more dependent on nurses, and have little rewards to offer nurses in exchange. In the nursing profession, nurses are obliged to serve and foster positive relations with their patients regardless of the situation (Kim 145-146).
Kim, Hesook S. The Nature of Theoretical Thinking in Nursing. New York: Springer Pub. Co, 2010. Print.
Neufeld, Anne, and Margaret J. Harrison. Nursing and Family Caregiving: Social Support and Nonsupport. New York: Springer Pub, 2010. Print.
Socio-Cultural Determinants of Substance Abuse
Substance abuse around the world today, takes place in pandemic proportions. It occurs in a socio-cultural environment with various factors affecting its use. The environment determines the availability, desirability and acceptability of the abused substances. Consequently, the drugs that an individual is exposed to and his/her behavior under the influence of drugs are determined by the individual’s position in the societal set up. This paper describes the socio-cultural factors that underline the emergence of drug use and its implications to the society. It will also explain the drug addiction defense mechanisms (Ruiz, Strain & Langrod, 2007).
Low socio-economic status is known to have a correlation with substance abuse. Studies conducted to find a link between the two indicate that social conditions associated with poverty strongly increase an individual’s vulnerability to drug use. Poor quality of education, for example, is linked to low economic status and the likelihood of engagement in perilous behavior such as substance abuse. Parents in low-income setups often work long hours and, therefore, do not have time to bond with their children and supervise them. Their performance in school dwindles and without prospects for future employment, there is increased risk of drug use. This leads to a vicious cycle of poverty and drug abuse (Ruiz, Strain & Langrod, 2007).
A survey conducted in the United States indicates that hopelessness also increases an individual’s chances of becoming a drug user. The incidences of substance trafficking and abuse were found to correspond with high rates of hopelessness among a cross section of the youthful population. Lack of personal vision for the future coupled with the lack of motivation and role models reportedly predispose the youth to drug abuse. The hopelessness experienced by a person’s family members and close peers also increases the risk of substance use (Ruiz, Strain & Langrod, 2007).
The social exclusion experienced by the members of the low social class predisposes them to drug abuse. The access to medical and social facilities is limited; hence, living conditions cannot improve. They are unable to get effective rehabilitation from the healthcare providers. This implies that the numbers of drug abusers increase, and diseases that arise from drug use also spread (Ruiz, Strain & Langrod, 2007).
Social set ups that are related to criminal neighborhoods increase the chances of one becoming a substance abuser. Studies show there is a relationship between crime and the ease of access to illegal substances. People who live in crime-ridden neighborhood, therefore, have access to the drugs because the criminal gangs also deal in illicit drugs. There are increased chances of young unemployed youths being used to ferry the drugs. This process exposes them to the drugs and consequently increases the risk of substance use among them (Ruiz, Strain & Langrod, 2007).
Research indicates that the drug addicts spend all if not most their money to sustain their habit. They often ignore all other responsibilities as provision of food, clothing and shelter. Indirect cost arises in the form of payment for rehabilitation and health services for drug users who develop addiction related disorders and family members often incur these or the government through health insurance. Family members of the drug users also suffer from psychological torture by seeing one of their own suffer from drug abuse (Ruiz, Strain & Langrod, 2007).
Certain Drug abuse disorders interfere with a person’s neuro-motor capabilities. This has led to accidents when controlling machinery and vehicles. Reports indicate a correlation between drunk driving and road accidents. Drug abuse also leads to increased levels of crime among the users. This is because of the desire to disobey authority that is characteristic of drug related mental disorders. Drug users often engage in criminal activities in order to get money to buy drugs because they are unable to secure jobs due to their condition (Ilgen & Kleinberg, 2011).
Suicide is a leading cause of death in the United States and research suggests that substance abusers are at an increased risk of taking their own lives. Studies reveal that men with substance abuse disorder are three times likely to die from suicide than non-substance users. Among women, the risk is higher and similar observations further show that individuals who abuse more than one substance are at an even higher risk of committing suicide because of multiple substance-induced mood disorders (Ilgen & Kleinberg, 2011).
Drug abuse is also strongly linked to violent tendencies. In a recent survey of addicts, 75 out of 100 drug users report having engaged in one form of violence. It also shows that drug users with suicidal tendencies are the most likely to engage in violent acts. This leads to poor interpersonal relationships between the drug users and family members (Ilgen & Kleinberg, 2011).
One of the defense mechanisms developed by drug users is denial and a user in denial is blind to health and other risks that he is exposed to due continued abuse of drugs. The mind of the user is cannot perceive of the consequences of drug use due the intense craving he experiences. The user, therefore, feels no compulsion to seek for help with the addiction. Repression is another mechanism in which addicts use drugs to manage stress, relieve painful feeling and cope with anxiety. Due to the abuse of drugs one’s ability to deal with these situations naturally diminishes, and the addiction persists (Whitbourne, 2011).
Reaction formation as a defense mechanism entails the expression of behavior in the outside that is completely opposite of one’s feeling on the inside. An addict, for example, may feel that abusing drugs is inward, but on the outside, he continues to abuse the drug. Intellectualization involves the ‘wishing away’ of thoughts that are undesirable. In this defense mechanism, a person accepts the existence of a situation but refuses to think about the emotional consequences (Whitbourne, 2011).
Rationalization in defense mechanism means explaining a problem away and in offering an explanation, individuals often find a way of blaming others or outside forces for their situation. It involves mental construction of causes beyond one’s control and blaming them. An addict, for example, may blame the person who availed the drugs or the government for failing to control the supply (Whitbourne, 2011).
Finally, in displacement as a defense mechanism, a person transfers his feelings of anger or hatred from the original target to a harmless victim. A person who harbors hatred against the society may transfer the feeling to himself by engaging in substance abuse. Another example occurs when a person is annoyed and in this instance, instead of hitting a person who has provoked him, he goes ahead and hits a windowpane. In this act, he displaces the anger from the person to the window (Whitbourne, 2011).
In summary, substance abuse has negative ramifications on the society and these effects are caused by the interaction between social and cultural factors. In an attempt to ameliorate the situation, interventions must not focus on incarceration and drug control only but must also incorporate policy that focus on the social-cultural determinants. This will ensure success in the global fight against drug and substance abuse (Ruiz, Strain & Langrod, 2007).
Ilgen, M., & Kleinberg, F. (2011, Jan 20). The Link between Substance Abuse, Violence and Suicide. Retrieved from: http://www.psychiatrictimes.com/substance-use-disorder/link- between-substance-abuse-violence-and-suicide
Ruiz, P., Strain, E. C., & Langrod, J. (2007). The substance abuse handbook. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Whitbourne, S. K. (2011, Oct 22). The Essential Guide to Defense Mechanisms. Retrieved from:
http://www.psychologytoday.com/blog/fulfillment- any-age/201110/the-essential-guide- defense-mechanisms
IOM future of Nursing lies in the fate of educational platforms laid in the current society. Professionalism is one way of assuring better practices in the future. Therefore, increasing proportion of nurses with baccalaureate degree to 80% by 2020 is one sure means of enhancing nursing practices. Graduates possessing such certificates are believed to comply with the acute demands that are ever in existence (Cherry &Susan 420). This is attained through enhanced competence levels among practitioners, and general availability of professionals who can adequately handle the dynamic needs of the sector. These are the reasons that would see me fit into this future plans. I intend to be counted among the 80% who are expected to acquire baccalaureate degree by 2020. Personally, I see this move as strategic towards an enhancement of nursing practice and professionalism.
The second reform involves doubling the number of nurses with doctorate degree by 2020, which is a step forward, and is likely to foster quality frameworks within this sector. Today, the policy and regulatory measures lag behind due to inadequate number of doctorate graduates who would easily come up with accurate measures. Graduates possessing doctorate degree are very crucial towards the sustenance of the field, which is exposed to uncertainties (Goudreau, and Mary 56). Therefore, the Future of IOM is assured if success of the number of nurses having doctorate degree is doubled. I aspire to be part of this process in order to boost the level of nursing practice into the public service. For instance, these nurses will become elevated to new levels of service provision, which would see the rise in the number of consultants. The nursing consultancy is likely to be enhanced amidst doubling the population of nurses by 2020. This is the benchmark the future of nursing is best placed. I aim to see this process complete successfully through sensitizing young nurses by engaging vigor and zest towards the full achievement of this goal. This is one fundamental means that would make me fit into this future IOM platform.
Engaging in lifelong learning is another crucial IOM platform that will see the future stake of nursing sector. Lifelong learning is a fundamental aspect that suffices competency and skills requirements in a field that is never static, but keeps experiencing changes. Therefore, progressive learning among nurses will assure its future sustainability due to ever changing conditions from the environment. This is one ideal framework that nursing sustainability measures within the nursing field is oriented. In addition, lifelong learning gives nurses the best practical and academic knowledge appropriate in handling acute problems that nursing sector undergoes.
Based on these recommendations, I find myself fit to adopt the third resolution. Having lifelong nursing education is what I aspire to attain. Currently, I hold a bachelor’s degree in nursing practice, and I have gathered practical practice in the field as a result of engaging in different internships. Based on this, my career option is to engage into more trainings and learning in order to meet future demands within this sector (Roussel 4). For instance, I aspire to undergo a continuous learning process that will enhance my knowledge with the current demands of the nursing profession. Increasing my level of education will serve the purpose of equipping me with the prerequisite knowledge and experience attributed to the nursing field. On the other hand, having a higher educational standard will transform my role in nursing field from being an attendant to consultant and policy developers.
Cherry, Barbara, and Susan R. Jacob.Contemporary Nursing: Issues, Trends, & Management. , 2014. Print.
Goudreau, Kelly A, and Mary C. Smolenski.Health Policy and Advanced Practice Nursing: Impact and Implications. , 2013. Internet resource.
Roussel, Linda. Management and Leadership for Nurse Administrators. Burlington, MA: Jones & Bartlett Learning, 2013. Print.
Addressing Family Violence
Family violence has been recognized as one of the universal public health and human rights issues that call for immediate attention. Family violence is usually biased against women and children and takes form of wife battering and child mistreatment. While prevention measures have been put forward in the last decade, there is still a long way to go in addressing this issue. The state should channel funds to address this issue through a number of interventions proposed below.
Toll free help lines; Steps should be taken to set up toll free help lines to the police. People should be able to reach out to the police easily in cases of family violence. Often calling the police may intimidate the abuser who usually would be wary of this in future.
Setting up community help centers; Community programs and hotlines should be set up in aid of addressing this issue; such centers would provide counseling, emergency accommodation and referral services to the victims.
Provision of medical treatment; Family violence sometimes results in serious injuries to the victims; such injuries should be treated medically to prevent further health issues. Detailed medical reports from qualified physicians would also prove invaluable in case of legal suits.
Mobilizing the community members against family violence would prove an essential empowerment tool in curbing domestic violence(National Resource Center on Domestic Violence, 2011). This involves appealing to communities to support, develop and execute policies that aim at transforming individuals and the community at large.Health education in this context would play the role of creating awareness to victims of their rights, legal procedures and first aid techniques in case of abuse to prevent deterioration of the situation. This would also empower members of the community on where to seek medical aid in cases of violence.
National Resource Center on Domestic Violence. (2011). Mobilizing Communities to Prevent Domestic Violence. Retrieved February 4, 2014, from VAWnet.org: http://www.vawnet.org/applied-research-papers/print-document.php?doc_id=1582