NURS 4211 Essay Discussions
WEEK 1 : Community Health Issues
Community has a great effect on the health and well-being of the residents that live there. It is important that residents are aware of community resources available, as well as take advantage of them to benefit themselves, and possibly reduce visits to the doctors and promote their health. Community and public health nursing is readily available in all communities, especially that of V.S., which is North Hollywood. The six basic elements of nursing practice incorporated in community health programs and services are: (1) promotion of healthful living (2) prevention of health problems (3) treatment of disorders (4) rehabilitation (5) evaluation and (6) research (“Current Nursing”, 2013).NURS 4211 Essay Discussions
The role of community and public health nursing in this community’s well-being through exercise classes, senior centers for development of intellectual and social aspects, and home health services that offer nurse, physical therapy, and home aids to the patients home, as ordered by MDs. In the case of V.S.’s community, these services that the form of the YMCA for senior-aimed group exercise classes, Shiraz ADHC and North Hollywood Senior center for recreational and daily health maintenance, as well as communication and relaxation with peers, and AGM Home Health Care as one of the home health service that serves the community.
With these available resources, and many more, residents can take advantage of self-health promotion, education, and have places to develop intellectual, interactive, and recreational activities.
Cultural Diversity
Cultural diversity plays a big role in the types of community centers and resources available. For example, because there is a large minority immigrant population of the Russian and Armenian descent in the area, having Shiraz ADHC, cater to that population makes the transition easier and their residence in the area smoother as well. As far as the YMCA, most of the attendees and instructors are of the Hispanic descent, and speak the language, which helps the attendees who are Hispanic immigrants easily understand and want to attend the classes available.
The North Hollywood Senior Center takes place at a nearby park, and has a variety of nationalities and vulnerable populations such as the elderly and low income populations, and provides recreational activities and community connections. AGM Home Health Care offers services to the area, and outside, and serves the vulnerable population of the elderly, frail, and knowledge deficient on self-care. Overall, there are many community resources that reach out to vulnerable populations and involve cultural diversity, making it easier for different types of residents to be accustomed to life in the community.NURS 4211 Essay Discussions
Epidemiological influences
Epidemiological influences within V.S.’s community involve abundance of fast food chains and restaurants, and some smoking around the community, that can cause for second hand smoke and cardiovascular and respiratory harm. According to “World Health Organization” (2014) epidemiology is “ the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems”.
With the immediate surroundings of V.S.’s dwelling having many restaurants, cafes, and food chains, it makes nutrition difficult to keep control of, which not only influences diabetic status, but weight, cardiovascular, and over all well-being as well. It is important to instruct patients that have special diets especially, about the need for fresh vegetables and foods to promote proper metabolic processes. Also, avoiding areas of smoke and hazards will greatly improve respiratory and cardiovascular function, and decrease patients’ and residents risks of complications related to them.
Healthy People 2020
Healthy People 2020 helps sets milestones and goals for the overall health and wellbeing of the nation. In the case of V.S., a Leading Health Indicator (LHI) to focus on would be – Reduce the proportion of persons with diabetes with an A1c value greater than 9 percent (“Healthy people”, 2014). There are many nursing diagnoses that relate to the community of V.S., three of which are:
1. Risk for improper nutrition due to abundance of fast food in community;
2. Readiness for enhanced self-health management due to available resources as evidenced by patient verbalization;
3. Knowledge deficit on remaining available community resources due to ineffective community health promotion (“Nursing diagnosis list”, 2014).NURS 4211 Essay Discussions
Interventions
To each diagnosis, there must be an intervention to help improve the status, and help achieve the LHI goal. In the case of risk for improper nutrition due to abundance of fast food in community, it is important to educate the patient, caregiver, and family members about the negativities of eating fast food on a regular basis, as opposed to controlling the type of food entering the body, in the form of fresh vegetables, fruits, and meats. Also, emphasizing the importance of proper diabetic diet, and the risks with non compliance such as retinopathy, neuropathy, increase in DMII symptoms, and an overall decline in physical health related to diabetic complications, may help patient make better decisions regarding diet.
Readiness for enhanced self-health management due to available resources as evidenced by patient verbalization has an intervention of assisting patient make a step-by-step plan as to how to begin and continue through with the self-health management. Finally, knowledge deficit on remaining available community resources due to ineffective community health promotion has an intervention of educating patient and family regarding additional community centers, such as senior centers, meals on wheels, parks, mall walker programs, senior field trip programs, and others. By providing constant updates and education to patient and family, there will be an abundance of knowledge regarding services in the community that can be used by the client, making it easier, safer, and more enjoyable for he or she to reside in the community.
Nurse Advocacy in Communities
The nurse’s role as advocate does not just remain within the confines of a hospital, clinic, or office. Making sure that the patient’s environment and community is sufficient and safe for the patient is within the advocacy line of the nurse as well. One way that nurses can advocate in communities is by visiting the centers that pertain to their patient’s, analyzing how they work, and making suggestions to management regarding changes to benefit the facility and residents. For example, in the case of the YMCA, a suggestion could include having on-site medical staff to assist in case of emergency, injury, or need, especially while working with elderly clients. Another suggestion would be for the ADHC to provide follow-up phone calls or visits to patient homes, or provide the same services during the weekend for patient who do not have a steady support system or care system at home. By giving the facilities a nursing point of view, it will help improve these already great facilities by incorporating safe nursing and health care, for a truly holistic experience.NURS 4211 Essay Discussions
Conclusion
Community health nursing and public health is a new aspect that must be addressed by nurses during patient care. Because patents spend the majority of their time in their communities and not in hospital, clinics, or other facilities with proper nursing care, assessing and being knowledgeable of his or her community will help nurses tailor treatments and education with regards to discrepancies in the community. Nursing care is holistic, and should encompass both home and hospital stays. Promoting proper self-health care to patients and families by encouraging use of proper community services and avoiding negative aspects of it will help prevent complications, and promote holistic health care.
WEEK 2 : Epidemic in the Community
There is an obesity epidemic in the USA which is expected to cost the nation if the situation is not looked into (Andreyeva, Sturm, & Ringel, 2004). Bipartisan policy centre said this through a webcast which it held in order to outline its propositions on how to curb this crisis.
An initiative by the bipartisan nutrition and physical program advises communities as well as private groupings to collaborate in enhancing healthy homes, workplaces, societies, as well as learning institutions.
This is according to a report concerning how America’s state of health and increase in rates of obese people endangers the economy. The increasing spending in healthcare in the USA is expected to reach about $4.6 trillion dollars every year and to consume about 19.8 percent of the G.D.P by 2020 (Letourneau, 2012).
Americans are generally overweight and unhealthy. The country uses $2.6 trillion in a year on healthcare. Such spending is the main driver of the country’s debt. In fact, the present healthcare costs could destroy the nation. As the obesity problem escalates, the nation is likely to deal with other difficulties other than the high costs in healthcare.
These issues include the inability of the armed forces to recruit new army personnel and retain qualified military personnel. There is also a high chance of a decline in the workforce productivity due to obesity.
The bipartisan policy centre called on the government and both sides of the political divide to help fight this obesity epidemic. This epidemic is a complicated issue but if we were to work together as a country and wholly as a globe in the fight against it, it would prove to be nothing more than a simple task that we would have dealt with.
In the policy centre’s report, some of the recommendations are worth considering which include one that says schools in the US should improve their physical activity offerings and nutrition, and they should do this in conjunction with the private sector (Blackburn & Walker, 2005).NURS 4211 Essay Discussions
It has been proposed that Centers for Disease Control (CDC) and several other private institutions collaborate in creating a database of standard workplace health initiatives. This program should be with a rigorous cost benefit analysis to help scale up best practices already in place in the government and also in the private sector.
CDC should also continue with their efforts of collecting and distributing information pertaining food, health fitness, and physical activity among many more other goals. The information propagated also includes awareness on the social determinants of health and their future costs. Bipartisan continues to commend that congress should continue supporting these monitoring and information acquiring functions.
In conclusion, all relevant organizations such as the government, insurance agencies, infirmaries, places of work, and societies have to accept, emphasize, and advance the need for mother’s role in breastfeeding their kids with an objective of significantly augmenting the US breastfeeding rates for the initial six months of a child’s living.
WEEK 3 : Evaluating Culture From the Nursing Perspective
Healthcare practices and regard for healthcare practioners vary across and within cultures. (Book 11) Patients differ due to various aspects. These differences constitute of patient illness, personality, socioeconomic class or education, however the most endless variation is cultural. (Page 8) Race, religion, language, education, ethnicity and economic status are the essence of culture that has a significant influence on an individual’s health and wellbeing. (Page 21) Skills are crucial for ensuring that nursing care is culturally congruent; knowledge of cultures is important for facilitating communication with people (page 2).Nurses shall use effective, culturally competent, communication with patients that takes into consideration the individuals verbal and non verbal language, cultural values and context and unique healthcare needs and perceptions. (Page 9)
Culture refers to learned and transmitted values, beliefs, norms and life ways of an individual or group that guide their thinking, decisions, actions and fundamental ways of living. Culture consists of primary and secondary characteristics and dynamically constructs and shapes the communication patterns, health beliefs, health practices and relationships of people. (Book 11) Cultures are classified by variability and diversity. (Page 1) Culture tends to provide guidelines for body adornment including clothing, and for food consumption, education, music, art, housing and a variety of other conditions of living. Cultures educate standards of good and bad, value systems, an understanding of time and what constitutes health and illness. Culture plays a fundamental role in the manner in which meanings are interpreted. Not all cultures agree on what health is as there are wide variations in beliefs about the causes and treatment of illness. (book14). These beliefs shape how a group perceives the process of life, how they define health and maintain wellness, what they believe to be the cause of illness and how providers should care for the ill. (Book 8)
Diversity refers to the differences in race, ethnicity, national origin, religion, age, gender, sexual orientation ability/disability, social and economic status or class, education and related attributes of people in society. (Book 10) Cultural diversity comprises of a distinct range of people embedded in a collective belief and value system established by standards, customs and a way of life. (Page 6).This diversity is embodied in the uniqueness and profusion of the identities of the groups and societies making up human mankind. Cultural diversity enables an extensive range of opportunities for individuals and groups within society. It is one of the major factors of development, understood not purely in terms of economic growth, but also a means to achieve a more satisfactory intellectual, emotional, moral and spiritual existance. (Page 5) The way in which people live highlights evidence of diversity through an extensive range of domains and environments. A variation in land, climate and setting is compound diversity in social and cultural characteristics or the reflection of individuals in the diversity of contexts in which healthcare is delivered. (Page 21)NURS 4211 Essay Discussions
Care is the essence and central focus of nursing. Caring is essential for health and well being, healing, growth, survival and also for facing illness or death. Cultural beliefs and practices are continuously evolving, making it necessary for nurses to acknowledge various cultures. Culture care is a broad holistic perspective to guide for nursing care practices. (Page 7) Culture plays a significant role in patient care as individuals adhere to specific beliefs and ideals as a way of life and these carry over into the most basic aspect of health and illness. (Book 13) Nursing requires sophisticated assessment and analytic skills, the ability to plan, design, implement and evaluate nursing care for individuals, families, groups and communities representing various cultures. The patient’s concept of illness and its causes will help the nurse to assess and prioritise learning opportunities. An increase in patient compliance and cooperation is evident when treatment plans incorporate the patient’s cultural values and beliefs (page 23). Nursing interventions based on cultural knowledge help patients and families adjust more easily and assist nurses in working effectively and comfortably with all patients regardless of their cultural background. (Book 10) The perception and awareness of health breakdown and illness and the cause differs within culture; these individual perceptions affect the approach to healthcare and how patients respond to care that is provided. (Page 3) The relationship between culture and cognition is vital in nursing as nurses must deal with the varying preferred styles of interaction, thinking and learning in relation to both themselves and patients in their care. This cultural awareness maintains a high quality of care and positive health outcomes. (Page 2)
It is essential for nurses to obtain fundamental knowledge and skills in cultural competency. Obtaining cultural information and utilising this knowledge ensures cultural competence. In order for nurses to be culturally proficient they must understand both their and their patients’ perception of the world, while preventing stereotyping and exploitation of scientific knowledge. Nurses portray cultural competence in nursing practice as a continual development working towards achieving a set goal of effectively working with a range of culturally diverse people whilst displaying awareness of diversity during care, a strong understanding of theory and practical skills in nursing and a crucial level of respect for others from different cultures. (Page 5) Effective nursing practice and cultural competence consists of nurses constantly aiming to provide care within the cultural limitations of their patience. An understanding of cultural diversity is vital in all aspects of nursing as it is critical that nurses understand and recognise differences within an individual and not contribute to stereotyping. Culturally competent nurses recognise the harmful effects of ignorance, ethnocentrism, prejudice and bias on the health of their patients and patient populations. Nurses serve as patient advocates by providing a voice for their patients’ needs and concerns. They also ensure the autonomy of their patient populations and their right to safeguard their values, address their health and healthcare needs and to voice their concerns. (Page 14)
Today nurses are confronted with unprecedented cultural diversity as a result of the increasing level of multiculturalism. The continually increasing multicultural population poses a significant challenge to nurses providing individual and holistic care to their patients (page 4) Culture greatly influences how people view their health and the healthcare services they receive.NURS 4211 Essay Discussions Appreciation and respect for cultural values and beliefs help nurses to gain an understanding towards culturally determined behaviours (Page 22) and enhances family support and acceptance of nursing goals that have been developed (book 10). Nurses who understand and value the practice of culturally competent care are able to effect positive changes in healthcare practices for clients of designated cultures. Nurses have an obligation to advocate for the addition of their patients cultural beliefs and practices in all dimensions of their healthcare. (Page 8) Individuals are socialised through family into a particular culture; Nurses are socialised into the nursing profession through the training undertaken and the acceptance of values and behaviours as appropriate to the profession. In relation to health and care the professional culture of nursing provides the protocol or guide for determining the definition of health and associated values beliefs and practices (page 15) Nurses and healthcare providers must acquire the ability and knowledge to communicate and be aware of health behaviours influenced by culture. Embracing this ability and knowledge can eradicate barriers to the delivery of health care. (Page 31)
WEEK 4 : Disaster Planning
During disasters such as an earthquake, storm, floods or a terrorist attack, response coordination is usually overwhelmed.Such scenarios demand comprehensive disaster preparedness planning if rescue and recovery efforts are to be effectively executed.The first phase of a disaster preparedness plan entails mitigation.
This is a pre-disaster management approach that mainly deals with the scale of a potential disaster and its projected effects. It encompasses all measures that can be put in place to minimize all the negative aspects of the disaster.
If property implemented, the mitigation part of a disaster preparedness plan helps allay the direct and indirect effects of the hazard. (Dheri, 2009) The next step in preparing the plan addresses the post-disaster management phase. This starts with the establishment of an incident command system. This is followed by the identification of qualified personnel or volunteers who will be responsible for various aspects of disaster response. They should be assigned functions such as incident command, finance, operations, logistics, operations, information and planning as well as any other roles necessary during a disaster.
The operations personnel should be qualified in critical disaster response aspects like site security, fire fighting, search and rescue, and first aid administration. A file with the names, titles, designations as well as home and cell phone numbers of all the identified personnel should be retained at a central location to enable their quick accessibility in times of emergency. Another major element in disaster preparedness is ensuring vital response items such as portable radios, fire extinguishers, flashlights, emergency first aid supplies are easily accessible and in proper working condition.NURS 4211 Essay Discussions
Most of these requirements can be internally met. (Volunteer Center Serving Howard County, 2003) Outside the organization, factors that need to be considered include identifying the nearest health clinic, police station and fire station as well as places where things like emergency generators could be obtained in case of a protracted power blackout during a disaster. Sources of additional water and food should also be identified. It is also advisable to estimate the number of people who could be affected by diverse forms of disasters.
Contacts of a local leading disaster management organization such as the Red Cross are vital in case mass shelter or its management training is necessary. When planning for disasters that might require evacuation, factors such as the number of people who might need evacuation, the evacuation site and the means of transport to the site should be considered. If a disaster is expected to be hard-hitting, the organization should put in place short-term measures to help those affected recover from the effects.
WEEK 6 : Advocating for Social Justice
Viewing the landscape of today’s society, it is clear that multicultural and social justice issues have never been more visible. Although prejudice, racism and inequality have always plagued our nation, society is no longer keeping secret or turning its cheek to the omnipresent consequences of privilege and marginalization. Everyone is affected and everyone has a duty to respond, but nobody more so than those “working the fields.”
Gone are the days of counseling in a silo. Our clients live in the real world. And in the real world, our clients suffer privilege and marginalization. Counseling and counselors would be well-advised to prepare for the spectrum of cultural issues that we may encounter in session. In other words, we need to enhance our multicultural competence. Not only is it written into the ACA Code of Ethics, but it also just makes common sense. If we want to continue to work with, for and on behalf of our clients, we need to ebb and flow with the tide, and this is the tide.
If you are a counselor, you might think that you already possess a good deal of cultural competence, but let me unveil three common statements that can lead to a false sense of cultural competence.
1) “I took a class in my master’s program, and it covered a lot of material. I know the multicultural theories and models. I must be culturally competent.”
2) “I have three black friends, and my neighbor is from India. I know how to talk to people of color, and I know their cultural norms. I must be culturally competent.”
3) “I don’t stereotype. I don’t judge others. I must be culturally competent.”
I must confess that, as a white counselor, I’ve found those words bouncing around in my own head from time to time. I used them to strengthen my belief that I was a culturally competent counselor. That belief made me feel good about myself — even if it wasn’t true. Those statements assuaged the guilt I felt knowing that I actually wasn’t as competent as I should be. I used those statements as excuses to avoid growing and sharpening my counseling skills because it was an area that challenged me and even scared me a bit.
Admitting that those three statements, even if factual, did not make me a culturally competent counselor was scary. It meant admitting that I wasn’t as great as I thought I was and that I might not be serving my clients to the best of my abilities. It also meant that I had to do something about it. And change is scary.
But change can be motivating and liberating too. Becoming a better counselor is exciting. Learning new things is exciting. Instead of leaning away from multicultural counseling, I leaned in.NURS 4211 Essay Discussions
Advocacy is important to community practice because it furthers the social justice goals of practitioners and their community partners. First and foremost, advocates may promote community psychology values when efforts are directed toward changing systems that perpetuate social problems. Advocacy may also help practitioners and community members secure resources and reduce barriers for the populations they serve. These types of efforts may influence the social environment as they create dialogue between community practitioners, community organizations, and policymakers, which has the potential to frame how the issue is discussed. Nonprofit organizations and citizen action coalitions are often closest to the problem and can serve as a bridge between government officials and the people they serve. Furthermore, advocacy can be an important service to the community when practitioners act as a resource to policymakers by providing knowledge, guidance, and mobilization. Finally, advocacy may be an opportunity to develop knowledge, skills, and abilities for community psychologists as well as their partners in the community. In this chapter we present a foundation for advocacy and social justice in community psychology practice. We first define advocacy and social justice and follow with descriptions of the skills and abilities necessary to this work. We then discuss training, education, and experiential opportunities that may lead to the incorporation of advocacy and social justice with community practice. Drawing from the first author’s experiences, we end with two distinct case examples where advocacy strategies were used to promote social justice among under-served and marginalized populations. (PsycINFO Database Record (c) 2016 APA, all rights reserved) NURS 4211 Essay Discussions