The scope of responsibilities for advanced practice registered nurses (APRNs) has increased in the past years. One key task that constitutes an APRN responsibility is advocacy. APRNs serve as advocates for patients by availing them with adequate information to enable them make decisions that promote their health. They also conduct patient consultations thereby improving patient satisfaction and acting as a bridge between doctors and the sick (Schmerge, 2016). These healthcare professionals promote community health by spreading awareness on the prevention of diseases.
In the past, advocacy was not considered a responsibility of advanced practice registered nurses. Although they provide care to patients by examining, diagnosing, and treating them, this was not defined as advocacy. However, they are now considered advocates because they are primary care providers (Schmerge, 2016). Additionally, APRNs have a responsibility not just to their patients but also to the public. For instance, advocacy currently involves political and legislative actions such as petitioning to policymakers to improve health infrastructure for the public. APRNs also advocate for their profession by fighting the legal barriers to their practice.
One of the major issues in APRN practice is the regulatory framework that governs the profession. For instance, in some states, the law requires APRNs to be supervised by physicians. This restriction curtails advocacy because it prevents APRNs from performing to the full extent of their education and competence (Schmerge, 2016). A trend that can be observed in APRN advocacy is the increased blurring of roles between them and other medical professionals. Since advanced practice registered nurses act as advocates, they share this role with other healthcare providers such as physicians. Consequently, patients enjoy a high quality of care provided by the team-based approach adopted by these professionals.
Reference
Schmerge, M. (2016). Promoting Patient-Centered Team-Based Care: An Advocacy Toolkit. Yale School of Nursing Digital Theses, 1075. Web.
Registered Nurses are certified by the Australian nursing and midwifery accreditation council to operate in various sections of the hospital in conjunction with medical officers, neurosurgeons, physical therapists, specialty nurses, and psychotherapists. RNs play multipurpose functions and may be liable for harmonizing resources that encourage patient well-being (Duff, 2019). Different duties performed by RNs incorporate assessing and decoding patient characteristics, executing diagnostic examinations, giving out drugs, and planning therapeutic strategies. These clinicians are needed to prepare the patient for diagnostic tests, help in procedures and post-surgery attention, document and conserve health data and help during clinical tragedies.
The RNs can also work in non-medical units that affect their relationship with clients. They can manage, administrate, educate, research, advise, regulate, and policy development areas that influence safety, efficient service delivery in the profession, and use the nurses professional skills. RNs are accountable for independent practice in diverse structures and various medical experts (Muirhead & Birks, 2019). For the RNs to deliver services accordingly, they need continuous skill development and retain their competence for proficient service to humanity.
My Vision for Nursing
My vision in the nursing profession is for the registering bodies to evaluate nurses psychologically before the registration. The current standard and capabilities only check on education and skills and assume that expertise is the most important aspect of nursing. My idea is based on the fact that the nursing career is an emotionally demanding profession (Brennan, 2017). The practitioners handle the severe cases of the sick in the hospital daily. Some of the issues they deal with can be traumatizing, especially when patients die in their care. Physicians also create attachments with clients or vice-versa, which might escalate to the unprofessional association if not controlled, and this is only possible if the nurses emotional intelligence. Maintaining boundaries is a key ethical concern in the healthcare sector and can be achieved with mentally stable personnel. Emotional awareness and psychological care help in reducing work stresses. However, many nurses are not mentally capable of managing their career hardships (Van der Heijden et al., 2019). The above-stated are reasons the field is experiencing high employee turnover.
Ensuring that medics are mentally prepared to execute their mandates is important to individual workers, patients, and the profession. Physicians with psychological intelligence are more self-aware of personal issues that can hinder their practice and take precautions. Emotionally aware clinicians interpret peoples behaviors under their care and can handle their patients in a more understanding manner (Van der Heijden et al., 2019). Clients that come to health care facilities are emotionally drained and expect whoever they meet in the hospital to support them mentally. Secondly, these medics can maintain a good working relationship with their colleagues, fostering teamwork and a good working atmosphere and resulting in quality performance. It is hard to relate well with fellow workers when one has psychological burdens.
Past research supports my vision by highlighting the importance of mental preparedness for nurses. Smith and Yang (2017) indicated that psychologically resilient nursing students are better equipped to deal with stressful events when they begin practicing than their counterparts. Foster et al. (2018) argued that emotional resilience curriculums could enhance nurses selfefficacy and capability to genuinely assess traumatic circumstances and restrain their emotional reactions to patients and workmates. Badolamenti et al. (2017) stated that nurses who had a high emotional labor awareness had high professional competence. The latter mentioned aspect is fundamental to balance undertakings with an appropriate degree of detachment to achieve best practice responsibilities and offer better patient care amenities. Park and Park (2018) revealed that emotional intelligence among nurses significantly influenced their clinical performance, with high levels improving outcomes while lower rates were deteriorating success. The above-discussed findings show the criticality of psychological well-being among nurses. The nursing registration boards should have a psychological evaluation as the top priority.
Communication in Nursing
The interrelationship is an important aspect of every profession; students in all careers must have a communication skill unit that teaches them how to coexist in the corporate world. The nursing field is all about interacting with people, hence equipping the students with relational competencies. First, communication is key in passing information to patients. Nurses are intermediaries between the doctors and their clients, and they, therefore, require proper ways of delivering information is required in health care. Secondly, communication is essential in organizing various practitioners to achieve maximum service delivery. For instance, a treatment plan might require the services of doctors, surgeons, nurses, and gynecologists all at once, which means teamwork must be exercised, which can only be achieved through proper communication channels (Ardalan et al., 2018). Also, it is key in creating and maintaining therapeutic rapport between nurses and their patients. Further communication is vital in coordinating various sections in the hospital and passing messages from employees to employers. Tutors must equip Nursing students with relevant communication skills before they graduate or begin practicing.
Past research has established the importance of communication in the nursing profession. Jeong and Kim (2017) documented that clinicians understand the doubts, fears, and anxieties of the patients through communication and can communicate empathy. Chan et al. (2019) argued that communication is vital when caring for the psychosocial needs of cancer clients. Gharaveis et al. (2018) found that collaborative communication between personnel reduced security issues in community hospitals emergency departments. Sibiya (2018) established that communication is a central factor of good interactions, teamwork, and cooperation, indispensable facets of professional function. The eminence of communication in relations between clinical officers and patients has a significant impact on patient care outcomes. Advancing nursing communication can reduce therapeutic inaccuracies and make a difference in the patients healing process.
Studies in the above section have proved that there is no nursing without quality communication.
Communication improves service delivery in clinical settings. Nursing colleges should ensure that all students are equipped with the skills to enhance their interactions when practicing. Training on communication skills should also be practiced on jobs to ensure that practitioners practiced when they learned as they interact with their clients. Through communication, I will make my vision for registered nurses known to the nursing professional board.
Conclusion
The Australian board of nursing and midwifery documents the standards and professional practices nurses must follow before accreditation. The career functions mandate the medics to be alert in performing their duties, taking all ethical, legal, and socio-cultural considerations into practice. However, the board seems to have forgotten how to take care of the staff to ensure that they are mentally sound for maximum performance. It is, therefore, vital to psychologically prepare the nursing for their sake, clients, and the profession. My vision is to adequately prepare emotionally through education to ensure that the pressure that comes with the inability to handle stress and difficult patients is eliminated. This work also established that communication is one way for students to voice their opinions to improve professional programs.
Additionally, communication is vital for nurses who work to deliver information to both patients and doctors. Suppose the concerned stakeholders begin to prepare medics in all aspects when they are still in college. In that case, it will go a long way in hindering workplace burnouts and enhancing service delivery.
References
Ardalan, F., Bagheri-Saweh, M. I., Etemadi-Sanandaji, M., Nouri, B., & Valiee, S. (2018). Nursing Practice Today. Nursing Practice Today, 5(3), 326-334.
Badolamenti, S., Sili, A., Caruso, R., & FidaFida, R. (2017). What do we know about emotional labor in nursing? A narrative review. British journal of nursing, 26(1), 48-55.
Brennan, E. J. (2017). Towards resilience and well-being in nurses. British journal of nursing, 26(1), 43-47.
Chan, E. A., Tsang, P. L., Ching, S. S. Y., Wong, F. Y., & Lam, W. (2019). Nurses perspectives on their communication with patients in busy oncology wards: A qualitative study. PloS one, 14(10), e0224178.
Duff, J. (2019). See one, do one, teach one: Advanced perioperative nursing practice in Australia. Journal of Perioperative Nursing, 32(4), 3.
Foster, K., Cuzzillo, C., & Furness, T. (2018). Strengthening mental health nurses resilience through a workplace resilience program: A qualitative inquiry. Journal of psychiatric and mental health nursing, 25(5-6), 338-348.
Gharaveis, A., Hamilton, D. K., Pati, D., & Shepley, M. (2018). The impact of visibility on teamwork, collaborative communication, and security in emergency departments: An exploratory study. HERD: Health Environments Research & Design Journal, 11(4), 37-49.
Jeong, S. J., & Kim, K. H. (2017). Empathy ability, communication ability, and nursing performance of registered nurses and nursing assistants in long-term care hospitals. Journal of Korean Academy of Nursing Administration, 23(3), 249-258.
Muirhead, S., & Birks, M. (2019). Roles of rural and remote registered nurses in Australia: an integrative review. Australian Journal of Advanced Nursing, The, 37(1), 21-33.
Park, S. H., & Park, M. J. (2018). The effects of emotional intelligence, nursing work environment on nursing work performance in clinical nurses. Journal of Digital Convergence, 16(4), 175-184.
Sibiya, M. N. (2018). Effective communication in nursing. Nursing, 119, 19-36.
Smith, G. D., & Yang, F. (2017). Stress, resilience and psychological well-being in Chinese undergraduate nursing students. Nurse education today, 49, 90-95.
Van der Heijden, B., Brown Mahoney, C., & Xu, Y. (2019). Impact of job demands and resources on Nurses burnout and occupational turnover intention towards an age-moderated mediation model for the Nursing profession. International journal of environmental research and public health, 16(11), 2011.
Causal inference may be defined as the process in which the effect of a certain phenomenon is determined. As a matter of fact, people navigate the world every day on the basis of knowledge received from causal inference. Causes inferred from all types of data help solve problems. Thus, this process may be applied to the evaluation of the efficiency of the STEADI algorithm for the prevention of falls in senior patients in a small clinic in Florida.
In general, randomized controlled trials may be regarded as the standard for the establishment of causal inference. An ideal experiment implies the division of participants into treatment groups, and the average effect will be estimated through the averages of variables in groups. At the same time, randomized controlled trials may be expensive, time-consuming, or practically impossible, especially in small clinical settings. Thus, for a small outpatient clinic, causal inference may be inferred from observational data.
The STEADI algorithm includes three core elements screening, assessment, and intervention to identify vulnerable individuals, at-risk factors, and methods of fall prevention on the basis of received information. In order to evaluate its efficiency, the algorithm should be implemented in relation to adults aged 65 or older. First of all, they should be screened annually with a 12-question tool to distinguish patients vulnerable to falls (Eckstrom et al., 2017). Subsequently, their fall history and all risk factors, including medications, comorbidities, poor visual acuity, feet and footwear issues, and potential home hazards, should be assessed.
Finally, together with a patient, a specific intervention plan should be created to reduce identified risk factors. A period of follow-up may last up to 3 months; during it, a health care provider may address barriers if they appear to improve patient receptiveness (Centers for Disease Control and Prevention, 2019). After one year, it will be possible to compare the number of falls before and after the implementation of the STEADI algorithm to evaluate its efficiency. Referring to causal inference, it will be clear whether a particular cause (the algorithm) has an effect (reduced number of falls).
The nurse is experiencing a lot of challenges relating to the health and safety needs of the community. One of the challenges is that clinical services offered at community health are inadequate and inaccessible. For example, working parents cannot access clinics for their children because of inconvenient opening hours. Drug abuse is also a problem that the nurse might identify as a need. Most of the teenagers in the community are involved in drug abuse, destroying their physical, social, and mental health (Balamurugan, 2018). Thus, drug abuse and inadequate healthcare services are some of the challenges the nurse might identify.
Low socioeconomic status and inadequate educational facilities are other challenges that the nurse might identify as a need. In the case study, it is stated that the socioeconomic level of the areas is low. This means that most households have little income to afford basic needs such as food, shelter, clothing, health, and many more (Coupe et al., 2018). It explains why most of the households are covered by Medicaid and Medicare. Drawing from the case scenario, the community does not have enough educational facilities for learning. It has one high school, one middle school, and one elementary school. Therefore, the nurse is likely to identify low income and inadequate learning facilities as a need in the community.
Health Policy Relevance
Yes, the problems identified above have a health policy relevance. The problems can be addressed through a health policy initiative. The first problem that the nurse is facing is the excessive use of drugs by teenagers. To address this menace, an anti-drug abuse campaign policy can be developed by the clinic. The second problem is the lack of learning facilities in the neighborhood and can be addressed through a policy. The clinic can create a policy to enable them to focus on social justice and advocate for the rights of the people (Asakura & Maurer, 2018). The other problem is inadequate care offered to the community. The clinic can develop a policy to have flexible opening hours to enable working parents to access healthcare for their children to address this problem. Thus, these problems can be addressed by adopting relevant health policies.
Health Policy Development
The problem I have chosen for policy development is the lack of adequate learning facilities in the neighborhood. The area has one high school, one middle school, and one elementary school from the case study. The agenda of the policy is to increase the number of learning facilities in the area. With an adequate number of schools, the children will go to school and reduce illiteracy level. The stakeholders to help develop this policy are the clinics leadership, community leaders, social workers, politicians, and education leaders.
The nurse should use the following steps in the development of the policy. First, the nurse needs to inform the clinics leadership about the problem and focus on social justice (Lewinski & Simmons, 2018). Second, after obtaining approval from hospital leadership, the nurse should engage with the community leader, social workers, and educational leaders. Third, the nurse should inform the stakeholders on the importance of increasing the number of learning institutions. These steps help in the creation of an effective policy.
There is also a need to consider aspects for implementation and political issues. Some of the considerations for implementation are the availability of funds, human resources, and the number of children that the current institutions cannot support (Lewinski & Simmons, 2018). Political issues include lobbying to allocate funds for building the schools. Politicians play an important role in the allocation of funds for development in the community. The analysis for outcome involves checking the existence of additional schools built in the area.
Balamurugan, J. (2018). Drug Abuse: Factors, Types and Prevention Measures. Journal of Advanced Research in Humanities and Social Science, 5(4), 14-20.
Michigan Governor Gretchen Whitmer held an April 27 press briefing on Covid-19. The press briefing overall took around one hour and was mainly dedicated to COVID-19 related issues. The briefing had three main parts: Governor Whitmers pitch, followed by experts reports presented by Dr. Joneigh Khaldun, Gerry Anderson, and Wright Lassiter, and a Q&A session (Wood TV8, 2020). Governor Whitmer demonstrated the ability to communicate her message to her audience successfully. Her pitch was well structured, supported by facts, and presented appropriately. As COVID-19 had hit the State of Michigan particularly hard, Governor Whitmers attention to the details was significant. She used printed reports and invited experts to support her performance and ensure people could get the best possible answers to their concerns. Governor Whitmer is a talented and experienced speaker; thus, this paper will analyze her speech in more detail.
Governor Whitmer opened her speech by informing her audience regarding order 2020-63, which had been signed. A short explanation of the orders importance followed by the clear statement that they continue to flatten the COVID-19 curve. Within the first 40 seconds, Governor Whitmer managed to demonstrate her empathy towards the listeners and introduced them to the main subject. Grabbing the attention of the listeners, she provides the next valuable insights dedicated to business owners. To ensure the message will reach the audience in an intended manner, it was adequately articulated and supported by all necessary information. It took her about 40 seconds to cover the topic; her clear, rhythmic voice and constant eye contact with the audience benefit to channel the message.
As Governor Whitmer moved to the next part of her speech dedicated to health insurance via The Healthy Michigan Plan, she again mentioned the audience at the core of the message. Governor Whitmer did a great job constantly gathering her audience around a key message delivered. Her speech took around 12 minutes, and she covered more than a dozen topics. In general, all of them were well structured and professionally presented in the described above manner. Nevertheless, Governor Whitmers speech had some issues, which often follow speakers who work under enormous pressure (Luoma-aho & Canel, 2020). For instance, during her speech, she stammered a few times. She worked with loads of numbers, names, and facts, and it is not surprising she had some minor difficulties in presenting them. Ideally, a speaker has to rehearse her speech until it is perfect, but unexpected interference can negatively affect the whole performance (Viera, 2019). Thus, it is crucial to learn how to stay on track no matter what, and Governor Whitmer demonstrated a remarkable ability to do that. Each time she faltered, she instantly regained the audiences attention due to the intonation, the power of her voice, and the contact with the audience. It is also worth noting that her gestures always remained calm and relaxed.
Governor Whitmers press briefing on Covid-19 held on April 27 is an example of a well-prepared speech; there, the speechs general elements help maintain the audiences attention and effectively convey the message. Over the years of professional practice, Governor Whitmer has developed self-confidence, the ability to work with an audience and report the facts and numbers while avoiding monotony and disinterest. Her speech was short and concise, which contributed to the assimilation of complex information by the audience. Due to her speech, Governor Whitmer managed to maintain her professional image and show people how the state and society cope with the current challenges.
References
Luoma-aho, V., & Canel, M. J. (Eds.). (2020). The handbook of public sector communication. John Wiley & Sons.
Viera, E. T., Jr. (2019). Public relations planning: A strategic approach. Routledge.
A commitment to academic ethics is essential when conducting statistical analysis as a research tool. Two pillars of such ethics are anonymizing the data and obtaining informed permission from respondents. These standards are compassionate in clinical research, where patient personal information and medical history are used as data. Understandably, not all patients are willing to provide personal data for publication, but on the other hand, clinical trials require accurate statistics and cannot be based on hypothetical values. This paper attempts to determine which of two strategies for using personal data, anonymization or pseudonymization, is the most acceptable for clinical research.
Definition of Terms
Both anonymization and pseudonymization refer to the processing of data of clinical significance used in research. Anonymization should be understood as depersonalizing medical information, avoiding the use of personal data, and presenting research-useful material in an anonymous form that completely eliminates the possibility of comparing such data to real people (MENTIS, 2019). In contrast, pseudonymizing data allows each of the data strings to be provided with a pseudo-identifier that is irrelevant to the reader but allows researchers to link the data to a specific respondent. Thus, both practices refer to data masking, but anonymization completely eliminates the possibility of matching, whereas pseudonymization leaves that possibility if additional information or a decryption key is available.
Scenario #1. Using Data Without Obtaining Consent
Obtaining consent from patients to use their data in specific studies takes time, and there is always the possibility of refusal. Both time commitment and refusal are not desirable for clinical trials. For this reason, the most reasonable practice in this scenario is to anonymize medical data so as to eliminate the possibility of linking it to real people. The use of non-consensual data is a rather sensitive topic, which means that the risk of litigation costs and reputational losses is high if research data are matched with real people. In this sense, pseudonymization does not solve the problem of eliminating this possibility, whereas complete anonymization meets the needs of clinicians.
Scenario #2. Use of Financial Data.
Patients financial data is also a sensitive topic, as a rare person would want to disclose their socioeconomic status and income to unknown people. At the same time, if a patient can afford to spend much money in medical facilities, then identifying him or her is associated with personal security risks. Therefore, as in the first scenario, an intelligent solution would be to use complete anonymization of the data, eliminating the possibility of identification. For the tasks of clinical trials, this approach will be sufficient since the data on insurance costs and the patients personal spending do not need to be accurately identified and can ultimately be used anonymously. This protects the safety of respondents and the reputation of clinicians, something that data pseudonymization practices cannot provide.
Scenario #3. The Need for Patient Connection
Some of the clinical research is aimed at solving applied problems, so the results of such research are of particular relevance to medical institutions. For example, studies of rare or fatal diseases may yield results that show the effectiveness of specific treatments or palliative care programs, so such work has not only theoretical but also tangible, practical value. The research design proposed in the scenario meets this characteristic, and so there is a need to use pseudonymization of the data. In this case, the researcher assigns a cipher to each of the respondents and publishes the data virtually anonymously. The reader will never know the patients identity, but the researcher always retains the ability to relate specific data to the person in a way that can be shared later and offer any of the solutions found. Anonymization would not be appropriate in this context, as in this case, even the researcher loses the opportunity to decipher the data and address the respondent directly.
Conclusion
To summarize the analysis above, it is paramount to note that both anonymization and pseudonymization are successful and practiced data masking methods. They cannot be compared in terms of effectiveness, as they are simply different strategies their choice is motivated by the authors need for follow-up. In the case of anonymization, there is no way to identify the patients identity, even for the researcher; independent parties or software can be used for this practice to anonymize the information thoroughly. In contrast, with pseudonymization, the researcher retains the ability to identify the respondent from the results of the study. For example, this is realized by using the decryption key that was previously used to encode the raw data. From the readers point of view, both options appear largely impersonal, but one cannot rule out the possibility that one of the readers might one day be able to figure out which patient the study is talking about. This raises threats to the personal safety and reputation of the clinician. It was shown that in two of the three scenarios, clinical data anonymization strategies were appropriate because their themes were related to data sensitivity; this involved personal information and financial information. In the third scenario, there was a need to relate the research findings to actual treatment practice, so in this case, anonymization would be useless, whereas pseudonymization would meet the needs of the researcher.
Reference
MENTIS. (2019). Anonymization vs. pseudonymization. Medium. Web.
Katsi Cook was born on January 4, 1952, in the Mohawk Tribe of St. Regis. Her father was a World War II and Korean War pilot, and he died in a plane crash when she was nine months old. Her mother grew up in Quebec and was educated by Catholic nuns; she also passed away early, her daughter was only eleven. For the rest of her childhood, Katsi lived with her grandmother, a midwife who helped with the birth process of many babies in Akwesasne. Cook was educated at a Catholic boarding school, though as a teenager, she began practicing the traditional religion of the longhouse. She attended Skidmore College and then transferred to Dartmouth as part of the schools first female class (Follet, 2005). Katsi decided to become a midwife after attending the inspiring Six Nations Loon Lake Conference.
Cook completed an internship in spiritual midwifery on a farm in Tennessee, followed by a clinical fellowship at the University of New Mexicos Womens Health Program. She was struck by womens lack of knowledge about reproduction and birthing traditions and recognized this loss of self-knowledge and cultural traditions as a consequence of colonization. This realization, combined with the communitys concern for sterilization of indigenous women, led Katsi to reassert childbirth as a critical factor in the healing and survival of the community. She made a substantial contribution to the process of empowerment through which women revitalized original culture. One of her most remarkable aidings is research in environmental degradation and maternal and fetal health. In subsequent investigations, Cooks reservations have acted as a bridge between the community, scientists, and government officials. Her historical background contributes to the peculiarities of a midwife career (Follet, 2005). Katsi has helped to understand the necessity to empower women and promote policies oriented to prevent cycles of violence in society.
Influencing Factors
An essential and the first sociological factor that inspired the heroine were the conversations of uncles. While still a child, she heard discussions about power and encroachment on the land belonging to the tribe. At the same time, she attended a clan meeting with her uncle, who headed it. Thus, feelings of social influence and political injustice caused the formation of womens opinions. Life in the tribe, which honored its traditions and legends about the struggle for rights, had a significant impact on the development of Katsis worldview (Follet, 2005). Additionally, political conferences on sovereignty motivated her contest for the medical rights of tribal women, primarily to ensure proper conditions for childrens birth.
It is valuable to note that cultural factors such as language and religion have affected Katsi Cook. The woman was able to learn the basics of nursing and midwifery because she knew the native language of the tribe and English. Many other inhabitants of her local society did not have such opportunities. The pernicious cultural habits of the tribe, which led to HIV, had a high impact on the formation of Katsi ideas. Thus, considering cultural, social, and political factors, the woman was determined to help renew cultural integrity. Moreover, many other midwives share the view that the government should pay attention to childbearing. Nonetheless, each tribe must have at least one midwife to control womens health (Follet, 2005). That is, these social, political, and cultural factors are relevant to future generations of obstetricians and have a meaningful influence on the choice of this profession.
Valuable Lessons
Katsi Cook is a faithful leader who practices midwifery to reestablish social integrity and attain environmental fairness through womens empowerment. Her speeches and guidance can be regarded as a real inspiration to future midwives. Above all, it is worth learning from her leadership skills and a commitment to continuous and uninterrupted education. In order to be successful in a career, it is necessary to constantly practice and gain new knowledge. One of the lessons that Katsi is trying to show us is environmental importance (Follet, 2005). It should be remembered that reproductive health and pollution are not parallel systems; they are connected. Consequently, it is necessary to limit the influence of negative factors on a woman and her unborn child. It is essential to monitor the future mothers health regularly and make all necessary appointments to maintain it in an excellent condition.
Katsis example inspires me to explore the well-being difficulties of local people. Thus, it will serve to identify problems that need to be addressed urgently. Furthermore, sacrifice and the desire to help women in childbirth is a fundamental feature of our profession (Follet, 2005). I hope to be as dedicated to working in the health care system as Katsi, and my contribution to womens reproductive care will be significant. It is also valuable for me to make an attempt to create a global mechanism for caring for womens procreative health. Therefore, I would like to continue Katsis work in cooperation with government agencies to implement comprehensive assistance to various tribes. In the future, I hope to establish organizations that will also be responsible for raising public awareness of womens health and the birth process. Moreover, I believe that my colleagues will support this idea, and we will now be capable of conducting gynecological consultations for poor people. It can be the first step towards access to obstetrics for everyone.
Reference
Follet, J. (2005). Voices of feminism oral history project: Katsi Cook. Sophia Smith Collection.
This post is completely correct in pointing out that nursing education is crucial in developing competencies that have a positive impact on clinical competencies and patient outcomes. There is no denying that statistically speaking, an increase in the number of nurses with BSN translates to better quality care for patients. For example, simulation-based training integrated into BSN education programs is directly connected to an increase in confidence and knowledge. This increase, in turn, translates to better chances to detect a clinically deteriorating patient reliably and perform an appropriate intervention in a timely fashion (Crowe, Evart, & Derman, 2018). Overall, it would be hard to argue that a high0quality nursing education is definitely conducive to better clinical performance and improved patient outcomes.
Yet the important thing to remember is that high-quality remains the operative word, and, unfortunately, it is not always the case with nursing education in its current shape. For example, there is considerable variability in the nurses competency in evidence-based practice (EBP), and this assessment includes nurses with BSN as well (Melnyk et al., 2018). It suggests that not all academic programs ensure EBP competencies with an equal degree of efficiency despite the fact that these are positively crucial for successful nursing practice. As mentioned above, a greater number of nurses with BNP leads to better patient outcomes, and nurses with BNP report somewhat higher levels of competency in EBP than those without (Melnyk et al., 2018). These statistics mean that, in a grand scheme of things, the proportion of efficient educational programs is greater than that of less-than-efficient. Still, there is definitely room for improvement, and it is necessary to remember that it is the quality of nursing education rather than the mere fact of it that translates to better outcomes.
This post raises an important point discussing the differences between Doctor of Nursing Practice (DNP) and Doctor of Philosophy of Nursing (PhD). It is true that these terminal degrees in nursing differ in focus, intended purpose, and the time needed to complete them alike (Nickasch et al., 2018). The post does a good job of outlining this difference: while DNP is generally practice-oriented and focuses on the application in clinical settings, the PhD is mainly research-oriented. There is also no arguing that ones nursing education, including the potential choice between DNP and PhD, should be taken in the context of ones aspirations and intended career path.
That being said, it is necessary to emphasize that the differences between DNP and PhD are not set in stone and do not amount to a strict division of labor that rarely, if ever, transcends the divide between the two. While research focus is commonly associated with PhD, this association should not serve as grounds to omit the DNPs roles as scholars. If anything, achieving a DNP requires one to be a competent scholar and researcher in ones own right and complete a scholarly DNP project. Moreover, some argue that the best way to foster these scholarly competencies is to promote DNP-PhD collaboration by pairing DNP-PhD faculty in DNP projects to assist DNP students comprehensive professional development (Carlson, Staffileno, & Murphy, 2018). In nursing, scientific research and practical application should go side by side, which is why the effective cooperation between PhDs and DNPs is positively crucial to move the nursing profession forward. Thus, while there are undoubtedly differences between these degrees, one should not perceive the two as firmly rooted in their respective specializations that rarely cross.
References
Crowe, S., Ewart, L., Derman, S. (2018). The impact of simulation based education on nursing confidence, knowledge and patient outcomes on general medicine units. Nurse Education in Practice, 29, 70-75. Web.
Melnyk, B. M., Gallagher-Ford, L., Zellefrow, C., Tucker, S., Thomas, B., Sinnott, L. T., Tan, A. (2018). The First U.S. study on nurses evidencebased practice competencies Indicates major deficits that threaten healthcare quality, safety, and patient outcomes. World Views on Evidence-Based Nursing, 15(1), 16-25. Web.
Carlson, E. A., Staffileno, B. A., Murphy, M. P. (2018). Promoting DNP-PhD collaboration in doctoral education: Forming a DNP project team. Journal of Professional Nursing, 34(5), 433-436. Web.
Nickasch, B. L., Lehr, M. M., Schmidt, B., Henne, T., & Wippich, C. (2018). Current perceptions: The DNP-PhD divide. Journal of Doctoral Nursing Practice, 11(2),107-113.
The purpose of this quasi-experimental study is to identify the programs potential to attract participants. The evaluation of clinical projects is often associated with the collection of quantitative data (through experimental or quasi-experimental designs) to identify the exact quantifiable outcome of the project (Cannon, 2017). Hence, the number of drug users applying to take part in the harm reduction program before and after the project implementation will be estimated. The number of the current participants and applicants of the existing program for drug users will be calculated at the beginning of the project. Records analysis will involve all the participants and applicants (irrespective of the participation status). Even those who withdraw from the project at any time during its implementation will be noted as participants.
At the end of the project, the number of the participants of the project and applicants for a new program (that will start right after the proposed incentive) will be calculated. The independent variable is the proposed harm reduction program that aims at attracting a larger audience and helping more drug users. The manipulated measures (in this case, the number of attracted people due to the developed project) are the dependent variable that is measured to capture the changes, if any (Eldridge, 2017). Thus, the dependent variables will be the number of applicants to a new project and the overall number of participants in the proposed project.
Such demographic data as age, gender, ethnicity, marital status, education, and employment will be noted. This information is necessary for the particular impact of the developed project on different cohorts (Eldridge, 2017). These findings will be utilized to further improve the program and make it more effective with different populations. The number of people who withdraw from the program will also be analyzed, and the reasons for their withdrawal, if available, will be analyzed.
The analysis of quantitative data is now facilitated by the use of technology. SPSS software will be utilized for the purpose of this study in order to ensure the reliability of the findings. As far as demographic data, descriptive statistics will be employed. This data analysis method is common as it enables the researcher to capture the peculiarities of the participants that can have an impact on the overall outcomes of the study (Ellis, 2016). The demographic characteristics of the applicants to the project before and after the implementation of the proposed harm reduction program will be compared. This analysis can help in identifying the exact cohorts interested in participating in the program.
The number of applicants to and participants of the harm reduction project before and after the proposed program will be calculated, and the change rate will be noted. The inferential analysis is instrumental in identifying the effectiveness of certain measures (Ellis, 2016). It is expected that the number of drug users seeking help through participation in the proposed harm reduction incentive will increase. In order to validate the results, the statistical significance will be measured with the help of the p-value analysis (Stockert, 2018). By checking the null hypothesis, the researcher may ensure that the developed program has certain outcomes and leads to statistically significant changes (Stockert, 2018). If the p-value is 0.05 or lower, the correlation between the measured variables will be seen as statistically significant. Therefore, the data are reliable and reflect the exact effects of the initiative.
References
Cannon, S. (2017). Quantitative research design. In C. Boswell & S. Cannon (Eds.), Introduction to nursing research (pp. 111-134). Jones & Bartlett Publishers.
Eldridge, J. (2017). Data analysis. In C. Boswell & S. Cannon (Eds.), Introduction to nursing research (pp. 375-402). Jones & Bartlett Publishers.
Ellis, P. (2016). Understanding research for nursing students (3rd ed.). Learning Matters.
Stockert, P. A. (2018). Evidence-based practice. In P. A. Potter et al. (Eds.), Essentials for nursing practice (9th ed.) (pp. 83-99). Elsevier Health Sciences.
Patient information: A. M., a 14-year-old Caucasian male.
Subjective
Chief Complaint: fever, nausea, multiple vomitus, and diarrhea.
History of present illness: The patient, a 14-year-old Caucasian male, came with his mother with a chief complaint of nausea, vomiting, and changes in the stool. The condition started one day ago with vomiting after eating cake at a friends birthday party. In 2 hours temperature 100,4 F and diarrhea with a strong smell, liquid, mucoid, and of greenish color. Within 24 hours, the patient vomited six times and went to the bathroom seven times. The patient cannot identify the foreign substance in vomit; the mother claims no signs of blood, brown or black color in vomit or stool. Any attempt to take some water, medication, or food end with nausea and recurrent vomiting. The mother of the patient also claimed six other children from the birthday celebration (three days ago) got similar symptoms.
Location: ventricle and small intestine Onset one day ago.
Character: recurrent vomiting and diarrhea Associated signs and symptoms: gastritis and duodenitis.
Timing: gets worse after any water or food intake.
Exacerbating/relieving factors: the absence of water and food intake.
Severity: 6/10.
Current medication: no previous medication intake.
Allergies: no known allergies.
Past Medical History: Vaccines: HepB (2006), DTaP, Tdap (2012), Hib (September 2019), IPV, PCV, MMR (2010). PMI: tonsilitis (October 2019), chickenpox (September 2013). No surgeries.
Social & Substance History: Studies in 8th grade, normal performance at school. Relationship with family and peers: well. Denies smoking or alcohol intake. Lives in an apartment with his mother and father.
Family History: mother, 45 y/o, healthy. Father, 47 y/o, has COPD. Grandfather from fathers side has HTN, AFib.
Mental History: No history of depression or anxiety. No growth, development, and psychological issues.
Violence History: Not known.
Reproductive History: Not sexually active.
Review of Systems
General: Weight is stable, with no temperature deviations, weakness, or fatigue.
Heent: Eyes: Vision functions are symmetrical, no blurred vision, double vision, and sclerae are clear. Ears, nose, throat: Hearing is bilateral; No runny nose, sore throat, sneezing, or congestion.
Skin: Clear.
Cardiovascular: No chest pain, pressure, or discomfort. No visual palpitations, and extremities have no signs of edema.
Respiratory: Breathing is calm, not shortened, with no sounds, no cough, or sputum.
Gastrointestinal: Vomiting six times per last 24 hours, diarrhea seven times for the last 24 hours. Abdominal pain in the epigastric region, no heartburn, no blood in the stool.
Genitourinary: Urination is painless, 3-4 times per day. Genitals with no visual signs of anomalies. Not sexually active.
Neurological: No headache, no history of trauma, dizziness, syncope, paralysis, ataxia, aphasia, dyslexia, or numbness in the extremities.
Musculoskeletal: Muscle contraction is symmetrical, no cramping, no muscle pain, no back or joint pain.
Hematologic: No dizziness, anemia, no bleeding, no bruising.
Lymphatics: Lymphatic nodes are not enlarged.
Psychiatric: No history of depression or anxiety. Psychological issues: Sleep distribution, stress because of the condition.
Endocrinologic: No signs of heat intolerance. No known history of polyuria or polydipsia. No growth and development issues.
Reproductive: Not sexually active.
Allergies: No signs of asthma or allergies.
Objective data
General: Vital signs height 64.0 in, weight 139.0 lbs, BMI 23.9 (Norm but at risk of overweight), BP 121/65 mmhg, temperature 100.4 f, pulse 71 beats/Min.
Heent: Eyes: Perrl, conjunctivae, sclera clear. Tms normal bilaterally.
Tonsils & pharynx: Clear.
Skin: Clear.
Cardiovascular: Heart sounds S1, S2 normal; No S3, no S4, no murmurs.
Respiratory: Chest exam reveals good air entry bilaterally. Clear to ippa with no adventitious sounds heard.
Gastrointestinal: Abdominal exam reveals positive bowel sounds, soft, non-tender to palpation in all quadrants. Hyperactive bowel sounds. Surface palpation is painless, deep palpation identifies pain in the epigastric spot. The stool is liquid, mucosal, of green color, and strong smell.
Genitourinary: Urination is painless, 3-4 times per day. Not sexually active.
Neurological: Neurologic exam is unremarkable; The patient is alert and appropriate for age.
Musculoskeletal: No deformities, full range of motion.
Lymphatics: Peripheral nodes are not palpated, painless.
Endocrinologic: Thyroid gland is not palpated.
Diagnostic results
Provisional diagnosis is acute gastroenteritis ICD-10 A09. Before the identification of the pathogenic agent, the diagnosis remains syndromic (Shane et al., 2017).
Assessment
Priority diagnosis in this clinical case is acute gastroenteritis (ICD-10 A09) as the patient has signs of gastritis (vomiting six times per day), enteritis (snagged stool sample: liquid, mucosal, of green color, and strong smell), and intoxication (fever 100.4 F). Acute beginning, fever, and involvement of the other children from the birthday party narrow the diagnostical search around gastrointestinal infectious disorders caused by viruses or bacteria.
Differential diagnosis:
Crohns disease (ICD-10 K50.1). A chronic disorder affects mostly the large intestine that has an inflammatory nature (Feuerstein et al., 2021). Nowadays, the pathology is more frequently met among adults and children and is believed to be multifactorial. The combination of genetic, and environmental factors, disbalance in gut microbiota, and non-regulative immune reactions lead to the initiation of the disease. Among the symptoms: are chronic abdominal pain, diarrhea, ulceration of the intestinal mucosa, and narrowing of the intestine lumen (Torres et al., 2017). Even though abdominal pain, diarrhea, vomiting (if the ventricle is damaged), fever refer to Crohns disease, the acute onset, stool characteristics, and the anamnestic connection with food intake (cake), and acute development of symptoms of other children, does not claim for the proposed differential.
Diarrhea-Predominant irritated bowel syndrome (ICD-10 K58.1). A functional disorder of the gastrointestinal tract that is interfering with the patients everyday life and life quality. Induced by stress, diet specialties, and possible genetic predisposition, IBS becomes a chronic disorder that is also met among children (Devanarayana & Rajindrajith, 2018). IBS has two types: diarrhea-predominant and predominant constipation. According to the diagnostic criteria, IBS must cause abdominal pain a minimum of 4 days in one month; changes in the frequency of defecation change the appearance of stool. However, the fact of the changed stool of the patient is not stress-related or diet-connected. Moreover, the episode developed fast and is the first in the patients history. Fever is also not a characteristic sign of IBS and cannot be caused by the irritated mechanisms of the pathogenesis.
Acute respiratory syndrome (ICD-10 B34.2). In the current circumstances, it is hard not to mention COVID-19 infection which initially might start with gastrointestinal symptoms such as diarrhea, fever, and vomiting (DAmico et al., 2020). The major chain causing diarrhea is the straight alteration by the virus enterocytes. The fever and diarrhea can be explained by the viral infection; however, the patient does not have any respiratory complaints. For the precise differential, it is essential to monitor the patients condition in case of new symptoms appearance.
Plan
Diagnostic plan: Stool testing for Salmonella, Shigella, Yersinia, C. difficile, and STEC (Shane et al., 2017).
Treatment: non-pharmacological step zero: hygiene to break the fecal-oral chain of transmitting. First-line therapy: oral rehydration 100-120 ml more judging the number of vomiting, additionally to the daily intake (salty water, juices, other liquids). According to USPTF, it is essential to focus on long-term perspectives in children under 18 screening (Kemper et al., 2016). Health promotion includes explanation of the possible agents that cause food poisoning, the importance of hygiene (hand washing).
Reflection notes
Due to this assignment, I have comprehended gastrointestinal syndromes can be met in various pathologies in different fields of medicine. During the patients examination, my aha moment was the connection to the cake intake and the number of other children with similar symptoms. The mother provided more specific information on HPI and the characteristics of the patients emissions. This can be explained by the mother being more attentive and accurate. In a similar patient evaluation, I would be more accurate with examining teenagers as they are more sensitive to personal questions and doctor examinations.
Kemper, A. R., Mabry-Hernandez, I. R., & Grossman, D. C. (2016). U.S. Preventive services task force approach to child cognitive and behavioral health. American Journal of Preventive Medicine, 51(4), S119S123. Web.