The introduction and literature review presents an important basis of research papers which defines the importance of the research. In this paper, the introduction and literature review thoroughly explain the researchs main goal and the nursing theories that will be used in the research. However, a more consistent presentation of important information and findings in the paper can significantly improve the overall quality of the research paper.
The theoretical framework part provides historical background to the nursing theories used in the research paper. Furthermore, important aspects of each nursing theory are described in this part of the paper. Thus, the initial list of theories that will be used in the paper featured at the end of the first paragraph provides a summary of the theories and their possible applications in the project. However, it will be more logical for the sequential narration to list the nursing theories at the beginning of the segment and explain their benefits in application to the project in a separate ending paragraph.
Furthermore, the literature review part features an extensive summary of findings on the topic of the correlation between depression and eye diseases. Thus, the review covers a wide range of studies on the negative effects of eye diseases on an individuals mental health. However, the quality of the literature review could be greatly improved by a more consistent exploration of relevant findings. For example, it would be more informative to start the literature review with depression and visual impairment statistics by stating that 3.8% of people experience depression and 8.1% have a visual impairment (WHO, 2021; McCann et al., 2022). The transition from the broad topic of the correlation between depression and visual impairments to more specific issues, such as possible causes and adverse effects of serotonin reuptake inhibitors, can also improve the papers consistency.
The review found no significant shortcomings in the papers theoretical framework and literature review. The research features a significant evidence basis from relevant findings, which increases its credibility. However, a more consistent narrative in the exploration of nursing theories and relevant findings can significantly improve the quality of the paper. Therefore, slight corrections in the papers organization will create a better impression on the research papers readers.
The 2015 Sustainable Development Goals established by the United Nations state that all Member States have agreed to pursue the progressive implementation of universal health coverage (UHC) to achieve this goal by 2030. This commitment includes ensuring all people have access to essential health services without exposing them to financial hardship. The US, which historically used a mixed private-public approach in healthcare, is the only post-industrial society where UHC is not an integral part of the health system. Cons of the UHC system include significant up-front investment, delayed medical care, and constraining medical progress due to the general inefficiency of government-run healthcare.
The considerable geographic size and racial/ethnic and economic heterogeneity render UHC deployment extremely challenging from a financial standpoint. Cost estimations for the universal healthcare proposal range between $-32-44 trillion over ten years, whereas deficit estimations fluctuate between $1.1-2.1 trillion per year, or approximately 5-10% of annual GDP (Zieff et al., 2020). Furthermore, Barber et al. (2020) note that cost, like UHC, is not a fixed point but a function that involves substantial variables, ranging from variations in provider payment rates to healthcare system efficiencies (p. 2). In other words, higher health expenditure would not necessarily correspond with a parallel improvement in implementation performance, which could widen the annual budget deficit and disbalance the federal budget. To compensate for this deficit, the government would have to increase federal taxes, possibly for all citizens. Even a moderate proposal of a 4% income tax plus a 7.5% payroll tax on all citizens, with higher taxes for higher-income citizens, would be not sufficient to sponsor this plan (Zieff et al., 2020). Thus, the implementational of UHC may likely be not pragmatic and feasible as in developed countries due to the massive upfront costs.
Alongside federal and individual costs, UHC, due to its bureaucratic government-run nature, would likely result in the general inefficiency of the healthcare system, significantly extending wait-times. Beyond perceived inefficiency, in the UK, for instance, the average wait-time for hospital-based care was 46 days, with some patients even waiting for over a year (Zieff et al., 2020). Along similar lines, lengthy wait-times due to universal healthcare are reflected in Canadians, who were waitlisted for 1,040,791 procedures, with the median wait-time for arthroplasty surgery ranging from 20-52 weeks (Zieff et al., 2020). These inefficiencies caused by the extensive restructuring in the healthcare system would significantly tamper with an individuals ability to obtain timely medical care, involving inconveniences in arranging appointments, office hours, and lengthy waiting times. This delayed medical attention, combined with the bureaucratic slowdown, would only exacerbate the health disparities for the under-treated marginalized segments of the population, including uninsured citizens, ethnic/racial minorities, and new immigrants (Tulchinsky, 2018). Essentially, the surged care visits due to removing the financial barrier between private and public healthcare, combined with the general wastefulness characteristic of bureaucratic intervention, would likely entail subnormal delayed medical care.
Moreover, the healthcare system inefficiencies due to significant government intervention would likely hinder medical entrepreneurship. The failure of the Clinton health care plan proved that managed care systems are markedly more efficient at cost-containment than the government, which explains their subsequent tremendous growth (Tulchinsky, 2018, p. 25). The rhetoric around the Clinton proposal was characterized by big government inefficiency and government meddling that could hinder medical innovation (Zieff et al., 2020, p. 2). In fact, without bureaucratic intervention, managed care systems, including HMOs, PPOs, and Medicaid, were able to develop a series of important innovations in health care delivery, payment, and information systems (Tulchinsky, 2018, p. 25). Moreover, the multisectoral deployment of UHC over an extended period would detract the scarce healthcare workforce from public health leadership, further reducing the efficiency of innovative management systems of health maintenance organizations (Barber et al., 2020). The red-tape intervention in implementing UHC would increasingly embroil healthcare systems in bureaucratic complexities, hindering healthcare entrepreneurship.
In summary, the disadvantages of implementing UHC in the US include significant upfront costs, untimely provision of healthcare, and impeding medical innovation due to the red-tape nature of government intervention characterized by general inefficacy. From a pragmatical view, these challenges render UHC deployment disadvantageous on the financial, service, and medical development fronts. The egalitarian progress towards healthcare equity might come at the cost of timely care and medical progress.
Nurse retention refers to the rate at which nurses remain in their current positions. Nurses are essential members of the healthcare workforce and are necessary for ensuring quality care for patients. Nurse retention is meant to ensure that the number of nurses practicing is sufficient to meet the needs of the populace. Nurse retention requires the input of many players within the healthcare field to ensure that the numbers remain effective in meeting patient needs. Improving nurse retention includes the employment of various leadership strategies that make the work environment encouraging for the workers to remain within their positions. This essay explores the mechanisms that can be used to increase nurse retention as a mechanism of bettering the healthcare environment. These include improving staffing, choice of a preceptor, onboarding process, modification of work conditions, improved assignment of responsibilities, and improving communication channels. The final part of this essay is the conclusion which provides a summary of all the suggests and reiterates the need for nurse retention.
One of the greatest causes of movement into other careers by nurses is the workload they are subjected to in the hospitals. Nurses are amongst the busiest members of any workforce across the globe, and this makes them easily fatigued. This is due to the inadequate numbers, and the ratio of nurses to patients is not as per the requirements of the World Health Organization. The inadequacy means that the nurses must conduct duties that should be conducted by other nurses (Cho et al., 2019). This leads to fatigue, and the work impedes the health and wellness of nurses in general. The healthcare system must address this challenge so that nurses can have sufficient time outside the workplace. The time consumed by the nursing profession, in general, is excessive, sometimes above the recommended working hours, as nurses are required to do overtime. This interferes with their personal lives and their ability to establish meaningful social connections. Employing more nurses will be critical in ensuring that this ratio is improved and more people are inspired to become part of the nursing profession.
Choice of an Effective Preceptor
A preceptor is an indispensable component of the healthcare environment, required for smooth operations. The right choice of a preceptor is crucial in ensuring new nurses maintain their positions within the workforce. The highest number of nurses deviate from their careers earlier on before they have gained effective experience that can create sustainable resilience. The role of a preceptor is to ensure that these nurses have sufficient encouragement to remain within the field during these early years (Whitehead et al., 2022). The functions of an effective preceptor should include providing encouragement and emotional support for the incoming nurses. They should also foster cooperation within the healthcare facilities to ensure the voices of new nurses are heard and their input considered in processes. The preceptors should also offer constructive feedback that is geared towards encouraging positive development in career practice, alongside a desire for an upward progression. These actions by a preceptor are likely to improve job satisfaction, foster professional relationships, and ultimately increase retention.
Bettering the Onboarding Procedures
Onboarding time within the nursing profession has recently experienced an increase since the onset of the COVID-19 pandemic. This is exhibited by the generalized confusion amongst healthcare workers and the diminished ability to meet various targets set by the healthcare management. Nurses are therefore forced to quit their careers and consider other alternatives due to the confusion and frustrations experienced. Standardizing and streamlining the onboarding process is a minimum that will ensure nurses settle into their stations faster, discharge duties better, and experience greater satisfaction from serving their people. Onboarding processes are also likely to accompany greater clarity for the other participants in the healthcare process (Kester, 2020). A generalized sense of understanding of function and integration of collaboration within the general operations are essential in the attainment of nurse retention.
Modify Current Work Conditions
Current working conditions are unfriendly to nurses and do not encourage retention, instead of leading to massive turnovers. The challenges experienced by nurses can be best described by these professionals. Nurses should be engaged in informative forums where they offer their thoughts on the current status quo and suggest modifications to the work environment, which can increase retention. Some of the overriding modifications that can better the lives of many nurses across the nation include better remuneration. Sufficient pay is part of any professions demand, and nurses are not an exception (Munro & Hope, 2022). The additional pay includes adjusting their salaries for things such as inflation, amongst other economic parameters. This is likely to ensure that nurses fully focus on their role within the healthcare centers instead of seeking alternative methods of making additional payments. Nurses can also benefit from overpaying benefits within the facilities if they attend to patients for periods greater than those stipulated in their employment contract. This can serve as motivation and foster dedication to the profession, eliminating turnover and increasing retention.
Improved Assignment of Responsibilities
Improved assignment of responsibilities within any healthcare facility is the height of guaranteed performance. Workers tend to perform better when each of them is aware of their contribution to the general workflow. When nurses arent aware of their professional responsibilities, they tend to overstep, sometimes performing the duties of other workers. This overindulgence stems from the proximity of nursing practice to the patients and the fact that they are exposed to the patients for longer (Zhang & Tu, 2020). This overzealous performance of duties makes the nursing profession appear more tedious than it is, causing detest. Nurses detest the profession based on this and seek alternatives that involve lighter workloads. Methods of assigning duties include having a duty rooster where each professional working within the workplace is aware of their responsibilities. Such awareness is crucial for ensuring that nurses enjoy their positions within the confines of their qualifications and without the extra burden of work. Retention is likely to increase, and turnovers are likely to become a past issue when nurses are well-informed of their duties.
Better Communications Channels
The role of communication within any professional organization cannot be overemphasized. Without communication, any workplace is bound to fail, and the healthcare field is not an exception. Communication channels must meet certain irreducible minimums to ensure that they fulfill the needs of the recipients of the information. Current technological advancements have made communication easier with the invention and use of various devices. There is a need for healthcare managers to ensure messages meant for nurses or other professionals arrive without any distortion. The messages must be received in an understandable manner that fosters cooperation among the nurses (Gensimore et al., 2020). The course of nurse turnover is often miscommunication, where the wishes of healthcare managers are not effectively received by their workers. Better communication will be vital in eliminating confusion, eradicating unnecessary questions around healthcare conduct, and bettering retention. The feeling of isolation by nurses will also be eliminated with better, holistic communication channels. Communication can also serve as a medium for encouraging the improvement of functions by the nurses. This entails modifying nursing practice based on the needs of management and patients, which is necessitated by the varying communications received.
Conclusion
In conclusion, the nursing profession is one of the noblest fields pursued by man. Nursing has been in existence for a significant part of human history and influenced the trajectory of healthcare over the years. The challenge of nurse turnovers has threatened to cripple the healthcare sector, and there is a need to explore mechanisms that can curb this challenge, encouraging nurse retention. Nurse retention can be attained by hiring more nurses to harmonize the ratio of nurses to patients and reduce the workload. The choice of a preceptor is essential in ensuring that new nurses have a great role model to model their career around and make better choices. The preceptor also serves to encourage retention. The onboarding process must be bettered alongside improving the current working conditions to meet new demands. The assignment of responsibilities must be harmonized to boost clarity, prevent confusion, and increase retention. Communication is an essential piece of the healthcare environment puzzle that must be addressed. Communication can be improved through the improvement of clarity and the implementation of actions that encourage inclusivity amongst all staff, encouraging nurse retention.
Florence Nightingale is most well-known for her participation as a nurse during the Crimean War. During her service there, she observed that the mortality was increasingly high, with as many as 4077 soldiers dying in one winter (Yoder et al., 2021). More commonly, the disease was the cause of frequent death, while battle wounds were less deadly in a statistical sense. In 1855, when a sanitary commission was sent to the hospital based in Scutari, Turkey, the sewers, latrines, and cesspits were cleaned and corpses were removed from water sources. Changes were noticeable, with mortality rates decreasing by more than 20% over the course of a few months.
This, as well as a number of other experiences, caused Nightingale to gather data in regard to medical care. She implemented a number of strategies, including sending surveys to hospitals, collecting, and assessing the provided information. Using her analyzed data, she was able to formulate reports and establish commissions focused on medical investigations. The research provided by Nightingale was able to determine a number of findings, including the proportion of recoveries and mortality rates of various diseases. Similarly, disease trajectories and recovery periods could be mapped. Details concerning demographics of certain diseases were also becoming more visible, such as information concerning illnesses in relation to gender, age, and other factors. Later in her life, many of her reports and strategies began to be implemented in the education of nurses. Nightingale did not only focus on the fight against disease but on other essential medical services, including patient care, hygiene, cleanliness, and efficient management.
A majority of the aforementioned components can be identified within current nursing practices and education. This signifies how fundamental Nightingales work has been to nursing and the general practice of medicine in the modern day. Nightingale was able to provide nurses with formal education and structured professional and medical practice (American Sentinel College of Nursing & Health Sciences, 2020). Her efforts with statistical data were essential in the application of such research to clinical practice. To this day, research, analysis, and application of scientific findings incorporate elements of Nightingales practice and ideology. Nurse-specific knowledge and research are also vital in providing adequate care. With emerging crises or health complications, it is important to implement ongoing investigations to formulate adequate solutions. Her holistic approach was what defined nursing as an important and specialized practice that harbored specific knowledge that had to be obtained.
Nightingale was also responsible for establishing the standards of nurse care. She prioritized a clean environment and equipment, hygiene of the patient, bedside care, and monitoring. These smaller but equally important steps led to an increase in the prevention of diseases and the improvement of hospital conditions. To this day, operational equipment, hygiene, and clean environments are the standards of any hospital setting in the world.
Nightingales impact on modern nursing and medical service is undeniable and essential for its future progress. The application of the latest research has been shown to lead to better patient outcomes, lower mortality, better use of resources, and improved abilities of nursing professionals. The core of her practice continues to elevate the standards of nursing. Equally important was her establishment of the values of nurses, prioritizing patient care. Research methods pioneered by Nightingale also allow nurses more control and knowledge within their practice and improve service without the excessive or unnecessary.
References
American Sentinel College of Nursing & Health Sciences. (2020). Florence Nightingale: the founder of modern nursing. The Sentinel Watch. Web.
It is important to note that one of the key aspects of nursing management revolves around conflict resolution strategies. The usual stakeholders or parties involve patients, their families or friends, nursing professionals, and the administration of a healthcare facility. Therefore, it is critical to understand how nurses can approach any form of conflict in a healthcare setting in order to ensure adherence to ethical and professional standards. Both nursing professionals and nursing managers should focus on constructive conflict resolution measures to achieve a positive outcome.
One should be aware that conflicts can be approached from a wide range of angles, and each strategy can lead to a differential outcome. Healthcare or clinical setting is a sensitive environment, where patients well-being is a major risk factor, and the latter group might not always be capable of properly voicing their concerns. A study suggests that nursing professionals used constructive/positive conflict management approaches rather than destructive/negative conflict management approaches (Labrague et al., 2018, p. 902). In other words, the core objective of conflict resolution for nursing professionals is to have a positive outcome, which is possible only if constructive methods are utilized.
Patient considerations need to be always accounted for in such cases since the latter is mandatory for constructive conflict resolution. Another study states that nurse managers preferred the collaborating style to manage conflicts (Ozkan Tuncay et al., 2018, p. 945). The main reason is rooted in the fact that it is a positive and effective conflict-management style, and that a variety of variables played a role in their decision to adopt this style (Ozkan Tuncay et al., 2018, p. 945). Thus, it is evident that a positive outcome is a goal that is achieved by a collaborative effort of nursing professionals and nursing managers.
References
Labrague, L. J., Al Hamdan, Z., & McEnroe-Petitte, D. M. (2018). An integrative review on conflict management styles among nursing professionals: Implications for nursing management. Journal of Nursing Management, 26(8), 902-917. Web.
The patient is a 28-year-old Hispanic woman, G3P1. Her last pregnancy was healthy. According to the cervix contractions and per vaginam measurements, the patient is in the first stage of labor in a latent phase (Durham & Chapman, 2019). Fetal position is the most common, and the patient can have a vaginal delivery. According to vital signs, the patient is anxious and excited. Before pregnancy, her BMI was 24,2, and her current BMI is 28,3. During pregnancy, the patient has not gained enough weight.
The nurses first actions are to set up electronic fetal monitoring, begin the Friedman graph, and assess fetal heart rate-uterine contraction (FHR and UCs) every 1 hour. It is also essential to identify the presence of bloody show and rupture of membrane (ROM), encourage the patient to relax, encourage void every two hours, and help find the position of comfort. The nurse can ask if the patient has pain and how strong it is. If the pain is sharp, non-pharmacological pain strategies should be initiated. The nurse can assist the patient in diversional activities and encourage control of breathing, position changing, and ambulation.
To assess the fetal biological system, the nurse does FHR every 1 hour, Leopold maneuvers, and SVE examination. To create a proper social atmosphere for the patient, the nurse identifies her support person (the husband) and assists both of them in their role. The nurse includes them both in patient teaching and care and encourages the husband to stay with the patient.
After SROM
FHR becomes category II: fetus rate decreases less than on 15 beats and stays in the normal borders, and prolonged decelerations are detected. The priority of a nurse is to assess fetal well-being. It is essential to deliver in 24 hours because the rupture of the membrane increases the risk of intrapartum infection (Durham & Chapman, 2019). The characteristics of the fluids were normal, with no signs of blood and other pathological substances. The SVE identifies softening of the cervix walls but still latent labor phase by all the measurements.
The patient should be kept at the hospital for complete monitoring and bed rest. Nursing management is to prevent any complications of the condition, as well as infection. Evaluating the membrane status can help with further tactics. Afterward, the number of SVEs should be minimized to prevent infection (Durham & Chapman, 2019). The next step is to obtain smear specimens from the vagina and rectum to test for streptococci.
Teaching. The nurse should also provide the patient with family education and encourage her and her husband to prepare for labor and birth. Explaining the treatments that will possibly be needed to prepare the patient psychologically.
Nursing diagnosis: Risk for infection due to loss of protective barrier. Moderate labor pain. Expected outcome: the patient will have no signs of any infection, such as increased temperature, changes in heart rate, different vaginal smell, or colorful thick vaginal drainage. According to the nurses pain management plan, the patient will have decreased pain using non-pharmacological pain management (breathing, position changing, walking).
Non-pharmacological pain management. Using patterned breathing allows focusing and improving the labor process. Explain to the patient that, due to active breathings, the oxygen accesses the baby better and staying well-hydrated helps her condition. Movement and comfortable position search can help identify the posture where the pain decreases. The nurse can help find the position and make sure it is safe. Method of focus and distraction can help visualize the active phase of labor and its successful outcome (Durham & Chapman, 2019). Such techniques can help reduce fear and anxiety and make the patient in a better mood.
2 A.M
Assessment. The patient entered the active phase of the first labor stage. Nursing priorities. The nurse informs the patient of the progress of her labor to get in contact with her and give her motivation to encourage her to be continuously active to maximize the effect of uterine contractions. Additionally, the nurse monitors FH, helps find positions of comfort, and monitors maternal vital signs and fetal vital signs depending on the doctors order. The nurse also helps with the needs of the patients if she needs to keep the bed clean and dry, putting on a forehead compressor with cold tissue and other comfort requirements. It is important to remind the patient to void as the full bladder can interrupt or slower the labor process.
Nursing diagnosis: acute labor pain. Expected outcome: the patient has decreased pain and can focus on productive contractions and being focused. Interventions: position of comfort, non-pharmacological strategies, breathing, helping with needs, and reminding of voiding.
04.10 A.M
Appropriate interventions are monitoring the contractions and FHR every 15-30 minutes, maternal vital signs every 1 hour, assessing pain, asking the patient of its degree and location, considering epidural anesthesia, offer oral fluids. Explain to the patient her progress and promote her comfort measures as well as non-pharmacologic strategies. Assist with the elimination of vomiting, explain that it is a variant of the norm, explain that the uterus and intestine might contract together, and that is why she had a regurgitation. The nurse prepares for delivery.
06.30 A.M
Priorities. The patient entered the second labor stage and can push now harder along with uterus contractions. FHR indicates the lowered heart rate of the fetus. Bradycardia of the fetus needs monitoring of the FHR every 5-15 minutes (or after every contraction) and suppose umbilical cord entanglement. Ask the patient to focus on breathing and pushing, assist in a comfortable position in pushing, and encourage upright positions. Rationale. The lowered rate and indirect hypoxia signs are frequent situations in the second stage of labor.
Nursing diagnosis: bradycardia of the fetus with possible cord entanglement. Outcomes: effective pushes with fetal descendants. Interventions: assisting support with relaxation breathing, identifying changes in tension, keeping the patient relaxed, reassuring the patients condition, and pharmacological pain management.
07.30 A.M
Help focus the patient for the final pushes. Update on the progress and encourage her husband to support her breathing and pushing. Prepare episiotomy if necessary. Encourage rest between contractions by breathing with the patient and using therapeutic touch. Rationale. Episiotomy might not be needed; however, it has to be prepared to prevent possible ruptures of vaginal walls.
08.15 A.M
The final period of the second stage. Control the fetal heart rate after each contraction, prevent the rupture of the vaginal walls with the help of hands, and prepare for episiotomy. If the loop is identified, lessen the tension around the newborn. The nurse should include lateral episiotomy if needed (second pregnancy might not be needed). Afterward, place the newborn on the mothers abdomen skin-to-skin, awaiting delivery of the placenta. It is essential to inspect the placenta after delivery so that it fully comes out with no pieces left inside the uterus. Suturing the episiotomy under anesthesia and monitoring the patients vital signs. Finally, labor summary, delivery summary for mother and baby, infant information, assessment, and documentation. The nurse stays with the woman and her family, answers possible questions, and guides her with further tactics and the delivery process.
Reference
Durham, R., & Chapman, L. (2019). Maternal-Newborn Nursing: The critical components of nursing care (3rd ed.). F.A. Davis Company.
Variance or clinical variation is a term that refers to the difference between similar processes and expected outcomes of the same stable healthcare processes. Some common causes of variance may include the overuse, underuse, or misuse of general healthcare practices and services, which lead to varying patient outcomes. Besides, a special-cause variation category includes deviance in the process caused by factors that are not the intrinsic parts of the procedure. One of the factors that may also cause variance is costs.
The cost factor and its effects on the variance in the healthcare process can be associated with the difference in payment structures. Specific public programs link spending and payment structures to quality improvement measures. As Ryan & Rodgers (2018) identified, the programs that link quality to spending are the Oncology Care Model, the Comprehensive End-Stage Renal Disease Model, and Home Health Value-Based Purchasing. As the study focused on seriously ill patients, the authors did not find much positive correlation between quality improvement measures and spending measures related to palliative care. Hence, the needs to be a balance between the payment structures and quality improvement measures, as the increase in spending does not affect the increasing effectiveness of care or patient outcomes.
Different sources identify different payment structures. Yet, the most basic two categories related to healthcare payment structures include retrospective and prospective payment systems. Most scholars agree that among the factors that affect quality outcomes, the socioeconomic variables of both patients and providers are significant. Hence, when choosing between prospective or retrospective payment structures, it is essential to evaluate their effect on both parties. Finding a balance between the interests and abilities of patients and healthcare providers is key to enhancing quality outcomes.
Reference
Ryan, A. M., & Rodgers, P. E. (2018). Linking quality and spending to measure value for people with serious illness. Journal of Palliative Medicine, 21(S2), S-74.
In its basic term, a prescription is a direction from a physician to a pharmacy to prepare medication for a patient. Therefore, one of the main general principles of prescription is to control the patients treatment and to avoid possible negative effects from incorrect doses. Looking at the relationship between the patient and the physician, the latter always has more knowledge and experience about treatment and remedies. Therefore, the second general principle is that the physician usually shares his or her knowledge aiming to cure the patient and protect his/her life.
A prescription is an important element of a treatment plan. This treatment plan analyses all previous patients sicknesses and allergies in order to provide the safest way of treating his/her disease. In addition, a prescription usually acts as a legal act that shows serious intentions of a doctor to treat a patient. If something goes wrong, the prescription will be a crucial element in the case against a physician. Thus, todays global pharmaceutical business excessively promotes many medications that force people to buy them. In many cases, people simply see the promotion and have a wish to buy medicine afterwards. Therefore, in many cases prescriptions protect consumers from buying unnecessary medications and help to avoid additional costs.
Lastly, a prescribed medicine always brings benefits and risks. Prescriptions can also be used in the lowest effective doses in order to monitor the efficacy of medications in a certain time period. Physicians work requires serious knowledge and professionalism, and the process of creation of a prescription should always be properly evaluated and controlled by other healthcare organizations.
There are many different kinds of ethical issues pertaining to the emergency care. The reasons for them are also different, such as time limitations, lack of information about a patient, lack of experience of healthcare staff, or possible physical incidents that happen with patients. Due to the high number of patients that arrive in Emergency, healthcare staff always have limited time available in order to make the first check and recognize a patients situation. However, the ethical code insists that all patients should be treated equally.
There are several ethical principles in reference to the emergency care. Among them are obligations to remove the possible harm, respect for a persons autonomy, contractualism or an agreement of moral behavior (McClelland 14). The main aim of the ethical behavior of emergency is to protect lives of patients, provide compassionate care, and show respect for all people that need help. Thus, there are three fundamental ethical elements that should be at the core of each emergency. First, the emergency should be fair and equitable. Thus, it should be focused on fulfilling the interests of a patient. In addition, one more important element is in respecting the patients autonomy. There are several more moral foundations of emergency care, such as quality, freedom of choice, affordability, compassion, mutual assistance, respect, and continuous studies to maintain the highest knowledge.
Lastly, the concept of emergency care is strongly interrelated with ethical considerations. The core ethical issues usually result in an inability of healthcare providers to fulfil their tasks, such as treating illnesses, reducing pain, minimizing suffering, and protecting life. With an increased number of ethical issues, emergency staff should focus their efforts on early elimination of them.
Works Cited
McClelland, Mark. Ethics: Harm in the Emergency Department Ethical Drivers for Change. OJIN: The Online Journal of Issues in Nursing 20.2 (2015): 14. Print.
A positive relationship between the employee and the employer is a crucial aspect of employment. In an effort to maintain high-quality service, foster self-driven motivation, and enhance employee engagement, managements need to nurture this type of relationship. Healthy relations are defined by labor agreements and collective bargaining agreements. The initial dictates the terms and conditions of engagement between the laborer and the employee organization. The latter explicitly defines fair wages and the working conditions of employment. Collective bargaining provides a foundation for the discussion of the salary, working time, training, equal treatment, among other agendas that may be the essence in employment. This essay will argue for the Labor relations between nurses and their employment body. In the form of two questions, the essay will highlight the critical aspects of labor relations mentioned above and illustrate how they come into play.
The nurses are entitled to additional compensation due to their supplemented engagement requirements. In reference to Geiger-Brown and Trinkoff (2010), registered nurses clock a total of 8 to 10 hours of work a day. This sums up to 40 hours a week and would equate to 80 hours if summed up over two weeks (Geiger-Brown & Trinkoff, 2010). At this level, the hospital employing the nurses in question requires the standard work time from its employed nurses (Holley et al., 2008). Nonetheless, on top of this standard regular working time, the nurses were required to be on-call for another 20 hours during this pay period. This is an additional requirement that should attract supplementary compensation if enforced (Geiger-Brown & Trinkoff, 2010). Such compensation represents itself in the form of wages, vacations, holidays, overtime payment, and shift premiums (Holley et al., 2008). According to Holley (2008), work rules that define compensation should be contained in a formal labor agreement. Once discussed, such rules should be implemented immediately when the situation arises.
The additional cost incurred from being on-call should attract further compensation. The nurses were required to respond to calls within 15 minutes. This meant that the nurses could only be within reach in terms of their location (Geiger-Brown & Trinkoff, 2010). According to the other aspect of their work rules (they ascertain the employee and employer job rights and obligations), it was required that the nurses be within the vicinity (Holley et al., 2008). Travels that would take more than 30 minutes away from the hospital were restricted.
Alcohol consumption and even medical visitations were censored. For these conditions to be met, the nurses need to procure a place to stay 30 minutes within reach of the hospital, which costs them more money (Holley et al., 2008). It also meant that in case of a personal emergency during the pay period, the nurses would not be allowed to respond to it. Such requirements would be unreasonable if no compensation followed. Holley et al. (2008) argue that such levels of commitment drain energy out of a health provider. It would be unethical if such services are not rewarded by increased vacation time, preliminary wages, or any form of compensation that the institution can offer.
On top of that, being on-call during the pay period indicated that the nurses were being called to provide additional skills and services. This meant that beyond their 40 hours a week schedule, this obligation implied that the nurses would add an extra 10 hours to the week (Geiger-Brown & Trinkoff, 2010). Based on the illustration provided by Holley (2008), any added service or skill offered by an employee to an organization or institution of health should attract additional compensation (Geiger-Brown & Trinkoff, 2010). To deliver high-quality services and their capability to maintain high productivity levels despite exhaustion, these nurses deserve compensation (Mamikhani et al., 2013). As a legal right and also as an ethical obligation, the hospital should acclimate its nurse employees.
Moreover, the additional working time intensifies the nurses routine, leaving them exhausted at the end of the day. Such strains on the physical body inhibit the nurses from furthering other aspects of their lives and would therefore require some aspects of compensation. Apart from risking their lives by daily exposure to bacteria and viruses, the hospital needs them to offer more of their time and energy to the same (McHugh &Ma, 2014). The only equalizing solution is for them to be afforded their due right, compensation. According to the standard rates for hours clocked while on call, the nurses in question should be paid a minimum of 30 dollars per hour (McHugh &Ma, 2014). This rate is inclusive of the differences that exist in wage payment in different regions. The compensation would also vary depending on the qualification of the individual nurses. Furthermore, additional bonuses and commissions should be incorporated.
It is legal for the hospital to subject nurses that violate the established work rules to disciplinary action. Assuming that the work rule that requires the nurses to be within reach and respond to calls in 30 minutes is indicated in the formal legal agreement, then the institution is allowed to take action against them (Holley et al., 2008). Legal relations form another relevant aspect of healthy employment relations. The labor-related laws offer management and employees a framework for defining their legal rights and responsibilities (Holley et al., 2008). The fundamental law foundations spoken of by Holley and colleagues uphold the right of employment bodies to discipline their employees.
The institution owners are afforded management rights. According to the managements rights clause, the governing body holds, retains, and exercises management functions, rights, privileges, and powers associated with them being in control (Holley et al., 2008). This supplies the hospital the legal rights to pass judgments on members of staff that defy the legal agreement (Holley et al., 2008). Nevertheless, for such decisions to be made, the same management needs to assign a person to investigate the issue before disciplinary action is taken (Holley et al., 2008). After the correct facts have been collected, the body can now determine the best action to take based on the level of rules violated.
Management functions are diverse, and the legal right to discipline employees is defined by these functions. In the case of the hospital, the institutional board is responsible for managing the facilities running in the hospital (Holley et al., 2008). It directs the working force, changes or fixes the number of hours and duration of work shifts, as well as alters the work schedule (Holley et al., 2008). The management also deals with the assignment of work, hiring, training, promoting, among other human resource duties (Holley et al., 2008). As a consequence of such responsibilities, they also bear the role of discharging employees for just cause and disciplining them for the violation of rules and regulations (Holley et al., 2008). Because the managing body understands the mission and objectives of the company or institution, they understand what needs to be done, how it needs to be done, and by who. They are then better positioned to maintain order by regulating operations and justly disciplining those trying to violate them.
In summary, the hospital is expected to offer its nurse employees compensation based on the additional skills and services they expect them to exercise. Apart from that, the amount of cost they incur to be able to achieve the requirements is high enough to earn them an allowance. These health workers are expected to dedicate their lives to their work, neglecting personal duties, especially during the on-call period. The restrictions to the vicinity and further censoring on who or where they can visit deprives them of a life outside their profession. Such expectations can only be matched by compensations that can come in different forms. The hospital can offer wages, vacations, holidays, overtime payments, and shift premiums to consolidate the work done by the nurses.
In addition to that, it has been shown that the management body has a legal right to disciple its workers when they violate a formal agreement or regulation that has been put in place. Their managerial functions afford them this power. Therefore, if a nurse violates the 30 minutes work rule that requires them to respond to a call within 30 minutes, they are eligible to receive any form of discipline as dictated by the legal agreement.
References
Geiger-Brown, J., & Trinkoff, A. (2010). Is it Time to Pull the Plug on 12-Hour Shifts?. JONA: The Journal of Nursing Administration, 40(3), 100-102. Web.
Holley, W., Jenkins, K., & Wolters, R. (2008). The Labor Relations Process (9tg ed., pp. 243-373). South-Western Cengage Learning.
When crises occur, individuals become traumatized and unable to lead normal lives. Such affected people might develop suicidal thoughts and find it hard to lead a normal life. In advanced cases, the affected individuals could be unable to pursue their life goals. Some possible risk factors for trauma include the death of a close person or relative, divorce, and discovery of a terminal disease. Injuries arising from physical abuse, catastrophes, fire outbreaks, or natural disasters could trigger a crisis. An interview was completed to understand how trauma intervention professionals cope with the emerging psychological problems.
Findings from the Interview
The selected question for this section was: Please describe your personal understanding of trauma intervention and what the profession means to you. The respondent identified that trauma intervention providers who competent people who possess unique skills (Watson et al., 2019). They can apply such abilities in different settings and collaborate with other services providers to meet the demands of people experiencing various challenges. When timely guidance and support is available, the beneficiaries will have higher chances of recording positive experiences. Workers in this field need to be aware of the possible barriers to effective service delivery and address them.
Conducting Crisis Intervention
The leading question for this section was: how do you conduct crisis intervention? During the interview, the respondent indicated that he followed five key steps. These included defining the problem and ensuring that safety was prioritized (Watson et al., 2019). The third approach was to provide personalized support depending on the nature of the crisis. The professional went further to implement a plan and allowing the client to remain involved throughout the process. The provider also considered the power multidisciplinary teams to deliver timely results.
Tools for Intervention
The question used for this section was: What tools do you use when providing crisis intervention support to your clients? The professional identified Crisis Assessment Tool (CAT) as an effective tool for achieving the intended goals (Illinois Department of Healthcare and Family Services, 2021). It allows the service provider to communicate with the individual and offer personalized support. It is also useful when the safety of the client is under threat. The next one was Suicide Risk Assessment Tool (SRAT) (Harris et al., 2019). This tool was capable of managing suicidal patients and providing the most appropriate care.
Coping with Crisis
The interviewer asked: How do you, as a crisis intervention provider, deal with trauma and crisis in your work setting? The respondent was clear that intervention experts were always at risk of fatigue and burnout. They could also become traumatized and be unable to achieve their goals. Those who want to achieve their goals and transform their clients outcomes need to unwind and take good care of their bodies (Rimondini et al., 2019). They should avoid all drugs and consider resources in their communities, such as focus groups and religious institutions. These measures can help deliver meaningful results and guide professionals to achieve their goals.
Maintaining Freshness
The respondent was required to provide an answer to this question: How do you ensure that you maintain the highest level of freshness as a crisis intervention expert. From the analysis, the professional indicated that he always maintained a proper plan that guided his use of various tools. The expert was also ready to engage his clients and establish positive relationships. He was always ready to take breaks and design sessions depending on the severity of the intended crisis. He remained optimistic and focused on the final outcomes as the most important source of inspiration.
Maintaining Enthusiasm
The question used for this section is: How do you maintain the highest level of enthusiasm as a trauma intervention professional? The respondent indicated that he had mastered a number of strategies to ensure that he remained involved and appreciative of her profession (Cheese & Cumming, 2021). The professional argued that he always took the issue of work-life balance seriously. He also collaborated with other professionals to provide services as a multidisciplinary team. He was also focusing on lifelong learning to acquire better ideas and theories for helping more clients.
Suggested Ideas for Others
This question was applied to get the relevant responses: What evidence-based strategies would you recommend to other crisis or trauma intervention experts? The respondent indicated that work-life balance was the first trick towards having a successful career. It was also necessary to establish multidisciplinary teams whenever immediate results are needed. The focus on the targeted clients should also be a priority to meet their needs (Rimondini et al., 2019). The respondent indicated that professionals who take such attributes seriously would have increased chances of achieving their goals while empowering their respective clients.
Continuation
The respondent went further to reveal that it was necessary for professionals in this field to take good care of their bodies. They should also establish positive relationships with their respective clients to support the deliver the best outcomes. Experts should also take timely breaks during their crisis intervention sessions. The concept of lifelong learning will equip them with additional ideas for meeting their clients needs (Substance Abuse and Mental Health Services Administration, 2020). The use of various intervention tools would also make it possible for these professionals to achieve their goals. The ideas will also make this profession meaningful and capable of meeting the needs of more clients in the future.
Services Agencies Provide
This question was posed to the interviewee: What services do crisis intervention agencies provide? The interviewee revealed that the presence of numerous intervention agencies in the community helped more citizens get personalized support whenever they faced different crises. Most of these agencies provide services that are unique and personalized in nature. The service providers identify existing challenges and opportunities for providing effective trauma support. The agencies promote the use of various tools and forums depending on the intended outcomes (Substance Abuse and Mental Health Services Administration, 2020). Beneficiaries accessing these institutions find it easier to achieve their health goals.
Services Available to Professionals
To get adequate responses, this question was used: What services are available to crisis intervention service providers in different agencies. While providing personalized services to clients, most of the agencies have designed proper mechanisms to meet the demands of trauma intervention professionals. For example, some institutions promote proper work weeks and schedules for meeting the needs of clients receiving continuous support (Substance Abuse and Mental Health Services Administration, 2020). The respondent indicated that it was necessary for such agencies to promote the concept of work-life balance. The strategy would ensure that more providers unwind and reduce chances of recording stress. The provision of adequate resources and reliable working environments allows trauma intervention service providers to remain contented. Consequently these individuals find it easier to provide personalized support to their clients.
Conclusion
The completed investigation shed more light on the role of trauma intervention services in any given society. However, most of the professionals in the field encounter various predicaments, such as depression and trauma. Such workers should engage in self-care and embrace the ideas of lifelong learning and wok-life balance. Agencies need to support their needs to transform the overall image of this field.
Watson, A. C., Compton, M. T., & Pope, L. G. (2019). Crisis response services for people with mental illnesses or intellectual and developmental disabilities: A review of the literature on police-based and other first response models. Vera Institute of Justice.