Works contained in this section (6):
- Health Planning Project
- Ethics Framework Case Study Discussion Post and Rebuttal
- Therapeutic Interventions
- Health Policy Discussion and Response
- Wikicountry Brazil
- History of Present Illness Write-Up: Breast/Axilla/Abdomen
Health Planning Project
NURS 492 – Community Health Nursing
Purpose of Assignment
The Health Planning Project requires that students work together in small groups to develop a proposal for addressing the health issue of an identified aggregate. The proposal will include assessment data, planned intervention strategy and an evaluation plan.
Student Approach to Assignment
I had taken the position of leader for this project. When my groupmates submitted project proposals, I had noticed that many had focused on obesity. We decided on the location, Richmond, VA, because there had been a rise in childhood obesity rates there. The project was seen as valuable because eating habits are established early in life and have beneficial effects for a lifetime. The site of interventions were chosen to be schools because the amount of time that they spend at school. As this was a group project, I delegated sections to my groupmates, but I reviewed each section and gave feedback to each member. I also wrote the introduction and summary/conclusion sections since I had supervised the project. There was a point where one of our group members had disappeared, and I had revise that section myself.
Reason for Inclusion of this Assignment in the Portfolio
I am proud of my group’s work in this assignment. Each member, save for the member who disappeared, was responsive, open, and respective to other members. The result was a well-polished essay. The project also targets children, a demographic that I do not ordinarily work with on my medical-surgical floor. Children have special considerations that we took in this project, namely, the influence on parents and adults and the influence of the school system. We also address the need for involvement in the community with organizations like Fit4Kids as allies.
Core Competencies
Critical Thinking
Nursing Practice
Communication
Teaching
Research
Leadership
Professionalism
Culture
How My Scope in Nursing Changed
My scope in nursing was changed in two ways: in terms of frame in reference and in terms of clientele. First, I was challenged to think about nursing at a community level, outside of the hospital. This is both larger than a hospital yet drastically smaller than a country. I have seen from this project that a population of people can have weakness in health promotion, and it can be exacerbated by socioeconomic status. While nurses can treat a person one-by-one in a clinic or hospital, it would be ideal for people to maintain their health. Thus, finding ways to promote health become much more important at the community level. Meanwhile, my scope has widened to children and adolescents, who I generally do not see on my medical-surgical floor. They have special considerations because of the influence of adults and school in their lives. It’s a different experience because they learn much by following adults’ examples. Education means that I would need to teach adults if I want to teach children.
The Health Planning Project requires that students work together in small groups to develop a proposal for addressing the health issue of an identified aggregate. The proposal will include assessment data, planned intervention strategy and an evaluation plan.
Student Approach to Assignment
I had taken the position of leader for this project. When my groupmates submitted project proposals, I had noticed that many had focused on obesity. We decided on the location, Richmond, VA, because there had been a rise in childhood obesity rates there. The project was seen as valuable because eating habits are established early in life and have beneficial effects for a lifetime. The site of interventions were chosen to be schools because the amount of time that they spend at school. As this was a group project, I delegated sections to my groupmates, but I reviewed each section and gave feedback to each member. I also wrote the introduction and summary/conclusion sections since I had supervised the project. There was a point where one of our group members had disappeared, and I had revise that section myself.
Reason for Inclusion of this Assignment in the Portfolio
I am proud of my group’s work in this assignment. Each member, save for the member who disappeared, was responsive, open, and respective to other members. The result was a well-polished essay. The project also targets children, a demographic that I do not ordinarily work with on my medical-surgical floor. Children have special considerations that we took in this project, namely, the influence on parents and adults and the influence of the school system. We also address the need for involvement in the community with organizations like Fit4Kids as allies.
Core Competencies
Critical Thinking
- Evaluates nursing care outcomes through the acquisition of data and the questioning of inconsistencies
- Revises actions and goals based on evidence rather than conjecture
- Engages in creative problem solving
Nursing Practice
- Applies appropriate knowledge of major health problems to guide nursing practice
- Performs direct and indirect therapeutic interventions that incorporate principles of quality management and proper safety techniques based upon assessment findings
- Implements traditional nursing care practices as appropriate to provide holistic health care to diverse populations across the lifespan
- Establishes and/or utilizes outcome measures to evaluate the effectiveness of care
Communication
- Adapts communication methods to patients with special needs
Special needs to consider are for the younger age group and the lower socioeconomic areas with limited communication methods. Public service announcements and advertisements can cater to, children and public forums may be presented in areas with limited communication. - Expresses oneself and communicates effectively with diverse groups and disciplines using a variety of media in a variety of contexts
- Produces clear, accurate, and relevant writing using correct grammar, spelling and punctuation
I was responsible for the revision, organization, APA format, and citations of this group paper. - Accesses and utilizes data and information from a wide range of sources to enhance patient and professional communication
Teaching
- Provides relevant and sensitive health education information and counseling to patients, and families, in a variety of situations and settings
Health education in this community-wide project includes methods to increase physical activity and to change eating habits to include more fresh foods while decreasing processed foods. The settings involve public forum, in-class lecture, and public advertising. - Uses information technologies and other appropriate methods to communicate health promotion, risk reduction, and disease prevention across the life span
Intended advertisement includes in-person public forums and television/internet sponsored infomercials. - Evaluates the efficacy of health promotion and education modalities for use in a variety of settings with diverse populations
- Uses information technologies and other appropriate methods to enhance one’s own knowledge base
Research
- Differentiates between descriptive nursing literature and published reports of nursing research
- Applies research-based knowledge from nursing as the basis for culturally sensitive practice
Nursing’s role in combating community obesity is that of advocate and educator. Research from Whitaker, Milam, Graham, Cooley-Strickland, Belcher, & Furr-Holden, (2013) had shown that a factor in obesity is also low socioeconomic status and inability to intake appropriate nutrition. So, sensitivity to size is required in when discussing weight and when providing low-cost but nutritious meal options, such as balanced school meals. - Applies research-based knowledge from the arts, humanities and sciences to complement nursing practice
- Evaluates research that focuses on the efficacy and effectiveness of nursing interventions
- Shares research findings with colleagues
Leadership
- Assumes a leadership role within one’s scope of practice as a designer, manager, and coordinator of health care to meet the special needs of vulnerable populations in a variety of practice settings
- Initiates community partnerships to establish health promotion goals and implements strategies to meet those goals
- Organizes, manages, and evaluates the development of strategies to promote healthy communities
Main strategies for the poorer community for health promotion is the food promotion, which is expected to assist in making fresh food more accessible in crowded or poor areas, and public service announcement educational forums. - Articulates the values of the profession and the role of the nurse as member of the interdisciplinary health care team
Professionalism
- Differentiates between general, institutional, and specialty-specific standards of practice to guide nursing care
- Advocates for professional standards of practice using organizational and political processes
Culture
- Articulates an understanding of how human behavior is affected by culture, race, religion, gender, lifestyle, and age
- Integrates knowledge of cultural diversity in performing nursing interventions
- Considers the impact of research outcomes and the effects of health and social policies, on persons from diverse backgrounds
- Maintains an awareness of global environmental factors that may influence the delivery of health care services
How My Scope in Nursing Changed
My scope in nursing was changed in two ways: in terms of frame in reference and in terms of clientele. First, I was challenged to think about nursing at a community level, outside of the hospital. This is both larger than a hospital yet drastically smaller than a country. I have seen from this project that a population of people can have weakness in health promotion, and it can be exacerbated by socioeconomic status. While nurses can treat a person one-by-one in a clinic or hospital, it would be ideal for people to maintain their health. Thus, finding ways to promote health become much more important at the community level. Meanwhile, my scope has widened to children and adolescents, who I generally do not see on my medical-surgical floor. They have special considerations because of the influence of adults and school in their lives. It’s a different experience because they learn much by following adults’ examples. Education means that I would need to teach adults if I want to teach children.
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492_health_planning_project_graded.pdf | |
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Ethics Framework Case Study Discussion Post and Rebuttal
NURS 403 – Career Pathway: Expanding Horizons
Purpose of Assignment
The purpose of this discussion is to have the student become familiar with ethical frameworks and to utilize an ethical framework in making a decision about a moral issues.
Student Approach to Assignment
This is an assignment that consisted two parts that addressed moral frameworks and end-of-life care. First, I responded to a case study where with a patient (“M”) with urosepsis and advanced Alzheimer’s was completely dependent on her health-literate husband for care. The moral issue was related to the PEG tube insertion and the best interest for the patient and her husband. The second part involved a rebuttal to another student’s post about a young girl (“F”) on life support and her religious mother. In this case, the moral issue was about how long the girl should be on life support. In both cases, I applied the MORAL Model to analyze the situations: massage the situation, outline the options, resolve the dilemma, act on the best option, and look back and evaluate.
Reason for Inclusion of this Assignment in the Portfolio
This assignment involved end-of-life care and moral issues. It was necessary to consider the amount of comfort for each of these incapacitated patients. However, it is a very sensitive subject for the dying’s loved ones, and in a sense they were also being cared for. This assignment was important because it involves patients who are terminal, whether they were young or old. The original post and the rebuttal were combined into one grade.
Core Competencies
Critical Thinking
Nursing Practice
Communication
Teaching
Research
Leadership
Professionalism
I used the MORAL model a second time in G’s case. The moral dilemma was that G’s condition meant she would only deteriorate to brain death, but her mother wanted to continue aggressive treatment. There was a decision whether to continue treatment or let G pass. With all the life support systems with little hope of recovery, G would not be comfortable in this state and prolonging her life would make her suffer more. I decided it was ethical and instead help G’s mother through the grieving process.
Culture
How My Ethical Perspective Changed
It was necessary to balance values of beneficence, non-maleficence, and paternalism in this assignment. Usually beneficence and non-maleficence are easy to attend to because the illnesses are treatable, but if the condition is terminal, treatment focus turns towards comfort. If the patient is completely incapacitated, then it becomes even more difficult because the patient’s wishes can become unclear. I see that the loved ones’ almost become the one who we are caring for because their feelings are put in consideration for the interventions that we enact. However, I also realize that the loved ones’ wishes and the patient’s wishes may not coincide, and between the two, nursing should respect the wishes of the patient. Giving appropriate end-of-life information to the family is sensitive and difficult, but taking too long a time to do so may also prolong the patient’s suffering. As a nurse, I would like to decrease or avoid the suffering of my patients.
The purpose of this discussion is to have the student become familiar with ethical frameworks and to utilize an ethical framework in making a decision about a moral issues.
Student Approach to Assignment
This is an assignment that consisted two parts that addressed moral frameworks and end-of-life care. First, I responded to a case study where with a patient (“M”) with urosepsis and advanced Alzheimer’s was completely dependent on her health-literate husband for care. The moral issue was related to the PEG tube insertion and the best interest for the patient and her husband. The second part involved a rebuttal to another student’s post about a young girl (“F”) on life support and her religious mother. In this case, the moral issue was about how long the girl should be on life support. In both cases, I applied the MORAL Model to analyze the situations: massage the situation, outline the options, resolve the dilemma, act on the best option, and look back and evaluate.
Reason for Inclusion of this Assignment in the Portfolio
This assignment involved end-of-life care and moral issues. It was necessary to consider the amount of comfort for each of these incapacitated patients. However, it is a very sensitive subject for the dying’s loved ones, and in a sense they were also being cared for. This assignment was important because it involves patients who are terminal, whether they were young or old. The original post and the rebuttal were combined into one grade.
Core Competencies
Critical Thinking
- Uses nursing and other appropriate theories and models to guide professional practice
- Uses decision-making skills in making clinical or professional judgements
- Revises actions and goals based on evidence rather than conjecture
Nursing Practice
- Implements traditional nursing care practices as appropriate to provide holistic health care to diverse populations across the lifespan
- Demonstrates an awareness of complementary modalities and their usefulness in promoting health
Communication
- Uses therapeutic communication within the nurse-patient relationship
Teaching
- Provides teaching to patients and/or professionals about health care procedures and technologies in preparation for and following nursing or medical interventions
- Provides relevant and sensitive health education information and counseling to patients, and families, in a variety of situations and settings
Research
- Applies research-based knowledge from nursing as the basis for culturally sensitive practice
Literature from Rowe (2010) was used to support the importance of prioritizing the family’s feelings during end-of-life care. M’s husband had been emotionally distressed about the PEG tube insertion, so deferring the insertion could relieve him. Meanwhile, allowing him to care for his wife in home hospice could satisfy his desire to care for his wife. - Applies research-based knowledge from the arts, humanities and sciences to complement nursing practice
Leadership
- Articulates the values of the profession and the role of the nurse as member of the interdisciplinary health team
Professionalism
- Understands the effect of legal and regulatory processes on nursing practice and health care delivery, as well as limits to one’s own scope of practice
- Applies an ethical decision-making framework and legal guidelines to clinical situations that incorporate moral concepts, professional ethics, and advocacy for patient well-being and preferences
I used the MORAL model a second time in G’s case. The moral dilemma was that G’s condition meant she would only deteriorate to brain death, but her mother wanted to continue aggressive treatment. There was a decision whether to continue treatment or let G pass. With all the life support systems with little hope of recovery, G would not be comfortable in this state and prolonging her life would make her suffer more. I decided it was ethical and instead help G’s mother through the grieving process.
Culture
- Articulates an understanding of how human behavior is affected by culture, race, religion, gender, lifestyle, and age
- Demonstrates sensitivity to personal and cultural definitions of health, and how these beliefs influence an individual’s reactions to the illness experience and end of life
- Considers the impact of research outcomes and, the effects of health and social policies, on persons from diverse backgrounds
How My Ethical Perspective Changed
It was necessary to balance values of beneficence, non-maleficence, and paternalism in this assignment. Usually beneficence and non-maleficence are easy to attend to because the illnesses are treatable, but if the condition is terminal, treatment focus turns towards comfort. If the patient is completely incapacitated, then it becomes even more difficult because the patient’s wishes can become unclear. I see that the loved ones’ almost become the one who we are caring for because their feelings are put in consideration for the interventions that we enact. However, I also realize that the loved ones’ wishes and the patient’s wishes may not coincide, and between the two, nursing should respect the wishes of the patient. Giving appropriate end-of-life information to the family is sensitive and difficult, but taking too long a time to do so may also prolong the patient’s suffering. As a nurse, I would like to decrease or avoid the suffering of my patients.
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ethics_framework_db.pdf | |
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ethics_framework_rebuttal.pdf | |
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Therapeutic Interventions
NURS 403 – Career Pathway: Expanding Horizons
Purpose of Assignment
The purpose of this paper is to define a clinical problem, review the literature for appropriate research supported nursing interventions, critique current practice and provide a plan for changing or adapting clinical practice.
Student Approach to Assignment
In the months prior to the assignment, I had noticed that I had been getting more and more patients that were diagnosed with “surgical wound infection.” I also remembered that my hospital had recently implemented mupirocin-based nasal swab prep in order to decrease the incidence of MRSA surgical site infections (SSI). I understand that surgical site infections can be dangerous to patients, so I chose it for my topic. First, I asked my fellow nurses and my unit manager about if they had noticed an increase in SSI, and many had agreed with me. Nurses from our surgical floor had informed me that patients don’t usually bathe after surgery. My manager had directed me to our hospital’s infection control nurses. They verified that SSI had been increasing in our hospital, and they shared with me some recent audits. The infection control nurses also gave me the email address of a Sage (the manufacturer of our chlorhexidine wipes and mupirocin ointment) representative, who had statistics and literature about mupirocin ointment. I make reference to this data in my writing.
Reason for Inclusion of this Assignment in the Portfolio
This assignment was my first experience with infectious disease control. It made me appreciate what this department does for a hospital. They continuously track data in order to find infection outbursts, then they must experiment with ways to decrease the outburst. I think that this kind of nurse cares for several people rather than any one patient. Because I was dealing with the outcomes of a population, I felt that the assignment had introduced me to the nursing process on a bigger scale than one-to-one interaction.
Core Competencies
Critical Thinking
Nursing Practice
Communication
Teaching
Research
Leadership
Professionalism
How My Frame of Reference in Nursing Changed
I generally had thought of nursing as a face-to-face caring profession. Since doing this assignment, I was able to meet the infection control nurses for our hospital, who work in nursing from a community level. They come up with general interventions and recommend new procedures that affect the patient and the practice at bedside. This sounds like it might be done from a distance, they actually have to keep close contact with the nurses on the floor in order to evaluate the effectiveness of the interventions. The interventions and policy changes that they make definitely affect the outcomes of the patients. The experience was valuable for me because I was able to experience nursing from this small community perspective. I can now appreciate nursing not only one-to-one, but also in a small community.
The purpose of this paper is to define a clinical problem, review the literature for appropriate research supported nursing interventions, critique current practice and provide a plan for changing or adapting clinical practice.
Student Approach to Assignment
In the months prior to the assignment, I had noticed that I had been getting more and more patients that were diagnosed with “surgical wound infection.” I also remembered that my hospital had recently implemented mupirocin-based nasal swab prep in order to decrease the incidence of MRSA surgical site infections (SSI). I understand that surgical site infections can be dangerous to patients, so I chose it for my topic. First, I asked my fellow nurses and my unit manager about if they had noticed an increase in SSI, and many had agreed with me. Nurses from our surgical floor had informed me that patients don’t usually bathe after surgery. My manager had directed me to our hospital’s infection control nurses. They verified that SSI had been increasing in our hospital, and they shared with me some recent audits. The infection control nurses also gave me the email address of a Sage (the manufacturer of our chlorhexidine wipes and mupirocin ointment) representative, who had statistics and literature about mupirocin ointment. I make reference to this data in my writing.
Reason for Inclusion of this Assignment in the Portfolio
This assignment was my first experience with infectious disease control. It made me appreciate what this department does for a hospital. They continuously track data in order to find infection outbursts, then they must experiment with ways to decrease the outburst. I think that this kind of nurse cares for several people rather than any one patient. Because I was dealing with the outcomes of a population, I felt that the assignment had introduced me to the nursing process on a bigger scale than one-to-one interaction.
Core Competencies
Critical Thinking
- Uses decision-making skills in making clinical or professional judgements
- Evaluates nursing care outcomes through the acquisition of data and the questioning of inconsistencies
- Revises actions and goals based on evidence rather than conjecture
- Engages in problem solving
Nursing Practice
- Performs direct and indirect therapeutic interventions that incorporate principles of quality management and proper safety techniques based upon assessment findings
- Establishes and/or utilizes outcome measures to evaluate the effectiveness of care
Communication
- Expresses oneself and communicates effectively with diverse groups and disciplines using a variety of media in a variety of contexts
- Accesses and utilizes data and information from a wide range of sources to enhance patient and professional communication
Teaching
- Uses information technologies and other appropriate methods to enhance one’s own knowledge base
Research
- Evaluates research that focuses on the efficacy and effectiveness of nursing interventions
Research by Spruce (2014) and van Rijen, Boten, Wenzel, & Kluytmans (2008) had supported that chlorhexidine wipes and mupirocin nasal swabs had helped decrease bacteria on the skin and in the nose. Meanwhile, there is not much literature about bathing after a surgery. I combined these two things together in order to suggest post-op chlorhexidine wipes.
Leadership
- Assumes a leadership role within one’s scope of practice as a designer, manager, and coordinator of health care to meet the special needs of vulnerable populations in a variety of practice settings
- Organizes, manages, and evaluates the development of strategies to promote healthy communities
- Delegates and supervises the nursing care given by others while retaining the accountability for the quality of care given to the patient
Professionalism
- Differentiates between general, institutional, and specialty-specific standards of practice to guide nursing care
- Understands the effect of legal and regulatory processes on nursing practice and health care delivery, as well as limits to one’s own scope of practice
How My Frame of Reference in Nursing Changed
I generally had thought of nursing as a face-to-face caring profession. Since doing this assignment, I was able to meet the infection control nurses for our hospital, who work in nursing from a community level. They come up with general interventions and recommend new procedures that affect the patient and the practice at bedside. This sounds like it might be done from a distance, they actually have to keep close contact with the nurses on the floor in order to evaluate the effectiveness of the interventions. The interventions and policy changes that they make definitely affect the outcomes of the patients. The experience was valuable for me because I was able to experience nursing from this small community perspective. I can now appreciate nursing not only one-to-one, but also in a small community.
![](http://www.weebly.com/weebly/images/file_icons/pdf.png)
403_urbano_therapeutic_nursing_interventions100.pdf | |
File Size: | 212 kb |
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Health Policy Discussion and Response
NURS 464 – Development of Case Management Skills: Clinical Pathways and Outcomes
Purpose of Assignment
The purpose of the assignment is to select an organization and answer these questions concerning its stance on a health policy in a discussion board post.
Then, respond to another student’s post by selecting a stance and supporting it with evidence.
Student Approach to Assignment
The organization that I had decided to write about was RAND Corporation, a research and policy organization. RAND Corporation uses research to arrive at policies. Of the policies that they make, I decided on health literacy because it is a major component in patient education and may be an indicator of readmission. I wanted to know it meant to be health literate and how to improve a population’s health literacy. For my response post, I chose to reply to a post about vaccination, a contemporary issue. I agree that vaccination should be promoted, but it there is misinformation abound. Based on research, I came up with an intervention for the community to promote vaccination by educating on social media.
Reason for Inclusion of this Assignment in the Portfolio
I examined two health policies in this assignment and succinctly take a position about both of them. I formed my responses by thinking of ways to build upon the policies presented to me, which required some puzzle solving and consideration for breadth of the population. This angle allowed me to consider health promotion and education at a community level. However, no single practitioner will affect a community’s health literacy or vaccine compliance, so I advise that the healthcare community as a whole educate about health behaviors.
Core Competencies
Critical Thinking
Communication
Teaching
Research
Leadership
Professionalism
Culture
How My Sense of Professionalism Changed
Policies are meant to be guidelines, but in some ways they are part philosophy. At a workplace, policies are in place so that there are standards across the hospital, but they are made in accordance to a mission. However, I see that policies may not always be perfect and because they are almost philosophy, they have pliability. I don’t discount RAND Corporation’s policies, but there is also a freedom build upon their policy in my own practice. Take health literacy, for example. I can promote health literacy for one adult client per RAND Corporation’s policy, but I can also promote health literacy of those around the client. For instance, it may be difficult to teach a child directly, but teaching the parent would benefit both child and parent. I can use policy as a basis for my standards of practice, but I am also able to make the practice my own and build upon policy.
The purpose of the assignment is to select an organization and answer these questions concerning its stance on a health policy in a discussion board post.
- Its history (when & how it started)
- copy & paste the specific web link to the health policy focus
- Is it public or private?
- Is it for-profit or not-for-profit?
- Main focus/mission of the organization
- Select & discuss one policy focus of the organization as available on their website. What is their stance on this policy
- Briefly discuss your stance on the policy & support with at least one source of professional literature
Then, respond to another student’s post by selecting a stance and supporting it with evidence.
Student Approach to Assignment
The organization that I had decided to write about was RAND Corporation, a research and policy organization. RAND Corporation uses research to arrive at policies. Of the policies that they make, I decided on health literacy because it is a major component in patient education and may be an indicator of readmission. I wanted to know it meant to be health literate and how to improve a population’s health literacy. For my response post, I chose to reply to a post about vaccination, a contemporary issue. I agree that vaccination should be promoted, but it there is misinformation abound. Based on research, I came up with an intervention for the community to promote vaccination by educating on social media.
Reason for Inclusion of this Assignment in the Portfolio
I examined two health policies in this assignment and succinctly take a position about both of them. I formed my responses by thinking of ways to build upon the policies presented to me, which required some puzzle solving and consideration for breadth of the population. This angle allowed me to consider health promotion and education at a community level. However, no single practitioner will affect a community’s health literacy or vaccine compliance, so I advise that the healthcare community as a whole educate about health behaviors.
Core Competencies
Critical Thinking
- Engages in creative problem solving
Communication
- Expresses oneself and communicates effectively with diverse groups and disciplines using a variety of media in a variety of contexts
Teaching
- Provides relevant and sensitive health education information and counseling to patients, and families, in a variety of situations and settings
- Uses information technologies and other appropriate methods to communicate health promotion, risk reduction, and disease prevention across the life span
- Evaluates the efficacy of health promotion and education modalities for use in a variety of settings with diverse populations
Research
- Applies research-based knowledge from nursing as the basis for culturally sensitive practice
- Applies research-based knowledge from the arts, humanities and sciences to complement nursing practice
- Shares research findings with colleagues
Leadership
- Initiates community partnerships to establish health promotion goals and implements strategies to meet those goals
Professionalism
- Differentiates between general, institutional, and specialty-specific standards of practice to guide nursing care
Culture
- Articulates an understanding of how human behavior is affected by culture, race, religion, gender, lifestyle, and age
- Considers the impact of research outcomes and, the effects of health and social policies, on persons from diverse backgrounds
How My Sense of Professionalism Changed
Policies are meant to be guidelines, but in some ways they are part philosophy. At a workplace, policies are in place so that there are standards across the hospital, but they are made in accordance to a mission. However, I see that policies may not always be perfect and because they are almost philosophy, they have pliability. I don’t discount RAND Corporation’s policies, but there is also a freedom build upon their policy in my own practice. Take health literacy, for example. I can promote health literacy for one adult client per RAND Corporation’s policy, but I can also promote health literacy of those around the client. For instance, it may be difficult to teach a child directly, but teaching the parent would benefit both child and parent. I can use policy as a basis for my standards of practice, but I am also able to make the practice my own and build upon policy.
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health_policy_db_rand_corp.pdf | |
File Size: | 162 kb |
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Wikicountry Brazil
NURS 458 – Studies in Professional Nursing: Global Health
Purpose of Assignment
The purpose of this assignment is to introduce the student to the major underlying determinants of poor health and their effect on the health of populations worldwide. The student will utilize these principles to create an informational wikipage for the country of their choice.
Student Approach to Assignment
I chose Brazil because I had a slight interest in South America and the developing nations there. I often heard of strife and poverty when hearing about Brazil, so I thought it would be an opportunity to learn about the country for myself. I started the project with an open mindset and enthusiasm because it was the first time I would get to understand Brazil.
Reason for Inclusion of this Assignment in the Portfolio
This semester-long project had required constant attention to Brazil as a topic, and it immersed me in the culture of Brazil. I enjoyed this assignment greatly, and I think it is representative of the cultural awareness that I had gained in the program. This project had also concentrated on the core competency of culture the most out of all projects that I had done in the program.
Core Competencies
Nursing Practice
Communication
Teaching
Research
Leadership
Professionalism
Culture
How My Understanding of Culture Changed
Classes I took before this would address cultures in passing and suggest that I basically just keep an open mind when interacting with anyone. While that is necessarily the case, there are a multitude of ways that culture affects a person’s perception. Culture entails a lifestyle, a history, and an environment, which all contribute to health. Brazilian culture is especially interesting because it is actually a combination of several cultures. There is the coastal culture and the inland culture, both of which included several indigenous tribes, and the Portuguese culture, which has permeated most of the nation. The way that Brazilians use several rituals to treat the ill is representative of many cultures and health providers must allow kind of freedom. I also found that industrialization and development has also introduced more elements of culture – culture continues to change over time. The nation sees growing pains in the form of poverty and illness and healthcare is charged to address those rapidly growing problems. Even though I have formally studied one Brazilian culture, it is fair to say that I have also seen shades of many cultures. Being culturally sensitive means to be considerate of a culture’s multitude of parts.
The purpose of this assignment is to introduce the student to the major underlying determinants of poor health and their effect on the health of populations worldwide. The student will utilize these principles to create an informational wikipage for the country of their choice.
Student Approach to Assignment
I chose Brazil because I had a slight interest in South America and the developing nations there. I often heard of strife and poverty when hearing about Brazil, so I thought it would be an opportunity to learn about the country for myself. I started the project with an open mindset and enthusiasm because it was the first time I would get to understand Brazil.
Reason for Inclusion of this Assignment in the Portfolio
This semester-long project had required constant attention to Brazil as a topic, and it immersed me in the culture of Brazil. I enjoyed this assignment greatly, and I think it is representative of the cultural awareness that I had gained in the program. This project had also concentrated on the core competency of culture the most out of all projects that I had done in the program.
Core Competencies
Nursing Practice
- Applies appropriate knowledge of major health problems to guide nursing practice
- Implements traditional nursing care practices as appropriate to provide holistic health care to diverse populations across the lifespan
Communication
- Expresses oneself and communicates effectively with diverse groups and disciplines using a variety of media in a variety of contexts
- Produces clear, accurate, and relevant writing using correct grammar, spelling and punctuation
- Accesses and utilizes data and information from a wide range of sources to enhance patient and professional communication
Teaching
- Uses information technologies and other appropriate methods to communicate health promotion, risk reduction, and disease prevention across the life span
This is an informational wiki including sections about health risks in the country which environmental pollution, poverty, and air pollution. I make recommendations for the involvement of the government to reduce these risks, such as support for those in the recycling business. - Evaluates the efficacy of health promotion and education modalities for use in a variety of settings with diverse populations
- Uses information technologies and other appropriate methods to enhance one’s own knowledge base
Research
- Differentiates between descriptive nursing literature and published reports of nursing research
- Applies research-based knowledge from the arts, humanities and sciences to complement nursing practice
- Shares research findings with colleagues
Leadership
- Organizes, manages, and evaluates the development of strategies to promote healthy communities
Professionalism
- Understands the effect of legal and regulatory processes on nursing practice and health care delivery, as well as limits to one’s own scope of practice
Culture
- Articulates an understanding of how human behavior is affected by culture, race, religion, gender, lifestyle, and age
- Demonstrates sensitivity to personal and cultural definitions of health, and how these beliefs influence an individual’s reactions to the illness experience and end of life
- Integrates knowledge of cultural diversity in performing nursing interventions
- Considers the impact of research outcomes and the effects of health and social policies, on persons from diverse backgrounds
One of the biggest social issues is Brazil’s social classes. The poor are looked down upon and not as well represented by the government. The poor class is so large that there is a sizable community that makes a living from recycling garbage called “catadores.” They even play a significant role many towns’ waste disposal. These people have been identified as being at occupational health risks so movements are ongoing to support catadores and their families. With that, the poorer class would also gain more recognition. - Maintains an awareness of global environmental factors that may influence the delivery of health care services
How My Understanding of Culture Changed
Classes I took before this would address cultures in passing and suggest that I basically just keep an open mind when interacting with anyone. While that is necessarily the case, there are a multitude of ways that culture affects a person’s perception. Culture entails a lifestyle, a history, and an environment, which all contribute to health. Brazilian culture is especially interesting because it is actually a combination of several cultures. There is the coastal culture and the inland culture, both of which included several indigenous tribes, and the Portuguese culture, which has permeated most of the nation. The way that Brazilians use several rituals to treat the ill is representative of many cultures and health providers must allow kind of freedom. I also found that industrialization and development has also introduced more elements of culture – culture continues to change over time. The nation sees growing pains in the form of poverty and illness and healthcare is charged to address those rapidly growing problems. Even though I have formally studied one Brazilian culture, it is fair to say that I have also seen shades of many cultures. Being culturally sensitive means to be considerate of a culture’s multitude of parts.
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History of Present Illness Write-Up: Breast/Axilla/Abdomen
NURS 305 – Health Assessment
Purpose of Assignment
The purpose of this assignment is to first use verbal assessment techniques a Monarch General avatar simulation, then use learned assessment techniques on a willing volunteer. The data obtained would be written in a History of Present Illness (HPI) and object exam in a clear fashion. This HPI focused on assessment of breast and abdomen.
Student Approach to Assignment
First, information from the avatar was gathered by asking the avatar questions. She had presented with abdominal pain, so it was important to look for information such as appetite, pain level and characteristics. As I was dealing with pain, I also collected information on how the patient attempted to treat the pain. The avatar was also of Hispanic origin, so it was also important to detect traditions or religious needs. After assessing the avatar, I was able to find a willing volunteer for a breast and abdomen exam. The volunteer had a history of breast cancer with lumpectomy, so it was a good opportunity to see an abnormal exam.
Reason for Inclusion of this Assignment in the Portfolio
The Monarch General simulations allowed me to exercise my assessment techniques, which are skills that I had hoped to learn from this program. This was the first time I had used avatars as practice for my skills, and it was interesting to experiment with. Afterwards, I was able to find a willing volunteer to perform a physical assessment. While this HPI is not perfect, the details of my assessments had improved to be increasingly thorough. I received feedback to include headings to improve my clarity in the future. Another unique feature of this assignment is that it gave me the opportunity to teach a breast self-exam with a return demonstration.
Core Competencies
Nursing Practice
- Demonstrates an awareness of complementary modalities and their usefulness in promoting health
Communication
- Uses therapeutic communication within the nurse-patient relationship
- Produces clear, accurate, and relevant writing using correct grammar, spelling and punctuation
HPI and objective exam language is more succinct than prose. In this HPI, I established a flow for from head-to-toe for the system that I was examining. I had received feedback to add titles to categorize the technique I was performing in order to improve clarity. However, my writing does indicate what technique was performed. The data I had noted was clear.
Teaching
- Provides relevant and sensitive health education information and counseling to patients, and families, in a variety of situations and settings
- Uses information technologies and other appropriate methods to enhance one’s own knowledge base
Culture
- Articulates an understanding of how human behavior is affected by culture, race, religion, gender, lifestyle, and age
- Demonstrates sensitivity to personal and cultural definitions of health, and how these beliefs influence an individual’s reactions to the illness experience and end of life
How My Assessment Technique Improved
The Nursing Assessment class was a class that I had looked forward to for building my assessment skills. Nurses must be able to detect small details, but on a medical-surgical floor, a full-head to toe assessment is not always possible. This class helped me build my focused assessment skills in the case that I cannot perform a full head-to-toe assessment. Details can indicate an early onset of a new condition. This class let me practice my inspection, auscultation, palpation, percussion, and skills. I think that palpation is the technique I learned most from because a mass could be detected anywhere in the body. For the abdomen, it might be obstruction or organomegaly. For the breast, it could mean cancer. I also realize that it is also a good time to educate and reinforce teaching about breast self-exams when assessing the breast. In any assessment, it can be a good idea to explain and educate about the patient’s body.
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