"Nursing / Doctor / Physician" Essays

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Patient With Acute Abdominal Pain Article Review

Article Review  |  4 pages (1,036 words)
Bibliography Sources: 1

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Elaine Cole, Antonia Lynch, and Helen Cugnoni authored a brief article entitled "Assessment of the Patient with Acute Abdominal Pain," which appeared in the May, 2006 issue of Nursing Standard. Both Elaine Cole and Helen Cugnoni currently (as of the time of the article's publication) hold positions in emergency medicine, while the former is also a lecturer in the area. Antonia Lynch is a consultant nurse, and the experience of the writing team is certainly a major asset to its credibility and reliability. This paper will present a brief summary and assessment of this practice guideline, assessing it in terms of its approachability, the clarity of its information, and the ultimate applicability of the information as presented. In order to accomplish this, a summary of the information will be provided.

Summary

The focus of this article, as the title implies, is on the general assessment of patients complaining of abdominal pain. An overview of the subject is given, with notes regarding the commonality of abdominal pain complaints and the many different ways in which this pain can be described. A large portion of the article is devoted to specific diagnoses, with ailments listed as subject headings and descriptions of the pain experienced and other possibly comorbid symptoms as a means of allowing nursing professionals to differentially diagnose from amongst these ailments. In this way the article provides both a general and a specific description of abdominal pain assessment methods for a wide variety of common complaints.

There are several key assessment areas that are identified in the article, beginning with obtaining a detailed history from the patient including specific attention to any previous complaints of abdominal pain. Analysis of the pain itself is also a large part of assessing patients with abdominal pain complains, and a great deal of space is devoted to a description of pain assessment in this article. There are also several other areas of assessment recommended for helping nursing staff achieve accurate and efficient diagnoses of abdominal pain complaints. Analysis of medications, recent and lifetime dietary habits, as well as family medical histories are all used as means of differentiating diagnoses. Rationales for these assessment methods are found almost entirely in the ultimate specific diagnoses of abdominal pain complaints, as the patterns of these illnesses can be discovered through these assessment areas.

When it comes to the specific strategies and tools discussed in the article there is very little given in the way of explicit detail other than that which can be circumstantially inferred from the described assessment methods. Communication is obviously key in achieving an accurate understanding of the pain the patient is experiencing, and calm persistence in this regard is a necessary tool or skill for the assessing nurse. No specialized equipment or tools are generally required for the assessment methods described in this article, though there are times when imaging techniques and other means of assessment are warranted. The article does not focus on any specific population, but rather notes the high degree… [read more]


Final Critique of Emergency Nurses Article Critique

Article Critique  |  3 pages (983 words)
Bibliography Sources: 1

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Emergency nurses' knowledge, attitudes, and experiential survey on advance directives," by Jezewski et al. (2007) is a qualitative paper. It seeks to assess the knowledge of emergency nurses about advance directives (AD) and how this correlates with their confidence and experience. The researchers use a device called the Knowledge, Attitudinal, and Experiential Survey on Advance Directives (KAESAD), developed in previous studies (Jezewski, 2005), to survey nurses belonging to the Emergency Nurse Association (ENA). The nurses surveyed resided in four different states in order to also assess knowledge of state laws regarding AD.

The researchers found that nurses' knowledge of AD was very poor ranging from 68% in general knowledge, 51% in knowledge about the Patient Self-Determination Act (PSDA), and 56% on state law knowledge. Nurses were experienced with AD, but not confident completing AD or assisting patients with AD. They also found significant correlation between nurses' confidence and the level of their education. Also, knowledge significantly decreased with providing direct care. Although these finding were statistically significant they were deemed not clinically significant by the researchers.

The introductory material of this paper was very lacking. This paper deals entirely with AD and the authors do not even define it. They simply list a few types of AD. It would have been very helpful talk about the history of AD, what they are and how they relate to nurses in the healthcare setting in at least one paragraph. Similarly, the authors refer to end of life (EOL) decision making, which they do not at all define or talk about in the introductory material. Another very lacking portion of the introduction was the literature review. The authors state that very little work of this kind had been done previously. However, in the discussion the authors refer to numerous similar studies and their results and how they compare to the authors' findings. The problem statement and purpose were very clearly stated. The authors do not state a hypothesis, but do list their research questions as the aim of the research. The importance of this work was also talked about. The authors assert that since emergency nurses work with patients in emergency settings that AD must be a part of their work and therefore assessing their knowledge and confidence in the subject would be important. It was also explained that this work attempted to go beyond other previous work by trying to correlate nurses' knowledge and confidence with experience and other factors.

The research design used accepted methods of sampling to get a large enough response for meaningful statistical analysis. An oversampling method was used due to generally low response to mail surveys. The data was collected from returned surveys and of those the usable surveys were analyzed. The authors did not discuss what made a survey usable or not. Ethical considerations were not mentioned. The authors used a device that was previously tested for reliability, content validity, internal consistency, and approved by the Health…… [read more]


Taking a Patient's History Article Review

Article Review  |  3 pages (1,038 words)
Bibliography Sources: 1

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¶ … patient's history involves more than just asking a serious of questions. There is a lot that goes into this process that the nurse should be aware of. The patient's history is important because it lays the blueprint of how to diagnose the patient's illness based on the history given. Not all nurses are skilled in this area. It takes much more than medical expertise to perform this task. The nurse must be an excellent communicator which means speaking as well as listening. She must also respect the patient's privacy and ensure that confidentiality is always maintained (Lloyd and Craig, 2007).

Every patient is different and patients will always have their own type of communication style. The nurse must be receptive to this and deal with the patient's accordingly. Professionalism and friendliness is always a plus. The person taking the patient's history should always introduce herself and make the person feel at ease. Using technical or medical terms is usually not a good idea as the patient may get confused as to what is actually being asked (42). The patient's consent is especially important and the nurse must be aware of whether or not the patient is mentally capable of giving consent (43). If it is determined that the patient is not mentally capable, then a guardian may need to answer any questions and in the case of a minor, one or both parents or a legal guardian should be present at all times.

The process to taking the patient's history is something that should be taught to nurses before they complete nursing school. Many time nurses are taught all of the technical and medical aspects of the job, but are not taught how to effectively deal with the patients. As mentioned before, the nurse should always introduce herself at the beginning of the process. This is not only considered professional, but it also serves as an ice breaker. Knowing how to ask questions as well as what questions to ask is also important. Open ended questions allow the patient to tell the nurse what the exact medical issues are that they are having. Once the nurse takes down this important information, she can then begin with the close ended questions such as asking the patient how long they've had the particular problem (43).

When taking the patient's history, the nurse should always focus on the symptoms instead of the diagnosis. This falls in line with the list of cardinal symptoms which serve as a guideline of what to look for based on what type of symptoms the patient has (44). Each symptom that the patient reports should be carefully examined as it could lead to many underlying hidden medical issues.

Sometimes taking the patient's history can be uncomfortable for both the nurse and the patient. The patient may have a history of drug abuse or may have been sexually abused. The nurse must skillfully and tactfully answer these questions and may preface them by telling the patient that… [read more]


Transition Shock: The Initial Stage of Role Essay

Essay  |  4 pages (1,247 words)
Bibliography Sources: 1

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¶ … Transition shock: the initial stage of role adaptation for newly graduated Registered Nurses (Duchscher, 2009), the author looks at the theoretical structure of the first changeover for new nurses to assist executives, instructors and experienced practitioners in order to sustain and ease professional modification suitably. The article is broken down into many different sections. These include an abstract, an introduction, background, data sources, discussion, implications for nursing, a conclusion and references section. The article is well laid out and appears to cover all the pertinent information that a reader would need to understand the author's account of their research.

This study looked at the way that new graduates connect in a practiced nursing function for the first instance and is often tackled with a wide variety and range of intellectual, physical, emotional, developmental and sociocultural alterations that are showings of, and extenuating issues inside the knowledge of evolution. Nurses that are new to the profession often recognize their first professional modification in conditions of the thoughts of nervousness, uncertainty, insufficiency and shakiness it creates. The Transition Shock theory centers on the facets of a new nurse's functions, tasks, associations and understandings that both arbitrate the force and period of the evolution knowledge and explain the initial phase of specialized position evolution for the new nurse.

It is currently thought that nursing graduates (NG's) face very challenging times. The majority of them make their initial move into the professional arena at a hospital. It has been shown that less than fifty percent of practicing nurses would presently advocate nursing as a career choice, while twenty five percent would aggressively discourage someone from going into nursing. Thirty three to sixty one percent of newly graduated people in North America alter their choice of jobs and get out of nursing within their initial year of practicing. The significance of looking at the progression of the new nurse's adjustment into professional practice communicates to the continuing confront nursing associations, educational institutions and those who make policies all to comprehend and react to the concerns that might be motivating these lively and enthusiastic nurses away from the nursing vocation.

Although it is apparent that the passage of evolution for the new nurse is frequently demanding, exasperating, disappointing and disenchanting, what continues to be uncertain are the phases of that passage. Transition shock is often offered as a direct, sharp and remarkable phase in the procedure of professional function adjustment for the new nurse. The devise of this phase includes fundamentals of transition theory, actuality shock, cultural shock, as well as speculation connected to professional function alteration, increase and expansion.

Existing knowledge puts forward that new nurses experience job performance pressure, moral grief, dissuasion and disenchantment throughout the early period of their beginning in the professional nursing function. What remains unclear is the relation among these practices and the course of time. While there has been previous confirmation in regards to the knowledge of evolution, researchers have not yet put this information into an… [read more]


Orthopedics Arthroscopic Versus Open Rotator Cuff Repair Research Paper

Research Paper  |  17 pages (5,702 words)
Bibliography Sources: 15

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ORTHOPEDICS: ARTHROSCOPIC vs. OPEN ROTATOR CUFF

ORTHOPEDICS: ARTHROSCOPIC vs. OPEN ROTAR CUFF

Arthroscopic vs. Open Rotator Cuff

Orthopedics: Arthroscopic vs. Open Rotator cuff repair

Cardsmax

Data was compiled to research Arthroscopic vs. open Rotator cuff repair. The findings suggest that regardless of the method utilized for repair there will more than likely be a need for maintenance repairs. Healing time… [read more]


Occupational Health and Safety Essay

Essay  |  3 pages (1,148 words)
Bibliography Sources: 1+

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Occupational Health and Safety

The nursing profession is prone to occupational health and safety issues. From biological infections to harmful chemicals, physically straining patient care routines to experiencing emotionally draining events, nurses are exposed to a wide variety of occupational hazards that make them vulnerable to serious injuries and diseases. Studies report a very high percentage of musculoskeletal disorders among nurses. Studies have also reported high incidences of latex allergies and needle stick injuries among nurses leading to dermatis, asthma and acquiring other dangerous infections. [Timmins et.al, (2008)] In Australia, the OHS act 2000 provides the framework for organizations to maintain a safe and healthy workplace. The legislation includes severe penalties for lack of safety provisions and compensation for affected workers. Workplace injuries not only affect nurses who have to undergo rehabilitation but also result in more burden for the already strained and overstretched nursing force. A brief overview of the OHS provisions pertaining to the nursing and health care industry, with a discussion of how nurses can avoid the environmental hazards by the creative use of ergonomic principles would provide more insight into the topic.

OH&S Policies

The OHS act 2000 provides the comprehensive legal framework for overseeing that workplace safety and health regulations are properly implemented. The law requires that employers must ensure the safety and health of all the employees. From the Health care organization's perspective this implies that the working conditions for nurses should meet the requirements of the stipulated standards. The act also necessitates the establishment of an OHS committee and selection of an OHS representative from within the staff. [NSW, (2009)] There are minor state specific amendments to the OHS act. The Workcover authority of NSW is in charge of supervising the enforcement of the OHS regulations in the hospitals and health service centers in the region. Similarly SafeWork SA is in charge of workplace safety regulations in South Australia and Worksafe, a department of commerce under the Western Australian government, regulates organizational safety issues in Western Australia. The OHS also requires employees to report any instances or workplace practices that could compromise the employer's implementation of OHS regulations such as unsafe or faulty equipments, injury or any other potential hazards.

Environmental Hazards Mitigation (Nursing Role)

Nurses, being primary care providers are affected by a variety of occupational health risks including biological, chemical and mechanical hazards in the course of their routine care delivery. Not only the safety of the nurses but also the safety of the patients depends upon nurses' awareness of the workplace hazards and how effectively they deal with these safety risks. This calls for active participation from the nursing staff, the OHS committee and the hospital management. As healthcare workers directly involved in caregiving, Nurses can help identify, eliminate and prevent potential environmental hazards. Nurses can be proactive and report any hazardous situation to the OHS committee and if the issue is still unresolved they can even report the matter to the appropriate safety authority such as Workcover (NSW), Worksafe… [read more]


Resp Report the Progress of Respiratory Distress Term Paper

Term Paper  |  2 pages (528 words)
Bibliography Sources: 1

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Resp Report

The Progress of Respiratory Distress

Respiratory issues are increasingly commonplace and increasingly dangerous to overall health and even life as patient age increases. In the article examined for this report, the patient presenting is not especially old, being only fifty-six years of age, but the manner in which his initial respiratory distress was initially handled by physicians and the progression of the patient's condition to his ultimate death is indicative of many of the issues and complications that might arise in presentations of respiratory distress and disturbance. In the meantime, the fact that many of the tests performed by physicians in this case failed to return conclusive results and that, indeed, the patient ultimately died despite the degree of attention paid to him points to the lack of full and total comprehension of respiratory distress and related symptoms and illnesses that exists, such that the physicians were unable to effectively address the multitude of issues that arose for the patient during the progression of his condition. From a purely academic standpoint, the failures in this case actually allow for abundant and effective additions to the knowledge regarding these issues.

The first way in which this can be seen is in the initial treatment and dismissal of the patient when he first presented with respiratory complaints. The other symptoms that the patient complains of at this initial presentation include fever and non-productive cough, which was in large part responsible for the initial diagnosis of community-acquired pneumonia. Though this diagnosis was not necessarily an error, it obviously (in hindsight) did not adequately address the…… [read more]


Watson Theory of Human Caring Research Paper

Research Paper  |  6 pages (1,820 words)
Bibliography Sources: 5

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Watson Theory of Human Caring

BODY and SOUL

Values and Assumptions

The theory of human caring by Jean Watson involves caring actions by nurses in their interaction with others (Fawcett, 2002). Its values and assumptions have a metaphysical, phenomenological-existential and spiritual slant, based on Eastern philosophy. Its values include a deep respect for the wonder and mysteries of life and… [read more]


Tattoo Views on Men and Women Article Critique

Article Critique  |  5 pages (1,465 words)
Bibliography Sources: 2

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Body Art Among Men and Women -- Literature Review

Armstrong, M., Roberts, a., Owen, D., & Koch, J. (2004). "Toward building a composite of college student influences with body art." Issues in Comprehensive Pediatric Nursing, 27(4), 277-295.

The purpose of the study was to investigate various factors in relation to intimate body piercings, such as those of the genitalia and… [read more]


Change Proposal Research Proposal

Research Proposal  |  5 pages (1,866 words)
Bibliography Sources: 5

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Change Proposal

America became aware of the AIDS epidemic in the early 1980's. By the mid-1980's it seemed as though it was the most talked about disease in this country. It was primarily known as a gay, white male's disease but as the years progressed it has become prevalent in other demographics. It was thought to be primarily a sexually… [read more]


Personal Leadership Development Plan Term Paper

Term Paper  |  3 pages (1,002 words)
Bibliography Sources: 4

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Leadership Development

Personal Leadership Development Plan.

Leadership development paper: A plan for action

Leadership development paper: A plan for action

Assess your practice for leadership attributes

My ultimate goal is to become a nurse on an (ICU) intensive care unit. Working on an ICU requires tremendous strength of character and decisiveness on the part of the nurse. The nurse must think quickly, give clear directives, and communicate a sense of confidence to the patient. In my current work as a nurse on a telemetry unit, I must also show confidence and give clear directions when dealing with patients with critical illnesses.

Summarize your strengths and areas for growth

I would describe myself as a compassionate person and a good listener, both of which are essential attributes when dealing with critically ill patients. A nurse must be empathetic when dealing with others and understand the physical and personal stressors caused by various illnesses. I am respectful to patients as well as to my colleagues, and I attempt to be fair in the ways in which I allocate tasks when I am in a leadership position.

Describe a plan which includes your personal and professional vision statement.

I strive to provide a caring and nurturing environment for my patients, one that is supportive of personal wellness. I strive to promote patient empowerment and maximize patient self-care. Even within ICUs, allowing patients to be mobile so long as it does not compromise their care has been found to be health-promoting. "Recent studies on early mobilization in medical ICU patients have demonstrated that such an approach is feasible and safe and have suggested potential benefits of decreased ICU and improved long-term morbidity" (Hildreth 2010:1).

At home, I hope to create a similarly caring and nurturing environment that promotes healthy interdependence and well as independence for my husband and children. I strive to balance the demands of home and work in an effective way, so that neither area of my life suffers as a result of my commitment to the other area. Personal and professional goals should be complementary rather than compete with one another. I intend to engage in effective self-care, to seek support when I need someone to talk to when I feel stressed out, and to strive to be organized when multi-tasking my life priorities.

Present two (2) professional short-term goals you want to accomplish this semester

I hope to use the experience I have gained in my current work as a telemetry nurse to obtain a position in an (ICU) intensive care unit.

I also plan to become more involved in professional nursing organizations by joining the ANA (American Nursing Association), and the AACN (American Association of Critical Care Nurses).

Present two (2) long-term professional goals you want to accomplish within the next (2) years.

I will complete my BSN degree within the next 2 years, and apply for a CRNA (Certified Registered Nurse Anesthetist) program.

Provide a description or outline for developing your expert power and credentials

As a member… [read more]


Ways of Know Research Paper

Research Paper  |  3 pages (896 words)
Bibliography Sources: 3

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¶ … practice? Provide specific examples for each type of knowing from the practice environment.

Nursing 'ways of knowing' are often classified under four basic rubrics: the empirical knowledge of nursing, which relates to technical practice; the ethical ways of knowing which relate nursing empirical knowledge to the nurse's professionalism and status as a moral being; esthetics (the ephemeral 'art' of nursing knowledge, based upon intuitive and compassionate insight); and personal knowledge relevant from past practice and also the nurse's daily life (Heath 1998: 1056).

The operation of ways of knowing underline the fact that simply disseminating treatment is often not enough to address a patient's needs. For example, a patient with uncontrolled diabetes might come to a hospital, and have his or her blood sugar stabilized using empirical practices by the nurse. However, from an ethical standpoint, the nurse may know that the individual needs additional social support to gain access to regular healthcare and diabetes management. Part of the nurse's ethical duty involves connecting the patient to social services within his or her community. From an aesthetic standpoint, the nurse knows that the patient's unstable life situation (irregular income and work hours) does not support a healthy lifestyle, and from personal knowledge of life and past practice the nurse knows that a regular eating, sleeping, and life schedule is essential in appropriate diabetes management, particularly if the individual is suffering from other mental health issues.

Q2. Identify your preferred paradigm and give supporting rationale for the choice.

I would currently describe my chosen nursing paradigm as holistic in nature (Van Sell 2002: 74). This is based in the fact that so many modern health complaints are due to lifestyle-related issues, such as a poor diet and lack of exercise. The reasons that America has increased rates of heart disease, high blood pressure, and Type II Diabetes are known. People might even have a vague understanding of the fact that they need to move more and eat less. However, helping patient's make lifestyle changes requires an intimate knowledge of a patient's family life and social environment. If the patient has trouble understanding how to eat healthy food on a budget, or finding safe places to exercise, the nurse should direct the patient to informational resources that make it easier for him or her to reach those vitally important health goals.

Q3. How would you change nursing's values and resources to promote knowledge development?

I think the field of nursing has made tremendous strides in shifting from a mechanistic view of human health, to a more holistic and systems-based view of the person. Many health deficits are not linked purely to individual behavior, but are the result of…… [read more]


Nursing Leadership Change Theory A-Level Coursework

A-Level Coursework  |  2 pages (730 words)
Bibliography Sources: 2

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Economically, this government initiative will reduce the demand for nurses, as many aides will be hired to perform the tasks formerly relegated to nurses. Socially, given that there is already confusion about the professional status of nurses and healthcare aides in the eyes of the lay public, the status of nurses will decline. Politically, funding may be reduced for increased nursing education.

Lewin's model of change: Strategic plan

Unfreezing

Nurses must become aware of the impact of this measure upon the profession, and strive to make the healthcare community, including patients, more aware of the potentially negative impact upon patient health. Local nurses' associations must urge their members to lobby their elected representatives against this measure. News advertisements should be run, citing statistics that support the need for nurses and their specific training and knowledge. The impact upon patient safety and human health should be stressed.

Change

Nurses must address the reasons that caused the original change to be proposed. If a nursing shortage was the cause, then one proposal might be to expand scholarship opportunities for nurses at a local college. This would expand the pool of available nursing candidates for hire and not necessitate the use of aides trained only 'on the job.'

Re-freezing

Lewin's model refers to 're-freezing' as the normalization of the change process, although a recent reconfiguration of Lewin change model is that rather than totally returning to stasis after change, organizations must remain flexible enough to be more responsive to changes in the future (Connelly 2010). Even if the nurses' organization successfully fights this change, the systemic pressures that gave rise to the attempt to threaten the profession have not gone away. Nurses must remain organized and mobilized to protect their professional integrity.

Q2. Retraining nurses that have been 'let go' due to budgetary cutbacks should focus upon using the nurses' current skill sets in new ways. For example, nurses with leadership and managerial experience could find work in hospital administrative roles, or in working in other business-related aspects of the health profession, such as for health insurance companies. Pharmaceutical and medical equipment companies often seek salespersons or employees with prior medical knowledge. Speaking to representatives of such companies…… [read more]


Moore Z, Price P. (2004). Nurses' Attitudes Research Paper

Research Paper  |  2 pages (548 words)
Bibliography Sources: 2

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Moore Z, Price P. (2004). Nurses' attitudes, behaviors and perceived barriers towards pressure ulcer prevention. Journal of Clinical Nursing, 13 (8):942 -- 952.

Retrieved December 17, 2010. doi: 10.1111/j.1365-2702.2004.00972.x.

According to Zena Moore and Patricia Price (2004), pressure ulcers, more commonly known as bedsores continue to be a problem in most hospital and extended care facilities around the world. Despite the fact that bedsores have existed since virtually the beginning of recorded medical history, no foolproof method exists to deal with them. However, patient's suffering can be greatly reduced with appropriate prophylactic care. Improved treatment of bedsores is essential, given that if the wounds are left untreated, infection as well as a loss of dignity and comfort can result for the patient.

The authors conducted their cross-sectional survey upon a randomly selected sample of three hundred staff nurses at an urban acute care section of an Irish hospital. This setting was selected to maximize the demographic diversity of the nurses surveyed. The purpose of the researchers was to determine the relationship of nursing attitudes towards pressure ulcers to the practical steps the nurses undertook to prevent pressure ulcers and to the perceived barriers to effective pressure ulcer preventative care.

Overall, the results of the survey indicated that nurses appreciated the need for pressure ulcer prevention and care. They also seemed to possess the necessary, required knowledge to engage in effective preventative techniques. But in the actual, rushed environment of the hospital, appropriate preventative care was not always administered in an effective manner. A lack of time and understaffing were the most frequently-cited reasons for nurses' failure to implement effective preventative procedures.

According to the…… [read more]


Self-Care Models Essay

Essay  |  2 pages (586 words)
Bibliography Sources: 1

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Nursing -- the Importance of Self-Care

Nursing is a profession that requires practitioners to be physically, emotionally, and spiritually healthy if they are to provide for the needs of their clients effectively. The field can be extremely stressful in ways that take a toll on physical and emotional health. Many aspects of nursing are challenging from a spiritual perspective as well in ways that require the practitioner to be as healthy as possible to cope with some of those challenges. Finally, professional nursing emphasizes the patient education role and the importance of helping patients understand health and wellness concepts from a holistic perspective. In all of those respects, the professional nurse must maintain his or her own health and integrity to cope with the challenges inherent in the field and to benefit their patients to the best of their abilities.

Physical Health

The nursing profession frequently requires practitioners to work long shift, overnight shifts, and to accommodate scheduling changes on short notice. Similarly, it is very common for nurses to develop sleeping difficulties associated with irregular work hours and vocational stress, and to encounter difficulties maintaining their own physical health because of all of those challenges (Tong, 2007). Therefore, it is important for nurses to understand how important regular sleep, good nutrition, and other factors are to their personal physical health. Otherwise, they will not be able to perform up to their highest capacity or to provide the greatest benefit to their patients (Tong, 2007).

Emotional and Spiritual Health and the Holistic Health Perspective

The nursing profession can also be extremely difficult on an emotional level because nurses are continually required to deal with people in high states of stress (Tong, 2007). Patients and their families can be tremendously demanding and coworker interactions…… [read more]


Evidence vs. Research-Based Practices Essay

Essay  |  2 pages (719 words)
Bibliography Sources: 1+

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Evidence vs. research-Based practices

According to the Behavioral Institute (2010), research-based practice "is a method for conducting research that ensures the research involves rigorous, systematic, and objective procedures to obtain reliable and valid knowledge," by using the scientific method of hypothesis testing. Research-based practice uses systematic methods of data-gathering and observation. Experiments often make use of controls, repeat testings, and other quality control measures. Scientific, rigorous data analyses "that are adequate to test the stated hypothesis and justify the general conclusion" are deployed (Scientifically-based research, 2010, Behavioral Institute). The measurement and observational methods that are used "provide valid data across evaluators and observers and across multiple measurements and observations" (Scientifically-based research, 2010, Behavioral Institute).

Evidence-based practice is also based upon research -- yet it has been subject to an additional, rigorous test -- the 'what works' test, in the ordinary, day-today-life of nursing practice. As well as having "gone through rigorous research," evidence-base practice has a "demonstrated a record of success" in treating patients and there is also "reliable, trustworthy and valid evidence to suggest the program is effective" in the real-life field of nursing (Scientifically-based research, 2010, Behavioral Institute).

As someone who has worked on a medical/surgical floor of a hospital in an urban setting, I am intimately acquainted with the difference between research and evidence-based practice. While research-based practice may work in the laboratory, ultimately nurses must test the methods used in the field, to see if they are useful on the day-to-day life of a unit floor. That is why research is often conducted in a separate fashion, compared ordinary, daily care, although research undeniably underlines the development of a nurse's standard operating procedures and administration of treatment. Ultimately, a BSN's practices are in support of both research and evidence-based methods, but in the nurse's day-to-day life, evidence-based practice is usually at the forefront of his or her consciousness.

Question 2: Joint Commission

According to the Joint Commission Standards (2010), nursing leadership involves creating a supportive environment that promotes high quality care and a team approach. However, in actual practice, the pressured environment of a nursing unit is not always conducive to promoting collaboration between staff…… [read more]


Negative Effects on Healthcare and the Undocumented Research Proposal

Research Proposal  |  2 pages (473 words)
Bibliography Sources: 3

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¶ … Music on Anxiety

It is widely known that surgery is a specific cause of stress and anxiety among surgical patients. This stress begins when patients first learn that they require surgery and continues throughout pre and post-operative phases. In many respects, stress is associated with higher instances of negative outcomes such as in relation to complications and the need for medications. Exposure to music is one factor that has been associated with stress reduction. This problem was clearly stated and is directly relevant to nursing.

According to the literature reviewed, surgical patients are more anxious than adults generally. It is not clear that this required substantiation because it seems obvious. The literature review also disclosed that anxiety in patients corresponds to medical complications and that medication alone may not necessarily reduce anxiety substantially. This literature is very relevant to the study as is the literature pertaining to previous studies I which exposure to different types of music were compared.

Theoretical and Conceptual Framework

The principle theoretical framework was the Stress Adaptation Theory of Hans Selye, MD, according to whish stress is unavoidable but the manner in which individuals respond to and adapt to stressors significantly determines the ultimate effect of stress. That theory posits that anything capable of reducing the patient's experience of stress is beneficial, which is extremely relevant to the research topic.

Research Variables

The independent variable was exposure or non-exposure to…… [read more]


Law Case Study

Case Study  |  2 pages (521 words)
Bibliography Sources: 0

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Law Case Study

Claim 1 - Karl vs. Dogwood

Karl has a very good negligence claim against the doctor. Dr. Dogwood had actual knowledge of the dangerous condition and exercised poor judgment in failing to take appropriate action immediately when he noticed the condition of the ECR grounding pad. That poor judgment was a breach of the doctor's duty of care to protect Karl from foreseeable harm during the surgical procedure. Karl will argue that the doctor knew or should have known that using the ECR pad in the condition it was in was too dangerous.

Possible Defenses

Dr. Dogwood might argue that his only mistake was in misjudging the severity of the burn that might result and that the ECR manufacturer is actually responsible for the harm caused by their products unfitness for its intended purposes. The Dr. will attempt to characterize this as a products liability case instead of a negligence case. Neither of those arguments is likely to be successful.

Claim 2 -- Karl vs. Hospital

Karl has a good claim against the hospital under the theory of respondeat superior because under that theory, the hospital is jointly responsible for the negligence of it employees. Specifically, the argument is that the hospital has an obligation to ensure the safety of patients by hiring competent doctors, training them properly, and monitoring their performance to identify possible risks to patients.

Possible Defenses

The hospital might argue that it is not responsible for an isolated instance of poor judgment of its employees unless there is other evidence that should have…… [read more]


Decision Support System Term Paper

Term Paper  |  5 pages (1,843 words)
Bibliography Sources: 5

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Decision Support Systems

Describe your understanding of the importance, challenges and barriers of terminologic systems in CDSS.

A clinical decision support system (CDSS) is a type of software designed to aid clinicians in their decision-making by matching individual patient characteristics and knowledge about the patient's disease to computerized databases "for the purpose of generating patient-specific assessments or recommendations" (CDSS, 2010,… [read more]


Electronic Medical Records First Student I Think Discussion and Results Chapter

Discussion and Results Chapter  |  2 pages (580 words)
Bibliography Sources: 4

SAMPLE TEXT:

Electronic Medical Records

First student

I think your response brings to light an important point: There is profound emotional resistance to shifting over to electronic record-keeping. Logically speaking, there is no reason why paper records cannot be damaged: paper can be destroyed in a flood or misplaced; messy handwriting can be inaccurately transposed from one set of records to another and a single copy of a file can be stolen or lost. Yet there is still tremendous fear about electronic record-keeping simply because it is a change in technology and it subjectively 'feels' less secure, because it is new. Although some institutions may indeed face 'financial barriers' at first in shifting to electronic records, the cost of inaccurate charts is surely far greater, in terms of patient health. The worry that doctors will become more 'computerized' in their attitude through the implementation of online record-keeping also reflects emotional rather than practical resistance to the new technology. Certainly, all of us have met doctors who only stare at a paper chart! The problem is with such doctors' interpersonal skills, not the new technology

More and more people are moving around the country, and have haphazard medical records. Having an understanding of a patient's health history is essential, and generalized databases of medical records would make this possible. If a patient is in an accident in another state (hardly an inconceivable occurrence), as you point out, knowing that a patient is a diabetic, allergic to penicillin, or has Type O blood could save his or her life.

While the ideal type of universal system is still a 'work in progress' as electronic record-keeping becomes more common, the systems that evolve will improve. Greater homogeneity between institutions EMR programs will facilitate accuracy and…… [read more]


Motivational Theories and Factors Essay

Essay  |  2 pages (676 words)
Bibliography Sources: 3

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Motivational Theories and Factors

Motivation and 'caring' professions: Improving the workplace atmosphere

Motivation and 'caring' professions: Improving the workplace atmosphere

Perhaps the most common method of motivating employees is that of increased financial compensation, or bonuses. This technique is frequently applied even in positions that are considered 'vocations' individuals undertake for intrinsic rewards rather than merely 'jobs.' However, because of the high levels of stress inherent in 'caring professions' such as nursing and teaching, providing employees with incentive payments is often cited as the solution for tension-laden or underperforming hospital and educational environments.

For example, pay-for-performance has become a popular method of motivating teachers to encourage their students to excel on standardized tests (Paulson 2009). An increasing number of nurse executives are also receiving bonus compensation based upon the criteria of financial performance, patient satisfaction, and relations with physicians and nurses, and RNs may receive compensation for taking undesirable shifts, working in areas of critical need, and meeting other benchmarks for improved patient outcomes (Bell & Bart 1991). Unfortunately, some types of financial motivation, such as initial bonuses for coming to an underserved and therefore more stressful hospital environment, do not necessarily result in long-term improvements in performance or improved retention. Furthermore, not all institutions have the resources to solely rely upon financial rewards as incentives for long-term improved performance.

Additionally, controversy may fester amongst employees regarding how outcomes are measured in pay-for-performance structures. Conflict is created by perceived unfairness, and bonuses may thwart rather than contribute to unit cohesion. Workers may also feel frustrated if they feel the criteria are unfair: teachers with difficult classes may receive less compensation than teachers with the same level of competence but better-prepared students with fewer learning challenges. Setting performance benchmarks for unpredictable outcomes of health and children's performance can make the worker feel less, rather than more in control over his or her compensation package.

A different view of the question of how to improve the atmosphere of a working environment might be what does not motivate people and what…… [read more]


PDP Short-Term Goal Term Paper

Term Paper  |  6 pages (1,718 words)
Bibliography Sources: 1+

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PDP

Short-term goal

My short-term goal is to complete my required coursework for this semester with a GPA of at least 3.0.

What external reality could prevent you from realizing your goal?

Succeeding in school demands a tremendous amount of emotional and physical stamina. Although I would like to say that I have the unqualified support of my family, I… [read more]


Evidence-Based Assessment Framework Essay

Essay  |  3 pages (897 words)
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Evidence-Based Assessment Framework

Evidence Based Assessment Framework for the Field of Nursing

First, let's look at how nurses can approach and organize their assessment in a structured manner, the term 'Nursing Assessment' means the sum up or collection of data regarding the complete physiological, sociological, psychological and the cultural (spiritual) background of the patient. It is the early stage of entire process where the nurse makes an overall assessment of the needs by the patient (here, the assessment is dependent on a pre-defined nursing model). The main aim here is to find out the nursing problems of the patient (problems may be regarded in actual or potential categories).

In the psychological tests, the intellectual as well as the emotional health are assessed. The health assessment of the intellectual abilities measure the cognitive functions, checkup of any sort of delusions or hallucinations, the check up of concentration levels and a measure of the patient's interests as well as hobbies. Emotional health is judged by checking on how the patient reacts to certain feelings and what its response to certain amount of feelings is.

The test of physical examination checks or observes symptoms like nausea. Here many techniques can be applied such as Auscultation, Inspection and so on (these add to the techniques main signs of patient's temperature, the rate of pulse and respiration, the patient's blood pressure and other checkup of different systems like cardiovascular and musculoskeletal processes.)

This complete assessment is then documented in the medical or nursing record of the client patient. This documentation process can be done on paper or any other sort of advanced electronic media like computer databases, these electronic databases are easy to use and also very safe. Anyone who has the authority in the healthcare team can then access these records.

Let's have a look on how nurses can make use of appropriate assessment tools to help them in the collection of information. The nurses use many different types of tools available in summing up the data which is needed in making the patient's diagnosis. Here, following are the main tools which are included such as charts, the chart of patient gives the data on its overall health status. It has many different types of information within it like ongoing medical condition, the overall plan of the patient's treatment, the patient's medical history and different types of information which are necessary in making a care plan.

The vital signs include the careful monitoring of the heart rate regularly, the monitoring of blood pressure, the measurement of the body temperature as well as the respiratory rate. All of these measurements help the nurses in stopping any fatal complications. They also help in the…… [read more]


Healthcare Leadership Research Proposal

Research Proposal  |  2 pages (465 words)
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Metro Health

MetroHealth Scenario Qs

The most important factors affecting physician-management relations at MetroHealth can be identified by the changes wrought as described in the scenario: the scope and organization of MetroHealth and the access to influence and decision-making power that it provides to physicians is of paramount importance in creating effective physician-management relationships. Physician revenue as a managerial measure of success is always a dangerous concept, and certainly proved detrimental in this scenario; the complexity of the organization and intentional withholding of power -- both situations that have begun to be addressed under White -- were also hugely influential factors in this relationship.

2)

Though revenue generation is not a successful measure of physician integration to the goals of the hospital system, rate of patient turn-over (along with timelines and costs of patient recovery) per-physician would be a useful method for determining the degree to which a physician is achieving the goals of the hospital system along with medical best practices. The financial viability of an individual physician's proven record of patient care can be assessed in order to determine their overall impact on the ability of the hospital system to continue providing care.

3)

The payment system at MetroHealth is based on the productivity of each individual physician, rather than on their revenue generation for the MetroHealth system. This ensures that the needs of the hospital and the community are…… [read more]


Bereavement in Acute Care Settings the Proposed Essay

Essay  |  2 pages (485 words)
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Bereavement in Acute Care Settings

The proposed study will examine the bereavement process as it occurs in acute care settings. The issue of bereavement has received wide study in a variety of settings, leading to a strong framework for understanding bereavement in more specific situations (Stephen et al. 2009). Little study has been focused at the process of bereavement specifically in acute care settings, however, among nurses and other patients, and it is an understanding of the bereavement process in this setting that this study will attempt to achieve.

This issue is especially pressing given the known effects that failures to effectively deal with the bereavement process can lead to. Bonds with those who have passed continue during the bereavement process, and can lead to difficulties when they are not dealt with in an effective manner (Field & Filanosky 2010). The suddenness and violence/severity of symptoms prior to death can also have an effect on how the bereavement process progresses, and the fact that this has not been specifically studied in an acute care environment means there is a lot of room for growth and progress not only in the knowledge in this area, but also in the practical applications of it in dealing with bereavement (Field & Filanosky 2010).

Some studies, largely in the form of literature reviews, have been conducted along this specific line of inquiry, leading to a basic preliminary understanding of the issue and providing the means for…… [read more]


Kidney Transplant Thesis

Thesis  |  3 pages (775 words)
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¶ … kidney donation and renal availability: A utilization of literature review in nursing research

Living donors are clearly superior and more desirable for kidney transplantation for a variety of reasons, and though there are some medical and ethical concerns with living donor renal transplantation new innovations can greatly reduce risks to living donors (Nakamura et al. 2008; Testa et al. 2009). There have also been enormous gains in the rates of living donors worldwide, largely as a response to educational campaigns aimed at informing the public of the need for donation and the increasing ease of the surgery on donors (Mayor 2009; Horvat et al. 2009).

This easement on post-surgery recovery and life for living kidney donors is the result of several new techniques and schemas, including newer minimally invasive procedures and methods for kidney removal during other surgical procedures (Nakamura et al. 2008; Testa et al. 2009). Both of these innovations, should they be made more widely known both in the medical community and amidst the general public, could greatly increase the number of living donors willing to donate kidneys to both known and unknown recipients. The success of traditional education efforts on increasing living donor donations will likely increase further with the addition of more contemporary information.

Though other methods for encouraging donation exist, including legal sales and forced cadaver donation, increasing living donation is the most medically and ethically sound and successful option available (Horvat et al. 2009; Testa et al. 2009). Focusing efforts on increased education is definitely called for.

Annotated Bibliography

Horvat, L.; Shariff, S.; Garg, A. (2009). "Global trends in the rates of living kidney donation." Kidney international 75, pp. 1088-98.

The rate of living kidney donors has increased by as much as fifty percent in many countries over the past decade, to the point that living donors (to both known and unknown recipients) now account for thirty-nine percent of kidney transplants for which current records are available. This suggests that efforts to increase living donorship over the past decade have been highly effective, and that the importance of living donors in combating the rising trend of end-stage renal failure that is appearing in the worldwide population. While other methods and plans are also being explored, the increase in living donors has had the most significant impact on renal transplantation…… [read more]


Why I Desire to Be a Member of Chi ETA PHI Sorority, Inc Essay

Essay  |  1 pages (316 words)
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Personal Statement -- Sorority Application

I am confident that I can contribute productively to the Chi ETA Phi Sorority because may values and goals are consistent with those of the organization, the academic institution, and the nursing profession. Specifically, I have maintained a 2.912 grade point average, which almost a full half-grade above the standards set by the college for nursing students. My choice of nursing as a course of study and eventual career aspirations is also consistent with the standards of personal character and integrity required by the Chi Eta Phi Sorority of its members and pledges.

I have always maintained a good reputation in the community, at home, in high school, and throughout my current academic career at the college. I fully recognize that as a member of the Chi Eta Phi Sorority, my personal choices, and actions, and decisions must be consistent with the values, ideals, and reputation of the organization because the conduct of…… [read more]


Unitary Human Beings an Examination and Explication Thesis

Thesis  |  10 pages (2,710 words)
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Unitary Human Beings

An Examination and Explication of a Grand Nursing Theory: Roger's Science of Unitary Human Beings

Despite the decades that have passed since her theory was first formulated, Martha E. Roger's Science of Unitary Human Beings remains a highly relevant and even necessary theoretical framework and way of approaching nursing today. Her continued basic yet fervent premises throughout… [read more]


Triumph of the Spirit Research Proposal

Research Proposal  |  2 pages (807 words)
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Conflict in Triumph of the Spirit

Have you changed who you are as a leader? As a leader, my style and philosophy has changed dramatically, but perhaps in subtle ways that would go unnoticed by most others. I have a good basic background in management, and have been a leader in both professional and personal organizations since High School. That said, the course, the readings, and above all, the observations and reflections have made it clear to me that it is the process of becoming a leader that keeps on vital, and on track.

Do you feel you are still the same kind of leader you were when you started the course? No, I am not the same "type" of leader as when I started the course. The course has helped me find ways to utilize different styles of management (leader as servant, congenial management, SixSigma, etc.). I believe I am now more of a coach; directive when necessary, but believing in teamwork and the intelligence and commitment of staff who know what needs to be done rather than having their lives managed for them. My attitude I s harsh in a way -- no one belongs in a healthcare organization if they have not mastered the basic job skills of attendance, focus, details, and patient respect. If I respect and value staff, I expect them to respect and value their clients and co-workers.

What do you think the role of nursing organizations such as ANA is for the nurse leader? In contemporary healthcare, we must be realistic about a few things: 1) We cannot properly advocate for nursing and patient rights ourselves, we must band together to do so, 2) There is far more information available on a daily basis than anyone can possibly review -- any help with sorting that information, or providing life-lines is welcome, 3) Sometimes it is difficult to share details and needed mentorship internally, organizations like the ANA allow professionals to network, dialog, and improve performance by interacting with other professionals.

Do you believe being credentials as a board certified nurse executive is important for a nurse leader/manager? If so, why? If not, why not? In many cases, professional nurses with long and varied experience do not necessarily need credentials to prove their expertise. However, that being said, there must be a national standard at which the profession holds up as the rubric necessary for a certain…… [read more]


Chinn Kramer Qs Questions From Thesis

Thesis  |  2 pages (558 words)
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Chinn Kramer Qs

Questions from Chinn & Kramer

Theory as described in Chinn & Kramer (2008) consists of a general way of organizing and perceiving knowledge, which necessarily causes some knowledge to be viewed as more important than others and thus changes the conclusions that might be drawn from the same set of knowledge in different theoretical frameworks. I'm not sure that I completely agree with this definition of theory; though the authors argue for the integration of nursing knowledge into a more unified nursing theory, I think that this will only maintain a hierarchy of knowledge. I hope to be able to use different theories and patterns of knowing in practice rather than prioritizing among them.

2)

The slow development of nursing education programs in universities and medical schools was one of the major battles of establishing nursing as a valid and integral medical science, and the formalization of such education is evidence of success in this field (Chinn & Kramer 2008). Without the educational opportunities afforded within the nursing progression, I am not sure that I would even still be in the profession; education provides for mobility and growth in addition to increased efficacy of care, and all of these are essential job elements for me.

3)

Chinn and Kramer (2008) define emancipatory knowledge as "the human ability to recognize social and political problems of injustice or inequity." I have never personally experienced a feeling of being especially closed out from a situation, expect during what I assume were the usual years of teenage awkwardness. I never felt that these feelings were fair, but gaining self-assurance regardless was the only way to remedy it.

4)

Deontology, teleology,…… [read more]


Minimizing the Perils of Appendicitis, by Joan Research Proposal

Research Proposal  |  2 pages (687 words)
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¶ … Minimizing the perils of appendicitis, by Joan Dell Rocca, CRNP, CCRM, MSN, it is very important for nurses to know how to act quickly when treating patients who are threatened by the dangerous condition of appendicitis. The appendix is a fingerlike organ that is attached to the cecum. The appendix has no know function, but when it becomes inflamed it can be very serious. Obstruction of the appendix lumen, most commonly by a hard fecal mass is typically what triggers this inflammation known as Appendicitis. Unsuccessful fluid drainage from the appendix lumen has been thought to let bacteria invade the appendix wall, which triggers infection. If an infected appendix isn't removed quickly, it can perforate and cause peritonitis. Perforation is most likely to occur within 48 hours after appendicitis develops (Rocca, 2007).

Abdominal pain is the characteristic symptom of appendicitis. It is often accompanied by additional signs and symptoms. Pain usually begins in the periumbilical region but often moves around. As inflammation increases, the pain often becomes more severe and localized in the right lower side. Patients who have rebound tenderness often are suffering from acute appendicitis and peritoneal inflammation. If the doctor applies firm, slow pressure to the abdomen at a point away from the reported pain and quickly releases it, this triggers severe pain and rebound tenderness is present. It is reported that patients often have nausea and vomiting. There is usually a temperature elevation of 99° F (37" C) to l00° F (38" C), but a normal temperature can be present. A patient will usually have an elevated white blood cell (WBC) count of greater than 10,000/mm. Signs and symptoms of perforation include a WBC count of 20,000/mm or greater: a tense, rigid abdomen; and a temperature of 102° F (39" C) or higher. Older adults with altered pain perception delay seeking treatment and are more likely to develop perforation because they don't seek immediate treatment (Rocca, 2007).

A patient that is suffering from appendicitis should be treated as would any surgical patient. Nurses should be aware that…… [read more]


Female Genital Mutilation Research Proposal

Research Proposal  |  2 pages (902 words)
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Female Genital Mutilation

Female Genital Mutiliation

Female Genital Mutilation (FGM) is practiced widely throughout the Middle East and Asia, with 2 million women and girls undergoing this barbaric custom every year. In Africa, 90% of women bear the painful scars of this custom, yet continue to support its practice, with the support of their religion and the male population, who look upon it as a way to tell if a woman is a virgin upon marriage. Although some countries have banned it, secret societies, such as Bondo, continue to practice it, and since its effects are not prominent, there is little political motivation to make it illegal or support a program leading to its eradication. The subject remains feared and taboo. In some countries, such as Sierra Leone, women cannot marry unless they undergo FGM and politicians refuse to criticize it. Since there exists a large number of women who make the practice of "circumcision" an occupation, it becomes a problem when attempts are made to wipe it out, since such a large numbers of practitioners hold an economic stake and yield political power in their country.

Out of a total of 271 NGO's in Sierra Leone, only 2 are working directly against FGM as part of their program. The Inter-African Committee Against Harmful Traditional Practices, headed by Linda Osarenren, suggests that the government create ways to compensate monetarily for the loss of clients, if the practice is made illegal. Other individuals work to dissuade practitioners from practicing this dangerous amateur surgery. Rugiatu Turay, of the Amazonian Initiative Movement says she has convinced 400 traditional practitioners from 111 villages to stop the harmful surgery. In the educational film describing these NGO programs, Razor's Edge, the screams of small girls continue to haunt the memory evoking desire to protect them against such barbaric mistreatment (IRIN, Razor's Edge).

Nurses are often the cultural broker in a climate where catalysts for change are needed. Nurses in affected countries may negotiate two or more cultures daily, serving as intermediaries at the most basic level, "communicating differences and similarities between cultures" (National, 2009).

The International Council of Nurses' (ICN) Code of Ethics Preamble says nurses must respect human rights, including cultural rights. Included under these cultural rights, according to some, are the right to practice FGM; however, the Code also claims that nurses' four fundamental responsibilities are to promote health, prevent illness, restore health and alleviate suffering. In each of these responsibilities the responsibility to eliminate FGM lies inherent. But the responsibilities of nurses conflict with those who claim that cultural traditions, such as FGM, should be maintained in countries where it is part of the religion and the culture, and has been practiced for 4000…… [read more]


Giger and Davidhizar Cultural Models Thesis

Thesis  |  4 pages (1,468 words)
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Giger and Davidhizar Cultural Model

This is a guideline and template. Please do not use it as a final turn-in paper.

This paper explores published articles, and the book, Transcultural nursing: assessment & Intervention, written by the authors of the Transcultural Assessment Model, Joyce Giger and Ruth Davidhizar, (Philadelphia: Elsevier Health Sciences, 2004). The Giger and Davidhizar

model is used… [read more]


Nurses in History Essay

Essay  |  1 pages (326 words)
Bibliography Sources: 0

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Nurses in American Wars

What experiences did nurses have during the various wars the United States was involved with that shaped the development of their profession? Around the time of the American Revolution, up to the Civil War, nursing in the U.S. was similar to nursing in Europe; nurses were not in the forefront at that time, according to Angel Learning. The earliest workplace for the professional nurse in America was the hospital, including the Philadelphia Almshouse in 1731 and Bellevue Hospital in New York City in 1658.

Meanwhile, as to nurses and wars, there is no doubt that nursing was extremely important during the bloody Civil War, and women such as Dorothea Dix, Clara Barton, and others cared for the wounded -- even working on the front lines of battles. As a rule women were not seen as fit to serve in military engagements, and yet during WWI once again female nurses were on or near the front lines performing medical services…… [read more]


Dressing an Open Wound Essay

Essay  |  3 pages (756 words)
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Nursing Practice: Principles of Open Wound Care

Wound care is an essential function in clinical nursing practice. Certain principles (such as asepsis) are applicable to all types of open wounds, but other aspects of proper wound care vary depending on the type of wound being dressed. Because of the potentially serious consequences of infection at the wound site, open wounds must be protected using techniques and material most conducive to optimal healing. Moreover, chronic wounds require different materials and additional techniques to maintain asepsis without simultaneously damaging healthy tissue. Already infected wounds, particularly those involving deep tissue layers, require a systematic approach to caring appropriately for tissues in fundamentally different states of health.

General Open Wound Care:

For the general care of superficial open wounds in the epidermis, the area should first be examined visually, preferably under a magnifying lens to rule out any foreign materials that could be more difficult to see after irrigation. Sterile gloves should be worn throughout and changed after irrigation and before disinfecting the wound. The wound should be irrigated with sterile saline solution if it resulted in circumstances that introduced foreign matter into the wound.

Ideally, irrigation with sterile 0.9% sodium chloride is the preferred method of disinfection in those cases (Taylor, Lillis, & LeMone, 2005; 1068). Otherwise, hydrogen peroxide is preferable to isopropyl alcohol because it causes less discomfort and because the bubbling of oxidation benefits the disinfection process. Wounds limited to the epidermis can also be treated with topical antibiotic ointments applied by sterile Q-tip before the application of the dressing. Adhesive dressings are appropriate for small wounds but can be associated with skin irritation.

Paper, plastic, or acetate-backed bandages are preferable because they are hypoallergenic and better tolerated in terms of comfort.

Chronic Wound Care:

For chronic wound care, the process is substantially the same except that padding should be applied to the external surface of the dressing as necessary to protect the area from pressure. Instead of paper, plastic, or acetate-backed bandages, chronic wound require material that is moisture absorbent, such as sterile gauze. Gauze is also preferable because it breathes and therefore inhibits the growth of anaerobic bacteria that are a potential risk of prolonged use of non-porous bandages (Taylor, Lillis, & LeMone, 2005;

Open chronic wounds…… [read more]


Importance of Mentor Mentee Relationship Thesis

Thesis  |  5 pages (2,168 words)
Bibliography Sources: 1

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Mills, J. & Mullins, a. (2008). "The California nurse mentor project: Every nurse deserves a mentor." Nursing economic$, 26(5), pp. 310-5 a. Mentoring generally and the specific program examined by the study are both identified in the title, in the first paragraph, and in a sidebar on the first page of the study.

The researchers assert in the first few… [read more]


Patients on Oxygen Research Proposal

Research Proposal  |  4 pages (1,197 words)
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NURSING

TEACHING as if the FUTURE MATTERS"

NANCY JOHNSTON, ET AL.

In this article, Nancy Johnston, Martha Rogers, Nadine Cross and Anne Sochan, all part of the faculty in the School of Nursing at York University in Toronto, Canada, pose a rather interesting question, one which at first does not seem to have anything to do with the profession of nursing -- "Is the human race making progress or (are) we simply hastening our demise?" The authors then follow this up by asking "Can we as citizens afford to avoid this question?" A reference to some people who believe asking such a thing is unhelpful "as it may lead to pessimistic conclusions" concerning the future of the human race upon planet Earth (2005, pg. 152). Obviously, being concerned about the future of humans on this planet is not a pessimistic topic, especially when we consider the role that professional nurses and other health officials will inevitably play in the long run. Thus, the authors of this article offer a very comprehensive plan related to teaching future nurses about national and international health policies and the global and planetary dimensions of health via a new teaching course called Nursing in the Global Context (2005, pg. 152-53).

This proposed teaching course, instead of focusing upon epistemological issues (questions of knowing), will devote itself to ontological questions "that speak to our understanding of reality, meaning and being" and will be based on the following five main premises. First, the overall health of an individual "cannot be understood apart from the environment" that sustains him/her, nor can it be understood without considering "the social and political structures that act to either promote it or undermine it." Second, a nurse must come to realize that poverty, disease, war and environmental destruction "know no national boundaries," due to the rapid expansion of global trade, travel, the Internet and other forms of electronic communication between peoples from diverse backgrounds and cultures (2005, pg. 153).

Third, every choice which a person makes in the present will somehow affect future generations; thus, "ethical decision-making requires responding to present needs" so as not to diminish the quality of life for future generations. Fourth, in order for all nursing students to possess personal concerns about the future of the human race on this planet, they must be shown that learning "must engage not only the mind, but also the heart and soul," and lastly, all nursing students and especially those who currently work in various health professions must come to understand "the meaning of health in a global context" (2005, pg. 153).

The authors then proceed to discuss in-depth a number of topics related to the above premises. First of all, they pose another question -- "What is most important of all?" In reference to suggesting that this question is "fundamental to any exploration of human existence" and to our planetary survival. As one might suspect, the answer is very simple and straightforward -- "it is the continued existence and flourishing… [read more]


Pain Assessment Thesis

Thesis  |  2 pages (633 words)
Bibliography Sources: 2

SAMPLE TEXT:

¶ … Learning pain assessment and management: A goal of the end-of-life nursing education consortium," Sherman et al. re-examine safety guidelines in the administering of pain reliving drugs and other pain management techniques in the care of patients with life-limiting illnesses and end-of-life patients (Sherman et al., 2004). Rather than a research study or literature review, this study outlines current knowledge and practices in the management of pain from the perspective of chronic disease and end-of-life treatment. The focus of the article is mainly on continued education of end-of-life nurses on the different causes and types of pain, as well as effective methods of treatment (Sherman et al., 2004). Safety of the patient is considered both in the direct results of the various pharmacological remedies most commonly used in the treatment of pain, as well as in the affect of decreased pain on other symptoms, general patient stress, and the quality of care provided by non-medical family caregivers (Sherman et al., 2004).

In addition, the article also outlines the barriers to pain relief, which if not understood will necessarily lead to mismanagement of pain (Sherman et al., 2004). Improving the quality of life is the most essential goal of pain management in end-of-life patients, and this cannot be accomplished without understanding the barriers to treatment (Sherman et al., 2004). Not only will treatment likely be ineffective, causing the patient greater pain, stress, and aggravation of other symptoms than is necessary, but mistreatment -- especially with pharmacological remedies -- can very easily endanger the patient's life (Sherman et al., 2004). Thus, in addition to the primary cause of improving the quality and condition of life for chronically ill and end-of-life patients, proper knowledge and skills of pain assessment and management are essential skills for a nurse at any level of practice for the safety and most basic well-being of the patient.

As a registered nurse in the…… [read more]


Griffiths, P. & Wilson-Barnett, J. (1998) Thesis

Thesis  |  1 pages (337 words)
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Griffiths, P. & Wilson-Barnett, J. (1998). "The effectiveness of 'nursing beds': A review of the literature." Journal of advanced nursing, 27, pp. 1184-92.

This literature review examined studies involving "nursing led in-patient units" in attempt to identify such units and determine their formation and performance. At the Loeb Center, the first of the major units covered in this review, a series of research studies shows that the nurses here were employed in a rehabilitative and therapeutic manner, rather than in the strictly medicinal setting of initial treatment centers. The Loeb Center focused on chronically ill patients recovering from an acute bout of illness, and the nursing-led units here were based on the premise that the particular advantages of nursing practice would be most beneficial to patients.

The same basic practices of the Loeb Center were used with perhaps even greater success at the Oxfordshire units covered next in the review. Hands-on nursing as primary care led to reduced stays in recovery units for patients receiving nursing-led treatment, and…… [read more]


Sandra Baker's Book Nursing Research Proposal

Research Proposal  |  1 pages (374 words)
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Sandra Baker's review of the book Nursing Knowledge and Clinical Practice by Sister Callista Roy and Dorothy a. Jones details the books' quest to determine how nurses learn and then apply knowledge. The review provides an overview of the books information, which includes the two main concepts of nurse learning that have dominated the field for the past several decades. These are problem-solving (knowledge comes from external sources) and process oriented (knowledge comes from inside). The book also puts forward a third notion of the universal cosmic imperative. This article repeats the book's concern that theory is not often enough tied to research, and comments that the book asks probing and insightful questions that require further research into learning theory and application.

An article by Rogers et al. In the Journal for Human Caring describes how the field of nursing has been changed by the advent and integration of human science. Individuality and creativity have become more encouraged in nursing education, and behaviorism is largely a thing of the past. Instead of seeing education as a linear thing with predictable results, this article details how nursing education…… [read more]