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Nursing

Cultural Impact

Introduction

Crack cocaine is a very addictive substance that had a unique beginning. Cocaine was initially extracted from the coca plant in 1862 and used in various medicines, some that could be purchased over the counter. It was even one of the common ingredients in the first Coca-Cola drink (Baumer, p. 312   ). Powder cocaine was first used recreationally by affluent member of society. It was very expensive to buy pure cocaine. Crack cocaine became a cheaper substitute for pure powder cocaine. Crack cocaine is produced by adding water and baking soda to pure cocaine. The substance is then baked and “cracked” into small pieces. This product produces an intense high, but only lasts about fifteen minutes. Crack cocaine became popular in the 1980’s and has had lasting negative effects on the black community. Black males are more likely to use crack cocaine than members of any other race. Crack cocaine has negatively affected the African-American community in several ways: crack cocaine usage increases sexual risk taking behaviors and violence among its users, users are at a higher risk of mental health issues, and chronic users develop health issues over time that could lead to heart attacks, strokes, and other gastronomical complications. Nonetheless, there are treatment plans geared toward helping African –American individuals overcome crack addiction. These programs range from out-patient to extended in-patient stays. They are operated by various organizations from hospitals to religious organizations.

Risky Behavior

Many crack addicts take part in risky sexual behaviors in order to fund their habits. When one thinks of prostitution or the exchange of sex for something else, one often thinks of women only. However, in the drug world men exchange sex for drugs just as often as women do. For example, one study conducted in an urban area found that both men and women engaged in trading oral sex for drugs or money; further, male respondents who acknowledged trading sex for drugs or money were more likely than women respondents to acknowledge having engaged in anal sex in trading for drugs ( Maranda, M.J., Han, C., & Rainone, G.A , p. 318) Also, more women reported using condoms than men, but also confirmed that if the customer insisted on not using a condom they would oblige. The study found that women often traded sex in efforts to gain access to more crack or to mentally escape the horrors of prostitution, while men reported heightened sexual urges when they were high on crack cocaine.  Maranda, M.J., Han, C., & Rainone, G.A reported, “Some women reported that they traded sex to support their drug addiction, others seemed to use drugs to cope with trading sex.” Consequently, the AIDS epidemic is growing due to the crack epidemic.  Maranda, M.J., Han, C., & Rainone, G.A adds that the best way to prevent the spread of HIV is to prevent behaviors that put people at risk. Using drugs often make people participate in risky behaviors in efforts to gain access to the drug.  (Maranda, M.J., Han, C., & Rainone p. 320)

Mental Illness

Crack cocaine use has also has been linked to onset mental issues.  Chronic crack use has been reported to produce side effects such as anxiety, paranoia, egocentric behavior, dysphoria, anorexia, and delusions. According to Baumer,

“Different routes of using cocaine are associated with different negative consequences. Crack users have a greater number of symptoms, and higher levels of anxiety, depression, paranoid ideation, and psychoticism. Psychiatric comorbidity among cocaine dependent users is not only increased for other substance disorders, but also for personality disorders.” (Baumer, p. 319).

Years of chronic use has been linked to more serious mental illnesses like schizophrenia. Scientists believe that because crack alters brain activity the imbalance can lead to the disease. Crack use blocks certain neurotransmitters and substances that allow brain cells to communicate with each other. The brains of people with the schizophrenia have less gray matter and some areas of the brain display less or more activity, just as the brains of crack users.  Baumer adds that using drugs also adds to the probability that a person will be violent. When persons with mental illness or drug dependency become violent, it is usually directed towards a family member (Baumer, p. 321)

Effects on Black Community

            Although crack cocaine is use by people from various races, it attacked the black community the hardest. Cocaine use has been linked to the increases in murder and incarcerations. High school drop-out rates have also increased since the introduction of crack cocaine. It is estimated that crack markets account for between 40-73 percent of drop in black males’ high school graduation rate. In essence, the introduction of crack cocaine to the black community did three things: increased the probability of a black being murdered, increased risk of incarceration, and increased the likelihood of selling crack as a potential income in the black home. All of the scenarios limit the benefits of a proper education. Consequently, high school seems less attractive to the black because he/she will only end up in jail, or he/or she could be earning some fast money by selling it.

Incidence and Prevalence

            According to the data from the National Survey on Drug Use and Health (NSDUH), young black adults  aged 18 to 25 years of age represent the highest rates of lifetime (60.5%), past year (34.6%) and past month (20.3%) use of crack cocaine. In 2007, 17 percent of state inmates and 18 percent of federal inmate’s admitted that they commit their crimes while high or in efforts to get money for drugs.  Also, 60 percent of prisoners polled reported prior drug use, while 79 percent reportedly were still using drugs. Sadly, nearly 75 percent of addicts that enter a recovery program will relapse. In 2008, 18.8 percent of blacks reported using crack cocaine, while the national average of crack use in 19.9 percent. Astoundingly, blacks only make up about 11.3 percent of the U.S. population.

Treatment Options

            Implementing an intervention program can be difficult; it depends on each individual addict. If the addict has family, the family needs to be equipped with the tools to help the addict. However, if the addict is alone, he needs an appointed support system to help him maintain his sobriety. Financial difficulty is the main obstacle that addicts deal with. Most of them do not have insurance or the funds to pay for a treatment program. Often non-profit organizations may be willing to help out financially. There are some free programs that addicts may enter into, but these programs are often overcrowded and cold take as long as a year waiting period before being admitted. Some addicts chose to go through a detox program and then continue with an out-patient facility. With out-patient, the addict is able to go home daily, but is required to attend certain meetings. With in-patient facilities the addict is required to remain in the facility for the duration of the program. Often many addicts are more successful with in-patient facilities. Sadly, many of them relapse after they complete the program and are back in their old environments. Consequently, many therapists suggest that the addict moves to another location in order to have a better chance at remaining sober.  Consequently, the program has to be designed based upon the needs of the addict and his/her family.

                                     Specific Treatment for African-Americans

A range of treatment programs have been developed in the last few decades that endeavor to address the issue of substance abuse within members of the African-American community. A 2006 report (Liddle et al) examined an intervention and treatment program developed within the larger context of family therapy that was designed to address the specific needs and concerns of adolescent African-American males in terms of substance abuse. This program aims to be “culturally specific,” and is based on a several core components intended to provide a therapeutic framework that both considers and derives utility from a number of cultural references and touchstones relevant to the African-American community in general and adolescent African-American males in particular.

            The therapeutic framework is predicated on the notion that African-American adolescent males live in an “intersection” of cross-cultural frameworks (Liddle et al, 2006). These include the overarching mainstream American culture, the American minority culture, and the African-American-specific culture. As such the therapeutic framework utilizes culturally-relevant components, such as music and movies, which address issues related to the specific issue of substance abuse as well as larger issues about family, inner-city life, and other cultural components that may be relevant to African-American male adolescents. This culturally-specific therapeutic framework is intended to promote a strong level of engagement and participation among subjects, as opposed to a top-down model of information dissemination.

            The culturally-specific therapy is considered to be an adjunct of the larger model of Multi-Dimensional Family Therapy (MDFT), and it attempts to address the “oppositional culture” and the “code of the street” in which young African-Americans are often raised. By developing a treatment program which embraces these cultural components –rather than attempting to subvert the or simply ignore them- the treatment approach seeks to draw out positive cultural references that support the avoidance of substance abuse and to emphasize and reinforce such references as a means of promoting abstinence and avoidance of drug and alcohol use. In short, the MDFT approach attempts to make it “cool” to not use drugs and alcohol by promoting this view through the use of culturally-specific references that are likely to be acknowledged and accepted by subjects. The report asserts that this culturally-specific MDFT approach shows strong promise as an effective approach to helping young African-American males develop and individual identity that aligns well with their larger cultural frameworks and promotes the choice not to use drugs and alcohol.

Implications

            Crack addiction is just as much an emotional and psychological addiction as it is a physical addiction. Many crack addicts are afraid of being without the drug.  Crack addicts are often dual drug users, which mean their crack addiction is often brought on by the use of some other illicit drug. As a result, healthcare providers must address the problem in a dual method. They must first address the psychological issues that the addict may be dealing with. Once that is done, they can give the addict tools to use to handle stress and other life issues without turning to crack as a coping mechanism. Most African Americans are afraid of being labeled as mentally ill or a “crack head”. As a result, healthcare providers have to careful to treat them with respect in order to gain their much needed trust. Health care providers and mental health workers must collaborate, which will bring expertise from both backgrounds to the forefront in order to help crack addicts gain and maintain sobriety. Most importantly, health care providers must convey that they understand that crack addicts are essentially just like any other person. They have just made bad decisions, but have the potential to become productive members on society once again.

References

Baumer, Eric P. (1994).  Poverty, Crack, and Crime: A Cross-City Analysis. Journal of Research in Crime and Delinquency, 31. 311-327.

 Liddle, H. A., Jackson-Gilfort, A., & Marvel, F. A. (2006). An empirically-supported and culturally-specific engagement and intervention strategy for African-American adolescent males. American Journal of Orthopsychiatry75(2), 215-225.

Maranda, M.J., Han, C., & Rainone, G.A. (2004). Crack cocaine and sex. Journal of Psychoactive Drugs, 36, 315-322.

Substance Abuse and Mental Health Services Administration (2012). Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings. Retrieved from http://www.samhsa.gov/data/nsduh/2k11results/nsduhresults2011.pdf

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Nursing

Global Health Issues

Global health issues affecting undeveloped countries have long been on the radar in the public eye, due to numerous infomercials and televised awareness campaigns to raise money for people in poor countries so that they have access to food, water, and healthcare. These awareness campaigns often report on millions of people in undeveloped countries dying due to the lack of resources and healthcare (Shah, 2011). This is an inequity in life that still exists in many parts of the world.

The World Health Organization (WHO) reports that almost 80 percent of noncommunicable disease deaths occur in lower income countries. In 2008, it is reported that 57 million people, globally, died from noncommunicable diseases such as cancer, diabetes, lung, and cardiovasular diseases, and about 25 percent of these deaths were people under 60 years of age. In addition, it is stated that improved healthcare, detecting diseases early, and getting people treated in time would result in a reduction of these deaths (WHO, 2010).

Scope of the Problem

            According to the Council on Foreign Relations, disease and death in undeveloped countries continues to rise inspite of new medical technologies and improved conditions in sanitation, nutrition, housing, and education. This is not just related to noncommunicable diseases; infectious diseases such as malaria, AIDS, SARS, the flu, and tuberculosis are also culprits and much of these occur in developing countries (CFR, 2013). The scope of this problem involves factors such as environmental health, maternal and child health, nutrition, ethics, and human rights issues.

            As it relates to environmental health, global health issues are often caused or made worse by negative environmental impacts such as pollution and health hazards caused by a lack in adequate sanitation of waste and water supplies. Satisfactory maternal and child health is affected by lack of resources, education, and healthcare access. Nutrition issues stem from low or non-existent food sources and little access to healthy food choices. In addition, ethics and human rights issues are related to all of the above. There is an unfair disparity in access to basic human necessities such as food, water, and healthcare, in undeveloped countries, and this speaks to a lack of ethics on the part of developed countries as well as of the governments of the undeveloped countries.

Solutions to the Problem

            As mentioned, improvements in healthcare access, early detection, and timely interventions are keys to eliminating much of the problems surrounding global health issues. However, most developing countries depend on health system funds from donors, which is not always reliable. Many developing countries receive up to 40 percent of their financial help from donor funds; however, there are times when the developing countries’ governments reduce their resource allocation, by up to 43 percent, to their needy when receiving assistance for health from other countries. Furthermore, many health systems in developing countries are undermined because of a shortage of healthcare professionals (less than 2.3 per thousand people), and this causes disparities in delivery of care (CFR, 2013).

Conclusion

            Unfortunately, it seems that there really is no immediate solution to the problem of global health issues, as long as obstacles such as governments blocking needed help from their countries and issues with poverty, sanitation, nutrition, education, and access exists. Poverty is the main cause of many global health issues. Poorer countries are often victims of the wealthy such as powerful pharmaceutical companies which is an example of a human cause, due to politics. Not all causes are natural causes. Addressing the problem of global health issues, therefore, is more a matter of social, ethical, and political factors that need to be changed before the world sees a reduction in unnecessary poverty, diseases, and deaths.

References

CFR. (2013, June 6). The Global Health Regime. Retrieved from Council on Foreign Relations: http://www.cfr.org/health-science-and-technology/global-health-regime/p22763

Shah, A. (2011, September 12). Global Health Overview. Retrieved from Global Issues: http://www.globalissues.org/article/588/global-health-overview

WHO. (2010). Global status report on noncommunicable diseases. World Health Organization.

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Nursing

Heart Disease in Baltimore

Introduction

            The development of a successful framework for managing heart disease in any community requires an effective understanding of the demographics and the challenges that groups face in support of developing strategies to improve outcomes. In particular, heart disease is a challenging condition that must be considered and evaluated in order to reduce risks and improve outcomes for community members. The following discussion will evaluate heart disease in Baltimore, MD in order to identify different strategies that might be useful in expanding knowledge and information regarding this condition to prevent serious complications.

This discussion will also address the importance of communication within nursing practice as a means of exploring the different dimensions of care and treatment that is required for communities such as Baltimore, MD. Nursing possesses a series of different ideas and expectations within the culture that must be addressed in an effort to produce successful outcomes in the area that emphasizes various communication strategies. These efforts will provide support in determining how to best utilize group communication as well as one-on-one communication to identify and solve problems effectively. These efforts will demonstrate the importance of nursing communication in supporting successful patient care and treatment outcomes at all times.

Part 1: Community/State Demographics     

            Baltimore, Maryland is a very diverse community with many different health concerns and a strong necessity to facilitate health promotion activities. Heart disease is a number one killer throughout the United States and carries a high degree of risk for many communities, including the Baltimore area. With the 2012 Census, the city of Baltimore had approximately 621,342 residents, of which 52.9 percent are females and 63.6 percent are African Americans (US Census Bureau, 2012). Whites make up 31.5 percent of the population and only 4.3 percent are of Hispanic or Latino origin (US Census Bureau, 2012). Almost 80 percent of this population has a high school diploma and 26 percent has earned a Bachelor’s degree or higher, with 50% owning their own homes (US Census Bureau, 2012). The median household income for 2007-2011 was $40,100 and 22.4 percent of the population is below the poverty level (US Census Bureau, 2012).  

            In the State of Maryland, there are 5,884,563 residents, with females comprising 51.6 percent of the population, while 61.1 percent are White, 30 percent are African American, and 8.4 percent are Hispanic or Latino (US Census Bureau, 2012). Within the State, 88.2 percent of the population has earned a high school diploma and 36.1 percent has earned a Bachelor’s Degree or higher, with a home ownership rate of 68.7 percent (US Census Bureau, 2012). Finally, the median household income for the State is $35,751 and 9 percent of the population lives below the poverty line (US Census Bureau, 2012). Based on these statistics, the City of Baltimore faces greater socioeconomic challenges than those of the State of Maryland, including the potential for greater health disparities. Therefore, it is important to identify these disparities and to address cardiovascular disease within the City as a serious health issue and a formidable threat to this population.

Part 2: Health Status

            The Baltimore City Health Department routinely provides reports regarding the health status of its local residents and identifies specific health disparities that require further consideration. Although some areas have experienced slight improvement, there continue to be many health disparities that must be addressed to improve outcomes throughout the city (Baltimore City Health Department, 2010). In general, the city fares worse than the State of Maryland in such areas as heart disease and infant mortality; therefore, the City must utilize its available resources in order to accomplish improved health outcomes throughout this community (Baltimore City Health Department, 2010).

Within Baltimore County, cardiovascular disease claims approximately2,000 lives annually; therefore, this community must identify methods to better manage existing disparities and to encourage greater compliance to improve health and wellbeing (Baltimore City Health Department, 2009). An agenda was established by the City Health Department in an effort to reduce the risks associated with cardiovascular disease and included such topics as reducing salt intake, expanding blood pressure screenings, enhancing health education by using Faith-based approaches, and smoking cessation efforts (Baltimore City Health Department, 2009). These efforts demonstrate the important impact of health promotion for this population group in order to reduce disparities and to improve outcomes (Baltimore City Health Department, 2009).

Within the City of Baltimore, there were approximately 200 deaths per 100,000 members of the population as a result of coronary heart disease in 2008, which is 53 deaths above the state average (Maryland Department of Health & Mental Hygiene, 2009).These findings suggest that Baltimore residents do not manage their overall cardiovascular health and face critical challenges that require additional education and guidance from community members (Maryland Department of Health & Mental Hygiene, 2009).Within the City of Baltimore, evidence also demonstrates that African Americans experience higher rates of death as a result of cardiovascular disease as compared to other population groups, thereby mandating additional education and prevention efforts within this community (Johns Hopkins Urban Health Institute). Furthermore, African Americans within the city have a higher rate of obesity than Whites (Johns Hopkins Urban Health Institute). These statistics provide further evidence that cardiovascular disease in Baltimore is higher in some population groups than in others, supporting the belief that these groups experience greater health disparities (Johns Hopkins Urban Health Institute).

In an examination of statistics evaluating specific neighborhoods of Baltimore, every single neighborhood that was evaluated, from wealthiest to poorest, reported heart disease as the leading cause of death (The Baltimore Sun, 2011). Therefore, it is important to identify different methods to promote the expanded delivery of healthcare services and health promotion activities to improve outcomes for this population group (The Baltimore Sun, 2011). In addition, it is important to recognize the value of surveys and discussion groups to identify health disparities in order to improve outcomes and to reflect on existing frameworks to achieve greater results. According to a study conducted by the National Heart, Lung, and Blood Institute (NHLBI) in public housing units in Baltimore, “Public housing residents had a preexisting knowledge and awareness of heart healthy lifestyles and CVD risk factors…One cardiovascular risk behavior, cigarette smoking, is pervasive among the demographic groups probed (excluding teen females) and accordingly smoking cessation is a critical element of any community outreach strategy that would be developed. Stress, from environmental and personal stimuli, is also cited by participants as a major barrier to improving health, including young adults ages 15–18. In fact, many participants cite stress as a primary risk factor for heart disease and a barrier to heart disease prevention” (NHLBI, p. 2). Based upon these indicators, it is necessary to evaluate the conditions that are evident within this community in an effort to improve knowledge and prevention strategies to reduce cardiovascular risks (NHLBI). The efforts that are made to conduct interventions throughout Baltimore are likely to be effective in providing knowledge and information to local residents who might improve their own health outcomes in the process.

One of the most staggering discrepancies in Baltimore regarding the health of its population is life expectancy, which differs by 20 years in some communities (Cohn and Marton, 2012). For example, the Roland Park community has a much higher life expectancy rate and a higher median income at $90,000, while Upton has a much lower life expectancy rate and a lower median income at $13,000 (Cohn and Marton, 2012). Nonetheless, heart disease is the number one killer in both communities; however, prevention and awareness of the disease vary dramatically (Cohn and Marton, 2012). These findings suggest that the residents of Baltimore in throughout all communities must be aware of the risks associated with heart disease, but that those in lower income communities must be provided with greater interventions in order to improve their cardiovascular health and wellbeing over time (Cohn and Marton, 2012). It is important to recognize these disparities and how to overcome the discrepancies in the health of Baltimore residents so that the risks associated with heart attack, stroke, and other conditions are reduced as best as possible (Cohn and Marton, 2012). In addition, this population group must be provided with the appropriate level of access to healthcare screenings and services in an effort to produce successful outcomes for individuals and families who are at the greatest risk for cardiovascular disease (Cohn and Marton, 2012).

            Finally, the development of a successful approach to prevent heart disease and improve disease management to prevent high mortality rates requires an effective understanding of the disparities that exist throughout Baltimore, particularly those that occur across minority groups. Since there are significant discrepancies in Baltimore in regards to specific populations, it is important to evaluate these differences and to take the steps that are necessary to provide local residents across different communities with     the tools and resources that are required to improve their health and reduce their risk of heart disease through healthy lifestyle choices and other factors that will improve their health and wellbeing in different ways.

Part 3: Communication Methods

            Nurses must exercise different methods of communication in the workplace and in working specifically with patients. One of the key factors to consider in this practice is time because there is typically limited time to address concerns with patients and with colleagues in the face of significant workload concerns (Hemsley et.al, 2012). Therefore, time is a critical component in managing communication between nurses and patients in different settings and in supporting the development of new perspectives to ensure that patient care is not compromised as a result of time constraints (Hemsley et.al, 2012). These efforts are important because they provide greater evidence of the ability of time to play a substantial role in how communication is addressed between nurses and their patients in different ways (Hemsley et.al, 2012).

            In the context of quality patient care, nurses must demonstrate their willingness to communicate with their patients through the utilization of structure and leadership in supporting effective communication between patients and with colleagues (Baird et.al, 2012). Nurse leaders must recognize that communication is a critical component of nursing practice and that nurses must identify areas of strength and weakness to ensure that patient care is not compromised in any way (Baird et.al, 2012). In addition, nurse leaders must establish the tone and an example for other nurses to follow in their efforts to develop effective communication in group settings and in one-on-one exchanges (Baird et.al, 2012). Also, nurses must develop effective skills to encourage interdisciplinary collaborations with colleagues to promote greater quality of care and treatment in these settings (Coeling and Cukr, 2000). Collaborations of an interdisciplinary nature are designed to strengthen knowledge and address weaknesses within team-based settings to facilitate improved quality of care over time (Coeling and Cukr, 2000). Similarly, team-based environments often encourage new approaches to common patient care problems and facilitate holistic strategies to promote care and treatment that not only support patients, but also clinical staff members in their own learning (Kvarnstrom, 2008).

Effective Communication Strategies

            Communication throughout nursing practice requires an effective understanding of the different elements that support idea sharing and positive outcomes. To be specific, “The main intention of communication and interaction in the health setting is to influence the patient’s health status or state of well-being… The process of communication is often described with a phase model; communication often happens during other interventions and tasks. In general, influencing factors can be organized into the categories of provider variables, patient variables, environmental and situational variables” (Fleischer et.al, 2009). From this perspective, it is important to demonstrate that nursing communication strategies are dependent on specific models and indicators that are grounded in other experiences to ensure that patient care experiences and interactions are not compromised (Fleischer et.al, 2009). At the same time, it is important to identify the specific phases of communication that are common in nursing practice in order to accomplish the needs of patient care and treatment in different ways to improve patient wellbeing (Fleischer et.al, 2009).

            Many different communication strategies are available to nurses to enable communication to be effective in their associations with other nurses and with patients. Therefore, one strategy to consider is collaborative communication, whereby “Collaborative communication and teamwork are essential elements for quality care and patient safety. Adverse patient occurrences are an extremely common outcome of communication failures…Although improving communication has been included as a Joint Commission’s National Patient Safety Goal for hospitals since 2003, in 2006, handoff communications were included as a specific communication subset” (Beckett and Kipnis, 2009). Under these conditions, it is expected that effective nursing care and treatment will be achieved through the continued efforts by nurses and nurse leaders to exercise effective communication at all times and to demonstrate the importance of collaborative communication in supporting all aspects of patient care at all times (Beckett and Kipnis, 2009). In particular, situations involving handoffs of patients to the next shift are particularly important in demonstrating that nurses are capable of handling communication in an effective manner (Beckett and Kipnis, 2009). These efforts are also important because they convey the importance of specific needs and challenges that patients face when nurses are unable to communicate effectively with their colleagues and with patients (Beckett and Kipnis, 2009). For many organizations, the basic task of shifting communication styles is important because it provides significant evidence that there are improvements in patient communication by nurses once these strategies are rolled out (Beckett and Kipnis, 2009). Therefore, it is important to identify the strategies that are likely to be most effective in this process and to ensure that they are executed as best as possible in nursing settings and across all population group (Beckett and Kipnis, 2009). This practice is essential to the discovery of new ideas and techniques to demonstrate the successful impact of patient care and treatment in a manner that is consistent with nurse professionalism and strength (Beckett and Kipnis, 2009).

Barriers to Communication

            In working with specific population groups, nurses must also demonstrate their ability to engage patients by expressing communication with respect to culture and language differences. Therefore, nurses must be able to effectively communicate with all patients and to recognize that in some cases, there are likely to be barriers to this communication unless interventions are conducted for these patients, such as the use of an interpreter for patients who speak a different language (Fatahi et.al, 2010). This is particularly important when providing technical information to patients to remove language barriers whenever possible so patients better understand what is taking place (Fatahi et.al, 2010).

            Oncology nurses, for example, barriers to communication are a common phenomenon that is characterized by the development of specific limitations in communication as a result of the poor translation of information by other healthcare providers, perhaps on different shifts or in different departments, thereby leaving patients and their family members confused regarding the information that they have received (Wittenberg-Lyles et.al, 2013). In addition, the article indicates that “Physician assumptions about nursing left nurses feeling uncomfortable asking for clarification, creating a barrier to team communication processes. Patient-centered communication and care cannot be actualized for nurses unless team roles are clarified and nurses receive training in how to communicate with physicians, patients, and family” (Wittenberg-Lyles et.al, 2013). This example demonstrates that there are significant barriers to effective communication by nurses to patients and their family members, often based upon confusion created by other healthcare providers (Wittenberg-Lyles et.al, 2013). These efforts are important because they convey that there are considerable weaknesses in the communication practices of other nurses and physicians, thereby creating much communication across different departments and nursing units (Wittenberg-Lyles et.al, 2013). As a result, it may be difficult for organizations to overcome these barriers unless additional training and clarification is provided to nurses to ensure that these barriers are eliminated or minimized as best as possible (Wittenberg-Lyles et.al, 2013).

            For nurses working with children and parents, there are other types of barriers and challenges that may exist that must be addressed as best as possible. However, some nurses might not possess the appropriate method of working with these patients and should be sensitive to the needs of this specific population group (Redsell et.al, 2010). Therefore, these needs must be met through the understanding of nursing-based perspectives and how these might influence communication in different ways so that the needs of this population are better met during nursing communication practices (Redsell et.al, 2010). The efforts that are made also demonstrate the attitudes of nurses regarding their patients and the treatments that they receive, because in some cases, these perceptions could be distorted by specific beliefs or judgments that are not beneficial to patients (Redsell et.al, 2010). As a result, it is important to identify the specific indicators of communication that are necessary to ensure that patient care is optimized at all times (Redsell et.al, 2010).

            For nurses seeking to improve their communication skills, it is important to recognize the value of developing new perspectives and approaches to nursing practice that will enhance communication in different ways. This may involve interventions that are likely to identify problems in such settings as chronic care, for example, so that there are sufficient opportunities to recognize problems to improve communication as best as possible (Boscart, 2009). In many organizations, ”Positive nurse–patient communication in chronic care is crucial to the quality of life and well-being of patients. Despite this, patients are dissatisfied with these interactions and nursing staff indicate the need for additional training” (Boscart, 2009). Therefore, it is necessary to identify specific areas where communication might be improved to reduce barriers and to expand patient compliance in chronic care settings (Boscart, 2009).

            Collaborative learning requires successful communication and the elimination of barriers through role clarification and trust amongst team members (U.S. Office of Personnel Management). This is best accomplished through flexibility and a full commitment to the team’s purpose and function (U.S. Office of Personnel Management). Furthermore, the development of effective critical thinking skills is essential in promoting productivity and encouraging a clear approach to a given problem in order to develop an effective solution (Elder and Paul). Higher level thinking and analysis must evolve so that individual contributions to teams and to the patient care experience are effective (Elder and Paul).

Health Assessment

            Baltimore, MD is a large metropolitan community that faces similar health risks to other communities with respect to heart disease and related conditions. It is important to identify the specific population groups that are most affected by this condition and to determine how to best approach disease management in order to facilitate optimal outcomes for this community. The City of Baltimore faces a great risk of heart disease that is not that unique from other communities; however, Baltimore has its own set of population demographics that must be properly identified and addressed so that the proposed action plan will be most effective for this community. Therefore, nurses and other healthcare professionals must take the steps that are necessary to create an action plan that will target this community and provide the necessary benefits as effectively as possible. An effective community-based assessment is critical to the success of a given strategic approach to improve public health initiatives and wellbeing (Williams, 2009; Walker et.al, 2011). Health assessments also require an analysis of specific populations in order to improve health promotion activities across these groups (Harris-Roxas and Harris, 2011).

            From an environmental perspective, it is important to identify specific indicators that may impact health assessments and promotion activities within communities (Collins and Koplan, 2009). Team-based activities are critical during the assessment process and support the expansion of activities for a given purpose (Elder and Paul), while also considering the impact of these activities in the team setting (U.S. Office of Personnel Management). Perhaps one area to consider is specific needs assessments for elderly persons versus younger age groups, with the former more likely to require advanced directives due to age and other factors (Taylor, 2012). Miller (2005) demonstrates that communication within a given setting is critical to the success of a healthcare directive and should be utilized in team settings to facilitate positive outcomes. Furthermore, collaborative efforts in a community-based setting should signify a commitment to the initiative and the people that it serves through effective communication channels, rather than weak ones (Kvarnstrom, 2008; Coeling and Cukr, 2000). Laverack (2006) encourages community empowerment through the development of specific initiatives that are designed to promote health and wellbeing. A successful example is the Kaiser Permanente Community Health Initiative, which has been effective in providing tools to local residents who otherwise might not have access (Cheadle et.al, 2010). Some community members may possess specific beliefs regarding therapies that may support improved health, but these are not always easily understood, including the use of alternative therapies to treat chronic illnesses (Fennell et.al, 2009; Hassan et.al, 2010; Ndao-Brumblay and Green, 2010).

            For the City of Baltimore, approximately 200 deaths occur per 100,000 members of the population resulting from coronary artery disease, which is well above the state average (Maryland Department of Health & Mental Hygiene, 2009). Therefore, it is strongly evident that many residents in Baltimore who face a greater risk of heart disease may not recognize this risk or are not taking the steps that are necessary to improve and maintain their own health (Maryland Department of Health & Mental Hygiene, 2009). In particular, African Americans face the greatest risk as a result of this condition and their needs must be addressed as a key component of a larger community-based effort to promote heart health and wellbeing, including the reduction of obesity rates within this population group (Johns Hopkins Urban Health Institute).

            According to the Baltimore City Health Department, “Baltimore, home to 637,455 people, is located in the wealthiest state in the nation, yet has nearly 20% of its residents living in poverty. Many of these are the working poor who cannot afford health insurance and who are frequent, but inefficient users of the healthcare system” (Baltimore City Health Department, 2009, p. 4). Under these conditions, it is important to identify the specific factors that play a critical role in the continued growth of the heart disease epidemic within Baltimore, given that poverty impacts approximately one-fifth of the City’s population (Baltimore City Health Department, 2009). Under these circumstances, outreach and prevention are difficult to accomplish when this population group do not have access to health insurance and services at all, or this access is severely limited (Baltimore City Health Department, 2009). These findings suggest that it is necessary to identify specific indicators that may reduce the risk of heart disease within this population through the development of an action plan that will address these concerns in a comprehensive manner to improve overall awareness of heart disease and the risks associated with this condition throughout the City of Baltimore.

Action Plan

            An action plan to reduce the risk of heart disease for Baltimore residents requires an effective understanding of the specific risks and challenges of this group and their level of understanding of this condition and how it impacts their daily lives. Some of the most important factors to consider include the following: “Cardiovascular disease behavioral risk factors include: inadequate physical activity and exercise, poor dietary habits, tobacco abuse and excessive alcohol intake. Community-based approaches seek to understand and address aspects of the socio-cultural environments that impact behavioral risk factors. Using the affected communities as the setting for intervention allows increased awareness and better understanding of the barriers and facilitators to behavior change” (Baltimore City Health Department, 2009, p. 9). These circumstances coincide with the lack of understanding of the specific factors that contribute to negative outcomes for this population and the challenges that they face, either without any form or health insurance or very limited coverage, both of which may lead to considerable consequences for their health and wellbeing (Baltimore City Health Department, 2009). Under these conditions, it is important to identify the specific factors that are represented by these phenomena in order to determine how to best move forward with action plan that is most appropriate for the needs of this population (Baltimore City Health Department, 2009).

            The utilization of local community-based services and principles is essential to the discovery of new perspectives and strategies to improve the cardiovascular health and wellbeing of Baltimore’s population. This is challenging because it requires an effective understanding of the limitations placed on residents due to their lack of knowledge and experience with cardiovascular disease and how it impacts their health in different ways. It is likely that a lack of knowledge regarding diet, nutrition, physical activity, tobacco use, and alcohol consumption are key contributors to the elevated risk of heart disease within this community (Baltimore City Health Department, 2009). Therefore, it is recommended that there must be additional factors in place that will promote a successful action plan for widespread implementation throughout this community (Baltimore City Health Department, 2009).

            Baltimore’s population faces risks that are not that different from other communities with respect to heart disease. Therefore, lessons learned across other populations might be useful in developing a strategy for this community and its people. The action plan that is chosen for implementation must consider the following key areas of development: long-term impact, the capacity for continuous development and expansion, improving policy, moving forward with an action strategy, and expanding collaborations with other communities (CDC). It is known that “The economic costs of heart disease and stroke rise each year. These costs include the numbers of people requiring treatment for risk factors or early signs of disease; emergency treatment for first or recurrent episodes of heart attack, heart failure, or stroke; and efforts to reduce disability and prevent recurrent episodes” (CDC, p. 4). These findings suggest that it is more important than ever to develop strategic approaches that will facilitate the support of new ideas and community-based initiatives to encourage cardiovascular disease prevention as best as possible for Baltimore residents (CDC).

            The impact of a strategic action plan to reduce the risk of heart disease also requires an effective understanding of the risks associated with this condition. Behaviors are perhaps the key to understanding how individuals respond to heart disease and in establishing its overall impact on health and wellbeing for a given community. In Baltimore, this appears to be particularly relevant because lifestyle behaviors for many members of the affected population lead to greater risks, including poor dietary consumption, smoking, excessive sodium intake, and limited physical activity, amongst others. Under these conditions, it is important to identify the specific areas where behavioral improvements might occur so that cardiovascular disease risk is significantly reduced.

            An action plan to reduce heart disease risk for Baltimore residents requires a detailed assessment of the population and its current lifestyle behaviors because this practice will facilitate the development of new ideas to promote positive lifestyle behavioral changes for the residents of Baltimore. Due to the costs of prevention programs and their limited impact in many cases, it is necessary to identify the specific factors that are relatively easy to measure and that might have a greater and lasting impact on the community at large. These efforts will demonstrate the importance of specific factors that will support long-term behavioral and lifestyle changes within this population.

            From a public-based perspective, the development of a strategic approach to reduce the risks associated with heart disease requires public support and intervention not only through financial means, but also through the utilization of knowledge and experience that is present within the Baltimore community. This coincides with national public initiatives to improve health and promote awareness of heart disease and other conditions that impact communities throughout the United States. These factors play an important role in reducing these risks and in enabling community residents to better understand how their own behaviors impact their health and wellbeing in different ways. This is an important step towards the discovery of new insights and approaches that will positively influence outcomes for these residents.

            Public health initiatives and other challenges must evolve so that there are significant opportunities for growth and development within communities such as Baltimore. In particular, this community faces significant racial disparities and such factors as low education levels and low incomes that may prohibit access to routine healthcare services (Shaya et.al, 2006). In addition, “People with lower socioeconomic status (SES) are more likely to be uninsured, have low-quality heath care, and seek health care less often; when they do seek care, the problem is more likely to be an emergency” (Shaya et.al, 2006, p. 140). Under these conditions, it is expected that there will be significant problems that continue over time that must be addressed through action plan efforts so that local residents will benefit from these initiatives and will improve their own cardiovascular health by utilizing these offerings (Shaya et.al, 2006).

            Establishing an effective action plan for the Baltimore community also requires an effective screening tool that will be utilized on a regular basis within the community to support long-term growth and wellbeing for this population, and in particular, African Americans (Shaya et.al, 2006). These efforts must coincide with other strategies in place within the community and should also reflect a means of expanding knowledge and growth of specific factors associated with community-based support of these offerings (Shaya et.al, 2006). From a behavioral perspective, enabling this community to recognize the benefits of positive behavioral changes may make an important difference in their ability to remain compliant in these endeavors (Shaya et.al, 2006). These creative approaches must demonstrate the importance of specific interventions and other factors that are instrumental in shaping outcomes for this group of residents (Shaya et.al, 2006).

            From a compliance-based perspective, the ability of local residents to accomplish the objectives of the action plan requires a continuous effort from social service and healthcare providers to motivate residents so that they are able to reduce their risk of cardiovascular disease over time. This is an important and meaningful accomplishment for the community and requires a greater understanding of the different challenges and limitations that exist in supporting the development of new ideas and approaches to facilitate improvements not only in lifestyle behaviors, but also in the ability to access specific healthcare services within the community setting. This is a critical offering that must be provided through the efforts made with the action plan and should be effective in supporting the development of new ideas and approaches to encourage growth and change within the members of this community, and in particular, those who face the highest risk of cardiovascular disease. With these steps in mind, local residents are likely to experience greater benefits and will be empowered to improve their health and wellbeing through specific lifestyle changes and behavioral modifications to accomplish these efforts in an effective manner.

            Key community organizations and professionals, such as nurses, social workers, pharmacists, churches, hospitals, clinics, schools, and others must identify areas where collaboration might be beneficial in supporting the long-term growth and sustainability of the chosen action plan. It is necessary to identify specific factors that are associated with positive outcomes for local residents that also address disparities in healthcare access, screening, and treatment for this population group. With these efforts in mind, it is necessary to also address methods of developing and sustaining an action plan that is cost effective and appropriate for the population in question and the needs of the local community at large. These efforts will provide significant and meaningful benefits to local residents in their efforts to achieve positive health outcomes for the foreseeable future. Since the risk of cardiovascular disease is significant for many residents of Baltimore, it is more important than ever to address these disparities and to consider the challenges of creating an environment that supports these objectives and developments over the long term.

Conclusion

            The disparities in health in Baltimore are best represented by the development of strategic approaches in community –based settings in order to gather data and to develop specific frameworks that will generate healthier outcomes for this group. Within this context, it is important to recognize the value of interventions that provide education and support to those persons at risk for cardiovascular disease in order to improve outcomes and create new opportunities for expanded health. With a diverse range of life expectancy within the City of Baltimore, it is more important than ever to recognize the different concerns associated with lower income communities and how this impacts health over the long term. From this perspective, it is likely that organizations that work collaboratively towards a set of common goals and objectives will achieve greater than anticipated outcomes in different ways to reduce their risk of heart attack, stroke, and other cardiovascular concerns. For the residents of Baltimore, it is more important than ever to provide them with a framework for the achievement of successful outcomes and the development of healthier lifestyle choices to improve general health and wellbeing over time.

            The identification and development of successful nursing-based communication strategies with patients and colleagues requires an effective recognition of the different challenges that exist in expanding communication to improve the quality of care. Recognizing barriers to communication is important in demonstrating the value of taking the steps that are required to improve communication to improve the quality of care. All populations deserve quality care and treatment from nurses at all times; therefore, continuous efforts must be made to accommodate these needs and to eliminate barriers to communication in order to promote successful outcomes and wellbeing for all patients. These contributions to nursing practice are critical because they shape the manner in which nurses identify with their patients and are able to communicate with them in different ways to ensure that patient care and treatment are not compromised in any way.

            The people of Baltimore face significant risks associated with cardiovascular disease and its impact on their lives. In particular, African Americans face a greater risk of cardiovascular disease due to various disparities within the culture itself and in obtaining routine access to quality healthcare services. Community-based initiatives must be established to expand knowledge and awareness of heart disease and its overall impact on local community residents. It is important for local community members with experience in public health and social services to participate in these endeavors to ensure that local residents are taking the steps that are necessary to improve their health and to minimize their risk of cardiovascular disease. Therefore, greater access to healthcare services must be achieved to improve lifestyle behaviors, screening mechanisms, and other factors that are active contributors to the reduction of risk associated with cardiovascular disease within this community. Finally, it is important for local organizations and professionals to identify areas where disparities exist and to address those disparities as directly as possible to reduce the long-term impact of heart disease on the community as a whole. These efforts will demonstrate the importance of specific factors and approaches that will facilitate greater outcomes and that will utilize specific community-based knowledge and experience to develop efforts to improve outcomes for local community members that will be consistent and routine over time.

            The proposed action plan must demonstrate that cardiovascular disease in the Baltimore area is taken seriously and requires a collaborative effort from a variety of community-based sources in order to accomplish the desired objectives and to facilitate successful results in reducing disparities and in shaping a healthier community for all residents. These efforts must utilize existing resources wisely and develop new strategies to facilitate growth and change within the Baltimore community setting. With these practices in place, the people of Baltimore will achieve greater than anticipated health outcomes and improved longevity over time.

References

Baird, B.K., Funderburk, A., and Whitt, M. (2012). Structure strengthens nursing                                    communication. Nurse Leader, 10(2), 48-49, 52.

Baltimore City Health Department (2009). Agenda to reduce cardiovascular disease                     

http://www.baltimorehealth.org/info/Keep%20the%20Beat%20-%20Baltimore%27s%20Cardiovascular%20Disease%20Agenda.pdf

disparities in Baltimore City. Retrieved from

 Baltimore City Health Department (2010). 2010 Baltimore City health disparities report

card.  Retrieved from http://baltimorehealth.org/info/2010_05_25_HDR-FINAL.pdf

 The Baltimore Sun (2011). Mapping the health of Baltimore’s neighborhoods.

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from http://data.baltimoresun.com/baltimore-healthy-neighborhoods/

 Beckett, C.D., and Kipnis, G. (2009). Collaborative communication: integrating SBAR to                     improve quality/patient safety outcomes. Journal for Healthcare Quality, 31(5),                         19-28.

Boscart, V.M. (2009). A communication intervention for nursing staff in chronic care.                            Journal of Advanced Nursing, 65(9), 1823-1832.

Centers for Disease Control and Prevention. A public health action plan to prevent heart disease                        and stroke. Retrieved from

http://www.cdc.gov/dhdsp/action_plan/pdfs/action_plan_full.pdf\

Cheadle, A., Schwartz, P.A., Rauzon,S., Beery, W.L., Gee, S., and Solomon, L. (2010).  The                 Kaiser Permanente Community Health Initiative: overview and evaluation design.                     American Journal of Public Health,100(11), 2111-2113.

Coeling, HVE, and Cukr, P.L. (2000). Communication styles that promote perceptions of                      collaboration, quality, and nurse satisfaction. Journal of Nursing Care Quality, 14(2),                 63-74.

Cohn, M., and Marton, A. (2012). City health data illustrates chasm between rich and poor                       neighborhoods. The Baltimore Sun, retrieved from

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Collins, J., and Koplan, J.P. (2009). Health impact assessment: a step toward health in all                       policies. Journal of the American Medical Association,302(3), 315-317.

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Nursing

Differential Diagnosis

            The patient in question, a 15 year-old with a persistent dry cough, should be examined thoroughly to determine the nature of the cough and any underlying or accompanying symptoms. Upon review of the patient’s prior medical history, the problem has been intermittent for approximately one year, but the symptoms are consistent and have not worsened. Performing a detailed assessment is required to determine the extent and cause of the dry cough and to determine if any specific factors might be at work. The patient does not experience wheezing to accompany coughing episodes. Evaluation of the patient must include an examination of lungs, airway, breathing, and overall appearance.

            The patient should undergo a chest x-ray to determine if any physical findings are present in relation to the cough that are significant in nature. In this case, the chest x-ray is the most natural approach because it conveys the importance of any findings that might require additional evaluation and possible treatment. In addition, if the x-ray does not present any significant findings, testing such as examination of the sinus cavities through nasoendoscopy and bronchoscopy might be necessary in this case. Finally, an exploration of iron deficiency through iron testing could be an indicator of coughing symptoms.

            The possible differential diagnoses for this patient include the following: 1) Asthma; 2) Non-Asthmatic Eosinophilic Bronchitis (NAEB); and 3) Gastro-oesophageal reflux disease (GORD). Each of these diagnoses requires its own set of tests to determine if the presenting symptoms correspond with the diagnosis. For example, a diagnosis of Asthma requires physical assessment to determine if wheezing is present. Testing includes spirometry with the use of the bronchodilator to determine if Asthma is the appropriate diagnosis. In this case, since the patient does not present with wheezing to begin with, the diagnosis of Asthma is unlikely.

            Non-Asthmatic Eosinophilic Bronchitis (NAEB) is also a possibility when the patient does not present with any significant symptoms other than a random non-productive cough that is not associated with wheezing episodes or other factors that could indicate the possibility of Asthma. The most common test to determine this condition is the sputum/broncho-alveolar lavage differential count. In addition, testing to evaluate exhaled nitric oxide is a possibility in this case.

            Finally, Gastro-oesophageal Reflex Disease (GORD) is a possibility when there are presenting symptoms of heartburn, acid regurgitation, and associated postural changes in these conditions, accompanied by a random cough without any wheezing symptoms. In this case, the first line of defense and testing is to prescribe proton-pump inhibitors for a period of at least eight weeks to determine their effectiveness in reducing coughing symptoms. In this case, it is likely that since the patient has not complained of a history of heartburn or acid reflux symptoms, this diagnosis is not likely.

            Based upon the information that has been provided through the patient’s medical history and current assessment, it is likely that the patient is suffering from Non-Asthmatic Eosinophilic Bronchitis (NAEB). Her symptoms indicate a dry cough without accompanying wheezing, along with increased physical activity over the past week due to swim training. Therefore, it is important to begin treatment for the patient to alleviate her persistent dry coughing symptoms, including the use of inhaled corticosteroids to produce antinflammatory properties. The use of an inhaled corticosteroid, particularly after periods of heavier physical activity, such as swim training, serves as an important means of alleviating possible symptoms over a period of time and in ensuring that the patient’s condition does not worsen beyond the current dry cough, particularly at the time of increased physical activity.

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Nursing

Healthcare as a Commodity

Healthcare is a general need of the human society. It is then important that they [the people] be given the chance to have full access to the provisions of healthcare facilities that could improve the status of their health. Notably though, the current situation in the society indicates that healthcare is not considered as a commodity. This means that the control on the pricing of medicines and other medical elements still belong to the administrators owning the companies who are producing the said products for the society to consume. There are some entities in the healthcare industry controlled by the government, however a large part of the said industry still belongs to privately owned companies that are of course most often than not dependent on the desire to acquire profit. In fact, it could be realized that the pharmaceutical industries belong to the top five highest grossing industries around the globe at present.

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Nursing

Assuring Patient Safety through Applying Proper Nursing Procedures and Communication in the Intensive Care Unit

Introduction

            Nurses are noted to be known for their role in hospitals and other healthcare facilities. They assist and they assure the patients of a good sense of recovery. Relatively though, more is expected from a nurse serving in the Intensive Care Unit. From the term “intensive’, it could be understood that nurses situated in this position are expected to give double if not triple the attention that they give to their patients and increase the cooperation that they have with their colleagues attending to the patients in the said section of the hospital. It is very important that nurses are properly briefed about the role that they play in the ICU not only for the patients but also for their colleagues, especially that of the doctors who are assigned to give attention to the individuals in the said area of the healthcare facility they serve.

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Nursing

Advanced Leadership in Action

Abstract

In health care, the importance of leadership in quality improvement has been assessed several times by different authors. During class, we have discussed several approaches to managing change, quality and service through effective leadership methods. The below advanced leadership overview is designed to summarize my understanding of the roles of different management practices.

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Nursing

New Nurse Orientation Program

Outline

Strengthening the orientation process

Costs related to nurse turn over

Benefits of Nurse Retention

Rationale for plans

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Nursing

Theories of Leadership

Outline

Introduction

Case study

Transformational Leadership

Transactional Leadership

Conclusion

  • Most Effective Style
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Nursing

Relational Schema on Database Table Systems Function

Abstract

This discussion and presentation on how a database functions to provide practical information about patients and their condition of recovery intends to show how IT operations could increase the efficiency of service that healthcare facilities provide to the society today. In a way, this discussion hopes to examine the tables and categories of information that a database stores especially in relation to the recovery of patients and how it provides an indication on the quality of service that the establishments of healthcare industries provide them with.

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Nursing

Emotional Intelligence

The Emotional Intelligence Appraisal represents a means of exploring my core skills and strengths related to personal and social competence. My score in self-awareness is higher than in self-management; therefore, I must work on improving the context of my emotions when I relate to others. In addition, my score in social awareness is higher than in relationship management. With the former, I am able to recognize what others are feeling in the moment so that I might adjust my perspective accordingly. Since my self-management score is low, I must recognize that my level of negative self-talk is too high and reflects poorly on my ability to achieve adequate self-esteem.

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Nursing

Leadership strength paper

Introduction

Building a successful team-based structure requires the identification of core strengths that drive effective leadership in a team environment. From a personal perspective, I believe that the most important strengths required to build a productive team include knowledge, innovation, experience, motivation, commitment, and risk-taking. Each of these characteristics is essential to the development of a team that will encompass these qualities and achieve the desired strategic objectives. Based upon my Strengths-Based Leadership Report (2013), I am focused, a relator, an achiever, I possess empathy, and I tend to provide significant influence in the lives of other people. Therefore, these opportunities are likely to allow me to continue on a path towards successful leadership in a team-based environment. I must also focus on self-reflection by utilizing past experiences and existing practice methods to improve the team environment and my leadership in this regard (Polchert).

Body

I am committed to making my team the best that it can be through my own actions, perspectives, and knowledge regarding the team’s direction and focus. Since I am empathetic by nature, I believe that this attribute is essential in supporting my team and each member, particularly when he or she lacks motivation, initiative, or direction. Therefore, it is important to utilize these characteristics to impart an environment of trust so that my colleagues are able to trust in my talents and abilities to lead the team in a successful manner. However, an environment of trust also requires mutual respect and continuous support to achieve the desired team outcomes. Based upon these core strengths, I believe that there are significant opportunities for my team to demonstrate growth as it evolves under the chosen strategy.

The development of a leadership strategy based upon these core strengths requires a means of exploring the dynamics of change and progress in the context of idea generation and creativity over time. These efforts will support the ability to explore new directives to maintain motivation, commitment, interest, and creativity within the team environment. Under these conditions, it is possible for the team to develop a long-term strategy that will emphasize core strengths and challenges in an effort to produce desirable results. At the same time, recognizing that all team members do not possess the same skill levels and core strengths is critical to the success of the team environment as it evolves. As a leader, I must work collectively with my team not only as a leader, but also as a valid contributor to enable team members to realize their own potential in the team-based setting.

Conclusion

It is necessary to continue to develop my core strengths in an effort to achieve greater outcomes and to serve as a support system for my team at all levels. As a leader, I must also recognize my own limitations so that I do not overstep in areas where I am not familiar or comfortable with the tasks at hand. I do not expect all team members to have the same type of strengths; therefore, we must work in a collaborative manner to achieve the team’s directives. At the same time, I must serve as a viable learning resource and share my knowledge with the team by building an environment of trust, commitment, and strength. This is critical to the success of the team and its goals.

As a team leader, I must assume the responsibilities associated with this significant task and create an environment that is conducive to progress and success at all levels. This is best accomplished through an open and creative dialogue that is designed to support the continuous development of new ideas and strategies to work collaboratively as a team and to minimize conflicts whenever possible. This will encourage the success of the team experience and the expanded learning curve of all team members in an environment that is conducive to progress and growth.

References

Gallup (2013). Strengths-Based Leadership Report. Pp. 1-4.

Polchert, M. Reflective nursing practice. Retrieved from

http://www.deltagammastti.org/docs/LeadingEdgeReflection2-09.pdfleadership strength paper

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Nursing

Nursing-Capstone: Prevalence of Obesity Among Children and Adolescents

Rate the measurement: – Someone asked, “Can you do Addition?” The response was another question…..“What is one + one + one + one + one + one + one + one + one + one?”  Again the response was obvious…. “I don’t know…  I lost count.” (Measuring Health Outcomes, 2013, chapter, 3). This is an indication as to how complicated measuring health outcomes in a program seeking to address  whether present obesity intervention strategies are ineffective or the target group has not been properly screened for appropriate interventions  can become. It is important to conceptualize what has to be measured. As such, present obesity intervention strategies are a major concept that must be operationalized in this capstone project. From the literature review effective obesity intervention strategies are techniques utilized in health promotion programs, which result in significant reduction in obesity rates among children and adolescents. For the purposes of this project an estimated 20% rate reduction after the first year individually and collectively is an indication of a successful health promotion program.

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Nursing

Health Disparaties

Introduction

Advances in medical technologies have provided many people with the chance to live longer, healthier lives. Nonetheless, there are many documented disparities between racial and ethnic population causing health equity to remain elusive. Health disparities are differences in health outcomes that are linked to one’s social, economic and or environmental disadvantages. These disadvantages are often caused by social conditions in which one lives, learns, and works, and responds differently from other counterparts. Health care disparities are a societal burden that manifests itself in multiple ways. Lack of insurance negatively affects the quality of health care provided to minority individuals. Minorities are often members of cultural societies that place negative stigmas on certain illness, and for this reason many minorities do not seek help for certain medical issues. For example, mental illness has a very negative connotation among minorities. Mental illness is often labeled as a disease that attacks the weak minded. As a result, many minorities suffer from depression for years and years without proper treatment.  Obesity is another illness that is often overlooked. Many minorities suffer from obesity as a result of cultural cooking. Most minorities have grown up eating certain types of foods that are prepared in unhealthy ways. They continue to eat these types of food their entire lives and as a result they suffer for obesity which can lead to high-blood pressure, cardiovascular disease, and strokes. Finally, many minorities lack the understanding and access to scientific knowledge and medical innovations because of cultural barriers. Minorities often have superstitions and home remedies for certain ailments. Often they feel that medical professionals do not know what is best for them. They are often times just very untrusting of medical professionals. As a result, if they do see a medical professional on a regular basis, they may still not take prescribed medicine out of fear that it will do more harm than good. Health care providers must promote a closer collaboration between staff and minorities, coordinate more effective investments in the research of the treatment of minorities, and facilitate public input and feedback from more minorities.