...of care (Poghosyan, Lucero, Rauch, Berkowitz, 2010). This transformation will now necessitate a restructure of the many roles within the health care professionals, including registered nurses (RNs). In 2008, the Robert Wood Johnson Foundation (RWJF), and the institute of Medicine (IOM) launched a two-year planned response to the critical need to assess and transform the nursing profession (Institute of Medicine, 2010). According to the Institute of Medicine (IOM) report, The Future of Nursing: Leading Changes, Advancing Health, suggest that the future of nursing is advancing with the opportunities that will transform the healthcare system by using knowledge and skills of nursing. The purpose of this discussion focuses on the impacts of the health care reform in nurses’ practice, education, and leadership. The implications on Nursing Education In the US, the health care system is changing dramatically. As the baby boomer population is aging, there has also been a surge of obesity triggering the complexity of chronic illness, such as diabetes, hypertension, and cardiovascular disease. These factors demand highly skilled and knowledgeable nurses in order to provide the utmost of specialized quality care. The education of nurses over the past decades is no longer adequately preparing nurses to deal with the complexity of the patient’s needs, condition, and economic background. A deeper understanding of the legal aspect of health care policies, public health recourses, negotiation...
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...increase demands for nursing care as this legislation is fully enacted. The ways in which nurses can provide solutions for enacting the legislation and caring for the millions of newly insured Americans are discussed. The act also provides for professional training and development of advanced practice nurses to meet the demands of increased care and increased patient load. Keywords: healthcare reform, nursing education, nursing roles Significance Of Nursing In The Implementation Of Health Care Reform Healthcare reform has captured our time and attention during the past few months, it has been a long and heated discussion. As the healthcare and its underlying payment system evolve in the face of the new Patient Protection and Affordable Care Act; healthcare for all, a long time dream of many nurses, will be realized. This act requires all Americans to be covered by health insurance by 2014. Goals of the act are to not only enhance access to affordable care but also focus on wellness and prevention, bring care back to being patient centered, emphasize chronic illness management, assist patients in making informed choices and improving coordination of care. It also emphasizes distributing highly educated nurses closer to medically underserved populations and lays the ground work to help lessen the shortage of nurses, nurse practitioners and nursing faculty (Carlson, 2010). Every healthcare...
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...funds provided by authorities. Funds supported by the government for public hospitals benefits the system where patients are provided with sufficient sickbeds, nurses, emergency wards, ambulance vehicles and food. These subsidies allow hospitals to prevent over flowing of patients left unattended during emergency and casual consultation times. In most general hospitals, subsidised funds allow hospital authorities to hire more nurses which increase the efficiency of patients being tended and decrease the workload on the doctors (Palmer and Short, 2010). Furthermore, the funds are greatly beneficial towards the practices of specialised doctors in certain types of patients such as cancer and other complicated diseases. In a health care system, technological factors are required to improve the quality of resources provided to patients and assist greatly in medical research departments. In most countries, health practitioners increased the adoption of Health Information Technology (HIT) which provides lower medical costs and improving quality provided to patients (Carter J.H., 2004). A large savings could be caused by advance equipment which reducing patients’ hospital staying, reduce the working hours of nurses and increases the effectiveness of drug application. Besides that, HIT increases the safety in medical practitioners where results provided by...
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...has exerted too much pressure on our daily lives that quite often develop a distorted view of our surrounding. We tend to forget how well we are doing, our failures and the effect of our action on the people around us. By developing reflective skills we gain an accurate picture of who we are, become aware of our hidden motivations and thinking styles, how we appear to other people. We also develop a better understanding of what motivates our performance and develop our insight and judgment(Bulman,2004).It also helps us have control of our thought process ,our emotions and responses to our sorroundings.Reflection therefore furnishes us with tools that enable us to achieve what we want in life. Learning in the health field is usually a challenge as there is usually a big gap between the ‘Know how and the do how’. Students usually find it very difficult to relate what they learn in class to what really happens in the real world (Callara, 2008). As such, there is an increasing need for reflection to be used in the learning environment. This will provide the students with abstract and cognitive thinking skills that will enable them relate what they learn in the class room to what happens in practice. It will...
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...Anne Johnston-Silverberg, MS, FNPc September 14, 2012 The Affordable Care Act: The Role of the Nurse Practitioner The recent implementation of the Affordable Care Act (ACA) has had a significant impact on the American health care delivery systems. The passage of this bill mandates that all Americans must have health care coverage and that insurance companies cannot disqualify applicants due to preexisting conditions (National Council of State Boards of Nursing, 2014). These changes will undoubtedly lead to an increase in the number of people seeking medical care, particularly those with chronic diseases. It is estimated that this influx in the number of patients will result in a primary care provider shortage of 20% by the year 2025 (Poghosyan, Boyd & Knutson, 2014). With many new physicians choosing to pursue specialties due to the promise of a larger salary, hospitals and clinics will need to start looking to other health care providers, such as nurse practitioners, to fill this role. The purpose of this paper is to discuss the role nurse practitioners play with regards to the Affordable Care Act by examining the history and qualifications of nurse practitioners, the current practice of nurse practitioners, the basics of the Affordable Care Act legislation, and potential nursing challenges. History of Nurse Practitioners The role of the modern day nurse practitioner emerged in the late 1960’s out of necessity for more primary care providers. When Medicare and Medicaid...
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...Quality Research Article Critique Factors Influencing Emergency Use of Nurse Practitioners: A Critique Problem and Purpose This is critique of a Qualitative Nursing article, the article is: Factors Influencing the Decision to Use Nurse Practitioners in the Emergency Department by Laurie A. McGee, MN, ARNP and Louise Kaplan, PhD, ARNP, published in Journal of Emergency Nursing, Volume 33, Number 5, October 2007. The problem that is stated in the article is there is a growing and serious problem facing the overcrowding of emergency rooms within the United States. There is a current epidemic of the population that relies on emergency room care as primary care. “The 2004 National Hospital Ambulatory Medical Care Survey (NHAMCS) reports an 18% increase in the number of visits to emergency departments from 1994 to 2004.” This causes long wait times and may cause emergency room doctors and nurses to be overworked allowing for a possibility for mistakes to handle the volume. “Overcrowding is defined as a situation in which demand for emergency services exceeds the ability of a department to provide quality care within acceptable time frames.” Overcrowding can delay care which is a patient safety issue and can lower patient satisfaction. “The Joint Commission on Accreditation of Healthcare Organizations' review of sentinel events has attributed patient deaths to delays in patient care. In hospital emergency departments, delay of treatment is the most common type of sentinel event.”...
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...WORKING According to the reviews, professionalism is growing in every field of works, as new changes and development are emerging in the health and social care. A nurse basic professional responsibility is to provide care and support to people who need helps to improve their health issues. Its professional responsibility is to provide nursing care and support to the people who have been suffering from deterioration of health. A traditional way of nursing is to just provide primary care and follow the order of the professional practitioner, but now new concept of therapeutic relationship and implementation of therapeutic process is evaluated (Fournier, 2000). Nursing practices includes variety of settings and these settings will affect the processes which are out of control over nurse’s influence. These processes may be government laws, policies, management decisions and orders of other professional practitioners. The code of ethics outlines the intention of professional nurse to accept the individual rights and respect these rights in medical practices. Such code of ethic for nurses may affect to fulfil their moral obligation and other ethical problems they may face during their professionalism. Nurses are encouraged to take part in discussion and take decision for their moral obligation which they are facing in taking care and supporting their patient. (Gelman, White, Carlson & Norman, 2000) Over the period of time, there has been increasing emphasis on the on collaborating...
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...that medical practitioners have to comply with, failure to which there very grave consequences both to individuals and health care institutions. Advance directives comprises of one’s wish about his or her health care decision in case he or she is incapacitated to an extent that they cannot make their own health decisions. The common functions associated with advanced directives include consent and capacity, artificial feeding, life-sustaining treatment, basic care, withdrawal or withholding of life-sustaining treatment, withdrawal of life-prolonging treatment, and euthanasia (assisted dying). Ideally, people usually tell doctors their wishes. However, in cases a person is not in a position to make their own health care decisions another means of communicating his decision are necessary (National Cancer Institute, 2011b). This is where advance directives come in. The two main types of advance directives are durable powers of attorney for health care and the living will. The...
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...the depression or anxiety is severe, medicine might provide relief. A dying person might also have some specific fears and concerns. He or she may fear the unknown or worry about those left behind. Some people are afraid of being alone at the very end. This feeling can be made worse by the understandable reactions of family, friends, and even the medical team. For example, when family and friends do not know how to help or what to say, sometimes they stop visiting. Or, someone who is already beginning to grieve may withdraw. Doctors may become discouraged because they can't cure their patient and feel helpless. Some seem to avoid a dying patient. This can add to a dying person's sense of isolation. If this appears to be happening, the nurse should discuss their concerns with the family, friends, or the doctor. People nearing the end of life may have spiritual needs as compelling as their physical and emotional concerns. Spiritual needs involve finding meaning in one's life and ending disagreements...
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...healthcare policies. As a dedicated nursing professional, with a great passion for learning, I strive to stay on top of these changes. I am determined to increase my knowledge to be an instrumental part of providing quality healthcare. The demands of nursing are high; however the rewards are even higher. Nursing requires both a supreme understanding of the science of health, and a caring bedside manner befitting only those who seek a position of such a personal involvement in the well-being of a patient. Academically, I will put forth all of my efforts into my studies. I will challenge myself, and work hard at all the obstacles that lay ahead. The combination of my past academic performance and personal standards of nursing excellence will provide the foundation of success in my Doctor of Nursing Practice (DNP) studies. It will require a great amount of time and energy; however I am excited to pursue this challenge. The rigorous and intense demands of the Doctorate program strongly match my capabilities. I have served in the armed forces and during my nursing career have provided care for many challenging situations such as veterans who suffer from Post-Traumatic Stress Disorder (PTSD). I am fully aware of what I need to do for any given situation and am able to manage stress in healthy ways. Professionally, I believe I am a strong candidate for the DNP degree. My work experience and education have instilled in me an exceptional mixture of teaching, critical thinking skills and accountability...
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...The Impact of the IOM Report on Nursing Lori VanDerveer-Hand Grand Canyon University October 6, 2013 The Impact of the IOM Report on Nursing Key Message #1:“Nurses should practice to the full extent of their education and training” (Institute of Medicine of the National Academies, 2010, p. 85). The impact that the IOM report has had on nursing and it’s future, as we know it has been colossal already. The report that was obtained in 2010 shows us the importance of nursing in patient centered care and the delivery of more primary care than specialty care as well as the focus of shifting care into the community instead of the acute care setting. If we as professionals can alter this shift in healthcare we will provide advanced quality care, decrease errors and provide better safety. The call for the advanced degree practitioner (APN) and physician assistant (PA) is vast; the IOM report is calling for advanced degree practitioners (APN) and physician assistants (PA) to be able to practice to the extent in which they were trained so that they may be able to take some of the burden off the shrinking medical profession and an already fragmented healthcare system. The hope is by giving the APN and PA a less restrictive role in health care it will help to streamline the fragmented healthcare system as well as significantly bringing down costs. These streamlined plans have already proved effective in the Geisinger Health...
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...the significant challenges and difficulties facing rural residents in a rapidly urbanizing Nation. According to the 1990 census, there were over 61 million people living in rural areas. That equals a population greater than that of the UK, Spain, France or Italy in 1996. Rural America touches almost every state. A large number of the Western states have a majority of land which is defined as rural. Generally, non-metropolitan populations have higher poverty rates, higher unemployment rates, and lower educational backgrounds than those individuals living in metropolitan communities. These same residents in non-metropolitan areas are afflicted with a poorer health status. There are higher rates of chronic disease, infant mortality, accidental farming-related injuries, occupational hazards, and trauma mortality in rural areas when compared to those living in metropolitan areas. A compounding factor affecting these already poor indicators is the significant lack of access to health care in these rural communities. The barriers to access are due to a variety of factors. Many of the residents of rural America have limited financial resources to pay for their medical care. In addition to poor finances, the residents must travel great distances to reach a health care practitioner. Often, these residents have difficulty obtaining transportation to get to the health care facility. (Merwin, Snyder, & Katz, 2006, 187) The lack of health care practitioners only intensifies...
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...THE IMPACT OF THE IOM REPORT ON NURSING EDUCATION With the rapidly changing health care settings and an evolving health care system ,nurses should achieve higher level of education through an improved education system that promotes seamless academic progression Ever changing technology and to cope the nurses need education through out life .In 2008 ,the Robert Wood Johnson Foundation ( RWJF ) and the Institute Of Medicine ( IOM ) launched a two- year initiative to respond to the need to assess and transform the nursing profession .The IOM appointed the committee on the RWJF Initiative on the Future of Nursing ,at the IOM , with the purpose of producing a report that would make recommendations for an action –oriented blue-print for the future of nursing. The nation needs highly educated nurses because of the demographics , socioeconomic factors, race and ethnicity. The US health care system was primarily built around treating acute illness and injuries but most health care today relates to chronic conditions ,such as diabetes ,hypertension ,arthritis, ...
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...wireless networks; and assess the use of social networking for group support for patients with similar medical concerns. Mobile Computing and Social Networking In today’s society, emerging developments in technology have greatly impacted the healthcare industry, especially when it comes to patient care and the monitoring of their vitals. Traditionally, patients communicate their health concerns to their physicians, who in turn schedule an appointment and conduct a series of tests and relay the results to the patient. When the tests dictate the need to monitor a patient’s vital signs, due to resultant findings, the patient is required to check in to a local facility for an extended period of time to be monitored around the clock by nurses, doctors, and other physician assistants. Once completed, the results are recorded manually, and stored in the patients’ records via the records management department. With the technological developments used today, wireless health monitoring systems are used to monitor patients’ vital signs, and a mobile device is now...
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...‘nursing is the care which puts the person in the best possible condition for nature to either restore or preserve health or to prevent or cure injury’. Nursing has its own entity and ethics which makes it a profession. In response to the rising health needs, the need for independent nursing is the demand of the hour. This concept are formulated and implemented in develop countries. This has helped in meeting the consumers’ demand for health benefits. In the early years of the nursing profession, it generally believed that nurses served and cared for their patients by assisting physicians. However, now days role of nursing a more expending, not only bring title as register nurses but also as nurses practitioner, advanced nurses practitioner and clinical specialty. Those nurses require undergoing specialized post basic training and most of them are quiet senior staffs. Furthermore , some of the specialty of nursing such as wound care nurse, stoma nurse, diabetic nurse and so on and some of them also been as referred from the doctor for furthered management. In the healthcare set up, if all patient care only being a nurse’s job, this organization will be failure. It need other professional collaboration for better outcome specially in patient care such as physician, surgeons, pharmacists, radiologists, phlebotomies, respiratory therapies, physiotherapies and so on. Each of them a play in difference role for example radiologist will performed radiology test, phlebotomies will running...
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