...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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...MIDW113 – Jodie Sparke S00163149_assess2 b). Postnatal case study – Gina is a 34 year old G2 P2 woman, day 2 post caesarean section. You enter her room to find her teary and upset; she tells you she had planned on having a natural birth in a midwifery led model of care. However, she experienced an emergency caesarean section after her baby showed signs of fetal distress. Describe and discuss the role and responsibilities of the midwife in providing pre and post-operative care to a woman in Gina’s position. You are expected to demonstrate, plan and evaluate safe, holistic, woman centred evidence-based midwifery care. This paper considers a postnatal case study of Gina, a day two post-operative, 34 year old Gravida 2 Para 2 woman. She experienced an Emergency Caesarean Section (ECS) resulting from fetal distress. This essay will investigate why birth can become an emergency and the evidence-based indications involved in decision making. It will explore the roles and responsibilities of a midwife in both the pre and post-operative support of a woman; based on a safe, woman centred and holistic approach to maternal care. It will discuss the emotional effects an ECS can have on a woman and her family as a crucial aspect in this case. An integral part of the preparation for birth is a birth plan. This allows the woman to detail how she would like her labour/birth to progress. It often includes the expectation of a natural vaginal birth. However, due to a variety of physiological...
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...Tina Limon Grand Canyon University Professional Dynamics NRS-430V ( NRS-430V-0105) Malinda Sever November 2, 2014 Why do need to look at transforming nursing education, nursing practice, and nursing leadership? This seems like it would be an easy task to achieve but it has been difficult. It can make our lives more pleasant , and our patients will have the best nurses caring for them , when they understand their nurses have the knowledge and skills needed to care for them. According to The Impact on Nursing 2010 Institute of Medicine (IOM), located in Washington, DC, report titled” The Future of Nursing” Nurse’s roles have evolved and scopes are driven by education and nurse’s talents. “Nursing Education Policy Priorities”, by Linda H. Aiken, University of Pennsylvania. With all the major changes in healthcare, there will be significant changes in the need for advanced education of nurses. This change includes the nursing roles of the increases the number of Nurse Practitioners (NP) and Physicians Assistants (PA) which help the decrease in Medical School applications. According to the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative “ Nurses are crucial in preventing medication errors, reducing rates of infection and even facilitating patient transitions from hospital to home.” This should be a priority for the primary goals of nursing education for ourselves as practicing nurses, and be supported and encouraged by the administration...
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...As I proceeded through my clinical rotations and had a thorough exposure to Internal Medicine, I found it both unique and intriguing. I was fascinated by the sheer diversity of cases, the amount of direct patient contact and the opportunity to develop long-lasting doctor-patient relationships. I am driven by the idea of being a “doctor of complex cases,” such as the man in his 70’s with multiple pathologies or the 18-year-old track star with a condition so severe that would challenge the smartest brain. So much of my zeal for Internal Medicine rests on a love of human complexity and how I can best help others. Moreover, there is much to be said about the compatibility of a physician’s temperament and specialty demands. To be an internist feels like I will slip on my comfortable...
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...SERVESahara India Pariwar, one of the largest business groups of India has entered the Healthcare sector with a view to become the Best and the Largest Player in this fast growing sector.The first of the three planned super-specialty hospitals is operational in Lucknow, Uttar Pradesh, India. Presently operating with 250 beds (expandable to 554 beds). Sahara Hospital Lucknow is poised to become one of the top hospitals in Asia.Sahara Hospital is expected to place Lucknow on the world map of destinations for healthcare of global standards. The hospital has specially designed suites for patients and their families coming from overseas for medical treatment in India, as a cost-effective and reliable option.With strength and commitment in our holistic healthcare delivery strategy- Sahara Hospital aims at bridging the gap between quality health care and affordability. It has conceptualized to be patient friendly and intends...
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...Following the morning rounds, I was reviewing some daily routines with my preceptor in her busy dementia Unit. Suddenly, the RPN is working on the floor, knocked at the door with a worried expression on her face. Consequently, we stopped what we were doing and paid attention to her problem. Stressed about a resident, she reported sudden onset of agitation and anxiety when this resident was getting assistance for toileting in her bathroom. As reported by the front line staff, the resident shook his fist at the mirror and was about to break it with her hair brush. However, we find out later that, the resident was thinking that her daughter is “trapped inside” the mirror and she was attempting to get her daughter out. To address the emergency...
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...become known to many historians and physicians as the founding father of medicine due to his taking it and making it a rational practice, free from magic and superstition. (Osborn, 2010.) The influences of Hippocrates are vast and still provide a basis for physicians today. He was the first to document medical histories and use patient histories to study their illnesses. He factored in all aspects of their lives including past medical problems, the climate in which they live, diet and their line of work. The Hippocratic collection is composed of Hippocrates writings from his research and practice of medicine. It is composed of sixty books documenting information on every part of the human body including the brain, skin and eyes. It is unclear as to whether Hippocrates wrote all of the collection, but it is thought to have been written by himself and his students. (Truman, 2013.) The myth of Asclepius and his contributions to modern medicine are surrounded by more fantastical stories of healing than, Hippocrates. According to ancient Greek history, Asclepius was so skilled in his surgical and healing capabilities, it appeared as though he could rise the dead to living again. According to myth, Asclepius was struck down by the gods who were angered that a mortal had this capability with a bolt of lightning. (Magiorkinis, Diamantis, Androutsos, 2008.) In modern terms, Asclepius' methods of healing take a holistic approach, bringing together the mind, body and the power of dreams. Patients...
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...these practices and so she roots them in the past, not in the playful present. She makes the claim that magic reclaims traditional “ways of knowing”. (Luhrmann 141). Dr. Oz’s vocabulary use and his connotations suggest traditional medicine and “alternative” medications as equally viable solutions. This line of argument helps only to blur the difference between scientifically proven and un-scientific methods. Besides the overly used term “magical”, the surgeon expresses a sentiment for the times when medicine was not even a word in the dictionary. This is literally what Dr. Oz said in his interview with Michael Specter: “I would take us all back a thousand years, when our ancestors lived in small villages and there was always a healer in that village—and his job wasn’t to give you heart surgery or medication but to help find a safe place for conversation” (Specter 5). The preceding passage is powerful and eye opening. In a single sentence, the M.D. from the University of Philadelphia expresses a longing or the time before contemporary medicine. It’s only to one’s imagination to materialize the nature of a healing that he was referring to. Finally, by implying a “safe place”, Dr. Oz welcomes an “alternative medicine”, because, he claims, traditional medicine does not allow such a comforting conversation to take place. In order to better understand his over-fixation on the “magical”, historical overview could be helpful. As Luhrmann points out, the New Age shamanism was spurred by the...
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...Concept Analysis Healing Matilda Linares-Cornejo Chamberlain College of Nursing Theoretical Basis for Advance Nursing Practice NR 501 Lizabeth Vincent March 25, 2016 Concept Analysis Healing Advance practice nursing encompassed a mosaic of knowledge. These knowledge is acquire through years of formal educational and preparation, through the development of a deeper mode of critical thinking, through life experiences, through the desire to achieve and provide the best one can offer, and through the final understanding that one does not have all the answers or the power but one can help others to alleviate their pain. Advance practice nursing preparation is a journey that takes the nurse through different paths designed to provide understanding to how nursing science has developed and continues to evolve. Nursing science has made great advances-this thanks to the many theorists that thought their theories have guided, provided, and developed essential concepts now use in nursing care delivery. The following will be a discussion about concept analysis and how this lead to the development of theories. The concept of healing will be discussed as it applied though Barbara Dossey’s Theory of Integral Nursing. Third, the concept will be evaluated using the concept analysis process, and the conclusion will be a summary of how the healing concept is utilized within the broad scope of advance nursing practice. Concept Introduction Healing is Barbara Dossey’s Theory of Integral...
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...Analysis of Jane’s Condition Jane Vuong, a 24 year old Vietnamese undergraduate student was admitted into the hospital Emergency Department presenting with anxiety, difficulty speaking, breathing and dusky lips following severe chest tightness during an exercise session at the local martial arts school. On examination she had a wheezing sound when breathing. She has no history of asthma but says she has some allergies which she treats with herbs. Her colleague who brought her to the emergency room also claims that Jane has recently had difficulty breathing while taking the stairs up to the martial arts studio and she no longer rides her bicycle to the studio. Jane is in her second year at the local University where she is studying cellular biology. Jane is a bright student who studies a lot and also works part time in the Universities’ research center which gives her extra cash. She admits that she has been having a dry cough for some months which she associated with allergies. She also relates her inability to ride her bike to her allergies. Jane smokes at least one packet of cigarettes on a daily basis, and during assessment appears to be in the pre-contemplation stage. Jane had six months earlier tested positive for hepatitis B. This surprised her a lot because she was asymptomatic. Though she denies drug use, she admits to having multiple sexual partners. She does not want to be in a long-term relationship because she claims it could complicate her life. She also admits...
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...In acupressure same points are used, but therapists massage them one or two at a time. Acupuncture is believed to have greater effects than acupressure. Acupuncture is considered useful in preventive healthcare. How traditional Chinese medicine is different from western medicine: Traditional chinese medicine (TMC) Western Medicine Focusses on holistic approach, whole body. Emphasize on specific part of the body Based on yin and yang Based on western medicine which focusses on anatomy, parasitology, pathophysiology etc., to know why and hoe diseases happen Experiential technology which is evidence based and gathered through personal experience Scientific technology which started with the discovery of electromagnetic waves and has immense influence on human life. The basis of TMC which is Yin and Yang are invisible Different TMC doctors have different therapies based on their individual experience All doctors and physicians follow the same rules and guidelines for any procedure. Doctors focus on illness along with the patients feelings Physicians focus on illness alone...
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...adjustments to the ever-changing population. The health care system is now reforming to a prevention rather than cure model. With changes in the healthcare system and the population, the Institute of Medicine (IOM) developed a report depicting the need for nursing to be transformed in the areas of practice, education and leadership. I believe this report will have a strong impact on the future of nursing as it relates to expanding practice, furthering education and demonstrating leadership, all of which will enable a nurse to work at the maximum potential within their scope. Transforming the practice of nursing will be beneficial in its future. It will enhance quality, promote health, prevent illness, and care for people of all ages and ethnicities. One concept involved in this transformation, is providing patient-centered care in all aspects. The IOM report refers to this as nurse guided care. “The nurse providing guided care offers eight services: assessment; planning care; monitoring; coaching; chronic disease self-management; educating and supporting caregivers; coordinating transitions between providers and sites of care; and facilitating access to community services, such as Meals-on-Wheels, transportation services, and senior centers.” (IOM, 2010, p.95) This is holistic approach enables the nurse to remain as the constant and provide a level of continuity of care throughout the entire...
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...overall wellness and quality of life. Due to the changes in health care in the United States, the levels of health care delivery are also changing. At the primary care level, a new model of care delivery was created call the Patient-Centered Medical Home (PCMH). This method emphasizes a collaborative approach among health care providers that offers high quality, easily accessible and cost effective health care that is centered around the individual patient’s needs whether they are acute, chronic or disease prevention. By implementing the PCMH we have already seen a decline in patient mortality and morbidity, decreased emergency room visits and hospital stay, not to mention a decrease in cost. In addition we have seen an increase in quality of care, patient access to care and overall patient satisfaction. The PCMH, with its core foundation being family medicine and primary care, addresses acute, chronic and preventative conditions through personalized care given by the doctors and nurses working directly with the patients to help them navigate through their own health care issues to help them figure out what they need and even what they don’t need....
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...I chose to review an article related to the treatment of chronic pain for a plethora of reasons. To begin with it will be on my first test, secondly it is one the reasons most people go to the emergency room and see their doctors. And finally in my opinion pain along with mental health illnesses may be the most often misunderstood and mistreated diagnosed in health care today; therefore as a nurse and patient advocate it is imperative that I attain a wide knowledge base on the subject of pain and its complimentary treatments. The article discussed a variety of complementary and alternative methods to manage and treat varying types of pain. The article was not inclusive of all CAMs, only the most common practices of complementary alternative medicine. Including on the list discussed was acupuncture, acupressure, homeopathy, naturopathy, and tai chi. These are the more common modalities of CAM, as well as other CAMs that were new to me such as Jin Shin Jyutsu, lymphatic therapy, myofascial therapy and craniosacral therapy. Also included were reviews and evidence base practice regarding some of these therapies. Though the article made mention of several research and clinical trials. For example, “In randomized clinical trials, qigong has been shown to be effective in significantly reducing pain when compared with the general pain care.” (Schulenburg, 2015, p. 322), it was not a research paper or clinical analysis. It is a journal article written by a registered nurse for...
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...transcultural nursing theory can assist the nurse in incorprating culturally competent care into their practice. Nursing standards regarding cultural commpetence are changing as more immigrants are entering this country and the health care system. Statistics According the the US Census Bureau in 2000 30% of the US population was an ethnicity other than non-hispanic whites. The projection is that it will reach 50% by the year 2050, while currently 90% of all nurses are caucasian (Maier-Lorentz, 2008). Brought into working terms that means that if a nurse has a six patient assignment, approximately two of the six will be from another culture and have different needs and beliefs. Nursing care revolves around giving holistic care to each patient. In order to provide holistic care to patients the nurse must be aware of the individual needs of that patients. The patients cultural background will determine what those needs are. If a nurse is unaware of the cultural needs, there is no way to provide a plan of care to meet the individual needs. Leininger’s Cultural Care Theory Leininger’s culture care theory is the first theory to be based on the cultural sameness (culture universal) and differences (culture-specific) that determine the plan of care for any patient. Nurses striving to care for patients holistically must understand the differences of many cultures. Leininger describes culture as a “set of values, beliefs and traditions, that are held by a specific group of people and...
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