...Public Health Nursing Vol. 22 No. 4, pp. 354—359 0737-1209/05 # Blackwell Publishing, Inc. SPECIAL FEATURES: PRACTICE CONCEPTS The Child Welfare System: Through the Eyes of Public Health Nurses Janet U. Schneiderman ABSTRACT Objective: This qualitative descriptive study investigates how public health nurses working within the child welfare system view the organization and the organizationÕs effect on their case management practice. Design: Semistructured interviews were conducted utilizing the Bolman—Deal Organizational Model. This model identifies four frames of an organization: symbolic, human resources, political, and structural. Sample: A purposive sample of nine nurses and one social worker was selected to participate in comprehensive interviews. Results: Data analysis identified two main themes. The first theme was the presence of organizational structural barriers to providing case management. The second theme was the lack of political influence by the nurses to change the structure of the organization; hence, their skills could be more completely utilized. Conclusions: Public health nurses who work in child welfare will need to systematically analyze their role within the organization and understand how to work in Òhost settings.Ó Nursing educators need to prepare public health nurses to work in non-health care settings by teaching organizational analysis. Key words: child protective services, organization, public health nursing. The purpose of this exploratory qualitative...
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...profession is very complex. Every day nurses deal with patients and medical care. There are some days when ethics and legal issues play a role. We were given examples of the legal complexities of nursing through two case studies we were to evaluate. For this paper we will discuss the legal responsibilities of nursing, how personal and societal values can influence ethical decision-making and how the ANA’s Code of Nursing Ethics would influence the final decisions. Legal Responsibilities of Nurses Nursing boards are governmental state agencies responsible for regulating the nursing practice. A nursing license obtained through state nursing boards validates that nurses have met standards for providing high quality care. Nurses are legally held accountable for administering medications accurately, educating patients and public on health issues, advocating for the patient regarding health care, and serving as a liaison between the patient and the physician. Professional standards are determined by Standards of Practice Acts and the American Nurses Association’s Code of Ethics. As professionals, nurses must also be familiar with ethical responsibilities and protect the rights of their patients and families. As the definition of liability has continued to expand through the judicial system, courts of laws have placed higher standards on the profession of nursing. Many times professional nurses are faced with litigations against facilities...
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...in a recent case study, brings up thought for ethical debate. Her outlook is poor, with or without surgery, and she has no advanced directive. Her husband and children cannot come to an agreement on whether life support should end or if all resuscitative measures should be attempted. The following paper will discuss how the American Nurse’s Association Code of Nursing Ethics would influence a final decision, how personal and societal values can influence ethical decision making, the fundamental legal aspects of each case study, and the legal responsibilities of nurses in the work setting. Regardless of any situation that may arise, every nurse has a set standard in place that must be followed. These are nonnegotiable, ethical standards, obligations and duties that every individual swears to when entering the nursing profession. These standards are all found within the American Nurses Association’s code of Nursing Ethics and Conduct. Whether dealing with patients and families during end of life decision making or dealing with nursing negligence within the court of law, the first provision in the code of ethics is the most imperative to remember. Nurses are always obligated to their patient’s best interest, therefore making them an unrelenting patient advocate. Many provisions are pointed out within the Nursing Code of Ethics. In the situation of dealing with Marianne’s family and medical treatments, there are many important things to consider. “The nurse respects the...
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...and research as both BSN and ADN nurses can sit for the same NCLEX-RN exam. There are multiple answer to this question, however the short answer is that nurse with a BSN degree has more opportunities to work in a variety of health care settings that offer an extensive array of opportunities for professional growth. (Moore, 2009) BSN student learn skills at a higher level that are required for exceptional practice. (Huston 7) The difference between the ADN nurse and the BSN nurse is not limited to the opportunities allotted but spans out to the education. The BSN nurse completes a curriculum that has a different focus than that of the ADN curriculum. The BSN curriculum emphasizes evidence based practice, leadership, critical thinking, and public/community health. (Moore, 2009) As part of this curriculum you receive crucial training in key areas like communication, leadership, and critical thinking- enhanced knowledge that will become ever more valuable in the complex and changing future of health care delivery. (Simons, 2012) BSN nurses can be and are not limited to bedside nurses, educators, case managers, discharge planners, administrators, and work in public health, home health, and community clinics. If you are thinking of joining any branch of the military, you will need to have your BSN. The BSN degree is not only a minimum for the military but also a minimum for most medical institutions, as it is the preferred degree. The ADN nurse has learned the...
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...Abstract The health care system is a complex part of the economy that emphasizes cost efficient methods of addressing the dynamic health needs of today’s population. The baby boomer generation is aging, and the cost of health care is at the forefront in the news. Case managers facilitate the process of navigating through the health care system to attain the proper treatment necessary for the patient, thus integrating a complex multidisciplinary health care system. Preparing new nurse case managers in this specialized field requires an advanced professional background based on education and experience. Keywords: case management, case manager, health care system The Growing Need for Case Managers The 65 years and older cohort in the United States will reach 20% of the population, reaching an estimated number of 80 million by the year 2050; while by the year 2020, a severe professional nursing shortage of two hundred and eight hundred thousand nurses is projected to occur. The discrepancy between the supply of nurses and the demand of health care services for an aging population is driving much emphasis on issues related to health care coverage, health promotion and prevention, and treatment of escalating chronic diseases that afflict this country, such as diabetes and dementia. The underlying message of this emphasis is the containment of health care cost, a burden patients will have to face when undertaking medical services, and revisions in...
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...The Future of Nursing: Leading Change, Advancing Health http://www.nap.edu/catalog/12956.html Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine PREPUBLICATION COPY: UNCORRECTED PROOFS Copyright © National Academy of Sciences. All rights reserved. The Future of Nursing: Leading Change, Advancing Health http://www.nap.edu/catalog/12956.html THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract No. 65815 between the National Academy of Sciences and the Robert Wood Johnson Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. International Standard Book Number 0-309-XXXXX-X (Book) International Standard Book Number 0-309- XXXXX -X (PDF) Library of Congress Control Number: 00 XXXXXX Additional copies of this report are available from the National Academies...
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...CHAPTER ONE Background to the Study In the rapidly changing system of health care, many different factors have affected and changed the perception about how health care is practiced today. The rights of patient are also affected. Patient rights have now become the center of attention in practice of medicine. Today, concerns about patients’ choice and the respect for their preferences, values and the access to medical care are getting more complex. The patients’ expectations are becoming higher and now they always want everything best (Rafique & Bhatti, 2014). Nurses are subject to numerous ethical and legal duties in their professional role, including the imperative to maintain patients’ privacy and confidentiality. Beginning in 1893, nurses take the Nightingale Pledge “I promise to do all in my power to maintain and elevate the standard of my profession, and hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling” (Gretter, 2012). The duty continues today, with hospital policies, state regulations, and federal law aimed at protecting patients’ confidentiality. Critical care providers are often privy to confidential information in the course of clinical practice. The dilemma may arise when confidential information is requested by family members or friends of the patient. Although at times it seems that regulations and laws are so stringent that any disclosure of health care information is forbidden...
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...Nursing Nurses face various ethical and legal issues in the medical setting. As professionals, nurses must be aware of these legal and ethical issues when they occur. Nurses have a legal and ethical obligation to respond to these issues. Being a professional nurse requires a nurse to assess the pros and cons of different situations, but also to withhold their personal beliefs and listen and respect the beliefs and traditions of others. Legally Nursing implications require nurses to maintain licensure, obey state and federal laws and to remain within their scope of practice. Within these legal and ethical issues the American Association Code of Nursing ethics, personal and societal values, legal aspects and legal responsibilities all affect decisions. Two different cases will be discussed and explored; an advance directive case involving a woman by the name of Marianne, and a malpractice case involving a nurse and the involved healthcare organization. The American Nurses Association Code of Nursing Ethics can influence the final decision made in the case study involving Marianne’s family by designating a surrogate. According to "American Nurses Association" (2011), “The nurse supports patients self-determination by participating in discussions with surrogates, providing guidance, referral to other resources as necessary, and identifying and addressing problems in the decision-making process” (1.4). In the case study involving malpractice, the nurse being called upon...
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...COMMUNITY HEALTH ISSUES FOCUS The role of communitybased nurses in health promotion Dean Whitehead Dean Whitehead is Lecturer, Faculty of Health, School of Nursing, University of Hull, East Riding Campus, Hull art of the ongoing process of National Health Service (NHS) reforms involves bringing about fundamental change in the way that primary health care is delivered in the UK (Department of Health and Social Security (DHSS), 1987; Department of Health (DoH), 1989a, 1996; Standing Nursing and Midwifery Advisory Committee (SNMAC), 1995). A considerable amount of discursive and legislative documentation has accompanied these reforms, which served to provide a ‘springboard’ for debate on current and future directions of health-related policy (DoH, 1989b, 1993a,b, 1997, 1998). There has also been a concerted and longstanding request for community nurses to adopt and incorporate both health promotion and educational activities into their workload. In the late 1980s, in its document Promoting Better Health: the Government’s Programme for P ABSTRACT It is the responsibility of all nurses to incorporate health promotional and health educational activities into their professional roles. Much of the literature around this issue relates to the specific role of community-based nurses in the primary healthcare team, and identifies their unique position and responsibility for pioneering the universal acceptance and adoption of health-promoting practices...
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...BACKGROUND OF THE STUDY Preventive care and health information education has been the advocacy of several hospitals in the Metro for the past few years due to the rapid increase in spreading illnesses in the city. One of the most dedicated in the advocacy of disseminating health care information is the hospital located at the heart of Quezon City, the Capitol Medical Center. Their commitment in excellent medical health care brings about the duty to provide equally excellent and accurate health care information. The medical center has come up with several methods as to how to disseminate information, from leaflets about different kinds of diseases and what you have to know about them to community seminars that discuss about several significant topics like family planning, Vaccination and the likes. However, current methods of spreading information about health care have many evidences that it successfully penetrates at a certain location at a time, thus, making information dissemination slow-paced and easily forgettable once the information reaches the next location. The case writer wondered if it was possible to make the information much more accessible to the people so that information would not only be disseminated fast but at a larger scale as well. KEY MESSAGES The goal of the campaign is to help doctors, nurses and other health proffesionals to be more accessible to the people who need them in order to be able to advise them about health care and disease prevention...
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...Select a topic based on the role of the nurse in community and public health. Locate at least three scholarly peer-reviewed journal articles on your topic. Discuss what evidence-based model or theory was used in each article and the end result. According to the Department of Health and Human Services (MacKay, Fingerhut, & Duran, 2000), more than 900,000 adolescents become pregnant each year. Three hundred thousand of these annual pregnancies occur in mothers under the age of 15, 78% are unplanned, creating multiple negative consequences for the adolescent and society.”(Pierangeli,L. 2006) This study addresses the community health nursing role in trying to reduce the number adolescent pregnancy by teaching students about abstance to prevent teenage pregnancy that abstained will also prevent STD. If a child hears the message about abstinence before they become sexually active it is received better. Therefore it reduces both STD and teenage pregnancies. “Worth the Wait is an abstinence education program designed for sixth through eighth grade students. It focuses on healthy relationship building, goal setting, and the challenges of parenthood. The WTW program consists of three main topic areas. They are: ‘healthy relationships,’ ‘parenting can wait,’ and ‘making good decisions. ”(Pierangeli, L. 2006) The Theory of Planned Behavior(TPB) (Ajzen, 1988, 1991; Ajzen & Madden,1986) is used in this study as a framework for reviewing the literature. The TPB is...
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...Careers in health visiting Join the team and make a difference 2 Welcome to the team web www.nhscareers.nhs.uk www.nhscareers.nhs.uk Welcome to the medical team 1 Contents Being a health visitor Entry requirements and training Your health visiting career 3 9 10 Working in the NHS What’s your next step? 12 16 2 Health visiting www.nhscareers.nhs.uk Foreword A career in health visiting offers the opportunity to work in an environment that is interesting, rewarding and challenging. Health visitors are specially trained public health nurses who play a crucial role in the healthcare team. As a health visitor you work in the community to improve the health and well-being of families and children. To train as a health visitor, you need to be a nurse or midwife. Some nurses and midwives train immediately after qualifying while others wait until they’ve gained some experience. There are few professions that offer the job satisfaction you get from health visiting. So, if you’ve got an interest in improving public health and helping children get off to the best possible start, you’ll find health visiting an incredibly rewarding career. www.nhscareers.nhs.uk Health visiting 3 Being a health visitor Health visitors are specially trained public health nurses working in the community to design and deliver care for families and communities. It is a diverse and satisfying role that involves building relationships with families. It suits nurses and midwives with an interest...
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...Competencies of Baccalaureate-Degree Nurses As health care becomes more complex and clinical knowledge expands, nurses must have the appropriate educational groundwork to competently perform their job. As the delivery of care to the community becomes more complex, the old adage of a nurse simply being a bedside caregiver has evolved. More emphasis must be placed on coordinated health care, including health promotion, maintenance, and affordable managed care. In an effort to provide community-based health care outside the inpatient hospital setting, health maintenance organizations, community health, outpatient centers, home, public schools, and nursing centers were developed (American Association of Colleges of Nursing, 1998). These developments command higher educated nurses to work in environments with an advanced skill-set so as to operate independently with regards to clinical decision-making and case management. Such responsibilities encompass delegation skills in addition to organizing medical care across multiple settings. Consequently, the American Association of Colleges of Nursing (AACN) identifies “the Bachelor of Science degree in nursing as the minimum educational requirement for professional nursing practice” (AACN, 2000, para. 2). Contrary to a nurse with an associate degree, a nurse with a baccalaureate degree is outfitted to work in all health care settings. The curriculum of the BSN program incorporates “clinical, scientific, decision-making, and humanistic...
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...2.6 HOURS Continuing Education ORIGINAL RESEARCH Probation and Recidivism: Remediation Among Disciplined Nurses ABSTRACT in Six States A link between a history of criminal conviction and a risk of professional misconduct highlights the importance of criminal background checks. O BJECTIVE : The researchers sought to determine what factors might affect the outcomes of remediation, including the likelihood of recidivism, among nurses who had been the subject of disciplinary action and had been put on probation by a state board of nursing. M ETHODS : Boards of nursing in six states, Arizona, Maryland, Massachusetts, Minnesota, Nebraska, and North Carolina, chose to participate in this exploratory study. A 29-item questionnaire was used to investigate the records of 207 RNs, LPNs, and advanced practice RNs (APRNs) who were disciplined and put on probation by a state nursing board in 2001, as well as to collect data on their employment settings, the boards’ actions, and remediation outcomes (the presence or absence of recidivism); 491 nurses who had not been disciplined served as controls. RESULTS: Among the disciplined nurses studied, 57% were RNs, 36% were LPNs, 3% held both RN and LPN licenses, and 3% were APRNs. Of the disciplined group, 39% recidivated between 2001 and 2005. Three factors were shown to influence the recidivism rate: having a history of criminal conviction, having committed more than one violation before the 2001 probation, and changing...
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...patient care. According to the American Association of Colleges of Nursing (AACN) Fact sheets: It continuously thrive to increase the highly qualified nursing workforce with education, so nurse will be more competent in clinical aspects and deliver high quality of care. Presently, successfully completion of Associate Degree in Nursing (ADN) or Baccalaureate Degree Nursing (BSN) graduate program study is the route to become a nurse in the United States, after passing the NCLEX exam. Both program are differed by when they started, reason for establishment and the study contents of it, are as follows. In 1952, ADN program is was first designed by the Mildred Montag, to alleviate the nursing shortage by creating technical nurses. Associate Degree in Nursing (ADN) is normally subsist of general education and clinical courses credits coursed and study time is 2 years long. It is normally awarded by the Community colleges and nursing schools. Upon completion of such program, nursing student is eligible for NCLEX-RN license exam. As stated by Creasia & Friberg (2011), ADN program is very successful nursing program, which make ADN nurse eligible to pass NCLEX-RN exam and start a career as nurse with strong clinical competency. While Baccalaureate of Science in Nursing (BSN) program was started in 1909 in University of Minnesota. This Program required 5 years of study, divided in 2 years of general education and 3 years of nursing credit courses, with more focus study in public...
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