Service provision in health facilities is usually offered by the health care team, including the nurses, physicians, clinicians, among others. However, the providers have different roles with others performed exclusively by physicians or nurses only. The incident-to services which were introduced sought to make service provision better, but it is easily confused at a time due to its unclear rules. This paper will explain its meaning, its requirements, and the importance of the nursing practitioner to know how the employer bills services.
Incident-to services are the ones that are billed to Medicare by physicians, but they do not perform themselves. The services are usually carried out by non-physician health care providers under close supervision by the physician (Alam, 2015). Therefore, they are service that needs a physician to be around to offer direction when there is need. The authority to bill for the services is provided by the Social Security Act, which includes coverage of Medicare supplies and services provided incident to professionally by the physician (Alam, 2015). The main reason for the eligibility of the service is that it is offered as a necessary but incidental part of professional services delivered by the physician during diagnosis and treatment.
To be able to come into the realization of the incident-to billing benefits, the set rules must be duly followed. One of them is that it applies only to Medicare; thus, services with its benefits cannot be considered; for example, diagnostic tests (Verhovshek & Verhovshek, 2018). Also, services that are billed incident-to should not take place in an institutional setting such as a skilled nursing facility or a hospital. Besides, the incident-to require that services offered to patients in the first do not meet the category of the incident to or in the case where there is a change in the care plan (Verhovshek & Verhovshek, 2018). In this case, physicians who are Medicare-credentialed must start the patient care, and if the patient comes in with a worsened complain, initial evaluation and management must be conducted. Furthermore, non-physician practitioners can provide follow-up services after the initial visit under direct supervision by the physician. However, it does not mean that the physician must be in the room but must be present in the office suite to offer guidance when needed (Verhovshek & Verhovshek, 2018). Other requirements state that the physician must be intimately involved in the course of treatment, both the qualified and the Medicare-credentialed physician needs to be employees of the group entity billing and, finally, the incident to service must be the kind that can be carried out in an office setting.
Incident to services as it applies to Medicare is prone to changes. Besides, different states have scopes of practice for NP, which are not similar; therefore, understanding the employer requirement is significant in reducing confusion that may arise in the whole process (Oliverez, 2017). There have been cases of dual payment, and thus, having good knowledge of what the employer bills will help in reducing the instances.
Conclusively, incident- to services are very useful to individuals seeking care because it gives the patient the chance to be offered by non-physician practitioners (NPP), though under supervision. Some requirements need to be considered to facilitate service providers such as primary care that must be attended by the physician, and NPPs need to offer services under direct supervision. Also, it is necessary to understand how the employer incident-to billing to minimize confusion that may occur.
References
Alam, M. (2015). Coding for “Incident-to” Services. Retrieved 30 October 2019, from https://www.mdedge.com/dermatology/article/100354/practice-management/coding-incident-services
Oliverez, M. (2017). Coding and Billing for NP and PA Providers in Your Medical Practice. CaptureBilling.com - Medical Billing Services. Retrieved 30 October 2019, from https://capturebilling.com/coding-and-billing-for-np-and-pa-providers-in-your-practice/
Verhovshek, J., & Verhovshek, J. (2018). Seven Incident-to Billing Requirements - AAPC Knowledge Center. Aapc.com. Retrieved 30 October 2019, from https://www.aapc.com/blog/44912-seven-incident-to-billing-requirements/
It is in 1977 that marketing was official recognized as a marketing concept when the FDA finally allowed health organizations to market their services since this ban violated the Federal Trade Act that protected free commerce. In 1977, the American Hospital Association hosted the first conference on healthcare marketing and the first book of healthcare marketing was officially published. Healthcare organizations that include health insurance organizations, pharmaceuticals and medicine manufacturing companies were among the first to embrace the concepts of marketing. The beginning of the 1980s marked an important mile stone for healthcare organizations. When hospitals realized that they play an important part in influencing the decisions of patients they choose to adopt mass advertising to promote their programs and services. They utilized billboards, televisions and radio commercials. Some health organizations have been able to effectively utilize advertising as a method of product promotion. However, the use of advertising to promote health services remains a problem for some organizations and some are stuck between these two extremes.
In the beginning of the 1980s the FDA paved way for broadcast direct to direct consumer advertising. Health organizations had the opportunity to market their products to interested. Organization were now in a position to educate their customers more about health service through the internet, phone, printed materials and commercial broadcasts. Since then advertising has been linked with demand for certain pharmaceuticals. After the advertisement of asthma medication, the sales of these medications increased (Reichel, 2018). The Use of antidepressants also increased as a result of advertisement. In 2015 the health service advertisement experienced drastic changes after the American Medical Association ban on expensive medication after the institution raised concerns that consumers were requesting new and more expensive drugs that were not necessary nor more effective than the already existing drugs.
Direct commercial customer advertisement has been linked with increase in drug prices. Consumer awareness about the existence of a certain drug increases the demand of the drug in question (Becker, et al., 2016). In 2010 research conducted showed that DTC advertainment by pharmaceuticals was responsible for 19% growth in drug expenditure from 1995 to 2007, this research went further to confirm that this demand was as a result of an increase in demand off pharmaceutical products. Advertisement in the health sector is still new and organizations are finding their way around the promotion concept.
Health Services Advertising "Pros"
The first advantage of health service advertising is that it provides the consumer with educational opportunities concerning new drugs and new services. Mostly, patients do not know anything concerning the drugs prescribed to them. Advertisements concerning new drugs can trigger the interests of the consumers who in return turn to doctors with questions about the new medicine in the market. Advertisement can help in encouraging patients to seek out earlier treatment. Diagnosis of some diseases aids in treatment an example is cancer which is easier to treat and place the patient in remission only with early detection (Adeoye et al., 2007). In severe cases if diseases such as cancer are not diagnosed at an early stage it becomes almost impossible to terminate the disease. Advertisements play an important role in persuading less compliant people to seek treatment.
Also advertising health services serves in encouraging individuals to visit health organizations. The appealing images used in advertisements helps to place tense minds at ease (Gaille, 2016). When patients suffering from non-terminatable diseases see drug advertisements they see hope for a cure that has not yet been recommended, that hope becomes a powerful healing tool for them. Patients have a lot of questions about drugs and thanks to advertisement they can find their answers in pamphlets and brochures handed over in hospitals and health organizations.
It helps reach a broader audience, when health service providers advertisers they have a high probability of reaching the targets audience resulting in the increase of health services consumers. (Weissman, et al., 2004) Hospitals are now in a position to advertise, new, capital intensive and high-tech equipment, this is advantageous since it is informative and could increase the speed by which new treatments are made. Advertisements present organizations promoting their products with an improved competitive advantage, health services offering organizations are competing for patients. On most occasion this competition is based on both the cost, the care delivered and quality of the care. Through advertisements organizations attracts a significant presence and more people learn of the services offered.
A large patient base results into more profit and revenue for the organization and there is no better way to attract customers than by advertising the services of the organization to a wider audience (Adeoye, et al., 2007). Advertisement increases the visibility of an organization and makes consumers more aware of the brand which in return arouses interest. When an organization markets its products and services it blocks and removes doubts from the consumers and decreases the chances of consumers being misinformed. Advertising also helps healthcare professionals showcase their skills and uniqueness and this helps patients in making choices.
Health Services Advertising "Cons"
Health service advertising can cause false health scares, advertising often discusses which symptoms accompanies a certain disease, this can terrify the audience to think they have experienced those symptoms before and tend to believe they have the disease in question in return they end up in hospitals to running tests and spending finances that they didn’t need to spend. Another disadvantage is that advertising increases cost incurred by patients. Advertising costs are often built into the prices of the drug being marketed. Patients incurs much of this cost when they pay high prices for the drugs (Adeoye, et al., 2007). Ultimately it is the patient who pays for the marketing efforts.
Often the side effects of a drug are understated in an advertisement, mostly the advertisement does not convey all the negative effects of a drug, overlooking these side effects puts the patient at risk. The health benefits to be obtained from the medication often seems to be overstated (Gaille, 2016). These advertisements often leave out crucial details. Ads that show patients who were treated in certain hospitals fail to present the consumers with the risky procedures that the patient underwent and the overall success chances of these procedures. Advertisement often encourages medication that is not always necessary. There are some health conditions which can benefit from change in lifestyles which is a non-drug treatment although as a result of advertisement many patients are looking for quick fix solutions that promise to fix their conditions instead of reclaiming their health.
The main purpose of advertising is to reach a target audience and market products to specific customers. However, advertisement may not always reach the targeted audience (Weissman, et al., 2003). The health organizations may lose its advertisement materials to the wrong audience. When organizations put up advertisements, they usually include only the information that is favorable for the company. One might think these advertisements are lying but they are not, they just skip the most crucial details but did not misinform consumers.
My Position on Health Services Advertising
With reference to knowledge gained from a marketing course and various marketing reading assignments I believe that promotion of any product or service, including healthcare services is important. In the 1990s when the marketing concept was discovered, health organizations realized that they will have to market their services to attract more loyal customers in the future. Advertising as a means of product promotion has spread an awareness about the existence of medications that consumers did not about. As an individual who has been equipped with the required knowledge of how to utilize advertisement to promote services and products, I believe that health service advertisement plays an important role in the health sector. I believe that health organizations that have not yet utilized advertisement should embrace advertisement to market its products. It is my belief that despite criticism advertising has been associated with a lot of social benefits. In the past health service consumers did not play a much vital role in in selection which hospital they are being admitted to, that decision was driven by the physician, but as a result of advertisement consumers are now active in making decisions after reviewing what different services are offered by different organization. I believe that health services advertisement has come to revolutionize the health sector.
Conclusions
Adverting of health services begun in the Mid 1970s since the FDA had termed the practice of advertising health services as unethical in the previous years. There are organizations that have fully embraced health service advertising, other organizations have failed to embrace advertising while others are stuck between these two extremes. The FDA paved way for health service advertising in 1980. Health service advertisement has its advantages that include providing consumers with detailed opportunities. Convincing consumers to seek early diagnosis. Despite the many advantages of advertising it cannot be ignored that health service advertising has come with its own disadvantages such as misleading consumers. My belief is that health service advertainment has increased the role consumers play when determining which health services to receive. Health service advertising is here to revolutionize the health sector.
References
Adeoye, S., & Bozic, K. J. (2007). Direct to consumer advertising in healthcare: history, benefits, and concerns. Clinical Orthopaedics and Related Research (1976-2007), 457, 96-104.
Becker, S. J., & Midoun, M. M. (2016). Effects of direct-to-consumer advertising on patient prescription requests and physician prescribing: A systematic review of psychiatry- relevant studies. The Journal of clinical psychiatry, 77(10), e1293.
Weissman, J. S., Blumenthal, D., Silk, A. J., Newman, M., Zapert, K., Leitman, R., & Feibelmann, S. (2004). Physicians Report On Patient Encounters Involving Direct-To- Consumer Advertising: Doctors see both positive and some negative effects on their patients and practices. Health Affairs, 23(Suppl1), W4-219.
Weissman, J. S., Blumenthal, D., Silk, A. J., Zapert, K., Newman, M., & Leitman, R. (2003). Consumers' Reports On The Health Effects Of Direct-To-Consumer Drug Advertising: This study found no widespread adverse health affects resulting from drug ads aimed at consumers, but society still needs to weigh in on the consequences of this advertising. Health Affairs, 22(Suppl1), W3-82.
Health care systems can be considered complex in that; the components that allow them to function interact in a non-linear way and over multiple scales. The complex systems that are used within the healthcare industry also produce result that are unexpected regardless of the prediction made trying to assess the changes that could occur in future (Lipsitz, 2012). The complex system is as a result of the networks originating from clinics, nursing homes and other institutions that come together create a network that makes up the health care industry.
Double loop learning has an advantage over single loop learning in that, the lessons learnt in organizational learning not only help in resolving issues that occur, but also finding different approaches to take when resolving conflicts or exploiting opportunities (Smith, 2013). An example of how double loop learning is better is because it is able to alter the norms used within an organization and improve them such that they create more opportunities in future.
Focusing on people within an organization helps to improve performance because the people are the ones responsible for accomplishing the objectives set by the health care organizations. The approach is beneficial in that it improves the value that patients place on the organization. Properly trained employees give better quality service and patients place increased value on the organization as a result (Lipsitz, 2012). In addition, employees are more likely to view the organization in higher regard for addressing their needs and this in return allows then to hold the organization in higher value as a result.
To increase the value of healthcare delivery and performance, health institutions focus on training employees. The training aims to improve their skills and competence and also to ensure that care givers have the rights information, knowledge and confidence needed to carry out their duties.
Strategies for High Standards of Nursing Practice and Care
In the current world, health facilities are under pressure to enhance their general delivery of high quality and patient-centered care. Due to that, various hospitals have implemented measures to improve their service provision. However, standards of care are evolving continuously as a result of the emergence of evidence-based practice, with other interventions becoming irrelevant. The approaches applied must also be flexible for health care practitioners to promote a smooth provision of health service. This paper will discuss some of the strategies that can be used by the care providers to meet the standards of practice and care.
Observation of the Nurses Code of Ethics
The ethical principles of nursing provide ways in which nurses are required to provide services to patients. The principle of beneficence indicates that clients must be offered with the care that benefits them. Besides, care should not harm the patient, whether intentional or not. The distribution of services should also be fair to all the clients (Burke, 2019). For example, when providing services to a group of individuals, nurses must ensure that they are fair, just, and equitably distributed among all the patients.
Furthermore, nurses are required to be accountable for all the actions or decisions they make concerning patient care. Therefore, they are supposed to accept the consequences of their actions. Additionally, sticking to the promises made to the patients is also crucial in promoting an excellent nurse-patient relationship, which aids in improving the patient outcome (Chang et al., 2019). This is usually done through the provision of high quality, safe, and competent care to the clients. Another critical factor is patient autonomy and self-determination, which occurs when nurses accept the uniqueness of each patient. Thus, it helps in appreciating patients own opinions, beliefs, values, and perspectives. Nurses must also ensure that they are truthful to the patients as well as giving them all the relevant information concerning their care.
Identifying Ethical Dilemmas and Taking Appropriate Interventions
Nurses have the responsibility to identify and act accordingly to ethical issues that affect patients and their colleagues. Having a good understanding of the whole ethical decision-making process is crucial in upholding good nursing practices and care provision (Burke, 2019). Like problem-solving, the crucial steps include defining the problem, collection of information, analysis, identifying possible solutions to help address the issue, choosing the best solution, implementation, and evaluation (CAC, 2019). With this, nurses will be able to reduce cases of conflicts at work and promote quality care delivery. Another essential element is informing the client and the staff of ethical issues that are likely to affect the care of the client.
Evaluation of Outcomes to Enhance Ethical Practice
Interventions employed to provide ethical solutions are evaluated just like other aspects of nursing care delivery. This will help in identifying the effectiveness of the solutions chosen as well as promoting ethical practice. Some of the criteria used to evaluate the interventions include whether the care providers are knowledgeable about ethics and its practice, the practice of ethical principles, level of knowledge of staff and patients on ethics, and the extent to which resources are utilized to solve ethical issues (Burke, 2019). This will provide valuable information that will help during the decision making the process.
Conclusion
In conclusion, the main strategy that will enable health care practitioners to meet the standards for practice and care is close consideration of the ethics and its practice. Therefore, observations of the ethical principles, having a good understanding of the approaches to solving ethical issues, and conducting an evaluation to determine effectiveness are some of the strategies. Besides, observing them promotes the delivery of high quality, safe, and patient-centered care, which are part of the standard practice.
References
Burke, A. (2019). Ethical Practice. Retrieved 5 November 2019, from https://www.registerednursing.org/nclex/ethical-practice/
CAC. (2019). 6 Steps for Making Ethical Decisions. Retrieved 5 November 2019, from https://www.coach.ca/6-steps-for-making-ethical-decisions-p159802
Chang, V., Cao, Y., Li, T., Shi, Y., & Baudier, P. (2019). Smart Healthcare and Ethical Issues.
Gambling disorder is defined as persistent and progressive addiction that often results in adverse physical, psychological, and socials consequences. Most individuals become addicted and get almost similar effects as they get from alcohol addiction. Besides, it can result in depression, migraine intestinal disorders, distress, among other anxiety associated problems (Hartney, 2019). Globally, gambling disorder has been on the rise over the last few years, with the number of people suffering from it in the United States, reaching 5.77 million as of 2012 (Newman& Legg, 2018). This paper will discuss the diagnostic criteria, risk factors, warning signs, and the treatment options available for the condition.
Diagnostic Criteria
According to the DSM-5 criteria, an individual must experience or show at least four of the following signs during the past 12 months:
The urge to gamble with an amount of money that is increasing for them to be excited
Persistent failure on an attempt to control, stop or decrease gambling
Gambling once more after losing money
Having frequent thoughts of gambling and making plans for it
Gambling when depressed
Being dishonest to hide gambling acts
Having problems at work or relationships because of gambling
Relying on other people to provide cash to use in gambling
Irritability or restlessness while trying to quit gambling
Risk factors for the Condition
Gambling can result in a wide range of challenges, including the addiction though no one can easily predict it. The majority of the individual who develops gambling disorder can be considered as dependable and responsible people; however, various issues can result in a shift in individual behavior. These are depression or anxiety job-related, stress retirement, loneliness, and other factors such as friends, and other addictions (Newman& Legg, 2018). Additionally, various studies have indicated that individuals with one addiction are more likely to develop another.
Furthermore, individuals with gambling addiction have also been associated with alcohol and drug use. The utilization of medication has also been associated with greater risk of developing a gambling disorder (Hartney, 2019). Although secondary addiction can come in to decrease gambling addiction, some individuals who gamble have no history of any other addiction, and thus, some of the risk factors that increase their susceptibility include anxiety conditions, and depression or personality disorders (Wang, 2019). Others are an addiction to drugs and alcohol, sex which is likely to affect more men than women and the use of medications such as dopamine agonist and antipsychotics
Warning Signs
The warning signs for gambling disorder may include financial challenges such as lack of food in the house, borrowing or requesting loans to gamble, becoming secretive on payslips, regularly falling short of money, missing of household items or valuables and presence of unpaid bills or disconnection notices (Zhao et al., 2018). It can also be manifested in the mood and behavior, for example, withdrawal from the family members, abnormal low performance at work, having to control, and manipulative behavior. Others include having fear and agitated or angry for no reason, and changes in personality (eating, sleeping, and sexual relationship patterns) (Zhao et al., 2018). Additionally, the person might also spend more time gambling, not being honest with unexplained absenteeism, taking a lot of days off and sick days, and spending an unusual amount of time to complete a task.
Treatments
Therapy
It involves help from mental health professionals who help an individual to identify the thought process that has led them to the development of the condition. The nature of the gamblers is that they have hope to win a more substantial amount of money someday; this makes them continue with the behavior, which then becomes a problem and interferes with their daily activities. Through therapies which could be cognitive-behavioral (CBT) or behavioral, they will be able to reduce the urge to gamble through systematic exposure to behavior. Besides, CBT helps in changing how individuals think and feel concerning gambling.
Medications
Medications such as antidepressants and mood stabilizers work to reduce the symptoms and medical conditions that are likely to come in as a result of gambling addictions. Some of the antidepressants can reduce the urge to gamble. Also, narcotic antagonists, which are used in the treatment of drug addictions, may help those with compulsive gambling disorders. Therefore, medication can play a significant role together with other strategies to manage the disease.
Self-help groups
This can be an excellent strategy to bring an individual with similar problems to speak with each other. This will promote a better understanding and also brings a sense of belonging to the gamblers. Through this, they can work together with a common goal of addressing the situation. This will also be involved in group strategies have discussions about their challenges, provide interventions that they feel it works for them as well as reaching out to others (Wang, 2019). This will help in the reduction of extreme cases that reach levels of depression and also withdrawal from family and friends.
Conclusion
Conclusively, gambling disorders have been on the rise over the years, which has made it a health concern. Some of the risk factors for the condition include depression and the presence of other addictions from drugs and alcohol. However, it has warning signs which can easily be noticed, such as taking too many loans to facilitate gambling behavior. The treatment options available include therapies, the use of medication, and making use of self-help groups.
References
Wang, P. (2019). What Is Gambling Disorder? Retrieved 15 October 2019, from https://www.psychiatry.org/patients-families/gambling-disorder/what-is-gambling-disorder
Hartney, E. (2019). How Gambling Disorder Is Defined According to Psychiatrists Verywell Mind. Retrieved 15 October 2019, from https://www.verywellmind.com/what-is-gambling-disorder-22015
Newman, T., & Timothy J. Legg, C. (2018). Gambling addiction: Symptoms, triggers, and treatment. Medical News Today. Retrieved 15 October 2019, from https://www.medicalnewstoday.com/articles/15929.php
Zhao, Y., Marchica, L., Derevensky, J. L., & Ivoska, W. (2018). Mobile Gambling Among Youth: A Warning Sign for Problem Gambling?. Journal of Gambling Issues, (38).
Substance use disorders, which have been considered to be a challenging pattern for alcohol use and other drugs has been closely associated with HIV/AIDS together with other sexually transmitted infections. However, it is necessary to note the fact that individuals contract HIV, which then results leads to AIDS when it is not controlled with the currently available drugs. This paper will discuss some of the factors contributing to the high prevalence of HIV/AIDS among alcohol and drug users.
HIV infection is usually transmitted in several ways, which consist of unprotected sexual intercourse with individuals infected and through contaminated injection. These are also considered to be the most common mode of transmissions among drug and alcohol users. This is because; smoking, drinking alcohol, or the use of the inhalable drug can interfere with the judgment of individuals (CDC, 2019). Hence, it predisposes them to participate in unsafe sexual behaviors, for example, having several sexual partners and sexual intercourse without a condom, which then explains the prevalence. Besides, individuals living with HIV and substance abuse experience rapid progression of the condition and are less likely to seek health services or adhere to the available antiretroviral therapy (CDC, 2019). Therefore, the condition worsens and progress to AIDS.
Most of the substances abused are associated with their risk factors. Alcohol is linked with risky sexual behaviors, which hurts the treatment process and opioids, increase the use of needle sharing and risky sexual behaviors together with other substances such as inhalants, methamphetamine and crack cocaine (CDC, 2019). Besides, other populations are at disproportionate risk for abuse of substances and HIV infection. Also, structural and social factors contribute to the challenges of preventing transmission among substance users.
Conclusively, substance and drug use interferes with individual judgments. Thus, it increases the risk of individuals engaging in risky sexual behavior, which increases the transmission of HIV among them. It also increases the chances of having multiple partners and sharing of needles with infected individuals. Hence, the high prevalence.
References
CDC. (2019). HIV and Substance Use in the United States. Retrieved 15 October 2019, from https://www.cdc.gov/hiv/risk/substanceuse.html
One of the major risk factors for diabetes is obesity, which affects about one third of adults within the United States. Obesity has been associated with some demographic and socioeconomic factors. The environments that people live in, and work in have a great influence on obesity and diabetes. The main aim of this study was to examine how work culture, environment and policies influence healthy eating and physical exercise.
A descriptive analytical study was conducted through interviews on 20 individuals from the national labour union. A total of 9 focus groups that included 61 workers participated in the study. All the data that was collected was audio recorded and later transcribed. The data was later on coded using the phenomenological approach to help find the common themes.
The results showed that very few wellness programs were offered to the workers. The labour union and the workers recognize the need for weight loss programs but did not know how to go about it. The employees discussed how their jobs left them stressed and too exhausted for exercise. Other workers indicated that they did not have finances, time to participate in the onsite gym and weight loss programs availed for them.
The findings of this study indicated that indeed work environment has a major influence on healthy living for the workers. Given the significant relationship that is there between the workers’ health and the work environment, it is important for employers and labour unions to consider focusing on implementation of fitness programs.
Quantitative Research Abstract
The quantitative study was conducted to try and understand the prevalence of type I and Type II diabetes based on demographics within the U.S. The data for this study was collected in three phases, the 1st phase was between the years 2000- 2005, the second phase was between the years 205-2010 and the phase 3 from the year 2010 to date. Six recruitment centres including Ohio, Seattle, Washington, South Carolina, Hawaii and California were used.
The centres conducted active surveillance using networks of paediatric and adults and health care providers. Medical cases were determined to be valid if diabetes is confirmed in the medical records and eligible through age, residence and health plan membership at diagnosis.
The results of this study indicate that there are a substantial proportion of youths with diabetes particularly the African Americans and the American Indians. Most of the youths that were found with type 2 diabetes are from low income homes, and they also suffer from obesity. A large proportion of youths with type 1 diabetes are also obese and they are distributed across ethic groups.
The findings of this study indicated that youths have a high prevalence for both types of diabetes. The youths need to be given first priority when it comes to health education on how to prevent and control diabetes. Most of the youths as indicated by the high rates of obesity among them do not engage in physical exercises. Long term follow up of youths with diabetes is important to help expand knowledge of the best approaches to control this disease among the youths.
Post-traumatic Stress Disorder Experienced by 9/11 Attacks Survivors
11th September the year 2001 is the most remembered day in the history of US terrorist attacks. Boeing 767 jet crashed into the North Tower of the World Trade Centre, followed by another plane crash in the Southern Tower (Fink, 2019). The two buildings collapsed just as a third and fourth planes hit the Pentagon and in a field in Shanksville, Pennsylania respectively. This attack led to the death of more than 2800 people and left many others psychologically traumatized and most survivors suffered from post-traumatic stress disorder (PTSD) (Fink, 2019). Trauma can be defined as a mental health disorder triggered by an event that is terrifying, either by experiencing it or by witnessing it (North et al., 2015).
Individuals that experienced traumatic events in their lives have temporary problems when it comes to adjusting and dealing with life situations. This research focuses on the psychological trauma that was experienced by the survivors, the extent of the trauma, the symptoms experienced and the treatment strategies applied to help deal with trauma. The study will also analyse the effectiveness of the treatment, mentioning some of the treatment strategies that were helpful and those that were not. The study will conclude by highlighting some of the lessons learnt from the attack on the best strategies to manage PTSD.
The survivors of 911 attacks
On the commonly known date of 11 September of 2001, The U.S was faced with one of greatest tragedies. The people that experienced most trauma from the attack were the ones that were in close proximity, this include the people that were in the buildings that were crashed. Six months after the attack, most of survivors could vividly explain their experiences clearly explaining what they saw and the most traumatizing images that they saw (Vitelli, 2018). Most survivors of the 9/11 attacks experienced varied PTSD symptoms months after the attacks. The largest number of them lost their jobs since their work stations were destroyed, and this led to increased stress because idleness led them to keep rethinking about the attack (Vitelli, 2018). One of the negative feelings that were experienced by most of the survivors after the attack is guilt. Most of them felt like they did not do enough to save their colleagues and friends, who were not as lucky as they were to have survived the attack. More than 70% of the 9/11 attack survivors suffered PTSD symptoms months after the attack and this greatly affected their lives after (North et al., 2015).
Symptoms of PTSD experienced by 9/11 attack survivors
PTSD symptoms can begin within the first month after the traumatic event, they can start to show even years after the event. The symptoms of PTSD can have significant effects on the lives of the victims as observed through the 9/11 attack and it can greatly affect their social lives and also affect their ability to conduct their normal duties (North et al., 2015). The symptoms of PTSD that were experienced by the 9/11 attack survivors can be grouped into four define types including;
Intrusive memories
The survivors of 9/11 attacks have confessed in many research studies to have experienced unwanted distressing memories of the traumatic event. The survivors have also experienced flashbacks of the attack where they relieve the attack experience like it is happening all over again (Bowler et al., 2017). The survivors have also indicated that they could not sleep well because they kept having nightmares on the attack a year after.
Avoidance
A common behaviour with people suffering from PTSD is avoidance. Most of the survivors of the 9/11 attack have confessed that they are not able to discuss the attack and they try as much as they can not to think about the happenings of that day. These survivors have illustrated in the studies that they have fear of fires, loud bangs and even fear getting into tall buildings because they remind them of the attack (Bowler et al., 2017).
Negative Variations in reasoning and attitude
People suffering from PTSD tend to have a very negative thinking, they are always thinking negatively about themselves and the people around them. Most of the survivors had a very limited hopeful thinking, months after the attacks. Most of them had no defined plans set for the future because they felt that the future was just a dream that could be destroyed in a minute (Yu et al., 2015). Most of the survivors did not have any friends and they often feel detached from their families. They were not able to maintain close relationships because they always felt emotionally distressed feeling like people would never understand their situations. Most of the survivors indicated their lack interest in leisure activities, things that they used to enjoy doing before the traumatic event no longer seem fun for them (Bowler et al., 2017).
Variations in both physical and expressive reactions
People with PTSD experience a change in their emotions whereby they easily get frightened, causing them to always be prepared for danger. Most of the 9/11 attacks survivors have been reported to have indulged in alcoholism and most of the have been served with over speeding tickets more than two times since the attack (Bowler et al., 2017). Insomnia was a common problem that was registered among the survivors and it can be linked with the fear that they will have dreams related the attack when they sleep. Most of the survivors up until now have no jobs all because they cannot concentrate, they often struggle with aggressive behaviours and this causes them to feel devastating embarrassment and guiltiness (Yu et al., 2015).
Treatment of PTSD for the 9/11 survivors
In trying to deal with the psychological distress that affected the survivors of the 9/11 attack the Department of Mental Health (DMH) responded very fast joined by other medical agencies (Jordan et al., 2019). They began by identifying three priorities; it first began by providing crisis intervention to the bereaved survivors. A mental health hotline that is sponsored by DMH known as LifeNet offered counselling in 5 languages via telephone (Jordan et al., 2019). The number of calls to this hotline increased and actually doubled in the days after the attack, meaning that people were really in need of counselling. DMH went ahead to establish care centres that helped in providing counselling and also to help the people search for their relatives in various hospitals (Lowell et al., 2018). The second thing that was done is that DMH working with the other providers developed a long-range plan to provide mental health services to the survivors. Support services were created through what was defined as Project Liberty and within a short time 120 sites had been established (Lowell et al., 2018). The third priority was to ensure that the public mental health system that was funded by DHM was maintained to help cater for the mental distress of the survivors and everyone that was affected by the attacks (Jordan et al., 2019).
Helpful Treatments
Trauma treatments basically involve counselling, which can be very complicated and the effectiveness depends on the structure used to implement it. One of the most helpful treatments of PTSD after the 9/11 attack was through the outreach educational program that was implemented under Project Liberty (Tull, 2019). The outreach educational program was structured to serve the purpose of what is known as the psychological first aid. This is where trauma victims are treated step by step by professional that analyse and understand the intensity of the trauma on the victim and what needs to be done after the first stage (Petrsoric et al., 2018). This strategy was most beneficial to the 9/11 attacks survivors because it helped educate the society about trauma.
The people were educated on the symptoms that determine if one is suffering from PTSD and so it helped the people to understand their symptoms and decide whether they wanted to be part of the program or not. The program was set up in such a way that it provided a short term crisis counselling services for everyone in need, after which a referral to longer term specialized mental health treatment was offered depending on the intensity of one’s trauma (Lowell et al., 2018). The survivors that were found to have intense trauma were directed to professional psychological counsellors that enrolled them into psychological programs to help them deal with their PTSD symptoms (Petrsoric et al., 2018). This was a much different from the common mental health counselling and it helped deal with some of barriers to mental health for instance lack of knowledge about the availability of services. It helped the society to understand the effects of the attack on mental health thus helped the society to offer more support to the survivors. The outreach program is an effective PTSD treatment program that worked and helped many survivors of the 9/11 attack deal with PTSD, it should be adopted in dealing with PTSD in major tragedies in the future.
Unhelpful Treatments
The choice to open up the normal counselling care centres where the survivors could go for brief counselling was a great idea, though it was not really effective. Research has showed that the prevalence of the PTSD symptoms among the survivors after the 911 attack only decreased by one third meaning that most of the trauma victims did not benefit from the set treatment PTSD options (Tull, 2019). There are many barriers to mental health treatment, and they may have affected the survivors from accessing the services provided to help deal with the psychological trauma from the attack.
For one most of the survivors were trying to avoid remembering the events, and so visiting the counselling centres was not an option for them because they would need to discuss the events of the attacks (Vance et al., 2018). Most of the survivors may have chosen not to visit the care centres because they did not realize that they were trauma victims, they had no knowledge of what PTSD is all about and did not know what the symptoms were (Tull, 2019). There is also the issue of stigma that surrounds the mental health issue; most of the survivors chose not to go to the care centres because they did not want the society to label them as mentally unstable. For those that chose to go for these brief counselling sessions, they were not really helpful to them because they only helped them feel better at that time without concentrating on the emotional processing of the trauma and this only increased the anxiety levels for the survivors (Vance et al., 2018).
The telephone counselling was also just like the visit to the care centres unhelpful, because it only provide some quick surface counselling that did not really touch on the progressive emotional distress faced by the victims (Tull, 2019). Most of the people that called the centres were people looking to find out about the details of their loved ones but not for real counselling that the survivors required. The call centre agents were not psychology professionals that understood how to deal with trauma victims (Vance et al., 2018). This means that they were ineffective in offering any real psychological help to the survivors that called in looking for some counselling after the attack.
Learning Reflections
Telling whether people will suffer from PTSD after a traumatic event is not a simple yes or no answer. Judging from what happened with the 9/11 attack; there are people experience very minimal symptoms after the traumatic event. There are others who have mild symptoms over time and there are those others that experience chronic elevated distress shortly after the traumatic event and it affects their lives for many years (Cook, 2016). There is another group of people that experience a minor disorder immediately, which increase and become severe with time causing them to be impaired. All this pathways are associated with factors that occur before, during and after the traumatic event not forgetting the external forces. The length in which an individual experienced the trauma, the medical conditions that one acquired as a result of the trauma for instance asthma and prior psychiatric conditions guided the pathways of PTSD (Jordan et al., 2019).
The 9/11 greatly helped to shed the light on how programs can sensitively be implemented in-order to meet the needs of trauma survivors. The prevention, screening and the treatments should always be targeted at the survivors and other people that have higher levels of trauma exposure and hence at higher risk of distress (Cook, 2016). The screening for significant distress should be particularly directed towards the individuals that have experienced severe traumatic exposure and those that have prior psychological difficulties. Educating the society about trauma and how it affects mental health of the victims is important and it helps in building a healthy support network for the victims (Jordan et al., 2019). This support network acts as a powerful buffer against distress and it hence becomes a key component to cure.
People in the society need to be taught how to take care of one another. More people need to be trained on psychological first aid, which greatly helped to take care of the trauma victims’ psychological needs. A systematic training on psychological matters that is employed nationwide need to be implemented to teach people how to recognize problems that require professional help so that they are able to make use of the resources that are available for them.
Vicarious Trauma
Providing psychotherapy to victims of trauma can produce PTSD symptoms to the psychotherapists, this is what is defined as vicarious traumatization (VT). VT is mainly caused by the internal interactions between the clinicians and the victims as they vividly repeat their experiences. This process alters the views and the relationships of the clinicians, aligning them similarly with those of the traumatized victim (Quitangon et al., 2016). The few studies that were conducted to understand VT after the 9/11 attacks, indicate that many psychotherapists experienced trauma but their experiences were dependent on various factors. The psychotherapists that had previous trauma exposure experienced intense psychological distress as compared to those that did not have previous exposure (Clement et al., 2015).
The psychotherapists involved during the 9/11 attacks experience symptoms such as emotional numbing, intrusive thoughts and images, heightened sense of distrust and intimacy difficulties. Age and marriage also greatly impacted on the clinicians’ risk of developing VT. Younger clinicians with less experience on the field had high risks of developing VT as compared to the more experienced clinicians that had been in the field longer (Clement et al., 2015). Married clinicians experience much less symptoms as compared to the single clinicians, this is attributed to the fact that having a spouse allowed for moral support, because they could discuss the events of the day with someone and this helped to reduce the effects of trauma exposure (Quitangon et al., 2016).
Based on experiences of the clinicians that took part in Project Liberty, risks of VT for clinicians can be reduced through additional education and training on traumatology. Modern disaster management has emerged since 9/11, renewed attentions have been focused on the safety as well as the wellness of the disaster responders that suffer a great deal of trauma from the disaster. Various training programs like Webinars have been created to help these responders to assess themselves and to help provide self-care before, during and after disaster (Quitangon et al., 2016). This is an effective strategy in helping improve the outcomes for the mental health providers who work hard to help the disaster victims recover psychologically.
Conclusion
The 9/11 attacks was the worst traumatic event that have been experienced in the history of the United States. Many people suffered from trauma most especially the survivors, who experienced seeing their friends and colleagues die and they could not do anything about it. These people experienced very intense symptoms that affected a great deal of their lives. Most of these people lost their jobs, meaning that they had to spend a lot of their time after their attack doing nothing, which led to increased distress for them. The society was not knowledgeable enough to understand the impacts that trauma has on psychological health of people involved. The best strategy in dealing with PTSD is through psychological first aid system, this involves educating the society about trauma symptoms and let them understand how they can affect people’s lives. Doing this will always ensure that the people at high risks of experiencing trauma symptoms from disasters are well taken care of and they are able to go back to their normal lives.
References
Bowler, R. M., Adams, S. W., Gocheva, V. V., Li, J., Mergler, D., Brackbill, R., & Cone, J.
(2017). Posttraumatic Stress Disorder, Gender, and Risk Factors: World Trade Center Tower Survivors 10 to 11 Years After the September 11, 2001 Attacks. Journal of Traumatic Stress, 30(6), 564–570. https://doi.org/10.1002/jts.22232
(2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol. Med., 45, 11–27. [CrossRef] [PubMed]
Cook, J. (2016). September 11th Attacks: What We Learned About Trauma. Retrieved from
"Power Plays and the Abuse of Power in Health Care Organizations"
In health care facilities, power struggles occur due to two major reasons. First, it occurs when physicians contribute different perspectives or agendas in making health care decisions. Each party thinks that their opinions are the best in creating a functional organization (Burns et al, 2011). Secondly, a power struggle occurs when different parties derive their power in different sources. Conflict arises in the different parties as they try to figure out which party should control the decisions or which party to rely upon. Note that the healthcare facility has multiple powers and the parties place different ideas to solve an issue. Some may have knowledge-based power, others may have high positions, and others may rely on administrative power (Burns et al, 2011). Power struggle arises in this situation in trying to figure out which group which be allowed to exercise power.
A healthcare facility could use the following methods to alleviate power imbalances. The first method is mediation. Mediation is a process where a hearing officer should listen to the different party's power and give each party a right to self-determination. The different powers should not affect one's self-determination but rather the hearing officer should empower and protect self-determination (Burns et al, 2011). A health care facility can also alleviate power imbalance through effective communication with physicians and building relationships.
Managers should prevent power abuse so that the organization can achieve its goals. Managers should ensure a balance of power to promote patients' safety and allow the workers to maintain control within the organization Note that abuse of power will result in corporate scandals, which will affect an organization's performance (Burns et al, 2011). Therefore, it is important to prevent power abuse so that the organization can maintain a good reputation and foster a strong physician-administrator relation, and more importantly, allows the physicians to have greater self-determination.
Effective negotiation approaches that can be used to change power abuse into a productive power are collaboration and compromise. Collaboration is the best to approach in that parties involved in power abuse will consider the interest of others, they will be able to manage power, and they will work better to support the organization (Burns et al, 2011). Workers will not only focus on personal ends but will also consider the organization's needs. The second negotiation approach is compromising. This approach will allow the workers to divide value and ensure that each one gets a satisfaction. Both parties will reach an agreement after considering the party's concern and interest.
Reference
Burns L., Bradley E., & Weiner B., (2011). Shortell and Kaluzny's Healthcare Management:
Organization Design and Behavior. Cengage Learning
A Review of the Film‘Wonder Woman’ Directed by Patty Jenkins
Over the years, superhero movies have been created with the main hero being the man. Movies such as Superman and Batman are some of the most renowned superhero movies of all time and they created the notion that comic superheroes are men. ‘Wonder Woman’ has however ticked the box by leaving a mark in the comic world as a female led comic film. The concept of wonder woman began in the 1940s, though this character has over the years only been viewed to be at her best when her narrative inclines into the feminist philosophy. Film makers always treat the kind-heartedness of this character as the key to helping understand her, instead of admiring her brutality in battle, and the audiences are privy to a hero who offers a power fantasy that honours the longings of women. No film has however, been able to create room for female fantasies like ‘Wonder Woman’ did. This film helped to show that women just like men can be rough, humorous, and self-confident and also designers of their destiny.
This story that was written by Allan Heinberg and directed in the film by Patty Jenkins follows the life of Diana the protagonist in the film. All her life, Diana has grown up under the protection of Olympus gods including her mother Queen Hippolyta; in Themyscira an all women secluded island paradise. Since her childhood, Diana desires to be trained the art of war despite defiance from her mother and her aunt Antiope takes on this role. Diana grows up to be a brave young woman who does not hesitate to help the people in need. It is this bravery that leads her leave the only life she has ever known to follow Steve to the world of man, to try and fulfil her duty as an amazon woman of stopping the war and saving innocent human lives.
‘Wonder Woman’ being a piece that is set long before Superman arrived on earth is a unique story. This is a story that is not concerned with continuity like it happens with other comic films; it stands on its own merit telling its own story. It is this element that helps Jenkins to assemble an incredibly compelling and well-constructed story. Wonder Woman can basically be described as a tight, skilfully drawn together narrative that feels more like an eccentric unconnected adventure rather than a channel to some better story to come.
Comic films always evoke amazement that can be humbling, exciting or both. Wonder Woman effectively tops at this right from the first chapter that is set in Themyscira, where there are intense fights with Antiope and tender scenes with Hippolyta and Diana. The scenes at the beginning are really interesting, particularly the scene where Diana illustrates that women do not need in order for them to be happy. Steve on his part is fascinated by her, and this helps the development of their story to be trustworthy. The attraction between Steve and Diana is stirring, which helps in making ‘Wonder Woman’ a very efficacious; love and superhero original narrative set in the course of one of the most inhumane wars. The fight scenes are well designed, fashionable and passionate but not ruthless like what would be anticipated from a batman fight.
The character of Diana greatly helps to make this film victorious by brilliantly inhabiting the mix of inquisitiveness, honesty, and kindness, all which has undergirded ‘Wonder Woman’ since the start. Diana effectively wears her suit without any disappointments and evokes a classic heroism, matching to past heroic films like Superman of 1970s. Pine does a great job of matching her hopefulness with world weariness and a sharp sense of humour, helping to make this film even more interesting. She is more than capable at bringing an emotive complication to a character most appropriately defined as a man in anguish. Diana as the wonder woman is brought out as a mechanical and energetic fighter, with her fierceness serving to focus the logic of kindness that describes her personality. This emphasis on trying to describe the reason for the violence within the film helps to give ‘Wonder Woman’ a weight that is rarely perceived in most other comic films. It also endlessly drives home the indication that all that Diana desires is to be a champion.
One thing that cannot go unnoticed in this film is the unevenness of the supporting cast. Some of the cast especially the villains for instance Doctor Maru and General Ludendorff are broadly painted with the little details given being too weak to give a lasting impact on the audience. Other characters such as Charlie, Chief and Sameer also similarly crafted with very little detail, though they are all play a major role in helping to make this film interesting and memorable. Wonder Woman is a humorous and hopeful movie, but it also touches on political matters which helps it to be more rational about the society. Feminism in the film is sneaky and it is only perceived in the moments when the women, mostly those of colour make comments about their life situations and when Diana faces prejudice from the influential men who doubt her intellect. ‘Wonder Woman’ effectively displays the love and acceptance among women in the film, irrespective of colour and age. These women train and socialize together in unity and one cannot help but admire the fierceness, kindness, loyalty and bravery they display.
To create the overall tone and style of the film, Jenkins wisely draws from traditional adventure films of the 1980s. One cannot help but notice similar atmosphere in Wonder Woman with movies such as Indiana Jones, which is a very creative decision. It is this concept that helps ‘Wonder Woman’ to feel familiar, timeless and comfortable, while at the same time bringing in a completely different structure of superhero comics. This is a movie that will greatly help to pave the way for other female-led superhero films in coming years.
‘Wonder Woman’ just like any other film has its flaws starting with the fact that the movie is way too long, which allows for the unnecessary sections to become strangely obvious while watching the film. The main antagonists of the movie are completely unmemorable when they are equated to the appeal and emotive depth of its protagonists.
‘Wonder Woman’ may have its flaws, but it will remain to be one of the best female led superhero movie ever created for a long time. Jenkins and all her collaborators did what was thought to be unmanageable in the comic world. They created a woman led Super hero movie that is inspiring, intense and compassionate, making this one of the most beautifully crafted comic movies of all time.
Works cited
Jenkins Patty. Wonder Woman, IMDb.com, 30 May 2017,
The nursing profession has been growing for decades, with more emphasis on the provision of quality, safe, and evidence-based care to the patient. I believe that nursing is as defined by the role of a nurse by Virginia Henderson as assisting individuals who are either sick or well in carrying out activities that he/she would do if the necessary strength, will, and knowledge was present and that contributes to health or recovery (or a peaceful death) and to performs this in a manner that the patients gain independence rapidly (Gonzalo, 2014). Professional responsibility, on the other hand, is the ability to make judgments and demonstrate excellent knowledge and being responsible for the actions taken or decisions made, while working to promote an environment that maximizes independence, health consumer safety and quality of life (Nursing Council of New Zealand, 2012). Also, being professional to me is the capacity to carry out all the activities that the society requires an individual to perform. This paper will discuss the need theory and professional responsibility, and how it complements my understanding of the meaning of nursing, and finally, describe the meaning of being professional.
The Need Theory
The need theory is one of the modern nursing theories that was developed by Virginia Henderson to identify the unique function of nursing. It focuses more on establishing patient independence to promote recovery. The approach emphasizes on the fact that individuals have basic needs that must be addressed to ensure normal functioning; therefore, it provides ways in which nurses can work to help in solving them (Gonzalo, 2014). Furthermore, the theory has four concepts, which include an individual, the environment, health, and nursing. The first concept in this is the patient who is referred in this case as an individual as is described as a person who needs care, which does not necessarily mean that the illness causes it.
Furthermore, the second concept is the issue of the environment, and although it is not well defined in the theory, it states that offering an environment that supports health is among the 14 client assistance activities. Health, on the other hand, is another concept that is considered to mean balance in all life realms in humans. It is considered to be the ability to carry out 14 activities without help (Parker & Smith, 2015). Finally, the last aspect is nursing, and this has the primary goal of ensuring that the patient is complete, independent, or whole. All of these aspects are well included in the definition.
Besides, activities that an individual can perform when they have the necessary strength, will, and knowledge in this theory are considered as the 14 components. It gives the holistic approach which has social needs, psychological spiritual, and physiological needs (Parker & Smith, 2015). They are activities that a nurse should help the patient in maintaining them to promote a healthy life or to a peaceful death. Some of the physiological needs include; eating and drinking adequately, selecting appropriate dressing, breathing normally, maintenance of the body temperature, and sleep and rest (Gonzalo, 2014). Additionally, the social needs of an individual can include working in a manner that initiates a sense of success and participation in various kinds of activities, including recreational ones.
Other needs include the spiritual need where the patient is allowed to worship according to their faith, and finally, psychological needs examples are, communicating with other people in delivery of opinions, fear, emotions or needs, and to discover, learn and to satisfy the interest that leads to normal growth, health, and making use of the available health facilities (McEwen & Willis, 2014). These activities are the ones that each one or every individual will deal with on a day-to-day basis to live a healthy life. Therefore, nursing, through the action of the health care provider, ensures that these needs are met to enable those individuals who require assistance to maintain them. It thus defines the work provided by the nurse as nursing.
Professional Responsibility
Professional responsibility usually involves the proficiencies associated with legal, professional, and cultural safety and ethical roles. One of the competencies under the processional obligations indicates that nurses should practice nursing in such a way that the consumer of the health service considers culturally safe. Care provided in the health care facilities needs to apply the principles of cultural safety that has four aims which include improving the well-being and the health status of people of New Zealand, promoting better provision of health services, acknowledging the differences in individuals seeking care and finally, understanding the power of health services and the impact it has on the families and individuals (Nursing Council of New Zealand, 2012). Culture affects the consumption of healthcare services, and thus, it must serve to protect the well-being of the consumers.
Also, nursing care should be provided in a manner that respects the consumer identity and the rights to hold on their values, beliefs, and goals. In this case, the basis of nursing should depend on the client's decisions and what the client considers right or wrong and acceptable or unacceptable should be fully acknowledged, and the necessary interventions implemented (Nursing Council of New Zealand, 2012). However, the patient's right to autonomy must be made a priority, with the caregivers choosing to provide care that is culturally right and acceptable by the patient’s faith.
Furthermore, nursing practice is all about developing a good relationship with the clients to facilitate the proper delivery of health services. Thus, the care should consider assisting the health consumer in having the necessary support they might require, for example, in cases that employ preferences, and culture. Besides, the practice needs to reflect on the values that impact nursing care concerning the patient's ethnicity, age, beliefs, culture, gender, disability, and sexual orientation. With approval from the client, consulting with their members of the culture or other groups can also be incorporated to promote a better understanding of the cultural norms and possibly avoid conflicts that may arise from a particular situation (Nursing Council of New Zealand, 2012). Additionally, the nursing practice should avoid imposing prejudice, and on the other hand, it must consider advocating in cases where it is apparent to promote the rights of the health consumer.
Nursing requires a collaborative approach that needs the involvement of various factors, with one of it being the cultural values and beliefs of the individuals seeking care. Culture is diverse with people having their own beliefs while on the other hand, nursing is all about meeting the social, psychological, physiological as well as the spiritual needs of the consumers (Nursing Council of New Zealand, 2012). Therefore, offering practice that is considered to be culturally safe is one way of providing care that s inclusive, and that serves the interest of the patient.
Being Professional
Nursing, like any other profession, has a defined purpose with aims and goals that it wants to deliver to its consumers. Therefore, being professional to me is having the chance to have a close relationship with the society that established it. The connection between the society and the nursing profession can be made through the provision of quality health services to those seeking them (New Zealand Nurses Organisation, 2017). Besides, nursing is guided by a set of values, its area of independent practice, and a distinct body of knowledge, and this is what is being professional.
Furthermore, being professional is taking the responsibilities for the action one took or the decisions they made, which resulted in inevitable consequences. Additionally, it also means, practicing within code, and providing sound judgment, advocating for better and appropriate health services for patients, and offering nursing practice in line with the standards set by profession. The provision of nursing services is also collaborative (New Zealand Nurses Organisation, 2017). In this case, being professional will mean the ability to work with colleagues to promote up-to-date knowledge of legal issues, be aware of the new trends, and having the ability to apply the findings of relevant studies to facilitate change and innovation in practice.
Also, acknowledging the rights and practice of co-workers is one of the most crucial parts of nursing practice. This is because conflicting opinions in the profession are inevitable, and they might require discussions for a resolution to be reached (New Zealand Nurses Organisation, 2017). Acceptance of a review of colleagues to allow intervention in the cases of poor practice is also professional because learning is an on-going process.
Within an organization, being professional will also include facilitating co-operation between the colleagues, and other group health care teams and applying the standards of practice in care delivery. It will also involve a review of competencies and maintaining accurate records of events and reviews of the current practice (New Zealand Nurses Organisation, 2017). Additionally, taking part in an ongoing negotiation between the profession and the society to ensure that their needs are met and are kept informed of changes in health care is also part of it. Therefore, being professional means understanding one's roles in the society, organization, in working with colleagues and with the patients.
Conclusion
Conclusively, nursing has undergone a series of development, with most of its emphasis currently focusing on offering high-quality care that is safe and supported by evidence. I believe that Virginia Henderson’s role of a nurse can define the nursing profession. Furthermore, the choice of the nurses to be responsible for the decisions and actions they make is what I consider as professional responsibility, and it includes the provision of services that are culturally acceptable by the recipient. Besides, being professional is the ability to carry out all the activities that an individual is required to do by their profession, and what the society expects from them. With this understanding and consideration of being professional and taking responsibilities, I believe nursing will serve its purpose.
References
Gonzalo, A. (2014). Virginia Henderson: Need Theory Study Guide. Retrieved 1 October 2019, from https://nurseslabs.com/virginia-hendersons-need-theory/
McEwen, M. & Willis, E. (2014). Theoretical basis for nursing (4th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Nursing Council of New Zealand. (2012). Competencies for registered nurses. Retrieved 1 October 2019, from https://www.tdhb.org.nz/services/nursing/documents/nursing-council-documents/Competencies%20for%20registered%20nurses.pdf
Parker, M. E., & Smith, M. C. (2015). Nursing theories and nursing practice (4th ed.). Philadelphia, PA: F. A. Davis Company
Since the time autism was used to describe a particular pattern of behavior among children, it has been a common condition that is often misdiagnosed. Besides, it has now been discovered that it is a lifelong condition that involves a number of various symptoms. Also, questions have been raised on the association between autism and the rise in the number of students enrolling in the STEM field. Recently, Asperger’s syndrome and autistic disorder were joined into a single condition called autism spectrum disorder (ASD). The prevalence of the condition is increasing in the United States, which has also resulted in the rise in the number of unemployed young adults having the spectrum over the years (Wei et al., 2013). However, various studies have linked ASD with higher function and higher chances of enrolling in the STEM field. This paper will discuss the enrollment of individuals with autism in the STEM industry and their work experience in the sector.
STEM Field Enrollment
The number of individuals with ASD enrolling in the STEM field has been increasing as time goes. Fortunately, this is the course considered in the United States to bring and improve the growth of economic competitiveness. Furthermore, the enrolment of the people with ASD in the STEM sector may be due to their more excellent aptitude towards systemizing, which is more than empathizing (Chen et al., 2015). Therefore, they have a more exceptional ability to perform analysis than having emotions and reacting to the social world.
It has been a belief that persons with ASD gravitate toward STEM majors in colleges, and this was confirmed to be true. A study that was conducted by Wei et al. (2013) indicated that the majority (81%) of the college students who had been diagnosed with ASD before, enrolled in a two-year community college at a particular point in their post-secondary careers. It also showed that the individuals in the STEM field had had a higher probability of remaining in the 2-year community college and twice likely to move into a 4-year university than their peers in the non-STEM field. Besides, the study found that 34% of the student diagnosed with ASD gravitated towards STEM majors (Wei et al., 2013). The findings were found to be higher than for the general population, which showed gravitation of 22.4%, yet they declared the STEM major in the college. Other filed that were likely to be chosen by an individual with autism were computer science (16.2%) and science (12.1%).
Although the participation of young adults in the STEM field is high, their rate of enrollment in post-secondary is the third-lowest among other categories of disabilities. However, the advancement in the early identification and management of children with autism is likely to boost the rate of enrollment; thus, it will raise the level of involvement of individuals with ASD in the STEM sector (Wei et al., 2013). Furthermore, post-secondary enrollment was found to be predicted by high school’s initial measurement of mental functioning skills, which acted as a barrier in the cases where they were lower than the basic level.
Additionally, one of the most crucial things to consider in individuals with autism is the desire for consistency and routine. Hence, changes that may occur or exposure to broader social dynamics or something new can become a challenge, which then affects the normal functioning in people with ASD (Lee et al., 2019). From, this there is a need to consider the provision of life skills to help them in preparation for dealing with difficult life situations.
Work Experience
The most challenging step experienced by individuals with ASD occurs during the transition from high school to work, tertiary education, and other community options. This happens because youth with ASD have similar aspirations as their counterparts without the condition. For example, having a good job that does not conflict with personal interest and strength, have opportunities for development and with fair wages (de Schipper et al., 2016). However, the rate of unemployment among individuals with ASD is still high in the United States.
Individuals with ASD have unique behavioral characteristics, communication, and social styles that create some difficulty in securing job opportunities in the market. However, they have specific skills and filled with the abilities to deliver. This includes trustworthiness, loyalty, exceptional attention to detail, and a good memory that can be well utilized in the workplace (de Schipper et al., 2016). Furthermore, they have creative talents that can provide a way for developing innovative products and, thus, being the stepping stone for businesses in this rapidly changing environment.
According to Curtin University (2018), individuals with autism have capabilities that fit well in the information technology sector only that, there is a need to establish programs that will focus on improving the skills outside the classroom and in a safer environment. This can be done through the involvement of program facilitators with a shared interest in that of the participants of the program. However, the multi-disciplinary approach needs to be employed in sourcing them, to bring in people from the science, engineering, and technology areas.
Previous research has also indicated that individuals with ASD have a higher probability of performing better in a work environment if they are prepared well and have the necessary transition support and services to facilitate the process. That brings suggestions that individuals with ASD can take up roles well when they equipped with the required access to activities in career development, for example, work placements and job shadowing (Lee et al., 2019). This is because they serve as an opportunity for the acquisition of employability and work skills.
According to Lee et al. (2019), an uncertainty that results from transition to adulthood is a challenging experience for individuals with ASD. However, work placement can give away that facilitates a smooth development to adult life for this group of people. They also found out that the work placement process, offering, and a chance to develop work-related skills, harnessing the individual’s interest and preparation for the working environment, gave the participants an ability to identify and realize their potential and uncover insights to the work environment. It also enabled them to envision there future and work as a team. With this, it is clear that providing an intervention for people with ASD where they can gain and get more experience can make them as well better opportunity to be as other workers.
Furthermore, the challenges in communication and socialization among individuals with ASD form the most significant barrier to employment. Through exposure, individuals with ASD can be able to explore their interests, strength, and abilities. This can be done by enabling them to work in a real work environment. Moreover, guiding those in the workplace to be involved in a work routine will also provide them with an opportunity to meet and interact with other colleagues throughout the working period also serves to encourage them.
Individuals with autism are also considered to have more advantages than others in the workplace due to their superior skills; thus, they present talent for employment. Bury et al. (2018) indicate the need to create awareness on the strength and capabilities of individuals with ASD and to make reforms in the human resource management that creates barriers to their employment. Furthermore, the challenges that exist among people with autism requires an individual difference approach. This will help in understanding their uniqueness and reduce the pressure on employees to outperform persons with ASD.
Conclusion
Conclusively, the number of individuals diagnosed with autism has been rising in the United States, and this has also been linked to the rise of people enrolling in the STEM field. Besides, evidence suggests that the number of individuals with ASD who gravitate to the STEM field is higher than that of their peers. This brings in their unique characteristics manifested in their behavior as less emotional and social and more of performing analysis of the world. With the technical skills and required in the STEM field. It places them in a better position to take on the roles in the sector. The social and communication challenges that individuals with ASD face forms a barrier which prevents them from securing employment opportunities that are well qualified to perform. Therefore, addressing these barriers will improve their chances to take on the roles because they have the skills together with their trustworthiness, loyalty, exceptional attention to detail, and a good memory linked to them. From this, individuals with ASD are in a better position to take on the roles in the STEM industry only that, there are challenges that prevent them from assessing them.
References
Bury, S., Hedley, D., Uljarević, M., Dissanayake, C., & Gal, E. (2018). If you’ve employed one person with autism ...: An individual difference approach to the autism advantage at work. Autism. https://doi.org/10.1177/1362361318794937
Chen, J. L., Leader, G., Sung, C., & Leahy, M. (2015). Trends in employment for individuals with autism spectrum disorder: a review of the research literature. Review Journal of Autism and Developmental Disorders, 2(2), 115-127.
de Schipper, E., Mahdi, S., de Vries, P., Granlund, M., Holtmann, M., Karande, S., ... & Zwaigenbaum, L. (2016). Functioning and disability in autism spectrum disorder: A worldwide survey of experts. Autism Research, 9(9), 959-969.
Lee, E., Black, M., Tan, T., Falkmer, T., & Girdler, S. (2019). “I’m Destined to Ace This”: Work experience placement during high school for individuals with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 1-13.
Wei, X., Jennifer, W., Shattuck, P., McCracken, M., & Blackorby, J. (2013). Science, technology, engineering, and mathematics (STEM) participation among college students with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 43, 1539-1546.
NURSING CARE PLAN FOR PATIENT WITH GASTROENTERITIS
Year 2 Care Plan Format
Organization of Data
Nursing Diagnosis
Expected Outcome (Goals)
Nursing Interventions/Strategies
Evaluation
Subjective (S): (mother)
· Abdominal pain
· Vomiting
· Loose stool
· No urine with the last eight hours
· Cold skin
Objective (O):
· Facial grimace
· Irritability
· Dry skin
· Cracked lips
· Decreased skin turgor
· Redness of the skin in the perineal area
· Dry mucous membrane
· The patient does not produce tears on crying
· Acute pain related to the medical condition as evidenced by abdominal pain, facial grimace, and irritability (HIGH)
· Fluid volume deficit related diarrheal stools as evidenced by lack of urine for past 8 hours, decreased skin turgor and Patient not producing tears on crying (HIGH)
· Impaired skin integrity related to persistent passing of loose stools as evidenced by dry skin, cracked lip and dry mucous membrane (INTERMEDIATE)
· The child will report a decrease of pain within 30 minutes
· The patient will demonstrate relaxation skills and free of pain within 1 hour
· The child will be hydrated and initiation of oral drinks will be done within 24 hours
· The child will not experience skin break down and cracks within 24 hours
· Monitor for the need for pain relief
· Removal of additional stressors or any source of discomfort as much as possible
· Determination of the appropriate pain relief method
Rationale:
· Monitoring of the pain will help I early identification of a need to relieve pain which might reduce the amount of analgesic needed for the child
· Clients may have decreased the ability to tolerate painful stimuli in the cases where there is additional stressors resulting from the environment, intrapsychic and intrapersonal factors (Wayne, 2016a).
· Patients with acute pain are usually administered with non-opioid analgesics unless it is contraindicated for the patient
· Monitor fluid input and output and keeping proper documentation of the information
· Monitoring of the weight of the child and comparing with the one taken during the admission
· Assess the level of consciousness of the child, the skin turgor, membranes, the color of the skin and temperature, capillary refill and eyes every four hours
Rationale:
· Monitoring input and output will help in determining if production exceeds input. An extended period of urine output might indicate signs of reduced renal function (Wayne, 2016b).
· Monitoring of the weight of the child will help in the determination of the degree of dehydration. It will also help in monitoring the effective of rehydration process being done
· Assessing the elements will help in identifying the degree of hydration of the child.
· Assess the skin of the perineal area for signs of skin breakage including the rectum or if there is irritation.
· Change diapers two hourly or as need be
· Application of A & D ointment four times or more each day
Rationale:
· Early assess, and provision of necessary services can reduce chances of the condition worsening.
· Changing diapers every two hours reduces contact that occurs between the skin and chemical irritants that are present in the urine and stool (Wayne, 2018).
· The ointment protects intact or reddened skin and act as a barrier and from being excoriated (Belleza, 2018).
The child reported a decrease in pain, and she demonstrated relaxation. The goals were met. However, the nursing care plan will be continued to facilitate comfort
The child has a normal fluid volume which will be shown by physical examination and lab evaluation. The goal is met.
The nursing care plan should be discontinued
There was a significant recovery and reduction of redness and cracking. The goal was partially met — nursing care plan to be continued.
References
Belleza, M. (2018). Gastroenteritis Nursing Care Management. Retrieved 8 October 2019, from https://nurseslabs.com/gastroenteritis/
Wayne, G. (2018). Impaired Tissue (Skin) Integrity – Nursing Diagnosis & Care Plan. Retrieved 8 October 2019, from https://nurseslabs.com/impaired-tissue-integrity/
RNpedia. (2015). Gastroenteritis Nursing Care Plans. Retrieved 8 October 2019, from https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/gastroenteritis-nursing-care-plans/
This website is owned and operated by PFS Limited.
Company Registration office is at:
2875 NE 194st St 404, Miami, FL 33180
Edudorm.com provides writing and research services for limited use only. All the materials from our website should be used with proper references and in accordance with Terms & Conditions
