Name

Location

Email

Cell phone

Objective

Dedicated graduate RN pursuing a career in the medical organization that will benefit from my education and the skills to provide the best care to the patient and community. Committed to offering best of care through effective education and counselling. Proven in leadership and pose a high ability for enhancing patients care and satisfactions and streamlining safety protocols for comprehensive patient care. Friendly and compassionate with excellent communication skills, flexible; available days, weekends, afternoons, weekends and holidays. Discreet and confidential in all dealings with patients and staffs.

Highlight of expertise

• Nursing Skills
• Ability to with stand pressure
• Fast learner
• Excellent communication skills
• Computer skills in MS Office, Outlook and Excel
• Strong organizational skills
• Trilingual
• Medical record keeping
• Solid interpersonal skills and objective oriented
• Strong customer services
• Strong organizational skills
• Energetic work attitude
• Conflict resolution
• Direct patient care
• Strong Critical Judgment
• Case management

Work experience

 Currently a Case Manager in a Mental Health Program

Duties include;

• Helping mental health clients attain their recovery goals and ensure patients get the best service from the program
• Helping patients access appropriate public mental health services when required and make sure that the patient is responding to the health services being offered.
• Examining the mental and physical state of patients, in addition to examining the co-occurring mental health and substance abuse.
• Collaborate with other team players to prepare treatment plans that are designed to meet the treatment needs of various patients. Involving the patients’ families and advocates in making decisions on treatment.
• Liaise with the patient to talk about the emotional wellbeing of the patients, how well they are able to deal with stress and illnesses, friendship and relationship with others and the daily living skills of the patient.
• Ensure that the privacy of the patient is respected.
• Help patients talk about their current situation and together establish goals that should be worked towards. Make decisions who will be involved in the treatment plan and talk on the strategies that will be used to reach these goals.
• Help patients learn coping skills that will create stability in their lives.
• As treatment progresses asses the mental health of the patients to measure their ability to exist and live together with others in the real world.
• Manage the files of the patient by adding notes to the records of patients based on the assessments and regular evaluations.
• Review progress notes in the patient’s files that are written by other members of the treatment team.
• Oversee the creation of individualized treatment plans for the patients that will help them met desired life goals. And collaborate with the rest of the medical team including doctors and nurses.
• Resolve crises and complaints in patient’s cases as they arrive.
• Oversee the completion of patients’ disability and insurance paper work as needed and make sure the paper work is properly documented.
• Cooperate with the rest of the team to design an after care treatment plan for patients that are being released from the program after successful completion of the treatment.
• Conduct house meetings to patients who have been released to check on their ongoing mental health and evaluate the progress and changes they are making.
• Provide a comprehensive case analysis for all patients enrolled into the program and ensure patients have access to specialized care.

Education Background

Intravenous Therapy Certificate Program

Substance use disorder testing instrument

Alcohol Use Disorders Identification Test (AUDIT)

Alcohol Use Disorders Identification Test (AUDIT) is a screening tool that is used to identify the level of alcohol consumption. It is used to help risky drinkers or individuals who drink too much and suffer from harmful consequences such as physical or mental harm, and other alcohol-related problems (Biddle & Babor, 2018). Many excessive drinkers go undiagnosed, but with this tool, the health care practitioners or non-health professionals can identify whether an individual had alcohol dependence. AUDIT is administered through a lifestyle questionnaire in primary care settings. Note that some patients may be unwilling to answer alcohol-related questionnaire or admit that they have alcohol-related problems. Factors such as alcohol intoxication and mental impairment may hinder clients from answering the questions correctly. However, research finds that there are factors that influence the patient to answer questions correctly. They include; a friendly interviewer, straightforward questions, confidential information, the screening is done when the patient is sober, and the purpose of the questionnaire is clearly stated (Biddle & Babor, 2018). Therefore, health care practitioners should ensure that these conditions are present to meet the goals.

Healthcare practitioners should not interview severely impaired patients. They should wait for the patient to be conscious and comfortable with the condition and also with the primary care setting (Biddle & Babor, 2018).  When the patient is stable, the health worker should inform the patient about the purpose of the interview and the questions to be asked. For example, the health worker can start by saying 'Now, I would like to know your drinking habits of alcoholic beverages such as beer, whiskey, wine, vodka, among others, in the past year. I request you to be truthful so that we can identify whether alcohol has impacted your health (Biddle & Babor, 2018). After giving an illustrative introduction, the health worker should start asking questions such as ‘do you drink alcoholic beverages?  How often?  When was the last time you drank?  Have you ever experienced health problems such as memory loss?  When asking these questions, the health worker should record answers since they will be used for interpretation.

  In interpreting results, the health care practitioner will evaluate the scores. For example, the points may be from 0-10. Low risks will be 0-4, while high risks will be five or greater.  0-4 means that the patient does not have alcoholic problems, and five or higher means that the patient is drinking too much, and he should stop drinking altogether (Meneses-Gaya et al., 2009).  The healthcare professional should help the patient stop drinking. He should evaluate the alcohol use disorder such as patients consume alcohol in large amounts; patients do not desire to cut down alcohol use; patients spend much time using alcohol, among other symptoms. If the health care practitioners confirm that there is a potential alcohol problem, he should educate the client on the effect of alcohol use, provide materials and services, and build a strategic alliance with NGO and religious groups (Meneses-Gaya et al., 2009). Note that the ultimate goal of alcohol disorder testing is to help the patient reduce drinking. Thus, after conducting the diagnostic system and evaluating the nature of problem drinking, health practitioners can provide other interventions such as environmental-level interventions and individual-level intervention.  The former intervention aims at controlling the availability of alcohol, and the latter aims at changing the client's attitudes (Meneses-Gaya et al., 2009). In both responses, schools and families, should intervene and help clients, especially youth, to stop drinking by providing knowledge, skills, rules, and expectations.

References

Higgins-Biddle, J. C., & Babor, T. F. (2018). A review of the Alcohol Use Disorders

Identification Test (AUDIT), AUDIT-C, and USAUDIT for screening in the United

States: Past issues and future directions. The American journal of drug and

alcohol abuse, 44(6), 578-586.

de Meneses-Gaya, C., Zuardi, A. W., Loureiro, S. R., & Crippa, J. A. S. (2009). Alcohol Use

Disorders Identification Test (AUDIT): An updated systematic review of psychometric

properties. Psychology & Neuroscience, 2(1), 83.

Assignment 2

Risk assessment checklist

 The purpose of assessment is to improve the treatment plan of clients with the co-occurring disorder (COD) while screening is a testing process to identify a particular disease and determine whether a further assessment is needed (SAMHSA, 2005).  In screening, health care practitioners apply basic counseling skills to ensure that if the client screening turns out positive, a thorough assessment is needed. Therefore, assessment involves understanding the nature of the problem and developing treatment planning. Unlike screening, the assessment goes further to obtain demographic information, problem areas, stage of treatment, and severity of the COD. The main role of assessment is to ensure that the client receives the appropriate mental disorder care (SAMHSA, 2005). Before creating the risks assessment checklist, it is important to understand that risk assessment identifies the harm that the client with mental and substance problem may cause to self or others.  From interview and observation, the health care practitioner can identify dangerous behaviors. 

Questions during the risk assessment

• Have you had any thought of ending your life or life of others?
• How do you feel at the moment?
• Have you ever had emotional problems?
• Did you talk to a counselor concerning the emotional problems?
• Have you ever had anxiety attacks?
• Are you aggressive?
• Do you need a remedy for these problems?
• Which method of treatment do you prefer?
• Do you have an interest in change?

 Risk assessment checklist

The above criteria is used to determine if the client has a serious mental problem and a substance abuse problem. The psychiatrist should assess the severity of the symptoms and determine if the client needs a substance abuse treatment. Before initiating treatment, the practitioner should find out if the client is taking any medication, and if he is visiting any mental health manager (SAMHSA, 2005). The purpose of asking this question is to promote collaboration and case management. The practitioner should also assess the strengths and supports to understand if the client can manage his condition. This promotes treatment engagement, especially for patients suffering from substance use disorder. Note that some clients have talents and interests, motivation to change, among other factors that may promote positive substance abuse outcome (SAMHSA, 2005). In providing treatment, it is essential to consider cultural needs through conducting the cultural assessment. Note that some patients may cause conflict in treatment to cultural issues. Thus, the practitioner should provide an individualized intervention concerning cultural factors. Another critical point is that the practitioner should create a therapeutic alliance to motivate the client to engage in a treatment plan (SAMHSA, 2005). Clinicians should also aid in recovery, which means that they should help clients change behaviors and live a meaningful lives, and more importantly, develop the ability for self-care, care for others, and self-worth.

Reference

Substance Abuse and Mental Health Services Administration. (SAMHSA). (2005). Substance abuse treatment for persons with co-occurring disorders: Treatment Improvement Protocol (TIP) Series, No. 42. Center for Substance Abuse Treatment

Strategic issues affecting Healthscope

Introduction

Medical institutions bear the responsibility of ensuring that everyone has access to the highest quality of medical care. Patients on the other hand expect the caregivers to maintain professionalism and offer the best care possible. Positive relationships between patients and caregivers are therefore important as they make it easier for caregivers to help patients because of the trust established between them. While the aim is to always have a positive impact on society, there are occurrences where health institutions encounter disputes with their patients and this makes it difficult to offer medical care. Various challenges exist in the medical field that create both challenges and opportunities for any medical institution. Healthscope, being in charge of various small hospitals in Sydney, often encounters various challenges that have significant impact on the way the hospital operates.

Strategic issues analysis

1. Medical reimbursements

One of the strategic issues that is likely to have an impact on Healthscope in the near future is the issue on medical reimbursements resulting from errors made by its caregivers. The institution is governed by laws and policies that place emphasis on preserving life and offering the best quality of medical care (Gawande, 2003). The health institution also has a moral obligation to preserve the well-being of all its patients. Other than a morally influenced code of ethics, the institution practices a great deal of professionalism when attending to patients to ensure that the best quality of medical care is provided. There are however occurrences where mistakes occur and the patients incur some form of harm or loss while under the hospital’s care.

            Medical reimbursements occur when the hospital engages in acts that cause harm to the patient either through the patient’s interaction with the hospital or with the caregivers that attend to patients. A good example of an incident that could result to patients seeking medical reimbursement is in relation to accidents made during surgery (Gawande, 2003). The emergency rooms at Healthscope are busy and doctors have to work around the clock attending to patients with different needs. Even with the careful considerations taken by the institution to hire qualified personnel, mistakes tend to occur especially during surgery. The mistakes result from various factors such as human error caused by fatigue, misdiagnosis or unavoidable circumstances that negatively impact the quality of care provided.

            Similar to other institutions, Healthscope is expected to notify all patients of any mistakes made during treatment while the patient was under their care. Notifying the patient is not only a legal requirement but also a moral obligation and fulfilling it is the responsibility of all employees working for the medical institution. When such accidents do occur the actions taken by the institution greatly determine the repercussions that will follow (Spath, 2011). In some cases, the accidents do not have major impact on the patient and the negative repercussions are not always serious. In such cases, the health institution has an easier time explaining to the patient what happened and what it intends to do in order to rectify the mistake made. There are however instances where the mistakes result to serious ailments, harmful side effects and even death (Spath, 2011). Healthscope faces major strains when resolving such issues especially in cases where the patients decide to take legal action.

            Healthscope incurs significant losses through medical reimbursement regardless of whether patients seek legal action or not. Since the institution is guided by a moral code, it takes on the responsibility of covering all costs incurred by the patient in rectifying the harm caused by mistakes made by its medical practitioners (Jenicek, 2010). Other than settling lawsuits, the institution also pays for treatment and compensation to patients to ensure that the mistakes made do not alter the relationship that the institution has with its patients (Spath, 2011). Since the goal is always to offer the best quality of medical care, settling the dispute also means maintaining a positive image and good relations with its patients.

            The cost that Healthscope incurs is not just as a result of the mistakes that its members of staff make but also errors on the side of its patients. When patients visit any health institution seeking medical help, the have some level of expectancy and want the best care possible. With such expectations, any treatment is expected to offer some form of relief provided that the patient follows the guidelines provided for by the caregiver (Olsen et al, 2010). Caregivers on the other hand have to provide all relevant information to patients regarding treatments, their condition and any side effects that may come about from the type of treatment the patient received. The complex nature of the human body however makes it difficult for caregivers to anticipate all possible outcomes that could result from a specific treatment regimen or from the medication patients take. While the caregivers try to ensure that all the information they have is shared with the patient, patients believe that as caregivers, all information, regarding negative side effects is something that health institutions should know (Patel & Rushefsky, 2014). As such, some mistakes may result from the patients lack of knowledge and despite the institution’s attempt to keep the patient informed, an unexpected outcome arising from the services offered by the institution are often treated as mistakes made by the organization and not its patients.

With the various advancements in technology and treatment methods, the care givers have a hard time keeping up with the changes introduced. New treatment methods are being introduced along with different forms of medicine whose effects on the body have not been fully understood. However, since these developments are intended to improve the quality of health, doctors have to learn as much as they can to reduce errors and misdiagnosing patients (IOM, 20003). Despite their efforts however, patients still expect the high standard of quality offered by most medical institutions and any mistakes often create challenges that the institution has to overcome.

1. Diversity

Another strategic issue that is likely to have a significant on Healthscope is the issue of diversity. With the workforce in all fields becoming more and more diverse, health institutions have to adapt to these changes not only in the way they handle their employees but also how they treat patients (KAbene, 2010). On the side of employees, Helthscope bears the responsibility of creating a conducive working environment for all members of staff. Medical practitioners in different departments require an ideal environment to treat and attend to employees. The nature of the environment and the working conditions determine the quality of service offered to patients. When the environment meets the standards expected by caregivers and the patients, the treatment process runs smoothly and better results are achieved.

In order to create the ideal working environment, Healthscope has to factor in the needs of the employees while taking into consideration the different requirements that people have depending on their culture. A good example is the case of mercy killings where care givers have to make the decision between preserving a patient’s life for as long as possible or ending it in order to protect he patient from the pain and suffering caused by the disease (Kabene, 2010). In some cultures, the act of taking one’s life is looked down upon as it is considered immoral not just in society but in the eyes of God. Since God is the creator, some believe that only he is responsible for determining when people die. In such cases, mercy killings, regardless of their benefit to the patient, are not condoned and care givers that belong to those cultures against them cannot execute such treatments. It is therefore important to consider diversity and its implications before assigning duties to caregivers (Kelley & Fitzsimons, 2000). Doing so will ensure that practitioners are capable and comfortable executing their responsibilities and that the care offered to patients is based on principles that agree with the customs and traditions of both the care giver and the patient.

Another major issue that Healthscope has to address in relation to diversity is the precaution that care givers have to exercise when treating patients.  Most, if not all, patients live their lives in accordance with their culture.  Their culture dictates the customs and traditions that different individuals practice (Szinovacz & Davey, 2008).  Due to the varying beliefs held by people from different cultures, people have different opinions regarding what is acceptable and what is not.  The differences extend to different aspects of life including health-care and some may consider certain treatments acceptable while others may turn them down if they are not in line with one's cultural practices. In a world that strives to embrace diversity, most institutions, including hospitals, have to adjust their business culture in such a way that their practices respect the customs and traditions of the people they interact with. 

When suggesting possible treatments with patients, for example, care givers must factor in the cultural group the patient belongs to so as to identify treatment methods or medication the person’s culture may object.  Culture has a string influence on the opinions ns and attitudes that people have about things they interact with on a daily basis (Good, 2011).  The customs and traditions have a huge impact on the personal identities that people have.  It is therefore a huge determinant if the things that people consider acceptable.  When offering treatment methods, care givers are required to discuss the procedures with the patient and explain what the treatment seeks to achieve.  Since the caregiver is required to share all relevant information, it is important to consider how the patient will react to treatment methods or medicine that may not be acceptable to the patient's culture (Good, 2011).  Helthscope must therefore educate it's caregivers on the importance of culture and why they need to gain knowledge about the diverse cultures that the patients belong to.  Since each culture has its set of acceptable norms, learning the different practices will make it easier to identify what an individual prefers and what will be considered unacceptable. 

The same approach should be observed when offering methods to prevent diseases.  In some cultures for instance, the act of vaccinating children is looked down upon and some mothers may choose to prevent their children from being vaccinated.  The decision is made despite having full information regarding the harm that the disease could cause if one gets infected (Good, 2011).  Despite people's desire to maintain good health.  Some customs and traditions may go against medical caregiver’s attempts to offer the highest quality of medical care.  Some parents decide to prevent their children from being vaccinated because their culture does not allow it. Caregivers must therefore find alternatives to the disallowed medical care or find a way to convince the patient to go against their culture for the sake of their well-being or that of a loved one. 

• Technology

            Like most organizations, Healthscope has to adapt to the various technological advancements occurring in the environment it operates in.  The incorporation of technology into most aspects of human life has made it a major necessity for businesses that seek to remain competitive (Audrain et al, 2017). Healthscope, being a business is pushed by both the desire to remain competitive and also offer the best medical care to its patients. In order to achieve this it, has to incorporate the use of different forms of technology so as to improve the quality of service offered. While adopting different forms of technology is intended to improve the quality of care for patients, its implementation may prove challenging for organizations in various ways.

            To begin with, the cost of purchasing equipment and training members of staff to use it is quite expensive. The quality of care that the organization strives to achieve requires state of the art technology which is often expensive (Hoyt et al, 2012). Purchasing the equipment adds on to the cost incurred to run Healthscope and this puts on a strain to the financial capability of the organization. In addition, technology keeps advancing and innovations lead to more advanced forms of technology being discovered. Healthscope therefore has to keep updating its technology and further train its employees to adapt to the changes introduced.

            Another challenge that inclusion of technology in care giving creates has to do with training medical practitioners how to operate the technology. Often times, technology is intended to improve quality by reducing the mistakes that occur due to human error. Despite the effectiveness of machines however, their success is also based on the capability of the people tasked with operating the technology (Eaton & Kennedy, 2007). Once technology is introduced into the organization, caregivers are required to enroll in different training practices meant to teach the members of staff how to operate the new technology. On the positive side, the training helps to improve the quality of care offered as care givers become more efficient and make fewer mistakes when aided by technology. There is however a downside in that the training adds on to the caregivers’ workload as they have to attend training and still carry out their responsibilities. Given the busy schedule of medical caregivers at Healthscope, the added responsibilities make performing more strenuous and the period during which new technology is introduced could negatively impact the quality of production offered (Patel & Rushefsky, 2014). This combined with the fact that technology is constantly evolving means that caregivers have to constantly learn different ways to use the technology and adapt to whatever changes come about.

            Technology also impacts on the quality of service offered especially when explaining to patients why a certain treatment method is better than the other. As is stipulated by the policies governing Healthscope and its own code of conduct, care givers have to explain treatments to patients before carrying them out in order to keep the patient informed. Since caregivers cannot carry out treatment without the patient’s consent, the inclusion of technology makes it harder for patients to convince patients to approve some treatments (IOM, 2003). The inclusion of technology makes the treatment process more complicated especially when dealing with a patient that does not understand how the technology will help. More time is spent explaining to the patient how the inclusion of technology is beneficial.  

            Even when the patient understands how technology stands to help, the treatment is often expensive and those without insurance covers have a hard time affording the high costs. While the quality of care is improved, patients have to incur the cost of care either directly or through their insurance agencies (Patel & Rushefsky, 2014). Some may opt out of treatments that are too expensive and this beats the purpose of incorporating technology in medical care in the first place. Care givers face a hard time convincing patients to choose the best level of care and in cases that require prompt treatment, delays in decision making result in more complications, or even death.

CEO leadership

            As CEO of Healthscope, the plan to improve efficiency at the organization will place emphasis on using the opportunities created in the environment the health institution operates in. while the three strategic issues pose major challenges for the organization in the near future, the same strategic issues can be utilized to create more opportunities than challenges. To overcome the challenges identified, I will engage all employees and stakeholders because they input will help the institution adapt to the changes and overcome the challenges.

The first step in the plan will be to ready Healthscope for the various technological advancements that are likely to occur in its immediate environment. Rather than waiting for new technology to be introduced and then try to adapt, the organization will instead assess the environment it serves and identify technological trends likely to occur in the near future (Gawande, 2003). Collecting data on technological trends will give Healthscope enough time to identify which direction technology in the medical field will be take early in advance (Jenicek, 2010). Early identification will make it easier for the organization to adapt as those in charge of incorporating technology into practices carried out within Healthscope will have enough time to prepare for its implementation. Early identification will enable better training as care givers will be trained early in advance on how to use the technology introduced. It will also help reduce the strain caused to fund new purchases as the organization will have enough time to budget for the technology as well as find ways to source funds to facilitate acquisition, implementation and training.

In relation to training, knowing which technology to implement in advance as well as the innovations likely to occur will help the organization to better plan the training programs for care givers. Rather than rushing to adapt to new innovative technology, keeping up with trends will keep the organization informed enough to prepare training routines meant to equip care givers with the skills and knowledge needed to operate not only the technology currently in use but also any innovations likely to occur in future (Kabene, 2010). The training routines will also be properly managed and their timing will be allocated in such a way that they do not become a burden to care givers (Kabene, 2010). To enhance efficiency, training will occur while the caregivers carry out their duties. This will help prevent interruptions to the flow of work. It will also speed up learning as care givers will be more likely to outdo themselves when their actions impact on the quality of care offered.

Other than training caregivers to use modern forms of technology when issuing treatments, the plan will also seek to educate them on the importance of culture. Often times, conflict resulting from differences in culture is caused by the belief that one culture is superior to another. When people develop the belief that their customs and traditions are more important than those practiced from people with different cultural backgrounds, they are less likely to respect the different opinions that their colleagues may have (Good, 2011).  As CEO, the goal will be to educate all employees on how to respect other people’s culture not only in the workplace but also when interacting with employees. If successful, care givers will be in a better position to help the patients because the form of treatment they suggest will take into account what is acceptable for the patient and what is not. Medical practitioners will also have an easier time working together as the diverse environment they work in will be free from negative attitudes caused by lack of understanding each other’s culture (Good, 2011). Colleagues will not only be aware of the different practices observed by other cultures, they will also know how their culture differs from others and why respecting these differences is crucial to maintaining the ideal working environment established.

Cultural awareness combined with the training that members of staff receive will go a long way towards reducing the cost incurred by Healthscope due to medical reimbursements. The errors that result in medical lawsuits occur due to human error and fatigue. Despite the challenges it creates, the introduction of technology in the medical field will help reduce some of the mistakes that care givers make due to fatigue (Kelley & Fitzsimons, 2000). Since machines do not get tired like humans, the quality of care will remain constant and free of errors. Patients will also receive better care as the technology will improve on the treatment method offered at Healthscope.

The technology will also make it easier for caregivers to research about the treatment methods they suggest to their patients. Unlike in the past where research was tedious and t8ime consuming, caregivers can easily research information about a disease or treatment regimen on the internet. While there is a significant amount of false or misleading information regarding health on the internet, caregivers can use their knowledge and experience to only rely on sources that are credible and discuss relevant information (Patel & Rushefsky, 2014). Caregivers will be able to research on a possible treatment, the type of medication that is likely to have the most effect and also the possible side effects that could come about from following the treatment program. Better access to such information will reduce the chances of the institution being sued as all factors will be taken into consideration before giving the go ahead for treatment.

The different forms of technology will further be used to enhance efficiency at the institution. Caregivers will receive training on how to keep electronic records for all patients that receive treatment at Healthscope. Since different medication has been proven to react differently when taken together, the records kept by the health institution will make it easier to track down all the treatments that the patient is under at the simple click of a button (Patel & Rushefsky, 2014). On top of consulting all caregivers attending to a patient, practitioners will just be required to access the patients file as all the information regarding treatment will be made available to all significant caregivers to help reduce wrongful treatments.

            The plan seeks to exploit the challenges it faces and turn them into opportunities. One way to achieve this is through the legal requirement for all practitioners to inform patients of any accidents, wrongful treatment or conduct that put the patients’ health at risk. Regardless of the negative repercussions that follow such as lawsuits and compensation sought by patients, reporting it can be used to an advantage by Healthscope. On the one hand, the health institution should strive to have the least number of medical accidents as proof of its quest to offer the best possible care to its patients (Audrain et al, 2017). Having the lowest number of lawsuits or cases where patients incurred some form of harm while under Healthscope’s care will maintain the positive image that the institution strives to achieve. The institution will therefore strive to maintain the highest quality of care so as to keep the medical mishaps as low as possible.

            Consecutively, reporting all medical mishaps as soon as they occur can also be used to benefit the institution. Since errors are prone to occur, Healthscope should ensure that it acts quickly to inform those affected. The institution should also take immediate action to rectify the mistakes made and compensate those affected (Audrain et al, 2017). The quick reaction and honesty in informing those affected will be seen as the institution’s commitment to help even when it is at fault and taking accountability for the role it played. Healthscope should however ensure that such mistakes are not common.

Conclusion

            The strategic issues that Healthscope has to overcome are as a result of the changes that occur in the environment it operates in. the change is caused by the various activities that human beings engage in trying to improve their way of living. The reliance on technology is meant to make things easier and also enhance safety and the quality of life. As such, people have in turn evolve to demand higher standards of quality in all aspects of life including health. Since technology is associated with improved quality, health institutions have adopted technology and incorporated it into its practice. Despite the challenges that come about, the same technology can be used to benefit Healthscope if used to overcome the challenges that exist in the environment it operates in. As Healthscope improves its quality of care it will continue to attract more people and lessons taught on embracing diversity will make it easier to handle employees and patients from all types of backgrounds. The plan will therefore make Healthscope better prepared to overcome the challenges it is likely to face in the near future and retain its policy of offering the best quality in medical care.

References

Eaton, M. L., & Kennedy, D. L. (2007). Innovation in medical technology: Ethical issues and      challenges. Baltimore: Johns Hopkins University Press.

Gawande, A. (2003). Complications: A surgeon's notes on an imperfect science. London: Profile Books.

Good, M.-J. D. V. (2011). Shattering culture: American medicine responds to cultural diversity.

Hoyt, R. E., Yoshihashi, A., & Bailey, N. J. (2012). Health informatics: Practical guide for         healthcare and information technology professionals. Raleigh, N.C.: Lulu.com.

In Menvielle, L., In Audrain, A.-F., & In Menvielle, W. (2017). The digitization of healthcare:    New challenges and opportunities.

Institute of Medicine, (2003) “Health professions education: A bridge to quality” National           Academies Press

Institute of Medicine, (2003) “The future of the public’s health in the 21^st century” National         Academies Press

Jeniceck M, (2010) “Medical error and harm: Understanding, prevention and control” CRC Press

Kabene, S. M. (2010). Healthcare and the effect of technology: Developments, challenges and             advancements. Hershey, PA: Medical Information Science Reference.

Kelley, M. L., & Fitzsimons, V. M. (2000). Understanding cultural diversity: Culture,      curriculum, and community in nursing. Sudbury, Mass: Jones and Bartlett.

Patel K and Rushefsky E, (2014) “Healthcare politics and policy in America” Routledge

Spath, P. (2011). Error reduction in health care: A systems approach to improving patient safety.            San Francisco, Calif: Jossey-Bass.

Szinovácz, M., & Davey, A. (2008). Caregiving contexts: Cultural, familial, and societal             implications. New York: Springer Pub.

Yong, P. L., Saunders, R. S., Olsen, L. A., & Institute of Medicine (U.S.). (2010). The healthcare             imperative: Lowering costs and improving outcomes : workshop series summary. Washington, D.C: National Academies Press.

Discussion: Basic Concepts of Physiology and Factors That Influence Disease

Nephrolithiasis kidney stones

Pathophysiology is a nursing practice where nurses focus on physiological processes that cause disease.  In order to make clinical judgments, nurses study the cause of disease, signs and symptoms, investigations and diagnosis, treatment, and prognosis (Huether  & McCance, 2008). These elements help nurses to make valuable discovery by understanding the human organs and the behavior of biological processes.

It is important to note that disease can be caused by many factors, such as genetic factors. McPhee & Hammer, (2014) states that some disorders are inherited or in other words, they occur due to alteration in the DNA sequence.  Other causes of genetic disease include structure re-arrangement that leads to deletion or duplication of genes.Another important point is that genetic condition may occur due to abnormal chromosomes during cell division.  Note that cells of an individual with the genetic condition have mutated genes which were inherited through sperm cell (McPhee & Hammer, 2014).  However, some cells may develop a new mutation in the body of the affected individual. Therefore, it is important to put into consideration the genetic background for a disorder to provide effective treatment and management for the disease.

For example, Nephrolithiasis kidney stones may occur due to genetic factors. These factors may impact Nephrolithiasis in that about 75% of stones contain calcium.  About 40%-50% of adult with nephrolithiasis have primary hypercalciuria, and 20% of patients report a family history of the condition (Khan & Canales, 2009).  Note that Nephrolithisisa occur when the kidney contain crystals or hard clumps of substances. The urine becomes supersaturated, and the levels of saturated are controlled by cells functions. Therefore, a patient may have crystal deposition in the kidney due to impaired cellular function. In other words, cellular dysfunction fails to regulate the excretion of calcium, oxalate, and citrate ions, and as a result, they cause kidney stones (Khan & Canales, 2009). In addition, renal epithelial cells support the crystallization inhibition, and this means that cells dysfunction will lead to ineffective crystallization inhibitors.  An important point to note is that many patients experience recurrent stone formation. For example, hypercalciuria (excess calcium), hyperoxaluria (excess oxalate) and hypocitraturia (excess citrate) have stone recurrences due to cellular dysfunctions.

 Focusing on genetic factors, kidney stones occur due to the development of supersaturating and crystallization.  These are formed in the kidney due to cellular defect. The cellular dysfunction occurs as a result of genetic modifications. For example, Hypercalciuria or excess calcium cause stone formation in the kidney. Soluble adenylyl cyclase (sAC) enzyme has hypercalciuria phenotype or genes for nephrolithiasis. sAC is found in male germ cells and it is expressed in kidneys (Khan & Canales, 2009). It also has a calcium-sensing receptor which is expressed in the parathyroid gland.  sAC causes intrinsic cellular dysfunctions and contributes to the stone formation by increasing the supersaturating. Some individual has soluble adenylyl cyclase gene mutations which cause cellular dysfunction and suppress the production of macromolecular inhibitors (Khan & Canales, 2009). As a result, the crystals grow and blocks the renal tubules.  Note that the participating ions regulate the urinary supersaturate. The ions may be affected by various genes which affect how cells respond. Mutations of these genes result in kidney stone formation (Khan & Canales, 2009). Most patients present symptoms, such as nausea and fatigue.  Recurring stones may present symptoms such as renal damage and kidney failure.  Thus, the interaction of genes should be an issue of concern in investigating stone formation in order to identity heritable components.

References

Khan, S. R., & Canales, B. K. (2009). Genetic basis of renal cellular dysfunction and the

formation of kidney stones. Urological research, 37(4), 169-180.

 Huether, S. E., & McCance, K. L. (2008). Understanding pathophysiology. St. Louis, Mo:

Mosby/Elsevier.

In McPhee, S. J., & In Hammer, G. D. (2014). Pathophysiology of disease: An introduction to

clinical medicine. McGraw-Hill Education Medical,

 Ethical principles of nursing

 First scenario

In the first scenario, I would apply the principle of respect for autonomy (Rumun, 2014). Note that the patient has moral value and dignity, and I would respect her choice to reject my recommendation as a physician. I have the confidence that blood transfusion will save her life, but because she refuses medical intervention because of her religious beliefs, I would respect her beliefs and set aside my own beliefs. As a young mother/patient, she very well knows that as a physician, I recommend what is best. However, she holds her religious principles tightly, and for this reason, I would respect her beliefs since it seems like they are significant to her health.

 Second scenario

 In this scenario, I would apply the principle of beneficence. In other words, I would provide the older person who has no family with emergency care. Note that as a physician, I am the first person on the scene and since the older person has a life-threating emergency, I would put the principle of beneficence into practice and save the patient's life (Ludwick & Silva, 2003). I would try too hard to do good to improve the patient's health.

 Third scenario

            In this scenario, I would apply the principle of beneficence. I would accept the husband's decisions with the motive of promoting good and minimizing harm (Bester, Cole, & Kodish, 2016). Note that in this situation, the female patient is unconscious, and this means she cannot decide on the treatment. In other words, she is not capable of giving informed consent.  Since this is an emergency, I would accept the husband's decision and administer emergency treatment (blood transfusion). The husband should decide on behalf of the female patient so that we can protect the patient from harm.

References

Rumun, A. J. (2014). Influence of religious beliefs on healthcare practice. International Journal

of Education and Research, 2(4), 37-47.

Ludwick, R., & Silva, M. (2003). Ethics Column:" Ethical Challenges in the Care of Elderly

Persons. Online Journal of Issues in Nursing, 9(1).

Bester, J., Cole, C. M., & Kodish, E. (2016). The limits of informed consent for an overwhelmed

patient: clinicians’ role in protecting patients and preventing overwhelm. AMA journal of

ethics, 18(9), 869-886.

 Introduction

            According to modern medical research, the prevailing diagnostic tests that are commonly used are considered to be one of the regulated activities that are solely carried out by nurses or medical professionals. Despite that, the truth is that the medical assessment and evaluation of a patient is something occurs as a result of seeking further investigations that can be aid as the fundamental element in nursing exercise (Trigg et al., 2010).   Although there are various studies that have been conducted for the purpose investigating the significance of the prevailing diagnostic tests, it is the responsibility of the medical professionals, parents, and caregivers to ensure that they have chronologically and critically appraised the evidences obtained from such studies. The reason for that is because it is the one that will have the possibility of ensuring the proper use of the best diagnostic tests (Shung et al., 2014). 

            On the other hand, what this implies is the fact that the general usage of the diagnostic tests, particularly X-rays, will have to be appraised through the use various criteria that are aimed at investing the perceived therapeutic or preventive measures. As a result of that, it will be important to take into consideration its sensitivity, specificity, positive and negative predictive values that come as a result of using them. Taking that into consideration implies that it is the one that will aid in determining whether it will assist in alleviating the condition of the patient. The various X-ray diagnostic tests that are carried out are aimed at removing uncertainty and anxiety in a patient (Swain et al., 2009). In this assignment, the use of X-rays will be evaluated for determining its effectiveness in the curing or managing various patient ailments.

A description of how the assessment tool or diagnostic test you were assigned is used in healthcare what is its purpose?

            According to modern clinical researches, X-rays are used by medical professional to create a visual representation of the internal human organs. The reason as to why such a diagnostic test is carried out is to assist medical professionals to carry out medical analysis and other associated clinical interventions. The same procedure will have to be conducted by clinicians so as to have a clear visual representation of the internal functioning of various organs or tissues. This is to imply that the aim of such a procedure is to assist in revealing internal human structures that are hidden by bines and the skin and also to aid in diagnosing and administering treatment (Nadine & Andrew, 2010).

             On the other hand, the use of such medical imaging is also aimed at establishing a clinical database of physiology and normal anatomy so as to enable the medical professionals to have the potential of identifying the patient’s abnormalities. It should be understood that although the use of this medical imaging for removed tissues or organs can also be conducted for various clinical reasons, those clinical procedures are regarded as being part of pathology. In conducting such procedure, it will also have to take into account the progress of other associated conditions of the patient, for instance, breathing difficulties, wheezing, or coughing (Trigg et al., 2010).  

How is it conducted?

            X-rays, as one of the medical imaging tests is conducted so as to enable the doctors to have the potential of viewing the physiology of the human internal organs or tissues. That in return assist in creating a clear picture of all the structures as well as the activities they undertake inside the human body. Ideally, in order to carry it out, once the patient have been prepared in to undergo such a procedure, the medical professional will have to ensure that he or she has instructed the patient on how to position his body so as to create clear internal body images. During such a procedure, the patient will be supplied with comfortable and loose clothing to wear (Kennedy et al., 2014).  Moreover, the patient can either be required to stand, sit, or lie down in the process of imaging his or her internal organs. For instance, the physician can take the image of the patient while standing in front of a specialized plate containing X-ray sensors or film. Equally, the patient can instructed to sit or lie on a specialized plate before moving a camera fixed to a steel arm so as to capture his or her X-ray images. To capture clear images, the patient will have to be reminded to stay still (Aichinger et al., 2004). 

What information does it gather?

            In the modern medical world, X-rays as one of the medical imaging techniques are used for the purpose of assisting in diagnosing and treating various ailments without inducing harmful side effect to a patient. This then implies that X-rays ultimately remains to be one of the important means of understanding the physiology of the internal organs of the patient without the need of invasive procedures or surgery (Nadine & Andrew, 2010). Ideally, X-rays are carried out to aid in examining an area where the patient might be experiencing discomfort or pain. It is also taken for monitoring the progression of any diagnosed ailment as well as checking how the treatment administered is working. The most common usage of X-rays involves checking broken bones, spotting pneumonia, tooth decay, digestive problems, and so on (Patrick, 2016).

Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values

            As much as the use of X-rays in medical field is concerned, what have to be taken into consideration is its dependably in diagnosing the perceived ailment or disorder. What this implies entails determining whether the patient will have the propensity of receiving the same results after being subjected to subsequent procedures. In the process of subjecting the patient to such a procedure, it is, therefore, important for parents or guardians to understand that he or she can experience some discomfort or pain. In order for the doctor to take accurate internal images concerning the physiology of the organs, it is important to stick to the instructions given before the exercise is undertaken. To improve its functionality the doctor can also provide the patient with painkiller beforehand (Aichinger et al., 2004). 

            In accordance to that, the X-ray test performance is also influenced by the patient’s physical or psychological state during the time of testing. Fatigue, motivation, and the patient’s levels of anxiety also have the ability of impacting the test result to be collected. What that implies is the fact that the predictive values being obtained will ultimately rely on the judgment of the rater or the doctor. Basically, random errors of measurements are what will enable the doctor to collect accurate measurement hence improving the sensitivity and the reliability of the tests carried out. Because of that, it because possible to produce repeatable, consistent, and dependable results concerning the ailment of the patient (Shung et al., 2014). 

                                                            References

Aichinger, H., Dierker, J., Joite-Barfuß, S., & Säbel, M. (2004). Radiation Exposure and Image Quality in X-Ray Diagnostic Radiology: Physical Principles and Clinical Applications.

In Trigg, E., In Mohammed, T., In Ford, L., In Montgomery, H., & In Vidler, V. (2010). Practices in Children's Nursing E-Book. Churchill Livingstone Press

Kennedy-Malone, L., Fletcher, K. R., & Plank, L. M. (2014). Advanced practice nursing in the care of older adults. Philadelphia : F.A. Davis Company

Nadine, B.S & Andrew, W. (2010). Introduction to Medical Imaging: Physics, Engineering and Clinical Applications: Cambridge Texts in Biomedical Engineering. Cambridge University Press

Patrick, C.B. (2016). Radiation Protection in Diagnostic X-Ray Imaging (Book). Jones & Bartlett Publishers

Shung, K. K., Smith, M., & Tsui, B. M. W. (2014). Principles of Medical Imaging. Saint Louis: Elsevier Science.

Swain, J. M., Bush, K. W., & Brosing, J. (2009). Diagnostic imaging for physical therapists. St Louis: Saunders.

Transitioning from Registered Nursing

The challenges that one faces when transitioning from a registered nurse to a nursing advanced practice role can be overcome using various strategies, one of which is mentoring. Although registered nurses have the skills and experience needed to transition into the advanced roles, they lack the knowledge needed to comfortably perform the new tasks (Fitzgerald et al, 2012). Mentors can therefore play a significant role in helping to adapt and teach them the basic skills needed to make smooth transitions. The mentors should be medical professionals who are not only in the nursing advanced practice roles but also those that are competent and can guide the registered nurses during the transition.

Another strategy that can be used is problem based learning where the registered nurses engage with professionals in the advanced nursing roles and explore different concepts and ways of performing duties (Fitzgerald et al, 2012). Problem based learning helps the registered nurses to develop critical thinking and further enhances the skills they us to assess hypothesis which aids in improving decision making. Since problem based learning exposes the registered nurses in transition to real life clinical experiences, they are able to learn under the supervision of those in the advanced practices (Elite Learning, 2015). Improved judgment and operational knowhow can help make the transition better as the registered nurses in transition will have the confidence and skills needed to adapt faster.

             Simulation is another strategy that can be used to ease the transition as it creates real life events that the registered nurses can learn from. Since simulation is only a depiction of the actual environment that the registered nurses will be working on, it enhances confidence and encourages learning especially because those going through it are aware that any mistakes made will not have any consequences (Fitzgerald et al, 2012). By creating simulations about the nature of environment the registered nurses will be working in after the transition, the strategy allows for faster learning and exposure to the new tasks without the consequences of making errors in real life settings.

References

Elite Learning, (2015) “RN to NP role transition” retrieved from,    https://www.elitecme.com/resource-center/nursing/rn-to-np-role-transition/

Fitzgerald C, Kantrowitz-Gordon I, Katz J, and Hirsch A, “Advanced Practice Nursing Education:             Challenges and Strategies,” Nursing Research and Practice, vol. 2012, Article ID 854918,            8 pages, 2012. https://doi.org/10.1155/2012/854918.

Personal Nursing Philosophy

Nursing for me is all about taking care of every patient and always using the knowledge that I have respectfully and honestly to deliver the best care to patients. As A nurse I consider my responsibility to offer spiritual, physical and emotional help to patients and their relatives irrespective of the environment. I associate myself with the theorist Jean Watson who argues that the responsibility of nurses is to take care of values, needs and experiences of the patient. Following Watson’s theory as my guide, I will address some of the key concepts of my nursing philosophy and how I relate my nursing philosophy to the nursing profession.

Nursing in the modern day has been affected by the technological developments like machinery, which are getting adopted in the health care system. Watson argues that curing a disease is not achieving health, a patient’s disease may be treated but they may not really get healed because they carry emotional burden (Ngonzalo, 2016). Healthcare should incorporate caring in its concepts, the only way caring is achieved is through responsiveness between the patients and the nurses. My personal nurse philosophy is basically branded by kind-hearted and ethnically sensitive care to all patients and their family members.  As a nurse, I always find it essential for me to be an advocate, provider, teacher and also a leader to the patient, because this is what helps ensure that I deliver the highest quality care. Nursing in my understanding, is all about empathy and appreciating people at all life situations. My belief is that a professional nurse needs to be personally committed to enduring training through formal schooling and real life experience in order to gain more knowledge in the nursing field.

My nursing philosophy categorizes the nursing field into four paradigms as described by Watson in her theory. The paradigms include; people, surroundings, nursing and health. Watson defines human beings or people as valued persons that should be cared for, valued, cherished, understood and helped. Health as Watson defines it is a great level of general physical, psychological and societal running in the existence of efforts that guarantee that diseases do not prevail (Ngonzalo, 2016). Health is an active state which exists on the scope of wellness to sickness, this normally shift in response to environmental aspects. Health is basically just about the quality of life, when am working at the hospital, I always encounter patients who have trauma experiences from suffering from multiple chronic diseases. These are people who suffer every day and all they hope for is to get well and regain their health so that they can have quality life.

The environment or surroundings is defined in the idea that nurses are professional that exist in every kind of society and so a caring approach is conveyed from one age group to the other, by the philosophy of the nursing vocation (Tang et al., 2019). This has hence worked as a unique way of helping the nursing profession to always cope coping with its environment. I believe that care is all about dealing with the whole patient, not just dealing with the health issue that patient is dealing with. I believe that the best way to take care of patients is to look past the patient and deliberate on the setting in which they live in. People are members of a much larger society that has different traits and features that influence the patients greatly. It is hence important to understand that patients cannot be separated from their environments because they work hand in hand.

Watson considers all-inclusive health care to be essential to the caring practice in the discipline of nursing. Nursing is a humanoid discipline of people and their well-being experiences which are dealt with by experts, scientific and moral human connections (Ngonzalo, 2016). I believe that nursing is all about getting involved with the individual patients, understanding and taking care of their needs both physical and emotional. As a professional nurse, I encounter various situations that require my ability to understand and take care of patients’ situations no matter how difficult it may be without bias.

Nursing is a process that utilizes all-inclusive, patient fixated and problem solving approach when it comes to dealing with patients and their relatives (Ngonzalo, 2016). Every patient has different needs and they thus require different action plans. It is always important to have care planned in respect to the needs of the patient which is why it is important to use the nursing process. The nursing process is an effective way to help cater for the specific needs of the patients. The first step in the nursing process in delivering health care is through assessment, where patient data is collected and analysed to understand their needs (Bliss et al., 2017).

Nursing diagnosis is the second step and it is where a clinical judgement is made to understand the response of the patient to their health needs. Diagnosis is important as it helps to reflect on the effects of a health problem in regard to nutrition, psychological effects and conflicts with family (Bliss et al., 2017). The third step is where quantifiable and attainable short term and long tern objectives are established depending on the assessment and diagnosis. The other step is implementation; this is where nursing care is realized in reference to the care proposal. At this stage, it is always important to ensure that there will be continuity of care for the patient during the time that they are hospitalized and whey they are ready to be discharged. The last step is evaluation, and his is where the status of the patient and the efficiency of the care provided by nurses is constantly assessed. The care design is always altered as required to ensure effective care is offered to the patient (Bliss et al., 2017).

My personal nursing philosophy is based on compassion and care. I believe that in the nursing profession, compassion and care are two important elements that help effective health care to prevail. As a nurse, it is always important to understand that one is not only taking care of the physical health of the patient, they are also caring for their emotional needs (Holopainen et al., 2019). I work in the surgical floor where I get to interact with different types of patients, suffering from various conditions. I sometimes have to take care of patients that are chronically ill and they require a lot of emotional care to help them cope with their conditions. Most of these patients spend most of their time at the hospital and so they become like family, they perceive me as not only their care provider but also their friend.

Most of the time is spent having social conversations with in addition to providing medical needs. Having these social interactions with these patients helps in meeting their emotional needs, this has positive effects on their recovery. Patients with chronic ailments are more affected emotionally and this affects their physical health because they lose hope in life (Tang et al., 2019) It is important as a nurse to offer emotionally support to patients and their families who suffer just as much as the patients. When a nurse has good relations with the patient’s family, they are able to understand some factors that could be affecting treatment and wellbeing of the patient (Holopainen et al., 2019). The nurse is in this case able to teach the patient and their relatives on the best care methods to help improve recovery for the patient. Good relations between the nurse and the patients ensure effective care is offered which helps improve the patient’s health condition and reduce frequent hospital visits for the patient.

Watson’s theory may not be effective in a health care unit where the ratio of the nurses to the patients is low. A nurse caring for many patients at the same time may not have time to initiate personal relations with the patients because of the workload. To cultivate a special connection with a patient, a nurse is required to spend adequate time with the patient. A nurse taking care of multiple patients at once may not have the time to spare for all the patients to learn about their personal lives as the theory requires. Another situation where the theory may be ineffective is for the patients that are unconscious. These are patients that cannot communicate, and so the nurses are only able to offer medical help without any emotional implications.

Nursing is a discipline that continues to progress and in order to support this progress, engagement of the nurses need to be increased. Nurses are health care providers but they also need to be more involved in the life of the patient in order for proper health care to be provided. Effective health care is only possible if the emotional needs of the patient are taken care of. My personal nursing philosophy is to ensure that I provide all inclusive care and this means considering the external factors that could affect recovery of a patient. Taking time to understand the patients and how their lives at home are like can greatly help understand some of the best health care strategies that can work for the patient. Engaging the patients, help them to open up and it becomes much easier to understand some of the underlying issues that they are facing which is affecting their health conditions. Effective health care can only be effectively demonstrated and practiced interpersonally. Effective caring does not only promote health but also individual and family growth.

References

Bliss, S., Baltzly, D., Bull, R., Dalton, L., & Jones, J. (2017). A role for virtue in unifying the

            “knowledge” and “caring” discourses in nursing theory. Nursing Inquiry, 24(4), n/a-``                   N.PAG. https://doi.org/10.1111/nin.12191

Holopainen, G., Nyström, L., & Kasén, A. (2019). The caring encounter in nursing. Nursing

            Ethics, 26(1), 7–16. https://doi.org/10.1177/0969733016687161

Ngonzalo, A. (2016, May 10). Jean Watson's Theory of Human Caring. Retrieved from

            https://nurseslabs.com/jean-watsons-philosophy-theory-transpersonal-caring/

Tang, F. W. K., Ling, G. C. C., Lai, A. S. F., Chair, S. Y., & So, W. K. W. (2019). Four Es of

caring in contemporary nursing: Exploring novice to experienced nurses. Nursing & Health Sciences, 21(1), 85–92. https://doi.org/10.1111/nhs.12561

“Good morning to you all. I am so happy to be among you during this meeting which gives me a good opportunity to talk about mental health and the physical well being. Being among you today gives me the opportunity to shed light on the factors that can cause mental health and disrupt the physical well being of an individual. In reality mental health and physical wellbeing are two sides of the same coin which means these two are very necessary if one is to live a healthy and happy life.

Physical wellbeing of an individual is very important.  Being physically well does not mean that one doesn’t have a disease. Physical wellbeing includes the lifestyle one chooses to live with the aim of preventing diseases and conditions that would cause adverse health. In order to improve your physical well being you should make sure that you eat well and remember an apple a day keeps the doctor away, always drink in moderation, stay hydrated and be active. A wise man one said all work and no play makes Jack a dull boy. Those are just a few things that should be done in order to improve your physical wellbeing.

I believe all of you are between the age of 16-23 and it is at this stage where you should take care and live healthy to avoid diseases that can alter your life style forever. Eat healthy, go to the gym and work out one in a while.  Physical health and mental health are greatly intertwined such that when one is not physically fit their health is greatly affected and when one is not mentally healthy their physical wellbeing is affected.  Enhancing your physical wellbeing is part of enhancing your mental health.  Nowadays we are too busy to even find time to exercise or time to catch a nap, you the younger generation are at risk of overweight and body pains which are bad for the physical wellbeing of the body. I believe some of us still find time to make a tweet on Instagram and follow up on posts maybe we should all take a piece of this time and invest it into taking care of our bodies thus enhancing our physical wellbeing and mental health. Maybe even spread the word out there using these platforms that people need to be physically well and mentally healthy.

It is important to hold meetings like this. They help one understand that mental health is an issues that affect people from all walks of life and women and men from all ethnicities.  When we talk about mental health it includes what affects us emotionally, psychological and socially. Mental health is responsible for affecting how we think, feel and manifest these feelings. Mental health is also a determinant of how we handle stress. Mental health issues can dramatically impact ones behavior and moods.  Enhancing ones understanding of mental health requires one to have a deep understanding of cultural diversities that are in the world and appreciating them.

Just to mention, Language barriers, underemployment, poverty and isolation from ones family are some of the causes of mental health problems such as depression and anxiety.  To overcome mental health issues and improve one’s overall wellbeing one should set goals that they should achieve in the following manner;

            Connect; one should develop and build their relationships with friends, family and neighbors as they connect and enrich each other.

Take notice; assess your surrounding and learn and appreciate what surrounds you. Start noticing the beauty that exist in the world and appreciate the little things in the world.

Learn; learning is a process and it takes time, therefore one should be patient. As an individual try doing something new out of the ordinary or rediscover an old interest. Take up new responsibilities. Learning is a process that inspires confidence which is very much needed for the mental wellbeing.

Give; Do something for the greater good. Help a stranger or a friend and you will be happy and satisfied and happy with yourself and your happiness will be linked to other people.

As I said earlier mental health can affect anyone from any social class and race. The bitter reality is that almost half of the population of the United States will suffer from mental health problems at one stage of their life. This mental health issue will be caused by different stressors in their life. As a nation we should take it upon ourselves and help these people recover. Detecting mental health at an early stage is important and helps in ensuring that mental health does not become a life sentence and does not disrupt the general well being of an individual.

I thank all of you who were struggling with the use of alcohol or substance abuse and choose to attend AA meeting to get overcome substance abuse, may you keep up the good spirit and assist others out there struggling to start their journey of recovery. Individuals suffering from mental health issues turn to using alcohol and other substance as a way to make them feel accepted and to alter their moods. I completely understand the desire to feel, it is just the means I disagree with.  One should bear in mind that some this means of feeling better puts their health at risk.

Substance abuse means that a person uses over the counter drugs, alcohol or any other drug and has made it a habit. Once a person gets used to using drugs their brain chemistry changes and when the brain chemistry changes their ability to make sound decisions can be affected also. Altering the brain’s chemistry also has grave impacts on one’s health.  These people are using drugs so that they can feel accepted and alter their moods and moods are influenced by the brain meaning these individuals are suffering from a mental health issues such as depression. Substance abuse will only make things worse since it will also affect their general health.

Mental health is a serious issue and perhaps that is why since 1949, Mental Health America and the National Alliance of Mental Illness began observing Mental Health Awareness month of May. I would like to inform you of this year’s theme #4MindforBody. This hash tag focused on educating the role of fitness, eating a balanced diet, maintaining a healthy sleeping pattern and proper hydration in maintain good mental health.

We are all aware that good mental health is an integral component of good general health and wellbeing which allows an individual to realize their strengths.  When one’s mental health is okay they will be able to positively contribute to the community in a manner that is positive. Mental health is important and I would like to encourage all of you to cope with stressors that can lead to mental health issues which in return will enhance your overall health. Your wellbeing matters.

I would like to highlight factors that contribute to ones mental health. These factors are Biological, life experiences and family history. Under biological factors there is genes and brain chemistry. Life experiences that can impact ones health include trauma and any kind of abuse. Lastly, under family history, if there are members of the family that one is directly related to and has or had mental health one is likely to suffer from mental health issues. It is also important to bear in mind that family history is not a guarantee that the same thing will happen to you. Plenty of evidence presented has suggested that leading a healthy life style which means one is avoiding stress and taking care of themselves makes a huge difference and enhances ones mental health and wellbeing. As I conclude I would like to remind all of you that you that taking care of your general health should be a priority for each and every one of you.

Thank you.”

Cons of Supervised Injection Site

Introduction

Supervised injection sites are also referred to as supervised injection facilities or medically supervised injection centers.  These supervised injection sites have been designed to provide an environment that is safe and stress free where people are allowed to inject illegal drugs freely. The legality of these supervised injection sites depend on the location and the political jurisdiction. These facilities offer sterile injection equipment, information of the drugs being used. To an a greater extent these facilities offer these people using this sites access to medical staff in case of an overdose.  Regardless of the fact that these sites are of great advantage they have their own share of disadvantages. These sites they are causing more harm than good. They are a threat to public safety and should not be allowed to operate.

            These sites are encouraging individuals to use drugs (Nova Recovery Center, 2018).  These sites fail to report the use of illegal drugs such as cocaine and heroin to law enforcement. Some drugs are illegal in other nations but these sites have provided individuals who abuse these drugs with a safe space to abuse these drugs freely not questioning the legality of these drugs in these nations. Using drugs that are illegal in a country is a crime (Nova Recovery Center, 2018). Essentially, drug users are getting away with a crime that has been deem illegal in the country.  These sites for a long time have acted protect, predators and peddlers. These sites argue that drug use is a personal choice which should not be the case since these drugs endanger the health of an individual.  Everyone is entitled to experience their own rights in their nation, the existence of these facilities infringes violate the rights of those who believe that drug use should not be allowed.

            These sites challenge the federal laws against drug use (Nova Recovery Center, 2018).  With continuous establishment of these sites the Federal government will lose power it has to regulate drug and substance use policies. If the Federal Law loses the control it has on drug policies the nation might lack uniformity when it comes to regulating the operation of these sites. In Canada 2008, one of these sites took the government to court to oppose that the government should stop overseeing its operation (Amethyst Recovery Center, n.d). This took place after the country refused to exempt the site from its policy on drugs and substances.  In court the Insite argues that such matters should be handled by the law governing the provinces and the Federal government was not allowed to interfere (Amethyst Recovery Center, n.d). These facilities are challenging the Federal law and the policies that it has in place concerning drug and substance use despite the fact that these laws are for the health and public safety of the people. Legalizing these sites create a legal conundrum. This should be reason enough for the federal law to abolish creation of these safe injection sites.

Operation of these sites only leave citizens with wondering if the government is fighting drug use or encouraging the use of these drugs (Amethyst Recovery Center, n.d).  a large percentage of individuals the community are not comfortable with the idea of allowing addicts to use drugs without facing any kind of repercussion.  Activities carried out by these facilities are a threat to the society and the government is misplacing its funds when it decided to use its funds to facilitate operation of these sites (Amethyst Recovery Center, n.d). Funds invested in these facilities could be put to productive use such as treating and rehabilitating these addicts instead of encouraging them to continue using these drugs. These funds can also be utilized by fighting drug trafficking in the country.

Studies that have been conducted have shown that safe sites are not reliable (Nova Recovery Center, 2018).  The initial goal of establishing these facilities was accepting the idea of people are going to use drugs, thus making them use them where they are supervised and nothing can go wrong.  These facilities also aimed at preventing overdose and getting many addicts to opt for treatment so that they can overcome their addictions.  A study conducted has found out that these sites may not be effective when it comes to preventing these addicts from overdosing and dying. Research documented in the International Journal of Drug Policy has shown that safe injection sites have only reduced crimes that are related to drug use a little but they have not been able to reduce the number of people dying as a result of an overdose and syringe sharing (Lopez, 2018).

Safe injection sites may be responsible for bringing crime to the surrounding community (Amethyst Recovery Center, n.d). Opening safe injection sites does not increase arrests for drug trafficking, assaults and other forms of crime in the surrounding communities. Residents of Moss Park has reported that since a drug injection site opened around that area in they are finding more used needles strewn in the lanes and dealers are now selling in plain sight and drug dealers are verbally attacking any passerby.  Drug addicts are allowed in the site most of the day but where they go after there remains a mystery (Beattie, 2018).Drug users remain a threat to the community and these sites are only protecting them instead of helping them overcome their drug use.

            Reducing harm should be an overall strategy that should be approached from another angel that is not creation of safe injection sites (Yuen, 2016).  What is the use of creating these safe environments for them to use the drugs while indirectly telling them that they have to find their own means of getting the drugs, these sites are encouraging them to commit crimes and then come and hide in there.  If the facilities aimed to help them they should provide them with the drugs themselves so that they can control quality and reduce the harm these people are posing to the rest of the community (Yuen, 2016). These sites are encouraging crime by encouraging the users of these sites to buy drugs from peddlers in the community and come use them in the facilities, the more the reason the government should not allow creation of these safe injection sites.

            Society cannot overlook the few advantages that these safe injection sites have brought to the community.  According to data given by Center for Disease control (CDC) about sixty people in ten thousand who share needles during drug injection results to HIV transmission thus making Injection drug use one of the leading causes of HIV transmission. Supervised injection sites have minimized the risk of HIV transmission by greatly reducing the sharing of needles by drug users by providing enough needles in these facilities.  These facilities have also reduced opioid overdose by offering medical staffs who are trained to administer noloxone incase an overdose happens in the site (Greenhalgh, 2018). This are huge advantages that have come with the opening of safe injection sites but are not reason enough to keep opening these sites considering that injection drug use is  not the only way these people can get HIV and an overdose is a personal choice an individual makes. The disadvantages of these sites outweigh the benefits they bring around and they should be done away with.

Conclusion

Safe injection sites are safe and hygienic sites that are established to enable injection drug users to use these drugs under supervision. These sites have brought with them many disadvantages thus the reason they should be abolished.  These sites protect illegal drug users who are violating the law by abusing these drugs. Operation of these sites challenges the control the Federal government has over Drug and Substance use policies. These sites harbor criminals who violate the law and offend others. Despite the advantages that come with establishment of safe injection sites the disadvantages outweigh the benefits thus establishment of these sites should be made illegal by the government at all levels.

References

Amethyst Recovery Center (n.d). The Pros and Cons of Safe Injection Sites. Retrieved from;             https://www.amethystrecovery.org/pros-cons-safe-injection-sites/

Beattie S., (2018). Do Supervised Injection Sites Bring Crime and Disorder? Advocated and        Residents Disagree. Retrieved from; https://www.thestar.com/news/gta/2018/08/15/do-         supervised-injection-sites-bring-crime-and-disorder-advocates-and-residents-   disagree.html

Greenhalgh. T., (2018). Supervised injection sites Pros and Cons. Retrieved from;             https://www.infectiousdiseaseadvisor.com/home/advisor-channels/hiv-aids-            advisor/supervised-injection-sites-pros-and-cons/

Lingle, C. (2013). A critical review of the effectiveness of safe injection facilities as a harm          reduction strategy (Doctoral dissertation, University of Pittsburgh).

Lopez G., (2018). A Study Questioning the evidence for Safe injection site has been retracted.     Retrieved from; https://www.vox.com/science-and-health/2018/8/22/17683364/safe-  injection-sites-study

Nova Recovery Center (2018). Safe Injection Sites: Are They Helping or Hurting. Retrieved        from; https://novarecoverycenter.com/addiction/safe-injection-sites/

Yuen J., (2016). Pros and Cons of Safe Injection Sites. Retrieved from;             https://torontosun.com/2016/07/03/pros-and-cons-of-safe-injection-sites/wcm/dcac73af-    4bc7-4895-9c3c-8564d0b3fcdf

Zhang, K. (2014). 'No easy fix': The Supervised Injection Site Debate in Canada (Doctoral           dissertation, Université d'Ottawa/University of Ottawa).

 What causes nursing burnout? And how can it be prevented?

Nursing burnout is as a result of many work-related issues. Nurses are people who deal with death daily, and they have to endure emotional strains as they deal with the loss of their patients and console grieving families. To an extent, this emotional strain may be overwhelming. In addition to emotional stress, they have to endure long shifts that last up to 12 hours or more (Ndawula, 2016).  Burnouts are a threat to the health of patients and the health of nurses. The objective of this study is to explore how burnouts can be managed.

Purpose and Theoretical Framework.

 The primary purpose of this study is to shed light and draw attention to the problem of burnout in the nursing profession. The possible causes of burnouts and strategies put in place to cope with burnouts. Two questions guided the whole study:

1. What causes nursing burnout?
2. How can nursing burnout be prevented?

The Job Demand-Resources Model and Maslach theory on burnouts are the two theoretical frameworks that help explore this study. These theories have been chooses because they are highly related to the topic of research, which is burnouts. The first theory, which is Job- resource model, explains how job demand and resources determine occupational stress and burnouts. This theory also supports all people from various occupations. The approach was formulated to support the emotional and physical wellbeing of all employees so that they can bring forth better results in the work they undertake. As mentioned earlier, this theory has two major parts. Under job demand, there are psychological, physical and social organization characteristics of the Job which vary from the pressure of the Job and workload, the uncertainties of the Job and conflicts that may occur at work. Under Job resources, there are social structures to assist the workers in working effectively. These resources include but are not limited to; safe and conducive working environments, good leadership, and working tools (Montgomery, Spânu, Băban, & Panagopoulou, 2015). In this model, when the demand for jobs high and the job resources are minimal workers experience burnouts and stress and vice versa.

            Maslach theory, which is the second theory that is appropriate for this study because it focuses on the occurrence of burnouts of individuals engaging in any kind of work.  The initial research for this theory involved the formation of an existing theory that would focus on burnouts. The primary interest of that research was to study emotions that led to occupational burnouts (Ndawula, 2016). According to this theory, any form of burnouts in any occupation is caused by a mismatch between the individual doing the job and the job demand. According to this theory, burnouts are in three dimensions, namely; emotional exhaustion, cynicism, and inefficacy. Emotional exhaustion is more noticeable in all three dimensions. This dimension has been characterized by emotional stress whose symptoms are, frustrations, and moodiness. In the second dimension, cynicism, people detach themselves from the Job. Some negative feelings accompany this detachment. It is in this dimension that job dissatisfaction occurs. In the last dimension, which is more complicated than the other dimensions the worker experiences an unwanted feeling of unworthiness, and the worker experiences a sense of reduced personal achievements (Ndawula, 2016). This theory sheds light on the consequences of burnout.

Methodology

 (Li, Guan, et al, 2014) conducted a cross-sectional study. The cross-sectional survey was carried out in Shenyang, China, in a month. The survey was carried out between May and July 2013. A total of 1559 nurses were asked to fill a questionnaire. The respondents of this survey were from five hospitals, three of the hospitals were university-affiliated hospitals, and the other hospitals were a provincial one and a municipal tertiary hospital. For nurses to be recruited for the survey, they were required to have an RN license that was given by the Ministry of Health and be working as a registered nurse during the time of the survey. The survey was not going to recruit head nurses and any nurse who was serving as an administrator. The survey was done anonymously for four weeks. In the end, 1995 clinical nurses were recruited. A total of 1662 questionnaires were returned, marking a return rate of 83.3% return rate. One hundred three questionnaires had missing data, therefore they were discarded after they were discarded 1559 questionnaire were analyzed. Before participating, all the participants were required to sign a consent form (Li, Guan, Chang, & Zhang, 2014).

Major findings and conclusion

From the study, it was determined that nurses with the characteristic of higher self evaluation experienced minimal emotional exhaustion since none of them showed any signs of emotional exhaustion such as moodiness or frustration. These nurses showed minimal signs of cynicism. It was also found out that burnouts occurred as a result of continuous work pressure that was not handled well. This pressure is defined in three dimensions that are in the maslach theory. Nurses between the age of 30-40 showed the highest level of emotional exhaustion, and the highest levels of cynicism (Li, Guan, Chang, & Zhang, 2014). Nurses who had stayed in the profession for about 15 years showed the highest score of burnouts in all three dimensions.

The data from the study suggests implementation of approaches which promote active coping styles that nurses can adopt is good way of helping to reduce burnouts among these professionals. When burnouts are reduced, nursing efficacy is reduced. According to the research-active copping can be a positive resource that can be used to fight burnouts. The research concluded to reduce burnouts, it is advisable that hospitals conduct nurse training on how to solve problems. This will be done to help nurses develop and be able to apply coping skills that will help them cope with the work stress they face. This training will help improve the health of nurses and they're well being, which in return will help reduce burnouts and increase the quality of healthcare offered by nurses (Li, Guan, Chang, & Zhang, 2014).  Is seeking their methods of preventing burnouts that were not included in the study were seeking early intervention once a nurse starts manifesting signs of burnouts.

 Annotated bibliography

An evaluative annotation is a critical analysis of the strengths, weaknesses, and biases of the source, and why one thinks its useful.

1. Li, X., Guan, L., Chang, H., & Zhang, B. (2014). Core self-evaluation and burnout among nurses: the mediating role of coping styles. PloS one, 9(12), e115799.

This journal examines how nurses experience burnouts and the role of coping strategies in reducing burnouts in nurses. This article also explores the various dimensions of burnouts as presented by the maslach theory. The articles explain how these multiple dimensions affect nurses of different age and different positions. Research on burnout conducted in the past has failed to be specific in the sense that it explores burnouts without picking one particular profession. A key strength of this research is that it focused on the burnouts experienced by one profession instead of generalizing all the professions. Another key strength of this article is that the proposed theoretical framework has been used throughout the whole study.  This article was also particular about the participants of the research and the position of the nurse involved. Another key strength of this article is the fact that when discussing the results of the study it was specific on the age group that experienced the various dimensions of maslach theory. The key weakness of this article is that it failed to state further the examples of coping strategies that should be employed to help prevent burnouts. This article is useful in that it has shown how burnout affects nurses and what can be done to reduce these burnouts. Nurses are a vital part of society. They are responsible for helping take care of others, which will be difficult if they are continuously affected by burnouts.

2. Ndawula, M. (2016). Burnout among Staff Nurses: Examining the causes, coping strategies, and prevention.

 This article helped provide insight into the maslach burnout theory and explaining the fundamental reason why the theory was developed. One of the strengths of this article is that it explains in detail all the three dimensions of the Maslach burnout theory and the signs of burnout at all these three dimensions.  Another key strength is that it discusses the causes of burnout in nurses and the possible actions that can be taken to reduce burnout. This made the article straightforward when relating with the theoretical framework of the paper. The only weakness of this article is that only a small part of it discusses this theory.  This article was useful since it suggested what can be done to reduce burnout in all the three dimensions of the theory.

3. Montgomery, A., Spânu, F., Băban, A., & Panagopoulou, E. (2015). Job demands, burnout, and engagement among nurses: A multi-level analysis of ORCAB data investigating the moderating effect of teamwork. Burnout Research, 2(2-3), 71-79.

This article proved to be useful since it provided another theoretical framework, Job- Resource that can be used to explore the possible causes and the possible solutions of nursing burnouts. The key strength of this article is that it explores this theory and how it relates to the burnout that nurses experience. This article was important since it shed light on another theoretical framework that is very suitable when exploring the same kind of research.  The only weakness of this article is that it failed to provide solutions that lie within the theoretical framework that can be used to solve the problem of burnouts.  

The evaluation

This document contains information on the causes of burnouts and the various signs of burnout syndrome. This document contains the results of a study that was conducted on nurses in China with the aim of identifying the causes of nursing burnout and how these burnouts can be prevented. The study concluded that burnouts can be prevented.

References

Li, X., Guan, L., Chang, H., & Zhang, B. (2014). Core self-evaluation and burnout among            nurses: the mediating role of coping styles. PloS one, 9(12), e115799.

Montgomery, A., Spânu, F., Băban, A., & Panagopoulou, E. (2015). Job demands, burnout, and   engagement among nurses: A multi-level analysis of ORCAB data investigating the      moderating effect of teamwork. Burnout Research, 2(2-3), 71-79.

Ndawula, M. (2016). BURNOUT AMONG STAFF NURSES: Examining the causes, coping       strategies, and prevention

Briefly describe your role or contribution to the group

            Taking into consideration my responsibilities in the American Academy of Physician Assistant (AAPA), the truth is that is that I act as a pre-physician assistant. Currently I am a student of the Toronto University and I am looking forward to complete my degree course by the end of the year 2019. As a result of that, my intention entail using the centralized application services as one of the ultimate means that can assist me to enter into a physician program that is integrated with the physical physician assistant (CASPA) cycle. This program is perceived to commence on April 26^th and end by March 15^th 2019. For the past eight years that have passed, I am working as one of the physical assistants at the Bronx Gardens Rehabilitation and Nursing Center initially termed as St. Barnabas Rehabilitation and Continuing Care Centre.

            In addition to that, the reason as to why I greatly acknowledge AAPA is the fact that it has the ability of broadening the minds of those learners who are interested with this profession. That always takes into account the diverse knowledge contained in the PA foundations taking into account the years of evolution it has taken. Moreover, what I came to realize is the fact that it offer pre-physician assistants the various instructions and guidelines that are applicable to the PA programs. Another opportunity that exists is the likelihood of attending conferences and seminars that enables a learner to gain insight regarding the PA profession. This implies that AAPA has the ability of providing valuable information concerning certain duties as well as other associated specialties that PA profession offers.  In connection to that, such a profession has the ability of enabling a student to gain diverse knowledge regarding the state law as well as other legislations.

            It is this scenario that compels me to ensure that I have utilized the knowledge obtained from this membership and integrate it in my new career as a physician assistant.  As one of the members of the AAPA, what I believe is the fact that I have several opportunities that can allow me to effectively engage with other qualifies physician assistants and other physician assistant learners throughout the world. In the process of working as a physical therapist assistant, I have had the opportunity of collaborating with social workers, nurse practitioners, doctors, qualified nursing assistants, and other occupational therapists. It is their expertise that I depended on as the ultimately means of delivering efficient care to the patients. I also had to depend on updates as well as other functional progress of the patients as the means of facilitating reasonable clinical outcomes.

            What the above consideration implies is the fact that it had the ability of offering me with the opportunity of appreciating the contributions and values of the physician assistant in the modern healthcare industry. Nonetheless, working as one of the physical therapist assistant before transitioning to the PA profession is something that I came to realize has the ability of bridging the PA’s gap as well as that of the therapist that works together. Therefore, my intention is to ensure that I have educated as well as shared my knowledge with those physician assistant students that come after me.