Heart Disease Stroke

            The first domain is the cognitive domain, which touches on development of mental skills and obtaining knowledge. This domain involves recollection of knowledge.  This domain is responsible for addressing the intellectual abilities of the learner and the capabilities of the learner. This domain is usually divided into six levels, which are; Knowledge, which is made up of the learner's mental skills to be able to memorize or to recall information. Comprehension, which consists of the learner's mental ability to understand things, application which consists of the learner's ability to apply the theories and ideas he or she has learned and analysis, which consist of the learner's ability to recognize and structure information and relating parts of information to each other. There is also synthesis of information which consists of the learner's mental ability to put together piece ideas together. The last one is evaluation, which is the ability of the learner to judge and design something like and essay (Aliakbari, Parvin, Heidari, & Haghani, 2015).  The first objective in the cognitive domain is to create an assessment tool that is based on a nursing theory for adult patients with heart disease and stroke. The second objective is to ensure that the patients with heart disease or stroke have their blood pressure checked regularly.

     The affective domain is responsible for identifying, understanding, and addressing how people learn.  The affective domain has five levels. These levels are receiving, which consist of the learner's mental capability to show awareness to a certain fact. Responding, which consist of the ability of the learner to respond to what is being taught. Valuing, which consist of the ability of the learner to place value on what is being taught. There is also organization which shows the learner's capability to organize and things. Lastly there is characterization which involves the learner's mental ability to merge things (Aliakbari, Parvin, Heidari, & Haghani, 2015). The objectives in this domain are; ensure that these patients can pay interest and attention to the efforts being made to help them keep their blood pressure under control.  When people are learning new things in a different setting the way they interact with the environment is greatly impacted therefore the second objective is to ensure that the patient's ability to make choices are morally right and in accordance to what is ethical.

     The psychomotor domain involves the learner's ability to use and apply the cognitive skills learnt, therefore this domain includes physical movement and coordination.  The first level is the perception, which includes the learner's mental ability to use sensor abilities to guide physical activities. Set is the next one, and it includes the learner's ability to be ready so that they can act mentally, emotionally, and physically.  Guided response is the other level, in the early stages of learning it is a little complex, therefore, a learner has to be guided to achieve adequate performance. Mechanism is the next level, which consists of the learner's ability to perform an activity repeatedly and effective. Another one is complex over response which is the learner's mental ability to perform a hard task. The next one is adaptation which is the learner's ability to modify and adapt to a motor activity that is suitable to the individual. The last level of this domain is Originality which involves the learner's capability to come up with new Motor skills which will be as a result of understanding the skills that were taught (Gronlund, 2004). The objectives in this domain will be to ensure the patient can measure their blood pressure and to revise changes taking place in the patients until they can adapt to unexpected experience.

References

Aliakbari, F.,Parvin, N.,Heidari, M., & Haghani, F. (2015). Learning Theories Application in       Nursing Education. Journal of Education and Health Promotion, 4.

Gronlund, N. E. (2004). Writing instructional objectives for teaching and   assessment(7^th ed.).  Upper Saddle River, NJ: Pearson Merrill Prentice Hall.

NURSING STAFF RATION AND PATIENT FALLS

Response 1

 Nurses play a crucial role in providing care for patients who visit emergency rooms due to falls and fractures. They administer medications and monitor patients to prevent serious problems (Clarke & Donaldson, 2008). Despite these demanding tasks, nurses suffer from staffing problems in that patients demand healthcare services but nurses struggle to meet their needs and at the end, they develop fatigue or burnout. They work long hours and carry out heavy workloads which at the end not only affects the nurses ‘well-being but they also lead to poor patients' outcome. Therefore, safe nurse staffing is very important to ensure that there are available nurses with the necessary skills and experience to offer continuum care (Clarke & Donaldson, 2008). Adequate nursing staff is also important to ensure that the patients receive quality care. Note that when the nursing home has an optimal nurse staffing, there is positive patient outcomes, shorter lengths of stay, patient satisfaction, and low rates of nurse burnout. However, insufficient nurse staffing levels bring devastating effects to the patients and the care provider. Note that when the nursing home lacks adequate nursing  staff, patients are dissatisfied, they spend many days in the hospital, the hospital experience higher readmission rates, and many more (Clarke & Donaldson, 2008). Hence, hospital administrators should focus on implementing adequate nursing staff to maximize the wellbeing of the patients and the staffs. The healthcare sectors should create working force planning systems responsible for identifying the staffing requirements, the patients' needs, staffing model, and determine the budget (Clarke & Donaldson, 2008). The importance of concentrating on safe staffing levels is that there will be lower mortality in the nursing home, there will be higher nurse satisfaction, the workloads will be reduced, and patient safety will be maximized. The hospital administrators should focus on supporting the workers so that they can preserve their passion in delivering quality care.

Response 2

Adequate nurse staffing is an important factor to consider in the nursing home since it is an element that is associated with better outcomes. Note that in the nursing home, all patients whether older or younger depending on staff. It is the role of the staff to provide quality care, ensure a safe environment, and prevent accidental hazards, among other duties (Clarke & Donaldson, 2008). However, staffs may not meet all patients' expectations due to inadequate nurse staffing. This means that when the needs are not met, the patients as well their families suffer physically and psychologically in that nurses do not offer quality care and they end up experiencing more injuries which increase healthcare costs. It is also important to note that inadequate nurse staffing does not only affect patients and their families, but nurses are also affected.  Nurses experience extensive workloads, they work long hours, they suffer from emotional baggage since they are exposed to sickness and death on a daily basis, and they lack enough time to care for their own needs (Clarke & Donaldson, 2008). Therefore, nurse staffing can affect the life of patients and nurses positively or negatively. Thus, hospitals need to restructure especially in the area of nursing staffing in order to solve the problems of heavier workloads, patient safety, nurses burnout, shortage of nurses, nursing education program, among other issues (Clarke & Donaldson, 2008). Adequate nurse staffing is the only solution to most of the problems that occur in the nursing home. In addition, deploying adequate nurse staffing will bring safe outcomes in terms of reduction of rates of errors, and reduction of complications.  In addition, deploying nurse staffing will bring positive clinical outcomes in terms of reduction of mortality, reduction of length of stay, reduction of errors and complication, and an increase of self-care.

Reference

Clarke, S. P., & Donaldson, N. E. (2008). Nurse staffing and patient care quality and safety.

In Patient safety and quality: An evidence-based handbook for nurses. Agency for

Healthcare Research and Quality (US).

Concepts of Health Information Systems

                                                            Introduction  

A new hospital is opening in Ferndale and I am hired to be in charge of the health information management systems and electronic health records (EHRs). It is my responsibility to come up with a comprehensive health information system to facilitate the provision of better health care services. In this paper, I will discuss the significant elements that an HIS will need in order to address an efficient and successful health information system. These elements include the use and content of EHRs, documentation guidelines, and the security of EHRs.

Uses of the EHR – Patient Care, Administrative, Billing, and Research

Patient Care

            Patient care is one of the most important uses of EHRs. The use of an EHR is beneficial to patient care because it can help reduce mistakes, enhance the safety of patients, and improve patient outcomes (Miller et al., 2016). As much as electronic health records are concerned, research indicates that they have the potential of enhancing patient care, foster performance measurement in experimental practice, as well as facilitate medical related research. As a means of improving patient care, it should be understood that EHR do not contain clinical or treatment histories of patient. It is mainly built for the purpose of storing clinical data gathered by the healthcare provider’s office. As evidence based tool, it will be offering physicians with an easy way of making decisions regarding the patient care. In the process of enabling the physicians to reduce therapeutic mistakes, it streamlines workflow, as well as enhances the safety of the patients (Cavalieri et al., 2015).

Administrative

            The EHR always will give the hospital the potential of storing and providing essential clinical data regarding a person’s care under a certain healthcare provider. These data consists of signs and symptoms, progress notes, past clinical history, demographics, prescriptions, laboratory information, and other associated problems. As a means of streamlining workflow, it also has the potential of supporting healthcare-related activities which in return strengthens the patient and clinician relationship (Schacknow & Samples, 2010). 

Billing

            With the electronic health record (EHR) systems in place, it implies that it will have the potential of improving the clinical practice management through cost savings and increasing practice efficiencies. Additionally, as much as billing is concerned, it will also benefit the clinical practices through reducing transcription expenses, decrease storage, chart pull, and re-filling, expenses which in return aid in improving automated coding and documentation capabilities. This will also improve the health of the patient through patient education and efficient disease management (Hlatky, 2013). 

Research

            Advancing this technique to randomized therapeutic trials, it will be possible to use the EHRs to facilitate patient recruitments, assess study feasibilities, as well as streamline the collection of information at the baselines and follow-up.  As a means of maintain privacy and security to healthcare information, it will be important to ensure that the challenges that are brought about through interlinking diverse systems and infrastructure maintenance have been addressed.  Similarly, a step will have to be taken towards collaborating with regulatory organizations, HER vendors, policy makers, healthcare industry, and the patients to facilitate greater use of this system (Cavalieri et al., 2015).

Content of the EHR – Patient Information, Demographics, and Consent         

Patient information

            An EHR contains the following patient information; medical histories, diagnoses, medications and allergies, date of immunizations, vital signs, progress notes, lab and test results, and administrative and billing data. All of this information is stored into a digital record, which can be shared amongst other providers and organizations that are involved in the patient’s care.

Demographics

            An EHR also contains patient demographics, including age, marital status, sex, preferred language, employment, race or ethnicity, and insurance. Patient demographics must be included in an EHR because they provide details identifying who the patient is. These features can also help physicians with determining their top differential diagnoses since some diseases are more commonly seen in specific demographics.

Consents

            In an EHR, consent gives staff members permission to share and access patient’s health information through a Health Information Exchange (HIE) for treatment, payment, and health care operation purposes (Lennon et al., 2017).

                                      Documentation Guidelines of EHR

            The operation management team takes the responsibility of documenting patients’ past and present clinical healthcare records through the use of a useful coding compliance program. In order to be in the position of accessing the effectiveness of the program during documentation, this team will have the duty of measuring various outcome indicators. There is also the need of using the contractor initiated program to aid in monitoring documentation requirements (Tharpe, 2016). 

                                                Ensuring compliance with HIPAA

            To ensure compliance with HIPAA, I will distribute the policies on privacy and security across the entire hospital setting for all staff members and assure that each member comprehends the privacy and security legal obligations. I will also talk to the staff about my expectations and clarify the importance that all information regarding the patient is kept safe and protected. I will also perform a risk analysis to put into the record the possible threats and any weaknesses that can be exploited to ensure the protection of personal information, integrity, and the accessibility of PHI for patients who were or are in our care.

            On the other hand, the privacy and security of the patients’ information is one of the issues that ought to be given greater consideration. Therefore, the general access to the hospital or the patients’ health information should only be done with after being permitted. As a means of monitoring compliance with authentication, it is vital to ascertain whether prominent security techniques have been put in place so as to ensure that the safety of the EHR. Moreover, there will be the need of ensuring that those within the department have read and understood the security safeguards that are contained in the HIPAA (health insurance portability and accountability act and in HITECH ( health information technology for economic and clinical health act). All that will take into account the technical, physical, and administrative safeguards provided by these acts (IGI Global & In Information Resources Management Association, 2018). 

Ensuring that data is secured

            To ensure that data is secured from internal and external threats including: intentional hacking, human errors, natural disasters, and equipment or software failures, I will provide a security system where only authorized individuals can gain access to information. As much as the protection of the patients and the organization’s information is concerned, one of the strategies that can be used to permit that is the use of firewalls. Regardless of the fact that this method can be costly, it has been proven to have the potential of securing the hospital’s network which in return protects the health care information that reside within the network. Depending on the scope and the needs of the organization, it possible to use any of the following firewalls, including packet filtering, status inspection, application level, or the net address translator. Another method that can be recommended is the use of digital signatures to prevent breaches whenever patients decide to view their information (Nass et al., 2009). 

            Nonetheless, it is important to use passwords and usernames that can aid in preventing breaches through the incorporation personal privacy. Passwords will have to include dates or names that can deter the hacker from speculating them. The passwords would be needed to be changed defined intervals where the reuse of a password is restricted, and the password is unique within a minimum number of characters (Sittig & Singh, 2015). I will ensure the authorization is based on a two-tier approach and managed through biometric identifiers such as scan of retina, finger, palm, or face recognition. The use of the two can also enable the health care providers to establish role-based access controls. It is also important to remember logging out from the system to avoid leaving organizational or patients PHI (protected health information) to unauthorized people (Nass et al., 2009). 

                                                            References

Cavalieri, R. J., Rupp, M. E., & Sigma Theta Tau International,. (2015). Business administration for clinical trials: Managing research, strategy, finance, regulation, and quality.

Hlatky, M. (2013). Comparative-Effectiveness Research in Heart Failure, An Issue of Heart Failure Clinics, E-Book.

IGI Global,, & In Information Resources Management Association,. (2018). Censorship, surveillance, and privacy: Concepts, methodologies, tools, and applications. Hershey, Pennsylvania Ptress

Nass, S. J., Levit, L. A., Gostin, L. O., & Institute of Medicine (U.S.). (2009). Beyond the HIPAA privacy rule: Enhancing privacy, improving health through research. Washington, D.C: National Academies Press.

Schacknow, P. N., & Samples, J. R. (2010). The glaucoma book: A practical, evidence-based approach to patient care. New York: Springer.

Tharpe, N. L. (2016). Clinical Practice Guidelines for Midwifery and Women's Health. Jones & Bartlett Learning, LLC.

Nursing theories

Nursing theories play a significant role in the nursing profession. Nursing theories are based on evidence from scientific researches. These theories are responsible for creating a framework that consist of approaches and strategies that are used to educate the healthcare providers.  An example of nursing theories is the Neuman Systems Model (NSM), which is based on the individual's ability to stress.  This theory has many assumptions, such as each of the clients is unique, and many universal stressors known and unknown exist.  The concepts of this theory are universal and are easily understood by those in the healthcare field. It has been used to guide nursing education, practices, and research.

Background

This theory gives forth the appropriate actions that should be taken in situations that involve stressors of a client-client system. This theory focuses on an individual as the central aspect. In a healthcare setting medical practitioners are responsible for taking care of client’s mental, physical, and spiritual health. This they do bearing in mind that stressors can affect the flexible line of defense of the client and cause a reaction (Smith & Parker, 2015).  This theory can be successfully applied in treating an individual or people in a group. This theory has received universal recognition as a valid theory and one that can be successfully be used to treat patients.

Theory description

Betty Neuman developed this theory so that she could provide a focal point for nursing students learning, and she did this based on her personal experience. During the development of her theoretical approach, she identified ten unique perspectives that are permanently aligned with her theory.  These ten perspectives play a vital role in defining and connecting concepts in the conceptual model. They also play a significant role in helping one to understand the conceptual model.  NSM  provides an approach that is holistic to the dynamic open client system which interacts with stressors and the efforts of the client and healthcare givers are responsible for maintaining a state of wellness in the client (Smith & Parker, 2015). The framework of NSM emphasizes that people are distinct individuals, and each have a different background ("What is the Neuman systems model?" n.d.).

Concepts in Dorothea Orem's Theory

The theory is made up of four unique ideas which are;

1. Knowledge
2. Understanding the requirements for one to offer self-care
3. The effect that the influences in one's culture and the environment have on the health of the individual
4. Awareness of the client's current health state and conditions.

The basis for the theory.

 This theory is based on;

1. Activities or actions that are taken by the client to ensure that they are maintaining a healthy living.
2. Condition that shows nursing intervention is needed after the client is unable to take care of one self.
3. Description of care that will be offered by nurses.

The above model breaks down the concepts of Orem's theory. The model is broken down so that the reader is guided through the progression of the table.

References

Description of the Model - Dorothea Orem's Self-Care Theory. (n.d.). Retrieved July 15, 2019,             fromhttps://www.researchgate.net/publication/225078080_Beginning_the_Recovery_Jou            rney_in_GV9Jm2u7rmsCe65wKzPTw5jtS38n2tVEGipts_from_Orem's_Self-            Care_Deficit_Nursing_Theory

Smith, M. C., & Parker, M. E.  (2015). Nursing theories and nursing practice. (4th ed.).   Philadelphia, PA: F. A. Davis Company.

                                                             Introduction

            According to the modern research, epilepsy and seizures have been realized to be the main factors that have the ability of impacting the nervous system. The reason for that is because it has been realized the majority of individuals suffering from this disease ultimately end up being affected by seizures that are ultimately derived from personal notions. Due to the fact these conceptions have extensively changed, the truth is that the same scenario is ultimately contained in other religious ideologies. The reason for that is because the general definition has been greatly perceived as being a synchronous excitation of the neuronal population. In the case of status epileptucus, it has been noted that seizures has the ability of lasting for minutes or seconds although it can be prolonged depending on an individual’s immunity. This indicates that the clinical manifestations always varies taking into account the manner in which in it impacts his or her muscular contractions (Webinar: Orrin Devinsky discusses cannabis compounds for epilepsy. (2019).

            Nevertheless, although the differences that exist between epilepsy and seizures are not well understood, the truth is that the two evolves differently. The reason for that is because as much as epilepsy result to spontaneous and recurrent seizures, it does not imply that an individual might end up having them. According to the modern research, seizures are always provoked are revoked from the initial epileptic conditions. What this implies is the fact that in case one seizure evolves in a person, it cannot be used as the main basis of suggesting that such an individual is affected by epilepsy. Preferably, the concept of epileptogenisis is what has been realized to have the potential of suggesting the manner in which sequential events end up altering the normal functioning of the brain which in return induces seizures.  As a matter of fact, research indicates that the abnormal discharge of neurons is as a result of them becoming hyperexcitable.

Then describe the pathophysiology behind epilepsy Finally, how could this webinar affect practice as an APRN

            Ideally, the intent of the Webinar series entails facilitating the free exchange of personal information amongst researchers which ultimately takes into consideration the views of the unpublished, published, as well as the hypothesis that might be withdrawn from the result being obtained. As a result of that, it implies that it is important for the associated organizations to have the potential of displaying essential information which will in return have the ability of illuminating the manner in which such consent ought to be perceived by others (Webinar: Orrin Devinsky discusses cannabis compounds for epilepsy. (2019).

            On the other hand, what the same information indicates is the fact that epilepsy is one of the complex ailments that comes with diverse medical characteristics which ultimately has the ability of predicting or precluding singular mechanisms.  This implies that the only means that can be used to gain an insight regarding the mechanisms that can be used to minimize the perceived features of epilepsy will have to take into consideration its epileptogenesis as well the manner in which the unprovoked seizures end up redefining it. Ideally, the commonest means that have been noted to have the ability of explaining the disruption which exists between individual normal balances entail understanding its inhibition and excitation.

            Due to the existence of various mechanisms, it implies that there is also the need of understanding the normal nervous system controls that has the potential of enhancing that balance. Regardless of that, another point of consideration is the fact that the need of understanding the seizures that end up developing in an individual brain is one of the factors that can is in illustrating the manner in which they are superimposed on the distorted nervous system. The reason for that is because there are different means that have been realized to have the ability of including diverse changes which in return enhances mechanistic predictions as one of the challenges (Webinar: Orrin Devinsky discusses cannabis compounds for epilepsy. (2019).

            Nonetheless, the need of understanding the mechanisms of seizures in an epileptic person have been realized to have the ability of making medical professionals to realize the manner in which the static conditions that that makes such a disease to continue evolving. For instance, in the process of using sequential lobe epilepsy, it is evident that individual genes, associated growth mechanisms, as well as neuronal plasticity have been realized to have the ability of playing an essential role in the establishment of hyperexcitability.  Despite that, the truth is that some of the critical controls that are used ultimately points towards the emergence of chronic seizures in the temporal lope epilepsy, which in return aid in signifying its severity, frequency, and persistence.

            On the other hand, what the modern research suggests is the fact that the generation of seizures in the human brain is something that has the ability of altering its normal functioning. The reason for that is because the central nervous system (CNS) is ultimately designed for the purpose of enhancing balance excitation as well as inhibition. In return, it implies that once the mechanisms of the CS have been changed, it will end up creating increased excitability as well as superimposing the intermittent seizures. The reason for that is because the mechanisms that end up establishing the excitability state is the one that aid in reflecting the means that are used for plasticity and normal growth. These mechanisms are also essential for enhancing limbic system functioning (Webinar: Orrin Devinsky discusses cannabis compounds for epilepsy. (2019). Therefore, what this implies is the fact that it is these mechanisms that has the ability of enabling the central nervous system (CNS) to have the ability of developing complex structures as well as other mechanisms that provides plasticity.  It is, therefore, important to understand the differences that exist between basic and medical research regarding epilepsy.

                                                            Conclusion

            To sum up, medical observations indicates that it is the existence of various forms of epilepsy that has the ability of inducing other associated ailment events. The reason for that is because the changes that evolves during its evolvement is ultimately result to delayed necrosis of the inhibitory interneurons. This could also induce the sprouting of the axonal collateral which in return results to self reforming or reverberating circuits. Therefore, individuals who might be at the risk of developing this disorder as a result of acquired lesion should take into account the importance of using the recommended anti-epileptogentic compounds that has the ability of preventing such network changes. It is also important for medical professionals to ensure that they have provided comprehensive health care as well as covering all aspects regarding epilepsy treatment.

                                                            References

Webinar: Orrin Devinsky discusses cannabis compounds for epilepsy. (2019). Retrieved 17 July 2019, from https://www.spectrumnews.org/features/multimedia/webinars/webinar-orrin-devinsky-discusses-cannabis-compounds-epilepsy

 How to Overcome the Challenge of Overworked Medical Staff

Overworked medical and hospital staff has for a long time, hindered the nursing profession from realizing its aspirations for the common good. Common good has been defined as the good that comes into existence when solidarity and equal agents build a community.  The principle of common good is intertwined with human dignity.  Overworking medical staff is against human dignity since it denies them the chance to experience their rights as they aspire to realize their aspirations for common good.

Common good cannot exist in a community that is not built by equal agents; therefore, overworked nurses cannot contribute to common good in a community. In a society that is developed by  common good everyone can flourish as together everyone’s makes contributions towards the realization of the goals that have been set. The social conditions that have been set should make it possible for everyone to participate (Donley, Grandjean, Jairath, McMullen & Shelton, 2006). These conditions are created by members of the society so that they can be able to pursue the goals in place working across their differences each of them embracing their responsibility according to their ability, calling or profession.

            A shared responsibility is when people participate freely. In this context, overworking nurses means that they are not participating willingly but have been forced to embrace their responsibilities (Melé, 2009). By overworking nurses, Human equality is not respected, human beings are equal in the eyes of God. For common good to exist there must be dignity in work. Work has to be viewed as more than just a means of making a living and when nurses are overworked their work is not accorded the dignity it deserves.

Despite overworked hospital and medical staff being a challenge that hinders the nursing community from realizing its aspirations for common good it can still be resolved in various ways. Human dignity is as a result of human beings made free by God. He created human being free so that they can do his bidding.  The only way they can do his bidding is by choosing to live and act within the framework of his law and because of this society is supposed to respect the freedom given to human beings by enabling men and women to carry out their responsibility to better their own lives and encourage others to co-operate with each other in their pursuit for common good (Melé, 2009). When this is done society will not overwork its medical and hospital staff.

John Paul II has repeatedly defended human rights. One of his concerns is that some people deny universality of human rights (John Paul II, n.d). Human rights in all aspects must be preserved, and among the human rights that John Paul II was promoting is the right to share in the building of society. In this context overworking nurses denies them the right to share in the right of building a society. Calling for awareness for human rights like John Paul II did will help in spreading awareness that the rights of nurses should be respected, thus they should not be overworked.

Nature calls for a balance in everything, therefore there should be a balance in the workload that nurses receive (O’Hanlon SJ, 2007).  Medical institutions should aim for a fair distribution of nurses in these institutions to ensure that the dignity of the work they are doing is maintained and to ensure that the human dignity of nurses is respected as they go about their daily activities (Audi, 2012). The work load of each nurse should be minimized. When a balance is maintained in the workload that is being received by nurses it will make it possible for the nursing profession to realize its aspirations for common good since they will be able to contribute to the society as equal agents.

The aspirations for human rights and dignity are on the rise and inequalities are deepening and there is a high need for new forms of education to foster the competence of societies (UNESCO, 2015). Education plays an important role in fostering common good. These new form of education should foster a greater justice, social equality and a global solidarity.  Education is the means of changing everything therefore; an education that teaches on the need for equality and social justice will bring about a change in the nursing profession and educate on the dangers of overworking medical and hospital staff. This will enable the nursing community to realize its aspirations for the common good.

Education is key to achieving set developmental goal (UNESCO, 2015). The nursing community has set out to achieve its goal which is realization of its aspirations for common good. Education lies at the very heart of every effort that is made to change and transform the world which people live within. A quality basic education is very much needed if people are to change how they view the world.  Quality education will shed light on the disadvantage of overworking medical and hospital staff and with them nurses. When this comes to light the medical participants will no longer be overworked thus giving the nursing community the chance to realize its aspirations for common good.

Promotion of human dignity, human rights, eradication of poverty and increase in sustainability is some ting that is required to build a better future for everyone (Wagner, 2005).  These factors are important to build a better future that will be founded on equal rights for everyone, a future that is founded on respect for cultural diversity and a future that is founded on social justice. The nursing community cannot be able to contribute to this future if they are overworked.  When education which is a transformative force is used to promote human dignity and equality which discourage overworking medical and hospital staffs then overworked nurses will no longer be a challenge hindering aspirations of the nursing profession for common good.

Acting in accordance to the catholic social teachings that state everyone is a believer who has been called by the Lord Jesus Christ to proclaim his gospel in a time where the economy is powerful and complex. Faith calls for everyone not to measure the economy by the fruits it produces but on how the economy touches human life and how much the economy protects human dignity (Rowlands, 2013). Acting in accordance to these teachings will ensure that nurses are not overworked.

Nurses are overworked in pursuit of economic excellence, the economic decision of overworking nurses has human consequences and completely diminishes the quality of justice (Sullivan, 1998). This goes against catholic social teachings that state that individual should use their resources to shape the economy and shape a society that protects the dignity and the basic rights of the people. Calling for people to align their actions to social catholic teachings will help in making sure overworked nurses are no longer a challenge that hinders the nursing community from realizing its aspirations for common good.

Overworked hospital and medical staff is a challenge that has hindered the nursing community from realizing its aspirations for common good. The nursing community has to move past this challenge to achieve its aspiration for common good.

References

Audi, R. (2012). Virtue ethics as a resource in business. Business Ethics Quarterly, 22(2), 273-    291.

Donley, S. R., Grandjean, C., Jairath, N., & McMullen, P. (2006). Nursing and the Common        Good .

John Paul II, (n.d) Respect for Human Rights

Melé, D. (2009). Integrating personalism into virtue-based business ethics: The personalist and    the common good principles. Journal of Business Ethics, 88(1), 227-244.

O’Hanlon SJ, G, (2007) How Much Equality is Needed for Justice? Retrieved from;             https://www.workingnotes.ie/images/stories/56pdf/equality.pdf

Rowlands, A. (2013). Catholic Social Teaching: Not-so-secret anymore?. Retrieved from;             https://www.thinkingfaith.org/articles/20130115_1.htm

Sullivan, J. W. (1998). Catholic education: distinctive and inclusive (Doctoral dissertation,          Institute of Education, University of London).

UNESCO (2015), Rethinking Education. Towards a global common good?

Wagner, W. J. (2005). Universal Human Rights, the United Nations, and the Telos of Human       Dignity. Ave Maria L. Rev., 3, 197.

 Causes of Nurse Burnout and Prevention Measures

Nurse burnout is an issue that has greatly increased in recent years and it is negatively impacting on provision of effective health care services. The work of nurses has continued to expand from the wardrooms, to the waiting rooms all the way to the boardrooms (Li et al., 2014). Nurses are on the frontline when it comes to direct medical care, health education for others, patient needs and also comforting patients and their families. Maintaining high quality care for nurses means taking time to become familiar with the patient and their families. This means that one has to make time for emotional conversations which greatly adds to psychological responsibilities for the nurse (Li et al., 2014). All this greatly contribute to stress for the nurses as they have to deal with chaotic shifts and attentive care all at the same time and thus resulting to nurse burnout. This paper analyses the research study conducted by Li, Guan, Chang & Zhang, (2014).

Purpose and Theoretical Framework

The objective of this research was to try and define the probable relationship of coreself-assessment, and the burnout pattern amongst nurse practitioners and some of the intermediating roles that managing styles used play in helping deal with the issue (Li et al., 2014).The authors references the Masclach theory on burnout, which argues that burnout is an extended reaction to prolonged interactive stressors on the job (Maslach et al., 1996). In the modern fiscal catastrophe and the pressures to stabilize financial plan with less fiscal assets add added burden on the nursing workforces because of lack of enough personnel which lead to overworking (Li et al., 2014). The authors further illustrate that usage of new expertise in the medical sector has brought in more challenges in regard to nurses obtaining new information and understanding new skills. Nurses are some of the professionals that are exposed to work stress which prime to negative effects on their psychological health and well-being (Li et al., 2014).

                                                               Methodology

            The study was steered through the use of a cross-sectional study which was directed in Sheyang China in the year 2013. The participants of this research were nominated from five different hospitals where they were all required to be registered nurses, 1,995 clinical nurses were recruited for the study (Li et al., 2014). The study did not include head nurses and administrators because these are the people that are supposed to ensure that nurses have a conducive working environment to avoid nurse burnouts. For data collection, the study used anonymous questionnaires that were distributed to the nurses and later collected in staff gatherings in all the selected hospitals by the third scholars within a four week period (Li et al., 2014).

The instruments used in the survey consisted of (MBI-GS) Maslach Burnout Inventory-General Survey which is a fifteen item character- report ration of job burnout. It comprises three main magnitudes; emotional fatigue, scepticism and professional effectiveness all which are recorded on a Likert scale from 0-6 that is never to everyday respectively (Li et al., 2014). A high emotional score and combined with low professional efficacy was an indication of high level burnout. MBI-GS has previously been used effectively in other studies which help to show its consistency and cogency in this research (Li et al., 2014).  The alpha coefficient for the three magnitudes of MBI-GS was 0.896, 0.747 and 0.825 correspondingly in the research (Li et al., 2014).

The second implement utilized in the research was core self-evaluation scale (CSE). This is a twelve item personality- report evaluation where items are evaluated from 1-5 that is powerfully differ to powerfully approve respectively. The use of CSE was effective and can be termed to be reliable and valid because it has formerly been utilized in Chinese populace.  The alpha number for CSE in this study was 0.745 (Li et al., 2014).

The other implement utilized for this study was (SCSQ) Simplified Coping Style Questionnaire. It is a twenty items, character-report that comprises two proportions; the first one is active coping that includes twelve items and the other one is passive coping that includes 8 items. The matters were evaluated using a four point Likert scale of 0-3 that is not once to very frequently respectively. This is an instrument that is commonly used in other studies effectively which proves its reliability and validity. The alpha coefficient for the two dimensions of SCSQ in this study was 0.796 and 0.728 respectively (Li et al., 2014).

Demographic data sheet was the other implement utilized in the research. All the data of the participants that included; gender where the male nurses were 60, while the female were 1,499, age where the participants were between the ages of 30 and 40 years, work experience, educational level and profession rank were all acquired from a controlled questionnaire (Li et al., 2014). The education level was structured as high school with 13.7%, junior college with the highest participants at 53.9% and undergraduate or above with 32.5%. The profession rank was categorised as subordinate nurse 48.5%, senior nurse 34.2%, and supervisory nurse 17.3% (Li et al., 2014).

The dissemination of burnout in definite demographic individualities was verified by one-way ANOVA. Pearson correlation was completed to assess the association amid the (CSE) core-self-evaluation, managing styles and burnout (Li et al., 2014). The researchers used the Pearson correlation and one ranked linear regression examination for all the three burnout scopes individually to test for intervening influence. During the first phase of the ranked linear regression evaluations, the regulator variables and the affirmative outcomes of adjustment exploration were supplemented into the model. Gender, age, education level, job rank and work experience were included in the model acting as prospective confounders (Li et al., 2014).

The fact that the level of educational and rank of the job is definite variables that do not have linear tendency; replica variables for the two were established. In the level of educational, high school level was established as the orientation cluster while in rank of profession; subordinate nurse was established as the orientation group. During the second phase, core self-evaluation (CSE) was supplemented while in the third phase both active and passive managing styles were supplemented (Li et al., 2014). 1,662 questionnaires were returned where 103 of them were discarded as a result of incomplete data (Li et al., 2014). This study hence analysed and used 1,559 questionnaires which were fully completed.

                                                              Major findings

              This study demonstrates that core self-evaluation (CSE) is a cohesive character variable that can distress occupation burnout (Li et al., 2014). It similarly demonstrates that managing categories have both undeviating and incidental consequence on burnout (Li et al., 2014). The data collected from this research suggests that the strategies that promote active coping styles for nurses can greatly aid to moderate job burnout and thus augment nursing effectiveness. CSE is a forecaster of job burnout; this is proved by the facts in the study, which indicates that nurses that have high CSE scores have less emotional exhaustions, cynicism and higher professional efficacy. The people who have high CSE scores always tend to have high personal confidence and admiration, and also a more prenominal grace (Li et al., 2014).

              The positive factors that relate to prevention of nurse burnouts for example, active coping, social support and hardiness are the most important buffering factors. This study demonstrates that active managing was destructively linked with emotive fatigue, and scepticism. Active coping was also confidently related with specialized effectiveness. The outcomes of this study bring about the awareness that managing styles have a considerable consequence on burnout, and active managing may be a constructive reserve for contesting burnout (Li et al., 2014).

              This study illustrates that, beginner nurses have more burnout experiences than their older co-workers. This indicates that amplified life involvement aids one to become more confident in their work, meaning there is reduced use of passive coping styles and there is reduced burnout (Li et al., 2014). Managing strategies that are dysfunctional by nurses lead to poor nurse patient associations and disappointments, and this leads to a gradual lack of individual achievement. The nurses that consequently deal with chronic illnesses, demise and other major circumstances while working tend to cultivate emotionally adverse features and outlooks of emotional fatigue (Li et al., 2014). When there are no operational resources approved to handle the fatigue, it clues to scepticism and condensed expert efficiency. When an efficacious managing style is assumed in this case active managing, nurses have the capability to attain their objectives and their specialized efficiency advances (Li et al., 2014). An enthusiastic coping approach can accrue in nurses effectively using problem solving skills to manage the problems they are faced with, and to effectively decrease their stress points.

              One way to deal with nurse burnout is to provide problem solving skills training; this will help the nurses to progress and engagement in active managing styles to handle the stress that they face while they are working (Li et al., 2014). The training would greatly improve on the health and well-being of the nurses, which will lessen nurse burnout hence improving the quality of healthcare.

                                                           Strengths of the research

This study is consistent and precise, which makes it very easy to evaluate. The researchers effectively compare their findings with past studies conducted on the same issue, this greatly help the findings of this study to be reliable. The study participants are analysed using an array of demographics for instance; age, sex, educational level and job rank. This helps to effectively show the demographics that are more affected by the issue of nurse burnouts and thus make it easier to come up with effective remedies to the issue.

                                                                Weaknesses of the study

              The research was directed in large general hospitals. This means that it does not categorically reveal the burnout felt by nurses in diverse medical institutions, and public well-being centres. The second limitation to this study is that it relied mainly on self-report measure which encourages the issue of bias as some of the data may have been fabricated. Future studies should try and include more objective parameters for instance behavioural, and psychological indicators. They should also take account of wider prompting aspects and offer more intuitive understanding in respect to inter-associations between self- assessments, managing styles and burnout for nurses.

                                                            References

Li, X., Guan, L., Chang, H., & Zhang, B. (2014, December 26). Core self-evaluation and

burnout among Nurses: The mediating role of coping styles. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4277418/#pone.0115799-Garrosa1

Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). Maslach Burnout Inventory. (3rd ed.).

            Palo Alto, CA: Consulting Psychologists Press

 Addressing the Challenge Facing the Nursing Community

Introduction

            The principle of common good is something that every aspect of social life must be related to for it to attain its full meaning. This principle stems from dignity, unity, and equality of all people.  Common good is total sum of social conditions which allow people whether they are in groups or individually to reach their complete fulfillment more fully and easily. In the nursing community, some factors hinder realization of the common good in the profession both locally and globally. One of these factors happens to be the fact that society has refused to accept the idea of  healthcare offered by the nursing community as an idea of common good and has made nursing an evidence-based practice, thus making any nursing practice require concrete proof in order to make sense and if the evidence lacks the nursing profession is treated as one with dubious value. This challenge has hindered the nursing community from realization of the common good on a local and global scale, and for the nursing profession to realize its aspirations for the common good, then this challenge has to be dealt with in the long run.

            Human dignity is as a result of human beings made free by God. He created human being free so that they can do his bidding.  The only way they can do his bidding is by choosing to live and act within the framework of his law and because of this society is supposed to respect  the freedom given to human beings by enabling men and women to carry out their responsibility to better their own lives and encourage others to co-operate with each other in their pursuit for common good (Byron, William, 2004). In this context, society should accept the healthcare offered by the nursing community since those in that profession are doing so to benefit themselves and ¸are also working towards the realization of their aspirations for the common good.

 It is advisable to take into account that when the research that acts as proof or a concrete base for a nursing practice or intervention was carried out and verified it and termed ethical according to that specific period. Each of these studies was responsible for advancing societal good but not common good in accordance to the Catholic thoughts.  Almost all the studies were deemed unethical by the church, and common good serves as a good tool in determining what is ethical as time evolves (Donley, Grandjean, Jairath, McMullen and Shelton, 2006), Nursing is an ever-changing field and the research carried in the past should not be used to judge actions that are being carried out today.

As discussed earlier, the principle of common good stems from human dignity.  According to John Paul II, the right to religious freedom is very fundamental after the right to life. In many ways, the pope has called for a legitimate exercise to one’s rights of freedom and in this case to the ruling authorities that oppress Catholics and deny them their right to religion of worship. The pope was on a mission to promote the basic human rights of people he was able to improve the dignity and centrality of each human good.  He was able to attain common good by calling for equality and dignity of all human beings, and he received an honorary doctorate as a recognition of his work in promoting human rights (John Paul II, n.d). In this context, the nursing community has extended a helping hand to those who need it. The nursing profession is defined by elements such as care and concern that are extended to the people they serve, and these elements are deeply rooted in the profession. Just like John Paul II, the nursing profession is working towards the common good and society should realize that and honor the work and contribution of the nursing community.

Any action or intervention taken by a nurse needs concrete proof to back it up. This has been a constant challenge to the nursing community as it seeks to realize its aspirations of attaining common good. For the longest time ever, the catholic church has championed rights talk as a legitimate way of promoting universal participation in what the church holds as authentic. The church has also endorsed that what is right is no more than the description of the justice that was given at a certain time and was required at the given circumstance. In regards to this, society should not judge the actions of the nursing profession on proof but on the rightfulness of the action that was taken at the desired time (Wagner, William, n.d). According to Mele (2009), for common good to exist, there must be a cooperation that enable the promotion of conditions that are responsible for enhancing the opportunity for the flourishing of all people within a certain given community. Concerning this, the society should promote the conditions that will allow the nursing community to work effectively and do away with notions such as the practice should be based on proof instead of the action that was right at that particular time.

As mentioned earlier the nursing profession is defined by elements such as care and concern these two are the virtues that supply nurses with reasons why a certain action or intervention is needed, they are also the virtues that motivate and define the kind of people they are and will be (Audi, 2012). In this context, society should not let the nursing profession be based on proof, but on the better decisions they make concerning the profession and what is ethical, and this will help towards the realization of common good.  Unity, human dignity, and equality for all are part of what contributed to attainment of the common good. The world is changing, and the education is changing with it, societies in every corner of the globe are undergoing transformation this transformation means going beyond what society knows and focus on learning and embracing new approaches for the greater good, equality and human dignity (UNESCO, 2015). In this context, society should leave its belief in the past, views such as nursing is an evidence-based practice and that healthcare offered by the nursing community is not part of common good, and embrace new beliefs that will help the nursing community realize its aspirations of the common good. That is one of the ways people can change and transform the world they live in.

Conclusion

The principle of common good stems from human dignity, equality, and unity among all people of a society.  The efforts of the nursing community towards realization of its aspirations towards a common good have been hindered by the fact that society has refused to embrace the idea that the healthcare offered by nurses is for the common good. Society should accept the healthcare provided by the nursing community since it is part of their pursuit for common good. Society should also do away with basing nursing profession on evidence and proof since some of the research were carried out at a time, they were deemed ethical and consistent, but times have changed. As societies all over the globe embrace change and form new ideas on the nursing community.

References

 Audi, R. (2012). Virtue ethics as a resource in business. Business Ethics Quarterly, 22(2), 273-    291.

Byron, William, (2004). Framing Principles of Catholic Social Thought, 2004, pp.10-15.

Donley, Grandjean, Jairath, McMullen and Shelton. (November-December 2006). Nursing and    the Common Good.

John Paul II, Respect for Human Rights

Melé, D. (2009). Integrating personalism into virtue-based business ethics: The personalist and    the common good principles. Journal of Business Ethics, 88(1), 227-244.

UNESCO 2015, Rethinking Education. Towards a global common good?

Wagner, William J., (n.d). Universal Human Rights, The United Nations, And the Telos of            Human Dignity

 Background

            Asthma is one of the disorders that is perceived to be sudden and fatal hence having the ability of highlighting some of the risks of complications as well as the health outcomes that evolves whenever this condition is not managed as required. As a result of that, research indicates that severe asthma has the possibility of causing the collapse of lungs amongst pediatric patients who could have seemed to be healthy at first (Carlsen & Gerritsen, 2012). Despite that, there exist no single tests that have been proven to have to aid in determining its magnitude hence the need of identifying the symptoms and signs associated with it. Consequently, in the process of treating it, it is important to take into account the effect it has on the airway smooth muscle (ASM). Conditions associated with acute asthma have been found to be severe and sudden once they emerge and in case they are not managed quickly, they end up developing into chronic asthma (Chanez, 2012). 

Pathophysiological mechanisms of chronic asthma and acute asthma exacerbation

            Asthma is perceived to be one of the chronic diseases of the human airway that is ultimately characterized by recurring and variable symptoms, underlying inflammation, bronchial hyper-responsiveness, and airflow obstructions. Basically, it is the interactions of these asthmatic features that have the potential of determining the medical manifestations as well as the severity of this disorder and the response to therapeutics.  On the other hand, pathophysiological mechanisms that are used for the purpose of exacerbating chronic and acute asthma entail determining the manner in which tightness of the chest, coughing, wheezing, and shortness of breath induces episodes of airflow obstructions (Kian et al., 2019).

            Nonetheless, the need of understanding the mechanisms of asthma pathophysiology is the one that have been noted to have the potential of enabling people to understand the manner in which such conditions are diagnosed as well as treated. Both chronic and acute asthma have been acknowledged to have the ability of affecting bronchioles, bronchi, and the trachea as a whole. Inflammation of these parts always occurs regardless of the lack of the signs and the symptoms associated with asthma (Brasier, 2014). 

Changes in the arterial blood gas patterns during an exacerbation

            Nonetheless, during an exacerbation, the expansion and the increase in mucus secretion from the mucus secreting cells results to the blocking of the arterial airways with thick plugs of mucus. Extreme airway impairment can also result of the damaging of epithelial peeling hence making the airway to be hyper-responsiveness. The same changes result to the loss of vital enzymes that aid in breaking down some of the inflammatory disorders. Conversely, during an exacerbation, the oxygen supply decreases as a result of the dilation of the arterial airways (Carlsen & Gerritsen, 2012).

            As a result of the sharp contractions of the smooth muscles of the bronchial, it is possible of the bronchospasm to result to result to the narrowing of the airways. Similarly, edema resulting from microvascular leakage has also been noted to have the potential contributing to the narrowing of the breathing system. In return, the dilation and leaking of the airway capillaries will end up increasing secretions that impairs the clearance of mucus (Kian et al., 2019).  Consequently, as a result of the lack of proper clinical attention, it is possible for the patient to experience the remodeling of his or her airway hence inducing changes to tissues and the cells of the respiratory tract. In return, such changes have the ability of causing permanent fibrotic injury or damage. Moreover, due to the fact that this remodeling is ultimately irreversible, there is a progressive loss of the normal functioning of the lungs (Kimura & Ryo, 2015). 

How genetics impact the pathophysiology of both disorders

            Genetics is one of the factors to have been realized to impact the disorders’ pathophysiology in patient in question. According to research, the development of both disorders in the patient is a result of the inheritable components regarding its expression. Despite that genetics that is entailed in the eventual development of these disorders remain to be an incomplete and complex picture. Thus, the complexity of the involvement of the genes in medical asthma has been recognized to have a linkage to the patient’s phenotypic characteristics (Duke, 2007). Such a linkage is not also associated with pathophysiological process of the disease or their medical picture.

Diagnosis and treatment for the patient based on the selected factor

            The analysis or diagnosis of these disorders based on his genetics, will have to take into account the historical information provided by his family. The reason for that is because diagnosis based on genetics will have to go beyond chest tightness, dyspnea, wheezing, or coughing. Such a diagnosis will also not be based on the signs and symptoms that could have been perceived to worsen both conditions, especially at night. The treatment for these disorders will have to take into account both long-term and acute treatment. The reason for that is because the existence of diverse genetic variations is the one that has the ability of determining the patient’s responsiveness to therapy (Kimura & Ryo, 2015). Likewise, after obtaining the required patient and family genetic history, it will be the main basis of deciding the type of drugs to use to convert enzyme inhibitors or countering the effect of certain acute and chronic asthmatic agents.

Construct two mind maps—one for chronic asthma and one for acute asthma exacerbation

                                     Acute asthma exacerbation mind map

                             Chronic asthma exacerbation mind map

                                                            References

Carlsen, K.-H., & Gerritsen, J. (2012). Paediatric Asthma: European Respiratory Monograph 56. Sheffield: European Respiratory Society.

Chanez, P. (2012). Asthma, An Issue of Clinics in Chest Medicine - E-Book. Saunders Press

Duke, P. (2007). Medmaps for pathophysiology. Lippincott Williams And Wilkin

In Brasier, A. R. (2014). Heterogeneity in asthma. New York : Springer Press

Kian, F.CElliot, I & Peter, G. G. (2019). Severe Asthma: Volume 84 of ERS Monograph. European Respiratory Society

Kimura, H., & Ryo, A. (2015). Pathophysiology and epidemiology of virus-induced asthma. S.L: Frontiers Media SA.

 The Path to Becoming a Respiratory Therapist

A Respiratory Therapist

The work of a respiratory therapist is to make a diagnosis, evaluate asses and offer treatment to individuals with cardiopulmonary system disorders (Respiratory Therapist Career. 2008). This is inclusive of any diseases or disorders which impact inhalation and lung capability of an individual. Respiratory therapy is an important part of patient care most especially because of the increasing occurrences of enduring lung disorders and ailments like enduring bronchitis, emphysema and chronic obstructive pulmonary disease (COPD) (Respiratory Therapist Career. 2008). A respiratory therapist is hence a very important health care specialist, and becoming one requires meeting the set educational, certification and state licencing qualifications.

Education

The standard requirement for one to be a respiratory therapist is a university education in the area. All the states in the U.S. that licence respiratory therapists necessitate the applicants to have completed a respiratory health care accredited degree, which takes four years to complete. This is what is standard as illustrated by the Commission on Accreditation for Respiratory Care (CoARC).

 It is possible for a candidate to be certified as a respiratory caregiver if they have a junior or associate degree which includes the candidate having some clinical experience in the field and two full years of academic study (Respiratory Therapist Career. 2019). Bachelor’s degree has however gained so much popularity in almost every field to help meet the demands of most of the employers today, so many Respiratory therapist positions always prefer to have candidates that have advanced education . Respiratory therapists are today choosing to pursue the Registered Respiratory Therapist (RRT) certificate, which is a progressive level certificate in respiratory care (NOVA College Respiratory Therapy Catalogue. 2019). The RRT credentials are today becoming the standard for licencing and this is expected to be the trend in coming years.

To be admitted in Nova Community College for a respiratory therapy course, one is required to attend the respiratory therapy information session which is available online. One must also have a minimum curricular GPA of 2.5 from their previous school with at least 15 completed credits (NOVA College Respiratory Therapy Catalogue. 2019). One must also complete a college composition and a mathematics test and get acceptable scores to get admitted to the school for the course. If a student begins the course and unfortunately leaves before completion for any period up to two years, they can be re-enrolled (NOVA College Respiratory Therapy Catalogue. 2019). The students are required to demonstrate proficiency in all the previously enrolled skills courses before they re-enter the program. The students are given tests which include both written and practical exams which help to evaluate their proficiency (NOVA College Respiratory Therapy Catalogue. 2019).

All the CoARC attributed programs purpose to bring out candidates that are capable in; both spoken and inscribed communication abilities, respiratory health service, biomedical disciplines and social skills. The respiratory care curriculum covers the following areas; care of the adult, paediatric and new-born patients, community respiratory health, disease management, health promotion and endowment of healthcare amenities to individuals with communicable ailments among many others (NOVA College Respiratory Therapy Catalogue. 2019).

Licencing of respiratory therapists

Once a student has completed a CoARC approved respiratory care bachelor’s program, he or she is expected to take and ensure he passes the Therapist Multiple Choice (TMC) exam which earns them the Certified Respiratory Therapist (CRT) exam that consists of 160 multiple questions to be completed in three hours. The exam fee is $ 190; this is what is considered in licensing in almost all states (Respiratory Therapist Career. 2019). There are however, selected states where the candidates that have the associate level or the bachelor’s degrees, can acquire impermanent licensure which allows them to start working and they take the CRT exam later.

It is important for the people that are interested in the respiratory care career to understand that even though the licensing board only requires them to have the CRT credentials for licencing, times are changing and employers continue to choose advanced education and this is having RRT credentials. The RRT exam consists of 60 questions and an additional 10 questions section where one is expected to treat an imaginary patient’s condition. Most of the respiratory therapists in critical care settings are required to have the RRT credentials.

For the respiratory therapists that are practising within the U.S., it is a requirement to have state licensure (Respiratory Therapist Career. 2019). The licencing requirements are similar in almost all the states when it comes to matters of level of education and accreditation necessities. Some of the necessities for licensure in Virginia state for instance, comprise; a finalized, signed and authenticated solicitation for licensure, transcripts sent to the state licencing panel from the instructive institution, authentication of the identifications referred directly from the National Board for Respiratory Care (NBRC) to the state licensing panel, submission of fingerprints and payment of the licensing fee which in West Virginia is $ 200 (NOVA College Respiratory Therapy Catalogue. 2019). In order for respiratory therapists to maintain their licences, they are required to renew the licences after every three years and they renewal fee is $ 55 even renewed in November and $ 65 when renewed in December; this is to discourage people from rushing in during the last minute (NOVA College Respiratory Therapy Catalogue. 2019).

It is possible for a candidate that have been convicted of crime or any offences that are related to drug abuse or sale of controlled substances to be denied licensure. In Virginia for instance, the Virginia Board of Medicine reserves the right of giving or denying licensure to respiratory therapy candidates (NOVA College Respiratory Therapy Catalogue. 2019).

Finances

The Respiratory care course as earlier illustrated takes about four years, one is required to complete 71 credits. There are 15 credits for the prerequisites, 13 credits for the 1^st semester, 15 credits for the 2^nd semester, 4 credits for the 3^rd semester, 12 credits for the 4^th semester and 12 credits for the last semester (NOVA College Respiratory Therapy Catalogue. 2019).

Tuition fee for the respiratory care therapy course in Nova Community College for instance varies depending on type of students. The out of state students pay the most tuition fee per credit followed by the business contract students and then the military out of state contract students (NOVA College Tuition Rates. 2019). All other students including the state residents, veterans and those that are dual enrolled pay the least tuition per credit.

Table showing tuition fee for Nova Community College

 It is important to note that Nova Community College does not offer housing for students so it is important to consider housing and food costs while taking the course there NOVA College Tuition Rates. (2019).

Career development

It is important for the therapists to continue with respiratory care education to help them keep updated with new developments in the field. Staying updated helps the respiratory therapists to always offer the highest quality respiratory care services. Continued education for respiratory therapists allows them to be familiar with latest information, in regard to healing and analytical methods which permits them to always offer the benign and most actual respiratory care to their patients (Respiratory Therapist Career. 2008). This continued education can either be learner directed or provider directed given that there are many courses that are available online.

Most of the states necessitate the respiratory therapists to have completed a series of their obligated on-going education hours, medical integrities or even the lawful facets of the healthcare (Respiratory Therapist Career. 2019). The accepted on-going education sources can differ depending on the state, but the licensing board recognizes some providers like NBRC Advanced certification, Accreditation Council for Continuing Medical Education, American Academy for Cardiology, American Nurse Association and American Lung Association among others in offering continuing education for respiratory therapists.

One way that respiratory therapists can advance their skills is through specialization in their area of clinical practice. For instance, a respiratory therapist can choose to work with patients in the paediatric unit, the critically ill adults or the patients suffering from heart conditions (Respiratory Therapist Career. 2008). Specialization is important because it allows the respiratory therapist to focus on one area and perfect in it thus helping him or her to give offer the best care to their patients. NBRC encourages specialization and it offers speciality authorizations in adult acute care, new-borns and paediatric care, sleep disarrays and therapeutic intercessions (Respiratory Therapist Career. 2019). Certifications in respiratory occupation technology are also presented in two stages, there is the certified respiratory function technician and there is the registered respiratory function technician.

A respiratory therapist can also advance their expertise by taking up managerial roles in the health care unit. One can choose to become a supervisor, the head of the department or even an administrator in the hospital. The American Association for Respiratory Care (AARC) encourages therapists to become coordinators of clinical education or director of clinical studies in the hospitals that they work in (Respiratory Therapist Career. 2008). To get such promotions, therapists need to increase their education qualification levels by maybe completing their bachelors and even acquiring a post graduate degree in the respiratory care field.

Respiratory therapists who have enough experience of may be ten years and above can also start their own home care service companies which is allowed by AARC (Respiratory Therapist Career. 2008). Home care services are becoming very common in the society today, as people prefer to have their own care givers that they can access any time they want. A respiratory therapist with a home care service will be able to attend to many patients who find it troublesome to visit general health facilities.

 It is also possible for some respiratory therapists to find advancement as product agents or even marketing consultants in respiratory apparatus industrialists (Respiratory Therapist Career. 2019). The need for respiratory care demands for some machineries and also medications which opens up more opportunities for respiratory care specialists. It is an equally important area in respiratory care which ensures that the rights apparatus and medical products that aid in respiratory therapy are manufactured (Respiratory Therapist Career. 2019). Having the right experts in the area can ensure that this medical field always get the best products to help provide the best care to patients.

Respiratory therapists can also advance their careers by taking up roles in the education sector. They can specialize as researchers in respiratory care where they seek to look into the best strategies to deal with issues in respiratory care units (Respiratory Therapist Career. 2008). Respiratory care research is important in helping understand new trends in the field and best strategies to incorporate these trends to ensure best care delivery for patients. Therapists can also become teachers and trainers in colleges and universities where they train new respiratory therapists in the field (Respiratory Therapist Career. 2019). This are positions that require a therapist to have a master’s degree to qualify hence further emphasising the need for continued education for respiratory therapists.

Respiratory therapy is a career that has developed greatly and it is expected to continue growing in the years to come. This means that respiratory therapy jobs will increase which is an advantage for people that chose this course as their area of specialization.

References

NOVA College Respiratory Therapy Catalog. (2019). Retrieved from

            https://catalog.nvcc.edu/preview_program.php?catoid=2&poid=158&returnto=96

NOVA College Tuition Rates. (2019). Retrieved from

            https://www.nvcc.edu/tuition/index.html

Respiratory Therapist Career. (2019). Retrieved from

            https://explorehealthcareers.org/career/allied-health-professions/respiratory-therapist/

Respiratory Therapists. (2008). Occupational Outlook Handbook, 1–3. Retrieved from

http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=28094689&site=ehost-live

 Consequences of Overworking Hospital and Medical Staffs

Introduction

The principle of common good is related to human dignity and equality. Every human being has individual rights that should be exercise when promoting common good. John Paul II defined common good as the good that comes into existence in a community build by solidarity and equal agent. In this context nurses who are on the forefront of providing healthcare are part of the medical and hospital staff who must experience their rights as they aim to promote common good, the fact that they are overworked has denied them the chance to experience their rights.

It is the responsibility of every member of society to consider their actions and how their actions impact other’s sense of dignity. The human dignity of an individual means a lot and has to be respected (Wells, Cynthia, 2015). Overworking medical staff disrespects their human dignity and where the human dignity of individuals is disrespected common good cannot be achieved.

Human dignity acts as an empowerment that empowers people to embrace their roles. When the human dignity of nurses is respected, they are empowered to embrace their roles in the society and contribute towards common good (Wells, Cynthia, 2015). Similarly, when their dignity is not respected, they are demotivated to embrace their roles properly thus not achieving their aspirations for common good.

The nursing community cannot be able contribute to the good that comes into existence when a community is built by equality since they are overworked and this is not in respect to human dignity which has a strong relation to the principle of common good. Overworked medical staff and hospital staff has been a challenge that has hindered the nursing community from realizing inspirations of the common good (Massaro, Thomas, 2015).

Common good is the good that comes into existence, the good that can be offered by the nursing community is quality healthcare. Nurses are people who spend a lot time with patients and have a tremendous impact on the health of the people they serve. Overworking nurses hinders them to attain personal satisfaction in their work and from attaining the goals of the organizations they work for (Cochran, Clarke, 1999).

Common good cannot be attained if there is no equality and, in a setting, where human dignity is not respected. To achieve common good, the human dignity of the nurses must be respected. Overworking them does not respect their human dignity, and this hider the efforts of the nursing community from realizing its aspirations for common good (Clark, Meghan, 2014).

Nurses are people who are face a lot of psychological stressors, and this put them at a risk of experiencing burnouts which will deter their performance (Donley, Rosemary, Grandjean, Cynthia, Jairath, Nalini, McMullen Patricia and Shelton, Deborah, 2006). This will be a hindrance to realization of the nursing professional aspirations of common good since the induvial right to rest that was given to all social being has not been accorded to them.

Nurses are people who make a living off caring for other people, and these are the sick, the disabled, and the frail. At times they may fail to see these sick people as human beings, but a means to earn a paycheck. Considering the rise in cases that involve nurses robbing and sexually assaulting their patients overworked and underpaid nurses are likely to dehumanize those under their care viewing them as a burden that should be managed so that they can move on to the next one (Dunlop, Tarsi 2013).

            Overworking nurses deny them the opportunity to build a community that is built by equal agents and equality (Riordan, Patrick 2016). Overworking them is evidence that their contribution is undervalued and many of them may consider to leave the profession. A decline in enrolment is as a result of underpayment and the few the nurses in the profession the more it is challenging for the nursing profession to achieve common good (Holland, 2016). 

Conclusion

Overworked medical and hospital participants and among them, nurses are, and this is a big challenge towards the realization of the nursing professions aspirations of the common good. Overworking nurse is against human dignity and equality, which are strongly intertwined with the principle of common good.

Cognitive Behavioral Therapy

 Part one: The scenario

The patient's name is Alexander Grey, and he is a 37 years cocaine addict. By the time it was noticed that he is struggling with substance use disorder he was showing all the symptoms of withdrawal such as a running nose, stomach ache, his pupils were dilated, he was always experiencing chills even when the weather was sunny, his heart rate was elevated and his blood pressure was also high. He was in good physical shape and showed no psychological problems. His wife is a calm woman and works as a fulltime teacher. They have two children together. His wife describes him as a reasonably calm man from the beginning but for the last six months he has been violent. The wife narrates how the mood of her husband changes allover sudden, at one moment he is polite, and the next moment he is angry at everyone and gets irritated by slight mistakes. The wife was always wondering what could be the cause of her husband's bad moods but one weekend she came home and found her husband sniffing cocaine on their bedroom table.  From that day, she has been pushing him to attend therapy treatment. In a span of six months since he started using, he had been fired from two jobs as a result of being late and picking up fights with his workmates.

 The child, Tom who is 14 years old describes his father as a man who has always been there for them. He always attended all the parents-teachers' conferences and all soccer games but for the past few months that have passed his father has not shown up at any of his soccer games and when asked why he is irritated and makes excuses all the time. The child also reports that the father has shown hostility towards him when he is left at home with him.  Three months after he started using cocaine, the performance of Tom has deteriorated in school. The first-time Alexander walked into my office he admitted that he was struggling with cocaine addiction. He is afraid that he will lose his family if he is not able to stop using cocaine. He openly admitted that he needed my help.

Part two: therapy

Taking Mr. Grey and his family through treatment is an essential part of helping him recover from his addiction.  The Cognitive Behavioral Therapy model is the one I will use to take them through therapy.  As seen from the client's condition, he has destructive and harmful thoughts, which is very much prevalent in people with substance abuse disorder. These negative thoughts patterns are harmful and destructive. Cognition is responsible for affecting the wellbeing of an individual and therefore helping the client, and in this case, Mr. Grey organize his ability to think alternatively to reduce distress and harmful behaviors such as picking up fights with his workmates is important (Center for Substance Abuse Treatment,1999).  CBT is a useful treatment model for people dealing with substance disorder since it is an active therapeutic modality; it is present-oriented, focuses on the problem at hand. Lastly, it is goal-directed. Also, I choose this CBT therapy because I like to focus on the psychiatric part of a dilemma and to develop a better understanding of the problem at hand and then develop a treatment program. Helping the client to become their own therapist with a dab of interpersonal therapy as well.

CBT is appropriate and helps explore the beliefs that make the client resort to destructive thoughts. This model also allows the therapist and the client to work together in identifying the harmful negative thoughts and helps to seek other alternative positive thinking.  CBT sessions are accompanied by other activities that are outside the sessions that help the client embrace the changes they are about to undergo and help them through the process of recovery, which is a lifelong process. CBT sessions can also be provided to individuals and group therapy. The skills of CBT are helpful, useful, and also practical and are easily incorporated into the everyday life of the client. It helps clients formulate coping strategies so that they can be able to handle potential stressors or difficulties that arise as they are being treated (Center for Substance Abuse Treatment,1999). All the above are reasons why I find the CBT model suitable to use as I take Mr. Grey and his family through therapy. 

            As mentioned earlier, the CBT therapy model is goal-directed. Using the CBT therapy model to help Mr. Grey and his family, there are initial goals that I hope to achieve. Goals such as keeping the family engaged during treatment, the family to understand how the treatment works. To offer high levels of support after undergoing treatment (Center for Substance Abuse Treatment,1999). Making sure that the patient is equiped with both behavioral and cognitive coping strategies that will help reducew his chances of relapse even after completing treatment.

During the initial session, I will explore the reasons Mr. Grey is seeking treatment and the extent to which his reasons to seek treatment are intrinsic or influenced by other factors. Using the information I will obtain from this initial session I will be able to come up with a treatment plan and identify behaviors to address during treatment. This session will give me an opportunity to asses the most dominant behaviors so that I can intervene with them first. This session will also allow me to know Mr. Grey's readiness to start his recovery journey. During this session, I will also go in-depth and learn the stressors that are pushing him towards using cocaine. During this session, I will negotiate with Mr. Grey to accomplish the goals that have been set.  The homework assignment of the first session is asking him to keep a journal like record of  how he feels when using the substance (Center for Substance Abuse Treatment,1999).

            During the sessions that follow I will introduce cue exposure training which will involve placing Mr.Grey in situations that have emotional cues associated with the substance he was using in order to bring about a robust physiological arousal reaction that brings about cravings, this I will do during one of our sessions. Cocaine dependent people such as my Client Mr. Grey have a habit of showing prototypical arousal and response the first time the drug-related cues are presented to them. Around the third session is when I will introduce the drug-related cue so that as we approach the 7th  session Mr. Grey will no longer be showing any physiological withdrawal and towards the 10th session he will no longer be experiencing cravings when cocaine is presented to him (Center for Substance Abuse Treatment,1999). I believe after presenting Mr. Grey with Cocaine related cues lowers his chance of dropping out of the treatment and will increase his chances of having cocaine-free days. In the later sessions, I will introduce the two significant people in his life, which is his wife and son in a few sessions. Since they are the people who are around him, and they need to be taught to positively reinforce Grey's addiction and also help him stay away from the substance. I will involve Mr. Grey and his family in developing a contingency contract that will help him reinforce positive behavior.

Also, in the sessions that follow, I will introduce coping strategies. These strategies can be in various dimensions; emotional focused or focused on avoiding the problem. These strategies will help with coping with urges, cravings, and temptations that arise when he is in an environment that will bring back the memory of how he used to feel when abusing the substance. I will also make sure I take him through anticipatory coping strategies so that he can deal with upcoming situations. This I will do by making sure that his coping skills are not, and thus, he will not be at risk of continuing to use the substance or relapsing. I will integrate both behavioral and cognitive coping strategies so as to strengthen his ability to resist using cocaine. Throughout all these sessions in the middle, I will make sure I bridge them together, and this I will do mostly using homework assignments (Center for Substance Abuse Treatment,1999). Homework assignments that I will give him in these sessions include collecting information on his feelings everyday and to test new beliefs.

 The therapy will last for 12 sessions, and each session will be carried out for in duration of one hour.  During the last session, we will tie all the loose ends and learn what the future holds for Mr. Grey and lastly help him get closure. End of treatment planning is very important, and it is something that I will have started in in the initial session. During this last session, we will review all the cognitive and behavioral skills Mr. Grey has learned. I will also take him through the tools he has learned in therapy and how he can use them to deal with potential stressors.  I  will also make sure I do not introduce anything new during this session since it may make it difficult to terminate the session. I will give Mr. Grey credit for his efforts in agreeing to come and getting through the therapy. The homework assignment for this session will be for him to plan a self-management time. Where he will be required to set a few minutes aside each week to check his mood and use the skills he has learned to solve his negative feelings to influence positive thinking. I will also take the opportunity to schedule booster sessions for him, which will be approximately one month after we have terminated the treatment (Center for Substance Abuse Treatment,1999). Over these booster sessions, I will help him refresh on the skills he had learned in therapy and check in with him about his self-management time and how he is managing stressors. 

References

Center for Substance Abuse Treatment. (1999). Brief Interventions and Brief Therapies for          Substance Abuse. Rockville (MD): Substance Abuse and Mental Health Services       Administration (US)(Treatment Improvement Protocol (TIP) Series, No. 34.) Chapter           4—Brief Cognitive-Behavioral Therapy.Available from:   https://www.ncbi.nlm.nih.gov/books/NBK64948/