Category: Leadership

Nurses play a valuable role in health care but they can also play an important role when disaster strikes. There are various tasks that a nurse can do to help any disaster situation, whether it is natural or man-made. A key job that a nurse can do is assessing patients. This can be done to determine how severe patients are from the disaster. Assessing patient’s helps doctors organize who they need to treat first. Things can get pretty hectic when a disaster occurs. It is important that the nurse remains calm and collected when assessing patients. Nurses also can’t hold be afraid to tell it like it is. If a patient is near death and has a low probability of survival, the nurse needs to make the decision to provide comfort and let the patient live out the remainder of their life. Nurses can also contribute by providing patients with first aid and medications. If people are in need of help but their injuries aren’t as extensive as others, a nurse can jump in and provide first aid. This could mean stabilizing a patient with a suspected spinal cord injury or tying off a gushing wound by providing pressure. These tasks can help save patient’s lives. Medication administration is also valuable in providing comfort to patients. Pain medications can be used to help alleviate immediate pain. When dealing with all of this commotion, a nurse needs to be able to step back and think about their own safety before jumping into something that can danger themselves.

The ANA Code of Ethics can present conflicting Provisions as a nurse has a duty to care for a patient yet, care for themselves. These two Provisions can conflict each other in times of disaster. In these types of situations, a nurse has to think about themselves and the issue at hand. If saving someone’s life is going to cost your own life, then that is not worth it. A nurse can only do some much in certain circumstances. It can be challenging for a nurse to make this decision. When a nurse spends their whole career helping people in need, these decisions do not get any easier. Sometimes, a nurse may need someone else to explain to them that helping someone in a certain situation can lead to harming themselves. The judgement is left up to the nurse as they should do what they feel comfortable doing. It would not be considered a breach in one code over another when they involve endangering yourself or the patient. 

Death with dignity is a very important topic as it can provide patients with a sense of comfort and give respect during their late stages of life. End of life can be challenging for patient as they experience a roller coaster of emotions including pain. Personally, I agree with physician assisted death as it gives the patient the control over their care. Instead of suffering from a terminal illness and waiting for themselves to die, it gives the patient the choice and terms on when they would like to no longer exist. I had a family member who was suffering from cancer and it was very challenging to watch them suffer knowing there is nothing that can be done. This topic can be challenging for some to discuss as they can have personal experiences that influence their viewpoint. Further research can be beneficial as it can provide more information on the topic and how it can affect patient care.

After viewing various literature, I have learned a great deal of information on death with dignity. I was surprised with how many states in the US have this process for patients. I assumed, with it being a very controversial topic, that there would be only one or two jurisdictions that allowed assisted death. With this, I also learned about some of the criteria that accompanies it. The patient must be of a certain age, be diagnosed with a terminal illness, and have decision making capacity. This process can challenge the first ethical principle of nonmaleficence as it directly causes the patient to die. This can a difficult concept as it is counteracting on what nurses and health care providers pride themselves on. Yet, the great picture should be looked at in these scenarios. If the patient can make decisions and a terminally ill diagnosis is made, then the decision should be in the hands of the patient. Death with dignity should be a “treatment” option that of which a patient can elect to go proceed with. This “treatment” option would be accompanied with consent and all other required documents for procedures. Healthcare workers look to help the quality of life in patients and with death with dignity, this can be accommodated. When dealing with terminally ill patient, health care workers are only providing comforting measure and prolonging the patient’s life, yet it may not be improving quality at all. Looking at the big picture can shed light into how a patient is feeling and can ultimately lead to providing the best care that health care workers can.

The use of electronic health records can be very important in when it comes to patient care. The patient’s information is uploaded in real-time so that all people holding the capability can look when needed. Having the records held online allows for easy access and control over their own records. The health records can include diagnosis, medications, immunizations, allergies, lab results, and so on. The implementation of HIE and electronic health records is a huge jump the medical field. These records can be accessed on smart phones, tablets, and anywhere internet access iv available. This can allow physicians and the health care team to access this data when needed.

HIE allows the health care team to be more efficient and provide better quality when it comes to patient care. Instead of forcing the medical staff to hold records in filing cabinets or in boxes, it is all virtual and at the providers fingertips. Having information such as vital signs submitted in real-time, it can reduce the readmission risk, reduce medication errors, decrease duplication of testing, and improve how physicians diagnose patients. HIE also provides safe and confidential information so that each patient knows who is viewing their information and when they view the information. This tracking system that is apart of HIE is used to prevent any breaches in HIPAA and ensures only the allowed people to view the records. Electronic health records can enhance how care is provided to all patients.

Trauma can have a significant impact on psychological, physical, spiritual, environmental, and social well-being. It can be life changing for a person to experience a traumatic event as it can stay with them for the rest of their lives. Traumatic experiences can be very damaging to a person’s mental health. The event or events that have occurred can trigger future negative reactions to things that resemble their traumatic event. Symptoms such as depression and anxiety can be directly correlated to trauma as a secondary diagnosis. A person’s physical well-being is also affected as well. Eating habits can diminish or escalate, sleep schedule can be derailed, and activity levels can plummet. These actions present as a person tries to cope with their traumatic experience or be a lasting effect of going through a traumatic experience. Socially, a person can become reserved and isolate themselves from others. Traumatic events can impact a person in ways that could be crippling. It is important to understand what happened during the event and try to work through the issues that present.

                 Adverse childhood experiences can develop into serious complications. Chronic illnesses, mental illness, and substance abuse are just a few examples of what can happen to an individual later in life due to ACEs. These events can cause things such as heart disease, diabetes, and respiratory illnesses. The stress that is induced from ACEs can cause physical damage to and individual. It can also cause mental inadequacies that can be life changing. It is important to recognize and establish early interventions to reduce further complications and reduce the occurrences of ACEs. Having programs available so that children can feel comfortable and safe when talking about their experiences. Promoting a healthy lifestyle is also very important in reducing the complications of ACE’s. Healthy eating, regular exercise, mindful thinking, and proper sleep can all help to reduce stress and promote well-being. This information is vital when practicing as a nurse.

               The Trauma-Informed Care principles are a key tool to use when handling a traumatic related situation. The principles look at understanding how trauma can impact a person in all facets of life and how that can be incorporated when giving care. The goal of patient care looks at the over all well-being rather than just the individual symptoms. When practicing, it is important to maintain patient safety. Providing the needed respect to allow a patient to feel safe both physically and mentally is key. Developing a trusting therapeutic relationship provokes a more safe and transparent care plan. This is important as a nurse because the patient will be more likely to express themselves which can help with diagnoses and maintaining their well-being. As a nurse, collaboration with peers and other health care professions will ultimately provide an enhanced care plan for all patients. This group work allows for sharing information between professions as well as with the patient. This entitles the patient to participate in their care and develop the course of treatment. Trauma informed care is very important in the healthcare role. It can drastically change the course of the patient’s health in a positive way.

The health or vulnerable and marginalized populations is widely underestimated which is a public health crisis. Many factors contribute and influence these populations. The individual, the environment, and the societal factors have a strong impact on their health The individual may have religious obligations that require them to not follow through with certain procedures. In the eyes of a health care worker this could be devastating, but it is important to recognize the different beliefs that people live by and how that can affect their health. An individual’s environment may not be able to support their needs. They could not have the needed facilities to treat what is needed resulting in a decreased health status. Society also plays a strong role in how well a person can maintain good health. Someone could live in a region where racial injustice is predominant. That person would not be able to go take care of themselves in the same sense that someone of different color could. All these factors contribute and influence the health of an individual and community. Money plays a huge role when it comes to and individual’s health as well. One may not be able to afford medical insurance and may have to pay out of pocket for procedures and appointments. One may have to choose between going to the doctor and putting food on their table. Individuals are likely to put aside medical conditions to afford more important things. This public health crisis needs to be rethought and changed in a way so that it is fair to everyone.

A keyway to start change is to rewire the way we think. For example, someone could decline getting a vaccine. Rather than just saying they should get the vaccine everyone is doing it; they should ask why. Many key things can influence how someone approaches health care. Not everyone is afforded the opportunity to make the best decisions possible. Does that person have health insurance? Transportation? Education? Resources? These drive the decisions we make yet some must set aside their health for a variety of reasons. As a community, we should look to help those less fortunate. Educate them, give them resources, give them the tools to help themselves. This ongoing public health crisis is important to everyone. We should all be educated and appreciate the things we have. When giving care, this information is important to know. As a nurse, I would educate patients and listen to their opinions. I would listen to what they have to say and try to help them the best I could. These populations are already at risk of decreased health it should be our job to help them.