3 postsRe: Topic 4 DQ 1

The method of delivery of health care along with regulatory control over the system differ from country to country. Cost-sharing required at point-of-service and range of benefits also vary globally. What is common is the incorporation of private insurance, but the importance varies considerably across nations (The Commonwealth Fund, 2019). According to the Commonwealth Fund’s new 11-country report, the “level of income defines the health care you receive far more in the United States than in other wealthy nations” (The Commonwealth Fund, 2019, para. 1). The study found that U.S. ranked last in providing equally accessible and high-quality health care, regardless of a person’s income. There have been great advances with access and coverage of health care in the U.S. due to the Affordable Care Act, but there are far too many Americans that continue to struggle with access to health care (The Commonwealth Fund, 2019).

The delivery of health care in the U.S. is comprised of a variety of public and private entities (Green, 2018). Government entities and in collaboration with community nonprofit organizations and faith-based organizations comprised the public health system. The private health settings include inpatient, outpatient, ambulatory, long-term care, mental health, home care, wellness center, and alternative care, which are regulated by the overarching governmental agencies (Green, 2018). Payment for medical services can by paid individually but the costs for services may not be feasible for most. Therefore, people rely on health care insurance, an arrangement with the government or private company, that will provide guarantee payment for health care services (Green, 2018). Whether private or public, the person must be eligible for these services. Either or, a person may accrue out-of-pocket costs. Although the percentage of uninsured people have decreased since the passage of the Affordable Care Act, there continues the existence of 28 million people who are uninsured in the U.S. as of 2017 (Berchick, 2018).

Studies have shown that physician-patient relationship that focused on quality and personalized preventive care resulted in positive health care expenditure outcomes and improved health management over a three-year time period (Musich, Wang, Hawkings, & Klemes, 2016). According to the Centers for Medicare & Medicaid Services, the U.S. health care spending increased by 3.9 percent in 2017. This equates to $3.5 trillion or $10,739 per person. Much of the expenditures can be reduced when the focus of health is on prevention and not disease management.

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Elizabeth Homrighausen 1 postsRe: Topic 4 DQ 2

Health care systems in the United States are quite complex. There are insurance companies that dictate what cares they cover, which providers and which medications. When thinking about the multiple players that contribute to the delivery of health care services, we must analyze if the it is adequate for the patients needs. “The USA is currently the only high-income country without nearly universal health-care coverage. Attempts to achieve universal health coverage have been made since the 1940s but – apart from the development of Medicare and Medicaid (which provides coverage for the poor, near-poor residents, including children, pregnant women, parents, seniors and individuals with disabilities) in 1965 – little progress had been made before the implementation of the ACA (Affordable Care Act)”(Rice , et al., 2014). According to Rice, Medicare and Medicaid cover approximately 30% of the population, and in 2012 about 18% were uninsured.

“The ACA is much more than just a health insurance law. It touches on almost every aspect of the delivery of the health service and was designed to encourage more primary care, to promote a greater focus on quality and prevention, and to encourage doctors, hospitals and other providers to coordinate care through new entities called accountable care organizations” (Rice , et al., 2014). I believe that the ACA will not completely fix our health care problems, but it is certainly a start. One of down falls to the ACA is higher premium costs for patients with private insurance causing financial burden for the middle-class families. The great thing about the ACA is that it promotes health by having insurance companies cover the costs of preventive care. The role of nurses is to advocate for our patients well being and educate on the importance of health promotion and the continuation of health care needs. We must also help inform them what their health insurance covers as far as care, many patients don’t entirely know what all their insurance will and will not cover. 

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1 postsRe: Topic 5 DQ 1

International Federal (2019) defines disaster as a sudden, calamitous event that seriously disrupts the functioning of a community or society and causes human, material, and economic or environmental losses that exceed the community’s or society’s ability to cope using its own resources. Disasters, whether natural or manmade, can take a significant toll on an individual or community, causing short and long-term distress (Falkner, 2018). Spiritual considerations surrounding a disaster is different for individuals and communities, because of their unique beliefs. Different cultures may respond differently to disasters, whether it is by praying, crying, doubting God, thinking that they are being punished by God, etc. If a disaster were a terrorist attack (manmade), people of different cultures may hold grudges and hate towards a certain ethnic group.

According to Maslow’s hierarchy of needs, basic needs must be met before psychological and self-fulfillment needs. For a nurse to assist with spiritual care, he or she must have the patient in safety and make sure that they had water, food, warmth, shelter, rest, and security. Correct me if I’m wrong, but we most likely would not assess a patient about spiritual needs if they are panicking and are in the middle of receiving medical care.

Spiritual considerations can arise surrounding any natural disaster by those who are impacted. Many problems that can arise during natural disasters would be destruction of homes, churches, religious centers, and sacred landmarks. Many cultures and religions hold special sentiments towards certain structures and the destruction of these could cause great loss and may affect the spirituality of individuals in a community. Disasters cause death in the hundreds or thousands and will cause devastation for many people who then may require spiritual support to help them cope with the loses.

A community health nurse can assist in the spiritual care of the individual, community, self, and colleagues in many ways. First, nurses should take care of themselves and be aware of their own emotional health before they could help others. Nurses must be aware of cultural differences and adjust their care according to their beliefs. Nurses are also expected to create a healing environment for the physical and spiritual self, which respects human dignity (Minority Nurse, 2013). Advocation can take place when a nurse finds a chaplain to provide psychological and spiritual support. Simple interventions, such as holding an individual’s hand and providing empathy and silence can be beneficial for one and provide reassurance. Taking the time to pray with individuals of a community can also provide support.

References

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3 postsRe: Topic 5 DQ 1

I find it hard to separate the natural versus manmade disaster given inconvenient reality of more frequent disasters with more intensity and scope caused by man-made climate change. Sure, we’ve always had extreme weather events. But they are getting more unpredictable, more frequent, more intense, and devastating than ever before because of human activity.

Spiritual care in the face of one of these disasters may become acutely needed. While not everyone has adopted religion or subscribes to a particular faith, chaplains are trained to provide psychosocial support when needed to help communities cope with emotional needs following a disaster event (GCU, 2018). Nurses may recognize a readiness for patients to receive psychosocial and spiritual support that a chaplain can provide, even if the patient does not expressly ask for one.

Culture plays a role in the response and reaction people may display following a disaster, and the PHN should be aware of the existence of these differences and incorporate them into the nursing process when planning for care. Responses may vary widely or even seem strange to an onlooker such as a nurse, but its cultural and trauma-informed to put those preconceptions aside and meet the individual where they are in processing the disaster.

Chaplains can also help tend to the spiritual and psychosocial needs of the first responders and disaster relief teams, including nurses. Taking care of one’s own mental and spiritual well-being before helping others is an important aspect of helping during a disaster.

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This is a discussion post, about 250 WORDS, tittle page not require In- text citation is required original work please, scholarly references are required for this assignment, website source strongly preferred.

QUESTION 2: 

Envision what the health care system of 2030 might look like? Describe at least two technological advancements that would be available to patients. How would technology help providers make health care decisions? How would patients and families interact with providers from their homes or in their communities? What would health care systems be able to do “in real time? A minimum of THREE academic references from credible sources are required for this assignment

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