Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use at least 3 references

                                                          Main Post

                               Needs of Military Veterans and Dependents

            Our nation’s assistance in helping military veterans and their families is lacking.  Two needs that need the most focus are healthcare needs, specifically mental health, and transitional support.  Many veterans end up homeless or lack health insurance once they enter the civilian world (Deyton, Hess, & Jackonis, 2008).  According to Deyton et al. (2008) two million veterans and 3.8 million of their dependents lack private health insurance.  Most hardworking veterans earn too much to qualify for Medicaid programs but make too little to afford insurance (Deyton et al., 2008).  As a Naval veteran myself, I experienced the intimidating act of leaving the military and starting a new life as a civilian in 2011.  During my exit from the military, I received an exit medical exam.  This exam included the physician doing a head to toe assessment and reviewing my medical record.  No focus was evident regarding my mental health.  I was told by the physician, “You are a healthy childbearing woman and have no need for assistance upon discharge.”  From there, I was on my own to transition into civilian care.  I am one of the fortunate ones who could find resources.  Many are not so lucky.  

Another need for veterans is transitional support.  Deyton et al. (2008) identify the lack of this support as another reason for homelessness and lack of health insurance access for veterans.  Before I discharged from the military, my superiors encouraged me to attend a Transition Assistance Program (TAP) class.  While participating in this class with about 50 others, I noticed only three other officers.  The rest were enlisted. In the military, officers have at least a bachelor’s degree.  The enlisted may also have some college background, but most are high school educated and trained on the job.  The three officers and I left the class with a stack of papers and extreme confusion.  While discussing our fears, we rationalized how fortunate we were that our education gave us opportunities on our exit.  Many others in the class were realizing challenges of employment as they described jobs in which they applied and were turned down.  Great fear was evident among the group.    

Advocating Efforts

The development of policy is necessary to getting veterans healthcare access and supporting their transitional process.  Deyton et al. (2008) point out resources available are fragmented, and integration is essential.  Policy at the Agency Secretary level requiring coordination of these resources can make this integration possible (Deyton et al., 2008).  As a Navy veteran nurse, I’m responsible for advocating for policy to make the transition smooth for military veterans and their families.

Advocating skills necessary for a transitioning military veteran policy include grassroots lobbying.  Nurses should focus on developing relationships with their local legislatures and educate those legislatures on nursing interests (Milstead, 2013).  Milstead (2013) identifies nurse constituents as valuable resources in grassroots efforts and suggests nurses join specialty nurse organizations to develop the skills necessary.  Nurses who anticipate lobbying for policy should educate themselves on the lawmaking process and ethics laws to be most effective in their efforts (Milstead, 2013).  Development in advocacy skills to participate in grassroots efforts are necessary to support policy in helping military veterans and their families.

Nurses are responsible for advocating for the health of the populations (Laureate Education, 2012).  In nurses’ daily lives, they develop relationships with clients and colleagues giving them the opportunity to show compassion and empower their clients and coworkers (Begley, 2010). With rapport built, nurses have the responsibility of spreading education about healthcare issues and holding their colleagues accountable (Begley, 2010).  Dr. Peter Beilenson explained that, in the eyes of legislatures, nurses are constituents who care for their patients without a business agenda (Laureate Education, 2012).  Nurses should realize their value and become active in advocacy efforts to help veterans and their families and other suffering populations.  

References

Begley, A. (2010). On being a good nurse: Reflections on the past and preparing for the future. International Journal of Nursing Practice, 16(6), 525-532.

Deyton, L., Hess, W. J., & Jackonis, M. J. (2008, Winter). War, its aftermath, and U.S. health policy: Toward a comprehensive health program for America’s military personnel, veterans, and their families. Journal of Law, Medicine, & Ethics, 36(4), 677–689.

Laureate Education (Producer). (2012g). The needle exchange program. Baltimore, MD: Author.

Milstead, J. A. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones and Bartlett Publishers.

 

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Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use  references

EXAMPLE OF A REFERENCE:

If you cannot locate a doi number, this is how the reference should look: 

Quelly, S. B. (2017). Characteristics Associated with School Nurse Childhood Obesity Prevention Practices. Pediatric Nursing, 43(4). Retrieved from https://www.pediatricnursing.net/issues/17julaug/abstr5.html

                                                   MAIN POST

Ethical and Economic Policy Challenges in Healthcare

            There is much tension today about policy decisions regarding healthcare due to economic and ethical challenges.  Economically, our nation struggles due to the rising demands of healthcare.  Demands have increased due to the changes in our nation’s demographics as the baby boomers have aged and required more healthcare services (Laureate Education, 2012).  In the article “For Baby Boomers, Health Care Where and When They Want It,” Barr (2014) describes how the baby boomers have much higher expectations than generations before them.  The number of senior citizens, along with the demands of this generation, increases the cost of healthcare.  Also, our requirements as a nation have increased due to significant new technologies (Laureate Education, 2012).  These technologies are welcomed by baby boomers who demand to have vast amounts of information regarding their healthcare (Barr, 2014).

Ethically, the struggle is determining how to supply the care, including new technologies and new treatments, even though it is expensive.  Of course, everyone would agree that we want those who are sick to get the care needed to live a longer, healthier life.  However, with the cost of healthcare, is this feasible?  For example, the Washington Post discusses a new drug, Provenge that costs $93,000 per patient (Stein, 2010, November 8).  Studies show it could extend a prostate cancer patient’s life by about four months (Stein, 2010, November 8).  Some may say this is a lot of money for only four more months of life.  Others may feel a day of life cannot have a price tag.  In the Washington Post, Stein (2010, November 8) mentions that government agencies such as Medicare spending a significant amount of money on a medication that will extend life by four months may prevent our nation from affording other treatments.  In the article, “As Healthcare Costs Continue to Rise, Providers Weigh Care’s Expense and Effect,” Walker (2015) discusses how considering the cost against the benefit of technology would help reduce cost.  Does someone really need to continue getting these expensive serial tests if they remain asymptomatic?  Limiting diagnostic testing to only when it is essential leads to more debate.  The baby boomers and other Americans feel the need to have all information possible (Barr, 2014).  Policymaking to ensure all citizens receive what they believe to be essential healthcare required to live a longer and healthier life remains an ethical and economic challenge.

References

Barr, P. (2014). For Baby Boomers, health care where and when they want it. H&HN: Hospitals & Health Networks, 88(12), 36–40. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=107841386&site=ehost-live&scope=site

Laureate Education (Producer). (2012). Healthcare economics and financing. Baltimore, MD: Author.

Stein, R. (2010, November 8). Review of prostate cancer drug Provenge renews medical cost-benefit debate. The Washington Post. Retrieved from http://www.washintonpost.com/wp-dyyn/content/article/2010/11/07/AR2010110705205.html

Walker, S. (2015). As healthcare costs continue to rise, providers weigh care’s expense and effect. ONS Connect, 30(4), 57. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=111511288&site=ehost-live&scope=site

 

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Respond  on two different days who selected different disorders or factors than you, in one or more of the following ways:

Share insights on how the factor you selected impacts the pathophysiology of the disorder your colleague selected.

Offer alternative diagnoses and prescription of treatment options for the disorder your colleague selected.

Validate an idea with your own experience and additional research.

                                      Main Post

Reproductive Disorders            

The reproductive system in males and females is an important part of everyday life. Disorders of the reproductive system can cause physical and emotional stress related to symptoms these disorders cause. Polycystic Ovarian Syndrome (PCOS) and Uterine Fibroids are just two of many reproductive disorders that wreak havoc on women. 

Polycystic Ovarian Syndrome

PCOS is a “syndrome,” or group of symptoms that affects the ovaries and ovulation. PCOS causes hormonal imbalances and metabolism problems. PCOS three main features are; cysts in the ovaries, high levels of male hormones, and irregular or skipped periods. PCOS is a hormonal imbalance along with metabolism issues that can affect overall health and appearance. “Between 5% and 10% of women between 15 and 44” (OWH, 2019), have PCOS and usually are diagnoses between their “20s and 30s trying to conceive but PCOS can happen anytime after puberty” (OWH, 2019). Common symptoms can include but not limited are, Irregular periods, heavy menstruation, male pattern baldness, weight gain, acne, and can increase the risk of heart disease. Diagnosis is based on symptoms, blood work, pelvic exam, and ultrasound. Treatment can include weight loss, increased physical activity, medications (metformin and birth control medications), and surgery.              Uterine Fibroids            

“Uterine fibroids are the most common noncancerous tumors in women of childbearing age” (CDC, 2019). “They are made of smooth muscle and other cells that can develop within the uterine wall itself or attach to it and can grow as single tumor or a cluster” (Stoppler, M, Davis, C, n.d.) “Fibroids can occur in up to 50% of all women and are one leading cause of hysterectomy” (Stoppler, M, Davis, C, n.d.). There is no significant reason as to why fibroids develop. Risk factors can include, family history, obesity, nulliparity, early on-set of menstruation, and “women of African descent are two to three times more likely to develop fibroids than women of other races” (Stoppler, M, Davis, C, n.d.). Symptoms can include, increase in menstrual bleeding, pressure in the rectum and bladder, which can cause constipation and frequency in urination, pelvic mass, and increase waist circumference. Diagnosis is based on pelvic ultrasound, endometrial biopsy, hysteroscopy, and laparoscopy. Treatment of fibroids depends on the severity of symptoms, trying to have children, general overall health, and size and location of the fibroids. If medically necessary to treat fibroids, sometimes medications can help, D&C can be an option, and surgery such as a myomectomy, and hysterectomy.

                                        Age as a Factor 

Unfortunately, age can play a role in women diagnoses with PCOS or Uterine fibroids, mainly because of the wanting to have children and the increased risk for cardiovascular disease. PCOS and fibroids usually develop after puberty and are usually diagnosed in childbearing years around 20-30 years of age. It can affect women getting pregnant and make for a difficult road ahead. “Polycystic ovary syndrome puts older women at increased risk of cardiovascular disease and type 2 diabetes following menopause” (Grassi, A, 2014). When a woman has gone through menopause, this causes a decrease in hormones which can decrease the size of fibroids and the development of fibroids. Fibroids need the hormones to develop so without the right number of hormones, fibroids may not develop. 

                                          References

Centers for Disease Control. (2019). Common Reproductive Health Concerns for Women. Retrieved from https://www.cdc.gov/reproductivehealth/womensrh/healthconcerns.html Galan, N. (2017). Fibroids after menopause: What you need to know. Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/319576.php  Grassi, A. (2014). PCOS in Aging Women — Beyond Hormones and Hot Flashes. Today’s Dietician. Vol. 16 No. 2 P. 40. Retrieved from https://www.todaysdietitian.com/newarchives/020314p40.shtml Stoppler, M, Davis, C, (n.d.). Uterine Fibroids. Retrieved from https://www.emedicinehealth.com/uterine_fibroids/article_em.htm#what_are_uterine_fibroidsOffice of Women’s Health. (2019). Polycystic ovary syndrome. Retrieved from https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

 

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Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use  references

                                                       Initial Post

My program is Nurse Educator and to do research on anything to do with this is a little difficult as there is not much information on it. I decided to do two types of searches based on how I might go with my master’s degree. The first search was nurse educators and what came up was an article on how to become a better nurse educator to nursing students. The most interesting statement made in this article hit close to home for me. “Teaching student nurses’ critical thinking and the ability to apply clinical reasoning skills remains a challenge in nursing education” (Wyngaarden, 2018). Being a nursing student is stressful but having to think outside the box but quickly can be even more difficult at times. Teachers are having a hard time connecting with students because not only is there a huge age gap between the student population but so many different learning barriers and language barriers they are trying to work around. 

The second search I did was nurse educators to patients. I research this as well because I have also thought about being an educator to patients to have one-to-one conversations about their illness. I feel as though patients might listen and understand better if they are working with someone one-on-one rather than a different nurse/doctor every other day while in the hospital. While I was working for Shands, they had a diabetic nurse educator who would not only do education with the patients during their hospital stay, but she would go to the clinic and speak with patients. Once a month she would hold a newly diagnosed diabetes class for patients and then once a week she would hold classes on how to continue to control your diabetes. She would charge $5 for the continuing education class. The money that she would make from this would go to buying supplies to hand out to patients who did not have any or could not afford it. 

For both searches, I used the Walden Library and found it to be the easiest way to look for my information. The Walden Library has a variety of articles/books/online journals to choose from. I will always recommend using the Walden Library for any type of research as this provides information from all over as well as the information is current. 

 

References

 

Walden Library. Accessed December 16, 2018, from     https://class.waldenu.edu/bbcswebdav/library

Flanders, S. A. (2018, January-February). Effective Patient Education: Evidence and Common Sense. MedSurg Nursing, 27(1), 55-58. Retrieved December 16, 2018, from https://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=2&sid=17e9bf97-558e-4e18-8a46-a242c62be6ab%40pdc-v-sessmgr02

Wyngaarden, A. V. (2018). ASSESSING THE VALUE OF ACTION RESEARCH. South African Journal of Higher Education, 32(6), 519-531. doi:http://dx.doi.org/10.20853/32-6-2974

     

 

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 Post an explanation of how the use of CBT in families compares to CBT in individual settings. Provide specific examples from your own practicum experiences. Then, explain challenges counselors might encounter when using CBT in the family setting. Support your position with specific examples from this week’s media. 

 

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