Respond to each one 200 words

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  Two separate responses 200 words each

I find myself to be most comfortable working with older adults between the ages of 70-85. As a nurse I have really only worked with the geriatric population. I work at a hospital in Arizona that is close to many different retirement communities. Our hospital’s average patient age is 74. This makes working with younger patients little more uncomfortable for me. I wonder if it is because younger patients are generally not as used to being in the hospital and I worry about not being able to calm their fears.

Cultures that are very different than mine also make me a little uncomfortable to communicate with them. I worry that I will offend the patient with something like eye contact. I work with a lot of Navajo patients. At first, I was nervous to work with Navajo patients because I did not know a whole lot about their culture, but as I have learned and worked with the Navajo, I have felt more comfortable being able to effectively communicate with them.

I had a patient from India and was nervous to be working with them for the same reason. This patient was one of the most kind hearted people I have ever met. By the time she was ready to be discharged I had learned a lot about her culture and enjoyed getting to know her.

            I do not feel uncomfortable communicating with other races, I feel more uncomfortable communicating with cultures that are different than mine. I think it is more that I am worried about possibly offending someone because of my own culture’s customs, and I can be unaware of other culture’s customs.  

            Communicating with someone of a different living situation is generally pretty easy for me as well. I have lived in communities that have a lot of diversity and that has helped me to understand the different living situations that people have.

            One thing I have recognized is that as a nurse, we work with so many different people. Everyone at some point in their life is going to need medical attention, and a nurse will be there to take care of them. As nurses we have to learn how to communicate with people who are very different from us and learn to adapt to the many different cultures and personalities we work with.

            When I was growing up, many of my experiences with how older adults are treated is mostly with respect. However, I also felt like older adults were seen as to be a burden on the family. I grew up learning that it may be best for older adults to be in an assisted living place. It has been found that many adult children are around the age of 60 or 70 when they are taking care of their 90-year-old parent (Graham, 2018, p. 1).  According to Graham (2018) Caregiving at the age of 60 or 70 can be very hard on the body and adds extra mental and physical stress (p. 1). I am not sure if having older adults in an assisted living is the best place for older adults, but I am interested in learning more about this topic this week.

Reference:

Graham, J. (2018, August 23). A late-life surprise: Taking care of frail, aging parents. Retrieved

from https://khn.org/news/a-late-life-surprise-taking-care-of-frail-aging-parents/.

2) 

Working in the healthcare settings, we come across many different people from different backgrounds, races, and living situation. The philosophy of any public space is the equality and standard way of thinking and feeling about others, but in reality, these differences could often cause tension and/or stress during the interaction of two people. When I come across a patient around my age group, I find that I speak to them as if they were a friend, often using slang and other gestures as I would with friends outside of the workplace. In contrast, with older adults I tend to speak a bit slower and professional due to the age difference. Being a 27-year-old Intensive Care RN, often times older patients initially feel as if my age will affect their care in a negative way because they relate young with inexperienced, therefore the tone and word choice are changed in order to instill confidence thru proper communication. The difference in gender can also have its changes of personality during a patient interaction. Being a male, I tend to talk to the guys a bit more straight forward and not so much emphasis on emotion, while with females, I tend to be more compassionate and understanding of their situation. As for the other factors that make a difference in people, race, sextual preference, living situation, that does not play a factor during patient communication as those are not important to me, instead I may feel the urge to ask more questions to get to know them and their culture or preferences if their difference interest me. 

             While growing up, the Latin culture has great respect for older adults. A young family member is always expected to take care of their older family members, especially the older females. Grandma’s, Aunt’s, and Mom are always the first to have priority in any situation, starting with the eldest one. The older males in the Latin culture are not left out behind, but typically are carefree to many situations, just wanting everyone to be happy regardless of where they stand. When I was about 5 years old in 1997, the respect for adults was already instilled in me. Always making sure that adults are respected and listened to what they asked of me. In 2007 I was 16, and things started changing, I would be able to challenge adults’ questions and figure out why things are the way that they are; this was a rebellious stage, but I was just trying to figure out why. Fast forward from the rebellious stage, 2011 I was 20 years old, and now had the knowledge as to why adults did what they did, and I understood the meaning behind it. The older adults in the family would now see me as an adult, and although the respect continued as such, I was now an adult as well with my own opinion and choice, regardless of their input. 

            The way we act and treat others is highly influenced by the upbringing that we have experienced as children, in my opinion, and therefore it is especially important for me to continue what I have been taught as a child, in the workplace, and continue the line of respect with those that surround me. In 2017, my niece was born, and now I find myself also educating her in what is acceptable and not acceptable in our eyes, to continue the same respect and behavior towards other, with her. For us, it doesn’t matter what color you are, which gender you like, where you live, which car you drive, which gender you are, what matters to us is the quality of person you are in the world and how you treat those that surround you.  
 

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Response to each person 200 words each

1) 

Preparing for disasters is something many only think about during “that season”; hurricane season, winter blizzards, tornadoes , fire, flooding etc. however, disasters can happen at any time, so continued and sustained preparedness is essential.

       For the most part I knew my level of preparedness as I’ve lived in many areas of the world where “that season” happened on a regular basis.  Essential documents stored in plastic bins, easily accessible to place in to a car in the event of needed evacuation or sheltering in place, food, water, medical documents as well; only once I was not prepared but many things were happening in my life at that time which caught me off guard.  I worked a disaster relief effort with the American Red Cross in the aftermath of Hurricane Andrew in southern Florida and learned many things due to that experience and my time in the military has prepared me for many other man-made disasters.

       We have recently moved to the southwest and I now own a home again, so we are not quite as prepared as we were previously as a homeowner.  The tools and supplies needed to secure my home at this time are lacking so this is a step in preparation that must be accomplished, otherwise, based on the checklist, I am still prepared for nearly any disaster that may strike, or at least I would hope to be! 

       From the perspective of a community health nurse; education is the key to disseminating information to community members.  From participating in and education regarding local flu outbreaks, encouraging vaccinations for those at risk or simple education regarding hand hygiene and the correct way of covering your cough, along with health and wellness to maintain the highest levels of immunity for something as simple yet as deadly as the flu can be, is important.  Man made, natural or environmentally fueled disasters are difficult to disseminate information except through ongoing education or community preparedness sponsored events or work shops.  Ongoing drills within the school systems or community centers will assist in preparedness for disaster specific to the geographical area.  Instructions; written, verbal or expressed for personal preparedness, the how and why, and where to find needed supplies would all begin and continue through education.  Reporting of potential outbreaks or disasters through proper channels would also provide the community with added resources.  In the event of a disaster, nurses would need to assist in identifying who is at risk and what to do regarding those individuals, their friends and families, as would the nurse.  But always keeping in mind the scope of practice and current knowledge base of the nurse.

                                                                                                         References

Clark, M.J. (2015) Population and Community Health Nursing (6th ed). Boston, MA: Pearson

Community Health Nursing in Disaster Management.  Retrieved from (authorstream.com)

How to Prepare for Emergencies.  Retrieved from (redcross.org)

2) 

preparing yourself for disaster is one of the best and smartest things we can all accomplish in life, both as medical field personnel and human beings in general. Disaster preparedness refers to measures taken to prepare for and reduce the effects of disasters. That is, to predict and, where possible, prevent disasters, mitigate their impact on vulnerable populations, and respond to and effectively cope with their consequences. wide efforts to give citizens the training, education, and resources they need to prepare in advance against the threat of a possible local disaster at an individual and collective level. Despite the frequency of stories seen on the news that prove the devastation of unexpected natural disasters or local violence, local governments struggle to impart on citizens the importance of preparedness. The optimistic hope that an unexpected disaster could never destroy one’s home or hurt one’s family, is a difficult misperception to overcome. The goal of community preparedness is to maximize citizens’ awareness of the importance of proactive planning, and encourage participation in disaster preparedness activities. Begin your planning by identifying local emergency response organizations and leaders and asking them to be part of your education and planning efforts. Use all available communication channels to recruit members of your community to participate in your emergency preparedness team. For tips on marketing communications for local government. Once you’ve recruited citizens to participate in your preparedness team, schedule regular meetings that are always open for others to join and attend. The first primary objective of the group should be to develop a disaster preparedness plan. By engaging citizens in the planning process, they will be more likely to encourage friends, family, and neighbors to get involved and will help spread your message of the importance of individual and community preparation. Make sure your emergency planning takes into consideration seniors, children, and community members with special needs. Identify all the senior centers, assisted living facilities, day care centers, schools, and adult day habilitation centers in your community. Work with their leadership to make sure you have a plan in place in the event that such facilities need to be evacuated, or receive urgent care.

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200 words for each response

1) 

The mission of the schools in the local area system that was investigated is to promote the health and wellness for the students and their families, their staff, and the community.  The county schools believe that the nurses should be committed to providing comprehensive, quality health care to students using a systematic approach to identify and meet the dynamic health needs of all students including chronic health conditions, disabilities, and those with acute and emergency care situation (Maryland Department of Health, 2019).  The professional school nurse is an important member of the multidisciplinary school team and collaborates with other disciplines to enhance the academic success of students.  The school nurse promotes improvement of children’s health, removes barriers to learning, and improves overall potential for academic success.  Parents are encouraged to contact their child’s school nurse to discuss any health related needs.  Some of the schools in the county have Wellness Centers where the center provides care that minimizes the physical and emotional conditions that become barriers to optimal school performance.  The goal is to make students available for learning by promoting health, preventing disease, and reducing behavioral risks.

One existing condition that the schools deal with is sickle cell disease (SCD).  Children with SCD are more susceptible to infection.  Infection is the most common cause of death in children with SCD (Maryland Department of Health, 2019).  Most children with SCD are vaccinated against infectious organisms and generally use prophylactic measures to decrease risk of infections.  Fevers should be taken seriously for a child with SCD.  Other health complications include chronic pain, stroke, vision problems, progressive organ damage, acute chest syndrome, priapism, pulmonary hypertension, and anemia.  Although people of all races and ethnicity can have SCD, in the United States SCD is most common among persons of African descent.  The condition is also common among persons of Hispanic, Mediterranean, Caribbean, and Asian descent.  There are various types of SCD ranging from mild to severe.  Each individual with SCD may have a different clinical presentation; therefore students may have individualize care plans.  The school nurse is always the leader of the school health services team.  Some students with SCD may have a designated school case manager to coordinate his or her Individualized Educational Plan (IEP).  The school nurse also serves as the liaison and advocate for the student.  The school nurse may also refer the student and or family for counseling, support groups, and medical care.  Moreover, the county has school-wide awareness and education regarding SCD management for school staff.  Awareness and education may include, but is not limited to: definition and types of SCD; effective SCD management principles; symptoms of a SCD crises to report to the school nurse; student’s emergency care plan/protocol; student’s emergency plans and protocols for substitutes including teacher, school health staff, transportation, coaches, and food services; necessary and approved accommodations during school or school-sponsored activities; confidentiality protections; disability awareness needed in classroom; student’s IEP; and education for school visitors or volunteers with student contact, as necessary per local policy (Maryland Department of Health, 2019).  It is recommended that school staff awareness and education is completed annually and whenever a student’s condition and care changes.

Reference

Maryland Department of Health. (2019). Management of sickle cell in schools. Retrieved from https://www.sicklecelldisease.org/files/sites/181/2019/06/SickleCellDiseaseGuidelines-1.pdf

2) 

I looked into a major school district in my area and found that the schools in my area have a nurse assigned to each school. The school nurse helps students with chronic illnesses like type one diabetes manage their illness. The school nurse also watches out for children with communicable diseases and decides to send them home if they have diarrhea, vomiting, fever, or a deep cough. Parents are also instructed to not send their kids to school if they have a communicable disease or lice. The school district policy is that children must be 24 hours being symptom-free before they can return to school. The school nurse cannot give medications that are prescribed three times a day at school unless the doctor says that medication during school hours. The school nurse will not give narcotics or any form of cannabis even with a doctor’s order. The school nurse will also provide hearing screenings in preschool, kindergarten, grades 1, 2, 6, and 9. The school nurse also will screen vision screenings during the same year as the hearing test. Another screening that the school nurse does is scream for scoliosis when kids are in sixth and seventh grades. The school nurse also makes sure that students are up to date on their vaccines in order to be entered into the school.

The school nurse helps promote Health by helping students who have chronic diseases manage their health. The school nurse also promotes health by sending kids home that show signs of a communicable disease and prevents communicable disease spread by making sure students are up-to-date on their vaccinations. Doing a quick screening for hearing, vision, and scoliosis will also ensure that all parents are aware if their child needs to see a provider for these medical conditions.

The Center for Disease Control [CDC] (2019) explains that school health services can promote health for students by providing acute and emergency care, care coordination, chronic disease management, and family engagement. The school nurse can help with acute or emergency care if a student is in a medical crisis like a seizure. The nurse can also respond if a violent crime were to happen on campus. The school nurse will coordinate health care with families, health care providers, administration, and teachers (CDC, 2019). The school nurse will work with students with chronic conditions by helping to manage their condition for example like helping children with glucose checks and providing insulin. The school nurse can also help engage families of students by giving parents health status updates and giving students extra dietary and physical considerations (CDC, 2019).

Reference:

Centers for Disease Control. (2019, May 29). School health services. Retrieved from

https://www.cdc.gov/healthyschools/schoolhealthservices.htm.

• . 

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200 words for each respond

1.

According to the Centers for Disease Control and Prevention (CDC, 2018), a community health assessment is a localized study of a specific group whether it is local, statewide, tribal, or territorial. This research helps organizations and the government identify specific health needs and issues through the gathering of data. Community health assessments are needed to help improve the overall health of the population. It provides agencies with facts and numbers that would create a better and clearer understanding of the areas they want to serve.

Benefits

            There are many tools available to help facilitate this endeavor. The majority of the models use similar processes. Their goal is to determine the community’s strengths, weaknesses, needs, and assets. Some of the benefits of choosing one model toolkit versus another depends on the number of steps and the depth of the research that the organization or group wants to perform. In addition, it seems that not all the toolkits are designed to assess the same type of data, and their focus appears to be different as well. Some are specific to hospitals, while others are more engaged on public health. Using a specific model to assess the community will ensure that the data collected would be used and analyzed to help improve, engage, and prioritize issues that affect the public. 

Agencies and Time Line

            When doing a community health assessment, agencies need to be involved in order to have a more comprehensive understanding of the surroundings and the people that live in the community. Agencies such as schools, healthcare organizations, private and governmental institutions, local workforce agencies, and churches are some of the key assets when conducting a community health assessment. All of their voices, input, and expertise are valuable resources. They could serve as tools that community health nurses may use to implement changes in their areas and help make a difference in the population. According to Catholic Health Association of the United States (CHAUS, 2015), hospitals should expect to spend approximately six to 18 months planning and conducting their community health assessment. This number will vary according to the size of the hospital, the size of the community, and the number of organizations involved in the process. In addition, the availability of financial resources will have an influence on the duration of the process (CHAUS, 2015).

The Role of the Public Health Nurse

            The role of the public health nurse in implementing the community health assessment model is essential in this process. The nurse can serve as a guide to educate, advocate, assess and evaluate individuals in the community. They have in-depth knowledge about the different determinants of health that affect the community as well as thorough understanding of the many aspects that influence the needs of the population. They also play a vital role in collaborating with agencies to help collect data and implement measures to achieve improvements in the health and social conditions of the most vulnerable populations.

References

Catholic Health Association of the United States. (2015). Assessing and addressing community

health needs. Retrieved from https://www.chausa.org/docs/default-source/community-benefit/2015-cbassesmentguide.pdf?sfvrsn=2

Centers for Disease Control and Prevention. (2018, July 24). Community health assessment and

health improvement plans. Retrieved from https://www.cdc.gov/publichealthgateway/cha/plan.html#three

2. 

Prior to this week, I was unaware of what a community assessment consisted of. I learned that most of these assessment tools consist of phases an steps to follow. This phases and steps include organizing a plan, engaging in the community, and developing a goal to achieve. You must then do the community health assessment, prioritize the information you have assessed, and develop the plan to achieve your goal. Once all of this has been established, you can implement this into the community and evaluate the process. On the CDC website, I chose the model Mobilizing for Action through Planning and Partnerships (MAPP). A brief description from the CDC website included was a framework for a community improvement planning and putting a strong emphasis on the engagement and collaboration in the community on a local level (CDC-Assessment, 2015). This specific community assessment plan to help improve community health. Through this plan, it allows communities to apply critical thinking to prioritize issues in public health and to help identify the resources needed to address the issues. This ultimately improves efficiency and effectiveness throughout the community and improves the overall outcome of the community. There are six phases to go through with this community assessment model. Stage 1 of this model includes how to get organized develop a partnership. Stage 2 is visioning which allows us to share community vision and goals to accomplish. Phase 3 includes the four assessments, we are able to analyze and collect data during this phase. Stage 4 helps you identify the issues within the community so you can base your plan upon the issues. Stage 5 helps you determine a plan and goals to reach while stage 6 is when you put your plan into action within the community  (MAPP, n.d). I feel that the community health nurse has a lot of research to do based on this community assessment. I think it would be best to team up with leaders through out the local community such as the health department and maybe even emergency services since they have so many statistics on our population for our community. I think a reasonable time frame would include four to eight months for a community assessment.

CDC – Assessment – Community Health Assessment – STLT Gateway. (2015, November 9). Retrieved from https://www.cdc.gov/publichealthgateway/cha/assessment.html.

Mobilizing for Action through Planning and Partnerships (MAPP). (n.d.). Retrieved from https://www.naccho.org/programs/public-health-infrastructure/performance-improvement/community-health-assessment/mapp.

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