Political actions in the healthcare sector are important to the LGBTQ community as the engagement of the nurses in political actions help improve their well-being. The nurses can actively participate in elections to put up to power the leaders they want or to bring down the leaders who do not fully satisfy their needs. The nurses can therefore engage in policy making by ensuring that manifesto of the leaders elected include the various policies they need. The nurses can ensure that the leaders being elected have the potential to listen to the various proposals of the nurses on the grounds of ensuring protection for the LGBTQ community (Amann, 2017). This will facilitate the incorporation of the recommendations of nurses in the policies. 

The nurses can stand to be elected as leaders into political position which is the most important as it pertains to LGBTQ and in all the patients. The nurses can act best in that position as they leaders can be able to implement the needed policies that will improve the healthcare sector. A nurse chairing a political position will have adequate knowledge on how policies will work in the healthcare sector and how LGBTQ community could be protected. The political position will facilitate the enhancement of the health care services for all the patients regardless of the category (Groenwald andEldridge, 2019). The political action will facilitate the improvement of the LGBTQ as awareness to the public reducing the stigma associated with them due to non-acceptance in the society.  

The nurses can also obtain training and be involved in city councils and committees where they can raise issues of concern within the industry. Participating in these trainings on political issues will facilitate the enhancement of the needed knowledge to the community on the LGBTQ. The participation in the committees will facilitate the enlighteningof the society on the healthcare delivery for all the patients (Kung and Rudner Lugo, 2015). The involvement will generate an opportunity for nurses to protect the LGBTQ from being denied some services and priorities.  

References 

Amann, C. A. (2017). Undergraduate Health Policy Education: Impacting the Future of Nursing. Groenwald, S. L., & Eldridge, C. (2019, August). Politics, power, and predictability of nursing care. In Nursing forum. 

Kung, Y. M., & Rudner Lugo, N. (2015). Political advocacy and practice barriers: A survey of Florida APRNs. Journal of the American Association of Nurse Practitioners, 27(3), 145-151. 

Role of Nurses in Influencing Policy Making
 Nurses as Political Actors

Nurses should see themselves as practitioners with the opportunity and obligation to impact current and future delivery systems of health care to be successful. The practice of nursing is based on human health science and caring psychology. This works from a context that holistically respects all people and aims to encourage and advance the health of people throughout their lives and throughout all levels of society (Lesbian, Gay, Bisexual, and Transgender Health, n.d).

A large number of the leading nursing associations encourage nurses to take part in the formulating of policies actively. For instance, the American Association of Colleges of Nursing underlines the job of nursing in strategy. It distinguishes, in its “Fundamentals” reports, the standard arrangement inclusion that ought to be tended to in instructive projects at the baccalaureate, master’s, and doctoral degrees of expert nursing. The National League for Nursing and the American Nurses Association additionally anticipate that medical caretakers should address the approach as a component of their expert job. Politically, nurses can play a significant role in influencing policies that influences the lives of lesbian, gay, bisexual, and transgender individuals (LGBT) (Burke, 2016). They include individuals from different ethnic and socioeconomic backgrounds, yet society has treated them as lesser beings. Nurses can influence policymaking concerning these groups in the following ways.

Lobbying political leaders; Through unique knowledge of their constituents ‘ needs, city and county officials have the power to implement policies and programs that protect LGBTQ people, improve community engagement, and open opportunities (Burke, 2016). Nursing leaders can, therefore, lobby political leaders to pass policies that favor LGBT.

Involvement in campaign groups; Many of these LGBT individuals face discrimination due to current policies in place. Nurses can join in their campaign and together fight for their rights. Sometimes, demonstrations are the only voice that the government hears and responds to.

Volunteer to engage in conferences or activities related to strategy. Prepare a fact sheet and help prepare a document to educate policymakers. Inform stakeholders regarding events that provide incentives for policymakers to tackle.

Conclusively, there is a need for changes to be effected on policies relating to LGBT rights to ensure they feel safe in society. As such, nurses should politically intervene with members of LGBT. They have the potential to have a profound global impact on politics. Nevertheless, it is nurses ‘ ethical and professional duty to intervene in policies they deem to be affecting their patients, LGBT notwithstanding.

References
Burke Sheila A. (2016). Influence through policy: Nurses have a unique role.Retrieved 29 October 2019, from https://www.reflectionsonnursingleadership.org/commentary/more-commentary/Vol42_2_nurses-have-a-unique-role
Lesbian, Gay, Bisexual, and Transgender Health. (n.d). Retrieved 29 October 2019, from  https://www.cdc.gov/lgbthealth/

 

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 Reply amanda

Question #2

       There are so many health indicators and concerns for a teen or woman who is a victim of sexual exploitation.  “In a systematic review of the impact of IPV on sexual health, IPV was consistently associated with sexual risk taking, inconsistent condom use, partner non-monogamy, unplanned pregnancies, induced abortions, sexually transmitted infections and sexual dysfunction”(Chamberlin & Levenson, 2011)  These are just some of the physical health concerns they may have.  There are so many emotional concerns that would be linked to sexual exploitation also.   Post-traumatic stress disorder (PTSD), including flashbacks, nightmares, severe anxiety, and uncontrollable thoughts, Depression, including prolonged sadness, feelings of hopelessness, unexplained crying, weight loss or gain, loss of energy or interest in activities previously enjoyed”(Joyful Heart Foundation, 2019). 

      Georgia specifically has a state wide domestic violence hotline. “Educational videos on temporary protective orders were distributed to Nurse Mangers in all 159 Georgia Counties and 19 Health Districts to utilize in trainings and seminars.  The tapes, obtained from the Georgia Commission on Family Violence, were designed to increase the nurses’ knowledge of services available to victims of domestic and sexual assault, and to enable them to direct these women to alternatives that can help reduce their exposure to violence.  Designed and developed a tri-fold pocket card (in English (Links to an external site.)Links to an external site. and Spanish (Links to an external site.)Links to an external site.), in collaboration with the Georgia Coalition Against Domestic Violence (GCADV),  that contains information on the signs of domestic violence, safety plans, options available to survivors of domestic violence, and a list community organizations that work with survivors of domestic violence”(DPH, 2018).

      In my county specifically I know there is an organization called Community Welcome House, Inc.  This organization helps domestic violence victims.  It provides, “Emergency housing sanctuary in the time of crisis Residents receive assistance with medical care, child care, counseling, financial assistance, vocational training, employment and permanent housing”(Domesticshelters.org, 2019). 

Chamberlin, Linda & Levenson, Rebecca. (2011). Guidelines for Addressing Intimate Partner Violence Reproductive and Sexual Coercion For Obstetric, Gynecologic, Reproductive Health Care Settings. American College of Obstetrics and Gynecology. Retrieved on March 17, 2019 from https://www.acog.org/-/media/Departments/Violence-Against-Women/Guidelines-for-Addressing-Intimate-Partner-Violence.pdf?dmc=1&ts=20190317T1155502488

Joyful Heart Foundation. (2019). Effects of Sexual Assault and Rape.  Retrieved on March 17, 2019 from http://www.joyfulheartfoundation.org/learn/sexual-assault-rape/effects-sexual-assault-and-rape

Department of Public Health. (2018). Violence against Women Prevention. Retrieved on March 17, 2019 from https://dph.georgia.gov/violence-against-women-prevention

Domestic Shelters, (2019). Retrieved on March 17, 2019 from https://www.domesticshelters.org/help/ga/newnan/30263/community-welcome-house

 Reply hollie 

Question 1—Domestic Violence

 Domestic violence can come in many shapes and forms. In some cases, physical injury can occur, while in other cases psychological abuse, deprivation, intimidation or other types of harm can occur (ACOG, 2012). The American College of Obstetricians and Gynecologists (ACOG) recognizes that routine visits and prenatal visits are an ideal time to assess for domestic violence (ACOG, 2012). Assessing for domestic violence can be done by using simple screening questions. These questions should not be asked in front of the abuser or other individuals. ACOG (2012) recommends using a framing statement and confidentiality statement before asking any questions. The framing statement lets the patient know that questions are being asked because relationships play a large role in health and the confidentiality statement lets the patient know that what she states today will not be told to anyone else unless reporting is required (ACOG, 2012).  

Risk Factors

 Two risk factors for domestic violence include: low education levels and drug and/or alcohol abuse (Huecker & Smock, 2018). Studies have shown that there is an inverse relationship between education levels and rates of domestic violence (Huecker & Smock, 2018). Men are more likely to perpetrate violence if they have low education and women are more likely to experience intimate partner violence (IPV) if they have a low education level (WHO, 2017). Alcohol and drug use are also risk factors for IPV. Alcohol and drug abuse is associated with an increase in the incidence of domestic violence, likely due to the inability of an impaired person to control violent impulses (Huecker & Smock, 2018).

Clinical Signs

 Obtaining a history, screening for IPV, and performing a physical exam can help point to IPV. Huecker and Smock (2018) state the most common injuries involved in IPV are on the head, neck, and face. Defensive injuries may also be present on the forearms (Huecker & Smock, 2018). A full physical exam should also evaluate the skin in areas covered by clothing (Huecker & Smock, 2018). Sexual abuse may be harder to identify physically, depending on the nature of the abuse (Huecker & Smock, 2018). Psychological complaints may include: anxiety, depression, and fatigue (Huecker & Smock, 2018). The patient may also have vague complaints, such as chronic pain, headaches, or chest pain (Huecker & Smock, 2018).

References

ACOG. (2012). Intimate Partner Violence. The American College of Obstetricians and Gynecologists, 518(1), 1-6. Retrieved from https://www.acog.org/-/media/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/co518.pdf?dmc=1&ts=20190318T0127216097

Huecker, M., & Smock, W. (2018). Domestic violence. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK499891/

WHO. (2017). Violence against women. Retrieved from https://www.who.int/news-room/fact-sheets/detail/violence-against-women

 

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Unintended pregnancy is something I know very much about, I had an unintended pregnancy at the age of 19.  Never in my wildest dream did I think it would happen to me, I knew the consequences of an intimate relationship, but at my age, I was invincible.  While I was sitting with my OB/GYN my options were discussed, and at that time there weren’t all these different ways to deal with an unintended pregnancy, you either had the baby or had an abortion, but abortions were not as “easy” as they are today.  Pills were not given and 10 minute procedures were not around, there was intense bleeding and pain and there was a very real chance that the reproductive organs could be damaged and the patient could never have children later in life.                I chose to have my child and I bless each day that I have her, but not all young women can easily make that decision and with advances in medicine they have more options than ever before.  I was amazed over this past week when I went to Planned Parenthood with a staff member, who is alone, we went over the many options that she had and she was educated in the different ways she could choose her way.  I am not saying that I agree with her choice or the choices of the other women that were in the waiting room, but the idea that they had many options is what I was impressed with.                The contraceptives offered to young adults, presently allow for options based on what fits their needs.  Teen pregnancy is prevalent in the nation and with recently approved long acting contraceptives for adolescents there are ways to help teens be more responsible with intimate relationships.  Intrauterine devices and implants are the choice for the main line of contraception for all women including the young adults.  Currently prescriptions for contraceptives show that the main choice is pills for young adults, some feel it is due to barriers of knowledge and cost (K. McKellen, 2018).  Nurse practitioners will be at the forefront of providing education to their patients, helping reduce the number of teen pregnancies and ensuring that all their patients have access to them.  According to a 2015 survey, only 3.3% of adolescents are using LARC’s for their last sexual encounter.  What has been found through this study was that the type of contraceptive chosen by the patient was directly based on the type of provider they see (S. Dixon, 2018).  Again, this is where nurse practitioners will be vital in aiding how teens and their parents view the use of LARC’s. How do you personally feel about youth and LARC’s?ReferencesMcKellen, e. a. (2018). The Latest in Teen Pregnancy Prevention: Long-Acting Reversible       Contraception. The Journal of Pediatric Medicine, e91-e97.Dixon, e. a. (2018). What Do Parents Know and Believe About LARC Use in Teens?       Journal of Adolescent Health, S37-S140. 

 

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The physical examination should include components that are relevant to the patient’s complaint and with the patient’s history in mind. Thyroid palpation and an abdominal assessment are appropriate for all individuals with complaints of painful menstruation. A pelvic examination and bimanual exam are appropriate tests for sexually active individuals (Osavande & Mehulic, 2014). Adolescents that are not sexually active with histories consistent with primary dysmenorrhea do not need to have a pelvic examination (Osavande & Mehulic, 2014). Laboratory tests may be used pending the relevance determined by the provider. Laboratory tests may include: pregnancy test, CBC, thyroid function tests, vaginal and endocervical swabs, erythrocyte sedimentation rate, and urinalysis (Osayande & Mehulic, 2014). Additional tests may be ordered as necessary.

Diagnosis and Differentials

Without more information, the initial diagnosis in this case would be unspecified dysmenorrhea (ICD-10: N94.6). Further information and evaluations may be needed to rule out secondary causes of dysmenorrhea, if clinical findings are suspicious for secondary dysmenorrhea. Differential diagnoses may be: primary dysmenorrhea, endometriosis, pelvic inflammatory disease, fibroids, or uterine cancer (Hackley & Kriebs, 2017).

Therapies

Pharmacological therapies for primary dysmenorrhea include NSAIDs or oral contraceptives (Osavande & Mehulic, 2014). Strong evidence supports the use of NSAIDs as the first line treatment for primary dysmenorrhea (Osavande & Mehulic, 2014). The choice of NSAID should be made on an individual basis, though over-the-counter ibuprofen, Aleve, or Midol are popular and effective choices (Osavande & Mehulic, 2014). The decision to use oral contraceptives should be made by the patient after thorough education and risks are explained to the patient.

The most effective non-pharmacological therapy used to treat primary dysmenorrhea is the topical application of heat (Osavande & Mehulic, 2014). Some dietary supplements, such as omega 3 fatty acids and B vitamins, have shown mixed effectiveness for controlling menstrual pain (Osavande & Mehulic, 2014). Lifestyle modifications can also assist in decreasing painful menstruation. Some evidence suggests low fat or vegetarian diets can decrease intensity and duration of menstrual cramps (Alsaleem, 2018). Obesity and smoking are other factors that can be modified to improve menstrual cramps, through weight loss and smoking cessation, respectfully (Hackley & Kriebs, 2017). Stress reduction techniques may also improve symptoms in stressed individuals (Osavande & Mehulic, 2014).

Follow-Up

If symptoms of primary dysmenorrhea improve with the pharmacological adjustments and non-pharmacological interventions, Osavande and Mehulic (2014) recommend continuing treatment and reassessing every six months. If symptoms are not relieved, the patient should return to the clinic for further evaluation after menstruation.  

References

Alsaleem M. A. (2018). Dysmenorrhea, associated symptoms, and management among students at King Khalid University, Saudi Arabia: An exploratory study. Journal of Family Medicine and Primary Care, 7(4), 769-774. https://dx.doi.org/10.4103%2Fjfmpc.jfmpc_113_18

Hackley, B. & Kriebs, J. (2017). Primary care of women. Burlington, MA: Jones & Bartlett Learning.

Osayande, A. & Mehulic, S. (2014). Diagnosis and initial management of dysmenorrhea. American Family Physician, 89(5), 341-346. Retrieved from https://www.aafp.org/afp/2014/0301/p341.html

 

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