First page shows the requirements and directions for how to perform this project. (Document name: 1)Please skip residency presentation section in first page.Page 6 to 9 consist of example scenarios wi

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First page shows the requirements and directions for how to perform this project. (Document name: 1)

Please skip residency presentation section in first page.

Page 6 to 9 consist of example scenarios with questions on it.

Page 2 to 5 describes the clarity state of decision making process in five parts.

Read the scenarios from each examples and

Explain each scenario description responses minimum of 3 pages of substantial analysis + decision making road map and explanation of road map.

5 scenarios(examples from page 6 to 9)   * 3 pages per scenario description response. So in total 15 pages of detailed analysis document in APA format.

What are your upcoming week’s specific learning goals and objectives?

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What are your upcoming week’s specific learning goals and objectives?

What are your upcoming week’s specific learning goals and objectives?
Were there any placement items/issues that occurred this week that you feel your instructor should be aware of that are private in nature and are more appropriately shared here than in the discussion board with your classmates?
Give a brief description of an objective you worked on this week. Make sure to cite at least one reference showing how your objective relates to the public health knowledge you’ve studied during this course or the public health course. You may choose to reference your e-text, journal articles, or videos you’ve studied during these courses or you may find an outside reference on your own to further enhance your public health knowledge and practices.

This was last week. Write about the experience at the clinical site.

Remember, your journal entries are an important aspect of clinical learning as they serve to help you reflect upon and get the most out of your community practice experience. Therefore, your journal entry should include the who, what, where, and when of your community practice experience. Remember, this should simulate a dialogue that would normally take place face-to-face with your community practice experience instructor.

Religion and Spirituality in Nursing

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Many people are tempted to think that religion and spirituality are the same. These two concepts may exist together, as many religious people have a spiritual component, but not every person is religious. Expressing spirituality through religious practices, compassion, through service to others, or passing on wisdom to the next generations, often brings deep personal satisfactions. Religion is defined to be the practical expression of spirituality, including specific believes and practices. Spirituality is defined as a system of believes, encompassing love, compassion and respect for life. Spirituality provides understanding of us, others and the universe. It represents feelings that people experience and requires abstract thinking and will.

From my perspective, religion can not exist without spirituality. As a religious person, I believe that spirituality represents for me an essential element that strengthens my belief in God. According to my experiences, spirituality is associated to happiness, health and morale. At the same time, I think that being spiritual, means that is not necessary to have religious believes.

For a better understanding of the differences between religion and spirituality, Koening, George and Titus (2004), gave a definition for religion as an organized system of beliefs, practices and symbols, designed to facilitate closeness to higher power, or God, and includes the understanding of one’s relationship with him, and responsibility to others. Religion establishes rules or customs such as attending church or synagogue, and participating in prayers or bible study groups. There are non-organizational religious activities that consist of more private and personal behaviors, such as individual meditation, reading the bible, listening to religious radio programs, or watching religious television programs. Sometimes religion is the primary motivating factor in people’s lives that drives behaviors, and influences decision making. That is why religious people may cope better with changes in physical health, and recover a lot quicker. Religion offers a way to express spirituality with social support, security, and a sense of belonging through religious affiliations, being significant in coping with age related, physical and emotional changes. Spiritual realities become most important, as the individual plans for his/ her future beyond death. Religious traditions appear to comfort ethnic groups, as they are looking for solutions for their unique problems. On the other hand, according to the same article mentioned above, spirituality is the quest for understanding the meaning and purpose of life, which can or cannot lead to the development of rituals and shared religious community. Many people may not be affiliated wit a religious tradition, but are still involved in a spiritual quest, seeking meanings in something outside their own personal egos. Spirituality is very subjective and means different things to different people. Their own beliefs define what the meaning of spirituality is. According to Tuck (2004), spirituality represents “the integrative force for experience of the whole and critical factor in the healing process. There is empirical evidence that spirituality has positive effects on physical, psychological and spiritual well-being and quality of life”

I strongly believe in spirituality, and I consider it as a search for meaning in life. Being a religious person, I believe in God and God’s works. My life is guided by beliefs and practices related to an organized religion. For me spirituality means the purpose of life, peace, emotional balance, and love for the people surrounding me. I like to promote positive attitude around me, to eliminate stress factors, to create harmony, focusing on helping people to achieve a state of comfort and well-being. I also focus on creating safe, healthy and warm environment for people that I am in contact with. I try to integrate all my beliefs into my professional life, by inspiring confidence, compassion and professionalism while caring for my patients. In my professional practice, I am concerned for the welfare of patients, other nurses, and other healthcare providers. I demonstrate understanding of cultures, perspectives and beliefs of others, being a good advocate for my patients. I am respecting the patients, and their rights to make decisions about their healthcare, by planning the nursing care in partnership with my patients, and providing information so that patients can make informed choices. I am designing the care provided by me with sensitivity to the individual patient needs. In my opinion, nursing care should cover all aspects of a person: the physical aspect, as well as the emotional aspect, such as mind and spirit that define us as human beings. I strongly believe that there is a tight correlation between body, soul and illness. Effects of illness over our physical body can influence our emotional, mental and spiritual state. I consider that the nurses’ role is to feel and capture the imbalance occurred, and to eliminate the barriers in the patient’s healing process. Spiritual care should be a delicate and positive approach, based on trust and good relationship between the patient and nurse in order to provide the best care, to support the patient’s hope for a better life. Hope is very important for the patients. It is evident in all specialties of nursing. As a short example I would like to present the case of a twenty-five year old lady, who was admitted to our epilepsy monitoring unit (EMU) for intractable seizures. She had a two years old baby at home, her only child and the light of her life. Her seizures started right after delivering her baby boy. She decided to have a whole work-up done, regarding a possible brain surgery that could offer her a seizure free life, so she could fully enjoy her little baby, and have her life back again. She went through the whole process of subdural grid placement (requiring an initial brain surgery), with the purpose of tracking the seizure focuses, in order to be evaluated. After a whole week of hard work, her evaluation regarding the treatment plan was presented to her by the physicians. According to the findings, she did not qualify to be a good candidate for lobotomy that would stop her seizures. When I went into her room to assess her, I found her quiet, depressed and crying. I postponed my assessment for the moment, asking her if I could offer her any help. Then she started confessing about her broken hope after the evaluation results were reveled. She stated that she feels helpless and hopeless. I gave her time to express her thoughts and feelings, listening patiently, and holding her hands. When she finished, I asked her if she knows what other options she would have for seizure control. Her face suddenly enlightened when heard that there would be other treatment alternatives. I provided her with verbal information and pamphlets about a device called neuro-pacer, which was at the moment in the study phase, but due to her young age, healthy background and type of seizures she was having, she could have been a perfect candidate for it. She stopped crying after this, her attitude had changed, showing sudden interest in finding out more information about the neuro-pacer. This example represents just one of the ways I am providing spiritual care to my patients, giving me the satisfaction of being a nurse.

From the prospective of other religions than Judeo-Christian, the way of understanding spirituality can be very different, due to each person’s religious affiliation. The spiritual concept is well known, and developed from Judeo-Christian prospective, and common elements have been identified. Caring for patients with different religions than Christian can be complex and difficult, especially when there is lack of knowledge about their specific beliefs and expectations. When this would be the case, through effective communication nurses can expand self awareness and discover patients’ needs. Beside communication with the patient, I try to explore the concept and provide a better picture of my patient’s spirituality, using internet, or other resources, such as coworkers or clinical instructors, in order to establish the patient’s spiritual plan of care. If the nurses demonstrate knowledge, interest and respect towards their patients’ culture, they will gain their patient’s confidence. More than this, addressing the patients’ spiritual needs contributes to a better outcome of the patient care, and even “several studies have shown that addressing the spiritual needs of the patient may enhance recovery from illness.” (Luk, Kwong, Wong and Tsang, 2007)

The role of spirituality in providing holistic care in nursing practice represents a common subject that captured the researchers’ interests. In accordance with Sipes (2008), the holistic care in nursing is known as comprehensive care, and considers the patient in its complexity. Holistic care addresses the physical, emotional, social, economical and spiritual needs of a person. Sipes (2008) states that as nurses, we must encourage patients to life as meaningful as possible, to encourage patients who are ill or debilitated, in order to get well and continue life. To do this, we must focus on our patient as a whole system. Spirituality is a key element in providing holistic care that helps to achieve a balance between one’s mind and body. The major goal in patient care is obtaining and keeping the balance between mind, body and environment, as this balance is essential for maintaining life:

Neuman describes adjustment as the process by which the organism satisfied its needs.

Many needs exist and each may disrupt client balance or stability; therefore, the

adjustment process is dynamic and continuous. All life is characterized by this ongoing

balance and imbalance within the organism. (Tomey & Alligood, 2006, p.319)

Research into the role and responsibilities Operating Room Nursing

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I chose to research Operating Room Nursing because I have always liked things that are fluid or non-static. My idea of an OR nurse is someone who is constantly moving, may be juggling several things at once, is very organized, neat and follows professional standards to the letter. They are someone who strives for excellence and wants to make a difference in someone’s life in many significant ways. Let’s begin with a question that seemed to creep up while researching this role. Is an OR nurse still a nurse? Yes! OR nurses still access, diagnosis, plan, intervene, and evaluate their patient’s just like as other nurse would.

The Registered Nurse in Perioperative Nursing practice performs nursing activities in the preoperative, intraoperative, and postoperative phases of the patient’s surgical experience. Based on the Standards and Recommended Practices for Perioperative Nursing – A.O.R.N, the operating room nurse provides a continuity of care throughout the perioperative period, using scientific and behavioral practices with the goal of meeting the individual needs of the patient undergoing surgery. This is a dynamic and continuous process and requires constant reevaluation of individual nursing practice in the operating room.

Generally, the patient enters the preoperative area and is assessed by the preoperative RN. The perioperative RN or Circulating Nurse interviews the patient with special emphasis on ensuring the patient has informed consent, has been NPO for at least 6 hours prior to surgery,

Operating Room Nursing

and has charted medical history to determine any special needs for the care plan. Procedures are explained and anxieties of the patient and family are addressed, therefore, the nurse develops a rapport with the patient that enhances the operating experience for the patient by building trust and assuring only the best of care will be given.

Planning the patient’s care in the OR is focused on patient safety. The nurse gathers all supplies needed for the procedure as determined by surgeon’s preference card (Seifert, 137) positioning equipment and any special supplies needed as determined by the assessment and patient history. This preparation assures that the nurse will be able to remain in the surgical suite as much as possible to provide care and to provide assurance to the anxious patient. In the case that a sterile field must be broken due to needing supplies or equipment, the situation of the nurse leaving the room is avoided as much as possible. However, surgical site infections (SSIs) are one of the most common types of healthcare-acquired infections. Most SSIs result from microorganisms found on skin, so meticulous skin preparation is crucial. Documentation must be made on old lesions, including rashes, moles and warts. Amount of hair on the body is also accessed. In the past excess hair was removed from incision areas, however, studies have shown that shaving can cause microcuts and increase the risk of SSIs. The first step is to assess the skin surrounding the surgical site. If a patient has unhealed wounds, scratches, or previous incisions, plan the skin prep area around those areas (Rushman, OR Nurse 9). The next step is to determine whether hair needs to be removed in the incision area. In the past, hair was removed because it was considered dirty and a potential source of infection. The current trend

Operating Room Nursing

is for the patient to use Chlorhexidine, which disrupts the cellular membranes of microorganisms. Skin prep may seem routine, but by following recommended practices as the patient’s skin is prepped may alleviate a costly SSI.

The circulating nurse and the scrub nurse/technician work as a team to protect the sterility of the operative field by maintaining constant surveillance. If a glove breaks, it is replaced immediately. The nurse provides for patient comfort in several ways, warm blankets are given, staying at the patient’s side until anesthesia had been induced and the anesthesia provider releases the care to the surgical team. Interestingly, a PerfecTemp Warming pad has been introduced to increase patient comfort. This pad replaces the standard table pad, warming and comforting patient’s from the minute they lie down to the minute they leave the OR, thereby reducing the 20 minute gap for preparation, thereby eliminating some operation time which is good news for the anxious patient.

The circulating nurse monitors vigilantly during the course of the operation. They are responsible for the smooth transition for the patient between the preoperative, operative, and postoperative phases. Evaluation of the patient’s response to the surgical intervention is ongoing and continuous. Should the surgical outcomes not be met, reassessment begins to plan further.

The patient under anesthesia is totally dependent on the surgical team for their total well being. The perioperative nurse is the patient’s advocate. They are that patient’s voice during the surgical intervention. Whether scrubbing, circulating, or supervising other team members,

Operating Room Nursing

the perioperative nurse is always aware of the total environment, as well as the patient’s reaction to the environment and the care given during the three aforementioned phases. The nurse excels in her/his knowledge of aseptic technique, patient safety, legal aspects, and management of nursing activities associated with the specific surgical procedure being performed. OR nursing is unique: it provides a specialty service during the perioperative period that stresses the need for continuity of care and respect for the individuality of the patient’s needs.

To protect the public, professional nurses are licensed. The state in which you are licensed dictates the scope of your practice according to legal and ethical guidelines. OR nurses also have codes of ethics and nursing standards of practice through the American Nurses Association (ANA). Legally, ethically, and morally, OR nurses have a responsibility to be patient’s advocates. The ANA’s code of ethics clearly endorses reporting any inappropriate or questionable healthcare practices, and outlines protocols. Organizations should have defined process for reporting questionable practices, but what if they don’t and it poses a risk for patients? The ANA’s code of ethics supports contacting the appropriate professional organization – even if it posed a risk to the nurse. As perioperative nurses, the OR nurse advocate’s for patients in the OR every day by simply reviewing the informed consent and other documentation to ensure patient decisions are accurately reflected, maintaining a safe environment, correcting breaks in sterility, and ensuring confidentiality. “With that trust comes

Operating Room Nursing

a responsibility to promote and advocate for patients, even when it means putting ourselves at risk” (Thompson, 2010).

After success on state boards and NCLEX Exam, the nurse wanting to be part of the OR must pass the CNOR – Certified Nurse Operating Room. The CNOR is a national certification exam which covers aspects such as sterilization techniques, maintaining a sterile field, critical thinking skills, exact dosage calculations, emergency situations like malignant hyperthermia, cardiac arrest, and so on. The exam consists of 200 questions and has an allotted time frame of 4 hours. National certification exams are an important part of a nurse’s career. Certifications increase the continuing education requirements beyond the state license requirements. To maintain CNOR certification, the nurse must obtain 150 continuing educational units specific to the OR every 5 years…..a continuous learning and teaching process.

In conclusion, the role of an OR Nurse is what I expected and more, namely, I had never considered the issue or hair removal. I thought someone else would perform that task as it seemed so minute, but after research, I now understand just how important hair removal is and why it is necessary. The perioperative environment is fast paced, unpredictable, and complex. In this environment, perioperative nurses are expected to work a variety of surgeries with patients of all ages (AORN Journal, Jan 2009, 249). Critical thinking skills enable perioperative nurses to understand and apply standards and guidelines to a variety of situations and specialty areas.

Operation Room Nursing

DHA-7011-8-MARCH-2021 QQ Week 8 – Assignment: Utilize Feedback through Review Self-Reflection and Literature Review In Week 7- you integrated and applied elements of the course content in the Signatur

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DHA-7011-8_MARCH_2021 QQ

Week 8 – Assignment: Utilize Feedback through Review Self-Reflection and Literature Review

In Week 7, you integrated and applied elements of the course content in the Signature Assignment, which allowed you to address a significant question or issue (i.e., through creative thinking, critical thinking, problem-solving, inquiry and analysis, etc.). Using the feedback from your Week 7 assignment, you will have the opportunity to complete a self-reflection and respond accordingly.  Reflect on and respond to how the feedback provided can help you improve your academic performance and contribute to your professional growth. In addition to your self-reflection, you will also conduct an independent literature review of relevant scholarly, peer-reviewed sources. Choose sources that support your ideas for enhancement of the course competencies and content areas where you have identified opportunities for improvement. For example, if your professor indicated you need improvement in the area of team leadership, select sources that would enhance your knowledge and skill base in this area.

Your Week 8 assignment has two parts.

Part 1: Self-Reflection

You will complete a self-reflection using the Feedback Review Template. The Feedback Review Template is located in this week’s Course Resources area.  To complete your self-reflection, seek clarity from your professor about the areas you did not understand or areas that require improvement. Schedule a one-to-one meeting with your professor to discuss the feedback provided and to inform your responses.  Use the Feedback Review Template to address the following themes:

·         How you developed and demonstrated the course competencies tied to this course.

·         The practical relevance of the course concepts and course competencies to your professional growth and career interests.

·         Future considerations (e.g., key trends or challenges) to keep in mind as related to the topics covered in this course.

Be sure to comprehensively address the feedback provided by the professor for your Week 7 Signature Assignment. As you complete the template, you will be asked to address the following questions:

·         What are the areas in which your professor indicated you did well? Why do you think you did well in this (these) areas?

·         What are the areas in which your professor indicated you need to improve? What can you do to improve in this (these) areas?

·         How did your professor’s feedback help your mastery of the course subject matter?

·         How did the Week 7 Signature Assignment and this course help you to develop the course competencies?

·         What aspects of this assignment can you take forward into your professional career and why?

·         How did this course contribute to your understanding of possible trends and/or challenges related to the profession of health administration in the future? What do you need to consider regarding the course topic and why?

Part 2: Annotated Bibliography

You will prepare an annotated bibliography of five scholarly, peer-reviewed resources to enhance your knowledge base related to selected course competencies and that is informed by your self-reflection and professor feedback. The resources must be current, published within the past 3-5 years. Each annotated bibliography should be no less than three robust paragraphs. Use feedback from your professor to identify scholarly, peer-reviewed sources that can help you improve in the areas noted (e.g., assignment enhancement, personal and/or professional growth, topic of further interest prompted by the course content).

Use the annotated bibliography guide from Academic Success Center (ASC)* to ensure that your annotated bibliography meets all requirements.

*Keep in mind for this assignment, each annotated bibliography should be no less than three robust paragraphs.

Assignment Requirements

Your assignment will be submitted in one single document with two parts.

Part 1 will be your self-reflection using the Feedback Review Template and

Part 2 will be your annotated bibliography.

To complete this assignment successfully, you must include:

·         Title page

·         Part 1: Based on the completion of your Feedback Review Template, provide a self-reflection summary on how this course contributed to your professional growth and your understanding of future trends and/or challenges related to your profession (2 pages minimum)

·         Include your Feedback Review Template

·         Part 2: An APA-formatted annotated bibliography of 5 scholarly, peer-reviewed resources addressing any one or all of the following areas:

o   Enhancement of the Assignment

o   Personal/Professional Growth and Development

o   Topic of interest for further investigation based on course content

·         References (additional to the annotated bibliography)

The completed assignment should address all of the assignment requirements, exhibit evidence of relevant scholarly, peer-reviewed research, concept knowledge, and demonstrate thoughtful consideration of the content presented in the course. The writing should integrate scholarly, peer-reviewed resources, reflect academic expectations and current APA standards.

C++ simple coding homework

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I need this done in 2 and a half hours. simple coding nothing too complex because the class just started

and I CANNOT use namespace


DESCRIPTION


WARNING: You are only allowed to use code covered in class, HW, or in the textbook up to Chp 3. Students who wish to use more advanced code must currently have an “A” in the course and obtain permission from me via email before starting the project. ALSO, code must be your OWN. Ask for hints, but write your own code! All students who copy from each other or get the same code by working together will receive zeroes.

This program will help users calculate quantities needed for a recipe. All the user needs to input is the number of servings and the name of the bread they will be using. Your program does the rest.

Below is the default recipe for bread. You must start with this. Then, based on how many loaves the user wants, you have to do the necessary calculations to figure out the new quantities for each ingredient.

Recipe: by bakers percentages

  • Starting water: 72%
  • rye flour: 10%
  • red wheat flour: 20%
  • King Arthur special patent flour 30%
  • Bread flour 40%
  • sourdough starter 20%

Normally after mixing the bread is allowed to rest

  • additional water 2.5%
  • salt 2%

Serving Units: In a home kitchen, consider the (ml or g) unit as indivisible. A person cannot calculate, for example, what half of an (ml) is. Also consider a loaf to be indivisible (Ex: You can’t have 7.5 loaves).

Bakers percentages are expressed in terms of total flour used. (By adding up the rye, red wheat and bread flour). For example making two loaves of bread is generally 1000g total flour. So rye at 10% would be 100g.

INPUT: You will need to first get the name of the bread, then the number of loaves desired.

OUTPUT:


NAME:

“Name of the bread”

NUMBER:

“number of loaves”


INGREDIENTS:


<blank line>

<tab>”ingredient in 20 spaces” “amount in 5 spaces” “g or ml”

Notes: The

bold

are lables for the program output

The stuff in quotes is output.

There are 10 spaces after the name before the NUMBER label

Check the output and make yours match

Getting the Mimir test cases correct is only PART of your grade. The rest will depend on the quality of your code. I will never remove points for things that are personal preferences. As you know, your author and I have slightly different styles. However, the proper use of constants, correct data types, and other standards of using this language will be enforced. Ask me questions during class if you have any doubts.


NOTE:

You have unlimited submissions. You may keep uploading your CPP file until you pass all test cases and are happy with your code. I will only grade the last submission. Location of your CPP in CLion:

C:Users[your name]CLionProjects

(look inside the folder with the name you gave your project)


NOTE:

for this assignment write it to run in CLion – ignore the need for extra lines of output


ACTIONS

Stress: Causes- Definitions and Impacts

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Definition of Stress

“Stress is the trash of modern life-we all generate it but if you don’t dispose of it properly, it will pile up and overtake your life.” Danzae Pace

“a reaction of a particular individual to a stimulus event”. (Skinner, 1985)

“stress may be viewed as the body’s response to any real or imagined event perceived as requiring some adaptive response and/or producing strain” (Elliot, 1988)

“stress can be considered as any factor, acting internally or externally that makes it difficult to adapt and that induces increased effort on the part of the person to maintain a state of equilibrium both internally and with the external environment”. (Humphrey, 1992)

“stress is caused by a multitude of demands (stressors), such as an inadequate fit between what we need and what we are capable of, and what our environment offers and what it demands of us”. (Levi, 1996)

“a particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well being”. (Lazarus and Folkman, 1984)

As can be inferred from the definitions above, there are three main ways to define stress. Firstly, we can define stress as a factor of stimuli a person is subjected to. The greater the pressure, the more will be the stress perceived. This takes into account the cumulative nature of stress. Secondly, stress can be defined as the response to aversive stimuli. This train of thought was publicised by Selye who also called the physiological changes that the body undergoes as a response to stimuli as the general adaptation syndrome (GAS).

Stress is a usual human reaction to pressure when confronted with challenging situations. This pressure is not only about what is happening in our surrounding, but also about the demands that we place on ourselves.

Stress is essentially a reply to a stimulus that interrupts our physical or mental equilibrium. A stressful event can trigger the “fight-or-flight” response which results in a sudden flow of hormones namely adrenaline and cortisol through the body. Stress is the “wear and tear” our bodies go through as we adjust to our continually changing environment. It has both physical and emotional results on us and can craft positive or negative feelings.

Stress is not a medical condition, but severe stress that continues for a longer period of time may lead to a diagnosis of

depression

or anxiety, or other severe mental health problems.

Causes of Stress

Stress triggering events are different for different individuals. According to surveys, stress related to work contributes the highest percentage. In the united states, 40% workers admit to have stress caused due to their work and 25% blame work as the biggest cause of stress in their lives.

In general, change in an existing situation of a human being causes stress. This is caused due to lack of control over the existing situation. The changes might be good or bad changes, but they might cause stress to a person. The few common causes of stress are:

  • Job interview
  • Examination
  • New relationship/ Breaking up of old relationship
  • Marriage
  • Serious illness in oneself or a friend or family member
  • Moving to a new place
  • Death of friends or family/ Birth of a child
  • Unemployment
  • Insufficient resources to manage the family
  • Caring for a disabled friend or family and many similar situations. This stress is causes as one has to re-adjust their life in accordance with the new phenomenon.

The below diagram depicts the three major reasons of stress in college going students.

Stress isn’t always caused by outside factors, sometimes it comes from inside. People can stress themselves by worrying about things. The internal factors causing stress are:

  • Fear and uncertainty about events that are outside someone’s control. Worrying about such events can only cause stress, but not any improvement of the situation.
  • Attitudes and perceptions of the world. A person’s point of view of events and situations can make a huge difference. The same situation may be perceived differently by different people and thus generate different level of stress.
  • Unrealistic expectations. When expectations don’t match reality, it causes stress.

The below graph shows the causes of stress in American citizens according to a survey.

Types of stress

All animals, including human beings have a natural stress response and it is very helpful. But severe stress can cause both physical and mental harm. There are various kinds of stress depending on its causes and effect.

A little amount of stress, called “acute stress” is the most common form of stress. It could be tolerable, in fact it might be constructive in the sense that it keeps a person active and alert. It is usually for a short term of time.

Also stress in long-term termed as “chronic stress,” can have major effect on both physical and mental health of a person. It often develops when a person loses hope of getting out of a bad situation and they stop giving effort to get out of it.

“Episodic Stress” is the kind of stress that originates from a continuous exposure to mismanagement and crisis in life. This is usually found in type ‘A’ personalities as the are always in a hurry, but always late. Episodic stress is caused by constant worrying, pessimism, anxiousness and depression.

“Traumatic stress” is the kind of stress caused by events threating one’s life. For example being in a major accident, involved in war, physically or mentally assaulted or having faced a natural disaster can cause

post-traumatic stress disorder

(PTSD).

Symptoms of stress

The signs of stress can show in various forms. Listed below are various signs of stress.


Physical Signs of Stress

  • Increased heartbeat
  • Sweating/ freezing hands
  • Headache
  • Shallow or erratic breath
  • Causing nausea, stomach upset
  • Fatigue
  • Disturbance in sleep
  • Weight gain/loss
  • Increased/decreased appetite, increased alcohol consumption


Cognitive Signs of Stress

  • Forgetfulness
  • Being unmindful, Difficulty in concentrating
  • Difficulty in understanding
  • Negative self-assessment and negative self perception


Emotional Signs of Stress

  • Getting angry, irritated easily
  • Anxiety, feelings of panic
  • Fear
  • Crying
  • Increased conflicts in personal life
  • Getting frustrated easily

Impact of stress

Stress is a major concern of the modern world. The below statistics depicts how it has impacted the human race.

  • 43% percent of adults suffer from stress related health problems
  • Stress related ailments contribute to 75%-90% of all doctor visits.
  • Stress is declared as a hazard of the workplace by the Occupational Safety and Health Administration (OSHA) declared. More than $300 billion is spent annually to cope up with stress in the American industry.
  • Untreated, chronic stress reactions can cause a lifetime prevalence of emotional disorder in more than 50% of people.

In long term, stress can cause serious impact on our body.

Stress Management

Stress managementrefers to the verity of medical and

psychotherapies

techniques which helps in controlling a patient’s stress levels. The treatment may be there for chronic stress or episodic Stress or traumatic stress.

Managing stress is all about taking charge. If one controls one’s thoughts, emotions, schedule, and the way one deals with problems, then they can overpower stress.


Step #1: Identifying the source of stress

The first step to manage stress is to identify the sources of stress in one’s life. The sources are not always evident and most of the times it is hard to find the real source. This might because we are well acquainted with our way of life and it’s hard to point out what is wrong with it. It is important to find the root cause of stress because that is the key to treat it.


Step #2: Change the situation

We should try to avoid the situation that is causing stress. If the situation is unavoidable, then we must try to alter it. Figuring out the key points to bring about a change in the current situation helps in dealing with stress. This might involve changing few things like communication, relationship or any other way of life. But this change has to be ensured so that it can lead to a less stressful situation.


Step #3: Adapt to the change

It is hard to adapt to any change. But we must ensure that changing the life style doesn’t result in more stress. Also it is advisable to cope up with the changes made as soon as possible. We can adopt to stressful conditions and also regain our sense of control by modifying our attitude and perception.


Step #4: Avoid further unnecessary stress

Stress can’t be always avoided. But we should make a conscious effort to keep it at bay. Isolating situations which causes unnecessary stress can help. Situations which might cause this kind of unnecessary stress could be eliminated in advance. We should just make sure that the peace of mind should be preserved at all cost.


Step #5: Time Management

Stress can be avoided by proper usage of time. Dividing up your work into small segments of doable chunks and dedicating proper amount of time to all activities in a day can reduce the stress in work environment. One should dedicate some buffer time for unexpected activities so that in case of any emergency, the time table is not shattered.


Step# 6 Meditation and breathing exercises

When stress takes over, the sympathetic ANS pumps adrenaline and other hormones into the body to prepare it for action. Usually, the parasympathetic ANS eventually takes over and calms the body down. You can help the parasympathetic ANS take over by practicing meditation and breathing exercises.

Combine meditation and breathing into one exercise by doing the following: Sit down comfortably and close your eyes. Begin taking slow, measured breaths. Take note of where in your body the breaths originate. After a while, let your body breathe entirely on its own while still focusing on the breath. Notice which parts of the body your breathing moves: From your hands and feet to the top of your head. If you begin to think about anything other than breathing, set your concentration back on those breaths and how they affect your body

Simple things can lead to relieve stress. For example talking to a trusted person (friends or family), calling up someone and have a friendly chat, talking to experts via phone helpline or internet, exercising, taking deep breaths, eating a healthy diet, taking a vacation, time management etc.

Conclusion

As can be inferred from the definitions above, there are three main ways to define stress. Firstly, we can define stress as a factor of stimuli a person is subjected to. The greater the pressure, the more will be the stress perceived. This takes into account the cumulative nature of stress. Secondly, stress can be defined as the response to aversive stimuli. This train of thought was publicised by Selye who also called the physiological changes that the body undergoes as a response to stimuli as the general adaptation syndrome (GAS).

Stress is a usual human reaction to pressure when confronted with challenging situations. This pressure is not only about what is happening in our surrounding, but also about the demands that we place on ourselves.

Job traits and Hackman & Oldham model Motivation and job satisfaction is important. Factors like job satisfaction, job expansion, job turnover, job enrichment, etc. should be ensured to ensure the minimal level of stress occurring at workplaces. Hackman & Oldham job traits model present in their paper have selected to study the impacts of job traits on job stress. In their study on a telecommunication company, Richard Hackman and Edward Lowler (1971) concluded that employees’ job satisfaction is higher and their performance and attendance in workplace is better when they feel traits like skill diversity, task nature, independence and engaging with other further in their job. This study paved the ground for Hackman and Oldham job traits model in 1975. Through a research, they found that employees’ job satisfaction and performance increase and their turnover and absenteeism decrease when they enjoy high levels of job traits such as skill diversity, job nature, task importance, independence and job feedback.

Hackman and Oldham job traits model consists of three parts:

(1) job major aspects including skill diversity, job nature, task importance, independence and job feedback;

(2) mental conditions including the feeling of having an important job, accountability, being informed of job results; and

(3) working and individual ramifications including promoting inner motivation on job qualitative performance improvement, job satisfaction promotion and mitigating job relinquish.

Stress is part of life and sometimes unavoidable. Sometimes a little amount of stress is helpful too. It is only when stress lasts for a longer period of time and exceeds one’s capability of handling it, stress becomes harmful. Stress impacts one’s physical and mental health, relationship, family, work environment and one’s whole life. But stress can be handled. Instead of stress manipulating one’s life, one can learn to manipulate the stress by oneself. By enhancing one’s vision, raising the available resources regarding stress, one can cope up with stress. It is important to know one’s strength and limits regarding handling stress. It is always advisable to take external help if needed to cope with the anxiety and stress in one’s life.


Useful contacts


Emotional / Relationships Problems

1. Aasra, Mumbai

Direct crisis intervention and counselling services for people who are depressed or feeling suicidal.

Phone:+91 22 2754 6669

Timings:All Days :24 Hours

Email:

aasrahelpline@yahoo.com

Website:

www.aasra.info


Depression, anxiety, obsession and mental health


Rethink Mental Illness

Support and advice for people living with mental illness.

Phone: 0300 5000 927 (Mon-Fri, 10am-2pm)

Website:

www.rethink.org


Depression Alliance

Charity for sufferers of depression. Has a network of self-help groups.

Website:

www.depressionalliance.org


CALM

CALM is the Campaign Against Living Miserably, for men aged 15-35.

Website:

www.thecalmzone.net

Contact the Stress Counselling helpline

Talk in confidence, 24 hours a day. Call:0800 092 3189


Useful books


The Relaxation & Stress Reduction Workbook

by Martha Davis, Elizabeth Robbins Eshelman, Matthew McKay – Publishers New Harbinger Publications: ISBN 1572242140


The Anxiety and Phobia Workbook

By

Edmund J. Bourne


The Feeling Good Handbook

By

David D. Burns

,

David D. Burns (Preface by)


References

Case study: nursing documentation in the electronic age

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You are caring for five patients on a busy, 28-bed neurological medical-surgical unit, which recently transitioned to all electronic documentation and healthcare computerized provider order entry (CPOE). There is no longer any bedside paperwork.

All of your staff members have completed the required training and you have been assigned as expert lead for any questions that may arise during your shift. The expectation is that all nurses and clinical staff will document all care delivery in the bedside computers located in each patient’s room or via the workstation on wheels (WOW).

However, you have noticed a trend with experienced nurses spending extra time at the end of their shifts (30 or more minutes) documenting the nursing care provided during the shift. The expectation is that they should be documenting care delivery as soon as it is complete rather than at the end of their shifts.

Answer the following questions based on the information provided:

Explain how you would address the concern with the delay in nursing documentation with your team.

Do you see the transition to all electronic documentation as having a positive or negative effect on patient-centered care? Support your answer with evidence from the literature.

Explore the role of advancement in information technology and its effect in patient care. Does more technology use improve time with patients? Use at least two sources to support your response.

Demonstrate an understanding of how evidence is developed and utilized in the process of retrieval, appraisal, synthesis and evaluation to improve patient outcomes.

/in /by

Demonstrate an understanding of how evidence is developed and utilized in the process of retrieval, appraisal, synthesis and evaluation to improve patient outcomes.

 

Demonstrate an understanding of how evidence is developed and utilized in the process of retrieval, appraisal, synthesis and evaluation to improve patient outcomes.
2. Employ principles of quality improvement, health care policy and cost effectiveness to assist in the development, initiation and/or evaluation of an effective plan for a micro system practice improvement that will improve the quality of health care delivery.

Health Barriers for Lesbian and Bisexual Women

/in /by

Evaluation of Marginalized Women: Lesbians

Lesbian and bisexual women are typically an invisible minority in the healthcare system due to the assumption of heteronormativity, which typically results in poor management of their sexual health needs.  Lesbian and bisexual women are defined as women who are disposed to experience sexual or romantic desires for, and relationships with other women (Johnson & Nemeth, 2014).  The relationship between the healthcare provider and the patient is dependent upon the delivery of quality and comprehensive sexual healthcare (Munson & Cook, 2016).  The discussions on safer sex, reproduction, or significant other inclusion in women’s healthcare may be different based on a woman’s sexual orientation.  Per Johnson and Nemeth (2014), lesbian and bisexual women often encounter insensitivity, discriminatory, biased, and deficient knowledge from providers who are not attuned to the needs of lesbian and bisexual women.  This paper will discuss the background and significance, socio-economic, social justice and its relationship to health disparities and health care, ethical issues, and plan of action for lesbian and bisexual women.

Background

Despite the recent shift in society towards same-sex relationships, lesbian and bisexual women continue to face

multiple barriers to equitable healthcare services

.  These barriers include lack of a welcoming environment, lack of health insurance, lack of communication, and lack of high-quality research and evidence-based guidelines, which leads to a delay or avoidance of seeking proper healthcare.  There is a difficulty in quantifying the number of lesbian and bisexual women in the United States due to the self-reported sexual identity not always correlating with sexual behavior (Knight & Jarrett, 2017).  Although the prevalence of same-sex behavior in women is estimated at 7.1%-11.2%, the number of women self-identifying as a sexual minority is lower, where one study showed that only 1.3%-1.9% of women in the United States are identified as lesbians and 3.1%-4.8% are bisexuals (Knight & Jarrett, 2017).

In the area of sexual health, Human Immunodeficiency Virus (HIV) and sexually transmitted infections (STIs) are predominately the focus among homosexual men, however, very little is known about the sexual health of lesbian and bisexual women because they are largely excluded from research and preventive health interventions (Corcoran, 2017).  Although the risks of HIV and STIs are lower in lesbian and  bisexual women in comparison to homosexual men, there are 17.4 million women who are living with HIV globally, which accounts for half the adult population living with HIV (Corcoran, 2017).

Socio-Economic Issues

Women who identify themselves as lesbian and bisexual are susceptible to socio-economic disadvantages.  Socio-economic factors such as in education, in workplaces and income can have a major impact on health (Corcoran, 2017).  Evidence from a study shows that lesbian and bisexual women are more vulnerable to the conditions of poverty, when compared to heterosexual people and couples (McGarrity, 2014).  McGarrity (2014) also states that the socio-economic status (SES) is fundamentally related to the quality of life, rights, and general well-being of lesbian and bisexual women.  In addition, discrimination may be related to the SES of women who identify themselves as lesbian or bisexual.  Among women between the ages of 18-44 years old, 23% of lesbian women and 29% of bisexual women are living in poverty compared to 21% of heterosexual women (MGarrity, 2014).

There are many cases where discrimination against and unfair treatment of lesbian and bisexual women remains legal. According to McGarrity (2014), the U.S. legal system does not prohibit discrimination on the basis of gender identity and sexual orientation, which includes the workplace.  Discrimination in the workplace is a significant factor in socio-economic differences among lesbian and bisexual women, which is often associated with harassment and  mistreatment due to gender identity (McGarrity, 2014).

Social Justice

A rich tradition in nursing that began with Florence Nightingale is the provision of social justice and advocacy for marginalized group.  The struggle to obtain quality healthcare by lesbian and bisexual women is often due to the complex conditions such as fear of disclosure and homophobic attitudes from healthcare professionals (Johnson & Nemeth, 2014).  Lesbian and bisexual women are found in every socioeconomic category and all racial and ethnic groups, yet they are known to underutilize the resources and services available in healthcare, in comparison to heterosexual women (Johnson & Nemeth, 2014).

Many lesbians and bisexual women do not disclose their sexual identity to healthcare providers due to past experiences of hostility, sexist and demeaning comments, withholding information, inappropriate jokes, less physical contact with clients, and inappropriate referrals to mental health, which often led to substandard quality health care (Johnson & Nemeth, 2014).   Despite recent laws that bans both the federal government and federal contractors from discriminating against lesbian and bisexual women, the lack of protection at the state and federal level continues (Johnson & Nemeth, 2014).  Because there is lack of health outcome data available on lesbian and bisexual women, obtaining support for change is challenging; therefore it is imperative for policymakers and providers to set a trend in collecting data on sexual orientation and gender identity in healthcare practices, organizations, and federal surveys (Johnson & Nemeth, 2014).  By quantifying the healthcare disparities of lesbian and bisexual women, gran funders, researchers, policymakers, and providers will progress in identifying and addressing the causes (Johnson & Nemeth, 2014).

Ethical Issues

Recently, there has been many significant and positive civil rights gains for lesbians and bisexual women in the United States, such as same-sex marriages.  With the struggles to gain equal rights for lesbians and bisexual women, the central tropes that have emerged are the beliefs of  being “born that way” (Powell & Stein, 2014).  Sexual orientation cannot change as well as one’s orientation is not affected by choice.

According to Powell and Stein (2014), whether sexual orientation is the result of choice, issues involving sexual orientation and choice are complicated.  There is strong evidence that an individual’s conscious choices do not necessarily lead to the development of sexual orientation (Powell & Stein, 2014).  The right simply to have same-sex attractions and not being allowed the right to act on these desires would be a nulled point.  The laws do not push women, racial, and ethnic minorities to hide or simplify their identities and therefore the same should be true for sexual minorities (Powell & Stein, 2014).

Plan of Action

Avoidance or delay of routine medical care is the most significant risk for lesbian and bisexual women (Curmi et al., 2016).  Curmi et al. (2016) also stated that there is a negative association between sexual orientation and receiving healthcare due to heteronormativity, which is evident within the healthcare system.  In order to properly reach equality in healthcare for lesbian and bisexual women, all public bodies, which includes all healthcare practitioners, must proactively promote the equality for lesbian and bisexual women through the Equality Act (Corcoran, 2017).  To reduce the health disparities, healthcare providers should encourage and ensure a welcoming and nonjudgmental environment to foster trust and open communication among lesbian and bisexual women (Corcoran, 2017).  The provider’s ability to appreciate diversity will likely promote the feeling of safety that will allow lesbian and bisexual women to come out to their providers.  Providers who are knowledgeable about women’s sexual orientation are more able to provide quality care and ensure better health outcomes (Munson & Cook, 2016).  Lastly, further education on how to appropriately deliver care to lesbian and bisexual women without discrimination should be provided to healthcare providers (Corcoran, 2017).  Furthermore, organizations with staff members that are knowledgeable and understands the need of lesbian and bisexual women and can provide tailored and dedicated need by working in partnership with the patients (Corcoran, 2017).

Conclusion

Despite the recent changes and civil right gains toward same-sex relationships, lesbian and bisexual women continue to experience a variety of barriers to quality healthcare.  These barriers lead to a delay or avoidance in seeking healthcare, which places sexual minority women at a high risk for multiple health conditions.  Discrimination, hostility, sexist and inappropriate remarks are some of the reasons why lesbian and bisexual women hesitate to disclose their gender identity and sexual orientation.  Socio-economic factors in education and workplaces plays a major impact on the quality of life, rights, and general well-being of lesbian and bisexual women.   Disparities can be reduced or eliminated by providing a welcoming and nonjudgmental environment along with promoting a feeling of safety to allow sexual orientation admittance.  Healthcare providers should be furnished with further education on how to appropriately deliver care to lesbian and bisexual women without discrimination.  Lastly, public bodies should be proactive in promoting equality for lesbian and bisexual women through the Equality Act.

References

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