NURS 6053/NURS 6053N/NRSE 6053C/NURS 6053C/NURS 6053A/NRSE 6053A: Workplace Environment Assessment

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NURS 6053/NURS 6053N/NRSE 6053C/NURS 6053C/NURS 6053A/NRSE 6053A: Interprofessional Organizational and Systems Leadership

Assignment: Workplace Environment Assessment

Clearly, diagnosis is a critical aspect of healthcare. However, the ultimate purpose of a diagnosis is the development and application of a series of treatments or protocols. Isolated recognition of a health issue does little to resolve it.

In this module’s Discussion, you applied the Clark Healthy Workplace Inventory to diagnose potential problems with the civility of your organization. In this Portfolio Assignment, you will continue to analyze the results and apply published research to the development of a proposed treatment for any issues uncovered by the assessment.

To Prepare:

  • Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
  • Review the Work Environment Assessment Template.
  • Reflect on the output of your Discussion post regarding your evaluation of workplace civility and the feedback received from colleagues.
  • Select and review one or more of the following articles found in the Resources:
    • Clark, Olender, Cardoni, and Kenski (2011)
    • Clark (2018)
    • Clark (2015)
    • Griffin and Clark (2014)

The Assignment (3-6 pages total):

Part 1: Work Environment Assessment (1-2 pages)

  • Review the Work Environment Assessment Template you completed for this Module’s Discussion.
  • Describe the results of the Work Environment Assessment you completed on your workplace.
  • Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed.
  • Explain what the results of the Assessment suggest about the health and civility of your workplace.

Part 2: Reviewing the Literature (1-2 pages)

  • Briefly describe the theory or concept presented in the article(s) you selected.
  • Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.
  • Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.

Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1–2 pages)

  • Recommend at least two strategies, supported in the literature, that can be implemented to address any shortcomings revealed in your Work Environment Assessment.
  • Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment.

The Effects of “To Err Is Human” in Nursing Practice

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The Effects of “To Err Is Human” in Nursing Practice

The 1999 landmark study titled “To Err Is Human: Building a Safer Health System” highlighted the unacceptably high incidence of U.S. medical errors and put forth recommendations to improve patient safety. Since its publication, the recommendations in “To Err Is Human’” have guided significant changes in nursing practice in the United States.

In this Discussion, you will review these recommendations and consider the role of health information technology in helping address concerns presented in the report.

To prepare:
•Review the summary of “To Err Is Human” presented in the Plawecki and Amrhein article found in this week’s Learning Resources.
•Consider the following statement:

“The most significant barrier to improving patient safety identified in “To Err Is Human”is a “lack of awareness of the extent to which errors occur daily in all health care settings and organizations (Wakefield, 2008).”
•Review “The Quality Chasm Series: Implications for Nursing” focusing on Table 3: “Simple Rules for the 21st Century Health Care System.” Consider your current organization or one with which you are familiar. Reflect on one of the rules where the “current rule” is still in operation in the organization and consider another instance in which the organization has effectively transitioned to the new rule.

By Day 3

Explain why illusions provide clues to perceptual mechanisms.

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Explain why illusions provide clues to perceptual mechanisms.

 

Text: Psychology Core Concepts: Zimbardo, Johnson and Hamilton 7TH EDITION (978-0-205183463) I cant found the text online maybe you can
Or You can access The Discovering Psychology video series on the internet for free!
Go to www.learner.org
Click on the blue tab near the top that reads “view programs”
Many film series will be listed. They are in alphabetical order. Scroll down to Discovering Psychology: Updated Edition. Click on it.
All 26 episodes from the series are listed in order. Double click on the box that says “VoD” next to the episode you wish to view. That’s it!
Type 1 page for each ½ hour video unit where you submit bullets outlining the content of each ½ hour lecture (not more than one page in length) AND, SEPARATELY, ANSWER ALL LEARNING OBJECTIVE QUESTIONS FROM THE ATTACHED/ENCLOSED PACKET( state each question before each of your responses. Make sure you cite page references from the text for each of your answers).
ANSWERS TO THESE QUESTIONS CAN BE FOUND IN VIDEO AND TEXT INSIDE FRONT AND BACK COVER OF TEXT WILL TELL YOU WHAT CHAPTERS CORRELATE WITH WHICH VIDEOS).
Week 8 Nov. 4 videos/Obj. units 15,16
Week 9 Nov.11 videos/Obj. units 17,18
Week 10 Nov. 18 videos/Obj. units 19,20
Week 4 Oct. 7 videos/Obj. units 7,8 Week 11 Nov. 25 videos/Obj. units 21/22
Week 5 Oct. 14 videos/Obj. units 9,10 Week 12 Dec. 2 videos/Obj. units 23/24
Week 6 Oct. 21 videos/Obj. units 11,12 Week 13 Dec. 09 videos/Obj. units 25/26
Week 7 Oct. 28 videos/Obj. units 13,14
Objective 7
After viewing the television program and completing the assigned readings, you should be able to:
1. Define and compare sensation and perception.
2. Describe how a visual stimulus gets translated into “sight” in the brain.
3. Describe the field of psychophysics.
4. Be able to distinguish distal and proximal stimuli.
5. Explain why illusions provide clues to perceptual mechanisms.
6. Describe Gestalt psychology.
7. Describe the phenomenon of perceptual constancy.
8. Describe the psychological dimensions of sound and the physiology of hearing.
9. Describe the difference between top-down and bottom up processing.
10. Discuss the senses of smell, taste and touch.
Objectives 8
After viewing the television program and completing the assigned readings, you should be able to:
1. Define learning.
2. Describe the process of classical conditioning and show how it demonstrates learning by association.
3. Cite examples of extinction, spontaneous recovery, generalizations, and discrimination.
4. Describe the process of operant conditioning.
5. Know the distinction between positive and negative punishment and between positive and negative reinforcement.
6. Describe how observational learning occurs.
7. Discuss the varieties of reinforcement schedules, including fixed ratio, variable ratio, fixed interval and variable interval.
8. Describe cognitive influence on learning.
9. Describe biological constraints on learning and some possible effects that learning can have on the functioning of the body.
Objective 9
After viewing the television program and completing the assigned readings, you should be able to:
1. Define memory.
2. Compare implicit and explicit memory.
3. Compare declarative and procedural memory.
4. Describe the processes of encoding, storage, and retrieval.
5. Describe the characteristics of short-term, long-term, and sensory memory.
6. Define Schema.
7. Describe the accuracy of memory as a reconstructive process.
8. Define amnesia.
9. Describe processes of encoding and retrieval in Long Term Memory (LTM).
10. Describe short term memory (STM), note its limited capacity, and discuss two ways to enhance STM.
11. Compare semantic and episodic memory.
12. Discuss proactive and retroactive interference.
13. Describe chemical and anatomical factors involved in memory.
Objective 10
After viewing the television program and completing the assigned readings, you should be able to:
1. Compare inductive and deductive reasoning.
2. Define the concept, “problem”, in information processing terms and describe some ways to improve problem-solving abilities.
3. Discuss the “historical roots of methods for revealing mental processes.”
4. Describe the study of language production.
5. Explain how ambiguity in language can be resolved.
6. Give several examples of how context influences language and understanding.
7. Explain the role of visual imagery in cognition.
8. Discuss the importance of prototypes and schemas in cognition.
9. Describe what we know about the relation between cognition and brain activity.
Objective 11
After viewing the television program and completing the assigned readings, you should be able to:
1. Describe contrasting views of why human thinking is irrational and prone to error.
2. Explain the notions of heuristic thinking and analytical thinking.
3. Compare definitions of problem solving and decision making.
4. Describe the anchoring bias, availability heuristic, and representativeness heuristic.
5. Discuss why the way a problem is framed can influence a decision.
6. Define decision aversion.
7. Describe how risk affects decision making.
8. Describe at least one way in which memory and decision making can affect each other.
Objective 12
After viewing the television program and completing the assigned readings, you should be able to:
1. Compare emotion and motivation and describe their interrelationships.
2. Describe three theories concerning the sources of motivation.
3. Discuss some of the forces that drive the motivation to eat.
4. Describe some of the factors behind the motivation for sex.
5. Define the need for achievement.
6. Outline the attributions for success and failure in terms of a locus of control orientation.
7. Describe the major theories of emotion and the universality of its expression.
8. Describe the relationship between physical states and the experience of emotions.
Objectives 13
After viewing the program and completing the reading assignment, you should be able to:
1. Describe the functions of consciousness.
2. Describe the different levels of consciousness and the kinds of processing that occur at each level.
3. Define circadian rhythms and describe their relation to the 24-hour day cycle.
4. Describe the stages of sleep.
5. Identify the major sleep disorders and the effects of sleep deprivation.
6. Discuss the difference between night dreaming and day dreaming, and describe lucid dreaming.
7. Explain Freud’s theory of dreaming and contrast it with the Hobson-McCarley theory and the information-processing theory.
8. Give examples of the difference between a dream’s manifest content and latent content.
9. Describe the issues concerning sleep that will arise as people’s lives become more driven and as world travel becomes easier.
Objectives 14
After viewing the program and completing the reading assignment, you should be able to:
1. Describe hypnotic techniques, experiences, and applications.
2. Explain the difference between psychological dependence and physical addiction.
3. Define the major drug categories, and compare the effects of specific drugs, such as stimulants and depressants.
4. List and describe the characteristics of the various extended states of consciousness, such as lucid dreaming, hypnosis, mediation, hallucinations, and drug use.
5. Describe the three levels of consciousness.
6. Explain the phenomenon of “discovered memory.”
Objectives 15
After viewing the program and completing the reading assignment, you should be able to:
1. Define personality.
2. Compare type and traits theories of personality.
3. List and describe “The Big Five” dimensions of personality.
4. Describe Freud’s theory of personality development and the role of the id, ego, and superego in the conscious self.
5. Describe how post-Freudian theories differ from Freudian theories.
6. Describe the major humanistic theories and their contribution.
7. Describe social learning and cognitive theories and their contribution.
8. List the five most important differences in assumptions about personality across theoretical perspectives.
9. Compare the value and accuracy of standardized and projective tests of personality.
Objectives 16
After viewing the program and completing the reading assignment, you should be able to:
1. Define assessment.
2. Describe several ways to measure the reliability and validity of a psychological test.
3. Identify the contributions of Galton, Binet, Terman and Weschler to the science of measuring intelligence.
4. Explain how IQ is computed.
5. Summarize Howard Gardner’s theory of multiple intelligences.
6. Describe the evidence for the genetic and environmental bases of intelligence.
7. List the four methodological techniques used the gather information on a person.
8. Discuss the links among intelligence, creativity, and madness.
9. Explain the function of vocational interest tests.
10. Discuss the controversies surrounding intelligence assessment.
Objectives 17
After viewing the program and completing the reading assignment, you should be able to:
1. Define and compare the difference among these terms: sex, gender, gender identity, and gender role.
2. Explain the role of pheromones in sexual arousal.
3. Describe evolutionary theory as it applies to sexual behavior.
4. Describe the similarities in and differences between males and females in the sexual response cycle and mating.
5. Summarize current research on homosexuality.
Objectives 18
After viewing the program and completing the reading assignment, you should be able to:
1. Describe Erikson’s eight psychosocial stages.
2. List the physical changes associated with aging.
3. Summarize the tasks of adolescence.
4. Discuss the central concerns of adulthood.
5. List the strengths and weaknesses of Kohlberg’s cognitive approach to moral development, describe the controversies around the issues of gender and cultural differences in moral judgment, and discuss the distinction between moral behavior and moral judgment.
6. Identify cultural factors that place youth at risk for unhealthy development.
7. Discuss the importance of attachment in social development.
8. List the biological and social factors that can affect health and sexuality in later life.
9. Describe the risk factors for an elderly person in a nursing home.
Objectives 19
After viewing the program and completing the reading assignment, you should be able to:
1. Describe Philip Zimbardo’s prison experiment and his conclusions about how people’s behavior is constrained by social situations.
2. Describe Solmon Asch’s experiment and his conclusions on the conditions that promote conformity.
3. Compare the major leadership styles in Lewin’s experiment and describe their effects on each group of boys.
4. Describe Stanley Milgram’s obedience experiments and his conclusions about conditions that promote blind obedience.
5. Describe the phenomenon of bystander intervention and how it reflects another aspect of situational forces.
6. Describe Serge Moscovici’s work on the influence of the minority on the majority.
7. Discuss various factors that contribute to aggressive behavior.
8. Explain why experimental research is necessary for understanding social influences on behavior.
Objectives 20
After viewing the program and completing the reading assignment, you should be able to:
1. Explain the fundamental attribution error.
2. Describe attribution theory.
3. Explain self-perception theory.
4. Summarize Rosenthal’s experiment that demonstrates the Pygmalion effect and explain its relation to self-fulfilling prophecies.
5. Describe the effect of cognitive dissonance on behavior and attitude change.
6. Describe the techniques used by cults to maintain control over their members.
Objectives 21
After viewing the program and completing the reading assignment, you should be able to:
1. Identify the seven criteria commonly used to determine abnormal behavior.
2. Describe the Diagnostic and Statistical Manual of Mental Disorders and how it is used.
3. Explain how psychological disorders are classified.
4. List and describe the major types of psychological disorders.
5. List the biological and psychological approaches to studying the etiology of psychopathology.
6. Summarize the genetic and psychosocial research related to the origins of schizophrenia, including subtypes and etiology.
7. Identify sources of error in judgments of mental illness.
8. Discuss stigmas against mental illness and how they can be overcome.
Objectives 22
After viewing the program and completing the reading assignment, you should be able to:
1. Describe early approaches to identifying and treating mental illness.
2. Identify the major approaches to psychotherapy.
3. Describe how psychiatrists, psychoanalysts, and clinical psychologists differ in their training and therapeutic orientations.
4. Identify the major features of psychoanalysts and explain the purposes of each.
5. Explain the goals of various behavior therapies.
6. Describe how counterconditioning can be used effectively to treat phobias.
7. Summarize the major rationale behind all types of cognitive therapies.
8. Describe the use of psychosurgery and electroconvulsive shock in the treatment of mental illness.
9. Identify the common forms of drug therapy and how they have changed the mental health system.
10. Summarize research on the effectiveness of psychotherapy.
11. Summarize the main features of client-centered therapy and Gestalt therapy and how these reflect the existential-humanistic perspective.
Objectives 23
After viewing the program and completing the reading assignment, you should be able to:
1. Define stress and list the major sources of stress.
2. Describe the role of cognitive appraisal in stress.
3. Describe the major physiological stress reactions, including the general adaptation syndrome.
4. Explain the relationship between stress and illness.
5. Describe various kinds of events that can lead to psychological stress.
6. Describe the types of coping strategies in coping with stress.
7. Explain the mind-body relationship in terms of the biopsychosocial model of health and illness.
8. Describe the effects of self-disclosure on health.
9. Describe biofeedback, how it works, and its role in behavioral medicine.
10. Discuss how personality types relate to different health outcomes.
11. List some things you can do to reduce your stress level, promote your health, and protect yourself from job burnout.
Objectives 24
After viewing the program and completing the reading assignment, you should be able to:
1. Describe how psychologists try to improve the human condition through the application of social psychological principles to social problems.
2. Identify at least three important stress factors for space travelers, and discuss how studying those problems can help people on Earth.
3. Define peace psychology and conflict negotiation.
4. Describe the problems faces by legal professionals when children serve as eyewitnesses.
5. Identify several signs that people are not getting enough sleep and identify the risks associated with sleep deprivation.
Objectives 25
After viewing the program and completing the reading assignment, you should be able to:
1. Describe some of the differences between EEG, ERP, CAT, MRI, PET, and fMRI techniques.
2. Describe how fMRI can be used to study visual pathways.
3. Describe some of the brain structures that underlie face recognition.
4. Support the similarity of imagery and perception by discussing the brain activity they have in common.
5. Explain how brain research can be used to help dyslexics learn to process language stimuli more effectively.
6. Describe how studies of the brain can reveal unconscious stereotypes.
Objectives 26
After viewing the program and completing the reading assignment, you should be able to:
1. Describe the differences between Eastern and Western cultures in terms of the weight given to individual and group factors to explain behavior.
2. Cite examples of how the Western value on individualism manifests itself.
3. Describe the African cultural values that have benefited African Americans in their struggle against bigotry.
4. List several factors that put Latino immigrants at risk for depression and alienation.
5. Cite evidence that psychology can help solve some of society’s most perplexing problems and cite evidence to the contrary.
Attachments:
psy_book.pdf
Psychology homework help
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What communication strategies can professional nurses use to specifically promote collaboration with other healthcare disciplines and professionals?

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What communication strategies can professional nurses use to specifically promote collaboration with other healthcare disciplines and professionals?

 

 

Interprofessional Collaboration Strategies Interprofessional Collaboration Strategies In today′s changing healthcare environment, it is more important than ever for professional nurses to be skilled in collaborating with professionals from other healthcare disciplines. What communication strategies can professional nurses use to specifically promote collaboration with other healthcare disciplines and professionals?

Reflective essay relating to a patient with COPD

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INTRODUCTION:

The purpose of this essay is to adopt Rolfe, Freshwater and Jasper (2001) model of reflection in reflecting upon my experience in practice placement while caring for a patient with a long term condition. This model will help to identify the learning needs and how it may be achieved. To maintain confidentiality in this essay with respect to the NMC code of conduct, I will be keeping the patient’s information anonymous, thus will be referred to as Elizabeth.

Reflection is an important element of learning (Arbel, 2009). John and Freshwater (2005) defined reflection as assessing previous experience to develop tacit and intuitive knowledge.

Rolfe et al (2001) model of reflection

propose a framework that uses Borton’s (1970) developmental model. Pryce (2002) explains that, this model is a simplistic cycle that is based upon three sample questions to reflect on a situation: What? So what? Now what? Hence, it is vital that student nurses reflect regularly so as to improve their practice, knowledge, skills and behaviour to care for their patients to the best of their ability. Ultimately, Botten (2012) stresses the importance of reflection for student nurses, as it enriches their clinical learning, enabling them to learn more about themselves and the way they practice.


WHAT

I met Elizabeth during my previous practice placement at the surgical ward, she is 70 years old and was diagnosed with severe chronic bronchitis approximately 8 years ago. She was admitted to the ward due to acute exacerbation of chronic obstructive pulmonary disease (COPD). According to Kauffman (2014), bronchitis is the Inflammation of the bronchi associated with partial obstruction of the bronchi by secretions or constriction. Chronic bronchitis is also included under the umbrella of COPD (Jindal & Vijayan, 2011). In regards to NICE (2010), about 3 million people have COPD in the UK, 900,000 have diagnosed COPD and an estimated 2 million people have COPD which remains undiagnosed. Also, according to department of health (2010) COPD mainly affect people aged over 45 with a history of smoking.


SO WHAT

Elizabeth stated that she was experiencing progressive dyspnea and increased cough. McCann (2007) stated, with chronic bronchitis, increased accessory use of muscles may be chronic and is preceded by a productive cough, sputum production and shortness of breath. At the time of assessment during admission, Elizabeth reported that she has been unable to care for herself and has difficulty managing her daily activities as she lives alone. Elizabeth’s personal hygiene appeared to have deteriorated and she was only able to speak in short sentences.

Elizabeth’s personal hygiene was deteriorating as a result of her inability to self-care. According to Field & Smith (2008), hygiene is fundamental for all people. The nurses used Roper et al (2001) and Orem (1991) nursing models in meeting Elizabeth hygiene needs. In addition to Field & Smith (2008), it is stated that, this nursing models helps patients to achieve the activities associated with their daily life independently. Following the care plan, the nurse assessed Elizabeth’s hygiene needs, taking into consideration any deficit that may affect her ability to care for herself. The nurse made sure that appropriate personal hygiene care including washing, oral care, hair care, mouth care and nail care was provided and this was discussed with Elizabeth in order to ensure her needs are fully met by protecting her right to privacy and personal choice. DOH (2003), states that personal hygiene is the physical act of cleansing the body to ensure that the skin, hair and nails are maintained in optimum condition. Dingwall (2010) also suggested that assisting patient in meeting their hygiene needs as well as helping them can develop a nurse-patient relationship and allow a skilled practitioner to assess how the patient is improving mentally and physically.

Due to the exacerbations, she had problems eating and swallowing, hence, simple routine nutritional screening was performed using a validated nutritional screening tool such as Malnutrition universal screening tool (MUST). According to Rice (2006) nutritional support is a vital part of nursing care because many patients with COPD are malnourished. This nutrition screening was carried out so that changes in her weight can be identified immediately and dietary changes can be started to improve her nutritional status as soon as possible. Specific dietary advice and support as well as general advice for meal planning were reinforced. Nazarko (2002) emphasised that, nutritional status is crucial to patient’s state of health. Referral to dietician and speech and language therapists was made to optimise her nutritional status, and assess and treat her swallowing difficulties. According Evans (2012), swallowing difficulties can make patient’s eating and drinking difficult and can often result in patients losing weight if no adequate support is given. Hence, Adjustment of food flavour, texture, density and temperature was made to help minimize dysphasia. Any liquid given such as water or ensure was thickened as they are difficult for the tongue to control and can easily splash into the trachea (Weetch, 2001).

Due to concerns regarding Elizabeth inability to carry out daily activities safely without risk of falls or accidents, which may result detrimental effect upon her health and quality of life, referral to the following members of multi-disciplinary team was made for further assessment to assist with her daily activities of living that may enable her to continue to live within her home safely. These members of multi-disciplinary team included; social services, physiotherapist, occupational therapist, social workers and age concern. According to Karen & Aidin (2011), Dyspnea causes many patients with COPD to withdraw from day-to-day activities and hobbies. Referral to rehabilitation services was considered to improve her breathing, oxygenation and endurance (NICE, 2006). Home care aide services were considered to assist Elizabeth with her activities of daily living care. Rice (2006) suggested, in planning care, it will be crucial to determine what activities of daily living the patient can perform.


NOW WHAT

In becoming an efficient nurse, there are some areas of improvement that needs to be considered for future practice such as; understanding more about activities of daily living for COPD patients, having more knowledge on assessment discharge, how they are done, package of care for COPD patients. These learning needs will be achieved through working closely within the multi-disciplinary team. According to Nehring & Lashley (2010), working within multi-disciplinary will give the student opportunity to enhance their professional skills and knowledge of patient’s care. Also, reading more about COPD exacerbation will enable the student to recognise a patient having exacerbation if it re-occurs in future practice, knowing how to manage their condition effectively, hence, providing high quality care.


CONCLUSION

COPD is a debilitating illness which causes patient’s emotional, social, psychological and physical distress due to the impact on daily living. This reflective essay has helped the student acknowledge the importance of reflection within practice as it allows professionals to convey thoughts of how they can improve on their practice to enhance effective delivery of care.

What types of staffing and training recommendations would you make for the community mental health center?

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What types of staffing and training recommendations would you make for the community mental health center?

You are a psychologist in an urban community that has seen a 200% growth in its immigrant population over the past 3 years. Eighty-seven percent of this population speaks a language other than English at home. You work for a community mental health center, which is seeing an increase in referral from this population primarily because of the children’s interactions with the school system. The children typically become bilingual quickly. The parents are typically less fluent in English than their children; however, approximately 30% of the adults in this immigrant population are fluent in English and hold advanced degrees and middle- to upper- middle class jobs. The remaining 70% primarily hold jobs that do not require higher education although many do have degrees from their country of origin.

Based on the reading, evaluate research and practice aspects in this applied context and use elements from previous learning in your program to address the following:

What types of staffing and training recommendations would you make for the community mental health center?
How would you facilitate intergroup work relations among staff at the community mental health center?
Would you support the use of the DSM-5 to diagnose clients with limited English proficiency?
How would you evaluate whether or not your staff is competent to work with this population?
Explain the rationales for your answers by providing evidence from the required readings.

Causes- Effects and Impacts of Hypertension

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Hypertension (HTN) also known as high blood pressure, is diagnosed when the force of systolic pressure which is defined as the force of blood being pumped out of the heart into arteries and the pressure exerted by blood against the artery walls and diastolic pressure, defined as the time the heart rests between beats and the force of blood being exerted against the artery walls, is measured as a numerical reading and is determined to be above normal. Normal range is considered when the systolic (top number) is less than 120mm and the diastolic (lower number) is less than 80mm.   When the force of blood pushing against the walls of the blood vessels is consistently registered as high over a period of time, a diagnosis of hypertension is given. It is recommended that an individual have their blood pressure taken in both arms to accurately determine their numbers.  There are two stages before an individual is considered in to be in hypertensive crisis. Hypertension Stage 1 is determined when blood pressure has a systolic reading between 130-139mm and diastolic reading between 80-89mm. Hypertension Stage 2 is determined when systolic numbers are 140mm or higher and diastolic numbers are 90mm or higher. An individual is considered in a state of hypertensive crisis when the systolic numbers are over 180mm and diastolic numbers are over 120mm. (AHA, 2019).  According to the American Heart Association, individuals from age 40-89 will doubled their increased risk of death from ischemic heart disease and stroke with every 20mm systolic or 10mm diastolic increase. (AHA, 2019).

Hypertension is also known as the silent killer because it has no real symptoms. High blood pressure may develop over many years. Symptoms when they do exhibit are usually present when an individual’s BP has reached a severe and possibly life-threatening level and may include headaches, nosebleeds and shortness of breath, dizziness, and occasionally blood spots in the eyes along with blurred or double vision but initially these symptoms are often mistaken as having other causes. An individual who smokes, consumes a diet high in sodium and fats, is overweight and leads a sedentary life should understand that these are signs and often are the contributing causes of high blood pressure. Women may experience these symptoms but may also have signs and symptoms specific to women including chest pain, blood in the urine, pounding in the ears, neck and/or chest, fatigue and/or confusion and irregular heartbeat. These signs and symptoms should not be ignored.

Hypertension will affect nearly everyone eventually. As mentioned, this is a disease that usually develops over many years. A high fat, high cholesterol diet will cause plaque to build up in the blood and arteries. Blood vessels carry blood to and from the major arteries. As the pressure the blood travels under increases, the force of the blood pushing against these walls causes damage to them in the form of small tears where bad cholesterol begins to attach and collect at the tears causing a narrowing of the arteries creating a situation where there is less blood flow passing through. When blood flow is restricted to tissues and organs, damage results. With a narrowing of the arteries, the heart has to work harder to pump the blood and with each pump the heart is less effective at achieving proper blood flow. Additionally, as individuals age, their heart muscle changes along with other organs and tissues in the body. Body functions slow and become less efficient sometimes causing organs and systems to work harder.  There has long been a theory that a reduction in sodium intake can help to lower blood pressure. Recent studies have discovered the opposite is true. A reduction in sodium seems to cause an increase in blood cholesterol and in women who are overweight, blood cholesterol may become even more elevated due to insulin resistance. There are many risk factors that can contribute to developing this disease including excessive smoking, alcohol abuse, high cholesterol and/or a high sodium diet such as from fast food, lack of exercise, obesity and stress. These are some of the factors that may be within an individual’s control. Other contributing factors that may be beyond and individuals control include age, genetics, stress (beyond one’s control), family history of hypertension, adrenal disease, thyroid disease, chronic kidney disease and diabetes. African American women are more salt sensitive than Caucasian women contributing to higher sodium levels in the body.  Women who are taking oral birth control are more at risk of having hypertension and this risk multiplies if they are taking oral birth control and are a smoker. While hypertension is easier to diagnose in women, the symptoms are often mistaken for other diseases. Racial differences play a part in hypertension as well with African Americans being at a greater risk than Caucasians. According to the National Institutes of Health, the life expectancy for African American men and women is significantly less than for Caucasians. African Americans are more likely to develop hypertension at an earlier age and have a higher rate of diagnosed cases of hypertension associated illnesses. (NIH, 2014).

“Stroke mortality risks are two-fold greater for African Americans. End-stage renal disease is five times more common for African American men and women. In addition, the age of onset of disease such as stroke is considerably earlier for African Americans. While high blood pressure affects all segments of the population, high blood pressure rates are more prevalent among African American men and women.”

(NIH, 2014).

Individuals diagnosed with hypertension have a myriad of changes and issues that will occur within their body.  Hypertension causes harm to the heart and blood vessels by making these systems work harder and less efficiently.  The first system that is damaged is the circulatory system. As stated earlier, blood vessels carry blood to and from the major arteries. As the pressure the blood travels under increases, the force of the blood pushing against these walls causes damage to them in the form of small tears where bad cholesterol begins to attach and collect at the tears causing a narrowing of the arteries creating a situation where there is less blood flow passing through. When blood flow is restricted to tissues and organs, damage results. With a narrowing of the arteries, the heart has to work harder to pump the blood and with each pump the heart is less effective at achieving proper blood flow. This extra work can cause enlargement of the left ventricle which is the side responsible for pumping blood throughout the body. This increases the risk of a heart attack and/or heart failure. A damaged artery may also be susceptible to an aneurysm which can go undetected until it bursts and may be life threatening. Hypertension may also be linked to dementia by contributing to a reduction in the blood flow to the brain. This condition can lead to memory loss, difficulty understanding concepts and possibly even a stroke. Damage to the blood vessels in the eyes may also occur. Hypertension can also impact the skeletal system by increasing the amount of calcium lost during urination leading to osteoporosis. Within the lungs, hypertension can cause a pulmonary embolism as well as an aneurysm. Reproductive organs are also impacted by hypertension since there is extra blood flow to these organs during arousal. Sexual dysfunction may take the form of men being unable to achieve an erection and women may experience less desire, problems with orgasm and vaginal dryness. Our kidneys play a major role in regulating blood volume and pressure, remove waste from the blood and filter waste from the body in the form of urine. When an individual has hypertension, the large and small blood vessels leading to and within the kidneys become damaged and impact kidney function leading to kidney disease and possibly kidney failure. The result is that the kidneys are no longer able to remove waste from the body and the individual will require dialysis and/or a transplant. Hypertension impacts every aspect of the body from system function to cells and tissue.

Hypertension is manageable if caught in time reducing the risk for many of the diseases associated with the condition. The NIH states that

“African Americans demonstrated poorer blood pressure compared with Caucasians.”

(NIH, 2014). Societal awareness of hypertension and treatments are the same for African American and Caucasians however, the response to medications have been different. According to studies, African Americans respond better to calcium channel blockers and diuretics while Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB’s) have been shown to be less effective.

The economic impact of hypertension is staggering.  The costs are incurred at both ends of the spectrum, from the range of treatments necessary for those who are diagnosed with the disease and the associated illnesses such as medications, rehabilitation and loss of productivity, and treatment of those who go undiagnosed or treated and the associated illnesses that result in the form of multiple organs  being affected, medication, rehabilitative care, increased medical costs and loss of productivity. According to HSR, of people diagnosed with hypertension only 68% report taking medication to control the disease. (HSR, 2011). The Milken Institute study discusses the issue of chronic illnesses on the U.S. economy.  The study reports that the chronic diseases are preventable and impact not only the health of our nation’s individuals but also the economic health of our nation in the form of lost productivity. stating that “…

the annual economic impact on the U.S. economy of the most common chronic diseases is calculated to be more than $1 trillion, which could balloon to nearly $6 trillion by the middle of the century”,

and, “

According to the study, seven chronic diseases-cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions and mental illness-have a total impact on the economy of $1.3 trillion annually. Of this amount, $1.1 trillion represents the cost of lost productivity”.

(Fight Chronic Disease, 2019). The study goes on to state that any funding spent on preventing chronic diseases will be worth the investment over the long term. With improvements in detection and early intervention, by 2023 40 million cases of chronic diseases can be avoided reducing the economic impact by 27% resulting in a savings of $1.1 trillion annually. Regarding the impact on healthcare costs, HSR reports that reducing the number of individuals with high blood pressure would save $37 per person annually in follow-up visits to the physician, declines in hospitalization related to high BP would be reduced by $92 per person annually. (HSR, 2011).

The bottom line is that any chronic illness impacts  every aspect of a person’s life as well as that of their families in the form of loss of productivity, increase in insurance rates, increase in treatment costs,  increase in cost of medications, strains on facilities in the form of long term care and chronic care required and lifespan.

References

What specific behaviors are associated with effective leadership?

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What specific behaviors are associated with effective leadership?

Summary:

To help students distinguish leadership characteristics in terms of communication within their team and in collaboration with other disciplines in exemplary leaders and managers encountered in everyday nursing practice. Identifying communication, teamwork, and collaboration characteristics helps students become aware of professional behaviors associated with achieving the mission of professional nursing.

Directions:

Submit a Prezi or PowerPoint or create a video presentation about characteristics of a nurse leader who displays exemplary collaboration, team-building and communication skills.

Discuss the following:
1.What specific characteristics framed this person as a leader in terms of communication, teamwork and collaboration?
2.How did this person relate to other health professionals including students?
3.What specific behaviors are associated with effective leadership?
4.In what ways is nursing leadership a dynamic, interactive process?
5.In what ways can nurses demonstrate communication, teamwork and collaboration leadership skills in contemporary health care environments?
6.Include a reference slide with a minimum of three references (within last five years) in APA format.

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Prescribing Procedures for Sexual Health Nurse Practitioner

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Introduction

The author has worked in Sexual health Department for the past 14 years and is currently employed as a nurse practitioner. The practitioner role entails working autonomously: taking accurate clinical histories, physical examinations, gains differential diagnosis & organises a plan of care. This plan of care often includes prescribing medications. It is increasingly becoming a necessity therefore in many specialist & autonomous nursing roles to become a Nurse Medical Prescriber (NMP) who will script the prescribing medication.

The Nursing and Midwifery Council (NMC) (2018) states that only qualified NMPs, who has successfully completed the non–medical prescribing course, may write a prescription.

The aim of this essay is to discuss the prescribing that took place for a patient that presented with genital ulcers in the Sexual Health Clinic. This essay is structured by applying the prescribing pyramid to aid practice (NPC, 1999) & adhering to the first principle, considered to be a holistic assessment.

The essay will also demonstrate an evidence-based approach to practicing as a safe independent prescriber. This can be achieved by presenting and analysing a prescribing scenario of a patient encountered within a known area of practice of Sexual Health.

The case study used is based on a female patient Katy who attended for treatment of recurrence of Herpes Simplex Virus (HSV). While this essay has been written from the perspective of a prescriber, in reality the prescription issued for this consultation was written by a qualified prescriber. To maintain confidentiality, in line with the code of professional conduct, throughout this essay, all names of patients, clinicians, hospital and all community trusts have been changed as per (NMC 2018).

This prescribing practice essay applies the Gibbs Model (1988). The author finds the model fits well with the seven principles of good prescribing and has been selected as it is something the author is familiar with and has used before.

Consider the patient

A full history was taken from Katy which included presenting complaint (PC) and history presenting complaint (HPC) including sexual history. The patient confirmed no changes in sexual history since her last attendance. A full medical, social and drug history, medication currently being taken, including herbal remedies, over the counter medicines and any known allergies was established. Open ended questions were posed by means of the patient being able to “tell her story”, for example, “what brings you to the clinic” (Peat, 2001). Closed questions were also asked, as suggested by Young et al (2009); these are helpful questions in gaining specific information related to the initial information given. For example if the patient mentions he/she have pain, an appropriate closed question would be “where is the pain?”.

It is Important for the NMP to have insight knowledge of signs and symptoms of possible differential diagnosis and be able to rule out red flags. In this case the following differential diagnosis & red flags for Syphilis chancroid & Bechet Syndrome were already ruled out. The patient received a negative syphilis blood test and negative Chlamydia and Gonorrhoea swab, followed by an examination of genital sores that showed no consistency with Behcet’s. There is no test that can determine definitively whether it is Behcet’s disease; therefore the diagnosis is primarily dependant on signs and symptoms. (British Association of Sexual Health & HIV BASHH 2015).

History revealed Katy had recurrent genital sores. Upon examination there was obvious Herpetic lesions consistent with HSV. Young et al (2009) states a sound history is an essential component of the assessment process and is vital to ensure safe practice and for the prescribing process. The diagnosis of Herpes was previously performed through Polymerase chain reaction (PCR) Wald A, et al (2003) from the affected area of skin. In this case no test or further investigations were carried out; this was because on examination the Ulcers were herpetic looking, with associated raised inguinal lymph glands. Therefore once the initial diagnosis of HSV is made, the NMP must be able recognise a recurrence HSV on clinical symptoms and thorough consultation using the Calgary-Cambridge guide to medical interview consultation model. This subsequently prevents unnecessary repeated expensive PCR tests. As previously stated, no further testing were required as the patient was previously diagnosed with HSV2 (Local Policy NHS TRUST 2018).

Strategy

Medical ethics is a system of moral principles that apply values to the practice of clinical medicine & in scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. Beauchamp and Childress (2008) developed the four principles of health care ethics.

This includes:

  • Principle of respect for autonomy,
  • Principle of non-maleficence,
  • Principle of beneficence,
  • Principle of justice.

These principles have been applied to aid and explore all of the available options to treat Katy.

Herpes Simplex Virus (HSV)

BASHH, (2015) Herpes simplex is the name given to two viruses in a family of herpes viruses. All of them, once caught, lay dormant in the body. The two viruses that cause genital herpes are: Herpes simplex virus type 1 & 2. Both types can cause symptoms on the genitals (genital herpes), the face (facial cold sores), or the hand or finger (called a herpetic whitlow) depending on where they are caught. Genetically HSV 1& 2 are slightly different but cause similar symptoms. Either can be caught anywhere on the body:

  • Type 1 is more likely to reappear when it is caught on the face and is less likely to recur when it is caught on the genitals.
  • Type 2 is more likely to recur when it has been caught on the genitals.

There is no difference in the visible symptoms caused by the two types, so it is only possible to establish which type you have caught through a laboratory test (BASHH 2015).

Autonomy

The patient should be provided with sufficient information such that he/she can decide on the appropriate management of their sexually transmitted infection.

When deliberating on treatment, it is important to bear in mind that other treatment options should be considered before writing a prescription; Katy was informed of the treatment options that were available. Katy also explored the option of not having any medication as, previously, the Herpes healed without treatment. But Katy was also aware that if she did not consider treatment she may have another attack. The NMP explained given that Katy had four Herpes outbreaks it would be beneficial to commence treatment; Patel et al (2015) states that treatment initiated early in an episode is most likely to be effective, as treatment prior to the development of papules is of greatest benefit. WHO (2016) guidelines recommend a suppressive therapy over episodic therapy & reassessment after one year for adults with severe recurrent clinical episodes (e.g. 4–6 times a year or more) or that cause distress due to an genital HSV infection. Taking into account the recurrence history & the distress this causes Katy, the NMP agreed with the patient that treatment would be appropriate.

Katy was provided with all the information that was required to decide on an appropriate course of action. The NMP also discussed the pros & cons along with the possible side effects of each treated option. In practice service users are given information from the BASHH (2015) guidelines, also the local policy which is accessed via the NHS intranet. Furthermore Katy was encouraged to refer to the patient information leaflet for Herpes which is in the medication box and the leaflet that was provided.

 

Beneficence

Patient with few recurrences may be best managed with episodic antiviral therapy or no therapy, whereas those with more frequent recurrences may find suppressive therapy more beneficial. Medical indicators considered when evaluating the potential suitability for suppressive therapy are the frequency, duration, severity and psychological impact of recurrences (BASHH 2015).

Katy discussed the number of recurrences & how this had an effect on her relationships. Katy expressed the interest in starting the suppressive treatment based on the number of herpes attack & how this had an impact on her personal life including relationships self-esteem and the stigma attached to it.

The relationship with the patient in terms of patient partnership in deciding best options is very important, having their options & views listened to & taken into consideration is important. This as a result can lead to better outcomes. The NMP reiterated information around Herpes, how there is no cure for genital herpes. However Katy was informed the treatments can relieve the symptoms. However, the medication given can decrease pain & shorten healing time (Patel et al, 2015). It can also decrease the number of outbreaks. Drugs such as aciclovir, valaciclovir, famciclovir, are a few medications given to treat the symptoms of herpes; these options were discussed with Katy.

Non maleficence

Although it was agreed to treat Katy the NMP took into consideration all the possible contraindications for the patient to commence the suppressive treatment as evidenced by the SPC (2019). Long treatment of Aciclovir is not recommended. In prolonged or repeated courses of aciclovir in severely immune-compromised individuals. In this case it may result in the selection of virus strains with reduced sensitivity, which may not respond to continued aciclovir treatment.

While the SPC (2019) suggests there are contraindications with long term use of aciclovir, the patient was not immune-compromised. Therefore there was no indication why it was not appropriate, due to safety, for the patient to commence this treatment. Nevertheless the risks and benefits should be carefully considered by the NMP, although ultimately the patient must decide whether the benefits outweigh the risks before consenting to a treatment.

Justice

The treatment for Herpes is complex, long and careful consideration or discussion with patient is important. aciclovir, valociclovir and famciclovir are the three preferred method of treatment according to the Local policy and BASHH guidelines (2014).

All options were discussed with the patient; the NMP decided that aciclovir 400 mg tablets twice daily for 3 months-6 months would be the choice of treatment; this was based on the BASHH (2014) & NHS local guidelines (2018). Further reasons for the choice of aciclovir are discussed below.


Consider choice of product

The NMP needs to take into consideration a few aspects when considering choice of treatment, very well summarised by the use of a Mnemonic EASE. (Prescribing Nurse Bulletin 1999).

  • How effective is the product;
  • Is it appropriate for this patient;
  • How safe is it;
  • Is the prescription cost effective.

The recommended treatment for adults with recurrent clinical episodes of genital HSV infection that is frequent, severe or cause distress, BASHH (2014) suggests aciclovir, valaciclovir and famciclovir for suppressive therapy. Recommended regimens are as follows:

•        Aciclovir 400 mg orally twice daily;

•        Valaciclovir 500 mg orally once daily;

•        Famciclovir 250 mg orally twice daily.

The NMP looked at the following evidence & this is what the findings were to support the decision to treat Katy with aciclovir. Gupta (2004) suggest all three treatments for Herpes to be equally effective. Valaciclovir, Famciclovir & Aciclovir are highly effective in suppressing the frequency and quantity of genital HSV shedding, Gupta et al (2004). A systematic review & clinical trial data on the efficacy of these treatments was supported by Lincoln & Goldmen (2016) & all three were seen to be as effective as the other.

Oral aciclovir, valaciclovir, & famciclovir reduce the duration and severity of recurrent genital herpes (Patel, 2015). The reduction in duration is a median of 1–2 days. Head-to-head studies show no advantage of one therapy over another or the advantage of extended 5-day treatment over short-course therapy. Prodrugs (such as valaciclovir and famciclovir) offer simplified twice-a-day dosing.

Aborted lesions have been documented in up to a third of patients with early treatment according to Wagenlehner (2016). Patient-initiated treatment started early in an episode is most likely to be effective, as treatment prior to the development of papules is of greatest benefit. Short-course therapies offer more convenient and cost-effective strategies for managing genital herpes episodically & should be regarded as first-line options. aciclovir, valaciclovir, and famciclovir all reduce the severity and duration of episodes, (BASHH, 2015).

Literature review also showed that patients who have taken part in trials of suppressive therapy have had to have at least six recurrences per annum. Such patients have fewer or no episodes on suppressive therapy. Patients with lower rates of recurrence will probably also have fewer recurrences with treatment (BASHH 2015). Patients should be given full information on the advantages and disadvantages of suppressive therapy. The decision to start suppressive therapy is a subjective one, balancing the frequency of recurrence with the cost and inconvenience of treatment.

Patients suffering from psychological morbidity for which the diagnosis causes significant anxiety may benefit from suppressive therapy. Patient safety and resistance data for long-term suppressive therapy with aciclovir now extends to over 20 years of continuous surveillance. Patel et al (2015) confirms that aciclovir is an extremely safe compound requiring no monitoring in previously well patients & only a dose adjustment in those with severe renal disease.

The following evidence was looked at & these findings were used to support the decision to use aciclovir. Treatment for Herpes is complex and divided into primary, episodic and suppressive. This was also guided by the BASHH (2014) and local NHS policy 2014. This aids the prescriber in choosing the correct medication, dose, route and duration for the specific conditions.

Individuals who have frequent recurrences, severe symptoms or episodes which cause distress will likely choose suppressive therapy over episodic therapy. To determine frequency or severity, episodes can be monitored for the first few months. Although the benefits of the medicines may be similar, the costs of valaciclovir and famciclovir are higher than aciclovir, & therefore aciclovir is preferred method of choice in the clinic.

The practitioner did not initially contemplate cost, but from a cost effective point of view, the Table below shows the relative cost of antiviral drugs used to treat BASHH (2015).


From the table we can see that if a patient is on suppressive treatment, this may become a cost burden to the clinic. NMP recognises that treatment should not be based on cost only. Due to financial constraints and local guidelines aciclovir is first line treatment. & NHS local guidelines 2018).

Negotiate a contract

When prescribing medicine to the patient Royal Pharmaceutical society (2016) requires that the patients consent and adherence with treatment must be considered. This is a shared contract which requires negotiation between the NMP & patient, Prescribing Bulletin (1999). The NMP discussed the option of not having treatment versus treatment; Katy confirmed she would prefer to take the treatment, given the recurrences she had over the past year. Allowing Katy to participate in the decision of her treatment means she is in control and as a result helps with adherence NICE (2016).

Dose and duration were then also clarified and the importance of taking the medication as prescribed & to complete the full course. On reflection, by discussing & deciding on the best treatment together this would hopefully promote concordance. Negotiating with patients & agreeing on a management plan is very important aspect of reaching patient centred care (Neighbour, 2005).

After receiving all treatment options available including benefits & possible side effects the patient agreed to start suppressive treatment aciclovir 400mg bd for duration of 3 months. The patient was given information on how to take the medicine & potential side effects.

Review

Katy was advised to return to the clinic in 6 weeks’ as per Local guidelines. Furthermore Katy was also advised to return or see her GP if symptoms worsened or did not improve after completion of treatment. NMP reiterated if symptoms occurred, to seek medical assistance early so that treatment could begin as soon as possible to reduce the risk of severe outbreaks and complications (BASHH 2015).

Record keeping

The consultation, examination findings & treatment were recorded on the electronic patient record (EPR) system as per local policy & the Code: Professional standards of practice & behaviour for nurses & midwives (NMC 2015). The records are accessible by the multidisciplinary team. The RCN (2018) States that good record keeping compiles a complete record of the patient’s/client’s journey through other services. It also allows to enable continuity of care for the patient/client both within and between services.

Reflection

The Gibbs (1988) model of reflection was applied; this allows the NMP to re-evaluate what went well, & what could have gone better during the consultation. The NMP is reasonably competent in history taking process; nonetheless the NMP felt the consultation took too long. The reason for this was the NMP being new to prescribing process it was crucial not to miss anything out. The decision to treat or not to treat was also daunting. For the patient this possibly was too long for them to be in the clinic, but on a professional point of view it allows the NMP to make sure they have written everything clearly and concisely.

This essay has focused on Katy treatment for HSV. The NMP is confident that the rationale for prescribing aciclovir was justified although initially the NMP felt a little pressure of only being able to prescribe aciclovir as first line treatment on the basis it was cheaper. Initially the NMP was unable to appreciate this, but this has now allowed the NMP to base decisions with an open mind together with sound comprehensive local & national guidelines to be able to decide on a choice of medications.

This essay has enabled the NMP to appreciate the benefits of nurse prescribing to both patient and nurse. The NMP recognises safe evidence based decisions should be made. NMP are accountable for their actions and must ensure that any decisions made cause no harm to the patient.


References

  • Bickley, L. (2008) Bates Guide to Physical Examination and History Taking. 6th Ed. London: Lippincott, Williams and Wilkins.
  • Beauchamp T.L, Childress, J.F (2009). Principles of biomedical ethics. 6

    th

    ed New York: Oxford University Press
  • British National Formulary: No.76 (September 2018-March 2019) London:Pharmaceutical Press
  • ahl, R. (2004). Charlie and the chocolate factory. 6th ed New York: Knopf.
  • Department of Health. (1989) Report of the Advisory Group on Nurse Prescribing. The Crown Report). London: HMSO
  • Department of Health. (1999) Review Of Prescribing, Supply And Administration Of Medicines. (The Crown Report Two) London: HMSO.
  • Department of Health. (2006) Medicines Matters. London: HMSO
  • Gupta R, Wald A, Krantz E, Selke S, Warren T, Vargas-Cortes M, Miller G, Corey L (2004)
  • Valacyclovir and Acyclovir for Suppression of Shedding of Herpes Simplex Virus in the Genital Tract

    The Journal of Infectious Diseases,

    Vol 190, (8), Available from

    www.jid.oxfordjournals.org

    [Accessed Dec 2018]
  • Gupta R, Warren T, Wald A. (2007) Genital herpes. Lancet London England. [PubMed][Accessed Dec 2018]
  • Patel.R, et al (2014) UK national guideline for the management of anogenital herpes
  • International Journal of STD & AIDS
  • Miserocchi, E. Modorati G, Galli L, Rama P. (2007) .Efficacy of valacyclovir vs acyclovir for the prevention of recurrent herpes simplex virus eye disease: a pilot study.
  • Nursing & Midwifery council,Standards of proficiency for nurse and midwife prescribers, Nurse and midwife prescribers. Accessed 14th December 2018
  • (NMC) 2018 Nursing & Midwifery council https://www.nmc.org.uk/standards/code
  • The Code Professional standards of practice and behaviour for nurses, midwives and nursing associates. Accessed 14th December 2018
  • National Prescribing Centre(1999) Signposts for Prescribing Nurses – General Principles of Good Prescribing. Prescribing Nurse Bulletin. (1): 1-4.
  • Neighbour, R. (2005) The Inner Consultation. How to Develop an Effective and Intuitive Consulting Style. 2nd Ed. Oxford: Oxford-Radcliffe.
  • Nursing and Midwifery Council (2006) Standards of Proficiency for Nurse and Midwife prescribers. London: Nursing and Midwifery Council.
  • Peat, I. (2001). How to take a sexual health history. Practice Nursing [online]. 12, (8).
  • Available from: magonlinelibrary.com [Accessed January 2019].
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    http://rcnhca.org.uk/top-page-001/record-keeping/

    [Accessed December 2018]
  • Silverman, J. Kurtz, S. Draper, J. (2005) Skills for Communicating with Patients. 2ND Ed. Oxford: Radcliffe.
  • Wald A, Huang M-L, Carrell D, et al. Polymerase chain reaction for detection of herpes simplex virus (HSV) DNA on mucosal surfaces: comparison with HSV isolation in cell culture. J Infect Dis 2003; 188: 1345–3151.
  • Wagenlehner FM, Brockmeyer NH, Discher T, Friese K, Wichelhaus TA. The presentation, diagnosis and treatment of sexually transmitted infections. Dtsch Arztebl Int. 2016;113:11–23. [PMC free article] [PubMed]
  • Workowski K. Sexually Transmitted Diseases Treatment Guidelines, 2015. . 2015 Available: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6403a1.htm. Accessed 19 December 2004. [PMC free article] [PubMed]
  • Young, K. Duggan, L. Franklin, P. (2009) Effective Consulting and History-Taking Skills for Prescribing Practice. British Journal of Nursing. (18) 17: 1056-1061.
  • Young, K. Duggan, L. Franklin, P. (2009) Effective Consulting and History-Taking Skills for Prescribing Practice. British Journal of Nursing. (18) 17: 1056-1061.

 

Cultural Relativism I have my ethical views and you have yours; neither my views nor yours are better or more correct. I may believe that a particular war was unjust- and you may believe that it was

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Cultural Relativism

I have my ethical views and you have yours; neither my views nor yours are better or more correct. I may believe that a particular war was unjust, and you may believe that it was just. Someone else may believe that all war is wrong……we each have our individual histories that explain how we have come to hold our particular views or attitudes. But they are just that-our own individual views and attitudes. We cannot say that they are correct or incorrect because to do so would assume some objective standard of right and wrong against which we could judge their correctness. Such a standard does not exist.

Cultural Relativism

Ethics: Theory and Contemporary Issues 9th Edition (p. 46)

Assignment 1 explored ethnocentrism. Assignment 2 will explore cultural relativism. This one will require deep pondering. You begin by asking yourself if there are certain absolute rights and wrongs. Then consider if you have ever violated an absolute wrong? How do you KNOW that something is absolutely wrong? By what standard do you judge others actions?

Remember applied ethics? Let’s explore some case studies so you can practice applying what you have learned.

First, we need to establish some assumptions:

·         You have established what is right and wrong for yourself

·         You have based your belief about what is right and wrong in such things as religion, education, humanism

·         One of those beliefs is “killing is wrong.” You could never kill. This belief is NOT relative to a culture or situation; it is an absolute metaethical wrong.

Case Study #1

You study the Inuit culture and find that the elderly would be stabbed or left to freeze on ice flows.  Death occurs swiftly. You think how barbaric this was and judge the culture as such. Now consider the way many elderly die in the U.S. today: confused, moaning, incontinent in diapers, a slow, agonizing death, perhaps being tube fed and given medications to prolong life. How would the Inuit of the day view our culture from this lens?

Case Study #2

You are studying ethics in war. You are not concerned about killing in war. War has different rules. Killing is OK in war. You HAVE to kill to be in war. Watch the trailer for Hacksaw Ridge. Private Doss participated in war yet held to his ethical beliefs. He did not kill, he saved, at great personal risk. Does this now mean that killing during war is wrong? Does it mean that killing during war is right? Does it support that everything is relative to our cultural beliefs?

Case Study #3

Lawrence Franks (84) promised his wife, suffering with dementia, that he would never put her in a nursing home. Lawrence lovingly cared for his wife for years until her condition became too serious, and he was unable to properly care for her. He felt that she was suffering. He then killed his 86-year-old wife to fulfill his promise. He was charged with murder. (https://www.foxnews.com/world/elderly-man-beat-dementia-stricken-wife-to-death-in-mercy-killing). Is Mr. Franks guilty of murder?

Case Study #4

Jungdan Chow and his family have a tradition passed down for generations. The entire family would go to the markets to pick out dinner. This was a very special dinner as delicacies they could not typically afford were carefully chosen and prepared. Even the young children could sense the excitement in the air as they strolled through the market. Bat and fresh, boiled dog, were chosen that day and they hurried home to begin the feast, feeling connected to their ancestors by hundreds of years of tradition.

…wet markets are the predominant food retail outlets for fresh produce and meat in Chinese cities. They have very few supermarkets…. hedgehogs and peacocks and wild rabbits and snakes, deer; crocodiles as well. Many of these wild animals, they’re not necessarily caught in the wild – right? – so they can be farmed animals. They’re just exotic food that’s not very commonly found. Eating wild animal is considered a symbol of wealth because they are rarer and more expensive. And wild animals are also considered more natural and, thus, nutritious, compared to farmed meat. It’s a belief in traditional Chinese medicine that it can boost the immune system.

Excerpted from: https://www.npr.org/2020/01/22/798644707/why-wet-markets-persisted-in-china-despite-disease-and-hygiene-concerns

Express your thoughts on cultural relativism.

Include the following aspects in the assignment:

·         How would you judge right and wrong from different cultural perspectives and different situations?

·         When making an ethical decision that will impact others, how would you assure that you are not viewing right and wrong from the perspective that only your culture knows?

·         To complete this, write one paragraph for each Case Study

·         There is no right or wrong answer here; you will be graded on the depth of your reflection

·         Cite any references.