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Trends and issues in nursing
The country has been making efforts to transport
its health care system to provide affordable, seamless, patient-centered,
quality care and evidence-based care that will lead to better health outcomes
accessible to all. To achieve the desired transformation, there is need to
remodel different aspects of health care system. Given that the nursing
profession forms the largest percentage of the health care workforce, the
report provides various recommendations that collectively serve as a blueprint
to ensure various things. The first is that nurses practice the full extent of
their training and education. The second is that there is provision for
opportunities for nurses to become leaders and help in redesigning and
improving efforts in healthcare. The third one is to improve nursing education.
Lastly is to improve data collection in order to improve policy making and
workforce planning.
The work of Robert Wood Johnson explores how
nurses’ roles, education and responsibilities should change considerable in
order to meet the increased demand for healthcare arising from health care
reforms aimed at improving the increasingly complex health system. This work
argues that nurses have a potentially huge impact in healthcare owing to their
numbers and time spent delivering patient care. Hence, nurses have unique
abilities and valuable insights to important contributions as partners with
other health care professionals towards the improvement of safety and quality
of care as pictured in the Affordable Care Act.
It recommends that nurses be fully engaged with
other health professionals by assuming leadership positions in healthcare. To
achieve this and more, the profession has a role to play by offering residency
training for nurses in order to increase the number of professionals with
bachelor's degree and those with doctorates. Additionally, institutional and
regulatory obstacles that hinder practices should be done away with. These
include limits on nurses' scope of practice in order to achieve the highest
level of benefits that arise from nurses' training, skills, and knowledge in
patient care. The work also includes a
recommendation by the Institute of Medicine in regards to the future of nursing
(Institute of Medicine, 2011).
Importance
of IOM
The IOM is a critical and timely call to current
efforts in healthcare aimed at improving healthcare quality and outcome. It
supports the development of policies, research, and implementation of
strategies aimed at promoting nursing education and practice. The IOM also reconceptualizes the role of
nurses within the context of nursing staff shortage, the entire workforce,
current and future trends and societal issues.
Role of
state-based action coalitions and how do they advance goals of the Future of
Nursing: Campaign for Action
State-based coalitions have a significant role to
play in the advancement of goals of the future of nursing (Zerwekh & Garneau, 2017). This can be done by redesigning nursing education, increasing the
capacity of nursing schools and expanding nursing faculty in order to ensure
that nurse training produces adequate and well-prepared nurses who can meet
today's and future healthcare demands. Additionally, they can examine and
implement structures to attract and retain nurses in multiple healthcare
settings around the State. This involves examining innovative solutions on the
areas of professional education and healthcare delivery.
Initiatives
spearheaded by my state’s action coalition
The first initiative is the increase in capacity of
nursing schools to meet current and future healthcare demands. The second
initiative involves putting in place human resource practices that attract and
encourage nurses to work in state facilities.
References
Institute of Medicine (US) (2011) Committee on the
Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the
Institute of Medicine. Washington (DC): National Academies Press (US)
Zerwekh, J., & Garneau, A. Z. (2017). Nursing
Today-E-Book: Transition and Trends. Elsevier Health Sciences.
Carolyn Morgan is the author of this paper. A senior editor at MeldaResearch.Com in nursing research paper writing service California. If you need a similar paper you can place your order from nursing paper writing services Pennsylvania.
Cancer
Introduction
A report by the American Cancer Society shows that more
than 226,000 women were diagnosed with breast cancer and more than 241,000 men
diagnosed with prostate cancer by 2012. The high prevalence is a cause of alarm
that calls for patient education and preventive services. The advanced practice
nurses ought to assist the physicians in educating patents on the potential
risk factors, available preventive services, and the existing drug treatments
for the patients diagnosed with cancer. Clinical implications of women’s cancer
depend on early detection and are achieved through preventive services. The assignment has a discussion of the
available preventive services to breast cancer, the impact of genetics and age
to decisions related to preventive services, drug treatment options, and the
short-term and long-term implications for treatments.
Prevention
methods
Some women are more prone to developing breast cancer
than others, hence necessary to know the individual risk that may be
empowering. The key to most of the preventive programs is measuring the risk
that goes beyond the lifestyle choices to the biology and genetics aspects. All
women are at risk of breast cancer, but not all of them have the same degree of
risk. Regular screening for breast cancer using mammography, breast
self-examinations, and clinical breast examinations are reliable
recommendations to limit mortality from breast cancer (The Canadian Task Force
on Preventive Health Care, 2011). A mammogram is a type of X-ray of the breast
and is the best way to identify a case of breast cancer in the early stages
when it’s easier to treat. Regular mammograms help to lower the risk of
succumbing to breast cancer. A clinical breast exam is an examination performed
by a doctor or a nurse using hands to feel the presence of lumps or other
changes. Individuals can also have breast self-examinations by being familiar
with how their breasts feel. Thus, it is easier to identify lumps, pain, or
changes in size and take action.
Influencing
factors
Certain factors influence the development of cancer such
as genetics, gender, age, and behavior. Genetics is a common cause of inherited
breast cancer when gene mutations are passed on from one generation to another.
In a family having a history of breast cancer, there is need to focus on the
trend of the disease as a preventive measure. As such, the decisions made about
preventive services need to have a consideration of the family history as
related to cancer. 5% to 10% of breast cancer cases are hereditary and are a
result of gene defects passed on from a parent (Dossus & Benusiglio, 2015).
As such, the advanced practice nurses and physicians need to fully examine the
history of the patient before making any decisions.
Age is a determinate factor in the decisions made on
prevention of breast cancer. The risk of developing the condition increases
with age of a woman, and most cancers develop in women aged 50 years and older
(Dossus & Benusiglio, 2015). In making decisions related to preventive
services, it is important to match the age of the patient with the potential
risk of developing breast cancer. In most instances, breast cancer cases are
identified after attaining 50 years due to lack of early screening when one was
young.
Treatment
methods
All is not lost for the patients diagnosed with breast
cancer since there are several treatment options available. The drug treatment
options available for breast cancer include chemotherapy and hormonal therapy
(DeSantis, Lin, Mariotto, Siegel, Stein, Kramer & Jemal, 2014).
Chemotherapy involves usage of drugs to destroy the cancerous cells that halt
the ability to grow and multiply. The drugs go into the bloodstream and reach
the cancer cells spread across all parts of the body. It can be administered
through an intravenous tube placed into a vein, an injection under the skin,
and a pill that is swallowed. Chemotherapy can also be given before surgery to
make it easier. A regimen of chemotherapy has a specific number of cycles given
over a set period (Miller et al., 2016). The common drugs used are
capecitabine, carboplatin, cisplatin, docetaxel, epirubicin, and paclitaxel
among others.
Hormonal therapy is an effective treatment for most
tumors that test positive for estrogen or progesterone receptors. The method
involves blockage of the tumors to prevent the recurrence of cancer and death
from breast cancer (Miller et al., 2016). The common drugs used for hormonal
therapy are Tamoxifen and Aromatase inhibitors.
Short-term
and long-term implications
The use of chemotherapy for treatment of breast cancer
has several short terms and long-term implications but varies with individuals
and the schedule of usage. The short-term effects include fatigue, the risk of
infection, nausea, vomiting, diarrhea, hair loss, and loss of appetite. They
can be controlled using supportive medications. The long-term implications of
chemotherapy include heart damage, nerve damage, or secondary cancers
(DeSantis, Lin, Mariotto, Siegel, Stein, Kramer & Jemal, 2014).
The use of Tamoxifen causes short-term effects such as
hot flashes, vaginal dryness, and bleeding. The likely long-term effects
include cancer of the lining of the uterus and blood clots. The use of
Aromatase inhibitors may cause muscle and joint pain, hot flashes, vaginal
dryness, and increased risk of osteoporosis.
Conclusion
Breast cancer can be treated if identified in the early
stages, hence necessary to have comprehensive prevention programs such as early
screening for the women at high risk. Factors such as genetics, age, and gender
are important considerations when making decisions on the appropriate
preventive measures against breast cancer.
References
DeSantis,
C. E., Lin, C. C., Mariotto, A. B., Siegel, R. L., Stein, K. D., Kramer, J. L.,
... & Jemal, A. (2014). Cancer treatment and survivorship statistics, 2014.
CA: a cancer journal for clinicians, 64(4),
252-271.
Dossus,
L., & Benusiglio, P. R. (2015). Lobular breast cancer: incidence and
genetic and non-genetic risk factors. Breast
Cancer Research, 17(1), 37.
Miller,
K. D., Siegel, R. L., Lin, C. C., Mariotto, A. B., Kramer, J. L., Rowland, J.
H., ... & Jemal, A. (2016). Cancer treatment and survivorship statistics,
2016. CA: a cancer journal for
clinicians, 66(4), 271-289.
Carolyn Morgan is the author of this paper. A senior editor at MeldaResearch.Com in nursing research paper writing service California. If you need a similar paper you can place your order from nursing paper writing services Pennsylvania.
Coursework
Coursework
The City-County Neighborhood Initiative
(CCNI) does build a capacity of the resident to address and also identify
violence and any other health inequalities in their neighborhood. Some of the
main goals of the initiative include empowering residents, ensuring concrete
improvements in the lives of residents, changing the city and county
institutions, and ensuring strong local grassroots organizations. The
initiative achieves its goals through engaging the residents in the community
capacity building and also in the street level outreach.
The local agencies empowering
communities may contribute to the planning process in public health through
allowing for community participation. Through community participation, it will
require consultation to enable the residents to become an integral part of
decision making and action process. The local agencies can consider the need
for developing more active communities in their right way where people see a
need and act upon it. In community participation, it will draw on the
enthusiasm and energy that exist in the community so that to define what the
community wants and how it wants to operate in the process of public health.
The local initiative focuses on helping
residents to identify and also address violence and any other health issues in
the neighborhood. Therefore, I believe that the initiative in a metropolitan
region in California has relevance to applying on the global scene. It is
possible to apply the aim of this initiative to the global scene as a way of helping
improve public lives through ensuring a safer environment, reducing violence in
communities, and improving the well being and health of the public. The
initiative can also apply in the effort of reducing health inequalities.
Reference
ACPHD
(2004). What is the City-County
Neighborhood Initiative (CCNI)?
Carolyn Morgan is the author of this paper. A senior editor at MeldaResearch.Com in nursing research paper writing service California. If you need a similar paper you can place your order from nursing paper writing services Pennsylvania.
Evidence-based practice
The selected public policy issue is the need for
mandatory and enforceable Tobacco-free policies at the workplaces in Kansas.
Tobacco use has continued to be a leading cause of preventable mortalities
among adults, despite various initiatives to reduce its prevalence. Collected
and analyzed data shows that more than 20% of the U.S population is tobacco
smokers, which is a worrying trend (Ablah, Dong & Konda, 2017). Tobacco
smoking is associated with various negative health implications, which make it necessary
to formulate public policy to reduce its prevalence and high mortality rates.
The proposed policy issue on mandatory and enforceable tobacco-free policies in
the workplaces has a goal of reducing the health impacts of tobacco to both the
active and passive smokers.
A study by Gao, Zheng, Chapman, and Fu (2011) was
conducted in China to evaluate the various workplace smoking control policies
and their effect on employee smoking behaviors and attitudes. It was reported
that a smoke-free workplace policy could have a significant association with
the reduced smoking prevalence and daily cigarette consumption. However,
restrictive smoking did not have any impact on employee smoking behaviors.
Cigarette smoking is among the most public health challenges that affect the
world, hence the need for smoke-free workplace policies due to its value in
protecting the non-smoking employees. There is reliable evidence that workplace
smoking control policies have a likelihood of impacting smoking prevalence and
consumption of cigarettes, especially to the places with such policies for a
shorter duration.
In the earlier years, workplace environments were
characterized by smoking in the offices, conference rooms, lunch rooms,
restrooms, and other places in the workplace. With time, there has been
increasing awareness of negative impacts of smoking of health. Many employees
are quitting smoking, and the non-smokers are becoming aware of the potential
negative impacts of the secondary smoke on health. There have been progressive
attempts by employers to enforce policies on the distance range from the
entryway that employers can smoke (Karimi, Ayah & Olewe, 2016). The
legislatures also resolved that employees have a right to clean air and
smoke-free businesses. For the protection of and enhancing indoor air quality
as well as contributing to health and well-being of all employees, companies
need are required to be smoke-free. The use of tobacco and smoking products
ought to be banned from the workplace to achieve the objectives of the policy.
The importance of implementing the public policy issue on
smoke-free workplaces is reducing the harm on health. Smoking has a negative
health effect on the smokers and those around them. It increases the risk of
strokes, heart attacks, and other related cardiovascular diseases. It also
causes cancer of the lungs, mouth, throat, bladder, kidneys, stomach, and
pancreas. Other possible diseases as a result of smoking are bronchitis and
tuberculosis which are all associated with chronic illnesses, disability, and
premature deaths (Hoffman & Tan, 2015). The number of deaths from
tobacco-related diseases is high about other causes, which is a cause for
concern. Tobacco also harms non-smokers that are exposed to smoke or the
environmental tobacco smoke. Other than smell and irritation of the eyes, the
exposure increases the risk of lung cancer and respiratory diseases. The United
States registers an estimate of more than 65,000 annual deaths of adult
non-smokers from heart disease and about 3,000 non-smokers for lung cancer
(Ablah, Dong & Konda, 2017).
Environmental tobacco smoke is common in the workplaces
in various parts of the world. It interacts with chemicals and radiations to
produce a multiplicative effect and also increases the risk of occupational
diseases. In the short-term, non-smokers may suffer from physical discomfort
and annoyance, irritation of the eyes, headaches, and sore throats. Long-Term exposure may cause heart disease
and lung cancer, which are serious negative implications (Holmes & Ling,
2016). For women, smoking affects the health of the baby way before they are
born. Smoking women have a higher risk of ectopic pregnancy and miscarriages
and can also give birth to low birth weight children or prematurely (Zhang,
Hsia, Tu, Xia, Zhang, Bi & Stanton, 2015).
As such, the enactment of policies on smoke-free workplaces helps to
reduce the employer’s legal liability, create a safe working environment, and
enhance the health outcomes of the employees.
Employers who are concerned about the health and well
being of their employees can create tobacco-free workplaces as required by the
state and local governments. A tobacco-free environment creates a safe and
healthier workforce and compels tobacco users to quit smoking. The employer
benefits from a reduction in the direct health care costs. Lower rates of
health, life, and disability health insurance coverage are possible in a
workplace where only a handful of employees use tobacco (Lee, Glantz &
Millett, 2011). The importance of having a smoke-free workplace policy in place
cannot be underestimated. The need to meet the legal requirements and to
eliminate the risk of prosecution for failure to comply with regulations on
enclosed workplaces requires the implementation of a smoke-free policy
(Heathfied, 2016). The strategy helps to promote a healthy corporate image,
enhance productivity, reduce absenteeism, and reduce the risk of litigation on
compensation costs related to passive smoking illnesses. Research has shown
that smoke-free workplace policy plays a major role in reducing smoking
prevalence rates and is a major step towards cessation (American Cancer
Society, 2017). There has been a consistent reduction in cigarette consumption
among the smokers where workplace smoking bans have been implemented. The
smoke-free policy in the workplace prevents the uptake of smoking by the
younger employees (World Health Organization, 2015). The costs as a result of
smoking are of importance to employers. The economic impacts due to smoking include
reduced health status of employees, lost productivity, and premature deaths and
retirement.
In a study by Houle and Siegel (2011), a discussion of
the potential public health consequences of the policies that barred employment
to smokers was provided. The move towards the promotion of smoke-free
workplaces for employees has been embraced in various companies to safeguard
the right of non-smokers to clear the air. The implementation of indoor air
laws has been considered as a protection of the public from secondary smoke in
public places and workplaces. The policies are supported by the public health
and tobacco control organizations but are instituted by employers. There are
several reasons postulated for implementing smoke-free workplace policies. Employers
cite the alignment of the workforce with organizational culture and the need to
control the rising health care costs. The opponents to the adoption of the
smoke-free workplace policies have based their arguments on discrimination and
privacy infringement. The Tobacco Control community supported the policies with
the view that they save employers resources by reducing the health care costs
and encouraging smokers to quit the behavior. Houle and Siegel (2011) designed
a model to consider the effects of smoke-free workplace policies based on
empirical evidence as opposed to smoke-free workplace policies. It is important
to analyze the potential implications with a focus on the employer, non-smoking
employees, and the smokers. The strategy ensures that the implementation of the
policy does not infringe on anyone’s rights and also serves the best interest
of the majority, but also respects that of the minority.
Recommended
Interventions
It has been established from research that tobacco-free
workplace policies can have significant impacts both to the employee and the
employer, and the general public at large. As such, there is a need for some
recommendations on how best to deal with the issue. One of the best
interventions is offering training on the essence of having a clean and healthy
workplace environment. Some of the smoking employees may be unaware of the
potential health and environmental implications that are associated with tobacco
smoking (Lee, Glantz & Millett, 2011). They need to understand the effect
of smoking tobacco on their health both for the short term and the long term.
Training would also be essential to create awareness of the rights of the
non-smokers who are commonly affected as passive smokers with nothing to do
(Myers, 2016). They need to understand that law protects them and that the
employer has an obligation of safeguarding their right to clear and quality
indoor air. Employers can protect the health of their employees and reduce the
costs of smoking by ensuring that the workplaces are smoke-free and also
implementing the programs that encourage smokers to quit. The smoke-free
policies are implemented easily and complied with if the employees take part in
developing the policy and are fully-informed about its purpose.
The main goal of the implementation of the policies
should be having a completely smoke-free workplace (Zhang, Hsia, Tu, Xia,
Zhang, Bi & Stanton, 2015). In practice, no safe level of exposure to environmental
tobacco smoke is safe, and even ventilation cannot fully protect employees from
exposure. The practice of having enclosed smoking rooms can be implemented as a
short-term measure, but ought to be phased out with time.
There can also be smoking cessation programs that make
the implementation of smoke-free workplaces easier and more efficient than
having it without such programs. Worksite cessation programs benefit both the
employee and the employer and are effective in reducing smoking prevalence
rates to the people at high risk. Various studies have reported high quit rates
after the implementation of smoking cessation programs. Such programs have been
found to be cost-effective and require low-costs of operation (Uang, Hiilamo
& Glantz, 2016).
With increased awareness of the harm caused by tobacco
and its products both to smokers and the people near them, the actualization of
smoke-free environments is becoming a reality. There is also increased shift
towards safe and clean indoor environments on a global scale (American Cancer
Society, 2017). As such, the employer ought to communicate the details of the
policy to the employees, provide information and support to the smokers,
provide training, and evaluate the implementation impacts regularly for
effectiveness.
Important
Ethical considerations
In the implementation of the smoke-free workplace
environments, there are certainly ethical issues of consideration. As evident in the resources reviewed, the
participants in the studies were required to show their consent in sharing
information for research purposes. It helps to ensure that data is acquired
voluntarily without any external influence or coercion. The implementation of
smoke-free workplace policies involves a consideration of the rights of both
the smokers and non-smokers. In most instances, the rights of smokers are
ignored such as the infringement of their privacy and likelihood of
discrimination against their personalities. They are important ethical issues
to consider in the policy implementation process for enhanced effectiveness.
Other issues of concern regard to confidentiality, and safety of the
information shared by any participant in the studies. It is mandatory to
safeguard the safety of all the information shared as relevant for the
formulation of the smoke-free policy.
Conclusion
There is need for mandatory tobacco-free policies in the
workplace environment to help in lowering the prevalence rates to
tobacco-related health, economic, and environmental impacts. The policies can
also be essential in encouraging tobacco cessation and possible quitting due to
the negative implications associated with its use. The implementation of
tobacco-free policies in the workplace requires a consideration of all the
underlying factors to ensure that it acts in the best interests of both smokers
and non-smokers.
References
Ablah,
E., Dong, F., & Konda, K. (2017). Tobacco-free policies at worksites in
Kansas: BMC Public Health, 17, 566.
American
Cancer Society (2017) Tobacco use in the workplace: A model policy.
Gao,
J., Zheng, P., Gao, J., Chapman, S., & Fu, H. (2011). Workplace smoking
policies and their association with male employees’ smoking behaviours: a
cross-sectional survey in one company in China. Tobacco Control, 20(2),
131–136.
Heathfied
S. (2016) Smoke free workplace policy for your company: No smoking.
Hoffman, S. J., & Tan, C.
(2015). Overview of systematic reviews on the health-related effects of
government tobacco control policies. BMC public health, 15(1),
744.
Holmes, L. M., & Ling, P. M.
(2016). Workplace secondhand smoke exposure: a lingering hazard for young
adults in California. Tobacco control, tobaccocontrol-2016.
Houle,
B., & Siegel, M. (2011). Smoker-Free Workplace Policies: Developing a Model
of Public Health Consequences of Workplace Policies Barring Employment to
Smokers. Tobacco Control, 18(1), 64–69.
Karimi, K. J., Ayah, R., &
Olewe, T. (2016). Adherence to the Tobacco Control Act, 2007: presence of a
workplace policy on tobacco use in bars and restaurants in Nairobi, Kenya. BMJ
open, 6(9), e012526.
Carolyn Morgan is the author of this paper. A senior editor at MeldaResearch.Com in nursing research paper writing service California. If you need a similar paper you can place your order from nursing paper writing services Pennsylvania.
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