Blog Reflection 5-7-13

I can’t believe this semester is almost over!   We’ve had so many interesting conversations and ideas that we’ve bounced off one another.  I really enjoyed reading everybody’s feedback on my posts and ideas regarding the wide array of topics. 

This course has taught me a lot about the many different roles nurses play in society, and it has really opened my eyes to all of the work done that goes unrecognized.  Nurses serve as advocates for children in so many ways because they are so important to the future of each community.  For example, community nurses do health screening for school age children to detect problems earlier, give referrals, and prevent larger problems later on in life.  It is the nurses of a community that work to educate, support, and assist all of its community members.  Nurses are advocates for so many people because they have the tools and knowledge to avoid preventable problems and increase the quality of life for each member of a community.

One of the main topics discussed that stands out to me is that of vulnerable populations.  I believe that nurses need to focus on helping everyone in a community, and it is those vulnerable populations that often are neglected.  Although often forgotten, these vulnerable populations affect many people and influence many factors within a community.  I really enjoyed learning more about vulnerable populations and reading everyone’s ideas regarding upstream thinking.  I firmly believe that there needs to be many changes in our healthcare system to get everyone on the same page of prevention instead of dealing with issues once they occur.        

Honors Credit: Addiction

My honors project focuses on the physiological and psychological effects of alcohol and opioid addiction on the human body and how addiction affects nursing care.Alcohol, for many years, has been a means of addiction for countless people. 61% of Americans report being current drinkers, 5% considering themselves heavy drinkers (Nies & McEwen, 2011). Alcohol abuse has led to many preventable deaths, ruined careers, and torn families apart and still does today. In more recent history a new type of drug addiction has been growing at an alarming rate and what is more disturbing is the fact that this addiction is common among school aged children, especially those in high school.  I am referring to the abuse of prescription opioids such as Vicodin and OxyContin.

A recent study states, “The non-medical use of prescription and over-the-counter (OTC) drugs has increased at least eighty percent since 2000… over fifteen million Americans age 12 and older have taken a prescription pain reliever, tranquilizer, stimulant, or sedative for non-medical purposes at least once… deaths resulting from drug overdose increased nearly fivefold since 1990, making drug overdose a leading cause of unintentional death in the United States…” (2011). Clearly this is a big issue in our country but specifically with our nations high school students. According to the National Institute of Health, 1 in 12 high school seniors have reported using Vicodin for non-medical purposes (2011). It has also been shown that those students participating in recreational use of prescription medications are more likely to abuse alcohol as well. As public health nurses, if we are to battle addiction in communities we need to start in our schools by promoting healthy lifestyles and educating the students about the consequences of drug and alcohol abuse.  

Figure 1: Retrieved from http://www.musahlotallah.com

I chose this photo to represent the abuse of drugs in schools. As aforementioned, it is a prevalent issue in our country right now so as nurses, we need to work towards creating a healthier environment for students. I have chosen the Transtheoretical Model to help me understand some of the barriers to creating healthier choices. I chose this theory because it emphasizes that change occurs in various stages and take place over time. It also states that behavior changes can be very difficult for a variety of reasons therefore leading to resistance of change. (Nies & McEwen, 2011).

The stages include precontemplation, contemplation, preparation, action, and maintenance. These stages describe the varying degrees of commitment to change from having no intention to maintaining a change for over six months. Students who abuse drugs in high school may initially resist making healthier choices for many reasons. For example, they may feel it will hinder their social relationships, perhaps all of their friends abuse drugs and in order to remain a part of the group they will continue the unhealthy practice. Giving up something they consider to be pleasurable or will require a change in their self-image are other factors that decrease willingness for change. 

Knowledge of these barriers to making healthy lifestyle decisions along with the concept that teenagers generally feel they are invincible shines light on the reason these choices are being made so frequently.  As we better understand this subject we can work towards halting harmful habits that begin in youth and eventually transform into addictive behaviors as adults.

References

National Institute of Health (2011). Prescription drug abuse: A fast-growing problem. Medline Plus, 6(3),       21. Retrieved from http://www.nlm.nih.gov/medlineplus/magazine /issues/fall11/articles/fall11pg21.html

Nies, M.A., McEwen, M. (2011). Community/public health nursing. N. O’Brien, C. Irwin (Eds.). Health                      promotion and risk reduction (pp 54-57). St. Louis, MO: Elsevier Saunders.

Sham, M.K (2011). Down on the pharm: The juvenile prescription drug abuse epidemic and the necessity             of holding parents criminally liable for making drugs accessible in their homes. Journal of Contemporary Health Law & Policy. Retrieved from: http://www.lexisnexis.com.proxy.uwec.edu      

Honors Credit: Family Nursing

My honors topic is family focused nursing. I feel that promoting and managing health at a family level is extremely important and beneficial. By providing care and educational opportunities to the family we hope that we are able to help all its members. Families work as a team, and when the entire team is focused on making healthy lifestyle choices it promotes adherence. Additionally, many families need each other for support when it comes to health issues. Children rely on their parents to keep them in good health, sick individuals may lean on family members for help and emotional support, and the elderly may rely on their children when their own health begins to fail. Family is incredibly important, especially when it comes to health and well-being.

The health of a family and the health of a community go hand in hand achieving a close relationship where one plays off the other. One example of this relationship that came to mind was immunizations. Communities must provide access to immunization services and families must take advantage of them, one does not work without the other.  I chose this image because it reminds us that it is important that everyone takes on the responsibility of getting vaccinated. Herd immunity, “a state in which those not immune to an infectious agent will be protected if a certain proportion of the population has been vaccinated of is otherwise immune”, is an example of how individual families affect the overall health of a community (Nies & McEwen, 2011, p. 497).

The family systems theory, which states that “the family is viewed as a system that continually interacts with its members and the environment”, further promotes the idea that family and community health are linked (Hockenberry & Wilson, 2011, p. 47). In order for a family to thrive it must have access to necessary resources which the community, or environment, provides. The community can be viewed as one large family made up of many, smaller families that work together to achieve optimum health status. The community is responsible for providing resources to families in order to keep them healthy. Immunizations, as I mentioned earlier, are not the only example of this. Others include food programs such as Women, Infants and Children (WIC), health care facilities such as doctor’s offices and hospitals, health promotion facilities such as the YMCA, and countless others. These programs are all beneficial to promoting health, but they are useless if families do not take advantage of them. Families must take responsibility for their own health and use these facilities for their intended benefits. It is the job of families to keep up to date on immunizations, seek out medical attention when they are ill and promote good health by eating well and exercising. A community that provides resources to maintain optimal health will foster healthy families, which in turn will create a healthy community. Families and communities are separate entities that must work together as one system to achieve the most ideal outcomes, especially when it comes to health.

References

Hockenberry, M.J., & Wilson, D. (Eds.).  (2011). Wong’s nursing care of infants and

 children (9th ed.) St. Louis, MO: Saunders/Elsevier.

Nies, M.A. & McEwen, M. (2011). Community/public health nursing: Promotion the

 health of populations (5th ed.) St. Louis, MO: Saunders/Elsevier.

Asthma - 4/30/13

Did you know that asthma affects more than 34 million Americans?  According to the WebMD Asthma Health Center, asthma affects this many people with symptoms such as wheezing, coughing, and tightness of the chest. 

http://www.webmd.com/asthma/default.htm

The above link will take you to the main home page for the Asthma Health Center, and from there, you can explore many different routes depending on the information you are searching for.  I chose the WebMD website because it is has an award-winning senior staff and editorial team.  WebMD is widely known for their in-depth, credible information and news.  It is written and edited by medical doctors that have been or are continuing practice. 

Much of the same information found on WebMD can be found in other sources such as the CDC website, Mayo Clinic, and Medical News Today.  WebMD seems to be easier to understand for most people and is directed towards your everyday person that didn’t attend any medical schooling.  They also tend to cover all aspects of care and the multiple variations that come among different people.  WebMD is directed towards parents and families, so it tends to be less intimidating than other informative sites. 

I think one of the main things to take away from the WebMD website is that the cause of asthma is not known.  This means that you should avoid the triggers that are known to correlate strongly with asthma.  Allergies are known to play a large role in whether or not a person develops asthma.  It is also well known that family history and genetics weigh heavy on the chances of having asthma.  Also, whether you already have been diagnosed with asthma or you are trying to prevent being diagnosed, it is important to avoid anything that is harmful to the respiratory system.  This especially includes smoking, second-hand smoke, occupational dusts, or environmental pollutions for example. 

 

All about asthma. (n.d.). Retrieved from http://www.medicalnewstoday.com/info/asthma/

Asthma. (2013, March 27). Retrieved from http://www.cdc.gov/asthma/

Asthma. (2012, May 26). Retrieved from http://www.mayoclinic.com/health/asthma/DS00021

Asthma health center. (n.d.). Retrieved from http://www.webmd.com/asthma/guide/asthma-overview-facts

Honors Credit: Cardiac Nursing

The emphasis of my honors topic is cardiac nursing. Ever since I was little I have been fascinated with how the heart works and its anatomy. This topic is also very near to my heart because I have many family members and friends that have had severe heart problems.  Additionally, the risk of heart disease and obesity runs prevalently high in both side of my family. Since I was young I vowed to always try and live a lifestyle that would prevent these issues, and if possible, help others do the same.

I have selected the American Heart Association (AHA) logo to represent my honors topic because it affects all people on a health promotional level. This organization is well known for promoting and maintaining a healthy lifestyle for your heart and overall well-being.  They provide information regarding nutrition, exercise, warning sign of strokes and heart attacks, stress management and much more educational tips for the young and the old. One way the AHA helps on a community level is by offering CPR courses that millions of health care providers have used.  Also AHA is one of the leaders in research and many people get involved to raise money for cardiac research and health. I remember in grade school our school participated in Jump Rope for Heart. This is a great program because it teaches children within the community, and schools everywhere, the importance of an active lifestyle in a fun and easy way. This event is not only for kids, but encourages teachers and parent involvement (American Heart Association, 2013).

Finally, there are many family theories that can relate to cardiology and the AHA. One in particular that is relevant is the family stress theory. This this theory explains how families react to stressful events that are either expected (ex. parenthood) or unexpected (ex. Illness/ unemployment).  In this event of an unexpected heart attack, this happens simultaneous while other life issues are going on. It can also put other members of a family at risk for break down (Hockenberry & Wilson, 2011). As nurses it is our role to offer coping and other resources to help families focus on getting through these events.  Nurses could use the AHA information for nutrition and exercise guidelines for changing a lifestyle for the individual and family. Another resource is stress management tips for the coping individual and family member. As we can see, this can also be in combination with family systems theory, where the family is made up of parts and that work together as a whole; what affects one members health will  affect the family’s dynamic (Hockenberry & Wilson, 2011). In the case of a heart attack it can affect everyone so it is important to be an advocate for health promotion and coping. One example that shows family systems theory clearly is if a parent was overweight, chances that their children will be overweight are increased due to similar lifestyles and nutrition. Most parents want to be a healthy and be and positive role model for their children, so by helping them with control their health their actions will also affect the lifestyles of their children.

References

 

American Heart Association. (2013). Retrieved from http://www.heart.org/HEARTORG/.

Hockenberry, M.J., & Wilson, D. (Eds.).  (2011). Wong’s nursing care of infants and children (9^th ed)

 (pp.  48).  St. Louis, MO: Saunders/Elsevier.

Wisconsin Air Quality- 4/29/13

According to the AIRNow.gov website, the overall air conditions for the United States ranged from good to moderate. On April 29^th, 2013 most of the central, east, and west areas of the U.S. had an air quality considered good while the Midwest had an air quality considered moderate. On the website good air quality (0-51) on the Air Quality Index (AQI) is considered satisfactory and air pollution poses little or no risk. Moderate (51-100) is acceptable air quality, however in a very small number of people who are unusually sensitive to pollution there is a moderate health concern. Overall, the greater the number on the AQI means a greater level of pollution, directly correlating health concerns. As I looked closer into Wisconsin’s air quality, it was categorized as “moderate.” Today, the state was colored yellow to demonstrate a moderate risk for health concerns; those who are unusually sensitive to air pollutants may experience some side health effects. 

The other categories a state may be categorized as are as follows. Unhealthy for Sensitive Groups (101-150) is when the general public will usually not be affected. Unhealthy (151-200) is where everyone may begin to experience health effects and those that are sensitive experience more serious health effects. Very Unhealthy (201-300) is when everyone is experiencing more serious health effects. Hazardous (301-500) is the worst and health warnings are sent out for emergency conditions; the entire population likely to be effected.

This site was very user friendly, and I had no trouble navigating to find information.  What a parent/caregiver can do as far as using this site is to click on the state of location or type in the zip code to pull up current city. For example, if a parent was taking care of their children in Eau Claire, today would show them that today is “good,” but tomorrow has a predicted index as “moderate.” If a child were unusually sensitive to air pollutants, parents/caregivers could plan out appropriate activities and administer PRN allergy medication as necessary. There is also a Parents Reference Page and a Teacher Reference page that breaks down the AQI for kids. Children are a vulnerable population and often feel the direct effects from air pollution. Because children are developing and often play outside, it is important that they understand what is going on as well. The site explains AQI intended for children from K-1^st grade by differentiating the levels by colors. As children get older, it will be easier for them to communicate how they are feeling and understand why by looking at the “color” for today. There are also games and quizzes available to test children's knowledge on air quality. 

When I first visited the airnow.gov website, one of the things that stood out to me the most was how one state’s air quality could be completely different from another. For example, today April 29^th, 2013 showed Minnesota’s AQI forecast as “good,” but as soon as I looked over at Wisconsin, the AQI was “moderate.” After I analyzed Minnesota a little more closely, the AQI forecast for today and tomorrow including highs/lows does not reach higher than a 38 on the AQI. On the other hand, Wisconsin showed a “moderate” warning for today and tomorrow with a high of 70 in Green Bay.  I thought this was interesting because Minnesota is a large state and all the cities are at little to no health risk. Wisconsin shows risk to those unusually sensitive to air pollution. I wonder what factors may contribute to the differences between these two neighboring states. Population density and location by Lake Superior and Lake Michigan are two factors that may affect Wisconsin’s pollution level along with the increase in temperature.

References

AIRNow. U.S. Environmental Protection Agency (EPA). Retrieved from http://www.epa.gov/airnow/index.html.

Extra Credit: Faith vs Medicine

Article: http://abcnews.go.com/Health/DiabetesResource/story?id=4536593&page=1#.UXntxLWfjsU

      Similar to what we talked about in class, I found one of the earlier articles dealing with the diabetic girl, Kara Neumann, from Wisconsin whose parents refused to seek treatment for her undiagnosed diabetes, which resulted in her death. Of specific interest to choosing this article was when I found that concern was brought to Kara’s Aunt, Ariel Gomez’s attention long before Kara slipped into a diabetic coma. Gomez’s call to the authorities alerted a cause for investigation of the child’s medical condition. Kara’s parents had been using the days during Kara’s declining health to pray for her wellness and not believe in the use of medicine as a cure. This of course brought up a major issue on the ethical standing of the rights a parent has to their child and their religious practices and to what situation calls for intervention by the state for the sake of the child’s wellbeing. This article is quite immensely relevant to the topic of religion and nursing care. As nurse’s we now know situations like these happen, but what we do not know is the best way to go about providing the best care for a patient without stepping on the toes of their personal beliefs and practices.

My questions for you on this topic are:

1. What interventions could have been implemented to Kara’s parent’s that might have prevented her death?

2. How far does the nurse’s responsibility reach in terms of suspecting a case like this? If caught earlier, should it be reported? Why?

3. It is the nurse’s responsibility to remain respectful and not allow personal religious beliefs get in the way of patient care. If asked directly by your patient about your own beliefs that you know are different from theirs, what would you be most inclined to say? (This happened to me once with a patient who had cancer, it was not easy to respond to)