Personal Ethics in Nursing Essay

Personal Ethics in Nursing Essay.

Ethics is the discipline that waits in the wings as a health-restoring resource when moral guidelines fail to do the job alone. Ethics provides a language, along with methods, and tools for evaluating the components of personal, societal, and group morality to create a better path for yourself and others. Some of its most important uses are to clarify, organize, and critique morality to highlight what does and does not fit in a particular situation (Purtilo, 2011).

A nurse cultivates personal ethics through personal, cultural, and spiritual values which becomes a moral compass for their professional ethics.

Personal ethics in combination with the code of ethics often assist the nurses in personal and social decision making during ethical dilemma. This ability prompts them to better respond to needs of the suffering patient and their own well-being. Nursing ethics shares many principles with medical ethics such as beneficence, non-maleficience, and respect for autonomy.

Nursing ethics however, can be distinguished by its emphasis on relationships, collaborative care and human dignity, because the health care climate is regularly changing, as is our society, it is crucial that nurses have a grounded understanding of ethics (Ward, 2012).

Born in a middle-class Christian family from South India, the strict traditional values helped to embed the concept of service through family and friends who taught me trust, respect, integrity, and responsibility for my education and beliefs.

One of my major spiritual values that kindled the concept of service within me is “do unto others as you would have them do unto you” which is found in the Bible. At an early age I started to practice this concept by not only self-respect for myself but mainly treating others with respect. Individuals may build their moral values from listening to their parents, grandparents, religious beliefs, friends, books, their local societal values and even watching television. Moral values and enthusiasm help an individual to understand one’s accountability to their profession to deliver harmless, a compassionate work atmosphere.

This empowers nurses to raise their self-confidence in their profession. Maintaining the existing responsibilities in the nursing field is vibrant to assist patients, families, and the general public. Our ethnic standards play a big role in nursing life. Nurses however should not be judgmental of patient’s beliefs and force their own beliefs in patient care. Hospitals under Joint Commission are responsible for addressing and maintaining patient’s privileges. These privileges include the accommodation; divine, mystical, particular Cultural values and follows while providing care to patients from diverse faiths.

Nurses must have reverence and not put down the patient’s faith and values, and provide care consistently. Being acquainted with a variety of different cultures, languages, and religions influence worldly views and nursing decisions in providing culturally sensitive care. The traditional spiritual and cultural morals along with diverse worldviews became the directorial moral compass to take the right decision on behalf of the patients and personal life and empowered to improve the confidence and capability as a nurse.

Values, Morals, and Ethics are often thought of as interweaved and to have the same denotation when each of solely have a different meaning for themselves. Values are one’s fundamental beliefs developed from childhood through family and society. Morals are values that attribute to a system of beliefs. Values are the language that has evolved to identify intrinsic things a person, group, or society holds dear. Not all values are moral values either. For instance, some things are cherished for their beauty, novelty, or efficiency they bring to our lives (Purtilo, 2011).

When values, morals, and ethics of nurse influence his or her professional conduct, it often tips to conflicting situation in one’s nursing practices. For example, the topic of abortion is frowned upon when looked at from a spiritual Christian standpoint. When a nurses’ spiritual doctrine is against abortion, it would be against their moral to assist in decision making to abort the baby even when the fetus is deformed, thus arising an ethical dilemma between personal values and coming to an ethical conclusion on aborting the baby.

Hospital management may develop a strong Code of Ethics in order to help regulate and maintain a professional atmosphere for nurses so that their decision making will be easier when they incur ethical dilemmas. A Code of Ethics not only serves as a guideline for nurses but also sets a standard for them to abide by. Being in the nursing field my tasks vary from caring, communicating, teaching, bedside care, and even advocating therefore the likelihood of ethical dilemmas are inescapable. Thus far I haven’t been faced with any major ethical dilemmas that would violate my spiritual doctrines that I uphold.

Most commonly the ethical dilemmas I’ve seen care providers face are usually due to religious and spiritual backgrounds of the patient. Some religions do not support induced death by humans and nurses may have trouble supporting the patient and family about cases like abortion. Although it is the individual’s right to make decisions about their bodies, the religious values do not allow one to be apart of the procedure. Therefore when I’ve been in minor ethical dilemmas while being a care provider I go by what is medically and ethically correct.

Nurses are an important element of the health care field because their decisions along with commitment play an essential role for the welfare and safety of humanity. If their decision making is based on personal, cultural, and spiritual values then at times they may be faced with an ethical dilemma. In situations where they’re beliefs may be tested, nurses are expected to either follow the Code of Ethics set out by their management or they should be professional and do what is medically right in order to deliver quality care.

Personal Ethics in Nursing Essay

The Process of Decision Making in Nursing Essay

The Process of Decision Making in Nursing Essay.

Critical thinking skills help nurses shape their actions. In other words, critical thinking is necessary to make good decisions. Good decision-making requires a good foundation of scientific knowledge. The nurse must also be aware of standards that should be followed. Internal and external variables such as the nurse’s personal experience, knowledge, creative thinking ability, education, self concept, as meshed with the nurses’ working environment, and situational stressors all can work to enhance or inhibit effective clinical decision making for a nurse.

Types of Decisions

Decisions can be grouped into two main types, programmed and non-programmed. programmed – meaning they are anticipated and routine. There are likely guidelines, policies, or procedures that can be followed. Non programmed – are unexpected, unique, and more complex.

Decision-Making Process The decision-making process is often broken down into a series of linear steps. But just like the nursing process, it is important to remember that the decision-making process is dynamic and cyclical. • Define the decision – Decision-making can only occur when there is a choice between actual alternatives.

• Gather information and deliberate – Data should be gathered about the alternative choices that are available. • Choose from among alternatives – Judgment about the merits of each alternative should lead to a preferred path. • Act – After a decision is made it must be implemented. • Evaluate – After taking a course of action, the results must be evaluated to determine if it was the best choice. This step is similar to the critical thinking skill of reflection.

Factors Affecting the Decision-Making Process There are numerous factors that can influence the decision-making process. These can be grouped into internal and external factors. • Internal factors include characteristics of the person making the decision. Critical thinking ability is paramount to making good decisions. • External factors relate to issues outside of the nurse that affect the decision.

The Process of Decision Making in Nursing Essay

Nursing Shortage Essay

Nursing Shortage Essay.


Compelling evidence suggests that regions of the United States face a nursing and physician shortage that our legislators, health officials, and medical professionals must address. To ensure that quality medical care is not harshly impacted, the hospitals and public health leadership, in general, will need to tackle the nursing shortage with solid long-term solutions.

It is no secret that the United States faces a critical nursing shortage, a trend that potentially threatens to undermine quality medical care. One single area of concern does not affect the shortage.

In fact, the hospitals, and nursing in particular, are witnessing a combination of problems that range in salary structure, medical economics/cost containment, post-graduate education, and an aging workforce (pending retirements of baby-boomers). The public health industry is not sitting idly by to address the shortage. It is critically reviewing the needs for both existing professions.

Definition of Nursing Shortage

Nursing shortage is defined as the inadequate number of qualified nurses to meet the projected demand for nursing care within a healthcare setting, where the demand for nurses is greater than the supply.

History of Nursing Shortage

Historical knowledge is important to analyze the present and prepare for the future. As we can see from the current shortage in America today, we learn that it is not a new problem. However what makes this current nursing shortage situation unique is that the causes are related to a multifaceted range of issues. The current nursing shortage is connected to supply and demand factors, demographic changes, population growth, and fewer students enrolling in nursing schools, RNs who are retiring or leaving the workforce and a growth in the baby boom population who will demand more healthcare services in the near future. These factors are occurring while many nurses are retiring and more jobs are being created. In addition, the nursing shortage is actually a worldwide phenomenon with areas like Western Europe, Australia, Canada and the Philippines facing shortages as well.

Economic factors have also contributed to the nursing shortage in the United States. Mark Genovese, spokesperson for the New York State Nurses Association explains, “For many decades the shortage was cyclical but as the economy tightened and as the insurance industry moved to a managed care model, there was less money in the system and hospitals had less money to work with and tighter budgets.”

Budgetary limitations affected the nursing workforce as many nurses began leaving the profession altogether. “They were forcing RNs to do more with less, handle more patients and work more hours. RNs started to leave the workforce because of the working conditions and fewer RNs entered the system,” explains Mark.

Americans are also demanding more quality healthcare services while many RNs are retiring, further exacerbating the problem. The HRSA has stated: “to meet the projected growth in demand for RN services, the U.S. must graduate approximately 90% more nurses from U.S. nursing programs.”

Decreased staffing means that there are fewer nurses to work with patients. This impacts job satisfaction and causes work related stress. In some cases it has led to many nurses leaving the profession altogether. A 2010 study published in Health Services Research found that over 75% of RNs feel that the nursing shortage is a huge problem that affects their quality of work as well as patient care and the amount of time that nurses can spend with individual patients.

Another important factor contributing to a lack of nurses is that there is a shortage of nursing school faculty to train a new generation of nurses in colleges and universities. The AACN’s 2008-2009 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing report found that nursing programs in the U.S. did not enroll 49,948 qualified students into their bachelor and graduate degree programs because they did not have an adequate number of faculty, clinical practice sites, teaching space, and were constrained by budgetary limitations. Two thirds of the nursing program respondents reported that a big reason for not accepting students was due to not having enough nurse faculty on hand.

The Southern Regional Board of Education conducted a study which found that the nursing faculty shortage in 16 states was caused by vacant faculty positions, retirements, resignations and a shortage of new candidates applying for faculty positions. Shortages like this pose a threat to the availability of nurse education. Defining the Problem

For those students interested in careers in healthcare, becoming a nurse right now could be the best decision for you. Currently, the United States is facing a severe nursing shortage. For several reasons, the number of nurses graduating and entering the workforce, and those already in the profession, is not enough to fill the growing demand. Currently, RNs are the largest group of healthcare workers in the US at roughly 2.6 million and that still isn’t enough to meet the need. According to experts, by 2012, there could be around 1.1 million unfilled nursing positions in the United States.

In the most basic sense, the current global nursing shortage is simply a widespread and dangerous lack of skilled nurses who are needed to care for individual patients and the population as a whole. The work of the world’s estimated 12 million nurses is not well understood, even by educated members of society. But nursing is a distinct scientific field and autonomous profession whose skilled practitioners save lives and improve patient outcomes every day in a wide variety of settings.

In the Truth’s view, the vast gap between what skilled nurses really do and what the public thinks they do is a fundamental factor underlying most of the more immediate apparent causes of the shortage. These causes include nurse short-staffing (due to inadequate pay and long work hours), poor work conditions, the aging nursing workforce, expanded career options for women, nursing’s predominantly female nature, the increasing complexity of health care and care technology, and the rapidly aging populations in developed nations, to name a few.

Other causes of the nursing shortage episode include: the aging baby boomer population and lack of employee incentives. There were seventy-six million Americans born between 1946 and 1964 and are now classified the Baby Boomer Generation. As this population reaches retirement age and beyond, they are requiring more medical treatments and nursing home and long term care facilities. This country is also seeing an increase in population in general, projected to grow 18% over the next two decades. With more patients flooding the healthcare system, there simply aren’t enough nurses to meet this growing need. However, those currently employed in the nursing field should be rewarded for being encouraged and motivated to stay in such a questionable field of employment.

In light of this nursing shortage, it should be relatively easy to find gainful employment after graduation should you choose to study nursing. According to the Bureau of Labor Statistics (BLS), more than 581,000 new Registered Nurse (RN) positions will be created through 2018, which will increase that workforce by an astounding 22%. The BLS also estimates that even as other sectors of our economy continue to suffer, the healthcare sector will only continue to grow. Since the recession began, more than 600,000 positions have been created in the healthcare industry. With so many Americans out of work in other fields, a career in healthcare, specifically in nursing, might be a viable career choice.

Literature Review

Today, the average age of nursing faculty in baccalaureate and graduate degree programs is 51.5 years and the rate of projected retirements will exceed the rate of re placements. Nurses enter the faculty role later in their careers and typically retire at an earlier age, around 62.5 years. More efforts need to be put into place to encourage those already teaching to remain in their positions even if it is in a limited capacity while future faculty are educated.

What factors are present that facilitate the desire for nursing faculty to retire? Kowalski, Dalley, and Weigand (2006) conducted a cross-sectional, randomized study of 129 nurse educators teaching in 61 schools of nursing to find out what personal decisions influenced their retirement plans. With a 37.6% response rate, results reflected that the mean age of planned retirement was 64.4 years. However, the mean age respondents would like to retire was 62.4. Factors influencing retirement included workplace issues, personal and family health, attitudes about retirement, and financial security.

One of the most important factors influencing retirement plans was financial security. Faculty members who were financially secure retired earlier. Job satisfaction was another important influencing factor resulting in early retirement. In lieu of the faculty shortage, the authors contend that studies such as this will offer insight into future retirement trends which may help bridge the gap between supply and the demand of nurse educators (Kowalski et al., 2006). From the results of this one study it may be important to consider the needs of the aging faculty by providing healthy, satisfying, and stimulating work environments, appropriate benefits packages, and relaxing mandatory retirement ages.

One serious factor contributing to the faculty shortage is financial. Not only are academic salaries much lower than they are for clinical practice and administrative positions of advanced practice nurses, but the cost of securing advanced academic degrees is costly. In 2004, the average salary of a master’s-prepared nurse practitioner in a clinical setting was $80,697 compared to $60,831 for that of a master’s-prepared nursing faculty member (Nevada Nurses Association, 2004). By increasing academic salaries and providing tuition allowances in return for teaching will indeed make teaching a more attractive career choice (Yordy, 2006).

Another important factor affecting the faculty shortage is that of job satisfaction, stress, and burnout. To maintain current faculty on the job, more research should be conducted on factors affecting job satisfaction and what works to provide a better environment. Gormley (2003) performed a meta-analysis study on nursing faculty job satisfaction and which factors had the greatest influence using a sample of six studies from 1976 and 1996. Nursing faculty are pressured not only to educate future nurses to provide safe and competent care, but also have many other professional responsibilities, such as publishing, conducting research, writing grants, performing community service, and maintaining their own competencies (Gormley, 2003). These responsibilities combined can become overwhelming and lead to job dissatisfaction especially as the faculty is aging.

In Gormley’s study (2003), factors that affected job satisfaction were perception/expectation of the leader’s role in curriculum and instruction, suggesting that the dean’s role has significant effects on faculty’s job satisfaction and role conflict/ambiguity. Shirey (2006) argues that prolonged stress can lead to burn-out in many faculty who then become “deadwood,” jeopardizing the quality and spirit of the institution. These faculty members can ward off potential new faculty who are even more vulnerable to the stresses of the teaching role.

It is imperative that academic institutions pay close attention to the needs of their faculty. Mentoring programs, self-renewal, and organizational engagement are key strategies to prevent burnout (Shirey, 2006). “A carefully structured and deliberate mentoring program can be an invaluable orientation as schools of nursing seek to provide an academic environment that is conducive to the professional and scholarly development of adjunct faculty members” (Peters & Boylston, 2006, p. 64).

One serious factor contributing to the faculty shortage is financial. Not only are academic salaries much lower than they are for clinical practice and administrative positions of advanced practice nurses, but the cost of securing advanced academic degrees is costly. In 2004, the average salary of a master’s-prepared nurse practitioner in a clinical setting was $80,697 compared to $60,831 for that of a master’s-prepared nursing faculty member (Nevada Nurses Association, 2004). By increasing academic salaries and providing tuition allowances in return for teaching will indeed make teaching a more attractive career choice (Yordy, 2006).

Program Analysis

Possible Solutions

For sustained change and assurance of evading the forthcoming shortage, solutions must be developed in several areas: education, health care systems, policy and regulations, and image. This shortage is not exclusively a nursing issue, but will require a collaborative effort among nursing leaders, practitioners, health care executives, government, and the media.

Creating Cultures of Retention

The American Nurses Association Magnet hospital program has had a proven success in raising the standards of nursing practice and improving patient outcomes. Currently there are 85 organizations that are designated Magnet hospitals. Magnet facilities are characterized by strong administrative support, adequate nurse staffing, strong communication, nurse autonomy, better control, and a vital focus on the patient and their family.

A growing body of research indicates that this program is making a positive difference for nurses, patients, and the hospitals as a whole. Research is proving that through this program, nurses are having increased satisfaction as well as increased perceptions of productivity and the quality of care given. Studies also indicate that these facilities have lower incidence of needle stick injuries, lower burn out rates, and double the retention of non-Magnet facilities. By adopting the characteristics of Magnet hospitals, facilities will be able to create a culture of retention that empowers and is respectful of nursing staff.

Strengthening the Infrastructure

In 2002 the Nursing Reinvestment Act was signed by President Bush to address the problem of our nation’s nursing shortage. This initiative was intended to promote people to enter and remain in nursing careers, thus reducing the growing shortage. The law establishes scholarships, loan repayments, public service announcements, retention grants, career ladders, and grants for nursing faculty. Many statewide initiatives are underway to address this issue as well.

In Pennsylvania, six new nursing education initiatives have been announced to address faculty shortage by encouraging current nurses to return to school, earn graduate degrees, and teach the next generation of nurses. Illinois is unveiling a plan to provide faculty scholarships and grants to nursing schools in order to expand student enrollment. California, whose nursing programs currently have wait lists over three years, is trying to expand nursing education through a $90 million initiative.

Nursing Shortage Essay

The Theories of Lenininger and Watson in Nursing Essay

The Theories of Lenininger and Watson in Nursing Essay.

As the healthcare system undergoes major transformations and the role of the professional nurse is expanding, having a definition of the goals and responsibilities of a nurse relative to other professionals within the healthcare community is vital. Nursing theories establish the scope and the significance of a nurse’s role as a healthcare provider. They provide a universal description of nursing that can be applied to nurses practicing within a variety of settings. This paper will examine how the theories of Jean Watson and Madeleine Leininger impact the manner in which professional nurses practice, specifically within the school nurse setting.

Jean Watson’s Philosophy and Science of Caring shows how caring is at the core of nursing practice and is more important than curing. Additionally, she believed that a holistic approach to care is central to the practice of nursing. Watson devised a framework for understanding nursing by developing the ten carative factors. The term carative is used instead of curative to emphasize the distinction between nursing and medicine.

According to Blais and Hayes (2011): Watson considers her work to be a philosophical and moral/ethical foundation for professional nursing and part of the central focus for nursing at the disciplinary level. It includes a call for both the art and science that embraces and intersects with art, science, humanities, spirituality, and new dimensions of mind-body-spirit medicine and nursing. (p. 109)

Madeline Leininger was the founder of transcultural nursing. Leininger defined human caring within the context of culture. She recognized that there was a lack of knowledge among nurses in regards to how different cultural backgrounds impacted human behaviors. She identified that care and beliefs about health and illness are imbedded in the values, worldviews and life patterns of people (Cohen 1991). Leininger like Watson also viewed caring as the essence of nursing and unique to the profession. However, she emphasized the aspects of care within a cultural context. Blais and Hayes explain that central to Leininger’s theory is the belief that cultures have differences in their ways of perceiving, knowing, and practicing care but that there are also commonalities about care among cultures (p 109).

A core principle of Watson’s (2008) theory is that nurses have a moral commitment to form transpersonal relationships with others. Nurses, “seek to recognize, honor, and accurately detect the spirit of the other through genuine presencing, being centered, available in the now-moment” (p 81). It is important for nurses to be present in the moment when caring for their patients. They need to be mindful of what they are doing and do it with the intention to care. Furthermore, the very presence of a caring nurse may be the difference between hope and despair. This aspect of caring is especially significant when working with children who have chronic medical conditions and their families. School nurses can provide this type of care by being engaged with the family and learning what is unique about their child. In the case of children with developmental disabilities, although there is no cure to their condition, nurses can focus on the progress they are making in their daily lives thus giving families a sense of hope and support.

Leininger believes that the goal of healthcare personnel should be to work toward understanding of care and the values, health beliefs, and lifestyles of different cultures, which will form the basis for providing culture-specific care (Blais and Hayes, 2011). Culturally competent school nurse are aware and respectful of the importance of the values, beliefs, traditions, customs and parenting styles of the children and families they serve. They also need to be aware of the impact of their interactions with others and take all of these factors into account when planning care for children and their families. For example, with an escalating number of Spanish-speaking immigrants in the school system, school nurses should provide educational written materials in Spanish as well as English and utilize translators to communicate pertinent health related information to Spanish-speaking families.

School nurses may encounter families who do not believe in immunizing their children because of religious beliefs. It is the duty of school nurses to provide education about the risks and benefits of immunizations and attempt to correct any misinformation or misperceptions that may exist. If the family makes an informed decision not to immunize their child, their religious beliefs must be respected and the child should be protected from communicable diseases. Furthermore, schools should provide frequent in-service programs on cultural competency. By respecting the values, beliefs and cultures of all individuals, nurses can continue to provide holistic and competent care to their patients in all areas of nursing.

The nursing theories of Jean Watson and Madeleine Leininger identify the act of caring as unique to the nursing profession. Nurses should continue to strive to provide holistic and individualized care that transcends cultural boundaries. By doing so the role of the nurse will remain a constant in the rapidly changing world of healthcare.

Blais, K. K. & Hayes J. S. (2011). Professional Nursing Practice: Concepts and Perspectives (6th ed). Upper Saddle River, NJ: Pearson Health Science Cohen, J. (1991). Two portraits of caring: a comparison of the artists, Lenininger and Watson. Journal of Advanced Nursing, 16, 899-909. Watson, J. (2008). Nursing: The philosophy and science of caring (rev. ed.). Boulder, CO: University Press of Colorado.

The Theories of Lenininger and Watson in Nursing Essay

The Professional Nursing Organizations Essay

The Professional Nursing Organizations Essay.

A. Functional Differences

The Professional Nursing Organizations and Regulatory Agencies for Nursing are what nursing professionals look to for standards, guidance, support, rules and regulations, along with licensure and discipline if necessary. One example of a professional nursing organization (PNO) would be the American Nurses Association (ANA). The role of the ANA includes: promotion/ development of the nursing profession, involvement with legislation and policy making, supporting the nurse in order for the nurse to provide quality care for the those receiving care.

The mission statement of the ANA is simple and direct… “nurses advancing our profession to improve health for all” (ANA, 2014). Individuals can become full members of this organization or be a subscriber. Full membership/ full access requirements include a Registered Nurse license and a membership fee. Subscribers can be non- RNs, paying a fee, but this does not include full access to all resources.

Being a member of the ANA presents many benefits including possible connections with all levels of medical professionals and access to a multitude of resources and articles.

Reasons why a nursing professional may not become a member of the ANA could include unawareness of how easily membership can be obtained, knowing that membership fees exist, or the fact that many resources are accessible on the internet easily for free. Regulatory Agencies for nursing usually are at a state level, such as the State of Tennessee Board of Nursing (BON). The TN BON mission statement is direct and includes “… mission is to safeguard the health, safety, and welfare of Tennesseans by requiring that all who practice within this state are qualified and licensed to practice” (TNBON, 2014).

The TN BON is backed by the governor, which selects the members of the board and includes 11 members (10 nursing professionals/ 1 consumer). This board is responsible for 3 main areas for the state of Tennessee– licensure/ certification, education/ curriculum for nursing programs, and practice of profession. The TN BON deciphers and gains impressions of statutes and administration rules to determine the appropriate standards of practice in an effort to ensure the highest professional conduct (TNBON, 2014).

If a complaint is filed against a nursing professional or misconduct is suspected, it is up to the Tennessee Board of Nursing to complete an investigation. The TN BON then determines if discipline and/ or penalties are necessary. The TN BON can and will suspend or revoke nursing privileges, if deemed necessary, in order to protect the health, safety and wellbeing of individuals (TNBON, 2014). Access to the TN BON information and resources is mostly free, with all meeting notes even being posted for public viewing on the website.

B. Nursing Code Examples

The Nursing Code of Ethics is the guide for nurses to follow in regards to morals ethics and professionalism. It includes 9 provisions that nurses are obligated to utilize in order to provide the best possible care to clients. Although all of the provisions touch each and every aspect of my nursing profession, two examples that influence my practice as the nursing director of a youth residential behavioral facility are #2 and #4. Provision 2 states “the nurse’s primary commitment is to the patient, whether an individual, family, group, or community” (ANA 2014). Working with behaviorally challenged adolescents in a residential care setting is extremely complex at times. These situations are frequently complicated because the youth are often in state’s custody, but the parents rights are still intact. My primary concern is the youth in the facility, yet being mindful to include, notify, and educate the parents as well.

The complication part arises when the parent refuses to support or agree to the plan of care designed for the youth. With the child being in custody of the state, there are many strict guidelines that have to be adhered to in addition to the expected nursing duties and standards. The child’s mental, physical and medical health are the main priority and when the parents are resistant to treatment, we sometimes have to take a legal approach in order to provide the best quality care available. Provision 4 of the Nursing Code of Ethics states “The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of task consistent with the nurse’s obligation to provide optimum patient care” (ANA 2014). This provision surrounds my position of being a nursing manager completely! Being a nurse manager and directing youth care workers of the facility is an extremely big responsibility.

It is my duty and obligation to ensure the safety of not only the children in the facility, but also the employees that work there. I am accountable both professionally and personally, even when I am not physically in the building. It is my responsibility to make sure all jobs are delegated appropriately and all those concerned are safe plus secure with the best available care possible. Only some of the employees have formal education or training, such as nurses… most employees are actually trained in the facility by the managers and the nurses. I am responsible for making sure the youth care workers and other personnel are educated on proper interaction, safety, infection control, policies and procedures from a medical standpoint.

C. Professional Traits

Four professional traits from the American Nurses Association Code of Ethics that I bring, as a member, to the interdisciplinary healthcare team would be from Provision 1 and Provision 3. As a nurse manager, I display and am responsible for ensuring that all team members are well aware of “Provision 1.1 Respect for human dignity” (ANA 2014). Our clients are children, and they come from many different unimaginable backgrounds. These youth are due respect and have individual rights as humans no matter what their histories are. I am also accountable for myself and my department to display professionalism. “Provision 1.5 Relationships with colleagues and others” (ANA 2014) enforces the fact that we all are to be respectful of each other.

Being the supervisor, educator and discipliner of employees, I hold myself to a higher standard of professionalism and am very mindful of this provision when interacting with colleagues. The youth in this facility all have very diverse medical and personal histories. These histories could include sexual exploitation or abuse, which in turn could bring along sexually transmitted diseases (just to name one possibility). This is a devastating situation for anyone, especially a child victim. “Provision 3.1 Privacy” and “Provision 3.2 Confidentiality” (AMA 2014) are self explanatory… I and all employees, carry the responsibility for teaching, displaying, and ensuring these children have the upmost supported privacy and confidentiality. As a member of a healthcare team, strict following in this provision allows me to build a rapport with the youth, that may give insight into these diverse histories. This allows the team to give a more holistic treatment for the individual.

D. Nursing Theory/ Theory in Professional Practice

My personal nursing basis comes from multiple influences. One example of a nursing theory that has influenced me in my profession would be the theory of Patricia Benner (Cherry, 2011). The theory describes that there are five levels of nursing competence. These five levels include novice, advanced beginner, competent, proficient and expert level nursing. I have had experience in different areas of nursing and in every position held, I have had to learn something new. What this means to me is that even though I have held a nursing degree for some years now, I may be in a position where I am not the expert level nurse. When I began my current position in adolescent care, I was definitely not the expert level nurse… this is because my experience in nursing care had been based on adult health. I was a competent level nurse when I began working with my current employer and with four years of experience in adolescent care now, I still continue to learn something new on a regular basis, whether it be lab values, medication dosages, education for teaching or therapeutic interventions.

E. Contributions

The contributions of Florence Nightingale seem to influence my nursing practice on a constant basis. Drive for a better way would be another way that Florence Nightingale’s contributions influence my practice. Her never ending drive to improve conditions for better healthcare is historically documented from improving the conditions in the military hospitals, sanitation, public health and use of documented statistics are just a few of the amazing things that Nightingale accomplished (Cherry, 2011). As a practicing nurse manager, statistics and documentation is utilized and thrived upon in my daily routine. Vitals, nutrition logs, sleep patterns, probability of incidences and behavioral changes are some of the areas that I study and document. Statistics and documentation surround every approach in modern day application in the medical world.

F. Scenario

As I noted earlier, working with children and their families can be extremely complicated at times. Beneficence and nonmaleficence are 2 principles that I work diligently to safeguard my clients and families with. Beneficence is “an ethical principle stating that one should do good and prevent or avoid doing harm; …to promote goodness, kindness and charity” (Cherry, 2010). Nonmaleficence is ” an ethical principle stating the duty not to inflict harm; …to help others further their own well being by removing harm and eliminating threats” (Cherry, 2010). An example of this would be when an adolescent with extreme self- harming behaviors was admitted to our facility for another primary diagnosis. During the admission assessment, the child revealed her hidden behaviors by showing multiple scars, then stated “my parents don’t know, please don’t tell them”.

My first priority was to ensure the child’s safety by removing objects that she could possibly harm herself with and notify the staff to heighten the level of awareness for safety precautions. Next, I explained to the child that it was necessary for me to inform her therapist and parents out of concern for her safety and to help prevent further harm. After explaining my reasoning to the child as to why it was necessary to inform her parents, she agreed that it was in her best interest to share this information in order to begin the process to rehabilitation. Trust and honesty and the promotion of this child’s health made this particular situation difficult but easy at the same time.

G. Conclusion

Nursing is a complex profession that includes guidelines that are headed by PNO’s and Regulatory Agencies. The Nursing Code of Ethics is the golden rule for moral and ethical nursing practice and this code is non-negotionable. Professional traits of the nurse play a huge factor when dealing with others, whether it be colleagues, patients or the public. There are many historical theorist and medical nursing icons that have laid the foundation for the nursing profession and practice. These theories and models are still contributing to the nursing profession in modern times and there are many examples of this that can be discovered within the nursing profession as well as my own practice.

The Professional Nursing Organizations Essay

Telenursing: The Future of Medicine Essay

Telenursing: The Future of Medicine Essay.

Telenursing is a new technology used to deliver nursing services to patients where the patient and the nurse communicate directly through audios or videos. It was developed in the 1970’s to curb the professional nurse shortage. Telenursing seeks to monitor a patient while at home, therefore preventing admission and readmission of a patient in a health facility. The telehealth equipment used to monitor the patient give out the patient health progress thus determining the status of their health. Telenursing has helped patients get the love and care they require from their family members, curbing the boredom that is experienced in a hospital setting.

This program has experienced some drawbacks and potential advantages to its users. A lot of concerns have been raised regarding the ethical issues that arise from telenursing. This paper focuses on the advantages and disadvantages of telenursing, discusses the ethical issues and legal requirements related to patient’s privacy and confidentiality.

Patients suffering from chronic diseases and congestive heart failure have been using the program due to its benefits.

They acknowledge that telenursing technology has continuously sought to improve the lifestyle of the people. Telenursing has been able to address the issue of the shortage of nurses. Nurses who are registered are not enough to serve everyone, therefore, making telenursing a good alternative. Through telenursing a nurse can provide monitoring, education, follow-up, remote data collection, remote interventions, pain management, family support, and multidisciplinary care in an innovative fashion (Peck, 2005).

The nurses through the use of telephones, audios and videos assess the progress of their patient from time to time. This has led to the provision of health services to patients regardless of the distance; leading to a reduction in the death numbers annually. The nurse has been given the advantage of attending to their duties since they can monitor the sick from home. This has reduced the long working hours associated with the medical field. Telehealth allows people to remain in their own homes, monitoring their chronic diseases in real time while supported by healthcare professionals who review the results and contact patients when necessary (Scullion, 2014).

Telenursing has also eased the burden of financial strain. Most patients who suffer from chronic diseases tend to be hospitalized for long periods of time amounting to high medical expenses. People that lack medical insurance cannot afford to pay, end up dying in their homes. The use of telenursing will check on the medical expenses leading to people getting better healthcare services that are much-needed.

The travelling expenses incurred during doctor’s appointments and checkups will also be curbed. The patients using the technology showed some level of satisfaction. The patients who have at one time used telenursing seem not to mind using it again. They state that though the nurse is not physically there, they can communicate their fears and how they are feeling; leading to treatment and encouragement where possible. Using telenursing is also convenient both for the patient and the nurse. The nurse while in the office can communicate to the patient at any time enhancing the satisfaction.

The disadvantages that come with telenursing could lead to complaints among the patients due to lack of face to face communication with the nurses. The program enables a patient to talk to their nurse through videos, leading to some patient’s feeling alone. Most patients would miss the personal care that a professional nurse has to offer. Just seeing the nurse around and talking to them makes the patient feel appreciated and well taken care of. Patients using telenursing miss the contact. Patients agree to have been taken care of in the best manner possible, but the physical touch was not felt. Therefore, the technology has a lot of advantages, but absence of the physical contact is highly missed by patients.

Another disadvantage that patients experience is the breakdown of the machine. The machine at some point could fail leading to unplugging then plugging afterwards. This could delay an issue that need to be addressed. It could also lead to timewasting since the nurse has to sit back and wait. The machine can also show images that are not clear leading to the misinterpretation of the nurse’s judgment on the patient. Telenursing also requires the use of internet connection that could not be available to the rural areas minimizing the use of the services to these places. Also, disasters like war could cause disruption on the internet services leading to lack of communication between the patient and the nurses. A workable internet service provider and intact telecommunication services are required at both ends. Telecommunications fail when there is any significant disruption on services, power, or trained people to initiate a telemedicine request (Merrell, Cone & Rafiq, 2008).

The machine could also at some point give false positive alerts since it is not a hundred percent efficient. If such occurs, a nurse could conclude that their patient is getting better. The nurse’s conclusion could lead to misdiagnosis of patient’s condition. There could also be an increased workload on the part of the nurse. Collection and analyzing of the patient’s data could take a long time leading to accumulation. The patient can also be given extra doses that are not necessary. Physical absence of the nurse can lead overtreatment. The patient could be back on their feet but since the nurse is not physically there, the nurse can miss noticing the improvements.

Telenursing could have some ethical issues that need to be addressed at an early stage. The nurse should be able to use the machine so that communication with the patient and treatment would be easy. The nurse should also master the skills of a good listener, communicator and observer because she solemnly depends on these skills in judging the health status of the patient. The nurse should also show caring and concern to boost the self-worth of the patient. She should also be courageous and patient with the sick to ensure that the best services are delivered. The nurses could experience some dilemmas in deciding the best advice to give leading to stress. During such moments, the nurse should relax and give the best advice they can think of.

Some of the negative ethical issues are privacy and security of the patient is not guaranteed due to the displaying of the machine. The nurse is not allowed to give the patient a lot of information so that assessment will run smoothly. However, that denies a patient’s right to information compromising the nurse’s integrity. Information about the patient should be communicated directly to them to ensure integrity and privacy. The nurse should also ask questions concerning the last talk with the patient to ensure the identity of the patient.

The nurse should communicate to the patient about his or her real condition to ensure that they take the necessary measures to escalate their health. Installation of the machine that monitors the health of the patient has proved to be easily operated, ensuring comfort of the patient. Good documentation of the patient’s medical reports should be ensured while the security issues that concern the use of technology should be communicated to the patient. The patient should also be informed on the possibility of loss of their medical documents due to the undependable nature of the internet.


Telehealth can help save money and improve care through efficient and accurate patient tracking and effective coordinated patient care, and by retaining experienced and dedicated nurses (Peck, 2005). Telenursing is a good health-technology that can be able to cut cost on both the patient and the nurse. Timewasting and travelling costs are avoided in telenursing. A nurse is able to examine their patient through video calls or audios, enhancing socialization. Once the machine has been installed, the patient finds it easy to operate since it is not complicated. Nurses get the extra time to spend with their families which enhances bonding. Telenursing, however, can give a wrong conclusion about the patient’s health since the nurse will judge the patient according to the voice. Also, identifying small wounds on the patient’s body might not be possible especially when the pictures displayed are not clear.

The patient also lacks the physical touch that comes with a face to face interaction. The patient could feel that the nurse is doing nothing if their health is deteriorating. Physical contact brings about assurance and moral support. When overtreatment occurs the medicines prescribed could harm the patient leading to a possible death or disability. The nurse therefore while dealing with the patient should be extremely cautious and observant. Telenursing has ensured that patients suffering from chronic diseases are not continuously admitted and discharged giving them the peace of mind. The aged also have benefitted by minimizing the troubles of visiting hospitals frequently.

Therefore, Manuel should take the job if he manages to secure it. The benefits that he is going to enjoy are numerous. The core business of the task will be ensuring the patient satisfaction with his services. Manuel will also be able to equip himself with the technological knowledge that comes with understanding of telenursing. Telenursing will also enable him to give his services to a larger group of people compared to face to face nursing. He will also be able to spare time to bond with his friends and family leading to his satisfaction.

Merrell, R. C., Cone, S. W., & Rafiq, A. (2008). Telemedicine in extreme conditions: disasters, war, remote sites. Studies in health technology and informatics, 131, 99-116. Peck, A. (2005). Changing the face of standard nursing practice through telehealth and telenursing. Nursing administration quarterly, 29(4), 339-343. Scullion, J. (2014). Placing a value on telehealth. Primary Health Care, 24(3), 12.

Telenursing: The Future of Medicine Essay

Define the following types of abuse: Physical abuse Essay

Define the following types of abuse: Physical abuse Essay.

Hitting, slapping, pushing or kicking, forcing people to eat or take medication, leaving people to sit in urine or faeces.

1.1b – Define the following types of abuse: Sexual abuse

Unwanted advances, indecent exposure or harassment, rough washing or touching of the genital area, rape, being forced to watch or participate in sexual acts. 1.1c – Define the following types of abuse: Emotional/psychological abuse Intimidation, not being included, being ignored, threats, bullying, humiliating and blaming. These include discrimination that relates to age, race, gender, sexuality, culture, religion etc.

1.1d – Define the following types of abuse: Financial abuse

Using an individual’s money without their permission or on items they have not requested, not giving correct change, taking store card points, taking the free item of “buy one get one free”. Not giving individuals enough money for food and essential items. 1.1e – Define the following types of abuse: Institutional abuse Poor care to people in group environments, for example, in a residential care home or in a day centre.

Food choices not provided for individuals with different dietary needs or requirements. The individual’s room and clothing not being kept clean. 1.1f – Define the following types of abuse: Self neglect

Individual not eating, washing, dressing properly. Not looking after themselves. 1.1g – Define the following types of abuse: Neglect by others Inadequate care or denial of an individual’s basic rights. 1.2 – . Identify the signs and/or symptoms associated with each type of abuse. These are the main types of abuse with some examples of signs and symptoms:

Physical – Unexplained bruises, scratches, cuts, fractures, broken bones, broken teeth. Sexual –Bruises around genital area. Individual becomes particular about washing genital area or wanting to hide themselves. Emotional / psychological – Abnormal behaviour or moods. Talking a lot and very fast or being unusually quiet. Appearing afraid or worried. Being concerned that care and support may not continue Financial – Shortage of money, reluctance to pay for things, complaining about price increases, unusual interest or lack of interest in their personal finances. Institutional – Individuals not eating properly, not dressing properly, not participating, staying in their rooms, not getting required attention and support, complaints from residents or family members. Dirty rooms and communal areas. Health and safety being ignored. Self-neglect –Individual gaining or losing weight, looking dirty or dishevelled. Not washing and smelling. Not caring about themselves. Medical issues not being taken care of. Lack of confidence and self-esteem.

Lack of social network, family and friends. Staying at home when they could get out and about. Neglect by others – Any of the above symptoms could be neglect or lead to neglect by others if left and not resolved. If you do not take action to report or resolve a situation where you believe abuse is taking or has taken place, you could be accused of neglect yourself. 1.3 – Describe factors that may contribute to an individual being more vulnerable to abuse. Some individuals are more vulnerable to harm or abuse than others. These are some of the reasons why: Individuals with a sensory impairment, for example, poor or no hearing or sight that might lead to communication difficulties. Individuals may lack the capacity to understand what is happening or that it is wrong. Lack of capacity could be for a number of different reasons and could be long term or short term. Individuals may be severely disabled.

Individuals may be physically or emotionally weak and rely on others for care. Individuals may have suffered brain injury and may not be able to communicate. Individuals may be unconscious.  Individuals who do not have good support networks around them. Individuals being cared for at home who are reliant on another person for care and support.

204 Cert.2 – Know how to respond to suspected or alleged abuse.

2.1 – . Explain the actions to take if there are suspicions that an individual is being abused.

The actions to take constitute the employee’s responsibilities in responding to allegations or suspicions of abuse. Always follow policies and procedures and report to the appropriate person(s), record the facts on appropriate paperwork, listen do not judge, stay calm and collected, and do not tamper with evidence.

2.2 – . Explain the actions to take if an individual alleges that they are being abused.

The key things you MUST do if an individual discloses abuse to you: Assume the individual is telling the truth. Speak to them in a calm and sensitive way. Listen carefully and make sure you record what was said including date, time and place. Reassure the individual and tell them that you have to pass this information on. Always follow your policies and procedures.

If the individual needs medical attention, call the emergency services or call a doctor as appropriate and inform your supervisor / manager immediately or another available senior person. If this is a criminal matter, for example, an alleged assault, rape or indecent exposure, you will need to call the police and if in any doubt consult your policies and procedures or contact your supervisor / manager immediately or another available senior person.

2.3 – Identify ways to ensure that evidence of abuse is preserved. In most circumstances you may not need to do anything except record the events that have given cause for concern. The best way to preserve evidence is to report the matter as quickly as possible. When needed you should: Make a written record of messages (e.g. answer-phone) to ensure they are not lost. Include the date and time and sign them Ensure written records (notes, letters, bank statements, medication records etc.) are kept in a safe place Don’t tidy up, wash clothes, bedding or other items.

Do not try to clear or tidy anything up
Try not to touch anything unless you have to for the immediate wellbeing of the victim – if you have to try to make a record of what you have done If any sexual offence is suspected try to discourage the victim from washing, drinking, cleaning their teeth or going to the toilet until the police are present Preserve anything used to warm or comfort the victim e.g. a blanket Try to ensure that no one else enters the premises or alleged scene of crime until the police arrive If you can, try and ensure that the alleged perpetrator does not have any contact with the victim Record any physical signs or injuries using a body map (click here) or hand drawing. Write a description of any physical signs or injuries including size, shape, colour etc. Always remember to sign and date your notes and any other records you have made

204 Cert.3 – Understand the national and local context of safeguarding and protection from abuse.

3.1 – Identify national policies and local systems that relate to safeguarding and protection from abuse.

The Care Quality Commission (CQC) regulates care homes and inspects every care home it registers. The CQC also registers home‐care or domiciliary care services. Any registered care provider must, by law, have a complaints procedure. Services have rules about the staff they employ and the standards of care they provide.

Everybody working with vulnerable adults and children has to complete a criminal record check by the Disclosure and Barring Service (DBS). The DBS helps employers to make safer recruitment decisions and prevent unsuitable people from working with vulnerable groups, including children. It replaces the Criminal Records Bureau (CRB) and Independent Safeguarding Authority (ISA).

The Deprivation of Liberty Safeguards (DOLS), implemented April 2009, provide a legal protection for those vulnerable people who are, or may become, deprived of their liberty. Safeguards exist to provide a proper legal process and suitable protection in those circumstances where deprivation of liberty appears to be unavoidable, in a person’s own best interests. These safeguards can apply to people who have a mental disorder and lack capacity to consent to the arrangements made for their care or treatment, but for whom receiving care or treatment in circumstances that amount to a deprivation of liberty may be necessary to protect them from harm and appears to be in their best interests. 3.2 – . Explain the roles of different agencies in safeguarding and protecting individuals from abuse.

Care Quality Commission (CQC): They have a role to play in safeguarding. If you have followed policies and procedures and reported a situation of abuse and you are not getting reasonable feedback about what action is being taken and you do not believe your complaint has been acted upon, or you suspect that your supervisor / manager is involved, and there is no-one else internally in your organisation you can talk to, you should contact CQC.

Disclosure and Barring Service (DBS): The DBS helps employers to make safer recruitment decisions and prevent unsuitable people from working with vulnerable groups, including children. It replaces the Criminal Records Bureau (CRB) and Independent Safeguarding Authority (ISA). The DBS are responsible for:

Processing requests for criminal records checks
Deciding whether it is appropriate for a person to be placed on or removed from a barred list. Placing or removing people from the DBS children’s barred list and adults’ barred list for England, Wales and Northern Ireland

3.3 – Identify reports into serious failures to protect individuals from abuse. In cases where suspected abuse or neglect has resulted in death, or abuse or neglect is known or suspected to be a factor in the death (including death by suspected suicide), or for cases of serious and significant harm, a Serious Case Review (SCR) will be undertaken 3.4 – Identify sources of information and advice about own role in safeguarding and protecting individuals from abuse.

Sources of information and advice include:
Care Home manager
Care Plans
Mandatory Training
Deprivation of Liberty Safeguards (DOLS)
Quality care Commission (CQC)
Citizens advice Bureau
Social Services
Health Services

204 Cert.4 – Understand ways to reduce the likelihood of abuse.

4.1a – Explain how the likelihood of abuse may be reduced by: working with person centred values

This ensures a carer can:

1. Define care values and explain the principles of care
2. Explain the importance of rights, privacy, respect and dignity in ensuring choice and independence 3. Explain the principles of delivery for a person centred approach to care delivery 4. Know how to use a care plan to help in delivering person centred care 5. Explain the responsibilities of the organisation and care worker in care delivery 6. Define the role of the care worker in establishing and maintaining effective work relationships 7. Explain how to utilise support and supervision to ensure effective practice 8. Explore ways to develop the knowledge and skills required to promote continual development of the care worker 9. Promoting empowerment

In using person centred values you can manage risks associated with:

Person centred approaches
Determining needs
How needs develop
Language preferences
Significant others
Eating problems
Supporting that development
Supporting the individual
Care values
Care planning
The care (service) setting
Working safely
Managing risk
Dealing with emergencies
Personal care
Dying, death
Mental health
Promoting independence

4.1b – Explain how the likelihood of abuse may be reduced by: encouraging active participation Active participation is an approach that empowers individuals in the activities and relationships of everyday life leading to them living as independently as possible. The importance to the individual as an active partner in their own care or support is that it brings physical, psychological, relational and over all wellbeing benefits. The likelihood of abuse is decreased as the individual engages positively by actively participating is area of their life, such as in personal care, the scope for abuse by others is reduced. 4.1c – Explain how the likelihood of abuse may be reduced by: promoting choice and rights An important feature of empowerment is to offer people genuine choice when it comes to the services and supports on offer.

This issue was highlighted by SCIE’s Service User Advisory Group on Safeguarding Adults. Without choice and the ability to exercise choice, the potential for abuse can become greater and the opportunity to escape it become harder. 4.2 – . Explain the importance of an accessible complaints procedure for reducing the likelihood of abuse. Every employer should have a procedure in place for raising any concerns or a complaint about abuse so that it is a simple process and encourages people to raise their concerns, however small they might appear to be. Complaints are very important as they often lead to an improvement in the service(s) provided. The complaints procedure can usually be found in the Safeguarding Adults policy and procedures. You will also need to be aware of the contact details for your Local Authority’s Safeguarding team.

204 Cert.5 – Know how to recognise and report unsafe practices.

5.1 – . Describe unsafe practices that may affect the well-being of individuals.

Unsanitary conditions can spread infection as cross-contamination can occur and can affect the well-being of the individual and others. Improper hand washing can also pose a risk. Dirty kitchen surfaces and equipment can spread infections, not covering hair when cooking can pose a risk to individual as cannot reporting faulty equipment when working or not having cleaning materials can also be unsafe.

In terms of health and safety not having risk assessments in place when a service user hurts themselves. Staff not checking when a service user is ill or unsteady on their feet. Staff not recording in care plans about a service user’s wellbeing and health and not monitoring them.

Other unsafe practices which also amount to abuse can occur such as leaving a service user on the toilet too long, ignoring or not listening to them.

Marks on body not taken seriously and complaints not taken seriously can put them at more danger, harm and risk of abuse. 5.2 – . Explain the actions to take if unsafe practices have been identified. If I identify unsafe practices then I must follow the whistle-blowing procedure and report to the appropriate person(s). I will report to my manager immediately or if it involves my manager then to another appropriate person(s). I will monitor all unsafe practices and make sure that I record and report in full all the evidence and then will talk to my manager because all unsafe practices are dangerous practices that could cause harm to the individual and others. For example, I talked to my manager last week about things being left on the stairs that may cause service users and others to fall over and hurt themselves. She has talked to the staff and now this has stopped.’

5.3 – . Describe the action to take if suspected abuse or unsafe practices have been reported but nothing has been done in response.

If suspected abuse or unsafe practices have been reported but nothing has been done in response or if it has to do with my manager then I will report to the next level or manager. If it has to do with my manager then I will report to management, then to the social worker and safeguarding team and to the care quality commission and even to the police depending on the response I get.

You may also be interested in the following: explain how the likelihood of abuse may be reduced by

Define the following types of abuse: Physical abuse Essay

Geopolitical: Nursing and Phenomenological Community Essay

Geopolitical: Nursing and Phenomenological Community Essay.

A geopolitical community is defined by Maurer & Smith (2013) as “a spatial designation–a geographical or geopolitical area or place. Geopolitical communities are formed by either natural or human-made boundaries.” A river, mountain range, or a valley may create natural boundaries. An example of this is most of the villages in Nepal, the country where I was born. Nepal is full of mountains, rivers, lakes, valleys and plateau. Most of the villages are naturally divided by hills, mountains and rivers. Human-made boundaries can be structural, political or legal in nature.

Structural boundaries can be roads, canals, bridges or rail road tracks, while, legal boundaries can be comprised of city, county, state, provincial, territorial or country lines (Maurer & Smith, 2013).

The differences in the geopolitical boundaries can be observed between counties of New York City or any other in major cities of USA. Political boundaries could be exemplified by school districts or congressional districts (Maurer & Smith, 2013, p.396). A phenomenological community can be thought of as an assembly of individuals who share the same viewpoint, relationships, values, interests, beliefs and goals.

A phenomenological community is looked at as a “relational rather than spatial designation” (Maurer & Smith, 2013). Geographical boundaries do not necessarily have to be shared in a phenomenological community.

Religious, cultural and social groups are prime examples of a phenomenological community because their values and beliefs set them apart from other groups (Maurer & Smith, 2013). All of us live in a geopolitical community and most of us are part of many phenomenological communities. Public health nurses have to face certain challenges while working with different community group. First of all there will be language and cultural barrier. Public health nurse are large autonomous. They practice without professional supervision. They practice collaboratively with other public health disciplines that have different perspective. To overcome the challenges some of the best practices for ensuring on going competencies include peer review, reflective practice, goal settings, obtaining knowledge of different cultures/ practices and self-evaluation.

Maurer,F.A. & Smith, C.M.(2013). Community/public health nursing practice. Fifth edition. Retrieved from Relevant challenges and considerations for public health nursing practice.(2011). Retrieved from

Geopolitical: Nursing and Phenomenological Community Essay

Nursing Portfolio Essay

Nursing Portfolio Essay.


Recently, due to contraception fills, adolescent pregnancy has been decreased, nonetheless, issues of adolescent pregnancy have increased worldwidely, because they are not uncovered superficially. First of all, adolescent pregnancy is an area where intensive nursing care and social and family support are required. In part 1, with regard to teens pregnancy and care, I have collected various artefacts and reviewed them. In this portfolio, I will show how those artifacts help me to learn nursing care with regard to adolescent pregnancy including teenagers, newborn and family.

In addition, I will present how I would utilize the artefacts to lead to my future nursing practice successfully.


The Victoria government report has helped me to understand the circumstances of teenagers who have experienced pregnancy and the effects relating to their pregnancy. As a future nurse, it is vital to know the social and environmental background of adolescent pregnancy. In terms of circumstances of pregnant adolescents, it has been found that pregnancy rates are higher among teenagers who include those factors as follows (The Victoria government 2014)

. family violence, or sexual abuse or conflict often occurs

. A teenager who has low self-esteem, low socioeconomic background

. An adolescent who has low maternal education

. rural or remote or Aboriginal or Torres Strait Islander residents.

As the webpage gives the information about complications with teenage pregnancy, I have known that teenagers have greater risks of medical complications during pregnancy and the reasons. The major reasons for their medical complications are that they find out their pregnancy late or do not know how to approach healthcare service (The Victoria government 2014). Moreover, their nutrition state during pregnancy is improper and hence, they experience premature labour and deteriorating their health condition such as anaemia and emotional distress.

Also, the charts from sccanny organization show children born to teenage mother have low birth weight, under 2.5 Kg (Scanny organization 2014). The information has taught me to be prepared the background knowledge of negative effects of teens pregnancy on both their children and themselves before look after an adolescent mother.


As soon as an adolescent has a baby, it can be a burden to her and her family rather than pleasure in normal pregnancy. Before making a nursing plan for an adolescent mother, it is essential to diagnose their depression and anxiety. The YouTube video shows what is their depression and anxiety precisely and succinctly. I have comprehended that their anxiety and depression come from the problems such as parenting difficulties, continuity of study or not and finance to breed their children (PCA 2014).

Nurse Review Organization’s webpage has provided me with disgnosis and intervention with respect to teen pregnancy (Nursereview 2014). In the future practice, I will educate their family to decrease a stereotype in relation to adolescent pregnancy and emphasize the significance of education for an adolescent mother if she is concerned about dropping her school. Besides, I will refer her to organizations to help her financial difficulties in raising her children and also advise her to take counseling programs with regard to her study.


The roles of a nurse include not only caring her patient but also talking to the patient’s family and educate them. Above all things, in adolescent pregnancy, family support cannot be overemphasized because a teen mother is not prepared to give birth and breed. This video gives very useful tips to persuade their family that might be upset or frustrated due to their daugther’s or girl friend’s pregnancy in order to help the teen mother as highlighting how the teen mother feels scared and worried about her pregnancy (999advicechannel 2011). As I learned in the video, I will explain the necessity of family support and ask the family to help their adolescent mother actively in the real practice. The cooperation among the adolescent mother, family and nurse will bring about successful outcomes in the perspective of mental and physical health of the teen mother and her child.

Moreover, advocatesforyouth website has offered what organization takes the initiatives and programmes for teens pregnancy in each country and the world (Graczkyk 2008). Therefore, I will recommend the programmes or organisations to a teen mother patient who does not have any family or partner that can support her in the future practice.


A more anxious and depressed teenager mother than an adult mother needs the delicate and attentive care of a nurse (Graczkyk 2008). Therefore, the role of nurse includes mothering teenagers, educating them and their family as well as conducting professional nursing practice for them (Grazkyk 2008). websites offers Australian vaccination schedule for new born. I will memorize the immunization schedules and also provide them to a teen mother under the hospital regulation (Baby Health 2014). In addition, I will educate adolescent mothers about the significance of immunization so that they cannot miss the proper time for immunization of their children.

Also, I will provide holistic education about how to care a new born baby to a teenager mother and father as I have seen the YouTube video. I will be pleased to demonstrate the ways how to feed, bathe and handle a newborn baby, otherwise, I will show the education video for teenage mothers and fathers. Moreover, I will tell them if there is any urgent situation regarding their baby, notify it to me or other nurses (InfirmaryHealth 2013).


Through this activity, I have become more confident and competent with respect to caring an adolescent mother. I have acknowledged that caring a teen mother is required a more considerate, and professional nursing mind that can consider their situation, anxiety and depression since a teen is not expected to be a mother as early as they can. I will facilitate the collaborative atmosphere among a teen mother, her family and me to create better outcomes of care in the health of the teen mother and the baby. Furthermore, I will provide explicit education for an adolescent mother and her family and guide them to appropriate programs and organization to help them. I am sure that I will play a major role as a nurse to care a teenager mother professionally and support them so as to prevent worse outcomes such as deterioration of their health and social problems.


999Advicechannel. (2011). _Teen pregnancy and support_. Retrieved from

BabyHealth. (2014). _Australian vaccination schedule_. Retrieved from

Graczyk. A. (2008). _Maternal mortality an overlooked crisis_. Retrieved from

Infirmary Health. (2013). _Caring for your newborn baby_. Retrieved from

Nurse Review . (2014_). The pregnant adolescent_. Retrieved from

PCA (2014). _The Effects of Teen Pregnancy PSA_. Retrieved from

Scanny Organisation (2014). _Teen pregnancy_. Retrieved from

The Victoria Government. (2014). _Teenage pregnancy_. Retrieved from

Nursing Portfolio Essay

Nurse Ratched vs. McMurphy… David vs. Goliath Essay

Nurse Ratched vs. McMurphy… David vs. Goliath Essay.

One powerful, one small, this is the base of the biblical story David and Goliath. The story, in which a not so strong hero takes down a strong and powerful leader, is much like McMurphy and Nurse Ratched in One Flew Over the Cuckoo’s Nest. The match up between McMurphy and Nurse Ratched is a raging and intense one. Through out the novel, One Flew Over the Cuckoo’s Nest, McMurphy and Nurse Ratched have always had conflict, as well as a sense of never-ending hatred and disagreement towards each other; which as the novel continues, grows stronger and stronger.

Undoubtedly, despite the chaos and tension between them, McMurphy gets the better of the match up, thanks to his ability to manipulate people, his bravery, and his popularity.

McMurphy’s strong ability of manipulation helps him overcome conflict and in many occasions over power Nurse Ratched. McMurphy’s ability to get others to agree with him and manipulate them gives him the extra advantage against Nurse Ratched.

In the novel McMurphy attempts to manipulate the other patients about watching the World Series game. He states, “This is where you get the edge, don’t you see that? We have to do this – or we’re whipped” (126) to try to convince and encourage the patients to vote against the Nurse Ratched to watch the game, but it was a failed attempt because the voting came out even (20-20). This event shows how McMurphy has a sense of control over the patients, as if he were their president or leader, and how McMurphy having all this power, usually leads him to manipulate for personal gain.

Another case that shows McMurphy’s great ability of manipulation is when McMurphy manipulates Chief Bromden to lift the control panel, “And that arm! That’s the arm of an ex-football-playing Indian if I ever saw one. You know what I think? I think you oughta give this here panel a leetlle heft, just to test how you’re comin’.”(225). After this McMurphy takes bets from the Acutes that it can’t be done. McMurphy, of course, had already hedged his bet by having Chief display his ability to lift the panel previously. This event shows how McMurphy tricks and influences people and patients wheatear it is for the good of the whole or for personal gain. McMurphy’s power to effect people’s decisions and manipulate them gives him a special ability that allows him to, many times, control the people around Nurse Ratched, and consequentially have more power over her.

McMurphy, as well as being manipulative, also has another special quality that helps him have the upper hand against Nurse Ratched. This quality is his bravery. McMurphy’s deep bravery allows him to do what others wont, as a result leading to change, whether good or bad. When McMurphy is denied a companion pass with Candy (prostitute) he responds by putting his hand through the glass of the nurses’ station, which he knows is not allowed. This shows how McMurphy is daring and brave enough to so directly challenge and disobey Nurse Ratched. As the plot continues McMurphy starts to “attack” Nurse Ratched by breaking Washington’s nose, disobeying the rules, and flirting with the student nurses.

His frequent “hits” towards Nurse Ratched is an indirect implementation of McMurphy showing Nurse Ratched that he is not scared nor is he going to give in. Another example of McMurphy’s bravery is when Billy dies and Nurse Ratched blames him for his death, “First Charles Cheswick and now William Bibbit! I hope you’re finally satisfied. Playing with human lives-gambling with human lives-as if you though yourself to be a God!” In retaliation for her lies and Billy’s death, he tears open her uniform, exposing her breasts to all the ptients.

Her sexuality, which is her one weak point, has been exposed; as a result, she is rendered defenseless in front of all the patients. This exposing of her weakness has helped in completing the path that McMurphy has forged, loosening her hold on the patients. She is no longer in complete control of them. This, “last act of bravery”, demonstrates McMurphy’s ability to face and deal with danger (nurse’s punishments). His bravery encouraged many of the other patients to step up as well. McMurphy’s bravery makes Nurse Ratched’s ultimate power, fear, negligible; thus giving McMurphy an advantage.


* Kesey, Ken. One Flew Over the Cuckoo’s Nest. published 1962: Signet edition 1986, New York.

Nurse Ratched vs. McMurphy… David vs. Goliath Essay