Respond 

Hiring more nursing assistants to assist during registered nurses'(RNs) shortage can be very challenging. Currently, I am working in the critical care unit (CCU), where we always used total patient care delivery assignments. The staff work 12-hour shifts, and each nurse is assigned for two patients, depending on the patients’ acuity. According to Marquis and Huston (2017), total-patient-care (TPC) nursing is the oldest patient-delivery model. With this model, one bedside nurse oversees the total care of patients during the assigned shift. The total responsibilities of the bedside nurse for a patient’s care include bathing, bed making, administering medications, vital signs, carrying out all ordered treatments, dressing changes, patient teaching, discharge planning, and updating patient care plan, etc (Marquis & Huston, 2017). We do not have nursing assistants in the CCU to help our nurses with all these responsibilities. Unfortunately, two months ago, we have about six nurses who resigned due to professional advancement and relocation.

Since we have a nurses shortage and hiring nurses is a long process, we (CCU leaders and the senior executive leadership) decided to collaborate with other departments to give us task nurses or nursing assistants which we called clinical partners (CP). Since both task nurses and the CPs will work under the supervision of the supervisor or the charge nurse, this delivery care model will fall under the functional-care model. A task nurse is a medical-surgical or telemetry nurse who is responsible for giving medications according to her job descriptions, checking blood sugar, etc. The nursing assistants’ tasks are to help CCU nurses in bathing the patients and foley care, changing linens, answering call lights, etc. 

Marquis and Huston (2017) noted that functional-care model (FCM) was found to be more cost-efficient due to the lower number of RNs required per shift. FCM involves assigning tasks to various team members based on the patients’ complexity or acuity of care needed. Generally, routine tasks are done by persons who are not RN, and the RN oversees more complex patients’ needs. With this model, the unit charge nurse makes the patients’ assignments for the team because she/he has more knowledge of all the patients’ needs (Marquis & Huston, 2017). However, switching from TPC to FCM has a significant impact on the patients’ quality of care in our unit. Our patients’ satisfaction dropped this month by 30%. Marquis and Huston (2017) outlined that the FCM quality of care was found to be less than with the total-patient-care model (Marquis & Huston, 2017). In my experience, hiring more nursing assistants to assist during nurses shortage will help to lessen the nurses’ workload in the CCU temporarily. On the other hand, having more certified critical nurses improve patients’ safety and outcomes. 

Meanwhile, hiring more nursing assistants to assist during nurses’ shortage can impact patients’ quality of care and staff satisfaction on St. Louis Medical Center (SLMC). As a nurse administrator at SLMC, I will use evidence-based practice, current literature, and scientific research to analyze proposed changes in nursing care delivery models. I will also make changes in work design to facilitate meeting organizational goals. Also, I will arrange a departmental meeting involving staff-led representatives from all nursing departments to ensure that everyone has a voice. Finally, I will empower each unit-based practice councils/members to be involved in unit problem solving such as short staffing and develop action plans to resolve the issues. During the meeting, I will seek feedback from my direct reports and the staff and ask them “what’s working well and what is not?” and to know what I can offer for them. 

One of the mechanisms used to promote employees’ growth and development in an organization’s long-term plan is empowerment and to support staff during times of difficult transitions (Choi, Goh, Adam, & Tan, 2016). Johnston and Villa (2018) outline that the Chief Nursing Officer should ensure successful engagement by integrating a shared governance council (SGC). SGC involves monthly meetings with bedside nurses to express issues, share best practices, develop action plans, and raise specific challenges to administration (Johnston & Villa, 2018).

References

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application. (9th ed.). Philadelphia: Lippincott Williams & Wilkins.

Choi, S. L., Goh, C. F., Adam, M. B. H., & Tan, O. K. (2016). Transformational leadership, empowerment, and job satisfaction: the mediating role of employee empowerment. Human Resources for Health, 14(1). doi: 10.1186/s12960-016-0171-2

Johnston, D., & Villa, J. (2018). Shifting culture: A new CNO leading to nursing excellence. Journal of Nursing Administration, 48(9), 422. Retrieved from https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=edb&AN=131663203&site=eds-live&scope=site

I need a respond for these 2 classmates. Response posts must be minimum 100 words eaach. Double space. References must be cited in APA format (6th) 

Peer 1 

Tobacco Free Florida refers to the Florida’s education program that aims at helping tobacco users quit. The program includes helpful strategies, facts about nicotine as well as motivational information that powerfully encourages a tobacco-free life (Tobacco Free Florida, n.d.). Meanwhile, a range of media channels plays an increasingly important role in promoting the mentioned program. More specifically, social media sites, such as Facebook and Twitter, are extremely popular today, especially among the younger generation, which creates a comprehensive platform for raising awareness about the issue at hand and advertising the program’s website (Jane, Hagger, Foster, Ho, & Pal, 2018). Zika Free Florida is another program that provides help and consultation to prevent development of Zika, disease that develops due to a mosquito-borne virus. Instagram and YouTube are another powerful tool to promote the agenda. The format of a video can have a significant effect upon a viewer evoking a strong emotional response. Instagram presents a visually appealing source of receiving information that is readily used by many users around the world, especially by those who like to travel to foreign countries and do not know what exactly one should expect.  

Childhood obesity is another important public concern that requires special attention in health policy development. Promoting awareness about the peril associated with childhood obesity is pivotal for maintaining the nation’s health and decreasing the burden of chronic diseases. Social media campaigns may help in this regard. Again, the use of Instagram may trigger the interest of policymakers, while providing parents with the necessary material aids (Edney et al., 2018). It should be noted that such social media as YouTube and Facebook may serve as a source of social support.The posts and videos in media challenge may contain information about the ramifications related to childhood obesity, which can help a user make a change in their lives. They may illustrate examples of how others have already achieved positive results, thereby increasing individual’s awareness about the effective strategies and health promotion techniques (Mason, Gardner, Outlaw, 2016). Users see that they are not alone with this program and may track each other’s progress getting inspired and motivated. Thus, social media can be considered as an active agent in raising awareness and encouraging to make a positive change in one’s lifestyle or environment. 

Peer 2 

Tobacco Free Florida refers to the Florida’s education program that aims at helping tobacco users quit. The program includes helpful strategies, facts about nicotine as well as motivational information that powerfully encourages a tobacco-free life (Tobacco Free Florida, n.d.). Meanwhile, a range of media channels plays an increasingly important role in promoting the mentioned program. More specifically, social media sites, such as Facebook and Twitter, are extremely popular today, especially among the younger generation, which creates a comprehensive platform for raising awareness about the issue at hand and advertising the program’s website (Jane, Hagger, Foster, Ho, & Pal, 2018). Zika Free Florida is another program that provides help and consultation to prevent development of Zika, disease that develops due to a mosquito-borne virus. Instagram and YouTube are another powerful tool to promote the agenda. The format of a video can have a significant effect upon a viewer evoking a strong emotional response. Instagram presents a visually appealing source of receiving information that is readily used by many users around the world, especially by those who like to travel to foreign countries and do not know what exactly one should expect.  

Childhood obesity is another important public concern that requires special attention in health policy development. Promoting awareness about the peril associated with childhood obesity is pivotal for maintaining the nation’s health and decreasing the burden of chronic diseases. Social media campaigns may help in this regard. Again, the use of Instagram may trigger the interest of policymakers, while providing parents with the necessary material aids (Edney et al., 2018). It should be noted that such social media as YouTube and Facebook may serve as a source of social support.The posts and videos in media challenge may contain information about the ramifications related to childhood obesity, which can help a user make a change in their lives. They may illustrate examples of how others have already achieved positive results, thereby increasing individual’s awareness about the effective strategies and health promotion techniques (Mason, Gardner, Outlaw, 2016). Users see that they are not alone with this program and may track each other’s progress getting inspired and motivated. Thus, social media can be considered as an active agent in raising awareness and encouraging to make a positive change in one’s lifestyle or environment. 

This is the original question if you needed to see what is about 

Reflect on Florida’s current health education programs such as Zika Free Florida, Tobacco Free Florida and consider what part the media plays in such disease prevention programs. Identify a specific public health issue that you believe needs to be highlighted in health policy and based on your textbook readings discuss how social media can be used as a health promotion tool to improve public awareness on the selected topic. 

THIS IS A RESPONSE TO DISCUSSION BELOW, PLEASE USE APA & IN-TEXT CITATIONS. NO MORE THAN 200 WORDS.

  I was always taught in nursing school that pain is what the patient says that it is. We cannot feel what the patient is feeling, so we have to believe the patient and what they are telling us. “McCaffery defined pain as ‘whatever the experiencing person says it is, existing whenever he says it does’” (Huether &McCance, 2017, p.336). Pain effects each and every person differently. There are many different types of pain caused by many different diagnoses and issues. “Acute pain is transient, usually lasting seconds to days, sometimes up to 3 months. It begins suddenly and is relieved after the chemical mediators that stimulate pain receptors are removed” (Huether & McCance, 2017, p.340). When I think of acute pain, I think of getting a shot. A shot hurts while we are receiving the shot but is quickly relieved once the shot is over. “Visceral pain often radiates (spreads away from the actual site of the pain) or is referred. Referred pain is felt in an area removed or distant from its point of origin- the area of referred pain is supplied by the same spinal segment as the actual site of pain” (Huether & McCance, 2017, p.340). An example of referred pain would be left arm pain during a heart attack. Pain that is radiating away from the actual site of where the hurt is. “Chronic or persistent pain has been defined as lasting for more than 3 to 6 months and is pain lasting well beyond the expected healing time”(Huether & McCance, 2017, p.340). We hear of a lot of people struggling with chronic back pain. 

Pain can feel throbbing, stabbing, aching, burning, cramping, squeezing, etc. There are different factors that affect pain as well. “There are important age and sex differences in the clinical presentations of chronic pain patients. Some older patients present with unique clinical profiles that may reflect cohort differences, and/or physiological or psychological adjustment processes. There appears to be a greater number of distinct chronic pain presentations among females” (Cook & Chastain, 2001, para.5). Age and gender are just 2 factors that can affect pain and the way it is perceived. “In general, the prevalence of chronic pain has been found to be 50% or more among people aged 65 years or older” (Karjalainen, Saltevo, Tiihonen, Haanpää, Kautiainen, & Mäntyselkä, 2018, p.6). Different diseases that patients have can cause patients to have pain. Ethnicity can also be a factor of pain. If we think about sickle cell patients, it occurs more in African Americans and can cause pain during a sickle cell crisis. Age does not affect who can get sickle cell but can affect pain. Sickle cell presents at birth but usually patients do not have any issues until the age of 5 or 6. Another example would be having a tonsillectomy. Everyone states that the pain and recovery is so much easier on young children than in adults. These examples just go to show that everyone perceives pain differently depending on different factors like age, gender, ethnicity, and diseases. 

References

Cook, A. J., & Chastain, D. C. (2001). The Classification of Patients with Chronic Pain: Age and 

Sex Differences. Pain Research and Management, (3), 142. https://doi-org.ezp.waldenulibrary.org/10.1155/2001/376352

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, 

MO: Mosby.

Karjalainen, M., Saltevo, J., Tiihonen, M., Haanpää, M., Kautiainen, H., & Mäntyselkä, P. 

(2018). Frequent pain in older people with and without diabetes – Finnish community-based study. BMC Geriatrics, 18(1), 73. https://doi-org.ezp.waldenulibrary.org/10.1186/s12877-018-0762-y

Carrie Smithson    2 posts   Re: Topic 7 DQ 2          In order to evaluate an evidence-based project, it is important to be able to determine the effectiveness of your change. In this discussion board, I will discuss one way that I will be able to evaluate whether my project made a difference in practice. The end goal of my project is to decrease admissions to the hospital by providing education on tobacco dependency. Tobacco use causes secondary illnesses such as heart attacks and strokes. Smoking is a major cause of coronary vascular disease and can raise triglycerides, lower HDL cholesterol, make blood sticky and more likely to clot, and cause thickening and narrowing of blood vessels (Centers for Disease Control and Prevention, 2019). Patients that are admitted with an acute diagnosis such as myocardial infarction and stroke, are often educated on risk factors. Some risk factors cannot be changed such as family history, age, and race. Other risk factors can be changed to promote health such as smoking, diet, and exercise. Once the education is provided, nurse managers can audit charts to determine if readmission of the same diagnosis is made. This is one way to evaluate if my project made a difference in practice. Another method to evaluate my project would be through follow up appointments. Every patient that leaves the hospital is made a follow up appointment with their primary care provider. During the follow up visit, the doctor can determine if the teaching performed in the hospital was effective. Success with a tobacco cessation program can decrease health risk tremendously, and that is the goal.  Resource  Centers for Disease Control and Prevention. (2019). Smoking and Heart Disease  and Stroke | Overviews of Diseases/Conditions | Tips From Former  Smokers | CDC. Retrieved from  https://www.cdc.gov/tobacco/campaign/tips/diseases/heart-disease-  stroke.html

Reference must include doi or retrieval URL