Thbate Rages On

The entry-into-practice debate in the United States continues to be one of the oldest and hottest professional issues nurses face as we enter the second decade of the 21st century. It appears that little progress has been made since 1965 in creating a consensus to raise the entry level into professional nursing practice, although experts do not agree even on that issue. Your neighbors ask you for information about considerations for selection of an appropriate nursing education program for their child.

1. Your neighbor is confused because both ADN and BSN schools preparing graduates for RN licensure meet similar criteria for state board approval and have roughly the same number of nursing coursework units. How would you summarize the arguments for changing or not changing the nursing entry level?

2. There is current evidence-based research that explores the impact of registered nurse educational level on patient outcomes. What does the current evidence-based research conclude about the impact of RN educational level on patient outcomes?

3. Achieving the BSN as the entry degree for professional nursing practice will take the best thinking of our nursing leaders. What will it require in order to successfully achieve the BSN as the entry degree for professional nursing practice?

Coment (1).  150 words citation and references 

Culture

19 years old female of the Hindu faith

Considerations

Health care providers should incorporate cultural competence in their services as a result of the increasing religious and cultural diversity. For both patients and health professionals to ensure quality health services, they need to consider cultural barriers. Evidence shows that there is a connection between poor cultural competence and low-quality health outcomes in health care practice. In this case, the client is a teenage girl who is admitted to the hospital with fevers (Gopalkrishnan, 2018).When dealing with teenagers, one should consider the legal requirements to maintain confidentiality, obtain consent, and language assistance services especially if the client is not a proficient English speaker. When interviewing her, the nurse should also consider her level of openness, special distance, taboo subjects, and eye contact.

Dealing with a female teenager of the Hindu faith requires one to have adequate knowledge of their beliefs and faith. According to the Hindu religion, all individuals are free to practice their religion the way they see fit. Besides, Hindus have a strong belief in karma, which is the law of cause and effect. They believe that each action, thought, and word makes up karma and affects their future and current lives. The nurse should consider this fact when interviewing the young girl as it may affect the decision-making process (Zavos, 2015). Also, Hindus believe that serious illnesses and other occurrences in their lives balance their lives and help them become better people. Hindus embrace the use of western medicine among many other options for treatments.

Resources

The United States provides health resources that help in effective communication among health care providers and Indian patients, which include the ward communication tool, language identification card, among others. Also, some Hindus may prefer fasting while in hospital, which may affect their wellness (Zavos, 2015). The nurse should ensure that the teenager is aware of the dangers of fasting when sick, while still considering the requirements of the Hindu religion.

References

Gopalkrishnan, N. (2018). Cultural Diversity and Mental Health: Considerations for Policy and Practice. Frontiers In Public Health, 6. doi: 10.3389/fpubh.2018.00179

Zavos, J. (2015). Digital media and networks of Hindu activism in the UK. Culture And Religion, 16(1), 17-34. doi: 10.1080/14755610.2015.1023814

Comment (2).   150 words citation and references 

Culture

Scenario: Admitting a 19-year-old female college student for fevers. Patient has immigrated from Russia to complete her education.

Considerations

When interviewing this patient, it is okay to shake her hand and make direct eye contact. As healthcare is not very accessible in Russia, it is safe to assume the patient has not had much experience being in a hospital, so it is important to make her feel comfortable. Explain your role thoroughly prior to conducting the interview. When obtaining a history of medication, be sure to ask about homeopathic remedies the patient might have used. When asking about mental health history, avoid using the word “mental” as it is taboo for this culture (Stratis Health, 2020). Instead, words such as depression or anxiety can be replaced. Russians are very hesistant to admit mental health problems or familial history of mental health problems. When assessing patient, always explain what you are going to do prior to doing it and why. Russian culture is very dependent on the family unit, so when delivering diagnoses, it may be wise to ask the patient if she has any family with her. Ask her who she would like to be involved in her medical decisions. Russians believe that if bad medical news is shared with the patient, it will only make them sicker (University of Washington Medical Center, 2007). It is important to know what your patient believes and if she wants the family to make decisions for her or if she wants to make them for herself. When considering the cause of the illness, take into consideration the lack of access to healthcare in Russia. Russians are not as likely to be vaccinated as U.S. citizens, so it is important to know the patient’s vaccination status. There is also a higher prevalence of TB and HIV in Russia. At this age, it is important to assess patient’s sexual activities. When assessing the patient’s sexual history, do so privately. Also, stress the importance of honesty in her answers. Patient may feel more comfortable with a nurse of the same sex, but if a male nurse were assigned to her, he can just ask her if she is okay with him taking care of her. The author was unable to find healthcare support systems that are specific to the Russian culture that are targeted for this patient, both locally and nationally. 

Resources

Falkner, A., & Green, S. Z. (2018). Adult Health Assessment. Retrieved from Health Assessment Foundations for Effective Practice: https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/4 

Stratis Health. (2020). Russians in Minnesota. Retrieved from Culture Care Connection: http://culturecareconnection.org/matters/diversity/russian.html

 University of Washington Medical Center. (2007). Communicating With Your Russian Patient. Retrieved from Culture Cues: http://depts.washington.edu/pfes/PDFs/RussianCultureClue.pdf