Write a paper of 3-4 pages, not including the title page and reference page, that discusses the following 3 elements:

• Provide an overview of how health care in the United States has evolved since the postindustrial period. 
• How has the evolution of medical technology, graduate medical education, and the professionalization of medical and nursing staff affected the delivery of care? 
• Why has the United States been unsuccessful in evolving the current health care system into a national health care system? 

Note: Use APA style and cite at least 3 scholarly references published within the last 5 years.

Please submit your assignment.

Comment1

As our lecture describes, “death is a particularly traumatic and difficult experience for both family and caregivers” (Grand Canyon, 2015). A rather interesting distinction I observed while working on both of these units and witnessing death in different underlying situations/stages: death on the oncology unit usually came after a long, hard fight with cancer. As such, patient’s families were often understandably distraught and through their grief expressed feeling “robbed” of time with their loved one. When death occurred on the geriatric unit however, family members would sometimes express feelings of gratitude that their loved one lived to a ripe age and felt at peace that their time had come, as it was expected. In witnessing these experiences, it made me understand that death is easier to swallow/digest for some when it occurs from natural age process versus caused by disease.

The acceptance of death and the grieving process is experienced differently by everyone. Personally, I feel my bedside experience as a nurse has helped me understand this process a great deal and I empathize greatly with the patients/families I have encountered.

Comment2

I have only witnessed death a couple of times at work. I have worked with hospice patients that visit the doctor’s office and these have been about comfort. Since I am a float in the clinic setting, I do not come across much death. I did when I worked on the medical floor; there, acceptance of the death depended more on if it was expected or not. I think that when we know death is going to occur it is easier to accept and come to terms with. When death is not expected it can be harder because of the sudden loss. I do not think that the lack of experience at work has shaped my view on death because I have dealt with it personally.

I think that I handle death fairly well because I grew up with death being a natural part of life. As we grew up on the farm it was normal to lose animals. We also have a very large extended family and we went to funerals fairly regularly. While others have viewed that as wrong or depressing to have children go to funerals, it was never viewed that way by my family because it was a part of life and we celebrated that life. I have not shielded my children from death either. My sister-in-law and I have different views on this; I accept her decision, she does accept not mine. She was upset when we brought our children to the first funeral on my husband’s side of the family but it was very natural to me. Death is only one step in life and should not be feared.

COMMENT1

Acute kidney injury has three categories, they are prerenal, postrenal, and intrarenal/intrinsic.  The first category, prerenal, means that the injury to the kidney occurs before the kidney itself.  This type of injury is caused because of reduced perfusion of the kidney. This reduction can be caused by absolute decrease in circulating volume caused by hemorrhage, dehydration, or burns. It can also be caused by relative decrease in circulating volume caused by, distributive shock, third-spacing and edema, or decreased cardiac output.  Another cause can be renal abnormalities such as occlusion or stenosis of the renal artery.  The second category is postrenal, this can be caused by obstruction of normal outflow of urine from the kidneys.  Things that can cause this are: benign prostatic hyperplasia, kinked or obstructed catheters, intraabdominal tumors, strictures, or calculi.  The third category is intrarenal/intrinsic, this involves either vascular, interstitial, glomerular, or tubular.  If it is vascular, it can be caused by vasculitis, emboli, or nephrosclerosis (due to primary hypertension, hypertensive emergencies, and urgency).  If interstitial, it can be caused by acute allergic interstitial nephritis or acute pyelonephritis.  If glomerular, it can be caused by acute glomerulonephritis.  If tubular, it can be caused by ischemic issues such as prolonged prerenal failure, transfusion reactions, or rhabdomyolysis.  Tubular can also be caused by nephrotoxic issues like prolonged post renal failure, certain antimicrobials (antibiotics, antifungals, and antiviral drugs), radiographic contrast media, certain cytotoxic chemotherapy agents, recreational drugs, environmental agents, and snake and insect venom.

COMMENT2

Obesity is measured by a screening tool measuring one’s body mass index (BMI). Body mass index is measured by your height and weight.  A BMI of 30.0 or higher means a person is obese. Being obese is an unhealthy weight that is over what would be normal.

What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?

Mr.C’s health risk includes heart disease, diabetes, cancer, respiratory issues, physical immobility issues, and mental issues. Premature death. (1)

If Mr.C has done everything to try and lose weight on his own and nothing has worked, then I believe bariatric surgery would be an appropriate intervention. Some patients don’t even try to lose the weight the correct way and go for the easy way out. Complications of having bariatric surgery will pose problems when the patient continues to live this unhealthy life style post-surgery. Bariatric surgery may improve quality of health. It may treat or control diseases such as diabetes, hypertension, and heart disease (2).

Topic: Discuss barriers to healthcare access for clients from one culture. You must select one culture (Cuban, Native American, Indian, Haitian, etc.) and discuss the barriers to access healthcare for this culture members.

Upload response in Moodle week 5

Minimum 150 words 

. Less than 2 references will decrease your grade.

 How does this Hospital experience meet your course objectives (Professional Capstone and Practicum) ? 

 Objectives:

During this course, the student will:

1. Work constructively with patients, communities, organizational leadership, and other change agents to improve practice within health care settings.
2. Apply Healthy People 2020 principles in nursing practice.
3. Synthesize nursing knowledge and concepts into an evidence-based change proposal for an issue or problem relevant to nursing practice and population health outcomes.
4. Identify resources required to implement a clinical change in nursing practice.
5. Communicate information and strategies to stakeholders in order to implement and sustain an evidence-based change proposal.
6. Determine reliable methods to measure the effectiveness of an evidence-based change proposal project in achieving the intended outcomes.