A Written Assessment for work in the nursing profession

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Question 1: Explain the ‘health’ and ‘wellness’.

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Health is the ability of an individual to function well physically, mentally, socially, and spiritually to be able to demonstrate the full range of one’s “unique potentialities within the environment in which one is living” (Farlex, 2013). Our Health can be affected by the way we deal with our social, physical and psychological issues in life. Shelter, food, education, social security, health and social services, income and employment are one of the factors that leads to the condition of our health. Wellness is “a state of complete physical, mental and social wellbeing and not merely the absence of disease and infirmity” (WHO, 1974). Wellness goes beyond the absence of symptoms and works toward achieving maximum potential and prevention of health problems. We tend to think that a person who shows no sign of illness is healthy. Positive thinking helps gives us answers, control and the way out of illness and problems whereas if we think negative it strips us of power and control. To achieve a good health we must involve ourselves to exercise, proper nutritional food, good sleep and healthy lifestyle.

Question 2: Health Models can provide nurses with a framework to help guide the focus of their nursing care. Describe two of these models and how they can influence a person’s health.

One of the health models is the Holistic Health Model. Holistic health is defined as a “wellness approach that addresses the body, mind and spirit or the physical, emotional/mental and spiritual aspects of an individual” (Perkins, 2007). By spiritual means the essence of who you are. Holistic health is how our physical state, mental state and experience in life responds to the status of our health. Nurses can help and encourage patients to engage in the healing process and practice a variety of self-care strategies to better their health and wellness.

Another one of the health models is The Illness-wellness continuum, which is a guide to help understand the degree of illness and wellness of an individual in terms of their health. “Illness is characterised by responsibility and purposeful actions to maintain high levels of health” (Central Institute of Technology, (n.d.), p. 64). This model will help guide the nurses in identifying the client’s level of illness and what methods of help and care they can give to the client to improve their health and wellness.

Question 3: There are a number of factors, which have an influence on our health. Please identify four factors and explain how they can influence a person’s health. Some factors that influence our health are as follows:

Employment/Income – Gives people the opportunity to earn money and enjoy it by spending for their needs and what they want. Our income will help us provide for our families proper nutrition, and safe shelter. Having a job will help pay our bills, medication, health insurance and other necessities. Physical Environment – Having to have clean air, water and surroundings will have a lesser impact to our health. Exposure to heavy metals, chemicals, and other environmental toxins and pathogens can affect our health as these can be harmful to our body. Having a healthy and safe working environment helps to reduce any injury or harm. Aside from these, having a safe house, communities and surroundings will help us achieve good health Nutrition – Proper nutrition, healthy food to eat has a big impact on our health.

If we eat unhealthy, fatty foods it will not only make us over weight but can be a cause of serious illness in our body. By eating plenty of fresh, green vegetables and having a balanced diet gives our body the nutrients we need to have a healthy life. Lifestyle – Lifestyle defines how we live. Being involved in sports, exercise regularly, eating healthy, having the right weight are all part of healthy lifestyle but if we involve ourselves to bad habits like smoking, alcohol and drugs then we wouldn’t achieve that good health that our body need. Question 4: People from other countries will face heath and illness issues than those we face in Australia. Choose a country other than Australia and identify two unique or different health/illness issues they face. Philippines faces a lot of health issues and one of them is tuberculosis. Tuberculosis is a “potentially contagious disease that can affect almost any part of the body but is mainly an infection of the lungs” (Tuberculosis, 2014)

It is a communicable disease which can be transferred from one person to another via air when they sneeze, cough or spit. Symptoms include coughing for more than two weeks, weight loss, cough with blood, chest pain and fever. About 10-15 people anually are infected with this disease by a tuberculosis patient. Normally, this disease infect adults but it can also be acquired by children. It is curable and preventable as well.

There was an estimated 260,000 people infected with tuberculosis in 2011 according to the WHO in the Philippines and 28,000 of them die per year. The prevalence rate is high with elders, urban porr, smokers, people with HIV, and those who suffer from malnutrition.

Another health issues that the Philippines faces is Malaria. According to the World Health Organization, over 12 million people in that country are at risk of death caused by malaria. Most of the cases occur in mountainous and forested areas that are infested with Plasmodium and other species. The virus can be transferred by the species by puncturing the human skin where the virus flow on the blood stream, spreading in the whole body. In an hour, malaria can kill a person if they are not aware that they have been bitten. The World Health Organization together with Department of Health came up with different programs which talked about treatments and awareness about malaria.

Question 5: a) What are some of the different health issues facing Aboriginal and Torres Strait Islander people here in Australia? Please describe at least 3 and include in your answer some of their health beliefs and practices that may have an influence on their health.

One of the most common health issues faced by Aboriginals and Torres Strait Islanders is ear disease/hearing loss, one in eight persons have a case of ear disease or hearing problems.

Heart and circulatory disease is also one of them. The indigenous people had the higher rate of heart and circulatory disease compared to non-indigenous people who live in Australia.

The last most common health issues faced by Aboriginals and Torres Strait Islander is Asthma. One in every six persons have asthma according to the survey done by Australian Bureau of Statistics. There was as much cases of indigenous people who live in non-remote area who has asthma.

The Aboriginal and Torres Strait Islander people greatly believe in traditional medicine and this highly influences their health. One aboriginal elder and medicine woman, Anna Warren, said that the core of the traditional aboriginal medicine is the “spirit”. She said that if the body is well, then the spirit will be well too. She added that it requires deep listening to be able to connect with the spirit.

For these indigenous people, they feel that western medicine is alienating and makes them uncomfortable to the point where they would avoid seeking treatment. Aside from this, many indigenous people do not trust the health care system due to their negative previous experiences (i.e. racism and mistreatment) while they were given services.

b) How should this influence how health care is delivered to Aboriginal and Torres Strait Islanders. Based on the website made by Creative Spirits, in order to make great improvements possible and to make the indigenous people feel more comfortable and for the health care system to regain the indigenous people’s trust, the following should be considered:

Employ indigenous staff – more indigenous patients will be at ease seeking help or treatment when they know that more indigenous staff work in the health sector.

Create an aboriginal-friendly feel – hospitals, clinics and other health care related pplaces should incorporate indigenous art works because this help them feel relaxed and connected with the place. The indigenous people will have the sense of belongingness and pride when they see their artwork displayed.

Verify informed consent – this is a process which should be stricty followed if an indigenous patient will undergo any medical procedure which involves the right person within the network of kinship and community relationships.

Help Aboriginal patients understand their disease – providing visuals, using clear and simple language, much better if native language is used will help the indigenous people understand what causes their condition.

Have culturally aware staff – Aboriginal culture training should be taught to the staff in order to give them better understanding and for them to offer respect to the indigenous people.

Offer low price treatments – medical treatments should be made affordable for the indigenous people as most of them have little or no income at all.

Question 6: Nursing as a profession has had many changes over the time. Compare nursing as a profession in 2014 to 1960 in the areas of education and professional appearance. During 1960 when it comes to professional appearance nurses use to wear white dresses, stockings and starched caps. It was during this decade that uniform also take a turn in the direction of more fashionable than in the past. Today’s nursing uniform was designed more for functions than form but are considered much more comfortable than those worn throughout the history. In 1985 – 1997 a two year training to become a general nurse was introduced and over the time hospital based training was also introduced and continued until 1980’s. The tertiary sector then took over all the RN education and degree level in 1990’s. The Enrolled Nursing education in WA was located in TAFE colleges, Mt Lawley in 1989. The development of post graduate nursing studies in Australia is still ongoing.

As a profession today Nurses role has taking on more technologically challenging roles than at any other point of history. Some nurses are taking over roles that were once reserve for physician. Nurses are becoming more specialized than in days past, there are specialties like OR (operating Room), Medical Surgical Nurse, Pediatric Nurses, Labor and Delivery nurse and even Psychiatric nurse. Continuing education and clinical experience go along way today to ensure that nurses are on top of their games.

Question 7: There are occupational health and safety issues that nurses should take into consideration when carrying out their nursing practice. Please explain what is meant by a) Infection Control – it means following procedures, standard and additional precautions to prevent the risk of infections from spreading. Nurses play a vital role in controlling the risk of potential spread of infection in their workplace and must always remember that patients and the health care providers alike are vulnerable to easily acquire any disease. Nurses must always think and apply the following practises:

-hand hygiene

-using personal protective equipment

-safe handling and disposal of sharps

-decontaminating equipment

-achieving and maintaining clean clinical environment

b) Manual Handling – is a procedure that involves physical movement of our body by way of lifting, pulling, pushing, carrying, holding or restraining of a person or individual. It involves repetitive actions and sometimes use of equipment can be involved. Nurses should follow the standards of manual handling to prevent injury, illness, pain and suffering of individuals in the workplace and to have a safe workplace.

Question 8: What are some of the professional development strategies you can use to maintain your skills and knowledge when you are qualified nurse? Performance review appraisal – which can be done by your manager’s review of your performance or you review the performance of your peers. Self-assessment – this will help you find out how you can further improve or develop your skills, attitudes and capabilities. Continuing education – by learning new skills, learning how to use new equipment or simply updating your knowledge and skills will help in gaining more knowledge and skills.

Question 9: Please explain the role of the Nursing and Midwifery Board; Australian Health Practitioners Regulation Agency and Industrial Organisations in nursing profession.

Nursing and Midwifery Board Australia has a broad function and one of them is registering suitably qualified and competent person as nurses, midwives and students. They are the ones that develop and approve the standards codes and guidelines for nursing and midwifery professions. They also are the ones that assess the knowledge and skills of overseas applicants for registration and determining suitability for registration in Australia. Nurses and midwives must be registered in Nurses and Midwifery Board of Australia and meet the boards registration standards to be able to practice in Australia.

AHPRA’S role is to protect the public’s safety. They publishes national registers of practitioner so important information about the registration of individual health practitioner is available. They are the ones that manage the registration and renewal processes for health practitioners and students around Australia. They also provide advice to the Ministerial Council about the administration of the National Registration and accreditation scheme. The development of registration standards, guidelines and codes are maintained and supported by them.

The ANF (Australian Nursing Federation) is one of the largest industrial organisations and the national union for nurses in Australia. They help with the progress and development of policy relating to: “Nursing and midwifery practice, professionalism, regulation, education, training, workforce, and socio- economic welfare, health and aged care, community services, veteran’s affairs, occupational health and safety, industrial relations, social justice, human rights, immigration, foreign affairs and law reform” (ANF, 2011, p. 2). The Autralian Nursing Federation’s function is the industrial and professional representation of nurses through activities of a national office and branches in every state and territories.

Question 10: How does the Scope of Practice Decision Making Framework influence your nursing practice. This will help us to determine and understand if we are capable enough to perform a given task. If the nurse have been given a task and is not confident or unsure of how to achieve it, the chart will help guide you as to what step you should take instead. We must understand carefully each steps to provide the best appropriate care for our patient and to help us achieve a safe proficient nursing care.

Question 11: There are three levels of care provided in different health care environments in the Australian health care system. Please explain what those three levels are and where we can expect to find each level of care. Primary Health Care – is the first point of health care and is part of Australian health system used most. Given to people living in their own community outside of hospitals. Its major task is the early detection and prevention of disease and the maintenance of health. Secondary Health Care – looks at the general services provided by a hospital.

A hospital stay for a brief but serious illness and mostly concerned with the provision of specific technical, therapeutic or diagnostic health care services. They usually focus on a specific health problem and can provide services by medical specialists e.g. cardiologist. Tertiary Health Care – Highly specialised and technical care provided in hospital to diagnose and treat disease. Individuals who has complex health problems, and require treatment from doctors and nurses with advance level skills. Entry into the health care system at this level is gained by referral from either the primary or secondary level.

Question 12:
a) What is the philosophy for Primary Health Care?
Primary Health Care’s main goal is to give provide better health for people.
“The philosophy behind primary health care is based upon”: (Gallagher, 2014, p. 8)

A holistic understanding of health as wellbeing rather than absence of disease (Gallagher, 2014, p. 8) Recognition of the multiple determinants of health including gender, housing, education, transport, planning, communication, social and other services (Gallagher, 2014, p. 8). Community input into health services which will be reflected by involvement of communities and individuals at all levels of planning and provision of services (Gallagher, 2014, p. 8). Equity in health care and prioritisation of services to the most needy (Gallagher, 2014, p. 8). Accessible, acceptable and affordable services and technology (Gallagher, 2014, p. 8). Eliminating causes of ill health through health promotion and disease prevention (Gallagher, 2014, p. 8). Recognition that primary health care must be based upon social, biomedical and health services research in order to provide effective health care (Gallagher, 2014, p. 8).

b) Explain the difference between health promotion and illness prevention Health promotion means encouraging and supporting the person or yourself to improve your health and wellbeing. Illness prevention is the way to promote good health and reduce the risk of illness to individuals and their family members through knowledge, education and healthy lifestyle.

c) Describe some of the factors you would consider if you were to design a health promotion campaign. In designing a promotion campaign I would think of the design of the campaign, presentation of it, which audience to present it to, contents of the message and how to advertise it. I would also include these following in promoting my health campaign: – promote the involvement of every individuals in physical activities and sports – provide education towards healthy lifestyle and harmful effects of drug and alcohol – to encourage everyone of eating healthy nutritious food

– promote the importance of having 8 hours of sleep
Health care promotion can help improve a healthy living and helps a person to build up strengths that will keep up and develop his or her good health and boost their quality of life.

d) What is your role as a nurse in the area of health promotion? Nurses are expected to be aware and acknowledge the health issues and factors that affects health condition. Nurses contributes to the promotion of their clients health and social wellbeing by; Promoting health and self-care, participating in providing health promotion interventions, being aware of the key health and social factors to be considered when carrying out an assessment of individual needs, being aware of the contributions of other professionals to assessment and intervention.

Question 13: How has the focus of the provision of health care changed over the last 20 years. There had been a lot of changes for the past 20 years in the health care here in Australia. Since 1984, there had been major changes in medicare which provides access to affordable high quality care and it is available to all Australian citizens and permanent residents. Medicare is also seen as “providing universal access to a set rebate, being well suited ti episodic careof ill-health; and enabling patient choice of health provider” (Department of Health and Ageing, 2009).

-In 1999-2000 The EPC (Enhance Primary Care) MBS was introduced to provide quality health care for elderly Australians, patients with chronic conditions and with multi-disciplinary care needs. -“In 2004 MBS items were introduced for a limited range of services provided by practice nurses when acting for, and on behalf of, a GP” (Australian Government, 2009). -In 2004 bulk billing incentive items were introduced to concession card holders and children aged under 16 -Chronic disease management was introduced in 2005.

Changes in general practise funding for indigenous people were also introduced. Aboriginal Community Controlled Health Organisations (ACCHOs) provides an important role to the delivery of primary health care to the Indigenous people. “In addition, the 2009-10 Budget announced that, from January 2010, a new Rural Primary Health Services Program (RPHS) would be established to consolidate a range of existing programs and introduce greater flexibility into primary health care service provision in rural and remote communities” (Australian Government, 2009).

Through the years the government have developed the National Age care programs which includes residential health care and community care services for elderly that funded by the Commonwealth, State and Territory Governments. Community age care support is available through; ‘Home and community care’ which address low care needs, ‘community aged care packages’ available for mid-level care needs, and ‘extended aged care at home’ and ‘dementia specific’ supported with high care needs. In 2002 the Department of Health and Aging was established. The Government put up programs to help multicultural Australians to provide help when accessing the health care and they did it in the form of pamphlets with different languages, telephone interpreter service and culture specific health services. “Australian government implemented some innovative solutions to health issues arising out of Australia’s unique history needs” (Central Institute of Technology, 2014, p. 23). Australians “have access to heavily subsidised medicines, pharmaceuticals and technologies prescribed by medical officers” (Koutoukidis, Stainton & Hughson, 2010, p.67).

Pharmaceutical Benefits Scheme (PBS) provides timely, reliable and affordable access to necessary medicines for Australians. The PBS is part of the Australian Government’s broader National Medicines Policy. The rates of hospital utilisation have increased because of the impact of the new technology and hospital organisation in reducing length of stay. Our government has increased their funding to expand the provision of sub-acute services. Our present and our future primary health care system is more accessible, clinically and culturally appropriate now. It’s more focus on preventive care including support of healthy lifestyle more safe, high quality care which is continually improving through relevant researched innovation and rise of health care promotion.