Recent studies indicate an increased frequency of mental illness, especially depression, amongst chronically ill patients. Today we are sharing a quiz with you to help you identify any changes in your mood or behaviour which may indicate depression.
Today I went for dialysis education to see which is going to suit my needs the best. It's not what I want, but until I find a live kidney donor, it's the only option I have. I've created a blog to keep my family and friends updated on my progress because it's too hard letting everyone know individually. My emotions are up and down and I apologize to all of those that I have been short with because I am not myself. I have never been one to openly express emotions or troubles so it's really hard for me to reach out to those I need. But I am reaching out now in the hopes that I can find someone who will join me on this journey by donating a kidney. There is a ton of information that I can provide to anyone who is willing to go the extra mile. It's not an easy process, but I guarantee it will be worth it in the end.
Family Nurse Practitioner is considered by https://seifertforgovernor.com to be a registered nurse who is usually in an advanced role of the practice who works in collaboration or independently with other healthcare professionals in order to give a family-focused care to the patients (Weiss, Nordlie, & Siegel, 2005). Arguably, they offer healthcare services that revolve around the family unit. The services include disease prevention, health promotion, counseling and direct care. Arguably this paper will look into the type of organization I would like to practice as an FNP, the kind and number of clients it normally receives. In addition, the paper will also identify the professional fit for the advanced nursing role.
In this paper, I have identified McDowell Healthcare center as the kind of organization I would love to practice my nursing role as an FNP. The center was established in 1989 and forms part and parcel of the Maricopa integrated Health system. Arguably, McDowell also offers individuals outpatient care for those who have met the income guideline and are not eligible for any kind of healthcare insurance. Ideally, this is possible by paying a small fee and the rest is covered by Ryan White Part A federal grant. Essentially, for those also who do not meet the qualification of getting grant assistance budget payment arrangements can be availed under the auspices of the MIHS.
The Type and Clients of the Organization
The healthcare center mainly specializes in HIV/AIDS treatments. Arguably, in the whole Maricopa County McDowell stands out as the only institution that offers a well-coordinated and comprehensive HIV/AIDS medical related treatment specifically tailored for adults. Although the institution focuses on HIV/AIDS treatment, services like behavioral healthcare, counseling, dental care and clinical research for new drug therapies. The healthcare center boasts of serving at least a hundred clients every day. The majority of these clients come to seek for HIV treatment and the rest for testing.
The Centre boasts itself for availing the Urban HIV Telemedicine program to its clients that reside within the near towns proximal to the health Centre. The program had been successfully initiated at the UCSF medical center. After the success story there McDowell opted to import the initiative to its clients who do not have to come to the institution on a daily basis for treatment. In detail, the program entails the usage of broadband video connections where patients can have interactions with the doctors in real-time giving them an avenue to do consultations without following the normal routine of availing themselves physically to the Centre. The programs offer several consultations including case management, nutritional guidance, pharmacology and medical advice.
Professional Fit for the Advanced Role
My professional fit in the Institution will be in the area of stress management particularly dealing with the HIV/AIDS patients. In most instances, when individuals are tested to be negative depression usually creeps in and they start believing that being positive is tantamount to a death sentence. Arguably, I have mastered several techniques of stress management and I believe working in McDowell essentially will give me an opportunity to ameliorate the depression HIV patients suffer because of the myths normally associated with the disease
Particularly I will be using the Mindfulness-Based Stress Reduction technique to deal with stress among the HIV/AIDS patients. MBSR is a mindfulness-oriented program that was created to help people ameliorate pain and various conditions, life issues which ordinarily cannot be treated in a formal hospital set up (Kabat-Zinn, 2003). The technique combines yoga, body awareness and mindfulness meditation to enable individuals to become more mindful. Arguably, MBSR was conceptualized at the University of Massachusetts by Jon Kabat-Zinn. Essentially, the program is usually offered in duration of eight weeks usually done in groupings. Ideally, certified trainers are the ones allowed to administrate the program.
McDowell Centre accepted my advanced role in stress management particularly allowing me to administer MBSR to patients suffering from depression, stress, and anxiety as a result of being tested positive for HIV/AIDS. The program commenced in a weeks’ time after the participants filled a self-report. Arguably, I administered mindfulness skills to the participants. I instructed them to take a deep breath simultaneously incorporating the body-scan meditations.
My advanced role being in the area of stress management I have been certified to use MBSR to patients suffering from stress-related illnesses. The technique incorporates instructions, group meetings, and homework. Arguably, the instruction part covers simple yoga postures, body scanning, and mindfulness meditation. Ideally, body scanning normally takes a long duration and it is the first part of MBSR to be administered. In the workshop body scanning would entail the person lying flat on the ground, and then tend to focus on some of the parts of the body specifically starting with the toes and then proceeding to the head. Essentially, Kabat-Zinn in his instructions has stated that the central basis of MBSR is the concentration of ‘mindfulness’ he called this focal point as “moment-to-moment, non-judgmental awareness” (Weiss, Nordlie, & Siegel, 2005).
MBSR is very effective, especially in my professional fit. Various clinical research conducted have proven that the therapy embracing mindfulness is very critical in alleviating stress, depression, and anxiety (Kabat-Zinn, 2003). Another aspect showing the effectiveness of MBSR is the study that showed that elaborated the therapy can tend to cure psychological distress and depression emanating from the chronic illnesses. Ideally, Hatha yoga proceeded, with the primary focus being on movement. Since the program is supposed to spread out for duration of eight weeks I gave the participants several CD’s covering Yoga and meditation exercises for them to practice in their homes. Arguably, this should be at least forty-five minutes a day and six days a week. In addition, to the mindfulness exercise, I also delivered some few lectures touching on living, emotions, and nutrition. I reminded the participants that it was important for them to incorporate the mindfulness practice to their daily life routine. I also came up with a session where members would share their learning and struggles very important to inspire each other.
After eight weeks the results were magnificent. The participants were given questionnaire that inquired whether the technique had impacted any changes in their lives. The majority of the feedback was in the affirmative bearing in mind a substantial part of the program is usually conducted in homes beyond the control of the certified trainer. Arguably, the HIV/AIDS patient who had enrolled for the MBSR in the McDowell institution reported that the levels of depression, stress, and anxiety had drastically reduced. Also, cases of improved sleeping patterns were reported and participants feeling more physically nourished.
Texas Board of Nursing and The Florida Nurse Practice Act
One should note that the advanced practice licensure is not suffice for an APRN to conduct his or her role according to the Texas Board of Nursing. Ideally, the additional requirement is that the APRN has to be certified in the area of his or her professional fit or population focus. Article 5 of the Rules of the State Board of Nursing supports role implementation. Article 5 is complemented by section 464.012 of the Florida Nurse Practice Act which also does support role implementation. The provision envisages that any nurse that wishes to be registered as an APRN ought to produce a current practicing license and also proof that he or she has met one or more of the requirements stated by the board.
In most instances family nurse practitioners operate under the directives of a physician. From the case study a great deal of resemblance can be drawn from a family doctor, so that they usually work with patients all around the clock. Thus, performing medical activities like conducting exams, diagnosing illnesses, and prescribing medication I have indicated that I would be interested to carry out my advancing role in McDowell center.
When a patient is diagnosed with a chronic illness, not only is he the one experiencing this change, but his whole family, all going through different emotions at the same time. With the decrease in physical health also comes an increase in mental health concerns. As the frequent hospital visits and medical consultations become the new normal, there can be instances that may bring a flurry of unresolved questions and heightened emotions.
Caregivers, although putting their best foot forward to help the patient cope with the physical illness, sometimes are taken aback with the lack of a positive response or gratitude from the patient.
Nurses, like any customer oriented industry, are expected to maintain a friendly and helpful demeanor while on the job, regardless of their actual emotional state over the course of a long workday. Nurses who provide emotional support to their patients, comforting and reassuring them in the depths of physical and psychological suffering, are providing not just their physical efforts but also their emotional efforts too.
A validation from the physician can go a long way in creating a positive environment in which patients will feel more open in expressing themselves better.Certainly a better patient experience is more about the quality, not the quantity, of the time shared time together.
In Conversation Series introduces a new medium in the exploration of the illness experience. We hope to have upcoming videotaped conversations with patients, caregivers and clinicians which we hope will convey these unique experiences from a variety of perspectives.
It is believed that every stressful or disturbing incident/ accident leaves a mark behind. The effects are not solely physical but also emotional and psychological. The medical term for this is “Post Traumatic Stress Disorder”. To read more about it, please check here
I don't know why it is exactly, but every time there are medication changes - even just dosage changes - it causes me to become overwhelmed and cry. It doesn't matter if I was prepared for it, it doesn't matter if it's only a small little change, it doesn't seem to matter at all why or how it happens, it always makes me cry.
In the last couple of months, there have been quite a few med changes on Codeigh's behalf. It seems like every week or so we're getting new instructions, something added, something taken away, new amounts. And you'd think dealing with it almost every week for two months would numb me up a little bit so the reaction changes. Maybe I'd just take it in stride and shrug my shoulders. But I can't. Every single time, I can feel it coming the moment the paper is handed to me, and the tears just start coming.
I remember when the concept of her coming home and us having to do daily meds was seriously foreign to us. The idea of giving her four oral meds at once, all around the 1 mL mark, was just about the worst thing in the world. How could we be so mean to our baby?
The Boyfriend, never having even given our other kids Tylenol, couldn't wrap his head around the nurses saying, "Even if she's upset, you have to just shove it in her mouth and try to make her swallow it". He just couldn't understand the cruelty of it.
But now, we laugh at four different meds. Those were the days! Remember when it was that easy?!? Because here we are, only a few months later, and she's now up to seven oral meds in the morning - one of which is a pill that gets crushed up and given to her, the blood thinner shot that we give her daily and five oral meds at night. Trust me, The Boyfriend has definitely gotten his head wrapped around it now!
Our whole life right now seems to center around the meds, and even though we were warned that it would be like this, I never really imagined that it would be like this. The whole day is timed around her med schedule. Our finances are all dedicated to the med schedule. No longer do we just figure out when payday is and what bills need to be paid - we also have to factor in medication expiry dates and when we'll need to replace this or that or get new syringes. With the constant changes, it's always pulling out her entire binder to get the latest dosages. Our only conversations right now seem to be about medications - "How did she do on her meds today?", "Do we still have enough Enoxaparin?", "I'm getting low on needles. I'll need some more".
Recently we were told that two of the medications have started to work, so a few more medications got added. She takes quite a few medications that are used in ways that aren't listed on prescription handouts. For example, she takes heftier doses of Enalapril and Indomethacin - on our paper it says "To control protein loses" - but essentially it causes kidney toxicity in hopes that lessening the function of her kidneys will also lessen the amount of protein she's losing from her kidneys. Those two meds have started working, meaning that her kidneys are beginning to lose function. To counteract that, they've had to put on her meds to level out the pH in her blood and another to reduce blood pressure.
Then we went to her nephrology clinic appointment...
The meds have worked too good at this point, so they have put a hold on both the Indomethacin and the Enalapril. She now only has about 30% of kidney function and is in Stage 4 kidney failure. Her potassium is very high. So we're holding off those meds, increasing a couple of other meds and keeping her away from potassium-rich foods (since she just recently started eating solids!). They're hoping that with the addition and subtraction of these meds, we can get her back into Stage 3 and maintain her there through medications for the next year at least, when she'll hopefully be big enough for a kidney transplant.
I haven't even cried about the renal failure yet, but the med changes...