Description
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Use at least 1 academic source for each response to your peers other than your textbook.
1.
Therapeutic Relationship: Case Study 2
Ana Miller
St. Thomas University
NUR-601-AP2: Health Promotion & Disease Prevention
Dr. Molin
March 19, 2024
Therapeutic Relationship
T.D. needs to exercise advocacy for the third-grade students under her care who have reported not receiving breakfast at home for more than a week. There are actions that she might initiate to exercise advocacy for students. T.D. could contact and meet with the parents to understand the situation better. T.D. would be able to connect the families with resources and support from the community such as food donations. She could also inform the school administration about the issue so that the children could receive free or discounted meals to ensure they are eating well. The students’ teachers should be informed so they can also be aware of identifying these issues in their classrooms. This issue could be further addressed at the district level in meetings to discuss food insecurity in the community. Adolescent food insecurity is a growing public health concern and is closely tied to several negative health behaviors and outcomes, including substance use, transactional sex, and poorer diet behaviors, which can have long-term health consequences well into adulthood (Mmari, 2023). The case study mentioned how T.D. is also faced with tough situations such as suspected child abuse and neglect, teen pregnancy, and alcohol and drug use among teenagers. The food insecurity that the students have could be one issue addressed in the school that helps alleviate stressors in students.
Moral distress is a frequent situation that healthcare providers should face. Please define and discuss a personal experience where you have faced Moral distress in your practice.
As a registered nurse (RN), I have personally experienced moral distress in my practice. Recently, my unit admitted a patient who lived at home with his nephew reportedly taking care of him. This patient is bedbound and suffers from contractions and paralysis. He was admitted with multiple pressure ulcers including an unstageable wound on his coccyx where his tailbone could be seen. These wounds were all very extensive and very sad to witness. From experience with this patient, it seemed like he could not advocate for himself, and the family did not seem concerned about the situation. He had to have dressing changes each shift and whenever necessary (PRN) and it would take about an hour to dress everything. The patient needed to be discharged to a nursing home and the patient and family refused and requested home health care. This was a difficult situation to witness since the patient required total assistance and nursing care.
Discuss how health promotion relates to morality.
Health promotion relates to morality because morality is often guided by ethical considerations that promote the health and well-being of individuals. Encouraging a holistic approach, health promotion examines many aspects of health and well-being, including physical, mental, sexual, community, social, and ecological health (Gerhardt-Strachan, 2022). When there are healthcare disparities in the community, health promotion can be seen in advocacy efforts, educating the community, or having free community health events. For example, advocating for nutritious meals in schools helps children eat a balanced diet while they are there.
Discuss your insights about your communication strengths and weaknesses. Identify situations in which it may be difficult for you to establish or terminate a therapeutic relationship.
In my communication at the hospital, I have strengths and weaknesses. I am good at actively listening to patients and their concerns. I always let the patient know that I will address their concerns to the doctor as their advocate. Sometimes I find weaknesses with empathy for patients who are noncompliant with their treatment plan and are constantly readmitted to the hospital. I do not show that I lack empathy but instead actively listen to the patient and provide education where it is necessary.
2.
Module 2 Discussion
Therapeutic Relationship
Viviana Maleno
St. Thomas University
NUR601: Health Promotion & Disease Prevention
Dr. Ruth Dassas-Molin
March 21, 2024
Therapeutic Relationship
Building trust between the patients and the healthcare providers is the most essential thing in the process of delivering quality healthcare service. J.J. designates building a therapeutic relationship with patients, and especially those suffering from altered sensory perception, through good communication and passing a message with patience and understanding as one of his priorities (Asan et al., 2021). This post sheds light on the causes of moral distress, the impact of health promotion on morality, and offers a personal reflection on strengths and weaknesses related to communication, enriching the discussion on patient-provider relationships and holistic care approaches.
Strategies for Building Trust
Trust in healthcare is a complex concept that is refined through various responses and interactions between healthcare providers and patients. Practices such as mutual listening, sympathy, honesty, and confidence play key roles in building and maintaining this trust. Active listening, for instance, guarantees that healthcare professionals thoroughly understand the needs and concerns of their patients, adopting a sense of being heard and respected. Additionally, empathy serves as a link that connects physicians and patients on a deeper level, facilitating a closer and more meaningful relationship based on understanding and compassion (Wu et al., 2021). Furthermore, the transparency inherent in the openness of information exchange between providers and patients is important to building trust. When patients feel they have access to clear and honest information about their care, they are more likely to feel invested and confident in their healthcare decisions. Moreover, the consistency of care delivery, marked by reliable services, further strengthens trust by demonstrating a commitment to quality and reliability. As patients consistently receive high-quality care, they develop a sense of confidence in the healthcare system’s capabilities and the skills of their providers, solidifying their trust and loyalty to the healthcare institution.
Moral Distress Experience
Clinicians often struggle with moral distress when confronted with ethical dilemmas in healthcare settings. In my own personal experience, I encountered such moral conflict when a terminally ill patient expressed a desire to end his own life, yet the hospital policy strictly prohibited such actions. Maintaining a balance between honoring the patient’s autonomy and adhering to organizational regulations presented a significant challenge, leading to emotional stress and ethical dilemmas. Finding a resolution that respected both the patient’s wishes and the hospital’s policies required careful deliberation and navigation of multifaceted ethical principles. Despite the struggle of the situation, it ultimately emphasized the importance of addressing moral distress in healthcare and the need for supportive mechanisms to help clinicians navigate such challenging scenarios while supporting patient-centered care and ethical values.
Health Promotion and Morality
Health promotion is an essential morality that encourages and develops actions and policies that support the practices that improve the health of individuals and communities alike (Solberg, 2021). Integrity of righteousness, goodwill, and respect, health promotion takes into consideration social factors of health and provides all key participants with equitable access to healthcare services.
Communication Strengths and Weaknesses
My strengths are active listening, empathy, and adaptability. On the other hand, I might find it hard to navigate through emotionally charged situations or deal with sensitive topics, too, like end of life (Beheshti et al., 2024). Establishing trust with patients can be particularly challenging in cases where they have encountered prior negative experiences or when they are resistant to participating in treatment. With continuous reflection and professional development, I continue to refine my communication skills and therefore able to build trust in communication with the patients.
In conclusion, building trust in healthcare settings requires thoughtful efforts focused on communication, empathy, and ethics. Addressing moral distress, identifying the moral aspects of health promotion strategies, and improving communication skills allow healthcare workers to encourage meaningful relationships and establish trust with patients, ultimately improving health outcomes and patient satisfaction.
3.
Cultural, Spiritual, Nutritional, & Mental Health Disorders: Case Study 3
Alexis Rodriguez
St. Thomas University
NUR 504 – Advanced Health Assessment
Dr. Geisly Quintana
March 18, 2024
The cultural, spiritual, nutritional, and mental health disorders are increasingly relevant in taking into consideration when properly completing a health assessment. In this case study, case study 3 will be elaborated on while completing an annual physical exam on a 23-year-old Native American in which appears with having anxiety and is seeking medical attention to assist with this. The patient also reported that he smokes pot and drinks alcohol to treat the anxiety he is experiencing. Throughout this discussion, the case study will be evaluated at a deeper level.
There are several factors related to the health of the patient in which derive from his socioeconomic, spiritual, lifestyle, and many other cultural factors. The socioeconomic factors that are related to the health of the patient include level of education in which lower levels have limited understanding of health literacy and awareness of certain preventative care along with an elevated level of poverty typically found throughout the Native American communities limit their access to a variety of things, including healthcare. In fact, there are very few instruments that measure unique components of Native American culture, thus limiting the understanding of cultural factors influencing the health and well being of Native American populations (Lowe et al., 2019). Spiritual factors that affect this patient include their cultural beliefs that emphasize holistic health along with ceremonies as healing practices that are conducted to promote healing and well-being. A major lifestyle factor that plays a role in influencing this patient includes the significant rise in substance abuse and alcohol in some Native American communities as a means to disconnect and resolve certain problems.
In conducting a comprehensive nutritional assessment, the five assessment domains are essential to be followed when completing this. The five assessment domains include food/nutrition related history, biochemical data/medical tests/procedures, anthropometric measurements, nutrition-focused physical findings, and client history. The most important assessment domain that one would utilize when conducting a comprehensive nutritional assessment is client history. The client history will allow an assessment that focuses on evaluating an individual’s psychological, cognitive, emotional, and overall mental health status and in this case including assessment of anxiety. Food or nutrition related history would be an essential assessment domain to utilize in completing this comprehensive nutritional assessment. The patient stated that his lifestyle includes drinking alcohol and smoking pot which in turn lead to negative food/nutritional history as a result.
The functional anatomy and physiology of a psychiatric mental health patient is essential and complex as it is a combination of factors that contribute to mental health disorders. The variety of functional anatomy and physiology includes neurotransmitter systems in which transmit signals between neurons in the brain that be dysregulated or imbalanced which further leads to psychiatric disorders. These neurons include dopamine, serotonin, norepinephrine, and gamma-aminobutyric acid that each play a role on the neurological aspect of an individual. The neuroendocrine system also plays a vital role in regulating the body’s stress response and abnormalities encountered in this system lead to psychiatric disorders as result of elevated cortisol levels that can present as depression, anxiety, and PTSD. As a result, the key concepts that must be taken into consideration by a nurse when assessing the functions of anatomy and physiology in psychiatry mental health. These key concepts understand the neurobiological basis of mental health disorders, recognizing the proper signs of dysfunction, and in applying appropriate techniques for psychiatric patients. In fact, because of the rising prevalence of poor mental health symptoms and the potential benefits of addressing mental health in the workplace, many organizations offer technology-based solutions to augment the treatment of mental health disorders (Krisher et al., 2024). Being proficient in the clinical assessment technique is key in nurses being proficient in the mental status examination, suicide risk assessment, substance use assessment, and psychosocial assessment in obtaining relevant information and assessing patterns of use, suicidal ideation, or even cognitive function.
To conclude, the cultural, spiritual, nutritional, and mental health disorders are extremely essential to understand in depth to be able to grasp the different outcomes for each patient. In understanding this information, the nurse can provide the most updated patient centered care to maintain safety and a better outcome.
4.
Cultural, Spiritual, Nutritional, & Mental Health Disorders: Case Study 2
Ana Miller
St. Thomas University
NUR-504-AP2: Advanced Health Assessment
Dr. Quintana
March 18, 2024
Cultural, Spiritual, Nutritional, & Mental Health Disorders
The patient presented in case study two is a 32-year-old pregnant lesbian who has been without complications thus far. She has been receiving prenatal care from an obstetrician and received sperm from a local sperm bank. She presents to the clinic for her annual physical exam with a chief complaint of vaginal discharge.
Discuss the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
When assessing a patient as a healthcare provider, the patient’s specific socioeconomic, spiritual, lifestyle and other cultural factors related to their health should be considered during the health history assessment. The patient’s socioeconomic factors should be assessed to verify that the patient has available resources for her and her pregnancy. The patient’s spiritual background, practices, and beliefs should be assessed so the healthcare provider can provide culturally sensitive care and understand if these factors may affect healthcare decisions. Understanding the patient’s lifestyle factors can help the healthcare provider assess potential risk factors for the chief complaint such as sexually transmitted infections (STIs) and offer resources for promoting overall health and well-being. The patient’s mental health should be focused on risk factors such as self-harm or suicide since she has a history of “cutting.” The healthcare provider should deliver culturally competent care as this patient is from the LGBTQ+ community. Healthcare professionals must try to understand the challenges that LGBTQ+ patients face and the unique security challenges that can arise when they seek medical care (Sarnese, 2024). The patient may experience unique challenges and concerns related to her pregnancy. Stressors concerning not being seen or respected as an LGBTQ+ person, or a same-sex couple, add to the stressors like fearing pain, loss of control, or injuries, as commonly experienced by pregnant people fearing childbirth (Hallström et al., 2022). The healthcare provider can deliver respectful and patient-centered care by ensuring the individual’s unique needs are understood and met.
Utilizing the five assessment domains, which ones would you utilize on your patient in conducting a comprehensive nutritional assessment?
When conducting a nutritional assessment on the patient, the nutrition-focused physical findings, biochemical, medical tests and procedures, food and nutrition-related history, anthropometric measurement, and client’s history would be utilized. The nutrition-focused physical assessment may include visual and physical findings. The healthcare provider can assess the patient for potential issues such as signs of vitamin deficiency, oral health, muscle wasting, edema, or altered body composition. The biochemical data, medical tests, and procedure assessment will allow the provider to see if the patient has any abnormal labs that could be affected by their nutrition. The food and nutrition-related history would reveal the patient’s eating habits and food allergies. It would also include any medications and dietary supplements the patient takes such as prenatal vitamins and Tylenol. The anthropometric measurements would include assessing the patient’s weight, height, body mass index (BMI), waist circumference, and body composition during pregnancy. The client’s history will be assessed for current and past medical, personal, family, psychosocial, and social history. The patient’s strong family history of diabetes puts her at risk for gestational diabetes and that should be assessed further.
Discuss the functional anatomy and physiology of a psychiatric mental health patient. Which key concepts must a nurse know in order to assess specific functions?
The functional anatomy and physiology of a psychiatric mental health patient are important for a nurse to know to assess for specific functions. Imbalances in neurotransmitters such as serotonin, dopamine, and norepinephrine are often associated with psychiatric disorders. These neurotransmitters regulate mood, cognition, and behavior. Neurotransmitters such as serotonin are linked to sleep regulation and sleep disturbances can exacerbate symptoms in psychiatric patients. Issues with the structure of the brain like decreased grey matter have been studied in psychiatric patients. Analysis of variance in whole-brain grey matter volume showed that the volumes of several brain areas, including the superior frontal gyrus, superior temporal gyrus, and cingulate gyrus, were decreased in patients with schizophrenia (Fan et al., 2022). The healthcare provider must assess the patient’s mental health and their family’s mental health history. They should also assess the patient’s social history including any use of alcohol or substance abuse. They should further identify any stressors in the patient’s life that can cause issues like anxiety or depression. Providing a comprehensive assessment for psychiatric patients is important for delivering patient-centered care that addresses any factors that influence the patient’s mental health and well-being.
