The Adult-Gerontology Nurse Practitioner - Research Paper Example

? THE ADULT-GERONTOLOGY NURSE PRACTITIONER (Insert s Here) Insert (Insert (Insert Date Here) Introduction and description of role Introduction Adult gerontology is the caring for the aged patients who may be found in nursing homes or even in hospitals. Due to their low immunity, the elderly people suffer from various illnesses such as diabetes, cancer, tuberculosis, lung infections etc. Thus, they require services from a more specialized advanced nurse who has the required experience and is conversant with these illnesses (Birchenall & Eileen, 1974). It is therefore the duty of an adult-gerontology nurse practitioner to provide the required care for these patients. Reason for choosing adult-gerontology I chose the adult nurse practitioner with the emphasis on gerontology because I have previously worked in a geriatric population in the nursing homes and with hospice. My interaction with the geriatrics in these homes was an inspiration to a new challenge in advanced nursing practice. In addition, through the interaction, I gained a lot of knowledge and experience in this advanced nursing field. Also, the elderly people suffer from many ailments that result from their low immunity hence provide room for more research and experience in the nursing field thus influenced me to choose to choose this topic. Roles of an adult-gerontology nurse An adult gerontology nurse provides a special care to the old people in the nursing homes. He or she is charged with the responsibility of ensuring that the nutrition levels of the patients are as required, the patients receive medication at the correct time, the patients undergo the required daily exercises and in some instances, they are charged with the responsibility of providing psychological support to the patients. Moreover, apart from assessment and diagnosis, they are supposed to develop a good relationship with the patient so as to ensure the best medical assistance. For them to deliver these important services to the patients, the adult gerontology requires vigorous training in this field. A practicing nurse requires a graduate degree in nursing and an operating license; failure to which the adult nurse practitioner would be imprisoned for operating illegally. Apart from going to the nursing colleges, nurses they require further training in seminars and workshops organized by their institutions or even their affiliate associations (Paige and Loney, 1977). Some states are also strict on the issuance of certifications before a nurse can fully practice. Scope of practice The American Nurses Association has a set of the scope and revised guidelines for nursing practices to be followed by all nurses operating in the United States. Adult nurse practitioners are allowed to asses and diagnose patients with injuries and other common diseases. He or she is able to order for lab examination of the patient and also analyze the lab reports so as to suggest the best nursing intervention. In addition, it is within the scope of the adult nursing practitioner to have a personal relationship with the patient that would be beneficial for the treatment of the patient. However, the adult nurse practitioners are limited to make some decisions on their own. This is because certain decisions require the consent of the family members who may be absent at that time. Comparison between adult nursing practitioner and family nursing practitioner A family nursing practitioner has the skills of prevention and containing of diseases. He or she is charged with the responsibility of assessing, diagnosis and treatment of patients with acute symptoms. Due to their expertise in general medical knowledge, they can be able to handle both the young and the older patients. In addition, family nurse practitioners require only a bachelor’s degree in nursing and a license from the state government in order to operate legally. However, an adult nurse practitioner is an advanced nurse with a specialization in the care of the elderly. Though he or she has a similar responsibility like those of the family nurse practitioner, those skills are more specialized hence more reliable in the discharge of their duties. Therefore, an adult nurse practitioner requires a postgraduate degree training preferably a masters or a doctorate degree. Typical day of a nurse The nursing profession has one of the busiest schedules in the whole world. After reporting to work at about eight o’clock in the morning, they have to go through the patients’ documents and reports so that they can be kept updated. The adult nurse practitioner ensures that the junior staffs dispensed the correct medication and at the correct time. During the day, they ensure that the patients are assessed, diagnosed properly, and those that require specialized examination are referred to the necessary departments. Moreover, they ensure that the geriatrics are given the required exercises and nutritional supplements, ensure the patients are entertained and also interact with the patients. In some cases, some nurses get so involved in their activities that they skip lunch or even take snacks for lunch. At the end of the day, they file a report about their patient’s observations and sometimes recommendations. These reports play a vital role during examinations by the doctors. Theoretical background and practice Patient exemplar The patient is an 88-year-old African American woman who has been hospitalized for the last nine months. She is currently on a ventilator and has been diagnosed of congestive heart failure, aortic aneurysm, respiratory failure and diabetes. In regard to her multiple illnesses; she is constantly being monitored by the nurses. Aortic aneurism is an abnormal swelling in the aorta thus resulting to a resisted flow of blood to other parts of the body. It may occur as thoracic aortic aneurysm of abdominal aortic aneurysm depending on the region of occurrence. This condition is commonly found in people above the age of 65 because of aging body tissues. In addition, the woman suffers from congestive heart failure; a condition that limits her heart from pumping enough blood to the tissues .The combination of aortic aneurism and CHF has resulted to the woman becoming very weak because the tissues lack enough blood thus becoming inactive. The 88-year-old woman showed severe signs of diabetes. According to the lab reports, her blood sugar levels were very high compared to the average diabetic person. Even though the doctors intervened to contain her diabetic condition, it was noted that her condition was not very stable. In addition, the lab report showed that the woman had an acute respiratory failure. This was due to the weakening of the lung muscles, which resulted to low breathing levels hence low exchange of gases. Because of respiratory failure, the skin of the woman had turned pale because of the accumulation of waste products in her body. Moreover, the 88- year old lady is faced with various psychosocial issues. Since she has been hospitalized for the last eight months, her new environment affects her psychologically. This is because it is monotonous and boring for hence causing mental fatigue. Also, she does not constantly enjoy the comfort of her family members who would be available if she was at home thus contributing to her psychological stress. Nightingale’s concept Analyzing Florence Nightingale’s concepts, the use of the concept of observation would be most realistic in this scenario. This is because the 88 year old woman suffers from various ailments hence observation of all the ailments are needed. She needs a close observation on the treatment of CHF, diabetes, respiratory failure and aortic aneurism. When using the concept of observation, the nurses should consider various avenues for collecting the required data. They should observe her body temperature, changes in heartbeat, changes in skin texture, facial expression, sleeping pattern, breathing pattern etc. However, with advancement in technology, the need for physical observation has been reduced (Mackenzie, 2011). This is because the special computer software and hardware are able to detect these changes and notify the nurses in case of an unusual occurrence. By using the concept of observation, nurses would be able to issue insulin in time, issue lung muscle relaxants when she is unable to breath properly, issue emergency medication that help the heart in pumping blood. Moreover, apart from providing advice to the patient’s doctors, observation allows the nurses to write a detailed report on the necessary nursing interventions that would help in saving the patients’ life. Application of quality safety education for nurses Patient centered care The patient centered care recognizes the importance of the patients in the provision of compassionate and well-coordinated care (Cronenwett, et al. 2009). In the above scenario, the nurses must have the knowledge that the woman requires physical comfort and emotional support. This is because she undergoes a lot of pain and struggle while facing her illnesses. In this regard, the nurses have to work harder in ensuring that she is given maximum comfort to prevent the pain caused by these ailments (Miller &Tetz, 2002). In addition, she requires the presence of family members, psychologists or a religious leader to provide an emotional support for her. With the presence of emotional support, she would be encouraged to work harder in fighting these ailments (Cronenwett, et al. 2009). The nurses should be able to have the skills on how to assess and treat pain and suffering in light of patient values, preferences, and expressed needs (Cronenwett, et al. 2009). Using these skills, proper assessment and observation of the patient would be done hence contributing to proper prescription of the medicines. However, for the success of this skill, the patient needs to clearly communicate her preferences and needs so that they may be taken into considerations. Concerning the nurses’ attitudes, they should willingly support patient-centered care for individuals and groups whose values differ from own (Cronenwett, et al. 2009). This is because different individuals have different opinions and the accommodating and listening to everyone would enable critical analysis of the situation hence best care to the patient. Therefore, the solidarity of the nurses would ensure quality service to the patients. Teamwork and collaboration Teamwork and collaboration is essential for the success of any nursing intervention that would help in improving the medical condition of the patient (Cronenwett, et al. 2009). In order for the nurses to cooperate, they need knowledge on how to identify system barriers and facilitators of effective team functioning and also examine strategies for improving systems to support team functioning. This would ensure that barriers to team work are rectified hence promoting proper teamwork and collaboration of the nurses (Lange & Grossman, 2006). The nurses also require the skills to function competently within own scope of practice as a member of the health care team, assume role of team members or leader based on the situation, guide the team in managing areas of overlap in team member functioning (Cronenwett, et al. 2009). Thus, these skills are beneficial in preventing loopholes during service delivery because all sections are covered. Finally, the nurses need to posses the attitude of respect for the unique attributes that members bring to a team, including variation in professional orientations, competencies and accountabilities; and respect the centrality of the patient/family as core members of any health care team(Cronenwett, et al. 2009). With respect among the nurses, each individual nurse would feel appreciated in his or her work hence being motivated to keep working harder for the benefit of the patient (Neumann and Ruga, 1995). Changes to care or environment In order to provide a more efficient nursing care to the patient, the following:- Good air conditioning Since the patient has respiratory failure, she may require a good air supply that would prevent her situation from worsening. The air in her room should be of the right moisture level, correct temperature and free from pollution. Therefore, the nurses should ensure that the air condition of the patient’s room supports her quick recovery. Emergency medication The patients’ room should have an emergency insulin medication. This would be of help in the event of the worsening of her diabetic condition hence she may be injected the insulin by the nearest person present. Frequent examination Due to the patient’s delicate nature, she may require frequent examination by the nurses and doctors. This examination can be done either using observation or scientific testing of tissue samples. By examining the patient frequently, the nurses would be able to prevent the worsening of her medical condition hence safeguarding her life (Smith, 1932). Evidence based support for the recommended changes According to the American journal of nursing, a good environment plays an important role in the healing process of a patient. This was arrived at from a research done in 1935 by Paul Burt, which indicated that patients with good and conducive environment recovered twice as fast as those in the normal hospital condition. Therefore, good air conditioning would provide an environment for quick recovery of the woman. Good air conditioning would also help in the safety of the nurses. The patient has a respiratory failure, which may have been caused by a lung infection hence maintaining a clean air environment around the room would ensure that the nurse does contact any airborne disease. In addition, this journal also proposed the provision of an emergency insulin injection on the bedside of the patient; that would be used in times of emergencies. Impact of information system and technology The use of technology in modern hospitals has played an important role in proper care for the patient. This is because technology has ensured a faster response to emergencies; precise monitoring of the patient and heart beat recovery by use of charges etc. For example, the 88-year-old woman has been kept alive by the ventilator system found in her room. According to the journal of clinical nursing, the incorporation of computers in the analyses of the heart beat were a great step in ensuring the safety of patients. By use of technology, the internal organs can be scanned by specific rays and results printed out thus allowing doctors to make correct prescriptions. In addition, technology has contributed to the treatment of fatal diseases like cancer by the use of radiation rays, which kill the cancerous cells (Kruse, 2013). Due to the use of the internet, doctors are able to access one’s medical history from a specific period. The access to such important information is vital in times of emergencies and facilitates easy diagnosis by the doctors. Since technology is dynamic, the hospitals should be updated with the current changes that take place in the hospitals hence ensuring the use of more efficient equipment (Bond, 1993). Summary In summary, the adult gerontology nurses play an important role in the provision of services to the old people. Their roles includes ensuring the patience exercise, taking medications, providing emotional support etc. for this reason, the nurses have a very involving schedule in their workdays. In a practical exemplar, the medical condition of an 88 year old was analyzed. She suffered from multiple diseases such as diabetes, aorta aneurism, congestive heart failure, and respiratory disorder. Using Nightingales’ theory, the concept of observation was found to be the most appropriate in the treatment of her ailments. In addition, the nurses required patient centered care and teamwork for the delivery of quality care as per the QSEN requirements. Finally, for there to be effective patient care, the nurses should consider a change of the environment and incorporation of modern technology. References Birchenall, J. & Eileen, M. (1974). Care of the older adult. American journal of nursing. 74(5), 960-961. Bond, J. (1993). Future trends in social gerontology. Cambridge journals. 3(6), 285-293. Huston, C. (2013). Impact of emerging technology on nursing care. Journal of issues in nursing. 4(5), 12-23. Kruse, A. (2013). Psychological gerontology in Germany: recent findings and social implications. British journal. 23(2), 131-163. Lange, J. W., & Grossman, S. C. (2006). The journey towards geriatric excellence in non-research-intensive university. journal of professional nursing. 2(22), 84-90. Mackenzie, E. (2011). Community/ public health nursing: one way nursing can make a difference. Journal of professional nursing, 27(5), 265-266. Miller, C. A, L. &, Tetz, K. (2002). Community-based strategies: introducing adult nursing students care. Lippincott’s nursing journal. 7(2), 12-34. Neumann, T. & Ruga, W. (1995). How to improve your unit’s environment. American journal of nursing. 95(4), 63-65. Paige, L. & Loney, F. (1977). Hospice care for the adult. American journal of nursing. 77(11), 1812-1814. Smith, M.R. (1932). Through improvement in nursing methods. The American journal of nursing. 32(6), 685-688. Cronenwett, L. et al. (2009). Quality and safety education for advanced nursing practice. Nursing Outlook 57(6), 338-348. Read More