Common Foundation Programme of Pre-Registration Nursing - Coursework Example

? Pre-Registration Nursing DipHe/BSc (Hons) Year Common Foundation Programme: Workbook. Question Cartoon. Question 2. If we have grown up in a middle class family it can be difficult to appreciate what life is like for people in a working class or poor family. If we are young, we may not understand what the implications of ageing are. We may not have experience of chronic disease and this means we might have unrealistic expectations of the patient. It is hard to deal with terminal diagnosis as a carer if we see nursing mainly as a way to improve health and cure people. If we conceive of health being a physical thing, we might miss some emotional and mental aspects We might have moral views which influence the way we see patients, for example thinking that alcohol, drugs, and inactivity are morally wrong. Question 3. You could add the following tips Eat only organic food, and wash everything very carefully. Don’t take up any dangerous jobs like mining or building and construction work. Don’t use mobile telephones for more than a few minutes at a time. Keep away from areas prone to natural disasters (tsunamis, hurricanes, volcanoes). Question 4. Starting at the centre of the diagram and working outwards the following influences have impacted on my own health and wellbeing: My family has been the single most important influence on my life, and without their love and support I would not be the person I am today, looking to start a nursing career. I have always been physically active, and my experience at school was very good. I used to love P.E. As I get older it becomes more difficult to stay active but at least in my childhood this was a very positive experience. I have experienced quite a moderate amount of variety and ability to spend money and enjoy the usual things like shopping and holidays. This has helped me to maintain good relationships with loyal friends. I find that living in the city is sometimes stressful, and the atmosphere when moving around can be quite polluted. I can feel the adverse effects on my lungs, especially in summer. I enjoy the internet, and keeping in touch with friends who have moved to different places. This is good for my mental health, and ensures I always have someone to talk to, even if they are far away. I think the UK is a good country to live in, because it has a moderate climate and good health and welfare systems. I can access doctors and dentists anytime, and this is something I never take for granted, especially when compared with some other countries in the world. Question 5. This question is answered in connection with a patient, Mrs X, who is 74 years old and suffering from unstable angina along with early stages of dementia. The points are once again taken from the inside of the diagram outwards. Mrs X is a widow, and the absence of her husband is a source of pain for her. It may contribute to her listlessness, because she misses him even though he died several years ago. She has one son, but he does not visit much, and this too is difficult. Mrs X is inactive most of the time because she has pain on exertion at unpredictable times, and this makes her scared of doing too much. She also spends frequent spells in hospital because of her angina. This makes her life unpredictable, and she is prone to confusion and depression. There is a good support system in the church that Mrs X attends. This offers her social and spiritual activities, although she is increasingly not well enough to take them up. Living in a flat which is several stories off the ground makes it difficult for Mrs X to get out and about. I suspect also that heating might be too expensive for her, because she seems to be hospitalized more in winter than in summer. I do not think Mrs X gets enough fresh air. Her lack of mobility and her fear of muggers and sudden illness stop her from enjoying walks or outings. One of the problems of Mrs X is that she feels excluded from a lot of modern society, and often talks about the past. The modern world is too complex for her, and she is retreating into memories that she feels comfortable with. Question 6. Poverty can lead to poor health in the following ways: Low income means that there is less choice in the type of food that can be bought, and the quality of that food tends to be lower. Poverty in mothers can lead to less healthy babies being born, and this sets up a poor start in life which has consequences later on. There is a lot of stress involved in poverty, and this can cause depression, or in some cases frustrations and even family violence. Poverty can lead to desperate choices such as taking up criminal activities to make ends meet. This can involve danger, such as guns , or social consequences such as prison. These are bad for both physical and mental health, and can start a person off n a series of poor personal choices. Poverty can lead to a generally poorer education level being attained. Since better education is usually linked with better health, this is an adverse effect. Relationships can be under strain because of arguments about money. This is not good for people’s health, and when a person becomes ill there is often not good family support. The relentlessness of poverty can lead to addictions, in order to achieve some release. This sets off a cycle of substance abuse which can trap people into very unhealthy lifestyles In extreme cases and without interventions at crisis times, poverty can lead to suicide. Poverty can mean that people do not take up the opportunities that society offers, for example people may choose not to go for medical checkups because of the cost of travel. In the UK heating is very expensive and there is a danger, especially for the very old and the very young, that cold and damp housing will cause hypothermia and chest infections. Question 7 The very existence of a National Health Service is a policy that aims to distribute resources on the basis of need rather than ability to pay. [See NHS Every hospital, trust or NHS institution has to have an equality and diversity policy, and this ensures that managers and staff constantly review all of their work to eliminate any instances where inequality could arise. See NHS Employers website under “Equality and Diversity” at: http://www.nhsemployers.org/EmploymentPolicyAndPractice/EqualityAndDiversity/Pages/Home.aspx The new Equality Delivery System (EDS) is being introduced in 2011/12 to promote best practice across the whole NHS system, including GP surgeries and hospitals. http://www.nhsemployers.org/EmploymentPolicyAndPractice/EqualityAndDiversity/Pages/TheNHSEqualityDeliverySystem.aspx#1 The “Positive Steps” guidance document is intended to support race equality in mental healthcare, with a focus on the needs of South Asian, African and Caribbean groups. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_066059 One preventive healthcare policy is the popular Change4Life programme, which aimd to reduce obesity in families. It targets women as well as men, and offers many different delivery methods, including internet and local resources. http://www.nhs.uk/change4life/Pages/change-for-life.aspx The policy to provide care through NHS Direct is a way of getting health advice to the public very quickly and inexpensively through telephone, internet and drop in centres. It reaches people who are housebound, or who lack the resources to attend physical locations. http://www.nhsdirect.nhs.uk/en Question 8. The Marmot Report is a very ambitious study which tries to capture all the influences on the health of the population and proposes a strategy for addressing the key issues. It two main aims: “to improve health and well-being for all and to reduce health inequalities” (p. 14) The report recognizes that this is a very difficult thing to achieve in a complex and modern society, and that absolute equality is impossible, because of all the diverse lifestyles and choices that people have. It suggests six main “policy objectives” which are: A. Give every child the best start in life B. Enable all children, young people and adults to maximise their capabilities and have control over their lives C. Create fair employment and good work for all D. Ensure healthy standard of living for all E. Create and develop healthy and sustainable places and communities F. Strengthen the role and impact of ill health prevention (p.13) The most important objective is the first one, because the document argues that health begins even before birth, and that resources targeted here will affect a person’s whole life. Care at the period towards the end of life is also a priority, because resources targeted here can enhance the quality of life greatly and reduce pressures on hospitals and other institutions. The document provides statistics to prove were inequalities currently exist, and to back up these policy areas. It ends with a plea for more investment, even though it is expensive, because the alternative of not doing these things will mean that inequalities remain, and will in any case cost even more than the programmes suggested. Question 9 As a nurse it is a basic principle to treat everyone with the same respect, even when this is more difficult with some people than others. An important role of the nurse is to be aware of patient needs even in cases where the patient cannot speak up for themselves, due to being too old, too young, too ill, or under pressure from family etc. It is all to easy to ignore people who are quiet, or to be frustrated with people who are very demanding and it is a nurse’s duty to put pressures and emotions to one side and to provide the care that the patient needs, regardless of superficial behaviours. A nurse should also be aware of other professionals that can help and should refer needy patients when appropriate. Work with families is also important, and there may be a need to spend more time with some patients and families for example those who do not speak English very well, or some people who have learning difficulties etc. A key principle is to be aware of what is happening, and to make decisions on what to do and when, rather than being carried along by events and habits. Each person deserves individual care, and a nurse needs to think what the patient needs, which can be different in each case. Question 10 This answer refers to the patient.co.uk website article entitled “Health Promotion/Lifestyle” available online at: http://www.patient.co.uk/showdoc/16 The article defines health promotion as being about “keeping healthy, living a healthy lifestyle, preventing illness, and preventing any existing illness from becoming worse”. Instead of a long introduction, there is just a list of different issues, along with web links to more detailed information, for example on “diet, obesity, smoking, exercise, alcohol, preventing heart disease, cervical screening …” etc. It also mentions immunisation and states that some screening tests and investigations are relevant to health promotion such as “well woman” and “well man.” The style is easy to read, and not at all academic, and the reason for this is that it is written for patients to read rather than for health professionals. The site also includes such wider ranging aspects of health promotion as accident and injury prevention, including road safety and some advice on Health and Safety, and Fire Prevention. Instead of writing detailed advice on issues such as cancer prevention and sexual health, the approach is to select the best practice in the UK and direct patients to that source on the internet. This very wide definition of health promotion encourages patients to follow up particular areas of concern and to consider things outside the purely medical area. Question 11 The police Social workers GPs Cancer Research UK CancerHelp UK MacMillan organisation Alcoholics Anonymous Counselling services Social workers Age Concern Shelter (for the homeless) Churches/Mosques/Synagogues/ chaplains Motability Talk to Frank (drug information) National Drug Prevention Alliance British Heart Foundation Family Planning Association Patient UK (and its website) Local Hospices Local Residential care homes Mencap Question 12 Health promotion is an important part of nursing because the public come face to face with health issues in situations where nurses can offer guidance and support. Examples of this can be in demonstrating to patients and their families Handwashing and hygiene tips Basic care for relatives In giving information on Drug administering Good sleep habits Hydration Safety in moving frail patients Access to resources for further help Ways to prevent crises Suggesting aids and supports Question 13 Read More