responses to colleges
1
Presidential agendas
The Opioid crisis
President George Washington Bush
President George Washington Bush in his presidency saw the opioid crisis sweeping across America affecting almost all age groups as a pandemic that if not aggressively tackled might easily get out of hand (The White House President Bush, 2008). He initiated a national drug control strategy with a three-point agenda. First stopping harmful drug use, healing drug users, and controlling the supply or availability of these harmful drugs (The White House President Bush, 2008). To adequately implement his agenda, local state and federal officials had to be involved. Therefore, his administration framed the opioid crisis as both public health issues as well as clinicians involved in prescribing the medications (The White House President Bush, 2008). President Bush necessitated improved and accurate collection of data which help guide resource allocation (The White House President Bush, 2008). His administration also created awareness for safer prescribing among clinicians and launched stigma reduction campaigns within various communities (The White House President Bush, 2008).
President Barack Obama
The Obama administration approached the opioid crisis as a matter of urgency observing that this crisis caused unnecessary deaths amongst all age groups across rural and urban communities (Nadelmann & LaSalle, 2017). This crisis was also exerting a strain on the resources and capabilities of local law enforcement (Nadelmann & LaSalle,2017). The presidents three-dimensional approach included raising awareness about the disease, supporting prevention and treatment programs, and initiating harm-reduction programs in drug use (Nadelmann & LaSalle,2017). These were viewed to be pragmatic and progressive. An openness to embracing new ways due to the rapid increase in opioid addictions and deaths (Nadelmann & LaSalle,2017). He initiated supervised drug consumption sites, heroin-assisted treatment, legalized syringe availability for HIV/Aids drug users to prevent the spread of HIV and law enforcement assisted diversion (Nadelmann & LaSalle,2017). President Obama in 2015 issued a memorandum directing federal agencies to conduct a review to identify barriers to treatment with medications and develop plans to address the barriers (Nadelmann & LaSalle,2017).
President Donald Trump
President Trump in 2017 signed an executive order to address the increasingly rising drug problem causing a decline in life expectancy in the United States (Madras et al 2017). The decline mainly attributed to drug overdose deaths and suicide (Madras et al 2017). The cause of the problem was linked to at least 30 factors with the primary factor being the health care system resorting to opioids for chronic pain managing (Madras et al 2017). The president signed a Commission on Combating Drug Addiction and Opioid Crisis which was tasked with regulations on overturning the crisis (Madras et al 2017). These guidelines had 56 recommendations that were rooted in innovative approaches to address prevention, treatment, rescue, recovery support, research, improved data analytics and accountability (Madras et al 2017). He focused on the high treatment standard treatment and recovery homes. The president signed legislation called the SUPPORT for patient and Communities Act was guided by the commission report (Madras et al 2017).
My take on the issue
Since every effort of the various presidents is aimed towards addressing the opioid crisis, it will be important to encourage all areas of proposed actions to be utilized for the benefit of the patients. My part will be to provide non-judgmental care and educate the population on the available resources to help address the rising opioid problem. Allocating funding toward more treatment facilities should be one of the top priorities to address this situation at hand.
References
Madras, B. K., & Connery, H. (2019). Psychiatry and the Opioid Overdose Crisis. Focus (American Psychiatric Publishing), 17(2), 128133. https://doi.org/10.1176/appi.focus.20190003
Nadelmann, E., & LaSalle, L. (2017). Two steps forward, one step back: current harm reduction policy and politics in the United States. Harm reduction journal, 14(1), 37. https://doi.org/10.1186/s12954-017-0157-y
The White House President George Bush (2008). ONDCP Fact Sheet:2008 National Drug Control Strategy. White House News. Retrieved from: https://georgewbush-whitehouse.archives.gov/news/releases/2008/03/20080301-1.html
The President’s National Drug Control Strategy Retrieved from: https://georgewbush-whitehouse.archives.gov/news/releases/2002/02/20020212-2.html
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2
Discussion 1: Presidential Agendas
Health Care Reform
President George W. Bush Jr.
According to President George W. Bush, Jr. believed healthcare needed to be affordable across the board. His plans where for healthcare reform and revision of health-related policies to lower costs making health insurance more affordable to the American people. He offered in his proposed tax cut incentives to make health insurance more affordable. His focus was on health care market reform and portability to where people could keep insurance if they lost their jobs. His plan for liability reform to protect practitioners from lawsuits. Even proposed electronic health records to make it easier to share records. Bush believed that patients should not have to change their doctors. His agenda as of 2006, refundable tax credits for low-income families, grants to states for aiding the chronically ill, increased funding to community health centers, and community health choices and prevention, just to name a few (The White House, n.d.).
President Barack Obama
President Barack Obama created the Affordable Care Act of 2010. His affordable healthcare goals, improved access to care, advanced biometric research, made healthcare coverage more affordable, improved accountability. He also addressed the growing opioid epidemic. He made emergency care accessible to all people. We were advocated for human rights and public health. He also increased access to mental health services. Furthermore, he promoted healthy living and teaching to combat childhood obesity. He reformed the healthcare delivery system in today we call Obama Care (The White House, n.d.).
President Donald Trump
According to the Georgia Public Broadcasting, President Trump is against the Affordable Care Act 2010, no resolutions to replace or amend the affordable care act have been finalized. Instead, Republicans are attempting to deem the ACA unconstitutional during the coronavirus’s pandemic amidst spreading throughout the United States. The president’s avoidance of health policy questions continues on his agenda to repeal the ACA. (GPB, 2020)
On August 14, 2020, Florida Senator Rick Scott composed a letter to President Donald Trump to restrict bailouts for the relief of the pandemic to liberal states as he states:
There are things Congress can do to help Americans and small businesses that are struggling. But we should’nt bankrupt our country. We must reject bailouts for liberal states that want to use taxpayer money intended for coronavirus response to backfill their poorly-managed budgets and pension plans. This includes allowing states flexibility to use CARES Act money to fund unrelated programs. We can’t let that happen.
Proposed to President Donald Trump in response to the pandemic, Senator Rick Scott wrote a plea to stop the relief of taxpayer dollars to payouts to liberal states instead to focus on families and small businesses and not fund liberal agendas (Scott, 2020).
What would I say differently in response to the media’s questions? This writer’s opinion a president with an upcoming election would have focused their agenda more towards the priority of the pandemic and public health. Be more transparent on its resolution’s ideals and goals to combat the spread rather than focusing on the preliminary agenda that had not been met during the first term. I would establish new agendas tailored to the institutional agenda and been more relevant to the universal agenda. It focuses more on what is happening in America versus trying to undo an act that offers emergency care to those who may have or may not have health insurance during a pandemic. That is this writer’s opinion during this discussion topic.
While President Donald Trump is revising and, or amending of the ACA in response to the budget, Liberal’s would like to keep the ACA. However, U.S. citizens, according to Kaiser Family Foundation 2017 are divided with 51% would not repeal, 19% would repeal, and 24% would like to make an informed decision on a replacement (Milstead & Short, 2019, pp. 177). Budgets are what republicans primarily focus on with appealing the Affordable Care Act in their belief of what upholds the U.S Constitution; Democrats focus on civil rights, health disparities, and economic securities (Milstead & Short, 2019, Table 12-1). Balancing the risk pool for health insurance coverage amidst the pandemic places strain on the economy, creating a healthcare burden on the U.S. healthcare system. US citizens spend more per capita on health coverage than other countries (Milstead & Short, 2019, pp. 175). In this writer’s opinion, the Obama administration attempted to combat co-morbidity by bringing about more health policy and awareness threw created health policy for the American people’s wellbeing. According to Milstead & Short, there is no evidence that increased spending health care spending reduces morbidity (Milstead & Short, 2019, pp. 174). Increased spending does not reduce morbidity than in other countries (Milstead & Short, 2019, pp. 174-175). Medicare and Medicaid recipients are promised benefits and could sue the U.S. Government if denied certain health coverages withheld due to costs no matter the finances (Milstead & Short, pp. 180-181). According to Kaiser Family Foundation in 2017, 20% received Medicaid with 87% in long-term care (Milstead & Short, 2019, pp 180-183). In this writer’s opinion, President Donald Trump is looking at the numbers and wants to revise the budget. However, it will face difficulty revising a plan that will pass the liberal agenda, which will veto that due to the conflict of interest of the Republican agenda, which gives rise to even greater conflict due to the pandemic and the rising national debt. This writer’s plan would be a more extensive shutdown with a better plan to promote small businesses and the American people with more stimulus and incentive to stay home. Would have provided incentives for research and grants to combat the spread of the virus months ago. Rather than funding to state in this writer’s opinion, I agree with a minimal decree to Senator Scott’s proposal in his letter. Regarding preventing a liberal agenda instead of the support of people and small businesses yet, no evidence to support his claims in his letter makes it weak and not supportive of his claims, and his letter seems bias.
References
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurses guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Georgia Public Broadcasting. 2020. Politics Chat: Trump’s Response To COVID-19 Surge And Plans For Reelection. Retrieved August 31, 2020 from
https://www.npr.org/2020/06/28/884351925/politics-chat-trumps-response-to-covid 19-surge-and-plans-for-reelection
Senator Rick Scott. 2020. Sen. Rick Scott to President Trump: Dont Let Democrats Use Coronavirus Relief to Enact Their Liberal Agenda. Retrieved August 31, 2020 from
https://www.rickscott.senate.gov/sen-rick-scott-president-trump-dont-let-democrats -use-coronavirus-relief-enact-their-liberal-agenda
The White House. (n.d.). Barack Obama. Retrieved August 31, 2020
https://obamawhitehouse.archives.gov
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Problem-solving is an essential aspect of high quality in clinical practice. This exercise requires clinical reasoning and quick judgment that guides the nurses to avoid potential adverse events and harm to the patient (McGonigle & Mastrian,2017). Nursing informatics ensures that the nurses can access a wide variety of knowledge that will enable them to engage in professional thoughts, reasoning, and judgment as they provide safe and quality care. The expertise of nurses is subject to continuous learning and assessment of individual performance about up to date knowledge available in the database (McGonigle & Mastrian,2017). Similarly, critical thinking can only be achieved through cognitive analysis of data, distinguishing facts, seeking supporting literature, forecasting, and transforming information.
A scenario that would make use of informatics in nursing is centered on the management of care provided to the patients. For example, a patient may undergo a diagnosis for prostate cancer using prostate-specific antigen test screening in a given hospital (Nagle, Sermeus, Junger & Bloomberg,2017) if the patient is referred to another hospital or seeks a second opinion from another specialist. The current physician will be able to determine that the client had been subjected to a similar test by cross-examining the patient. The physician will then have an impetus to seek patient records from the first hospital to enable him or her to review the results and recommend other screening tests. The data required, in this case, are the results from diagnosis and screening that the patient went through in the previous hospital. Further information in comorbid conditions and drug contraindications that could influence the results of the test (McGonigle & Mastrian,2017). Through the use of electronic health records from the previous hospital, the doctor can access the data of the patient, particularly biodata (age and gender, lab results, and clinical notes. Practically the doctor can also receive a fax or email of patient data, for example, blood pressure. Text messaging services can also be used since they promote unbiased care, as explained by Storck (2017). The information obtained from previous records will guide the doctor in developing a current diagnosis and care plan. Notably, the physician can also refer to the diagnostic and treatment procedures obtained from the other hospital as well as the available security measures that protect patient data from unauthorized access.
A nurse practitioner will, therefore, rely on medical analysis and judgment before making any clinical decisions. This will involve data collection, analysis, inferences, and coming up with a treatment plan. The management, on the other hand, needs to interpret and modify data to enhance the process of decision making using information systems, as explained by Sweeney (2017). The current developments in health care are tapering towards telemedicine and virtual doctors. Therefore, nursing informatics will ensure that patients can access proper diagnosis and evidence-based treatment.
References
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Nagle, L. M., Sermeus, W., Junger, A., & Bloomberg, L. S. (2017). Evolving Role of the Nursing Informatics Specialist. Forecasting Informatics Competencies for Nurses in the Future of Connected Health, 212.
Storck, L. (2017). Policy statement: texting in health care. On-Line Journal of Nursing Informatics, 21(1).
Sweeney, J. (2017). Healthcare informatics. On-Line Journal of Nursing Informatics, 21(1).
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4
The Application of Data to Problem-Solving
Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?
Obesity is a health complication associated with severe health conditions and diseases like stroke, coronary heart diseases, Type 2 Diabetes, and Gall bladder disease. Nurses require the knowledge to measure and determine whether a patient is obese and improve their health condition and lifestyle. For example, suppose a patient visits a health center exhibiting symptoms like breathlessness, snoring, joint and back pains, increased sweating, and an inability to cope with physical activities (Center for Disease Control and Prevention, 2020). In that case, a nurse should ascertain whether they are obese.
According to Obesity Canada (2020), a nurse should know how to ascertain whether the patient is obese, collect primary data from the patient, and know-how the Body Mass Index or BMI test is undertaken. In this regard, the nurse should use weight and a tape measure for measuring the patients height and weight (McGonigle and Mastrian, 2017). After acquiring his weight and height, the nurse should divide the patients weight measured in kilograms by her height that was ascertained in square meters (Obesity Canada, 2020). The data attained from the BMI approach of measuring diabetes can provide various types of knowledge. The data acquired from the BMI test can be used to determine whether a patient is underweight, is expected, overweight, obese, or experiences severe obesity. In this case, when a nurse finds out the patient’s BMI is less than 18.5 kg/m2, the patient is underweight, and if his BMI ranges between 18.5 and 24.9 kg/m2, the patient is considered normal.
Moreover, if the nurse finds the patient’s BMI range from 25 to 29.9 kg/m2, the nurse should know he is overweight. A score of 30 to 39.9 kg/m2 in the BMI test implies the patient is obese, and a score equal to or greater than 40 kg/m2 implies the patient experiences severe obesity (Obesity Canada, 2020). Thus, the patient data acquired from the BMI test conducted by a nurse can determine whether the patient is underweight, normal, overweight, obese, or experiences severe obesity.
From this experience, the nurse leader can use clinical reasoning or judgment in forming knowledge in various ways. Firstly, the nurse can use clinical reasoning or judgment in developing understanding by determining whether the scores attained from the BMI compare to the symptoms the patient exhibits. In this case, if a patient’s scores read more than 40 kg/m2, the nurse leader should ascertain whether he exhibits the symptoms associated with severe obesity before confirming the condition. Secondly, the nurse leader can use clinical reasoning and judgment in forming knowledge on the trends of obesity in a region and advise health authorities of any dangers they pose. For example, after ascertaining that most of the patients visiting the health center possessed a high BMI score, the nurse leader can recommend that health authorities advocate dietary changes in the region. Lastly, the nurse leader can use clinical reasoning or judgment in forming knowledge about the treatment strategies that should be used on different patients. For example, the nurse leader can recommend low calorie or carbohydrate diets for severely obese patients and more balanced diets for underweight patients. Using clinical reasoning, nurse leaders can help ensure increased communication, efficiency, and healthcare delivery (McGonigle and Mastrian, 2017).
References
Center for Disease Control and Prevention. (2020). The Health Effects of Overweight & Obesity. Retrieved from https://www.cdc.gov/healthyweight/effects/index.html
McGonigle, D. and Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Obesity Canada. (2020). Measuring Obesity. Retrieved from https://obesitycanada.ca/managing-obesity/measuring-obesity/
The White House. (n.d.). George W. Bush. Retrieved August 31, 2020 https://georgewbush whitehouse.archives.gov
