Public Health and Primary Care - Essay Example

? Public Health and Primary Care and Section # of Public Health and Primary Care Introduction The doctors play an important role in maintaining the health of patients, in diagnosing the diseases on time and most importantly by saving them from fatal infections. The doctor plays the major role in saving the patient’s life. However, the doctor is never seen all the time around the patient. It is the nurse who spends more time with the patient looking after him. A nurse, even though considered lower to a doctor in degree, plays more important roles than a doctor. A nurse is responsible for the time to time update of a patient. Patients are more attached to nurses than doctors since they spend more time with them and develop some degree of attachment. The nurse understands the needs of the patient even by his gestures if he cannot speak and is in extreme pain. The responsibility of a nurse is to prevent infections from reaching the already immune compromised patient. A nurse counsels and consoles the relatives of the patient and helps them by informing them about the patient’s health, time to time. In some workplaces where there are not enough doctors, it is the job of the nurse to diagnose health problems of the patients. A nurse should protect the privacy of his/her patient at all times since some people lose the manners of using the washroom and if the nurse makes faces or feels disgusted the patient will feel uncomfortable around the nurse and hence will not be able to share his problems related to his health openly, with her. A nurse should take care of the patient’s privacy when changing his clothes and should always keep the room clean which produces a pleasant environment, hence making it easier for the patient to regain his health. A nurse should at all times ensure the removal of all harmful things from the room. (Stanhope, M. & Knollmueler, R.N., 1997). Nurses are the true healers, they stand by the side of the patient when the patient is sick and has sleepless nights out of fear or pain. They are one of the most important health workers, since they are present at the time of birth of a person; they take care of the new born and also guide the parents about the precautions to be taken in the initial days and months after a baby is born. Nurses are also present at the time of death of a person or when he faces a severe accident. They never get frustrated by the behavior of the patient as they know how to handle people when they are stressed. (Aitken, S., 2009). Nurses are the prime care takers of patients. Some patients are released earlier due to some reasons even though their treatment is still due which is why nurses are sent to their homes to take care of them. Community Nurses Community nurses are present in every locality. The community nurses have the same role as the nurses working in hospitals. They both have the responsibility to look after sick patients and record any changes in their health. However, community nurses are found to be given more duties to perform as they provide health care at the house of the patient. These nurses access a range of services for patients and arrange additional care from other agencies such as social workers. The work of the Community nurse is varied and can range from removal of suture to taking care of a dying patient. Community nurses are responsible for participating in service development by attending meetings and participation with audit. They assist the District nurse in preparing nursing care plans. It is their duty to identify and report the needs of patients and their families. They need to maintain good communication with the patients and offer support and guidance to the patient’s relatives. They have to take part in health education to promote positive health care. Community workers learn and train learners and other professional workers. They must co-operate with other professionals to ensure quality patient care. Community health workers are required to take professional training to keep updated and most importantly read professional journals to gain more knowledge on nursing which would help them to improve patient care. (Anderson, E.T., 2007). The community nurses have the same role as the nurses working in hospitals. They both have the responsibility to look after sick patients and record any changes in their health. However, community nurses are found to be given more duties to perform as they provide health care at the house of the patient. A nurse, whether working in a community or at a hospital is responsible for the patient’s health. Nurses have to be alert all the time in order to detect any changes in the patient’s behavior. Nurses working in a hospital have the advantage of inter professionals working together. They can call for help in a hospital anytime when they feel things are getting out of hand whereas community nurses have to be very learned and experienced because they have to handle problems and crucial situations alone. They along with the public health workers are responsible for promoting health within the community through strategies outlined by the health professionals and the government. Strategies of health promotions within the community It is very important for the people of a community to be aware of their health status and of the health promotions which can help them maintain their health. Precaution is the best cure of all diseases. Thus, if a person takes good care of his health through teachings from community workers or other concerned people he can manage to stay healthy. Health can be promoted by investing in building healthy public policies to ensure the awareness of health maintenance within the community. Health can be promoted by strategies including legislation, fiscal measures, taxation and organizational change. It can be achieved by the combined efforts of all the sectors. Health promotion policies can be made successful by identifying the obstacles which produce difficulties in the adoption of a healthy life especially in non-health sectors. The community should be well aware of common diseases which are communicable and non-communicable. Some of the communicable diseases are Herpes, Malaria, Mumps, HIV/AIDs, Influenza, Chicken Pox and Whooping Cough. They, can be transmitted from one person to another while non-communicable diseases are Heart disease, Stroke, Cancer, Asthma, Diabetes, Osteoporosis, Alzheimer’s disease, cataracts etc. Non-communicable diseases are affected by genetics, family history, environmental factors and lifestyle. Awareness can be increased by arranging workshops which educate the people of the circumstances which lead to such diseases. (Jones-Phipps & Craik, C., 2008). Like the general community, Vera too was unaware of the symptoms and risks of diabetes. In her case, her brother had the history of diabetes which increased the incidence of her having it too. Along with that she was of old age and was obese. All these factors increased the risks of her having diabetes. As most of the people are scared from the names of such diseases they get shocked and depressed when they are diagnosed of diabetes. Awareness towards the causes of such factors can be achieved by teaching students the risk factors and treatments of such diseases so that they can help the people around them. People belonging to low socio economic status can be educated with the help of social health workers who go visit these people and keep a check on their health status along with telling them about these diseases and ways of preventing them from occurring. People should be aware of the consequences which occur due to lack of hygiene. Most importantly the disadvantages of an unhealthy lifestyle should be presented to the people so that they can improve their lifestyle in order to stay healthy. People should be encouraged to change unhealthy habits such as smoking and drinking and replacing unhealthy food with healthy food. The importance of exercise should be emphasized which is a prime factor in maintaining health. (Becker, G., 2006). Vera got upset when she found out about her diagnosis of diabetes because she did not have enough knowledge about the disease and was unaware of the factors which might have caused it. Education about diseases and their prevention should be localized and people should be encouraged to learn about them by publishing about each disease in weekly columns of newspapers or on the internet so that people can easily get access to the information related to such dangerous diseases. Some of the organizations in UK are working on the education of diabetes and its prevention. Diabetes UK and the Association of British Clinical Diabetologists (ABCD) believe that all people with diabetes should have equal access to the best possible diabetes care and health outcomes provided on the basis of clinical need. For the prevention of diabetes, the best way is to take a thorough history of the patient and his family and maintain proper records of the patient. There are different ways of keeping records. The main purpose of keeping records is to provide a picture of the patient’s health status including any improvement or worsening of his health from the past. Strategies for record keeping “The basic building block of any system is information which improves the standards and quality of the system.” (Kennedy Report, 2001, p. 394) Patient’s records are very important for planning the treatment of the patient. For instance if a person undergoes an accident and is brought to the hospital, it would be beneficial to have his reports in hand instead of getting tests done at that time for the reduction of risks which can occur during the surgery or operation. Diabetic patients who undergo coronary artery bypass are at risk of developing renal complications, neurological dysfunction and at a double risk of being hemo transfused. Patients’ health records can be electronic or paper based. A proper health record includes registration of birth and any accidents or emergencies that the patient may have experienced. It should include the record of any sort of operation. Ever person should have administrative records which may include personnel, estates, financial and accounting records and also notes associated with complaint handling. X-rays and imaging reports are important to provide the damage done inside the body; therefore any person who meets an accident should get their X-rays done to avoid inconvenience for the doctors in selecting a treatment plan for the patient. An efficient way of recording details of the patient are by recording surgeries by audio and videotapes, cassettes and CD-ROM. Photographs, slides and other images are other means of keeping records of the patients. Computer databases, output and disks and other electronic records have also proved to be beneficial. This way authentic information of the patient can be preserved. In order to improve quality, organisations have to have proper information of the patient. A proper history is required to plan, implement, manage and evaluate services. It would be beneficial for the health service to attain an integrated information system across health and social care. This way the needs of patients, clinical staff and the departments of health and social care can be fulfilled. Patient-held records can help in planning a structured care to ensure that patients get regular checkups of eyes, feet, blood pressure and their blood glucose to keep it in control. A good diabetic’s care can be achieved by educating the patient and health professionals. Patient records facilitate continuity of treatment even when patients change their residence or doctor or go on holiday and especially when they need emergency care. A good patient record provides ease to the inter-professionals working on the case. By looking at the records they can rule out the complications and therefore plan out a strong treatment plan. It is important for the inter-professionals working together to discuss the patient records so that the treatment planned for the patient may not trigger any of the complications that the patient may have. Inter-professional working The primary care team needs to be proactive, consistent, comprehensive and flexible in order to provide care and support to the patient. People requiring medical care mostly have to interact with more than one health professional. The complexity of the patient’s needs decides the number of professionals needed in one case. When more than one professional is involved the treatment tends to be more effective since the experience and knowledge of different professionals combine providing with new and better ideas for the treatment plan. However, there may be instances when the professionals disagree with each other. The working of many professionals together can save the cost of the treatment for the patient while increasing the quality. (Clifton, M., Dale, C., Bradshaw, C., February 2007). The professionals working together for the treatment of diabetes type 2 may include a family Physician, Nurse Practitioners, Nurses, Nurse Educators, Patient Education Specialists, Dietitians, Pharmacists, Social Workers and Health professional trainees. However, some issues develop through sharing of documents of patients’ with other professionals. Sharing of documents can lead to the violation of privacy of the patient. For instance if a patient’s pictures or personal information is present in the document and the other professional presents it in a class or seminar, then this leads to disruption of the privacy of the patient which is ethically wrong. Therefore, records and documents of the patient should only be kept in between the professionals, working on the case. (Meads, G. et al., 2005). Diabetes Mellitus Type 2 Diabetes mellitus type 2 – formerly non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes – is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. Diabetes is often initially managed by increasing exercise and dietary modification. If the condition gets complicated then the person is prescribed medicines. Patients with diabetes have higher death rates than people who do not have diabetes regardless of sex, age, or other factors. Heart disease and stroke are the leading causes of death in these patients. All lifestyle and medical efforts should be made to reduce the risk for these conditions. People with type 2 diabetes are also at risk for nerve damage (neuropathy) and abnormalities in both small and large blood vessels (vascular injuries) that occur as part of the diabetic disease process. Such abnormalities produce complications over time in many organs and structures in the body. Management of type 2 diabetes focuses on lifestyle interventions, lowering other cardiovascular risk factors, and maintaining blood glucose levels in the normal range. Adjusting to life as a Type 2 Diabetic can be a challenge but it is important to work with healthcare professionals to come up with a plan that lets people lead as normal a life as possible. A change in diet and meal planning is almost certainly going to be a part of a diabetes treatment plan, as the foods a person eat will affect the blood sugar level. This can affect family meal times since they have to choose certain foods over others as well as eat regularly to avoid fluctuations in blood sugar. It can be difficult for the other members of the family to adjust, especially if they're accustomed to certain foods that the patient can no longer consume. Blooding monitoring equipment, test strips, medication and insulin all cost money. Getting life insurance may also be more difficult and more expensive, get it. Therefore, financial considerations have to be made to manage this disease. Costs of a change in diet and memberships to the gym, or the purchase of exercise equipment, are all things that also need to be considered. It therefore causes a huge impact on budget and savings and add to the expenditure. (Gough, S.CL., et al., 2009). Public Health Public health is the science and art of improving and protecting the health of communities through education, promotion of healthy lifestyles and researching for diseases and prevention of injury. It is the responsibility of public health to make improvements in the health and well being of people in local communities all over the world. Their prime purpose is of preventing health problems before their occurrence. True job satisfaction is achieved by public health workers when they see the world changing into a better place with healthy human beings. Government policy on diabetes is outlined in the National Service Framework for Diabetes standards. According to the outlines, the government has aimed to promote a balanced diet and exercise to help people lose weight in order to prevent diabetes. It is working on increasing awareness of the clinical features of diabetes among both health professionals and the general public. This is aimed by promoting follow ups and regular testing of individuals with high risk of developing diabetes. It has taken advanced steps to enable people with diabetes to gain control over the day-to-day management of their condition in order to experience the best possible quality of life. This has been made possible by patient education to improve knowledge, blood glucose control, weight, diet, activity and well-being. Patient-held records are given importance to facilitate self-care and personal care plans are enhanced. The citizens are informed time and again about improving blood glucose control, controlling hypertension, cessation of smoking. The people most susceptible to have diabetes are encouraged to have regular checkups done in order to detect complications. Specialist nurses are assigned for the care of diabetic patients and the need of improved communication between hospital staff and the diabetes specialist team has been emphasized. The government has ensured support for the people who require integrated health and social to fight the developed complications of diabetes. (Currie, L., Morell, C., Scrivener, R., June 2003) Conclusion Diabetes is the fourth common cause of death in the UK (Alberti, 1997). The risk of occurrence of diabetes increases with age. (Meneilly and Tessier, 1995), however older people with diabetes have fewer symptoms of diabetes as compared to the younger people (Sinclair, 1994). Half of all older people with diabetes remain undiagnosed. Those who are diagnosed have often had diabetes for many years before diagnosis (Harris et al, 1992). It is the government’s responsibility to promote education of such diseases so that people have an idea that the symptoms they are experiencing may lead to serious risk factors and can even prove to be fatal. People therefore should at least have sufficient knowledge about the common occurring diseases if not all. This way they would be able to understand the importance of getting treatments done in the initial stages of the disease like in the case of Vera. If she would not have been diagnosed at an early stage her diabetes would have progressed involving other organs and eventually death may have occured. Reference Aitken, S., 2009. Community Palliative Care: The Role of the Clinical Nurse Specialist. Wiley-Blackwell. Anderson, E.T., 6th edition, 2007. Community as Partner: Theory and Practice in Nursing. Lippincot Williams and Wilkins. Becker, G., 2006. The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed. 2nd Edition. Da Capo Press. Clifton, M., Dale, C., Bradshaw, C., February 2007. The impact of effectiveness of inter-professional education in primary care. Royal College of Nursing. Currie, L., Morell, C., Scrivener, R., June 2003. Clinical Governance: an RCN resource guide. Royal College of nursing, London. Frier, B.M. & Fisher, M, ed., 2nd edition, 2007. Hypoglycaemia in Clinical Diabetes (Practical Diabetes). Wiley-Interscience. Gough, S.CL., et al., 2009. Impact of obesity and type 2 diabetes on health-related quality of life in the general population in England. Volume 2009:2 Pages 179 - 184 DOI 10.2147/DMSO.S7088 Jones-Phipps & Craik, C., 2008. Occupational therapy students' views of health promotion from http://findarticles.com/p/articles/mi_6805/is_12_71/ai_n42419762/ McMillan, C.C., et al., 2004. The development of a new measure of quality of life for young people with diabetes mellitus: the ADDQoL-Teen. From http://www.hqlo.com/content/2/1/61 Meads, G. et al., 2005. The Case for Interprofessional Collaboration: In Health and Social Care (Promoting Partnership for Health). Wiley-Blackwell. “Patient-held records” from http://www.diabetes.org.uk/About_us/Our_Views/Care_recommendations/Patient_held_records/ Silberner, J., 2005. Keeping confidence. (medical privacy): An article from: The Hastings Center Report. Hastings Center, Volume: v27 Issue: n6 Page: p8(1). Stanhope, M. & Knollmueler, R.N., 1997. Public and Community Health Nurse's Consultant: A Health Promotion Guide. C.V.Mosby. Stewart, P., 2009. Health Promotion for Nurses: Theory and Practice. T & F books UK; 1st Edition. “The role of the nurse on the health care team” from http://www.wpro.who.int/internet/files/pub/85/1-6.pdf Walshe, C. & Luker, K, A., 2010. District nurses’ role in palliative care provision: A realist review. International Journal of Nursing Studies 47, 1167–1183. Word Count= 3115. Read More