The Role of a Registered Nurse in a Non- Rural Healthcare and That of a Rural and Isolated Practice - Term Paper Example

Emergency Care Name: Institutional Affiliation: Introduction Cardiovascular is also called a heart disease that affects the heart and the blood vessels. The many problems that accompany cardiovascular are through the process called atherosclerosis. Atherosclerosis emanates as a result of the accumulation of plague in the linings of the arteries thus the blood does not flow smoothly due to the formation of a clot. The blood clot formed on the linings of the arteries causes the leads to heart attack. However, there is situation where the formation of the clot completely blocks the walls of the arteries, in such a case the muscles may die thus further complicates the situation leading to stroke. The kind of the stroke that is common is when the blood supplying the brain is cut off, and it is called an ischemic stroke. In such a case, the brain cells will die to make it difficult to talk or even to walk. However, there are cases when the blood vessels of the brain bursts, a stroke called hemorrhagic stroke. However, when a lot of the cells in the brain have died, the supply of the oxygen in the brain will die, and the condition may be permanent. Question two: The outline of the case Atherosclerosis may be brought by high blood pressure. For instance in the case of Mr. Smith, blood pressure of 122/88mmHg and the high rate of heartbeat of 83beats/ minute and a respiratory rate of 24 breaths/ minute. The high blood pressure in Mr. Smith could be as a result of the of the blood clot on the walls of the arteries, subsequently leading to a high blood pressure and heart beats and respiratory rates. Moreover, atherosclerosis can also be caused by smoking as in the case of Mr. Smith. In addition, diabetes, the absence of exercise, obesity, too much alcohol, and high blood cholesterol among others also causes atherosclerosis. The research shows that 13%, 5%, and 9% of cardiovascular deaths are as a result of high blood pressure, obesity and smoking respectively. However, the condition of Mr. Smith can be improved by avoiding smoking, doing regular exercise to help reduce the body weight and treating the blood pressure. The overweight brings the problem to the stomach because there is the buildup of pressure inside the stomach; thus the acid in the stomach are directed to the esophagus that is called acid influx. Therefore, it causes digestion problem since the acids are imperative in digestion in the stomach. On the other hand, in the case of smoking, the chemicals Mr. Smith inhale while smoking further causes acid influx because of the relaxation of the muscles that divides the esophagus and the stomach. Question three: The role of a registered nurse in a non- rural healthcare and that of a rural and isolated practice A registered nurse (RN) is known as someone who has pursued a nursing program and has done an exam that gives him or her certificate and a nursing license. The scope of nursing practice is under the control of the professional body of council. A registered nurse can work in a various professional setting for instance supervising other health care workers like the newly employed nurses who are awaiting registration, orientating nursing students, and those who do not have enough experience. In most cases, nurses are taken as that only work in the hands of doctors and whose major role is to nurse the sick that is not the case. Today nurses have undergone through professional certification that make them be competent in executing their duties. Today nurses care for patient who have very complicated ailments and require technological care. In rural health care, it is nurses who mostly do the duties of the doctors since doctors are very few and so competitive. However, in the urban health care, there are doctors; therefore the nurses may have limited work especially in a case where the sick needs to be taken care of appropriately. Furthermore in the non-rural health care, there are very complicated cases of ailments since most people prefer the urban health facilities as compared to the rural health care facilities. Therefore, it becomes more challenging when it comes to the roles of non-urban nurses as compared to the rural nurses. In addition, the heath-care reforms and the advancement in technology put a significant gap between the non-rural nurses and the rural nurses. There is a greater technological expansion in urban areas as compared to rural areas. For instance, the online administration of drugs is common in urban as compared to the rural areas where the nurses do manual administration of drugs in most cases. Rural and isolated practice registered nurse (RIPERN) is an authorization of practice in rural areas in and remote parts of Australia. The certification for rural and remote practice is offered at a post- graduate level or the level of diploma. In Australia, it is renowned by the Australian Health Practitioner’s Registration Authority (AHPRA). Midwifery is the only endorsement that AHPRA recognizes. Only the endorsed RIPERN nurse can administer the drug but only under a drug therapy protocol (DTP). DTP ensures that the health management contract (HMP) is in place so that the nurses can follow it to the letter. HMP is in cooperated in a manual called Primary Clinical Care Manual (PCCM). Updates in PCCM after two years so that the content is in order with what is on the ground (Daly, 2009). The nurses working in remote and rural areas in Australia take roles that allow them to get discretion in clinics. In Australia, the nurse who is practitioner should be that who is registered and known by the territory regulatory authority, and nobody can use that title unless or he or she get it from the body. Such restrictions are put so that whatever the nurse does can improve the condition of the sick even in rural areas. Such practices are restricted to not- rural areas more than the remote areas. Therefore, such a nurse with the skill can give proper advice to Mr. Smith and also administer special treatment to him. Mr. Smith should know that smoking is dangerous to his life. Question four: The triage category relative to the case relative to the case Triage is a way of knowing how to determine the priority given to the patient according to the condition of the patient following the condition that the patient is in by the time he or she is admitted. Triage is a French term meaning to isolate or to select. There may be cases whereby there is an agent need to transport two patients to destination so as tom seek medication. In such a case, the triage can be used to determine who should be given priority. Due to the technological advancements, triage is today based on the scientific procedures in determining the need for the patient. Triage follows steps for instance in our case study (Briggs, 2006). Upon the arrival of Mr. Smith in the hospital, the nurses should balance the need for the pain he is undergoing and the blood pressure. The medical officer on duty should notify the doctor immediately who will there give the direction whether Mr. Smith will wait, or the treatment will start immediately. After that, the investigation process takes place, and the details of Mr. Smith are recorded and any history of the first aid diagnosed to Mr. Smith. Moreover, a thorough nursing checkup especially by the nurse doing the treatment after the first aid should be done. While following the above steps, the nurses on duty should always take into the protocols (Grossman, 2003). In the case of Mr. Smith, it must have been urgent because of the ambulance and the time it took was only two hours then he goes to the hospital. The nurse will from that point forward take the medical history of Mr. Smith. I will further support the fact that the case Mr. Smith condition is supposed to be as emergency case following the argument that he has a high blood pressure that is deadly. After the treatment of the patient, there should a close monitoring put in place as the nurses continue to administer to other patients. In the case of severe pain, like the chest of Mr. Smith, it is advisable following the Humane Practice Mandate in not more than 10 minutes of admission to the emergency department. Question five: Stabilization and management of Mr. Smith Mr. Smith is supposed to do a lot of exercises so as to help reduce the body weight. Moreover, he should monitor the food diet he is taking, such as reducing the diets rich in cholesterol, fats, and lipids. On the other hand, he should stop or minimize the rate at which he smokes. Mr. Smith is provided with quick performance of assessment of his medical history. The exercise will enable Mr. Smith to burn some of the calories that have accumulated in the body. The pain that Mr. Smith experiences in his chest could be as a result of cardiovascular disease. Therefore, before the registered nurses embark into acute diagnosis of the problem, the pain should be treated within ten minutes of his arrival. Advising Mr. Smith to reduce the intake of foods that are rich in fats and cholesterol will reduce the accumulation of the acid in the stomach that leads to the stomach pain. Moreover, doing exercise will burn the fats that accumulate in the walls of the intestine and the linings of the arteries that cause the increase in blood pressure. Mr. Smith some are triaged as soon as he enters the healthcare center, from that point forward, stabilization follows immediately (Bisanzo, 2007). Due to the chest pain, oxygen can be used to stabilize Mr. Smith because of the chest pain. Again he also put on cardiac monitor. Due to the outcome of the triage, a registered nurse can opt to stabilize Mr. Smith by putting oxygen on his nose, oxygen, and cardiac monitor at the same time. However, it is advisable that the registered nurse administer oxygen so as to acquire the rapid therapeutic benefit (Peacock, 2009). Further, to that the registered nurse or the doctor should look at the veins in the neck of Mr. Smith and further consider the heartbeat of Mr. Smith and orders for the saline fluid. After getting appropriate result, the registered nurse should now execute the necessary steps in the treatment of Mr. Smith. Question six: how rural and isolated practice endorsed nurse function The Rural and Isolated Practice endorsement authority started the enrollment of nurses so as to help in the supply of drugs to the healthcare facilities in rural and other isolated areas in Australia. The bringing of the nurses in the rural and remote areas was mainly to improve the healthcare services in the rural and isolated areas so as to improve the lives of the patients in such areas. Moreover, the plan was also initiated so as to meet the increasing demand for the health services. The cases of emergency also contributed toward the initiation of endorsing nurses in the rural and isolated areas. The legislation on drugs and poison in Victoria gave the nurses an opportunity to administer and supply drugs to particular places in the rural setting. The step led to growth of healthcare facilities in the rural areas (In LoBiondo-Wood, 2014). The endorsed nurses in the rural and isolated areas are supposed to work together with the clinical team or even work in place of the t medical team whenever they are not around and during cases of emergencies. Furthermore, the endorsed nurses contribute to proper management of the patients especially when the cases are not planned like in emergency. However in most cases the doctors are not present at the health care facility when the patients arrive, therefore it is the role of the registered nurse to carry out the assessment and perform the triage. The triage will enable the nurse to determine whether the presence of the doctor is necessary. However, the healthcare must have a policy that the nurse will follow before he or she calls the doctor. In addition to that, there are decisions that the registered nurse must take depending on the level of the emergency or the condition of the patient. For instance when the situation is more threatening, the endorsed nurse will use the medicine on the patient after getting the orders from the doctor. Again the nurse can contact the doctor over the phone and use the prescription given. On the other hand, in not- emergency cases the therapist can prescribe the medicine. Moreover, the rural and isolated endorsed nurses work best und the guidance of CPM. The nurses should participate in upgrading the kind of services that they deliver to the patients in the rural and isolated areas. Moreover, the registered nurses are supposed to embrace mutual respect in the heath profession, and again the roles should be taken based on the knowledge that one is having in the profession. Thirdly they should show high level of accountability in their work. Lastly, registered nurses are supposed to practice joint decision making in the work. Electrocardiogram (ECG) Test 12- Lead ECG is essential to tool for paramedic especially in the emergency cases. Further to that it is necessary to knowing the proper placement of every electrode on Smith. However, when it is not correctly placed, it can lead to a wrong diagnosis or undesirable changes in ECG (Caroline, 2013). Electrocardiogram was used to record the rhythm and electrical functioning of the heart of Mr. Smith. This was done following the high blood pressure that was recorded. Moreover, ECG could detect whether the reason for his high rate of heart beat was because of heart attack or if the heart were working under strain or if some parts are enlarged or damaged. However, there are cases when ECG is normal, in such a case, the Emergency Department Nurse will decide on other test following the symptoms that Mr. Smith shows. On the other hand when the ECG test is abnormal, it will not be a clear indication that Mr. Smith is having a problem in the heart; therefore another test will be needed to back it up. The problem of the heart is displayed on the ECG strip. The recordings appear like wave line with frequent bumps and spikes. The heart of an average person should show a similar heartbeat to everybody. However, in the case of Mr. Smith the Emergency Department Nurse can know that he has a heart problem when the waves are too small or too big; close or far apart. In short, the appearance of the spikes will depend on the problem at the heart of Mr. Smith Conclusion Rural and related endorsement in the rural and isolated setting provides nursing sensitive outcome indicators that aim drawing connection between the result of the treatment the patients have gotten and the nursing involvements. In the health care centers, nurses take part in very important roles and they can either build or destroy the reputation of the health care. Nurses in a health care in the rural setting should be more so as to reduce the complication of the patients in any given healthcare. The organizational system in any healthcare should put in place an excellent kind of leadership that will ensure that the rules set in the healthcare care for the benefit of the patient is uplifted. However, such a step will also improve the discipline among the workers in the healthcare. The healthcare should conduct a process that will analyze the cause so as to respond appropriately to the sentinel event such as the one described in patients in our case study. In addition, it is also important to carry out the failure mode and effect analysis (FMEA). Conducting FMEA reduces the failure outcome of the steps that will subsequently follow when performing the actual treatment ad drug prescription. The cause analysis considers the causative factors that led to the patient’s outcome. References Bisanzo, M., Filbin, M. R., & Bhatia, K. (2007). Emergency Management of the Trauma Patient: Cases, algorithms, evidence. Philadelphia: Lippincott Williams & Wilkins. Briggs, J. K., & Grossman, V. G. A. (2006). Emergency nursing: 5-tier triage protocols. Philadelphia: Lippincott Williams & Wilkins. Briggs, J. K., & Grossman, V. G. A. (2006). Emergency nursing: 5-tier triage protocols. Philadelphia: Lippincott Williams & Wilkins Caroline, N. L., Caroline, N. L., & American Academy of Orthopaedic Surgeons. (2013). Nancy Caroline's emergency care in the streets. Burlington, MA: Jones & Bartlett Learning Daly, J., Speedy, S., & Jackson, D. (2009). Contexts of nursing: An introduction. Chatswood, N.S.W: Elsevier Australia. Grossman, V. G. A. (2003). Quick reference to triage. Philadelphia: Lippincott Williams & Wilkins. Group, M. T. (2008). Emergency Triage. Chichester: John Wiley & Sons. In LoBiondo-Wood, G., & In Haber, J. (2014). Nursing research: Methods and critical appraisal for evidence-based practice. Long, S. S., Pickering, L. K., & Prober, C. G. (2012). Principles and practice of pediatric infectious diseases. Edinburgh: Elsevier/Saunders Peacock, W. F., & Cannon, C. P. (2009). Short stay management of chest pain. New York, NY: Humana Press. Watcher, R. M., Goldman, L., & Hollander, H. (2005). Hospital medicine. Philadelphia [etc.: Lippincott Williams & Wilkins. Read More