cultural diversity issues and its impact on nursing professionals’ practice. It assesses a client hailing from a different culture, and employs information derived from the assessment determining and reflecting on health practices and beliefs of the client’s culture. Lastly, nurses’ role in the care of patients hailing from diverse backgrounds care is analyzed, and a conclusion is drawn.
Client Interview Data
Client’s health beliefs in relation to cultural diversity
The client comes from a family-focused background, in which she plays the role of chief household organizer and attends to her family and their needs. She believes one ought to lead a life of a good and virtuous individual, and support one’s family, particularly in times of need. In her opinion, sickness must be tended to, for preserving life. She believes in healthcare professionals and services they offer, for leading a healthy life. She is comfortable having healthcare professionals take care of her health needs.
The client’s culture impacts her appearance, though not to a significant extent. With regard to healthcare services, the client has a few cultural and personal preferences; for instance, she is very particular when it comes to maintaining her modesty and prefers certain tests/physical examinations to be conducted by a female healthcare provider. The client believes in always appearing feminine and presentable.
How you anticipate changing this person’s health behavior and what are the risk factors presented?
The patient’s behavior change must occur in five steps (i.e., the 5C intervention):
Construction of problem definition: The behavior change process ought to begin with considering the affliction of the patient. This principle lies at the core of patient-centered healthcare delivery. When any patient suffers from an issue that troubles him/her, starting with his/her problems is a good idea unless the healthcare team has detected additional problem(s) that proves to be immediately debilitating or life-threatening. This strategy, when applied to the client in question, will increase her confidence in her own capacity to change, whilst increasing clinician influence and credibility. The second part of this step is specifying the patient’s problem. As the client possesses crucial information with regard to her problem, one must, as a clinician, play the part of facilitator for her self-examination, and aid her in correctly defining her health problem so that healthcare providers can help resolve it.
Collaborative objective setting: Specific goals must be set and the basis for these must be concrete actions (for instance, taking care not to snack after dinner) instead of mere values (such as healthy eating). Furthermore, targets need to be measurable (i.e. questions such as how often or how much need to be addressed; for instance, she may be instructed to take a 30-minute walk thrice a week). Also, behavior should be addressed (e.g. exercise), and not physiology (for instance, weight loss). Lastly, goals must be action oriented, realistic, and challenging. Care must be taken to ensure goals are neither extremely difficult (as this may discourage the patient), nor overly easy to accomplish (as such goals will not provide any sense of accomplishment).
Collaborative resolution to the problem: This involves formulation of strategies for achieving the goal and identification of obstacles to goal achievement.
Committing to bring change: At this stage, commitment to the established objectives and strategies must be made, and when the client will begin must be decided. Usually, it is helpful if one formulates a clear written agreement, or “behavioral contract,” regarding what the client and the clinician are expected to do. The agreement is not strictly enforceable; rather, it serves the purpose of making responsibilities explicit. A copy of this agreement must be provided to the patient for serving as reminder to her.
Continuing support: Studies demonstrate that interventions of a long-term nature prove more successful in diabetes care those that are short-term. This must be expected with all chronic health conditions, but not in case of acute ailments. Therefore, it is imperative to engage in relapse prevention planning, as every patient will be prone to relapse at some point of time. In other words, they will experience instances in which their level of self-care will revert to suboptimal stage (Peyrot & Rubin, 2007).
Illness beliefs and customs
The client in question is a Portuguese Azorean, hailing from the island of Sao Miguel Acores, off the Portuguese coast.
The client displays a generally positive attitude. Her background is quite family-oriented. She plays the role of chief household organizer and attends to her family and their needs. The client’s overall beliefs about life are that one ought to lead a life of a good and virtuous individual, and support one’s family, particularly in times of need. In her opinion, we should tend to sickness, for preserving life. She is comfortable having healthcare professionals take care of her health needs. She first gauges her feelings before deciding on seeking assistance with her health; she decides whether or not feels sick, as well as whether her problem requires medical attention. The women of her culture prefer the services of female healthcare professionals in deference to their husbands, irrespective of whether they are living or not. The client can process, to a fair degree, what the clinician explains to her; in case she does not, her daughter (who accompanies her to her medical appointments) translates and explains the healthcare provider’s message. Client takes care to mention if she has not understood, and if she requires any additional education/information. She believes her genetic makeup contributes partly to the diseases she is diagnosed with. However, she also believes that nothing can be done to avert what has been planned for her by God. The client has no problem with her weight (i.e., she does not believe she ought to weigh less) or care better for her well-being; however, these opinions are not culture-related. In addition to availing herself of the services of modern clinicians and their medication, the client makes use of medical rubs, herbal remedies, and prayers when it comes to handling sickness.
The client in question is a private person, in every aspect of life. Thus, in the medical/healthcare setting, she is naturally reserved. She prefers to have female healthcare professionals tend to her. She wishes to receive an explanation with regard to any physical examination prior to its performance, as well as to understand what the clinician requires of her. She is not opposed to physician/nurse touch for comfort and for the purpose of physical examination. She has no issues with having healthcare providers of different social classes or age groups attend to her healthcare needs. She opens up to providers of nationalities other than her own, as she believes all individuals have something unique to offer, and individuals from other cultural/ethnic backgrounds can potentially provide insightful ideas that may assist her with diabetes management.
Spiritual/religious beliefs and practices
The culture of the client is very indicative of her religion and spirituality. She is Roman Catholic, firmly believes in the higher God, prays the rosary on a daily basis, and expresses her religious beliefs without having others’ opinions and thoughts influencing them. While she does endeavor to attend church once every week, this does not always happen.
Worldview beliefs and social structures
Family constitutes the social network of the client. Her family members often jeopardize her health concerns by claiming that food she is supposed to abstain is not really very detrimental to her health. They try to reason that everybody deserves cheat days, and anything eaten in little quantities ought not to make any difference. She believes her family is supportive, and defines support as caring for and being around her, taking care of family needs in the event she cannot do so herself, and supporting her when in need.
Differences between literature regarding the culture’s traditional health and interview data and possible explanations
Potential health care problems/concerns for the client and their cultural / diversity group
Diabetics have an increased likelihood of developing eye-related issues, such as:
Cataracts refer to clouding and thickening of eye lens. The lens forms the component of the human eye that aids focusing on the objects we see. Diabetics are more prone to developing cataracts, which tend to impair one’s night vision and blur one’s vision in general. Cataracts that begin interfering with an individual’s vision may be removed through surgery.
Diabetic retinopathy — an eye problem unique to diabetic patients — involves a change in their retina, which is a light-sensitive membrane at the rear of the human eye. This modification of retina arises from abnormal growth in, or damage to the tiny retinal blood vessels, and is believed to be connected with persistent high levels of blood sugar. Normally, such changes are not apparent until a child reaches adolescence and has been a diabetic for many years. Initially, an individual suffering from retinopathy might not have problems with vision, but if the problem worsens, the patient may even lose eyesight.
Diabetic Nephropathy or Kidney Disease
High levels of blood sugar have a damaging effect on blood vessels within the kidneys, resulting in diabetic nephropathy or kidney disease, wherein the kidneys, whose function is filtering wastes present in the body, cease to work properly. For individuals with diabetic nephropathy, waste products that isn’t filtered out, accumulate in the bloodstream and may harm other organs. Similar to diabetic neuropathy and retinopathy, kidney disease:
Will likely develop in diabetics who persistently fail to control their blood sugar levels effectively
Normally doesn’t appear until adolescence
Is aggravated by tobacco use and high levels of blood pressure
During its initial stages, diabetic nephropathy shows no symptoms. However, if it is allowed to progress to the point where the kidney fails, it becomes an acute health threat.
Diabetic Neuropathy or Nerve Damage
Another complication among long-term diabetics is damage to nerves, known as diabetic neuropathy. This condition may involve nerves situated in several different areas of the patient’s body. Tingling, numbness, or sharp pain in the lower legs or feet represents some of the most widely-occurring early symptoms. Nerve damage that goes untreated is capable of causing other health issues. For instance, on account of numbness, individuals suffering from neuropathy may not recognize if they have any irritation or cuts on any foot, and the wound may get gravely infected prior to its discovery. As nerve damage may occur anywhere in a person’s body, problems may arise in virtually any of the body’s organ systems, such as the eye, digestive tract, heart, and urinary system. Nerve damage risks among diabetics increase with time. While diabetic neuropathy has greater likelihood of occurring after a patient attains puberty, it may also arise among younger patients who do not effectively control their blood sugar.
Blood Vessel and Heart Diseases
Diabetics have greater risk of contracting specific cardiovascular diseases, such as heart attack (resulting from blockage of blood vessels that supply the heart with blood); stroke (arising from blockage of blood vessels that supply the brain with blood); and blood vessel blockage in the feet and legs, leading to infections, foot ulcers, and, in extreme cases, loss of a patient’s toe, a foot, or the lower leg. High levels of blood sugar contribute to these problems, but its connection to these cardiovascular diseases is relatively less clear compared to its connection to complications relating to the eyes, nerves, and kidneys. Nevertheless, it is a known fact that, whether or not an individual has diabetes, risks for the aforementioned problems is more in individuals who smoke, have a family history of stroke or heart attack before the age of 50 years, are obese, suffer from hypertension, or have abnormal blood lipid levels (cholesterol or triglycerides) (Long-term Complications of Diabetes, n.d.).
Potential therapeutic interventions for the client and/or their cultural group
Irrespective of their ethnic/cultural background, the fundamental principles of treating clients with compassion, respect, and honesty remain most vital. An enhanced understanding of patients’ cultural beliefs may help improve the therapeutic relationship, and hence, patient compliance.
Therapeutic interventions for this diabetic patient and others belonging to her cultural group involve;
Controlling blood sugar and ensuring levels are as near to normal levels as possible.
A healthy blood sugar range for a majority of diabetics is from 90 to 130 mg/dl (milligrams per deciliter) prior to having meals and below 180 mg/dl between one and two hours following a meal. Blood sugar control represents the most crucial element in avoiding diabetes-related complications and resulting discomfort. Diabetes may be effectively managed through:
Exercising for no less than half an hour daily, is recommended for diabetes patients. Physical activity carried out on a regular basis aids in managing diabetes. However, diabetics need to discuss exercise plans with their healthcare provider or physician prior to commencing them. A few good means of exercising include:
Brisk walks (out in the fresh air or at home on a manual/electric treadmill).
Swimming or water aerobics
Roller-skating or ice-skating
Choosing Healthy Food
Proper, Nutritious, and balanced food forms a key element in the management of diabetes. Individuals suffering from the condition must work with the diabetes care unit for developing a nutrition plan that is in line with their personal dietary preferences, whilst maintaining normal blood glucose levels. By opting for nutritious food as well as balancing the quantity and kinds of food consumed with level of activity, diabetics’ blood sugar can be maintained at near-normal levels. Some tips on selecting healthy foods for the whole family include:
Eating plenty of fruits and vegetables. Meals need to have variety. A greater quantity of non-starchy vegetables, like green beans, spinach, broccoli, or carrots, which are rich in minerals and vitamins, must be consumed with meals.
Whole grain food must be preferred over processed grain foodstuffs such as regular pasta, white bread, or white rice. For instance, whole-wheat spaghetti can be combined with pasta sauce or brown rice can be combined with stir-fry.
Fish must be included in meals twice or thrice a week. Lean meats such as turkey and chicken without skin must be preferred. For preparing fish and meats using less fat, all visible fat must be trimmed and low-fat methods of cooking (e.g., broiling, stir frying, grilling, poaching, or roasting) must be adopted.
Taking Medication Properly
It is imperative for diabetes patients to be aware of what medication they have been prescribed, why they have to take these, and how. Diabetes patients need to make sure they inform their healthcare provider or doctor whether they are consuming other supplements such as herbs.
Checking Blood Sugar
A healthcare provider/doctor must explain to diabetes patients how blood sugar is to be tested and how frequently testing is required (HeathNY, 2015).
Observations from the interview regarding nonverbal and verbal communication
No different technique was needed with the client interviewed. She made eye contact without hesitation and had no restrictions answering any interview questions. She proved to be quite open with her views and thoughts when answering questions, and was very forthcoming and pleasant. The client’s posture was relaxed — she placed her hands atop the table, patiently waited for the next question, accepted all information provided, and did not question me. The client’s demeanor ensured it was easy to communicate with her, and suggestions and recommendations could be conveyed comfortably to her, with regard to her condition and its treatment.
Health policy regulations that might affect this person’s care
Implementation of action plans, National Diabetes Initiatives, or NCD (non-communicable diseases) action plans or programs wherein diabetes is separately addressed
Actively-implemented or well-designed NCD or national diabetes initiatives that address diabetes as a separate component represent a good means of organization, structuring of practice and policy response, and collective engagement of lawmakers, service providers, civil society institutions, and funders, for combating diabetes.
Affordable Care Act (ACA)
Reforms to the ACA will be enacted. Though, traditionally, insurance agencies have denied coverage owing to pre-existing criteria, the ACA aims at eliminating that option, potentially facilitating provision of affordable health insurance for diabetes patients. Diabetics may expect to enjoy more insurance options, together with a broader array of covered healthcare.
Ethical considerations of this patient and their cultural and its alignment with the American Nurses Association (ANA) Ethical Code
One of the ethical considerations is racism and discrimination, which remain a component of society’s tradition and fabric, and have negatively impacted minority populations, nursing professionals, and the general healthcare system.
Patients may be discriminated on the basis of age, gender, ethnicity, race, sexual orientation, religion, ability, and any other trait by which individuals differ.
The ANA is dedicated to eradicating racism and discrimination in the nursing profession, and educating nurses, in nursing practice and the organizations wherein they work. The 1994 position statement of ANA on Human Rights and Ethics is centered on the beliefs listed below:
Every human being deserves to be respected as an end in him/herself, and hence, is worthy of enjoying equitable healthcare services; this equitability must be ensured in the following areas: availability, accessibility, quality, and affordability;
Justice necessitates having regard for differences among individuals and groups. When these differences result in disproportionate distribution healthcare quantity and quality, remedial action is necessary;
As nursing care represents an indispensable but, at times, limited commodity, care allocation has become a pressing problem that can’t successfully be addressed by excluding certain individuals, or when particular groups have to bear the burden of limited care access;
ANA’s “principle of justice” is applicable to nurses, both as healthcare recipients and providers. ANA is devoted to taking care of the necessity for ethnic and racial diversity in nursing staff, as diversity represents a crucial component in delivering equitable and fair care to patients (American Nurses Association, 1998).
How your culture (beliefs, values, religion, orientation, etc.) influences your nursing care
The heuristics of physicians are challenged from time to time, by the manifestation of rare diseases, or in their interaction with individuals whose life experiences, cultural mores, and illness, are drastically different from those of physicians and other healthcare providers. Some heuristics that guide clinical practice decision-making depend on personal bias, which may be both internal and external (i.e., derived from sources like the surrounding society). My practice is impacted by culture, which creates external as well as internal biases. Explicit biases, of which holders are aware, and implicit biases, of which they aren’t, are both capable of influencing treatments offered to individual patients. Bias leads physicians to offer second-rate care to a few patients as compared with others suffering from the same clinical problem. Overcoming the effects of unconscious or implicit bias is possibly a bigger challenge, owing to lack of consciousness regarding its presence. Implicit bias’s impact on medical/clinical decision-making has been established by a research that explored the existence of implicit racial/ethnic bias towards Afro-American patients in 287 Boston and Atlanta physicians. All participating physicians denied bearing feelings of explicit racial/ethnic bias towards patients of African-American origin, but implicit association examination indicated that they bore attitudes that characterized patients of this ethnic/racial group as being generally less cooperative, and particularly when it comes to medical procedures (Rosen, 2014).
Extent to which your beliefs, prejudices, or bias influence your thinking and nursing care? Give several examples
Ethnic/racial bias exists in the area of healthcare as well, though it occurs more subconsciously. Some of the few examples include;
Aggregate bias: If physicians believe aggregated data, like those employed in developing guidelines for clinical practice, do not apply to their own individual patients, they are bringing up the aggregate misconception. The notion that patients are exceptional or atypical can result in commission errors, for instance, ordering tests such as x-rays when guidelines suggest that none is needed.
Ascertainment bias: This occurs when physicians’ thoughts are influenced by past expectation; gender bias, and stereotyping represent good examples of ascertainment bias.
Anchoring: The inclination to decide on salient characteristics perceptually in the initial presentation of the patient very early on in the process of diagnosis, and not adjusting this initial perception taking into consideration later information is called anchoring. This “cognitive disposition to respond” (CDR) might be seriously compounded by confirmation bias.
Availability: This represents the disposition of judging things as occurring frequently or being more likely, if they come readily to mind. Therefore, recent exposure to any disease can inflate the possibility of its diagnosis. Conversely, if any disease is less widespread or hasn’t been seen since long, it might not be diagnosed properly (Miller, 2014).
How you will ameliorate your biases
Assumptions should never be made about other people and their beliefs. If necessary, thoughtful and professional questions should be asked pertaining to their cultural practices.
Patient knowledge of health issues and their treatments must be gauged. Regard must be given to the support group of patients, such as friends, family, and religious leaders.
The place/role of women and men in the client’s society must be understood. For some cultures, it is the family’s oldest male member who makes decisions for all family members even when it comes to medication/treatment-related decisions.
Most notably, an attempt must be made to gain patient trust, to establish a stronger patient-nurse relationship. While this can be a time-consuming process, all will profit if it is accomplished. In case of patients who speak a different language, an interpreter is desirable (Anderson, 2012).
How the knowledge from this assignment will influence your future nursing care of clients from different cultures/orientations. Discuss several examples.
Knowledge acquired from conducting this interview and subsequent analysis will aid me in becoming culturally-sensitive, and competent when dealing with people from other cultures. For instance;
As a practicing nurse, I have acquired a fair deal of expertise in transcultural nursing and am fairly confident when it comes to carrying out cultural evaluations. In case of the client in question, when administering insulin to her, I will take care not to leave for her a selection of foods that her culture forbids. Such an act would amount to negligence and cultural incompetence, as, clearly, the patient will not eat it. And, even if I order for a new plate of food, a dangerously-long time period will pass between administering insulin and eating. This will adversely impact her health outcomes. Moreover, cultural pain (i.e., psychological stress resulting from actions that are culturally-inappropriate), is an emotionally stressful phenomenon, which impacts insulin needs and metabolic rate. Such potentially fatal situations can effectively be prevented by performing cultural assessments and accommodating cultural values of the patient in the care plan.
A second example: I will be able to assess my client for folk medication/therapy usage. Consider a hypothetical situation wherein a hospitalized client who routinely drinks herbal tea with ginseng as a constituent at home continues to drink this concoction in the hospital as well, without my knowledge. If I administer digoxin — a heart medication — to this client, a combination of ginseng and digoxin may lead to adverse drug reaction and death. This is another dangerous and culturally-incompetent situation which can be averted by culturally competent and sensitive nursing actions. Avoidance of cultural assessments and lack of knowledge on transcultural nursing in care planning and implementation may have devastating results (Jeffreys, 2008).
Analysis of the key nursing role
Roles to meet this patient’s healthcare needs
Nursing professionals have always contributed significantly to ensuring patient safety. This healthcare provider group spends the maximum time, among all healthcare providers, with patients, and is positioned to avert medication errors, guarantee that patients receive appropriate therapy, and offer safeguards from issues like skin breakdowns or falls. Bedsides, these professionals are also well aware of problems with the healthcare structure, which cause delays in patient care or reduce its effectiveness. As care coordinators, nursing professionals will more likely identify inefficiencies and be capable of recommending change.
Modern changes to nursing education prepare all levels of nurses to take on leadership roles. An increasingly compelling demand has been voiced for making a bachelor’s nursing degree a minimum educational requirement for RNs (registered nurses). National nursing license test standards have been raised appropriately, as well. Some experts in the field assert that nursing professionals ought to acquire their master’s nursing degree within a decade of obtaining their license, for strengthening RNs’ position in healthcare settings, wherein a number of other professionals, like physicians, physical therapists, and pharmacists hold master’s and doctoral degrees. In the role of clinical decision-maker, nurses need to utilize their skills in critical thinking for making decisions, setting goals, and promoting patient outcomes. Such skills include patient assessment, problem identification, intervention planning and implementation, and outcome evaluation. Nurses employ clinical judgment (i.e. the ability of discerning what is best for patients) for ascertaining the best strategy for each patient.
Nursing professionals are frequently healthcare generalists, who are able to practice with multiple staff levels, offer a wide array of technical patient care, and, coordinate with other healthcare providers’ work for meeting patient goals. Clinical leaders (or nurses who dedicate their time to caring for patients and ensuring ideal patient outcomes) and nurse managers (who deal with issues of management, like policy development or budgeting) are employed by organizations like the United States VA (Veterans Affairs) Department in their endeavor to increase clinical care safety and quality. Nurses play a critical part in efficient, superior-quality patient care delivery. Lessons derived from Magnet Hospitals and hospitals that implement front-line employees-driven performance enhancement initiatives like TCAB (Transforming Care at the Bedside) demonstrate how hospital staff (including nurses), supported by their leadership, may be actively engaged in improving hospital care efficiency as well as quality (Needleman & Hassmiller, 2009).
While challenging one’s healthcare organization or a physician on patients’ behalf may have personal negative impacts, another extremely important nursing role is acting as patient advocates. Nurses working at patients’ bedside typically recognize potentially important issues like high infection rate among the patients of a particular surgeon, sexual or verbal abuse, and misuse of specific types of costly medications. Nursing professionals are taught that they have a moral obligation to report the aforementioned issues for protecting the patients under their care. Patient advocacy is perhaps the most significant nursing role. In this role, they are responsible for protecting patient rights. When an individual is sick, he/she cannot act the same way as he/she does in good health. Nurses can act on patients’ behalf, support their decisions, and stand up for their best interests always. This empowers patients, whilst simultaneously recognizing that values of patients supersede those of their healthcare providers.
APNs (advanced practice nursing professionals), similar to nurse practitioners (NPs), certified nursing midwives, clinical nurse specialists, and certified RN anesthetists now accept roles that were, at one time, reserved only for doctors. These professionals can offer direct patient care when it comes to educating staff, delivering babies, administering anesthesia, and pediatric or adult primary care. APNs diagnose and cure injury or illness, prescribe drugs, and assume overall patient care management (Greenwood, 2016).
Nurses as caregivers offer hands-on patient care in various settings, including taking care of patients’ physical needs, ranging from overall care (tending to all basic routine needs of a patient) to aiding patients with disease prevention. Nurses maintain dignity of patient by professing skilled delivery and knowledgeable care. Additionally, nurses are responsible for holistic patient care, which stresses the fact that the entire individual is more than the aggregate of his/her parts. In other words, nurses also attend to patients’ psychosocial, cultural, spiritual, and developmental needs. Caregivers’ role includes every skill and task linked to nursing care, in addition to other elements making up the entire individual.
In the role of communicator, nurses understand that effective strategies for communication, aid healthcare environment improvement. Obstacles to proper communication may hamper the process of healing. Nurses have to communicate with patients, their families, and other healthcare team members effectively. Further, nurses are in charge of written communication in the form of patient charting; this forms a major component of care continuity.
Manager of Care
Nurses collaborate with other individuals in the healthcare team as care manager and ensure cohesive patient care. They direct and coordinate patient care by professionals as well as nonprofessionals for confirming that patient goals are achieved. They are also in charge of continuity, right from the instant any given patient gets hospitalized, until the time of their discharge, and beyond. Management of care entails overseeing instructions for home care as well. Nurses working in hospital settings have a responsibility to prioritize and manage multiple patients’ care simultaneously, adding a new dimension to the care management process.
Nurses as educators aid patients in learning about health, therapy, medicines, and procedures, in addition to dealing with challenges that may be encountered by them in the course of, and subsequent to, their illness. Often, patients have queries, and may face confusion regarding their well-being. Nurses as teachers might also have to instruct the members of a patient’s family with regard to how they may help the patient. Furthermore, nurses provide important ‘discharge instructions’ (i.e. instructions regarding what must be done after returning home) are imperative for ensuring easy self-care by patients at home.
Opportunities and challenges of Nurses’ role
This role provides nurses a chance at further developing a multicultural healthcare approach and becoming culturally aware. Nurses in this role will gradually start reflecting the diversity observed in the population served. Nurses who are more adept at being culturally acclimatized, will support improved care for underserved groups, and can;
Realize population diversity and cultural differences.
Build personal self-awareness as well as examine personal belief systems.
Solicit experienced, diverse team members’ advice.
Describe and assess on basis of direct observation and facts.
Share experiences honestly with fellow staff and team members for ensuring communication lines between stakeholders are proficient, effective.
Acknowledge all discomfort, concern, or hesitation.
Always practice politically-apt communication and avoid making stereotypical remarks or assumptions.
Enroll in inclusiveness and diversity seminars.
Maintain a general rule to commit attention as well as time when communicating.
Cease making judgments based on limited interaction or personal experience (Coe, 2013).
Accessibility and availability of support and information
The most widely occurring theme in every group was possession of diabetes-related information and knowledge, and the communication of this to patients, their families, and coworkers are crucial to superior-quality patient care. Primary care nursing assistants and nurses relied on different kinds of assistance from coworkers with specific diabetes-related clinical knowledge, when interpreting and acting on personal clinical observations. Of particular importance is effective communication with doctors for determining their autonomy and confidence in clinical decision-making.
This was typically found to be absent, though several nursing assistants and nurses worked same shifts at nursing homes and district nursing facilities. Inconsistent delivery of diabetes care and inadequate teamwork occurs, since care standards and goals were inconsistent.
Lack of autonomy and professional confidence
Nurses should be provided with sufficient training and assistance, coupled with enhanced confidence and professional competence, for having autonomy when it comes to making on-the-spot care decisions. Skill in diabetes and other such specialties is becoming increasingly vital, for enabling primary care nursing assistants and nurses to note, assess, and take action in regard to the growing aging patient population’s complex needs (Graue, Dunning, Hausken, & Rokne, 2013).
Healthcare providers that will be contributing to the patient’s wellness program and develop strategies to promote high quality Inter-professional communication to achieve the intended positive patient outcomes.
General Practitioner (or GP)
For a number of diabetics, GPs represent the key healthcare provider; posing health- and diabetes- related queries and communicating their healthcare needs to GPs is usually a sound idea. GPs possess specific information as well as support in the area of diabetes management, particularly, type 2 diabetes mellitus.
Endocrinologists are doctors specialized in treatment of growth disorders, diabetes, thyroid disease, and adrenal gland disorders. Individuals suffering from type 1 diabetes mellitus, which is an autoimmune condition, may be at greater risk of contracting other endocrine system autoimmune diseases.
These are typically nurses, but may also be other professionals, such as Social Workers, Dieticians, Podiatrists, Psychologists, and Aboriginal Healthcare Workers. Diabetes Educators are qualified in any one aforementioned area, and have received their Diabetes Education degree and earned diabetes management specialization from an accredited University.
Type 2 diabetes mellitus management by only controlling diet is a common, initial strategy for many individuals. Even after commencement of insulin/medication, food management continues to be vital to maintain appropriate sugar levels. When taking oral hypoglycemic medication/insulin, regular carbohydrate intake becomes extremely important, to prevent hypoglycemia. Type 1 diabetes mellitus patients must learn about nutritious food selections and particularly about types and amounts of carbohydrates present in foods, in addition to managing insulin-carbohydrate ratio.
Diabetics are at a somewhat increased risk for contracting gum disease. Presence of excessive blood sugar within the mouth helps bacteria breed, and this can result in infection. Therefore, diabetes patients must visit a dentist once every 6 months and ensure that they inform the dentist of their diabetes diagnosis.
American Nurses Association. (1998). Discrimination and Racism in Health Care. Silver Spring, MD: American Nurses Association.
Anderson, L. (2012, October 10). Cultural Competence in the Nursing Practice. Retrieved from Nurse Together: http://www.nursetogether.com/cultural-competence-nursing-practice
Coe, S. (2013, January 15). Cultural Competency in the Nursing Profession. Retrieved from Nurse Together: http://www.nursetogether.com/cultural-competency-nursing-profession
Graue, M., Dunning, T., Hausken, M. F., & Rokne, B. (2013). Challenges in managing elderly people with diabetes in primary care settings in Norway. Scand J Prim Health Care, 31(4), 241-247.
Greenwood, B. (2016). Role of a Nurse in Health Care. Retrieved from Chron: http://work.chron.com/role-nurse-health-care-6967.html
HeathNY. (2015, January). How is Diabetes Managed? Retrieved from New York State Department of Health: https://www.health.ny.gov/diseases/conditions/diabetes/managing_diabetes.htm
Jeffreys, M. (2008). Dynamics of Diversity: Becoming Better Nurses Through Diversity Awareness. National Student Nurses Association.
Long-term Complications of Diabetes. (n.d.). Retrieved from Kids Health: http://kidshealth.org/en/parents/complications.html#
Miller, I. (2014, December 7). Bias in nursing practice. Retrieved from The Nurse Path: http://thenursepath.com/2014/12/07/bias-in-nursing-practice/
Needleman, J., & Hassmiller, S. (2009). The Role Of Nurses In Improving Hospital Quality And Efficiency: Real-World Results. Health Affairs, 28(4), w625-w633.
Peyrot, M., & Rubin, R. R. (2007). Behavioral and Psychosocial Interventions in Diabetes. Diabetes Care, 30(10), 2433-2440.
Rosen, D. (2014, November 23). How Bias and Stigma Undermine Healthcare. Retrieved from Holistic Primary Care: https://www.holisticprimarycare.net/topics/topics-o-z/reflections/1653-how-bias-and-stigma-undermine-healthcare.html
What is culture? (n.d.). Retrieved from University of Minnesota, Center for Advanced Research on Language Acquisition: http://www.carla.umn.edu/culture/definitions.html
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We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
There is a very low likelihood that you won’t like the paper.
Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.
We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.
You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.
We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.
You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.
Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.
You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.
The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.
Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.
You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.Read more
Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.Read more
Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.Read more
Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.Read more
By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.Read more