NR 443 Week 5 DQ 2 Priority Setting When Working With Vulnerable Populations. A Graded.This week, we have discussed many different vulnerable populations.
... [Show More] Choose a vulnerable population
and discuss what you think the top three priorities are for a CHN working with them. Cite at least one
scholarly reference that supports your decision.
Respond
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(an instructor response)
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Instructor Hamilton Email this Author 2/18/2015 8:55:15 PM
Hi Class,
Our 2nd discussion will focus on setting priorities when working with vulnerable populations.
I came upon this article in the current issue of the American Journal of Nursing entitled “Mental Health
Care in America’s Youths”. As we discuss the various vulnerable populations this week, I thought this
would be a good one to share to all of you. It’s one of the few articles in the peer-reviewed journal.
Below is the link to the web page. Since it’s free, you can download the PDF article from the site if you
want. Please feel free to share any thoughts you have on this thread for this article…~Dr Hamilton
Link -
http://journals.lww.com/ajnonline/Fulltext/2013/06000/Mental_Health_Care_in_America_s_Youths.20.
aspx
Class: You may begin posting in this TD on Sunday, March 29, 2015 for credit.
Respond
Collapse Mark as Read RE: Priority Setting When Working with Vulnerable Populations Jessica
Parker Email this Author3/30/2015 8:44:24 PM
Instructor Hamilton & Class:
I have worked with many from the vulnerable population of disabled and developmentally disabled
patients. The top three priorities for this population would be difficult to narrow down (should be
different with each case depending on the disability). First, we need to listen to the patient & family and
be an advocate. Attempt to help the patient with any community services that could be provided. Many
times, safety is a major issue. We need to ask if the patient is safe in their current living situation or if
Adult Protective Services is needed to intervene to be an advocate for the patient. We need to be
cognitive of the patient's rights even though the patient themselves may not be able to voice their own
concerns. The patient should be in the most integrated living situation that is appropriate for them -
trying to live more in a community setting rather than an institutionalized setting (Krahn, Klein Walker, &
Correa-De-Araujo, 2015). And always consider the caregivers/family members' concerns and stress
levels.
Krahn, G. L., Klein Walker, D., & Correa-De-Araujo, R. (2015). Persons With Disabilities as an
Unrecognized Health Disparity Population. American Journal Of Public Health, 105(S2), S198-S206.
doi:10.2105/AJPH.2014.302182
Respond
(an instructor response)
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Instructor Hamilton Email this Author 3/31/2015 6:42:49 AM
Excellent point Jessica, I agree as the nurses we need to assess if the patients best needs are considered
by the family caregiver. Recently in the local news a 67 year old disabled woman was found dead in her
daughters apartment and autopsy revealed severe malnourishment, dehydration, and multiple pressure
ulcers as well as soiled sheets with urine/feces. The daughter admitted her mothers care was much more
than she could handle but she needed the social security benefits to pay bills. At the health department
we would perform well-being checks on the elderly if called. Public announcements are made if anyone
has concerns regarding elderly relative or neighbors to call and a nurse will go see them, law
enforcement also will offer this service. I am not sure if people just do not pay attention or if they do not
want to become involved. Education and awareness are key.~Dr Hamilton
Respond
Collapse Mark as Read RE: Priority Setting When Working with Vulnerable Populations Gloria
Rundle Email this Author 3/31/2015 8:34:00 PM
Dr. Hamilton and class
We had several patients that came to our clinic that were elderly and had their children or grandchildren
caring for them. Unfortunately these patients were not receiving the best care from their families. One
example was a granddaughter that was caring for her grandmother that had dementia. This
granddaughter had small children and a confused grandmother living with her. When the physician
suggested that the grandmother may benefit from a skilled care facility the granddaughter adamantly
refused. The nursing staff had noted that the grandmothers condition was starting to progress.
The granddaughter told the nursing staff that she had to care for her grandmother because without her
grandmothers social security check she would not be able to support herself and her children. The last I
knew the granddaughter was continuing to care for her grandmother. We did see a few cases where the
patient was finally hospitalized after being cared for by a family member that ended up being
transefered to a long term care facility because the care giver finally admitted they could no longer care
for their family member.
Gloria
Respond
Collapse Mark as Read RE: Priority Setting When Working with Vulnerable Populations Kathryn
Dore Email this Author 4/1/2015 2:44:11 PM
Hi Gloria,
I have seen more many cases like this too. I feel bad for all of them. It is hard to make ends meet these
days and I am hoping that she is trying to take good care of her grandmother well just can't so its not
just about the money. As nurses we have to assess the situation and make sure that the patient is safe or
do we need to make a social service consult. Also, the granddaughter may need education about safety
for her grandmother and for her family. As grandmother get more and more confused she could leave
stove on or wander outside. So education is key for everyone. If the patient can not take care of herself
and if there is elder neglect or abuse then it should be reported.
Respond
(an instructor response)
Collapse Mark as Read RE: Priority Setting When Working with Vulnerable Populations
Instructor Hamilton Email this Author 4/1/2015 6:40:39 PM
Gloria thanks for the story, I am wondering if this is more common than the community truly knows. The
major focus of the public health nurse then becomes what is in the best interest of the elderly person
and also what services could we find for the family. Holistic nursing...in this case is the elderly person
stimulated enough for her developmental level or overstimulated by the environment. This is not
unusual for the elderly to be admitted for the 72 hour period until placement is found, this also give the
caregiver a break and a reality check of not having the 24/7 responsibility. Great post!~Dr Hamilton
I would like to share a link we often refer people to prior to this happening...elderly need to anticipate
the future...while they still can :) I am raising parents, my mother needs to be in LTC my father is still fully
functioning and treats my mother like a queen and always has, I am there for support and always on
call....so far he is her "assisted living" care giver but there are days when he appears tired. He will not
make the decision for her as she still has all her faculties but is challenged with diabetes, noncompliance,
and weakness as a result of her immobility/poor protein intake...he ran a steel mill for 50 years and she
was in health care for 30 years fully aware of her condition/rights/choices....they are the most awesome
couple, to listen to them when they think you are not is inspiring, love, patience, empathy...
http://www.agingcare.com/taking-care-of-elderly-parents
Respond
Collapse Mark as Read RE: Priority Setting When Working with Vulnerable Populations Cherry
Jaudalso Email this Author 4/5/2015 1:26:20 AM
Dr. Hamilton,
They are an awesome couple, you're very lucky to have someone like them to look up to...and they're
lucky to have you. I love seeing elderly couples that have been together for a long time, and I love
hearing their stories. I once took care of this sweet 90-year old lady who's husband would not leave her
side. He said he's been with her for 70 years, why leave now. He looked at her with much adoration, and
it was really inspiring.
Sorry, I'm a bit off topic. Thank you for sharing, and thank you for the link.
Cherry :)
Respond
Collapse Mark as Read RE: Priority Setting When Working with Vulnerable Populations Rachel
Foreman Email this Author 3/31/2015 7:50:14 AM
Jessica, class, and Professor Hamilton,
Thank you for your post, I enjoyed reading it. A lot of times the developmentally ill person cannot
express what they do or do not want, but on the other hand there are others who are able to tell you
exactly what they want or don't want. You as the nurse have to do what is best for the patient because
you are their advocate. Either the parents or someone else (a health care proxy/surrogate) makes the
decisions for these individuals.
Rachel
Respond
Collapse Mark as Read RE: Priority Setting When Working with Vulnerable Populations Erica
Meyerhofer Email this Author 3/31/2015 6:10:36 PM
Professor and Class: [Show Less]