NR 506 Week 7 Graded Discussion Topic: RN as Healthcare Policy Leader
As a health policy professional leader, communicating with lay audiences is an
... [Show More] important skill in promoting the health of the community for master prepared registered nurses. Develop a concise position statement reflecting the research findings and recommendations by experts as they relate to medical marijuana services in the community.
ANSWER
A position statement is an organization, company or persons statement on a specific subject. As an advanced practice nurse and a leader in the field, I will need to develop several stances on subjects as they affect my patients and practice. From the list provided in this week’s question, I want to discuss the use of medical marijuana services in the community. Part of a position statement is justifying one’s position with evidence. Marijuana is currently a Schedule I controlled substance so the study of the uses of the drug are constrained (Whiting et al., 2015). However, medical marijuana is currently legal in other countries and in 23 states in the US (Whiting et al., 2015). Several diseases like chronic pain, glaucoma, and spasticity have been proven to show relief of signs and symptoms of the disease with the use of medical marijuana (Whiting et al., 2015). Whiting et al. (2015) conducted a systematic review of 79 articles, a level I study, the highest in the level of evidence pyramid. While the results did not reach statistical significance in all of the 79 randomized control trials, most showed improvement in symptoms with the use of medical marijuana, with minimal but some adverse effects (Whiting et al., 2015).
As a future Family Nurse Practitioner, I will be treating patients with many of the ailments that can be helped by this drug. In making my decision, I looked to what the position of the American Nurses Association (ANA) is. The ANA recognizes the potential benefit of medical marijuana and would like to see the government reclassify the rating of controlled substance to allow for more and better research on the subject (Nursing World, 2016). As my patients advocate, I think it behooves the us to use all of the tools we have. If this medication can alleviate symptoms and bring relief to patients we should do it. With the opioid epidemic plaguing the nation right now, the use of something with minimal to no adverse effects is something that should at the very least be researched. I plan on practicing in Ohio, and the initiative for medical marijuana passed in 2016. Currently no dispensaries are open, but by the time I graduate they will be. This is something I will be following to see how it will affect my practice.
References
Nursing World. (2016). Therapeutic use of marijuana and related cannabinoids. Retrieved from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/ANAPositionStatements/Position-Statements-Alphabetically/Therapeutic-Use-of-Marijuana-and-Related-Cannabinoids.pdf
Whiting, P. F., Wolff, R. F., Deshpande, S., Di Nisio, M., Duffy, S., Hernandez, A. V., Keurentjes, K., Lang, S., Misso, K., Ryder, S., Schmidlkofer, S., Westwood, M., Kleijnen, J. (2015). Cannabinoids for medical use: A systematic review and meta-analysis. Jama, 313(24), 2456-2473. doi:10.1001/jama.2015.6358
Hi Christy:
Great post. I was going to write about this subject myself, but went a different direction. Breastfeeding in today’s society is so incredibly hard on top of the natural barriers and obstacles many women may face. I had a beautiful baby boy in February 2016 and breastfeeding was terribly difficult for us. I had a planned c-section due to his transverse lie, then he was born with tongue tie. I also was shaking so badly from the spinal that I was not able to hold him for a while after birth so we missed that golden hour. More and more things happened and we ended up having to supplement. He was not able to latch even though we corrected the tongue tie. About a month in of exclusive pumping, I developed my first round of mastitis and the antibiotics I had to take gave him thrush. This was followed by two more rounds of mastitis. During this whole time, I had post-partum depression and anxiety and crippling guilt about not being able to feed my baby because “breast is best.” Finally, about 8 weeks in I had to decide that he needed a healthy mother who wasn’t driving herself crazy trying to breastfeed. This is one of the hardest things I have ever had to do. This decision still plagues me and makes the subject of breast feeding near and dear to me. It is hard enough to do and to possibly have to give up because one cannot do what they need to at work is awful. Many employers offer breast feeding rooms and say that the mother can take the time, but in reality, that doesn’t always happen. Take my hospital for example. The breast-feeding rooms are few and usually far from the unit. In addition, they are locked, so you have to obtain the key or find someone to let you in. Management says they support the mom’s but finding 15-20 minutes two or three times a shift to go pump is next to impossible with the acuity of our patients and staffing. Much can and should be done to improve this for working mothers. As future advanced practice nurses, some of whom may work in women’s health, this is a great cause to lobby for and try to correct. I don’t know what I would have done if I had returned to work with all my complications and been forced to stop or lost production due to lack of resources.
Christy Sambolin
4/11/2017 6:27:45 PM
RN as Healthcare Policy Leader
Professor and class,
This subject is close to my heart for personal reasons. Mother’s breastfeeding their babies is a convenience to the community. Working to reduce workplace hurdles to breastfeeding will help to increase breastfeeding rates and the duration of breastfeeding, which will help to improve the health of mother, baby, and the community as a whole.
Breast feeding infants is a natural process with many benefits to both mother and baby, which then lends ease to employers as well (Cabrera & Smith, 2016). Breast milk is the healthiest choice for feeding babies and sole breastfeeding of babies is proposed until 6 months of age with ongoing breastfeeding until two years old (Cabrera & Smith, 2016). The advantage that affect employers as an outcome of babies being breastfed are reduced frequent absences from work due to healthier mom and baby, decreased costs for healthcare and insurance because of mom and baby being healthier, and higher rates of employee retention related to higher morale (Cabrera & Smith, 2016).
Even with the proof showing the many benefits to be gained by mothers, babies, and even employers; breastfeeding rates remain less than choice. Studies showed that in the United States in 2011 only 79% of mothers breastfed their babies originally after birth with only 49% of mothers still continuing to breastfed at 6 months and only 27% still breast feeding at 1 year (Cabrera & Smith, 2016).
Even though the welfare of mothers still run into many roadblocks to breastfeeding when returning to work. Some of these barriers include employer’s lack of knowledge about breastfeeding, lack of support from staff and supervisors from the lack of knowledge, obstinate hours, lack of satisfactory areas to pump milk to include clean well lit areas with outlets and a means to store the pumped milk, and necessary time granted to pump milk at work (Cabrera & Smith, 2016).
Christy
Reference
Cabrera, G., & Smith, N. (2016). Breastfeeding: Working Mothers (United States). CINAHL Nursing Guide.
Instructor STILLERreply to Susan Franklin
4/13/2017 7:10:23 PM
RE: RN policy leader
Susan,
Thank you for discussing this very important issue. I am passionate about educating nurses on end of life care. I have one graduate student who is choosing to work on educating the nurses on her OB unit on handling the delicate and sad situation of babies who are born lifeless. How does one approach the parents regarding this event? I have seen poorer care given by nurses who are new to the field and who have no experience with this type of client. I am attending an ELNEC (End of Life Nursing Education Consortium) training in Savannah, Georgia on the 24th for Core Training on End of Life Care for educators. I hope to bring this information back and teach all of the nurses I can find! I have done this before and couldn't get anyone to host this type of education. Wish me better luck this time!
Dr. Cate Stiller
Dr. Stiller:
I cannot imagine how to deal with infant loss and parents. As a RN that works in a post-operative setting, we are focused on maintaining and improving life. My unit has 24 private rooms. A few times a year we receive hospice patients where end of life is eminent. I feel very unprepared to care for them. The conflict inside me to want to do things rages when we do not have to take vital signs or monitor them on telemetry. I wish I had a few more tools in my toolbox for this. A few weeks ago, I went into work and received report on a patient. He was a newly diagnosed with multiple myeloma and was suffering with cardiac amyloidosis among many other signs and symptoms. His journey had been short, over the last month or so be became more and more ill and was in the hospital receiving swan therapy, not knowing what was happening to his body. The diagnosis was delivered the day before I assumed care for him. I worked three of the next four days. Saturday and Sunday were days of gaining more information and gaining a clearer picture of what was going happening. There was no less than ten people in the room at any time both days. I spent much of this caring for his edematous and weeping lower extremities, monitoring him and trying to lift their spirits. I wanted him to know that we were going to do everything we could and I would let them know anything as soon as I found it out. I was going to be off on Monday. The patient and the family were to get the plan of care and the rest of the picture when the cardiologists and oncologists met with them Monday morning. They begged me to pick up a day, they wanted me with them since they knew the news would be difficult. Unfortunately, I was unable to pick up the day. Tuesday when I came in, I received my update report and it was a whole new world. The patient and family decided that they did not want to pursue treatment and would be going home that day or the next with hospice. He did not want to be in the hospital any longer and the choice was to pursue quality over quantity. I had grown fond of him and this hit me hard. I know it is his choice and I cannot assume or imagine what I would choose if in that situation. I felt awkward and numb and at a loss for what to say. That day we did not have to monitor him, take vitals, monitor I&O’s or do any of the standard things. I had a long conversation with the hospice nurse who came to help set the family up with all of the equipment and things they would need at home. What she does is the opposite of my job, but still as valuable a service to the patients. We all learn about death and dying, and it is as much a part of life as birth. It seems like such a foreign concept to me. Most people prefer to die at home (Ellershaw, O'Brien, & Murphy, 2017). More often than not though, it happens in the hospital (Ellershaw, O'Brien, & Murphy, 2017). I think that nurses like myself should be versed a little more in death as well as life. I know that when completing my continuing education credits for my RN renewal, I’m going to look into a few classes to get new tools.
Reference
Ellershaw, J., O'Brien, B., & Murphy, D. (2017). Breaking new ground in hospital palliative and end-of-life care: Liverpool's academic palliative care unit. European Journal of Palliative Care, 24(1), 36-41. [Show Less]