Integrating CNA’s and LVN’s can aid in a nursing shortage by helping meet the needs of patients
The following assignment consist of replying to fellow class mates, each reply should be 150 words each. you may or may not use scholarly articles.
521 Post 1: Reply to the following post with 100-150 words
Reply 1 (replying to Felipe) : Integrating CNA’s and LVN’s can aid in a nursing shortage by helping meet the needs of patients. Ethical implications occur when mistakes are made. One ethical principle implicated when a mistake occurs is non-maleficence. For example, in our scenario Brendan pushed IV medications on a patient and was out of scope for Brendan. Although was asked by a registered nurse to do so, there could be prior patient assessment, labs that need to be reviewed, and orders to reviewed. Furthermore, depending on the medications it can have specific instructions to administer. If an adverse reaction would occur it could cause harm to the patient thus failing our obligation to do no harm implicating non-maleficence (Pozgar, 2024, p. 14). For the hospital leadership the value of fidelity is implicated. According to Pozgar (2024), fidelity is faithfulness, being true to our commitment and obligations to others (p. 29). The hospital leadership and workers must be committed to providing safe care. The stress of being short cannot dictate decision such as incorporating LVNs and CNA’s if it is placing patients at risk. The way I would address the mistakes that occur by the LVNs and CNAs would be through education. I would ensure that the CNAs and LVNs Know their scope of practice. Furthermore, I would educate the nurses on the CAN’s and LVNs scope of practice but also provide delegation training. In our scenario, it was a registered nurse who asked Brendan to give IV push medication. This tells me, if I was a nurse leader in this situation, that education is needed at all levels. Education on each licensed personal is essential to avoid mistakes that may result in harm to patients. When the behavioral health unit I currently work at is short we utilize a LVN and RN team to cover for the shortage. Although it must be done, I feel it is not fair to the patients and nit fair for the nurse. Yes, LVN’s can aid with some tasks but it also adds task for the nurse. For example, review of charting, complete assessments, talk to the families, take all medical orders. The workload feels as if it grows rather than shrinks. The ethical principal that come to mind is distributive justice. According to Pozgar (2024), it means that all persons be treated equally and fairly (p. 17). It is not fair for the patient that I as the nurse with 12 patients have less time with their nurse. It is also not fair for nurses as they know are responsible for more patients and they are responsible for the LVN’s action.
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Reply 2 (Replying to Megan O); The integration of Certified Nursing Assistants (CNAs) and Licensed Practical Nurses (LPNs) into patient care, while intended to improve service delivery, brings about several ethical concerns, particularly when errors occur. These concerns are deeply entwined with the fundamental ethical imperative of non-maleficence, or the duty to do no harm (Butts & Rich, 2023). This imperative is challenged when CNAs and LPNs, who might lack full training or adequate supervision, contribute to mistakes that compromise patient safety and care quality. These roles, often under direct supervision, raise crucial questions about accountability and the transparency needed in healthcare delivery. CNAs and LPNs are often put in a position where they are asked to provide care that is outside their scope of practice. This can introduce a multitude of errors as CNAs and LPNs are not trained or certified to do certain tasks that they are asked to perform.
Nonmaleficence is at stake in this scenario for hospital leadership, the healthcare team, the patients, and the CNAs/LPNs. While the CNAs and LPNs are trying to help the RNs by providing care that is outside their scope of practice, they are actually introducing the risk for harming the patients because they have not been adequately trained or educated on the tasks they are performing.
If I were a part of the hospital leadership team in this situation, I would make sure to educate the CNAs, LPNs, and RNs on the scope of practice and delegation. I would also make sure to continuously monitor the CNAs, LPNs, and RNs on the floors to make sure they are providing appropriate and legal care. I also think it’s important to mandate adequate RN staffing to make sure that RNs aren’t put in a position where they feel like they need to delegate tasks to CNAs and LPNs that are outside their scope of practice. The ethical principles of nonmaleficence and beneficence would be guiding my decision-making process.
I have never worked with LPNs but I work with CNAs frequently in the inpatient setting. I find CNAs to be very helpful in providing patient care and aiding in ADLs. I honestly wouldn’t be able to care for my patients without the aid of CNAs. On shifts that we are short-staffed and don’t have CNAs, my patient care is seriously affected. I have never been tempted to ask my CNAs to work outside of their scope of practice and always ask my charge RN or another RN to help me if I need.
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561 Post 1
Reply 1 (replying to Megan) :In the film And the Band Played On, various factors are depicted as obstacles to the initial response to AIDS, rooted in both societal and institutional challenges. The discrimination and stigma directed towards the primary groups affected by AIDS—homosexuals, intravenous drug users, and Haitians—hampered prompt and empathetic reactions from both the public and government authorities. Moreover, a notable shortfall in funding and political backing for early AIDS research meant that public health officials faced difficulties in obtaining the necessary resources, a situation exacerbated by the disease’s link to marginalized communities. Additionally, the unfamiliarity with HIV’s characteristics and the way it spreads posed scientific hurdles that impeded the development of effective measures. Competition for recognition and funds within the scientific community also contributed to delays in progress.
It is unlikely that the AIDS outbreak could have been completely stopped at its onset due to the complexity of its transmission and the nature of the virus. However, its initial impact and spread could potentially have been mitigated through earlier, coordinated public health interventions and broader research initiatives if not for the prevailing stigma and lack of political and financial support.
Advocacy is a key element in the film, with activists and scientists working diligently to draw more focus and allocate more resources toward AIDS research and patient care. Their efforts were instrumental in combating the stigma and bureaucratic hurdles that hindered early response measures, enhancing the visibility of the issue. This ultimately led to increased governmental involvement and public backing.
Today, HIV/AIDS does not garner the same level of urgent media attention it did at the height of the crisis in the late 20th century, mainly because treatment advancements have transformed it into a manageable chronic illness for many in developed nations. Nonetheless, it continues to be a significant global public health concern, particularly in areas where access to treatment and educational resources is restricted.
In the 21st century, the story of HIV/AIDS is one of significant progress and ongoing challenges. Advances such as antiretroviral therapy (ART) have transformed HIV from a fatal diagnosis to a manageable condition for those with access to treatment. Initiatives like the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund have expanded global treatment and prevention efforts. Despite these advances, the development of a vaccine and a cure for HIV remain critical goals. The evolution of HIV/AIDS from a deadly disease to a manageable condition underscores the importance of scientific research, public health policy, advocacy, and international cooperation in addressing global health crises.
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Reply 2 (replying to Chidi): During the early stages of the fight against acquired immunodeficiency syndrome (AIDS), various factors hindered progress. One of the main reasons was the stigma and discrimination faced by early AIDS patients. Since the initial victims were mostly homosexual men, the disease was negatively labeled as the “gay plague,” leading to a delayed response from the public and medical communities. Due to this delay, the government and medical community were slow in allocating funds for researching the deadly disease. Inadequate public health responses and the spread of misinformation further added to the uncertainty surrounding the disease. Additionally, many people were in denial about the severity and nature of AIDS. (Shilts & Schulman, 1993). In my opinion, it was improbable to halt the AIDS epidemic because of the disease’s characteristics, its mode of transmission, and the limited knowledge available at the time. Nevertheless, if there were early interventions, public education, and more funding for research, it could have potentially decreased the number of AIDS infections and fatalities.
The movie emphasizes the significant role that gay community activists played in the fight against the government’s lack of urgency, social indifference, and public stigma. The neighborhood promoted public education, funding for research, and rights for those who suffered from the deadly illness. Today, HIV/AIDS remains a significant global health issue, despite the decreased publicity it receives. International days such as World AIDS Awareness Day help to draw attention to ongoing challenges and new medications and treatments, as well as preventative measures to ensure healthcare coverage. Nevertheless, media coverage and publicity have changed, and AIDS now competes with other global health crises for attention.
The story of HIV/AIDS in the 21st century is one of significant medical advancements. Treatments have transformed a diagnosis from a death sentence to a manageable chronic condition. Preventative options have also been developed to help prevent transmission. While there are still significant challenges in parts of the world, international efforts have aimed to address them with global funding. Unfortunately, there is still a stigma associated with HIV/AIDS in many communities, but increased public education has helped to address this issue.
561 Post 2
561 Reply 1 post 2 (replying to arlen): The stress faced by middle-aged adults is influenced by their jobs and the culture they belong to. Things like job stability, how happy they are at work, cultural expectations, and taking care of others all play a big part. Dealing with these stressors can affect how they feel and how well they’re doing. Having flexibility and support at work can help them handle these challenges better. Jobs and culture are extremely important in shaping the stress middle-aged adults go through.
Work-related issues, such as having a steady job, enjoying their job, and dealing with money problems, can really affect how they feel. Middle-aged adults sometimes have a hard time finding jobs or face unfair treatment because of their age. In some cultures, not having a job or not moving up at work can make people feel bad about themselves.
Culture also affects what’s expected from people and what role they play in their community. Values like taking care of family members and showing love are often decided by culture. Middle-aged people, especially, might feel stressed from taking care of kids with special needs or their elderly parents. This can lead to health problems, money troubles, and maybe even losing out on job opportunities. Also, middle-aged people often take a moment to think about their life’s purpose during this time, which can bring up stress about relationships and planning for retirement.
Finding ways to deal with these stressors is important. Things like having flexible work hours, taking time off when needed, and getting support for caregivers can help a lot. But things are always changing, like with new technology and how the world economy works, which can make it tough for middle-aged adults to keep up at work. So, they need to keep learning and adapting to stay on track.
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561 Post 2 reply 2 (replying to John T): Filipino culture has a high regard for occupation and cause for psychosocial stressors that affect middle aged adults. Filipino culture is rooted in values that require their children to succeed (Chan-Nauli, 2018). These values consist of striving for more in their occupational choices, having expectations to think the same, and family recognition (Chan-Nauli, 2018). Striving for more relates to having prestigious careers such as nursing, engineering and being a lawyer (Chan-Nauli, 2018). If it is anything else, but these jobs they are judged and encouraged to pursue these types of careers at a young age (Chan-Nauli, 2018). Also, there is an expectation, whether older or younger, for Filipino culture to think alike. Homogeneous thinking is having the same thought process and lifestyle choices to create a long lasting career disregarding different age of thinking. Older Filipinos from the homeland tend to expect to have values such as hard work, respect to elders, and pride. Hard work in Filipino culture means working and not taking much vacation to destress. This is rooted in the farming mentality of Filipinos to produce and passed on to generations. Productivity and pursuing more to create a bright future is instilled in culture and values. Respect to elders may be in the form of doing what they want for you, but not considering what you want for yourself. This may place unnecessary stress on an adolescent and later as a middle aged adult. Filipino pride is making a mark in society and family. These values and expectations may result in a high responsibility state for adolescents and may translate to later stress or post traumatic stress disorder (PTSD). There is always an expectation to do more and doing the next step, but there may be little appreciation for the good that one has done (Samuels, 2023). This may bring constant anxiety, lack of sleep, depression from failing and increased burnout as symptoms of the psychosocial stressors of productivity, pride and respect. Also, working as nurses, lawyers and engineers are high stress jobs that may precipitate further anxiety, depression, hypertension and irritability. As middle aged adults that focus on Generativity vs Stagnation, Filipino culture may be different for the future generation of their children or nieces and nephews (Cherry, K, 2023). Generativity is making a mark by developing relationships with family, commitments to other people and mentoring others. The child that experienced stressors such as having high expectations and performance may either take the mentorship as yes do the same as me or no do not be engulfed in the productivity mentality. There may be a positive reinforcement towards productivity or a negative reinforcement by encouraging having an experience for life rather than focusing on performance and wealth. For me, I have experienced the Filipino culture and expectations. Currently, I am a workaholic and always trying to find the next step. Yes it does give me anxiety and low esteem at times, but I love being busy. The downside is that I do not rest as often as I should. It is only now that I am finally taking a vacation from work, but I am still full time in school. I also work two jobs. Overall, I love the challenge and staying busy for now, but I know I’ll slow down soon. As a nurse in Cardiac ICU and Cardio Thoracic ICU, anxiety, worrying and perfectionism is present, but it is alleviated by having a reliable team.
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