This chapter focuses on women, who are HIV positive, from a global perspective. It illustrates more easily what makes groups of people, and in this case women, vulnerable and then consider vulnerability from a global health (GH) perspective using the chronic illness, HIV. The chapter presents some examples of situations that make women vulnerable to HIV and, once infected, vulnerable for life, and use a case-based approach to highlight women as a vulnerable population. It also focuses on the real ethical issues that occurred with each case, which one anticipate will help prepare the new GH nurse for practice in the global environment. The chapter demonstrates by using an exemplar of HIV-positive women, vulnerable populations exist both within and outside the United States. Reasons for vulnerability may include stigma, victimization, mental illness, migration, limited access to needed health care or food, or substance use.
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This chapter reviews prevention, including genetic counseling. It discusses genetic testing for diagnosis as opposed to screening and the treatment for genetic disease. Methods of prevention begin with education of the public and health care professionals and identification of those at risk. Genetic counseling is the process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease. The malignant cells often exhibit aneuploidy as well as translocations that are found only within the tumor cells. Genetic errors that arise from specific cell lines are somatic mutations. It is suggested that there is a thorough collection of family, genetic, and medical history for children entering the adoption process. Nurses may play a variety of roles in genetic counseling that reflect their preparation, area of practice, primary functions, and setting. The chapter explains the incidence of chromosome abnormalities.
- Go to chapter: Next Steps Toward Practice Knowledge Development: An Emerging Epistemology in Nursing
This chapter focuses on introductory arguments about the Doctor of Nursing Practice (DNP) student and graduate’s clinical scholarship, a future practice-oriented nursing epistemology. It explores a model of scientific inquiry and stewardship for the nursing discipline through the development of a body of practice-oriented nursing knowledge to improve health. There is a very strong case to be made that the “good science” evolving from the DNP programs where nursing epistemology and practice knowledge development is valued is indeed being conducted within the framework of a Mode 2 knowledge production paradigm. Finally, there is an operational concern for how practice knowledge is made formal within the academy before it is then further synthesized, reduced, and disseminated in journal format and oral presentation. Practice knowledge generation only needs rigor, proper mentoring, an inquiring mind, and some creativity.
Objectives have been used for decades in nursing education to set the stage for what is expected of students and to guide faculty in planning teaching and assessment. However, nursing education is evolving and the timeworn practices used to write objectives must evolve as well. This chapter focuses on how to write broad behavioral objectives to support learning in a constructivist, learner-centered online environment to guide teaching and learning that are in step with today’s innovations in education and that follow the call for radical transformation in nursing education. Objectives focused on the desired learning outcomes or intended behavior changes, termed performance. The psychomotor domain is the skills domain in the narrow sense of the word, in that this domain provides a means of identifying outcomes that involve fine, manual, and gross motor movements.
This chapter provides a guide to conducting a life history from conceptualization to dissemination. Life history is used to explain an individual’s understanding of social events, movements, and political causes, that is, how individual members of groups or institutions see certain events and how they experience and interpret those events. As it is unlikely that nurses will be conducting traditional fieldwork to gather life histories because of the extensive periods of time involved, the chapter describes the process for collecting focused life histories by researchers whose only purpose is to document the story of the participant and not to frame this life history within a broader ethnography. It considers life history as a sociocultural methodology and leave oral history on historical research and life review to the one on clinical literature.
This chapter presents an overview of the state of the art ethnographies conducted by nurses and highlights a few works by the early generation. An extensive search of the literature was conducted to identify ethnographies completed by nurses. Nursing knowledge was a common thread throughout the literature reviewed. The literature review revealed the progress nursing is making in recognizing this gap and attempting to close it. Nursing knowledge is essential in patient care. Using the ethnographic method of inquiry, nurses have been able to identify areas of need both in knowledge and practice and make recommendations for enhanced practice. Caring and patient advocacy were other common themes in the literature. Caring is the essence of nursing and consequently should be incorporated in nursing research. The common purpose of the ethnographic studies reviewed was to explain or understand a phenomenon to increase nursing knowledge.
Teaching Cultural Competence in Nursing and Health Care, 3rd Edition:Inquiry, Action, and Innovation
Preparing nurses and other health professionals to provide quality health care in the increasingly multicultural and global society of the 21st century requires a comprehensive approach that emphasizes cultural competence education throughout professional education and professional life. The ideas and suggestions presented in this book are offered to stimulate new ideas and invite health professionals to explore new paths on the journey to developing cultural competence in themselves and in others. The book is divided into five parts. Part I is composed of three chapters filled with resources to help educators begin teaching cultural competence. Essential background information about the multidimensional process of teaching cultural competence offers a valuable guide for educators at all levels who are planning, implementing, and evaluating cultural competence education. Educators and researchers are continually challenged to measure outcomes following educational interventions. Part II addresses this challenge by introducing several quantitative questionnaires and assessment tools and discussing implementation and data interpretation strategies in a detailed, user-friendly approach that can be easily adapted by novice and advanced researchers. The tools include Transcultural Self-Efficacy Tool (TSET) and Clinical Setting Assessment Tool-Diversity and Disparity (CSAT-DD). Parts III, IV, and V offer a wide selection of educational activities that can easily be applied by educators everywhere. Three chapters provide a general overview and a menu of activities for use in three areas: the academic setting, the health care institution, and professional associations. Five chapters creatively link strategies via detailed case exemplars that spotlight various populations and settings. The book’s final chapter presents important implications for educators everywhere.
In this chapter, the author began working in international medical humanitarian aid, with an organization called Medecins Sans Frontieres/Doctors without Borders (MSF). Pediatrics and Pediatric Intensive Care are where the author’s nursing career had started. With assignments in the Democratic Republic of the Congo (DRC), Haiti, and South Sudan, the author have provided care for people who have been displaced due to conflict, victims of war trauma, women with high-risk pregnancies, malnourished and critically ill children, and people with HIV and tuberculosis, and responded to outbreaks of preventable illnesses such as measles and cholera. MSF opened the Sibut project, with a focus on providing care for young children and women of child-bearing age. The security system includes daily contact with all of the village leaders in Sibut, including the Catholic priests, the imams at the Muslim mosque, the village elders, and the militia leaders.
The author worked in a public health research lab, after graduation from college. She liked the flexibility of nursing and the promise to always have a job. She was fascinated by the intricacy of the mind-body intersection and how horribly wrong things could get with seemingly small perturbations. She felt that nursing school discouraged any consideration of a career in psychiatric nursing, as a mentor shared a comment by one of her advisors years ago that “only the bad nurses go into psychiatry”. A common occurrence was the admission of patients with psychiatric needs in addition to medical comorbidities. She cared for patients who had anxiety as a consequence of hospitalization, depression due to chronic illness, persons suffering from acute delirium, as well as someone with dementia secondary to HIV. Later she accepted a job at a local community health center that serves a predominance of Latino immigrants.