this is a discussion engagement. Please reply to each one with atleast 3 sentences. Please have separate
answers for each one. Please no negative comment.
End of life care to hospice patients can be challenging to caregivers and families because of the physical
and emotional toll caregiving may take on the caregivers. Caregivers experience burnout when they are
physically, psychologically, and emotionally drained from caregiving’s complex task, which requires
physical, emotional strength, and commitment. According to WebMD (2020), Caregiver burnout is a state of
physical, emotional, and mental exhaustion. It may go along with a change in attitude — from positive and
caring to negative and unconcerned. Burnout can happen when you don’t get the help you need or try to do
more than you’re able — either physically or financially.
In this scenario, it can be seen that the parishioner’s daughter, who happens to be a nurse, is the only
caregiver to her father who is on hospice, and she has been trying to meet all his physical needs around
the clock!. Meeting the physical need of her dying father around the clock involves all the activities of daily
living like toileting, self-care, feeding, etc., which non-arguable is taking all the time and the physical
strength that she may need to also care for herself. The faith community nurse can engage the faithcommunity as a whole to volunteer support to this family working with the leaders of the faith community
and its health ministry to reach out to members who are willing to volunteer to support the family of their
hospice parishioner. “Health ministries are visible activities, programs, and rituals of faith organized around
health and healing of the congregation’s membership and offered by the faith community nurse, clergy,
layperson, or community resource.” (Lancaster,2016).
Most faith-based organizations have health ministries with volunteers to reach out and address the health,
physical, and emotional needs of its members, even the non-members. The faith-based nurse can also set
an example to start the ball rolling by initiating volunteer service to encourage others to volunteer. Effective
planning of the volunteer services should be made to have enough support to prevent caregiver role strain
and burn out of the volunteers. The faith-based nurse should also plan the volunteer services so that it
does not interfere with the volunteers’ lives. For example, instead of sending one volunteer for the whole
day, it can be arranged so that two volunteers split over one day and volunteer for lesser hours.
Lancaster, M.S. J. Public Health Nursing: Population-Centered Health Care in the Community. [VitalSource
Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9780323321532/
WebMD (2020). Recognizing Caregiver Burnout. Retrieved fromhttps://www.webmd.com/healthyaging/caregiver-recognizing-burnout#1
This topic is close to my heart and we deal with this situation very so often, sometimes, the hardest people
to deal with are the family with Nurses that is eaither close to the family or out there from the other country
of other states that would like to take care of the their parents. In this situation, I would like to ask the RN
Case Maganer (RNCM) that is assigned to the Patient and assess the situation. If not, I will be the one to
go, then I will ask the daughter how can I help? Who are the other family member that can provide support
or in their church group that can be supportive. As a Nurse, we need to identify the strenght of the
caregiver, “Burn out” is real and by any means we need to stop or solve the situation. I will also call our
Social worker (Psychosocial support) to gather all the support she can offer to the Daughter. I hope this
Daughter is willing to accept outside help. My experienced this year, that our Patient was declining fast
from Dementia to Advanced Alzheimer’s in 2 months, the only daughter took an early retirement from
Adventist Health in Glendale to take Care of the Father, after 2 months, she started to get “burn out” and
become suspicious, everything needs to be locked, only allowed Nurses and HHA visits, Declined Social
Worker/MSW and Spiritual Counselor, even though how much we offer, but she calls for help often but
refused to increase License Nurses and HHA visits. She controls everything at home. I was ready to call
Adult Protective Services (APS), but I know there’s no neglect, abuse and the place is clean/orderly and
safety was not jeoparized. But only 3 people allowed in the house to visit. I need to respect her wish and
she’s grieving on her own way.
One of the best thing about hospice care is the Interdiciplinaty Team (IDT) – a team meeting with The
Medical Director, DON, Skilled Nurse, Home Health Aide, Social worker (MSW) and Spiritual Counselor
(SC) every 14 days as mandated by Medicare to discuss the care and update on how we can improve
Patient and Caregiver/family on the End of Life journey for the Patient. This is a good example of helping
out, getting the support from the family, community and available resources to relieve the burden of maybe
Meals on Wheels, offer to arrange private caregivers, increase In-Home support service (IHSS), then I will
offer the possibility of using the Short term respite care. that If your usual caregiver (like a family member)
needs a rest, you can get inpatient respite care in a Medicare-approved facility (like a hospice inpatient
facility, hospital, or nursing home). Your hospice provider will arrange this for you. You can stay up to 5
days each time you get respite care. You can get respite care more than once, but it can only be provided
on an occasional basis. Which is from the beginning or during explanation of Election of Benefits (EOB),when they sign in to elect hospice for the care of th Patient, Medicare has 4 levels of Care, Routine level of
care – in which the Nurse will visit the patient according to their accuity (2/week, 3/week, daily/7 days or
accordingly depending on the Patient’s needs; General In Patient (GIP) – Usually in Skilled Nursing Faciity
or Hospital, Patient’s care is higher level that Medicare will incresed the reinbursement to pay for the care
of the 24/hr Skilled Nursing needs. Then Continuous Care – a License Nurse will be at Patient’s bed side –
this high level of care like having distress like Shortness of breath, fever, anxiety, nausea/vomiting,
diarrhea/constipation that mediction for comfort is not enough and happens to be in the Board and Care,
Independent Living, Assisted Living Facility, or private home that doesn’t have any skilled personnel to
continuously administer the medication or manage the symptoms of discomfort. Then Respite Care –
Patient will be sent to facility that has 24 hour Skilled Nurse on duty that is approaved by Medicare.
According to the Patient’s need, the agency will arrange placement and transfer the Patient to the facility,
Patient will bring 5 days supplies of his needs and medications that will be indorse by a Hospice Nurse to
the facility to have continuity of Patients care.
Furthermore, this can only be carried out if the Patient is coherent, safe to travel, and aggreable to go to a
place for few days to a facility to relieve the family/daughter from the responsibility or having respite care.
A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid
Services. Retrieved from.
Electronic health records can be used to improve the population health in various ways. First, EHR ensures
that patient records are readily available when required at the point of care. The reliable accessibility is
useful, especially in emergencies where the care provider can go quickly through the patient’s history
before making the treatment decision (Chin & Sakuda, 2012). The EHR also has a crucial role in improving
population health because it not only keeps a record of the drugs used by patients and allergies, but it also
can prompt the doctor when the patient is about to be prescribed with a medication that can trigger an
allergy. The EHR allows the doctor to correct medical errors (Asri et al., 2015). There is a connection
between the data gathered from the electronic health record and how care is delivered because the EHR
offers a comprehensive medical history of the patient, an action that is critical to treating the patient (Chin &
Asri, H., Mousannif, H., Al Moatassime, H., & Noel, T. (2015, June). Big data in healthcare: Challenges and
opportunities. In 2015 International Conference on Cloud Technologies and Applications (CloudTech) (pp.
Chin, B. J., & Sakuda, C. M. I. (2012). Transforming and improving health care through meaningful use of
health information technology. Hawai’i Journal of Medicine & Public Health, 71(4 Suppl 1), 50.
Electronic health records can be meaningful in the improvement of population health in various ways (Chin
& Mai‘i Sakuda, 2020). There are so many ways in which these can improve population health. The first
way these can improve the population is by collecting efficient data mostly in a method or form that the data
can be shared between several health care facilities and organizations that will be leveraged to help in theimprovement and prevention activities in a more quality way. It can also improve public health reporting and
surveillance. Doing these, then public health will improve because of the improved health surveillance and
The data collection gathered from electronic health can help a lot in the care for patients. For instance,
when a health care provider has access to all the accurate information or rather data from the patients, the
patients will tend to receive better health care from the health personnel. A patient was brought to a health
center after being treated at a previous hospital. He was in a serious condition that he could not talk. But
the use of electronic health records helped, and it improved the patient outcome.
The electronic health record was retrieved from another health organization where the patient had already
visited earlier. These then gave the health personnel the scope on what they were dealing with, which
made them stabilize the patient outcomes. The electronic health record can bring negative impacts while
being used. It might cause several consequences that were not being intended for such medical errors
increasing. These can bring a lot of problems for the patient and also the medical personnel. Each
employee should be trained properly on how to use EHR to retrieved and enter data properly. EHR
frameworks can change the manner in which medical services is conveyed when these advances are
planned, executed, and utilized suitably. EHR can promp unintended unfavorable results, for example,
dosing blunders, inability to identify genuine ailments, and postponements in therapy because of the
inability to enter data correctly (Bowman, 2013).
Bowman, S. (2013) Impact of Electronic Health Record Systems on Information Integrity: Quality and
Safety Implications. Retrieved from https://perspectives.ahima.org/impact-of-electronic-health-recordsystems-on-information-integrity-quality-and-safety-implications/
Chin, B., and Mai‘i Sakuda, C. (2020). Transforming and Improving Health Care through Meaningful Use of
Health Information Technology. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3347738/
My week was great and I learned about the use and importance of Re-Engineered Discharge (RED).
According to Mitchell et al. (2017), RED is an effective tool that prepares both the patient and their family
on the patient’s discharge, reduces hospital re-admission rates, and improves patient and family
satisfaction. The reason why I got exposed to RED is that post-discharge follow-up through the phone is
the 12th element in RED. I was mandated on making follow-up calls until a patient visits the facility for their
assigned follow-up. I have learned that all patients classified in RED needs to be called every 2 to 3 days
following discharge. As a nurse, my role is to answer any questions regarding care, address the patient’s
misunderstanding, and actions.
The second nursing component that I learned this week is the aspect of continuity of care. As a nurse
dealing with patients at end of life or during palliative care, I learned the significance of meeting their needs.
Through the process, I have applied the holistic approach to the patients and their families. According to
College & Association of Registered Nurses of Alberta (2008), nurses apply evidence-based judgment and
critical thinking skills to assess the patients’ needs in a holistic approach that comprises physical,
emotional, and social needs. While making the phone call, I acted as a navigator by offering information,
education, support, and resources. This
has made me view the role of making follow-up not as a mere process of making calls but rather as a
College & Association of Registered Nurses of Alberta. (2008). Registered Nurse Roles that Facilitate
Continuity of Care. College & Association of Registered Nurses of Alberta website.
Mitchell, S. E., Weigel, G. M., Laurens, V., Martin, J., & Jack, B. W. (2017). Implementation and adaptation
of the Re-Engineered Discharge (RED) in five California hospitals: a qualitative research study. BMC health
services research, 17(1), 291.
As a home health nurse, I can definitely say that business has been much busier lately. Many patients that
are vulnerable and may not be willing to go outside feel more comfortable with one set nurse coming in and
assisting with care. Since the pandemic, home health care has received a greater acceptance. As the
article states, COVID has impacted the nursing homes more than anyone else. Many elderly patients are
afraid to go to nursing homes therefore many people would prefer to be in a home than in a communitybased setting. And now that providers have noticed the impact of COVID as well, many are not as quick to
send their patients to nursing facilities vs home health care.
Home health care is much more individualized and personable. Most families can appreciate the benefits
once they receive the services. Once patients realize that they can care for themselves in a timely fashion,
they are less preoccupied with doctor visits.