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this is a discussion engagement. Please reply to each one with atleast 3 sentenc

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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 faith community 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
WebMD (2020). Recognizing Caregiver Burnout. Retrieved from
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. References: A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Retrieved from. 3.
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 & Sakuda, 2012).
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. 1-7). IEEE.
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 the improvement 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 reporting.
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
Chin, B., and Mai‘i Sakuda, C. (2020). Transforming and Improving Health Care through Meaningful Use of Health Information Technology. Retrieved from
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 learning process.
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 community-based 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.
Joseph, S., 2020. Home Health Care Is A Bright Light During Covid-19 With An Even Brighter Future. [online] Forbes. Available at: [Accessed 8 December 2020].

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