Assignment #3a

Name: KRIZHEL MIRJA CAWAS

 In your own words and experience, as a professional nurse how do you

shape the future of nursing?

The future of nursing profession is no doubt that the health care system is
constantly changing and working to improve laws, to the best of its ability. Whether
nurses like it or not we are a part of the ever changing health care system.
I believe that nurses should be active in transforming the profession of nursing
along with the health care system. Regardless, of backgrounds, race, and age all nurses
can contribute to the future of the nursing profession.
To shape the future of nursing I will engage myself in higher education; and
taking masterals is one of the reasons for future nursing. I believe that nursing
education is one of the links to effective patient care, as well as safety. It implies that
higher education nurses receives, the higher optimum level of care. Advancing my
current level of education will be a boost to my career as hospitals are seeking nurses
that are more qualified to handle responsibilities; as J. Ryan said, “an advanced degree
in nursing helps in preparing an individual for higher-level responsibilities with a
higher pay”. Having an advanced degree would enable me to work with complex
information management systems, which necessitates advanced skills in analysis to
enhance quality and efficiency in patient care.
In the future of nursing, it is likely to change after advancing my level of
education because hospitals and nursing homes are handling more responsibilities that
require nurses with in depth knowledge on medical practices. Change in technology,
increase in chronic disease patients, and the rising life expectancy are likely to create
more duties, as hospitals endeavor to handle the aging population.
Suggesting an organization for re-echoing knowledge to nurses with less
proficiency is a must for me. The more experienced nurses must mentor all the less
proficient nurses to show the correct way. Nurse leaders should also sit on boards of
health care organizations and sit on policy-making commitees. As fore me, I am not
sure what the future holds for me.
An improved education system that promotes seamless academic progression can
be achieved through higher levels of education and training of nurses. Academic
institutions have a responsibility to prepare nurses to meet diverse patient needs and
advance science to provide highest levels of
quality care to patients. There is a need to transform nursing education to work
effectively with other health professionals in a fast-changing health system, globally.
Continuous lifelong learning through modern methods of learning and teaching and a
dynamic curriculum will prepare the nurses to meet the challenges of the new
millennium.

 Identify a pressing issue or problem in your professional practice.

1) EXTENDED HOURS
Nurses usually stay in thier hospital jobs for about two to three years, as this is
the required length of work experience for nurses to go abroad. There is no actual data
in the Philippines related to occupational injury or illness but a few nurses’ gets
infected with tuberculosis from exposure to TB patients.
There is no available data regarding injuries among nurses. Needlestick injuries is
not uncommon in the hospital setting and isusually left unreported. Fatigue is
common as nurses are usually overworked and the lengthof shift lasts from eight to
more than twelve hours. With the changing shifts of the nurses in a every few days,
the incidence of sleep disorders may increase since their biological clocks are
constantly adapting with the frequent change of shifts and schedules.

2) NURSING INFORMATICS
Implementation of nursing informatics is also limited to lectures in the classroom
and used in some large hospitals.
Nurses spend a lot of time on documentation and it will be very helpful to fully
implement computerization of medical records in the hospitals. Nurses would save a
lot of time in documentation and accuracy of records will be improved since poor
handwriting issues would be eliminated. On the other hand, it will be costly to train
nurses on the use of the program electronic documentation.
The path for full implementation of electronic documentation and other areas of
nursing informatics is still a long and rough road for Filipino nurses in the country.
Nurses must learn and practice using the computer and its basic fucntions and
programs to hasten the road for nursing informstics in every hospital.

3) OCCUPATIONAL HEALTH AND SAFETY ISSUES AMONG NURSES

Nurses face considerable occupational health and safety risk in their daily duties.
Despite the importance of occupational health and safety among nurses, it is not
given much attention. The Philippine Nurses Association must look into this and
advocate ways of promoting health and safety among health care providers.
A surveillance system must be enforced to collect data regarding this matter.
Occupational health nurses must also explore strategies to help nurses recognize the
potential seriousness of work-related injuries and illnesses.
Occupational health nurses must also advocate for better occupational health and
safety policies. There should be a formal regulations regarding this matter.
Other potential work-related injuries and illnesses may include job stress, verbal
abuse, and back pain. This areas must also be looked into.

4) NURSING CRISIS
The existence of nursing profession in undeniable. Highly skilled and
experienced nurses go out of the country to seek better employment opportunities
with a much higher compensation and both monetary and nonmonetary benefits. This
leaves the country with inexperience novice nurses.
Many people aspire to be nurses and with the increased demand for nursing
schools, almost every college or university now offers Bachelor of Science in Nursing
(BSN) degree. The deterioration of quality of nursin g education is very evident in the
results of the Nurse’s Licensure Exam (NLE) with only 40% passers.
The increased number of nurses is not proportionate with the increase in jobs.
Both local and abraod, causing nurses to “volunteer” to hospitals without pay while
actually doing the functions of a staff nurse. Nurses are baited to such schemes in the
hope of receiving a certificate of employment for two to three years, which can serve
their ticket for a job abroad.
The current decline in the number of enrollment fro BSN in nursing schools led
to colleges of nursing to lessen the number of faculty and some colleges to voluntarily
close the program. However, many schools are opening master’s degree in nursing.
This prompted the Commisiion on Higer Education to issue a ban on opening new
nursing programs.
Both the government and nurses must do their part in hepling solve the nursing crisis.

5) ETHICAL ISSUES ON NURSING PRACTICE

Nurses face ethical dillemma in their practice of the profession. They are faced
with a morsl dilemma on different issues. However, few nurses have actual ethical
training. They need more training regarding this matter to better enhance their ethics
confidence and ability to act as a moral agent.

6) SALARY: UNDERPAID AND OVERWORKED

The compensation of nurses depends on many factors. Aside from specialty, their
place of work tends to affect the salry they get. Salary is one of the reasons why
nurses leave the hospital. Nursing is one of the most expensive courses that you can
ever major in; they must invest in the board exam, gain two years of experience and
pay additional fees such as fpor language exams if they plan to work for abroad. It can
take a nurse anywhere between five and 10 years to qualify for work abroad. An
estimated 13,000 nurses leave home for these jobs annually. Nurses would rather
leave the country than to work in the country because of low salary.

7) ACCESSIBILITY OF HEALTH CARE INSTITUTIONS THIS PANDEMIC

Since the beginning of the pandemic, visits to primary care physicians and
outpatient specialists have declined, and many hospitals have postponed or cancelled
elective procedures. At the community level, stakeholder accounts revealed
disruptions to healthcare services. Access to basic human needs such as food was also
interrupted. Most residents survive through highly insecure employment in the
informal sector, often undertaking multiple jobs that pay low daily wages – this was
also disrupted, and the cost of buying medicine was already a problem for many
residents.
 ACCESS TO HEALTH CARE DURING COVID-19
PANDEMIC

Krizhel Mirja O. Cawas

Masters in Nursing, Saint Paul University

Philippines

MAN 201 (Foundations of Nursing Practice)

Professor Lilian Gonao

August 22, 2021

BACKGROUND
The COVID-19 pandemic has dramatically changed how patient care is delivered
in health care practices. To decrease the risk of transmitting the virus to either patients
or health care workers within their practice, providers are deferring elective and
preventive visits, such as annual physicals. Many patients are also avoiding visits
because they do not want to leave their homes and risk exposure. 
Health care has undergone monumental changes in response to the COVID-19
pandemic. In the early months of the pandemic, some aspects of hospital activity
stopped, and staff and resources were redirected to care for acutely ill COVID-19
patients. Outpatient activity was either postponed or took place remotely. Planned
non-urgent treatment, including diagnostic care, was also postponed and sometimes
closed to new referrals.
Changes outside of hospitals have been equally large. Face-to-face care was
mostly suspended in the community, unless it was urgent. For services such as general
practice, the public were told to phone their GP surgery in the first instance, as
practices began total triage and adapted their services to protect patients and staff
from infection.
Some shifts are a direct result of the crisis response: more patients waiting
much longer for planned hospital treatment and for diagnostic tests, alongside sharp
falls in referrals to outpatients. Other shifts were less predictable as they were patient-
led, and a reduction in desire to seek care. Fears about contracting COVID-19 have
played a part in keeping some people away from health care services.
Primary care plays a pivotal role within the community, it is responsible for the
majority of patient contact with the health system, and it affects both planned and
unplanned flows into the rest of the system. 
Patients have been harmed by this reduction in access and use, and they continue
to suffer and die at home from conditions for which they would ordinarily seek care.
While deferred high-value care increases morbidity and mortality, the unanticipated
pause in care delivery also provides an opportunity to revisit entrenched health care
practices that may not be effective or efficient.
The COVID-19 pandemic has changed the health care landscape. It has created a
novel sense of scarcity, which has forced health systems to cut profitable services and
prioritize seriously ill patients.
The COVID-19 crisis demonstrates the importance of placing primary health care
at the core of health systems, both to manage an unexpected surge of demand and to
maintain continuity of care for all.

 What is the issue or problem?

Tabuk city is one of the far flung place in CAR region, a one-hour drive to
Tuguegarao City and it has hospitals and with least of the specialists, and the other
islands have small medical centres with limited resources. Sometimes, when
somebody who lives in a small island needs to visit a specialis; they have to go to
Tuguegarao. Thus they have to spend money in the plane/bustickets, and when these
trips are usual, this cost a lot of money. But not only is the money a problem. Due to
covid there is decrease in health care to health facilities because most people are
afraid to have contact with Covid-19.Most priorities in the hospitals are the ones who
need urgent care. The same happens for those people with children, and they are
forced to let them with their families. Instead of that, we can send the information in
some other way, and there is where this application comes into scene. This project
proposes to use internet to reduce these problems, and to allow patients to use a web
application to send/receive some information, and avoid or at least reduce the number
of times per year that a patient must travel to one of the main islands, and to reduce
the risk of having Covid-19. By using this application, patients can get some
important information about their illnesses. They can also send their own information
to the doctor. Doctors will use this information to control the evolutions of their
patients. Whenever a doctor finds one of the measurements out of the normal range,
he can send an email to the patient, telling him to come to the hospital for a check, or
to take some specific medicine. This way, the patients do not need to go to the main
islands so often, and then they can reduce the risk of these annoying and virus. This
web application can be also be useful in some places, where distances are longer and
sometimes you need some hours travelling by car to go to the hospital. It can be also
useful in some cases like when a patient have some difficulties in going to the hospital
so often (handicap people, elder people who have nobody to take care of them, etc.).
Summarizing, the main goal of this proposal is to provide a useful tool that the
users (patients,nurses, doctors and internet surfers) can utilize to reduce some of the
problems their ilnesses causes. Since different kind of people will use this tool, it must
be simple to use and to understand. This application must allow the interaction
between the patient and the doctor. Since we are working with databases, the security
is an important factor to take into consideration. The application must be reliable and
not allow unauthorized access to the data. A primary goal for the doctor is to be able
to view the personal and medical information of their patients. They must be able to
read all the forms that the patient has sent or to be able to read the appointment
requests of the patients. Another goal for the doctors is to be able to use the
application to contact the patient (via email, videocall, messenger,etc.). In the case of
the patients, the goal is to receive some medical information about their illnesses, and
to be able to send information to the doctor.

 How does the issue/s or problem affect or impact nursing practice?

The recent Coronavirus disease 2019 (COVID-19) pandemic outbreak has forced
many countries to adopt specific austere “lockdown politics,” which had reduced the
spreading of the infection. Considering the lack of vaccination, it is reasonable to
think that, especially for children and older people, most of these lockdown measures
will be prolonged for the next months, even if it is still too soon to precisely predict
for how long.
Interruption of school, sport, and other social activities is forcing children to stay
home for most of their time, in close contact with (often idle) parents. Moreover,
lockdown has a direct effect in the reduction of activities in non-COVID emergency
rooms and hospital wards caused by the shift of personnel towards COVID-units and
by a diffuse “germaphobia” (fear of germs and infections, and as a consequence of
hospitals). In most of the hospitals many “COVID-units” (as well as COVID-pediatric
units) have been quickly created, and, at the same time, in the other units, activities
have been focused more on patients affected by severe and acute conditions, reducing
the care and assistance for patients affected by chronic or rare diseases.
Lastly, the economic breakdown, expected in most of the countries, will probably
involve the national health systems, especially pediatric departments and units not
involved in emergency and infectious diseases, limiting the experience, progresses,
and even the simple management of many genetic, congenital, and chronic disorders,
with severe social effects, especially for children.
The coronavirus disease 2019 (COVID-19) pandemic has created unprecedented
challenges to providing medical care for patients with conditions other than COVID-
19. 
Delayed care has been widely reported during the COVID-19 pandemic, both for
perceived serious medical issues and all types of medical care generally. Among those
reporting delayed care, more than half (57%) said they experienced negative health
consequences as a result.

 What nursing trend can you propose to solve the issue or problem?

Teleconsultations are part of the healthcare pathway and provide an additional

solution to primary care physician’s follow-up. This service allows you to:
 have access to specialists at any time, without any waiting period;
 get advice on choosing a specialist depending on your illness or condition;
 benefit from advice before seeing a doctor;
 get information on the seriousness of your illness or condition;
 obtain a second medical opinion;
 benefit from a more detailed explanation of a diagnosis provided by your primary
care physician;
 receive regular medical follow-up.

Telemedicine began from the humble beginnings of the first telephone call from
Alexander Graham Bell to his associate, Watson. These systems already have been
used for educational programs, consultative care, image transfer, second opinions, and
direct acute patient care. Most of the original programs failed because of several
reasons, primarily because of lack of funding when a grant ended. The major lesson of
these programs is that a solid business plan is needed initially for long-term survival.
The reliability of telemedical examinations has been demonstrated superficially,
but more conclusive work in this area is needed. Studies that evaluate clinical,
financial, and satisfaction outcomes are required simultaneously. Further integration
of medical informatics into telemedicine systems is needed before these systems can
achieve more acceptance. Twenty years ago, few people predicted this technologic
revolution. Innovations arise almost daily. The future seems promising for telemedical
systems, but much work is required. Partnerships with industry must move beyond
niche projects, and regulatory and medicolegal issues must be resolved.
Anesthesiologists can expect their practice to be affected directly by technology,
and should embrace it, evaluate it, and help lead its use in this millennium.