Feb 23, 2024 NURS 6050 Discussion Presidential Agendas
NURS 6050 Discussion Presidential Agendas
NURS 6050 Discussion Presidential Agendas
I enjoyed reading your post and agree that the Coronavirus (COVID-19) is a hot topic within the nursing community. Due to COVID-19, it is hard to even think about any other issues happening in nursing right now. In your post, you talk about autonomy in nursing, which I always valued when practicing medicine. Autonomy is the ability to act on his or her own values and interests (Greaney & O’Mathúna, 2017). Personally, I do not want to practice medicine with a parental lens; I want to practice as a coach who can guide and educate my patient to make the best decision for themself. Since COVID-19 began, I believe that allowing patients to make the best decision for themselves has been taken away. I have seen many health care providers forcing their opinions and beliefs onto their patients. It remains critical for health care workers to remember that ultimately it is up to the patient to make the decision they want regarding their health and wellness.
In order to help guide patients, I often used the evidence-based practice approach. Evidence-based practice is a problem-solving approach used in a clinical setting that incorporates evidence from well-designed studies (Milstead & Short, 2019). As a nurse, I think it is important to educate people on how to conduct research so they can make decisions they feel comfortable with for themselves and their loved ones. In your post, you mentioned that getting vaccinated is a personal choice, and I agree with you. People often seek the advice of their medical provider on whether or not to receive a vaccine. In addition to the advice, I also like to provide patients with information on how to find research that may be helpful when making their decision. I hope that moving forward, medical providers and patients can continue to make their own medical decisions without repercussions.
Greaney, A.-M., & O’Mathúna, D. P. (2017). Patient autonomy in nursing and healthcare contexts. Key Concepts and Issues in Nursing Ethics, 83–99. https://doi.org/10.1007/978-3-319-49250-6_7
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Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jonest and Barlett Learning
The healthcare system is highly sensitive and that is why presidents have to make critical decisions and ensure the safety of their citizens. I agree with you that the opioid epidemic is one of the healthcare issues that rose to the presidential level. Opioid misuse presents various health risks and that is why it was necessary to engage the presidential intervention. President Bush’s administration approached the issue in three ways. First, the administration provided efforts to stop the kids from using the drug. Secondly, the treatment for those already using the drug was expanded and finally, the flow of the drug into America was controlled. The measure would be undertaken for infectious diseases that arise, Breaking the infection cycle is important in managing health crises and emergencies (Hedberg, et al., 2019).
The Obama administration approached the issue more comprehensively and approved the CAR bill to fight the epidemic. Similarly, President Donald Trump declared the epidemic a national state of emergency and this was appropriate. I agree that health issues require urgent intervention to curb the causative factors and prevent the issue from spreading further and this is what the three presidential administrations did.
The presidents must be sensitive to identify the impacts of given health issues and develop appropriate policies that will minimize the harmful effects the citizens suffer (Smith, 2020). In this case, the use of opioid drugs was on the rise and the level could have been very disastrous if the relevant measures developed were not adopted. It is important that government systems set aside funds to handle medical emergencies whenever they rise because they cannot be postponed (Katz, Attal-Juncqua & Fischer, 2017).
NURS 6050 Discussion Presidential Agendas References
Hedberg, K., Bui, L. T., Livingston, C., Shields, L. M., & Van Otterloo, J. (2019). Integrating public health and health care strategies to address the opioid epidemic: the Oregon Health Authority’s Opioid Initiative. Journal of Public Health Management and Practice, 25(3), 214-220. doi: 10.1097/PHH.0000000000000849.
Katz, R., Attal-Juncqua, A., & Fischer, J. E. (2017). Funding public health emergency preparedness in the United States. American journal of public health, 107(S2), S148-S152. doi: 10.2105/AJPH.2017.303956
Smith, H. J. (2020). Ethics, Public Health, and Addressing the Opioid Crisis. AMA Journal of Ethics, 22(8), 647-650. doi: 10.1001/amajethics.2020.647.
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Introduction
In both history and at present, almost every American has had to deal with a crisis that started at some point and rose to the presidential level, and became a presidential agenda. Be it terrorism, economic calamity, a natural disaster, or a political scandal, the Presidents have handled them using their own means, which sometimes attract praise and criticism in equal measure (Darlene, 2020). This brief paper looks into how the last three American former presidents handled health care and what could have been done differently
The Presidential Responses
In the year 2003, President Bush had to handle the issue of the AIDS epidemic crisis and SARS. His commitment to fight AIDS received praises from both Democrats and Republicans alike. One way in which he handled AIDS was through the creation of the President’s Emergency Plan for AIDS Relief (PEPFAR) that ensured huge amounts of funds were made available to help fight AIDS. President Obama also made strides in his response to the AIDS epidemic. During his campaigns, he promised a comprehensive National HIV/AIDS strategy for the USA. True to his word, President Obama delivered on the same promise (Crawley, 2020). The strategy set up by the Obama administration is still the guiding force behind the collective efforts. Besides, Obama brought for the first time consistent yearly HIV prevention increases.
Even though there have been research efforts to help end AIDS, the epidemic is still there, and President Trump also has to deal with the same in his own way. President Trump set up a ten-year initiative to end the HIV epidemic (Hiers, 2020). The plan had federal resources to help in implementing the plan. The plan was a good one since the effort included so many rural and southern areas. However, I feel that the plan is wholly medical. Therefore, in his position, I would advocate for more emphasis on strategies that can help the community to adhere to the treatment plan.
NURS 6050 Discussion Presidential Agendas References
Crowley J.(2020, January, 29). PRESIDENT OBAMA’S LEGACY OF LEADERSHIP ON HIV/AIDS.https://oneill.law.georgetown.edu/president-obamas-legacy-of-leadership-on-hiv-aids/.
Darlene S. (2020, March, 23). Presidents in health crises: Trump more hands-on than many
https://apnews.com/article/3bab4e7404ecb093dc89181d40988d41.
Hiers, K. (2020). Implementing the Trump Administration’s “Ending the HIV Epidemic” Plan in the Southern United States. Doi: 10.2105/AJPH.2019.305452
The population health topic I am choosing is the opioid epidemic. I chose this because it affects such a large population in today’s world. According to the Centers for Disease Control and Prevention (2022), drug overdose deaths have increased by nearly 5% from 2018 to 2019 and quadrupled since 1999. Over 70% of the 70,630 deaths in 2019 involved an opioid. In 2020, 91,799 drug overdose deaths occurred in the United States. The number continues to rise, and drugs seem to be more accessible.
Regarding social determinants, people from low socio-economic classes have poorer health. They are more likely to use tobacco, drink alcohol at high risk, and use illicit drugs. Drug-dependent people are particularly likely to be unemployed and to experience marginalization, both of which can exacerbate their problems and prevent seeking or benefiting from treatment (Spooner,2017). Drug abuse is not shy when it comes to whom it affects. People in low socioeconomic classes happen to get slammed with drug abuse as we have not provided the right accessibility for them.
One of President Trump’s solutions was to build a wall. Theoretically, the wall would stop illegal drugs from coming in, and this wall was supposed to be built on the Mexican border. He also said he would enhance access to addiction services, end Medicaid policies that obstruct inpatient treatment, and expand incentives for state and local governments to use drug courts and mandated treatment to respond to the addiction crisis (Kaiser Family Foundation,2017). Although some think the wall may help, it is not the solution to the epidemic. In some cases, working from the outside inward works, but in this case, I think this epidemic needs to be approached from the inside out.
In this case, I would have started the solution on the inside. I would have targeted what we can control right now. Stopping Illegal drugs from coming in will help in the long run, but you must focus on what illegal drugs are happening in the US. Building a wall doesn’t stop the use, trading, selling, or buying we are currently dealing with. I would work to eliminate those issues, do more research on who this affects the most, and start there. We know people from low socio-economic classes struggle the most, so I start there and work my way out. Maybe we start focusing on getting these people out of this low-income rut. We provide schooling, daycare, and opportunities some people will never receive. Even starting there seems small, but I would further it with Trump’s plan to enhance access to drug addiction services like counselors. I would hold more doctors accountable and pharmaceutical companies pushing these opioids for money.
According to the Democrat National Committee (2020), President Biden’s solution includes holding people accountable such as big pharmaceutical companies, executives, and others, responsible for their role in triggering the opioid crisis. Biden will create effective prevention, treatment, and recovery services available to all through a $125 billion federal investment. Most importantly, we will stop overprescribing pain medication to citizens. I think Biden’s solutions to this epidemic were much better; these solutions start inward and target the people in the US struggling. I believe the solutions listed will help the country see a decline in opioid deaths, but they won’t solve the issue altogether.
As much as I agree with this approach, I don’t think the primary producers of these drugs are being held accountable enough. I would figure out a way other than fines to serve these companies. Possibly suspending their production may be a helping solution. The problem is these companies are laced with money, so half the time, they don’t even blink at the request to hand over money due to fines. I wouldn’t change much to Biden’s policy otherwise. I think his approach gives people accessibility, and that’s truly what we need to end this epidemic.
Centers for Disease Control and Prevention (2022). Death Rate Maps & Graphs. Centers for Disease Control and Prevention. Retrieved August 30, 2022, from https://www.cdc.gov/drugoverdose/deaths/index.html
Democrat National Committee. (2020). The Biden plan to end the opioid crisis. Joe Biden for President: Official Campaign Website. Retrieved August 30, 2022, from https://joebiden.com/opioidcrisis/
Kaiser Family Foundation. (2017, January 9). President-elect Donald Trump stands on six health care issues – election 2016: The issues. KFF. Retrieved August 30, 2022, from https://www.kff.org/report-section/where-president-elect-donald-trump-stands-on-six-health-care-issues/#opioid
Spooner, C. (2017). SOCIAL DETERMINANTS OF DRUG USE. National Drug and Alcohol Research Centre (NDARC). Retrieved August 30, 2022, from https://ndarc.med.unsw.edu.au/
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Unfortunately, VA healthcare reform is faced with similar challenges of establishing universal health care but on a smaller scale. Agendas, interest groups, insurance stakeholders, pharmaceutical suppliers, and access to care are all variables in creating policies that appear to be relentless barriers to healthcare reform; however, change is a process. The evolution of the CHOICE act to the Sgt. Ketchum Rural Veterans Mental Health Act of 2021 is promising. Findings from this living body of veteran health data and research will continue to shape policy improvement. I am hopeful that with each future bill and amendment passed, a new layer of protection will be provided to those who have sacrificed their lives to protect us.
NURS 6050 Discussion Presidential Agendas References
Albanese, A. P., Bope, E. T., Sanders, K. M., & Bowman, M. (2019). The VA mission act of 2018: A potential game changer for rural GME expansion and Veteran health care. The Journal of Rural Health, 36(1), 133–136. https://doi.org/10.1111/jrh.12360 American Association of Colleges of Nursing. (2016, December 13). VA ruling on APRN practice: a breakthrough for veterans health care. Message posted on the American Association of Colleges of Nursing Listserv:web@aacn.nche.edu Department of Veterans Affairs (2018b). VA National Suicide Data Report: 2005–2015. Retrieved from https://www.mentalhealth.va.gov/ docs/data-sheets/OMHSP_National_Suicide_Da ta_Report_2005-2015_06-14-18_508-compliant.pdf Monteith, L. L., Wendleton, L., Bahraini, N. H., Matarazzo, B. B., Brimner, G., & Mohatt, N. V. (2020). Together with veterans: Va national strategy alignment and lessons learned from community‐based suicide prevention for rural veterans. Suicide and Life-Threatening Behavior, 50(3), 588–600. https://doi.org/10.1111/sltb.12613 VA.gov: Veterans Affairs. RURAL VETERANS. (2016, January 19). https://www.ruralhealth.va.gov/aboutus/ruralvets.asp. Veterans Health Administration, D. U. S. for O. and M. (2013, May 8). VA.gov: Veterans Affairs. Enhanced RANGE Program. https://www.lexington.va.gov/services/Enhanced_RANGE_Program.asp.
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NURS 6050 Discussion Presidential Agendas
Thank you for the question. I see this health care disparity as a priority within the context of social determinants of health because of its pervasive nature. According to the Health People 2030 objectives, social determinants of health (SDOH) are the dynamic qualities and characteristics of the environment an individual is born into, lives, learns, works, plays, worships, and ages. These environmental qualities and characteristics are considered social determinants because they will directly or indirectly determine or impact the health, functioning, risks, and quality-of-life outcomes of the people living within it (Office of Disease Prevention and Health Promotion, 2021). The Healthy People 2030 Framework identified the following five domains of SDOH: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context.
Shortages of mental health care providers and poor access to mental health care services, especially in rural areas, fit perfectly under the health care access and quality domain; however, these same disparities have direct and indirect impacts on the existing four domains as well. Most mental illness diagnosis and disorders include a variable of pathology impacting your quality of life, or the impairment of your perception that thereof.
Thus, the psychiatric mental health patient population in general, including veterans, require a scaled-up version of services due to the vary nature of the pervasiveness of untreated mental conditions on all domains of health and functioning. Effective mental health treatment has the power to help an individual function at work (economic stability), encourage self-actualization and improvement (by harnessing access to education or investing in their children’s), and find purpose and belonging in a community (neighborhood and community context). I would say the mental health provider shortage and poor access to mental health care services in the rural veteran community is a good place to start developing interventions and policies that can be translated to a larger population of people in need.
NURS 6050 Discussion Presidential Agendas References
Office of Disease Prevention and Health Promotion. (n.d.). Social determinants of health. Social Determinants of Health- Healthy People 2030. https://health.gov/healthypeople/objectives- and-data/social-determinants-health. Chisholm, D., Sweeny, K., Sheehan, P,. Rasmussen, B., Smit, F., Cuijpers, P., & Saxena, S. (2016). Scaling- up treatment of depression and anxiety: A global return on investment analysis. The Lancet Psychiatry, 3(5), 415-424. https://doi.org/10.1016/s22150366(16)30024-4
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Pilar, Thank you for your post. Suicide continues to devastate the military community at an alarming rate. This nurse is personally aware of 5 deaths within this past year alone at the base we were stationed at. This can be attributed to the culture of the military when it comes to how a person who is suffering from mental illness is treated. I can speak firsthand to this as I have a very close friend that has been struggling with her mental health and when she hinted at it to her bosses she was made to feel as if her job was in jeopardy because heaven forbid military men and women are human and suffer mentally.
Active-duty members are not allowed to seek mental health treatment from an outside provider, Tricare mandates that all active-duty members must receive a referral from their Primary Care Provider to receive mental health services (Military One Source , 2020). I would like to see a President change that requirement, as many military men and women do not seek treatment because they must go through their PCP and that goes on their permanent record. I believe mental health services should be covered without a referral.
NURS 6050 Discussion Presidential Agendas Reference:
Military One Source . (2020, August 12). 7 Counseling Options for Service Members and Their Families. Retrieved from Military One Source : https://www.militaryonesource.mil/confidential-help/non-medical-counseling/military-and-family-life-counseling/7-counseling-options-for-service-members-and-their-families/
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I do agree with you that the presidential agenda has been crucial in enactment of policies that have had a resounding impact on the general well-being of the American public. One of the key presidential agenda is the CHOICE Act of 2014 under the Obama administration (Ohl et al., 2018). Some of the salient features of this act include; improvement of access to care from non-VA providers, additional expansion of access to care and reviewing and expanding capacity and processes (Sayre et al., 2018). Under the Veterans Choice Act, there is the veteran’s choice fund and this was to be in operation for three years until the exhaustion of the fund. Moreover, the VA is mandated to develop a system of tracing and paying the claims for the care provided to the veterans by the non-veterans under the program or any other non-VA entities. This is meant to help the veterans in the rural areas to be able to access quality care a month them proper mental health guidance and assistance after years of war (Kaboli & Fihn, 2019).
NURS 6050 Discussion Presidential Agendas References
Kaboli, P. J., & Fihn, S. D. (2019). Waiting for Care in Veterans Affairs Health Care Facilities and Elsewhere. JAMA Network Open, 2(1), e187079–e187079. https://doi.org/10.1001/jamanetworkopen.2018.7079 Ohl, M. E., Carrell, M., Thurman, A., Weg, M. V., Pharm, T. H., Mengeling, M., & Vaughan-Sarrazin, M. (2018). “Availability of healthcare providers for rural veterans eligible for purchased care under the veterans choice act.” BMC Health Services Research, 18(1). https://doi.org/10.1186/s12913-018-3108-8 Sayre, G. G., Neely, E. L., Simons, C. E., Sulc, C. A., Au, D. H., & Michael Ho, P. (2018). Accessing Care Through the Veterans Choice Program: The Veteran Experience. Journal of General Internal Medicine, 33(10), 1714–1720. https://doi.org/10.1007/s11606-018-4574-8
I agree with you that most people living the US and the world have had mental illness at one stage of their lives. It is absolutely true that most communities have neglected mental illness such as emotional distress, depression, and stress. Unexpected and sudden death is common among mental health patients. Persons with mental illness are known to have poor health status and considerable premature mortality. I concur with my colleague that the previous presidents, George W Bush, Barrack Obama, and Donald Trump, have made fundamental reforms to reduce the number of mental health patients in America. Bush created a commission that come up with 19 impressive recommendations to reduce mental illness. His successor, Obama, signed ACA that added mental health patients to Medicaid. Lastly, Trump supported a group of health clinics for mentally ill patients with US$700 million.
Mental health disorders affect a person’s feeling, thinking, mood, or behavior, such as anxiety, depression, panic disorder, prevalence, schizophrenia, or bipolar disorder (Valentine, & Shipherd, 2018). These conditions may either be chronic (long-lasting) or occasional, affecting the person’s ability to perform their daily activities. In 2019, nearly 21% of Americans had a mental illness. The number signifies that 1 in 5 Americans experienced mental health disorders in 2019 (Czeisler et al., 2020). Mental health disorder does not discriminate, and it can affect all people regardless of their social status, income, geography, age, sexual orientation, ethnicity/race, or spirituality/religion. Unfortunately, people who are mentally ill do not want to talk about it. There is nothing to be ashamed of about this
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