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HE302 March 12th and 19th lecture notes.docx

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Health Sciences
Renee Mac Phee

th HE302 March 12 , 2012 Regulated health profession: nursing History of Nursing - Today nursing is a comples occupation - Duthes of a hospital nurse are varies and specialized - 12 century o Healing and caring for the sick came to be though of as actis of Christian charity o Nursing became fill time occupations for the sister is nuns of the church tho Work with the sick and founded hospitals and - 13 century o Military nursing  Knights of st john of Jerusalem admitted women into their order so that teyu th could nurse the wounded - 16 century o Nursing disappears as the respectable service for devout Christian women and it s organizations were destroyed as a result of the Protestant Reform o Patients now shared the same dirty sheets o Windows were boarded up because it was believed that fresh air would make people sick o Germs spread and multiplies due to filth in airless environments o Women who did continue to work in the hospitals were subject to working among rats, debris, contaminated water supplies, contagious diseases o Mortality rates for nursing staff were almost as high as that of the patients o Quebec 1617  Naries rollet Hebert  Thought to be the first woman to provide nursing care in “Canada” thill a young country at the time  Nursing sisters aka nuns and members of carious religious orders emigrated to what is now quebec city and monreal to establish hospitals and treat those wounded in the wars  There nurses were more like modern nurses in that they administrated medicines th th o 18 and 19 centuries  Epidemics of smallpox, influenza, measles, scarlet fever, typhoid, typhus, and tb threatened the health of all Canadians  In response nursing sisters from various other established hospitals as places where the sick could be segregated and cared for Historoy of burses - 1 program for nurses in st catherines in 1874 o Established by towo former nurses from Florence nightingales school in the uk and a doctor o Offered a 2 year program based on pratical nursing experience in a hospital settings o By 1900 there were 20 hospital based school in Canada  1909=170 1930 approx 200 - 1919 the first Canadian uni based degree program was established at UBC - The program emphasized technical skills following orders adhering to established medical practice --- not the development of nursing knowledge through research - Charlotte MacLeod & VON o First woman in Canada to be the cheif superintendant for.... - When you graduate from nursing school you have a different formal nursing cap The face of nursing Today - Most female of all occupations o -87.7 % of the workforce --- second place =clerical/admin positions o Males tend to be over-represented in psychiatry, critical care, emergency care, and administration o Male nurses tend to have an higher average age usually because that is their second career - March 1, 2011 the following were ‘entitled to practice’ in Ontario o 111672 RN o 36677 RPN o 1800 NP - Entitled does not mean that they are... o 97017 employed in nursing gspecifically o 1785 employed in nursing and non nursing(not necessarily point of care, out in feild) o 3408 employed in non nursing o 2166 on leave o 7296 not employed - Check out distribution of RN in Canada mls - Not the very, very small number of individuals who hold either a Master’s or PhD - Salaries vary by pros length of worked etc - Generally though o 34-44 $/hrsask o 32-43 Alberta o 30-40- bc o 03-41 ontario o Academics allowances stat holidays, premium all vary in terms of avaliabliity by prvince and amount - During any given week in Ontario more than 13000 RN (7.4%) are absent from work due to injury, illness, burnout or disability - Rate of absence is 80% higher than the Canadian average - More than 16 million nursing hours are lost due to injury of illness---- the equivalent of 9000 full time nursing positions - Cost of overtime (labour and business centre) , absentee wages and replacement RNs to be between $962 mill and 1.5 billion - Evidence to suggest that there is a correlation between overtime absentee and poor patient outcomes - Low level of RN staffing have been associated with serious complications Becoming a Nurse Today -small number of universities and a small number of colleges -she is posting slides fast track nursing programs two years or 18 months The “profession of Nursing - The occupation of ‘nurse’ has long been perceived as a ‘paraprofessional’ because relative to medical practitioners - This may be related to 4 characteristics associated with the role of a nurse o Tech knowledge derives from med and needs to be approved by MD o Usually to assist MD in their works rather than replace them in terms of diagnosis and treatment o Work tends to take place at the request of physicians ie medcal orders o Lack of prestige associated with medicine - Nurses have worked very hard and in many ways reach professional status by o Inceasing edu requirements o Forming their own college to handle questions of practice and the discipline of its members o Carving out a body of knowledge that is separate from that of ther healthcare workers o Emphasizing the special qualitites and skills that nursing hace and that physciand fo not have - Similar to physicians, nurses have a o Regulatoy college (NCO) o Professional association (RNAO) o Union (ONA) Nursing Shortage in Canada - Predictions from the Canadian Nursing Association indicate that Canada will be short 780000 registered nurses by 2011 and by 2016 will rise to 113000 - Largest contributing factor to the shortage is retirement of the largest section of the nursing workforce the baby boomers o More than 24% of current workforce is eligible for retirement at current age 55 o Average age of RNs in ON is 45.9 years and it is rising steadily - Greatest shortage are being faced in critical care areas - Research suggests that 12000 new graduates are needed to address the projected shortages - While grads increases by 95.5% between 2004 and 2007 rates need to increase another 27% - Solutions being implemented: o Fast track programs (2 and 3) year degrees o Distance learning o Going to school through the summer o Increasing number of online courses o Introduction of simulation labs in order to expedite “hands on” learning modules Nursing and Medicine Link Allied Health Professionals - The term allied heath refers to a number of healthcare professions - Does not encompass dentists, nurses or physicians - Allied health professionals support, aid, and increase the efficiency of the nursing and medical teams - Due to an ageing populations, cost control and advances in tech allied healthcare professionals are expected to grow over the next decade Regulated allied health profs in Ontario - Audiologists - Dietitians - Medical lab techs - Medical radiation techs - Occupational therapists - Pharm - Physio - Respitory therapists - ------------------------- Health force Ontario has established the AHPDF fund in order to - Provide professional development opportunities to an increases number of allied health prof with objectives - Expand current skills and leadership capacity to improve healthcare service quality - Facilitate the retention of valued allied health professionals in Ontario - Assist allied health profs to adapt to changing expectations and health care needs - Maintain and build Ontario’s capacity as a competitive employer - Practicing member of 9 allied health profs will be able to apple for as much as $1500 for professional development courses and programs - The purpose of the fund is to develop skills and enhance knowledge and leadership capacity among allied health profs Team Work! Why do we need teamwork? - 28% of Ontario’s nurses reported they were physically assaulted at work over the past 12 months by a patient - Approximately 46% of Canadians physicians reported they were in advanced stages of burnout - The average number of days work lost due to illness or disability was at least 1.5 times greater for workers in health care than the average for all workers - 75% of family doctors are abused by patients - -34% of nurses working in hospitals and long term care facilities reported physical assault from a patient and 47% reported emotional abuse - 1/3 of hospital workers is at risk of burnout due to the dramatically increasing complexity and intensity of the their work - A study of personal support workers in LTC in Ontario, Manitoba and NS found that 43% experienced physical violence on a daily basis - It cost $22, 000 to $64,000 per nurse turnover, estimated to be between 0.75 to 2 times the salary of the departing individual o Cost for education, training, orientation - Trend data indicates that Ontario faces a significant reduction in its health human resources workforce by 2010 - Unless new ways of practising health care are introduced, Ontario will face a significant shortage of health care workers and Ontarians will risk receiving sub-optimal care - The education system needs to prepare current and future providers to work in a multi- disciplinary, collaborative, team-bases models Team Work Terminology - Interdisciplinary o A group of health care professionals from diverse fields who work in a coordinated fashion toward a common goal for the patient; collaborative approach - Intraprofessional team o A team of professionals who are all from the same profession, such as three physical therapists collaborating - Multidisciplinary team o A team of professionals, including representatives of different disciplines, who coordinate the contributions of each profession, which are not considered to overlap, in order to improve patient care; collective approach - The latest... - Interprofessional care (IPC) team o Provision of comprehensive health services to patients by multiple health caregivers who work collaboratively to deliver the best quality care within and across settings o Encompasses partnership, collaboration and multidisciplinary approach to enhancing care outcomes o It is cornerstone of healthforceontario’s strategy Why need IPC? - IPC envoi offers less fragmentation in services delivery - IPC can help improve patient care while increasing provider satisfaction within a respectful and collaborative environment - A more seamless approach to providing services and less stress on the patient and their family since their care is handled by an integrated team - ---------------------- - Interprofessional care has also been shown to: o Help contribute to reduction in clinical and admin. Errors o Better coordination and enhanced working environments o Better staff morale o Increase patient satisfaction New Roles in Healthcare - For nurses o Nurses performed flexible sigmidoscopy  A RN with extended specialized education in anatomy, physiology and pathophysiology who works in a physician to perform flexible sigmoidoscopies (ie diagnostic procedure used to screen for abnormalities in the lover third of the colon) o Surgical first assist  Works with the surgeon and the rest of the operating room team to ensure the safe outcome for a surgical patient before, during and after surgery  A RN can perform this role with an additional certification in surgical first assistance - For other professions o Physician assistant  Th
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