Reflection on Learning

Q1 The selected practice problem is Nursing Shortage. This practice problem is related to Chronic Disease (Chapter 10) as discussed by Bemker and Ralyea (2018). According to Bemker and Ralyea (2018), chronic diseases such as arthritis, diabetes, heart disease, cancer, and stroke, are the major causes of death, hospitalizations, and disability in the country. Even though most chronic diseases are preventable, they are quite common in the country and costly to treat and manage. Most chronic diseases are caused by poor lifestyle choices such as sedentary living, physical inactivity, and bad dietary choices. Effective management and treatment of the many chronic disease cases in the country require a relatively high number of qualified nurses. However, Buerhaus et al. (2017) note that there is has been a shortage of nurses in the country, which is detrimental to the efforts initiated towards the prevention, treatment, and management of chronic diseases. Buerhaus et al. (2017) add that although most RNs work in hospital settings or private practices, in the future, many nursing positions will be in long-term care centers due to the ever-increasing cases of people with chronic diseases. Currently, the nursing shortage is a major practice problem that makes it difficult to deal with the chronic disease dilemma in the country.

Q2 There are several social determinant risk factors associated with the nursing shortage practice problem. First, there is the issue of the aging workforce. Haddad, Annamaraju, and Toney-Butler, (2020) note that the nursing workforce is aging with more than one million RNs currently being older than 50 years old. This implies that in the next decade or so, one-third of the nurses will be retiring. With the few resources available for training large numbers of nurses, the problem of nursing shortage is likely to increase if radical solutions are not implemented. Second, there is the aspect of gender. The majority of nurses tend to be women. When these women start having children, they face the problem of balancing between their families and their careers. Many of them go on long leaves while others do not return to nursing (Haddad, Annamaraju, & Toney-Butler, 2020). In turn, this causes a shortage of nurses especially when the nurses who are absent are at the prime ages of their careers. This is why it is important for more males to take up nursing positions since socially, they are less likely to be adversely impacted by family life compared to females. Finally, there is the issue of poverty. Before one can become a registered nurse, he/she must spend huge sums of money on the relevant education, exams, and certifications. Although there are many people who wish to be nurses, they cannot afford to do so since most individuals are in the low-income bracket. Hence, the federal government and relevant stakeholders should consider facilitating more sponsorships for interested nurses to curb the nursing shortage problem in the country.

Q3 A related Healthy People 2020 goal is “Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death” (CDC, 2020). The foundation measure category of this goal is 'general health status.' This goal aims to ensure that there are fewer cases of preventable diseases in the country. This will be mainly achieved through prevention rather than cure. However, for people who have already contracted preventable diseases, they will require high-quality care for them to live good-quality lives. This is why a shortage of nurses is detrimental to the achievement of this goal. A higher number of nurses ensures that the country has the manpower to promote healthy living and effectively manage people who are already sick. If this goal is attained, the measures of progress would be a higher life expectancy, less chronic disease prevalence, better mental and physical conditions, improved dietary choices, and improved physical activity among people, among others.

Q4 One evidence-based objective to address the Healthy People 2020 goal described above is to have a population-level intervention characterized by the promotion of healthy lifestyle behaviors and regular checkups. Such a program can be run by nurses since they have the relevant medical expertise and can offer credible information to the masses. The program will sensitize people on the importance of adopting certain behaviors such as reducing smoking, eating healthier foods, reducing alcohol intake, being physically active, and regular checkups for the identification of risk factors that may make one develop chronic diseases (Reynolds et al., 2018). This program will aim to equip people with the knowledge of how to live well if they are to have a high life expectancy and limited cases of illnesses.

Q5 One measurable objective to address the Healthy People 2020 goal is to check for chronic disease prevalence after every ten years or so (Smith et al., 2017). In this regard, the best way to know if the goal is being met is to find out if the number of chronic disease cases is constant, reducing, or increasing. Ideally, there should be a constant decline in chronic disease prevalence as time goes by. If there is no decline, then there will be a need for a new intervention to be formulated and implemented.

References

Bemker, M. A. & Ralyea, C. (2018). Population health and its integration into advanced nursing practice. DEStech Publications, Inc.

Buerhaus, P. I., Skinner, L. E., Auerbach, D. I., & Staiger, D. O. (2017). Four challenges facing the nursing workforce in the United States. Journal of Nursing Regulation, 8(2), 40-46.

CDC. (2020, December). Healthy People 2020. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/healthy_people/hp2020.htm

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. StatPearls [Internet]. National Center for Biotechnology Information.

Reynolds, R., Dennis, S., Hasan, I., Slewa, J., Chen, W., Tian, D., ... & Zwar, N. (2018). A systematic review of chronic disease management interventions in primary care. BMC Family Practice, 19(1), 1-13.

Smith, M. L., Towne, S. D., Herrera-Venson, A., Cameron, K., Kulinski, K. P., Lorig, K., ... & Ory, M. G. (2017). Dissemination of chronic disease self-management education (CDSME) programs in the United States: intervention delivery by rurality. International Journal of Environmental Research and Public Health, 14(6), 638.