Community Nurse in Preventative Care
The wellbeing system is continually evolving with the current concern placed on preventative health. This notion is becoming popular among health circles due to activities like mass education for populations, mitigating infection risks before disease occurrence, and promoting public health. These initiatives are vital due to lifestyle factors that have led to more people requiring treatments for chronic ailments. Subsequently, there is a need for more nurses able to utilize their skills in providing evidence-based and patient-centered care to their clients (Ellis, 2019). These medical practitioners can make a difference through their role in screening victims, counseling them, and offering the necessary treatments. Therefore, everyone expects a nurse to promote activities like regular rest, avoidance of substance abuse, behavior modification for advanced patient outcomes, and weight management programs. Community nurse in prevention care is a multifaceted concept that requires so much more than merely understanding the caregiver’s roles.
Part A
Variables like the escalation of health care costs are some of the significant reasons for the importance of preventive care. Also, more insurance companies are becoming more open to the idea of supporting disease prevention rather than cure (Benedictine University, 2020). A community nurse often engages society in health promotion, population research, and offering direct services. They may also identify chronic ailments in the demography while instituting wellness programs where applicable. These directives help in reducing teenage pregnancies, obesity, and drug abuse. For HIV, the complex nature of prevention means that the community nurse has to employ many approaches in advancing the population’s wellbeing. These schemes are often grouped by institutions, community, or population-based (National Research Council, 1996). The roles of the caregiver are divisible into three categories based on the level of prevention. First, there is primary prevention defined by many authors as initial steps undertaken to educate society and intercept diseases. This prevention level’s end goal is to live freely while minimizing infection risks (Center for Substance Abuse Treatment, 2000). Subsequently, actions in this stage may include immunizations, forcing individuals to adhere to road safety rules or face lawsuits, and initiating patient-specific programs to minimize ailment risk. The efficiency of these cautions makes them the most economical approaches. In Jennifer’s case, the community nurse should prevent Ben from acquiring HIV by counseling him.
Second, the community nurse can adopt secondary approach strategies if Ben’s HIV test comes back positive. This prevention level is the early identification of a disease such that the health care provider should screen Ben to check his status. This level includes small acts like dispensing antiretrovirals for immediate disease (Mottiar & Lodge, 2018). In the case of a positive return, the caregiver should make Ben understand the situation. They should also be willing to include the victim in decision-making concerning lifestyle changes and the use of condoms, abstinence, and having only one partner (Fisher & Smith, 2009). These activities form part of the more massive behavior change approaches. This prevention level is more viable than other tactics when interventions consider the differences between positive and negative patients. Other crucial variables are the patient’s mental health, population risks, and access to computers (Brown & DiClemente, 2011). The last consideration is vital since the nurse can also administer secondary programs via technological means. For instance, they have a telecommunications group where HIV infected persons hold regular meetings over their conditions.
Third, HIV prevention can still take place when an individual already has the disease. In this case study, the focus will be on measures to minimize Jennifer’s chances of transferring the disease to Ben. The community nurse can help the couple actualize a care plan that will assist them in their relationship. This stage includes extra behavioral changes and strict adherence to medications to prevent more consequences, especially in the future (Benedictine University, 2020). A critical tertiary prevention method includes offering palliative care to upgrade the patient’s life quality. However, any selected choice must be ethnically relevant to avoid resistance from the community. This program should also include a food policy since people with HIV rely on proper nutrition to improve their wellbeing. The community nurse should consult with the couple to incorporate their extended families for smoother management of the virus. When used to complement other interventions, this strategy helps combat the risk of other HIV patients’ ailments. Many victims are often susceptible to acquiring cardiovascular diseases, which means controlling the disease will be difficult.
Part B
Jennifer and Ben are identifiable as a serodiscordant couple. This title is because only Jennifer is living with HIV. Her efforts in meeting with a nurse are to limit the chances of transmitting HIV to her spouse. Discordancy seems like a great idea to ensure that even those infected with HIV can lead everyday lives without discrimination. Unfortunately, the lack of an HIV cure leads to sufferers relying on antiretrovirals to minimize the condition (Gitahi et al., 2020). Consequently, they can engage in unprotected sex activities and, therefore, numerous struggles before having children. Every action they take must focus on preventing the other partner from getting infected. Ultimately, the family may last or end based on adopted coping interventions. The community nurse has an uphill task of supporting Jennifer and Ben concerning their HIV situation. Foremost, they should encourage Ben to get tested to determine his health status. This activity must only ensue and proper counseling and his understanding of the possibilities ahead. Afterward, the nurse can guide them in living their lives either as HIV patients or as a discordant couple. Some of the key coping strategies include protecting during sexual encounters, antiretroviral consumption, and reproductive health promotion.
Protection measures such as the use of condoms are one of the basic HIV prevention techniques. According to Hallal et al. (2015), this approach averts the probability of infection by 17-18 %. Additionally, condoms minimize one’s risk of obtaining Sexually Transmitted Infections (STIs). The condom use results for Jennifer and Ben may vary as the results depend on the specific couple and their compliance level. Studies prove that there are more success chances in a serodiscordant relationship if the woman is positive rather than when the man is positive (Hallal et al., 2015). Jennifer and Ben may be skeptical about the initiative due to gender differences, age variables, reduced sexual pleasure, and family roles differentiation. The community should create a rapport with the couple for them to express their thoughts on condom use. This initiative includes having clear guidelines on the varied dimensions of the wellbeing of patients with HIV. Also, it encompasses sessions on acquiring knowledge over subjects like pathophysiology, drug resistance, drug side effects, and preventing transmissions (Rouleau et al., 2019). Further, the caregiver should advise them on protective measures (Flannigan & Niesner, 2007). Most importantly, they are better placed to enhance efficiency and better patient outcomes by reminding them of the correct way of using the prevention strategy.
Apart from the use of condoms, the community nurse can guide Jennifer and Ben to comprehend the risks of HIV transmission. Research shows that more people are unaware of risky sexual practices (Hallal et al., 2015). The authors offer an example of anal sex, which is expected but enhances one’s chances of contracting HIV by almost 50%. Consequently, there are campaigns to employ antiretroviral at various stages of HIV transmission. A non-infected partner like Ben is more likely to get infected with HIV if their infected spouse has a high Viral Load (VL). This concept encompasses a quantifiable approach to the virus levels in an individual. Hallal et al. (2015) allude that VL is part of most diseases. The results of a two-year study depicted those under regular treatment were less likely to suffer from the consequences of their diseases. The intervention group proved the assumption with minimized primary health care events as compared to the control group. Hallal et al. (2015) ascertain that the transmission falls by more than 90% when the positive partner adheres to their treatment guidelines. Therefore, the community nurse should ensure that Ben takes their dose of Pre-exposure Prophylaxis (PrEP). This HIV prevention drug consists of a daily intake of Tenofovir or its integration with Emtricitabine. Over time, these drugs have proven to be effective in comparison to their placebos. Also, they offer better results in males than females. Nevertheless, community nurses are bound to face some challenges when trying to implement adherence to antiretroviral. First, there are misunderstandings on the roles of nurses. People know that physicians prescribe treatments, but the caregiver must ensure that the client complies with the medication (Rouleau et al., 2019). However, there is no clear cut explanation of the nurse’s autonomy regarding HIV clinics where they will do so much more than merely supporting a physician. Nurses attend their schooling without specializing in HIV management. This notion considers the challenges in many nursing schools (Jamshidi et al., 2016). Worse still is the unavailability of HIV courses in all regions. Consequently, gaining more knowledge in HIV prevention may be hectic and demoralizing for the caregivers.
Second, the health care systems face political interference that limits the accessibility of services. Many unnecessary policies prohibit nurses from reaching their full job potentials and handling challenges facing couples living with HIV. For example, many caregivers have trouble identifying their jurisdiction when managing diseases. Correspondingly, their training focuses on theory rather than the useful bits (Ellis, 2019). As a result, the burden falls on these caregivers to find viable solutions to sustain a patient’s antiretrovirals use. Their efforts face deterrence due to the inadequacy in evidence related to HIV prevention techniques. Even though the community nurses may settle on implementing similar interventions for most conditions, there are instances where their decisions need to be specific to the illness. Lastly, there is an incongruence in the nurse’s perceptions towards the adherence of HIV medications. Most of them believe that the patients are intrinsically triggered to consume the drugs. Alternatively, nurses have an optimistic view of the role of the drugs. Nevertheless, this attitude may hinder the relationship between nurses and the patients if the victim lacks the intent to adhere to the medication.
The community nurse can also support Jennifer and Ben by guiding them in a healthy reproductive life. Serodiscordant couples are also entitled to fulfillment by starting families and bearing children to uphold their legacies. There are several approaches that the caregiver can encourage Jennifer and Ben to adopt, such as vitro fertilization. This method heavily relies on technological integration (Sauer et al., 2009). This approach is viable if Ben was a positive partner. Fortunately, it consistently proves to be safer than other methods. Otherwise, the nurse can recommend VL reduction through the Highly Active Antiretroviral Therapy (HAART). This technique will include Jennifer appropriately taking her drugs. If she complies with the treatment instructions and lacks an STI, the doctor can authorize unprotected sex between her and Ben. Alternatively, the physician will recommend self-insemination as it cancels the mixing up of genital fluids (Schwartz et al., 2014). However, the community nurse must guide the counseling session for the couple since there are several risks to this strategy, like sexual health and fertility evaluation, as outlined above. According to Beyeza-Kashesya et al. (2009), these three strategies should complement other attempts to try concurrent relationships to ensure family continuity and advocate for rational decision-making among couples.
In conclusion, community nursing roles in the prevention of HIV and any other diseases are involved. Nonetheless, nurses have to carry out their roles in improving the wellbeing of populations. In a usual setting, these caregivers engage in health promotion, research, and direct care to control teenage pregnancies and drug abuse, among other societal challenges. For HIV, community nurses need to actualize various plans in the different levels of prevention. At the first stage, nurses can educate the masses against the dangers of contracting HIV and avoiding the menace. The second prevention category should implement early detection and medication strategies to prevent one from getting to an advanced disease stage. Lastly, they can implement a patient-specific care plan to ease the management of HIV. Overall, couples affected by the disease can adopt strategies like the use of condoms, antiretrovirals, and safe reproductive measures.
References
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