Day 6: Observation Clinical

Now that you have had 3 days in the Cherokee Health Care System, what are some of the most critical issues this culture encounters daily? 

          To me, it seems that a critical issue is patients not showing up for appointments. During my two clinic shadows, there were many patients that did not come to their appointments. I was told that there is no penalty to patients that have no-call/no-shows. Back up north, there are charges to patients who do this and the risk of being refused making appointments because of inconsistency. We are given cards with appointment times, and most patients put the appointment in their phone calendar. I have also seen an uprising in text alerts for appointments. Going to appointments is important in order to ensure health and prevent delays in necessary care.

Are there any prevalent conditions that you have noted? If so, are they related to genetics, culture, or deficient knowledge/health maintenance?

          The only condition that I have seen in high prevalence is that of detoxing. On one clinical day, there were many patients that were in the process of detoxing. This was a community issue, though we have been told that this is prevalent everywhere and the small area makes it seem as though it is high. I did not see another condition in excess with the people coming to the hospital for care.

What is the nurse’s role in health promotion and health maintenance?

          The nurse should be providing education to the patient and their family on necessary topics to ensure that health maintenance will be continued at home. The nurse should ensure that the teaching was effective and the nurse should be confident that the measures taken will ensure that the patient and the family can maintain the health measures at home. The nurse should also be looking at the community to see the prevalence of certain health conditions to educate future patients on, even if it is not exactly why they are receiving care. According to Kemppainen, V., Tossavainen, K., & Turunen, H. (2012) , “nurses can be considered general health promoters, with their health promotion activities based on sound knowledge and giving information to patients (p 499).”

In your opinion and observation, who is at the center of the health care system? Is this similar or different than your previous experiences in health care outside of Cherokee? Why or why not?

          The center of the health care system are the patients, in other words, the community. Without a community to care for, the hospital team would have nothing to work from. The care provided and measures taken depends on the status of the community involved and what their needs are. I believe that this is the philosophy everywhere throughout every field in healthcare. Patient-centered care is the main focus of the medical team and we are slowly expanding our focus to the family as well as the population.

Reference

Kemppainen, V., Tossavainen, K., & Turunen, H. (2012). Nurses’ roles in health promotion practice: An integrative review. Health Promotion International, 28(4), 490-501.