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One case that stands out the most to me is a patient I had during my first few months as a bedside Nurse. This patient, who was in his 40s, had advanced pancreatic cancer with metastasis. Of course, the patient had extreme pain that was very difficult to manage despite high doses of different opioids, PCA pumps, and other pain management strategies. During his 2 months on my unit, I watched him continue to deteriorate. He began to have no appetite and lost weight, and it came to a point where he was on pressors to support his blood pressure. It seemed like every day got worse and worse, and he ultimately stopped talking. My role for this patient was to be his bedside nurse, help coordinate his care, and provide emotional support to the patient and his family. In his last days, the family decided on hospice/palliative care to keep him comfortable. This case has always stuck with me because this was when I realized what Nursing meant. This was an aspect of Nursing where not everyone gets better and leaves the hospital.
Concepts from Kindig’s Model apply to this patient’s outcomes for a few reasons. The main outcome of this patient was his quality of life during his last days. Another point to note is an example of the determinants/factors. He had access to healthcare and a supportive social environment. Even though there are some flaws in the system, the healthcare policies that are already in place ensured that the patient had access to pain management resources and palliative care programs.
Reference
National Advisory Council on Nurse Education and Practice. (2016). Preparing nurses for new roles in population health management: Based on the 132nd and 133rd meetings of the NACNEP. Health Resources and Services Administration.
After reading the case, compare to the case below as to factors that affected the outcome. Use a minimum of 3 scholarly sources cited including HP 2030 and NACNEP 2016. (references from the last 5 years only). One example that stands out above all others in my mind is a testament to the transformative power of holistic nursing. We encountered a patient facing numerous social and economic barriers: uninsured and living far from any healthcare facilities. As the attending nurse, my role extended beyond immediate clinical care to address these crucial social determinants of her health. Recognizing her situation as a social issue spurred us into action, leading us to systematically remove any obstacles that might hinder her access to care. Collaborating with a social worker, we facilitated her health insurance application and arranged transportation, ensuring she received the vital care she needed. This situation is especially striking because it demonstrates the incredibly broad function that nurses can have in a healthcare system that is way beyond clinical responsibilities. We helped that existing health issue and removed obstacles from potential future crises—a win-win for the patient and community. That is the essence of Kindig’s Model, which I am revisiting to include in a discussion about “Preparing Nurses for New Roles in Population Health Management.” On the left hand of Kindig’s Model, one could interpret that health outcomes can be advanced by influencing more proximate determinants through direct health interventions – these are not just medical but also mobilizing social/community assets to improve access to care. The right side of the model is how we get to those outcomes; here, our interventions included tackling root causes like insurance coverage and transportation necessary for maintaining healthcare management over time. The holistic approach to care benefits the patient and is consistent with more significant health policy priorities and effective use of healthcare resources, highlighting nursing’s place in population health management. References National Advisory Council on Nurse Education and Practice (NACNEP) Based on the 132nd and 133rd Meetings of the NACNEP 2016 Health Resources and Services Administration (HRSA) Preparing Nurses for New Roles in Population Health Management. (2016). please make sure to compare two cases as the question ask.
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