Self-Reflections on N493/N494: Community Health Nursing & Research

This document contains a student's self-reflections on two nursing courses, N493 Community Health Nursing and N494 Essentials of Nursing Research, along with discussions on Medicare and Medicaid. The reflection on N493 highlights the course's impact on understanding epidemiology, risk factors, health promotion, family and community assessment, and cultural competence. The N494 reflection focuses on the role of research in nursing practice, the use of technology in research, and ethical considerations. The discussions on Medicare and Medicaid address the challenges faced by these programs, including financing, affordability, and providing care for chronic conditions, as well as Medicaid's role in providing healthcare to various populations across different states. This assignment showcases the student's understanding of key concepts and their application to real-world healthcare issues.

Discussion 1
Self-reflection on N493 Community Health Nursing
Nursing is a complex profession and it requires lots of skills and knowledge as
people’s health status is associated with the quality of care provided by the nurses. In order to
enhance the skills, nurses are meant to undergo several courses and programs and one of
them is community health nursing course (Sarkar, Dallwig & Abbott, 2015). Being a nursing
student, I also underwent this course and it helped me in gaining more knowledge from a
theoretical as well as a scientific framework. It provided me concepts about epidemiology
and disease transmission. Also, there were clear discussion regarding the comprehensive
assessment of several risk factors and different health problems. The course provided a
practice experience component which is focused in developing and evaluating the health
promotion programs for the improvement of health status of people. Again, the course is
mainly aimed to community health and I have learned family assessment along with
community assessment and community-based homecare in this context. Focusing to promote
and preserve health of populations, I completed this health promotion project with a practice
experience of 90 hours. This learning will help me as a professional nurse in my clinical
settings. I learned how to incorporate value-based behaviour and ethical judgements while
working as a RN in future. Apart from that, cultural issues are amongst the greatest barriers
of healthcare and this course helped me to have a deep understanding about the importance of
cultural competence. Implementing evidence-based practice is helpful in providing cost
effective quality of care which is multidimensional and along with the course objectives, I
learned how to integrate evidence-based practice. I believe, in future, while working as a
professional nurse, the learning from this course will provide me advantage of working with
latest technologies and it will also ensure my leadership advocacy skill which will assist me
in developing a successful career as a nurse.

Discussion 2
Self-reflection on N494: Essentials of Nursing Research
Nursing research is an important term and as a nursing student I have also learned
about it through a course, essentials of nursing research. This course was an extremely
helpful course as it helped me to have an insight on the role of research in the practice of
professional nursing. Various methods and analytical tools are there which can critically
evaluate the nursing research process and I was totally unaware of them, but through the
course I learned about their function and also about the different role of qualitative and
quantitative research processes. This course was mainly focus to develop skill among the
nurses regarding the implementation of evidence-based literatures in the current nursing
research practice. With the advancement of technology and utilization of several databases in
healthcare purpose has been a new essential tool in health sector and this course opened my
eyes that how technology can be properly utilized in order to locate research information
(Trent et al., 2016). In every profession, there must be some ethical challenges and healthcare
sector is not an exception. From the learning in this course, I realized how an ethical research
practice can be successfully explored. However, I can say that upon the completion of this
course I will be able to enrich my knowledge in articulating the role of research and their
application in various nursing problems. While working as a professional nurse in my clinical
settings, I will integrate my knowledge from this learning in utilizing technologies to retrieve
hierarchical levels of evidence to address different clinical objections. Also, I will apply my
critical thinking and written communication skill to integrate research findings into my
nursing practice. Finally, I can say that this course increased my confidence level and now I
know how to identify legal, ethical as well as cultural considerations that include in research
and it will help me to provide a care of better quality.

Discussion 3
Medicare’s biggest challenge today
The federal government sponsors some health insurance programs and Medicare is
among them. This insurance program covers medical insurance for the disables, elderly and
the low-income Americans. This program took effect in the year 1965 and this healthcare
coverage is provided by the US government to a wide range of groups that include federal
employees, veterans, military personnel, and Native Americans. In this purpose, a largest
proportion of health expenditure is accounted by this health insurance program. It provides
health care service along with residential care to more than 50 million Americans. However,
since the economic climate was changing and studies have shown that the outlook is no
longer positive as Medicare is facing various kinds of challenges. According to the
researchers, the economic situation in many states levelled off unexpectedly and in most of
the cases it also deteriorated. The report also stated that the outlook for immediate future with
this health insurance program seemed to be less optimistic. Without finding additional funds,
there is no way to accommodate millions of baby boomers aging into the program. Again,
affordability is another major challenge. Covering the cost-sharing for various services is
becoming a challenging task for this health insurance program. This program is also facing
challenges while providing health services to the patients with chronic health issues.
Medicare centres have launched many payment and delivery system reforms for significant
health needs for the patients with chronic disease. Therefore, the biggest challenge that the
program is facing is financing mechanism and the structure of the program is also an issue as
it has failed to keep the pace with the changes in the health care system. According to some
observers, the first priority should be to improve its internal working structure in order to deal
with all other challenges the program is facing (ASA American Society on Aging, 2019).

Discussion 4
Medicaid can be considered to be 50 different programs
Medicaid is a health insurance program especially for the people of lower income
group and it is financially connected with the federal government and the states. 76 million
Americans got health insurance in the year 2015, with the help of Medicaid and it was close
to 25% of US population. It is the largest single payer of the nursing home care and works in
collaboration with Child Health Insurance Program (CHIP) and in this regard it provides
health insurance coverage to one-third children of Unites States. Each of the states has its
own Medicaid program and the contribution of federal government vary according to the
states. The government plays an important role to provide health insurance coverage in
collaboration with Medicaid. Apart from that, it also provides health coverage to the pregnant
women and new mothers from lower income group. As per the authorities, Medicaid spends
almost 65% of its resources to the benefits of elderly as well as disabled people and it is not
surprising at all because disables and elderly people are more likely to face challenging health
circumstances than any other people. Even, Medicaid plays a major role in improving
healthcare standard by providing financial support during health emergencies in the rural
areas. As per the study conducted by the Georgetown University Health Policy Institute, 45%
of children living in rural areas, get benefit from Medicaid or CHIP. Medicaid is profoundly
working across a vast area and providing a lot of health services to different people of
different communities especially to women, pregnant and mothers, children, disabled and
elderly people of lower income groups and living in rural areas. It is administered by the
states and as a result it can be said that, there are actually, more than 50 different Medicaid
programs are performed throughout the United States (Peter G. PETERSON FOUNDATION,
2017).

References
ASA American Society on Aging. (2019). Medicare at 50: Lessons and Challenges.
Retrieved from https://www.asaging.org/blog/medicare-50-lessons-and-challenges
Peter G. PETERSON FOUNDATION. (2017). FIVE THINGS YOU MAY NOT KNOW
ABOUT MEDICAID. Retrieved from https://www.pgpf.org/blog/2017/07/five-
things-you-probably-dont-know-about-medicaid
Sarkar, N., Dallwig, A., & Abbott, P. (2015). Community health nursing through a global
lens. Studies in health technology and informatics, 209, 135-139.
Trent, M., Chung, S. E., Gaydos, C., Frick, K. D., Anders, J., Huettner, S., ... & Butz, A.
(2016). Recruitment of minority adolescents and young adults into randomised
clinical trials: Testing the design of the Technology Enhanced Community Health
Nursing (TECH-N) pelvic inflammatory disease trial. European Medical Journal.
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