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    "ENVIRONMENTS OF CARE"

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    edyzonmarby10

    Posts : 17
    Join date : 2009-06-21

    "ENVIRONMENTS OF CARE"

    Post  edyzonmarby10 on Thu 08 Apr 2010, 1:00 pm

    "ENVIRONMENTS OF CARE: PREPARING A NEW GENERATION OF NURSES"



    Journal Response by GROUP #3:
    Juco, Melissa,
    Mananquil, Ann Marby
    Marasaigan, Iza Therese
    Medalla, Jerrick



    ==================================




    “Many were called, but few were chosen” a famous quotation that everyone knows. Thousands of student nurses are taking the licensure exam two times a year and only a fraction of that will pass. Most of the passers will opt to work in a hospital setting while the others will work in the many fields of nursing like in the community. Reasons for the scarcity of nurses entering community workforce is they are afraid of leaving their comfort zone and mastery. According to Ervin and colleagues and the National League for Nurses that Community-based curriculum is recommended to be used by nursing schools as a guide for undergraduate nursing education. Community-based curriculum focused on giving health education and rehabilitation not just the sick but also to the well individuals and families. For the past years the community based model is preferred but there are major concerns now being raised. These are:

    1. Scarcity of CHN nurses who are willing to be a CHN professors.
    2. Vague rules: Before you become a CHN nurse you need at least one year of working experience in a hospital as a staff nurse
    3. The increasing population of elderly that needs hospital care also increases the demand for more nurses being employed in the hospital. This will entice more nurses to opt for hospital setting than in the community.
    The Environment Care Model (ECM) perpetuated by Ervin and colleagues which is composed of four environments namely: internal environment care, social environment care, physical environment care, and global environment care. The author of the said model suggested that nursing undergraduates must be oriented to the four environments so that they will become much familiar to much wider concept of their profession. The figure below is the Environment Care Model (ECM) made by Ervin and colleagues. The aspects of each environment are needed to be realized and experienced by the nursing undergraduates for them to be able to prepare themselves to the reality of their profession.






    For example, in the genetic aspect of internal environment, the nursing undergraduates can interview nurses who are experts in genetics. In the cultural aspect of social environment, the nursing students may interview Muslim nurses about issues regarding post mortem care. In the water aspect of the physical environment, the nursing undergraduates may write to the city Mayor regarding clean water for drinking. In the emergency response aspect of the global environment, the nurse undergraduates may help to assist in triaging and engaging in charitable works in time of crisis such as food and water shortage.
    The ECM model of Ervin and colleagues is quite commendable but there are others who opposed to their work. The phenomenon of role transition about curriculum advancement has been a topic of research and concern for practicing nurses, educators, and administrators for many years.

    The Environment of Care Model (ECM) proposed a new curriculum to help prepare the new generation of nurses on other branches in a non-hospital setting. This curriculum addresses the rapid change in nursing.
    Opposed feature, ECM curriculum may not be as sophisticated as it is. Their view of point in this curriculum has been implemented already in the Philippines. The only difference is they emphasize the needs to do which has been doing here in our country. Like the Associate in Health Science Education (AHSE) program constitute the general education component of all baccalaureate degrees leading to the health profession. Student are equip with competencies needed to land jobs as a nurses aid, and community health aides (CHED 1999) which mean as early as 2nd year the student were already been in training for a hospital and non-hospital setting.
    In a community setting we have a family care plan, community diagnostic and emersion which is offered as early in the 2nd to 3rd year level. Their curriculum in fact is a well-researched program that was carefully developed by the country’s dedicated deans and noted nursing academicians in consultation with different nursing sectors and specialty groups. In fact, our nursing curriculum’s conceptual framework has been hailed as a blueprint for excellence and has been adopted by many Asian and western countries. And it has been presented at numerous international conventions and accepted by our nursing colleagues globally (Francisco 2009). The sited problems in ECM was deliberately answer by our curriculum under the courses of health ethics, foundation of nursing, health care 1 and etc. as early as freshmen nursing students were thought the ethics and commitment involved in the profession.


    Guide Questions:

    •In the current Philippine setting, would you recommend a community-based curriculum for nursing education? Why? Why not?

    •What nursing issues do ECM resolve?

    •If you are the Dean of a nursing institution, and would like to adopt the ECM model, what can you add to the different aspects of the four environments?

    •Discuss with your group the positive and negative outcomes of ECM. What changes will evolve from the present curriculum to ECM?



    REFERENCES:

    1.Smith, L.M.; Emmett, H.; Woods, M. (2008). Experiential Learning Driving Community Based Nursing Curriculum. Lifted from http://www.ncbi.nlm.nih.gov/pubmed/18759536 on April 7, 2010

    2.Frank, B.; Adams, M.; Edelstein, J.; Speakman, E.; Shelton, M. (2005). Community-based Nursing Education of Prelicensure Students: Settings & Supervision. Lifted from http://findarticles.com/p/articles/mi_hb3317/is_5_26/ai_n29211660/ on April 7, 2010

    3.Mawn, B. & Reece, S. (2000). Teaching in Nursing: A Guide for Faculty‎. 2nd ed. pp100-101. St. Louis, Missouri, Saunders Elsevier.
    (http://books.google.com.ph/books?id=QWk4Uz9UQSoC&pg=PA101&dq=Mawn+and+Reece&cd=1#v=onepage&q=Mawn%20and%20Reece&f=false)

    4.Buerhaus, Staiger and Auerbach. (2003). Policy and Politics in Nursing and Health Care pp 459, 510-511. St. Louis, Missouri, Saunders Elsevier.

    5.Reid Ponte, et al. (2004). Policy and Politics in Nursing and Health Care pp 449. St. Louis, Missouri, Saunders Elsevier. A Study on the Impact of Nursing Staff Mix Models and Organizational Change Strategies on Patient, System and Nurse Outcomes. Lifted from http://www.chsrf.ca/final_research/ogc/mcgillis_e.php on April 7, 2010

    7.R. FRANCISCO. (2009). Nursing Education in the Philippines. The Philippine Daily Inquirer
    8.Rona (2008).‘Nursing competence’ in the global market. Under Nursing news
    9.CHED Memorandum Order (MO) No. 5, series of 2008 otherwise known as “Policies and Standards for Bachelor of Science in Nursing Program”.

    kayemagd
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    topic 3

    Post  kayemagd on Thu 08 Apr 2010, 2:21 pm

    University of the East
    Ramon Magsaysay Memorial Medical Center, Inc.
    64 Aurora Boulevard, Brgy. Dona Imelda, Quezon City

    GROUP 6
    Aquino, Felix
    Magdael, Rutchelle Kaye
    Sarmiento, Noel
    Vallarta, Aldrin Vincent

    As the world population grows, there is a growing need and demand for healthcare workers that will aid on the increasing number of congenital or acquired diseases not only in the hospital setting, but also in a community-based set-up. Hence, a rigid community-based curriculum is needed to hone the future community healthcare nurses to effectively attend to the needs of the society.

    According to Smith and colleagues (2008), authentic learning in the context of diverse and dispersed community based nursing practice, is difficult to ensure. However the intent to improve the health status of the population served through community practice nursing interventions, guided by primary health care principles, is common to all clinical placements. Moreover, Cotroneo (2000) pointed out that eliminating health disparities requires health professionals who are trained and adept in community-based leadership. To be effective, these leaders must read the environment, manage within and across organizations and systems, and work in partnership with communities. These skills are generally absent from health professionals' education. Nursing, as a health care discipline, has a foundation of skills and values that position to assume these roles.

    Maximising student exposure to rural and remote facilities, enhancing experiential learning opportunities and engagement in teaching material is the key to enhancing learning outcomes that create long term benefits for rural and remote communities. Supported experiential learning is the ideal medium to increase student learning outcomes, confidence in their clinical abilities, autonomy, responsibility and decision making ability. This engagement of students in the learning process whilst exposing students to a broader scope of clinical practice ensures development of the independent practitioner skills necessary for rural & remote practice appropriate for the beginning practitioner (Smith, et al, 2008).

    As a result of these curriculum developments, the graduates will be more readily accepting of and willing to choose rural & remote clinical facilities and communities as legitimate places for their professional careers. Once active within the communities, the graduates will be better placed to independently access the information needed for continued professional development and maintain professional competence within the rural and remote facilities (Smith, et al, 2008).

    In conclusion, experiential learning is highly individual. Students learn from their own experiences as well as third-person experience through stories in authentic learning environments. Through proper curriculum and exposure, it will encourage more students to consider the community as also an ideal place to hone their nursing knowledge and skills as a future registered nurse.

    REFERENCES:

    Smith, L., Emmett, H. & Woods, M. (2008). Experiential learning driving community based nursing curriculum. Rural and Remote Health. 8:901. Retrieved on April 8, 2010 from

    Cotroneo, M., et al. (2000). Community-based nursing leadership curriculum: planning for the future health of communities. The 128th Annual Meeting of APHA. Retrieved on April 8, 2010 from
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    melissa.juco

    Posts : 20
    Join date : 2009-06-21
    Age : 32
    Location : Quezon City, Philippines

    Re: "ENVIRONMENTS OF CARE"

    Post  melissa.juco on Thu 08 Apr 2010, 2:42 pm

    kayemagd wrote:


    Maximising student exposure to rural and remote facilities, enhancing experiential learning opportunities and engagement in teaching material is the key to enhancing learning outcomes that create long term benefits for rural and remote communities. Supported experiential learning is the ideal medium to increase student learning outcomes, confidence in their clinical abilities, autonomy, responsibility and decision making ability. This engagement of students in the learning process whilst exposing students to a broader scope of clinical practice ensures development of the independent practitioner skills necessary for rural & remote practice appropriate for the beginning practitioner (Smith, et al, 2008).

    In conclusion, experiential learning is highly individual. Students learn from their own experiences as well as third-person experience through stories in authentic learning environments. Through proper curriculum and exposure, it will encourage more students to consider the community as also an ideal place to hone their nursing knowledge and skills as a future registered nurse.




    Journal Response by GROUP #3:
    Juco, Melissa Frances
    Mananquil, Ann Marby
    Marasaigan, Iza Therese
    Medalla, Jerrick



    Thank you, GROUP #6, for raising that very interesting bit of information on 'Experiential Learning". In addition to your response, experiential learning, according to Smith (2003), is also known as "informal education" and includes learning that is organized by learners themselves. Smith implies that 'Learning from experience may also be called nature's way of learning where education occurs as a direct participation in the events of life.'

    In relation to community-based curricula, experiential learning may bridge the gap between the teachers and learners as learners delve into more reflective / intrapersonal exercises during community immersions.



    REFERENCE:

    Smith, M.K. (2005). David A. Kolb on Experiential Learning. The encyclopedia of Informal Education. Lifted on April 8, 2010 from http://wilderdom.com/experiential/ExperientialLearningWhatIs.html

    arneljamolangue

    Posts : 7
    Join date : 2009-06-21

    Re: "ENVIRONMENTS OF CARE"

    Post  arneljamolangue on Thu 08 Apr 2010, 4:55 pm

    University of the East
    RAMON MAGASAYSAY MEMORIAL MEDICAL CENTER
    Graduate School
    Aurora Blvd., Quezon City

    "ENVIRONMENTS OF CARE: PREPARING A NEW GENERATION OF NURSES"

    Group #4 – Journal Reaction
    AQUINO, Camille
    FADERA, Juan Carlo
    JAMOLANGUE, Arnel
    LACISTE, Chloe Anne


    If we may, from a popular text message, ‘’I realized that being a nurse is incomparable. As we care for our patients, we learn how to cover our sorrow with a smile. We learn how to stay vigorous despite all the tasks we endure. We learn to give hope even though ours is unclearly seen. We learn how to give strength even at times we are weak. Nobody would know what kind of life a nurse has…unless they become one.”

    In our undergraduate years, community immersion was given a lot of importance. For three semesters, we were sent to different communities. We were assigned to stay at different foster families, ate with them, and bonded with them. Through this, we are able to observe and know the people, their beliefs and their values. We were able to be conscious of the available resources, their livelihood, political system, etc. Through assessment, their needs were realized. Through collaboration, problems were prioritized. Through team work, programs were designed.

    For community immersion to be effective, the faculty for C/PHN must be well qualified, by being at par with the current trends through formal graduate education and continuous experience in this specialty.
    With these competencies, the C/PHN will be able to provide broad experiences for the students that are evidence-based. Collaboration with the PHN leaders and community partners also would enhance teaching (Collier. et al, 2009).

    Some communities are really poor and to help them respond to their health care needs, Community-Academic partnerships have been proven effective. This joint venture is able to create novel ideas to give solution to the health discrepancies and improve health outcomes (Fauchald, 2004). Students are able to learn while being at the community, and the community is also helped to improve their status.

    With its mission of “Improving the health situation of the most vulnerable communities”, the Community Health Nursing Services (International Federation of Red Cross and Red Crescent Societies) is conscious that it is imperative to strive more and reach out to significantly make a change in the health care status of these vulnerable communities.




    References:

    1. http://www.redcross.org.ph/Site/CHNS/Home.aspx
    2. Collier, J. and Davidson, G. et al.,2009. Academic Faculty Qualifications for Community/Public Health Nursing: An Association of Community Health Nursing Educators Position Paper. Public Health Nursing, Vol. 27 No.1, pp 89-93.
    3. McCann, E. Building a Community-Academic Partnership to Improve Health Outcomes in an Underserved Community. Public Health Nursing Volume 27 Number 1 January/February 2010

    arneljamolangue

    Posts : 7
    Join date : 2009-06-21

    Re: "ENVIRONMENTS OF CARE"

    Post  arneljamolangue on Thu 08 Apr 2010, 5:01 pm

    University of the East
    RAMON MAGASAYSAY MEMORIAL MEDICAL CENTER
    Graduate School
    Aurora Blvd., Quezon City

    "ENVIRONMENTS OF CARE: PREPARING A NEW GENERATION OF NURSES"

    Group #4 – Supplemental
    AQUINO, Camille
    FADERA, Juan Carlo
    JAMOLANGUE, Arnel
    LACISTE, Chloe Anne

    Andragogy or adult learning theory claimed that as individual gets older, the role of educator is minimized. Therefore it assumed that workshops and seminar help adult to acquire knowledge and experience. Community-based interdisciplinary curriculum is an experiential course wherein quality patient care is optimized by working in interdisciplinary health care teams. This program is intended to provide an ideal background for interdisciplinary teamwork to prepare future health care professional. It will give a better understanding of how other disciplines work and this will help them to collaborate effectively with other interdisciplinary teams. It has four target areas that health care students need to learn: (Lennon-Dearing & Florence et. al)
    1. The chronic care model
    2. Knowledge of and the ability to use quality improvement processes
    3. Interdisciplinary training
    4. Community-based learning experience.






    References:

    1. http://www.redcross.org.ph/Site/CHNS/Home.aspx
    2. Collier, J. and Davidson, G. et al.,2009. Academic Faculty Qualifications for Community/Public Health Nursing: An Association of Community Health Nursing Educators Position Paper. Public Health Nursing, Vol. 27 No.1, pp 89-93.
    3. McCann, E. Building a Community-Academic Partnership to Improve Health Outcomes in an Underserved Community. Public Health Nursing Volume 27 Number 1 January/February 2010
    4. Lennon-Dearing, R. & Florence, J. et. al (2008). A Rural community-based interdisciplinary curriculum: a social work perspective, 47(2):93-107. Retrieved April 08, 2010 from CINAHl database

    Ma. Martell Reyes

    Posts : 13
    Join date : 2009-06-21

    Re: "ENVIRONMENTS OF CARE"

    Post  Ma. Martell Reyes on Thu 08 Apr 2010, 5:32 pm

    Group 2

    DAGUASI, CLIFF RICHARD
    LACANILAO, FATIMA
    LUIS, MARY ANN KRISNA
    MAPATAC TOMAS III
    REYES MA. MARTELL


    "ENVIRONMENTS OF CARE: PREPARING A NEW GENERATION OF NURSES"

    Learning is everywhere, it can be acquired by means talking to other people, sharing experience, reflecting and also from our environment hence, the community where we interact can be a medium of learning. Community based learning in Nursing education is one of the solutions for the problem in the shortage of nursing educators and nursing leaders. Preparing and exposing the students for the environment will prepare them to be a nursing academician Thies &Ayers(2004) .

    Community-based learning enriches coursework by encouraging students to apply the knowledge and analytic tools gained in the classroom to the pressing issues that affect local communities. Working with faculty members and community leaders, students develop research projects, collect and analyze data, and share their results and conclusions with the organizations and agencies that need the information, as well as with their professors. Not only does the community benefit, but students' understanding of the subject is also greatly enhanced (Princeton University, 2008).

    This kind of learning innovation is widely known because of its cost-effectiveness. (Canadian Nurses association 2003). There are available studies to prove the effectiveness of community nursing practice. The incorporation of clinical nursing care, case management and preventive services combined with public health nursing was a great help in conserving dollar cost per effective intervention. Erkel, Morgan, staples, Assey & Michael (1994). The study of Krahn & Guasparini (1998) proves the cost-effectiveness of community nursing.Nurses on a school-based program who delivered hepatitis B vaccine to 6th graders in Columbia made a savings of $75 per person.

    Nursing Community-based curriculum for nursing education can be beneficial in such a way that it can provide opportunity for faculty practice, new and expanded avenues for community collaboration and research initiatives (Mcahon & Niles 2000). The curriculum provides an active participation of the nursing students with the context they are trying to grasp. Moreover, this learning will be applied in a real situation which provide opportunitiest to experience working with individuals and families in acute care settings to working with families and groups in community settings. Through out the practice, students will have the chance to utilize reflective thinking abilities, collaborate with the faculty and peers, and expand their first hand experience. Finally, they may be able to develop a caring attitude that is not only bound for themselves but also for others (Rockford College, 2010).

    Divulging nursing students to the environment is a way of enhancing the students their ability and providing opportunities to enrich their professional roles and responsibilities as a nurse



    Reference:

    Rockford College (2010). Nursing Department and Community Based Learning. Retrieved April 8, 2010 from http://www.rockford.edu/?NurseCBL.

    Krahn & Guasparini (1998). Cost and Cost effectiveness of a Universal Cost and Effectiveness of a Universal School based Hepatitis B Vaccination Program. American Journal of Public Health. 889(11),1638-44.

    Oermann & Heinrich (2004.)Annual Review of Nursing Education, Volume 2; Volume 2004.

    Thies &Ayers(2004) Community-based student practice: a transformational model of nursing education.Retrieved las April 8, 2009 from http://www.ncbi.nlm.nih.gov/pubmed/15682583.

    NA(2003).Nursing in the community. Ottawa, ON. Canadian Nurses association.

    Erkel, Morgan, staples, Assey & Michael (1994). Case Management and Preventive services among infants from low income families. Public Health Nurse 119 (5), 352-60.

    Princeton Univesity (2008). Community based Learning Inititiative. Retrieved last April 8, 2010 from http://www.princeton.edu/~cbli/.
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    Efren F. Alvarez Jr.

    Posts : 13
    Join date : 2009-06-21
    Location : Lipa City, Batangas

    Re: "ENVIRONMENTS OF CARE"

    Post  Efren F. Alvarez Jr. on Thu 08 Apr 2010, 5:49 pm

    University of the East
    Ramon Magsaysay Memorial Medical Center, Inc.
    GRADUATE SCHOOL
    Aurora Boulevard, Quezon City

    GROUP V
    Alvarez, Efren Jr. F.
    Facto, Christian Jay J.
    Monterozo, Mary Lynn R.
    Nidar, Joy H.


    Community-based curriculum is an excellent addition in a nursing education program in the Philippines. There are many communities which are far from hospitals and clinics and their main venue for health care are health centers usually manned by community nurses. The curriculum itself gives a holistic approach and is ideal since communities tend to be far from hospitals and clinics. Nurses who learned well from community-based curriculum can address the concerns in the community assuming community health nursing is the field they will pursue.(Staats, 2003)

    But then the problem lies on the application of the curriculum. It was already pointed out that there is the scarcity of CHN professors. The curriculum is useless when the professors themselves lack the mastery of the subject. Experience is a fundamental principle in the curriculum (Smith, Emmet & Woods, 2008) so an experienced CHN nurse is needed as a professor.

    The unexperienced professor cannot be expected to inspire the students in pursuing the field. At the same time hospital work is a more appealing field for new nurses. As students, they have more exposure to hospital work and most lessons taught to them are more applicable to hospital settings. If the students were given a more fulfilling experience during their exposure they may consider working in the community. “Maximising student exposure to rural and remote facilities, enhancing experiential learning opportunities and engagement in teaching material is the key to enhancing learning outcomes that create long term benefits for rural and remote communities .” (Smith, Emmet & Woods, 2008)

    The nursing faculty should put effort in ensuring that the professors they put in the community health subjects have ample experience as community health nurses. Future nurses can fill the gap of community nurses in the Philippines if the community-based curriculum are strengthened by investing on experienced community nurses and training those lacking. More learning experience should be required for the students as well.



    References:

    Smith, L., Emmett, H. & Woods, M. (2008). Experiential learning driving community based nursing curriculum. Rural and Remote Health. 8:901. Retrieved April 8, 2010

    Staats, C.R. (2003). THE DEVELOPMENT OF A COMMUNITY-BASED Baccalaureate Curriculum Model
    in a Culturally Diverse Health Care Delivery Area. Nursing Education Perspectives, Vol . 24 No.2. Retrieved April 8, 2010 from http://nln.allenpress.com/doi/pdf/10.1043/1536-5026%282003%29024%3C0094:TDOACB%3E2.0.CO;2?cookieSet=1

    jerrick

    Posts : 4
    Join date : 2010-04-08

    reply to group 1

    Post  jerrick on Thu 08 Apr 2010, 6:04 pm

    Effectiveness of interprofessional education (IPE) does bring as a very promising change in our curriculum not only to the nurses but also to other field of medicine. It help resolve the chasm in health care system as a result of complexity in health care, changes in the public’s health care needs and challenges in the health care delivery system.

    IPE as viewed by institute of medicine 2003 as the new vision for health professions education in which All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches and informatics. With this program it help unveil the direction of health care in the next century. It help create a new model that address the rapid changes in health globally. “Health science education needs to be transformed by integrating parts of what are now separate academic programs and by a focus on team building” Health Council of Canada 2005

    As a result with the advantages of IPE and its known effectiveness it outlast the proposed curriculum
    Environment Care Model (ECM). Additional research are still needed to strengthen the proposed curriculum.




    1.Health Council of Canada 2005. Health Renewal in Canda: Acelerating change (page 36-37)
    2.Institute of medicine 2003. Health Professions Education: A Bridge to Quality,

    jerrick

    Posts : 4
    Join date : 2010-04-08

    Re: "ENVIRONMENTS OF CARE"

    Post  jerrick on Fri 09 Apr 2010, 1:30 am

    reply to group 4


    The community base exposure help our student to participate the different level of care in a different scenario it help them socialize with the community, groups families and individual at home, in places of work in health center, prevention of illness, promotion of health and rehabilitation (R. Freeman). It gives them opportunity for evaluating the health status of people and groups and relating to there newly learned theory and skills. The community is also a perfect place of practice for freshmen to senior year like vital sign taking, client education, making a health program, periodic measurements of progress.

    Reference:
    1.R. Freeman 2000. Community health nursing services in the Philippines page 27

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