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Free Essays on Health and Medicine:

 

The National Health Service (NHS) Structure

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The National Health Service (NHS) offers a range of services throughout primary and community healthcare, intermediate care and hospital-based care. It also provides information services and support to individuals in relation to health promotion, disease prevention, self-care, rehabilitation and after-care, (DoH, 2009).
The NHS is divided into two sections: primary and secondary care. Primary care is the first point of contact for most people when they first have a health problem. This may involve consulting a doctor, dentist, pharmacist or optician. NHS walk-in centres and the NHS Direct telephone service also comes under primary care (DoH, 2009). Secondary care - known as acute healthcare, can be elective care or emergency care (DoH, 2009).
Guidelines and Policies
All members of health care providing services, must work within and adhere to, guidelines set out by the National Institute for Clinical Excellence (NICE) and fulfil the requirements of the National Service Frameworks (NSFs).
NICE, an independent organisation, makes recommendations to the NHS, local authorities and other organisations in the public, private, voluntary and community sectors, on how to improve people's health and prevent illness and disease. It provides guidance regarding new and existing medicines, treatments and procedures, and treating and caring for people with specific diseases and conditions (NICE, 2011).
National Service Frameworks and strategies are policies set by the NHS, that define clear quality and standard requirements for the care specific patient groups and diseases. Strategies are developed in partnership with health professionals, patients, families, carers and other agencies to be truly inclusive, and are based on the best available evidence of what treatments and services work most effectively (DoH, 2010).
Clinical Governance frameworks aim to preserve high standards of care, by ensuring national and local policies, protocols guidelines and standards are adhered to.

Tuberculosis

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Tuberculosis (TB) is the leading cause of death in the world from a single infectious disease. Little is known of the pathogens that cause it and how to treat it effectively. There was a decline in tuberculosis in the United States in the last century but the disease is now increasing. This increase has multiple causes including changes in social structure in cities, HIV epidemic, and a failure by some public entities to improve their public health programs.
In the United States since 1985 there has been an increase in cases of tuberculosis. This is due largely to the increase of Human Immunodeficiency virus (HIV) infections which occurred during the same period of time. More recently there has also been an increase in the number of cases of multi drug resistant (MDR) strains of tuberculosis due to patient non compliance with medication. M

Resources

Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium tuberculosis. In: Mandell GL, Bennett JE, Dolan R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Orlando, FL: Saunders Elsevier; 2009:chap
Iseman MD. Tuberculosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;
http://www.cdc.gov/TB/

ycobacterium tuberculosis is the cause of TB in humans. Humans are the only known reservoir for the bacterium. Mycobacterium bovis is the etiologic agent of TB in cows and rarely in humans, but both cows and humans can serve as reservoirs. Humans can also be infected by consuming unpasteurized milk. This method of transmission can cause the development of extra pulmonary TB, as seen in history by bone infections that caused hunched backs.

Basic procedures in personal hygiene

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Infections are a major cause of human suffering and premature death. It is essential that control of infection is issues of very great practical importance for every health care professional. To prevent and to help reduce the risks of infection, it is essential to follow certain basic procedures of cleanliness. Disease causing organisms live in and on the body and can affect others if a high standard of personal hygiene is not maintained. This is why attention to personal hygiene is important. Wearing clean clothes and regular washing helps to protect people against infection. Looking after self is a priority when caring for others which is why it is essential for all care workers to look after themselves. Wounds such as cuts, grazes scratches and boils can be very easily infected. Keeping the wounds properly covered with a suitable waterproof dressing is the best way to prevent it from happening. By doing this, it would make both the care worker and service user protected from infection.
Cleanliness for care workers must be applied to;
* Self for example personal hygiene which consists of keeping nails and hair short, showering or bathing daily, wearing clean clothes, keeping hair clean and having clean teeth.
* Equipment for example the items used to provide care and to treat service users
* Environment for example the floors, furniture
* Food preparation for example preparing, cooking and serving meals.
When considering personal cleanliness care workers should pay attention to all parts of the body. These factors are Cleanliness, dress, protective clothing, hand washing, hair care, footwear and oral hygiene. Personal cleanliness also includes keeping nails and hair short, showering or bathing daily, wearing clean clothes, keeping hair clean and having clean teeth.

Therapeutic relationships in nursing

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In this reflective assignment I will provide information to establish how I have used and improved my interpersonal skills with patients and the staff I worked with. I will also show how I established a therapeutic relationship with a selected patient from my second placement. I will provide a brief description of my chosen patient and the importance of gaining informed consent and patient confidentiality will be discussed. I will utilise Roper, Logan and Tierney’s (2003, p.81) Model of Nursing, which places importance on the 12 activities of living (ALs) and focused on the most appropriate of the 12 activities. Gibbs’s reflective cycle was chosen to reflect upon each step of the therapeutic model in Jasper (2003, p.77).
To define therapeutic communication it involves using of carefully chosen ways of communication to help the patient and their family to overcome stress and the inevitable situation the patient finds him- or herself in, McHugh Schuster (2000, p. 7). Stein-Parbury (2005, p.4, part 1) describes a therapeutic relationship as 'listening without judging and responding with understanding help to create a relationship based on acceptance and respect. In effective Nurse- patient interactions there is an orientation on the part of the nurse to be of benefit to the patient and more importantly the patient feels assisted in some way by the interaction.’
Patient A is a 65 year old lady who lives on her own somewhere in the north east. She has been suffering from chronic obstructive pulmonary disease (COPD) for the past five years. She was a heavy smoker until approximately 3 years ago, but managed to stop smoking with some help. Up until 6 months ago she coped well with her illness and managed to control her symptoms. Unfortunately, her health started to deteriorate over the last 6 months and she was admitted to the ward I worked in, on my second placement, after a severe attack of breathlessness. A neighbour and good friend of patient A had accompanied her to hospital.

Carl Rogers

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Carl Rogers was born on January 8, 1902, in Oak Park, Illinois, a Chicago suburb. Carl was the fourth of six children that grew up in the Pentecostal Church. The very conservative, well behaved Carl, however, would soon turn into one of the most influential psychologist that the world has ever seen.
Rogers was quite smart and could read well before kindergarten. He spent his childhood in the church, and breezed his way through school. After he graduated, his first career choice was agriculture at the University of Wisconsin–Madison. That choice was then followed by history, and then religion. At age 20, following his 1922 trip to China, for an international Christian conference, he started to doubt his religious convictions. To help him clarify his career choice, he attended a seminar entitled Why am I entering the Ministry?, after which he decided to change his career. After two years he left the seminary to attend Teachers College, Rogers moved to Columbia University and obtained an MA in 1928 and a PhD in Psychology in 1931.
In 1951, Rogers was the first to conceptualize Person-Centered therapy. Rogers developed his Person-Centered approach to psychotherapy after becoming frustrated by the standard methodologies and procedures used in Freudian psychoanalysis and other therapies. He found that he obtained better results by listening to his patients and allowing them to direct the course of treatment. In his book, On Becoming a Person, he wrote ""Unless I had a need to demonstrate my own cleverness and learning, I would do better to rely upon the client for direction of movement"" (Rogers 1961). Rogers believed that if you were aiming for a good turn out with your patient, you needed to have unconditional positive regard (Respect), genuineness and honesty (Congruence), and empathic understanding (Empathy). In other words, for Rogers, an effective therapist does not need any special technique, just the three qualities of respect, congruence, and empathy. Without these three qualities, no technique would be successful.

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