Nurse Consultant Associates

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New Article by Dr. Goodyear

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Many countries around the world are facing aging populations and an increased need for caregivers. According to a UN report (http://www.un.org/en/sections/issues-depth/ageing/) nearly every country is experiencing an increase in the number of older people in their populations. The number of older people is expected to more than double by 2050 and this dramatic increase will result in societal changes. One of these changes is the increased need for skilled caregivers.

Dr. Rosemary Goodyear recently published an article on developing a train the trainer model in Taiwan to increase the number of skilled caregivers in the community. According to Dr. Goodyear, “It is possible that this model of using an intensive training session will be adopted by other cities in Taiwan to help ease their shortage of qualified caregivers.” Dr. Goodyear will be returning to Taiwan in the summer of 2019 to continue her work with the Ministry of Health to develop a community-based caregiver curriculum for nurse practitioners who work in Taiwan. The majority of NPs in Taiwan are employed in hospitals but there is great need for NPs in the community to manage care for the aged.

To read the article by Dr. Goodyear, click on the following link: https://authors.elsevier.com/a/1YUR55XgHbSbzy. This link will be active until March 21, 2019. No sign up, registration or fees are required

NPs Around the World

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Have you ever wondered about NP practice in other countries? The NP role around the world is diverse. Educational, regulatory requirements and scope of practice vary by country. For example, nurse practitioners in New Zealand must have a minimum of four years of experience in a specific practice area and complete a clinical master’s degree, and register with the Nursing Council. New Zealand NPs have a broad scope of practice and have the same prescribing authority as medical doctors.1

In Taiwan, NP became the legal title for advanced practice nurses in 2000 but the scope of practice was not clearly defined until 2016. While the scope of practice is broad, physician supervision for some activities is required and NPs do not have independent prescriptive authority.2 However, the role of the NP in Taiwan is rapidly changing and expanding. As the population ages, more NPs are needed to care for the elderly.

In an article in the FAANP forum, Dr. Rosemary Goodyear describes the development and evolution of NPs in Taiwan and the new focus on developing Long Term Care programs. You can read about this at https://www.aanp.org/images/documents/FAANPForum/2018-6.pdf.

1. New Zealand Ministry of Health (2017) Nurse Practitioners in New Zealand https://www.health.govt.nz/our-work/nursing/nurses-new-zealand/nurse-practitioners-new-zealand.

2. Chiu, H., Tsay, S.L., Tung, H.H. (2016). A giant leap in the development of nurse practitioners in Taiwan: from statue to regulation. Journal of the American Association of Nurse Practitioners 28; 622-627.

 

Health Policy: Should Students Care?

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By Dr. Barbara Sheer

After the tragic events at Parkland Florida, the high school students mobilized and became activists. They not only went to the Florida legislature but marched on Washington DC. March For Our Lives was a nationwide protest calling for an overhaul of our gun policies. Marches and events occurred over the country with high profile star support. National news covered the event. The granddaughter of Martin Luther King spoke as well as kids as young as 7. If high school students can mobilize the nation and make a difference, can nurses have a similar impact on health care?

Legislation in Washington not only affects the health of the individuals in our nation but also global health, which may have both direct and an indirect impact on us. Economic sanctions aimed at political punishment in a variety of countries have led to increased morbidity and mortality. Did you know that on becoming president, Trump signed a global gag rule to ban international aid funding linked to abortion-related family-planning services? This could impact up to 26 million women worldwide (Chen, 2118). The “Global Gag Rule” links major funding from USAID to strict rules on avoiding facilitation or promotion of abortion in any way. USAID is a leading contributor to global family planning programs. In addition to family planning, these services include financial support for maternal and child health services, nutrition, HIV/AIDS, and prevention and treatment of tuberculosis, malaria programs. This policy change can have far reaching effects on water, sanitation and hygiene programs; and result in detrimental effects on prevention and treatment of health conditions. Trade agreements can affect the availability of key drugs for the treatment of many communicable and non-communicable diseases (Gupta, 2006).

As nurses our priority is to the patient. Being a global society, nurse need to focus on population health. We need to become activists, but how do we learn to do this? It is imperative that health policy and experiences be included in all nursing programs. Health policy is broader than just writing legislation or lobbying our legislators. Nurses must also understand the economic factors at work in policy development and the consequences of policy change. To do this, nurses must have the skills to assess the impact of policy change on health outcomes and organizational processes. DNP students, in particular, could carry out projects to critically analyze health policy results. In an article on medical students and health policy, Rajesh Gupta discussed the critical need for medical students to become policy scientists as well as good clinicians. Nursing students also must become health policy scientists and strive to improve health outcomes through health policy expertise in formulation and evaluation. Nurses need to think globally and act locally and we can learn from the high school students to raise public awareness of policies.

NCA can help you in revising health policy courses or curriculum. NCA consultants have experience in policy and global health and can help you to tailor nursing education programs to enhance current health policy courses and/or thread policy throughout the curriculum.

Chen, M (2018, March 6). Trump’s Abortion Gag Rule Is Hurting Reproductive Rights Around the Globe. Retrieved from https://www.thenation.com/article/trumps-abortion-gag-rule-is-hurting-reproductive-rights-around-the-globe/

Gupta R (2006) Why Should Medical Students Care about Health Policy? PLoS Med 3(10): e199. https://doi.org/10.1371/journal.pmed.0030199

Keywords: nursing education, curriculum, policy, global health

Dr. Goodyear presents in Taiwan

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Dr. Goodyear (third from right) met and spoke with the Minister of Health (Dr. S.C. Chen) of Taiwan Central Government during the 2017 Global Health Forum in Taiwan [October 22-23, 2017].

Dr. Goodyear was invited to present about the Train the Trainer program initiated to prepare interprofessionals “how to teach caregivers”. She, along with other nurse leaders, presented on “Transformation of Integrated Care: Innovation Advanced Long Term Care Training Project”. Dr. Shwu-Feng Tsay (Director General Department of Nursing and Health Care) moderated the session and Prof. Annette Kennedy, President of International Council of Nurses, led the responses and Q & A session following the presentations.

Preparation for Working in the International Nursing Community Part 2

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By Rosemary Goodyear

Getting ready to work in international health requires some preparation. Last month we discussed finding and identifying international health organizations and learning about what they do.

Another level of preparation begins with a self-assessment of what motivates your wish to move into international work? Five themes have been found to influence people to become inspired, and to become involved; 1) Desiring training and experience within different populations; 2) Humanitarianism; 3) Response to a disaster; 4) Intellectual curiosity; and 5) Escape from a vexing life situation.1 Once you identify what has induced this interest, a personal SWOT analysis can be carried out by identifying your strengths, weaknesses, opportunities and threats you bring to this search. The results will provide insight into your desires and objectives and help you establish goals and direction for you international work.

Prerequisite knowledge for international involvement includes gaining an understanding of the governmental, political, economic, and cultural realities that exist in the nation you will visit. This will provide a scope of what to expect during your stay in this nation. Exploring the rules and regulations of the nursing profession in the practice field in the nation to be visited, is part of your research. This is essential prior to departure. An important step is to determine the current health care system in place in the nation/ state and its influence on the health care being provided to the citizens. This is essential knowledge for you as you plan for an international experience.

Before you can move forward with an international experience, there are personal requisites each individual must achieve and master. I call it WRAP. Wisdom, Respect, Audience, and Patience. These are the fundamentals each nurse must explore and achieve before embarking on an international healthcare experience. Wisdom must be gained through research into the nation’s history and current state of health care that exists today. Respect for each individual’s social, cultural, ethnic, and religious expression must be explored and understood prior to departure. The audience of individuals and nurses you will encounter and work with during your stay in a nation must be understood, respected and supported thought the work you carry out during your presence in the nation. Having patience for a different pace of life, business and processes is foundational to each working project when visiting the nation of assignment or selection.

Last prepare yourself to work on a mutually selected project with your host nation, where you can bring expertise, facilitate learning and growth, to reach the mutual goals of your host and yourself. Finally be prepared for a life change as an outcome of this experience.

References:

  1. Basch, PF. Textbook of International Health, 2nd Ed. Oxford Press; NY. 1999.
  2. Dalmida, SG. Amerson, R. Foster, J. McWhinney-Dehaney, L. Magowe, M. Nicholas, PK. Pehrson, K. and Leffers J. Volunteer service and service learning: Opportunities, partnerships, and United Nations millennium development goals. Journal of Nursing Scholarship 2016; 48: 517-626.

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