Seth Kahn’s (2011), article entitled, “Putting Ethnographic Writing in Context,” identifies ethnography as the study of “relationships, rituals, values, and habits that make people understand themselves as members of a group.” Ethnographers adopt a stance of observation, as well as participation to better understand the discourse among members within a particular group, or discourse community (Khan, 2011). This ethnographic research will “connect what community members know and do, with what they say and how they say it” (Devitt, Bawarshi, & Reiff, 2003). The purpose of this study is to explore how nurses, working in a cardiac catheterization laboratory, learn the ‘local knowledge’ necessary to communicate with a multidisciplinary discourse community successfully. To protect the identity of participants in this study, the name of the laboratory included in the study will be identified as the XYZ Cardiac Catheterization Laboratory. Cardiovascular diseases have long been the leading cause of death in the United States (Narang et al., 2016). Research predicts the progression of cardiovascular disease will affect forty percent of our population by the year, 2030 (Narang et al., 2016). Furthermore, research shows that the cardiovascular workforce is inadequate to meet the rising demands of this patient population (Narang et al., 2016). In particular, a subset of cardiac nurses, a cardiac catheterization laboratory nurse is a key member of this cardiovascular workforce.
As a graduate of the Doctor of Nursing Practice in a Family Nurse Practitioner specialty, I aim to challenge myself further in the field of nursing by providing efficient and effective care to individuals of all ages. In the role of Family Nurse Practitioner, I will be able to care for infants, adults, and elderly patients, and help them to manage acute and chronic illnesses. I will also focus on improving quality of life by offering preventative care options to patients. Furthermore, I would be able to provide more in depth care and establish rapport with patients and families to help them care for their own personal health through assessment, diagnosis, and treatment. Currently, as a Registered Nurse on a Cardiology Intermediate Care Unit,
Current literature continues to reiterate the indicators of a major shortage of registered nurses (RNs) in the United States. The total RN population has been increasing since 1980, which means that we have more RNs in this country than ever before (Nursing Shortage). Even though the RN population is increasing, it is growing at a much slower rate then when compared to the rate of growth of the U.S. population (Nursing Shortage). We are seeing less skilled nurses “at a time of an increasingly aging population with complex care
There will be a need for additional catheterization labs, surgical suites and expanded cardiac rehabilitation programs. There needs to be better coordination of care to ensure timely scheduling of procedures. Education programs need to be developed emphasizing cardiac risk factors, healthy living and lifestyle modifications.
For over a decade researchers have been performing studies examining the effects patient-to-nurse ratios have on adverse outcomes, mortality rates, and failure-to-rescue rates of patients and on job dissatisfaction and burnout experiences of nurses. Aiken, Sloane, Sochalski, and Silber (2002) performed a study which showed that each additional patient per nurse increased patient mortality within 30 days of admission by 7% and increased failure-to-rescue by 7% as well. This same study also showed that each additional patient per nurse resulted in a 23% increase in nurse burnout and a 15% increase in job dissatisfaction. Additionally, Rafferty et al. (2007) performed a study in which the results showed that patients in hospitals with higher patient-to-nurse ratios had a 26% higher mortality rate and nurses were twice as likely to have job dissatisfaction and experience burnout. Blegen, Goode, Spetz, Vaughn, and Park (2011) performed a study where results showed that more staffing hours for nurses resulted in lower rates of congestive heart failure morality, infection, and prolonged hospital stays. The same study also showed that increased nursing care from registered nurses resulted in lower infection and failure to rescue rates and fewer cases of sepsis.
Heart Failure affects nearly 5.8 million people in the United States. The American Heart Association reports that the total economic cost of heart disease and stroke in 2011 was $320.1 billion. ("Efforts to Prevent Heart," 2015). More Medicare dollars are spent for the diagnosis and treatment of heart failure than for any other diagnosis (Schneider, O'Donnell, & Dean, 2011). Hospital admissions for heart failure are very common, especially among Medicare aged patients, and heart failure hospital readmissions are a major contributor to rising healthcare costs. Evidence suggests that factors influencing readmission rates for heart failure patients include knowledge deficits in nursing education, standardized patient education, and transitional
I work in the coronary care unit. Coronary artery disease is the most common chronic disease I see in my patients. According to American Heart Association, heart disease is the no. 1 cause of death in the United States, killing over 370,000 people a year (Heart and Stroke Statistics, 2015). It also states that about 750,000 people in the U.S. have heart attacks each year among them, about 116,000 die. It is scary to know that cardiovascular disease claims more lives each
When nursing any patient with heart failure it is important to have an understanding of how the heart should work to understand how it stops working correctly. This knowledge is important as writtler (2006) (cited in Jones) feels that district nurses have little knowledge when it comes to heart failure. Patient, Writler (2006) feels that by understanding how the heart works and how it is damaged we, as district nurses will be able to recognise the signs of heart failure earlier7a?.
R E V I E W S H E E T 30 Anatomy of the Heart
Cardiac diseases alone have been estimated, direct and indirect costs, for the overall American population are “approximately $165.4 billion for 2009” (CDC, 2013). A survey found that heart disease accounted for 4.2 million of the hospitalizations in 2006. In 62% of these cases were short stay hospitalizations and occurred amount peoples ages 65 and older. These hospitalization rates also vary by gender, racial, and ethnic groups.
No matter which perspective the view is from, most everyone would agree that millions of nurses worldwide are involved in a profession that is constantly changing and changing at a very quick pace (Robert Wood Johnson Foundation, 2011). This transformation is due to a number of factors like demographic changes, the shortage of health care professionals, economic downfalls on the health care system, and evolving technology (Robert Wood Johnson Foundation, 2011). In an effort to support and promote the future of nursing and advancement in health care, the Institute of Medicine (IOM) and Robert Wood Johnson Foundation (RWJF) took on a 2 year initiative that
safe patient care across the United States (Needleman et al., 2011). Fewer RNs result in
CRNAs are a way to provide cost-effective services- as they are less costly to employ than anesthesiologists, in a time where healthcare facilities are scrambling to cut healthcare costs. As such, CRNAs will continue to be in high demand particularly in medically underserved areas and as they continue to become more widely recognized and accepted as a source for healthcare (Inner Body, 2013).
With over 2 million jobs, registered nurses represent the largest health care occupation (Windle, 2008, p. 209). Although nurses are the biggest health care occupation, there continues to be a shortage in the United States. The shortage has worsened because of rising healthcare costs and a focus on cost containment, which has negatively impacted nurse work environments (Keeler and Cramer, 2007, p. 350). With demand for healthcare expecting to continue to increase and financial pressures becoming more burdensome, these shortages will likely become even more critical in coming years if not adequately addressed (Love et al., 2006, p. 558). The U.S. Bureau of Labor Statistics estimates 1.2 million nurses will be required to fill new and vacated nursing positions by the end of 2014 (Windle, 2008, p. 209).
Cardiovascular disease is a substantial concern and has emerged as one of the leading health issues. In examining cardiovascular disease, its incidence is astounding. Each year approximately one million men and women die, averaging one death every thirty three seconds (Heart, 2013).The death rate for cardiovascular issues such as myocardial infarction and CHF claim more lives than cancer and Aids combined. Heart disease will be the number one cause of death by the
Cardiac catheterization is often referred to as coronary angiography or a coronary angiogram. It is a radiographic procedure that is used to look at and visualize the heart and the coronary arteries. During a cardiac catheterization it is possible for the cardiologist performing the procedure to see how effectively blood is flowing through the coronary arteries. In addition, this procedure allows the cardiologists to see how blood is moving through the chambers of the heart and how effective the heart valves are functioning. A cardiac catheterization can also allow for the visualization of the movement of the walls of the heart to see if the pumping action of the heart is normal.