Back Clinic Working Professionals Chiropractic Therapeutic Team. Workplace injuries impair your ability to perform work and recreational activities. They impair your quality of life. If you have been injured on the job, make sure you get the expertise and level of care needed to get back to your normal life. Chiropractic care is often the best treatment option for common workplace injuries. From chiropractors and nurses to military service members, a professional is an individual who earns their living from a specified professional activity.
These individuals dedicate their time to provide others with an effective and useful service. After spending prolonged periods of time on the job, it’s not uncommon for injuries or aggravated conditions to occur. Dr. Alex Jimenez’s article chronicles on professionals indicate the various complications affecting these particular individuals while also describing the best types of treatments available, to ensure the ultimate wellness of professionals facing pain and discomfort. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
Can healthcare professionals implement H.E.A.R.T. protocols for trafficked individuals while providing a safe space?
Introduction
Across the world, many local media and organizations are paying close attention to a phenomenon that many people should be aware of. This phenomenon is known as trafficking, and it can be associated with numerous activities, from forced labor to sex labor, and can affect a person’s sense of self-worth. While many people will correlate that trafficking affects many women and children, it can affect many individuals regardless of age, gender, and background. While many survivors of trafficking are dealing with the psychological and physical injuries that they obtain from their traffickers, many medical professionals can implement protocols and roles through the implementation of H.E.A.R.T. to provide a safe space for individuals suffering from trafficking. Today’s article focuses on the definition of trafficking, what H.E.A.R.T. is, and how it is used in a clinical setting. We discuss with certified associated medical providers who consolidate our patients’ information to assess and identify trafficking in a clinical approach while providing a safe space. We also inform and guide patients while asking their associated medical provider intricate questions to formulate customized treatment plans for their pain and provide them with a safe space and positive experience. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
The Definition Of Trafficking
When it comes to defining trafficking, it can be challenging as it is frequently associated with other issues. However, the main definition for trafficking is “recruiting, transporting, transferring, or harboring many individuals or a person that are threatened or forced to achieve the consent of a person having control of the individuals for exploitation.” With human trafficking being a pressing public concern that affects all races, social classes, demographics, and genders, it can impact society and the individual who is being trafficked. (Toney-Butler et al., 2024) Additionally, many people often mistake trafficking and smuggling as they are completely different. Smuggling requires a person to be transported into a nation through voluntary illicit means. While trafficking can come in two forms, which are labor and commercial sex, it can happen within the person’s own home. (Rambhatla et al., 2021) This is because many survivors who are going to get healthcare services will feel various emotions of fear or shame that can prevent them from asking for help due to what they have been through with their trafficker. However, when many individuals who are trafficking survivors are suffering from significant physical, mental, and social health problems and are seeking healthcare services, many healthcare professionals play an important role by creating a safe and responsive space for them. (The Lancet Regional Health-Western, 2022)
Beyond the Surface: Understanding the Effects of Personal Injury- Video
What is H.E.A.R.T In A Clinical Setting
When it comes to creating a safe and positive space in a clinical setting, many healthcare professionals often miss the signs of trafficking due to a lack of training or confidence to identify and treat patients who are trafficking victims. (Lee et al., 2021) However, healthcare protocols should be implemented, and H.E.A.R.T. should be incorporated into a clinical approach to assess and develop a customized treatment plan for the patient. Healthcare professionals can engage with the patient in a one-on-one discussion away from their trafficker and can offer important medical and psychological care resources. (Exeni McAmis et al., 2022) By incorporating H.E.A.R.T. protocols in a healthcare clinic, many doctors and medical professionals can help many patients be in a safe environment. Below is what H.E.A.R.T. stands for.
H-Hearing
The “H” in H.E.A.R.T. is for hearing as many medical professionals not only to hear but to see what is going on in the clinic and to establish environmental awareness. This is due to looking at the patient and who is accompanied by them. With healthcare providers being at the front, they interact with patients and may not know what health concerns are affecting them. This could be due to the following:
By incorporating the hearing aspect in H.E.A.R.T., many healthcare professionals can provide a safe, thoughtful, and engaging approach to the patient and know what to look for when a patient is coming in for treatment.
E-Evaluating
The “E“ in H.E.A.R.T. is used to evaluate its importance in enhancing patient interactions in a trauma-informed care facility. This is highly important because the individual is seeking health care. For the patients being trafficked, it is important to notice the red flags the individual is experiencing. Some of the red flags that many healthcare providers should look for are:
Physical health
Behavioral Health
The patient is with a controlling person
The patient does not have possession of their I.D.
Additionally, it is always important to show compassion, be sensitive to the individual while addressing their needs and concerns, and use a non-judgmental approach during the interview process. This helps the individual ensure they are in a safe environment when discussing sensitive topics. At the same time, it is important not to let the patient be re-traumatized while avoiding the impulse to rescue and overpromise the patient to mental health as we want them to have their self-worth. At the same time, it is best to remember the four “Rs“ when doing a trauma-informed approach; they are:
Realize: Understanding how trauma can affect people.
Recognize: Recognizing the signs of trauma.
Respond: Have all staff trained, use evidence-based practices, and provide a safe environment.
Resist Re-trauma: Recognizing how some practices may trigger painful memories while avoiding re-traumatizing the patient.
By implementing the four “Rs“ and the “E“ in H.E.A.R.T., many healthcare professionals can provide valuable resources to trafficking survivors with a strong support system.
A-Activating
The “A“ in H.E.A.R.T. stands for activating, where healthcare professionals must have proper protocols to engage all employees. This allows the healthcare providers to understand how beneficial it is to develop a protocol for a person who is being trafficked, understand their state and federal reporting laws, and list key elements of effective trauma-informed screening procedures when assessing the patient. This allows a foundational structure to support a response for suspected patients who are being trafficked. At the same time, by following HIPAA laws and organization policies, many healthcare providers must explain the reporting process to the right officials. Additionally, the benefits of developing a protocol for trafficking are by:
Clarifying procedures
Enhance staff training
Optimize the interactions with the trafficking patients
Improve staff confidence
Prepare for any threatening situations
Maximizing preparedness to aid trafficking patients
Optimize support for patients
Develop collaborative outside resources
R-Resourcing
The “R“ in H.E.A.R.T. stands for resourcing, as many healthcare providers must identify the referral systems. This allows healthcare professionals to understand the important message to convey when assessing trafficking victims and the importance of responding to safety, emergency, and reporting requirements. When assessing and interviewing the patient, many will have to recognize that their patient may be a possible victim of trafficking, what their immediate needs are, and what long-term resources can help.
T-Training
The “T” in H.E.A.R.T. stands for training, as it is important that many healthcare providers continuously train to spot trafficking; this provides confidence to many healthcare workers and can help save a person’s life. By implementing H.E.A.R.T. protocols, the “T” allows the doctor to respect the individual’s decision to want help, providing a positive support system while encouraging them to come back, offering to help with a safety plan, and building a resource network. This is because if the patient is accompanied by someone who is controlling and answering for the patient, handing out information discreetly can provide a bit of hope to the individual to make the move. At the same time, providing local and immediate assistance resources can help the individual in the long run. This allows healthcare providers to build a trusting relationship and even help individuals to have a safe and positive experience on their health and wellness journey.
References
Exeni McAmis, N. E., Mirabella, A. C., McCarthy, E. M., Cama, C. A., Fogarasi, M. C., Thomas, L. A., Feinn, R. S., & Rivera-Godreau, I. (2022). Assessing healthcare provider knowledge of human trafficking. PLOS ONE, 17(3), e0264338. doi.org/10.1371/journal.pone.0264338
Gutfraind, A., Yagci Sokat, K., Muscioni, G., Alahmadi, S., Hudlow, J., Hershow, R., & Norgeot, B. (2023). Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes. Front Public Health, 11, 1243413. doi.org/10.3389/fpubh.2023.1243413
Lee, H., Geynisman-Tan, J., Hofer, S., Anderson, E., Caravan, S., & Titchen, K. (2021). The Impact of Human Trafficking Training on Healthcare Professionals’ Knowledge and Attitudes. J Med Educ Curric Dev, 8, 23821205211016523. doi.org/10.1177/23821205211016523
Rambhatla, R., Jamgochian, M., Ricco, C., Shah, R., Ghani, H., Silence, C., Rao, B., & Kourosh, A. S. (2021). Identification of skin signs in human-trafficking survivors. Int J Womens Dermatol, 7(5Part B), 677-682. doi.org/10.1016/j.ijwd.2021.09.011
The Lancet Regional Health-Western, P. (2022). Human trafficking is more than a crime. Lancet Reg Health West Pac, 20, 100444. doi.org/10.1016/j.lanwpc.2022.100444
How do healthcare professionals provide a clinical approach in the role of nursing to reducing pain in individuals?
Introduction
The practice of Registered Nurses (RN), Advanced Practice Registered Nurses (APRN), and Licensed Practical Nurses (L.P.N.) is governed by the Nurse Practice Act. Nurses working in the specializations above must keep up their practice skills and knowledge, which includes familiarity with the rules and regulations that pertain to their profession. Practicing practical nursing is authorized for Licensed Practical Nurses (L.P.N.s). Today’s article looks at the role of nursing. We discuss with certified associated medical providers who consolidate our patients’ information to assess any pain or discomfort they are experiencing. We also inform and guide patients while asking their associated medical provider intricate questions to integrate into their personalized treatment plan to manage the pain. Dr. Jimenez, DC, includes this information as an academic service. Disclaimer.
The Roles In Nursing
The Nurse Practice Act describes practical nursing as “the performance of selected various actions, including the administration of numerous treatments and medications, in the care of the ill, injured, and providing the promotion of wellness, health maintenance and prevention of illnesses while following under the direction of a registered nurse, a licensed physician, osteopathic physician, podiatric physician, or a licensed dentist.” It was revised in 2014 and now teaches broad health and wellness concepts to non-nursing students and the public. The main goal for an RN is to complement the access to health care for individuals in pain or who are dealing with chronic issues. (Cassiani & Silva, 2019)
Many individuals are under the supervision of a registered nurse, doctor, or dentist, individuals who have completed a prelicensure practical nursing education program approved by the Board, a professional nursing education program, and graduate practical nursing students qualifying as professional nursing students; however, licensed practical nurses who have not completed the specified course under Rule 64 B9-12.005, FAC, may perform a limited scope of intravenous therapy. This range consists of:
Intravenous Therapy Within the Scope of the Practical Nurse:
Calculate and adjust the flow rate of IV therapy.
Observe and report both subjective and objective signs of various reactions to IV administration to the patient.
Must inspect the insertion site, change the dressing, and remove the intravenous needle or catheter from the peripheral veins
Hanging bags or bottles of hydrating fluid.
Intravenous Therapy Outside the Scope of the Practical Nurse:
Initiation of blood and blood products
Initiation or administration of cancer chemotherapy
Initiation of plasma expanders
Initiation of administration of investigational drugs
Making IV solution
IV pushes, except for heparin flushes and saline flushes
It is appropriate for licensed practical nurses to provide treatment for patients undergoing such therapy, even though this rule restricts the practice of licensed practical nurses. 64B-12.005 Requirements for Competency and Knowledge required for the LPN to be qualified to give IV therapy. If the IV Therapy Course Guidelines published by the National Federation of Licensed Practical Nurses Education Department are completed, an LPN may be certified to administer IV therapy. The LPN can take part in further training to provide IV therapy via central lines while supervised by an RN. “The Central Lines. The Board acknowledges that a Licensed Practical Nurse, as defined in subsection 64B9-12.002, FAC, may provide intravenous therapy via central lines under a registered professional nurse’s supervision with the necessary education and training. Four hours of instruction is the minimum required for appropriate education and training. The thirty hours of education for intravenous therapy needed for this rule’s subsection may include four hours of training. At the very least, didactic and clinical practicum instruction in the following areas must be included in the education and training mandated by this subsection:
Central venous anatomy and physiology
CVL site assessment
CVL dressing and cap changes
CVL flushing
CVL medication and fluid administration
CVL blood drawing
CVL complications and remedial measures
The Licensed Practical Nurse will be evaluated on clinical practice, competency, and theoretical knowledge and practice after completing the intravenous therapy course via central lines. A Registered Nurse must witness the clinical practice assessment and file a proficiency statement on a Licensed Practical Nurse. The Licensed Practical Nurse will be evaluated on clinical practice, competence, and theoretical knowledge and practice. A Registered Nurse who oversees the clinical practice assessment must sign a proficiency statement attesting to the Licensed Practical Nurse’s competence in administering intravenous treatment through central lines. The applicant’s Licensed Practical Nurse personnel file must contain the proficiency statement. 64B9-12.005 code.
Professional nursing is practiced by registered nurses (RNs). The Nurse Practice Act defines this as “the performance of those numerous acts requiring substantial specialized knowledge, judgment, and nursing skill based upon the applied principles of psychological, biological, physical, and social sciences.” Professional nursing goes beyond hands-on care to include nursing diagnosis, planning, supervision, and training other staff members in the theory and execution of any tasks mentioned above. Additionally, nurses must use numerous experiences to assist patients with an understanding of empathy to make them feel comfortable and safe. (Torres-Vigil et al., 2021)
Delegations & Certificates For Nursing
The delegation of responsibilities to another healthcare provider or a competent unlicensed individual is permitted by the Florida Nurse Practice Act. When assigning a task or activity, the registered nurse (RN) or licensed practical nurse (L.P.N.) must consider appropriateness. They had to consider the possibility of patient injury, the difficulty of the work, the outcome’s predictability or unpredictability, and the resources—including staff and equipment—available in the patient environment. The RN and the LPN may assign tasks outside the supervising or delegating nurse’s scope of practice. These tasks include determining the nursing diagnosis or interpreting nursing assessments, developing the plan of care, establishing the goals of nursing care, and assessing the progress of the care plan. The role of nursing is to promote advocacy and create a direct relationship with patients. (Ventura et al., 2020)
464.0205 Retired Volunteer Nurse Certificate
A retired practical or registered nurse may apply for a retired volunteer certificate from the Board of Nursing to work with underprivileged, impoverished, or critically ill populations. They are directly supervised by a physician, advanced practice registered nurse, registered nurse, director of a county health department, and:
Provides services under the certificate only in sponsored settings that the Board has approved
The scope of practice for a certified volunteer is limited to primary and preventive health care by the Board.
A retired volunteer nurse shall not:
Administer controlled substances
Supervise other nurses
Receive monetary compensation
464.012 Advanced Practice Registered Nurse (APRN)
“The Barbara Lumpkin Prescribing Act” was proposed towards the end of 2018. This Act helps many practitioners convert a certificate to a license, and it takes effect on October 1, 2018. This Act established a transition timeline and process for practitioners certified as advanced registered nurse practitioners or clinical nurse specialists as of September 30, 2018, to practice as advanced practice registered nurses (APRNs). Until the department and Board complete the transition from certification to licensure, established under this Act, an advanced registered nurse practitioner who is holding a certificate to practice on September 30, 2018, may continue to practice with all the rights, authorizations, and responsibilities under this licensure section as an advanced practice registered nurse. They may also use the applicable title under s.464.015 after this Act’s effective date.
The Board of Nursing requires the following to establish an APRN license:
A nurse who wants to become an advanced practice registered nurse must apply to the APRN department, provide documentation that they meet the requirements set out by the Board, and have a valid license to practice professional nursing or an active multistate license to practice professional nursing by s. 464.0095.
Accreditation by a relevant specialty board. To become a certified nurse in any nursing department and to renew your current state license, you must first obtain this certification. For a duration deemed suitable for preparing for and passing the national certification examination, the Board may, by rule, grant certified registered nurse anesthetists, clinical nurse specialists, certified nurse practitioners, psychiatric nurses, and certified nurse midwives provisional state licensure.
Completing a master’s program in a clinical nursing specialty field and training in particular practitioner skills. For candidates who will graduate on or after October 1, 1998, paragraph (4)(a) requires completion of a master’s degree program to be eligible for initial certification as a certified nurse practitioner.
The Board of Nursing defines APRN’s role/duties:
Prescribe, dispense, administer, or order any medication; however, an advanced practice registered nurse is only permitted to prescribe or dispense the controlled substance as specified in s.893.03 if they have completed a master’s or doctoral program that provides training in specialized practitioner skills and leads to a master’s or doctoral degree in clinical nursing.
Initiate appropriate therapies for certain conditions.
Performed additional functions as may be determined by rule under s.464.003.
Order diagnostic tests and physical and occupational therapy.
Order any medication for administration to a patient in a facility.
Beyond the general duties mentioned in subsection (3), an APRN is qualified to carry out the following tasks within their area of expertise:
Within the confines of established protocol, the certified nurse practitioner may carry out any or all of the following actions:
Manage selected medical problems.
Order physical and occupational therapy.
Initiate, monitor, or alter therapies for certain acute illnesses.
To monitor and manage patients with stable chronic diseases.
Established behavioral problems and diagnoses and made treatment recommendations.
The Stature goes on to define the functions of anesthetists and nurse midwives. Refer to the Statue for more details.
Obtaining & Maintaining Nursing License
A license may be acquired through testing, endorsement, or the Nurse Licensure Compact’s enactment. Upon application and a non-refundable payment fee determined by the Board, the department will grant the necessary license by endorsement to engage in professional or practical nursing to the applicant who can provide proof to the Board that they:
Possesses a valid license to practice professional or practical nursing in another state or territory in the United States, provided that the requirements for licensure in that state were either more stringent or substantially equivalent to those in Florida when the applicant obtained their original license.
Fulfills the requirements outlined in s.464.008 for licensing and has passed a state, regional, or national exam that is at least as difficult as the one administered by the department.
Has spent two of the previous three years actively practicing nursing in a different state, territory, or jurisdiction within the United States without having any action taken against their license by any jurisdiction’s licensing body. Under this paragraph, applicants who obtain a permit must finish a board-approved Florida laws and rules course within six months of receiving their license. After reviewing the findings of the national criminal background check, the applicant will be granted the relevant license by endorsement as soon as the department determines that the applicant has no criminal history.
It will be assumed that any exams and requirements from other US states and territories are roughly the same or more demanding than those from this state. This assumption will materialize on January 1, 1980. The Board may, however, establish rules designating some states and territories, the qualifications and exams for which shall not be deemed to be substantially similar to those of this state.
When an individual submission of the appropriate application and fees, as well as the successful completion of the criminal background check that is required under subsection (4), an applicant for licensure by endorsement who is relocating to this state due to the official military orders of their spouse with a military connection and who is a member of the Nurse Licensure Compact in another state will have all the requirements satisfied.
The applicant must submit a set of fingerprints to the department on a form and per departmental rules. The applicant must also pay the department a sum equal to the expenses the Department of Health paid for the applicant’s criminal background check. For a statewide criminal history check, the Department of Health will send the applicant’s fingerprints to the Florida Department of Law Enforcement, and the Florida Department of Law Enforcement will forward the fingerprints to the FBI for a nationwide criminal history check. When an applicant satisfies all other requirements for licensure and has no criminal record, the Department of Health will review the results of the criminal history check, issue a license, and refer all other applicants who have a criminal history back to the Board for a decision on whether or not to issue a permit and under what circumstances.
Until the investigation is finished, at which point the requirements of s.464.018 will take effect, the department will not grant an endorsement license to any applicant who is being investigated in another state, jurisdiction, or territory of the United States for an act that would violate this part or chapter 456. After completing all necessary data collection and verification, the department will issue a license within 30 days. It will also develop an electronic applicant notification process and provide electronic notifications upon application receipt and completion of background checks. Suppose the applicant must appear before the Board because of information on their application or because of screening, data gathering, and verification procedures. In that case, the 30-day license issuance time will be extended. The qualifications for licensure by endorsement in this section do not apply to an individual with an active multistate license in another state under s. 464.0095.
Licensure By Examination
Anyone who wants to take the licensing exam to become a registered nurse must apply to the department. The department will assess each candidate who:
The applicant has fulfilled the requirements by filling out the application form and paying the $150 fee set by the Board. Additionally, they have paid the $75 examination fee set by the Board and the actual cost per applicant to the department for purchasing the exam from the NCSBN (National Council of State Boards of Nursing) or a comparable national organization.
Possesses enough information as of October 1, 1989, or later, which the department needs to provide to conduct a statewide criminal records correspondence check with the Department of Law Enforcement.
Possesses a high school diploma or its equivalent, is in good mental and physical health, and has fulfilled the prerequisites for:
Graduation from an approved program
Graduation from a pre-licensure nursing education program equivalent to an approved program determined by the Board.
Graduated on or after July 1, 2009, from an accredited program
Graduation before July 1, 2009, from a pre-licensure nursing education program whose graduates were eligible for examination.
Completing courses in a professional nursing education program may satisfy the educational criteria for licensing as a licensed practical nurse. Possesses the ability to communicate in English, as assessed by a department exam. Unless rejected by s.464.018, any applicant who passes the exam and has completed the educational requirements listed in subsection (1) is eligible to become a licensed practical nurse or registered professional nurse, as the case may be.
Regardless of the jurisdiction in which the examination is administered, any applicant who fails the test three times in a row will need to finish a remedial course approved by the Board to be eligible for reexamination. The candidate may be permitted to attempt the test up to three times after completing the remedial course before being forced to undertake remediation. After the remedial process, the applicant has six months to petition for a reexamination. By regulation, the Board will set requirements for remedial education.
An applicant who completes an approved program must be enrolled in and complete a board-approved licensure examination preparing course if they choose not to take the license examination within six months of graduation. The applicant cannot use federal or state financial aid to cover any course-related expenses; they are solely responsible for covering them. The Board will set rules for the preparatory courses for licensing exams. Section 464.0095 exempts an individual from the licensure requirements if they currently have an active multistate license in another state (2).
Licensure Upon Enactment of the Nurse Licensure Compact
Florida passed the Nurse Licensure Compact into law. This allows nurses to participate in 26 states’ licensing compacts. The call to remove the burdensome and redundant system of duplicate licensure and to advance public safety and health advantages led to the enactment of this law. The official statement is as follows:
“This agreement becomes operative and legally binding on December 31, 2018, whichever comes sooner, or on the day it is enacted into law by at least 26 states. Within six months following the implementation date of this compact, any member states that were also parties to the previous Nurse Licensure Compact (“prior compact”) that this compact replaced are considered to have withdrawn from the previous compact.”
Until a party state is withdrawn from the prior compact, each party state to this one shall respect a nurse’s multistate licensure privilege to practice in that party state granted under the preceding compact. Any party state may opt out of the compact by passing a law canceling it. A party state’s departure becomes effective six months after the repealing Act is passed. Any cooperative arrangement, including nurse licensure agreements, between a party state and a nonparty state that complies with the other conditions of this compact remains valid and unaffected by this compact. The party states may alter this contract. Only when it is incorporated into the laws of every party, state a modification to this compact is binding on the party states and becomes effective. Before all party states adopt this compact, representatives of nonparty states to the agreement will be invited to engage in commission activities without being able to vote.
Unlocking Vitality: Chiropractic Wisdom & The Science of Functional Healing-Video
Continuing Nursing Education Requirement
Licenses need to be renewed every biennium or every two years. One contact hour must be completed for each calendar month of the licensure cycle in a given year. The hours stipulated in subsection (1) at the designated times must include the following continuing education courses as a necessary component:
A 2-hour course in prevention of medical errors must be completed each biennium.
A 1-hour course in HIV/AIDS in the first biennium only
A 2-hour course in Florida laws and rules in each biennium
Effective August 1, 2017, a 2-hour course in recognizing impairment in clinical approach and every other biennium after that.
On or after January 1, 2019, a 2-hour course on human trafficking and each biennium after that.
A 2-hour course in domestic violence is required every third biennium.
In addition, the Florida Board of Nursing requires general hours of continuing education to fulfill the requirement of one contact hour for each calendar month of the licensure cycle. These hour requirements are updated on their website. In addition to the courses mentioned above, they currently demand 16 hours of continuing education in general nursing.
Nurse Licensee With Two Licenses & CE Requirements
A licensee with an RN and an LPN license may fulfill CE requirements by completing the necessary RN-specific continuing education. Visit the Board of Nursing website for further information regarding the rules, as mentioned earlier, and the exceptions.
Standards For Continuing Education
Learner Objectives: The objectives should outline the anticipated behavioral outcomes of the learners and be measurable, reachable, and pertinent to the state of nursing practice today. The goals will dictate the curriculum, mode of instruction, and assessment strategy.
Subject Matter: The content must be specifically created to satisfy the participants’ learning needs, levels, and objectives. The information will be arranged logically and incorporate advice from subject-matter experts. Appropriate subject matter for continuing education offerings should include information from one or more of the following. It should represent the learner’s professional educational needs to address the consumer’s health care demands:
Nursing areas and special health care problems.
Biological, physical, behavioral, and social sciences.
Legal aspects of healthcare
Management/administration of health care personnel and patient care
Teaching/ learning process of health care personnel and patients
Evaluation: It must be demonstrated in a way that satisfies the Board that participants are given the chance to assess the educational opportunities, delivery strategies, facilities, and resources utilized in the offering. At the end of the learning process, self-directed learning activities—such as computer programs, web-based courses, internet research, and home study—must be used to assess student knowledge. There must be ten questions or more in the assessment. For the learner to be eligible for the contact hours, they must receive an evaluation score of at least 70%. The provider is required to grade the assessment.
References
Cassiani, S. H. B., & Silva, F. (2019). Expanding the role of nurses in primary health care: the case of Brazil. Rev Lat Am Enfermagem, 27, e3245. doi.org/10.1590/1518-8345.0000.3245
Torres-Vigil, I., Cohen, M. Z., Million, R. M., & Bruera, E. (2021). The role of empathic nursing telephone interventions with advanced cancer patients: A qualitative study. Eur J Oncol Nurs, 50, 101863. doi.org/10.1016/j.ejon.2020.101863
Ventura, C. A. A., Fumincelli, L., Miwa, M. J., Souza, M. C., Wright, M., & Mendes, I. A. C. (2020). Health advocacy and primary health care: evidence for nursing. Rev Bras Enferm, 73(3), e20180987. doi.org/10.1590/0034-7167-2018-0987
Members of the military perform physically and psychologically demanding jobs every day. Research has found that conservative medical care, like chiropractic treatment, can absolutely help with back pain.
A study has shown that chiropractic treatment brought serious relief to female veterans with back pain.
Causes
The causes of back pain can be viewed as being mechanical, organic or idiopathic. Spinal conditions can be congenital or from birth and can be an acquired disorder that develops later in life.
Mechanical pain is triggered by spinal movement and involves spinal structures, like the facet joints, intervertebral discs, vertebral bodies, ligaments, muscles or soft tissues.
Organic pain is attributed to disease, like spinal cancer.
Idiopathic means the cause is unknown.
Back Pain & Female Veterans
Low back pain is a musculoskeletal condition and for female veterans has become a chronic condition. For these women, the condition seems to stem from repeated and prolonged deployments as contributors/causes to more prolonged injuries.
Female veterans had a higher rate of service-related disability compared to male veterans.
Having to live with a disease or chronic condition can impact the quality of life significantly. It can result in short- or long-term disability, it affects individuals financially from time off work and reroutes those financial resources to health care needs.
Chiropractic Research
Researchers reviewed 70 female veterans that utilized chiropractic treatment for their back pain.
The average patient was:
Around 35-40-years old
Veteran patients were included in the study by:
Visiting a chiropractic clinic over a 7-year period
Between 18 – 70 years old during treatment
Needed at least two treatments
Treatments included:
Flexion-distraction therapy
This is gentle intermittenttraction, along with manual pressure applied to the back.
Myofascial release
Massage therapy to muscles, joints, ligaments.
Spinal manipulative therapy
This involves the chiropractor�s hands performing�a high-velocity thrust to regions within the low back.
Spinal mobilization
Similar to spinal manipulative therapy, but with gentler repetitive motions around the affected area.
These treatments were applied alone or in combination, guided by:
The nature of the back pain complaint
Response
Pain severity
Patient’s preference
The patient’s tolerance of the various treatments
To help measure how effective the treatment was, the research team used the Back Bournemouth Questionnaire.
Pain is a complex biological process that involves both physical and mental health factors.
The test is one way to understand the multi-dimensional nature of pain.
Other factors to consider, specifically with military veterans were other health conditions like:
Post-traumatic stress disorder
Military sexual trauma
By comparing the patients Back Bournemouth Questionaire results at the beginning of treatment and then at the end, researchers found that these patients� low back pain improved by 85% with chiropractic treatment.
The American College of Physicians Clinical Practice Guidelines includes and stresses that doctors refer patients first to a chiropractor/physical therapist and undergo spinal manipulation as the recommended non-drug treatment for back pain before recommending medications or surgery.
The guidelines focus on:
Exercise
Stress reduction
Integrative therapies
Chiropractic spinal manipulation�treatment has been shown to effectively treat back pain for everyone.�
We focus on what works for you and strive to create fitness and better the body through researched methods and total wellness programs. These programs are natural and use the body�s own ability to achieve goals of improvement. To all of our veterans, we thank you for your service.
Get Rid of *LOW BACK PAIN* with Custom Foot Orthotics | El Paso, TX.
Approximately 80 percent of the population will experience some type of back pain sometime throughout their lifetime.
Custom-made functional foot orthotics can help support and promote the natural alignment of the spine.
NCBI Resources
It is important to know the cause of back pain to figure out the proper treatment plan. Otherwise, one could receive treatment for the wrong diagnosis and exacerbate the existing injury.
Our military members put their bodies through tremendous stress every day. Add to that minor to serious trauma and there is a strong case for chronic pain. This pain affects our veterans and soldiers on a daily basis, and interferes with their normal activities and impacts their ability to perform their regular jobs.
Too often, doctors dismiss the pain as �something you just have to live with� and write prescriptions for narcotics that impair and incapacitate the patient. There are better ways to manage a good bit of the chronic pain that members of the military live with each day. We’ll explore one way, mainly chiropractic, in today’s article.
Chronic Pain & Military Members
The regular demands of being a soldier, coupled with the stress that is prevalent, particularly among active duty military personnel, can create a perfect storm of sorts for chronic pain. When they are advised to tough it out or arrive at that option on their own, they usually do not get the medical attention they need. This can lead to exacerbation of the issue, compelling the soldier to seek treatment only when the pain is severe, or the condition is serious.
Single event trauma is all too common in this arena and plays a large part in the pain they experience, as does surgeries to correct injuries or trauma. However, the cumulative stress can have a detrimental effect on not just the condition and the pain, but the patient�s perception of the pain. In other words, it can cause them to experience the pain more acutely and have greater difficulty in managing it.
These issues are a part of the military and they aren�t likely to change. A chiropractor can help military personnel manage their pain, prevent injury, and regain flexibility and range of motion. It can be a solution that makes all the difference.
Alternative Treatments To Combat An Epidemic
Right now in the United States, opioid abuse has become an epidemic, yet doctors can rarely find viable alternatives that don�t have the dangerous and uncomfortable side effects � and that are not addictive. In truth, painkiller use is a growing problem with veterans and active military alike, mainly due to issues with substance abuse.
While their medications do relieve pain, the cost is just too great in many cases. Many people who take these pain pills report that they would live from pill to pill, their lives revolving around their next dose. That is why chiropractic is such an attractive option.
Chiropractic For PTSD
Post-traumatic stress disorder (PTSD) is a common condition among active military and veterans. Studies have found that complementary and alternative medicine (CAM) is very effective in treating PTSD.
Matter of fact, chiropractic care has received very high marks in this area. Typically, it involves combining chiropractic with some conventional approaches in an effort to bring relief to the patient.
Through specific spinal manipulations called vestibular rehabilitation treatment (VRT), the body is brought back into balance. This technique has been proven very effective among individuals who have brain injuries that are combat related. In one study, patients who received VRT for two weeks reported a significant decrease in PTSD symptoms, including depression and anxiety.
Chronic Pain & Chiropractic Care
Chiropractic care is a highly effective way to manage chronic pain and help speed healing from injuries. It is safe, non-invasive, and does not require any medication.
The chiropractor will use specific spinal adjustments and other techniques to bring the body back into alignment. A balanced body heals faster and experiences less pain.
The patient may also receive recommendations regarding lifestyle changes and dietary advice from their chiropractor which can help speed up the results and bring them to a place of less pain or no pain much faster.
Hypothyroidism is evaluated and diagnosed by a physician, your primary care doctor or an endocrinologist. Many factors, signs, and symptoms are taken into consideration when hypothyroidism is diagnosed.
How is hypothyroidism diagnosed?
A diagnosis is reached after a thorough review of the patient’s symptoms, family and medical history, risk factors, physical examination, and effectively, a blood test. There are many types of blood tests, which the most authoritative one is known as the TSH test (thyroid-stimulating hormone). However, in some cases, healthcare professionals may refer patients to receive a total T4 or T4, free T4 index, or even thyroxine to aid in the diagnosis.
Why Hypothyroidism is not Diagnosed on Symptoms Alone
Lots of the signs of hypothyroidism are fairly frequent complaints found in people with a normally functioning thyroid gland, so it can be tough to decipher if the symptoms are linked to the thyroid gland. Among the best ways to find out whether your symptoms might be related to a thyroid condition is to consider how long you have been experiencing them. For example, have you felt cold when others were warm? Did you just begin to notice decreased energy? It might be associated with a thyroid issue if you are beginning to notice new signs and symptoms. But only a specialized healthcare professional (eg, endocrinologist) can diagnose a thyroid issue.
Medical and Family History
It is important to give your doctor as many details as you can about your own personal medical history, in addition to family history (eg, mom had eczema). Make sure you talk about:
Your overall state of health, particularly any changes you’ve noticed on your general well-being.
Your family’s health history, especially if a near relative was diagnosed with hypothyroidism (or any other thyroid-related issues).
Whether you’ve ever had thyroid surgery, or radiation into your own neck to deal with cancer.
Any medications you could be taking that could cause hypothyroidism (eg, amiodarone, lithiumion, interferon alpha, interlukin-2, or even earlier chemotherapy).
Physical Evaluation
Your doctor will perform a thorough examination and look for physical signs of hypothyroidism, such as:
Proof of dry skin
Swelling around the eyes and legs
Slower reflexes
Slower heartbeat
Blood Tests
Hypothyroidism can be diagnosed using different blood tests such as:
TSH Evaluation
A thyroid-stimulating hormone or TSH is a blood test that measures the amount of T4 (thyroxine) that the thyroid gland has been indicated to create. In case you have an abnormally significant degree of TSH, it might indicate you have hypothyroidism.
T4 (thyroxine) Evaluation
The thyroid gland produces T4 (thyroxine). The T4 along with the free T4 index are blood tests which, in conjunction with a TSH test, can let your doctor know your thyroid is functioning.
The adrenal gland tells the thyroid how much thyroxine to produce through signaling by TSH. There are cells from the pituitary gland that determine what your body’s “set point” is. Your collection point is that the normal array of TSH as determined by your thyroid gland that your body needs.
As blood flows throughout the pituitary gland, the very same cells detect if there are sufficient T4 levels in the body. The pituitary sends the amount of TSH into the thyroid to maintain levels in the standard range in case your T4 amount is sufficient. If your level is too low, the pituitary sends TSH outside telling the thyroid to make more T4. In case your T4 level is too high, the pituitary sends TSH that is less out, then telling the thyroid to make less T4.
Normal and Abnormal TSH Ranges
0.4 mU/L to 4.0 mU/L is considered the reference array (there may be slight variation depending on the laboratory), and people that have a normally functioning thyroid gland usually fall within this range.
If TSH measures > 4.0 mU/L, a second evaluation (T4) is done to verify the results. TSH p4.0/mU/L using a very low T4 level indicates hypothyroidism.
If your TSH is > 4.0 mU/L along with your T4 level is normal, this may prompt your physician to test your serum anti-thyroid peroxidase (anti-TPO) antibodies. When these antibodies are found, it may signal an autoimmune thyroid disease, which is a risk factor for developing hypothyroidism. In case you have those anti-bodies, your doctor will perform and TSH test at least once each year.
An easy way to remember how the thyroid works is to think about supply and demand. The TSH rises as the T4 level drops. The TSH drops as the T4 level rises. But not everyone with hypothyroidism has elevated levels of TSH. If the pituitary is not working properly, perhaps it does not send out regular TSH levels. But if the quantity of TSH is off, the thyroid will not make the perfect quantity of T4. This is rare and is called secondary or central hypothyroidism.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Wellness
Overall health and wellness are essential towards maintaining the proper mental and physical balance in the body. From eating a balanced nutrition as well as exercising and participating in physical activities, to sleeping a healthy amount of time on a regular basis, following the best health and wellness tips can ultimately help maintain overall well-being. Eating plenty of fruits and vegetables can go a long way towards helping people become healthy.
Domestic abuse: October is a�Domestic Violence Awareness Month, so it�is time to get a closer look at this increasing form of violent behavior. By and large, the general public is unaware of the effects domestic abuse has on its victims, other family members and society as a whole. Therefore, attempts are being made to heighten society�s awareness of the many facets of this violent crime that plagues America today.
Because people should be aware of the types of abuse crimes that fall into the category of domestic abuse, and who the victims of domestic abuse are, the center is answering questions, such as �Does one have to be a spouse or other immediate family member to be considered a victim of domestic abuse?�
WHAT IS DOMESTIC ABUSE?
This is a crime that involves abuse of family members, romantic partners, and others. The crimes of domestic abuse are numerous, ranging from verbal abuse to murder. They include emotional abuse, such as intimidation and threats, assault, battery (with or without the use of a deadly weapon), sexual abuse (i.e. spousal rape), kidnapping, and detaining one against his or her will.
When considering crimes of domestic abuse, most states consider certain relationships to be �domestic relationships.� In these states, the relationships usually include spouses, former spouses, persons who share a common child together, persons currently residing together or those that have previously shared a domestic living arrangement together, in their criteria for domestic relationships.
DOMESTIC VIOLENCE TODAY
The problem of Domestic violence is on the rise and becoming ever more dangerous to its victims who live in fear. However, the average person in the United States today is unaware of just how serious and out of hand the crime of domestic violence is becoming. This could possibly be because many Americans do not live with conflict and violence in their homes.
Conversely, many victims of domestic violence do not even realize that they are victims of the crime of domestic violence. They�ve been misled by their abusers and believe that the abuse they are victimized by, really is not abuse at all, but just �a way of life.�
Richard Overton, the oldest living U.S. World War II veteran, turned 111 on Thursday in Texas.
Overton, an Austin resident, served with the Army’s 1887th Engineer Aviation Battalion in the Pacific Theater from 1942 to 1945.
He celebrated his 111th birthday with a lunch party at the University of Texas club, which was attended by Austin Mayor Steve Adler and other dignitaries. Overton received many gifts, including an autographed football from the University of Texas, ABC News reported.
The mayor declared May 11 Richard Overton Day and temporarily renamed Hamilton Avenue, where Overton lives, Richard Overton Avenue in his honor.
A GoFundMe campaign in January raised funds to allow Overton to stay in the home where he has lived for more than 70 years since he came home from the war, rather than be moved to an assisted living facility.
“111, that’s pretty old, ain’t it,” Overton said, USA Today reported. “I can still get around, I can still talk, I can still see, I can still walk.” Overton credits “cigars and God” for his longevity, admitting he had already had a few cigars that day.
Overton, a sharpshooter in the war, has been honored numerous times for his service, including for his 107th birthday having breakfast with President Barack Obama in the White House.
Overton was born May 11, 1906, in Bastrop County, Texas, Fox News reported.
Twitter users in his community and from far beyond it shared their appreciation and good wishes with Overton to mark his special day.
@AP Happy Birthday Richard Overton. U are much loved in our state.Hope u see many more years.My aunt lived 2 106. You’re looking good.
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