Professional Approaches in Forensic Nursing

Forensic Nursing is comparatively a new profession and is holding great potential possibilities for nurses keen in expanding their horizons of knowledge a step ahead of their counterparts and achieve the status of Expert in the field of Clinical Diagnosis. The next step gives rise to Legal nurse consulting capable of assisting in criminal prosecution cases besides providing help to Sexual Assault victims.

There are many other areas, where knowledge and experience of Forensic nursing can be usefully deployed. Forensic Nursing is a vast field of specialization. A Forensic nurse earns comparatively a higher salary package and continued education leads to Consulting Forensic Nurse.

The news of nursing shortage is being spread in all quarters. This is a time to make an entry into Forensic nursing, because at present many nurses busy in their core activities are not aware of forensic nursing and more entrants in general nursing shall bring a point of stagnation in general nursing career.

Now is better than Later:

At a later time the entry to Forensic nursing is going to be highly tough, when there are more applicants available to make entry into forensic nursing career. It is not very far when the health care providers shall be looking for Consulting Forensic nursing to assist them in preference to a general nurse.

There are many acronyms like CFN, SANE, SAFE, FNE, SAE etc. which are not known to the Nurses as yet. They are all programs related to Forensic nursing.

If one decides to become a forensic nurse, there are plenty of financial rewards and perks available to the candidates on completion of their training, which are not to be found in traditionally opted general nursing.

Victims Assistance training is held in the Westchester County SANE Program. The training is scheduled in the main office at Elmsford.

The Trainer & the Training:

The Training is conducted by Barbara Rome, who is Assistant Professor in Westchester Community College. She is holding the position of Sexual Assault Nurse Examiner in the New York state as well at national level and is a practitioner of SANE in Putnam and Westchester County for more than a decade and she has testified in criminal proceedings before grand jury innumerable times. She has Master of Science Degree qualification.

Victims Assistance Services is part of Westchester Community Opportunity Program Inc., which although is private organization operating on the principle of not-for-profit. This is an organization, which works for diverse causes as a social service organization, with full dedication for helping masses and brings change in their lives for better.

The topics covered in the Forensic Nurse training include responding to Mass Fatality incidents including management of mass fatality scenes defusing the stressful condition of the responders, techniques helping reconstruction of human face, DNA studies and their role in human identifying, odontological forensic identification techniques etc.

One gets opportunity to learn the techniques from professionals, who are practicing these techniques to produce evidences, which are relied to help the victims and prosecute the criminals.

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Prospects of Certified Nursing Assistant

There are situations, when one is not in position to spend three or more number of years in a nursing degree course, besides incurring expenditure for such a course. In such circumstances to become a Certified Nursing Assistant (CNA) is very appropriate decision. After becoming a CNA, one gets the opportunity to handle all the patient caring under the supervision of a Registered Nurse and is known by different designations like patient care technician or home health aide depending on the locations, where one is working.

The most urgent task of the CNA is supporting physical as well as emotional requirements of the patient, while the patient is admitted for treatment in the health care facility like a hospital, nursing home etc. The job profile of a CNA includes bathing of the patient, changing his / her clothes, helping in feeding, recording daily the vital signs like temperature reading, pulse feeling, measuring blood pressure, respiration rate etc. on resumption of the duty.

All these are hard jobs and while performing them, the CNA leaves a deep impact in the minds of the patient. When the CNA is working in the patient’s home environment as home health aide they take care of elderly person in the family or a person having developed a physical disability or a person convalescing after the treatment of a disease.

Becoming a Certified Nursing Assistant:

For becoming a CNA one is required to possess a high school diploma or a GED qualification. There after the CNA training course is of 2 to 5 months duration depending upon how many hours of training one completes in a week. The training is carried out in a vocational or a community college or even a hospital. The training duration varies from 75 hours to 100 hours depending upon the state, where one plans to work.

The CNA training includes basics of health care, skills related to personal care, anatomical studies and human physiology, role of nutrition in health, effective communications etc. The CNA students are also required to work in clinical real time conditions and learn the skills, which they shall be required to perform while working at a job in a health care facility.

CNA training course has been developed for helping the students to pass compulsory CNA State certification examination. There are 21 competencies, which are part of CNA job and one has to learn them and practice also. These competencies are defined in the Federal law governing CNA training. Among them the most prominent are reading and recording of vital signs, ensuring healthy environment where the patient stays during admission, looking after emergency procedures and safely transferring the patient, when required.

Anticipated Expansion in Nursing Jobs:

The field of nursing offers highest number of jobs and by the year 2014 there shall be more than 27 % expansion in the services of nursing. According to US Bureau of heath statistics nursing is the fastest growing profession in US at a time when other sectors are in deep recession leading to lay offs. It is the right time to change the career if one is facing stagnation in the present career.

One earns on an average $10 per hour and about 10 % of the CNAs are earning about $14 per hour.

After one passes the certification examination, the name and particulars of the individual are included in the State Nurse Aid Registry and one becomes eligible to work in all the health care facilities under the supervision of a Registered Nurse. This is the beginning of a nursing career having options of online continued education and further advancement in the career. The CNA Certification is valid for period of 24 months and before the expiry of the 24th month one has to get the recertification done by appearing in the state administered examination for the purpose.

The CNA job is carried out round the clock and to facilitate the day working is divided into three shifts of morning, after and Night. Working in a particular shift is altered once in a month so that every one gets fair chance of working in all the shifts every month by rotation.

Progression from CNA to Registered Nurse:

There is potential to earn more with the increase in experience. A Certified Nursing Assistant can advance in his career to become a registered nurse by following online continued education online in one’s spare time and complete bachelor’s degree course in nursing and pass the state administered examination to become a Registered nurse.

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CNA Training Options in Michigan

For persons interested in making career in nursing field, cna training is the first and foremost basic step required to be taken for becoming eligible to get CNA certification. The CNA Training program is conducted by technical or community colleges in the state of Michigan. The two major community colleges in Michigan are Lansing Community College and Whitenaw Community College located at Ann Arbor.

Lansing Community College CNA Training:

There are above 30,000 students enrolled with Lansing Community College every year. By it’s massive size it happens to be third ranking among other community college in Michigan. The Campus of the College is situated in downtown Lansing. There are more than 240 certificate courses and associate’s degree training courses conducted here. Those candidates desirous of achieving CNA certification usually do their registration with Lansing Community College’s CNA training.

Long Term Care Training for Nurse Aide:
It is Certificate Training course lasting for Eight hours resulting into State Certification for nurse aides. This training course stresses upon basics of nursing skills required for performance of the job functions of CNA. The subjects taught in this course are those already covered in CNA classes and is aimed at refreshing what has been learned in respect of infection control, effective communication practices, patient’s rights and the broad functions of long-term nurse aides.

The course is designed for helping graduates to undertake jobs in nursing homes or long-term health care facilities. Besides getting certificate of completion, graduates become eligible for taking the State Competency Evaluation Nurse Aide examination.

Acute and Long Term Nurse Aide Certificate of Completion:

The training course is having 8 hour credit and is combination of Long term care and acute care nurse assistant /patient care technician course. By completing this course the person can work in hospitals, clinics, home healthcare service providers or long term care service providers. This certificate course prepares graduates candidates making them eligible for appearing in the State Competency Evaluation Nurse Aide examination.

Washtenaw Community College (WCC) CNA Training Course:

It is situated in southeastern region of Michigan and conducts about 100 credit programs and has enrollment of above 20,000 students. The school was established in 1965 and conducts its courses at the main campus besides four centers situated in the near vicinity of Ann Arbor. The college conducts CNA training course through its associated School of Nursing and Heath Science.

Basic Nursing Assistant Skills Certificate of Completion:

This 3-week, 90-hour certificate course is combination of classroom instructions, work routine in clinical labs and 26-hour clinical experience in the area hospitals, clinics and other similar settings. Basic nursing assistant skills are demonstrated to the students and they are made to practice, which enables them to carry on their job in diverse types of health care settings. After completing the training course the students become eligible to take the state certified nursing assistant examination, which helps them in their CNA certification enables them for working as a CNA. CNA certification is valid for 24 months and one is required to take a State administered test for getting the certification validated.

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Considering Expansion of Nurse Practitioner Role

Presently there is shortage of Primary Care Physicians triggering argument in favor of Expansion in the role of Nurse Practitioners in the light of New Federal Health Law bringing around additional one million natives of Michigan as beneficiaries of insurance cover by the year 2014.

The Legislation regarding expansion of scope of practice for nurse practitioners, is also likely to be considered after the Legislature finishes with the state budget, most probably in the month of August, as the word is spread by Connie Knapped, in the capacity of president of Michigan Council of Nurse Practitioners.

Knapped feels the matter has an urgency factor, because of the implications of new health law, because there are not many other alternative options to depend on.

The Situation of Locked Horns:

In all probability, there shall be an opposition to such a move by the Physician’s block.
The move shall be directly affecting the money, which the Physician’s are enjoying in the present situation. The move means shifting some of the activities, which nursing practitioners shall handle independently, which are at present being handled by the Physicians, because the nursing practitioner works under the supervision of the physician.

The physicians in turn get payment for the supervision offered since the present Michigan related law imposes that the Nursing Practitioners prescriptions are approved by the physician. Besides the supervision role of the Physician in relation to nursing practitioner can harm the revenues of the nurse practitioner, which has to be compensated by charging higher fee from the patients.

There can be an issue of increased liability to the nursing practitioner, with physician getting out of the supervisory role in certain specific conditions.

The Falling Short of Physician Numbers:

Considering the present situation of a would be physician intending to go for primary care practice, shall require from now onwards, minimum eight years training and by 2014, he or she shall be still under training and hence shall not be available by then.

With the present scenario Michigan is losing nurse practitioners, who are moving to other states, where nursing practitioners are permitted to practice. Comparatively Arizona State is very small in size than Michigan, where nurse practitioners are permitted to practice, the number of nurse practitioners is around 5600, whereas Michigan has only 3600 nurse practitioners. There are 28 states, which are planning to allow expansion in the powers of nursing practitioners as per Associated Press reporting on the subject.

Doctorate Qualifications of Future Nurse Practitioners:

By the year 2015 most of the new nurse practitioners shall get qualified with Doctorate degree based on the goals of educators in nursing field and doctorate degree shall become a standard for all nurse practitioners as viewed by American Association of Colleges of Nurses.

There is definitely requirement of legislation as per views expressed by the Michigan Council of Nurse Practitioners (MCNP), because there are hindrances in accessing, health care, which has become costly and the quality has suffered in Michigan due to the present language used in respect of advanced practice registered nursing (APRN) in the state’s Public Health Code, framed in the year 1978. As a consequence there are very few registered nursing practitioners in the state of Michigan.

Improved Impact of New Legislation:

The legislation under consideration shall have a positive role in improving the conditions of access to the healthcare. This shall be helpful in stabilizing and increasing the number of nursing practitioners in the state. There shall be necessary changes in the regulations affecting institutions, who wish to employ more health providers. With the new legislation the nursing practitioners shall be in a position to prescribe pharmacopoeia and non-pharmacopeias medicines.

According to Knapper State Rep. Leisa Liss, D-Warren, have agreed for sponsoring the legislation.

On the contrary Michigan State Medical Society contradicts MCNP’s views, which is lacking in supportive evidence in relation to denial of access to Michigan’s current Public Health Code. It has been pointed out that in other states the nursing practitioners are not having the powers, which they are enjoying in Michigan. Speaking about the present law “It has flexibility and there is team spirit in it and not the least old law is required to be repealed.” Expansion in the authority of nurse practitioners is not going to improve the shortage of primary care physicians and insurance coverage is not any big thing”

View of Medical Economist:

The Medical economists are of the view that with the new legislation the American spending on healthcare shall be significantly reduced. Present health care costs needless to be high and can be reduced by substitution of Nurse Practitioners in place of physicians in certain areas, where there is unnecessary overlapping.

There are areas ranging from minimum 25 % to even 90 percent where the nursing practitioners can be effectively replaced with the present physician’s presence resulting into significant cost reduction.

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Origin of Nursing Education Concept

The Feelings of Nursing Student:

One feels proud of following the thoughts and principles of Florence Nightingale, when one studies in a nursing school and completes the course and becomes a qualified nurse.

Florence Nightingale is the great personality behind every aspects of nursing including idea of establishment of nursing school, which came into existence in the year 1860 at St. Thomas Hospital, London by the name Nightingale Training School for Nurses. It is the first school of it’s kind in the world history. She was of the view that the nurses need training and developing observatory skills and display kindness to patients and realizing their needs, which they themselves are unable to take care.

Result of Vision & Motivational Forces:

Florence had the vision that after training the qualified nurses shall be in a position to serve at all the hospitals in UK. So far the activities were localized only. The idea of Qualified nurses, which she conceived met with great success and as a result many of the Britain Universities started courses for educating nurses. University of Manchester has the distinction of first University, where there was facility of Degree level learning.

The entry to the nursing courses operated by many universities is Five standard Grade or GCSE. The student should have studied English, Maths and Science preferably Bio Science with two High A-levels in their education. Students over the age of 21 get a chance to enter this course after clearing college access course with job experience of health assistant or nursing assistant.

The Nursing Training schedule:

As per the present nursing education the schools offer three year degree course in nursing in UK, which relates to course studying in the classes side by side gaining practical training in the hospitals.

During the first year of the course one learns anatomy, physiology and basics of healthcare. The second year offers specialized nursing care in any of the fields like adult nursing, pediatric nursing, mental health or nursing care for patients with disability. After choosing one of the above fields the nurse thereafter works in the specialized field when they get the placement.

After studying in the third year the nursing course is completed. One has the choice to end the education with diploma or continuing with degree essays. Students who had chosen midwifery as their area of specialization at the beginning of first year make their registration with Nursing & midwifery council have the eligibility to do a job and carry on practice legitimately.

Nursing Schools Fulfilling Objectives:

Nursing Schools are established to impart nursing education through various diploma or degree courses after completion of the courses and passing the related examination one attains the status of a qualified nurse. The curriculum of nursing education and qualification achieved varies from school to school and the region, where it is located. There has been tremendous expansion of the healthcare services and so also the nursing education witnessed revolutionary changes in the techniques and contents based on the present day advancement in technology and specializations in medicine and surgery.

Role of State Health Boards:

The Nursing education is subject to approvals by State Health Boards and the courses vary from state to state and in the present day scenario there are vast number of reputed Universities conducting their nursing diploma and degree courses through affiliated colleges and schools.

On successful completion of the nursing education one is required to pass the State Health Board sponsored theoretical as well as practical examinations like National Council Licensure Examination abbreviated as NCLEX, for Registered Nurses the examination is NCLEX-RN.

After passing these examinations the student is registered with the registry of the State Health Board and is in a position to get employment as Certified Nursing Assistant or Registered Nurse depending upon the education qualifications completed.

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