When it comes to health care ethical issues, there are almost as many ethical issues as there are health issues to be treated. There are laws in place to direct the behavior of almost every person in the health care personnel chain, from the nurse to the nurses aide who assists them and the doctor who ultimately gets to try and make the decisions to treat within the confines of the insurance system ruling over the life of the patient in question.There are ethical issues that are clearly defined, such as the requirements for treatment decisions when a patient has a Medical Power of Attorney or a Living Will. Then there are thealth care ethical issues that don’t have such clearly defined areas, such as whether it is allowable to withhold a possible lifesaving treatment from a patient only because their insurance will not pay for it.Health care providers must make their treatment decisions based on a great many determining factors, perhaps the most constraining of which is the insurance reimbursement regime. If doctors and other health care providers could just treat their patients and have only that to worry about, what a wonderful world it would be. But doctors have to constantly worry about whether or not they and possibly the facility where they practice will be paid by the insurance companies. The next most important factor which affects health care providers ability to provide the care patients truly need is whether or not the patient has been truthful with the information they have given to the health care provider, and whether or not they have had access to health care to establish and maintain their health care needs.Ethical concerns also come into play with patients whose family constellations are unclear. A patient who has a spouse has a straightforward next of kin when decisions have to be made. When a patient is separated from their spouse, and even perhaps has a new significant other, the next of kin can be much more difficult to determine, and protecting all health care providers-doctors, hospitals, etc from the liability risk of allowing the person who does not have a legal right to make decisions for a patient is a necessity. The health care ethical issues presented by these kinds of situations are very delicate.One important ethical concern in health care is the need to protect oneself from the very real danger of the transmission of communicable diseases in bodily fluids. Especially in cases where a patients history is not available, health care providers have the right and the responsibility to protect themselves from viruses and bacteria that may be present in the body fluids of patients to which they are exposed taking care of these patients. However, this must be balanced with the possibility of making patients feel accused or uncomfortable by these same protective measures.One last important health care ethical issues, especially in this day in age, is the protection of private, personally identifying information. Patients records used to be kept in public places where almost anyone could read them-filing pockets outside their doors, for instance. This kind of situation is not longer allowed, and records are more closely guarded nowadays, and many hospitals now rely on records kept entirely on computers.Ethical issues are a part of almost every field, but health care has a special place in the system, where people are trusted with making those who are sick feel better, those who are injured able to return to their prior lives, and those who have chronic conditions and those who love them more able to cope with the demands of living with those conditions.

The health care industry is very broad and consists of numerous professions outside of becoming a doctor or nurse. Students interested in working in health care have many educational options to choose from. Degree programs are available online from many colleges and universities.Because the field is so broad, students choose a concentrated area to gain their education in. Becoming an epidemiologist, vascular technologist, physical trainer, wellness instructor, and much more are some professions that can be entered when students work through a health care degree program. Specific areas of instruction can include:Health EducationHealth SciencesPublic HealthOnline schooling offers students certificate programs and degrees at various levels making it possible for students to complete the correct training for their chosen field. Students should research what educational requirements exist so they understand how long schooling will take. This is essential so students finish the correct amount of schooling for their desired occupation. Some careers may only require students to complete an associate’s degree program and others may require graduate degree training. Education online allows new students and already working professionals to gain the necessary knowledge to advance within a specific health care industry.Students that want to work in the administrative side of health care have the option of entering health information technician training. Coursework centers on teaching students about the maintenance of health records. This facet of the industry is extremely important for proper health care delivery and billing. Education focuses on giving students the skills to understand medical terminology, pathophysiology, data management, and pharmacology. Online education is widely available at the associate’s and bachelor’s degree levels, which give students the knowledge to become health information technicians.Individuals that want to work more in the medical treatment side of the industry can consider enrolling in a physician assistant program. Students learn how to work alongside a physician by performing patient exams and ordering lab tests. Schooling provides students with the ability to practice medicine when supervised. Students explore numerous health care services that may include treating minor injuries, diagnosing illnesses, and prescribing medications. Most online schooling opportunities are at the master’s degree level because it’s the standard educational level required for work. However, certificate and bachelors degree programs are offered to prepare students for graduate training.Other possible degree programs prepare students to teach others about good health practices and enter a variety of occupations as radiographers, nuclear medicine technologists, health scientists, and nutritionists. Degree programs in public health, health education, and health science can be completed at multiple levels through online education.Health care careers are available to students that have an education. Accredited online colleges and universities offer training and students can enter a career in the industry upon completion. Full accreditation is provided to programs that offer students a quality education that will prepare them for a successful career. Agencies like the Distance Education and Training Council (http://www.detc.org) are approved to accredited online learning programs. Students should explore the many schooling options available and begin the process of entering the field.DISCLAIMER: Above is a GENERIC OUTLINE and may or may not depict precise methods, courses and/or focuses related to ANY ONE specific school(s) that may or may not be advertised at PETAP.org.Copyright 2010 – All rights reserved by PETAP.org.

Home Health Care Nursing Information and OverviewHome health care is allowing the patient and their family to maintain dignity and independence. According to the National Association for Home Care, there are more than 7 million individuals in the United States in need of home health care nurse services because of acute illness, long term health problems, permanent disability or terminal illness.Home Health Care BasicsNurses practice in a number of venues: Hospital settings, nursing homes, assisted living centers, and home health care. Home health care nursing is a growing phenomenon as more patients and their families desire to receive care in their homes. The history of home health care stems from Public Health Nursing where public health nurses made home visits to promote health education and provide treatment as part of community outreach programs. Today academic programs train nurses in home care and agencies place home health care nurses with ailing individuals and their families depending on the nurse’s experience and qualifications. In many cases there is a shared relationship between the agency and the academic institution.Many changes have taken place in the area of home health care. These include Medicare and Medicaid, and Long Term Care insurance reimbursement and documentation. It is important for the nurse and nursing agency to be aware of the many factors involved for these rules and regulations resulting from these organizations. Population and demographic changes are taking place as well. Baby boomers approaching retirement and will present new challenges for the home health care industry. Technology and medical care in hospitals has lead to shorter inpatient stay and more at-home rehabilitation. Increases in medical outpatient procedures are also taking place with follow-up home care. This has resulted in the decrease of mortality rate from these technologies and medical care has lead to increases in morbidity and chronic illness that makes the need for home health care nursing a greater priority.Home Health Care Nurse Job DescriptionThrough an array of skills and experience, home health care nurses specialize in a wide range of treatments; emotional support, education of patients who are recovering from illnesses and injury for young children and adults, to women who have experienced recent childbirth, to the elderly who need palliative care for chronic illness.A practicing nurse must have the skills to provide care in a unique setting such as someone’s home. The nurse is working with the patient and the family and must understand the communication skills for such dynamics. Rapport is evident in all nursing positions, but working in a patient’s own living space needs a different level of skill and understanding. There is autonomous decision making as the nurse is no longer working as a team with other nurses in a structured environment, but is now as a member of the “family” team. The host family has cultural values that are important and are different for every patient and must be treated with extreme sensitivity. Other skills include critical thinking, coordination, assessment, communication, and documentation.Home health care nurses also specialize in the care of children with disabilities that requires additional skills such as patience and understanding of the needs of the family. Children are living with disabilities today that would have resulted in mortality just twenty years ago. Genetic disorders, congenital physical impairments, and injury are just a few. Many families are familiar with managing the needs of the child, but still need expert care that only a home health care nurse can provide. It is important that a home health care nurse is aware of the expertise of the family about the child’s condition for proper care of the child. There are many complexities involved, but most important, a positive attitude and positive reinforcement is of utmost importance for the development of the child.Medication coordination between the home health care nurse, doctor, and pharmacist, ensures proper management of the exact science behind giving the patient the correct dose, time of administration, and combinations. Home health care nurses should be familiar with pharmacology and taught in training about different medications used by patients in the clinical setting.Many advanced practicing nurses are familiar with medication regiments. They have completed graduate level programs. Home health care agencies believe that a nurse should have at least one year of clinical experience before entering home health care. Advanced practicing nurses can expedite that training by helping new nurses understand the home health care market and teaching.Employment and SalaryAccording to the United States Department of Labor, there were 2.4 million nurses in America, the largest healthcare occupation, yet many academic and hospital organizations believe there is a gross shortage in nursing staff. The shortage of nurses was 6% in 2000 and is expected to be 10% in 2010. The average salary for hospital nursing is $53,450 with 3 out of 5 nursing jobs are in the hospital. For home health care, the salary is $49,000. For nursing care facilities, they were the lowest at $48,200.Training and continuing educationMost home health care nurses gain their education through accredited nursing schools throughout the country with an associate degree in nursing (ADN), a Bachelor of Science degree in nursing (BSN), or a master’s degree in nursing (MSN). According to the United States Department of Labor, in 2004 there were 674 BSN nursing programs, 846 ADN programs. Also, in 2004, there were 417 master’s degree programs, 93 doctoral programs, and 46 joint BSN-doctoral programs. The associate degree program takes 2 to 3 years to complete, while bachelors degrees take 4 years to complete. Nurses can also earn specialized professional certificates online in Geriatric Care or Life Care Planning.In addition, for those nurses who choose to pursue advancement into administrative positions or research, consulting, and teaching, a bachelor’s degree is often essential. A bachelor’s degree is also important for becoming a clinical nurse specialist, nurse anesthetists, nurse midwives, and nurse practitioners (U.S. Department of Labor, 2004).All home health care nurses have supervised clinical experience during their training, but as stated earlier advanced practicing nurses hold master’s degrees and unlike bachelor and associate degrees, they have a minimum of two years of post clinical experience. Course work includes anatomy, physiology, chemistry, microbiology, nutrition, psychology, and behavioral sciences and liberal arts. Many of these programs have training in nursing homes, public health departments, home health agencies, and ambulatory clinics. (U.S. Dep. of Labor, 2004).Whether a nurse is training in a hospital, nursing facility, or home care, continuing education is necessary. Health care is changing rapidly and staying abreast with the latest developments enhances patient care and health procedures. Universities, continuing education programs, and internet sites, all offer continuing education. One such organization that provides continuing education is the American Nurses Association (ANA) or through the American Nurses Credentialing Center (ANCC).ConclusionThere are many rewards to becoming a home health care nurse. Some rewards include the relationship with a patient and their family, autonomy, independence, and engaging in critical thinking. The 21st Century brings with it many opportunities and challenges. We must meet these challenges head on – there is an aging baby boomer population, a growing morbidity factor due to increased medical technology and patient care, and the growing shortage in nursing care.Becoming a home health care nurse today is exciting and an opportunity to make a difference one life at a time. With clinical experience and proper education, a home health care nurse will lead the future of medical care.