“Synthesis on Public Health Impacts of Climate Change”

“Synthesis on Public Health Impacts of Climate Change”

Dr. Gina S. Itchon, MD, MMED Sc

Mindanao State University- Iligan Institute of Technology 
September 6, 2012 @ 8 AM, Institute Mini Theater

The climate of the Philippines is influenced by complex interactions of various factors such as Philippine geography and topography, semi-permanent cyclones and anti-cyclones, principal air streams and linear systems such as “amihan” or the northeast monsoon and “habagat” or the southwest monsoon, ocean currents, local thunderstorms, tropical cyclones starting from a low pressure area to a tropical depression and leads to a tropical storm and then worst becoming a typhoon; and most recently, the human activity has been accepted to affect and somehow change our climate. Today, the world is faced with one of the most serious problems brought about climate change. And that is the issue of global warming. Global mean surface temperatures have increased 0.5-1.0°F since the late 19th century. The 20th century's 10 warmest years all occurred in the last 15 years of the century. Of these, 1998 was the warmest year on record. Global warming arises when there is an increased atmospheric concentration of greenhouse gases. The greenhouse gases are subdivided into two categories of sources. These are the primary sources and the artificial sources. Primary sources are natural existing gases in our atmosphere such as carbon dioxide (CO2), nitrous oxide (N2O), methane (CH4), water vapor and ozone (O3). While, man made sources are simply the product of human activity such as halo carbons used as cooling agents and propellants, etc, chlorine liberated from CFC’s, bromine used in flame retardants, and other compounds created from industrial processes. Other contributory factors which significantly share emissions of gases are an increased agriculture, deforestation, landfill, industrial production and mining. Because there is a climate change, how does it affect the lives of every Filipino individual? Philippines is visited by average of 20 typhoons every year. With the projected increase in temperature, this could mean much stronger and more intense tropical cyclones. It is highly susceptible to typhoons located within Pacific Typhoon belt area. The Philippines is an archipelago composed of 7,100 islands with low lying areas. There is highly susceptible to sea level rise among longest coastlines in the world with 32,400 km. (Susceptible to storm surges). There will be climate variability and extreme weather like what we had experience the 2011 enormous flash flood brought by Typhoon Sendong and massive damages caused by Typhoons Ondoy and Pepeng were worst in history. Another is poor urban quality; heat stress and air pollution and social disruption. Hence we could say, these are not just coincidence, but rather, all of these are related to climate change. In the health care sector, the impacts are greatly devastating. Studies have shown that aside from sunburn, skin cancers, and cataracts, wearing certain sunglasses may enhance exposure of the lens and retina to harmful UV rays. This is because the iris opens wider to compensate for the reduced visible light and then more penetration of UV can reach the retina. Another, UV rays can suppress the human immune system leaving the body vulnerable to many diseases caused by bacteria and viruses. Experts predict that an estimated 10 % reduction in the ozone layer will result in a 25 % increase in non-melanoma skin cancer rates for temperate latitudes by the year 2050. Next is an increase in vector-borne infectious diseases such as dengue fever which was known to be seasonal but is now whole year round infection and unpredictable food security like the rice crisis in last 2008. Lastly,very dry months will result to the possibility of water shortage. Increasing population will result to increasing demand for water. As concern citizens, it is a great challenge on how to adapt and mitigate to this climate change. So, what can we then contribute to help alleviate this concern? In my opinion, we should it start it first in our home.Change lights and replace the conventional bulbs. Look for energy saver products. Heat and cool smartly equipment tuned annually. Seal and insulate your home (air-conditioned rooms)Sealing air leaks and adding more insulation to your home. Use friendly electricity that is generated from renewable energy sources such as wind and the sun. Reduce, Reuse, and Recycle. Re-cycle newspapers, beverage containers, paper and other goods. Use water efficiently. Be smart when irrigating your lawn or landscape; only water when needed and do it during the coolest part of the day, early morning is best. Turn the water off while shaving, brushing teeth and hand washing. Do not use toilet as a waste basket because water is wasted with each flush. It is said that only 2% of world’s water is fresh water. Therefore, conserve water. Furthermore in the health care setting, what should be our adaptation and mitigation measures? Although this is not our main responsibility but as nursing students, we cannot just neglect these. It is strongly suggested to conduct a study and proposal on database system of communicable diseases related to climate change, in evaluating the implementation of ecological solid waste management and the recycle, re-use and reduce program to hospitals, laboratories and medical devices, and in constructing geo-hazard mapping of Iligan City. These researches will be recommended to the City Health Office of Iligan. Another is to establish more linkages and workable partnerships with the government and private sectors to conduct community awareness, proper warning system, mutual aid arrangement and mock, drill training practice in line with the National Disaster Risk Reduction Management and Council plans and policies.

Be a Client Advocate!

Nursing Ethics

by: Xandy Jaraba

The healthcare team is subject to legal, moral, and professional obligations which can be very challenging.   These obligations are generally considered very important responsibility of the health care team to give what is due to all patients.   As a nurse leader, your obligations are always professional; however there are legal significance if these obligations are breached.   You must also consider not abusing these obligations. Because, moral issues can occur such as  breached of confidentiality. Yet other instances breaching the guidelines is inevitable in order to produce good and quality outcomes of care. And is therefore can be justified.Can end really justify the means? Now here comes our ethics.

Ethics is concerned with the principles and right conduct as they apply to the nursing profession. It reinforces the nurses’ ideals and motives in order to maximize the reflectivity of their service. In other words, it is a set of moral and practical guidelines that affects your decision making whether big or small.

Full disclosure enables the doctor and nurse to identify conditions properly and to treat the patient properly. In return for the individual's loyalty, the doctor and nurse usually should not reveal private marketing and sales communications or details without the individual's show approval. However, there are certain exclusions to the rule. This will be done if an individual attempts suicidal, is a national threat, has a grave and communicable disease and is required by law.

Despite these moral and lawful responsibilities, entry to private individual details has become more frequent. Electronic wellness computer allow increased accessibility and transmission to personal data.  The health care team in incorporated distribution techniques or networks now has entry to the private details of all the sufferers within their system or network. Confidential details also are published through scientific databases and distributed directories. Discussing these details allows the patient to be treated more efficiently and securely. The challenge for physicians is to use this technology, while remembering and improving individual secrecy.

Your primary concern is to be a client advocate.   A client advocate is the one who provides and defends the cause of another.  In the nursing profession, you have to secure your client's rights.   A client's rights can vary from being responsible for their own health care and decision making based on trust and respect, to the benefit of the professionals being responsible to make sure that the individual has all equal health care services at their hands to get their needs met.

You must be fully aware of the moral and rights of clients to self-determination. You must ensure that clients understand their therapies and effects of any therapies they are going through.   A good professional must be an effective customer by showing assertiveness; and understanding the rights and principles of every client.

Courtesy of Google.com for the pictures.

Nursing ethics & Jurisprudence NF Cañizares, RN, MAN

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Can You Delegate a Task Without Jeopardizing the Patient's Safety?

Nursing Management

by: Xandy Jaraba

 

In dealing with management problems today, nurse leaders continue to use some previous principles. Since the first management research, advocates have discovered much about human behavior; furthermore society has modified extremely, offering current management advocates with new ideas and difficulties. However, even these days one of the most important features for the manager remains that of being an efficient totalitarian. This means as a manager, it is wise always to follow the management process. This consists of achieving organizational objectives through planning, organizing, directing, staffing and controlling.

Each management operate has a preparing and managing stage. The conventional, or traditional, management technology is targeted on development in the workplace and on delineating business limitations to efficiency. The workers were believed to be inspired completely by financial benefits, and little attention was given to employee job fulfillment. The era of management technology increased out of the Hawthorne studies, which highlighted the needs of the employee for identification. Concepts of participatory and humanistic management appeared during these times. Features are not obvious cut and that management is sometimes combined with leadership roles. So, to be an effective leader you need to learn how to be an effective manager.

One of the important highlights about the management process is delegation which is also known as directing. Let's talk about delegation. Delegation is basically assigning orders and instructions. In other words, delegation is getting the work done through people. Yet in the reality, it’s not that simple at all. It must be objective and goal-oriented. There is simultaneous division of labor. Hence, you as a nurse leader need to direct others to perform and achieve goals.

Moreover about delegation is the responsibility and authority for the task. Both can be transferred to another but not the accountability. The responsibility is to do and accomplish the task. Like in the team, there is somebody who is assigned to do vital signs taking and follow-up meds. That will be the person’s responsibility. On the other hand, the accountability refers when a person accepts ownership of the results. Ever heard of the doctrine of “respondeat superior”? It is when the manager or leader is held liable for the act of his employees. Thus, the accountability remains to the nurse leader or manager. Although in some instances, it can be shared because you cannot just blame the one without the other.

So what are the frequent mistakes why delegation fails? They usually happen when there will be under delegation, over delegation and improper delegation. You need to consider the viewpoint of each professional health levels. Selection requires place throughout the management procedure and is one of the most crucial functions of management. 

So, how can you delegate tasks without jeopardizing the patient’s safety? When you’re thinking about delegation, you need to know what can and cannot be done. There are principles you need to understand. It might be the rules you need to follow. These are the RIGHTS of delegation. The right tasks, person, communication, feedback, supervision and time.

The right task usually falls in the manager's discretion and judgment if the task is, can be done. You have to check the task if it is easy, moderate or difficult to do. Second, the right person must be fittingly chosen. He/she must have the ability and quality to perform and accomplish task based on his/ her level of competency. It is important to take note the nursing roles of each members of the team. To the licensed practical nurses or vocational nurses, you cannot delegate complex task that requires assessment, evaluation and calculations. Third, the right communication requires better communication skills in order to give brief, concise and clear instructions or orders. Ask for any clarifications to know if he/she understands. Learn to speak moderately, do not talk fast. Limit the use of unnecessary gestures, it may lead to misinterpretations. Fourth is the right feedback. This means you need to give remarks and observations. It must be a constructive criticism. This will develop their self-esteem to become better in accomplishing task. Fifth, the right supervision refers to your major responsibility to monitor your people, to keep them on the track, and to check everybody’s work. Lastly, ensure right timing. 

Remember as a nurse leader you work in the interdisciplinary team. These rights will help you so that you can delegate tasks efficiently without jeopardizing the patient’s safety.

Courtesy to google.com for the pictures.