NURS 6050 Discussion: Presidential Agendas

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NURS 6050 Discussion: Presidential Agendas

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Every citizen, regardless of political affiliation, has a stake in healthcare policy decisions. As a result, it’s no surprise that healthcare issues have become such high-profile components of presidential agendas. It’s no surprise that they’ve become such contentious agenda items.

Consider a topic that has reached presidential proportions. How did each president (Trump, Obama, and Bush) handle the situation? What would you do differently if you could?

To Prepare:

Review the Resources and reflect on the importance of agenda-setting.
Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.

By Day 3 of Week 1

Post your response to the discussion question: Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

By Day 6 of Week 1

Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

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*Note: Throughout this program, your fellow students are referred to as colleagues.

RE: Discussion – Week 1

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Hello Kirsten,

I found your post so relevant to the present rise in mental health issues. Throughout the covid pandemic we have seen a rise in the reported numbers of addiction and mental health illness. Mental health has always lacked enough resources and medical professionals to properly help the amount of people affected or needing some form of intervention. Torales et al. found that, “This outbreak is leading to additional health problems such as stress, anxiety, depressive symptoms, insomnia, denial, anger and fear globally. Collective concerns influence daily behaviors, economy, prevention strategies and decision-making from policy makers, health organizations and medical centers, which can weaken strategies of COVID-19 control and lead to more morbidity and mental health needs at global level.” (Torales et al., 2020) Even as health care professionals we have seen and heard of our colleagues suffering from increased levels of anxiety and even suicide. April 2020, we learned of the NYC ER doctor Lorna Breen dying by suicide. The Washington post published, “Breen’s father, Philip C. Breen, told the New York times that she had described coronavirus patients flooding her hospital and sometimes dying before they could be removed from the ambulances. She had no history of mental illness but seemed detached before she died, the Times reported. (Washington post, 2020) It is a tragedy that this individual underwent such a traumatic experience with no reprieve. Medical institutions were not prepared for this pandemic but as a society I feel we have failed at acknowledging mental health and the need for mental reprieve. Professionals like this doctor felt extremely overwhelmed with the death tolls. I remember seen the mobile morgue parked outside my hospital and been desensitized to the events we were facing. The feeling of despair as we watched people die will forever be part of our memories of this pandemic. We watched people of all ages die, we heard the voices of the family members as they called out to their loved ones to pull through, and we wrapped bodies by the numbers each day. Bhattacharjee elaborated, “A survey conducted during the last week of March 2020 showed that 72% of Americans felt that their lives were impacted by the outbreak, which was a 32% increase from the survey conducted only 2 weeks earlier. The results show a positive correlation between COVID-19 infections/casualties and growing public concern. These observations suggest possible increase in mental health illnesses in United States as a consequence of the pandemic. (Bhattacharjee, 2020) The fear of the unknown, the devastation of the rising death toll, the loss of income or employment are amongst the stressors that helped trigger some underlying mental health issues. Mental health should be addressed better as a nation. The stigma against and the lack of resources make it difficult for people to seek or obtain help. Specially during these difficult times, we failed at having support groups or better access to mental health providers.

References:

Bhattacharjee, B., & Acharya, T. (2020). “The COVID-19 Pandemic and its Effect on Mental Health in USA – A Review with Some Coping Strategies”. The Psychiatric

quarterly, 91(4), 1135–1145. https://doi.org/10.1007/s11126-020-09836-0

Iati, M. and Bellware, K. “NYC emergency doctor dies by suicide, underscoring a secondary danger of the pandemic”, The Washington Post, April 28, 2020.

Torales, J., O’Higgins, M., Castaldelli-Maia, J. M., & Ventriglio, A. (2020). The outbreak of COVID-

19 coronavirus and its impact on global mental health. The International journal of social psychiatry, 66(4), 317–320. https://doi.org/10.1177/0020764020915212

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Learning Resources

Required Readings

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Chapter 1, “Informing Public Policy: An Important Role for Registered Nurses” (pp. 11–13 only)
Chapter 2, “Agenda Setting: What Rises to a Policymaker’s Attention?” (pp. 17–36)
Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 171–180)
Chapter 12, “An Insider’s Guide to Engaging in Policy Activities”
- “Creating a Fact Sheet” (pp. 217-221)

NURS 6050 Discussion: Presidential Agendas

Post by Day 3 and Respond by Day 6 of Week 1

To participate in this Discussion:

Week 1 Discussion

RE: Discussion – Week 1 Attachment

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Addressing Opioid Crisis

The opioid issue or epidemic has been one of the most discussed topics at the presidential level for years. It is also consistent with my experiences as a nurse in an acute care hospital, where I frequently encounter people abusing prescription painkillers, heroin, and fentanyl. According to the Centers for Disease Control and Prevention (2020, March 19), 128 people die daily from opioid overdoses, and between 1999 and 2018, about 450 thousand deaths were registered. In response to the rising number of deaths and devastation caused by the opioid crisis throughout the United States, the last three presidents have taken a variety of national measures.

Former President George Bush established the National Drug Control Strategy (Justice.gov, 2006), which focuses on three key components: preventing drug use before it begins, treating drug users, and disrupting the market for illicit substances. Despite the strategy’s intriguing goals, community cases continued to fluctuate.

Next in line is the former President Barack Obama, who signed into the 21st Century Cures Act, which “funds a $1 billion proposal to combat the opioid epidemic and enacts mental health reforms focused on serious mental illness, suicide prevention, and mental health parity protections” (Obama White House, 2015). This act included funding the fight against opioid epidemic to provide the resources and treatments people need (Obama White House, 2016). The money may be used to improve prescription drug monitoring programs,to make treatment programs more accessible, to train health care professionals in best practices of addiction treatment, and to research the most effective approaches to prevent dependency (Wikipedia, n.d.).

This was then followed by President Donald Trump administration, who issued a nationwide call to action by declaring opioid crisis as a public health emergency in October 2017. According to the White House (n.d.), the proposed measures include:

Part 1 reducing demand and over-prescription, including educating Americans about the dangers of opioid misuse. Part 2 is cutting down on the supply of illicit drugs by cracking down on the international and domestic drug supply chains that devastate American communities. Part 3 is helping those struggling with addiction through evidence-based treatment and recovery support services. In 2018, President Trump worked with Congress to pass the SUPPORT Act, thesingle largest legislative package addressing a single drug crisis in history.

Undeniably, these strategies are still in progress, and as a nation we continue to fight for this battle. Unfortunately, drug overdose continues to impact our communities, and it is even leaving us with devastating deaths. If I have to address it differently, I will give more attention to the most vulnerable population who are the younger adults and reinforce education and community action. As a nurse, I can also contribute by helping officials collect new ideas by sharing and interpreting data in the health care system that affect patients and professionals. I will also be an advocate for those who are hesitant to disclose their main concerns and make sure that they will have support systems available. Each individual can do something by adhering to the nation’s policy and implementing it.

References

21st century cures act. (n.d.). Wikipedia. Retrieved September 1, 2020, from https://en.wikipedia.org/wiki/21st_Century_Cures_Act

3 letters that explain why president obama is signing the cures act. (2016, December 13). whitehouse.gov. Retrieved September 1, 2020, from https://obamawhitehouse.archives.gov/blog/2016/12/12/3-letters-explain-why-president-obama-signing-cures-act

Ending america’s opioid crisis. (n.d.). The White House. Retrieved September 1, 2020, from https://www.whitehouse.gov/opioids/

Improving health for all americans. (2015, December 1). whitehouse.gov. Retrieved September 1, 2020, from https://obamawhitehouse.archives.gov/the-record/health-care

National drug control strategy: February 2006 [PDF]. (2006). Justice.gov. https://www.justice.gov/archive/olp/pdf/ndcs06.pdf

Understanding the epidemic. (2020, March 19). Centers for Disease Control and Prevention. Retrieved September 1, 2020, from https://www.cdc.gov/drugoverdose/epidemic/index.html

File Addressing Opioid Crisis.docx (38.241 KB)

Hello Crisanta,

I enjoyed reading your discussion regarding the opioid crisis. I found this discussion to be informative and well written. Unfortunately, as a psychiatric nurse, I often encounter individuals who are struggling with substance abuse, as well as mental health illness. Nurses not only provide these clients with physical and psychological care but provide education regarding the risks of substance addiction, including the physical and psychological consequences, the potential harm to relationships and family life, and the impact on fulfilling basic needs such as holding down a job. Nurses educate patients regarding treatment options, including those they can use on either an inpatient or outpatient basis and those they can use to cope with substance cravings.

Research has shown that several underlying factors are responsible for drug addiction. A combination of physical dependence, sexual addiction, violence in the family, and parental history of alcohol/drug use is associated with youth substance addiction (Ahad, 2017). Substance addiction is also followed by some other issues, such as mental illness, domestic violence, economic deprivation, housing needs, and residence in dangerous neighborhood environments (Ahad, 2017).

President Trump announced on August 10, 2017, his intention to declare a national emergency following the recommendation of the President’s Commission on Combating Drug Addiction and the Opioid Crisis. Opioid misuse is one of the nation’s most severe preventable public health challenges. To date, more than 600,000 deaths have occurred, with 180,000 more expected by 2020 (Gostin et al., 2017). Of the 20.5 million US citizens 12 years of age or older with opioid use disorders in 2015, 2 million have been addicted to prescription pain relievers (Gostin et al., 2017). A national emergency declaration authorizes public health forces, mobilizes resources, and encourages creative measures to combat a rapidly growing population.

Hydrocodone, oxycodone and overall opioid prescribing have been in a multiyear decline beginning in 2012 through early 2017 (Rose, 2018). Total opioid analgesic prescriptions decreased 4.5% from 2011 to 2014, prompting rises in tramadol (+25.5%) and buprenorphine (+49.4%) prescriptions (Rose, 2018). One study I found interesting reported that chronic pain as a medical cause of suicide is second only to bipolar disorder (Rose, 2018). The distress, exhaustion, and hopeless chronic unrelieved pain can invite thoughts of suicidal ideations. Death is no longer feared but becomes now a welcoming prospect of permanent relief from pain and anguish (Rose, 2018). A concern would be that the decrease in prescription opioids would lead to more frequent street usage, causing an increase in substance abuse, overdoses, and suicide attempts and completions related to unrelieved pain. This concern is why I feel it is so important that the United States continues to address the Opioid Crisis, as well as other substance abuse addictions.

I agree with your intervention to incorporate educational encouragement and community action programs. An issue must be brought to social consciousness. Addiction outreach programs should offer mentor programs, workshops, fun activities, awareness-raising rallies, drug take-back events and mediators to reintroduce users and loved ones. A peer education program (PEPs) study was conducted in Turkey. PEPs put into effect the use of providing peers with positive role models for each other. The study was carried out to determine the effect of a PEP on the basic knowledge of adolescents about addiction and on the level of self-efficacy that is needed to avoid substance abuse. The program lasted 3 months, the adolescents were from 14-16 years old. After completing the program it was determined to have shown effectiveness and applicability of the PEP in preventing substance abuse among high-school adolescents (Demirezen, 2020). I feel your discussion post was well thought out and presented. The Opioid Crisis is a much-needed topic to bring awareness to. I enjoyed reading your work!

References

Ahad, A., Chowdhury, M., Kundu, I., Tanny, N., & Rahman, M. W. (2017). Causes of Drug

Addiction\among Youth in Sylhet City of Bangladesh. IOSR Journal Of Humanities And Social Science (IOSR-JHSS), 22(5), 27-31.

Demirezen, D., Karaca, A., Konuk Sener, D., & Ankarali, H. (2020). Agents of Change: The Role of the

Peer Education Program in Preventing Adolescent Substance Abuse. Journal of Child & Adolescent Substance Abuse, 1-12.

Gostin, L. O., Hodge, J. G., & Noe, S. A. (2017). Reframing the opioid epidemic as a national

emergency. Jama, 318(16), 1539-1540. https://10.1001/jama.2017.13358

Rose, M. E. (2018). Are prescription opioids driving the opioid crisis? Assumptions vs

facts. Pain Medicine, 19(4), 793-807. http

Name: NURS_6050_Module01_Week01_Discussion_Rubric

	Excellent	Good	Fair	Poor
Main Posting	Points Range: 45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	Points Range: 40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	Points Range: 35 (35%) – 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.	Points Range: 0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness	Points Range: 10 (10%) – 10 (10%) Posts main post by day 3.	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%) Does not post by day 3.
First Response	Points Range: 17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Response is effectively written in standard, edited English.	Points Range: 15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	Points Range: 0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response	Points Range: 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Response is effectively written in standard, edited English.	Points Range: 14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	Points Range: 0 (0%) – 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation	Points Range: 5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days.

Total Points: 100

Name: NURS_6050_Module01_Week01_Discussion_Rubric

RE: Discussion – Week 1

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Each year in the U.S., millions of people are affected by mental illness. The CDC reports that 50% of Americans will at one time in their life be diagnosed with a mental disorder (CDC, 2019). As nurses, we must understand the physical, social and financial impact mental health has on our nation. We must raise awareness, reduce the negative stigma, and advocate for better health care.

I focused my post on mental health care because it is my nursing specialty. After reviewing what the last three presidents have accomplished, I was surprised and pleased with president Bush’s and Obama’s attempts to address mental health; however, I was disappointed in President Trump’s apparent lack of support.

In 2002 President Bush created the New Freedom Commission Act, which would improve mental health services for children, adolescents, and adults by coordinating treatments and services to promote their successful integration into the community (President`s New Freedom Commission on Mental Health, 2019). His support for mental health didn’t stop there. Throughout his presidency, he continued to make positive changes for those living with mental illness. In his final year as president, he signed an act establishing health insurance coverage for people with mental health disorders, seeing it as just as important as physical health (Hart, 2016). Two years later, under the Obama administration, President Obama signed the Patient Protection and Affordable Care Act, much like Bush, demonstrating that mental health is as important as physical health. In 2016, the president proposed a budget that included a new $500 million investment to increase access to mental health care (Hart, 2016). As stated above, both Presidents acknowledged mental health and the importance of treating it as equal to physical health. Conversely, during his time in office, President Trump advocated for the reduction in Medicaid funding to each state, which directly impacted the mental health services to the aged and disabled who qualified under this program (The Trump Administration and Mental Health, 2018).

If I were to do anything different, I would have built on the legacy of Bush and Obama to increase awareness, policies, and funds to address mental health. Mental health issues are not going away, and decreasing funding for programs that meet the needs of the mentally ill is a step in the wrong direction.

References

Data and Publications – Mental Health – CDC. (2019). CDC. https://www.cdc.gov/mentalhealth/data_publications/index.htm

Hart, J. (2016). How Presidents Have Shaped Mental Health Care | NAMI: National Alliance on Mental Illness. Nami.org. https://www.nami.org/Blogs/NAMI-Blog/February-2016/How-Presidents-Have-Shaped-Mental-Health-Care

President`s New Freedom Commission on Mental Health. (2019). Unt.edu. https://govinfo.library.unt.edu/mentalhealthcommission/

The Trump Administration and Mental Health – The Gooden Center. (2018, May). The Gooden Center. https://www.goodencenter.org/trump-administration-mental-health/

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