Positive response to post 150 words with response due October 20 at 10:00

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One of the most important ways community health nurses can provide care that is culturally competent is through education and finding ways to stay up-to-date so that the patient’s culture and values are thoroughly understood.  Establishing rapport is the fundamental first step with any patient to help in understanding what a patient believes about health and how they value their own health.  Due to the vast amount of cultures and subcultures, it is difficult to know everything about each practice.  But, according to Maurer & Smith (2013), nurses can master the knowledge and skills associated with cultural assessment and learn about some of the cultural dimensions of care for clients representing the groups most frequently encountered.  Communication that is effective is key and the nurse will need to assess both verbal and nonverbal components. It is ideal if the nurse speaks the same language or has interpreter services to develop the plan of care.  In addition, the nurse must be aware of their own beliefs, biases, and assumptions while being sensitive to the patient’s differences.  When the nurse uses the following strategies, the patient is getting care that is integrated with cultural competence. 

Cultural preservation is about promoting the patients’ culture and healthy practices.  An example would be in the Vietnamese culture and a mother who is on labor & delivery unit.  The father may not be present, as men do not always attend deliveries. Also, the mother may be reluctant to feed the colostrum, believing it to be bad for the baby.  A barrier could be language as many in this culture read and write well in English but may not speak it fluently.  The nurse needs to assess the patients understanding thoroughly while being patient and encouraging the mother.  If there is uncertainty, an interpreter should be used. 

Cultural accommodation refers to patients using folk practices within the Western health care if it does not have adverse effects on their health.  This method is a supplement to their medical treatment plan.  An example is the use of a shaman or “medicine man” which some cultures such as Native Americans use often and can assist in healing through communication with spirits.  A potential barrier would be the use of equipment such as rattles and drums for a patient who was in contact isolation.  Also, fasting and cleansing rituals may not be appropriate for a patient hospitalized with a diagnosis such as small bowel obstruction. 

Cultural repatterning promotes patients to change harmful health practices while being respectful to their cultural traditions.  This can be challenging as a patient may not have been educated in the past and is part of their “normal” life.  An example would be traditional foods in some cultures are very high in salt when prepared.  If a patient has a chronic condition such as heart failure, the patient must know about the harmful effects of salt and can potentially cause an exacerbation.  A barrier could be the patient does not know how to prepare their traditional meals to lower salt intake and this is where the nurse can teach label reading or refer the patient to a nutritionist to help achieve the best health outcome. 

Cultural brokering is when the nurse who fully understands the patient’s culture and values, will advocate for that patient to safeguard their care in the Western health care system.  An example is a patient who is Jehovah Witness and has an order for a blood transfusion.  The nurse has already had a conversation with the patient who has made wishes known for no blood products and does not eat the blood of animals.  A barrier is that the patient may have weakness or anemia symptoms without some form of treatment.  The nurse can then contact the physician to discuss alternative treatments to help the patient while respecting their wishes of no blood products. 

Maurer, F.A. & Smith, C.M.  (2013). Community/public health nursing practice (5th ed.). St. Louis, MO: Elsevier Saunders.

Positive reply to post 150 words with references due October 20

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Being culturally sensitive is a very important part of being a nurse.  We are called to care for the sick and be their advocates.  Even if we pray and worship differently, dress differently, eat and speak differently does not mean any one of us should be treated with less respect in any part of our life.  Underneath it all, we all the same in human make up.  We all get sick, and we all need ways to get better and heal.  Understanding what others view as important in their healing process plays a very important role in the persons care.  I really feel we can all learn something from each other.  Sometimes the “American way” isn’t always the best way. Even if it is, we are not to push it on someone who does not feel that way.  We teach and advise and in the end let the patient make their choice.

 

 Cultural preservation is about promoting the patients’ culture and healthy practices. An example of this would be a Chinese patient using acupuncture to relive pain as opposed to high doses of pain medications.

 

Cultural accommodation is working with a persons cultural beliefs in providing their care and promoting it. Jamaican cultures believe that salt can keep demons and spirits away. Allowing the patient to keep a bottle of salt at his or her bedside does not harm anyone and it demonstrates cultural accommodation by the nurse.

 

Cultural re-patterning involves the nursing discouraging the use of cultural practices that have been proven harmful. Some cultural practices are harmful to the patient. For example some herbs can cause harm to patients when used, for example the Msemei herb, which has been used by medicine men in Ghana to cure cough in children, has been proved to be harmful to health.

 

Cultural brokering is the use of cultural practices combined with the health care practices to improve the healing process of the patient. In Mexican culture many are Catholic. A person in the ICU had her grandmother visiting her.  Grandmother was taking holy water from the hospital entrance and putting it on the IV site, face and in patients wound.  Eventually the nurse found out what was happening and while discouraging the spiritual practice of using the “dirty” holy water, she instead encouraged that she pray and use rosary beds in place of it as the Holy water had many hands going in daily leaving a lot of bacteria.

 

A possible barrier is always whether or not the patient is willing to comply with what the nurse is trying to suggest.  Some patients may still feel they cannot trust us and may secretly do their rituals without us knowing causing themselves harm. 

 

 

Huber, Lauren. (May 2009).Making Community Healthcare Culturally Correct. Retrieved 10/18/17 from Americannursetoday.com

 

Actforlibraries.(2017).Cultural Competence Cultural Brokering Health Care.retrieved 10/18/17 from www.actforlibraries

cpmment Discussion Module 4

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commen  on those 2

1-Rebecca Crispi    

Discussion Module 4 

. Research and select a state or local debris management plan 

2. Read the plan and conduct a critical review answering: 

•What types of hazards is the state/local authority threatened by? 

• 

In New York, the plan mentions storm debris, flooding, droughts, spills and invasive species.   

•Does the policy/plan consider the types of debris produced by those hazards? 

•Does the policy/plan discuss how to collect, sort, and dispose of the debris? 

• 

Yes, this plan does consider the types of debris produced by the hazards and how to dispose of them. For example, the plan for storm debris mentions numerous types of cleanup, some being:  

Asbestos containing materials – disposed at a “permitted municipal solid waste (MSW) landfill” as per NY State ACM Disaster Guide.  

Asian Long Horned Beetle debris – trees must be chipped a certain way and then possibly quarantined.  

Dead animals – disposed at a MSW landfill or “on- site.” 

Electronic waste – must be recycled according to NYS Electronic Equipment Recycling & Reuse Act 

Household hazardous wastes – must be stored in a safe place until it can be taken to hazardous waste facility for proper disposal.  

Utility poles – these are said to be reused or taken to a MSW landfill. 

•Does the policy/plan mention FEMA’s rules for reimbursement for debris management? 

• 

This document gives a link to FEMA website, which does explain eligibility, insurance settlement, reasonable cost. There is an entire chapter dedicated to the costs of debris removal, including different type of contracts such as piggyback contracts and prohibited contracts. 

https://www.fema.gov/pdf/government/grant/pa/demagde.pdf 

•How does the plan identify human and physical resources specified for the debris management function? 

• 

“All personnel conducting debris operations should be trained, at a minimum, on items such as identification of hazards and proper use of personal protective equipment. Additional training specific to job duties should be conducted to ensure the health and safety of the staff working at the site. Personnel should also be trained in identifying the different solid waste types, such as HHW and e-scrap, to ensure all wastes are separated and managed properly.”  

This is basically saying that people who are going to be involved in debris removal and disposal need to know what they are doing, be properly trained. Not only should they be trained on how to dispose of the materials but they also need to be able to identify different types of debris and wastes so they are taken to the right place.  

•Did you learn anything from reading the plan that was not explored in the course?  If so, what? 

• 

I learned a lot from reading this document. I never realized, nor did I ever think about, how much is involved in disposing of debris. I never thought about how there is going to be hazardous wastes and dead animals, let alone certain beetles and trees that need to be chipped to a certain dimension and then quarantined. It was a very interesting document to read because I did not know anything about debris removal beforehand.  

•What is your overall assessment of the policy/plan?  (e.g., what are its strengths and weaknesses?) 

•What recommendations do you have to improve the plan? 

 

Overall, I find this document to be thorough and very detailed. I think it does a great job outlining the different risks, and providing links to policies and other organizations that are involved in the debris removal process. It even includes a handout that can be given to residents of the area on how to expedite and organize to efficiently remove the debris.  

To be honest, I don’t know how I would improve this plan. I find it to be easily read and navigated. I find there is great detail and specifics that lets any person reading the plan get an easy grasp on what they would need to do.  

 

https://www.fema.gov/pdf/government/grant/pa/demagde.pdf 

http://www.dec.ny.gov/docs/materials_minerals_pdf/2015disasterdebris.pdf 

http://www.dec.ny.gov/regulations/8751.html 

http://www.dec.ny.gov/docs/materials_minerals_pdf/acmguidance.pdf 

2- Doug Harper    

As we continue along this journey together in Emergency Management, I have to admit I never until starting this Module even considered debris management, really knew anything about it, and was not aware of how as a function of a disaster it is so critical in so many ways. I have to say debris management is fascinating in itself as a byproduct of a disaster. But when taken as a whole of what we as EM managers need to consider in the recovery phase, adding debris management to the recovery phase can truly be a daunting task.

I was fortunate enough to have within Toronto’s Emergency Plan a fully accessible/transparent debris management plan/document (https://www1.toronto.ca/City%20Of%20Toronto/Office%20of%20Emergency%20Management/Files/pdf/ESFs/Debris%20Management%20ESF/Debris%20Management_Plan_ESF_A_160429.pdf). This document was refreshed and rewritten in May 2016 so it is quite current.

The document in my opinion is an example of pre-event recovery planning. I can attest to debris management as my city sustained a significant flash flood rain event in July of 2013 that dropped 126mm (5″) of rain in two hours and broke a single day rainfall record for the city (http://www.cbc.ca/news/canada/toronto/toronto-floods-leave-power-system-hanging-by-a-thread-1.1304807). The amount of debris due to flooded basements was unprecedented. I can recall seeing curbside mounds of entire basement contents street after street left for special pickups using 26 ft straight trucks and pure manpower to move into the trucks. Some areas were able to secure dump trucks and loaders, but being prime summer construction season in Southern Ontario, the availability of dump trucks was a logistical issue from the private sector. Removal of curbside household goods took months.

I do appreciate this was only a flash flood rain event. I can not imagine the damage if a F3 or greater tornado took a direct hit to Toronto. The amount of debris for a city of almost 3 million persons would be significant. Yes our housing stock does contain many brick structures, but our building codes for years were not designed for more common events to the south as seen more frequently by the southern and mid US states. I do not know of any homes built prior to the most recent generation of new construction techniques that would consider using hurricane straps on roof structures in my city. Welcome to climate change.

As we read in Chapter 4 of Dr. Phillips book there will be both direct and indirect debris to be managed. One thing that stood out was Toronto does not identify and have a plan for indirect debris (spoiled foodstuffs and public goodwill donations) much to my surprise. Toronto uses the terminology of “Phases”: (1) Make safe (2) Recovery. Pretty simple concepts indeed. I also noted right out of FEMA was the use of windshield surveys for PDA’s and the use of aerial photography surveys. All in all from my limited knowledge to date of debris management it did seem like a good starting point.

I have attempted to give a very brief reply to the 8 questions asked:

•What types of hazards is the state/local authority threatened by? Broad based and the term “situations”. They do not define specific hazards such as tornado, flood, hurricane, etc.  

•Does the policy/plan consider the types of debris produced by those hazards? It does talk about trees, sand, gravel, building and construction materials, vehicles, personal property, general waste or hazardous wastes 

•Does the policy/plan discuss how to collect, sort, and dispose of the debris? It does using a combination of city equipment and staff, and that of private contractors but not for the homeowners themselves (see below comments) 

•Does the policy/plan mention FEMA’s rules for reimbursement for debris management? N/A due to Canadian example. However along the same thought process, there was no reference to federal funding via the Ministry of Public Safety and Emergency Preparedness Canada 

•How does the plan identify human and physical resources specified for the debris management function? Very well as each municipal department that is expected to play a role in debris management is identified. These are: Solid Waste, Transportation Services, Toronto Water, Parks, and Forestry departments 

•Did you learn anything from reading the plan that was not explored in the course?  If so, what? Nothing “new” stood out from the 11 page document 

•What is your overall assessment of the policy/plan?  (e.g., what are its strengths and weaknesses?) I give it a B. Yes something to start the discussion. I was very impressed with the pre-planning for Temporary Debris Storage and Reduction (TDSR) sites. Toronto on a yearly basis revisits the site selections for a review. However as mentioned above no comments in regards to indirect waste. It really is a broad based document as it does not get into the minutia of setting up grids or Sectors for debris management, it does not talk about separation zones curbside by the homeowners themselves, nor does it deal with top tier government financial assistance 

•What recommendations do you have to improve the plan? Drill right down into to “nuts and bolts” of how it will be done and what the homeowner will be expected to do 

To summarize my city has at least spent time in the form of human resources to pre-plan for debris management. Saying that Toronto can do better. maybe an idea for my thesis???

506 Comment 2 DQ 2

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Advocacy for nurses goes beyond just advocating for the patients (Gaylord & Grace, 1995).  Being a nurse advocate also encompasses standing up for what is ethical in nursing practice and for the profession itself.  Nursing history provides us with many strong role models that acted to change the profession, starting with Florence Nightingale.  She established the foundation for nursing practice being recognized as a profession, and set guidelines for nursing standards for her time (Sanford, 2012).      

Dorothea Dix helped to reform mental health by collecting data on mentally ill patients, and after forming a partnership with a well-known physician, was able to petition for the first state mental health institution in Massachusetts (Petiprin, 2016).  After the success there, she proceeded to campaign in other states.  Dix then asked for federal funding for the mentally ill, and became frustrated with the lack of action.  She went to Europe and continued working for reform abroad until her services were required during the civil war, where she was appointed as Superintendent of United States Army Nurses.  After the war, she continued to be a voice for the mentally ill, but due to the countries financial issues, was unable to see reform. 

A modern nurse advocate is Rose Ann DeMoro.  She is the executive director of the California Nurses Association and National Nurses United (Marinucci, 2010).  One of her greatest accomplishments was getting patient-nurse ratios approved for the state of California.  She is expanding her sights to other states to improve work conditions for them as well.  Advocating for other nurses is part of our obligations to each other.          

According to Zolnierek (2012) challenges exist for the nurse advocate.  Nurses may lack communication skills that clearly demonstrate the need for policy change.  They may also be afraid of retaliation when policy changes disrupt the normal flow or creates problems for organizations.  Understanding how to address an issue can also be an uncertainty.  Policy changes may require many people to come together to find a strategy that solves the problem.  Finding evidence-based resources that demonstrate the need for policy change is something the advanced practice nurse is educated to do.  The increase of education level can lead to great change in the future of nursing.

 Refernce :1

Reply to post in positive way 150 words with references due October 29 at 1:00 pm

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Exercise is such a powerful weapon against many preventable, yet devestating diseases.  The first disease that comes to mind would be cardiovascular disease.  Which makes perfect sence in simple terms.  Taking care of the muscle that is responsible for pumping blood through your body as well as the system that circulates that blood makes perfect sense.  However cardiovascular disease typically inculed multiple conditions that lead to this disease but can be controlled, reduced, or avoided by regular exercise. 

 

Blood pressure contributes to the effeciency of the cardiovascular system by controlling the pressue that is exerted when the heart pumps blood through the system as well as the relaxation period between beats.   If the pressure is to high this can compromise the patency of the vessels and lead to a decline in cardiovascular health. According to the CDC 1 out of every 3 Americans have high blood pressure.  “Physical activity not only helps control high blood pressure (HBP or hypertension), it also helps you manage your weight, strengthen your heart and lower your stress level.” (American Heart Assosication, 2016).

 

Cholesterol levels are also something that can contribute to cardiovascular disease if they are to high.  According to the CDC 37.1 of Americans have high LDL levels which is classified as the harmful cholesterol.  Too much bad cholesterol and to little good cholesterol can cause fatty depositis within the sytem which can potentially block blood flow.  Exercise is something patients can do to improve the HDL while decreasing the triglycerides.  “Exercise has the greatest effect on triglycerides (lowers them) and HDL, the good cholesterol (increases it).” (Cleveland Clinic, 2016).

 

Obesity is also another risk factor for cardiovascular disease.  According to the CDC more than 1/3 of Americans are Obese.  This condition can be cured by diet and exercise.  This condition is caused by an excess in calories compared with the intake.  When we exercise we burn calories.  If we burn more than we consume by practicing regular exercise we will reduce our weight.  “It’s a no-brainer. Exercise burns calories. The more you exercise, the easier it is to keep your weight under control.” (American College of Sports Medicine, 2016).

 

As a nurse it is our committment to our patients to educate them on what they can do to prevent or improve their condition.  For a patient with any of the conditions listed above I would suggest they shoot for 30 minutes of moderate activity 5 days a week.  In order to get patients to even attempt a change like this you have to find out about their lifestyle and committments.  For example you can expect a working single mom to be able to afford a gym membership and take time away from her children to exercise.  I would suggest that she encorporated exercise into her daily routine and plan this out at the beginning of each week.  If she usually drives two blocks for soccer practice she may be able to swap out walking instead.  This also instills good habits for her children.  Whatever plan of care you present to your patient, it must work for them or they simply will not be compliant and most importantly…..healthy.  

 

 

COMMENT AUDRE

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I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

While discussing my evidence-based practice change of early mobility with my mentor, we discussed many financial, quality, and clinical aspects of my project. The aspect that may prove to be the most difficult in my project is the financial aspect. In order to properly implement a protocol on mobility of ICU patients, education is a priority. As an ICU nurse, if my manager told me we were now expected to engage in early mobility of our patients I would be terrified. My mentor and I discussed the needed education and agreed that having a physical therapist spend some time with nurses on developing mobility plans would be the best way to demonstrate mobility expectations. This may require additional pay for the nurses, and possibly physical therapists. Along with hands on education, having nurses on both day shift and night shift become mobility champions would provide needed resources for the nurses. This too would require additional pay for the education time spent in training. While there would be some upfront costs associated with the implementation of my project, the end result would produce improved patient outcomes and a decrease in costs due to a reduction in hospital length of stay for the patients involved. According to Ronnebaum, Weir, and Hilsabeck (2012), an early mobility protocol resulted in a savings of $22,000 per patient (Ronnebaum, Weir, & Hilsabeck, 2012).

The Institute of Medicine defines quality as “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Agency for Healthcare Research and Quality, 2012). Improving patient outcomes, such as reduced time in ICU and in the hospital, is one quality aspect of my project. Implementing early mobility directly impacts quality by reducing complications such as DVT, pressure ulcers, and muscle wasting seen in bedrest.

The clinical aspect of early mobility in ICU patients will probably be the most challenging part due to the assessment and change in practice needed. There are many barriers associated with my evidence-based practice project such as safety concerns, time constraints, and availability of support staff. While discussing this with my mentor we agreed that education and support from the physical therapy department and physicians will be an important factor in the clinical changes needed to implement the plan. Early mobility requires nurses to mobilize patients either by range of motion, assisting with in-bed activities, and even assisting with out of bed activities such as walking. At Banner Estrella most critically ill patients are on bedrest, so this may be a challenging clinical change.

References

Agency for Healthcare Research and Quality. (2012). Understanding quality measurement. Retrieved from Agency for Healthcare Research and Quality: https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/chtoolbx/understand/index.html 

Ronnebaum, J., Weir, J., & Hilsabeck, T. (2012). Earlier Mobilization decreases the length of stay in the intensive care unit. Journal of Acute Care Physical Therapy, 204-210.

COMMENT ANDRE

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I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

Two different methods used in the evaluation of evidence include the AORN Research Evidence Appraisal Tool and the Rapid Critical Appraisal. While both approaches help the reader determine quality and relevance to practice changes, the AORN Research Evidence Appraisal is a more in-depth tool. Using a Rapid Critical Appraisal allows the reader to determine the level of evidence, how well it was conducted, and how useful it is to practice. The hierarchy of scientific evidence goes from strongest to weakest:

Meta-analysis and systematic reviews

Randomized control trials

Control trial without randomization 

Case-control or study cohort

Systematic review of qualitative or descriptive studies

Qualitative or descriptive study

Expert opinion or consensus

Many times the level of evidence can be found in the abstract, making it easy to find the information and decipher the level of evidence quickly. When looking at how well the study was conducted, three questions may be answered:

Why was the study done?

What is the sample size?

Are the instruments of the major variables valid and reliable? 

The reader then must decide if the study and results are relevant to the practice change (Fineout-Overhault, Melnyk, Stillwell, & Williamson, 2010).

The AORN Research Evidence Appraisal Tool looks at the quality of evidence in the study and summary based on yes or no questions and rates the quality of evidence as High, Good, or Low quality/major flaws. While this approach is a more comprehensive tool, it takes a significant amount of time based on amount of articles being evaluated (Spruce, Van Wicklin, Hicks, Conner, & Dunn, 2014).  

Attached is a copy of the AORN REsearch and Evidence Appraisal Tool

Fineout-Overhault, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Evidence-based practice step by step: Critical

appraisal of the evidence: Part I . American Journal of Nursing, 47-52.

 

COMMENT CHANTAL

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I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 10020 WORDS

A financial aspect of my project that needs to be taken into account is the cost of training and bringing about new nurses. Due to the fact my focal point in this assignment is understaffing and the effect it has on workers and patient care; the most common solution would be to accomodate appropriate staffing which would require the hiring and training of new workers overtime to decrease the issue of high patient ratio. This can cause an issue in regards to the financial aspect because there will be an increased cost of funding for hiring and training of new nurses. The long term effect will hopefully decrease costs in this area by decreasing nurse burnout rates and increasing nurse retention rates in facilities.

Quality is defined as “ Degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” ( IOM 1990 ; 2013 , para 3). A quality aspect that needs to be taken into account is how the change will benefit patient quality overall. We must account for how patient care will be affected in a positive manner after implementing the change. For example, the increased staffing rates will positively benefit the quality of care because patients who are at higher risks due to higher needs are getting their needs met in a timely manner and nurses are able to provide better care because they are working in a more comfortable environment.

An important clinical aspect is the education factor for older generation nurses. This is a factor to consider as older nurses will be expected to adapt to new technologies and practices brought about to improve efficiency in facilities. Older nurses will not only have to accomodate newer nurses and help incorporate them into the daily bustle of things, they will also have to learn how to use and improve their skills in relation to practice change, increased uses of technologies and other changes made in the field over time.

References

Institute of Medicine (IOM). (1990). Medicare: A strategy for quality assurance. (Lohr, KN, Ed.). Washington, DC: National Academy Press.

 

Utilization of Public Data Sets

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PLEASE READ ENTIRE ASSIGNMENT BEFORE BIDDING ONCE BID IS ACCEPTED I WILL NOT ACCEPT AN INCREASE IN FEE AND ANY INCREASE WILL BE DISPUTED

 

Select or generate a dataset that is meaningful to you and your interests in the health care industry by using one of the links below:

Evaluate the dataset and determine how it is valuable for improving health care operations or policies. (This might require the creation of a chart or graph to interpret the data.)

Write a 700- to 1,050-word report or create a 7- to 10-slide presentation with your evaluation of the dataset and what value can be gained from it. Include the following:

  • The source of the data
  • Why the data is important
  • What trends it documents
  • What changes in operations or policies can be made to improve quality or efficiency.

Cite 3 peer-reviewed sources to support your report.

Format your paper or presentation according to APA guidelines.

Include a copy of the dataset along with your report.  

Include a copy of your Turnitin report and Grammarly report along with your assignment.  You must have a Turnitin match less than 25%.

I WILL PROVIDE THE TURNITIN AND GRAMMARLY REPORT MYSELF

Discussion 13 B

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Please answer to this discussion post with a minimum of 250 words. No citation or reference needed for this answer. Thanks 

Trace the history of cannabis use and its effect on health (select one current article from a nursing journal on the benefits and/or hazards of smoking cannabis). 

Cannabis Sativa can be traced to the Asia continent in China since 1500 BC. The cannabis seeds were used in making animal feeds, oil-based paints and fiber used to make ropes. Fedorova (2017) stated that cannabis can be used for medicinal purposes like treating cancer and posttraumatic stress disorder. Cannabis is an anti-epileptic drug. Cannabis causes lung problems to the users for it contains caffeine components in it. Persons taking it are known to have decreased in memory.

Who are the stakeholders both in support of and in opposition to medicinal cannabis use? 

Government, security apparatus, health professionals, and human activists are the stakeholders supporting or opposing medicinal cannabis use. Those in support the use say it has no addictive levels when used in small amounts. Those against say that the use exposes the users to severe conditions like lung cancer. Cannabis can be used in managing pain while those opposing says it will be abused in large quantities and frequently leading to addiction (Fedorova, 2017).

What does current medical/nursing research say regarding the increasing use of medicinal cannabis. 

Marijuana has shown positive effects in eliminating pain and in cancer management. According to Fedorova (2017), patients with severe pain record reduced pain for a long time after using marijuana. Use of cannabis eliminates cancer patient’s experience depression, loss of appetite, insomnia, vomiting and nausea and all this. The drug is administered in chemotherapy session as a means to boost appetite, eliminate depression or make persons have a normal sleep.

What are the policy and future practice implications based on the current prescribed rate of cannabis?

Laws and regulations will be passed and adopted by governments and global health organization. The laws and regulations will encourage the industrial use of marijuana to make drugs. Accordinh to Fedorova (2017), the laws and regulations on marijuana use will ensure there is an increase in revenue, decrease in the misuse of the drug and elimination of black market. Given that cannabis drugs will be over the counter safe consumption of cannabis will be achieved.

References 

Fedorova, E. V., & Lankenau, S. E. (2017). Illicit drug use among young adult marijuana users in los angeles: Implications for medical use. Drug & Alcohol Dependence, 171, e62.

Pinkas, J., Jabłoński, P., Kidawa, M., & Wierzba, W. (2016). Use of marijuana for medical purposes. Ann Agric Environ Med, 23(3), 525-528.