The National Department of the health of Papua New Guinea and WHO confirmed on April 28, 2018, that the strain of the poliovirus that was first reported in a child is now circulating in the Morobe Province in Papua New Guinea. On June 22, 2018, the Center for Disease Control and Prevention confirmed the same virus was screened from the stool specimen of two other children in the community ( World Health Organization, 2018 ). This means that the disease was circulating within the community, which is a sign of an outbreak.
Establishing a functional Team
The first step towards building an active nursing team involves understanding the team boundaries. To understand the limits of any team, one must be able to understand the prevailing culture of every member of the team, this would help in establishing interventions that do not go against the beliefs and principles of the team. Secondly, there is a need to be clear about the purpose of the team. As much as every nurse on the side has their respective duties, there is a collective purpose of the team, and that is to prevent the poliovirus outbreak. This purpose should be clear from the start. Another factor would be necessary when establishing a functional squad would be understanding the team dynamics such as employee turnover, the anticipated work stress and the changes in the delivery plan. These are just some of the issue that the team leader should consider establishing a functional team, although it takes more than the stipulated facets. When undertaking such activities, the team leader ought to open-minded to suggestions and use their interpersonal skills effectively.
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Communication
Communication is key to activity that requires joint cooperation, and this mission is not exceptional. Fortunately, English is one of the four languages spoken in Papua New Guinea. The affected area which is the Morobe province. English and Tok Pisin are the most common languages. This means that communication among the members of the team would not be a barrier. However, the affected population, who are the major stakeholders in this process, could present a language barrier problem. Papua New Guinea has over 800 different dialects (it is the most linguistically diverse state in the word). The Morobe province is inhabited by over 100 different dialects; this means that for the rural population who do not understand English, the team would need to hire an interpreter.
Nursing interventions
Since Poliovirus has a vaccine, the first step would be to prevent the disease from spreading, by administering the vaccines to the natural population, especially children under the age of 5 years. The second, intervention would be giving a medical response to the affected people to reduce the symptoms presented by polio. Lastly, nurses have to provide emotional support to the affected patients and their respective families as they conduct a community awareness about the disease.
The reason behind prioritizing this intervention, is to firstly curb the outbreak and help the affected population to return to normalcy; secondly, it would help in relieving the directly affected community (this is among the sole duties of nurses) and lastly, creating public awareness in cases of a public health crisis.
Systems Specific Assessment
For individual patients, the nurses performed a general polio assessment on patients, which includes, looking at patient’s history, examining the patient and establishing an appropriate intervention that is acceptable to both the patient and the nurses.
For the community risk assessment, the nursing team was examining the population immunity, quality of acute flaccid paralyzes surveillance and other specific factors such the areas with active polio transmission, history of outbreaks and the capability to respond to such outbreaks in future. This holistic intervention would render the whole process sustainable both for the nursing team and the general population.
The patients that ought to be recommended to the doctor are young children below the age of five years; this is because this group tend to vulnerable to contracting infections due to their developing immune system and would always need particular attention
Infection Control
For the patients in the shelter, the team used both precautions, managing spills, and proper cleaning as the best interventions to help in curbing more infections. The nurses were taught on the importance of infection control, and the impacts of failing to implement the right procedures for infection control.
Assignments & Delegation
I am a hands-on person; therefore, when assisting the physician, I would prefer working in take part in the active treatment aspect of patient care.
Implementing Care
Since most of the patient affected by polio are young children, this group has a low endurance level and cannot sustain any pain or discomfort. Therefore, medically, this group would be demanding painkillers. Painkillers ought to be provided by the government or partnering organizations such as doctors with no borders. For patients at home, their medicines will be distributed by the local nurses, or supporting public health officers.
Psychological concerns
As a trained nurse, the best way of responding to the mental needs of the affected population is through offering counseling and therapy. Nurses caring for a patient over a week are likely to suffer from work-related stress and depression (Vos, Craig, & Cooper, 2015). To relieve caregivers from such stress, they should be given some time off from work, and the group should encourage teamwork and support for each other.
Confidentiality
With the current development in technology, the patient's privacy could be breached by either the nurse positing the patient's picture on social media, or accessing the patient's information from a personal computer (Petrik, Billera, Kaplan, Matarazzo, & Wortzel, 2015). The healthcare records kept in the shelter are inpatient records and are kept by a trained health records officer.
Violence and abuse
So far in the region, there are no reports of violence and abuse, apart from the rapid insecurity cases, which has been existing even before the outbreak. In the shelter, there has not been any case of crime. However, there is a potential that criminals might take this advantage to steal children from the shelter for trafficking.
Culture & Religion
In Papua New Guinea, women have been given the sole responsibility of managing household affairs, therefore when undertaking any intervention aimed at improving the public health one should target the women mostly, because they are the ones responsible for hygiene in the family. 96% of the population are Christians (Crivelli, Russell, Jarillo, & Fernández-Dols, 2017). Therefore, when caring for a patient whose culture is different, the medical practitioner should establish interventions that are in tandem with the patient's culture.
Global Health Organization
These organizations include the World Health Organization (WHO), Center for Disease Control (CDC), Doctors with no Boarders and the Red Cross, among others. Nurses with a postgraduate degree and have a humanitarian work experience can join these organizations.
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References
Crivelli, C., Russell, J. A., Jarillo, S., & Fernández-Dols, J. M. (2017). Recognizing spontaneous facial expressions of emotion in a small-scale society of Papua New Guinea. Emotion , 17 (2), 337.
Petrik, M. L., Billera, M., Kaplan, Y., Matarazzo, B., & Wortzel, H. (2015). Balancing patient care and confidentiality: Considerations for obtaining collateral information. Journal of Psychiatric Practice® , 21 (3), 220-224.
Vos, J., Craig, M., & Cooper, M. (2015). Existential therapies: A meta-analysis of their effects on psychological outcomes. Journal of Consulting and Clinical Psychology , 83 (1), 115.
World Health Organization. (2018). Papua New Guinea confirms poliovirus outbreak, launches a response . Retrieved from; http://www.wpro.who.int/papuanewguinea/en/ , on July 11, 2018.
