Discussion – Endometriosis

Endometriosis is a chronic inflammation of the uterus, causing the endometrial tissue to fall outside the uterus and leading to pelvic pain and risk for infertility (Chapron et al., 2019).

Etiology

The actual causes of endometriosis remain uncertain. However, the development of the condition is linked to hormonal, neurological, and immunological factors that mostly contribute to the development of the symptoms of endometriosis (Saunders & Horne, 2021). These underlying factors are believed to interact with various aspects of the individual’s internal and external environment to influence the development of endometriosis.

Epidemiology

Endometriosis is classified as a common gynecological condition. It is currently estimated to affect around 10 percent, roughly around 190 million of the women at their reproductive age (World Health Organization, 2023). Women at their early reproductive age are at an increased risk of developing the condition compared to other age groups. Regardless, endometriosis is a syndrome that can affect women of any age.

Pathophysiology

Endometriosis lesions can occur spontaneously in menstruating species such as humans (Saunders & Horne, 2021). Due to the fluctuations in hormones across the menstrual cycle, inflammation occurs in the endometrial tissue. The inflammation causes the development of scar tissue, which can then lead to the growth of endometrial tissue and fall outside of the uterus (Saunders & Horne, 2021).

Clinical Manifestations

Endometriosis is commonly manifested in chronic pelvic pain (cyclical and non-cyclical), pain during sexual intercourse, and menstruation periods (Saunders & Horne, 2021). Other notable symptoms of the condition are painful defecation and urination, nausea, depression, and issues with getting pregnant.

Work-up

Endometriosis can be diagnosed using diagnostic imaging technologies such as transvaginal ultrasound and magnetic resonance imaging (MRI) (Chapron et al., 2019). The work-up for endometriosis also considers the patient’s medical and family history regarding the condition. Diagnosis can also include physical examinations of the uterus and pelvis.

Non-Pharmacological and Pharmacological Management

Endometriosis can be managed using either non-pharmacological and pharmacological management methods or a combination of both. The non-pharmacological methods of managing endometriosis involve changes in the patient’s lifestyle, including eating habits and activity levels. The patient can also opt for physical therapy to improve the condition’s outcomes.

Pharmacological options include non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics such as ibuprofen and naproxen (World Health Organization, 2023). Other hormonal regulation methods include combined oral contraceptives, gonadotropin-releasing hormone (GnRH) agonists, and aromatase inhibitors (Saunders & Horne, 2021). Surgery also remains an option for managing endometriosis.

Education and Follow-up

Since endometriosis is majorly unpreventable, education involving knowledge of the condition, the need for early and regular check-ups, and the need for treatment are necessary to prevent complicated outcomes. After treatment, it is important to follow up on the patients to ensure the treatment is successful, as well as provide support throughout the treatment period. Patients should be provided with information about the condition, its potential impact on fertility, and available interventions.

Conclusion

Endometriosis is a significant gynecological syndrome with unknown etiology. Education, early diagnosis, treatment, and follow-up are required to prevent complications, pain, and infertility.

References

Chapron, C., Marcellin, L., Borghese, B., & Santulli, P. (2019). Rethinking mechanisms, diagnosis and management of endometriosis. Nature Reviews Endocrinology 2019 15:11, 15(11), 666–682. https://doi.org/10.1038/s41574-019-0245-z

Saunders, P. T. K., & Horne, A. W. (2021). Endometriosis: Etiology, pathobiology, and therapeutic prospects. Cell, 184(11), 2807–2824. https://doi.org/10.1016/J.CELL.2021.04.041

World Health Organization. (2023). Endometriosis. WHO. https://www.who.int/news-room/fact-sheets/detail/endometriosis.

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Discuss Etiology, Epidemiology, Pathophysiology, Clinical Manifestations, Work-up, Nonpharmacological and Pharmacological management Education,and Follow-up for the diagnosis of Endomeotrosis . 500 words

Certified Nurse Midwife

Certified Nurse Midwives (CNMs) are Advanced Practice RNs (APRNs) who are specialized in the provision of healthcare services focused on women’s reproductive health and childbirth. A CNM, therefore, is a registered nurse who has completed their master’s or a doctoral degree and has gained clinical experience and knowledge from education and application of their education in real midwifery care settings (Schuiling et al., 2019).

CNMs usually provide their care services in primary care settings. Their roles include attending to the reproductive health needs of women. CNMs provide preventive and maintenance health care services to women’s reproductive health. They also provide appropriate care throughout the continuum of pregnancy. Therefore, CNM roles include taking care of women during pregnancy, childbirth, and during in post-partum. They also carry out other auxiliary roles, such as the provision of education and care services during and post-abortion (Mainey et al., 2020). To carry out their roles, CNMs are required to possess core midwifery competencies in women’s productive health, pregnancy, childbirth, newborn care, and management of sexually transmitted diseases (STDs).

Additional Educational and Certification Requirements to Become a Certified Nurse Midwife

A Certified Nurse Midwife is previously noted as an APRN who has completed a Master’s or doctoral degree program and has attained certification and licensure for CNM practice and roles. The educational requirements for a Certified Nurse Midwife include the need to first attain a registered nurse (RN) license before entering the midwifery education program. The RN must obtain a graduate degree from an accredited college or university or have an existing RN practice license. An RN who has not completed her graduate education and lacks a graduate degree can undertake a bridging program to qualify for the midwifery program and achieve a CNM professional designation.

An RN must complete a midwifery program accredited by the Accreditation Commission for Midwifery Education (ACME) (Schuiling et al., 2019). The ACME is an accrediting agency that ensures the midwifery education programs provided by colleges meet the set standards and the needs of the community (American College). A registered nurse will further be required to pass an examination provided by the American Midwifery Certification Board (AMCB) to be professionally certified as a CNM (Marzalik et al., 2018).

After the completion of their education and certification process, Certified Nurse Midwives must obtain practice licensing before they can legally practice in the US. The licensure of practice can be obtained across the US from any of the CNM licensing bodies, such as the existing nursing boards like the American Midwifery Certification Board (AMCB). Others include the medical boards in the particular state of certification or the particular state’s departments of health. Once licensed, a CNM has the authority to practice in all 50 states of the US, the District of Columbia, and other US territories (American Midwifery Certification Board, n.d.).

Certified Nurse Midwife Importance in Healthcare

Certified Nurse Midwives play an important role in healthcare. As nurses, CNMs are excellent advocates for patients, especially women’s productive health. Their contribution to health care through practice and research is improving patient care and health outcomes. CNMs’ roles and practices in healthcare and research have been attributed to the improvement of quality in maternity care, birth experiences, and birth outcomes for women and newborns (Trego, 2020). The role of CNMs is proving to be essential in healthcare as women seek person-centred reproductive healthcare outside of hospital settings.

Moreover, CNMs provide education on family care and reproductive health. Women who seek care and are cared for by CNMs receive better reproductive health, prenatal care, and education as compared to the care delivered by other health professions. CNM-provided post-partum education leads to increased rates of breastfeeding and better outcomes for the mother and their child. A study comparing the birth outcomes between nurse-midwives and physicians in a military health system found that CNMs attended to more births with better quality health outcomes for women than physicians (Hamlin et al., 2021). Births assisted by CNMs are also more likely to need lower rates of labour augmentation, reduced need for neonatal intensive care unit admissions, reduced neonatal deaths, and reduced cases and risks of severe maternal morbidity (Loewenberg Weisband et al., 2018).

Certified Nurse Midwife Approach to Patient Care

Certified Nurse Midwives, like other nurses, are not only concerned with the physical outcomes of care, but they also focus on the mental and psychosocial needs of their patients. Therefore, they employ a holistic approach to the provision of care services. The holistic approach in nursing focuses on the person as a whole and appreciates and integrates the link between the mind, body, spirit, social and cultural, emotions, and environmental elements in the wellness of patients (Rosa et al., 2019). Poor perinatal mental health in maternity care settings has led to poor outcomes in pregnancy, childbirth, and in mother’s health (Bayrampour et al., 2018). Evidence-based perinatal palliative care competencies and practices in midwifery can help develop holistic care in midwifery and achieve better birth outcomes and experiences (LoGiudice & O’Shea, 2018).

 References

American Midwifery Certification Board. (n.d.). Why AMCB Certification. Retrieved June 7, 2022, from https://www.amcbmidwife.org/amcb-certification/why-amcb-certification-

Bayrampour, H., Hapsari, A. P., & Pavlovic, J. (2018). Barriers to addressing perinatal mental health issues in midwifery settings. Midwifery, 59, 47–58. https://doi.org/10.1016/J.MIDW.2017.12.020

Hamlin, L., Grunwald, L., Sturdivant, R. X., & Koehlmoos, T. P. (2021). Comparison of Nurse-Midwife and Physician Birth Outcomes in the Military Health System. Policy, Politics, and Nursing Practice, 22(2), 105–113. https://doi.org/10.1177/1527154421994071

Loewenberg Weisband, Y., Klebanoff, M., Gallo, M. F., Shoben, A., & Norris, A. H. (2018). Birth Outcomes of Women Using a Midwife versus Women Using a Physician for Prenatal Care. Journal of Midwifery & Women’s Health, 63(4), 399–409. https://doi.org/10.1111/JMWH.12750

LoGiudice, J. A., & O’Shea, E. (2018). Perinatal palliative care: Integration in a United States nurse-midwifery education program. Midwifery, 58, 117–119. https://doi.org/10.1016/J.MIDW.2017.12.024

Mainey, L., O’Mullan, C., Reid-Searl, K., Taylor, A., & Baird, K. (2020). The role of nurses and midwives in the provision of abortion care: A scoping review. Journal of Clinical Nursing, 29(9–10), 1513–1526. https://doi.org/10.1111/JOCN.15218

Marzalik, P. R., Feltham, K. J., Jefferson, K., & Pekin, K. (2018). Midwifery education in the U.S. – Certified Nurse-Midwife, Certified Midwife and Certified Professional Midwife. Midwifery, 60, 9–12. https://doi.org/10.1016/J.MIDW.2018.01.020

Rosa, W. E., Dossey, B. M., Watson, J., Beck, D. M., & Upvall, M. J. (2019). The United Nations Sustainable Development Goals: The Ethic and Ethos of Holistic Nursing. Journal of Holistic Nursing, 37(4), 381–393. https://doi.org/10.1177/0898010119841723

Schuiling, K. D., Sipe, T. A., & Fullerton, J. T. (2019). Compensation and benefits surveys for certified nurse-midwives and certified midwives. Nursing Economics, 37(3), 126-151.

Trego, L. L. (2020). Why Nurses Are Essential to Research on Birth Outcomes in the United States. Journal of Obstetric, Gynecologic & Neonatal Nursing, 49(4), 336–347. https://doi.org/10.1016/J.JOGN.2020.05.004

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ASSIGNMENT: As a starting assignment, you’ll have the opportunity to review some components of organizational behaviour:

Define organizational behaviour (business).
Describe different components of organizational behaviour.

Explain how the understanding of organizational behaviour can lead to the success and failure of an organization.

Format:

Make sure you follow this format:

Title Page

Introduction

Define organizational behavior. (APA Level 1)
Describe different components of organizational behaviour. (APA Level 1)
Explain how the understanding of organizational behaviour can lead to the success and failure of an organization (APA Level 1)

Conclusion