Vulnerability to Homelessness and Social Exclusion Among Young People Leaving Care

It is a fact that in the country, the numbers of young people who leave care tend to be extremely vulnerable to homelessness, social exclusion, among many other negative factors. Most of these young people are often individuals who lack any family relationships that are normally necessary in the establishment of proper guidance as well as stability to ensure their future success within the society. Unlike those young people who have had a normal life where their familial and social relationships are stable, those who leave care without such stability of tend not to be psychologically capable of moving on from care with the educational success that can secure their future. Those with close familial relationships often leave their families later and their future moves are normally planned beforehand so that they know what their next step in life is and how they are going to tackle it. An example of those young people who leave care in a planned way are those who go for higher education, expect to get a job, and afterwards plan to have children. Those who move on from care swiftly have been found to be the one who are more likely not to shun challenges; in fact, challenges are welcome for them. This makes it possible for them to have a high self esteem which also results in their developing the necessary confidence that guarantees their independence. However, there are those who do not have the same advantage within the society and these normally live dysfunctional lives where they have no personal connections with anyone, including family, and these normally end up in situations such as homelessness and social exclusion. The latter is normally caused by the involvement of some of these young people in vices which go against the norms of the society; creating a situation where it is difficult for them to be accepted by the society.

The government should adopt long term, housing-led, integrated homelessness strategies at national, regional and local levels so that the homeless situation among young people can be dealt with effectively. It is a fact that there are a large number of young people who, while living in care, have experienced more disruptions instability, as well as constant movement (Lovell & Gillen, 2007). These individuals have been found in many instances to leave care much earlier than their counterparts and because of few qualifications, they have ended up being unemployed, resulting in homelessness. It has therefore become of massive importance for the government to ensure that the cases of young people in foster care are closely followed, and that these young individuals are kept under constant supervision even after leaving care. One of the most important things that the government can do is to directly address the homeless issue among young people who leave care because this can be a starting point in ensuring that they gain some semblance of stability in their lives. This can be done through the developing of low-cost housing units that these young people can afford and this would go a long way in preventing these individuals from ending up in homeless. Furthermore, it is important for the government to put in place measures that will help young people leaving care to have greater access not only to affordable housing, but also to a number of low skilled jobs that will enable them to have an income. Dealing directly with homelessness among these young people will go a long way in enabling them to become independent faster than if they were left to their own devices.

In order to prevent young people leaving care from becoming vulnerable to homelessness and social exclusion, it is important for the government to provide guidance for them as soon as they enter care. This is the reason why it is important to increase the number of child welfare officers who can not only monitor the development of the young people in their new environment, but also address those problems that these individuals might be facing under care. Welfare officers should undertake their responsibilities very seriously especially towards those individuals who are within their jurisdiction. As representatives of the government, these officers have to perform their tasks in the most professional way that they can so that they can achieve efficiency in addressing the problems affecting young people before they leave care (Cheminais, 2008). When dealing with these individuals, the welfare officers have to provide counseling and any means of support that they can when these young people are going through a crisis that may have come about because of such occurrences as death, or an illness. It is also important for the welfare officers to ensure that they are alert for a breakdown in the foster relationship, and if this is the case, ensure that the child is removed from such an environment before the young person resorts to leave. Addressing the latter problem would be most helpful in the prevention of homelessness among those young people who might decide to leave care early as a result of a breakdown of the relationship between them and their foster parents. If the young people are taken to a new and stable foster environment, it is likely that they will be able to develop themselves enough, through academic achievement and social wellbeing, to be able to become successful in life.

It is the responsibility of the government to make sure that foster parents are provided with enough information concerning how to best be able to take care of and help the young people under their care realize their full potential. Welfare officers should be given the responsibility of providing firsthand information to foster parents on how to deal with their foster children or when the latter observe that a young person is undergoing a problem which may need intervention. When dealing with these young people, welfare officers have to be mandated with the responsibility of providing letters of referral or reports that will help young people leaving care obtain services such as crisis accommodation or social security benefits that are open to them (Selby, 2011). One of the means through which a welfare officer might be able to gain success when dealing with problems that affect a large number of young people who have left care is through getting them into small groups and guiding them in sharing their experiences. It is most likely that such interactions will enable these individuals to support each other and to learn the social skills that will help them function positively in the society. Among the most fundamental duties that have to be assigned to welfare officers is to make sure that they provide assistance to community groups to plan, and carry out programs that have been designed to help young people in care to adjust themselves into the society. The development of effective programs, such as academic and planning programs are essential for the eventual integration of these young people into the society as independent individuals. It is essential for the welfare officers to conduct relevant research on those community problems which might, both directly, or indirectly, affect young people during and after care and attempt to come up with solutions for them through contacting their foster parents as well as looking at the records of welfare and healthcare agencies.

In most cases, it is normally the dire conditions or environments that young people encounter during care that makes them leave it early and without any planning, they often end up being homeless. It should therefore necessary to ensure that legislation is passed empowering welfare officers to act according decisively if they find that those children placed under care are not living in a suitable environment (Modi, Clark, Wolfe, Costello & Budge, 2013). Welfare officers have to be vigilant so that all the young people under care in the country are safe from abuse, neglect and harm within their foster homes. Whenever they get any credible information concerning any harm or risk to a foster child of any age, they should on such information as swiftly as possible so that the safety of the young person can be guaranteed. If a welfare officer believes that a young person under foster care may need protection, the officer has to conduct a thorough investigation and evaluation to ascertain the continued safety of this individual. Despite it being a fact that it is the responsibility of the government to ensure that those under foster care are kept from harm, individuals from the public should also take action to ensure that they contact the relevant government agency if there is concern about any foster children they believe is undergoing any harm or is at risk of being harmed. The welfare officers, when conducting their investigations concerning possible abusive environments, have to be ethical by not disclose the identity of the people who have provided them with information concerning the young people in question (Taylor, 2006). Thus, young people under care will be able to live in their foster homes with the confidence that they are safe from any harm, and this is likely to enable them to concentrate on important things in life such as academic excellence and other activities that encourage self development.

The justice system has to be reformed in such a way that any young offenders that are convicted of minor crimes should be given another chance to make their lives right. While the justice system has been designed to try and discipline juveniles in ways that are distinctive from adults, there are certain times when controversial sentences are handed down to young people and when they have served their sentence, these individuals find it difficult to reintegrate into the society (Taylor, 2006). It is understandable that some people would seek to have the young offenders receive a harsher punishment for their crimes, especially considering the high number of crimes being committed by them. The juvenile justice system has been changed so much to the extent that it is almost indistinguishable from the adult justice system. The question of whether it is time for the juvenile justice system to be reformed for the purpose of ensuring that young people who leave care are protected from social exclusion should be seriously considered. While it is a remarkably easy thing to try and sentence juveniles as adults, it is an exceedingly rare thing for those responsible to think of the consequences of their actions. One would say that juvenile crimes are not justified by such sentences because when juveniles are sent to prison, they are exposed to an environment which can turn them into hardened criminals. Instead, the government has to develop proper surveillance programs on young offenders as an alternative to putting them in custody (Morton, 2005). In addition, a new range of community sentences have to be created as a means of ensuring that young offenders are not only kept out of prisons, but that they also pay for their crimes in a more constructive manner. The government should also develop a system where there is a wide range of residential placements that include intensive fostering for young persistent offenders whose lives can be changed for the better through the love and attention that they deserves.

The fact remains that the increasing vulnerability of young people leaving care is a real crisis in England and Wales as they are exposed to the likelihood of ending up homeless as well as being excluded from society. In order to deal with this situation, it is necessary for the government to ensure that it is actively involved in the process so that the solutions can be implemented more effectively. There is the need for there to be adequate funding and effective policies to ensure that this problem is dealt with swiftly and efficiently. It has been found that some of the government policies such as social inclusion, regional development, migration, financial regulation, health and human rights policies have been fundamental in the addressing of the complex causes of homelessness and social exclusion among those young people who leave care at an early stage without any plans for their immediate future.

Anna Caroline Maxwell and Nursing in America

One would suggest that Anna Caroline Maxwell displayed many leadership qualities in her quest to develop the nursing profession in America. She did this through her determination to ensure that nursing as a profession was recognised and respected not only by the government but also by the society. In addition, she displayed her leadership skills in all the positions that she was given, as seen when she worked as a matron in New England and as a superintendent in Massachusetts (Myrick, Yonge, Billay & Luhanga, 2011). She was a very good organiser who worked hard to ensure that all of her students gained the necessary funding that they needed after she founded a training school for nurses. Her leadership skill was instrumental for the continued patronage of the financier John Stewart Kennedy for the Presbyterian Hospital’s nursing school over which she was the director. Because of her passion for her job and her need to continue training nurses, Maxwell tended to take many jobs on the field as a means of supporting such institutions as the military.

Maxwell made massive contributions to the nursing profession in America and she did this through agitating for and helping to found nursing schools which were instrumental in making nursing an accepted profession not only in the United States but also in the rest of the world. In order to diversify nursing so that it was not just practiced in hospitals in times of peace, Maxwell requested and was given permission to become an active participant in the treatment of the wounded during the Spanish-American war (Telford, 2014). It was through her efforts that the Army Nurse Corps was founded and all of the members of this institution were given the rank of officer in the military. In this way, Maxwell ensured that nurses came to be involved in almost every aspect of American life, from times of peace to those of war (D’Antonio & Lewenson-Faan, 2011). Thus, nurses were allowed to fulfil their patriotic duty through providing their services during wars and this helped to raise their profile as selfless individuals who would put themselves in harm’s way to protect the lives of people.

Maxwell advocated for the need for all people in the society to receive medical attention whenever they needed it and it is for this reason that she worked hard to ensure that a significant number of nurses were trained to cater for them (Schultz, 2012). Because of her determination to have more nurses in the military for example, she used her persuasive skills to ensure that nurses were given recognition within this institution and this resulted in their being given the position of officer as well as the formation of the Nurse Corps (Riley, 2000). In addition to her efforts in the military, Maxwell worked towards the formation of the Presbyterian Hospital's nursing school and she became its first director, serving in this position for almost three decades. It was through her forceful advocacy as well as determination that she was able to ensure that there was continued training of nurses for the purpose of offering better medical services in hospitals and other healthcare institutions. Thus, Maxwell can be considered to have been a major advocate for the recognition of nursing as a serious profession in twentieth century America.

Maxwell came to the realisation that the conditions in hospitals were less than ideal because despite the large number of patients who needed care, there were very few nurses who could attend to them efficiently. In order to remedy this situation, she worked towards the development of institutions which would ensure the training of more nurses to satisfy the demand for them by patients (Anderson, 1981). In addition, during her tenure as a field nurse during the Spanish-American War, she found that a large number of soldiers at Fort Thomas suffered from a variety of diseases, such as measles and typhoid, which could only be treated through proper care. This made Maxwell all the more determined to train nurses who would be able to take care of these soldiers and with this training; the nurses were able to clean the environment around the field hospital so that it was conducive for the treatment and recovery of soldiers who suffered from illnesses. In this way, Maxwell was able address the various challenges and obstacles which affected healthcare in a variety of situations.

Future generations of nurses will have a lot to thank Maxwell for and this will include many aspects of the nursing profession as it is today. One will find that if not for her efforts, it is possible that the nursing profession would not have received the recognition that it deserved and would have instead have been relegated to the background as an unimportant profession. In addition, nurses have to thank Maxwell for realising early that there was the need for trained nurses to be available in all types of hospitals because it is this training which determined whether a patient lived or died (Maxwell, 1907, p.33). The latter used to be the case in most circumstances before the advent of trained nurses because most of those who conducted nursing were not trained and did not know whether what they were doing was right for the patient or not. Therefore, because of Maxwell’s efforts, nursing became a prestigious calling with millions of people all over the world aspiring to become a part of this select profession.

Maxwell’s actions based on her advocacy for the need to have trained nurses as well as making nursing more professional has had an immense impact on the way that I perceive the profession. This is mainly because of the fact that she completely changed the face of nursing so that it developed into an effort by nurses to genuinely help those individuals who were in need of healthcare. Furthermore, her efforts to provide her services even into very dangerous places such as the warzones of the First World War and before that the Spanish-American War has made the nursing profession all the more admirable for me and has made me realise that nursing as a profession is one which has a prestigious history with a lot of which to be proud.

Continuous Quality Improvement and Patient Satisfaction

Introduction

It is the duty of a nurse to ensure that there is continuous quality improvement in his or her works so that there can be patient satisfaction as a consequence. It is because of the need to improve the quality of their services towards patients that it is imperative for nurses to be concerned about the way that they are able to provide these services in a manner which is as efficient as possible. Quality improvement can only be achieved through continuous efficiency because this is the best manner through which the nurse can be able to note any discrepancies in the way that patients are receiving services and make improvements accordingly (Levsey, Campbell & Green, 2007). There are circumstances where the nurse is required to provide some form of personalized care especially for individuals who are critically ill and cannot do even the most basic things for themselves. In such circumstances, the nurse has to show a lot of devotion for his or her work because without such devotion, the ability to provide the best quality of healthcare for the patient will be limited. It is therefore important to make sure that the patients’ wellbeing is catered for since it is the nurse’s duty to keep the patients as comfortable as possible during their stay in the medical institution. Nurses, because of their continuous interaction with the patients are often the best placed to provide reliable information to the doctors concerning the patients’ progress and because of this; nurses have to be extremely efficient in their work so that they can ensure a positive patient outcome.

Supplies

One of the best strategies that nurses should put into practice to ensure patient satisfaction is to make it their duty to keep a constant supply of the different items that a patient might require in the patient’s room. In this way, in case of emergency, there will be no need to look for these items when the patient wants them the most because such a process means that a lot of time is wasted and the latter might cost the patient his life (Draper, LaDou & Tennenhouse, 2011). Moreover, the nursing manager should ensure that each of the patients’ rooms is filled with cupboards which are well stocked with the necessary supplies so that nurses do not have to go a long way before getting the items that they need to better serve the patients. Moreover, such a move would ensure that the nurses keep working without any need to interrupt what they are doing in order to get supplies.

Uniforms

There are many instances where nurses in a hospital are hard to distinguish from the patients and this is the reason why the nursing managers have to develop uniforms which make this distinction clear (Radcliffe, 2000). Once nurses can be distinguished from patients, they are better able to be of service because patients and their visitors will know who to go to when they are in need of assistance. Moreover, it has been proven that a large number of patients tend to feel more confident in the presence of individuals who are easily recognized as nurses because nurses instill the confidence in them that they are being looked out for. The result of such confidence is that there is an improvement of patient outcome while at the same time the nurses are able to provide the services that their patients need almost on demand. The recognisability of nurses is important because they are the most significant people in any medical institution since they are the ones who are tasked with taking care of patients. The constant presence of nurses in their uniforms makes it possible for them to carry out their duties more efficiently while at the same time providing the patients with the means of recognizing and identifying with the people who are taking care of them.

Hourly Rounds

It is important for nurses to develop a routine of undertaking hourly rounds so that they keep an active look out on their patients. Hourly rounds are important because they provide the nurses with an up to date details concerning the patients’ progress and this helps those individuals who need extra care for their health to improve. Furthermore, this process is important for the patients because the latter become more confident in making their recovery since they know that there is somebody constantly looking out for their welfare. One of the results of hourly rounds is that there are fewer instances where patients have to ring the bell summoning a nurse and instead ensures that the nurse caters for all of the patient’s immediate needs.

Bedside Report

It is important for nurses to adopt a strategy which ensures that patients get their reports in a more personalized level (Lucia, Otto, Palmier, 2009). This strategy can be achieved through providing patients with their reports on the bedside so that it is possible for them to become active participants in their care. The participation of patients in their care and the catering for their desires by nurses makes the patients feel in control of their recovery process and this helps in the achievement of favourable outcomes. Furthermore, bedside reports make is possible for the patients to get to know more of their current status at a more personalized level; providing them with the opportunity to ask relevant questions and raise their concerns.

Conclusion

The discussion above has shown that among the best strategies that nurses should put into practice to ensure patient satisfaction is to make it their duty to keep the rooms of patients well stocked with supplies in case they are needed for emergencies. In addition, there are many instances where nurses in a hospital are hard to distinguish from the patients and this is the reason why the nursing managers have to develop uniforms to help patients find them whenever they need any help. Furthermore, this discussion has shown that it is important for nurses to develop a routine of undertaking hourly rounds so that they keep an active look out on their patients. Finally, nurses have to ensure that patients get their reports at a more personalized level so that they can participate in making decisions concerning their recovery process.

Healthcare Reform

Health care reform in the United States has been undertaken by the Obama administration with the aim of ensuring that all citizens of the country are able to attain medical services at reasonable costs. The cornerstone of this policy has been disease prevention so that the number of individuals who are actually being treated for  diseases is reduced significantly. Furthermore, the new health care system has been designed to move from a treatment oriented initiative to one which is based more on the prevention of diseases because this is the only way through which diseases can be combated and gotten rid of completely.

There has developed a national prevention strategy which is meant to find the most effective way that can be used to ensure that a disease prevention oriented society is developed. In this way, the society will be able to take measures, through being made aware of potential threats towards their health, to protect themselves against disease (Hogg,  Baskerville and Lemelin 20). Nurses in such a scenario will play a significant role because with their knowledge of the various conditions at hand, they will be able to deal directly with members of their communities to ensure that potential diseases are dealt with effectively. The government has created a preventive task force which has been designed to find ways of dealing with diseases before they occur through the use of evidence-based medicine and this has been done to ensure that steps are taken to reduce the impact of disease on individuals in the society. This task force includes nurses, who, with their training, and in conjunction with other medical professionals, are capable of identifying and working towards the prevention of diseases before they reach critical stages.

Under the Affordable Care Act, the federal government developed a scheme through which disease can be prevented as a result of the transformation of the societies or communities within which Americans live. One of the biggest causes of disease in the United States is the environment within which individuals live and where they spend most of their time. In most cases, environments which are unclean or where there is industrial activity whose waste is not disposed properly, have the most potential of bringing about serious medical conditions for members of that community (Chang, Hays, Shekelle, et al 665). The federal government has dedicated itself to the awarding of grants for such areas so that members of these communities can be able to live in an environment that is disease free. Nursing plays a serious role in ensuring that information concerning such areas as well as the medical conditions that affect members of these communities is brought to the public. As the principle caregivers in most circumstances, nurses are often the ones who witness firsthand the effect of the environment on individuals and this is the reason why they are important in helping to establish preventative measures against diverse medical conditions. Among the initiatives that nursing might play a role in is improving the living environment of communities.

One of the goals of the Affrodable Care Act is to ensure that all Americans are able to live longer and more productive lives as a result of being able to access low cost health care. While this may be the case, the objective of helping Americans live longer cannot succeed without the involvement of the nursing profession because it is the latter that makes it possible for communities to develop initiatives that prevent disease and promote health. The federal government has expressed its willingness to support such initiatives through the provision of funding at a state and community level (Smith, Alexander, and Beech). This funding would, however, go to waste if caregivers such as nurses were not active participants in the initiatives because it is they who have a better understanding, through their day to day interactions, how the members of the community live and what they need to ensure that disease among them is prevented. Furthermore, nurses play a significant role in matters concernignt the screening process of some conditions which might lead to diseases. For example, nurses might take part in the screening and treatment process of an individual who is suspected of suffering from depression and doing so will prevent this condition from leading to far worse conditions such as mental disorders. Moreover, alcohol misuse has become a serious problem in the society and it has been responsible for the development of diverse medical conditions which are extremely difficult to treat. Nursing can play a role in the prevention of alcohol misuse leading to serious disease through taking care of individuals in rehabilitation so that they can recover from their habit and return to normal lives unhampered by disease.

In conclusion, health care reform has made it possible for the federal government to develop a scheme through which disease can be prevented as a result of the transformation of the societies or communities within which Americans live. Furthermore, there has developed a national prevention strategy which is meant to find the most effective way that can be used to ensure that a disease prevention oriented society rather than one based on treatment. In both of these schemes, as has been seen above, nursing has an active role to play since nurses are often the primary caregivers in most communities.