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Before taking a new medicine, it is important that the patient is informed about possible effects related to the medicine. Many a time, patients end up using new medicines the wrong way because of lack of information from the hospital staffs who give the medicine. A patient, who is the beneficiary of the medicine, ought to know what he/she is likely to experience with the new medicine; and therefore make the decision of either taking the medicine or declining it. In fact Ho et al. (2015) argue that informing a patient about a new medicine assist them make quicker and right decisions.    

In a case where a patient visits a hospital and he/she is about to get a new medicine, the hospital staff on duty should take time and clearly explain to him/her how the medicine is to be used. For instance, describe the number of doses and time to take each dose. Besides, he should motivate the patient’s interest to knowing more about the medicine and even allow him/her ask questions. Through the questions, the patient will learn more and have right information about the new medicine, which will put him/her in a better position to use the medicine as expected. (Firkins et al., 2018)

The hospital staff on duty should explain to a patient, any other likely side effects that might arise with the new medicine.  Many a time, hospital staffs describes side effects of medication in a way patients fail to understand. That is, they fear that the patient might reject the idea to use the drug.  Firkins et al. (2018) acknowledge that there are drugs that end up giving unexpected results in some users. To mean, they show the wrong result which either could be due to patient’s health status that may fail to match with the new medicine or wrong use of the medicine. In either case, the article advices that the hospital staff on duty should explain any side effects associated with such medicine.

To do this, the hospital staff can use two nursing strategies to improve the patient’s experience and response. Firstly, stimulate the patient’s desire to know more about the new medicine. Usually, patients do not want to associate themselves with new medicines simply because they fear the unknown about such medicine. Secondly, talk to family members taking care of the patient and enlighten them about the medicines and how to go about side effect issues.  By so doing, the family members will help the patient conform to the requirements for the new medicine and reduce likelihood of side effects.  (Brown et al., 2016).

  A respiratory disorder refers to the abnormal conditions that disrupts the normal working of the lungs and other respiratory components. The respiratory system consist of an upper respiratory pathway and a lower respiratory pathway. The upper respiratory pathway consists of the larynx, pharynx and nasal pathway, whereas the lower respiratory pathway includes the bronchi, trachea and the lungs. The respiratory system is basically involved in provision of oxygen to the blood and elimination of carbon dioxide out of the body. In conditions where individuals find themselves experiencing complications within their respiratory system; then they should seek medication as fast as possible (Mannucci, 2015). Asthma and cystic fibrosis are perfect example of respiratory disorder that needs nursing care.  In this regard, the paper considers a case study phenomena involving a nurse and two children who are suffering from different respiratory diseases and need to be attended to.  Ultimately, the evaluation captures the manner in which nursing care should be applied to a child suffering from Asthma and lung infection with focusses on how to make best decisions, before and after the treatment.

       In the first part, the case provides a scenario where a nurse is attending to a girl-child, Gloria, who is suffering from breathing problem. The nurse on duty at the Pediatric unit has received the 8-year-old girl who is experiencing breathing problem and possesses a family background of cystic fibrosis. The primary duty of nurses is to counsel and be mindful of sick patients by ensuring that they are up to regular medication. Following that mucus pops out while Gloria is coughing, the nurse suggests knows that something is highly affected within her respiratory system. However, the nurse cannot start giving medication to Gloria without a clear picture of what she is suffering from.


    Gloria’s situation is complicated and commands care from an expert who understand the whole thing better. To start attending to Gloria, the nurse must first gather information and know if her family is having any traces of cystic fibrosis. According to Jessup (2016), cystic fibrosis is an autosomal recessive pattern and can be passed from the parents to the children, thus, treating the disorder in expectant mothers can reduce the risk to the unborn child. Family’s history with cystic fibrosis is very helpful at this point. The nurse will be in a position to understand if the complications were inherited from the parents or they are self-induced. If the information suggests that the condition was inherited then the nurse will check on the environment in which the family is established, and examine if the condition is influenced by environment.

            Second, the nurse must be very keen to find out why Gloria is having challenges in breathing and observe how she coughs. The symptoms are a reflection of what is happening in our bodies, thus, coughing up mucus means that the lungs must have been greatly affected for a long period of time. The mucus signifies that something could be wrong within his respiratory tract. Therefore, the nurse must be very observant for some good time and observe every sign and physical manifestation of likelihood of respiratory disorder. Besides, she must be keen to note changes in every fluid discharged by Gloria.

            Third, she could observe the nature of body growth, coiling of the toes and hand fingers as well as any trace of sinus infection. When the breathing channel is troubled, blood is not well distributed in the whole body. In effect, some parts of the body end up deformed. The nurse can observe the body extremities and note if the blood is not well circulated in the body. She can then conclude that the respiratory path is affected.


             Thus, she should order for a sweat (chloride) test, pulmonary function test, sputum culture test and genetic test to a certain her observations. The first test, sweat (chloride) test, assist in the examination of cystic fibrosis. In carrying out the test, the skin is made to release sweat that is collected into a special apparatus then analyzed. The purpose of pulmonary test assist in the examination of how well the lungs perform. They entail exams that check on the size of the lungs as well as flow of the exchange gases therein. By carrying out the pulmonary test, the nurse will identify how much is the lung affected.  

                 The purpose of carrying out a sputum culture test is to examine any organisms possible to affect the respiratory system. The nurse will be in a position to examine the existence of parasites and organisms in the respiratory tract: that could be in a position to interfere with Gloria.  The genetic test is important as well because it will assist the doctor know of the history of Gloria’s family as cystic fibrosis is concerned.

                  In the second part, the case provides a scenario in which Jimmy Jones, 6 years old, has been hospitalized for 3 days and found to be suffering from asthma. Jimmy is to be released for home and the nurse wants to suggest to Jimmy’s family about ways to care for their asthmatic son. Ideally, Jimmy is too young to follow the prescribed medications and therefore the nurse ought to involve an adult, preferably from the family circle.

            The nurse should know about variables that can interfere with Jimmy’s asthmatic condition as well as his routine of coming to the hospital for checkup and then inform the adult member of Jimmy’s family. The parents must be informed to ensure that Jimmy is kept away from exposure to things items like tobacco and  textile dust that have been suggested to cause asthma (Cockcroft, 2018). Additionally, the nurse should inquire if the family members know about his asthmatic condition and their willingness to help Jimmy proceed with   medications on a regular standing. Once the family members’ proof pledge to support Jimmy in his journey to recover from asthma, the nurse will remind them of the checkups assigned to monitor Jimmy’s progress.

             Asthma can make a child have a very low self-esteem such they fear associating with their fellow children. Children should be in a position to interact with their colleagues and play as that promotes a sense of oneness and enjoyment amongst themselves. When a child is undergoing low self-esteem as a result of asthma-related complications, then there is high chances that the child will isolate himself/herself from the rest. Continued isolation will make the child grow into an antisocial being who never prioritize team working in the society for the betterment of the society.

               In brief, the purpose of the study has been achieved by using case studies to suggest how a nursing care is applied. Both the lung infections and asthma disease are perfect examples of respiratory disorders. The patients suffering from respiratory disorders should reach to nurses to give them best care that can assist them heal better and faster.


Social determinants of health encompass those elements which influence the health and wellbeing of an individual. Child development and the overall health of the family is affected by various factors such as genetic characteristics, biology, family values, culture, and gender. The family plays a role in providing enough support through multiple ways such as socioeconomic resources, good parental upbringing, and the family environment. The overall health of the community is dependent on the health services at their access and healthy living (McMurray & Clendon, 2011). This essay looks into low income, poor health, and childhood in relation to a health inequality perspective. 

The first part of the essay will give an overview of income as one of the leading social determinants of health while also looking into income inequality, its behavioral and social factors and its role in poverty. In this part, different data will be used to show the psychosocial factors and their impacts on health. The final piece will then look into the social conditions that deteriorate the health of the poor people and their health in the present society. The second part will concentrate on the review of literature while analyzing the policies, strategies, plans, and frameworks which are being put in place by the government to solve the problem of health inequalities and low income in the society. Finally, the last part of the paper will give a summary of the issues discussed in the entire essay and provide final comments from a personal point of view concerning low income and health. 

 Income and health are two interrelated disciplines whereby each of them depends on the other. The lower the rate of pay, the higher the percentage of ill health. Nevertheless, according to Welsh et al., the two are different and can be separated into two types which are absolute and relative (2010).In most of the developed nations, relative poverty is evaluated by use of factors that stop the poor classes from sharing social amenities with the high socioeconomic classes. Absolute poverty in such countries is unknown because everyone can access water, shelter, and food. Lack of adequate income, poor housing, and limited education access are some of the factors that lead to relative poverty and directly relate to health and social inequality. Eaton et al., suggests that one of the most affected groups by relative poverty and are highly vulnerable to poor health and bias are those people with low income and the unemployed (2011).

Despite the tremendous growth that has been experienced in these developed countries alongside improved health services and life expectancy, the link between income and health inequality is broadening at an alarming rate. This according to Eaton and his colleagues is one of the major misconceptions when dealing with inequalities. Emphasis is put that the distribution of income is more affluent to the health aspect than the wealth of the country. On another occasion, Black et al. discovered similar statistics and evaluated them in relation to the population with poor health and material disadvantage (2013). By use of the Townsend deprivation score, he outlined that the mortality rate was higher and more self-reported illnesses have been on the rise among the population residing in areas that have highs scores.

Nevertheless, research indicates that this data needs to consider essential because there is adequate evidence to prove the relationship between the relationship between low income and poor health. According to Leung et al., salary is among the socioeconomic determinants of health and goes along with employment, safety, housing, transport and education (2012). People who have a low income are likely to have low levels of education and mainly deal with unskilled work, are unsafe and reside in inadequate housing. Research according to Leung and his colleagues indicates that infants who are from lower socio-economic status in the USA are more susceptible to respiratory diseases than those in high social classes because of the unconducive environmental factors such as housing, smoking and bottle feeding. In his research, he also discovered that children who come from low-income families are more likely to copy the parents' habit of smoking than those in high-income families. In the thematic discussion by Lohse concerning smoking, the deprivation extent is utilized to show the reduced rate of smoking in affluent classes and how it has increased in the common areas of developed countries over a prolonged period leading to an increasing rate of health inequality (2013). By use of these instances, it is clear that low income alongside other socio-economic factors contributes to certain behaviors which are associated with the health resources of the individual and his abilities to prevent or deal with poor health in the future.

            From the recent research done on the relationship between income and health, it has been found out that poor food choice which is as a result of low income affects the health of the consumers. For instance, a mother opts to buy cakes and biscuits for her children because they are cheaper and can satisfy them easily unlike regular food (Welsh et al., 2010). Moreover, where there is money shortage, the mothers tend to go without food to be able to feed the children which lead to poor nutrition that affects their overall health. Although such decisions appear to be rational, income is seen as a restrictive condition that not only lead to short term impacts but long term health deterioration. Moreover, the issue of having different classes of people as determined by the levels of income is another issue that has contributed to poor health.

 People of social class do not associate with those of low class which leads to poor relations, high-stress levels, loneliness and poor relationships that lead to emotional deprivation and psychosocial illnesses. Cohesion is another social factor that impacts the health of the community (Lohse, 2013). Various researchers have looked into life expectancy data from the time there was a war up to date to establish the improvements in health despite the discouraging situations. Research records show that in the time of war, life expectancy increased as a result of more food supply across all classes. On the contrary, the present generation operates by individual goals, appearance and accomplishments thus becoming more disintegrated and increasing in the inequalities of health among the poor and wealthy individuals.

It can be concluded that societies which have a feeling of safety, support and belongingness are likely to be healthy despite the various economic and materialistic factors. In reference to this, egalitarian societies are seen to have good psychosocial health that leads to happier people who have low levels of stress and deprivation levels (Black et al., 2013). The NHS has put in place strategies to ensure there is health equality for both high and low social classes through the creation of policies that relate to childhood and coming up with various approaches to prevent ill health. Moreover, welfare benefits and pensions have been increased as well as prioritizing policies to minimize income inequality for expectant women. Governments have also put in place measures to improve the situation by increasing family benefits outside work as well as the tax credits which has led to a tremendous increase in employment opportunities. Nevertheless, the tendency of measuring low income before housing expenses makes it hard to compare the data between poverty and earnings.

 To sum up, the essay has elaborated into details the various social and behavioral aspects that affect imbalance in income as well as its potential outcomes on family health. Moreover, it has looked into the psycho-social element of health and income in human lives. It is therefore clear that the essence of gaining knowledge of good health behaviors and the adaptation strategies since birth has been elaborated for the sake of having better future health in the adult stage of life. Regarding this, the essay has highlighted the various strategies that NHS has proposed and implemented to minimize inequalities in health through the creation of more accessible services to families through the promotion of campaigns that mainly aim at the youths and children. Moreover, through analyzing the various issues that society faces today, the essay looked into the local authorities' policies to come up with improved communities and good health among its people. From the various literature that have been reviewed by multiple researchers, there have been essential social methods and their implementation in health which have been evaluated and analyzed to determine the benefits of partnering with agencies when dealing with income and health issues. In the final part of the essay, different reports by government and private research institutions have been combined alongside their plans to minimize inequalities in the social and health aspects.

The Effects of Medication Errors & Labeling on Patients and Healthcare.

Various studies have examined effects that errors in medications and labeling of containers has on the lives of patients and the entire healthcare sector. Presently, in the health care system, mistakes such as wrong use of dose, misdiagnosis and poor time interval in the medication process as well as false labeling of containers occur. As a result, various complications are experienced because of such errors thereby leading to an adverse reaction to patients. It is the high number of incidences of medication errors in Canadian health centers that led to the choice of discussing the topic. Discussion on the effects of medication errors is important to healthcare practitioners because in most instances, they are the ones held responsible when complications on labelling and errors in medication arise. In this essay, it is argued that errors in medication and labeling are core ethical issues in healthcare with far-reaching implications on patient service and provider’s integrity.

According to Farrell et al. (2015), errors in the usage of drugs among older adults creates an abnormal reaction in the body system and could lead to the person falling sick or developing cognitive complications. If not addressed in time the person would be forced to stay in hospitals for an extended period, and in some cases, the person can die. Similarly, poor labeling of the containers in which drugs are placed could lead to wrong usage of medicines that would affecting the health of the user (Farrell et al., 2015). Medical errors occur as a result of incomplete information or poor execution and follow up on patients and their dose intake. Medication errors can be corrected at any time by ensuring that patients use medicines as prescribed by taking dosage at the right time and the required quantities and correctly labeling stored containers holding medication.

In this regard, the topic on medication errors and labeling is important since it addresses a significant issue that has raised various ethical concerns in Canada. Presently, the health care of Canada is at a terrible spot following more challenges that arise as a result of medication errors and poor labeling of containers. The country needs healthy workers and leaders to work corporately and develop every sector of the economy. However, errors in the medication and labeling of vessels create more significant threats to the aim of achieving a prosperous economy. On the other side, more cost is incurred in treating complications that arise from the wrong usage of medicine. Families are spending large amounts of money in managing individuals who form difficulties as a result of a medical error. Instead, such money should be utilized for economic development.

 Similarly, the occurrence of an error in medication and labeling creates a bad reputation on the career of health care. The society can conclude that such errors in medication could be as a result of incompetent professionals in the field of medicine. In such a case, many citizens would opt to access medication outside Canada. According to Plews-Ogan (2016), error in medication is a severe threat in the health care sector in that it devastates the reputation of health care as a profession. A solution to this issue will highlight specific strategies to help doctors and clinicians sail through this problem; taking note of what they have not done well and made improvements accordingly. (Plews-Ogan, 2016). Therefore, addressing the issue of medical error in Canada is essential to reduce the consequences and costs. In order to solve the problem, the paper will discuss at depth, the effects of medication errors and labeling in Canada. The discussion will be anchored on three arguments as follows.

Medical errors put nurses into various ethical dilemmas and issues that they have to struggle with and make decisions. In a case where a medication error has occurred; nurses have to consider multiple factors before informing the patient about the mistake or keeping quiet about it. Firstly, the nurse is fixed between informing and not informing the patient that a mistake in the medication process. Secondly, the nurse is in dilemma of holding the secrecy or informing the caretakers about the mistake. Thirdly the nurse is in difficulty of weighing between loosing trust by revealing the error or keeping the secret to see the patient die slowly. Fourthly, the nurse is faced with the dilemma of maintaining confidentiality of the organization by staying silent or putting the organization at risk by informing the patients about the errors. In both instances, there are two conflicting alternatives for the nurses once they do mistake in their process of medication.

The ethical issues that face the healthcare entities as a result of medication error are grouped into five aspects: justice, disclosure and right to knowledge, beneficence and Nonmaleficence, veracity and autonomy and right to self-determination (Kangasniemi, Pakkanen and Korhonen, 2015). The aspects suggest the reason for every choice made within the healthcare sectors; thereby connecting the theoretical and practical understanding of the moral knowledge about medication error. In simple, these concepts explain as to why healthcare professionals like doctors, nurses and medical students come up with ways of approaching situations where errors in medication process has been asserted. In this regard, the paper will analyze three aspects to support the opinion to declare medication error an ethical issue in the health care sector.

The first argument is based on the concept of autonomy and right to self-determination. In this aspect, patients are considered as essential individuals with powers to decide matters relating to their health (Evans et al., 2015). The health care entities are supposed to allow patients to express their opinions about what kind of medication they want with respect to their beliefs and values. By doing this, the healthcare providers are in a position to create strong bonds with the patients and must promise to keep the secrets of their patients and safeguard the confidentiality of the health information. Similarly, the nurses are in the position to understand how to approach the condition of the patient and come up with a better way to cure the disease. Besides, the nurses get to provide the right counseling services to their patients based on how to control the disease.

In a case where the medical error happens, patients have rights to be informed about it. According to Casimiro et al. (2015), health professionals are required to educate patients about every operation so that patients understand and make the right decisions based on their customs and beliefs. By making patients aware of the activity undertaken, the healthcare givers ensure that recognizes the positive and negative sides of a procedure. Furthermore, possession of such information by the patients protects nurses from blames when a medical error is enumerated as part of the possible effect of the method. Most people like to give blames when things have grown out of help. Likewise, patients and their relatives shout to the watchmen and any other person around the premises in moments of danger.

The second argument is based on the concept of beneficence and nonmaleficence. In this concept, health care providers are entitled to do what they believe is useful to their patients. That is to say; every health care provider must strive to increase the chances of healing by giving medication while reducing the opportunities to make medical errors.  According to Tagin et al. (2015), the principle of beneficence and nonmaleficence requires healthcare entities to do to the patients what is right without inflicting any pain in the process. The medication process should therefore be framed to look good without causing any harm to the patients. Nurses get themselves in situations where the process of doing well end up resulting in some pain to the patient — for example, a nurse injecting a patient to treat typhoid fever. The patient feels pain in the region that is inserted. However, in such a case, the nurse will have to solve the dilemma by weighing between the two possible outcomes and proceed with the medication once the benefits outweigh the potential harm from the exercise of injecting the patient.

In this regard, nurses are faced with various cases that need them to refer to this concept and make a decision whether to proceed with the medication or tarry the process. In such instances, both sides of the possible outcomes is considered, and could limit treatments directly because the process would inflict much pain on the patient. Therefore, it is essential that health care professionals attend to complications as a result of medication errors without doing further harm to the health of the patients.

The third argument is based on the concept of disclosure and the right to knowledge. In this aspect, patients need clear information from health care professionals to assist them in making the right decisions and judgments. According to Stacy et al. (2017), patients can only make the right decisions when they are convinced and understand the entire the process. Therefore, failing to inform patients on medical errors leads to making of improper judgments that later end up killing their trust on the professionals. On the other hand, the disclosure of information enables patients to create the right senses thereby increasing their confidence to their care providers.

Healthcare professionals have a mandate to inform patients about medical errors to assist in making right choices. The best way to do this is by making a clear plan that captures the whole idea of medical error. For instance, nurses can st

Long-term care services are the social and medical services that are put in place to meet the needs of disabled persons of any age. However, the service mostly serves the ageing population that face difficulties without the care of other people. There are many different groups, each having a particular stake in the prosperity of long-term care systems. Success is measured in each of these groups according to their own priorities. Nursing home stakeholders are interested and they demand their participation in their medical care as baby boomers start to seek long-term care (Leach 2010).

 Long-term care services and diverse programs have continued to evolve throughout the years though there are many challenges accompanying its evolution including, low staffing levels, poor leadership, regulations, and funding. These challenges have continued to paralyze long-term care systems and thus recommendations need to be put in place to address these challenges.

Most long-term care continuum all over the world fail to treat their service providers and residents with dignity and respect. This factor has led to inadequate staffing levels. Official data reveals that staffing levels do not meet the required measures for the number of direct care providers set for ample care. Furthermore, workers are not substituted when they are sick or on a vacation or when there is a vacancy. This issue is alarming since residents become aggressive towards the care providers due to delay or lack of care. Workers also get injured in the line of duty while rushing to provide services and some come to work when they are sick knowing that otherwise there is no one else to issue the care (Stone & Harahan 2010).

More staff proportionate to the number of residents has not been hired despite more money funded by the long-term residential care. Funds have been prioritized towards renovating or building more institutions. The long-term care staff complains that the funds that are allocated to this sector do not benefit them nor the residents. Most of them claim that the ministry classification is not genuine since the annual funding for residents is only classified once a year. Managers should make good use of these funds and hire more trained staff and should always treat their staff and residents with dignity and respect for the betterment of the long-term care system (Tourangeau et al, 2010).

Other critical factors are lack of autonomy and organization of work. Provision of 24-hour care is a necessity but this should not pave way for the creation of irregular shifts. These irregular shifts might affect the home life of the staff and the continuity of residential care. Shifts need to be regulated. Workers also should not be denied their choice of scheduling. So many workers should not be scheduled on a part-time basis since it will prevent the regular care of residents and also secure staff employment. Workers should also be involved in decision making since they are the experts on daily needs in long-term care (Tourangeau et al, 2010).

. The long-term care workers are also paid lowly relative to their peers and their skills as well as work experience. Benefits and better pay will always keep workers on toes and will allow continuity of residential care.

The healthcare systems should come up with appropriate resolutions to reduce the problems that are faced in the continuum of long-term care services and the service payment systems. Managers must be updated and stay attentive to the trends of data, they should be ready to diversify current programs, and work together with other care providers to serve a large number of people by availing effective, efficient, affordable and accessible care.




Bullying is an existential problem in the American social system. It has persisted for decades primarily in schools but has extended to the workplace, social media, transport, and business. Due to its recurrence in the mentioned sectors, considerable efforts have been mounted towards resolving cases that may result in crises. Bullying in school, in particular, has received much attention from the education administrators and healthcare providers. Nurses are, therefore, in the frontline in addressing cases of bullying in the school environment. In rural schools of America, incidents of harassment are as rampant as those in urban schools. As a result, there have been scholarly works that nurses practicing in schools have documented to expound on the issue and give it a clinical perspective.

 In "Elementary School Nurses' Perceptions of Student Bullying," published in the Journal of School Nursing, Hendershot et al. (2006) illustrate the school nurses' perception of bullying, their level of preparedness in resolving cases, and the immediate actions they take when students report harassment from their foes. The survey involved 600 school nurses, but only 400 responded to the study. Among the respondents, the majority (99%) were women. White female nurses contributed to 92% of the participants. These nurses were certified by the state and worked legally in these schools. The highest percentage of participant nurses worked in rural and suburban schools, and only a small portion worked in urban institutions. In particular, 45% of those nurses were from suburban schools, 25% were from rural schools, 20 % in urban schools and 7% served in the city schools. It is thus deducible that data obtained from this study was representative of the situation in rural schools.

 According to the findings of the study, most school nurses received complaints from elementary school children. 23 % of the respondents indicated that indeed bullying existed in the American school system, while 9% confirmed to have experienced cases of bullying in their working areas. A paired t-test showed significance in both percentages. Some of the strategies that nurses used in dealing with bullying included referring the cases to the school principal, documenting injuries, sending the victims to a counselor, and discussing the matters with the teachers. 

 In another study titled "An evolutionary concept analysis of school violence: From bullying to death" published in the Journal of Forensic Nursing, Jones, Waites & Clement (2012) characterized the scope of school violence which they say spans from bullying to death. The investigators in this study applied Rodgers and Knalf's model and CDC's criteria of youth violence and bullying to gather data. This criterion covers any case of "slapping, sexual assault, use of weapons, and punching." This study involved the database search for school violence using online tools like MEDLINE, Psycho-INFO, and CINAHL. A total of 110 articles from MEDLINE were randomly sampled for data analysis.

 The study identified bullying as a principle isoform of school violence. It also exposed that presence of electronic media gadgets in the school allows students to access the internet where they experience cyberbullying. The presence of street gangs in the school property was a problem even in rural schools. Thus, the data represented here applies to many schools in rural America.

 The concepts in both studies are core nursing practice subjects. In the first study, nurses mentioned that they document injuries from victims of school bullying. Documentation of patient observation is critical in nursing practice. A nurse has a mandate of making clear and self-explanatory patient notes for future reference. The nurses surveyed for this project were school nurses. However, nurses in both primary and specialty care should keep documents of injuries from bullying including the number of bruises, the depth of cuts, and any systemic effects of the initial assault.

Further, as the study shows, referral of cases to psychotherapy is a mandate for nurses coming across bullying cases. A nurse should strive to make an emotional assessment of the patient and accurately identify the need for review by the necessary professionals. However, a nurse should refer a patient only after treating the wounds that the one might be having.

 Sharing bullying cases with the principle and teachers is another response to bullying that nurses indicated as taking. In the same manner, a nurse should form a habit of peer-reviewing cases to assess damage and devise prevention strategies. For example, a nurse can miss an emotional breakdown in a bullied student, but a colleague may be able to capture it and make recommendations for referrals.

In the second study, there is evidence that nurses are in the frontline in assessing school violence for forensic purposes. Nurses in whichever level of care should understand the basis of school violence and offer treatment or offer referrals. A nurse working in the school setup should also offer scientific guidelines in addressing the root cause of bullying in rural schools. For example, they should advise the school principal on social media policy to prevent students from accessing sites that may expose them to cyberbullying. Additionally, they should do psychoanalysis to identify students that may belong to street gangs and take action to mold them into better citizens by liaising with the local authorities.

In conclusion, a nurse plays a very significant role in addressing bullying in and out of school. According to published studies, nurses have a role to play in documenting violent cases, treating students, and making appropriate referrals.