This poem tells the story of Hazel, a cleaning woman, recounting to her friend Laverne about an encounter she had with a talking frog while cleaning. The frog promised Hazel that if she kissed him, she would become a princess. However, Hazel did not believe the frog and instead hit it with her mop and flushed it down the toilet three times, rejecting the chance to change her life circumstances. The poem explores themes of missed opportunities and women being limited by societal expectations and stereotypes of their station in life.

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Evidence-based practice
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Evidence-based practice
Evidence-based practice
Evelyn Chicas
Herzing University
Professor Koenig
NU560-7: Research Methods and Evidence-Based Practice
June 6, 2021PICO Question
Short-staffing among nurses does affect patient care and clinical
outcomes? Introduction
Short-staffing in medical practitioners most specifically nurses
are not very uncommon. Short-staffed shifts usually occur when
the number of admitted patients in a care unit surpasses the
highest capacity per nurse set by standards of clinical safety and
quality. However, unfortunately, short-stuffing in nursing is a
very common occurrence in almost every department of
healthcare centers. Nowadays, prevalence of chronic illnesses
increases the clinical load hence, is majorly responsible for
short. However, in this study, the author is going to analyze and
explain three different articles on the topic. Study analysis
In the study of Enns, C. L., & Sawatzky, J. A. V. (2016)
the concept of emergency nurses’ perspective on factors
affecting patient care was studied. One of the main objectives of
the study was to find the association between the staff-shortage
and patient care and clinical outcome. It is a interview -based
qualitative descriptive study, where as part of a larger study, a
subsample of emergency nurses of Manitoba hospitals, Canada

2. were interviewed by the researchers. They were asked with two
important questions including “what does care mean to you?”,
and “What affects caring in your practice in the emergency
department”. However, the first question is not relevant in
aspect of this study, therefore, author is to focus more on the
second question that was asked to the nurses in order to find
whether staff-shortage affects patient care or not specifically in
emergency department. Nurses who work in public hospitals in
Manitoba, Canada were chosen as participants of the study and
interview was designed and conducted by the researchers. Tools
that have been used by the researchers include tape-recorded
face-to-face interviews with individual participants. Descriptive
interviews were made. In this study, staffing issues were
significantly stated by the participants that it directly affects
their ability to deliver optimal nursing care (Enns & Sawatzky,
2016).
In the second study chosen by the author, the researchers
designed a quantitative review in order to ‘identify nursing care
most frequently missed in acute adult inpatient wards and
determine evidence for the association of missed care with
nurse staffing’ (Griffiths et al.,2018). This study is a
quantitative systematic review, where the researchers obtained
relevant evidences from Cochrane Library, Embase and Medline
and CINAHL. Quality appraisal tool was been followed and it
was based on the National Institute for Health and Care
Excellence Quality Appraisal Checklist for studies reporting
correlations and associations. In this study, a total of 14 studies
found association between higher reports of missed care and
low staffing levels.
The study of Smith et al., 2020, was a retrospective,
observational study and the study was developed by the
researchers in order to investigate the association between
failure to respond to patients with deranged physiology and
nurse staffing levels. Patients’ vital signs and administrative
data were been obtained from a total of 32 general wards of an
acute hospital located in England. The participants of this study

3. were nursing staffs. National Early Warning Score was been
used in order to assess vital signs of the patients and to know
the association of staff shortage with impaired care. In this
study, it has been shown that staffing levels of registered nurse
highly influence the rates of failure to provide proper response
for patients with most abnormal vital signs.
Reference
Enns, C. L., & Sawatzky, J. A. V. (2016). Emergency nurses’
perspectives: Factors affecting caring. Journal of Emergency
Nursing, 42(3), 240-245. Carol L.EnnsMN, RNJo-Ann
V.SawatzkyPhD, RN
Griffiths, P., Recio-Saucedo, A., Dall'Ora, C., Briggs, J.,
Maruotti, A., Meredith, P., Smith, G. B., Ball, J., & Missed
Care Study Group (2018). The association between nurse
staffing and omissions in nursing care: A systematic review.
Journal of advanced nursing, 74(7), 1474–1487.
https://doi.org/10.1111/jan.13564
Smith, G. B., Redfern, O., Maruotti, A., Recio-Saucedo, A.,
Griffiths, P., & The Missed Care Study Group. (2020). The
association between nurse staffing levels and a failure to
respond to patients with deranged physiology: a retrospective
observational study in the UK. Resuscitation, 149, 202-208.
https://doi.org/10.1016/j.resuscitation.2020.01.001
Appendix
Matrix Table
Article/Reference (in APA format)
Purpose of the Article/Study Question
Variables (i.e.; Independent vs. Dependent)
Study Design
Sampling
Methods
Instrument
Findings/Results

4. Enns, C. L., & Sawatzky, J. A. V. (2016). Emergency nurses’
perspectives: Factors affecting caring. Journal of Emergency
Nursing, 42(3), 240-245. Carol L.EnnsMN, RNJo-Ann
V.SawatzkyPhD, RN
The main objective of this study is to explore the perspective of
nursing staffs regarding staff shortage and the association of it
with care standard and patient outcome.
Dependent variable: Patient outcome
Independent variable: Staff shortage
It is a qualitative study where invitation to participate in this
study were mailed to all ED nurses in the province of Manitoba,
Canada by the provincial nurses’ regulatory body.
The researchers of this study have mailed all ED nurses in the
province of Manitoba, Canada by the provincial nurses’
regulatory body. Where a total of 17 convince sample of
registered nurse was selected from an overwhelmingly positive
response.
Qualitative research methodology.
Tape recorder and data analysis tools
Staff-shortage has impact over care standard.
Griffiths, P., Recio-Saucedo, A., Dall'Ora, C., Briggs, J.,
Maruotti, A., Meredith, P., Smith, G. B., Ball, J., & Missed
Care Study Group (2018). The association between nurse
staffing and omissions in nursing care: A systematic review.
Journal of advanced nursing, 74(7), 1474–1487.
https://doi.org/10.1111/jan.13564
The purpose of the study is to assess the association between
nurse staffing and omissions in nursing care

5. Dependent variable: Missed care
Independent variable: Nurse staffing
Qualitative systematic review
A total of 11,269 references were obtained. Following
exclusion, 57 studies were kept for further review and from
them 40 papers were excluded due to not measuring associations
with nurse staffing, type of article, not adult medical/surgical
wards and reporting medication errors without discriminating
errors due to delayed or omitted administration
To develop this quantitative systematic review the researchrs
searched CINAHL, Cochrane Library, and Embase and Medline.
Research appraisal and data analysis tools
A total of 14 studies found a significant association between
low nurse staffing levels and higher reports of missed care.
Smith, G. B., Redfern, O., Maruotti, A., Recio-Saucedo, A.,
Griffiths, P., & The Missed Care Study Group. (2020). The
association between nurse staffing levels and a failure to
respond to patients with deranged physiology: a retrospective
observational study in the UK. Resuscitation, 149, 202-208.
https://doi.org/10.1016/j.resuscitation.2020.01.001
The main purpose of this study is to explore the association
between nurse staffing levels and a failure to respond to
patients with deranged physiology
Routinely collected patients’ vital signs and administrative data
were been used in order to find the association with nurse
staffing.
Dependent variable: Failure to respond to patients with
deranged physiology
Independent variable: Nurse staffing levels
Random sampling
Retrospective, observational study
NEWS analysis, patients’ vital sign assessment tools and data
analysis tools.
Staffing levels directly influence the rates of failure to respond
for patients with the most abnormal vital signs

6. Alamri 1
“Hazel Tells Laverne”
Everyone should have the right and ability to direct his/her life
in the way they desire. People should never fall for any kind of
stereotypes. The leading representations might negatively affect
what a person believes. in the past, the society represented
women to be illiterate. Contrary, woman fell for the stereotype
that says that men are always taking advantage of them. In our
story, the main character, Hazel meets a talking frog. The frog
promises her that if she kisses him, she would become a
princess. The maid blows away the chance of turning around her
whole life. With no dreams and things to believe in, life is
nothing but following what people expect us to be and do.
This poem first struck me as slightly comical and lighthearted,
but when I analyzed the deeper meaning of the poem, I found
there was a somber meaning behind it. Hazel, who is a cleaning
woman, recounts a story to her friend LaVerne. The story is
similar to the old fairy tale The Princess and the Frog, only this
time, our princess is slightly hesitant to kiss the frog. Al though
Hazel had her chance to kiss the frog and become a princess,
she was halted due to her self-perception and consciousness.
Hazel thought the idea of being a princess as utterly ludicrous
and unbelievable. A woman of her situation and way of life
would never be able to rise above what she already was and
become something superb and attractive. It is evident that Hazel
believes she is forever trapped in her present life. No means of
magic could even transform her real life. Hence, this poem
interprets missed prospect, and the opportunities people miss
out on because of their self-constructed restrictions. This poem
comprises a theme with the expression, "me a princess."
(Machan,641). She utters this as if the notion itself is entirely
unbearable and out of the question. The colloquialism used in
the poem gives it a lot of character. The word usage and
spelling used by the writer adds on to the funny surface portion

7. of the poem and provides readers with a hint at Hazel's
character.
I believe that Katharyn Machan is trying to show how women
were expected by society to be uneducated. The writer creates
this by slurring some words together and not adding any
punctuation. The author uses diction and syntax. The vocabulary
used, and lack of any punctuation gives the readers the sense
that they are hearing the narration of a story of an uneducated
woman. Words like “cleanin,” “musta” (Machan,641), and “ta
flushm” (Machan,641) are informal, but they add flavor to the
poem. I got the impression of an uneducated, blue-collar,
countrywoman seeing this frog. This woman did not know any
fairy tales or princess stories, so she got rid of that talking frog.
This poem is where there is a little room for interpretation and
guesswork; it is straightforward. The diction is carefully crafted
to be informal to give it the feeling of a simple, funny story.
Contrary to the usual fairytale pattern, Hazel does not wish to
kiss the frog and become a princess. Contrasting with the
stereotypical image of a girl, Hazel has a sense of independence
in her character. Additionally, the lack of punctuation resembles
the speaking pattern of what Hazel said, which characterizes her
as a loudmouthed fast-thinker who most likely tends to ramble.
This particular poem mocks affection with its hilarious tone.
It’s spoken through the eyes of a caretaker in a community
lavatory, and it depicts the traditional “Princess and the Frog”
tale as ludicrous and uncultured. She calls the frog a “green
pervert” although, in the fairy tale, the princess was astonished
by the speaking frog, she decided to follow its instructions. The
janitor discloses the sentiments a number of individuals have
concerning this fairy tale that the story is silly since frogs don’t
speak, and anybody eager to listen to a frog would be foolish.
The janitor responds in the manner one would assume, by
striking the frog with her mop and flushing it down the
lavatory, “an i hitsm with my mop an has ta flush the toilet
down three times me” (Machan,641).The subject of this poem is
that one should not constantly be keen to trust whatsoever

8. people tell you; the lady cleaning the toilet had no intent in
considering that she was a princess, mostly because she is an
associate of the lower class and would never contemplate
herself to be the Royals. Additionally, one should never take the
easy way out. The lady is a low-class employee that is perhaps
in debt and have fiscal concerns. So, it would be easy for her to
get lost in the word that this speaking frog is telling her.
Becoming a princess would mean that all of her glitches would
be resolved. She would have the money of the country she ruled
behind her, and people would look at her a look of respect and
honor. The latter would also be important because, at the level
of work that she is accustomed, people would rarely see her as a
person. As a princess, she would have fame a fortune. So, she
had every reason to dream, but it is important that she did not
merely consent to this "prince" but stood for what she believed
in.
There is also an aspect of irony in the fact that the woman finds
a talking frog. You don’t expect the frog to talk since frogs
can’t speak but in this poem it does. Also, the frog tells the
woman that if she kisses him, she will turn into a princess, “an
he says kiss me just kiss me once on the nose” (Machan,641). It
is ironic how the woman does not kiss the frog to better her life.
Instead, she thinks the frog is a pervert and throws him in the
toilet and flushes it three times until it is completely gone.
Symbolism is another aspect of the poem. On the apparent of
the poem, the reader identifies a rather amusing tone. The event
in which the frog is talking and promising prosperity to the
woman and how she hits it and flushes down the toilet is
hilarious to consider. Nevertheless, the actual symbolism in the
poem is that of the frog as the woman’s ambitions. It appears as
absurd to her that she could be anything more than a maid as it
is to contemplate the fact that kissing the frog that sprang out of
the lavatory might transform one into a princess. She has no
assurance in becoming anything more than a maid. She has no
sureness in herself at all. Actually, she contemplates it
completely absurd to even consider that she could ever be a

9. princess. She has become so contented in this hardworking and
self-justifying way of life that she doesn’t even taunt to
visualize anything else. She is virtually terrified of change.
Nevertheless, the terminating line of the poem that says, “me a
princess” (Machan,641) nearly gives the sensation that she
envisages it for an instant after her communication is finished.
She allows herself to daydream for a while. Nonetheless, she
does not sense that she is good enough to be a princess or
anything of the kind that is improved than the way of life she
now leads. Hazel's response after the frog requests for a kiss is
figurative of how women perceive men in the society. Hazel
echoes her doubt three times signifying uncertainties among
women.
Personification is also evident in this poem. The author
attributes human characteristics to an animal. The frog is
portrayed to have human aspects such as talking, “so helpmegod
he starts talking bout a golden ball” (Machan,641) and the fact
that the woman refers to the frog as he, “an he says.”
(Machan,641)
The writer uses rhythm in the poem. She uses consonance to
bring about rhythm in the poem. “swimmin aroun an tryin” (
Machan,641) and “once on the nose” (Machan,641) bring about
the rhythm of the poem by use of consonance. Alliteration is
also evident when the persona says, “the toilet down three
times” (Machan,641), which bring about an occurrence of the
same letter at the beginning of words within the statement. The
persona also uses inversion as an element of poetry. She uses
hysteron-proteron when she says, “up pops this frog.”
(Machan,641). The goal is to call attention to the more
important idea by placing it first. The person also uses
repetition in the poem when she says “an how i can be a
princess me a princess” (Machan,641)and “kiss me just kiss
me.” (Machan,641) Repetition is used to highlight a sensation
or impression, create rhythm, and improve a sense of insistence.
Poetry is a method of understanding how language and
representation structures function. It is an earnest manifestation

10. of deep feelings, or emotion, and aesthetics, or a sense of what
is attractive about the world. The use of elements of poetry so
that it is more natural for one to analyze and understand the
theme of the poem.
Work cited
Katharyn Howd Machan. “Hazel Tells LaVerne”- poem
The Bedford Introduction to Literature Eleventh Edition-
Meyer, Michael. New York: Bedford, 2016. Print
Poetry
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