1 Assignment 4: Cultural Information Paper Due in Week 10 and worth 300 points Your new employee is going to be moving overseas! Develop a cultural information paper that will help them understand how to make the transition. (NOTE: You are able to choose any country–please make sure the county of choice is logical for the position.) Include in this paper:  a short introduction to the country,  the local customs,  what to expect, and  a list of what is needed to work in the country. o For example: Certain countries require a work visa. Include the requirements for the work visa. Include country-specific information needed to live and work in that country such as:  transportation availability,  housing costs,  union influence,  work week,  typical vacation time, and  anything specific to the country we would not experience in the US. o For example: Some countries the children wear uniforms and go to school all year This paper should be 6-8 pages. NOTE: The position moving overseas is the job in your description from Week 3. Find creative ways to incorporate your work from that assignment into this one. Your assignment must follow these formatting requirements:  Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.  Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length. Points: 300 Assignment 4: Cultural Information Paper Criteria Unacceptable Below 70% F Fair 70-79% C Proficient 80-89% B Exemplary 90-100% A 1. Provides an introduction to the country and customs, and what to expect there Weight: 20% Did not submit or incompletely discussed an introduction to the country and customs, and what to expect there. Partially discussed an introduction to the country and customs, and what to expect there. Satisfactorily discussed an introduction to the country and customs, and what to expect there. Thoroughly discussed an introduction to the country and customs, and what to expect there. 2 2. Gives details on what is needed to work in the country Weight: 30% Did not submit or incompletely discussed the details on what is needed to work in the country. Partially discussed the details on what is needed to work in the country. Satisfactorily discussed the details on what is needed to work in the country. Thoroughly discussed the details on what is needed to work in the country. 3. Provides information about life in the foreign country: transportation, housing, schooling for children, and anything unexpected Weight: 20% Did not submi ...

1. 1
Assignment 4: Cultural Information Paper
Due in Week 10 and worth 300 points
Your new employee is going to be moving overseas! Develop a
cultural information paper that will help
them understand how to make the transition. (NOTE: You are
able to choose any country–please
make sure the county of choice is logical for the position.)
Include in this paper:
expect, and
o For example: Certain countries require a work visa. Include
the requirements for the
work visa.
Include country-specific information needed to live and work in
that country such as:

2. the US.
o For example: Some countries the children wear uniforms and
go to school all year
This paper should be 6-8 pages.
NOTE: The position moving overseas is the job in your
description from Week 3. Find creative
ways to incorporate your work from that assignment into this
one.
Your assignment must follow these formatting requirements:
12), with one-inch margins on all
sides; citations and references must follow APA or school-
specific format. Check with your
professor for any additional instructions.
the student’s name, the professor’s
name, the course title, and the date. The cover page and the
reference page are not included in
the required assignment page length.
Points: 300 Assignment 4: Cultural Information Paper
Criteria
Unacceptable
Below 70% F
Fair
70-79% C

3. Proficient
80-89% B
Exemplary
90-100% A
1. Provides an
introduction to the
country and customs,
and what to expect there
Weight: 20%
Did not submit or
incompletely
discussed an
introduction to the
country and
customs, and what
to expect there.
Partially discussed
an introduction to
the country and
customs, and what
to expect there.
Satisfactorily
discussed an
introduction to the
country and
customs, and what
to expect there.
Thoroughly

4. discussed an
introduction to the
country and
customs, and what
to expect there.
2
2. Gives details on what
is needed to work in the
country
Weight: 30%
Did not submit or
incompletely
discussed the
details on what is
needed to work in
the country.
Partially discussed
the details on what
is needed to work in
the country.
Satisfactorily
discussed the
details on what is
needed to work in
the country.

5. Thoroughly
discussed the
details on what is
needed to work in
the country.
3. Provides information
about life in the foreign
country: transportation,
housing, schooling for
children, and anything
unexpected
Weight: 20%
Did not submit or
incompletely
discussed life in the
foreign country:
transportation,
housing, schooling
for children, and
anything
unexpected.
Partially discussed
life in the foreign
country:
transportation,
housing, schooling
for children, and
anything
unexpected.
Satisfactorily
discussed life in the

6. foreign country:
transportation,
housing, schooling
for children, and
anything
unexpected.
Thoroughly
discussed life in the
foreign country:
transportation,
housing, schooling
for children, and
anything
unexpected.
4. Provides information
about the work culture in
foreign country: union
influence, work week,
and typical vacation time
Weight: 20%
Did not submit or
incompletely
discussed the work
culture in a foreign
country: union
influence, work
week, and typical
vacation time.
Partially discussed
the work culture in a

7. foreign country:
union influence,
work week, and
typical vacation
time.
Satisfactorily
discussed the work
culture in a foreign
country: union
influence, work
week, and typical
vacation time.
Thoroughly
discussed the work
culture in a foreign
country: union
influence, work
week, and typical
vacation time.
.
5. Clarity, writing
mechanics, and
formatting requirements
Weight: 10%
More than 6 errors
present
5-6 errors present 3-4 errors present 0-2 errors present

8. The Affordable Care Act and its Impact on Nursing and
Healthcare Organizations
The passage of the Affordable Care Act (ACA) created
health reforms in the United States and affected nursing practice
in many ways. The ACA, also known as Obamacare, is a law
that was approved in 2010 and it aimed to ensure that more
people in the United States had health insurance coverage,
improve the quality of health care, regulate health insurance,
and diminish health care spending in the country (Galan, 2018).
Nine years after the passing of the law, it remains at the
forefront of healthcare issues. With more people having health
insurance, this health reform created a significant impact on the
nursing workforce. Currently, the rate of uninsured in the
country is steady at its historic low of 8.8 percent (Coombs,
2018). The ACA placed a high demand for nurses and nurse
practitioners with more people having the means to seek for
healthcare needs.
The Effect of the Affordable Care Act in the Organization
In the past five years, Baptist Health System, the organization
where I am currently employed has felt the impact of the ACA.
The volume of the patients in the emergency department
decreased, and acuity increased. The ambulatory services in the
organization have greatly increased, so there is a shift of patient
visits from the emergency rooms to urgent care facilities and
primary care services. The expansion of health insurance led to
improved access to health care services reducing the need to use
the emergency rooms as a primary source of health care,
especially for patients that received public insurance programs.
The Organization’s Response to the Effect of the Affordable
Care Act
Now that more people have increased access to health care,

9. many organizations are making modifications in their healthcare
system’s delivery of care. Pittman and Scully-Russ (2016)
stated that in response to the ACA, healthcare organizations are
adopting concepts of moving staff to ambulatory and home care
settings, generating new jobs that involve care coordination,
and developing new modes of healthcare delivery to address
consumerism. Some of the said changes are evident in the
organization where I currently work.
Baptist Health System, in response to the increasing
demand for nurses, created a nursing residency program. As a
charge nurse of the A&R department of my facility, one of my
roles is to facilitate the training of the resident nurses. The
residency program sponsors the training of new graduates with
their choice of nursing specialty where they are given didactic
and clinical training within 3 weeks and providing them basic
salary during the program. The program helped encourage new
nurses to work within the organization, allowing them to work
in specialty areas even without prior experience, and promoted
retention due to the contract of three years that they have to
fulfill after graduating from the program. Many of the new
nurses were employed in psychiatry department.
With regards to adopting of new healthcare settings,
TMH, within the last five years, opened ten urgent care
facilities, six primary care centers and recently opened a free-
standing emergency department to help cater to the increasing
needs of patients to access health care. Current staff nurses of
the organization were prioritized to transfer to the new
ambulatory care settings.
ACA also resulted to generating new jobs that involved
care coordination (Pittman & Scully-Russ, 2016). In my facility,
new nursing positions like case management and transfer center
nursing coordinators were opened to serve as care coordinators
to the new healthcare settings.
Moreover, to support the new ambulatory settings, the
organization granted scholarships and tuition reimbursement
programs for current employees interested in furthering their

10. education with masters and doctorates in nursing for family or
acute care nurse practitioner track. Graduates of the program
are then hired in any facility within the organization to work as
nurse practitioners, also encouraging retention of nurses within
the organization.
In addition, with staffing shortages resulting from the
ACA, it is difficult for single primary care professional to
effectively and efficiently manage patient care needs (Norful,
de Jacq, Carlino, & Poghosyan, 2018). A new care delivery of
two primary care professionals such as a physician and a nurse
practitioner co-managing a patient helps to meet the increased
demands for health care. To date, 15 nurse practitioners are
working in the organization who availed of the scholarship and
tuition reimbursement programs.
With all the change initiatives within the organization
due to the ACA, the importance of the leaders effectively
communicating to the staff the major changes in the delivery of
care of the organization play a significant role. Communication
and knowledge are crucial for the team to embrace the major
innovations. Many employees were initially resistant to change.
The directors, managers, and supervisors in my facility went to
leadership and sensitivity training to help the staff cope with
the rapid changes. According to Marshall and Boone (2017), for
innovations to happen, leaders should empower their employees
to be involved and contribute to the change. By keeping the
staff informed and making them a part of the change, leaders
can obtain their support to welcome the changes.
Conclusion
The ACA has affected healthcare in many ways. Healthcare
organizations were affected and are continuously changing to
adapt to the effects of the ACA. Leaders have a crucial role to
help with the changes be made acceptable to the staff.
References
Coombs, B. (2018). Rates of uninsured in US hold steady at
historic low 8.8 percent. Retrieved from
https://www.cnbc.com/2018/09/12/rates-of-uninsured-in-us-

11. hold-steady-at-historic-low-8point8-percent.html
Galan, N. (2018). The affordable care act: An update. Medical
News Today. Retrieved from
https://www.medicalnewstoday.com/articles/247287.php
Marshall, E., & Broome, M. (2017). Understanding contexts for
transformational leadership: Complexity, change, and strategic
planning. In Transformational leadership in nursing: From
expert clinician to influential leader (2nd ed., pp. 37-62). New
York, NY: Springer.
Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018).
Nurse practitioner-physician co-management: A theoretical
model to alleviate primary care strain. Annals of Family
Medicine, 16(3), 250-256. doi:10.1370/afm.2230
Pittman, P., & Scully-Russ, E. (2016). Workforce planning and
development in times of delivery system transformation. Human
Resources for Health, 14(56), 1-15. doi: 10.1186/s12960-016-
0154-3
Response 1
The Patient Protection and Affordable Care Act, which is also
known as the Affordable Care Act (ACA), and popularly
referred to as Obamacare is a comprehensive health care reform
law that was passed by Congress in 2010 (HealthCare.gov, n.d.).
The law reform of the Affordable Care Act (ACA) has three
primary goals. The three primary goals are to make affordable
health insurance available to more people, expand the Medicaid
program to cover all adults with income below 138% of the
federal poverty level and to lower healthcare cost by supporting
innovative medical care delivery system (HealthCare.gov, n.d.).
In early 2017, the Affordable Care Act repeal and replacement
budget reconciliation bills in the Ways and Means and Energy
and Commerce committee was introduced (Jost, 2017). The
budget reconciliation bills titled the American Health Care Act
was passed by both houses of Congress to prepare budget
reconciliation legislation to replace the Affordable Care Act
(Jost, 2017). What this means is that the legislation’s tax cuts
will give wealthy Americans, health insurers, and providers tax

12. breaks, dismay for Medicaid recipients and state Medicaid
programs, federal funding for Medicaid steadily reduce, and bad
news for the poorer and older individuals that live in areas
where health care is expensive (Jost, 2017).
The United States is known for having the best health care
system in the world; however, it leads the world in health care
spending with its residents sicker and more likely to die of
preventable conditions that are in other wealthy countries
(Schneider & Squires, 2017). Some of the most advanced
specialty health services in the world are offered in the United
States, yet most Americans cannot afford the high-quality health
care, making the health care outcomes worse than other high-
income countries (Schneider & Squires, 2017). Healthcare
professionals such as nurses are always being faced with not
only assessing the community to address health issues but are
also in an environment of scarcity, competing for funds with
limited resources.
It is, therefore, crucial for nurses to know their importance in
health care and the integral role they play in patient-centered
care, better outcomes, and the impact on the cost of health care.
Nurses play an essential role in the health care policy by
advocating for patients and individuals. From the bedside to the
Congress, nurses can help shape the health care system. Nurses
play a crucial role in delivering care and leading changes,
especially in the Affordable Care Act (American Nurse Today,
2010). Knowing part of how to be engaged and be part of the
solution for a better patient outcome at reasonable health cost is
crucial for nurses (American Nurse Today, 2010). Nurses need
to be prepared for the future to provide care across all settings.
According to the American Nurse Today (2010), for nurses to
be prepared to help lead the country to a healthcare system that
is more equitable and provides a higher quality care nurses must
address challenges such as using nurse-led innovation, generate
evidence and engage in research. Nurses must also redesign
nursing education, expand the scope of practice, diversify the
workforce, embrace technology, foster interprofessional

13. collaboration, develop leadership at every level, and be part of
the discussion. Nurses today are at the historical juncture in the
health care delivery where they can play a pivotal leadership
role to support the health of families and communities
(Wakefield, 2013).
References
American Nurse Today. (2010). Nursing’s role in healthcare
reform. Retrieved from
https://www.americannursetoday.com/nursings-role-in-
healthcare-reform/
HealthCare.gov. (n.d.). Affordable Care Act (ACA). Retrieved
from
https://www.healthcare.gov/glossary
Jost, A. (2017). Examining The House Republican ACA Repeal
And Replace Legislation. HealthAffiars.
Retrieved from
https://www.healthaffairs.org/do/10.1377/hblog20170307.05906
4/full/
Schneider, E. C., & Squires, D. (2017). From Last to First-
Could the U.S. Health Care System Become
the Best in the World? The Commonwealth Fund. Retrieved
from https://www.commonwealthfund.org/publications/journal-
article/2017/jul/last-first-could-us-health-care-system-become-
best-world?redirect_source=/publications/in-brief/2017/jul/last-
to-first-could-
Wakefield, M. (2013). Nurses and the Affordable Care Act: A
call to lead. Retrieved from

14. https://www.reflectionsonnursingleadership.org/features/more-
features/Vol39_3_nurses-and-the-affordable-care-act-a-call-to-
lead
Response 2
significant part of having quality healthcare and excellent
patient outcomes is having the right type and number of
clinicians (Squires, Uyei & Jones, 2016). Another aspect of this
shortage is the economic situation of the country. Economists
indicate that the nursing job market runs counter to the overall
economy (Alameddine, Baumann, Laporte & Deber, 2014). In
short, when there is an economic downturn, there is a surge in
healthcare demand (Spetz, 2015). Nurses who exited the field
during economic booms can return back when there are
financial hardships as part-time or full-time workers (Spetz,
2015). Presently, 2.7 million RNs are working in the country.
However, close to half a million hold licenses but are not
working in the field. Various factors such as job satisfaction,
the impact of their job on their health, demanding work
environments are all reasons why nearly 34% of nurses leave
within two years of graduating (Spetz, 2015).
Geography is a critical factor to consider. Some regions are
more affected by the nursing and overall healthcare professional
shortage. Rural areas especially struggle to attract healthcare
professionals (National Conference of State Legislators
[NCSL], 2017). APRNs are believed to be able to cover the gap
of a lack of primary care physicians in some of these areas that
have limited access to primary care. These areas are unable to
bring in and retain these APRNs causing greater disparities in
rural areas and other underserved populations (Hain & Fleck,
2014).
Adding to this issue is the aging of the US population.
According to the United States Census Bureau (2018), by 2030,
all of the baby boomers will be 65 years and older. Thus, the
older population will expand significantly such that older
people are projected to outnumber children. Rowe, Fulmer, and

15. Fried (2016) write that with the increasing aging population, the
health needs of this population, and the existing infrastructure
to support their health has to be revisited. Older adults
compared to the younger cohort are more likely to have chronic
health conditions like arthritis, diabetes, hypertension, heart
disease and much more (Rowe et al., 2016).
Furthermore, one of the main ethical concerns with this issue is
that in an attempt to provide more care to more Americans, the
healthcare system has become overwhelmed. The ACA may
have underestimated the number of Americans who would
leverage the changes in the law (Gleid & Jackson, 2017). These
changes mean that the current workforce and the future
workforce may struggle to provide quality care to the patients
that now have access to care (Gleid & Jackson, 2017). Thus,
healthcare executives and lawmakers have a responsibility to
consider the impact the increased coverage is having on the
healthcare workforce.
Experts indicate that APRNS can cover this gap in
physician shortage. Yet, in many states APRNs are not allowed
to practice to the full extent of their training which limits these
professionals and ties doctors in physician agreements that take
up time that they could be using in direct patient care and ties it
up in supervisory roles over APRNs (Hain & Fleck, 2014).
Bodenheimer and Smith (2013) report that there is sufficient
evidence to show that interfering with full practice and
prescribing authority is harmful to patients and creates more
gaps in care that can otherwise be covered by APRNs.
References
Alameddine, M., Baumann, A., Laporte, A. & Deber, R. (2013).
A narrative review on the effect of economic downturns on the
nursing labor market: implications for policy and planning.
Human Resources for Health,10(23). doi:10.1186/1478-4491-
10-23
Glied, S., & Jackson, A. (2017). The future of the Affordable
Care Act and insurance coverage. American Journal of Public

16. Health, 107(4), 538-540. doi:10.2105/AJPH.2017.303665
Hain, D. & Fleck, L. M. (2014). Barriers to nurse practitioner
practice that impact healthcare redesign. The Online Journal of
Nursing, 19(2). doi:10.3912/OJIN.
National Conference of State Legislators. (2017). Healthcare
workforce shortages and maldistribution. Retrieved from
http://www.ncsl.org/portals/1/documents/health/LToblerKBHL1
115.pdf
Rowe, J. W., Fulner, T. & Fried, L. (2016). Preparing for better
health and health care for an aging population. Journal of the
American Medical Association, 316(16), 1643-1646.
doi:10.1001/jama.2016.12335
Spetz, J. (2015). Too many, too few, or just right? Making sense
of the RN supply and demand forecasts. Nursing Economics,
33(3), 176-179
Squires, A., Uyei, J. S. & Jones, S. A. (2016). Examining the
influence of country-level and health system factors on nursing
and physician personnel production. Human Resources for
Health, 14(48). doi:10.1186/s12960-016-0145-4
Response 3
Hi Semiloore,
I currently work in a mental health outpatient program,
but prior to a year ago I was an emergency room (ER) nurse and
I absolutely felt the impact of the Affordable Care Act (ACA)
over the 4 years I took care of patients at the hospital facility
where I worked. But not in the same way that you have
described the impact that your healthcare facilities ER felt
during the shift when more patients began to receive healthcare
insurance coverage. The ER’s would fill with patients daily and
wait times increased steadily; with more patients insured, it
appeared that more patients would come to the ER versus going
to an urgent care or primary doctor for non-critical medical
attention. Of course, this impacts workflow, patient care, and
staffing needs.
I have also recently taken on a per diem position for a home

17. health care agency, and as you have mentioned and according to
Pittman & Scully-Russ (2016), healthcare systems are beginning
to change the method of care delivery to the community, based
on the individual need for its citizens by providing home care
and ambulatory services.
In my own healthcare facility, regarding the inpatient units and
departments in the hospital, nursing leaders and administration
have been working for several years now on how to support
their current staff with severe nursing shortages while also
preparing for the continued scarcity of registered nurses for the
future. It is imperative that our nursing leaders prepare and plan
for the future changes of our healthcare delivery to the public
while managing our staffing ratios and employee retainment,
with the ability to continue to provide consistent, safe, quality
care to our patients. According to Marshall and Broome (2017),
change agents are the leaders and supporters of a new
environments that can enact the change that is in a healthcare
organization. There are many steps to the process which include
understanding the urgency for change, forming a coalition,
creating and communicating the vision for that change,
empowering and planning the change, and solidify and promote
the new idea or approach (Marshall & Broome, 2017). I
completely agree with you that our nurse leaders are the key
factor to help facilitate this transformation across healthcare
systems nation- wide and can help preserve the quality of
patient care while continuously considering the impacts these
changes may have on nursing staff. Great post!
References:
Marshall, E., & Broome, M. (2017). Understanding contexts for
transformational leadership: Complexity, change, and strategic
planning. In Transformational leadership in nursing: From
expert clinician to influential leader (2nd ed., pp. 37-62). New
York, NY: Springer.
Pittman, P., & Scully-Russ, E. (2016). Workforce planning and
development in times of delivery system transformation. Human

18. Resources for Health, 14(56), 1-15. doi: 10.1186/s12960-016-
0154-3
Running head: Job DESCRIPTION
1
Job DESCRIPTION 4
Job Description
Larry Ratliff
HRM 500
Strayer University
July 19, 2019
Dr. Thomas
Job overview
Training and Development Specialists Administer, deliver and
create teaching program for organization and businesses. To
achieve their responsibilities, they need to develop training
program and determined what is needed in the training facility.
The role of Training Specialist is to help, organize and manage
program which train workers and advance their knowledge and
skills. The training specialists will offer training using group

19. discussions and Open learning classes. The training will be
done in form of web-based program, video, and self-guided
instructional manual.
Responsibilities and duties
1. Design and generate teaching manuals, course materials, and
online learning modules.
2. Evaluate training program required through consultations
with workers, through surveys, or discussions with managers
3. Monitor, evaluate, and update modules training program to
ensure they are successful.
4. Give training to students using various instructional
techniques
5. Carry out administrative tasks like planning classes,
coordinating registration, and monitoring costs.
6. Review training materials and curriculum and choose the
appropriate materials.
7. Testing courses and activities in the open learning program to
ensure they run correctly.
Qualifications
Education
Training and Development Specialists should have bachelor’s
degree in education, social science, education and
organizational psychology or human resource. In addition, the
applicant must have strong background in computer science or
information technology.
Work experience
Applicant must have 10 years’ experience in teaching, training
and development, or instructional design. Increasingly, one
must have experience in information technology.
Licenses, Certifications, and Registrations
Suitable candidate must be a registered member of American
Society for Training and Development or International Society
for Performance Improvement.
Personality and Interests
Applicant must show interest in assisting and encouragement
students according to the company code framework. Helping

20. interest indicate motivation on counselling, assisting, teaching
and serving learners.
Skills
1. Analytical skills to evaluate training programs, training
material, methods and select the best in each situation
2. Instructional and teaching techniques and skills to address
concerns of particular group of students
3. Interpersonal skills to help in work together with trainees,
mentors and subject-matter experts
4. Speaking skills, ability to communicate info clearly and
facilitate couching.
Laws considered when creating the job description
The design and formulation of the job description depends
on many factors such as company culture, existing federal and
state labor laws, and employment laws. Job descriptions are
established guideline for workers performance and they are used
for appraisal time. They are important communication tools
because they help employees perform ethical tasks. First, job
description is a company formal or informal documents based
on organizational culture and what works for the workforce
(Diana, 2017). Regardless of formality, the document should
give accurate information about job description, expected skills
and responsibilities. Job description involves of important job
functions, explanation of duties or responsibilities physical
demands, critical skills, conservational factors, and roles of
ADA among other federal laws which govern occupation such as
Occupation Safety Health Act (OSHA Act). The salary paid to
workers is governed by the “Fair Labor Standard Act (FLSA)”
(JAN, 2019). Federal laws groups workers into exempted
overtime employees and non-exempted employees. The
exempted workers are excluded from overtime regulations,
minimum wage, and other rights provided by the FLSA (JAN,
2019). Workers who fall with the non-exempted positions are
paid federal minimum wage for period worked and paid
overtime of “not less than one and a half times their hourly rate
for hours worked past 40 each week” (Diana, 2017).

21. References
Diana, M. (2017, March 1). Preparing Useful and Legally
Compliant Job Descriptions. Retrieved July 18, 2019, from
https://www.njbia.org/wp-content/uploads/2017/03/Preparing-
Job-Descriptions.pdf
JAN. (2019). Accommodation and Compliance: Job
Descriptions. Retrieved July 18, 2019, from
https://askjan.org/topics/jobdesc.cfm
Running head:
JOB DESCRIPTION
1
Job
D
escription
Larry Ratliff

22. HRM 500
Strayer University
July 19, 2019
Dr. Thomas
Running head: JOB DESCRIPTION 1
Job Description
Larry Ratliff
HRM 500
Strayer University
July 19, 2019
Dr. Thomas