Times Magazine

Times Magazine
The High Cost of Care–Bitter Pill
By Steven Brill
Summary
Steven Brill feels that American health care is eating away at our economy and our treasury and
discusses the costs associated with the provision of health care services in the U.S.. The article
explores the medical world through the medical expenses incurred by a 64–year–old Janice S., Sean
Recchi, A 42–year–old from Lancaster, Ohio and several other egregiously billed patients. The
article poses the question: why exactly are the medical bills so high; in particular hospital bills?
The U.S. spends more on health care than the next 10 biggest spenders combined: Japan, Germany,
France, China, the U.K., Italy, Canada, Brazil, Spain and Australia. 10 of the 20 occupations ...
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As it relates to the textbook, this describes some of the scope of the hospitals; which refers to the
range of activities which the firm performs internally, the breadth of its product and service
offerings, the extent of its geographic market and its mix of businesses. But unlike with the electric
company, no regulator caps hospital profits. To the extent that author Steven Brill found any
consistency among hospital charge–master practices, this is one of them: hospitals routinely seem to
charge 2V2 times what expensive implantable devices cost them, which produces that 150% profit
margin.
Besides, studies delving into the economics of the medical marketplace consistently find that a
moderately higher or lower price doesn't change consumer purchasing decisions much, if at all,
because in health care there is little of the price sensitivity found in conventional marketplaces, even
on the rare occasion that patients know the cost in advance. Most hospital administrators defend
such chargemaster rates at all, they maintain that they are just starting points for a negotiation. But
patients don't typically know they are in a negotiation when they enter the hospital, nor do hospitals
let them know that.
Millions of insurance plans have annual payout limits, though the more typical plans purchased by
employers usually set those limits at $500,000 or $750,000 –– which can also quickly be consumed
by a catastrophic illness.
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Shouldice Hospital
Decision Case #13
Shouldice hospital offers an enriched and comfortable experience for patients accepted into the
program for hernia operations. As soon as they arrive at the hospital they are interacted with very
closely. Administrators and surgeons spend time with their patients prior to the operation to ensure
that their needs are met and that their stay at Shouldice is a comfortable and successful one. After a
normal hernia operation at a hospital or another institution, patients are encouraged to check out,
whereas Shouldice recommends a resting period for up to four days to recover fully, with the help of
on–site nurses. This four day period is also a small vacation for patients, which after any surgery is
important in the ... Show more content on Helpwriting.net ...
On the fourth morning, patients were ready for discharge. During the stay, patients were encouraged
to take advantage of exploring the premises and make new friends. Patient's attitudes were the most
important element of the Shouldice program. On many occasions, patients tend to request to stay an
extra day because it is so relaxing. The process in which the patient goes through, the end result
defiantly matches the value and benefits in why people choose Shouldice for this specific operation.
* Tangibles: The Shouldice Hospital contains two facilities in one building–the hospital and the
clinic. On the first level, the hospital contains the kitchen and dining rooms. The second level
contains a large, open lounge area, the admissions offices, patient rooms, and a spacious glass–
covered Florida room. The third level has additional patient rooms and recreational areas. The
recreational rooms range simply from pool tables to an exercise gym. All patients' rooms have no
telephone or television, which is to promote exercising. Patients will then be forced to walk in and
out of their rooms if they would like to use other facilities, with the added bonus of exercising to
help with a quick recovery. The whole hospital is also floored with carpet to offer a comfortable
environment, compared to a hospital where there is a disinfectant tile smell.
* Reliability: Shouldices' reliability has a very good track record from patients who

Resume
Health Care in the Early 1960s
Rosemary A. Stevens, Ph.D.
My topic, health care in the early 1960s, has a double set of meanings for me. I am a historian, and
the 1960s are now "history," ripe for new interpretations. Yet I was also an immigrant to the United
States in 1961, fresh from working as an administrator in the British National Health Service. The
period immediately before the Medicare legislation in 1965 shines in my memory with the vividness
of new impressions: those of a young health care student trying to make sense of the U. S. health
care system, and indeed, of the United States. The health care system and the United States as a
society stand, in many ways, as proxy for each other, now as then: The whole tells you much ...
And I worked so hard that I have pernicious anemia, $9.95 for a little bottle of liquid for shots,
wholesale, I couldn't pay for it (Subcommittee on Problems of the Aged and Aging of the
Committee of Labor and Public Welfare, 1959; Corning, 1969). Members of the initial Medicare
population, born in the late nineteenth century, had survived two world wars, a major economic
depression, and enormous changes in the organization of work, mass production, rapid urbanization,
and modern communications. As beneficiaries of the 1935 Social Security legislation, they were
members of a culture of entitlement. By 1964, 83 percent of the population 65 years of age or over
were eligible for Social Security benefits; and there were almost three times as many aged Social
Security beneficiaries as there were 10 years earlier.' Yet before Medicare there were no entitlements
' Not all those who were eligible for benefits received them; the comparable figures were 63 percent
in 1960 and 74 percent in 1964 (U.S. Department of Health, Education, and Welfare, 1965).
12
for the potentially catastrophic burdens of hospital and doctors' bills. Government programs were
segmented into programs designed for apparently "deserving" Americans, notably veterans and
Federal employees, and for different categories of the poor, State by State, who were by definition
"less deserving." Social class, like race, was a topic to which

Patient Confidentiality Essay
Patient Confidentiality
As healthcare providers, maintaining a patient's confidentiality, human dignity and privacy is
expected at all times. Nurses are faced with maintaining patient confidentiality on a daily basis. The
Coded of Ethics for Nurses is the framework of nonnegotiable ethical standards and obligations that
all nurses are to uphold. Nurses are to be accountable for their actions and are expected to advocate
and strive to protect the rights, health and safety of patients (American Nurses Association, 2011).
Constant patient turnovers, visitors and numerous workers in and out of the emergency area can
make it difficult for staff to maintain patient confidentiality. Due to lack of space and to give quick
group report, ... Show more content on Helpwriting.net ...
According to the ANA (American Nurses Association), it is the duty of nurse to protect the patient's
rights, safety, health and advocate for the patient. By treating the patient in an open area, invades
their privacy, can cause embarrassment and most of all jeopardize trust between the patient and care
giver. This negligent care could also lead to legal ramifications in the future against the hospital. By
breaking this trust, the patient may also omit valuable information that could affect their treatment
ultimately causing them harm. Some patients may become noncompliant with their prescribed
treatment. It is essential that effective communication between patient and care provider occurs at all
times. . Healthcare providers are obligated to give safe and effective care.
As an effective and ethical leader, it is of most importance that they create and foster an ethically
principled environment. In this scenario, the importance of patient confidentiality would be
identified and addressed with all staff members of the health team. Ethical behaviors would be
discussed with each team member in order to ensure that the healthcare needs of the patient are met
as well as their privacy protected. A new process would be implemented so that patients would be
identified by assigned numbers instead of identified by name. Also it would be enforced that no
patient be treated in an open area unless some

Ethics Paper
Administrative Ethics
Le'Chonnia Ware
HCS/335
November 5, 2011
Brenda Boyd
Administrative Ethics
There is an article that spoke about two women who both had heart attacks on the same day. Both of
the women went to the same hospital. The hospital was not equipped to handle two heart attacks that
happen that close. This article bothered me because of how this situation was handled. It should not
have happen the way it happened. Instead of trying to save both lives a doctors' made a decision that
only one of them needed the surgery. In health care ethics supposed to stay with you. Treat people
with respect and let them know that you would do your best to take care of them. There are enough
hospitals and technology to help assist with ... Show more content on Helpwriting.net ...
This hospital, the ambulance, the doctors, and other staff members knew they already had one
massive heart attack victim. Working in a hospital you should know what the hospital is capable of.
This was a lack of communication, management, experience, and respect for others.
The Outcome
With the decision being made that Sarah would have the surgery because she was younger was not a
good decision. Because they operated on Sarah, she could recover. She was able to continue living
her life with her loved ones. On the other hand Marguerite passes away the next day because she did
not receive the surgery. Now we can say it was her time to go, God wanted it to happen like. The
fact is no one has the right to play God. There were so many things that went wrong.
Conclusion
Ethics is the study of moral principles governing the appropriate conduct for a person or a group of
people. When you grow up you are taught about respect for yourself and others. The respect that you
are taught should stay with you for the rest of your life. When you decide to take a career in health
care you decide to put your ethics in to play. You are caring for other people who think that you have
their best interest. You are supposed to help make people feel better, and be honest. In the article that
did not take place. You do not say who lives because of their age. Dr. K, Marguerite friend should
have spoken up.

My Personal Philosophy of Nursing Essay
This paper is a first attempt at forming and articulating my own philosophy of nursing.
Our course, Transition to Professional Nursing, is barely two weeks old and already I am being
enlightened and challenged to expand my experience of nursing. I will attempt to explain my
personal journey and experience thus far including how and why I got here, my beliefs about
nursing and related values, and my visions for the future.
The Nursing Choice Nursing came in a round–about way for me. I had little direction when I
graduated high school and had already disregarded the nursing field due to an incident with a family
member (who was a nurse) that had left a negative impression about the nursing field on me. I
entered college planning on ... Show more content on Helpwriting.net ...
Care enough to listen, to do a thorough job at all you do whether it be assessing, documenting or
routine patient care. Care enough to see beyond the chief complaint and think about what may be the
root cause of the patients' symptoms. Care enough to be ethical at all times and to complete invasive
and potentially embarrassing procedures with as much empathy and compassion as possible. Care
enough to connect to and treat your patient and their families and visitors with respect and dignity.
Do everything in your power to provide the most suitable environment and emotional tone for the
patient, and care enough to strive for the best possible outcome for the patient, both in the hospital
and beyond, advocating for the patient when necessary. Even by definition the word "care" can be
applied to different aspects of nursing. According to The Oxford Pocket Dictionary of Current
English (2009), among the meanings of the word care are:
1. The provision of what is necessary for the health, welfare, maintenance, and protection of
someone or something.
2. Serious attention or consideration applied to doing something correctly or to avoid damage or
risk.
3. Feel concern or interest; attach importance to something. Upon reading about the different
nursing philosophies and the ANA Code of Ethics, I found that this core value, my perceived
essence of nursing, is supported by both historical and ethical factors. Jean Watson's entire

Essay about Health Care Transparency
Health Care Transparency
HCS 235
Health Care Transparency Healthcare transparency has been defined by the Institute of Medicine
(IOM) as making available to the public, in a reliable and understandable manner, information on
the health care system's quality, efficiency and consumer experience with care, which includes price
and quality data, so as to influence the behavior of patients, providers, payers and others to achieve
better outcomes (American College, 2010). Transparency allows consumers to make better informed
decisions. It also helps health facilities convey information to the public. With more information in
the open, there will be less overall confusion. People will be better equipped ... Show more content
on Helpwriting.net ...
Patient satisfaction surveys will also help potential patients understand the environment they are
about to enter. If a staff is rude and curt than the public will have access to this. Essentially, this will
encourage health care providers to give optimal quality of service to each and every patient. Of
course, it's important that a patients expectations are not too grand. Nothing in life is perfect and
people should understand this. Busy hours and numerous patients can cause fatigue. After all, health
care providers are still human. Perhaps if all physicians were machines then we could expect them
all to be perfect. Performance of medical procedures will enlighten a patient of how well a hospital
is able to provide a service. This in turn will allow consumers to make the best choice when
selecting a facility for providing care. Someone needing back surgery should be able to locate and
choose a facility right for them. If a facility performs poorly with back surgeries, the public has a
right to know so that they can avoid this. People have the right to make the most well informed
decision. Facility treatment of patients should definitely be transparent. If a facility is trying to hide
something it can't be good. People have the right to know how well a facility treats their patients.
This also encourages a facility to always do their best. Ultimately, everyone wants

Character Analysis: Nellie Bly Vs. Tlahuicole
Hunter G. D2B3 Who Wins? Nellie Bly Takes the Lead When we were kids, we would all find a
scavenger hunt easily enjoyable. But this time, it isn't children that are competing, it will be an
adventurous explorer versus a brave and daring fighter. Nellie Bly vs. Tlahuicole. You may be
familiar with these names and know exactly who these people are. But for those who don't,
Tlahuicole is said to be the greatest, and fiercest fighter ever to live. He would hit his enemy's over
the head with heavy stone clubs. Nellie Bly is a great adventurer, famous for traveling the whole
world, and writing the book "Around the World in 27 Days". If the two were to go head–to–head in
a global scavenger hunt, it is quite obvious that Nellie Bly would be the winner. "But why" you
might ask. Well, first of all, scavenger hunts are about finding things, and if it's global you will have
to travel the world. Nellie Bly has already done this, so she will know exactly where to go to find
the thing that she is looking for. Don't believe me, it's documented in her book "Around the World in
27 Days". Even if she forgets where to go, she can use her book to guide her. This gives her a very
large advantage over Tlahuicole. But this is not the only reason that she would win a global
scavenger hunt against him. ... Show more content on Helpwriting.net ...
Once you do so, getting to the location is the easy part. So this will give Tlahuicole a very large
disadvantage because of the fact that Nellie Bly is much smarter than he is. One reason that she can
be considered smarter, is because she played a big roll in the modern oil drum being invented, and
we all know that if you are going to invent something, or even help invent something, you have to
be quite intelligent. Unlike Nellie Bly, Tlahuicole doesn't have any record of an invention of any
sort. Therefore, it is obvious that Nellie Bly has the upper hand in

Vying for Patients, Hospitals Think Location, Location.
INTRODUCTION.
Hospitals are health care institutions that are normally located in areas that are densely populated.
There are over 17,000 hospitals in the whole world. In accord with the original meaning of the word,
hospitals were originally "places of hospitality", and this meaning is still preserved in the names of
some institutions such as the Royal Hospital Chelsea, established in 1681 as a retirement and
nursing home for veteran soldiers. (http://en.wikipedia.org/wiki/Hospital#General)
In general, hospitals are normally located in areas where they are other major hospitals as a way to
acquire materials at low transportation costs. Unlike other businesses like franchises like
McDonalds that would prefer to be in an area where ... Show more content on Helpwriting.net ...
b. Accessibility. Easy access of the hospital in terms of near main transportation routes and stations
improves on sales and profit optimization because patients are able to be delivered to the hospital
easily especially in times of an emergency.
c. Customer friendly. The friendliness of the doctors, nurses and staff to patients not only helps in
the sales market share and profit optimization but research shows that friendly doctors and nurses
helps in the faster recovery of patients.
d. Advertising. Research shows that the more advertising is done for a service or product provider
the more increase in sales there is. This in turn leads to the increase in the market share and
optimization of profits.
e. Avalabitility of parking is one of the most important facts for any company especially hospitals
because when there is an emergency ambulance cannot be bothered on finding parking and need
places with enough parking space.
f. Building and leasing costs. This is an important factor for most companies to minimize overall
cost to offer lower prices to customers and also optimize profits but for hospitals this is of little
relevance because good qualities building in good locations don't come cheap.
g. Upgrading facilities in hospitals can include acquiring of newer equipment like imaging
equipment, physical therapy equipment, and so on. Now updated medical equipment is most
important in the health care business because as patient needs keep changing so does the

Nursing
Personal Definition of Nursing
April Vialpando
Ms. Penne McPherson in partial fulfillment of
NR444 Professional Role Development
Regis University
January 22, 2013
Personal Definition of Nursing
The definition of nursing has many different meanings depending on whom you ask. To some a
nurse is simply the person who brings you your medication and takes your vital signs. To others,
including myself, it is someone who keeps you safe and watches over you while you are in a
healthcare setting. A nurse along side a physician with the patients best interest in mind to care for
them not only physically but emotionally and mentally. A nurse must have the knowledge of that
exact medication you are receiving. I must know the signs and ... Show more content on
Helpwriting.net ...
I've seen many families complain about this while working in the Emergency Department. I think
there is a time and place for this and it is not at the nurse's station, we have a lounge for catching up
and making plans. I think that dressing in a professional manner also shows our patients that we
believe that being a nurse is more than merely just a job. I worked full time at a job to pay my way
through nursing school so I could have a career. I want my patients to know that I take my license
seriously and provide them with the best care I possibly can.
Practice Examples that Support Nursing Values Over the last eight years of my nursing career I have
had the opportunity to care for patients of all ages, ethnicities, and degrees of illnesses. Compassion
is a very important nursing value. I cared for a young mother who at the age of 22 had to experience
delivering a baby that she would not be able to take home with her. I sat in her room and held her
hand while she cried, screamed and tried to make sense of the tragedy. Sometimes the best words
are the unspoken ones. On another occasion I had the opportunity to care for an elderly patient whos
family lived far from the hospital. She had reached the end of her life, and she was okay with that.
Her only request was not be alone when she took her last breath. She was very weak, but able to
thank me over and over for being with her. What an honor it was to share that experience. Life

Case Study: Edgewood Lake Hospital Essay
Case Study: Edgewood Lake Hospital – Leadership in a Rural Healthcare Facility During
Challenging Economic Times
[NAME]
[DATE]
Case Study: Edgewood Lake Hospital – Leadership in a Rural Healthcare Facility During
Challenging Economic Times
Edgewood Lake Hospital (ELH) which opened in 1945, is a 30–bed, independent, not–for–profit
hospital located in rural northern California. It provides inpatient and outpatient services to the
close–knit community that resides within the forested and lakeside town the facility is nestled in.
Although it is known for its great track record for quality and is held in high regard by the
surrounding community, it has steadily experienced financial losses from 2006 through 2009. These
losses can be ... Show more content on Helpwriting.net ...
Looking closely at the environment external to ELH will allow for possible threats to the hospital's
success to be revealed and curtailed if possible. Upon scanning the external environment,
opportunities for improvement should be identified and made an integral part of the final strategy to
restore and revitalize ELH to its former glory.
Threats
The most direct threat to ELH is the strong community competitor, Creekside Trails Hospital. It is a
45–bed, for–profit facility located 35 miles away on the other end of the lake and is 50 years newer
than ELH having been opened in 1995. It is a for–profit organization and offers more specialty
services, namely cardiology care. This threatens ELH's livelihood not only by creating a more
appealing alternative for citizen seeking medical attention but also by becoming a viable option for
current ELH staff looking for a more stable and promising place of employment.
Another threat is the current state of rural hospitals nationwide. According to the case study, about
25% of Americans live in rural areas and only about 10% of physicians actually practice in rural
areas. There is a 15% gap in the ratio of rural citizens to available practicing physicians. This is a
threat to ELH's need to attract and hire more physicians. In relation to rural hospitals, citizens have
longer drive times to their medical facilities. This causes them to delay routine visits which
subsequently exacerbates

Professionalism in the Workplace of Nursing Essay
In a highly respected profession such as nursing, professionalism is an important element to staying
employed and setting one's self apart from the rest of the applicants when competing for a potential
job. By definition professionalism are the qualities and traits that describe a professional. While
knowledge is crucial in any profession, according to an article published by the University of
Kansas (2012), "all medical professionals must strive to retain those humanistic qualities integrity,
respect, and compassion that constitute the essence of professionalism." Whether you work in a
hospital or administration these three qualities encompass the core of nursing and exemplify what it
means to be a professional.
Integrity is the ... Show more content on Helpwriting.net ...
Even if no one found out about this mistake, eventually it could happen again if you don't take the
necessary steps to correct your mistake, and this time it could be deadly for your patient.
Being respectful and considerate to your patient is necessary for providing excellent patient care. It
is also important to be respectful and considerate to your colleagues; arriving on time, being a team
player, doing above the minimum as often as you can are all excellent ways to show this. It is
essential to ensure that the workplace is an "environment in which all colleagues enjoy equal respect
and where they can advance to their full potential." (Professionalism initiative, 2012) If everyone
treated their colleagues with respect, it would make the workplace very hospitable and help provide
better patient care, which is the main purpose of nursing. An environment without respect can
become hostile and impair the growth of your colleagues and yourself which can lead to giving
substandard care to your patients and their families.
Compassion is a crucial aspect of nursing; it involves seeing the patients as more than just a medical
problem. Patients look to nurses as a source of comfort to help them deal with their emotions and
understand their medical problems. In Norway, a study was conducted to find the role of
compassion in nursing and

Proposal Plan Part 1
Proposal Plan, Part I
Vanessa Lecoin
University of Phoenix
HRM 595 Human resources capstone
As vice president of Human Resources for VS Lecoin 's Family Hospital I am responsible for 500
employees. I have a proposal that will address what type of staff VS Lecoin 's Family Hospital
requires, what type of organizational behaviors we should include in the facility toward our staff,
workforce diversity, implementing diversity, employee relations, and employee retention plans. I
also want to focus on why we should not use outsourcing for this facility.
Brief background on the VS Lecoin 's Family Clinic and objectives VS Lecoin's Family Hospital is
medical facility that has a collaborating team of pediatricians, family ... Show more content on
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By allowing these modifications into action, we will be able to keep our employees and recruit new
ones.
Outsourcing not an option for workforce planning
Outsourcing may not be a good option for organizational workforce planning because VS Lecoin 's
Family Hospital is a family and community run organization and outsourcing will not allow the
organization to maintain a warm community atmosphere. Outsourcing creates an atmosphere where
patients may interact with third party vendors during customer service calls or emergency calls with
employees more likely not from the same country, familiar or fluent with the English language, or
speak the language very clearly enough for the patients to understand (Cotriss, 2009). Socially
outsourcing creates a hardship for locals to access the position because the positions is would be
offered to vendors outside the country. Outsourcing is a conflict of interest if VS Lecoin 's Family
Hospital hires outside of the community instead of hiring within the community, this would not
create a community atmosphere that goes against VS Lecoin 's Family Hospital goal. Outsourcing
creates an environment which the outside sources only know scripted information regarding the
organization instead of acquiring firsthand personal knowledge regarding VS Lecoin

Philosophy of Nursing Practice Essay
Compassion and Caring: My Philosophy of Nursing Practice In nursing, it is important to have a
personal philosophy of the profession. It dictates how a person deals with the day–to–day tasks and
obstacles that nurses will face. Patient populations are ever–changing, with some much sicker than
others, and various lengths of stay expected. The nurse will encounter different cultures and beliefs
in their practice, some contrary to their own. Their philosophy of nursing will be evident with how
they handle the various aspects of the job. One thing that all patients have in common is that they
are in a vulnerable situation. They are in the hospital, many confined to their room or bed. Some
have family with them. Others must face their ... Show more content on Helpwriting.net ...
I knew that I did not want to be like that, but that I wanted to take care of sick people and be there
for them. I wanted to be the nurse that was able to have a conversation with her patients and still
manage to keep them healthy.
Essence of Nursing The core of nursing is and should be knowledgeable patient care. The nurse
should be well rounded and possess enough knowledge to know not only the technical aspect of
patient care, but also how to tend to the patients' emotional needs. Kagan, Smith, Cowling & Chinn
(2009) say "It can be argued that the overemphasized focus on technological and medical
interventions rather than on services underpinned by caring practices and humanist nursing values
puts the health of all humans at risk" (p. 75). While medical interventions are necessary, the nurse is
responsible for carrying out those interventions in a humane and caring way. If the focus is on the
technical side of nursing, the patient as a person is easily forgotten. I believe that to truly care for a
patient, the nurse must act as a patient advocate. In more recent times, the nurses' role as a patient
advocate is expanding and becoming more widely recognized. Influential authors have shown that
nurse's role is to speak up for a patient when they are not able to speak up for themselves. Ann
Hamric (as cited in Mahlin 2010, p. 248) says that a nurse's

Pat Family Centered Care
Patient and Family Centered Care Kimberley Masterson WGU0713 Stacy Stratton–Mentor Practice
Setting Wellington Regional Medical Center is located in Wellington, Florida. It is a 233–bed,
acute–care hospital, owned by a subsidiary of Universal Health Services, Inc., a highly respected,
healthcare management organization. Wellington Regional Medical Center is owned and operated
by a subsidiary of Universal Health Services, Inc.(UHS), a King of Prussia, PA–based company, that
is one of the largest healthcare management companies in the nation. Wellington Regional is proud
to have provided high–quality healthcare("About Wellington Regional Medical Center – Palm
Beach, FL | Wellington Regional Medical Center," n.d.) services to the ... Show more content on
Helpwriting.net ...
The age ranges from 23 weeks gestation to usually 40 weeks gestational. However, a readmission of
an infant within ten days post delivery may be readmitted if previously born within our facility.
There are no maximum lengths of stay. Our ultimate goal is one of the 40 weeks gestation.Early skin
to skin initiation is the preferred form of early bonding, and early initiation of teaching and family
participation is encouraged from the get go. Wellington serves a community that has a majority of
White Non–Hispanic population. The outlying communities that utilize our services compromise a
majority of Hispanic, Latino, Haitian, African American population. Currently, our staff is
compromised to meet the majority of the population; we lack in the services in clientele that have
recently migrated to the country or have limited understanding of the English language. We offer a
language line and certain staff members that are utilized to facilitate in translation. Unfortunately,
they are not always available. The author is employed as the Manager of the Neonatal intensive care
unit. The unit uses a primary nursing care model and an all registered nurse staff. The group is
headed by a nurse manager who reports to the Director of women's services. Currently, the unit
achieves a daily census of 12; our breastfeeding rate is 90 percent, and our focus is on family–
centered care. Family–Centered

Coram Boy Essay
What do we learn about life in the 18th century and how successfully does the writer convey this
information whilst telling us a good story?
The story is set in the 18th century and includes factual information which plays a vital part in the
storyline. It uses this information whilst entertaining the readers with a fictional storyline. It is based
on one thing in particular, hence the title "The Coram Boy", this is The Coram Hospital.
A main factor in the storyline is the way the writer portrays society's attitude to poverty in the 18th
century. The poor people were treated tremendously different to higher classed people. A lot of
people were even living on the streets. For example, "He picked his way through the hordes of
homeless ... Show more content on Helpwriting.net ...
Alexander is much higher classed. It shows how he feels to be in the company of those higher
classed. This is then contrasted by "The food was borne in on silver platters by white–gloved
manservants; food he had never even seen before: venison pie, partridge breasts, grilled trout, slivers
of ham, trifle with cream and jam, cheese and little biscuits" this shows the wealth of Alexander's
family. These two examples clearly show the difference between different classes.
The next main factor in the story is society's attitude towards illegitimacy. Any woman who bore a
child out of wedlock was treated with disgust and held an air of shame and disgrace. This caused
those who did happen to have their children out of wedlock to give them up and send them off to
orphanages in hope their child would be alright. A lot of these single mothers tried to send their
children to one such orphanage called "The Coram Hospital". An example is when Melissa, a young
girl just found out she was pregnant and says "'And Mama? What about Mama? The disgrace. We'll
both be thrown out. Destitute." This is a good example of the consequences of illegitimacy. If
anybody found out about such circumstances the mother and her acquaintances would be thrown out
and homeless. The writer includes this factual information in the story and it entwines

Marketing Audit: Peace Memorial Hospital Essay
Name goes here MKT/551 Professor Joe Zimmerman Marketing Audit Overview May 31, 2011
Table of contents page Case Study: Peace Memorial Hospital: Downtown health Clinic
.......................... 3 Executive Summary ................................................................................ 3
Environmental Aspects ....................................................................... 5 Demographics
................................................................................ 5 Politics ... Show more content on
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As a result of these concerns, the hospital's Administrator, Dr. Mahon instructed Sherri Worth, the
Assistant Administrator, to conduct a research. The results of the research confirmed that the PMH
needed to build an ambulatory clinic in the downtown area. The main objectives of this new addition
was to increase PMH's referral base, to increase referrals of privately insured patients, to liaise with
business community and to become self–supporting in three years after opening. The DHC was
realizing most of its objectives when Worth heard that someone was conducting a survey to
determine whether there is a need to construct another clinic directly north of the DHC offering very
similar services. Upon informing PMH's administrator Dr. Mohan, worth had to report on DHC's
performance to date to see how they can compete for patients in the event of possible competition.
After her presentation she was asked to draft an analysis of DHC's position and to specify and
evaluate alternatives in the case of competition for its services. The marketing audit can be defined
as a systematic examination of a business's marketing environment, objectives, strategies, and
activities (David Jobber). An audit is used to identify key strategic issues, problem areas and
opportunities. If a business wants to put in place a plan of action to

Hcr 22 Understanding the Patient Intake Process
Understanding the Patient Intake Process
Tabitha Neufind
HCR 22
September 28,210
Felecia Pettit–Wallace
Understanding the Patient Intake Process The intake process of patients is different from practice to
practice, but the main purpose of the process is retrieve new and established patients information
during check in at a providers office, a hospital, or clinic. By having an efficient intake process a
efficient patient flow can be maintained. Healthcare just like any other type of service industry is
reliant on possessing satisfied clientele. Scheduling practices help to manage the patient flow by
establishing certain guidelines regarding how late a patient can arrive, and still be seen without
disrupting the patient flow ... Show more content on Helpwriting.net ...
If a patient has a co–pay is the co–pay required at the time of service or can they be billed for it at a
later date. For patients without medical insurance making them aware of their financial obligations
helps to reduce the time that is spent explaining the financial aspects. Let the patient know that the
provider is willing to make payment arrangements, or that they offer a discount for payment in full
at the time of service, or maybe there is a sliding fee scale that is offered based on the patients
income. Offering financial assistance is just not helpful to those without insurance, but also to those
that do have insurance. Patients can sometimes have high out–of–pocket expenses and deductibles
that they are required to pay for certain services. Financial counseling informs the patient of their
financial responsibility and how the practice is willing to help so that they can receive the care that
they need. Having a good patient flow is key to establishing a respected practice with patients who
are happy, and healthy. Patient flow not only effects the amount of time a patient waits to see a
doctor, but also effects the time and care that a doctor has to spend with their patients. There are a
variety of techniques that a practices, clinics, and hospitals can implement to ensure a that the intake
process is effective and maintains a good patient flow.
References
Okotie, O. T.(2008). The Effect of Patient Arrival Time on Overall

Career Path of a Surgeon
Introduction
The career path as a surgeon is a physician who specialises in a specific treatment of injury, disease,
or deformity through operations. Surgeon's correct physical deformities, repair bone and tissue after
certain impairment, or perform defensive surgeries on patients with a major disease or disorder. The
changing nature of surgeons has changed in expeditious manner during the past 20–30 years and yet
is still planning to change dramatically over the future. The job demands of a surgeon keep
increasing due to having such a large population, as the population grows the demands of surgeons
will only increase as the population increases. There are 32 different major types of surgeons some
of them include: Brain Surgeon, ... Show more content on Helpwriting.net ...
The surgery industry is a male dominated and a lot of employers believe women can't handle the job
due to high stress level in comparison to what males can. Women are trying to fight this ridiculous
sexist and make it an equal opportunity for both genders. However, it will happen in duration of
time.
The results show that in 2006 males had 67.8 of fulltime jobs, whereas women had a small amount
of 11.3%
Figure 1.2. |
Job growth is expected to expand throughout the future years especially in 2014 due to the health
care is extended to expand at a rapid rate. Referring to figure 1.2. Below the statistics show the
historical employment rates in a hundred thousand figures.
Figure 1.3.
The graph shows that in 2000 the employment rate for surgeons was at 23,000 and in 2009 increased
rapidly to 64,000. Whereas, in 2011 the rate dropped back down to 56,000. The employment rates
are always a surprise but due to population and more health care needed the rates are guaranteed to
increase.
The role of OHS&W in the workplace
Occupation Health Safety and Welfare stands for (OHS&W.) OHS&W helps protect the
safety and welfare of employees in their workplace.
OHS&W in the medical industry includes * Including and providing information,

The Foundling Museum
To what extent has the Foundling Museum uncovered the 'hidden histories' of Georgian London's
poverty–stricken families?
Word Count: 1432
Since 2004 the Foundling Museum has stood as a site to memorialise the Georgian Foundling
Hospital; this institution cared for London's abandoned children, foundlings. In a recent podcast,
Laura Gowing described the stories of these children and their mothers as 'hidden histories'. She
claims that the Foundling Museum offers a narrative for figures who are otherwise overlooked by
historians. This essay will assess Gowing's statement by first discussing the way in which the
museum presents the hospital's abandoned children. Here, a particular focus on temporary
exhibitions will show how the narrative ... Show more content on Helpwriting.net ...
Historians have previously disregarded the lives of these women out of belief that they were 'objects
of male sexual aggression with no sexual desire or expression of their own'. The museum's
permanent display of these 'unfortunate women' is limited to their petitions, which were written in
hope that the staff would allow their child to be admitted into the hospital. Although the temporary
exhibition, 'The Fallen Woman' has attempted to correct this through a sound installation, intended
to give these women a voice, its source remains founded upon petitions. This means that the ability
of the museum to uncover the history of unfortunate women is already limited by the availability of
sources. Yet instead of using these petitions to gain as much information about these women as
possible, the museum chooses to refer to them only in relation to foundling children. This ignores
the context in which these mothers signed their petitions. Thus we must rely on alternate sources of
information to understand the lives of these mothers. Evans' article on London's mass of 'unfortunate
women' uses the Foundling Hospital petitions for such a purpose. She cites petitions in which
women express their 'great distress' in handing over their children. They claim that factors such as
'illegitimacy' and 'poor state of health' is what forced them to make this decision. If Evans has shown
that such details of these

Essay about Compassionate Care
The purpose of this essay is to look at barriers of compassion and what nurses could do overcome
these barriers. Three sub topics will be looked at over the course of this essay and a conclusion will
be made to evaluate these essays findings and to provide some input into battling these barriers so
that patients can receive high standards of patient care.
The definition of compassion in the oxford dictionary is ''sympathetic pity and concern for the
suffering or misfortunes of others''. Oxford dictionary (2013) However senior lecturer Penny
Harrison says there is no accurate definition for compassion as it is a word that can be understood in
different ways. Harrison, P. (2009)
The importance of compassion is vital in any care setting ... Show more content on Helpwriting.net
...
Compassionate care is a big talking point right now in the media and within the healthcare sector
with the Francis report being published earlier this year regarding the failings by Mid Staffordshire
and Scotland are now waiting for their own report to be issued regarding the failings at the Vale of
Leven in Dumbarton. The nursing and midwifery council have already started on some the
imperative changes to be made that the Francis report issued. The chief executive of the nursing and
midwifery council has said in her executive statement regarding the Francis report that they are to
re–examine the current teaching that nurses receive and the professional standards. Smith, J.
(Nursing and Midwifery Council) all of these failings are all relate d to compassionate care. The
people who died in these hospitals were clearly not heard when they complained of feeling unwell
and did not receive compassionate care so why was this? Next to be discussed is compassion fatigue
and how this may reflect onto nursing practice in providing sufficient compassion.
Compassion fatigue is widely known in the health care profession. Nurses working overtime and
long working days to provide care for the patient and the patient's families are a continuous stress on
a nurse's emotional and physical well–being especially if the nurse is providing the patient with end
of life care as this contributes to both physical and mental work. Vital

Essay on Concept Analysis
Concept Analysis Carrie G. Alexander Chamberlain Concept Analysis The concept of comfort is one
that nurses provide every shift; however, it is not always easy to define. Katherine Kolcaba's
Comfort Theory will be used. Walker and Avant's method for concept analysis will be used. The first
step is to select a concept, which is comfort. The next step is determining the purpose of the
analysis. The purpose is to define what comfort means and what comfort measures are and how they
are used in nursing. The third step is to identify the uses of the concept of comfort. This includes
definitions of term comfort and a literature search. The fourth step is to determine the defining
attributes of comfort. This allows for insight into the ... Show more content on Helpwriting.net ...
A variety of definitions and meanings evolved about comfort with the term being related to both the
patient and family. The first research study was a study on the experiences of family members being
present during resuscitation efforts in the emergency room after a trauma. Some of the benefits of a
family member being present are: the family feeling empowered and supportive, maintaining
family–patient relationships, closure in a life shared and fostering the grief process (Leske,
McAndrew, & Brasel, 2013). Data was collected over two years in a level one trauma center
with trauma patients that had one family member present and were admitted to the surgical intensive
care unit after resuscitation. The family member was interviewed two days later for an average of
ten to thirty minutes in a quiet room away from the patient. The sample size of the study was twenty
eight and the majority of the sample was female. The results showed that the majority of family
members that were present felt that there role was to be supportive and protect the patient during the
trauma. They felt that being present was comforting to them and the patient, regardless of the
outcome. Another common theme was that the family felt comforted knowing that everything
possible was done for their family member. This study was limited due to the small sample size.
Although the conclusions are valid, more research with a

Research Critique 2 Patient Falls
Research Critique, Part 2
Jennifer Bullard
Grand Canyon University
Introduction to Nursing Research
NRS433
Martha Schmidt
October 07, 2012
Research Critique, Part 2
The purpose of this paper is to critique an article on the circumstances and characteristics of why
patients fall in the hospital setting. The article being critiqued defines a fall as an unexpected drop
from a sitting, standing, and lying position, which include an assisted fall (where someone helps
guide them to the floor), slipping from a chair to the floor, and when a patient is found on the floor
(Hitcho et al., 2008). This critique will discuss data collection, data management, analysis, and
interpretation of the findings.
The Washington University ... Show more content on Helpwriting.net ...
There was some researcher bias because some of the information that was collected from different
sources conflicted, and the person who collected the data best judgment was used. Many patients
recall of the circumstances surrounding their fall was not dependable.
The study's findings revealed that of the 183 patients that fell while hospitalized, the average age
was 63.4 with the ages ranging from 17 to 96. It also discovered that many of the falls were
unassisted, occurred in the evenings and in the patient's hospital room, and had fallen during
ambulation. It was also discovered that falls related to elimination increased the risks for injury. Out
of the medical, cardiology, neurology, surgical, oncology, orthopedic, and women/infant units that
were included in the study, the medical and neurology units had the highest incidence of falls. These
units also had the highest patient to nurse ratios (Hitcho et al., 2008). These findings also determined
that falls occurred when patients were unassisted, ambulating, and were related to elimination needs.
Because of these findings, prevention measures should focus on increasing staff assistance while
patients are ambulating and supervised/assisted toileting schedules need to be provided. The
findings can be applied to all areas of nursing. Despite prevention efforts, threats to reimbursement,
and good intentions, falls still remain a serious and costly

A Daring Paradigm
Running head: HEALING HOSPITAL: A DARING PARADIGM
Healing Hospital: A Daring Paradigm
Jolly Joseph
HLT–310V Spirituality in Health Care
Professor: Patricia Mullen
11/06/2011
Healing is the process of restoring the wellness. It can also refer as curing or soundness. While
healing process is underway, the person who gets healed is achieving a spiritual totality. Healing
takes place when a person becomes ill. During this restoring process, the illness is completely
eradicated and allows the patient to gain maximum health before the illness. Healing is required for
those who are suffering from serious illness. Healing is the way to obtain wellness and restoration of
spirituality. ... Show more content on Helpwriting.net ...
This is very clear from the name itself. In the context of radical loving care the patient gets the
loving care from all the caregivers. This makes the patient satisfied and shows the fulfillment of
patient's necessary. According to www.newsreview.com, "It brings tears to my eyes how well they
treat you here, the Chico resident said, these are the most caring people I've ever seen" (Cantu,
2011). In the article the author explains how the loving care of the staff is given to their patients.
Also, the loving care is very much related to the spirituality. Spirituality has a vital role in all of the
three vital components of the healing hospital. Especially, the most important component of healing
hospital, culture of radical loving care, has relationship to spirituality.
Also, there are many challenges for healing hospitals in five characteristics such as, technology and
prescription drugs, business factors, bureaucracy, cynicism, and failed leadership. According to
Chapman, it is clear that the importance of loving care has decreased as technology enhancement
and scientific learning increased (2007). If we consider business factors, it is true that the way we
spent money is what we see as valuable for us. By utilizing this many of the old charitable hospitals
became high revenue corporations in these days. Therefore, business factors are crucial. Another
challenging factor of the healing hospital is bureaucracy. Bureaucracy is very obvious while
evaluating what

Tom Jones Essay
Joy Thompson
Mrs. Larson
AP British Literature and Composition
December 11, 2011
Refusal to Return: Finding Bliss at Upton Although Tom Jones by Henry Fielding is appropriately
known as a comic novel written to no set of absolute rules, the work shows many characteristics
similar to epics. In epic novels the main protagonist is normally known for following a set series of
events called "the hero's journey." The hero's journey is often a three part adventure consisting of a
departure, an initiation, and a return, through which the protagonist learns much about their
strengths and weaknesses having departed from their "world" to another. In the new "world" they
face challenges, enemies, and temptations that usually lead to ... Show more content on
Helpwriting.net ...
Being cast out by Mr. Allworthy and having no hope of being with Sophia, Tom decides to leave his
home and set out for Bristol. The speaker if the novel remarks "...we left Mr. Jones...on his Road to
Bristol; being determined to seek his Fortune at Sea; or rather, indeed, to fly away from his Fortune
o Shore" (234). These unfortunate events led to Tom's call to adventure and puts him on the road
that leads him to the inn at the town of Upton as well as to a state of mind that insulates him from
any call to return to his "previous world." In the traditional epic the call to adventure is normally tied
to the reason the hero needs to return. During his time in his new world before he arrives at Upton,
Tom befriends Benjamin Partridge, who is actually also a cause of Tom's going to Upton. According
to the epic hero's journey, Benjamin is considered part of the second step known as tests, friends,
and enemies. He is for the most part a good friend to Tom throughout the series of events in the
novel. When Tom sets out at his first stop prior to Upton, he decides to join the army and meets
Benjamin Partridge when he needs both a haircut and a wound tended. Tom finds fellowship with
Benjamin and leaves the army to go with Partridge in another pursuit which leads him to Upton
where he goes through the step of the "refusal to return." "Mr. Jones, and Partridge, or Little
Benjamin...having left their last Quarters in the Manner before

Essay about Executive Summary
Executive Summary
Mary Job
NRS 451 V
Dinwiddie Sandra
April, 22, 2012
Pressure ulcer prevention (PUP) in surgical patients has become a major interest in acute care
hospitals with the increased focus on patient safety and quality of care. A pressure ulcer is any area
of skin or underlying tissue that has been damaged by unrelieved pressure or pressure in
combination with friction and shear. Pressure ulcers are caused due to diminished blood supply
which in turn leads to decreased oxygen and nutrient delivery to the affected tissues (Tschannen,
Bates, Talsma, &Guo, 2012). Pressure ulcers can cause extreme discomfort and often lead to
serious, life threatening infections, which substantially increase the ... Show more content on
Helpwriting.net ...
The vulnerable bony areas prone to pressure ulcer are back, heels, hip, spine, elbows, shoulders and
back of head. Studies have proved that total operating time and overall number of surgical
procedures are significant predictors of pressure ulcers. A research conducted by Lindgren et al
found that 14.3 % of surgical patients acquired a pressure ulcer during the time from surgery to
twelve weeks after surgery. For every thirty minutes the surgery went beyond four hours, the risk for
a pressure ulcer increased by approximately thirty three percent.
As we are all aware that there is no reimbursement for a hospital acquired pressure ulcer and the
cost for each pressure ulcer has to be absorbed by the facility. A patient's development of a pressure
ulcer while under the care of health care provider or facility is viewed as grounds of a professional
liability law suit. The mere existence of pressure ulcer is often viewed as a physical evidence of
medical negligence. The cost to treat pressure ulcers are expensive, the United Sates (US) health
care system spends more than one billion dollars annually to treat pressure ulcers. It has been
estimated that the cost of treating pressure ulcers is 2.5 times the cost of preventing them
(Whitehead &Trueman, 2010). In order to reduce the strain on hospital budgets caused by
pressure ulcers, we need to implement a planned approach to PUP and

Emtala
Background
EMTALA is the Emergency Medical Treatment and Labor Act that was developed in 1985 as part of
the Title IX of the Consolidated Omnibus Budget Reconciliation Act that went into effect in the year
1986 (Sara Rosenbaum, 2012). EMTALA was developed after an article was published in 1986 that
documented how Cook County Hospital in Chicago was receiving patients that were "dumped"
there that were unemployed, minorities, and lacked health insurance (Singer, 2014). This problem
also occurred in 1983 in Dallas where over 200 patients were transferred between hospitals that
were not stable (Singer, 2014). EMTALA is under the direction of the Department of Health and
Human Services and was developed to address the needs of Americans ... Show more content on
Helpwriting.net ...
The filing of the complaint must be completed within 72 hours of the transfer (Sally Austin, 2011).
As a result of this, it has been difficult to see whether or not EMTALA has truly been successfully
implemented and effective (Sara Rosenbaum, 2012). Another disadvantage is that EMTALA only
requires hospitals to treat "true emergencies", which are subjective in nature. The last revisions in
2003 for EMTALA by policymakers and CMS limited EMTALA to only patients that arrived to the
emergency department, not to other areas of the hospital, such as a doctor's office appointment or
outpatient surgery (Sara Rosenbaum, 2012). Another negative consequence of EMTALA that is not
addressed by the law is that emergency department physicians can still be held liable and face
malpractice issues by uninsured patients (Singer, 2014). There have been legislative proposals by
members of Congress that are working to change this to include physicians as members of the
Public Health Services, which would address these concerns (Singer, 2014). These hesitations by
physicians has forced some hospitals to close their emergency departments in California to avoid
these financial consequences of lawsuits (Friedman, 2011). As a policymaker, EMTALA was

Effects of Nurse Staffing on Patients Outcomes
This study focuses on the issue of nursing staffing and its effects on the outcomes of the patients. To
begin with, the tem nursing staffing will be defined and followed by a discussion of nursing staffing
in relation to the nurses themselves. Nursing staffing levels and their effects on the patient outcomes
will also be discussed with regards to morbidity and mortality besides other indicators of patient
outcomes, the impact of nursing staffing levels to quality of care as well as an overview of past
studies as far as the relationship between nursing staffing levels and the outcome of the patient is
concerned.
Nursing staffing The term nursing staffing refers to the levels of nurses that are employed at a
particular institution. ... Show more content on Helpwriting.net ...
Additionally, the factors that were found to profoundly affect this opinion are the competence of the
staff, teamwork, flexible delivery system, and a balance of positions in relation to the needs of the
patients that are under their care.
The study by Aiken et al in 2002 revealed that there was a higher chance of nurses experiencing job
related burnout in hospitals with high Patient nurse ratios. Further, nurses in institutions which had
the highest rates of patient to nurse ratios were twice likely to suffer from dissatisfaction from their
jobs. These influenced the decisions of nurses to leave their current jobs and thus creating more
staffing problems that would lead to more negative patient outcomes.
Nursing Staffing and the Patient There are various outcomes that are thought to be directly related to
the staffing of nurses in any institution are associated with the patients, such as morbidity mortality,
nosocomial infections, falls, pressure ulcers, suicide, and length of hospital stay, medication errors,
post operative complications, infection rates and adverse events such as cardiac or respiratory
arrests, most of which are negative patient outcomes (Flynn and Mckeown, 2009). There are various
studies that have focused on this relationship such as the study by Aiken et al in 2002 however,
according to Liang et al (2012); most of these studies have been carried out in western countries.
Flynn and Mckeown also studied the relationship between

Snowstorm Lawsuit
The Snow Storm Lawsuit
Strayer University
Identify and explain at least three legal considerations.
The first legal consideration in this case is related to corporate liability. The hospital itself is
negligent under this doctrine. Corporate negligence is the failure to provide the equipment, facilities,
and staff to carry out the duties of the corporation in accordance with the established standard of
conduct (Showalter, 2007). Corporate negligence is evident in this case in regard to the failure to
ensure that sufficient healthcare personnel were available to provide the established standard of care
to the patients in the facility. Moreover, the personnel that were required to remain at the hospital
from the day shift were likely ... Show more content on Helpwriting.net ...
Therefore, an increased incidence of falls and resulting injury are a foreseeable result of the staffing
shortage.
Identify and explain three ethical considerations. Leaders in healthcare organizations are often faced
with a variety of ethical issues. Ethical considerations will be discussed from a leadership
perspective. The ethical considerations related to this case are the responsibility to patients,
responsibility to employees, and responsibility to the organization. Responsibilities to patients
includes providing quality care that meets established standards, ensuring there are mechanisms in
place to monitor and evaluate the performance of healthcare personnel, hiring and retaining
competent professional staff that meet licensing and accreditation standards, and consistently
reviewing, researching, and implementing evidence–based practices. This case fails to demonstrate
ethical conduct in terms of responsibilities to patients specifically in regard to staffing, which, in
turn affects quality of care. Responsibilities to employees include providing an adequate and safe
work environment, ensuring that employees are equipped with equipment, facilities, and sufficient
staff to perform their duties within the established standards of care, promoting the appropriate use
of employee's knowledge and skills, and providing a mechanism for employees to voice ethical
concerns. This case fails to meet this ethical standard as evidenced by not providing sufficient

Positioning and Differentation
Positioning and Differentiation Paper
For Referencing Only– Do Not Copy
Positioning and Differentiation Paper The positioning and differentiation strategies of two nearby
hospitals, St. Francis Hospital located in Roslyn, New York and the Schneider Children's Hospital in
New Hyde Park, New York will be discussed in this article. These two institutions are located in
Long Island, New York and are approximately 5.2 miles apart from each other, servicing the nearby
counties of Queens, Nassau and Suffolk. These renowned facilities are recognized for their specialty
services throughout New York as well as the United States. The intent of this article is to examine
the positioning and differentiation marketing strategies of these ... Show more content on
Helpwriting.net ...
Special services are provided for Lyme disease, the deaf, food allergies, immunology, human
genetics, cardiac surgery, emergency and trauma. The facility proclaims to be "a destination hospital
for children across the United States and around the world" (Schneider Children's Hospital, n.d.,
para. 1). SCH is the only hospital located on Long Island dedicated to the care of children. It has
prided itself on being named one of America's best children's hospitals for two years in a row by the
U.S. News and World Report (Best Children's Hospitals: General Pediatrics, 2009). These rankings
are based on good community standing, patient outcomes and care–related issues as patient volume,
nursing care, advanced technology and recognition by outside organizations. The hospital has
several consultation centers throughout Long Island and New York City to offer specialized
healthcare to children right in their own community. The Centers provide specialized services for a
broad range of medical conditions such as heart disease, neurological disorders, cancer, Lyme
disease, growth deficiencies, and other childhood illnesses. The main marketing strategy to attract it
target audience is through a community newsletter, its participation in community events and
sponsorships, a pediatric mobile unit for the uninsured, television, radio and newspaper
advertisements. The institution asserts that it provides the only pediatric emergency

Pressure Ulcers Essay
Evidence Based Practice & Pressure Ulcers
Matthew Slawter
Chamberlain College of Nursing
NR451 RN Capstone Course
November 2014
Evidence Based Practice & Pressure Ulcers Evidence based practice (EBP) gives nurses a method to
use critical appraised data and scientific evidence that is proven to confirm the delivery of quality
health care to a patient population. Pressure ulcer prevention continues to be a major and growing
concern among todays patients and healthcare providers. This problem is a concern because
prevention of pressure ulcers can be accomplished through good skincare techniques and increased
education of nurses. The field of nursing along with the healthcare industry can benefit from simply
decreased the ... Show more content on Helpwriting.net ...
Thus, the expected outcome is that there is prevention of skin breakdown relating to pressure ulcers
during hospitalizations for patients.
Step 2: Scope of practice question Pressure ulcers are a problem and can lead to poor patient
outcomes as well as hospital fines. Evidence based studies have shown that "the average cost of care
in an acute care hospital for a patient with a stage III or stage IV pressure ulcer reported by the
Centers for Medicare & Medicaid Services (CMS) is $43,180" (Jackson, 2008). Pressure ulcers and
other skin breakdowns are among the most significant adverse events causing distress for patients
and their care givers and compromising patients' recovery from illness or injury (Gardiner, 2008). It
is the tasks of nurses to ensure prevention of these complications is part of the daily care regimen.
Steps 3, 4, and 5: Team An interdisciplinary team of professional staff is a necessity to overcome the
issue of pressure ulcer development among patients. Relevant stakeholders would include a nurse,
nurse aide, dietitian, and a hospitalist. The primary responsibilities of the nurse consist of
completing and documenting skin and risk assessments, monitor progress and/or changes in
medical/skin conditions, report patient problems to the hospitalist, and work with the wound team

Hsm 541: Week 2 – You Decide Essay example
HSM 541: Week 2 – You Decide
Krystal Richards
Professor Alan Flower
Middlefield Hospital has been a great healthcare facility to the Middlefield area. Middlefield
Hospital consists of a 450–bed tertiary facility in a major urban area in the Northeast. The hospital is
an integrated health system that provides the full array of inpatient and outpatient services. The
hospital enjoys a reputation of quality care in the area. In recent years, there are areas of concern
that need to be addressed. As I have been assigned the position as the new Chief Executive Officer
(CEO) of Middlefield Hospital, I will provide strategies and recommendations needed for
implementation to turnaround the hospital into a more positive experience not ... Show more content
on Helpwriting.net ...
To improve the performance, there need to be upgrades with the systems that the hospital uses to
keep track of the patients information. I recommend using Epic as a tool to help keep all of the
patient's information confidential and easy to access with a click of a button. This will allow for
every department to have access to a certain patient's file whether to be from a doctor entering notes
about the patient's visit, to health insurance billing department making sure that copays and such are
being paid and their accounts are kept up–to–date. The hospital governance plays an important role
because of the need for funds to help keep the hospital. By providing more outside events to raise
money for the hospital will be a great start to being able to fully provide for each patient that comes
through Middlefield Hospital doors. Since the employee morale is going down, I think it is
important to obtain a good relationship with the local university, Essex University, to provide jobs
and internships to the students in the nursing program. This nursing program will make sure that our
managers will be able to teach classes at the university and help train the students to be prepared to
work in the hospital. This should address the problem of the employee turnover rate to decrease and
bring down the number of nursing vacancies. Nurses are a very important part of the hospital
because they are by the patient's side more than the doctor can be, so they have to show

Importance of HIPAA and the Bill of Rights in the...
Why is important for the HIPAA and the Bill of Right work in the healthcare system. Both the
HIPAA and Bill of Right significance to the healthcare system all around the United State because
of the strict guideline that were implemented to make the healthcare facilities a better place; for both
patients and healthcare officials. These two laws that have been implemented, they have been the
corner stone for many years. Those have helped balance the right for patients, physicians, nurses and
others officials who are working in different healthcare facilities. Since the formed President Bill
Clinton signed HIPAA policy in to law, it has been a driving for the healthcare facilities though out
the United ... Show more content on Helpwriting.net ...
Whenever any healthcare personal violates the HIPAA policy the punishments can be minor to
server. The individual who bleaches privacy of any medical records the punishment can be verbal
warning without further punishment the individual doesn't violates the rules and regulation. If the
individual in question violates the rule or regulation the individual can be place on probation,
suspended without pay until further notice. Some one can be signed to look over you and check out
all what you do on regular basic as you work. If you have authorization for high level clearance
documents, it would be stripe from whoever violated the rules and regulations. The final stage of
solving this problem can resolve in the termination of the individual. Many other problems popped
up the healthcare facilities where this individual previously work could be huge trouble because of
the poor judgment of this individual. This problems could be results in lawsuits on top of lawsuits
for this organization. Years can passed before all the lawsuits settle as a result a huge amount funds
would gone to the patients and the lawyers. Because of the poor judgment, it can result in a great
cause for the organization, it would be in violation of HIPAA policy and it can be shut permanently
or charge of very high finders because of this problem. Also, if the facility doesn't get shut down,
many of the patients can remove themselves from this healthcare facility because of the fear

A Description of the Learning Organisation Within the a&E...
The concept of a learning organization knows its roots back to Garratt in 1987, which later on in the
late 90's was revived by Peter Senge. Senge (1990) focuses on the organization acting as a unit
where innovative ideas are generated and common goals are reached. Collective commitment of the
team is fundamental. Furthermore, according to Senge (1990), the organization must go through 5
domains in order to reach the productivity of a learning organization: systems thinking, personal
mastery, mental models, building shared vision and team learning. Therefore it is clear that
organizational learning goes beyond knowledge. This notion involves the process of action and
reflection (Carroll & Edmondson, 2002) or action learning (Revans, ... Show more content on
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Unfortunately the A&E department allocates very little time to cater for open dialogue sessions.
Although there is a great sense of teamwork amongst the multidisciplinary team, discussions are
usually done at the managerial level. Furthermore there are instances where staff feels threatened to
voice their perspective (Sheaff & Pilgrim, 2006). In fact as described by Snell, 2002, a
hierarchy could be dangerous to a learning organization. Leaders should be the gatekeepers of the
organization culture making them accessible (Snell, 2002). One issue leaders of the A&E
department may not be sensitive to the psychological aspect of nurses. A day full of heart touching
situations can bring a surge of emotions which maybe hard for an individual to cope with. As
suggested by Stinson, et al., 2006, " time to smell the roses", is the opportunity where staff can find
time to reflect and enjoy leisure activities together. This is also makes way for a better relationship
between staff members, which in turn gives a quality patient care. Another troublesome issue
concerning the A&E is the fact that parts of the A&E department are being used as a ward.
This is both creating unsafe nursing practice and is in the way of emergency nursing care. This issue
is attracting media and public criticism that in turn leads to job dissatisfaction. This all creates a
viscous cycle, which ultimately affects the patient care.

Sophia Western vs. Lady Bellaston On the 4th episode of...
Sophia Western vs. Lady Bellaston On the 4th episode of the novel Tom Jones
Sophia Western vs. Lady Bellaston
On the 4th episode of the novel Tom Jones, the author has once again given its audience another
surprise. Sophia Western and Lady Bellaston are both secretly fighting for the love of the same man.
They both like Mr. Jones. However, they refuse to let each other know about their own feelings
towards this man. Although they are both wealthy women, they differ in their appearance, attitudes,
and most important on their feelings towards Mr. Jones.
They look very different from each other. Ms. Western is very young, probably in her early 20s. She
has long blonde hair and does not need any makeup to appear beautiful; ... Show more content on
Helpwriting.net ...
To keep her honor, she escapes her house because she would not marry a man she is not in love with
even when her father in forcing her to do so. Lady Bellaston, however, is the total opposite; she
appears to be a fine honorable lady when she is in fact a corrupt widow. She corruptively treats
younger man of her craving with money, expensive wear, and special attentions. These men in return
have to satisfy the sexual thirst of the older Bellaston.
Sophia is a conservative girl from the country; she in not used to the liberal life of London. In
contrast, Lady Bellaston has no limits when it comes to libertinism. For instance, in one part of the
novel, she hires actors to perform very sexually inclined show at her mansion.
During the erotic play, Sophia leaves the room as she tells Bellaston who follows her up the stair
how insulted and humiliated she felt to have observed such a coarse show.
It's obvious that both women want Tom Jones, however their purpose with him is very different. To
Sophia, Tom means her lifetime sweetheart for whom she is willing to sacrifice her family and
estate.
In contrast, to Lady Bellaston he's just another of her sex toys, with the difference that she's
obsessed with him because he's probably the only man who has rejected her and admitted to her face
to be totally in love with another woman. Beyond that, Sophia is a pure woman who
would

Tom Jones Education Analysis
Eighteenth century England held different expectations for the education women would receive,
their roles in marriage and the family, as well as society, and their sexuality. These expectations
were largely different depending on whether the woman was from the poor and working class, or
from the middle and upper classes. It is through these social expectations of women that the
characterizations of women in Henry Fielding's novel Tom Jones will be explored and criticized.
The characterizations of Mrs. Waters, Mrs. Western, and Sophia Western will be the primary focus,
but Mrs. Fitzpatrick, Bridget Allworthy, and Lady Bellaston are also characterizations that merit
consideration Education, particularly literacy, was rising among both the lower classes and women
during the age of Enlightenment. A women's education was now thought of as essential to her future
occupation as a mother, who would need to teach her own children in their formative years, and it
was for this reason that a woman's education was vastly different than a man's.
The education of "middle– and upper–class girls [was] significantly different from [that] of poor,
artisan, or labouring girls" (Simonton 35). Middle– and upper–class woman could receive private
tutoring or go to boarding school and they had more access to tools of learning, such as books. As a
lower– or working–class woman, they might forego schooling in favour of work, or if they did go to
school it would generally be for a brief time and with

Ronald Reagan Ucla Medical Center
Ronald Reagan UCLA Medical Center,
Los Angeles, CA
HSM 310
2012
Scarlett Vidaurre
Professor Lee
8/5/2012
The mission of the Ronald Reagan UCLA Medical Center is to provide excellent patient care in
support of the educational and scientific programs of the schools of the UCLA Center for the Health
Sciences. Ronald Reagan UCLA Medical Center was built in response to the damage incurred by the
old hospital structure during the 1994 Northridge earthquake. The new hospital, which replaces the
1955 facility, is one of the first hospitals in the state to meet the latest California seismic safety
standards. This state–of–the–art building will serve as a pillar of strength to the local community,
even during those times when acts of ... Show more content on Helpwriting.net ...
Every floor harbors a number of ICU rooms. These are laid out so that the bed is in the center of the
room allowing staff to treat a patient from all sides. In the event that a patient needs to be moved
from an ICU room to surgery, the ceiling boom in an ICU room has an equipment arm and portable
trolley with battery that detaches and can go with the patient, saving critical preparation–for–
transport time. All of these features are built into each room to allow the rooms to function as needs
develop. Unlike most hospitals, every floor here is dedicated to a particular specialty and all of the
support equipment and supplies for those patients is located on the very same floor. Crisscrossing
corridors in the nurse's area make access to the supplies equal–distance from any of the patient
rooms. Finally, every floor has its own satellite pharmacy, dialysis storage, respiratory therapy
workrooms, and resident doctor sleep rooms, making every floor nearly self–sufficient. The latest
wireless technology has been installed so that the hospital is paperless, that is, it uses advanced
communication technologies that provide both medical professionals and patient's better access to
relevant medical records and research data. Clinical staff has access to electronic patient charts at
every bedside. Patients and visitors have wireless Internet access throughout the building. And,
wireless digital technology makes it possible to boast a film–less imaging environment. At

Essay on Arnold Palmer
OPERATIONS MANAGEMENT STRATEGIES AT ARNOLD PALMER HOSPITAL
Question 1
Arnold Palmer Hospital exists due to its customers who are the patients. Knowing the customers'
expectations is very important for improving the hospital's services because as part of the total
quality management at the hospital where process of continuous improvement, there is always room
for improvement and perfection. If patient(s) is or are disgruntled by any service(s), the hospital
should be thinking about ways to improve their process. Further, a patient's assessment enables the
hospital to know whether their services would be recommended to others as word of mouth is the
best advertising. Also, patients will not have the expertise to judge the quality of ... Show more
content on Helpwriting.net ...
Patients today can judge better regarding their health care quality than anyone else. When patients
are given quality service experience and provided with the detailed information on their health
problems and the corresponding medical diagnosis and treatments they will be in a position to judge
the health care he/she receives
Question 2
Customer satisfaction is everything. It is through the detailed survey that initiates quality initiatives
and process changes based on this surveys of which the implemented change start at the grass root
levels with staff closest to the area of need identified from these surveys. Arnold Palmer Hospital
further builds the culture of quality by observing the four quality quadrants as analysed by the
executive team namely service, quality, finance and human resources that make the organisation
focus on same goals, vision and to be in the same line to achieve same result of quality culture. So,
it would be very important for me to ensure that the hospital staff cares for the patients, and that the
staff is responsive to the patient's needs. Further, all the four determinants of quality have to be
successfully met of which are:
Reliability: Creating a culture that radically reduces system failure and effectively respond when
failures do occur is the goal of high reliability. The concept of reliability has to be used to make
patient care better. It is used to achieve patient safety, quality, and efficiency goals.
1.

Secondary Trauma
Secondary Trauma
So often, we focus on our clients and not enough on ourselves. The books read remind me to be
mindful of self–care. Beginning with Dr. Wicks who is an engaging writer. My perception is that he
is very caring, and that is revealed in his work.
The seeds of secondary stress and the seeds of true passionate involvement in the fields of
counseling, psychology and social work are actually the same seeds.(Wicks, 2008) Secondary
trauma or Burn out is a challenge for many individuals the field of counseling. Secondary trauma is
commonly referred to as "the stress resulting from helping or wanting to help a traumatized or
suffering person. Burnout is a state of emotional, mental, and physical exhaustion caused by ...
They arrive consistently late to work and call in sick when healthy; they also express becoming
emotionally distant from co–workers.
(Remington)
The job has taken a toll on their mental and/or physical health to the point where friends and family
express concern. (Remington) Upon hearing rumors of layoffs, you pray, "Please, God, take me!"
They do not have enough work to keep busy, but lack motivation to seek new assignments.
(Remington)Time drags and they constantly watch the clock. The lights around their desk or
workspace burn out frequently.
Secondary Trauma
"I think the most important thing about burnout is to recognize it's a cry for help from the Clinicians
poor, exhausted body and untapped spirit".
They say insanity is doing the same thing and expecting different results. If a
Clinicians is experiencing burn out and continue working in the same job at the same pace for the
same long hours, they will only get an increased feeling of burnout. It is time to try something,
anything, different.
Discuss the importance of effective supervision while providing case management. If a Clinicians
finds they are going through Burn Out, they should schedule a heart–to–heart with their supervisor.
A good supervisor should be able to present a couple of solutions to try. This can be delegating
more

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