BOARD OF REGISTERED NURSING
PO Box 944210, Sacramento, CA 94244-2100
P (916) 322-3350 F (916) 574-8637 | www.rn.ca.gov
BUSINESS, CONSUMER SERVICES, AND HOUSING AGENCY • GOVERNOR EDMUND G. BROWN JR.
NPR-B-03 06/1995 AN EXPLANATION OF SCOPE OF RN PRACTICE INCLUDING STANDARDIZED PROCEDURES
REV. 07/1997, 01/2011 1
AN EXPLANATION OF THE SCOPE OF RN PRACTICE
INCLUDING STANDARDIZED PROCEDURES
The Legislature, in its 1973-74 session, amended Section 2725 of the Nursing Practice Act (NPA),
amplifying the role of the registered nurse and outlining activities which comprise the practice of nursing.
LEGISLATIVE INTENT
The Legislature recognized that nursing is a dynamic field, continually evolving to include more
sophisticated patient care activities. It declared its intent to recognize the existence of overlapping functions
between physicians and registered nurses and to permit additional such sharing and to provide clear legal
authority for those functions and procedures which have common acceptance and usage. Prior to this,
nurses had been educated to assume advanced roles, and demonstration projects had proven their ability to do
this safely and effectively. Thus, legal amplification of the role paralleled the readiness of nurses to assume
the role and recognized that many were already functioning in an expanded role.
SCOPES OF PRACTICE
A knowledge of the respective scopes of practice of registered nurses and physicians is important in
determining which activities overlap medical practice and therefore require standardized procedures.
Failure to distinguish nursing practice from medical practice may result in the limitation of the registered
nurse's practice and the development of unnecessary standardized procedures. Registered nurses are
cautioned not to confuse nursing policies and procedures with standardized procedures.
1. Scope of Registered Nursing Practice
The activities comprising the practice of nursing are outlined in the Nursing Practice Act, Business and
Professions Code Section 2725. A broad, all inclusive definition states that the practice of nursing means
those functions, including basic health care, which help people cope with difficulties in daily living which are
associated with their actual or potential health or illness problems, or the treatment thereof, which require a
substantial amount of scientific knowledge or technical skill.
In Section 2725(a), the Legislature expressly declared its intent to provide clear legal authority for functions
and procedures which have common acceptance and usage. Registered nurses must recognize that the
application of nursing process functions is common nursing practice which does not require a standardized
procedure. Nursing practice is divided into three types of functions, which are described below.
A. Independent Functions
Subsection (b)(1) of Section 2725, authorizes direct and indirect patient care services tha ...
1 posts ReTopic 4 DQ 1Under The California State Board of R.docxhoney725342
1 posts
Re:Topic 4 DQ 1
Under The California State Board of Registered Nurses a Register Nurse (RN) is permitted to perform a Standardized Procedure for medical functions. The process to allow the nurse to engage in the Standardized Procedure requires various components to be fulfilled. The Standardized Procedures shall include a written description of the methods used in developing and approving them and any revision thereof.
Safeguards for the consumer are provided which, together, form a requirement that the nurse be currently capable to perform the procedure. The registered nurse who undertakes a procedure without the competence to do so is grossly negligent and subject to discipline by the Board of Registered Nursing.
As a Manager of a Department engaging in a Standardized Procedure process would need to be in place. There must be in writing, dated and signed by the organized health care system personnel authorized to approve it. It must specify which standardized procedure functions and requirements the RN may perform, specify the scope of the procedure and under what circumstances. The initial and continuing evaluation for training and education must be included along with evaluation of the competence of those nurses authorized to perform the standardized procedure functions. There would be needed to keep competency of the Standardized Procedure in the employees file and provide for a method of periodic review in the organization of the standardized procedures ("An explanation of scope of RN," 2011).
An explanation of scope of RN practice including standardized procedures. (2011). Retrieved from http://www.rn.ca.gov/pdfs/regulations/npr-b-03.pdf
1 posts
Re:Topic 4 DQ 1
There are many questions that need to be asked when a new procedure is being presented. The procedure needs to be researched if it is within the standards of practice. The standards of practice are the science of nursing with specific details associated with a specialty procedure (ANA,2016). Each specialty has its own standard of practice. This will help determine if the new procedure can be adapted. The procedure needs to be commonly recognized, standard of practice in the clinical area, and doesn’t require diagnosis or medical knowledge (CA-BRN, 2011). There will need to be a collaboration with other facilities within that state and then nationally to determine if this new procedure is an acceptable practice for that area. The procedure will need to be an evidence-based practice.
Once this new procedure is a viable change, it will then need to be put into practice. The staff will need to be educated on this new procedure and documentation through in-services, literature information and skills training. Applicable information will be provided to all persons involved including physicians, nurses, and ancillary staff. This will Include the who, what, when, where, why and how for this change of practice (CA-BRN, 2011). The physicians will also need to be educated on ...
What You Will Learn • Long-term care is heavily regulated because.docxeubanksnefen
What You Will Learn • Long-term care is heavily regulated because the government is a major payer and the recipients of services are among the most vulnerable. • The Nursing Home Reform Act continues to play a major role in regulatory oversight by enforcing substantial compliance with the Requirements of Participation through the survey and enforcement process. • Interpretive Guidelines clarify and explain each standard in detail. Although the guidelines provide directions to personnel conducting surveys, they also assist nursing home personnel in understanding what practices they must implement to comply with each standard. • The traditional survey is being phased out and replaced with the computer-based Quality Indicator Survey. • The seriousness of each deficiency is indicated by its severity and scope. Remedies, such as civil monetary penalties, are based on the seriousness of the deficiencies. • An acceptable plan of correction must address five elements for each deficiency cited. • Compliance with the Requirements of Participation incorporates compliance with the Life Safety Code®. Administrators must become thoroughly familiar with the Requirements of Participation and the main requirements of the Life Safety Code®. • Nursing homes are required to comply with the accessibility standards for the disabled under the Americans with Disabilities Act. • Under the Occupational Safety and Health Act of 1970, OSHA is responsible for ensuring the safety and health of nursing home employees. Nursing homes are legally required to comply with OSHA standards and recordkeeping rules. Introduction The health care sector has been the object of numerous regulations, for two main reasons: (1) The government is a major payer for individuals receiving health care services under Medicare, Medicaid, and other public programs. By committing a significant amount of tax dollars to the delivery of health care, the government retains a vested interest in how the money is spent by private organizations that deliver health care. (2) Health care in general, and long-term care in particular, provide services to the frailest and most vulnerable individuals in society. Many of them are physically and/or mentally incapacitated and have no one else to act on their behalf. The regulatory system is deemed obligated to protect vulnerable populations against negligence and abuse, to ensure that they receive needed services for which they are eligible, and to ensure that the services provided meet at least certain defined minimum standards of quality. Administrative agencies have the power to enforce the rules and regulations that they formulate. The most important federal agency regulating nursing facilities certified as skilled nursing facilities (SNF) or nursing facilities (NF) is the Centers for Medicare and Medicaid Services (CMS), an administrative agency under the U.S. Department of Health and Human Services (DHHS). The U.S. Department of Justice enforces comp.
Physicians can pose problems by not responding to facility calls and inquiries, taking liberties with notes and statements in the residents\'
medical records, and present risk due to issues and investigations with the Medical Board. This program offered providers guidance on managing such difficult issues, including how to identify, resolve and document these issues. The program will discuss issues of residents\'
rights, physician credentialing programs and other relevant legal
issues.
1 posts ReTopic 4 DQ 1Under The California State Board of R.docxhoney725342
1 posts
Re:Topic 4 DQ 1
Under The California State Board of Registered Nurses a Register Nurse (RN) is permitted to perform a Standardized Procedure for medical functions. The process to allow the nurse to engage in the Standardized Procedure requires various components to be fulfilled. The Standardized Procedures shall include a written description of the methods used in developing and approving them and any revision thereof.
Safeguards for the consumer are provided which, together, form a requirement that the nurse be currently capable to perform the procedure. The registered nurse who undertakes a procedure without the competence to do so is grossly negligent and subject to discipline by the Board of Registered Nursing.
As a Manager of a Department engaging in a Standardized Procedure process would need to be in place. There must be in writing, dated and signed by the organized health care system personnel authorized to approve it. It must specify which standardized procedure functions and requirements the RN may perform, specify the scope of the procedure and under what circumstances. The initial and continuing evaluation for training and education must be included along with evaluation of the competence of those nurses authorized to perform the standardized procedure functions. There would be needed to keep competency of the Standardized Procedure in the employees file and provide for a method of periodic review in the organization of the standardized procedures ("An explanation of scope of RN," 2011).
An explanation of scope of RN practice including standardized procedures. (2011). Retrieved from http://www.rn.ca.gov/pdfs/regulations/npr-b-03.pdf
1 posts
Re:Topic 4 DQ 1
There are many questions that need to be asked when a new procedure is being presented. The procedure needs to be researched if it is within the standards of practice. The standards of practice are the science of nursing with specific details associated with a specialty procedure (ANA,2016). Each specialty has its own standard of practice. This will help determine if the new procedure can be adapted. The procedure needs to be commonly recognized, standard of practice in the clinical area, and doesn’t require diagnosis or medical knowledge (CA-BRN, 2011). There will need to be a collaboration with other facilities within that state and then nationally to determine if this new procedure is an acceptable practice for that area. The procedure will need to be an evidence-based practice.
Once this new procedure is a viable change, it will then need to be put into practice. The staff will need to be educated on this new procedure and documentation through in-services, literature information and skills training. Applicable information will be provided to all persons involved including physicians, nurses, and ancillary staff. This will Include the who, what, when, where, why and how for this change of practice (CA-BRN, 2011). The physicians will also need to be educated on ...
What You Will Learn • Long-term care is heavily regulated because.docxeubanksnefen
What You Will Learn • Long-term care is heavily regulated because the government is a major payer and the recipients of services are among the most vulnerable. • The Nursing Home Reform Act continues to play a major role in regulatory oversight by enforcing substantial compliance with the Requirements of Participation through the survey and enforcement process. • Interpretive Guidelines clarify and explain each standard in detail. Although the guidelines provide directions to personnel conducting surveys, they also assist nursing home personnel in understanding what practices they must implement to comply with each standard. • The traditional survey is being phased out and replaced with the computer-based Quality Indicator Survey. • The seriousness of each deficiency is indicated by its severity and scope. Remedies, such as civil monetary penalties, are based on the seriousness of the deficiencies. • An acceptable plan of correction must address five elements for each deficiency cited. • Compliance with the Requirements of Participation incorporates compliance with the Life Safety Code®. Administrators must become thoroughly familiar with the Requirements of Participation and the main requirements of the Life Safety Code®. • Nursing homes are required to comply with the accessibility standards for the disabled under the Americans with Disabilities Act. • Under the Occupational Safety and Health Act of 1970, OSHA is responsible for ensuring the safety and health of nursing home employees. Nursing homes are legally required to comply with OSHA standards and recordkeeping rules. Introduction The health care sector has been the object of numerous regulations, for two main reasons: (1) The government is a major payer for individuals receiving health care services under Medicare, Medicaid, and other public programs. By committing a significant amount of tax dollars to the delivery of health care, the government retains a vested interest in how the money is spent by private organizations that deliver health care. (2) Health care in general, and long-term care in particular, provide services to the frailest and most vulnerable individuals in society. Many of them are physically and/or mentally incapacitated and have no one else to act on their behalf. The regulatory system is deemed obligated to protect vulnerable populations against negligence and abuse, to ensure that they receive needed services for which they are eligible, and to ensure that the services provided meet at least certain defined minimum standards of quality. Administrative agencies have the power to enforce the rules and regulations that they formulate. The most important federal agency regulating nursing facilities certified as skilled nursing facilities (SNF) or nursing facilities (NF) is the Centers for Medicare and Medicaid Services (CMS), an administrative agency under the U.S. Department of Health and Human Services (DHHS). The U.S. Department of Justice enforces comp.
Physicians can pose problems by not responding to facility calls and inquiries, taking liberties with notes and statements in the residents\'
medical records, and present risk due to issues and investigations with the Medical Board. This program offered providers guidance on managing such difficult issues, including how to identify, resolve and document these issues. The program will discuss issues of residents\'
rights, physician credentialing programs and other relevant legal
issues.
Appropriate Level of Care and the 2– Midnight Rule Where It Stands as of NOWBESLER
This article from the December 2014 issue of the Lone Star Express, a publication of the Lone Star chapter of HFMA, reviews the current state of the 2-Midnight rule. It reviews key elements of the rule, the focus of Medicare documentation requirements, and best practices for compliance.
Credentialing refers to the process of collection and verification of the evidences of credentials of a doctor who is to be given the responsibility of
treating patients in the hospital. The process
ensures the authenticity of the details provided
by the healthcare practitioner or doctor.
The Heartaches Associated with Billing for Cardiac DevicesPYA, P.C.
PYA Principal Denise Hall-Gaulin and Consulting Manager Joanna Malcolm presented a free webinar for the Georgia chapter of the Healthcare Financial Management Association, on Tuesday, December 6, 2016.
The presentation was geared toward C-suite hospital leaders, compliance officers, in-house counsel, operational leaders, and patient accounting leadership, and covered:
The criteria for implantable cardioverter defibrillators (ICDs), pacemakers, and other devices
The documentation requirements for payment
The prerequisites for a clean audit
The Filipino registered nurse believes in the worth and dignity of each human being, recognizes the primary responsibility to preserve health at all cost.
In Ontario, Independent Health Facilities (IHF) are licensed by the Ministry of Health. Doctors may have hands-on training to help patients manage illness, and investors may have the capital to acquire a medical facility. But very few people understand the bureaucratic process associated with transferring IHF licenses. Here is a little info n the complex bureaucracy.
For more info: http://medpros.wysework.com/healthcare-services/diagnostic-imaging/
One of the recent developments facing the public administration of.docxarnit1
One of the recent developments facing the public administration of corrections is that there has been an increasing call by public officials and the citizenry to privatize the prison systems in the United States. Discuss the following in regard to this:
First, from the perspective of a public-sector correctional administrator, make 2 arguments for keeping the jails in public hands.
Second, from the perspective of a private-sector correctional facility manager make 2 arguments for turning the correctional system over to the private correctional industry.
Briefly discuss the types of challenges that each sector—both public and private—may face.
Are there any legal issues, either criminal or civil, that need to be addressed before privatization can occur?
Support your viewpoints from your readings and other appropriate outside sources, in APA format.
Please submit your...
(More)
Reading Assignment:
Peak, Chapters 9, 10, 11
.
One paragraph for each question 1.Discuss the work of Chuck C.docxarnit1
One paragraph for each question:
1.
Discuss the work of Chuck Close as we saw in the film in class. How does he work: show how he takes an image and changes it by the way he interprets it. Philip Glass states in the film: “It is the old idea of form and content, and what our generation did was include process”: apply this idea to Chuck’s work.
Look at EACH of the artists below on the Art 21 website.
Answer the following questions for each artist:
·
How does this artist work? Intuitively or intellectually?
·
How important is process to this artist?
·
What do you think this artist is trying to communicate?
·
Where do they get the ideas for their art ?
Barry McGee and Margaret Kilgallen
James Turrell Gabriel Orzoco
Shahzia Sikander Maya Lin
Ann Hamilton Do Ho Suh
Sally Mann
2.
In your text, pages 104-112, there is a discussion about the different roles of artists across cultures and time. What role do you think artists have in contemporary culture in the United States? What role do you think they should have? How important are the ideas and thoughts of artists to the development, maintenance, and structure of culture? Cite examples from your text about the different roles artists could play in modern culture.
3.
What is creativity (to you)? Find two examples of art you think is really “creative” describe why you think these works are “creative”. Explain why you think they are creative works. Do you exercise creativity? If not, why not? If so, how do you exhibit creative ideas and tendencies? Explain why you think creativity is important to culture.
.
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Appropriate Level of Care and the 2– Midnight Rule Where It Stands as of NOWBESLER
This article from the December 2014 issue of the Lone Star Express, a publication of the Lone Star chapter of HFMA, reviews the current state of the 2-Midnight rule. It reviews key elements of the rule, the focus of Medicare documentation requirements, and best practices for compliance.
Credentialing refers to the process of collection and verification of the evidences of credentials of a doctor who is to be given the responsibility of
treating patients in the hospital. The process
ensures the authenticity of the details provided
by the healthcare practitioner or doctor.
The Heartaches Associated with Billing for Cardiac DevicesPYA, P.C.
PYA Principal Denise Hall-Gaulin and Consulting Manager Joanna Malcolm presented a free webinar for the Georgia chapter of the Healthcare Financial Management Association, on Tuesday, December 6, 2016.
The presentation was geared toward C-suite hospital leaders, compliance officers, in-house counsel, operational leaders, and patient accounting leadership, and covered:
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The documentation requirements for payment
The prerequisites for a clean audit
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One of the recent developments facing the public administration of corrections is that there has been an increasing call by public officials and the citizenry to privatize the prison systems in the United States. Discuss the following in regard to this:
First, from the perspective of a public-sector correctional administrator, make 2 arguments for keeping the jails in public hands.
Second, from the perspective of a private-sector correctional facility manager make 2 arguments for turning the correctional system over to the private correctional industry.
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Reading Assignment:
Peak, Chapters 9, 10, 11
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One paragraph for each question 1.Discuss the work of Chuck C.docxarnit1
One paragraph for each question:
1.
Discuss the work of Chuck Close as we saw in the film in class. How does he work: show how he takes an image and changes it by the way he interprets it. Philip Glass states in the film: “It is the old idea of form and content, and what our generation did was include process”: apply this idea to Chuck’s work.
Look at EACH of the artists below on the Art 21 website.
Answer the following questions for each artist:
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How does this artist work? Intuitively or intellectually?
·
How important is process to this artist?
·
What do you think this artist is trying to communicate?
·
Where do they get the ideas for their art ?
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3.
What is creativity (to you)? Find two examples of art you think is really “creative” describe why you think these works are “creative”. Explain why you think they are creative works. Do you exercise creativity? If not, why not? If so, how do you exhibit creative ideas and tendencies? Explain why you think creativity is important to culture.
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One rich source of fallacies is the media: television, radio, magazines, and the Internet (including, of course, commercials.) Identify two distinct fallacies you see committed in the media. Do you think it is more likely that you will not be fooled by these fallacies having studied logic? What do you think those presenting these arguments assume about the logical skills of their viewers? Is this a good or bad assumption for them to make? 150 words
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One Review of two pages is due the tenth week of class. It must be.docxarnit1
One Review
of two pages is due the tenth week of class. It must be a minimum of two typed pages, double spaced.
Your grade will drop significantly if it is less than two pages.
Scan any program, flyer, or ticket stub from the concert. Your grade will be lowered without this proof of attendance.
You must go to the concert during
this quarter!
Concerts attended during any other time frame are unacceptable and will receive an F.
the concert name is under the influence of music.
the singer name is sage the gemini. and the three songs are red nose, gas pedal and college drop.
Reviews should include the following:
1.
Name of the artist or group. Describe the musician(s) and instruments played. Briefly describe the audience and setting. How did the surroundings affect your experience?
2.
What were your expectations before attending the performance? Were those expectations met?
3. Describe two or three of the songs. Discuss any musical elements which stood out. For example:
Mood- what was the mood of the music? Exciting, sad, romantic?
Style- Rock and Roll, R and B, Hip Hop, Grunge, etc.
4.
Which was your favorite song and why? Which was your least favorite and why?
5. What did you like or dislike about the musicians playing and why?
6. Did you enjoy the performance on the whole? Why or why not?
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online 5 weeks. There are Weekly 1- (Reading Assignments 1 – 1.docxarnit1
online 5 weeks. There are Weekly :
1- (Reading Assignments 1 – 14)
28%
2- based reflective writing assignments
(Application Assignments 1 – 14)
28%
3-
Participation
in online discussions (Assignments 1-14)
14%
and one
Research report.
20%
also
Community Engagement/Experiential learning activities report
10%
See the attachment for more details.
.
Online Discussion #6 The Passing of Time2727 unread replies.2929 .docxarnit1
Online Discussion #6: The Passing of Time
2727 unread replies.2929 replies.
Please watch this video in its entirety. It is only about 13 minutes.
https://www.ted.com/talks/stephen_wilkes_the_passing_of_time_caught_in_a_single_photo (Links to an external site.)
Your to dos for this discussion:
1. Now that you have had a bit of photography history, and gained a bit of appreciation for the beauty you can find in everyday images. I'd like you to take 3 photos of something (landscape, building, people, animal, objects, anything) that is outdoors.
·
· Take the 1st photo in the morning
· Take the 2nd photo (of the same image) in the afternoon
· Take the 3rd photo (of the same image) in the evening/night
Same image, same point of view, same angle, same composition (meaning point your camera in the same direction/same distance).
2. Briefly describe 3 new concepts/ideas you learned from this video. The concept/idea can be about photography, art, science, anything. There is no right or wrong answer. I just want to know what are the top 3 things you learned. Number your concepts/ideas 1 through 3. Please briefly describe what is it you learned and why it is a new thing for you.
3. Embed the 3 photos in your post. What have you learned from looking at the 3 photos you took? What have you learned between the photos you took and looking at the photos in the video.
1. Example:I observe how the beauty of nature invite us to appreciate the bright of the day and night and we could join the gorgeous vision with colors and multiples contrast an the same moment mix with material objects at the same time such as nature places, buildings and surround people or animals as a part of the artwork.
2. I also observe ho in the second picture more intense sunlight the in color and also could be observe as the peak of their brightness and I remember how it was related to the video the comparison of daytime in one of the first pictures of rocks and the spectator could see the different of colors with one part less brighter than the other in that place. Also is mention the time guide us and believe is true for example depends of what we see in the day we have an idea of the time it is.
3.-Also Impact to me part of the video when is mentioned how animals understand better than humans that we have to share our resources and they are agree to do it. Also something that I don’t used to appreciate that I believe is a excellent reflex ion that we are observing through the windows of the time is everyday and every moment which allow me to compare the admirable invaluable treasure in these pictures at famous places such as Yosemite .
I like this outdoors pictures due that is something that now helps me to appreciate more the windows time and also that this could guide me to be more observant and encourage me to analyze the infinity ways that I could appreciate more the art pictures with these different colors ,in shadows, in day time and specially in their uniq.
One to two page summary explaining the following 1.A basi.docxarnit1
One to two page summary explaining the following:
1.
A basic explanation of Moral Virtue Theory, Duty Theory, and Utilitarianism.
2.
A comprehensive explanation of which theory you feel best represents your personal ethical viewpoint and why you feel this way.
I need this by today midnight eastern standard time. Please advise
.
ONEWAY alcohol BY ratingSTATISTICS DESCRIPTIVES HOMOGENEITY.docxarnit1
ONEWAY alcohol BY rating
/STATISTICS DESCRIPTIVES HOMOGENEITY
/PLOT MEANS
/MISSING ANALYSIS
/POSTHOC=TUKEY ALPHA(0.05).
Oneway
Notes
Output Created
07-JUN-2013 12:39:57
Comments
Input
Data
C:\Users\donn\Documents\GCU Lead fac\Project with Judy for modifying PSY845 to introduce SPSS\drinks database -revised for course applications DH.sav
Active Dataset
DataSet1
File Label
SPSS/PC+
Filter
Weight
Split File
N of Rows in Working Data File
35
Missing Value Handling
Definition of Missing
User-defined missing values are treated as missing.
Cases Used
Statistics for each analysis are based on cases with no missing data for any variable in the analysis.
Syntax
ONEWAY alcohol BY rating
/STATISTICS DESCRIPTIVES HOMOGENEITY
/PLOT MEANS
/MISSING ANALYSIS
/POSTHOC=TUKEY ALPHA(0.05).
Resources
Processor Time
00:00:00.33
Elapsed Time
00:00:00.42
[DataSet1] C:\Users\donn\Documents\GCU Lead fac\Project with Judy for modifying PSY845 to introduce SPSS\drinks database -revised for course applications DH.sav
Descriptives
Alcohol by Volume (in %) for brand
N
Mean
Std. Deviation
Std. Error
95% Confidence Interval for Mean
Lower Bound
Upper Bound
VeryGood
11
4.9000
.17889
.05394
4.7798
5.0202
Good
14
4.6000
.38829
.10377
4.3758
4.8242
Fair
10
4.5100
.34140
.10796
4.2658
4.7542
Total
35
4.6686
.35295
.05966
4.5473
4.7898
Descriptives
Alcohol by Volume (in %) for brand
Minimum
Maximum
VeryGood
4.70
5.20
Good
4.00
5.50
Fair
3.90
5.00
Total
3.90
5.50
Test of Homogeneity of Variances
Alcohol by Volume (in %) for brand
Levene Statistic
df1
df2
Sig.
1.420
2
32
.256
ANOVA
Alcohol by Volume (in %) for brand
Sum of Squares
df
Mean Square
F
Sig.
Between Groups
.906
2
.453
4.357
.021
Within Groups
3.329
32
.104
Total
4.235
34
Post Hoc Tests
Multiple Comparisons
Dependent Variable:
Alcohol by Volume (in %) for brand
Tukey HSD
(I) Rated Quality of Brand
(J) Rated Quality of Brand
Mean Difference (I-J)
Std. Error
Sig.
VeryGood
Good
.30000
.12995
.069
Fair
.39000
*
.14093
.025
Good
VeryGood
-.30000
.12995
.069
Fair
.09000
.13354
.780
Fair
VeryGood
-.39000
*
.14093
.025
Good
-.09000
.13354
.780
Multiple Comparisons
Dependent Variable:
Alcohol by Volume (in %) for brand
Tukey HSD
(I) Rated Quality of Brand
(J) Rated Quality of Brand
95% Confidence Interval
Lower Bound
Upper Bound
VeryGood
Good
-.0193
.6193
Fair
.0437
*
.7363
Good
VeryGood
-.6193
.0193
Fair
-.2382
.4182
Fair
VeryGood
-.7363
*
-.0437
Good
-.4182
.2382
*. The mean difference is significant at the 0.05 level.
Homogeneous Subsets
Alcohol by Volume (in %) for brand
Tukey HSD
a,b
Rated Quality of Brand
N
Subset for alpha = 0.05
1
2
Fair
10
4.5100
Good
14
4.6000
4.6000
VeryGood
11
4.9000
Sig.
.784
.082
Means for groups in homogeneous subsets are displayed.
a. Uses Harmonic Mean Sample Size = 11.436.
b. The group sizes are unequal. The harmonic mean of the group sizes is used. Type I error levels are not guaranteed.
Mean.
One Paragrapher per question.1) The internet has significantly.docxarnit1
One Paragrapher per question.
1) The internet has significantly changed the way that organizations conduct their business operations in breaking down barriers that previously existed. In what ways do organizations have to change their business models and operations due to the effects of the internet? Use specific examples to justify your conclusions.
2)
The content up to this point covered microeconomics. Are there any concepts covered that you found most useful or interesting, or some concepts you find difficult?
3) Find an article on a current event related to microeconomics. Briefly summarize the article.
.
Online Dating and its effects on our Interpersonal Communication..docxarnit1
Online Dating and its effects on our Interpersonal Communication.
Are we closer, or further apart?
1-
Summarize new ideas on the topic (positive and negative effect on Interpersonal Communication)
and
conclude with how online dating relates to Interpersonal Communication
2
-
In the second portion of the paper you will discuss how learning to function within a Small Group is an essential part of the larger human experience (use your own life, work, pop culture, research, etc to elaborate your position)
*Page count for the paper is 4 double spaced pages* MLA style
You are required to use 2 outside sources for this major paper.
Please be sure to include formal citations.
(You can use our text, popular press (newspaper/magazines), academic articles, etc)
Due Tuesday June 25th at 8PM-Original work only
.
ONE QUESTIONLARGE CLASS I have given you the whole module under th.docxarnit1
ONE QUESTION
LARGE CLASS I have given you the whole module under the question requirements.
QUESTION
You need to teach vocabulary of character personality traits such as honest, stubborn, or sensible. NOT moods such as ahppy and sad.
When considering presentation techniques have in mind the target language is NON VISUAL you can’t draw honest so think of another way to convey the meaning
Please include
List of words of words you will teach
Assumed knowledge of students list of vocabulary structures you will expect your students to know
Anticipated problems.
Solution
s.
Prearations and aids
Step by step entire lesson and timing
THIS IS MY LAST CHANCE HELP
Understandably, before teachers begin teaching their first large class, they tend to think about the challenges inside the classroom. However, after a few days, it becomes clear that responsibilities outside class are equally challenging.
Welcome to this module on
teaching large classes.
Teaching large volumes of students at any one time is always a challenge, and so it is particularly important for the teacher to be well prepared. This module can help you overcome the difficulties generated from a large class, but it will also help you make the most of the benefits that it can provide.
In this module, you will find out:
a variety of methods and techniques to help you teach a large class of students to communicate in English
how to manage your time outside class
ways to manage a large group of students
how to keep your students participating and motivated
how to cater for students with different proficiency levels
how to arrange students
how to promote learner independence
how to organise feedback
how to monitor and assess student performance in a large class
WHAT DO WE MEAN BY LARGE CLASS
When we say 'large' we generally mean a class of 30-60 students, in some instances up to 100. The educational system of some countries precludes the formation of language groups that are so large, however in other countries, for instance India, China or South Korea, such classes are quite common.
School administrations may choose to split students into smaller groups for the following reasons:
Overpopulation and a lack of teachers.
The traditional belief that still prevails in some parts of the world where the aim of a language course is to prepare students for an examination (usually a formal, written, grammar-based one) rather than teach them to communicate in English. A lesson is therefore viewed as a lecture where a certain amount of knowledge is to be passed on to the students.
Depending on room size it would be difficult to divide the class but definitely possible.
Assess competency and delegate stronger class members to lead smaller groups within class room.
Delegate 4 class members if your class is 60 and instruct them each to distribute and collate homework.
Failing to prepare before entering the class means the class is doomed to fail
Rising to the challenge stimulates professional gro.
Once the training analysis is completed, the organization and employ.docxarnit1
Once the training analysis is completed, the organization and employee development human resources specialist uses adult learning theories to turn the training needs into training materials, courses, and instructional design.
Address the following elements of understanding the adult learning model:
Explain the theories of adult learning principles.
Compare the differences between child/adolescent and adult learning models (pedagogy and andragogy).
Discuss the concept of learning styles, personalities, and how these concepts are combined with adult learning in organizational training and development programs.
Explore the options that organizations have in applying adult learning to a comprehensive training and development program.
.
Once each individual selects their own feature topic, then each pers.docxarnit1
Once each individual selects their own feature topic, then each person should prepare their own
2 page text report that explains and presents the essence of the particular WSJ feature they are reviewing, plus some appendices as noted below
. The objective of each member’s individual 2 page report is to efficiently & effectively communicate a GENERAL message regarding what the WSJ feature section is about, as well as key and interesting insights presented in the section and gained through your work.
An example is provided at the end of this document.
.
Once the Application has started up and you are at the Start Page, s.docxarnit1
Once the Application has started up and you are at the Start Page, select the create a new project option. When presented with the New Project window like the one below, be sure that you have highlighted Console Application under the Templates window. Now give the new project the name INV_GRAB in the Name field, and have the location field pointing to the F:\SAI430 folder you have on the F: drive. The diagram below depicts what your New Project window should look similar to.
Once you have done this, select OK to complete this operation. You may get a "Microsoft Development Environment" message box stating that the project location is not a fully trusted .NET runtime location. You can ignore this and just select OK. You should now see your new project listed in the
Solution
Explorer window on the upper right hand corner of the editor window. You are now ready to begin setting up your form.
STEP 2: Setting Up a Database Connection
Back to Top
The first step now is to set up a database connection with Access and then a data set that can be used to transport the data from the database to the application to be written to a file. For the purposes of this lab and your project, you will only need data from two columns in the ITEMS table of the INVENTORY database, but we will control that with the code written later. The following steps will lead you through the process of setting up the connection.
To begin, you need to add the following three namespaces to the top of your application code:
using System.IO;
using System.Data;
using System.Data.OleDb;
Since you are going to be not only connecting to a database but also writing data to a file, you will need all three of these listed.
Now you can set up the connection to your Access database that you downloaded and put in your folder. The actual connection string is @"Provider=Microsoft.JET.OLEDB.4.0; data source=F:\inventory.mdb". This is a standard connection string for MS Access. You will want to precede this with the command - string conString = so that the finished connection looks like this.
string conString = @"Provider=Microsoft.JET.OLEDB.4.0; data source=F:\SAI430\inventory.mdb";
This is simply defining a string variable named conString and assigning the connection string to it. We will use this variable later.
Now we need to define an OleDbConnection that will be used to connect to the database. To do this you will need to define a connection variable as a new OleDbConnection and point it to the connection string defined in the previous step. Your code should look like the following.
OleDbConnection conn = new OleDbConnection(conString);
Now you can connect and open the database with the following command entered right below the line above.
conn.Open();
Last, we need to declare a variable that will be used later on. Although this really has nothing to do with setting up the database connection, this is as good a place as any to do this. You need to define a single variable named rowCount as an.
Once an individual has become a victim of a crime, there is the myst.docxarnit1
Once an individual has become a victim of a crime, there is the mystique of the victim not knowing how the criminal justice system operates and what role the victim plays in the system. The police chief of Anytown Police Department has compiled a group of staff members to put together an instructional document that would explain to a victim about the criminal justice system. You and your group are the team tasked with compiling this document.
As a group, draft a paper that depicts the various roles and responsibilities of the criminal justice system components: law enforcement, the courts, and corrections. Include what civil proceedings a victim can seek against an offender. Finally, include a section that describes a victim’s advocacy program, as well as highlights the services and activities provided to crime victims.
Group Project Portion (1)
As a group, determine how the following sections of the paper will be divided among the members with regard to victims, roles, and responsibilities:
Law enforcement
Courts
Corrections
Civil Court proceedings
Victim’s advocacy programs
Be sure to divide the above sections equally among members.
Individual Portion
Conduct your research, and write your portion of the comprehensive document that was assigned to you during the Group Portion (1).
Be sure to reference all sources using APA style.
Group Portion (2)
Meet as a group and compile your Individual Portions into the final comprehensive group submission.
Read through the final group document, and post a comment for each section in the Small Group Discussion Area.
The comments should explain one of the following to the individual writers:
Important information that was missed and why it should be included in the final document
Which part of the writer's Individual Portion is most significant to the value of the group document
Be sure that all responses are of high quality and offer valuable feedback.
.
Once again, open and read aboutMuseo Nacional de Banco Centr.docxarnit1
Once
again
,
open and read about
Museo Nacional de Banco Central de Ecuador
and the
Fundación Guayasamín
.
Write about upcoming shows and exhibitions at either of these museums. Use the future tense and
ir
+
a
+
infinitivo
in your answer.
.
One function of a leader is to provide the vision for the organiza.docxarnit1
One function of a leader is to provide the vision for the organization they lead. Being a role model and leading the way forward are important aspects of leadership. If you were leading an internet retailer or other organization that involves innovative technology and organizational flexibility, describe the process you would engage to create a vision for the organization and how you would get employees involved in that vision.
.
One afternoon at work, Natalie received a phone call from her daught.docxarnit1
One afternoon at work, Natalie received a phone call from her daughter’s teacher. It seemed that Brandi had got into trouble, and Natalie would need to meet with Brandi’s teacher and the school principal. Natalie could not imagine what the trouble could be. Brandi was a straight-A student, played soccer, and was part of the school band. She also helped out with chores at home. On the way to the school, Natalie decided she would not jump to conclusions but would hear Brandi’s side of the story. Then, she would let Brandi have a piece of her mind!
At school, Natalie met the school principal; Brandi’s teacher; and a crying, red-eyed Brandi. Brandi and two other girls had stolen a pack of cigarettes from a teacher’s purse and were caught smoking in the woods behind the school. Worse, one of the other girls had stolen the teacher’s prescription medication, though Brandi said she did not know anything about that. The principal and teacher said that this was a serious breach of trust and was against school policy. They knew Brandi and were “shocked” that she was involved in this activity. In private consultation with Natalie, they said that Brandi was involved with the wrong crowd, but there was still time to intervene before she developed a pattern of bad behavior.
Natalie left the meeting angry with Brandi, but also feeling guilty and responsible. She had been working extra hours and was often busy with her schoolwork. Perhaps she had neglected Brandi or missed important warning signs. She would ground Brandi, but more importantly, she would pay much closer attention to whom she befriended and where she went. Natalie decided she would establish a schedule where she would help the girls’ do their homework.
Natalie felt tired. After all the years of guidance and parenting, how could “two stupid tweens” undo all her hard work? She felt she had worked hard teaching Brandi and Jenny how to make good decisions and to know right from wrong. She worried what the next ten years would bring. She pondered the possibilities of other peer influences, alcohol, drugs, and boys.
Research differential association theory and social learning theory as applied to criminal behavior and crime using the textbook, the University online library resources, and the Internet. Select two scholarly, peer-reviewed articles for use in this assignment.
Based on the scenario, your readings and research, respond to the following:
How could Brandi’s behavior be explained using differential association theory?
How could Brandi’s behavior be explained using social learning theory?
What are the strengths and limitations of these two theories as applied to this example?
Be sure to support your responses using the selected resources.
Write your initial response in 4–6 paragraphs. Apply APA standards to citation of sources.
.
One of the key aspects of developing a strategy for the human elemen.docxarnit1
One of the key aspects of developing a strategy for the human elements in information technology (IT) project is to identify the roles and responsibilities of those affected by and involved with the projects. These people are called the
stakeholders
, and they will be the ones who determine the success of the projects. The key aspects of a project's success include the identification of the stakeholders and planning and preparing for the strategies of communication between those stakeholders.
For this assignment, you will continue to work on the Human Elements in IT Strategy document by identifying the stakeholders and defining their roles and responsibilities within the IT projects. You will then establish a strategy for communication between these stakeholders, including the methods of communication and identification of the key artifacts of project information that must be communicated during project execution. This is the Key Assignment First Draft.
The project deliverables are as follows:
Update the Human Elements in IT Strategy document title page with a new date.
Update the previously completed sections based on instructor feedback.
IT Project Stakeholders
Stakeholder Identification, Roles, and Responsibilities
Create a list of the key stakeholders in your organization’s IT projects.
Describe the roles and responsibilities of each stakeholder with respect to IT projects.
Summarize the issues related to the organization's IT projects that are important to each stakeholder.
Stakeholder Communication
Develop a strategy for communication between the stakeholders identified in the first part of the assignment.
The communication strategy should identify the major communication that should occur during the project and the key artifacts that should be communicated.
For example, a design document should be one of the key artifacts, and it should be communicated to specific project stakeholders.
A communication matrix would be appropriate for this part of the assignment.
Be sure to update your table of contents before submission.
.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
BOARD OF REGISTERED NURSING PO Box 944210, Sacramento, .docx
1. BOARD OF REGISTERED NURSING
PO Box 944210, Sacramento, CA 94244-2100
P (916) 322-3350 F (916) 574-8637 | www.rn.ca.gov
BUSINESS, CONSUMER SERVICES, AND HOUSING
AGENCY • GOVERNOR EDMUND G. BROWN JR.
NPR-B-03 06/1995 AN EXPLANATION OF SCOPE OF RN
PRACTICE INCLUDING STANDARDIZED PROCEDURES
REV. 07/1997, 01/2011 1
AN EXPLANATION OF THE SCOPE OF RN PRACTICE
INCLUDING STANDARDIZED PROCEDURES
The Legislature, in its 1973-74 session, amended Section 2725
of the Nursing Practice Act (NPA),
amplifying the role of the registered nurse and outlining
activities which comprise the practice of nursing.
LEGISLATIVE INTENT
The Legislature recognized that nursing is a dynamic field,
continually evolving to include more
2. sophisticated patient care activities. It declared its intent to
recognize the existence of overlapping functions
between physicians and registered nurses and to permit
additional such sharing and to provide clear legal
authority for those functions and procedures which have
common acceptance and usage. Prior to this,
nurses had been educated to assume advanced roles, and
demonstration projects had proven their ability to do
this safely and effectively. Thus, legal amplification of the role
paralleled the readiness of nurses to assume
the role and recognized that many were already functioning in
an expanded role.
SCOPES OF PRACTICE
A knowledge of the respective scopes of practice of registered
nurses and physicians is important in
determining which activities overlap medical practice and
therefore require standardized procedures.
Failure to distinguish nursing practice from medical practice
may result in the limitation of the registered
nurse's practice and the development of unnecessary
standardized procedures. Registered nurses are
cautioned not to confuse nursing policies and procedures with
standardized procedures.
1. Scope of Registered Nursing Practice
The activities comprising the practice of nursing are outlined in
the Nursing Practice Act, Business and
Professions Code Section 2725. A broad, all inclusive
definition states that the practice of nursing means
those functions, including basic health care, which help people
cope with difficulties in daily living which are
associated with their actual or potential health or illness
problems, or the treatment thereof, which require a
substantial amount of scientific knowledge or technical skill.
3. In Section 2725(a), the Legislature expressly declared its intent
to provide clear legal authority for functions
and procedures which have common acceptance and usage.
Registered nurses must recognize that the
application of nursing process functions is common nursing
practice which does not require a standardized
procedure. Nursing practice is divided into three types of
functions, which are described below.
A. Independent Functions
Subsection (b)(1) of Section 2725, authorizes direct and indirect
patient care services that insure the safety,
comfort, personal hygiene and protection of patients, and the
performance of disease prevention and
restorative measures. Indirect services include delegation and
supervision of patient care activities performed
by subordinates.
Subsection (b)(3) of Section 2725, specifies that the
performance of skin tests, immunization techniques and
withdrawal of human blood from veins and arteries is included
in the practice of nursing.
NPR-B-03 06/1995 AN EXPLANATION OF SCOPE OF RN
PRACTICE INCLUDING STANDARDIZED PROCEDURES
REV. 07/1997, 01/2011 2
Subsection (b)(4) of Section 2725, authorizes observation of
signs and symptoms of illness, reactions to
treatment, general behavior, or general physical condition and
4. determination of whether these exhibit
abnormal characteristics; and based on this determination, the
implementation of appropriate reporting or
referral, or the initiation of emergency procedures. These
independent nursing functions have long been an
important focus of nursing education, and an implied
responsibility of the registered nurse.
B. Dependent Functions
Subsection (b)(2) of Section 2725, authorizes direct and indirect
patient care services, including, but not
limited to, the administration of medications and therapeutic
agents necessary to implement a treatment,
disease prevention, or rehabilitative regimen ordered by and
within the scope of licensure of a physician,
dentist, podiatrist or clinical psychologist.
C. Interdependent Functions
Subsection (b)(4) of Section 2725, authorizes the nurse to
implement appropriate standardized procedures or
changes in treatment regimen in accordance with standardized
procedures after observing signs and
symptoms of illness, reactions to treatment, general behavior, or
general physical condition, and determining
that these exhibit abnormal characteristics. These activities
overlap the practice of medicine and may require
adherence to a standardized procedure when it is the nurse who
determines that they are to be undertaken.
2. Scope of Medical Practice
The Medical Practice Act authorizes physicians to diagnose
mental and physical conditions, to use drugs in
or upon human beings, to sever or penetrate the tissues of
human beings and to use other methods in the
treatment of diseases, injuries, deformities or other physical or
mental conditions. As a general guide, the
5. performance of any of these by a registered nurse requires a
standardized procedure; however, activities
within each of these categories have already become common
nursing practice and therefore do not require
standardized procedures; for example, the administration of
medication by injection requires penetration of
human tissue, and registered nurses have performed this
function through the years.
In Section 2725(a), the Legislature referred to the dynamic
quality of the nursing profession. This means,
among other things, that some functions which today are
considered medical practice will become common
nursing practice and no longer require standardized procedures.
Examples of medical functions which have
evolved into common nursing functions are the measurement of
cardiac output pressures, and the insertion of
PICC lines.
STANDARDIZED PROCEDURES FOR MEDICAL
FUNCTIONS
The means designated to authorize performance of a medical
function by a registered nurse is a standardized
procedure developed through collaboration among registered
nurses, physicians and administrators in the
organized health care system in which it is to be used. Because
of this interdisciplinary collaboration, there
is accountability on several levels for the activities to be
performed by the registered nurse. Section 2725(a)
defines "organized health care systems" to include, but are not
limited to, licensed health facilities, clinics,
home health agencies, physicians' offices, and public or
community health services.
GUIDELINES FOR DEVELOPING STANDARDIZED
PROCEDURES
6. Standardized procedures are not subject to prior approval by the
boards that regulate nursing and medicine;
however, they must be developed according to the following
guidelines which were jointly promulgated by
the Board of Registered Nursing and the Medical Board of
California. (Board of Registered Nursing, Title
16, California Code of Regulations (CCR) section 1474;
Medical Board of California, Title 16, CCR Section
1379.)
(a) Standardized procedures shall include a written description
of the method used in developing and
approving them and any revision thereof.
NPR-B-03 06/1995 AN EXPLANATION OF SCOPE OF RN
PRACTICE INCLUDING STANDARDIZED PROCEDURES
REV. 07/1997, 01/2011 3
(b) Each standardized procedure shall:
(1) Be in writing, dated and signed by the organized health care
system personnel
authorized to approve it.
(2) Specify which standardized procedure functions registered
nurses may perform and under
what circumstances.
(3) State any specific requirements which are to be followed by
registered nurses in
performing particular standardized procedure functions.
7. (4) Specify any experience, training and/or education
requirements for performance of
standardized procedure functions.
(5) Establish a method for initial and continuing evaluation of
the competence of those
registered nurses authorized to perform standardized procedure
functions.
(6) Provide for a method of maintaining a written record of
those persons authorized to
perform standardized procedure functions.
(7) Specify the scope of supervision required for performance
of standardized procedure
functions, for example, telephone contact with the physician.
(8) Set forth any specialized circumstances under which the
registered nurse is to immediately
communicate with a patient's physician concerning the patient's
condition.
(9) State the limitations on settings, if any, in which
standardized procedure functions may be
performed.
(10) Specify patient record-keeping requirements.
(11) Provide for a method of periodic review of the
standardized procedures.
An additional safeguard for the consumer is provided by steps
four and five of the guidelines which, together,
form a requirement that the nurse be currently capable to
perform the procedure. The registered nurse
who undertakes a procedure without the competence to do so is
8. grossly negligent and subject to discipline by
the Board of Registered Nursing.
SUMMARY OF RN FUNCTIONS UNDER STANDARDIZED
PROCEDURES
Registered nursing functions under standardized procedures may
be summarized as follows:
WHO: the registered nurse
WHAT: may perform a medical function beyond the usual scope
of RN practice
HOW: in accord with a written standardized procedure
developed by nursing, medicine and
administration
WHERE: in an organized health care system
WHEN: after the RN has been evaluated and approved as having
met the education and experience
requirements specified in the procedure
WHY: because the standardized procedure authorizes the RN to
exceed the usual scope of RN practice
NPR-B-03 06/1995 AN EXPLANATION OF SCOPE OF RN
PRACTICE INCLUDING STANDARDIZED PROCEDURES
REV. 07/1997, 01/2011 4
9. TO DETERMINE IF A STANDARDIZED PROCEDURE IS
REQUIRED
Ask each question below in the order presented. Continue only
until your answer points to "S.P. required," or to "S.P. not
required."
1. Is the function commonly recognized as nursing practice?
NO YES ⇒ S.P. not required
⇓
2. Is it the standard of practice in the community that RNs
perform this function in the clinical area for which it is being
considered?
NO YES ⇒ S.P. not required
⇓
3. Does the function require the nurse to:
Diagnose disease,
Prescribe medicine or treatment, or
Penetrate or sever tissue?
NO YES ⇒ S.P. required
⇓
4. Does safe performance of the function require judgment
based on medical knowledge beyond that usually possessed by
the
10. competent RN in the area for which it is being considered?
NO YES ⇒ S.P. required
⇓
S.P. not required
WHO DEVELOPS STANDARDIZED PROCEDURES?
Health Facilities licensed by Dept. of Public Health
1. Organized Health Care Systems
Health Facilities not licensed (CCR 1470): Clinics,
Home Health Agencies, Physicians Offices, Public or
Community Health Services
2. Collaborating:
Administrators, and Health REGISTERED NURSES
Care Professionals, including
PHYSICIANS
LEGISLATIVE INTENT
Mitchell, J. G. (2001). Urban sprawl. National Geographic,
200(1), 48–74.
11. Retrieved from the Walden Library databases.
Section:
Earthpulse
THE AMERICAN DREAM has long promised life, liberty, and
the pursuit of a spacious single-family home in the suburbs
(with a pool, even). But as new generations of home seekers
look for breathing room in the burbs and the lands beyond, the
dream has been displaced by all too familiar worlds-places
plagued by traffic jams, high taxes, and pollution.
Tom Spellmire lives with his mother on an 87-acre farm in
Turtle Creek Township, Warren County, Ohio. One county
away, to the south, lies Cincinnati. One county north, Dayton.
Spellmire's is a place of silos and barns and a turn-of-the-
century white frame farmhouse with a green roof. Another farm
or two can be seen along the road in one direction. But going
the other way, after a mile or so, you begin to run out of green
roofs and open fields, and what you see instead are the kinds of
manicured lawns and picture windows that for half a century
have signified fulfillment of the American dream.
One blustery day late last year I traveled with Tom Spellmire to
see how that dream had been playing around Warren County.
Harvest time was behind him then, the corn and soybeans taken
in, the winter wheat planted. Crops from a homestead of 87
acres couldn't begin to pay all his taxes, so Spellmire leases
2,400 acres from other landowners, though this is not as many
acres as were once available to him. As we drove south, then
west into an adjoining county, he could point to a subdivision
(like Four Bridges) or an industrial site (Mitsubishi Electric)
saying, "We used to farm all this land."
Spellmire is a tall, ruddy, intensely focused man who served on
12. Ohio's Farmland Preservation Task Force in the 1990s. And he
is not happy about the prospects for farming in Warren County.
"Believe it or not," he says, "this county is promoted as having
rural character, but the zoning codes, in effect, say: 'We want to
develop everything.' That's why the county is a haven for real
estate investors."
When investors come, can developers be far behind? And
behind the developer comes the family in search of a home in
the suburbs. We drove past or through a dozen new subdivisions
that day. The Meadows at Mason. Heritage Club. Hickory
Woods. Simpson Creek Farms. Presently we arrived at a
subdivision called Trailside Acres, featuring homes that we
figured might sell for up to half a million dollars apiece. At the
end of a cul-de-sac Spellmire gestured toward a wide, open field
we could see in the distance beyond the slim side yards of the
big houses.
"We lease that farm," he said. "We rotate corn, soybeans, and
wheat on it." Then he shook his head. "And what I find so ironic
is that all these people who live here look out their back
windows and see this fine old farmstead. When I'm out there on
a tractor, the subdivision kids are hanging over their fences,
watching me. And you know what their parents say to the
people who own that farm? They say, 'You're not going to sell it
for development, are you? Are you?'"
AN OLD SAYING has it that you can't have your cake and eat it
too. So it would seem in the land of the manicured lawn and the
picture window, the treeless cul-de-sac, the sterile shopping
center, the blockbuster mall, the corporate campus, the
amorphous parking lot, the clogged highway that inevitably
fails to serve its desired function as soon as it is built. Yet most
Americans who live among these icons of suburban growth
aren't terribly troubled by them. It's the way things are, a
tolerable nuisance even if the process does gobble up the land,
13. skewer the fabric of community life, and erode the economic
base of older towns and central cities. And perhaps it is
tolerable to so many because it has become so familiar. After
all, outward growth of this kind has been occurring in most
regions of the country since the end of World War II. Region to
region the scenario has almost always been the same: As a city
ages, crime and other urban problems induce many of the
affluent residents to move out.
Cincinnati, for example, a century and a half ago the second
most populous municipality west of the Appalachians, had by
the 1960s begun to hemorrhage its population into the exurbs of
its own county, Hamilton. And by and by Hamilton began
hemorrhaging too, into Warren and other adjacent counties.
"Why are the people leaving?" John Dowlin, a Hamilton County
commissioner, put the question to himself when I called on him
at the county courthouse in downtown Cincinnati. "I don't think
it's just a racial situation." African Americans now make up 43
percent of the city's population of 330,000. "All the polls show
that the people moving out are unhappy with the public schools.
And they want larger homes on larger lots. I think what we're
seeing is that same old thing--people wanting a piece of the
American dream."
The media and the professional planners have long had another
name for it. They call it sprawl. And they have measured its
imprint on the nation in a hundred and one different ways. Here
are just a few of them:
· Seventy million Americans lived in the nation's urbanized
areas in 1950; these regions covered some 13,000 square miles.
By 1990 the urban-suburban population had more than doubled,
yet the area occupied by that population almost quintupled--to
more than 60,000 square miles.
14. · Phoenix, Arizona, one of the Sunbelt's fastest growing
communities, has been spreading outward at the rate of an acre
an hour. Atlanta, Georgia, another overachiever, boasts a
metropolitan area that is already larger than the state of
Delaware.
· Sprawl is claiming farmland at the rate of 1.2 million acres a
year. Throw in forest and other undeveloped land and, for net
annual loss of open space, you're waving good-bye to more than
two million acres.
· Sprawl keeps a person in the driver's seat. The suburban
family, on average, makes ten car trips a day (keeping in mind
that most families have two vehicles). A commuter living an
hour's drive from work annually spends the equivalent of 12
workweeks, or 500 hours, in a car. Traffic delays rack up more
than 72 billion dollars in wasted fuel and productivity.
· So pervasive is sprawl, extremists are using it to justify their
acts of ecoterrorism. Last year in suburban New York several
houses and a condominium, all newly built and unoccupied,
were set afire; earlier, gasoline was used to torch a luxury house
for sale in Colorado.
· By 2025 the United States will be home to nearly 63 million
more people than are here today. If current trends prevail,
they're going to need more than 30 million new homes. Most of
those homes will be single-family, detached units built beyond
the edge of today's newest suburbs. And most of the families
occupying those houses will be in and out of their cars at least
ten times a day.
A part from the fact that the Greater Cincinnati area today ranks
high on almost anyone's list of the nation's most sprawl-
threatened metropolitan regions, I suspect it was the homing
instinct that brought me back to southwestern Ohio. I grew up
15. there through the 1930s and '40s, in a quiet neighborhood only
four miles from downtown Cincinnati, in a house near the end
of a winding sylvan street called Garden Place. My father was
in the real estate business. He developed raw land into
residential subdivisions. The one I remember best was way out
near what was then the far north edge of Greater Cincinnati, in
the village of Woodlawn, at a place called Mayview Forest. It
really was a forest then--oaks and hickories, and big sycamores
down where the West Fork of Mill Creek cut through. I loved
going to that forest with my father, seeing the limestone pools
in the stream and smallmouth bass in the pools and squirrels in
the hickory trees. While I fished or hunted, my father drove
wooden stakes into the ground at the corners of his house lots.
Now Mayview is just another old subdivision, and the north
edge of Greater Cincinnati is miles beyond it, rolling inexorably
toward a confluence with Dayton in the once and former
cornfields of Butler and Warren Counties.
"This is one of the largest and fastest growing communities in
Warren County," Dan Theno was saying with a proud smile.
Theno is the director of economic development and community
relations for Deerfield Township. We were sitting in his office
just off U.S. 22, a thoroughfare so congested at rush hour that
the township trustees are begging the state for a major
widening. Theno said, "We're more than 25,000 residents now.
We're heading on a hundred million dollars of new development
a year. We're putting up 600 new homes a year. Sure, good
schools here are a primary draw. But so are jobs. We've got
over 800 businesses right here in Deerfield, including some big
names like Hewlett-Packard."
To illustrate how aggressively the township is inviting such
growth, Theno handed me a slick 24-page special advertising
section that appeared in Cincinnati Magazine. Describing
Deerfield as "a township for tomorrow," the promotional copy
reflected Dan Theno's enthusiasm for the way Greater
16. Cincinnati has expanded into this corner of Warren County.
"Where rolling fields of corn once flourished," the lead article
declared, "businesses and residential communities have sprouted
seemingly overnight, providing jobs and housing for the Tristate
population as it moves north...."
But not everyone in southern Warren County feels as cheerful as
Dan Theno--or, for that matter, as threatened as Tom Spellmire,
the farmer. Over in Mason I turned into a subdivision cul-de-sac
to visit the home of Jim and Helen Fox, neither of whom
believes that growth necessarily means progress. Jim Fox was
born and raised in Mason and is now the city's vice-mayor.
Helen Fox is co-founder of a small grassroots group called
Balance, which seeks to put a brake on the way Mason and
Deerfield have been growing.
"Every other day there was a story in the newspaper," Helen
Fox said, explaining what motivated her to get active. "Traffic
snarls one day, schools can't keep up the next--800 new students
projected for Mason every year for the foreseeable future. And
the day after that it's something else. So rather than get sick
about it, we decided--Hey! What can we try to do to slow down
this runaway train?"
We sat in the kitchen over coffee. The vicemayor was away at
work. She explained that the mission for Balance was just
getting out the word about sprawl and maybe finding the funds
to buy up a few of the green spaces remaining. "But let's be
realistic," she said. "We're not going to change Mason now. It's
so far along. I just hope it's not too late to make other parts of
Warren County see what's happening so that they can become
more thoughtful about how they want to grow in the future."
The urge to move on lies entrenched in most Americans. It is a
kind of cultural impulse, as one historian has defined it, "to
withdraw from the great world and begin a new life in a fresh,
17. green landscape:' Here is the tired city, out there the fresh
country, the pastoral Jeffersonian ideal, the sort of place where
that fellow Thoreau built a hut and grew beans, far from the
townies living lives of quiet desperation.
So begins the succession from country to suburb to sprawl.
Contrary to popular opinion, the suburb was not an invention of
the 20th century. By the late 1800s suburbs galore--rural
communities brought closer to the urban workplace by the
moving miracles of streetcars and steam--ringed most of the
older cities in the East. If Boston could have its Concord, then
Manhattan would have the Bronx and Staten Island too. After
the Civil War there were even a few new communities designed
specifically for suburban living. One of the first was Riverside,
Illinois, straddling a rail line nine miles west of the Chicago
Loop. Laid out by the landscape architect Frederick Law
Olmsted and his parkmaking partner Calvert Vaux, Riverside
would become what one Olmsted biographer described as an
"agreeable" community, "knit in upon itself by curving streets, a
place apart but in convenient reach of a great city."
With Chicago's Riverside as an inspiration, if not a model, the
great cities reached out to enlarge or establish other convenient
and agreeable places apart--Scarsdale and Swarthmore and
Shaker Heights, and Mariemont, right there on the eastern flank
of Cincinnati.
At the end of World War II the United States faced an acute
shortage of housing and promptly declared war on that. Loan
programs previously created under the Federal Housing
Administration and the Veterans Administration encouraged the
development of single-family, detached houses in the suburbs.
And the secret to that effort was the guaranteed fixed-interest
mortgage, which in many cases made it cheaper to buy a house
than to rent an apartment.
18. By most accounts nothing moved the suburbs so efficiently
toward sprawl as a certain stroke of President Dwight
Eisenhower's pen, signing into law the Federal-Aid Highway
Act of 1956, which launched a 41,000-mile interstate highway
system. Among other things, the interstates would grease the
skids for commerce, industry, and a burgeoning roster of fast-
food emporiums to roll off the exit ramps into a countryside
previously reserved for corn. And it was thought at the time that
the interstates would facilitate the evacuation of central cities in
the event that our Cold War nemesis might post an
intercontinental ballistic missile into city hall. Voila! A
warhead did explode, but it wasn't nuclear. It was sprawl.
One of the most congested peripheral corridors in the nation is
the stretch of Greater Cincinnati's own beltway, I-275, as it
brushes the topside of Hamilton County to scoop up I-75 from
Dayton and I-71 from Columbus before sending them on their
converging way to and through inner neighborhoods of the
central city. From his Turtle Creek farmhouse north of the
beltway Tom Spellmire can get to either of these interstates in
less than 20 minutes. That fact alone may explain why, given
the bracketing proximity of three superhighways, Warren
County is on such a roll, and why Tom Spellmire's farming
future isn't.
You'd never guess it from the looks of Greater Cincinnati and
most other metropolitan regions around the country, but there is
an alternative to mindless sprawl. Some people call it smart
growth.
Smart growth rests on the assumption that we can curb sprawl
by building better kinds of new communities, by fixing up and
filling in the old ones, by finding ways to get people out of at
least some of their cars, and by going out into the countryside
to preserve large tracts of open space before the developers can
19. pave them. This is one tall order, and only time will tell to what
extent it can be filled.
One measure of how the nation might be willing to tackle the
smart-growth agenda is the ballot box. Last November referenda
authorizing bonds or tax increases to pay for land conservation,
.neighborhood redevelopment, or mass transit passed
overwhelmingly; voters said yes to seven of every ten growth-
related initiatives in state and local elections. And in Ohio
voters approved a 400-million-dollar measure for redevelopment
of abandoned industrial sites and--good news for Tom
Spellmire--farmland and green-space preservation.
Smart-growth advocates looking for further encouragement or
inspiration are likely to turn to the one state that has managed
better than any other to put a brake on runaway sprawl. That
state is Oregon. And the man who designed the brake was its
governor from 1967 to 1975, Tom McCall.
Early on, McCall ordered a study of land use patterns in the
crop-rich Willamette Valley. Among other things, the study
found that in the 1960s Clackamas County lost 100,000 acres of
farmland to development flowing outward from Portland.
Oregon, said McCall, was under siege from a "buffalo-hunter
mentality" inserting "cancerous cells of unmentionable ugliness
into our rural landscape." The legislature agreed and enacted a
law mandating urbangrowth boundaries for Oregon's 240 cities.
Development was to be contained inside the boundaries. Outside
the boundaries, farmland and forestland were to be protected by
zoning, the minimum lot size set at 80 acres.
As a result of the rural zoning program, some 25 million acres
of privately owned farmland and forestland are now shielded
from sprawl throughout the state. There's no way you can make
a subdivision out of houses on 80-acre lots.
20. "Oregonians hate two things," Mike Burton was saying. "They
hate sprawl. And they hate density." Burton is the executive
officer of Metro, Portland's metropolitan planning agency and
the nation's first (and, so far, only) popularly elected regional
government. Metro oversees land-use plans and the urban-
growth boundary that encompasses 24 cities, including Portland,
in the three-county region. So when Burton speaks of people
hating both sprawl and density, he is simply putting a spin on
that impossible human urge to have it both ways. Obviously, to
avoid hateful sprawl outside, density somewhat less hateful
must be accommodated inside the urban-growth boundary.
And yet today there isn't a whole lot to dislike about Portland.
It is a handsome, tight little city of some 529,000 people (up
from 366,000 in 1980) tucked into the confluence of the
Willamette and Columbia Rivers; its downtown, pedestrian
friendly; its residential areas growing up rather than out; its
growth in transit use outpacing its increase in auto use. Its open
spaces range from Forest Park, at nearly 5,000 acres the largest
woodland park within any city in the United States, to a
riverfront greenway named in honor of the late Tom McCall.
Some critics, mostly homebuilders, contend that Portland's
growth boundary is riddled with flaws, that it hasn't been as
flexible as the law intended, that it has raised housing prices
substantially. But defenders of the system say it's the region's
hot high-tech economy that's inflating the housing market. And
even with that, they say, it is still less expensive to live in
Portland than in San Francisco or Los Angeles, which do not
have urban-growth boundaries.
From downtown Portland I rode the MAX (the Metropolitan
Area Express aboveground light-rail system) out to the western
suburbs to take a peek at a place I'd been hearing a lot about, a
place called Orenco Station. MAX has 33 miles of light-rail
track, and the idea at Metro is to use MAX as a magnet for new
21. residential and commercial development, all within the growth
boundary and all within walking distance of a light-rail station.
Orenco is one of those stations.
From the station the walk to town center is a long quarter mile.
You have the feeling, as you approach across an open field, that
you are about to enter a village stylishly snatched from the 19th
century. There are cottages and bungalows and Main Street
shops with bay windows. When the community's 200 acres are
fully developed, there will be 1,800 units of mixed housing
types, including home-office town houses, lofts, and rental
apartments.
But just as there are those who would criticize Portland for
being less than perfect, so can one also hear groans that Orenco
and other so-called new urbanist experiments are simply
attempts to disguise America's flight to the suburbs with a new
suit of clothes.
Over the years, I became addicted to reading the country
through an airplane window. It is a habit I acquired before jet
engines took us higher and faster than propellers could, before
we began to lose, for any number of unearthly reasons, the
visibility one would expect from a cloudless sky. Still, the
visibility was pretty good the last time a jetliner lifted me out of
Chicago's O'Hare International Airport. I could see the
gleaming office towers down in the Loop and the big blue lake
and the suburbs sprawling north. The suburbs looked gray.
I had been down there where the gray begins to get green a day
or two before, to check out another new railside community
called Prairie Crossing. This one is a bit different from
Oregon's mixed-use Orenco Station. This one features roomy
frame houses with rocking chair porches clustered around or
within more than 350 acres of open space, including an organic
farm, a swimmable lake, a restored prairie, and--in place of the
22. concrete gutters and detention basins of a conventional
development--a network of grassy swales and cattail marshes to
filter the storm-water runoff.
Once upon a time the acres at Prairie Crossing might have been
developed with conventional homes and non-native landscaping.
But along came Victoria and George Ranney, Jr., with a better
idea. Victoria Ranney is a conservation and cultural activist
who edited a volume of the papers of Frederick Law Olmsted
and who appears to see the land through Olmstedian eyes.
George Ranney is president of Chicago Metropolis 2020, a
group of business and civic leaders seeking to make some
regional sense out of the chaos of Greater Chicago's 1,200
disjointed political jurisdictions.
Among the Ranneys' guiding principles for Prairie Crossing is a
statement on economic and racial diversity. It holds that "a mix
of incomes and races is essential to the future of our society"
and expresses an intent to keep prices down "so that some
homes will be within the range of families needing affordable
housing." Several African-American families have purchased
homes in Prairie Crossing, and the community has done far
better on the racial diversity scorecard than many of its
neighboring subdivisions. Its homes, however, sell in the range
of $270,000 to $428,000--hardly affordable to lower--and
middle-income families.
When the Ranneys pursued the economic side of their diversity
principle and presented a plan that included garage apartments,
they hit a stone wall. Officials in Grayslake, Illinois, with
permitting authority over Prairie Crossing, resisted the idea of
any apartments. So did some of the Crossing's own residents,
fearing that apartments might lower the value of their homes.
And perhaps there was something else, some kind of unspoken
distress, a glimpse through that crack that has never been fixed
in the picture window of the American dream: the dread of
23. living next door to a cultural stranger, to a person of noticeably
lesser means.
I was mulling the issue of affordable housing as the plane from
O'Hare began its wide turn east toward the lake. I was thinking
of how, all too often in cities like Chicago and Cincinnati,
efforts to make over the inner-ring neighborhoods only reduce
what little affordable housing there is. A renovated brownstone
downtown may look good to the empty nester who is sick of
vehicular life in the suburbs.
But where does the dislocated downtowner of lesser means go
when he cannot afford to buy into that gentrified brownstone?
Move to a new subdivision in the suburbs? Can't often afford
that. Besides, most new subdivisions don't want him.
In my earlier peregrinations through Deerfield Township and
Mason, Ohio--those booming communities with the trophy
homes and the 800 businesses strung out between the bracketing
interstate highways--I had heard that the lack of affordable
housing was beginning to take its toll. I remembered one of
Helen Fox's colleagues telling me that the folks in the trophy
homes weren't taking the low-paying jobs. "You go into the
supermarket and stand in line behind a dozen people," said
Tracy Molitors. "And why? The store can't hire enough cashiers
to man the empty checkout slots. You see 'Help Wanted' signs
all over the place."
Officials in Warren County say that they are beginning to
address the problem of affordable housing. In the meantime a
consortium of funding partners including the federal
government has decided to subsidize JobBus, an expanded
reverse-commute service that buses hundreds of workers from
downtown Cincinnati to Deerfield and Mason to fill the
lowpaying jobs the locals don't want.
24. And then, as my jetliner flew out over Lake Michigan,
Chicago's unofficial but effective urban-growth boundary, I
remembered George Ranney saying, "Sooner or later it has to
come. People have to live closer to their jobs. We've simply got
to have housing that's affordable to the workforce where it
works."
Then I heard another voice. It was Tracy Molitors', speaking to
my memory of our meeting in a kitchen in Mason, Ohio. I had
asked her where this national experience called sprawl was
going to end. And she said, "End? Why there's no end in sight,
the way it's going. We just keep moving farther and farther out
until one of these days we'll all be rubbing elbows. All the way
across America."