RESPONND TO CHARLIE POST and compare your classmates observations w.docx
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RESPONND TO CHARLIE POST and compare your classmates' observations with your own--are there any connections between the way you and your classmates interpret the relevance of art? If your interpretation about the relevance of art differs significantly from one of your classmates' observations, how do you account for this variance? What can you learn from this? Charlie post During this class I have learned that all art is interpreted by each individual. Meaning that everyone sees something different or sometimes the same. In earlier works were very religious. and slowly progressed into emotion and love like the Rococo art. I learned that art is always progressing and deeply reflects the time and place or events that happened during that time. Society is reflected in art of that time and vise versa, society of the time needs shock and awe. Art is very emotional and has been a way to self expression for many years. What I have learned in humanities has opened my mind to understanding art. Its not just a painting to me anymore it is an expression of the artist soul. and has allowed me to open my mind to the many works of art and from many time periods this by far has been my favorite class. I feel like I was blind before this class there is so much to art that I now understand. I am so thankful for this class my mind is finally free. Discussion 1 Listen to the " Four Functions of Management " podcast. Respond to the following in a minimum of 175 words: Explain how you are currently using the four functions of management in your place of employment or your personal life. What are some attributes of a manager? DISCUSSION 2 THERE IS A ASSIGNMENT ATTACH BELOW .
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EXPRESS 101
I believe that expressive arts have the potential to transmit values at a greater level than than the reflective arts. Philosophy and history is sometimes a challenge to express and understand. While this is the preferred method for some, I believe that is harder to understand for the masses. The visual and performing arts can be interpreted and appreciated by almost all who are privy to be exposed. People have different learning modalities. I believe that people who appreciate philosophy and history have a stronger auditory learning preference. Lectures and discussions on such topics appeal greatly to these individuals. People who have visual and tactile learning modalities would prefer the artistic means of learning about culture. I am one of these learners. I have great difficulty listening to a lecture but can read and study visual objects at great length. I also prefer hands on activities. The expressive arts give you a great many ways to appreciate and understand something from its authors perspective. When I see a fabulous work of art or hear a heart stirring piece of music, I desire to learn more about it. What caused the artist to create the work of art? What did they wish for us to gain from being exposed to it? I personally am drawn to ask more questions when exposed to this type of learning.
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EXPRESS 102
The areas that I feel are the most effective within a culture are philosophy and performing art. Th’;/ese two for me go hand in hand. The reason I say philosophy over history is because, history is like a circle of things that to me happen over and over again. But with philosophy you get a more inside look on the beliefs, values and morals of those around you. I feel you gain more from this knowledge then from the knowledge you may get from history. I think performing arts you can see ones philosophy. They can bring out different parts of their philosophy in their art. You are able to visualize and act out some the philosophies and beliefs within your culture too. There is more you can learn about others values and more about your can show about your own values and philosophies. To me this was more difficult for me, in that to me history is what has happened, it is unchangeable. It also repeats its self. But philosophy is ones take or views on things, which to me is art, cause are is the expression of ones views. So I have answered these questions, in the way I understood them.
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I believe that expressive arts have the potential to transmit values at a greater level than than the reflective arts. Philosophy and history is sometimes a challenge to express and understand. While this is the preferred method for some, I believe that is harder to understand for the masses. The visual and performing arts can be interpreted and appreciated by almost all who are privy to be exposed. People have different learning modalities. I believe that people who appreciate philosophy and history have a stronger auditory learning preference. Lectures and discussions on such topics appeal greatly to these individuals. People who have visual and tactile learning modalities would prefer the artistic means of learning about culture. I am one of these learners. I have great difficulty listening to a lecture but can read and study visual objects at great length. I also prefer hands on activities. The expressive arts give you a great many ways to appreciate and understand something from its authors perspective. When I see a fabulous work of art or hear a heart stirring piece of music, I desire to learn more about it. What caused the artist to create the work of art? What did they wish for us to gain from being exposed to it? I personally am drawn to ask more questions when exposed to this type of learning.
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Respond to at least two colleagues by doing the following· Note.docx
Respond to at least two colleagues by doing the following:
· Note similarities and differences between how you plan to apply what you have learned and how they plan to apply their knowledge in their field experiences and careers.
· Identify an additional way that your colleagues might find what they have learned useful.
Student #1 (John):
Within the social work research, the following evaluation strategies can be defined: scientific-experimental, management-oriented, qualitative-anthropological and client-oriented (Osis, 2016). The scientific-experimental approach is aimed primarily at the development of the social work science and the client-oriented approach features more applied nature and is used to implement changes in the society. The management-oriented methodology helps to evaluate the effectiveness and performance of social institutions and the qualitative-anthropological connects the historical and modern observations of changes within the society.
Given the nowadays tendencies, the new field for social research emerged. These are social networks, where users leave personal information, interact with each other and comment on different political, economic or cultural events. According to the Code of Ethics for social workers, when evaluating or conducting research with the use of any technologies they should receive informed consent of the participants and ensure their confidentiality. It is essential to secure safety and prevent any harm or damage to participants` physical and mental health (NASW Code of Ethics, 2017). Another change of research environment pertains to multicultural and multiethnic societies. In these terms, the key principle for social workers should be social justice, as it encompasses social welfare for everyone (Chukwu, 2015). They should pay more attention to cultural and ethnic differences and include these insights to their researches and evaluations. “Social workers can also use research for policy reform efforts by critically examining legal and public discourse and the extent to which they comply with human rights principles” (Maschi, Youdin, Sutfin & Simpson, 2012). Currently, social workers act as the main promoters and champions of human rights and social justice.
In order to be able to provide highly qualified research or evaluation, the skills should feature transferability. It means that social practitioners should able to explain how their activity is informed by their knowledge base and being able to apply their knowledge and skills to new situations through appraising what is general and what is particular in each situation (Trevithick, 2000). The theory and practice should be effectively combined. Moreover, the special approach to the terminology should be used. It means changing terms of patient, case or subject to a client, person or consumer. Similarly, it is better to use an assessment or evaluation than diagnosis, study or examination (Cournoyer, 2017). The appropriate theoretical frame.
Respond to the capstone discussion question.As a manager for a.docx
Respond
to the capstone discussion question.
As a manager for a large multinational corporation, you travel around the world giving presentations and conducting meetings. You always try to include humor as an icebreaker. What potential barriers could you face when delivering your presentation in the United States, China, the United Kingdom, and India? Are you able to give the same presentation in all four locations? Why or why not?
Format
your paper consistent with APA guidelines.
Must have referenes
Click
the Assignment Files tab to submit your assignment.
Assignment #2
Post
your response to the following questions:
In what ways has learning about world religions influenced the way you think about religion?
Why is it important to learn about other peoples' beliefs and attitudes?
How will you utilize this information in the future?
Must have references
.
Respond to at least two of your colleagues in one or more of t.docx
Respond
to at least
two
of your colleagues in one or more of the following ways:
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
POST 1
According to Cleary and Hunt, (2011), recent studies have shown the majority of nursing doctoral candidates are female, clinically experienced, and in their 40s or 50s at the time of starting their PhD. Based on that criteria, this writer fits exactly into that criteria. It is noted that other disciplines tend to start doctoral training much earlier (Cleary & Hunt, 2011). As a practicing nurse of 30 years, most of it as an Associate Degree nurse the recognition of the PhD nurse was seen as a profession in a nursing league of their own. According to Michael and Clochesy, (2016), the PhD in nursing was predominant throughout the 20th century with members of the academic nursing community recognizing the need for the development of knowledge to inform practice and to promote the credibility of the profession. Nursing theorists such as Jean Watson and Patricia Benner were game changers in the industry of theoretical nursing. The ability in achieving higher levels of education and in conducting research are hallmarks of professionalism (Houser, 2018).
This writer has a passion for teaching students and wants to be the best instructor she can be. She chose to go down the path of the PhD in Nursing education to increase skills and knowledge to improve what is delivered to students every day. The PhD is being pursued to separate myself from the growing amount of DNP faculty that she works with daily. Being an alumni with Walden University for the MSN, it was an easy choice to pick Walden University for the terminal degree. Michael and Clochesy, (2016), states the PhD and DNP represent complementary and alternative approaches to the highest level of educational preparation in nursing. PhD programs prepare nurse scientists to conduct original research and to generate knowledge that may be broadly applicable or generalizable using advanced research designs and statistical evaluative methods. Conversely, DNP programs prepare students for advanced specialty practice at a high level of complexity with a concurrent focus on the development of knowledge and skills required for translation of evidence to improve health outcomes and health care delivery (Michael & Clochesy, 2016).
Michael and Clochesy, (2016), also states two of the main reasons for not completing a doctoral program are financial and family stresses. Strategic plans must include financial considerations (e.g., research costs), support systems and a systemic approach to the d.
Respond to the capstone discussion question.As a manager for a l.docx
Respond
to the capstone discussion question.
As a manager for a large multinational corporation, you travel around the world giving presentations and conducting meetings. You always try to include humor as an icebreaker. What potential barriers could you face when delivering your presentation in the United States, China, the United Kingdom, and India? Are you able to give the same presentation in all four locations? Why or why not?
Format
your paper consistent with APA guidelines.
Must have referenes
Click
the Assignment Files tab to submit your assignment.
Assignment #2
Post
your response to the following questions:
In what ways has learning about world religions influenced the way you think about religion?
Why is it important to learn about other peoples' beliefs and attitudes?
How will you utilize this information in the future?
Must have references
.
Respond This week we explore the importance of utilizing the.docx
Respond
This week we explore the importance of utilizing the appropriate resources and scheduling. A fundamental aspect of project management is the ability to identify available resources and outside resources that may be needed for successful project management. In order to follow the implementation plan, deadlines, and financial funding, a project manager must know what physical and human resources to use. Project management requires extensive planning and use of resources in order to receive approval, educate staff members, and recieve increased approval of staff (Karakashian & Schub, 2017).
Some human resources that will be concerning to secure or manage are nursing leadership roles such as the CFO or CNO, as they are often busy but will be dependent on their approval and financial backing to move forward. Human resources and a nurse educator will also be responsible for nurse recruitment and setting up training programs and shared governance models. Another human resource is contractors to facilitate and schedule renovations and expansions. Lastly, securing a nurse informatics specialist might also be difficult as they are limited and in high demand. This role is essential in implementing acuity-based programming. Some physical resources that a project manager must secure are available time, new software systems, online resources that provide evidence-based information and guidelines, new equipment, and change management frameworks (Schub & Walsh, 2017).
I look forward to reading everyone’s post on resource management in project management, and seeing the different resources available that I may have overlooked. Thank you.
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respond The PICOT question that is proposed for my final pro.docx
respond
The PICOT question that is proposed for my final project:
P: Are patients that are in the hospital who receive patient education lead to an increase in HCAPHS scores? I: with education to the staff and updated documentation policies, C: As opposed to those that do not? O: Increase HCAPHs scores and decreased readmissions at 30 days T: over 12 months.
Information that will need to be obtained includes what our current HCAPHS, the readmission rate and diagnosis of the patients are. What the cost of the current stay is on all the different levels of the hospital. How does HCAPHS affect reimbursement? What is the baseline documentation being done on education and care plans? The survey’s on the staff’s perception of what needs to be documented. How much time and what the cost of the hourly staff chosen to audit compliance of patient documentation of education and care plans. As one audits charge, there is a need to try and identify what are the deficits in the education and is there a correlation to the patient being readmitted to the facility (Burnett, Lee, Doherty, Suh, Kim, …, Choi, & Suh, 2018). The difficult part of my PICOT questions is that much of the information is subjective instead of objective. From my project, my true hope is that the policies of the organization will be updated with what is expected and that the staff will be educated on the proper way of documenting in the chart. One of my biggest concerns is that many do not give themselves enough information even to remember a patient or situation if that chart is ever brought to court for some reason.
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respond Roussel, Thomas, and Harris (2017) report that a mic.docx
respond
Roussel, Thomas, and Harris (2017) report that a microsystem analysis includes five P’s of purpose, populations, processes, patterns, and providers. A comprehensive analysis using a standardized approach to high light opportunities for improvement. Our purpose is to find the cause of the increase in malpractice claims and improve patient outcomes. The population is patients with operative procedures using Davinci robotics. The process is the Davinci robotic procedure. Next, patterns to narrow the search to understand cause and the providers are the nursing staff working in the OR. Jones, Polancich, Steaban, Feistritzer, and Poe believe quality and patient safety requires efforts from all nursing leadership. The nurse executive (CNO) is paramount to the team and drives the vision of nursing to deliver safe, quality, efficient, patient-centered care (2017, p.186). The leadership skills of CNO are necessary to achieve high-quality patient care and excellent clinical outcomes (Jones, Polancich, Steaban, Feistritzer, & Poe). The CNO establishes the direction and identifies goals to provide the foundation for strategic planning.
The first action as a leadership team is to determine if all the claims revolve around the same type of issues by gathering data on the claims. I will meet with the quality team and nursing leaders to identify the issues. Once we study the data then we will determine how to proceed. Does it appear to be a process issue or a person issue? Is there a lack of knowledge? From the data, we find a trend with procedures done by Davinci robotic surgeries. The clinical nurse leader will observe a Davinci surgery to examine the workflow process to determine areas of opportunity. The process is mapped out in detail to determine areas of concern. It was found that Davinci procedures are now being performed with new equipment. The data is further examined to determine a pattern. Is the data related to a process, structural, or outcomes-based to decide what needs to be improved? We must decide if there is a flaw in the procedure or equipment. Finally, we look at the staff and their experience, education, and familiarity with the procedure and equipment. Is there a knowledge-based error? We know from our previous reports that staffing has been a concern and there are many new RNs working in the OR. We look at the roles of all staff associated with the procedure including the providers. The data shows that many newer nurses may be unfamiliar with the use of the new equipment, so we have an area of opportunity to educate and train the staff. The education plan, communication plan, and timeline will be developed and shared. This communication will explain the plans for the change and allow for additional input if necessary. Physicians and key stakeholders will also need to be informed about the change in advance of implementation. This gives time for additional training of physicians and ancillary staff. Listening to the feedback.
Respond The medical center where I work is a large teaching.docx
Respond
The medical center where I work is a large teaching institution in New York City is made up of 7 hospitals. They believe in educating the next generation of health care professionals, developing groundbreaking research, advancing innovative, patient-centered clinical care and serving the needs of our local, national and global community. The vision of the institution is to be the #1 academic health system in the nation in high-quality patient centered care, education and research. The culture is based on respect, teamwork, innovation, empathy, excellence and responsibility.
The mission and vision is reflected in the organizational culture and leadership through their behaviors. How leadership chooses to do their job everyday demonstrates the core values of the organization. My personal philosophy of nursing is based on respect. Patient care suffers when nurses are not respected (Stievano, Bellass, Rocco, Olsen, Sabatino, & Johnson, 2018). It is crucial that nurses operate in a moral work environment that involves respect to improve patient outcomes (Stievano, et al., 2018). The hospital’s Credo is based on respect. This is how my project aligns with the core values of the institution.
One theoretical approach to understanding how change may be achieved is Rogers’ diffusion model. He argues that certain characteristics of the innovation itself may facilitate its adoption. Factors influencing acceptance include promotion by influential role models, the degree of complexity of the change, compatibility with existing values and needs, and the ability to test and modify the new procedure before adopting it (Mohammadi, Poursaberi, & Salahshoor, 2018).
Current research suggests that the most effective communication strategy is face-to-face exchange (Mohammadi, Poursaberi, & Salahshoor, 2018). It provides an opportunity to tailor information to recipients and allows the advocate of the change to explore and, if necessary, modify the reasons why a shift in clinical behaviour should occur. Interpersonal communication is usually more effective when there is a high degree of professional resemblance between the individual attempting to introduce the innovation and the recipient (Mohammadi, Poursaberi, & Salahshoor, 2018).
Luckily, I think it will be relatively easy to implement changes related to a healthy work environment. I believe the majority of people want to work in an environment that is positive, supportive and frowns on bullying and incivility. Through communication as well as role modeling proper behaviors, Rogers’s diffusion of innovation framework will assist in the transformation.
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respond The ability to communicate effectively is a critical.docx
respond
The ability to communicate effectively is a critical skill for nurse leaders (Roussel, Thomas & Harris, 2016). In the healthcare setting such as a hospital, nurses work various shifts, and communication can be challenging. Nurse leaders will need to utilize fundamental communication skills to achieve organizational goals (Roussel et al.,2016). There are various traditional ways that leaders can communicate with their staff, such as through emails, text, or even instant messaging (Roussel et al., 2016). Leaders are also finding creative ways to connect with every team members, so the message remains consistent.
One strategy that I would use as a leader to improve communication and empower the members of my team working various shifts is to restructure team huddles. The huddle is a quick meeting given while standing that last approximately fifteen minutes (Johnson, 2018). The huddles can also occur at any time of the day (Johnson, 2018). Providing huddles at various times of the day will allow effective communication with members of the team that works on various days and shifts.
Also, because everyone is assembled, it allows staff to participate in a discussion and give feedback on the information shared. Another way to share information about the magnet designations is to have it displayed as screen savers on the computers nurses use to document. The messaging on the computer screen is a strategy that is used at my workplace to update the employees on new initiatives, and it is useful.
Another strategy is establishing a bulletin board where the staff spends time, such as the break room, nurse’s station, or even restrooms. Ensuring the messaging reaches everyone helps make each member feel part of the team. Another strategy would include leadership rounding. The leader could visit and meet with staff members and provide updates and share information on the magnet designation.
References
Johnson, I. (2018). Communication Huddles: The Secret of Team Success.
Journal Of Continuing Education In Nursing,49
(10), 451–453.
https://doi-org.chamberlainuniversity.idm.oclc.org/10.3928/00220124-20180918-04 (Links to an external site.)
Roussel, L., Thomas, P., & Harris, J. (2016).
Management and leadership for nurse administrators.
(7th ed.). Burlington, MA: Jones & Bartlett Learning.
.
Respond Hello group - informative discussions! Many of you have .docx
Respond
Hello group - informative discussions! Many of you have or will experience power gap differentials and blurred lines of authority. Navigating these can be challenging. Please identify strategies for navigating these potential obstacles to effective communication and collaboration within vertical, horizontal, and system-wide structures.
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respond EXPERIENCEThe Reduction in workforce paper ex.docx
respond
EXPERIENCE
:
The Reduction in workforce paper explored the knowledge and the decision making process required to plan and execute the organizational changes at Roxboro Medical Center. The job of restructuring and reducing the workforce of an organization will always significantly impact the staff. In the setting that we were given, the CNO was tasked with reducing nursing leadership by 30%. Human resources provided guidelines and additional information to assist in the decision making process. It is especially important for key stakeholders to be involved from the outset of the process to assure organizational policy and procedure are adhered to.
The model that was chosen for this organizational staff reduction is Kotter’s change model which relies on stepwise planning and implementation of a strategic plan on a short timeline while also promising ownership for employees. Faced with the development of a plan to reduce the organization's workforce, it is the responsibility of management to use an approach that strengthens the organizational mission and values. Transparency, sensitivity, and open communication are essential and will allow staff members to better understand the decision making process during this challenging time. To assure the buy-in of the staff, the change model that is used to research and plan for the staff reduction must incorporate proven rationales and reassurance of an improved work-life balance along with increasing autonomy and ownership. The organization must remain transparent and communicate openly and often identifying details of the plan and timeline while identifying strategies in order to execute the plan and gain facility-wide acceptance and support.
REFLECTION
:
During the time that I was doing research and writing this paper, the Covid-19 pandemic was surfacing and I actually was faced with making some similar decisions at my own organization. I am a manager in perioperative services and when the Governor placed a moratorium on elective surgeries our caseload decreased by about two thirds. Hospitals face many financial obstacles today and are often forced to use an approach such as staff layoffs to maintain their financial viability (Daniels & Ritter, 2018). The first wave of cuts that I had to make was dismissing all travel staff giving them two weeks’ notice. At this time, I also took all non-benefitted employees off the schedule. Ten days later I realized that we were still overstaffed and cut everyone’s FTE by 25%. Another week passed and our CEO and CNO tasked all managers with cutting our staffing budget by another 20%. Emotions and feelings may affect the initial acceptance of the change due to misconceptions about the process of the reduction in force and when issues of trust exist (Walker & Karau, 2016). This was gut-wrenching for me, I knew how devastating this would be to many of my staff members. Feelings of guilt and being at fault is quite common for managers who are faced with .
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respond
Communication is integral in the field of nursing. Nurses act as the hub of communication, relaying and interpreting information between physicians, caregivers, family members and patients. The ability to establish effective communication in nursing is imperative to providing the best care and patient outcomes possible (Bender, Williams, Su, & Hites, 2016). At any workplace, good communication is vital. Effective communication removes obstacles that detract from efficiency and collaboration. As a nurse executive, I should create the structure and processes that facilitate effective communication within in my team. To improve communication to and between team members, my focus would be improving both the content and the coverage of team members’ communication.
To begin with, I would provide role clarity at the workplace. One of the most effective structural ways to improve the content of communication within a team is to invest in role clarity (Marquis & Huston, 2017). It helps everyone on the team know from the beginning which content is most relevant to discuss with different team members. I would promote role clarity by explaining to each employee what metrics will be used to define success in their role. Another way of enhancing communication is by creating an open door policy. This would encourage free communication by removing any potential barriers.
Empowering team members would enable them have the authority or power to execute certain functions. Additionally, empowering people also makes them more confident, for instance, in decision-making (Marquis & Huston, 2017). One major way in which I would empower my team members is by including them in the decision-making process of our healthcare organization. Through this inclusion, their views are likely to be heard by a higher authority.
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Respond As the unit director for the emergency department an.docx
The document discusses strategies for reducing medication errors by taking a system-wide, interdisciplinary approach and including all stakeholders. It emphasizes the importance of considering not just patients, but also members of the organization who deal with medication, like nurses, pharmacists, and IT. Reducing errors requires understanding differences between specialties, like how insulin is administered differently in pediatrics than other fields. It also stresses the need to examine organizational culture and climate, using respectful communication and transparency to learn from mistakes without blame. The goal is to empower staff to share about errors to improve systems and reduce future issues.
Respond with 150 words and 2 references with 1 being the textbook, b.docx
Respond with 150 words and 2 references with 1 being the textbook, biblical reference
Cullen, F. T., & Jonson, C. L. (2017).
Correctional theory: Context and consequences
(2nd ed.). Thousand Oaks, CA: Sage. ISBN: 9781506306520.
*Barry**
The Pros and Cons of a Pure Deterrence Theory
As one reviews the application of a pure deterrence theory in America corrections operations today, the absence of empirical evidence in the development of many such theories remains evident. Based on this author’s research and personal observations of local corrections operations in practice, it appears that many pure deterrence programs develop more like a knee jerk response to various challenges within the corrections system. America’s public opinion historical suggests that felonious offenders should be incarcerated through determinate or indeterminate sentencing. The political reaction to public opinion has been to increase incarceration to satisfy safety issues within our communities. Indeed, incarceration does stop that offender from bringing harm to our communities (Cullen, Jonso, & Nagin, 2011). The increased prison populations serve to create overcrowding conditions within prisons, however, which serves to increase violence, more dangers to over-worked corrections personnel, and a resulting increase in parole or felony probation diversion strategies to lessen this burden. One reactive strategy is the use of Intensive Supervision Parole/Probation (ISP) (Hyatt & Barnes, 2017). The question remaining is, how valid is this strategy, and what challenges have arisen within this strategy?
What is Intensive Supervision Parole/Probation ( ISP)?
The theory behind ISP assumes that a specific offender is more prone to recidivism if he or she is awarded the standard probation or parole, which requires minimal reporting such as monthly office visits with the parole/probation officer or even lesser challenging requirements such as phone calls to the officer. ISP, therefore, has arisen as an immediate solution to this challenge. The parolee/probationer is required to submit to more intensive visitation or office visits, drug testing, and other more stringent requirements, which, by design, are perceived to gain more control over the offender, which forces compliance (Hyatt & Barnes, 2017). However, one must ask if this is a pure form of rational emotive behavior therapy, or does it merely delay the inevitable by creating controlled robotic responses? Does history offer examples in intensive parenting controls gone wrong?
Challenges within ISP
The more significant and obvious error within the application of the theory of ISP rests with the increased caseload resulting from the diversion of offenders from incarceration into the parole/probation system. Many states developed parole in absentia program, which is designed to work with offenders with less than a five-year sentence. The offender is released on parole immediately the following sent.
Respond on 2 different days who were assigned different case stud.docx
Respond
on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues' differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.
Main Post
Knee Pain SOAP Note
Patient Information:
SJ, 15-year-old WM
S.
CC
- Pain in both knees.
HPI
: 15-year-old white male presents with pain in bilateral knees. Pain onset was 1 week ago after football practice. Pain is described as “dull”. Associated s/s include clicking in one or both knees and a catching sensation under the patella. SJ describes pain as dull and constant, pain rated at 3 on a scale of 0-10. Pain is exacerbated by movement and relieved by rest.
Current Medications
: No medications, no OTC medications or vitamins.
Allergies:
seasonal allergies only
PMHx
: Immunizations current, flu shot received from PCP 10/5/19. No previous injuries, hospitalizations, or surgeries.
Soc Hx
: 10th grade student, on high school football team (offensive lineman), has played football since age 6. Denies alcohol use, denies tobacco use, Denies use of illicit drugs. Honor student, popular in school with many friends. Lives at home with dad and two younger sisters. Mom is active duty/deployed currently. Currently learning to drive in driver’s education at school.
Fam Hx
: No significant medical history in parents. Maternal grandmother died at 80 of lung cancer, grandfather at 81 of MI. Paternal grandmother has osteoarthritis, grandfather has DM.
ROS
: GENERAL: Denies weight loss, fever, chills, weakness or fatigue.
HEENT: Head: denies headache,
Eyes: Denies visual loss, blurred vision, or double vision, denies hearing loss, nasal dysfunction or sore throat.
SKIN: denies rash or puritis.
CARDIOVASCULAR: Denies chest pain, chest pressure or chest discomfort. Denies palpitations or edema.
RESPIRATORY: Denies shortness of breath, cough or sputum.
NEUROLOGICAL: Denies headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. Denies change in bowel or bladder control.
MUSCULOSKELETAL: Knee pain, with clicking and catching sensation under the patella. Denies back pain, stiffness.
HEMATOLOGIC: Denies anemia, bleeding or bruising.PSYCHIATRIC: Denies depression or anxiety.
ALLERGIES: Denies food or drug allergies, allergy to pollen.
O.
VS: BP 123/68; P 89; RR 18; T 97.6; O2 98%; Wt 179; BMI 25.68
General
- AOx4. Pt appears healthy and well nourished, athletic build. Well groomed, no acute distress noted.
Cardiovascular-
Regular rate/rhythm. S1/S2 heard, no murmurs, gallops, or rubs noted.
Respiratory
- RR even and unlabored. Clear to auscultation bilaterally with no wheezing, rales, rhonchi, or crackles.
Musculoskeletal-
joint stability normal in upper extremities, no tenderness to palpation. Lower bilateral popliteal tenderness upon palpation, Rt quadricep angle 18 degrees, Lt qua.
RespondWhat is artCompare your current thinking to .docx
Respond
What is art?
Compare your current thinking to the definition you wrote in week one.
In what ways has your personal definition of art expanded or changed over the course of this session?
Reflecting on your exploration of the visual arts across varied times, places, and cultures, how has this course influenced your thinking about the ways we as humans are more alike than different?
Select a work of art that illustrates your current definition of art.
Share your selected artwork and discuss in what ways it illustrates your current definition of art.
Will you use the same work of art or select something new?
Is more than one artwork needed to fully illustrate your new definition?
From what cultures and times will you find your examples?
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respond As the nurse executive in an acute care hospital, I .docx
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As the nurse executive in an acute care hospital, I welcome collaboration among advanced practice nurses (APN) and the clinical staff for many reasons. Advanced practice nurses can take on acute services, be readily available and in all honesty are far more approachable, accessible and can provide a sense of trust into our patient population when being compared to a PGYI or newer medical student. Often times our medical residents or surgical residents lack empathy and lack a collaborative effort that makes our admissions and discharges flow in less than desired manner. As a whole, the unit gravitates toward reaching out to the APRN for effective communication when placed in a position to communicate between families, patients and our medical teams.
An organizational chart could absolutely be utilized to enhance and improve collaborative communication and facilitate trust among different departments through reflexivity. From the article
Margaret Archer, Modes of Reflexivity: The Structured Agency of Nursing Action,
communicative reflexivity is said to be our inner conversations which required confirmation and communication with others before we act. A nurse who predominantly uses communicative reflexivity will consider what their peers are thinking and will want to act in such a way as to fit in (Goodman, 2017). Although the nursing profession especially as a clinical provider we tend to use our professional critical thinking skills and act on our best nursing judgement, we tend to disconnect from our peers and resources such as the APNs to confirm our actions before we act. Although working together as a team is essential for the unit to function properly in crisis situations, I often times see nurses perform on “auto-pilot”, working independently without collaborative efforts that could be in the best interest of our patient population. Facilitating collaboration between available APNs and clinical staff is essential to improving patient outcomes and building a higher self-esteem among staff. Being validated that our critical thinking, assumptions and interventions are correct from someone with higher level education can be very empowering.
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RespondThe brokerage firm of E. F. Hutton was charged with fe.docx
Respond:
The brokerage firm of E. F. Hutton was charged with federal criminal violations of interstate funds transfers. In reviewing the case, the lawyers for the government discovered internal Memoranda from and between branch managers in several states that outline a process for check kiting (a literal stringing together of checks and deposits) that enabled E. F. Hutton to earn interest on phantom deposits.
In 1985 E. F Hutton was found guilty of check kiting managers of the firm use check kiting technique to obtain legal interest over large sums of money, lawyers of government discovered internal memoranda from an between branch managers in several states that outlined process for check kiting that unableed E. F Hutton to earn interest on phantom deposits. E. F Hutton was charge with federal criminal violations.
The case will be tried in the Federal District Court by the United State Attorney, under the Federal Court System because the Federal District has the jurisdiction that involved cases from different states and also the damage exceeds $75,000. Because is a federal crime it is tried a Federal district.
The obligations of the layer is to draft the documents without a perfume with the complete facts and transaction of the fraud committed. The company’s obligation was to show the correct financial statements, the company have the right to provide the correct documents and financial statements to the court. Company have to take steps in order to avoid any future possibilities of having any more frauds.
EFH manager should not disclosed the documents to the government. Managers need communicate to the directors about the situation and look solutions to find the way to avoid future fraud for happen.
Respond:
The phrase Stare Decisis comes from Latin and means "let the decision stand". It is a doctrine that allows judges to examine previous cases as examples to make decisions about new cases. Stare Decisis is closely connected to the idea of a precedent. This means that if a Supreme Court has previously made a ruling on a similar case, it will use that precedent as a model for another case. However, following a precedent does not necessarily mean that all similar cases will be decided in the same way. Other factors, such as context or changes in societal views, can also influence whether or not a precedent will be followed.
One of the most talked about recent U.S. Supreme Court decisions was the April 2018 decision of Janus v. American Federation of State, County and Municipal Employees. The case was brought by Mark Janus, a child support specialist who worked for the state government in Illinois. He sued the union, saying he did not agree with its positions and should not be forced to pay fees to support its work. By a 5-to-4 vote, the court ruled that government workers who choose not to join unions may not be required to help pay for collective bargaining. This ruling overruled the court's 1977 decision in Abood v. Detroit Bo.
RespondEXPERIENCEI had been a bedside nurse for 24 years.docx
Respond
EXPERIENCE
I had been a bedside nurse for 24 years before I transitioned into my current position as an Accreditation Specialist. I have been in my position a little over two years and due to being a bedside nurse I never had to deal with any budgeting issues. My husband tends to all our personally finances. I honestly have to admit, I am not good with money. My husband is so much better in planning and saving for the future, I have more of a spontaneous personality. I paying more attention and asking more questions to my department manager and director in regards to our budget. They have quarterly leadership meeting where our organizations financial information is discussed. After these meetings, my leaders share the information and are willing to answer any of our questions. They want to be transparent to allow us to be educated and knowledgeable in regards to our organization.
REFLECTION
The pre-conceived notion I had of healthcare financial and budgeting principle is of staffing. I did not realize developing a staffing budget consisted of a certain formula. I was unaware of the number of factors related to identifying the full-time equivalents (FTEs) needed to staff a hospital floor. I now understand that an FTE consisted of 2,080 hours/year for a full-time employee. And patient hours are a major factor, the percentage of direct admits from the emergency room (ER). The budget also has to take into consideration the skill mix needed for your organization.
Two concepts that were very interesting to me were the nonprofit and for-profit concepts. They only difference is that non-profit organizations do not pay taxes. For profit hospitals are owned and operated by financial cooperation’s and have access to larger sums of money when needed. Nonprofit organizations are more community oriented and focuses on what the community needs. They are typically in area that are financially well off but that is not the case for the organization I am affiliated with. My community is poor and Medicaid and Medicare are a high percentage of our reimbursement. Quality verses quantity is always a main focus for us. We do not provide a lot of specialty services but what we offer is quality care with the capability to stabilize and transfer to affiliated hospitals. We like to ensure our patients are receiving quality care not matter where they are sent.
IMPLICATIONS FOR THE FUTURE
My proposed project is implementing a sepsis bundle checklist to improve sepsis bundle compliance in the Emergency Department (ED) to improve patient outcomes. This project is not a high cost to the organization. The sepsis bundle checklist can be created by our quality department and once passed through the form committee for approval it can be rolled out for use. The education department will be involved to develop the education for the staff and providers to ensure the checklist is getting implemented correctly. The checklist will be printed in our print shop so each .
respondStaffing issues have always been a major area of conc.docx
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Staffing issues have always been a major area of concern within the health field. Adequate staffing affects the patient safety, staff morale and finances of the organization. It’s important that organizations take note of concerns related to their staffing and take the necessary steps to ensure that adequate staffing within the units.
The staffing in my organization varies depending on the unit and level of care or acuity of the patients. For starters, patients enter into the Emergency Department and are typically cared for by a nurse who is assigned a team of 3-4 patients. Nurses who work on the medical/ telemetry units are assigned a 1:6 nurse: patient ratio. Nurses who work on the Intermediate Care or Step Down unit is assigned a 1:3 nurse:patient ratio. ICU and CVICU patients are assigned at a 1:2 or 1:1 nurse to patient ratio.
There could be a number of variables that affects the staffing ratio. The shortage in healthcare professionals is one of the greatest variables affecting the staffing ratios. When there is not enough employees on duty, nurses and nurses assistants are forced to work under staff. Patients and families notice when there is a shortage of staff, and they tend to lose their faith in their provider when they’re working short. It’s important that staff understand the importance of managing up the organization and notify their leader if they are feeling overwhelmed instead of venting to the patients.
As it stands now, my organization has some of the lowest nurse to patient ratios which is currently mandated by the organization itself. Our organization takes pride in patient safety, and focuses on safe quality care as a whole. This staffing ratio affects the organizational budget as a great deal of resources is put into recruiting qualified staff as well as using alternative staffing agencies to assist with nursing and support staff coverage.
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clinical examination of hip joint (1).pdf
described clinical examination all orthopeadic conditions .
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Respond to at least two colleagues by doing the following· Note.docx
Respond to at least two colleagues by doing the following:
· Note similarities and differences between how you plan to apply what you have learned and how they plan to apply their knowledge in their field experiences and careers.
· Identify an additional way that your colleagues might find what they have learned useful.
Student #1 (John):
Within the social work research, the following evaluation strategies can be defined: scientific-experimental, management-oriented, qualitative-anthropological and client-oriented (Osis, 2016). The scientific-experimental approach is aimed primarily at the development of the social work science and the client-oriented approach features more applied nature and is used to implement changes in the society. The management-oriented methodology helps to evaluate the effectiveness and performance of social institutions and the qualitative-anthropological connects the historical and modern observations of changes within the society.
Given the nowadays tendencies, the new field for social research emerged. These are social networks, where users leave personal information, interact with each other and comment on different political, economic or cultural events. According to the Code of Ethics for social workers, when evaluating or conducting research with the use of any technologies they should receive informed consent of the participants and ensure their confidentiality. It is essential to secure safety and prevent any harm or damage to participants` physical and mental health (NASW Code of Ethics, 2017). Another change of research environment pertains to multicultural and multiethnic societies. In these terms, the key principle for social workers should be social justice, as it encompasses social welfare for everyone (Chukwu, 2015). They should pay more attention to cultural and ethnic differences and include these insights to their researches and evaluations. “Social workers can also use research for policy reform efforts by critically examining legal and public discourse and the extent to which they comply with human rights principles” (Maschi, Youdin, Sutfin & Simpson, 2012). Currently, social workers act as the main promoters and champions of human rights and social justice.
In order to be able to provide highly qualified research or evaluation, the skills should feature transferability. It means that social practitioners should able to explain how their activity is informed by their knowledge base and being able to apply their knowledge and skills to new situations through appraising what is general and what is particular in each situation (Trevithick, 2000). The theory and practice should be effectively combined. Moreover, the special approach to the terminology should be used. It means changing terms of patient, case or subject to a client, person or consumer. Similarly, it is better to use an assessment or evaluation than diagnosis, study or examination (Cournoyer, 2017). The appropriate theoretical frame.
Respond to the capstone discussion question.As a manager for a.docx
Respond
to the capstone discussion question.
As a manager for a large multinational corporation, you travel around the world giving presentations and conducting meetings. You always try to include humor as an icebreaker. What potential barriers could you face when delivering your presentation in the United States, China, the United Kingdom, and India? Are you able to give the same presentation in all four locations? Why or why not?
Format
your paper consistent with APA guidelines.
Must have referenes
Click
the Assignment Files tab to submit your assignment.
Assignment #2
Post
your response to the following questions:
In what ways has learning about world religions influenced the way you think about religion?
Why is it important to learn about other peoples' beliefs and attitudes?
How will you utilize this information in the future?
Must have references
.
Respond to at least two of your colleagues in one or more of t.docx
Respond
to at least
two
of your colleagues in one or more of the following ways:
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
POST 1
According to Cleary and Hunt, (2011), recent studies have shown the majority of nursing doctoral candidates are female, clinically experienced, and in their 40s or 50s at the time of starting their PhD. Based on that criteria, this writer fits exactly into that criteria. It is noted that other disciplines tend to start doctoral training much earlier (Cleary & Hunt, 2011). As a practicing nurse of 30 years, most of it as an Associate Degree nurse the recognition of the PhD nurse was seen as a profession in a nursing league of their own. According to Michael and Clochesy, (2016), the PhD in nursing was predominant throughout the 20th century with members of the academic nursing community recognizing the need for the development of knowledge to inform practice and to promote the credibility of the profession. Nursing theorists such as Jean Watson and Patricia Benner were game changers in the industry of theoretical nursing. The ability in achieving higher levels of education and in conducting research are hallmarks of professionalism (Houser, 2018).
This writer has a passion for teaching students and wants to be the best instructor she can be. She chose to go down the path of the PhD in Nursing education to increase skills and knowledge to improve what is delivered to students every day. The PhD is being pursued to separate myself from the growing amount of DNP faculty that she works with daily. Being an alumni with Walden University for the MSN, it was an easy choice to pick Walden University for the terminal degree. Michael and Clochesy, (2016), states the PhD and DNP represent complementary and alternative approaches to the highest level of educational preparation in nursing. PhD programs prepare nurse scientists to conduct original research and to generate knowledge that may be broadly applicable or generalizable using advanced research designs and statistical evaluative methods. Conversely, DNP programs prepare students for advanced specialty practice at a high level of complexity with a concurrent focus on the development of knowledge and skills required for translation of evidence to improve health outcomes and health care delivery (Michael & Clochesy, 2016).
Michael and Clochesy, (2016), also states two of the main reasons for not completing a doctoral program are financial and family stresses. Strategic plans must include financial considerations (e.g., research costs), support systems and a systemic approach to the d.
Respond to the capstone discussion question.As a manager for a l.docx
Respond
to the capstone discussion question.
As a manager for a large multinational corporation, you travel around the world giving presentations and conducting meetings. You always try to include humor as an icebreaker. What potential barriers could you face when delivering your presentation in the United States, China, the United Kingdom, and India? Are you able to give the same presentation in all four locations? Why or why not?
Format
your paper consistent with APA guidelines.
Must have referenes
Click
the Assignment Files tab to submit your assignment.
Assignment #2
Post
your response to the following questions:
In what ways has learning about world religions influenced the way you think about religion?
Why is it important to learn about other peoples' beliefs and attitudes?
How will you utilize this information in the future?
Must have references
.
Respond This week we explore the importance of utilizing the.docx
Respond
This week we explore the importance of utilizing the appropriate resources and scheduling. A fundamental aspect of project management is the ability to identify available resources and outside resources that may be needed for successful project management. In order to follow the implementation plan, deadlines, and financial funding, a project manager must know what physical and human resources to use. Project management requires extensive planning and use of resources in order to receive approval, educate staff members, and recieve increased approval of staff (Karakashian & Schub, 2017).
Some human resources that will be concerning to secure or manage are nursing leadership roles such as the CFO or CNO, as they are often busy but will be dependent on their approval and financial backing to move forward. Human resources and a nurse educator will also be responsible for nurse recruitment and setting up training programs and shared governance models. Another human resource is contractors to facilitate and schedule renovations and expansions. Lastly, securing a nurse informatics specialist might also be difficult as they are limited and in high demand. This role is essential in implementing acuity-based programming. Some physical resources that a project manager must secure are available time, new software systems, online resources that provide evidence-based information and guidelines, new equipment, and change management frameworks (Schub & Walsh, 2017).
I look forward to reading everyone’s post on resource management in project management, and seeing the different resources available that I may have overlooked. Thank you.
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respond The PICOT question that is proposed for my final pro.docx
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The PICOT question that is proposed for my final project:
P: Are patients that are in the hospital who receive patient education lead to an increase in HCAPHS scores? I: with education to the staff and updated documentation policies, C: As opposed to those that do not? O: Increase HCAPHs scores and decreased readmissions at 30 days T: over 12 months.
Information that will need to be obtained includes what our current HCAPHS, the readmission rate and diagnosis of the patients are. What the cost of the current stay is on all the different levels of the hospital. How does HCAPHS affect reimbursement? What is the baseline documentation being done on education and care plans? The survey’s on the staff’s perception of what needs to be documented. How much time and what the cost of the hourly staff chosen to audit compliance of patient documentation of education and care plans. As one audits charge, there is a need to try and identify what are the deficits in the education and is there a correlation to the patient being readmitted to the facility (Burnett, Lee, Doherty, Suh, Kim, …, Choi, & Suh, 2018). The difficult part of my PICOT questions is that much of the information is subjective instead of objective. From my project, my true hope is that the policies of the organization will be updated with what is expected and that the staff will be educated on the proper way of documenting in the chart. One of my biggest concerns is that many do not give themselves enough information even to remember a patient or situation if that chart is ever brought to court for some reason.
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respond Roussel, Thomas, and Harris (2017) report that a mic.docx
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Roussel, Thomas, and Harris (2017) report that a microsystem analysis includes five P’s of purpose, populations, processes, patterns, and providers. A comprehensive analysis using a standardized approach to high light opportunities for improvement. Our purpose is to find the cause of the increase in malpractice claims and improve patient outcomes. The population is patients with operative procedures using Davinci robotics. The process is the Davinci robotic procedure. Next, patterns to narrow the search to understand cause and the providers are the nursing staff working in the OR. Jones, Polancich, Steaban, Feistritzer, and Poe believe quality and patient safety requires efforts from all nursing leadership. The nurse executive (CNO) is paramount to the team and drives the vision of nursing to deliver safe, quality, efficient, patient-centered care (2017, p.186). The leadership skills of CNO are necessary to achieve high-quality patient care and excellent clinical outcomes (Jones, Polancich, Steaban, Feistritzer, & Poe). The CNO establishes the direction and identifies goals to provide the foundation for strategic planning.
The first action as a leadership team is to determine if all the claims revolve around the same type of issues by gathering data on the claims. I will meet with the quality team and nursing leaders to identify the issues. Once we study the data then we will determine how to proceed. Does it appear to be a process issue or a person issue? Is there a lack of knowledge? From the data, we find a trend with procedures done by Davinci robotic surgeries. The clinical nurse leader will observe a Davinci surgery to examine the workflow process to determine areas of opportunity. The process is mapped out in detail to determine areas of concern. It was found that Davinci procedures are now being performed with new equipment. The data is further examined to determine a pattern. Is the data related to a process, structural, or outcomes-based to decide what needs to be improved? We must decide if there is a flaw in the procedure or equipment. Finally, we look at the staff and their experience, education, and familiarity with the procedure and equipment. Is there a knowledge-based error? We know from our previous reports that staffing has been a concern and there are many new RNs working in the OR. We look at the roles of all staff associated with the procedure including the providers. The data shows that many newer nurses may be unfamiliar with the use of the new equipment, so we have an area of opportunity to educate and train the staff. The education plan, communication plan, and timeline will be developed and shared. This communication will explain the plans for the change and allow for additional input if necessary. Physicians and key stakeholders will also need to be informed about the change in advance of implementation. This gives time for additional training of physicians and ancillary staff. Listening to the feedback.
Respond The medical center where I work is a large teaching.docx
Respond
The medical center where I work is a large teaching institution in New York City is made up of 7 hospitals. They believe in educating the next generation of health care professionals, developing groundbreaking research, advancing innovative, patient-centered clinical care and serving the needs of our local, national and global community. The vision of the institution is to be the #1 academic health system in the nation in high-quality patient centered care, education and research. The culture is based on respect, teamwork, innovation, empathy, excellence and responsibility.
The mission and vision is reflected in the organizational culture and leadership through their behaviors. How leadership chooses to do their job everyday demonstrates the core values of the organization. My personal philosophy of nursing is based on respect. Patient care suffers when nurses are not respected (Stievano, Bellass, Rocco, Olsen, Sabatino, & Johnson, 2018). It is crucial that nurses operate in a moral work environment that involves respect to improve patient outcomes (Stievano, et al., 2018). The hospital’s Credo is based on respect. This is how my project aligns with the core values of the institution.
One theoretical approach to understanding how change may be achieved is Rogers’ diffusion model. He argues that certain characteristics of the innovation itself may facilitate its adoption. Factors influencing acceptance include promotion by influential role models, the degree of complexity of the change, compatibility with existing values and needs, and the ability to test and modify the new procedure before adopting it (Mohammadi, Poursaberi, & Salahshoor, 2018).
Current research suggests that the most effective communication strategy is face-to-face exchange (Mohammadi, Poursaberi, & Salahshoor, 2018). It provides an opportunity to tailor information to recipients and allows the advocate of the change to explore and, if necessary, modify the reasons why a shift in clinical behaviour should occur. Interpersonal communication is usually more effective when there is a high degree of professional resemblance between the individual attempting to introduce the innovation and the recipient (Mohammadi, Poursaberi, & Salahshoor, 2018).
Luckily, I think it will be relatively easy to implement changes related to a healthy work environment. I believe the majority of people want to work in an environment that is positive, supportive and frowns on bullying and incivility. Through communication as well as role modeling proper behaviors, Rogers’s diffusion of innovation framework will assist in the transformation.
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respond The ability to communicate effectively is a critical.docx
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The ability to communicate effectively is a critical skill for nurse leaders (Roussel, Thomas & Harris, 2016). In the healthcare setting such as a hospital, nurses work various shifts, and communication can be challenging. Nurse leaders will need to utilize fundamental communication skills to achieve organizational goals (Roussel et al.,2016). There are various traditional ways that leaders can communicate with their staff, such as through emails, text, or even instant messaging (Roussel et al., 2016). Leaders are also finding creative ways to connect with every team members, so the message remains consistent.
One strategy that I would use as a leader to improve communication and empower the members of my team working various shifts is to restructure team huddles. The huddle is a quick meeting given while standing that last approximately fifteen minutes (Johnson, 2018). The huddles can also occur at any time of the day (Johnson, 2018). Providing huddles at various times of the day will allow effective communication with members of the team that works on various days and shifts.
Also, because everyone is assembled, it allows staff to participate in a discussion and give feedback on the information shared. Another way to share information about the magnet designations is to have it displayed as screen savers on the computers nurses use to document. The messaging on the computer screen is a strategy that is used at my workplace to update the employees on new initiatives, and it is useful.
Another strategy is establishing a bulletin board where the staff spends time, such as the break room, nurse’s station, or even restrooms. Ensuring the messaging reaches everyone helps make each member feel part of the team. Another strategy would include leadership rounding. The leader could visit and meet with staff members and provide updates and share information on the magnet designation.
References
Johnson, I. (2018). Communication Huddles: The Secret of Team Success.
Journal Of Continuing Education In Nursing,49
(10), 451–453.
https://doi-org.chamberlainuniversity.idm.oclc.org/10.3928/00220124-20180918-04 (Links to an external site.)
Roussel, L., Thomas, P., & Harris, J. (2016).
Management and leadership for nurse administrators.
(7th ed.). Burlington, MA: Jones & Bartlett Learning.
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Respond Hello group - informative discussions! Many of you have .docx
Respond
Hello group - informative discussions! Many of you have or will experience power gap differentials and blurred lines of authority. Navigating these can be challenging. Please identify strategies for navigating these potential obstacles to effective communication and collaboration within vertical, horizontal, and system-wide structures.
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respond EXPERIENCEThe Reduction in workforce paper ex.docx
respond
EXPERIENCE
:
The Reduction in workforce paper explored the knowledge and the decision making process required to plan and execute the organizational changes at Roxboro Medical Center. The job of restructuring and reducing the workforce of an organization will always significantly impact the staff. In the setting that we were given, the CNO was tasked with reducing nursing leadership by 30%. Human resources provided guidelines and additional information to assist in the decision making process. It is especially important for key stakeholders to be involved from the outset of the process to assure organizational policy and procedure are adhered to.
The model that was chosen for this organizational staff reduction is Kotter’s change model which relies on stepwise planning and implementation of a strategic plan on a short timeline while also promising ownership for employees. Faced with the development of a plan to reduce the organization's workforce, it is the responsibility of management to use an approach that strengthens the organizational mission and values. Transparency, sensitivity, and open communication are essential and will allow staff members to better understand the decision making process during this challenging time. To assure the buy-in of the staff, the change model that is used to research and plan for the staff reduction must incorporate proven rationales and reassurance of an improved work-life balance along with increasing autonomy and ownership. The organization must remain transparent and communicate openly and often identifying details of the plan and timeline while identifying strategies in order to execute the plan and gain facility-wide acceptance and support.
REFLECTION
:
During the time that I was doing research and writing this paper, the Covid-19 pandemic was surfacing and I actually was faced with making some similar decisions at my own organization. I am a manager in perioperative services and when the Governor placed a moratorium on elective surgeries our caseload decreased by about two thirds. Hospitals face many financial obstacles today and are often forced to use an approach such as staff layoffs to maintain their financial viability (Daniels & Ritter, 2018). The first wave of cuts that I had to make was dismissing all travel staff giving them two weeks’ notice. At this time, I also took all non-benefitted employees off the schedule. Ten days later I realized that we were still overstaffed and cut everyone’s FTE by 25%. Another week passed and our CEO and CNO tasked all managers with cutting our staffing budget by another 20%. Emotions and feelings may affect the initial acceptance of the change due to misconceptions about the process of the reduction in force and when issues of trust exist (Walker & Karau, 2016). This was gut-wrenching for me, I knew how devastating this would be to many of my staff members. Feelings of guilt and being at fault is quite common for managers who are faced with .
respond Communication is integral in the field of nursing. N.docx
respond
Communication is integral in the field of nursing. Nurses act as the hub of communication, relaying and interpreting information between physicians, caregivers, family members and patients. The ability to establish effective communication in nursing is imperative to providing the best care and patient outcomes possible (Bender, Williams, Su, & Hites, 2016). At any workplace, good communication is vital. Effective communication removes obstacles that detract from efficiency and collaboration. As a nurse executive, I should create the structure and processes that facilitate effective communication within in my team. To improve communication to and between team members, my focus would be improving both the content and the coverage of team members’ communication.
To begin with, I would provide role clarity at the workplace. One of the most effective structural ways to improve the content of communication within a team is to invest in role clarity (Marquis & Huston, 2017). It helps everyone on the team know from the beginning which content is most relevant to discuss with different team members. I would promote role clarity by explaining to each employee what metrics will be used to define success in their role. Another way of enhancing communication is by creating an open door policy. This would encourage free communication by removing any potential barriers.
Empowering team members would enable them have the authority or power to execute certain functions. Additionally, empowering people also makes them more confident, for instance, in decision-making (Marquis & Huston, 2017). One major way in which I would empower my team members is by including them in the decision-making process of our healthcare organization. Through this inclusion, their views are likely to be heard by a higher authority.
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Respond As the unit director for the emergency department an.docx
The document discusses strategies for reducing medication errors by taking a system-wide, interdisciplinary approach and including all stakeholders. It emphasizes the importance of considering not just patients, but also members of the organization who deal with medication, like nurses, pharmacists, and IT. Reducing errors requires understanding differences between specialties, like how insulin is administered differently in pediatrics than other fields. It also stresses the need to examine organizational culture and climate, using respectful communication and transparency to learn from mistakes without blame. The goal is to empower staff to share about errors to improve systems and reduce future issues.
Respond with 150 words and 2 references with 1 being the textbook, b.docx
Respond with 150 words and 2 references with 1 being the textbook, biblical reference
Cullen, F. T., & Jonson, C. L. (2017).
Correctional theory: Context and consequences
(2nd ed.). Thousand Oaks, CA: Sage. ISBN: 9781506306520.
*Barry**
The Pros and Cons of a Pure Deterrence Theory
As one reviews the application of a pure deterrence theory in America corrections operations today, the absence of empirical evidence in the development of many such theories remains evident. Based on this author’s research and personal observations of local corrections operations in practice, it appears that many pure deterrence programs develop more like a knee jerk response to various challenges within the corrections system. America’s public opinion historical suggests that felonious offenders should be incarcerated through determinate or indeterminate sentencing. The political reaction to public opinion has been to increase incarceration to satisfy safety issues within our communities. Indeed, incarceration does stop that offender from bringing harm to our communities (Cullen, Jonso, & Nagin, 2011). The increased prison populations serve to create overcrowding conditions within prisons, however, which serves to increase violence, more dangers to over-worked corrections personnel, and a resulting increase in parole or felony probation diversion strategies to lessen this burden. One reactive strategy is the use of Intensive Supervision Parole/Probation (ISP) (Hyatt & Barnes, 2017). The question remaining is, how valid is this strategy, and what challenges have arisen within this strategy?
What is Intensive Supervision Parole/Probation ( ISP)?
The theory behind ISP assumes that a specific offender is more prone to recidivism if he or she is awarded the standard probation or parole, which requires minimal reporting such as monthly office visits with the parole/probation officer or even lesser challenging requirements such as phone calls to the officer. ISP, therefore, has arisen as an immediate solution to this challenge. The parolee/probationer is required to submit to more intensive visitation or office visits, drug testing, and other more stringent requirements, which, by design, are perceived to gain more control over the offender, which forces compliance (Hyatt & Barnes, 2017). However, one must ask if this is a pure form of rational emotive behavior therapy, or does it merely delay the inevitable by creating controlled robotic responses? Does history offer examples in intensive parenting controls gone wrong?
Challenges within ISP
The more significant and obvious error within the application of the theory of ISP rests with the increased caseload resulting from the diversion of offenders from incarceration into the parole/probation system. Many states developed parole in absentia program, which is designed to work with offenders with less than a five-year sentence. The offender is released on parole immediately the following sent.
Respond on 2 different days who were assigned different case stud.docx
Respond
on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues' differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.
Main Post
Knee Pain SOAP Note
Patient Information:
SJ, 15-year-old WM
S.
CC
- Pain in both knees.
HPI
: 15-year-old white male presents with pain in bilateral knees. Pain onset was 1 week ago after football practice. Pain is described as “dull”. Associated s/s include clicking in one or both knees and a catching sensation under the patella. SJ describes pain as dull and constant, pain rated at 3 on a scale of 0-10. Pain is exacerbated by movement and relieved by rest.
Current Medications
: No medications, no OTC medications or vitamins.
Allergies:
seasonal allergies only
PMHx
: Immunizations current, flu shot received from PCP 10/5/19. No previous injuries, hospitalizations, or surgeries.
Soc Hx
: 10th grade student, on high school football team (offensive lineman), has played football since age 6. Denies alcohol use, denies tobacco use, Denies use of illicit drugs. Honor student, popular in school with many friends. Lives at home with dad and two younger sisters. Mom is active duty/deployed currently. Currently learning to drive in driver’s education at school.
Fam Hx
: No significant medical history in parents. Maternal grandmother died at 80 of lung cancer, grandfather at 81 of MI. Paternal grandmother has osteoarthritis, grandfather has DM.
ROS
: GENERAL: Denies weight loss, fever, chills, weakness or fatigue.
HEENT: Head: denies headache,
Eyes: Denies visual loss, blurred vision, or double vision, denies hearing loss, nasal dysfunction or sore throat.
SKIN: denies rash or puritis.
CARDIOVASCULAR: Denies chest pain, chest pressure or chest discomfort. Denies palpitations or edema.
RESPIRATORY: Denies shortness of breath, cough or sputum.
NEUROLOGICAL: Denies headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. Denies change in bowel or bladder control.
MUSCULOSKELETAL: Knee pain, with clicking and catching sensation under the patella. Denies back pain, stiffness.
HEMATOLOGIC: Denies anemia, bleeding or bruising.PSYCHIATRIC: Denies depression or anxiety.
ALLERGIES: Denies food or drug allergies, allergy to pollen.
O.
VS: BP 123/68; P 89; RR 18; T 97.6; O2 98%; Wt 179; BMI 25.68
General
- AOx4. Pt appears healthy and well nourished, athletic build. Well groomed, no acute distress noted.
Cardiovascular-
Regular rate/rhythm. S1/S2 heard, no murmurs, gallops, or rubs noted.
Respiratory
- RR even and unlabored. Clear to auscultation bilaterally with no wheezing, rales, rhonchi, or crackles.
Musculoskeletal-
joint stability normal in upper extremities, no tenderness to palpation. Lower bilateral popliteal tenderness upon palpation, Rt quadricep angle 18 degrees, Lt qua.
RespondWhat is artCompare your current thinking to .docx
Respond
What is art?
Compare your current thinking to the definition you wrote in week one.
In what ways has your personal definition of art expanded or changed over the course of this session?
Reflecting on your exploration of the visual arts across varied times, places, and cultures, how has this course influenced your thinking about the ways we as humans are more alike than different?
Select a work of art that illustrates your current definition of art.
Share your selected artwork and discuss in what ways it illustrates your current definition of art.
Will you use the same work of art or select something new?
Is more than one artwork needed to fully illustrate your new definition?
From what cultures and times will you find your examples?
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respond As the nurse executive in an acute care hospital, I .docx
respond
As the nurse executive in an acute care hospital, I welcome collaboration among advanced practice nurses (APN) and the clinical staff for many reasons. Advanced practice nurses can take on acute services, be readily available and in all honesty are far more approachable, accessible and can provide a sense of trust into our patient population when being compared to a PGYI or newer medical student. Often times our medical residents or surgical residents lack empathy and lack a collaborative effort that makes our admissions and discharges flow in less than desired manner. As a whole, the unit gravitates toward reaching out to the APRN for effective communication when placed in a position to communicate between families, patients and our medical teams.
An organizational chart could absolutely be utilized to enhance and improve collaborative communication and facilitate trust among different departments through reflexivity. From the article
Margaret Archer, Modes of Reflexivity: The Structured Agency of Nursing Action,
communicative reflexivity is said to be our inner conversations which required confirmation and communication with others before we act. A nurse who predominantly uses communicative reflexivity will consider what their peers are thinking and will want to act in such a way as to fit in (Goodman, 2017). Although the nursing profession especially as a clinical provider we tend to use our professional critical thinking skills and act on our best nursing judgement, we tend to disconnect from our peers and resources such as the APNs to confirm our actions before we act. Although working together as a team is essential for the unit to function properly in crisis situations, I often times see nurses perform on “auto-pilot”, working independently without collaborative efforts that could be in the best interest of our patient population. Facilitating collaboration between available APNs and clinical staff is essential to improving patient outcomes and building a higher self-esteem among staff. Being validated that our critical thinking, assumptions and interventions are correct from someone with higher level education can be very empowering.
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RespondThe brokerage firm of E. F. Hutton was charged with fe.docx
Respond:
The brokerage firm of E. F. Hutton was charged with federal criminal violations of interstate funds transfers. In reviewing the case, the lawyers for the government discovered internal Memoranda from and between branch managers in several states that outline a process for check kiting (a literal stringing together of checks and deposits) that enabled E. F. Hutton to earn interest on phantom deposits.
In 1985 E. F Hutton was found guilty of check kiting managers of the firm use check kiting technique to obtain legal interest over large sums of money, lawyers of government discovered internal memoranda from an between branch managers in several states that outlined process for check kiting that unableed E. F Hutton to earn interest on phantom deposits. E. F Hutton was charge with federal criminal violations.
The case will be tried in the Federal District Court by the United State Attorney, under the Federal Court System because the Federal District has the jurisdiction that involved cases from different states and also the damage exceeds $75,000. Because is a federal crime it is tried a Federal district.
The obligations of the layer is to draft the documents without a perfume with the complete facts and transaction of the fraud committed. The company’s obligation was to show the correct financial statements, the company have the right to provide the correct documents and financial statements to the court. Company have to take steps in order to avoid any future possibilities of having any more frauds.
EFH manager should not disclosed the documents to the government. Managers need communicate to the directors about the situation and look solutions to find the way to avoid future fraud for happen.
Respond:
The phrase Stare Decisis comes from Latin and means "let the decision stand". It is a doctrine that allows judges to examine previous cases as examples to make decisions about new cases. Stare Decisis is closely connected to the idea of a precedent. This means that if a Supreme Court has previously made a ruling on a similar case, it will use that precedent as a model for another case. However, following a precedent does not necessarily mean that all similar cases will be decided in the same way. Other factors, such as context or changes in societal views, can also influence whether or not a precedent will be followed.
One of the most talked about recent U.S. Supreme Court decisions was the April 2018 decision of Janus v. American Federation of State, County and Municipal Employees. The case was brought by Mark Janus, a child support specialist who worked for the state government in Illinois. He sued the union, saying he did not agree with its positions and should not be forced to pay fees to support its work. By a 5-to-4 vote, the court ruled that government workers who choose not to join unions may not be required to help pay for collective bargaining. This ruling overruled the court's 1977 decision in Abood v. Detroit Bo.
RespondEXPERIENCEI had been a bedside nurse for 24 years.docx
Respond
EXPERIENCE
I had been a bedside nurse for 24 years before I transitioned into my current position as an Accreditation Specialist. I have been in my position a little over two years and due to being a bedside nurse I never had to deal with any budgeting issues. My husband tends to all our personally finances. I honestly have to admit, I am not good with money. My husband is so much better in planning and saving for the future, I have more of a spontaneous personality. I paying more attention and asking more questions to my department manager and director in regards to our budget. They have quarterly leadership meeting where our organizations financial information is discussed. After these meetings, my leaders share the information and are willing to answer any of our questions. They want to be transparent to allow us to be educated and knowledgeable in regards to our organization.
REFLECTION
The pre-conceived notion I had of healthcare financial and budgeting principle is of staffing. I did not realize developing a staffing budget consisted of a certain formula. I was unaware of the number of factors related to identifying the full-time equivalents (FTEs) needed to staff a hospital floor. I now understand that an FTE consisted of 2,080 hours/year for a full-time employee. And patient hours are a major factor, the percentage of direct admits from the emergency room (ER). The budget also has to take into consideration the skill mix needed for your organization.
Two concepts that were very interesting to me were the nonprofit and for-profit concepts. They only difference is that non-profit organizations do not pay taxes. For profit hospitals are owned and operated by financial cooperation’s and have access to larger sums of money when needed. Nonprofit organizations are more community oriented and focuses on what the community needs. They are typically in area that are financially well off but that is not the case for the organization I am affiliated with. My community is poor and Medicaid and Medicare are a high percentage of our reimbursement. Quality verses quantity is always a main focus for us. We do not provide a lot of specialty services but what we offer is quality care with the capability to stabilize and transfer to affiliated hospitals. We like to ensure our patients are receiving quality care not matter where they are sent.
IMPLICATIONS FOR THE FUTURE
My proposed project is implementing a sepsis bundle checklist to improve sepsis bundle compliance in the Emergency Department (ED) to improve patient outcomes. This project is not a high cost to the organization. The sepsis bundle checklist can be created by our quality department and once passed through the form committee for approval it can be rolled out for use. The education department will be involved to develop the education for the staff and providers to ensure the checklist is getting implemented correctly. The checklist will be printed in our print shop so each .
respondStaffing issues have always been a major area of conc.docx
respond
Staffing issues have always been a major area of concern within the health field. Adequate staffing affects the patient safety, staff morale and finances of the organization. It’s important that organizations take note of concerns related to their staffing and take the necessary steps to ensure that adequate staffing within the units.
The staffing in my organization varies depending on the unit and level of care or acuity of the patients. For starters, patients enter into the Emergency Department and are typically cared for by a nurse who is assigned a team of 3-4 patients. Nurses who work on the medical/ telemetry units are assigned a 1:6 nurse: patient ratio. Nurses who work on the Intermediate Care or Step Down unit is assigned a 1:3 nurse:patient ratio. ICU and CVICU patients are assigned at a 1:2 or 1:1 nurse to patient ratio.
There could be a number of variables that affects the staffing ratio. The shortage in healthcare professionals is one of the greatest variables affecting the staffing ratios. When there is not enough employees on duty, nurses and nurses assistants are forced to work under staff. Patients and families notice when there is a shortage of staff, and they tend to lose their faith in their provider when they’re working short. It’s important that staff understand the importance of managing up the organization and notify their leader if they are feeling overwhelmed instead of venting to the patients.
As it stands now, my organization has some of the lowest nurse to patient ratios which is currently mandated by the organization itself. Our organization takes pride in patient safety, and focuses on safe quality care as a whole. This staffing ratio affects the organizational budget as a great deal of resources is put into recruiting qualified staff as well as using alternative staffing agencies to assist with nursing and support staff coverage.
.
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