Your patient is a 23-year-old female with a history of headaches.
Nursing Question
Your patient is a 23-year-old female with a history of headaches. This morning she was experiencing a really bad headache as her boyfriend was driving her to the university. He thought she was sleeping and by the time they got to the school, 45 minutes later, she was not waking up. She was diagnosed with a cerebral aneurysm and you are taking care of her in the Neurological ICU.
Scenario: Hello, I am Isabella. I am 72 years old and a recent widow after the death of my husband Ben, 6 months ago. I have to tell you, things have not been easy for me in this life. But I have always believed you have to take care of yourself. Even when times get rough, I do as much as I can. I might be a little unorganized sometimes so don’t ask me what day it is!
Back when Ben got really sick, we decided it was best for me to stop working so I could take care of him. I loved my job at Sears. I had worked there more than 20 years, ever since Sandra my daughter was in high school. I loved being with people and helping them find just exactly what they were looking for.
At first, Ben could still do things for himself. He had his little daily routine of things to do. He would get up and read the paper, walk down to the little breakfast diner to have some coffee and talk to all his friends there. In the afternoon we would go to doctor’s appointments and do the shopping and other errands. He was still real handy around the house. As time went on, Ben got a little sicker everyday, to the point where in the last year I was doing everything for him. I have to tell you, I was getting so tired and run down, never being able to sleep the night through or have a restful meal.
Our daughter Sandra, as busy as she was with her own life—it being a mess and all—would still try to help out as much as she could. Usually, she would come over with a meal once a week, and stay with her Daddy while I went to mass or had a cup of tea with a friend. Her daughters would come and read stories to their “pa-pop” and sit near him. The smile on his face during those visits made the whole day better.
Ben’s medications and equipment were really, really expensive. Now, since he worked for the Railroad he had a pretty good pension and health benefits in retirement, but they would not cover the cost of everything, even after he got Medicare when he retired. Pretty soon we were nearly completely out of money. Outside of the house, we owned an old car.
One day, one of the neighbors told me about a program which was helping one of her sisters in another state, PACE. She said they did wonderful things for both the patient and wife. Well, I asked Sandra about it, and she looked on the computer at the library and found out that PACE had a program here, Total Longterm Care. Well, Ben called TLC and someone came out to the house to talk with us about it. We filled out the form to see if we were eligible, and we were! Everyone there was so helpful!
They told us that TLC would take care of Ben’s medication and equipment, his doctors would even give him a place to go visit and spend a few hours when he wanted. To top it off, they would come pick him up for visits or doctor’s appointments and bring him home. The social worker, Cindy, also told me that they would send someone to help clean up the house a little and take care of some of his needs on days he was at home. They helped out so much let me tell you!
But now I’m back to watching every penny since Ben’s death. Just my arthritis medication is over a hundred dollars a month. I try to stay with the pills. But if I bought them all like the doctor says, I’d be broke. So I break them in half or skip a day here and there to help stretch them out. Sandra has told me I should get Part D insurance for my medications, but it is just too confusing and overwhelming to me.
See, since my Ben died, Sandra has been helping me. I never even wrote a check before because Ben always did that. But now that he is gone, there just isn’t enough money for food and medicine and taxes and everything. I think Sandra is stealing from me though because I think I should have enough money. But since I don’t know much about the bank account, I can’t argue much and have to do what she says.
Sandra and the girls moved in just last week. But now I think Sandra is stealing from me. She came home from shopping or work or something, I don’t remember for sure right now. Well it must have been shopping because she was going to get her shopping bags out of the trunk. I came to the door to see what she was doing. I noticed the mail was in the box by the front door. I opened one bill and it said over $100 was due! How could it be $100? She must not be paying the bills. So when she was buying more stuff but not paying my bills, I just had to tell her off.
See, she keeps telling me lies. I just can’t take it anymore. She is just getting too big for her britches I tell you because she told me if I didn’t like it I could leave. Right then and there I told her she needed a good spanking. Oh the neighbors heard it alright. And they called the police for me too. They know. I bet one of their children is stealing from them too. But Sandra got to talk to the police first. And get this, they arrested me! How humiliating!
I spent the night in jail. I was so mad and scared. My sister, Rosella, came and got me from jail —which was Sandra’s fault in the first place—and then Sandra made it so I couldn’t go into my own house! That was the last straw. I fainted and was taken to the emergency room. They said I had a panic attack this morning. Somebody from social services came while I was at the jail, but I said I’d rather live with my sister than to go with them. Now my sister’s husband won’t let me stay there. The only thing I could think to do was call Cindy, the woman at TLC who was so helpful with Ben. She is going to meet with me and Sandra at the house this afternoon.
Instructions:
Read the scenario above, and then answer the following questions:
What problems are specifically Sandra as far as her caregiving role?
Should Sandra try to make any adjustments to repair her relationship with her mother? How will this help to fulfill her role as a caretaker for her mother?
Your paper should be:
One (1) page or more.
Use factual information from the textbook and/or appropriate articles and websites.
Cite your sources – type references according to the APA Style Guide
You are a staff nurse in the intensive care unit (ICU) at one of your city’s two hospitals.
You are a staff nurse in the intensive care unit (ICU) at one of your city’s two hospitals. You have worked at this hospital for 5 years and transferred to the ICU 2 years ago. You love nursing but are sometimes frustrated in your job due to a short supply of nurses, excessive overtime demands, and the stress of working with critically ill patients.
The hospital has a closed shop, so union dues are deducted from your pay even though you are not actively involved in the union. The present union contract is up for renegotiation, and the union and management have been unable to agree on numerous issues. When the management made its last offer, the new contract was rejected by the nurses. Now that the old contract has expired, nurses are free to strike if they vote to do so.
You had voted for accepting the management offer; you have two children to support, and it would be devastating to be without work for a long time. Last night, the nurses voted on whether to return to the bargaining table and try to renegotiate with management or to go out on strike. Again, you voted for no strike. You have just heard from your friend that the strike vote won. Now, you must decide if you are going to support your striking colleagues or cross the picket line and return to work tomorrow. Your friends are pressuring you to support their cause. You know that the union will provide some financial compensation during the strike but believe that it will not be adequate to support yourself and your children. You agree with union assertions that the organization has overworked and underpaid you and that it has been generally unresponsive to nursing needs. On the other hand, you believe that your first obligation is to your children.
DQ: List all of the reasons for and against striking. Decide what you will do. Use appropriate rationale from outside readings to support your final decision.
Discussion Protocol. Please observe the following 3 x 3 rule: when writing your weekly discussions: – A minimum of three paragraphs per DQ. Each paragraph should have a minimum of three sentences.
All answers or discussions comments submitted must be in APA
This week you reflected upon the difference between a “manager” and a “leader” and discussed this concept with your classmates and professor in the discussion board. In a written essay please answer the following questions:
What are the differences between leaders and managers? What characteristics are similar and what are different?
Provide a total of three examples. First, of someone who has great managerial skills. Second, another individual with great leadership skills. Third, another person with poor managerial skills. These can be made up individuals or examples you have seen without any identifying information. Discuss how the staff of each individual would be affected by the skills of the leader/manager.
Complete the Emotional Intelligence Test Discuss your scores and what they mean. What did you learn about yourself as a leader? (Note that a 10 on the EI test means strong. On the score page, click on the blue “here” under “interpreting your GEIT scores, click here” for more information on each section and what it means.
Assignment Expectations:
Length: 1500 to 2000 words total (at least 500 words per question prompt)
Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three (3) scholarly sources are required for this assignment.
Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.
Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf)
Requirements: Length: 1500 to 2000 words total (at least 500 words per question prompt)
Weiss, S. A. & Tappen, R. M. (2015). Essentials of nursing leadership and management (6th ed.). F.A. Davis Company. Read chapters 1 and 2.
Research an economic opportunity that might be available within your health care setting that will provide ethical and culturally equitable improvements to the quality of care. Then, write a 2-4 page proposal for an initiative to take advantage of that opportunity, supported with economic data and an analysis of the prospective benefits. Please follow scoring guide to ensure a pass grade.
– APA format
– References must be within the past 5 years
INTRODUCTION
Note: Each assessment in this course builds upon the work you have completed in previous assessments. Therefore, you must complete the assessments in the order in which they are presented.
Master’s-level health care practitioners are charged with the responsibility of constantly scanning the external environment for shifts in the supply of, and demand for, services. Concurrently, leaders must examine their organization’s strategic direction and determine whether adjustments must be made to current service offerings, whether equipment updates are needed, whether staffing models should be changed, and whether other decisions must be made. Each decision that is proposed must be evaluated in terms of the organization as a system, alignment with the organization’s mission and strategy, available internal resources, potential contract and payer source implications, and the short- and long-term economic effects at both the micro and macro levels.
PREPARATION
Research an economic opportunity that might be available within your health care setting—at both micro (departmental, neighborhood) and macro (organizational, community) levels—that you believe will provide ethical and culturally equitable improvements to the quality of care. Then, propose an initiative to take advantage of that opportunity. Support your proposal with economic data (sector growth, supply versus demand, cost versus reimbursement, et cetera) and an analysis of the prospective benefits for your department and for the organization overall.
Such economic opportunities might include offering a new service line, working to improve a service line already offered, retiring an outdated or unprofitable service line, or any other initiative you believe will be of benefit to your organization in the short and long term. One example is a recently launched partnership with a local bicycle-sharing company. Your organization partners with them to host healthy community events that offer free screenings for early detection of various health issues. Free screenings help fulfill some of your organization’s preventive and healthy lifestyle initiatives, while also potentially driving referrals to other services provided by your organization.
Note: Your proposal will serve as the basis for subsequent assessments in this course.
Note: Remember that you can submit all, or a portion of, your draft proposal to Smarthinking for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
INSTRUCTIONS
The requirements for your proposal, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document forma, length, and supporting evidence.
Analyze the economic factors of supply and demand associated with your proposed initiative, within a context relevant to your organization or care setting.
What additional information would improve your analysis?
Explain how relevant economic and environmental data support your proposed initiative.
How does the data illustrate a potential opportunity and the economic viability of your proposal?
Write concisely and directly, using active voice.
Proofread your proposal before you submit it to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal.
Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
Your assessment should also meet the following requirements:
Format: Format your proposal using current APA style. Use the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your proposal. Be sure to include:
A title page and references page. An abstract is not required.
A running head on all pages.
Appropriate section headings.
Length: Your proposal should be 2–4 pages in length, not including the title page and references page.
Supporting evidence: Cite 3–5 authoritative and scholarly resources to support your proposal. Be sure that your sources include specific economic data.
Portfolio Prompt: You may choose to save your proposal to your ePortfolio.
COMPETENCIES MEASURED
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment scoring guide criteria:
Competency 1: Analyze the effects of financial and economic factors (such as cost-benefit, supply and demand, return on investment, and risks) in a health care system on patient care, services offered, and organizational structures and operation.
Analyze the economic factors of supply and demand associated with a proposed initiative, within a context relevant to a particular organization or care setting.
Competency 2: Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered.
Explain why a proposed initiative presents a viable and beneficial economic opportunity for an organization.
