CASE STUDY

Mr. Jones is a 65-year-old man whose wife died 6 months ago after a long illness. The couple had been married 45 years, and they were devoted to each other. They had three children who are now in their 30s. Two of the children live several hundred miles away, but one son lives with his wife and two preschool children less than 1 mile from Mr. Jones’s home.

Mr. Jones provided much of the care for his wife during her illness. Although her care was time-consuming and fatiguing and kept him at home much of the time, he was grateful that he could care for her. He now is alone in their home, is very lonely and uninterested in preparing meals or eating, and lacks energy to return to his former community and social activities or even to interact with his son and family.

The hospice nurse contacted Mr. Jones for follow-up bereavement counseling. She told him that although he had “passed” a routine physical examination the week before, she was concerned about his continuing sadness and lack of energy. The nurse reassured him that it was not uncommon to grieve for many months after a major loss. She asked him if he thought his wife would have had a similar experience if he had been the first to die. His response was that his wife would have had an even more difficult time adjusting. The nurse and Mr. Jones then spent some time reflecting on his loss and feelings, and talking about his response. The nurse’s initial question and Mr. Jones’s resulting insight that his grief was not as bad as his wife’s would have been helped him transcend his immediate experience of loss and find some meaning in his grief.

This illustration is an example of an inward expansion of self-boundaries indicative of self-transcendence. Other expressions of self-transcendence might help Mr. Jones facilitate his own healing and regain a measure of well-being.

In terms of outward expansion, Mr. Jones, with some encouragement, might reach out to his son’s family to begin to reconnect to the world outside himself. Walking to and from his home to theirs could expand his sensory world and provide opportunities to interact with other people and with nature along the way. Spending time with his grandchildren could be enlivening through the joy young children can bring to an older person, as could a sense of satisfaction derived from being helpful to his son and daughter-in-law.

Offering at a future time to use the skills he learned while caring for his wife through volunteering with hospice would be an example of transcending temporally. Integrating his memories of Mrs. Jones into his current life would be another example of temporal self-transcendence.

Transpersonal self-transcendence is another important experience for Mr. Jones. Although he was unable to attend church services for several years, he had in the past found worshiping with others a source of comfort. His spiritual life might even be expanded to consider new spiritual dimensions such as that found in the possibility of “being with” his wife again someday or in some way experiencing her presence in the present. Returning to church or to addressing spiritual dimensions outside of organized worship that relates Mr. Jones’s understanding of death to some greater or divine design is another example of transpersonal self-transcendence.

#1 How does the term pharmacology differ from clinical pharmacology?

#2 Give examples of how nurses utilize pharmacology in clinical practice.

Respond to the two the two post ATTACHED by sharing ideas for how shortcomings discovered in their evaluations and/or their examples of incivility could have been managed more effectively. 3 REFFERENCES EACH

 POST 1

Why workplace is or is not civil

Determining the civility of a workplace is something that I have not considered doing before this assignment. After completing the Clark healthy workplace inventory, I found that my workplace is moderately healthy, scoring 71 (Clark, 2015).  While completing the assessment, I found myself thinking extremely hard on the questions. I often had to think about how the questions have affected me personally, the unit, then the organization. Based on the assessment, I will say that the workplace is both civil and not civil. Clark (2015) explained that for a workplace to be considered healthy, it must have skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership according to the American association of critical nurses (p.2). Based on this, I think my unit specifically needs to work on all of them but mainly on skilled communication.

Incivility in the workplace and how was this addressed 

Since working on the unit, I have found that leadership finds it extremely hard to address issues. For example, when a nurse is late multiple times to work, they won’t address the issue, yet expect the charge nurses to address it. Although this seems to a great way of approaching the issue, it becomes hard when they feel like they are not supported. There have been multiple complaints to leadership about lateness, but this seems to be an ongoing issue because it hasn’t been addressed by the manager. Instead, act like it does not exist especially when they are friends with the individual. It is important for leaders to be transparent with staff and to treat them equally. By not addressing issues at the workplace can negatively impact employee physical and mental health, job satisfaction, productivity, and commitment to the work environment (Clark,2013).

To address this, I spoke with the manager expressing my concerns with another staff. I explained that it was unfair to hold others accountable and everyone needed to be treated equally despite the length of time you have known them personally. Although this issue was talked about with leadership, it is still present as I have observed people coming to work 15 minutes and later without any consequences. Due to the inability to approach staff and address issues, many have stopped approaching leadership whenever there is a concern due to thinking that it won’t be addressed. Since this issue is ongoing and haven’t been resolved, Griffin and Clark (2014) suggest cognitive rehearsal in addressing incivility and bullying behaviors as it has been proven to be an effective way to control the work environment.

References

Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.

Clark, C.M. (2013). Creating and sustaining civility in nursing education. (2nd ed.).  Indianapolis, IN: Sigma Theta Tau International.

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. Journal of Continuing Education in Nursing, 45(12), 535–542.

POST 2

Pauline Kiragu 

RE: Discussion – Week 7

COLLAPSE

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Workplace Environment Assessment

The results of my work environment showed an incivility score of 54. According to Clark, 2015, this means that it’s an unhealthy organization and hence very uncivil.

I was surprised that I have not paid enough attention to some very important details about my organization. For example, the issue of workload in our organization has been a great deal of a problem, the ratio of nurses to patient has always been very high due to lack of enough nurses to work; this has been a great challenge.

Comprehensive mentoring program for all employees also lacks in our organization. The lowest score was communication at all levels of the organization. Effective communication in health care is a mainstay of patient safety and staff perception of a healthy work environment. (Jones et al., 2019). Communication in our organization is not utilized well, for example, the chain of command is not effectively followed due to disorganized problem-solving techniques. A lack of skilled communication in healthcare settings has been shown to negatively affect patient safety and quality. (Jones et al., 2019)

A healthy work environment has been described as a workplace that is positive, supportive, safe, collaborative, empowering, motivational, collegial, professional, respectful, caring, and satisfying. (Saunders et al., 2021). One idea I believed before conducting this assessment and was confirmed is the opportunities for promotion and career advancement. In our organization, chances of getting promoted are very low because of the slow progress in the growth of the organization and high turn over rate of employees. Meaningful recognition promotes job satisfaction/retention, personal psychological well-being, and less job stress, which all contribute to establishing a healthy work environment. (Saunders et al., 2021).

I experienced incivility in my workplace two weeks ago when I complained of the work overload to my supervisor. We were short two nurses in the unit and that affected the nurse to patient ratio. The supervisor only stated that she will communicate with the manager, but she did not get any help for me. I was forced to work with alot of patients which was not safe for me or the patients. I ended up contacting the manager about the issue. I am still waiting to hear the feedback.

The positive results of authentic leadership are optimism, trust, work satisfaction, engagement, low turnover, and creativity. (Saunders et al., 2021). I hope to implement this lesson to my organization if at all I ever get a chance to.

References

Jones, L., Cline, G. J., Battick, K., Burger, K. J., & Amankwah, E. K. (2019). Communication Under Pressure: A Quasi-Experimental Study to Assess the Impact of a Structured Curriculum on Skilled Communication to Promote a Healthy Work Environment. Journal for Nurses in Professional Development, 35(5), 248–254.

Saunders, J., Sridaromont, K., & Gallegos, B. (2021). Steps to Establish a Healthy Work Environment in an Academic Nursing Setting. Nurse Educator, 46(1), 2–4.

M.Clark, C. (2015). Conversations to inspire and promote a more civil workplace . Retrieved from https://www.myamericannurse.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

Bottom of Form

Explore the influence of Jean Watson’s Theory of Human Caring on your future role as an APN. The student will explore the concepts and caritas processes from the Theory of Human Caring and present how these concepts may impact their future APN role.

Directions:

1. The student will create a PowerPoint and include speaker notes that may be added to the speaker note section on each slide.
2. The presentation should be limited to no more than 10 slides. See suggested slides below.
3. If you are unfamiliar with Dr. Watson’s theory see this overview.

A suggested outline for the presentation may include the following slides:

Slide 1 – Introduction to yourself and future planned APN role and practice

Slide 2 – Previous experience with Watson’s Theory of Human Caring

Slide 3 – Core Concepts of the Theory Applicable to the APN role

Slide 4 – Core Concepts of the Theory Applicable to the APN role (as needed)

Slide 5 – Five Carative Factors or Caritas Processes You Plan to Use in the APN Role

Slide 6 – Five Carative Factors or Caritas Processes You Plan to Use in the APN Role (as needed)

Slide 7 – What Does the Theory of Human Caring Mean to You

Slide 8 – APN Implications of Theory of Human Caring

Slide 9 – Summary/Main Points

Slide 10 – Reference

Speak notes are required for this presentation. They are used to help you remember what you will be saying as you give the presentation. You can record the power point or add detailed speaker notes. Do not bog down you slide with cluttered wordy slides use them in the speaker note section. Use images, graphs, pictures on the slides. Remember to add citations to the speaker notes, and add a reference slide.

Write three important things that is associated with the various topics.

1). Alzheimer’s Disease: Teaching About Donepezil

a.

b.

c.

2). Bowel Elimination: Common Causes of Constipation

a.

b.

c.

3). Chronic Obstructive Pulmonary Disease: Developing a Plan of Care

a.

b.

c.

4). Chronic Obstructive Pulmonary Disease: Priority Action for Dyspnea

a.

b.

c.

5). Cognitive Disorders: Interventions for a Client who has Alzheimer’s Disease

a.

b.

c.

6). Eye and Ear Disorders: Teaching for Timolol Eye Drops

a.

b.

c.

7). Fluid Imbalances: Manifestations of Dehydration

a.

b.

c.

8). Hypertension: Blood Pressure Categories

a.

b.

c.

9). Medications Affecting Blood Pressure: Client Teaching for Captopril

a.

b.

c.

10). Pain Management: Evaluating Pain Level for Client Who has Aphasia

a.

b.

c.

11). Pharmacokinetics and Routes of Administration: Administering Ophthalmic Medications

a.

b.

c.

12). Stroke: Complications of Immobility

a.

b.

please see the attached instructions, rubric and essay with policy to base the power point on. must follow all direction on the rubric.

Health-Related Policies

Health policies entail the actions, plans, and decisions made by relevant parties and are meant to accomplish significant healthcare goals in a country. Health policies are associated with the attainment of several things among the future definition. They offer a model for primacies and the expected duties and responsibilities of distinct teams, including encouraging consensus and allowing people to understand more about health. This paper explores various health bills, including H.R.4704 Advancing Research to Prevent Suicide, H.R.1418 Competitive Health Insurance Reform Act, and H.R.5663 Safeguarding Therapeutics Act.

H.R.4704 Advancing Research to Prevent Suicide

Summary of the Bill and Riders

The H.R.4704 Advancing Research to Prevent Suicide Act of 2019 was presented and introduced by Republican McAdams Ben on October 16, 2019. The bill is responsible for directing the National Science Foundation (NSF) to provide reviewed grants to higher education institutions. According to Congress.Gov (2021), the grants advocated for by the bill are meant to enhance multidisciplinary research that is related to suicide. The bill encourages studies related to preventing suicide and treating any complication that would prompt suicidal thoughts. It addresses the gaps evident in suicide prevention and treatment research by encouraging various parties, including doctoral students, to apply for the NSF grants.

Population Affected by the Issue

The bill presents an opportunity and platform for further studies that will benefit several populations. Funding research regarding suicide prevention and treatment, the bill can help veterans that have been affected by Post-Traumatic Disorder (PTSD) who contemplate suicide. The legislation will also affect adolescents that experience significant life challenges, along with ill patients.

Role of Healthcare Experts

Professionals in the medical field are crucial because they help educated affected members regarding the legislation and what it means for healthcare. In the past, research and education about suicide have been limited, making it important for experts, such as nurses and physicians, to understand how the legislation affects suicide prevention.

Pros and Cons

One advantage of this bill is that it will help prevent suicides across several United States populations. Increasing suicide rates among depressed teens will be eliminated after research enhances suicide prevention. One disadvantage connected with this bill is that there will be excessive use of funds, which does not guarantee positive results in the field. Even though research can help prevent suicide, it may not effectively reduce suicides among vulnerable populations.

Expert Testimony and Personal Opinion

Little et al. (2016) explain that researchers and other academics must come together to ensure they prevent suicide among vulnerable populations. The researchers indicate that the Advancing Research to Prevent Suicide Act of 2019 is effective legislation for the process. I believe the introduction of the bill is beneficial to vulnerable populations that are at risk of suicide.

H.R.1418 Competitive Health Insurance Reform Act

Summary of the Bill and Riders

The H.R.1418 Competitive Health Insurance Reform Act of 2020 was introduced on February 28, 2019, and was sponsored by Democrat Peter A. DeFazio. The bill underwent the House and Senate committees and became Public Law on January 13, 2021. The legislation presents that nothing supersedes or modifies antitrust law operations regarding health insurance, including dental insurance operations (Congress.Gov, 2021). The Public Law also prohibits unfair courses of action in health insurance competition.

Population Affected

The H.R.1418 Competitive Health Insurance Reform Act will be affected by several populations, including medical professionals and patients. Health insurance providers in the US are also affected by the act because it prohibits unfair competition. For patients, the law may protect them from unfair exposure to expensive insurance plans.

Role of Medical Experts

Medical experts understand the cost of insurance and how it affects patients. For this reason, they can play a crucial role by advocating for this Public legislation and ensuring that it is adhered to and ascertain that all insurance providers act accordingly.

Pros and Cons

The legislation is beneficial to patients and other people in the US because it protects them from insurance providers’ unfair methods. It also ensures the providers adhere to the law when dealing with all forms of insurance. However, the disadvantage of this law is that it may limit the operations of insurance providers.

Expert Testimony and Personal Opinion

Lexology (2020) criticizes the Competitive Health Insurance Reform Act of 2020 by presenting that it negatively affects competition because it limits insurance providers’ operations. Individually, I think the Competitive Health Insurance Reform Act is detrimental because it may lead to higher insurance premiums.

H.R.5663 Safeguarding Therapeutics Act

Summary of the Bill and Riders

The H.R.5663 Safeguarding Therapeutics Act is sponsored by Republican Brett Guthrie, a representative for Kentucky congressional district (GovTrack.gov, n.d). The bill was enacted after being signed by former US President Donald Trump on January 05, 2021. The legislation extends the Food and Drug Administration (FDA) authority to certain products from other countries, including medical devices (Congressional Budget Office, 2020).

Population Affected

The legislation affects many parties, including healthcare organizations that import medical devices from other countries. It may lead to the destruction of several medical devices by the FDA, leading to the loss of millions.

The Role of Medical Experts

In recent years, counterfeit medical products have increased in the markets, which impacts effective healthcare delivery. For this reason, medical professionals need to ensure that the legislation is followed and active under the FDA. Medical professionals should lead the destruction of counterfeit medical devices.

Pros and Cons

One advantage of the Safeguarding Therapeutics Act is that it ensures counterfeit medical devices are destroyed, leading to effective medical care for patients that the counterfeit devices would have impacted. However, one disadvantage of this legislation is that it may cost the FDA millions in destroying these contrabands.

Expert Testimony and Personal Opinion

BioWorld (2020) presents that the Safeguarding Therapeutics Act is crucial because it increases the effectiveness and use of high-quality medical devices. Nonetheless, individually, I think that the destruction of counterfeit medical devices by the FDA is the best available alternative.

References

BioWorld. (202, December 10). House passes a stopgap spending bill. Retrieved February 2021 from https://www.bioworld.com/articles/501100-house-passes-stopgap-spending-bill

Congress.Gov. (n.d.). H.R.1418 – Competitive Health Insurance Reform Act of 2020. Retrieved 24 February 2021 from https://www.congress.gov/bill/116th-congress/house-bill/1418

Congress.Gov. (n.d.). H.R.4704 – Advancing Research to Prevent Suicide Act. Retrieved 24 February 2021 from https://www.congress.gov/bill/116th-congress/house-bill/4704

Congressional Budget Office. (2020, November 25). H.R. 5663, Safeguarding Therapeutics Act. Retrieved 24 February 2021 from https://www.cbo.gov/publication/56800

Govtrack.us. (n.d.). H.R. 5663 (116^th): Safeguarding Therapeutics Act. Retrieved 24 February 2021 from https://www.govtrack.us/congress/bills/116/hr5663

Lexology. (2020, December 29). Senate approves bill eliminating the antitrust exemption for health insurers. Retrieved 24 February 2021 from https://www.lexology.com/library/detail.aspx?g=da4efa0d-5a48-47d2-a5b1-eccd01c8cc2d

Little, T. D., Roche, K. M., Chow, S. M., Schenck, A. P., & Byam, L. A. (2016). National Institutes of Health Pathways to Prevention Workshop: advancing research to prevent youth suicide. Annals of internal medicine, 165(11), 795-799.

Advocating is the practice of educating law makers about issues that are important to the field of nutrition and dietetics. The Illinois Academy of Nutrition and Dietetics and will be hosting a virtual lobby days webinar and/or town hall meetings this semester on licensure. To complete this assignment, you will need to attend the virtual lobby days and/or a virtual town hall meeting. You will need to write a reflection paper about the relationship between the government and community nutrition (2-3 pages). In addition, you will need to write and send a letter to your legislator about a nutrition related issue (   IAND  )

Advocacy Options: Advocacy Assignment (40 points): Advocating is the practice of educating law makers about issues that are important to the field of nutrition and dietetics. The Illinois Academy of Nutrition and Dietetics and will be hosting a virtual lobby days webinar and/or town hall meetings this semester on licensure. To complete this assignment, you will need to attend the virtual lobby days and/or a virtual town hall meeting. You will need to write a reflection paper about the relationship between the government and community nutrition (3 pages). In addition, you will need to write and send a letter to your legislator about a nutrition related issue and/or complete an action alert through the Academy of Nutrition and Dietetics (1 page). View one of 2 options below- both are offered through IAND for Free for members. Please let me know if you have any issues finding either. Visit eatrightillinois.org and then click on professional development Under Live and Recorded Webinar you will find our 2021 IAND Public Policy Licensure Town Hall (Recorded) or 2021 Public Policy Webinar For the Letter portion- you can either send a letter on a topic of your choosing to your state or federal legislator. You can also use the template on our website to send a letter to your IL State Rep on our licensure bill. You can find information and the template on eatrightillinois.org/advocacy/licensure scroll down and you will find a link that says, “click here to download a copy of the IAND constituent email template to send to your STATE representative.” To find your lawmaker I would recommend using the following link.. https://elections.il.gov/ElectionOperations/DistrictLocator/DistrictOfficialSearchByAddress.aspx You can use the map and look for your State Rep. Your State Rep and State Senator will have an office in Springfield in addition to an office in your district. Your Federal Rep will have an office in Washington D.C. and one in your district. If you choose to send a letter on HB3585, the letter needs to go to your IL State House Rep. You can click on details to view option 1 or option 2- 2021 IAND Public Policy Licensure Town Hall (Recorded) or 2021 Public Policy Webinar- Both are free for members Alternatively, you can also complete an action alert on a federal issue through eatright.org. https://www.eatrightpro.org/advocacy/take-action/action-center The current Action Alerts: 1. Prioritize Nutrition Funding 2. Support Diversity in Nutrition in Dietetics in Allied Health 3. Tell Senators to Co-Sponsor the School Food Service Modernization Act 4. Expand MNT for Eating Disorders in Medicare 5. Support Medicare coverage of IBT for Obesity by RDN’s I completed one of the action alerts and it took me 18 seconds..a total of 2 clicks. Super easy!

1. Watch the film Shakespeare in Love. Write 300 + words about the film and how the play Shakespeare was writing started out as a comedy and moved into a tragedy.  What elements did it have that made it a comedy and what was either added or taken away from the play he was writing to turn it into a tragedy.  Use Examples from the book pages 181 – 185. DO NOT WRITE A SYNOPSIS OF THE MOVIE!

Info on the Film

• Title – Shakespeare in Love (1998)
• Directed – John Madden
• Written – Marc Norman and Tom Stoppard
• Starring – Joseph Fiennes, Gwyneth Paltrow