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  • SOC 320: Public Policy & Social Services Essay

    SOC 320: Public Policy & Social Services Essay

    SOC 320: Public Policy & Social Services

    For your journal entry, you will explore aspects of your personal experience and beliefs regarding significant public policies and what you have learned in your readings.  For this journal assignment review the following resources:

    Rebecca Onie: What if our healthcare system kept us healthy?

    Health Reform Hits Main Street: The YouToons Explain the New Health Law.

    Illustrating Health Care Reform: How Health Insurance Coverage Will Work.

    As you reflect on these resources, please address the following questions:

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    What are the major current health care issues and policies in the United States today?

    In my opinion, the policies surrounding this health care issue and the people who make them, are not thinking twice about preventative care and are not concerned with preventing illness but seemingly are willing to promote the use of more medication instead of treating the real issues at hand. Medication is not always the correct answer, there are problems at home that cause the illness, but no one seems to care. If we chose to care, then we would realize that prescribing medicine isn’t the one and only answer. One of the interesting things about the policy treatment was when Rebecca Onie spoke to Dr. Geiger about how the Washington beaurocrats expressed to him how he was not allowed to prescribe food for patients, and Dr. Geiger explained to them that food is the prescription for malnutrition (Onie, 2012). SOC 320: Public Policy & Social Services Essay. I am not sure that everyone has the best intent in mind for the health of the nation. Everyone has this straight and narrow path they are supposed to follow, but no one ever bothers to take a turn and consider the other options. It always comes down to how much money matters, whatever is cheaper wins.

    What is the Patient Protection and Affordable Care Act – 2010?  How did this policy change the health care system in the United States?

    The Patient Protection and Affordable Care Acts are the actions of the government to help Americans become insured so that everyone has the chance to see a doctor and become a healthier person in the process. Before this, the government did not guarantee any access to healthcare and did not provide access for certain groups (Theodoulou & Kofonis, 2012). What this means, is that there were no legal protections or any way around to receiving healthcare for individuals with certain health conditions. If you did not have any way to pay for your healthcare, then you were not insured plain and simple. Insurance plans were able to discriminate against you based on your health condition or concerns. If you had something severely wrong with you, the health insurance companies were allowed to say no, simply because you were too much of a risk. Also, the access to care was a choice and not necessarily a right of a citizen (Theodoulou & Kofonis, 2012). This quote talks about the rights of doctors, hospitals, and other physicians to have the choice not to see neither accept an individual as a patient based upon current health status and any pre-existing condition which the patient may be dealing with. This system was based solely on one’s ability to pay for services and not for the medical need neither necessity of the service SOC 320: Public Policy & Social Services Essay.

    Describe one strength and one weakness of the Patient Protection and Affordable Care Act – 2010.

    Since the (ACA), Affordable health care is now guaranteed, the ability to put a decision back into the hands of the individuals and not of the hands of the physician, is the best modification. Also, the name of the Affordable Care Act can be somewhat of a misleading term. Personally, I thought that it meant that insurance would be affordable for everyone to get However, I have learned that affordability is not always what we believe. I’m glad that we now have somewhat of choice and that those who could previously not be covered can now have coverage. However, affordability has a lot to do with our health status as well! In this way, the naming of the ACA is somewhat of a misleading term. However, it is still a good plan that has been put in place so that people may have some way to guarantee they can receive insurance benefits. The requirements of the required health insurance is a weakness of the ACA. Some people cannot afford insurance and trying to base it on someone’s income with rising costs of living it is not so simple to say based on one’s income that someone should be able to afford a certain amount for insurance payments.

    How are you affected by healthcare policies in the United States? If you are not affected, why not?

    I do not believe that there is a single person that has not been affected by the healthcare policies in the United States. The policies do not deal with only one set of health insurance, but they are also involved in the stipulations for help with Medicare, Medicaid and other federally funded aid programs to cover healthcare. Personally, I do not have to pay for health care because my husband is in the military SOC 320: Public Policy & Social Services Essay. Lucky for me none of this is a concern but what about the individuals who are not military and do have to worry about this? Those people could die, God forbid, from complications with illnesses simply because they don’t have the money obtain medical insurance. Or, they don’t have money to purchase the food required to keep them healthy. The policies that are currently in place are better policies which have positively affected many people. However, those same policies also drive insurances out of the State exchange programs and into private sectors which lead to less competition within the exchanges and thereby driving the costs higher even for those who will get “extra help” to cover some of the costs of insurance. So, although tax credits are received with the ACA, those credits are not always enough to get someone over the hurdle of affordability (Kaiser Family Foundation, 2010).

    What were your thoughts on the healthcare system in the United States prior to this week’s readings? How has your perspective been either reinforced or changed now that you are more informed?

    My thoughts on the healthcare system have not changed before reading this week’s required readings, and will probably not change soon. The ACA is a game changer, and it is a good thing that it has been implemented. However, the costs that are associated with healthcare are not beneficial to individuals who are healthy. If it is mandatory that people purchase health insurance, there must be some added value to those purchases. Having to pay more than 4,000 dollars a year for heath insurance is a little outrageous. Realistically speaking, many young people are healthy and are being forced to pay for this health insurance that they can not afford. At the end of the day, I’m not sure how to change the healthcare system for the better but forcing someone who can not afford health care is not the road to go down. Although there were a few things I liked in the Paul Ryan’s replacement plan, it also still lacks the fundamentally of what we need as a country. SOC 320: Public Policy & Social Services Essay.

    The purpose of the journal activity is to allow you to thoroughly reflect upon what you have learned during this course, particularly this week, and to provide you with an opportunity to relate this what you have learned this week to your experiences. The reflective journal is not a formal written assignment. However, you are expected to adhere to conventional rules of grammar, sentence structure, spelling, and punctuation while focusing on clearly conveying your thoughts.

    References:

    Kaiser Family Foundation. (n.d.). Illustrating health care reform: How health insurance coverage will work [Interactive map]. Available from http://healthreform.kff.org/profiles.aspx

    Kaiser Family Foundation (Producer). (2010).
    Health reform hits Main Street: The YouToons explain the new health law
    [Video file]. Available from http://healthreform.kff.org/the-animation.aspx

    Onie, R. (2012).
    Rebecca Onie: What if our healthcare system kept us healthy?
    [Video file]. TEDMED. Available from http://www.ted.com/talks/rebecca_onie_what_if_our_healthcare_system_kept_us_healthy.html

    Theodoulou, S. Z. & Kofinis, C. (2012).
    The policy game: Understanding U.S. public policy making
    . San Diego, CA: Bridgepoint Education, Inc. SOC 320: Public Policy & Social Services Essay.

     

    Public policy is one way that society addresses social problems through the use of laws and regulations adopted by governments.  In this discussion, review the American Sociological Association article
    Sociology and Public Policy
    (Links to an external site.)Links to an external site.
    and address the following:

    1. Consider and explain the following statement, “Public policy is both what government does and what it does not do” (Theodoulou & Kofinis, 2012).

    2. What determines whether a policy is enacted or not?

    3. Who holds the power and authority to create, enact and/or change public policy?

    4. What is the difference between public versus private concerns in relation to policy making and the government’s role in this process?

    5. Describe two ways that social science research helps to design good public policies.  Why are social science research skills important for analyzing the impact of existing policies?

    Your initial post should be at least 300 words in length. Support your points with scholarly references, appropriate citations, and full references at the conclusion of your post. Cite your sources in APA format.

    http://www.asanet.org/sites/default/files/savvy/footnotes/apr09/asa-forum_0409.html

    https://content.ashford.edu/books/AUSOC320.13.1/sections/sec1.2 SOC 320: Public Policy & Social Services Essay

     

    SOC 320 Public Policy & Social Services

    Public Policy on Social Security

    Introduction

    Thesis Statement

    It is not difficult to understand why Social Security is our country’s most popular government program. The Social Security program began as a way to implement “social insurance” during the Great Depression when poverty rates exceeded more than 50 percent for senior citizens living in America when a great number of people were negatively affected by economic conditions. According to Theodoulou & Kofinis (2012) the Depression indicated that many were not saving sufficiently for retirement, much less an economic emergency. With that being said, Social Security has sparked a debate between public and private perspectives as funding for the program has become more an issue than ever before. Therefore, this paper will look at the issues and changes in Social Security and how it seems to teeter on promoting “equality” and efforts to provide “adequate” and affordable protection for the citizens of the United States.

    Body paragraph #1- Topic Sentence #1

    The original purpose of Social Security was to offer an insurance policy for retirees. This plan had an employee work force providing money for the Social Security fund in an effort to pay those in retirement. However, along the way the life expectancy of individuals increased and the ratio of those actively working and those in retirement started to drop (Anders & Hulse, 2006). This meant that the money that was coming in would not be enough to support the money that was going out. SOC 320: Public Policy & Social Services Essay.

    Supporting Evidence

    In 1983, a Social Security Trust Fund was created to use the excess funds from payroll tax revenue in an attempt to overcome the shortfall in future Social Security needs (Morse, 2011). These funds were to be invested so that the funds would grow and protect the system for years to come.

    Explanation

    The system that was created to grow and protect the funds, instead the funds were placed into non-negotiable treasure bonds, which would be just like having an “IOU” from the government.

    So What?

     
    References

    Anders, S. B., & Hulse, D. S. (2006). Social security: The past, the present, and options for reform.
    The CPA Journal, 76
    (5), 20-31. Retrieved from
    http://search.proquest.com/docview/212258051?accountid=32521

    Morse, D. E. (2011). Social security is in the red.
    Benefits Law Journal, 24
    (2), 1-3. Retrieved from
    http://search.proquest.com/docview/866765228?accountid=32521

    Theodoulou, S. Z. & Kofinis, C. (2012).
    The policy game: Understanding U.S. public policy making
    . San Diego, CA: Bridgepoint Education, Inc. SOC 320: Public Policy & Social Services Essay.

  • NURS 6050 Agenda Comparison Grid and Fact Sheet Example

    NURS 6050 Agenda Comparison Grid and Fact Sheet Example

    Agenda Comparison Grid Template

    Agenda Comparison Grid
    and Fact Sheet or Talking Points Brief Assignment Template for Part 1 and Part 2

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    Part 1:
    Agenda Comparison Grid

     

    Use this
    Agenda Comparison Grid
    to document information about the population health/healthcare issue your selected and the presidential agendas. By completing this grid, you will develop a more in depth understanding of your selected issue and how you might position it politically based on the presidential agendas. NURS 6050 Agenda Comparison Grid and Fact Sheet Example

     

    You will use the information in the Part 1: Agenda Comparison Grid to complete the remaining Part 2 and Part 3 of your Assignment.

     

     

    Identify the Population Health concern you selected.

    Abortion

    Describe the Population Health concern you selected and the factors that contribute to it.

    Abortions has been a debate in healthcare for many year, but most recently, it has become a huge topic of discussion and debate in politics. Abortion laws affect many different populations and there are many factors that contribute to the debate. Factors that contribute to abortion are the effects abortion has on birthrates, the economic impact of abortion, changes of sexual behavior among teens. A recent study was performed to determine the factors affecting the mental well-being of a woman after abortion. Implications of the study included; Source of stress experienced by women after abortion and the effects abortion has in regards to religious beliefs (Annas, G. n.d.). According to a 2011 study of the British Journal of psychiatry 81 percent were likely to experience a mental health disorder such as anxiety disorder, depression, alcohol abuse, marijuana abuse, and suicide (Laguna Treatment Center, 2019). Other studies, found that women were more emotionally stressed if they were denied an abortion (Laguna Treatment Center, 2019). The reason for this was they were not prepared to have children, rape, the child had birth complications, and parents of the child were unable to care for the baby, or shame. NURS 6050 Agenda Comparison Grid and Fact Sheet Example

     

    Administration (President Name)

    (Current President)

    Donald Trump

    (Previous President)

    Barack Obama

    (Previous President)

    George W. Bush

    Describe the administrative agenda focus related to this issue for the current and two previous presidents.

    On January 19, 2018, while speaking to participants at the annual March for Life, a rally for activists who opposed abortion, President Donald Trump said that his administration “will always defend the very first right in the Declaration of Independence, and that is the right to life. We are protecting the sanctity of life and the family as the foundation of our society (whitehouse.gov, n.d.). President Trump is % against abortion. He has always maintained that is and will always be the case for him as long as he is president.

     

     

     

     

     

     

     

     

     

    Obama strongly supported a women’s right to choose to terminate her pregnancy for any reason through legal and safe abortion procedures as defined by Roe. Obama wound do just about anything and everything he could to preserve a women’s right to affordable and unfettered abortion on demand as promoted by tax subsidized abortion providers like Planned Parenthood. (
    www.nrlc.org
    , April, 201). He believed it was a moral issue and did not feel the government should be involved. Obama enacted the freedom of choice Act in 2008, which would codify the right to abortion by eliminating all federal and state-level restrictions on the procedure (The federalist, 2019 para.9).

    President Bush is likely the president that was the most sensitive on the subject than the other two presidents.

    Bush supported a constitutional amendment making the procedure illegal – except in cases of rape, incest and when the woman’s life was in jeopardy. But he also added that Americans didn’t support the measure, so there was no need to pursue it. He also added that he not require his Supreme Court nominees to pass an anti-abortion litmus test (Abortion without the rhetoric, 2012). He did not believe in intentional death of babies, but he  believed women should have some rights initially, but then he took away funding, and settled for Partial abortion.

    Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.

    Trump signed an executive order reinstating the ban known as the Mexico City Policy. This policy prohibits the U, S. giving federal family planning funding to international health groups that provide abortion care” (Freiburger, C., 2019).This would include organizations such as Planned Parenthood.

    Shortly afterwards, the President’s press secretary Sean Spicer made a bold statement that stated, “ Mr. Trump was/is standing up for all Americans – including the unborn” (Freiburger, C., 2019).

     

     

     

     

     

     

     

    The Obama administration finalized a rule to stop states from withdrawing federal money from Planned Parenthood and other health clinics that provide abortions.

    The protections were in effect two days before Donald Trump took office.

    Under the rule, states are legally required to distribute federal funds for services related to contraception, fertility, pregnancy, sexually transmitted infections and breast and cervical cancer screening, regardless of whether they also perform abortions (Annas, G. n.d.).

     

    NURS 6050 Agenda Comparison Grid and Fact Sheet Example Upon taking office, President Bush reinstated the “Mexico City Policy,” also known by critics as the “Global Gag Rule.” This rule required that all non-governmental organizations (NGOs) that receive federal funding must refrain from performing or promoting abortion services (prolifeprofiles.com, n.d.).

    Explain how each of the presidential administrations approached the issue.

    Trump’s major actions on abortion during his first two years in office were: Signing a resolution that allowed states to withhold federal funding for health care providers that perform abortions into law; Reinstating the Mexico City Policy, which prohibited foreign aid and federal funding for international NGOs that performed abortions or offered related services; and issuing a proposal to modify the Title X family planning program that proposed making family planning clinics that refer patients for abortions and share finances or facilities with abortion providers ineligible to receive funding from the program. Additionally, healthcare providers would not be required to provide abortion counseling if it violated their moral or religious beliefs (Israel, M., 2018).

     

     

     

     

     

     

     

     

    As president, Obama dedicated himself to promoting abortion, rather than reduce them as he promised. He has done this by; expanding abortions through Obamacare, appointing a bevy of pro-abortion judges and officials, moving to strip medical professionals of conscience rights, and forcing taxpayers to fund groups who provide abortions in other countries (Annas, G. (n.d.).

    NURS 6050 Agenda Comparison Grid and Fact Sheet Example

    On November 5, 2003, Bush signed into law the “Partial Birth Abortion Ban Act,” which prohibited a form of late term abortions dubbed “partial birth abortions” by pro-life groups and referred to in medical literature as “intact dilation and extraction.”  Under this law, “Any physician who, in or affecting interstate or foreign commerce, knowingly performs a partial-birth abortion and thereby kills a human fetus shall be fined under this title or imprisoned not more than 2 years, or both.” In 2007 its constitutionality was upheld by the U.S. Supreme Court, in the case of Gonzales v. Carhart; Bush supported the Texas Parental Notification Law which required doctors to notify a parent or guardian by phone or certified mail at least 48 hours before performing an abortion on a minor girl.  It also allowed a judicial bypass where extenuating circumstances existed, provided a $10,000 fine for failing to notify and waived notification in cases of medical emergency.

     

    In his own words he stated, “I will lead our nation toward a culture that values life — the life of the elderly and the sick, the life of the young, and the life of the unborn. I know good people disagree on this issue, but surely we can agree on ways to value life by promoting adoption and parental notification, and when Congress sends me a bill against partial-birth abortion, I will sign it into law”

    (On the issues.org, n.d.).

     

    Part 2: Agenda Comparison Grid Analysis

    Using the information you recorded in Part 1: Agenda Comparison Grid, complete the following to document information about the population health/healthcare issue your selected

     

    Administration (President Name)

    (Current President)

    (Previous President)

    (Previous President)

    Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?

     

    The Centers for Disease Control and Prevention (CDC), the government agency currently responsible for compiling U.S. abortion data.

     

    In 1996, as well, the Food and Drug Administration (FDA) took significant steps toward approving the use of medical (nonsurgical) abortion in the United States, essentially by “preapproving” the use of mifepristone, popularly known as RU 486, as an abortifacient.

     

    The Department of Health and Human Services play a huge role in addressing administrative policies for abortions.

     

     

     

    How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?

    President Trump addressed abortion often in his run for president. He has already addressed the issue as the president. President Trump’s first day in the Oval Office on Monday, he signed a ban on federal money going to international groups that perform or provide information on abortions.

    During his first week in office, Obama made it clear that he would support abortion when he made it a priority to overturn the Mexico City Policy. Republican President Ronald Reagan first created the Mexico City Policy in 1984, stopping funding for international groups which perform or provide information on abortions. It was reinstated by George W. Bush and then it was overturned again by President Barack Obama in 2009 (Bilger, 2018).

    NURS 6050 Agenda Comparison Grid and Fact Sheet Example

    The Mexico City Policy created by President Reagan was reinstated when President George W Bush took over in 2001. Also in 2001, President Bush declared that federal funds could not be used for embryonic stem cell research, which requires the destruction of human embryos. Instead, Bush promoted adult stem cell research, which does not destroy embryos. In 2002, Bush signed the Born-Alive Infants Protection Act, which extends legal protection to infants who survive induced abortions by providing them with identical legal protections as babies who are born prematurely.

     

    In 2003, President Bush signed into law the Partial-Birth Abortion Ban Act, which prohibits late-term abortions.

     

    In 2004, Bush signed the Unborn Victims of Violence Act, which defines a child “in utero” at any stage of development as human, and accords the child the legal rights of the victim if subject to certain crimes that involve death or injury.

     

    In 2005 and 2006, Bush appointed two pro-life justices, Justice John Roberts and Justice Samuel Alito, respectively, to the U.S. Supreme Court.

     

    In 2007, both justices voted to uphold the federal Partial-Birth Abortion Ban Act of 2003, which was challenged in a lawsuit.

     

    In 2007, Bush also sent congressional Democratic leaders a letter threatening to veto any bill that weakened existing pro-life policy.

     

    In 2008, Health and Human Services Secretary Mike Leavitt issued a regulation to protect the rights of federally funded health care providers to decline to participate in services to which they morally object, including abortion.

    (Ryan, 2009).

    Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?

    I personally would choose President George W. Bush. His stand on abortion laws were more from a sympathetic and personal approach. He was very much a Christian President and this played a big role into his views and his acts on the subject, while the others are very much opposite. President Trump does not seem to view the sides of abortion that in fact may warrant it, such as a rape victim. President Obama is very much an advocate for abortion and is adamant that abortions should be a choice for women regardless of the reason. He does not seem to have regard for anyone’s ethical or religious beliefs on the matter.

    References:

    Abortion without the rhetoric. (2012, April 04). Retrieved from https://abortion.info/politics/presidents-and-abortion/george-w-bush-2001-2009/

    Annas, G. (n.d.). Abortion Politics and Health Insurance Reform | NEJM. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMp0911513.

    Bilger, M. (2018, December 13). Barack Obama, The Abortion President, Receives Human Rights Award. Retrieved from

    Barack Obama, The Abortion President, Receives Human Rights Award

    Freiburger, C. (2019, February 22). Trump admin cuts $60 million from Planned Parenthood. Retrieved from
    https://www.ontheissues.org/Celeb/Donald_Trump_Abortion.htm

    George W. Bush Former President of the U.S. (R) Tier 4 – Personhood Never. (n.d.). Retrieved from http://prolifeprofiles.com/george-w-bush-abortion

    Ryan, J. (2009, January 16). Bush Had Best Pro-Life Record of Any President, Say Pro-Life Groups. Retrieved from
    https://www.cnsnews.com/news/article/bush-had-best-pro-life-record-any-president-say-pro-life-groups
    .

    The Federalist. (2019). How The Obama Presidency Normalized Abortion Extremism. Retrieved from https://thefederalist.com/2019/03/04/how-the-obama-presidency-normalized-abortion-extrimism/

     

     

    Note: Part 3: of the Module 1: Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief is a 1-page Fact Sheet or Talking Points Brief the you will create in a separate document. NURS 6050 Agenda Comparison Grid and Fact Sheet Example

  • NURS 6050 Week 1 Discussion Role of Government in the U.S. Health Care System Essay Examples

    NURS 6050 Week 1 Discussion Role of Government in the U.S. Health Care System Essay Examples

    Week One Initial Post: The Role of Government in the U.S. Health Care System

    After much consideration of the question; is healthcare a right or a privilege? I concluded that healthcare is a right. Our nation was founded on the idea that society should ensure an opportunity for “life, liberty, and the pursuit of happiness.” This is from our declaration of independence (Knickman & Kovner, 2015, p. 4). In those powerful words, I believe the Government has committed to all citizens the provision of healthcare. Healthcare is essential to life, which is necessary for all other human endeavors. The Government has a role to improve health policy by addressing access, cost, and quality (Laureate Education, 2012d). It is in so doing will all populations have a fair chance to live healthy productive lives. NURS 6050 Week 1 Discussion Role of Government in the U.S. Health Care System Essay Examples

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    Adequate family income, high-quality educational opportunities, and being socially connected are all key factors that predict the health of a given person (Knickman & Kovner, p. 5). These indicators of good health create disparities in the health of the poor. In the United States, medical care, and its associated outcomes depend on ones’ income level, race, and geographical location (Knickman & Kovner, p. 8). The affordable care act has indeed made it possible for more people to have healthcare. The fact remains the insurance in many cases is not truly affordable. Individuals are paying exorbitant premiums and associated deductibles which may keep them from seeking medical care. But keep in mind that is the plight of the fortunate. Our Government has a lot of work to do still to make healthcare affordable and accessible to all.

    I chose to discuss how the issue of socioeconomic status is impacting healthcare delivery. At the heart of much of the day-to-day struggle among the nation’s poor is the persisting lack of access to adequate and affordable healthcare (Clarke, 2018). Clarke describes in a recent publication in U.S. Catholic the social disenfranchisement of poor Americans. He describes their increased risk for preventable diseases. The healthcare delivery organizations are plagued with the cost associated with managing these diseases of populations who can not pay for services received. Clarke considers the current state of health care a remarkable failure in an era when every other advanced economy has long managed to provide universal healthcare. I believe we are way beyond the ability of individual communities to help themselves. Subsidiarity urges that needs are best addressed at the lowest possible level of authority (Clarke, 2018). Clarke further explains that when the poor are faced with the challenges of mere survival as a direct result of the impoverishment of social supports, subsidiarity and personal responsibility break down. This current climate calls for the Government to step-up.

    References

    Clarke, K. (2018, 03). Poor Americans
    . U.S. Catholic,
    83, 42. Retrieved from
    https://ezp.waldenulibrary
    . Org/login?url=https://search-proquest-com.ezp.waldenulibrary.org/docview/2036351842?accountid=14872

    Knickman, J.R., & Kovner, A.R. (Eds.). (2015).
    Health care delivery in the United States
    (
    11
    th
    ed.). New York, NY: Springer Publishing.

    Laureate Education (Producer). (2012d).
    Introduction to healthcare delivery, part 1
    . Baltimore, MD: Author.

     

     

    The Role of Government in the U.S. Health Care System

    As stated in the course text, 
    Health Care Delivery in the United States
    , “the health care enterprise is one of the most important parts of the U.S. social system and of our economic system as well” (Kovner and Knickman, 2011, p. 4); however, with millions of citizens uninsured, rising costs, massive health disparities, and the need to improve quality and access, many view health care as a broken system. As such, it continues to be a significant political issue in the United States. Most agree that something needs to be done to fix the health care system, but the methods and solutions for addressing problems vary greatly, particularly with respect to the role government should play. Proponents of varying approaches often have strong, emotional opinions, making compromise difficult.

    In this Discussion, you will consider the role of government in health care, and you will examine the impact of a social, economic, technological, ethical, or legal issue on health care delivery.

    To prepare:

    With this week’s Learning Resources in mind, consider this question: Is health care a right or a privilege?

    Review the media presentation for this week, focusing on the role of the government in health care including Affordable Care Act.

    Pinpoint a social, economic, technological, ethical, or legal issue that could, or has, affected health care delivery in the United States.

    Locate a current article from the popular press (within the past 6 months) related to the health care issue you identified. How does this article inform your understanding of the influence of your selected issue in the health care debate?

    By Day 3

    Post
     your position on whether health care in the United States is a right or a privilege, and explain what you believe to be the proper role of government in health care. Justify your position. Explain how the social, economic, technological, ethical, or legal issue you selected is impacting health care delivery and whether this issue should be addressed by the government or by private entities. Identify the article you selected, and explain how this article informs your stance.

     

    Benjamin Fernandes

    The Role of Government in the U.S. Health Care System

    The question of: Is health care a right or a privilege, can be debated forever. According to the text, “our nation is built on the idea that society should ensure an opportunity for ‘life, liberty, and the pursuit of happiness’” (Knickman & Kovner, 2015, p. 4). Life being the key word in this statement. Health care is an important role in ensuring life. The statement “life, liberty, and the pursuit of happiness” is taken directly from our Declaration of Independence. Is not the role of the government to protect its citizens? The Patient Protection and Affordable Health Care Act 2010 (ACA) expanded the role of the government in health care. The ACA was designed to protect patient rights and make health insurance more available to the people. The theory was to make health care more available and affordable to the public. As this week’s video stated, the U.S. provides some of the best health care in the world as far as technology to deliver. The video also goes on to explain how on average, people in the U.S. end up pay more for health care in comparison to other countries (Laureate Education (Producer), 2012d).

    We are a pivotal place, waiting and watching, to see which direction our nation will go. We have two candidates debating on issues, and we will have to choose which person to lead our nation in the coming years. This is vitally important to myself and the state I live, much like others across this country. New Hampshire finds itself in a crisis with opiate abuse. According to a local newspaper, the issue is “More Americans are dying from opioids than at any time in recent history, with overdose deaths hitting a peak of 28,000 in 2014” (Ronayne, 2016). When speaking of ensuring life, this statistic is going in the wrong direction. Internationally, the BBC wrote an article about the heroin and opiate crisis in the U.S., writing “The US is in the throes of a heroin and opioid epidemic – drug overdose has become the leading cause of accidental death, overtaking traffic accidents” (Pressly, 2016). While one candidate is electing to stop drugs via policing and tackling the issue through the judicial system, the other is electing to put money toward health care. According to the Concord Monitor (Ronayne, 2016), the candidates plan “would send more money to states to expand drug treatment and mental health services, promote greater availability of the overdose reversal drug naloxone and support better prevention programs in schools, among other things.” In NH, we find ourselves with one of the worse rankings in opiate abuse and death rates. Even worse we rank in the bottom for resources for those suffering from addiction. As a nurse working in the busiest emergency departments in the state, we see the effects of having few resources available for our patients.

    The U.S. Constitution states that life is a right given to all citizens of the U.S. Providing health care to those citizens helps protect the same right.

     

     

    Post
     your position on whether health care in the United States is a right or a privilege, and explain what you believe to be the proper role of government in health care. Justify your position. Explain how the social, economic, technological, ethical, or legal issue you selected is impacting health care delivery and whether this issue should be addressed by the government or by private entities. Identify the article you selected, and explain how this article informs your stance.

     

    Health care in the United States has become a major topic of discussion. There are varying opinions on each end of the spectrum. In my opinion, I feel that health care is a right to all citizens of the United States. Working in the medical field, I have seen medical conditions that could have been prevented if the person had health care coverage. Of course, I have also witnessed instances where people abuse the system, but in my opinion, those cases are few and far between.

    I do not believe that no one should have to be sick or in constant pain to not have access to health care including those who are poor. I know some of the issues related to health care are that many believe that only those who pay taxes should have health care but I disagree. The United States government I believe should ensure that all citizens have health care.

    The United States government is one of the largest payers for health care with Medicare, Medicaid, and the Veteran Administration (VA) system (Laureate Education, 2012). And from personal experience, I firmly believe that the government can provide excellent health care coverage for citizens. There are many other industrialized nations including France and Canada that provide adequate health care for their citizens, and I believe the United States should do this as well. NURS 6050 Week 1 Discussion Role of Government in the U.S. Health Care System Essay Examples.

    As the Declaration of Independence says that our nation is built on “life, liberty, and the pursuit of happiness” (Knickman & Kovner, 2015). And by this, I take it to mean, that all citizens have the right to have the things they need including health care. I believe the government should create regulations that ensure all citizens have health care that they can afford and those who are disabled or poor should have access without limitations. Millions of Americans still lack insurance coverage or have inadequate coverage (Knickman & Kovner, 2015).

    An article I found titled “Health care in the United States: A right or a privilege,” discusses how health care is a right and not a privilege (Bauchner, 2017). The article states that a consensus needs to be made regardless of how health care is to be provided or who provides it (Bauchner, 2017). The article mentions the fact that since 2010, 22 million Americans have obtained health care coverage since implementing the Affordable Care Act (ACA) (Bauchner, 2017). One thing people should think about is how the government provides access to emergency services, education, postal service, military, and many other things, but has not found a way to provide health care for all citizens. NURS 6050 Week 1 Discussion Role of Government in the U.S. Health Care System Essay Examples.

     

    References

    Bauchner, H. (2017). Health care in the United States: A right or a privilege. Retrieved August 29, 2017, from http://jamanetwork.com/journals/jama/fullarticle/2595503

     

    Knickman, J. R., & Kovner, A. R. (Eds.). (2015). The current U.S. health care system. In
    Health care delivery in the United States
     (11th ed.). New York, NY: Springer Publishing.

     

    Laureate Education (Producer). (2012).
    Introduction to healthcare delivery, part I
    . Baltimore, MD: Author.

     

     

    Discussion – Week 1

    The Role of Government in the U.S. Health Care System

    As stated in the course text, 
    Health Care Delivery in the United States
    , “the health care enterprise is one of the most important parts of the U.S. social system and of our economic system as well” (Kovner and Knickman, 2011, p. 4); however, with millions of citizens uninsured, rising costs, massive health disparities, and the need to improve quality and access, many view health care as a broken system. As such, it continues to be a significant political issue in the United States NURS 6050 Week 1 Discussion Role of Government in the U.S. Health Care System Essay Examples. Most agree that something needs to be done to fix the health care system, but the methods and solutions for addressing problems vary greatly, particularly with respect to the role government should play. Proponents of varying approaches often have strong, emotional opinions, making compromise difficult.

    In this Discussion, you will consider the role of government in health care, and you will examine the impact of a social, economic, technological, ethical, or legal issue on health care delivery.

    To prepare:

    With this week’s Learning Resources in mind, consider this question: Is health care a right or a privilege?

    Review the media presentation for this week, focusing on the role of the government in health care including Affordable Care Act.

    Pinpoint a social, economic, technological, ethical, or legal issue that could, or has, affected health care delivery in the United States. NURS 6050 Week 1 Discussion Role of Government in the U.S. Health Care System Essay Examples.

    Locate a current article from the popular press (within the past 6 months) related to the health care issue you identified. How does this article inform your understanding of the influence of your selected issue in the health care debate?

    By Day 3

    Post
     your position on whether health care in the United States is a right or a privilege, and explain what you believe to be the proper role of government in health care. Justify your position. Explain how the social, economic, technological, ethical, or legal issue you selected is impacting health care delivery and whether this issue should be addressed by the government or by private entities. Identify the article you selected, and explain how this article informs your stance.

    Read
     a selection of your colleagues’ responses. Focus particularly on those questions raised to which you can add comments based on shared experiences or situations. Consider how your colleagues’ postings reflect and/or differ from your own perceptions and opinions.

    By Day 6

    Respond
     to at least two of your colleagues 
    on two different days
     in one or more of the following ways:

    Ask a probing question, substantiated with additional background information, evidence, or research using an in-text citation in APA format.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research NURS 6050 Week 1 Discussion Role of Government in the U.S. Health Care System Essay Examples.

    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.

    Reference:

    Kovner, A. R., & Knickman, J. R. (Eds.). (2011). Health care delivery in the United States (10th ed.). New York, NY: Springer Publishing.

    Click on the 
    Reply
     button below to reveal the textbox for entering your message. Then click on the 
    Submit
     button to post your message.

    Healthcare, A Right Or A Privilege?

    In today’s world, we know that healthcare is both accessible and inaccessible, depending on many factors. I believe that every person should be provided, safe and efficient care. “The World Health Organization (1984) defines
    health
    as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”(Knickman and Kovner, 2015) NURS 6050 Week 1 Discussion Role of Government in the U.S. Health Care System Essay Examples. Everyone should be able to have access to services that would help to improve or sustain their health. It is hard as a nurse to know that patients will cancel their appointments or ultrasounds because the cost will be a financial burden for them. That is not making healthcare a privilege, it makes it inaccessible and untrustworthy. For example, I had lab work ordered from my physician, I had called my insurance company to check if the tests would be covered. The insurance company could not tell me how much the procedure would cost, or if I would get a bill, they could not even give me an estimate on the cost. I am stable enough that I had the test done, and was able to afford the bill, but what about the patients that are not. There is a way of making changes in healthcare and making it more accessible and affordable for patients.

    Whether healthcare is a privilege, or a right can easily relate into the role of the government in healthcare. The government should be able to provide affordable care, whether from private insurance companies or government agencies. “In comparison to England, Canada, France, and China, the United States pays significantly higher prices for medical care” (Knickman and Kovner, 2015) NURS 6050 Week 1 Discussion Role of Government in the U.S. Health Care System Essay Examples. Relatively speaking the US could negotiate prices of services before they have been provided, instead of after. Between local, state and federal government there are many hands in the pot of healthcare. To take better care of our population, insurance and accessibility of care need to be reviewed and revised by the government.

    Recently, I read an article about the presidential administration making it easier for consumers to buy temporary healthcare plans at a more affordable rate than previously available. In this article, Luhby states “The Trump administration estimates that 200,000 Obamacare enrollees will move to short-term plans next year. Also, 300,000 people who now buy individual market polices outside of the Obamacare exchanges will switch to short-term plans and another 100,000 uninsured folks will purchase them next year” (2018). This seems a good way to help those who may have a gap in their insurance or cannot afford a very high premium. It would surely make healthcare more accessible to those with some sort of financial woe NURS 6050 Week 1 Discussion Role of Government in the U.S. Health Care System Essay Examples.

    References

     
    Knickman, J. R., & Kovner, A. R. (Eds.) (2015). Health Care Delivery in the United States (11
    th
     ed.). New York, NY: Springer Publishing.

     
    Luhby, T. (2018, August 01). Trump administration makes it easier to buy alternative to Obamacare. Retrieved from https://www.cnn.com/2018/08/01/politics/obamacare-short-term-health/index.html NURS 6050 Week 1 Discussion Role of Government in the U.S. Health Care System Essay Examples

  • Assignment 1: Structural Versus Strategic Family Therapies sample essay

    Assignment 1: Structural Versus Strategic Family Therapies sample essay

    Structural and strategic therapies are two professional approaches that apply systems thinking to view the family as a single emotional unit with parts that are related to make up the whole family. In fact, they perceive the behaviors exhibited by the different family members as being informed by the family’s functioning. To be more precise, individual family members are inseparable from the network of relationships that characterize the…

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    Students will:

    Compare structural family therapy to strategic family therapy

    Create structural family maps Assignment 1: Structural Versus Strategic Family Therapies sample essay

    Justify recommendations for family therapy

    To prepare:

    Review this week’s Learning Resources and reflect on the insights they provide on structural and strategic family therapies.

    Refer to Gerlach (2015) in this week’s Learning Resources for guidance on creating a structural family map.

    The Assignment

    In a 2- to 3-page paper, address the following:

    Summarize the key points of both structural family therapy and strategic family therapy.

    Compare structural family therapy to strategic family therapy, noting the strengths and weaknesses of each.

    Provide an example of a family in your practicum using a structural family map. Note: Be sure to maintain HIPAA regulations.

    Recommend a specific therapy for the family, and justify your choice using the Learning Resources.

     

    Structural versus strategic family therapies sample essay

    Part 1.

    Structural and strategic therapies are two professional approaches that apply systems thinking to view the family as a single emotional unit with parts that are related to make up the whole family. In fact, they perceive the behaviors exhibited by the different family members as being informed by the family’s functioning. To be more precise, individual family members are inseparable from the network of relationships that characterize the family. In addition, they acknowledge that conflicts are a common occurrence among family members, and that there is a need for professional help to direct the family in addressing the conflict. The professional help takes the form of therapies that are based on family systems as is the case with structural and strategic therapies that apply objective and scientific processes in treatment (Matson, 2013).

    Structural family therapy was developed by Salvador Minuchin. It is based on the awareness that every family has a structure that is exhibited through family patterns, behaviors and relationships in the therapy sessions. Using role plays, therapists are able to apply structural therapy to explore the subsystems within the family, such as sibling and parental subsystems (Wright, Stern & Phelan, 2012). Assignment 1: Structural Versus Strategic Family Therapies sample essay.

    Strategic family therapy was designed by Cloe Madanes, Milton Erickson and Jay Haley who examined family functions and processes that include problem-solving patterns and communication as presented by families outside the therapy sessions. It applies paradoxical interventions, redefining problem scenarios and reframing with the intention of creating the desired change. It is based on the premise that change can rapidly occur without intensively analyzing the source of the reported problem (Wright, Stern & Phelan, 2012).

    A comparison of the two therapies (structural and strategic family therapies) reveals that they are similar in exemplifying groundbreaking therapeutic approaches for treating dysfunctions in families perceived as systems. They both focus on the hierarchical organizational power structures, communication patterns and interpersonal relational styles as the sources of the family dysfunction and solution. Still, there are differences between the two. Structural family therapy focuses on interpreting contact in therapy while strategic therapy focuses on interpreting contact outside therapy. Assignment 1: Structural Versus Strategic Family Therapies sample essay. In addition, structural therapy resolves the maladaptive dynamics in the family through evaluating the family structure while strategic therapy resolves the issue through evaluating relationships. Yet another difference is that structural therapy explores functional expectations and does not seek to present a solution while strategic therapy explores family dynamics and seeks to present a solution (Wright, Stern & Phelan, 2012)..

    Part 2.

    F

    ——-

    M

    – – – – – – –

    C … C

    This is a family of four members comprised of a father, mother and two children. The father is dominant, the mother is submissive. The family is experiencing blocked parental communication.

     

    The issue reported in the family is best addressed through strategic family therapy. In this case, the therapy will emphasize on understanding the intricacies of communication patterns, hierarchical structures, and systemic processes to include the invisible and visible repetitive rules, repetitive behavioral patterns, and family functions. This allows the therapist to emphasize the father’s dominance and mother’s submissiveness as a hindrance to parental communication, showing how the hierarchy in the family structure is faulty and caused the dysfunction (Matson, 2013) Assignment 1: Structural Versus Strategic Family Therapies sample essay. In applying strategic therapy, the therapist seeks to aid the family to correct the communication problem by modifying personal interactions among the family members so that the family is no longer dominant that he stifles the other members of the family, while the mother is no longer submissive that she is unable to protect the children. Besides that, strategic therapy would also help in exploring the behavioral processes and sequences that help in either maintaining or exacerbating the dysfunction reported as a problem (Finch, 2012) Assignment 1: Structural Versus Strategic Family Therapies sample essay.

     

    References

    Matson, J. (2013).
    Handbook of treatment approaches in childhood psychotherapy
    . New York, NY: Plenum Press.

    Finch, A. (2012).
    Specialty competencies in clinical child and adolescent psychology
    . Oxford: Oxford University Press.

    Lebow, J. (2012).
    Handbook

    of clinical family therapy
    . Hoboken, NJ: John Wiley & Sons.

    Wright, P., Stern, J. & Phelan, M. (2012).
    Core psychiatry
    (3
    rd
    ed.). New York, NY: Saunders/Elsevier. Assignment 1: Structural Versus Strategic Family Therapies sample essay

  • NU420M3 Organizational Structure Essay

    NU420M3 Organizational Structure Essay

    Explore parts of the organizational structure and how the structure impacts nurse leaders/managers. Analyze how the evolution of healthcare organizations impacts nursing leadership roles. Discuss how nurse leaders can influence organizational structures today.

    In nursing, an organizational structure is defined as the way in which the tasks are allocated, supervised, coordinated, and directed to meet the set goals (Benzer et al., 2017). It improves the efficiency of workflow and productivity as well as sets the procedures and rules to govern the activities. These organizations are guided by mission, vision, philosophy, and values of healthcare settings that impact nursing.  The mission describes the purpose of the existence of the organization and reflects on the values held, target customers and the products and services provided NU420M3 Organizational Structure Essay. The vision gives a comprehensive and clear image of the organizations future while the values present the core ethics and principles that the organization abides to. This paper seeks to explore the organizational parts, impacts of the structure, evolution of healthcare organizations and the effects on leadership as well as the influence of the nurse leaders on the structure of the organization in the contemporary society.

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    Parts of the organizational structure

    Nursing organizations employ particular elements namely degree of formalization, work specialization, centralization or decentralization, span of control, chain of command, and departmentalization to engage workers and management interactions (Brunsson & Olsen, 2018). Their structures are decentralized which allows fast operation, adaptability, and agility with high level of personal urgency. Most of the healthcare institutions employ a hierarchical organizational structure with the high, middle, low and direct level parts. This is characterized by the high-level part held by the top corporate, followed by the middle managerial level, the supervisor level marking the lowest level of administration as well as the direct level with providers that interact directly with the patients.

    How the structure impacts nurse leaders/managers?

    The structure has increased the flexibility of the leaders which allows them to easily adapt to the changes in healthcare. On the other hand, it has increased the quality of their leadership through informed decision making, effective communication and engagement of teams at different levels of the organizational structure. It has also improved their working environments with clearly described roles and tasks for their positions being spelt clearly to avoid overload and confusion. Furthermore, the working relationships for the leaders have improved due to smooth interaction with the workers and the other leaders. Senior nurse also report increased job satisfaction and influence in senior management team decisions (Lambert et al., 2017).

    Evolution of healthcare organizations impacts on nursing leadership roles

    The organizational structure supports nurse managers in the assignment of tasks and communication. This is possible through the chain of commands that ensures a hierarchical flow of information within the hospital. Employees are also able to give feedback to the managers which help them in informed decision-making. Moreover, the decentralized organizational structure gives different leadership levels to give their input towards the achievement of the objectives, goals, and vision. The leaders are also able to specialize in their areas of interest since the structure provides a description of the duties and responsibilities of each administration level.

    How nurse leaders can influence organizational structures today?

    Nurse leaders support flexibility which allows the advocacy of policies that strengthen the organizational structure. They can also create interdisciplinary teams in the organization to promote informed decision-making and collaborative efforts that influence the adoption of new structures that support the changes in the healthcare sector. Moreover, they empower the workers through the creation of awareness to prevent resistance and encourage commitment to better the organization structure (Neubert, Hunter & Tolentino, 2016). This allows the organization to work together towards achieving the set goals.

    References

    Benzer, J. K., Charns, M. P., Hamdan, S., & Afable, M. (2017). The role of organizational structure in readiness for change: A conceptual integration. 
    Health services management research
    , 
    30
    (1), 34-46.

    Brunsson, N., & Olsen, J. P. (2018). 
    The Reforming organization: making sense of administrative change
    . Routledge.

    Lambert, E. G., Qureshi, H., Klahm, C., Smith, B., & Frank, J. (2017). The effects of perceptions of organizational structure on job involvement, job satisfaction, and organizational commitment among Indian police officers. 
    International journal of offender therapy and comparative criminology
    , 
    61
    (16), 1892-1911.

    Neubert, M. J., Hunter, E. M., & Tolentino, R. C. (2016). A servant leader and their stakeholders: When does organizational structure enhance a leader’s influence?. 
    The Leadership Quarterly
    , 
    27
    (6), 896-910.

     

    Organizational Structure

    Organizations, like pyramids, begin with a solid foundation.  This foundation is usually started by the development of mission or vision statements.  It is not unusual for a mission and vision statement to be combined into one broad statement (Darbi, 2012).  A vision statement draws a mental picture of what the organization wants to achieve.  A mission statement is more of an action statement.  These statements are written in a way that captures the organization’s values.  The vision and mission statements define the purpose for the organization.  They also guide all stakeholders to portray themselves with the desired attributes implied in the statements. NU420M3 Organizational Structure Essay  One hospital’s mission statement may be “to continuously improve the health and well-being of the community we serve”, or “to be the partner of choice as we transform healthcare for the people”.

    Strategies are the methods that the organization uses to achieve its vision.  The organization’s values will be incorporated into each strategy.  The goals are the intended outcomes from the strategies attempted.  While strategies can be fluid, goals should be consistently focused on the important aspects (Hofstrand, 2016).  The process of developing goals and strategies evolves into the development of a policy and procedure of the organization.

    Most organizational designs focus on chains of command with a hierarchy of authority (Hancock & Hanley, 2013).  Organizational designs will also separate staff based on their areas of knowledge (Carroll & Rudolph, 2006).  This is especially demonstrated in any hospital setting as it is divided by medical-surgical units, emergency departments, intensive care units, and so on.  Although they are divided, the groups work interdependently by sharing resources, information systems, and social practices.  Each area of specialty is often led by a shift supervisor who reports to a unit manager, who reports to an area manager, who reports to a nursing director, who reports to a facility administrator, who, finally, reports to an owner or board of directors.

    “The ability of nurses to practice in a professional manner may be influenced by the organizational culture of their work environment” (Manojlovich & Ketefian, 2002, p15).  When staffing is low, resources are scarce, and census is high, stress is also elevated which is a fast road to burn out.  Nurse leaders who do not feel supported, respected, or empowered by their organization will fail to provide quality of care and patients will suffer the consequences.  Nursing leaders need opportunities to practice and develop their professionalism.  Nurse leaders should be experienced in their field of expertise and nurtured to be leaders.  They need role models to learn from. NU420M3 Organizational Structure Essay.

    On the other hand, nurse leaders also need to be aware of their own values and beliefs and recognize when they are in conflict with those of the organization.  The nurse leader needs to be able to interpret the organization’s strategy and direct it to the front line staff in a way that they will understand (Hancock & Hanley, 2013).  Nurse leaders can be effective and efficient and directly impact patient outcomes (Kavanagh, Cimiotti, Abusalem, & Coty, 2012).  An effective nurse leader could transform a unit from one of poor outcomes to positive.  An effective leader can create a working environment that satisfactorily supports the staff members so they can productively perform in their assignments.

    Health and healthcare have evolved through the centuries in attempts to provide higher quality of care and better patient outcomes.  From the earliest days of medicine, thought to be witchcraft, to the days of modern technology, healthcare has evolved.  However, today there is a strain between healthcare organizations and bureaucratic controls (Carroll & Rudolph, 2006).  As the cost of healthcare rises, access to healthcare decreases, and disparities are created.  To address this problem, the United States has developed a value-based healthcare system that is centered on providing high quality of care at the lowest possible cost (Badash, et.al., 2017).  Many legal reforms have been made to transform to effective healthcare systems but over-regulation impedes transitions NU420M3 Organizational Structure Essay.

    References

    Darbi, W.  (2012, July).  Of mission and vision statements and their potential impact on employee behaviour and attitudes: The case of a public but profit oriented tertiary institution. 
    International journal of business and social science, 3
    (4), 95-109.  Retrieved from
    https://www.ijbssnet.com/journals/Vol_3_No_14_Special_Issue_July_2012/11.pdf

    Hofstrand, D.  (2016, August). Vision and mission statements – A roadmap of where you want to go and how to get there. 
    Iowa State University extension and outreach, File C5-09,
    1-4
    .  Retrieved from
    https://www.extension.iastate.edu/agdm/wholefarm/html/c5-09.html

    Carroll, J. & Rudolph, J.  (2006, December).  Design of high reliability organizations in health care. 
    Quality and safety in healthcare, 15
    (Suppl. 1), i4-i9.  Doi: 10.1136/qshc.2005.015867

    Hancock, L. & Hanley, D.  (2013, February).  From our readers: Nurses leading from the middle. 
    American nurse today
    ,
    8
    (2).  Retrieved from
    https://www.americannursetoday.com/from-our-readers-nurses-leading-from-the-middle/

    Manojlovich, M. & Ketefian, S.  (2016, April)  The effects of organizational culture on nursing professionalism: Implications for health resource planning. 
    Canadian journal of nursing research, 33
    (4), 15-34.  Retrieved from
    http://cjnr.archive.mcgill.ca/article/view/1656/1656

    Kavanagh, K., Cimiotti, J., Abusalem, S., & Coty, MB (2012, October 22).  Moving healthcare quality forward with nursing-sensitive value-based purchasing. 
    Journal of nursing scholarship, 44
    (4), 385-395.  Doi: 10.1111/j.1547-5069.2012.01469.x NU420M3 Organizational Structure Essay

    Badash, I., Kleinman, N., Barr, S., Jang, J., Rahman, Suraiya, R., & Wu, B.  (2017, February).  Redefining health: The evolution of health ideas from antiquity to the era of value-based care. 
    Cureus, 9
    (2), e1018.  Doi: 10.7759/cureus.1018 NU420M3 Organizational Structure Essay

  • Assessing and Treating Adult and Geriatric Clients With Mood Disorders Essay

    Assessing and Treating Adult and Geriatric Clients With Mood Disorders Essay

    Introduction

    This assignment involves making three decisions regarding the treatment choices for an elderly Hispanic man diagnosed with major depressive disorder. According to Cornish (2015), it is important to always utilize evidence-based practice for better health outcomes. For this assignment, the treatment decisions will be based on the latest research evidence. the paper will also discuss ethical aspects likely to affect the treatment of the client.

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    Decision Point One

    The chosen first decision is for the client to begin taking Effexor XR 37.5mg orally. The reason for choosing the decision is because the efficacy of Effexor in the treatment of depressive symptoms has been demonstrated. The medication works by increasing the amount of neurotransmitters norepinephrine and serotonin in the brain; these neurotransmitters control mood, appetite, sleep, emotions, anxiety, perceptions, and aggression, which are important aspects in depression (Gitlin, 2018) Assessing and Treating Adult and Geriatric Clients With Mood Disorders Essay.  Another reason why this Effexor was selected is due to its safety among the geriatric population (Higuchi et al, 2016).

    By choosing this decision, the expectation was that the depressive symptoms for this client would significantly improve due to the medication’s efficacy in the treatment of depression. Another expectation was that the medication would have minimal or no side effects for this client (Li, 2017).

    Nonetheless, the outcome of the decision that was chosen was different from the expected outcome as indicated by the client having no notable change in the depressive symptoms. This can be attributable to the small dose of Effexor XR 37.5mg that was not effective in improving the symptoms (Stahl, 2013).

    Decision Point Two

    The second decision that was chosen is to have an increased dose of Effexor to 75 mg. this decision was chosen because higher doses of Effexor have been shown to be safe, effective and well-tolerated when it comes to the treating depressive symptoms (Li, 2017).

    The expectation of choosing this decision was that there would be symptom remission for this client and that he would tolerate the high dose and have minimal or no side effects. According to Stahl (2013) patients are able to well tolerate higher doses of Effexor like 75 mg per day and the higher doses are effective in treating symptoms of major depressive disorder.

    As per the expectations, the client had notable symptom remission after four weeks as reported and as MADRS demonstrated 25% symptom decrease. The reason for the symptom improvement is the efficacy of a higher dose of Effexor (Higuchi et al, 2016). Secondly, just like it was hoped, the client tolerated the increased dose well because no side effects were reported.

    Decision Point Three

    The third decision that was chosen to have the Effexor dose increased to 112.5 mg orally per day. The reason behind choosing this decision is because evidence indicates that an increased dose of Effexor is more effective due to the increased action of the medication in inhibiting reuptake of norepinephrine and serotonin. Li (2017) performed a study that showed that a dose of 75 mg of Effexor was a selective inhibitor of 5-HT reuptake whereas a higher dose of Effexor acted as an inhibitor or both norepinephrine and serotonin.

    Therefore, increase the dose of Effexor to 112.5 mg per day for the client hoped that the symptoms of major depressive disorder for the client would significantly improve and as a result, the client will have complete symptom remission. Evidence shows that an elevated dose of Effexor has better efficacy when it comes to symptom improvement (Bombardier et al, 2014). In addition, it was hoped that the client would tolerate the higher dose of Effexor and hence have no adverse effects.

    Ethical Considerations

    Treatment of the geriatric population involves various ethical issues. Ethical issues for this client consist of the ability to make decisions and informed consent. For the informed consent, it is important for PMHNP to explain to the client all information about the available treatment options to ensure that the client makes an informed treatment decision (Stark et al, 2018). Nonetheless, at times the older adults have problems when it comes to process and understand information especially when they have mental health problems (Stark et al, 2018). Therefore, the PMHNP should ensure that the client clearly understands the information for him to make informed and independent treatment decision.

    Conclusion

    The decision that was first chosen for this client is starting Effexor XR 37.5mg due to the medication efficacy in treating depression. Additionally, the medication is safe and well-tolerated among the geriatric population. Nonetheless, with Effexor XR 37.5mg the client did not manifest symptom improvement and as a result, the second decision was increasing the dose to 75 mg. With the increased dose, the client manifested symptom improvement. The last decision was to increase the dose to 112.5 mg with the aim of ensuring complete symptom remission. Ethical issues relevant during the treatment of the client are the ability to make decisions and informed consent.

     

     

    References

    Bombardier C, Fann J, Wilson C, Allen H, Scott R, Warren A, Brooks L, Warms C, Temkin N & Tate D. (2014). A randomized controlled trial of venlafaxine XR for major depressive disorder after spinal cord injury: Methods and lessons learned.
    J Spinal Cord Med
    . 37(3): 247–263.

    Cornish F. (2015). Evidence synthesis in international development: a critique of systematic reviews and a pragmatist alternative. 
    Anthropology & Medicine
    . 22(3), 263-277.

    Gitlin M. (2018). Antidepressants in bipolar depression: an enduring controversy.
    Int J Bipolar Discord
    . 6(25).

    Higuchi T, Kamjima K, Nakagome K, Yuko A, Rio I & Imaeda T. (2016). A randomized, double-blinded, placebo-controlled study to evaluate the efficacy and safety of venlafaxine extended-release and a long-term extension study for patients with major depressive disorder in Japan.
    Int Clin Psychopharmacology
    . 31(1), 8–19.

    Li X. (2017). Short-term efficacy and tolerability of venlafaxine extended-release in adults with generalized anxiety disorder without depression: A meta-analysis.
    PLoS One
    . 12(10), e0185865.

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.).
    New York, NY: Cambridge University Press.

    Stark A, Hanna K, Stein J, Maier W, Heser K, Wiese B, Mamone S, Hans K, Bock J, Steffi G & Martin S. (2018). A qualitative study on older primary care patients’ perspectives on depression and its treatments – potential barriers to and opportunities for managing depression.
    BMC Fam Pract
    . 19(2).

     

    BACKGROUND INFORMATION

    The client is a 32-year-old Hispanic American male who came to the United States when he was in high school with his father. His mother died back in Mexico when he was in school. He presents today to the PMHNPs office for an initial appointment for complaints of depression. The client was referred by his PCP after “routine” medical work-up to rule out an organic basis for his depression. He has no other health issues with the exception of some occasional back pain and “stiff” shoulders which he attributes to his current work as a laborer in a warehouse.

    SUBJECTIVE

    During today’s clinical interview, client reports that he always felt like an outsider as he was “teased” a lot for being “black” in high school. States that he had few friends, and basically kept to himself. He describes his home life as “good.” Stating “Dad did what he could for us, there were 8 of us.” He also reports a remarkably diminished interest in engaging in usual activities, states that he has gained 15 pounds in the last 2 months. He is also troubled with insomnia which began about 6 months ago, but have been progressively getting worse. He does report poor concentration which he reports is getting in “trouble” at work.

    MENTAL STATUS EXAM

    The client is alert, oriented to person, place, time, and event. He is casually dressed. Speech is clear, but soft. He does not readily make eye contact, but when he does, it is only for a few moments. He is endorsing feelings of depression. Affect is somewhat constricted, but improves as the clinical interview progresses. He denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment and insight appear grossly intact. He is currently denying suicidal or homicidal ideation. The PMHNP administers the “Montgomery- Asberg Depression Rating Scale (MADRS)” and obtained a score of 51 (indicating severe depression).

    RESOURCES

    § Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389.

    The Assignment

    Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

    At each decision point stop to complete the following:

    Decision #1

    Which decision did you select?

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? Assessing and Treating Adult and Geriatric Clients With Mood Disorders Essay.

    Decision #2

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

    Also include how ethical considerations might impact your treatment plan and communication with clients.

     

    Assessing and Treating Adult and Geriatric Clients with Mood Disorders

    Introduction

    This assignment involves making three decisions regarding the treatment choices for an elderly Hispanic man diagnosed with major depressive disorder. According to Cornish (2015), it is important to always utilize evidence-based practice for better health outcomes. For this assignment, the treatment decisions will be based on the latest research evidence. the paper will also discuss ethical aspects likely to affect the treatment of the client Assessing and Treating Adult and Geriatric Clients With Mood Disorders Essay.

    Decision Point One

    The chosen first decision is for the client to begin taking Effexor XR 37.5mg orally. The reason for choosing the decision is because the efficacy of Effexor in the treatment of depressive symptoms has been demonstrated. The medication works by increasing the amount of neurotransmitters norepinephrine and serotonin in the brain; these neurotransmitters control mood, appetite, sleep, emotions, anxiety, perceptions, and aggression, which are important aspects in depression (Gitlin, 2018).  Another reason why this Effexor was selected is due to its safety among the geriatric population (Higuchi et al, 2016).

    By choosing this decision, the expectation was that the depressive symptoms for this client would significantly improve due to the medication’s efficacy in the treatment of depression. Another expectation was that the medication would have minimal or no side effects for this client (Li, 2017). Assessing and Treating Adult and Geriatric Clients With Mood Disorders Essay.

    Nonetheless, the outcome of the decision that was chosen was different from the expected outcome as indicated by the client having no notable change in the depressive symptoms. This can be attributable to the small dose of Effexor XR 37.5mg that was not effective in improving the symptoms (Stahl, 2013).

    Decision Point Two

    The second decision that was chosen is to have an increased dose of Effexor to 75 mg. this decision was chosen because higher doses of Effexor have been shown to be safe, effective and well-tolerated when it comes to the treating depressive symptoms (Li, 2017).

    The expectation of choosing this decision was that there would be symptom remission for this client and that he would tolerate the high dose and have minimal or no side effects. According to Stahl (2013) patients are able to well tolerate higher doses of Effexor like 75 mg per day and the higher doses are effective in treating symptoms of major depressive disorder.

    As per the expectations, the client had notable symptom remission after four weeks as reported and as MADRS demonstrated 25% symptom decrease. The reason for the symptom improvement is the efficacy of a higher dose of Effexor (Higuchi et al, 2016). Secondly, just like it was hoped, the client tolerated the increased dose well because no side effects were reported. Assessing and Treating Adult and Geriatric Clients With Mood Disorders Essay.

    Decision Point Three

    The third decision that was chosen to have the Effexor dose increased to 112.5 mg orally per day. The reason behind choosing this decision is because evidence indicates that an increased dose of Effexor is more effective due to the increased action of the medication in inhibiting reuptake of norepinephrine and serotonin. Li (2017) performed a study that showed that a dose of 75 mg of Effexor was a selective inhibitor of 5-HT reuptake whereas a higher dose of Effexor acted as an inhibitor or both norepinephrine and serotonin.

    Therefore, increase the dose of Effexor to 112.5 mg per day for the client hoped that the symptoms of major depressive disorder for the client would significantly improve and as a result, the client will have complete symptom remission. Evidence shows that an elevated dose of Effexor has better efficacy when it comes to symptom improvement (Bombardier et al, 2014). In addition, it was hoped that the client would tolerate the higher dose of Effexor and hence have no adverse effects.

    Ethical Considerations

    Treatment of the geriatric population involves various ethical issues. Ethical issues for this client consist of the ability to make decisions and informed consent. For the informed consent, it is important for PMHNP to explain to the client all information about the available treatment options to ensure that the client makes an informed treatment decision (Stark et al, 2018). Nonetheless, at times the older adults have problems when it comes to process and understand information especially when they have mental health problems (Stark et al, 2018). Therefore, the PMHNP should ensure that the client clearly understands the information for him to make informed and independent treatment decision. Assessing and Treating Adult and Geriatric Clients With Mood Disorders Essay.

    Conclusion

    The decision that was first chosen for this client is starting Effexor XR 37.5mg due to the medication efficacy in treating depression. Additionally, the medication is safe and well-tolerated among the geriatric population. Nonetheless, with Effexor XR 37.5mg the client did not manifest symptom improvement and as a result, the second decision was increasing the dose to 75 mg. With the increased dose, the client manifested symptom improvement. The last decision was to increase the dose to 112.5 mg with the aim of ensuring complete symptom remission. Ethical issues relevant during the treatment of the client are the ability to make decisions and informed consent. Assessing and Treating Adult and Geriatric Clients With Mood Disorders Essay.

    References

    Bombardier C, Fann J, Wilson C, Allen H, Scott R, Warren A, Brooks L, Warms C, Temkin N & Tate D. (2014). A randomized controlled trial of venlafaxine XR for major depressive disorder after spinal cord injury: Methods and lessons learned.
    J Spinal Cord Med
    . 37(3): 247–263.

    Cornish F. (2015). Evidence synthesis in international development: a critique of systematic reviews and a pragmatist alternative. 
    Anthropology & Medicine
    . 22(3), 263-277. Assessing and Treating Adult and Geriatric Clients With Mood Disorders Essay.

    Gitlin M. (2018). Antidepressants in bipolar depression: an enduring controversy.
    Int J Bipolar Discord
    . 6(25).

    Higuchi T, Kamjima K, Nakagome K, Yuko A, Rio I & Imaeda T. (2016). A randomized, double-blinded, placebo-controlled study to evaluate the efficacy and safety of venlafaxine extended-release and a long-term extension study for patients with major depressive disorder in Japan.
    Int Clin Psychopharmacology
    . 31(1), 8–19.

    Li X. (2017). Short-term efficacy and tolerability of venlafaxine extended-release in adults with generalized anxiety disorder without depression: A meta-analysis.
    PLoS One
    . 12(10), e0185865.

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.).
    New York, NY: Cambridge University Press.

    Stark A, Hanna K, Stein J, Maier W, Heser K, Wiese B, Mamone S, Hans K, Bock J, Steffi G & Martin S. (2018). A qualitative study on older primary care patients’ perspectives on depression and its treatments – potential barriers to and opportunities for managing depression.
    BMC Fam Pract
    . 19(2). Assessing and Treating Adult and Geriatric Clients With Mood Disorders Essay.

  • Crohn’s Disease Evidence-Based Clinical Intervention SOAP note format essay

    Crohn’s Disease Evidence-Based Clinical Intervention SOAP note format essay

    Your Evidence-Based Clinical Intervention should be submitted in a Microsoft Word document following APA style and should include the following:

    **** CROHN’S DISEASE

    The medical problem/diagnosis/disease.

    Typical presenting signs and symptoms including:

    Onset, Characteristics, Location, Radiation, Timing, Setting, Aggravating factors, Alleviating factors, Associated symptoms, Course since onset, Usual age group affected

    Concomitant disease states associated with the diagnosis

    The pathophysiology of the problem.

    Three differential diagnoses and the usual presenting signs and symptoms in priority sequence with rationales.

    Reference to at least two current journal articles that show evidence-based practice as how to best treat this disorder related to the primary differential.

    The expected outcomes of the intervention.

    Algorithms if available.

    A typical clinical note in SOAP format.

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    Subjective Data

    Chief complain- abdominal pain

    History of Presenting Illness
    -C.K is a 40-year-old African American with Crohn’s disease. She presented to the emergency department with complaints of severe abdominal pains for two days, diarrhea, vomiting and nausea.  The abdominal pain was of sudden in onset, sharp in nature and radiated to all parts of the abdomen. On a scale of 0-10, she rated the pain 5/10. Crohn’s Disease Evidence-Based Clinical Intervention SOAP note format essay. The pain was accompanied with three episodes of diarrhea, nausea and four episodes of vomiting. C.K reported that for the fear of vomiting and diarrhea, she did not eat anything but only drank several glasses of water. The following day, the pain worsened to 9/10 and thus decided to come to the ER.

    Medications-
    mesalamine 500 mg QID and omacor 900 mg QID

    Allergies-
    None

    Past Medical History- Diagnosed with Crohn’s disease in 2013

    Past Surgical History-
    none

    Personal Socio-economic History
    -Married lives with the husband her two children aged 11 and 14. All are in good health. Is a smoker for 30+pack years but does not take alcohol. She denied the use of any other illicit drugs and substances. Her diet generally comprises of small food carbohydrates and proteins but admits to not observing a healthy diet.

    Immunization History-UpToDate

    Family History- mother is deceased died due to complications from hypertension and type 2 Diabetes Mellitus. Has two sisters, one was diagnosed with hypertension. Father is alive and was diagnosed with schizophrenia.  The paternal grandmother died of leukemia.

    Review of Systems

    GIT-
    denies jaundice, weight loss, anorexia, has nausea, vomiting, diarrhea, and abdominal pain

    CNS-
    denies dizziness, vertigo, seizures, tremors and paresthesia

    Respiratory-
    denies wheezing and cough

    Crohn’s Disease Evidence-Based Clinical Intervention SOAP note format essay

    CVS-
    denies chest pains, dyspnea, syncope, palpitations, edema, and PND

    HEENT-denies loss of vision, blurred vision, diplopia, eye pain, eye discharge, ear discharge, ear pain, nosebleeds, dysphagia, voice hoarseness, and nasal discharge

    Musculoskeletal-denies limb or joint pains, joint swelling, stiffness and muscle weakness

    Immunologic-
    denies exposure to HIV, urticarial and persistent infections

    Endocrine-
    denies heat and cold intolerance, polyuria, polydipsia, and polyphagia

    Psychiatric-
    denies anxiety, depression, suicidal ideation, mental disturbance, paranoia, and hallucinations

    Objective Data

    General Exam-
    middle-aged lady who is obese, alert and oriented in time, place and person

    Vital Signs-pulse rate 80bpm, temp-36.5
    0
    c, respiratory rate-16cycles/min, O
    2
    Sat-97% on the RA, BP-120/81mmHg, pain score-9/10

    Systemic Exam

    GIT-
    abdomen is soft, non-tender and not distended, no palpable masses has hyperactive bowel sounds on auscultation, has RUQ tenderness on palpation, no splenomegaly

    CVS-
    normal S1 and S2, no murmur or gallop rhythm, no palpitation, no edema, JV not distended.

    Rectal-
    no sores or lesions, guaiac positive stool on examining finger

    HEENT-
    normal conjunctiva, PEBRL, no exudates or hemorrhage, has a normal visual acuity, the ears are normal with no deformities, canals bilaterally clear, intact tympanic membranes, ho hearing loss, no fluid, normal septum and nasal mucosa, no nasal discharge, normal tongue, no exudates or erythema on posterior  pharynx, no masses on the neck, midline trachea, no enlargement.

    Respiratory-lungs bilaterally clear on auscultation, normal respiratory effort

    Skin-
    no lesions, indurations or subcutaneous nodules

    CNS-
    oriented in time, place and person, memory intact, cranial nerves 11-XII intact, normal reflexes

    Musculoskeletal-
    deferred gait and posture due to pain, no bone or joint deformities, normal ROM  and strength of all joints, no joint tenderness

    Assessment

    Laboratory Diagnostic Tests:

    Blood Chemistry

    Na-136

    K-2.9

    Cl-103

    C02-26

    BUN-9

    Cr-0.7

    Gluc-90

    Ca-9.7

    Mg-1.3

    PO4-2.2

    Complete Blood Count

    WBC-4.4

    Hb- 10.8

    Hct-32.8

    Plts-311

    Total Bili-0.2

    AST-13

    ALT-22

    Alk Phos-87

    GGT-52

    Lipase-13

    ESR-30mm/hr

    Radiologic Tests

    Abdominal X-ray-
    there was several dilated loops of the small bowel with levels of distal gas and air-fluids. This potentially indicates thickening of the walls of the colon to suggest active colitis in a patient diagnosed with Crohn’s disease. There was no central effusion

    CT scan of the Abdomen-there was thickening of the mucosa; terminal ileum was consistent with active Crohn’s disease, no fistulas, no bowel obstruction, no abscesses. Crohn’s Disease Evidence-Based Clinical Intervention SOAP note format essay.

    Differential Diagnoses

    Exacerbation of Crohn’s Disease-C.K presented with diffuse abdominal pain of sudden onset, accompanied by the symptoms of nausea, diarrhea, and vomiting. High chances are that the chronic pain is from Crohn’s disease exacerbation since the use of prednisolone has helped to resolve her history, symptoms, laboratory and radiologic findings (Kalla et al., 2014).  Crohn’s disease has an unknown etiology and can affect any part of the GI tract. Although patients can at times be asymptomatic, in case of exacerbations, patients present with the complaints of abdominal pain, nausea, diarrhea, fever and possible weight loss. The patient’s abdominal imaging also detected an active form of the disease thus the most likely diagnosis.

    Obstruction of the Small Bowel-
    is also a potential differential since it happens following blockage of the GI contents. A patient presents with complaints of constipation, abdominal pain, reduced appetite, vomiting and nausea following distension of the abdomen and fullness (Paulson & Thompson, 2015). On the contrary, C.K was able to pass stool in this case and never experienced any form of abdominal distension or constipation.  Besides, the likelihood of obstruction of the small bowel to present with guaiac positive stool on examining finger is very minimal. Although the small bowel had dilated loops as revealed by the abdominal x-ray which also occurs in obstruction of the small bowel, the abdominal CT scan was clear that this was thickening of the ileum mucosa, highly suggestive of Crohn’s disease.

    Acute Ischemia of the Mesenteric-ischemia of the mesenteric artery happens when there is reduced blood flow following a vasospasm or occlusion that causes hypoperfusion. Patients usually present with severe abdominal pain of rapid onset that is localized in the peri-umbilical region, vomiting, and nausea (Clair & Beach, 2016).  Its risk factors include a hypercoagulability state or obstruction of the small bowel. However, C.K is less likely to have acute mesenteric ischemia since her vital signs were within normal range and her abdominal pain was of sudden onset and localized in the RUQ. Crohn’s Disease Evidence-Based Clinical Intervention SOAP note format essay.

    Plan

    Immediate Intervention- Starting IV fluids: phenegram12.5mg with 10mls Normal Saline, fentanyl 40mcg to prevent nausea, vomiting, and rehydration (Torres et al., 2017).

    Pharmacotherapy- prednisone 60mg for two weeks, the patient will be required to slowly taper the dosage by 10mg every two weeks. The patient will, however, continue with her omega-3 supplements and other drugs for Crohn’s disease (Lichtenstein et al., 2018).

    Health Promotion and Disease Prevention-The patient will have to observe a specific diet to prevent exacerbations and help in symptoms alleviation. In this case, the most recommended dietary changes include: avoiding carbonated drinks and foods rich in fiber. Crohn’s Disease Evidence-Based Clinical Intervention SOAP note format essay.

    References

    Clair, D. G., & Beach, J. M. (2016). Mesenteric ischemia. 
    New England Journal of Medicine
    , 
    374
    (10), 959-968.

    Kalla, R., Ventham, N. T., Satsangi, J., & Arnott, I. D. (2014). Crohn’s disease. 
    Bmj
    , 
    349
    , g6670.

    Lichtenstein, G. R., Loftus, E. V., Isaacs, K. L., Regueiro, M. D., Gerson, L. B., & Sands, B. E. (2018). ACG clinical guideline: management of Crohn’s disease in adults. 
    American Journal of Gastroenterology
    , 
    113
    (4), 481-517.

    Paulson, E. K., & Thompson, W. M. (2015). Review of small-bowel obstruction: the diagnosis and when to worry. 
    Radiology
    , 
    275
    (2), 332-342.

    Torres, J., Mehandru, S., Colombel, J. F., & Peyrin-Biroulet, L. (2017). Crohn’s disease. 
    The Lancet
    , 
    389
    (10080), 1741-1755. Crohn’s Disease Evidence-Based Clinical Intervention SOAP note format essay

  • Personal and aesthetic knowledge development essay

    Personal and aesthetic knowledge development essay

    The focus of this week was uncovering how we develop personal knowledge, and the importance of asking critical questions that underpin meaning and significance. Using the assigned readings and your professional experience as a starting point, answer the following:

    ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

    1. Compare and contrast the main attributes of personal and aesthetic knowledge development. In your response describe how both types of knowledge development are important for making advancements in nursing practice.

    2. Identify how personal knowledge leads to personal shifts in aesthetic knowing. In your response discuss how asking the critical questions, “What does this mean?” and “How is it significant?” can be used to cultivate aesthetic knowing. Personal and aesthetic knowledge development essay.

    Personal knowledge describes the knowledge that we own from self-actualization, reflection, experiences or observations while aesthetic knowledge refers to the perception of the patient with regard to the patient and their needs (Haase et al., 2018). Aesthetic knowledge is characterized by the understanding of sound, taste, smell, look and feel of things by the practitioners which supports questioning and opening up (Leight, 2002). Personal knowing is significant in the establishment of authenticity and creation of therapeutic relationships that promote integrity of practice as well as the wholeness of the practitioner. On the other hand, aesthetic knowing is important in that it develops new understanding of phenomena which helps in the identification of the patients’ needs through new perspectives.

    Personal knowledge leads to personal shifts in aesthetic knowing in several ways. For instance, through personal knowledge which offers personal understanding, the nurse is able to understand the patients’ needs through a reflection of their experiences. Additionally, personal knowledge creates a foundation of knowledge that helps in questioning the patient as well as promoting aesthetic reflexivity since it is the knowledge that nurses possess before studying nursing (Campbell et al., 2018) Personal and aesthetic knowledge development essay.

    Aesthetic knowing involves the creation of new understanding of phenomenon which makes it an art in nursing. Asking questions encourages the development of new ideas and creations essential in understanding the patients and the patient’s needs. As such, critical questions like “What does this mean?” and “How is it significant?” can be used to cultivate aesthetic knowing. They help in opening up the nurses mind as they try to seek new solutions to problems. They also help determine the relevance of particular phenomenon in healthcare and how they can be used to improve the outcomes of the patient.

     

    References

    Campbell, T. D., Penz, K., Dietrich-Leurer, M., Juckes, K., & Rodger, K. (2018). Ways of Knowing as a Framework for Developing Reflective Practice among Nursing Students. 
    International journal of nursing education scholarship
    , 
    15
    (1).

    Haase, K. R., Thomas, R. T., Gifford, W., & Holtslander, L. F. (2018). Ways of knowing on the Internet: A qualitative review of cancer websites from a critical nursing perspective. 
    Nursing inquiry
    , 
    25
    (3), e12230.

    Leight, S. B. (2002). Starry night: Using story to inform aesthetic knowing in women’s health nursing. 
    Journal of Advanced Nursing
    , 
    37
    (1), 108-114. Personal and aesthetic knowledge development essay.

  • Nursing theory perspectives and values essay

    700 Week 5 Discussion Nursing theory perspectives and values essay

    This week’s content introduced essential components that contribute to the development of empiric knowledge in the nursing discipline. This week also addressed how we go beyond words and create meaning. Using the assigned readings and your professional experience as a starting point, answer the following:

    1. In chapter 7 Chinn and Kramer (Knowledge Development in Nursing: Theory and Process 9th edition) provide four definitions from the nursing literature that emphasize different perspectives and different underlying values that involve nursing theory (pg 156) Nursing theory perspectives and values essay. Add to this list by identifying an additional definition from the nursing literature that expands your understanding of the definition of theory. In your response provide a direct quote from the source, and then paraphrase the direct quote into your own words.

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    2. Identify a word that has a common meaning when used in the context of nursing (e.g., hypothermia). After you identify the word, explain how everyday direct and indirect experiences shape perceptions (create meaning) of what the word means to the discipline Nursing theory perspectives and values essay.

    Nursing theory must provide basic principles that underpin nursing practice and help in advancing knowledge and research. In clinical practice, nursing theory is practiced at two main levels namely: situation-specific and general levels. In situation-specific levels, theories provide theoretical rationales that guide nursing actions in clinical settings. In general levels, nursing theories promote dedication and orientation to nursing philosophies and perspectives for integration in all aspects of nursing practice. From nursing literature, the definitions which emphasized the various perspectives and values that underlie nursing theory are as follows:

    It is a reasonably interlinked set of confirmed hypotheses

    This description reveals nursing theory as a specific form of expression that is guided by reasonable rules which need the testing and confirmation of hypotheses using scientific and empiric research methods.

    ü  It is a conceptual framework whose invention aims at addressing a specific purpose

    This definition emphasizes the aims of creating a theory and reveals the essence of a theory having a purpose.

    A creative grouping of knowledge, ideas, and experiences with symbolic representation that strives to explain a particular phenomenon

    This definition reveals that a theory should promote understanding of a given phenomenon which can or cannot be directly applied in clinical practice Nursing theory perspectives and values essay

    Collection of logical and conceptual principles which act as a central point of reference for an inquiry

    Although this definition fails to address a specific purpose for nursing theory or suggest a particular method for theory development

    Another definition of theory from nursing literature that expands my understanding is:
    theory is an innovative and thorough structuring of ideas which illuminate a purposeful, tentative and systematic view of a phenomenon
    (Marañón & Pera, 2015).
     
    This definition means that theory cannot be objective to reveal what should be observed. Therefore, it is based on assumptions, ideas, personal judgment and value choices of a theorist to explain specific possibilities and perceptions. Nursing theory perspectives and values essay.

    A word with a common meaning when used in the nursing context is caring. In a nursing context, it refers to an act of empathy, concern, and kindness to other people (Norman, Rossillo & Skelton, 2016). It can also mean looking after a person who needs assistance to achieve individual goals or maintain health status. From a sociological context, caring is defined as an act of compassion.

    References

    Chinn, P. L., & Kramer, M. K. (2014). 
    Knowledge Development in Nursing-E-Book: Theory and Process
    . Elsevier Health Sciences.

    Marañón, A. A., & Pera, M. P. I. (2015). Theory and practice in the construction of professional identity in nursing students: A qualitative study. 
    Nurse Education Today
    , 
    35
    (7), 859-863.

    Norman, V., Rossillo, K., & Skelton, K. (2016). Creating healing environments through the theory of caring. 
    AORN Journal
    , 
    104
    (5), 401-409. Nursing theory perspectives and values essay

  • Abstract Concept of Critical Thinking Essay

    Abstract Concept of Critical Thinking Essay

    This week’s content introduced the processes involved in creating conceptual meaning. In addition, content related to the relationship between concepts and theory development was presented. Using the assigned readings and your professional experience as a starting point, complete the following.

    Retrieve a published concept analysis or research study that explores either an abstract or concrete concept. Answer the following questions about the article:

    • Why is this an important concept to address?

    • What are the defining characteristics of the concept?

    Abstract Concept of Critical Thinking Essay

    • What is the conceptual meaning of the concept?

    • Is the conceptual meaning valid and reliable? Provide a supporting rationale.

    • How does, or how might this concept support theory development?

    The Abstract Concept of Critical Thinking: Importance, Defining Characteristics, and Conceptual Meaning

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    A concept can be described as the thinking behind an idea. This idea itself may be abstract or concrete. In the nursing profession, research is the tool that is used to give rationale for every action that is taken in the process of treating and caring for patients. It is also the basis for all rationale attributed to interventions aimed at disease prevention. This is what has come to be known as evidence-based nursing practice (Foley & Davis, 2017). But for any research to be carried out there must first be a concept developed to guide the research, and point it to the direction that it is supposed to follow to come up with the required answers.  This is the thinking behind the research idea. Critical thinking is one of the concepts in nursing practice that is widely used to guide decisions in day-to-day practice. This paper examines an article that discusses the analysis of this concept as it relates to the nursing profession.

    Why is Critical Thinking an Important Concept to Address?

    Critical thinking is about questioning everything and oneself before taking any action. In nursing, it is about asking oneself why one is taking the particular action one is about to take. More importantly, it is about the nurse asking themselves whether it is worthwhile to take that particular action and if it will be helpful and beneficial. The concept of critical thinking can be traced back to the early philosophers and thinkers like Plato and Socrates (Von Colln-Appling & Giuliano, 2017). In nursing, therefore, it is a very important concept to address because it is through questioning that evidence-based nursing practice is entrenched.

    The Defining Characteristics of Critical Thinking as a Concept

    According to Von Colln-Appling and Giuliano (2017), the defining characteristics of critical thinking as a concept are acquisition of knowledge and its application, analysis of present information, informed decision making, and reflection on the decision made. This means for the nurse to be a critical thinker they must first acquire nursing education Abstract Concept of Critical Thinking Essay. This will allow them to analyse information like laboratory results and make informed decisions about what to do in the circumstances. After that they can then reflect on the decision they made and see if it was the best one to make. That is what the concept of critical thinking is about (Von Colln-Appling & Giuliano, 2017),

    Conceptual Meaning of Critical Thinking as a Concept

               
    Critical thinking as a concept means that the underlying principle is that you do not just accept an argument or a conclusion for the sake of it. Rather, you question the basis and rationale of such arguments and conclusions critically before accepting them. The arguments and conclusions must be not only reasonable, but also “well-thought out” and cogent (Carbogim et al., 2016).

    Validity, Reliability, and Support for Theory Development of the Conceptual Meaning of Critical Thinking

    The conceptual meaning of critical thinking is indeed reliable and valid. This means that any nursing researcher can ask the same question about it, conduct research on it, and still come out with the same identical results as the one that is being discussed here. The rationale to this is that critical thinking will always be defined by knowledge and its application, analysis of results at hand, rational decision making, and reflection of the same. Any researcher who is using this concept as the basis for their research must come up with or acknowledge these characteristics of critical thinking. Critical thinking as a concept supports theory development in that it provides the conceptual framework for the theory. Abstract Concept of Critical Thinking Essay.

    References

    Carbogim, F., & Bertaccini de Oliveira, L., & Püschel, V.A. (2016). Critical thinking : Concept analysis from the perspective of Rodger’s evolutionary method of concept analysis.
    Revista Latino-Americana de Enfermagem, 24
    , e2785. Doi: 10.1590/1518-8345.1191.2785

    Foley, A.S., & Davis, A.H. (2017). A guide to concept analysis.
    Clinical Nurse Specialist
    . Doi: 10.1097/NUR.0000000000000277

    Von Colln-Appling, C., & Giuliano, D. (2017). A concept analysis of critical thinking: A guide for nurse educators.
    Nurse Education Today, 49
    , 106-109. Doi: 10.1016/j.nedt.2016.11.007 Abstract Concept of Critical Thinking Essay