As nurses we will be faced with dilemmas and problem solving on a daily basis. Our own personal beliefs can also affect how we may treat or even care for a patient. It shouldn’t but it could possibly happen. If you see that happening, ask the nurse manager to switch with another nurse as that patient deserves proper care without judgment.  If you were against a certain vaccination and you had to provide that vaccination and patient education to a patient, you must provide them with accurate information, side effects, statistics all while you put your beliefs behind.

I personally experienced an ethical dilemma at work when I was scheduled to give a patient an injection. This patient had his blood work drawn and saw the doctor and was waiting for me to give him the injection. In the chart, the doctor had approved the treatment however based on the orders and the guidelines this patient was to not get the injection. I went looking for the doctor in the clinic and of course, he is with the next patient which can take about 20 minutes. So while waiting I asked one of our experienced RN’s what she feels I should do and to look into the chart more closely just in case I missed something. She reviews it and says to give it but upon asking why she said the doctor-approved it so it’s fine. I knew that something didn’t seem right so I had to continue to wait and explain to the patient that I was waiting for the doctor to review the treatment again. Once the doctor was available, I had him review the medication order and guidelines per the drug as I felt he had made an error. Turns out that the doctor was wrong and that the patient indeed did not need the treatment that day.  Our textbook states that we as nurses in a health care setting must work closely with physicians, pharmacist and other clinic staff. I believe that I utilized my resources as an LPN and made the right choice by getting a second opinion even though I still did not agree with her response. As a nurse, it is acceptable to not agree with someone but you need to explain your reasoning for something as the other nurse did not provide an acceptable reason for me.

Reference

Catalano, J. (2015). Nursing Now! Today’s Issues, Tomorrow’s Trends. Philadelphia. F.A Davis Company

Please respond to the discussion above.

 

Submit an evidence-based practice paper about cultural competency in  mental health nursing. An evidence-based practice paper allows you to  explore best practice and help improve client outcomes on a psychiatric  unit. Your paper should describe how you, as a nurse, will include – or  have included – cultural awareness in a client diagnosed with a mental  illness. The person you describe could be someone in your clinical  setting, someone you have worked with in the past, or a theoretical  client. 

Remember that culture can also include gender equality, sexual  orientation, and other cultures besides race and religion – including  cultures unique to one particular family. Your paper should be at least 3  pages (double-spaced, not including the title or reference pages) in  APA Format and include:

• Assessment: Discuss what you would assess in  regard to a client’s culture. For example, are there specific dietary  requirements? Are schedule changes necessary to avoid conflicts with  religious practices? Who is the spokesperson for the family? What would  you assess?
• Diagnosis: List any mental health nursing diagnoses this person has or may be at risk for. Include at least one cultural diagnosis.
• Planning: What planning needs to be done to ensure the cultural and emotional safety of the client? 
• Implementation: What are interventions that would  ensure the safety of your client in regard to culture? Include at least  two interventions. For example, if your client has religious beliefs  that affect the ability to take medications, what interventions would  you create to ensure the client’s safety? What can you do to make sure  the client’s cultural needs are met?
• Evaluation: How will you evaluate whether your implementation was effective? Make sure the parameters are objective and measurable.
• In your summary, discuss whether any completed  interventions were successful. What could be done differently in the  future? If the interventions have not yet been carried out, you might  discuss some institutional changes that could be made to ensure cultural  safety for all clients in that setting. 

Your paper should utilize proper APA guidelines and include at least  three scholarly sources to support your paper. A scholarly source is a  source that has been peer reviewed and has appropriate authors that are  credentialed. For more information on APA, please visit the Online Library. 

Rubric:

Patient Description

Points: 1 (10.00%) 

Complete description of the client including (6 items): age, race, religion, marital status, children, and living environment

 Assessment     

Points: 1 (10.00%)
Complete assessment including assessment in regard to culture

Diagnosis      

Points:  2 (20.00%)
3 complete nursing diagnoses,  including at least one cultural diagnosis. Each nursing diagnosis includes 3 components: diagnosis, related to, and defining characteristics.

Planning     

Points: 2 (20.00%)
Includes outcomes in SMART goal format for each of 3 nursing diagnoses

Implementation     
Points:  2 (20.00%)
Includes 2-3 Nursing Interventions for each outcome

Evaluation     

Discussion of success or changes needing to be made to make the plan successful. If plan not yet carried out,  potential institutional changes to setting for cultural safety.

Grammar     

Points:  1 (10.00%)
Paper is properly formatted in APA,  3 scholarly sources are cited in the paper and in reference page, use of  complete sentences and errors do not detract the reader from the message, the paper  is 3-4 pages in length

  

In recent years, hormone replacement therapy has become a controversial issue. When prescribing therapies, advanced practice nurses must weigh the strengths and limitations of the prescribed supplemental hormones. If advanced practice nurses determine that the limitations outweigh the strengths, then they might suggest alternative treatment options such as herbs or other natural remedies, changes in diet, and increase in exercise.

Consider the following scenario:

• As an advanced practice nurse at a      community health clinic, you often treat female (and sometimes male      patients) with hormone deficiencies. One of your patients requests that      you prescribe supplemental hormones. This poses the questions: How will      you determine what kind of treatment to suggest? What patient factors      should you consider? Are supplemental hormones the best option for the      patient, or would they benefit from alternative treatments?

To prepare:

• Review Chapter 56 of the Arcangelo      and Peterson text, as well as the Holloway and Makinen and Huhtaniemi      articles in the Learning Resources.
• Review the provided scenario and      reflect on whether or not you would support hormone replacement therapy.
• Locate and review additional articles      about research on hormone replacement therapy for women and/or men.      Consider the strengths and limitations of hormone replacement therapy.
• Based on your research of the      strengths and limitations, again reflect on whether or not you would      support hormone replacement therapy.
• Consider whether you would prescribe      supplemental hormones or recommend alternative treatments to patients with      hormone deficiencies.

With these thoughts in mind:

Post a description of the strengths and limitations of hormone replacement therapy. Based on these strengths and limitations, explain why you would or why you would not support hormone replacement therapy. Explain whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies and why.

This work should have Introduction and conclusion

– This work should have at 3 to 5current references (Year 2012 and up)

– Use at least 2 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com

Required Readings

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

• Chapter 33, “Prostatic      Disorders and Erectile Dysfunction” (pp. 527-544)
       This chapter examines the causes, pathophysiology, and drug treatment of      four disorders: prostatitis, benign prostatic hyperplasia, prostate      cancer, and erectile dysfunction. It also explores the importance of      monitoring patient response and patient education.
• Chapter 34, “Overactive      Bladder” (pp. 545-564)
       This chapter describes the causes, pathophysiology, diagnostic criteria,      and evaluation of overactive bladder. It also outlines the process of      initiating, administering, and managing drug treatment for this disorder.
• Chapter 55, “Contraception”      (pp. 959-970)
       This chapter examines various methods of contraception and covers drug      interactions, selecting the most appropriate agent, and monitoring patient      response to contraceptions.
• Chapter 56, “Menopause” (pp.      971-994)
       This chapter presents various options for menopausal hormone therapy and      examines the strengths and limitations of each form of therapy.
• Chapter 57, “Osteoporosis” (pp.      985-994)
       This chapter covers various options for treating osteoporosis. It also      describes proper dosages, potential adverse reactions, and special      considerations of each drug.
• Chapter 58, “Vaginitis” (pp. 995-1006)
       This chapter examines various causes of vaginitis and explores the      diagnostic criteria and methods of treatment for the disorder.

Holloway, D. (2010). Clinical update on hormone replacement therapy. British Journal of Nursing, 19(8), 496–504

This article examines the purpose, components, and administration of hormone replacement therapy (HRT). It also presents benefits, risks, potential side effects, and alternative treatment options of HRT.

Mäkinen, J. I., & Huhtaniemi, I. (2011). Androgen replacement therapy in late-onset hypogonadism: Current concepts and controversies—A mini-review. Gerontology, 57(3), 193–202. 

This article examines the role of testosterone levels in the development of hypogonadism. It also explores health issues that are impacted by testosterone levels and the role of testosterone replacement therapy.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

U.S. Preventive Services Task Force. (2014). The Guide to Clinical Preventive Services: Section 2. Recommendations for Adults. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html

This website lists various preventive services available for men and women and provides information about available screenings, tests, preventive medication, 

Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply “The Road to Evidence-Based Practice” process, illustrated in Chapter 4 of your textbook, to create your proposal.

Include the following:

1. Provide an overview of the problem and the setting in which the problem or issue occurs.
2. Explain why a quality improvement initiative is needed in this area and the expected outcome.
3. Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
4. Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
5. Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.
6. Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

 

Strengths-Based Leadership

It is relatively easy to describe our acquired expertise, but most of us struggle when asked to describe our natural talents.
—Rath, 2007, p. 21

Recognizing innate talents is critical not only for leveraging one’s own strengths, but for fostering a workplace environment in which everyone’s contributions are respected and maximized. This is valuable because “the opportunity for individuals to play to their strengths most of the time is the key factor that shows the greatest correlation to outstanding performance in the widest range of business outcomes including profits, productivity, customer satisfaction, and safety and employee retention” (Buckingham, 2011, p. 5).

Charged with the complex and considerable goal of promoting health care quality and safety, nurse leader-managers must learn how to draw upon each person’s strengths to foster collaboration toward this shared purpose.

In this Discussion, you assess your own strengths and consider how they can be applied in a health care organization to improve quality and safety.

To prepare:

• Review the Learning Resources focusing on strengths-based leadership.
• If you have not already done so, follow the instructions in Strengths Finder 2.0 to complete the online assessment and read the sections in Part II that are associated with your five top strengths.
• Consider the results of the assessment. What insights, questions, or concerns arise as you think about these results?
• Think about how your identified strengths relate to your current role as a leader-manager and to the professional contributions that you hope to make now and in the future. Give focused attention to patient safety and health care quality; how and why are your strengths valuable for promoting optimal patient outcomes and creating systems-level change?
• Evaluate strategies for applying your strengths in the health care workplace. Identify at least two that you can use to add value to a team or workgroup to improve quality and safety.

By Day 3

Post a brief description of your identified strengths and explain how and why they are beneficial in your role as a nurse leader-manager. Explain at least two strategies for applying your leadership strengths in a health care organization to improve quality and safety.

Read a selection of your colleagues’ responses.

 

Required Readings

Rath, T. (2007). Strengths finder 2.0. New York, NY: Gallup Press.
Part I, “Finding Your Strengths—An Introduction” (pp. 1–31)
Part II, “Applying Your Strengths” (pp. 33–172)Read Part I first, then complete the online assessment as instructed in the book. Read the sections in Part II that are associated with your five top strengths.

Note: You must purchase a new, unopened copy of this book in order to acquire the access code that you will need to complete the online assessment.

Buckingham, M. (2011). Strong leadership. Leadership Excellence, 28(1), 5.
Retrieved from the Walden Library databases.

The author explains how strengths-based leadership creates competitive advantage for organizations. “The opportunity for individuals to play to their strengths most of the time is the key factor that shows the greatest correlation to outstanding performance in the widest range of business outcomes including profits, productivity, customer satisfaction, and safety and employee retention” (p. 5).

Cooper, H., & Cottrell, R. R. (2010). Charting your career path through clear professional values and purpose. Health Promotion Practice, 11(1), 13–15.
Retrieved from the Walden Library databases.

This article provides direction for clarifying professional values and purpose, and using that for career development. “The importance of understanding and articulating values at an individual level is that they can assist in developing one’s unique contribution to one’s profession, just as a professional organization’s values assist in directing the organization” (p. 14).