Read the case below on Dax Cowart which will be the topic of the Ethical Issue Paper. You will identify both sides of the issue and then analyze the case using ethical theory and principle to support your comments.See the guidelines and grading rubric for details on the assignment. Once completed, the paper will be submitted in the Assignment Submission Area to the link labeled Ethical Issues Paper. Once submitted, the paper will go directly to Turnitin which is a plagiarism tool. Once you have received your similarity report and made any required edits to ensure the similarity percent is below 24%, submit the final paper to the link under the Assignment Submission area labeled Final Paper Submission for grading.

Ethical Issue Paper Grading Rubric

Ethical Issue Paper

Potential 

Points

Actual

Points

Earned

Comments

Assignment-Related Criterion

Introduce the ethical issue

·  Clearly states the purpose for the paper in first or second paragraph (APA 2.05)

·  Fully describes background of the case.

·  Clearly identifies the two opposing views. 

10

Analyze the ethical issue

·  Clearly explains the ethical implications and effects of this issue, without bias, on healthcare today.

·  Identifies, compares and contrasts opposing views with supporting references-based on facts and not personal opinion. 

·  Applies ethical theory and principle to support both sides of the issue. 

·  Identifies interdisciplinary team members and all stakeholders. 

30

Resolution

·  Briefly discuss a possible resolution. What can/should be done to resolve the issue? This can be just a few paragraphs on a possible resolution. 

20

Conclusion

·  Recaps main ideas

·  Reflects on how the discussion within the paper has changed own prior beliefs on the topic. 

20

• Assume that you are leading a staff development meeting on regulation for nursing practice at your healthcare organization or agency.
• Review the NCSBN and ANA websites to prepare for your presentation.

The Assignment: (8- to 9-slide PowerPoint presentation)

Develop a 8- to 9-slide PowerPoint Presentation that addresses the following:

• Describe the differences between a board of nursing and a professional nurse association.
• Describe the board for your specific region/area.
  • Who is on the board?
  • How does one become a member of the board?
• Describe at least one state regulation related to general nurse scope of practice.
  • How does this regulation influence the nurse’s role?
  • How does this regulation influence delivery, cost, and access to healthcare?
• Describe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).
  • How does this regulation influence the nurse’s role?
  • How does this regulation influence delivery, cost, and access to healthcare?
• Include Speaker Notes on Each Slide (except on the title page and reference page)

Comment 1

Change can be very scary and intimidating. It can be even more intimidating when change comes from someone who you are not familiar with or who is new. You do not know their intentions and what they stand for. Reorganization without no input from any employees can lead to conflict because the employees were not taken in to consideration and were not informed prior to the new changes taken place. Communication would be a great way to start managing any conflict. According to Huber, “usually the best place for a work group to clear the air is in a group meeting” (2014). Arranging a meeting to introduce the new director and allowing the employees to get to know the new director will be a great first step. Allowing the new director and the employees to build a rapport will help build a great foundation to their relationship. At this time the new director can explain his/her ideas to reorganize the department and the reason behind the changes. Creative problem solving is another way to manage conflict because “all parties work together collaboratively to arrive at a solution that satisfies everyone, and all parties feel that they win” (2014). Having an open dialogue and open communication lets both parties express their opinions and thoughts to find the best solution for the department. After all, they should both have the same vision and goal which is to have a successful and outstanding department.

comment 2

An engaged and motivated workforce is vital to the success of any organization. Employees want to know that they are valued and appreciated. When decisions that affect their work were made without their input, employee morale takes a nose-dive.  The fastest way to lose employees is to make changes without any sort of warning, especially change that comes from an outsider with whom they have neither built trust nor gained support.  

 Unhappy employees are not likely to feel motivated and perform their best. The low morale that this creates leads to high employee turnover and can be costly for the company.  Companies invest billions of dollars in valuable time and resources hiring, orienting and training new employees. This causes disruptions in the normal flow of business. It is not conducive to team building and the overall success and profit margin of the company.

Sometimes change is necessary and it may be impossible to involve every employee in every issue but it is important to explain why change needs to happen and it is important to get their input before any drastic changes are made that affect their duties and performance. Change that is communicated with energy, enthusiasm and employee inclusion and in the context of grander vision will gain better acceptance and support. When employees are given the opportunity to share their feedback, they feel valued and appreciated. They see their place and their future within the organization. They take a more active role in the company and take ownership of their job.

 Assignment 5.1: Write two argumentative paragraphs. In Week 4, you completed the research needed to write your essay. You gathered sources- at least one per paragraph- and created an annotated bibliography. This week, you will write two of the three argumentative paragraphs. Look at the essay outline you created last week to remind yourself which paragraphs you will write. Example Thesis: Seniors who live in elderly homes enjoy the advantages of this decision. Example Outline: Argument 1: Socialization Argument 2: Medical Care Argument 3: Constant care companion According to the example outline, I am writing Arguments 1 and 2, socialization and medical care. Now it is time to review the annotated bibliography completed Week 4. Organize the information to place within the paragraph. Example Annotated Bibliography: Argument 1: Socialization Keffle, H. “The Eefect of Living in a Nursing home on Socialization in Elderly People.” Journal of Advanced Nursing • Seniors who lived in nursing homes developed 23% greater muscle mass in six months (432). • The “relaxed state of being” is when an elderly person lives with his friends and shares their experiences. • The “anxious state of being” is when seniors live alone. Keffle’s research shows that in a sample population of 100 seniors, those who lived alone were more likely to suffer physical and psychological effects. Example Paragraph Outline Example Argument 1 Paragraph Nursing homes provide an array of activities for seniors that  benefit their quality of life. Whether it is going to the center for an ice cream or attending music night in the banquet room, seniors who live in a large group help keep each other active. In a 2012 study, researchers found that seniors who lived in nursing homes developed 23% greater muscle mass in six months (Keffler 432). Clearly, those who worry about their aging parents ought to consider the physical benefits of being social. Moreover, the social life at nursing homes helps seniors exercise their brains. Playing games, such as bingo and cards, learning to dance or cook and simply navigating the grounds force the brain to continue working. All nursing homes incorporate dynamic activities because they know it will help improve the quality and longevity of the elderly. Lastly, the friends elderly people meet in a nursing helps them discover the most valuable benefit of allcompanionship. In the Journal of Nursing, Keffle shows how regularly interacting with others who share the same experiences improves their attitude to a “relaxed state of being” while those isolated suffer an “anxious state of being” (2012). Ultimately, her study proved that seniors engaging with others were more likely to have a positive outlook on life, which increases their chances of a better life. • three different colors = three different supporting details • three sentences for each supporting detail • within-paragraph transitions- “Moreover” and “Also”-  introduce new supporting details • last sentence = concluding statement (restatement) When beginning Argument paragraph 2, make sure to use an across-paragraph transition. The purpose of an across-paragraph transition is to connect the previous paragraph to the new paragraph. It is a strategy to remind the reader of the previous paragraph’s purpose right before you begin the new paragraph. To do so, first you need to think of the relationship between the two paragraphs. In this essay, the second Argument paragraph adds an additional point in convincing the reader. Therefore, the relationship between the two paragraphs is that of a addition. The following expressions are commonly used as acrossparagraph transitions of addition: • In addition to _______ , ________________ . • ________ not only _________ but also _______ . Use the same strategies as Argument 1 to create Argument 2. • Consult your essay outline.  Example Essay Outline: Argument 1: Socialization Argument 2: Medical Care Argument 3: Constant care companion Example Paragraph Outline It’s time to write the across-paragraph transition of addition. Example Argument 2 Paragraph Seniors in nursing homes enjoy not only the benefits of social activities but also the advantages of having medical personnel on site at all times. You notice that the writing structure of Argument 1 is the same as Argument 2. The only difference is that Argument 2 begins with an across-paragraph transition of addition. Don’t forget to include quotes or paraphrases in your paragraphs. Refer to Week 4 reading chapters. Once you have written Arguments 1 and 2, upload your work to the class site. Make sure to include your working thesis.  

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

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

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.