End-of-life care becomes an issue at some point for elderly clients. Even with the emergence of palliative care programs and hospice programs, the majority of elderly people do not die in their own home as is their preference. What are the reasons for this trend? Discuss what you can do as a nurse to support your clients in end-of-life care and in supporting their desires. Support your response with evidence-based literature.

1-I like these questions!  Our hospital does have drills but we have not had an “active shooter” drill yet.  We talk about it within our department but not as an entire hospital yet.  They have set up emergency response communication via  text messaging and they have used that a few times but not for anything catastrophic.  The topic makes me sick and sad as this is becoming our reality and that this is becoming a part of life.  

I did perform CPR on a Grandfather who was attending “”Disney on Ice” at our huge arena.  It was a snowy night and I got there early.  I was on the level above when I saw him go down and heard the screams from family.  Not many people there yet.  By the time I had gotten down to the level where he was seemed like an eternity.  He was pulse less and blue.  I did do CPR and continued until EMS arrived.  He did die at the hospital and I later found out if was from a pulmonary embolism.  The family was very thankful and obviously devastated.  

I have been called several times from the stands at my girls sporting events to help with injuries or emergnecies as most of us as nurses have been.  

RKim 5 Re:Re:T

2-enjoyed reading your post and also feel like the tertiary prevention phase is very important in the recovery phase. This is the phase that will help individuals long term . The aftermath of the 2010 Haitian earthquake was devastating it is at this phase focus can be put on prevention measures such s counseling, chronic disease rehabilitation, services for housing and any type long term maintenance.

MKim 5 Re:Comp

3-I can definitely identify with compassion fatigue. I am a mental health nurse and each night I clock in I have the privilege of being a listening ear for someone who feels that life is hopeless. Sometimes I am able to lift spirits sometime not. What I try to do is take my time away so regardless of how much they call me stating staffing is low I don’t come in. During that time off I go  do to the gym, spend time with my family and most importantly worship,  pray and praise my Lord.

apaaaaa style 

1. Discuss the importance of effective communication in the personal relationship, the therapeutic relationship, and the relationship within the interprofessional health-care team.

2. What similarities and differences can you identify among the above interactions?

3. Explain the concept of congruence between verbal and nonverbal communication.

4. There are many pitfalls to electronic communication. Identify a situation in which an electronic form of communication may result in a miscommunication. What other method of communication would have been more effective?

5. How have you seen ISBAR used during your clinical experiences?

6- Develop a hand-off report for yourself. Include items that you believe are pertinent for safe and effective nursing care. Refer to the information in the chapter for creating this report form. Using the information from the chapter, determine the effectiveness of the system currently in use on your unit for communicating shift-to-shift reports.

7-Dr. Roberts comes into the nurses’ station demanding, “Where are Mr. Adams’s lab reports? I ordered these stat, and they’re not here! Who’s responsible for this patient?” How would you, as the nurse, respond?

8-Explain the concept of accountability in delegation. What are the legal ramifications of accountability in delegation?

9. Dennie and Elias arrive in the unit for the 7:00 p.m. to 7:00 a.m. shift. Both nurses completed orientation 4 weeks ago. They find that they will be the only two RNs on the floor that night. There is a census of 48 clients. The remaining staff consists of two NAPs/UAPs and one LPN. What are the responsibilities of the RN, NAP/UAP, and LPN? Can Dennie and Elias effectively delegate client care tasks and care safely for all 48 clients? Use the Delegation Tree to make your decisions.

10. Discuss the differences between direct delegation and indirect delegation.

1. You have to observe delegation procedures in your assigned unit:

A-What considerations does the RN take into account when delegating patient care?

2-You have to look at the unit census and prioritize the patient care:

A- Give the rationale foryour choices.

3.Answer the following questions during your clinical experiences:

a. What specific tasks did your patients require that you might have been able to delegate?

b. How effective was your nurse/preceptor in delegating tasks to others?

c. How did your nurse/preceptor ensure that the tasks were completed safely and appropriately?

  

Select a state health policy reform innovation and describe the rationale, how it was adopted (e.g., federal waivers, passage by state legislature), the funding structure, and (to the extent statistical data are available) its impact. Summarize the findings in a 1-2-page, single-spaced memo.

A few examples of state innovations include Vermont’s single payer system, Massachusetts’ health reforms and Kentucky’s Medicaid healthcare program.

Important: Rationale/Adoption, Funding Structure, Impact on Healthcare, APA Format, 3 References.