NURSING ROLE AND SCOPE – DISCUSSION WEEK 3 – 2025 REQUIREMENTS APA FORMAT LESS THAN 20 PLAGIARISM 400 WORDS AT LEAST 2 CITATIONS 2 REFERENCES DQ 1

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NURSING ROLE AND SCOPE – DISCUSSION WEEK 3 – 2025

 REQUIREMENTS:

APA FORMAT

LESS THAN 20% PLAGIARISM

400 WORDS

AT LEAST 2 CITATIONS & 2 REFERENCES

DQ 1:

·      Select one question as your DQ 1

·      Follow the discussion questions participation and submission guidelines.

·      Follow the 3 x 3 rule: minimum three paragraphs per DQ, with a minimum of three sentences each paragraph.

·      All answers or discussions comments submitted must be in APA format according to Publication Manual American Psychological Association (APA) (6th ed.) 2009 ISBN: 978-1-4338-0561-5

·      Minimum of two references, not older than 2015.

Chapter 3: Philosophy of Nursing

1.  Where do you see yourself and your understanding of truth on the continuum of realism and idealism?

2.  How would you define person? Look at the following attributes given to a person: (1) the ability to think and conceptualize, (2) the capacity to interact with others, (3) the need for boundaries, and (4) the use of language (Doheny, Cook, & Stopper, 1997). Would you agree? What about Maslow’s description of humanness in terms of a hierarchy of needs with self-actualization at the top? Another possibility is that persons are the major focus of nursing. Do you see humans as good or evil?

3.  Where do you see yourself and your understanding of truth on the continuum of realism and idealism?

4.  What are your beliefs about the major concepts in nursing—person, environment, health, nursing?

5.  Do you believe there is more than one right answer to situations? How do you value the whole individual? What barriers prevent us from responding to the contextual needs of our patients?

6.  Do I believe in health care for everyone? Does health care for everyone have value to me as a person? Does it have value to me as a nurse? What value does universal health care have to my patients?

7.  How does my personal philosophy fit with the context of nursing? Does it fit? What areas, if any, need assessing?

Nursing Role & Scope – Week 3 – Philosophy Of Nursing – 2025 Please answer the question below Chapter 3 Philosophy of Nursing 2 How would you

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Nursing Role & Scope – Week 3 – Philosophy Of Nursing – 2025

Please answer the question below:

Chapter 3: Philosophy of Nursing

2.  How would you define person? Look at the following attributes given to a person: (1) the ability to think and conceptualize, (2) the capacity to interact with others, (3) the need for boundaries, and (4) the use of language (Doheny, Cook, & Stopper, 1997). Would you agree? What about Maslow’s description of humanness in terms of a hierarchy of needs with self-actualization at the top? Another possibility is that persons are the major focus of nursing. Do you see humans as good or evil?

  Follow the discussion questions participation and submission guidelines.

·      Follow the 3 x 3 rule: minimum three paragraphs per DQ, with a minimum of three sentences each paragraph.

·      All answers or discussions comments submitted must be in APA format according to Publication Manual American Psychological Association (APA) (6th ed.) 2009 ISBN: 978-1-4338-0561-5

·      Minimum of two references, not older than 2015.

Please provide Plagiarism Report

Case #2 Anxiety Disorder, OCD, Or Something Else? – 2025 The Assignment Examine Case 2 You will be asked to make three decisions concerning the diagnosis and treatment for

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Case #2 Anxiety Disorder, OCD, Or Something Else? – 2025

 

The Assignment:

Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

  • Decision #1: Differential Diagnosis
    • 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?
  • Decision #2: Treatment Plan for Psychotherapy
    • 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: Treatment Plan for Psychopharmacology
    • 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 and their families.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

Rubric:

 

Quality of Work Submitted: The extent of which work meets the assigned criteria and work reflects graduate-level critical and analytic thinking.–

Excellent 27 (27%) – 30 (30%)Good 24 (24%) – 26 (26%)Fair 21 (21%) – 23 (23%)Poor 0 (0%) – 20 (20%)

Quality of Work Submitted: The purpose of the paper is clear.–

Excellent 5 (5%) – 5 (5%)Good 4 (4%) – 4 (4%)Fair 3.5 (3.5%) – 3.5 (3.5%)Poor 0 (0%) – 3 (3%)

Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

Understand and interpret the assignment’s key concepts.–

Excellent 9 (9%) – 10 (10%)Good 8 (8%) – 8 (8%)Fair 7 (7%) – 7 (7%)Poor 0 (0%) – 6 (6%)

Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

Apply and integrate material in course resources (i.e., video, required readings, and textbook) and credible outside resources.–

Excellent 18 (18%) – 20 (20%)Good 16 (16%) – 17 (17%)Fair 14 (14%) – 15 (15%)Poor 0 (0%) – 13 (13%)

Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e., video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.–

Excellent 18 (18%) – 20 (20%)Good 16 (16%) – 17 (17%)Fair 14 (14%) – 15 (15%)Poor 0 (0%) – 13 (13%)

Written Expression and Formatting
Paragraph and Sentence Structure: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused—neither long and rambling nor short and lacking substance.–

Excellent 5 (5%) – 5 (5%)Good 4 (4%) – 4 (4%)Fair 3.5 (3.5%) – 3.5 (3.5%)Poor 0 (0%) – 3 (3%)

Written Expression and Formatting
English writing standards: Correct grammar, mechanics, and proper punctuation.–

Excellent 5 (5%) – 5 (5%)Good 4 (4%) – 4 (4%)Fair 3.5 (3.5%) – 3.5 (3.5%)Poor 0 (0%) – 3 (3%)

Written Expression and Formatting
The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–

Excellent 5 (5%) – 5 (5%)Good 4 (4%) – 4 (4%)Fair 3.5 (3.5%) – 3.5 (3.5%)Poor 0 (0%) – 3 (3%) 

Case #2 Anxiety Disorder, OCD, Or Something Else? – 2025 The Assignment Examine Case 2 You will be asked to make three decisions concerning

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Case #2 Anxiety Disorder, OCD, Or Something Else? – 2025

 

The Assignment:

Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

  • Decision #1: Differential Diagnosis
    • 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?
  • Decision #2: Treatment Plan for Psychotherapy
    • 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: Treatment Plan for Psychopharmacology
    • 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 and their families.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

Rubric:

 

Quality of Work Submitted: The extent of which work meets the assigned criteria and work reflects graduate-level critical and analytic thinking.–

Excellent 27 (27%) – 30 (30%)Good 24 (24%) – 26 (26%)Fair 21 (21%) – 23 (23%)Poor 0 (0%) – 20 (20%)

Quality of Work Submitted: The purpose of the paper is clear.–

Excellent 5 (5%) – 5 (5%)Good 4 (4%) – 4 (4%)Fair 3.5 (3.5%) – 3.5 (3.5%)Poor 0 (0%) – 3 (3%)

Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

Understand and interpret the assignment’s key concepts.–

Excellent 9 (9%) – 10 (10%)Good 8 (8%) – 8 (8%)Fair 7 (7%) – 7 (7%)Poor 0 (0%) – 6 (6%)

Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

Apply and integrate material in course resources (i.e., video, required readings, and textbook) and credible outside resources.–

Excellent 18 (18%) – 20 (20%)Good 16 (16%) – 17 (17%)Fair 14 (14%) – 15 (15%)Poor 0 (0%) – 13 (13%)

Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e., video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.–

Excellent 18 (18%) – 20 (20%)Good 16 (16%) – 17 (17%)Fair 14 (14%) – 15 (15%)Poor 0 (0%) – 13 (13%)

Written Expression and Formatting
Paragraph and Sentence Structure: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused—neither long and rambling nor short and lacking substance.–

Excellent 5 (5%) – 5 (5%)Good 4 (4%) – 4 (4%)Fair 3.5 (3.5%) – 3.5 (3.5%)Poor 0 (0%) – 3 (3%)

Written Expression and Formatting
English writing standards: Correct grammar, mechanics, and proper punctuation.–

Excellent 5 (5%) – 5 (5%)Good 4 (4%) – 4 (4%)Fair 3.5 (3.5%) – 3.5 (3.5%)Poor 0 (0%) – 3 (3%)

Written Expression and Formatting
The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–

Excellent 5 (5%) – 5 (5%)Good 4 (4%) – 4 (4%)Fair 3.5 (3.5%) – 3.5 (3.5%)Poor 0 (0%) – 3 (3%) 

Literature Review: The Use Of Clinical Systems To Improve Outcomes And Efficiencies – 2025 New technology and the application of existing technology only appears in healthcare settings after careful and significant research The stakes are high

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Literature Review: The Use Of Clinical Systems To Improve Outcomes And Efficiencies – 2025

  New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of a positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

  • Review the Resources and reflect on the impact of      clinical systems on outcomes and efficiencies within the context of      nursing practice and healthcare delivery.
  • Conduct a search for recent (within the last 5 years)      research focused on the application of clinical systems. The research      should provide evidence to support the use of one type of clinical system      to improve outcomes and/or efficiencies, such as “the use of personal      health records or portals to support patients newly diagnosed with      diabetes.”
  • Identify and select 4 peer-reviewed research articles from your research.
  • For information about annotated bibliographies,      visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies

The Assignment: ( 5-6 pages not including the title and reference page)

In a 5-6 page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:

  • Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
  • Include an introduction explaining the purpose of the paper.
  • Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
  • In your conclusion, synthesize the findings from the 4      peer-reviewed research articles.
  • Use APA format and include a title page.

1)  Identify the 4 peer-reviewed articles, citing each in APA format, 

2)  Summarize each study explaining:

a) improvements to outcomes,

b) efficiencies (to staff, patient, facility as a result of implementing the clinical system/clinical technology described in the article), and 

c) lessons learned from the application of the clinical system/clinical technology. Be specific AND provide examples., and

3) in your conclusion, synthesize the findings from the 4 peer-reviewed research articles. 

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

· Chapter 14, “The Electronic Health Record and Clinical Informatics” (pp. 267–287)

· Chapter 15, “Informatics Tools to Promote Patient Safety and Quality Outcomes” (pp. 293–317)

· Chapter 16, “Patient Engagement and Connected Health” (pp. 323–338)

· Chapter 17, “Using Informatics to Promote Community/Population Health” (pp. 341–355)

· Chapter 18, “Telenursing and Remote Access Telehealth” (pp. 359–388)

Dykes, P. C., Rozenblum, R., Dalal, A., Massaro, A., Chang, F., Clements, M., Collins, S. …Bates, D. W. (2017). Prospective evaluation of a multifaceted intervention to improve outcomes in intensive care: The Promoting Respect and Ongoing Safety Through Patient Engagement Communication and Technology Study. Critical Care Medicine, 45(8), e806–e813. doi:10.1097/CCM.0000000000002449

HealthIT.gov. (2018c). What is an electronic health record (EHR)? Retrieved from 

https://www.healthit.gov/faq/what-electronic-health-record-ehr

Rao-Gupta, S., Kruger, D. Leak, L. D., Tieman, L. A., & Manworren, R. C. B. (2018). Leveraging interactive patient care technology to Improve pain management engagement. Pain Management Nursing, 19(3), 212–221. 

Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32–40. 

Required Media

Laureate Education (Producer). (2018). Public Health Informatics [Video file]. Baltimore, MD: Author. –Downloads– Download Video w/CC Download Audio Download Transcript 

Laureate Education (Producer). (2018). Electronic Records and Managing IT Change [Video file]. Baltimore, MD: Author.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

· Chapter 5, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 124–188)

· Chapter 6, “Critically Appraising Qualitative Evidence for Clinical Decision Making” (pp. 189–218)

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010a). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. American Journal of Nursing, 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Critical appraisal of the evidence: Part II: Digging deeper—examining the “keeper” studies. American Journal of Nursing, 110(9), 41–48. doi:10.1097/01.NAJ.0000388264.49427.f9

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010c). Evidence-based practice, step by step: Critical appraisal of the evidence: Part III: The process of synthesis: Seeing similarities and differences across the body of evidence. American Journal of Nursing, 110(11), 43–51. doi: 10.1097/01.NAJ.0000390523.99066.b5

Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses Association, 15(3), 202–207. doi:10.1177/1078390309338733

Laureate Education (Producer). (2018). Appraising the Research [Video file]. Baltimore, MD: Author.

Advance Clinical Practicum Discussion 1 – 2025 Describe your current knowledge of the facility you chose for your practicum experience and

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Advance Clinical Practicum Discussion 1 – 2025

 

  • Describe your current knowledge of the facility you chose for your practicum experience and your reasoning for choosing this particular facility. Also, share one vulnerable population that can be found within your facility’s community and your experience dealing with this population. If you do not have experience with this population, what research will you do before you start?

I work with the medicare population as a Case Manager at an Insurance company

Evidence-Based Project, Part 3: Critical Appraisal Of Research – 2025 Conduct a critical appraisal of the four peer reviewed articles you selected by completing the Evaluation Table within

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Evidence-Based Project, Part 3: Critical Appraisal Of Research – 2025

 

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

                                                             USE  ANY 4 FROM  THESE STUDIES 

  

Kampiatu, P., & Cozean, J. (2015). A controlled, crossover study of a  persistent antiseptic to reduce hospital-acquired infection. African journal of infectious diseases, 9(1),69. https://doi.org/10.4314/ajid.  v9i1.2.

  Ho, H. J., Poh, B. F., Choudhury, S., Krishnan, P., Ang, B., & Chow, A. (2015).  Alcohol handrubbing and chlorhexidine handwashing are equally effective in removing methicillin-resistant Staphylococcus aureus from  health care workers’ hands: A randomized controlled trial. American journal of infection control, 43(11), 1246–1248. https://doi.org/10.1016/j.ajic  .2015.06.005.

  Saito, H., Inoue, K., Ditai, J., Wanume, B., Abeso, J., Balyejussa, J., & Weeks,  A. (2017). Alcohol-based hand rub and incidence of healthcare-associated infections in a rural regional referral and teaching hospital in  Uganda (‘WardGel’ study). Antimicrobial resistance and infection control, 6, 129. https://doi.org/10.1186/s13756-017-0287-8.

 Kritsotakis, E. I., Kontopidou, F., Astrinaki, E., Roumbelaki, M., Ioannidou,  E., & Gikas, A. (2017). Prevalence, incidence burden, and clinical impact of healthcare-associated infections and antimicrobial resistance:  a national prevalent cohort study in acute care hospitals in  Greece. Infection and drug resistance, 10, 317–328.https://doi.org/10.  2147/IDR. S147459 

  Sadule-Rios, N., & Aguilera, G. (2017). Nurses’ perceptions of reasons for persistent low rates in hand hygiene compliance. Intensive & critical care nursing, 42, 17–21. https://doi.org/10.1016/j.iccn.2017.02.005

Module 6: Assignment N493 – 2025 Module 6 Assignment N493 Put your project to work Create materials for your

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Module 6: Assignment N493 – 2025

  

Module 6: Assignment N493

Put your project to work! Create materials for your presentation. These can include your speaker notes, PowerPoint for the presentation, or poster board. Hold the event at the designated and approved location. Take photos of yourself or record a short video of the location (this may be a table you have set up, a booth location, or a meeting room). Please include the photo OR video of you at the location as this will be the evidence that the event took place. This will be evidence that the event took place.

Submit your presentation materials, including your photos or videos

Show in your pictures: Your educational materials, your education table or booth, and some of the people that you gave instruction to, and include pictures. If the people at the education session do not want their picture taken, that is ok, just take some of you doing the presentation. 

Submit 2 or 3 pictures of your presentation Do not submit more than 3 pictures due to you will overload the drop box and be unable to submit your other tools such as power points (if you used one), or handouts that you used, etc. If you submit too many files, the drop box will be full. Don’t forget the log of at least 10-15 hours must be submitted into project concert.

NRS 493 -0503 Professional Capstone – 2025 Throughout the RN to BSN program students are required to participate in scholarly activities outside of clinical

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NRS 493 -0503 Professional Capstone – 2025

Throughout the RN-to-BSN program, students are required to participate in scholarly activities outside of clinical practice or professional practice. Examples of scholarly activities include attending conferences, seminars, journal club, grand rounds, morbidity and mortality meetings, interdisciplinary committees, quality improvement committees, and any other opportunities available at your site, within your community, or nationally.

You are required to post at least one documented scholarly activity by the end of this course. In addition to this submission, you are required to be involved and contribute to interdisciplinary initiatives on a regular basis.

Submit, by way of this assignment, a summary report of the scholarly activity, including who, what, where, when, and any relevant take-home points. Include the appropriate program competencies associated with the scholarly activity as well as future professional goals related to this activity. You may use the “Scholarly Activity Summary” resource to help guide this assignment.

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

APA style is not required, but solid academic writing is expected.

Healthcare Ethics – 2025 This week students will complete an APA paper to address the following

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Healthcare Ethics – 2025

 

This week students will complete an APA paper to address the following case study.

Mr. Corley Case Study:

Walter and Sheila Corley were married on January 20, 1984.   At the time, they lived in Texarkana, Arkansas.   Their son Jerry was born in July 1985.   Later that year, the Corleys separated and were divorced.   Sometime thereafter, the Corleys reconciled and resumed living together, holding themselves out to others as a married couple.   In February 1988, the Corleys moved to Mr. Corley’s hometown of Ferriday, Louisiana.   The Corleys were remarried in December 1988.

Neurofibromatosis, a disease of the peripheral nerves of the body, is a condition marked by the presence of numerous neurofibromas, which are tumors or growths arising from the Schwann cells which form the covering membrane or sheath of a nerve fiber.   Persons with neurofibromatosis frequently have café au lait spots of varying sizes on their bodies as well.   In addition, people afflicted with neurofibromatosis experience a significantly increased risk of developing cancer.

In 1978, Mr. Corley was diagnosed with neurofibromatosis and had four neurofibromas removed from his head, arm, hip and leg by a physician in Texarkana.   Thereafter, a few months prior to his return to Louisiana in 1988, Mr.  Corley, who had no other known health problems, began experiencing low back pain.

On February 11, 1988, Mr. Corley sought medical treatment from Dr. Maurice Gremillion, a family practitioner in Ferriday.   On that date, Mr. Corley complained that he had been experiencing low back pain and abdominal discomfort for approximately four months.   He also noted that he had intermittent right shoulder pain and trouble sleeping.   At Mr. Corley’s request, Dr. Gremillion ordered a total work-up which included x-rays of the lower spine, chest, kidneys and gall bladder, as well as an upper GI series.   Dr. Gremillion also prescribed Flexeril, a muscle relaxer, and Anaprox, an anti-inflammatory pain medication.   Dr. Gremillion, feeling that Mr. Corley should be seen by a specialist, then gave him a written referral to E.A. Conway Medical Center in Monroe for an orthopedic evaluation.

E.A. Conway, which is part of the L.S.U. system, is a teaching facility staffed by permanent, full-time physicians as well as by doctors who are employed on a temporary, rotating basis as interns and residents following their graduation from medical school.   The general operating procedure of E.A. Conway at the time of Mr. Corley’s presentment was that all new patients, even those who have referrals to a specific service or department, first go through the emergency room.   At that time, a patient is charted and evaluated by an emergency room physician.   From there, the patient is either treated or referred to a specific clinic for further follow-up.   In most cases, patients see different doctors each time they report to the hospital or one of its clinics.

On March 2, 1988, Mr. Corley, accompanied by Sheila Corley, reported to the E.A. Conway Emergency Room. The Corleys presented admitting personnel with all of Mr. Corley’s records from Dr. Gremillion, including the x-rays and other test reports.   Dr. Bruce Fuller, an emergency room physician, took a history from Mr. Corley and reviewed Dr. Gremillion’s notes and the x-ray reports.   He also conducted a routine physical examination and had x-rays made of Mr. Corley’s low back.   Notwithstanding the presence of several growths and café au lait spots on Mr. Corley’s back and torso, Dr. Fuller was unaware that his patient had neurofibromatosis.

Dr. Fuller found everything to be within normal limits and it was his impression that Mr. Corley was suffering from low back pain based on minimal subjective complaints of pain.   Dr. Fuller continued Mr. Corley on the medication prescribed by Dr. Gremillion and made an appointment for him with the Orthopedic Clinic on March 16, 1988.

On that date, Mr. Corley was seen in the Orthopedic Clinic by fourth year resident McIntyre Bridges.   Dr. Bridges does not recall looking at or reading the x-rays or reports from Mr. Corley’s previous examinations.   Dr. Bridges conducted a physical exam, which was normal, and started Mr. Corley on a conservative course of treatment for low back pain.   Dr. Bridges’ notes from this date indicate his awareness of Mr. Corley’s neurofibromatosis.

Mr. Corley was next seen on April 20, 1988 by Dr. David Mehta.   At the time, Dr. Mehta was doing a surgical internship and was rotating through the Orthopedic Department.   Dr. Mehta’s notes reflect that his physical exam of Mr. Corley was normal, but that he felt that Mr. Corley had a posture problem and referred him to physical therapy for correction of his posture.   Again, the notes do not reflect whether Dr. Mehta reviewed any of Mr. Corley’s previous medical records, x-rays or reports.

On September 14, 1988, Mr. Corley was seen by fourth year surgical resident Keith White.   On that date, Mr. Corley noted that his pain had worsened and was occasionally affecting his walking.   Dr. White’s examination yielded no objective findings of low back pain, but he did notice several café au lait spots indicative of neurofibromatosis so he ordered a CT scan of Mr. Corley’s low back to rule out any neurofibroma changes in the nerve roots.   Dr. Ellis, a radiologist at E.A. Conway, interpreted the CT scan as showing arthritis consistent with fibrosis or spinal stenosis and possible edema of the right L-5 nerve root, which, according to Dr. White, may or may not have been the cause of Mr. Corley’s back pain.   As with Drs. Bridges and Mehta, Dr. White did not review any of the previous medical records, x-rays or reports.   Mr. Corley’s last visit to E.A. Conway was September 21, 1988.   On that date, Dr. White reviewed the results of the CT scan with Mr. Corley, continued him on an anti-inflammatory drug and encouraged him to continue his back exercises.   Dr. White instructed Mr. Corley to return to the clinic in three months.

Thereafter, on October 26, 1988, Mr. Corley, plagued by constant back pain and beginning to experience difficulty breathing, consulted Dr. Rick Maxwell, a chiropractor, who did a full spinal x-ray which revealed a markedly diminished right lung area.   Dr. Maxwell sent Mr. Corley to his father, also a chiropractor, who confirmed that there was a potential problem with Mr. Corley’s right lung and recommended that he see a pulmonary specialist.

On October 31, 1988, Mr. Corley presented to Dr. Gremillion complaining of chest congestion and shortness of breath.   Dr. Gremillion diagnosed him with bronchitis and implemented treatment accordingly.   Mr. Corley returned to Dr. Gremillion on November 14, 1988 with complaints of shortness of breath and marked weight loss.   Subsequent diagnostic testing confirmed the presence of a very large mass in Mr. Corley’s right chest.

Prior to his death on January 23, 1990, Mr. Corley received radiation and chemotherapy treatment at LSU Medical Center in Shreveport.

Corley v. State Department of Health Hospitals. http://caselaw.findlaw.com/la-court-of-appeal/1071352.html

Student should address the following questions regarding this case in an APA paper

  1. What are the facts of the case? This should include: what do we need to know, who is involved in the situation, where does the ethical situation take place, and when does it occur?
  2. What is the precise ethical issue in regards to autonomy, nonmaleficence, beneficence, fidelity, and justice?
  3. Identify the major principles, rules, and values of the case.  Values are sets of beliefs about good and bad, right and wrong, and about many other aspects of living and interacting in the society with others. A principle is a personal rule that governs personal behavior. A rule is generally imposed by a figure of authority, and used to guide and govern people.
  4. Is there legal ground for this case, if so what? Who is at fault? What legal action should be taken?
  5. Are there alternatives to the actions completed in this case by both the patient and healthcare facility? Do you feel the physicians were following hospital protocol?
  6. If you were a member of the ethics committee at this facility, what actions or changes would you recommend changing? Why?

For the case study, an APA formatted paper should be used, and needs to include a title page, level headings, references and citations. This assignment should include at least 2 references and should be at least five pages in length. Students should address the proposed questions providing ample detail, examples, and additional support.

Assignment Expectations:  

  • Length:
    • answers must thoroughly address each question in a clear, concise manner; complete answers will likely take 5-6 pages
  • Structure:
    • reference page required
    • address each question in a numbered list
  • References:
    • Two references required
  • Format:
    • save your assignment as a Microsoft Word (.doc or .docx), Open Office (.odt) or rich text format (.rtf) file type