Respond to your colleagues  by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.

At least 2 references in each peer responses!

   For a policy to be developed in nursing, both the competing needs and the agenda must align. For example, during the beginning stages of the COVID-19 outbreak, many students and trainees were going to be potentially involved in the care of infectious patients. Due to the virus, there was a huge probability that the students and trainees would be exposed, and the need to conserve the personal protective equipment (PPE) outweighed the need to provide an education to these students and trainees during this time (Gallagher & Schleyer, 2020). So, policies were made to stop and remove students and trainees from the hospitals. When the hospitals made this new policy, they inadvertently also created a shortage in workers, requiring many of them to work overtime, as well as created and increasing the risk for burnout on the existing staff. The new policy created will affect patients, because many of the hospital workers are overstressed and perhaps, less trained or qualified to care for the patient.

Sometimes a policy may seem to present a positive benefit, but have a negative impact on patients or even sometimes the workforce. According to Nancarrow (2015), what would work best is a flexible workforce, which has the potential to optimize our healthcare accessibility. A flexible workforce is one that can promptly respond to labor shortages and distribution of resources in an efficient way so that the needs of the staff and patients are met (Nancarrow, 2015). Resuming the training of new hires and students and starting up a residency program would help out the workforce shortage and ease some of the healthcare burnout (Wildermuth, Weltin, & Simmons, 2020). The COVID-19 pandemic is a chaotic time, but also a great time for educators. Educators can take this time to impart “strategies for improving end of life care, allocating scarce resources, and caring for patients who chose to be non-compliant during the self-quarantine recommendations (Gallagher & Schleyer, 2020).”

Respond to your colleagues  by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.

At least 2 references in each peer responses!

   For a policy to be developed in nursing, both the competing needs and the agenda must align. For example, during the beginning stages of the COVID-19 outbreak, many students and trainees were going to be potentially involved in the care of infectious patients. Due to the virus, there was a huge probability that the students and trainees would be exposed, and the need to conserve the personal protective equipment (PPE) outweighed the need to provide an education to these students and trainees during this time (Gallagher & Schleyer, 2020). So, policies were made to stop and remove students and trainees from the hospitals. When the hospitals made this new policy, they inadvertently also created a shortage in workers, requiring many of them to work overtime, as well as created and increasing the risk for burnout on the existing staff. The new policy created will affect patients, because many of the hospital workers are overstressed and perhaps, less trained or qualified to care for the patient.

Sometimes a policy may seem to present a positive benefit, but have a negative impact on patients or even sometimes the workforce. According to Nancarrow (2015), what would work best is a flexible workforce, which has the potential to optimize our healthcare accessibility. A flexible workforce is one that can promptly respond to labor shortages and distribution of resources in an efficient way so that the needs of the staff and patients are met (Nancarrow, 2015). Resuming the training of new hires and students and starting up a residency program would help out the workforce shortage and ease some of the healthcare burnout (Wildermuth, Weltin, & Simmons, 2020). The COVID-19 pandemic is a chaotic time, but also a great time for educators. Educators can take this time to impart “strategies for improving end of life care, allocating scarce resources, and caring for patients who chose to be non-compliant during the self-quarantine recommendations (Gallagher & Schleyer, 2020).”

 Respond  by providing feedback on each  colleague’s therapeutic approach based on a narrative family  therapeutic perspective. Support your feedback with evidence-based  literature and/or your own experiences with clients.

NOTE: Positive comment

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A married couple in their fifties husband and wife with no children who have been married for longer than 20 years ,the husband has recovered from alcoholism  and has relapsed twice over a significant period of time and then relapsed again so currently he has 27 days sober ,he is very angry that he was not able to maintain his sobriety ,but he demonstrate concern that at this point in time he does maintain a so he is working hard. Coming to this current family session and that .I’m discussing but I have also seen some time in a  group  session with  other people who are recovering from alcohol ,drugs use .He speaks this 1st wife in these other sessions as though and does not understand what he is going through and that she is  always asking  him What about me?, What about my Any?, What are you going to do about that Why  are you spending time talking to these, other people and anyway that is his presentation of her at this meeting .  

I met his wife 1st time at this meeting and she initially explained that she  did not know about alcoholism  from 10 years of their marriage .I have not yet been able to discussion how that was that he managed to keep it from her for 10 years but how that she knows about it she state that she is more than willing to try to help him, she wants to listen to him and she state that he does not talk to her at all he has currently undergone some type of the accident that caused him some physical damage through he is unable to work so he is unemployment and he has whole her during the day and he does not particularly show any great interest and discussing cry of this needs with her, he actually state that it is easier for that he just reminds me what about the subject and discusses it with the other people in groups that he think understands him more, so what I looking at today in that type of therapy which is an understanding that the people have problems  and they are sometimes resistant on having on new problem  sand they are sometimes determining how they are going to act about their problems as focus. What the couple communication is a big factor in expressing what their need and desires are and explain one to the other what they need from each of the trust in wife has expressed such as lack of trust in her husband that it is very difficult from her not to think that he is going to be just healthy lined to her about crying that it shows the other concerned that it shows  me some medication for depression and now truck how to decrease his. Drinking and the no truck has helped him but there are some side effects such as causing an increased economic depression .I have recommended that he discuss his medication that he is currently taking with the primary care provider or his p[psychiatric to see if they confirmed  a resolution to that. 

Please go to the following web address:

https://adfs.rasmussen.edu/adfs/ls?wa=wsignin1.0&wtrealm=urn%3aextranet%3aportal&wctx=https%3a%2f%2fportal.rasmussen.edu%2f_layouts%2f15%2fAuthenticate.aspx%3fSource%3d%252F&wreply=https%3a%2f%2fportal.rasmussen.edu%2f_trust%2fdefault.aspx  Please sign in with the following information:

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Password: Adalynn!0823

Click on Courses on the top, and then click on US Healthcare Systems, click on Module 6, then assignments. Scroll down to Module 06 Final Exam. Complete that exam.

• Select a client whom you have observed or counseled at your practicum site.
• Review pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.

The Assignment

Part 1: Comprehensive Client Family Assessment

With this client in mind, address the following in a Comprehensive ClientAssessment (without violating HIPAA regulations):

• Demographic information
• Presenting problem
• History or present illness
• Past psychiatric history
• Medical history
• Substance use history
• Developmental history
• Family psychiatric history
• Psychosocial history
• History of abuse/trauma
• Review of systems
• Physical assessment
• Mental status exam
• Differential diagnosis
• Case formulation
• Treatment plan

Part 2: Family Genogram

Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents).

Patient 

D.H, 26-year-old male Hispanic, was admitted from home from the ED for inpatient psychiatric evaluation and treatment. Allergies to latex, shrimps. He has a history for depression, PTSD, paranoia, anxiety and pseudo-seizures.

Chief complain: Pt has neglected his ADLS and hygiene, not slept and eaten in the past few days before his admission. Pt expressed he has no motivation to live, admits suicidal ideation with no plan, denies homicidal ideation, auditory and visual hallucinations. He stated, “the recent anxiety and depression is from working from home due to COVID, I usually work at the warehouse as a call center representative.”  The pt lives with spouse and after he signed the release of information form, pt’s spouse was unavailable when called.

The individual counselling therapy, bio/psychosocial was completed as pt was cooperative, redirectable despite having racing thoughts. He admitted to sexual abuse at 5 years old by the maid but stated he didn’t want to talk about it. The pt was easily distracted, showed signs of depression. He has had 1 prior hospitalizations for mental problems but stated “I was anxious and wanted to calm down at that time.” Pt admits to alcohol use, but no usage lately, also admits to marijuana use 6 months ago.

Dx: Risk for suicide, danger to self, depression, Unspecified Bipolar disorder and related disorder, Major depressive disorder w/o psychosis features, unspecified trauma disorder, unspecified anxiety disorder.

Psychosocial and contextual factors– trauma, marital stress, substance use

Meds: Sertraline 100mg PO qAM, Zyprexa 5mg QAM PO, Xanax 0.25mg PO q6h PRN for anxiety.

Treatment plan:

Problems: Suicide ideation w/o plan Goals: no SI.   Modalities: medication and therapy Problems: Anxiety   Goals: decrease anxiety.   Modalities: medication and therapy

Problems: Insomnia  Goals: Improve sleep   Modalities: medication and therapy

Medication Plan: Initiate Seroquel 50mg at HS for mania and Prazosin 1mg at HS for trauma.

Activity therapy: Engage pt in group focused therapy, improve coping skills and managing moods.