Start by reading and following these instructions:

1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.

2. Read the required chapter(s) of the textbook and any additional recommended resources.  Some answers may require you to do additional research on the Internet or in other reference sources.  Choose your sources carefully.

3. Consider the discussions and any insights gained from it.

4. Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Assignment:

Your assignment this week will be an APA paper to include title page, level headings, and a reference page.

Case study #1 

Mrs. Franklin-Jones was admitted from the Emergency Room to Cardiac Intensive Care one week ago with a diagnosis of acute myocardial infarction. She has recovered as expected and is moving to the cardiac step down unit today. She is talking with Nurse Julie Hernandez, as she gets settled in her new room, “I was really surprised when I got that bad pain in my chest! I knew I had high pressure but I just didn’t think it was that bad. I try to take my medicine like they told me to in the clinic but sometimes I forget. I guess that I need to study those papers they gave me about what foods I should eat and not eat. I better take care of myself! Momma had bad pressure and it killed her! Who knows—I may even have to learn to cook different than I was taught in Jamaica! I may have to let Tomas do the cooking. He’s got more time at home now than I do since he lost his job. There isn’t too much time between my shifts at the school cafeteria and my new housecleaning job. You know my sister is coming up from Jamaica to see me. I think she is bringing me some bush tea. That’ll set me right!”

• Using      Leininger’s Culture Care Model, what factors in the story shared by Mrs.      Franklin-Jones should be considered by Nurse Hernandez when planning for      the patient’s discharge?
• Why      is the theory of Culture Care Diversity important in the delivery of      nursing care for all patients?
• Using      Leininger’s Theory of Culture Care Diversity and Universality, develop a      plan of care for Mrs. Franklin-Jones.
• Discuss      the strengths and limits to Leininger’s Theory.

Case Study #2

Claude Jean-Baptiste is recovering from post-hip replacement surgery and has been transferred to the Rehabilitation Institute adjacent to the hospital. When he enters the unit, he sees welcoming signs written in several languages including his own, Creole. Since there are no nurses on that shift that speak Creole, they use a language line to ask for translation services. During this initial nursing assessment, the translator informs Mr. Jean-Baptiste that the nurses invite him to have a relative at his side so that they can be sure to understand and meet his needs. He is asked about Haitian customs and beliefs that they might honor. Mr. Jean-Baptiste is encouraged to bring food and spiritual care items, and to share the warmth of his culture with the nursing staff.

• Discuss      assumptions of the Transpersonal Caring relationship. What is the nurse’s      role?
• How      is love, as defined by Watson, evident in this caring moment?
• How      can the nurse creatively use self to create a healing environment?
• Discuss      the strengths and limits to Watson’s Theory.

This paper should include 2 outside references and your book. The essay should be between 1500 and 1750 words in length

• Write an Essay on the relationship between Nursing Theories and Advanced Practice.
• Use the APA style and send it via Blackboard for evaluation. Your essay must have a minimum of 1000 words and use at least 3 bibliographic references. Avoid plagiarism by submitting your work to SafeAssign.

**** ESSAY MUST BE ABOUT (nursing Theories and Advanced Practice) and the history of the advanced practice meaning THE ADVANCE NURSING PROFESSION WHICH IS A MASTER DEGREE IN NURSING.

*** MUST HAVE 1000 WORDS APA STYLE NO PLAGIARISM

helpful links

• Topic: Nursing theories and theorists

https://nurseslabs.com/nursing-theories/

Topic: The evolution of the Advanced Practice Nursing in the United States

• https://www.jognn.org/action/showPdf?pii=S0884-2175%2815%2933785-0

helfull link!!

https://onlinemasters.ohio.edu/blog/the-importance-of-nursing-theory-in-nursing-education/

As the healthcare industry experiences an increased demand for administrators/managers, it is necessary to ensure those serving in these roles have the knowledge, skills and abilities (KSAs) to accomplish the strategic goals of the organization. As you prepare to move forward in your career, what have you identified, (based on research) to be the necessary KSAs to be successful in this role? Describe the impact of successful healthcare administrators (based on research) in at least one organization (direct or non-direct care).

Must include at least 3 peer-reviewed, scholarly references. All sources must have been published within the last five years. 1000 words

 

Since P4P has been around for a number of years, one would think that its effectiveness should be clearly documented. However, Peter Kongstvedt says that results have been mixed. He concludes that “positive results remain ambiguous, at least on a broad basis.”

Review various P4P program results and effectiveness on the Internet or through your college’s Online Library, which you can access in the Resources tab.

Write a 2-page report of your findings. Specifically, address strengths and weaknesses of this compensation method, both from the point of view of the health plan and the physician. Cite at least two sources. List sources in APA format.

REPLY1

Moral distress has been something that every healthcare professional has encountered in their career. “Researchers have shown that moral distress is a wide spread problem for health care providers including nurses, pharmacists, social workers, physicians, and health care managers in a wide range of acute and community health care settings” (Pauly et al., 2012). A clinical situation that a nurse may encounter that may cause moral distress is when a patient in critical care unit has a poor prognosis and on the ventilator. Family would still want to have everything done on the patient and keep the patient on the ventilator even if the physicians state that the patient might not be able to be weaned off the ventilator. The Four A’s is used as a guide to identify and analyze moral distress. The four A’s are: ask, affirm, assess, and act. The first A is ask. Ask the appropriate question to be aware that moral distress is present. The questions that should be asked in this situation are: “what would the patient want,” “what are the reasons for the family to have the patient kept on life support,” “what is the prognosis of the patient.” The next A is affirming the distress. Affirming the distress is letting your fellow colleagues know and aware why you feel that way. Next A is to assess sources of moral distress to prepare for an action plan. The sources would be the patient’s prognosis and the family’s decision about the patient. Last part of the Four A’s is to act to implement strategies to preserve integrity and authenticity (Butts, 2016). By talking to family and the healthcare team, that would be acting to preserve integrity and authenticity to have the moral distress addressed.   

REPLY2

  Moral Distress is caused by nurses’ work that involves hard moral choices that result in an emotional or physical suffering, painful ambiguity, contradiction, frustration, anger, guilt and an avoidance of patients (Butts, 2015). Furthermore, it is a situation when a nurse feels that task differs from what he/she thinks it is ethically the correct thing to do. According to American Association of Critical-care Nurses (2004), nurses use the Four A’s plan as a guide to identify and analyze moral distress:

1. Ask appropriate questions to become aware that moral distress is present. For example, a nurse is faced with a situation when family members decide to remove do not resuscitate (DNR) orders for a 90 year old terminally ill patient because the family states “We are not yet ready to let go, we need to give our dad a fighting chance”. They still decided this even though they were given all the information they needed to make a decision. The nurse follows the wishes of the family to get the order done, even though the nurse feels like it is the wrong decision to do. The nurse feels angered and frustrated with this decision. The nurse then asks herself “Am I feeling this way because of this decision by my patient’s family?”
    
2. Affirm your distress and commitment to take care of yourself and address moral distress. The nurse in this situation acknowledges the feeling of distress and decides to make a commitment to address the moral distress.
    
3. Assess sources of your moral distress to prepare for an action plan. In this situation the nurse recognizes that the source is the decision of family members to remove DNR orders for the patient who is elderly and terminally ill. She feels it’s futile. She feels like the patient would suffer unnecessarily when the patient arrests.
    
4. Act to implement strategies for changes to preserve your integrity and authenticity. In this situation, she may decide to seek support from her charge nurse or other senior nurses on how they dealt with this type of situation.