The Affordable Care Act was signed into law by President Barack Obama in March 2010. Many of the provisions of the law directly affect health care providers. Review the following topic materials:

1. “About the Affordable Care Act”
2. “Health Care Transformation: The Affordable Care Act and More”

What are the most important elements of the Affordable Care Act in relation to community and public health? What is the role of the nurse in implementing this law?

 Due: Oct 13 at 11:59pmCalendarEnglish Composition 1Details

Discussion 4.1 (A)

Step 1: Respond to the prompt in 250 words or more:

Prompt: What is the greatest misconception regarding your field? Where did this opinion come from? How does this stigma, label, or stereotype affect you? 

Step 2: After you make your initial post, make two additional response posts to earn full credit.

APA format 3 references please use 2 from the discussion post 1 page long

Simulated Learning Experiences

                Simulation learning provides students the opportunity to practice and master their skills in a structured setting.  Students who engage in simulation learning activities demonstrate both personal and professional growth (Swanson, Schaeffer-Fraase, & Riggins, 2019).  The purpose of this discussion is to describe a previous learning experience and to explain how simulation learning would enhance my learning experience and would more effectively achieve the same objectives. 

Nursing Education in 1984

                My nursing school did not incorporate simulation centers or structured skills labs in their curriculum.  Instead, we learned our skills on live people – either a classmate or a hospitalized patient. I learned how to give injections and perform venipunctures on my classmates.  However, the first time I inserted a foley catheter or a nasogastric tube was on a patient.  Even worse, as nursing students, we were assigned relatively stable patients during our clinical rotations.  While it is logical to assign a stable patient to a student, this practice ensured nursing students were unable to learn their learning skills before entering the profession.  As a result of this educational approach, I did not learn how to start an IV, prepare and hang IV solutions, draw blood, connect a patient to telemetry, perform wound care or any of the other essential nursing skills until I was on the job.  This complete lack of preparation for my role as a nurse created a steep learning curve.  However, I was not alone in my struggles as the clinical education I received was typical of nursing school at that time.

Retroactively Improving Nursing Education in 1984

                Simulation learning using mannequins was introduced in 1911 when a life-sized doll was made to teach nurses how to turn, transfer, and dress patients (Aebersold, 2016).  Just three years later, in 1914, the mannequin was upgraded to allow nurses to learn injection skills (Aebersold, 2016).  However, even though these mannequins were introduced over 70 years before I entered nursing school, the nursing schools in my area had yet to include simulation learning in their curriculum.  I entered the nursing profession fully aware that I did not possess the skills I needed to provide quality patient care.  Students who engage in simulation learning are provided the opportunity to develop their skills in a controlled setting (Cant & Cooper, 2017).  Although simulation technology in 1984 was limited compared what is available today, my nursing school could have placed a hospital bed in a room along with the basic equipment found in an inpatient hospital room and a mannequin. Additionally, rather than practicing simple skills such as turning and repositioning the patient, the faculty could have created scenarios for the students to address such as finding the patient on the floor and Code Blue situations.  Students who engage in simulation learning activities have increased clinical self-efficacy and decreased anxiety (Shahsavari et al., 2017).  Additionally, a direct correlation has been identified between simulation performance and clinical practice (Judd, Fethney, Alison, Waters, & Gordon, 2018).  Had I been prepared with the skills and critical thinking skills provided in simulation learning, I would have been a much safer and more accomplished graduate nurse. 

Summary

                Simulation learning has become an integral part of nursing education.  However, as with all teaching methods, simulation learning methods must continually be evaluated and modified to ensure the activities are appropriate, and learning objectives are met.  After all, not only does the nursing student benefit from simulation learning, but their future clinical settings and patients do so as well.   

References

Aebersold, M. (2016). The history of simulation and its impact on the future. AACN Advanced Critical Care, 27(1), 56-61. doi:10.4037/aacnacc2016436  

Cant, R. P., & Cooper, S. J. (2017). Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review. Nurse Education Today, 49, 63-71. doi:10.10 16/j.nedt.2016.11.015

Judd, B., Fethney, J., Alison, J., Waters, D., & Gordon, C. (2018). Performance in simulation is associated with clinical practice performance in physical therapist students. Journal of Physical Therapy Education, 32(1), 94-99. doi:10.1097/JTE.0000000000000024

Shahsavari, H., Ghiyasvandian, S., Houser, M. L., Zakerimoghadam, M., Kermanshahi, S. S., & Torabi, S. (2017). Effect of a clinical skills refresher course on the clinical performance, anxiety and self-efficacy of the final year undergraduate nursing students. Nurse Education in Practice, 27, 151-156. doi:10.1016/j.nepr.2017.08.006

Swanson, K., Schaeffer-Fraase, K., & Riggins, J. (2019). Peer teachers: Learning in the nursing skills lab. In Sigma’s 30th International Nursing Research Congress. Calgary, Canada: Author.

4 postsRe: Topic 3 DQ 1

A vulnerable population is a group of people who need special considerations in regard to their health and overall welfare (Falkner, 2018).Vulnerable populations are individuals who are not able to advocate for themselves due to physical, cognitive or mental disability, emotionally unstable people, children and incarcerated individuals.These populations usually have several social determinants of health(SDOH) that contribute to their vulnerability.These SDOH can include poverty, socioeconomic status, race and ethnicity, sexual orientation and no insurance or the underinsured.

 In the United States there are many vulnerable populations.One group that gets a significant amount of media coverage is the lesbian/gay/bisexual/transgender/questioning (LGBTQ) population.The inequality and hardship this group often encounters within the medical community and the higher instance of medical conditions such as Hepatitis B, HIV and AIDS is what makes this population considered vulnerable (Falkner, 2018).In the US, it is estimated that 10 million adults identify as LGBTQ (American Nurses Association [ANA], 2018).Many individuals within the population have reported prejudice from medical providers, leading to reluctance to seek care or delay in treatment due to the bias experienced.The stigma in society, discrimination and failure to recognize the unique civil and human rights deters individual self-determination and access to care which causes negative health outcomes and overall increase in morbidity and mortality (ANA, 2018).All nurses, not just CHN need to understand their own preconceptions and bias when caring for this vulnerable population.Ethically, nurses have a responsibility to provide safe, competent care to all individuals regardless of age, sex, sexual preference, race, ethnicity or socioeconomic status.

Respond

It is crucial that this decision, and the communications surrounding it, be handled in a well-planned and systematic fashion.  Just today, our manager walked into the office that five of us share and stated that a sixth person would be joining us.  I have learned that change is constant in our department, and people are shuffled all over as space permits; however, one of my office-mates angrily said, “he really could have told us before bringing in the sixth person and announcing that she would be joining us”.  It was a good example of how staff feel about poor communication.

Moreland and Apker (2016) note that nurses feel excluded when leaders inconsistently communicate policies and don’t invite feedback or input into decision-making.  Therefore, as the nurse administrator, I would prepare a plan to communicate the difficult decision to eliminate tuition reimbursement benefits.

First, I would explore the reasons why the decision was made.  Was it cost-prohibitive to maintain?  Did staff obtain tuition reimbursements, only to leave as soon as they received their BSN or MSN?  Did it engender annoyance from staff who already had their degrees and could not take advantage of the benefit?  I believe that transparency is best when communicating a change in policy.

Next, I would do my best to inform all direct reports at the same time, perhaps in a meeting.  There are few things worse in an organization than for the information to get “leaked” by a few people, and then turn into a rumor with untruths.

Before I tell the direct reports, I would have an email/text/snail mail document prepared, so that all staff could receive it before the rumor mill starts.  Having a written form of communication allows me to control the message and get all the pertinent points noted.  The document would end with an invitation for all staff to contact me if they have any questions or comments.  Being accessible to staff would, I hope, create some good feelings to offset the loss of tuition reimbursement.