PART A

In the following case, identify the ideals, or ideals and obligations, that are in conflict. Examine the action taken or proposed and decide whether it achieves the greater good (or lesser harm).

2. The issue of health care rationing was an important factor in the debate over the health care bill that President Obama signed into law in 2010.
Whether such rationing will occur remains to be seen.  If it does, though, it will undoubtedly have the greatest effect on the elderly — that is, some government administrator or health care panel may decide that certain expensive medical procedures will not be approved for people above a certain age.
Similar decisions could also be made about the level of care given in assisted living facilities and nursing homes.

PART B

Select ONE of the inquiries below to answer.

For the one you select to respond, identify the conflicting obligations and decide whether the action taken is morally right.  Be sure to consider the requirement of proportion.

13. A very competent druggist, well versed in the latest pharmacological studies, receives a prescription from a physician and recognizes that it is for a dangerous, highly addictive, and largely discredited medication.  She calls the physician and is told curtly to mind her own business.  As the customer waits in the front of the store, the druggist ponders the situation. “Should I refuse to fill it? Should I tell the customer I am certain the doctor has made a mistake?  Should I call the medical board and report the incident?”  She decides to fill the prescription.

OR

15. A doctor on duty in a hospital emergency room one Halloween night treats a 15-year-old boy whose eye was injured by an exploding firecracker.  He notices the boy is drunk.  Because the extent of the injury is not certain, he has the boy admitted to the hospital and notifies his parents.  When they arrive, the boy is under sedation, so his drunken condition escapes their detection.  Nevertheless, the doctor informs them that their son had been drinking.

OR

16. A psychiatrist is treating a very disturbed and potentially violent man. One day the man tells her that he has recurring thoughts of killing a stranger, whom he will choose at random.  He details exactly how he will carry out the crime.  A few days later the psychiatrist reads in the newspaper that the very same crime her patient described has been committed.  She has no doubt that her patient committed it; every detail is identical.  The psychiatrist would like to inform the police, but she decides not to.

You should have a total of TWO answers for this activity.  Submit your answers for Part A and Part B in a Word Document. 

In a reflection of 450-600 words, explain how you see yourself fitting into the following IOM Future of Nursing recommendations:

1. Recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80% by 2020.
2. Recommendation 5: Double the number of nurses with a doctorate by 2020.
3. Recommendation 6: Ensure that nurses engage in lifelong learning.

Identify your options in the job market based on your educational level.

1. How will increasing your level of education affect how you compete in the current job market?
2. How will increasing your level of education affect your role in the future of nursing?

While APA format 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.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Choose two issues or challenges that the leaders of today’s health care organizations face. Select from among the following topics:

1. Staff Shortage (Physicians, Nurses, Allied Health Providers, Ancillary Services)
2. Reorganization in Response to Merger or Consolidation of Services
3. Layoffs as a Result of Declining Revenues
4. Influx of Registry, Part-Time, and Temporary Contract Staff
5. Poor Performance Outcomes Leading to a Reduction in Medicare Reimbursement Dollars
6. Poor Job Satisfaction Rates Resulting in Turnover

You are the manager of an ancillary service department at a large, 500+ bed hospital. Develop a proposal (750-1,200 words) that is directed toward your staff, in which you address the following:

1. Inform the staff of the two issues (from the topics provided) your organization is facing.
2. Describe the impact of these issues on your department.
3. Describe how improved communication, collaboration, and teamwork can improve conditions in your department.
4. Identify at least two examples from the required or recommended readings of techniques found to foster inclusion and improve communication and collaboration.
5. A minimum of three academic references from credible sources are required for this assignment.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center. Only Word documents can be submitted to LopesWrite.

In approximately 500 words, reflect on the Doctor of Nursing Practice (DNP) degree.  Using at least 5 evidenced-based articles found through an academic library search that are no older than 5 years, describe (1) the history and purpose of the degree, (2) the current state of the DNP, (3) the future state of the DNP, (4) how DNP-prepared APNs will assist with transformative healthcare and help solve complex health problems, and (5) the advantages of having the DNP and reflect on your own thoughts on why (or why not) the degree would be appropriate for your career path. 

150-180 words APA format with references and in-text citations. 

Within the healthcare field we as nurses and future practitioners are faced daily with changes in our field. Whether it be current trends in healthcare, changes within our organizations or laws we embrace the changes to aid in the improvement of quality of care for the patients. Along with changes we are also faced with the many stressors that occur within our practice of work. Many stressors can occur such as issues with nurse patient ratios, healthcare breaches, and most importantly nursing shortages. The main stressor here I would like to focus on is nursing shortages with increased workloads. Retention is a key topic when addressing nursing shortage. According to Laureate Education, issues within healthcare will become more and more of a challenge for healthcare workers, therefore it is imperative to be able to adapt to the stressors (Laureate Education, 2015).

My organization is a non-profit healthcare facility. Located in Norfolk, VA we are a Level one trauma center as well as Magnet recognized organization. Working in such a facility in the heart of our community, we are faced with many challenging work shifts, difficulty workloads and most importantly a nursing shortage. I have seen in my organization units working understaffed, nursing managers and other members of leadership forced into staffing to take on patient assignments to not place the entire burden on bedside nurses. The assignments are heavier at times, the patients are a lot sicker and we seem to feel that we don’t have enough help in certain areas to properly treat our high acuity workloads. These types of issues place major stresses on staff members. Everyone becomes overwhelmed, displayed angers amongst staff, longer working hours, while feeling unappreciated at times.  Over the years the nursing shortage has been a huge issue with some of the factors being lack of properly trained educators, an abundance of turnover rates as well as challenging workloads (Haddad & Tony-Butler, 2019).

Addressing Issues  within Organizations

For such current issues within my organization, being in a leadership role I have seen the forefront of all that is being done to address our nursing shortage. For instance, we hold daily meetings that incorporate our staffing support services. This allows all members in our organization at the leadership level the insight on what extra staff help we have for the next few shifts. This allows everyone to critical think and plan ahead about areas where shortages may be occurring to plan for coverage of the gaps. Another area of tackling staffing issues within my organization has been incentive pay. Staffs are offered “call pay” which is extra pay for working extra shifts. Staff will be paid double pay for providing their time with covering staff shortages on certain units. This has allowed nurses to pick up extra hours to cover shortages decrease intense workloads, as well as offering a pay incentive. My organization has also extended contracts to travel nurses to work different assignments ranging 10-13 weeks. Having these nurses come in also works because those units critically short are offered help from a nurse assigned to them and only them for this period of time. Now although this is a temporary fix, we have had some of these nurses become our own staff nurses which increases our staffing.  With nursing shortages in our organization, it has been more common for staff to adjust and work with what they have. The Affordable Care Act (ACA) has made various ways to implement measures within healthcare to support the many struggles faced in this field, therefore allowing organizations to change delivery systems for improvement of patient care (Pittman & Scully-Russ, 2016). Although we still may seem to not see much change happening, many organizations such as my own are working hard to support their team members.

References

Haddad LM, Toney-Butler TJ. Nursing Shortage. [Updated 2019 Jan 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493175/

Laureate Education (Producer). (2015). Leading in Healthcare Organizations of the Future [Video file]. Baltimore, MD: Author.

Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human Resources for Health, 14, 1–15. https://doi-org.ezp.waldenulibrary.org/10.1186/s12960-016-0154-3