Compliance requirements can lead to significant losses in health care when fines or penalties are levied. Describe the challenges internal political environments and external political regulations have on human resource groups and their ability to ensure a health care organization can focus on patient-centered care. Provide supporting references for your response. PLEASE INCLUDE IN-TEXT CITATION AND REFERENCE

Mrs. Smith was a 73-year-old widow who lived alone with no significant social support. She had been suffering from emphysema for several years and had had frequent hospitalizations for respiratory problems. On the last hospital admission, her pneumonia quickly progressed to organ failure. Death appeared to be imminent, and she went in and out of consciousness, alone in her hospital room. The medical-surgical nursing staff and the nurse manager focused on making Mrs. Smith’s end-of-life period as comfortable as possible. Upon consultation with the vice president for nursing, the nurse manager and the unit staff nurses decided against moving Mrs. Smith to the palliative care unit, although considered more economical, because of the need to protect and nurture her because she was already experiencing signs and symptoms of the dying process. Nurses were prompted by an article they read on human caring as the “language of nursing practice” (Turkel, Ray, & Kornblatt, 2012) in their weekly caring practice meetings.

The nurse manager reorganized patient assignments. She felt that the newly assigned clinical nurse leader who was working between both the medical and surgical units could provide direct nurse caring and coordination at the point of care (Sherman, 2012). Over the next few hours, the clinical nurse leader and a staff member who had volunteered her assistance provided personal care for Mrs. Smith. The clinical nurse leader asked the nurse manager whether there was a possibility that Mrs. Smith had any close friends who could “be there” for her in her final moments. One friend was discovered and came to say goodbye to Mrs. Smith. With help from her team, the clinical nurse leader turned, bathed, and suctioned Mrs. Smith. She spoke quietly, prayed, and sang hymns softly in Mrs. Smith’s room, creating a peaceful environment that expressed compassion and a deep sense of caring for her. The nurse manager and nursing unit staff were calmed and their “hearts awakened” by the personal caring that the clinical nurse leader and the volunteer nurse provided. Mrs. Smith died with caring persons at her bedside, and all members of the unit staff felt comforted that she had not died alone.

Davidson, Ray, and Turkel (2011) note that caring is complex, and caring science includes the art of practice, “an aesthetic which illuminates the beauty of the dynamic nurse-patient relationship, that makes possible authentic spiritual-ethical choices for transformation—healing, health, well-being, and a peaceful death” (p. xxiv). As the clinical nurse leader and the nursing staff in this situation engaged in caring practice that focused on the well-being of the patient, they simultaneously created a caring-healing environment that contributed to the well-being of the whole—the emotional atmosphere of the unit, the ability of the clinical nurse leader and staff nurses to practice caringly and competently, and the quality of care the staff were able to provide to other patients. The bureaucratic nature of the hospital included leadership and management systems that conferred power, authority, and control to the nurse manager, the clinical nurse leader, and the nursing staff in partnership with the vice president for nursing. The actions of the nursing administration, clinical nurse leader, and staff reflected values and beliefs, attitudes, and behaviors about the nursing care they would provide, how they would use technology, and how they would deal with human relationships. The ethical and spiritual choice making of the whole staff and the way they communicated their values both reflected and created a caring community in the workplace culture of the hospital unit.

Critical thinking activities

Based on this case study, consider the following questions.

1. What caring behaviors prompted the nurse manager to assign the clinical nurse leader to engage in direct caring for Mrs. Smith? Describe the clinical nurse leader role established by the American Association of Colleges of Nursing in 2004.
2. What issues (ethical, spiritual, legal, social-cultural, economic, and physical) from the structure of the theory of bureaucratic caring influenced this situation? Discuss end-of-life issues in relation to the theory.
3. How did the nurse manager balance these issues? What considerations went into her decision making? Discuss the role and the value of the clinical nurse leader on nursing units. What is the difference between the nurse manager and the clinical nurse leader in terms of caring practice in complex hospital care settings? How does a clinical nurse leader fit into the theory of bureaucratic caring for implementation of a caring practice?
4. What interrelationships are evident between persons in this environment—that is, how were the vice president for nursing, nurse manager, clinical nurse leader, staff, and patient connected in this situation? Compare and contrast the traditional nursing process with Turkel, Ray, and Kornblatt’s (2012) language of caring practice within the theory of bureaucratic caring 

N492 Assignment Mod 2:

Assignment:

Identify an older adult age 65 +, use a 1st and last initial. Execute a therapeutic assessment interview with them for at least two interview sessions assessing their self-identified:

• Demographics,      life time education and career/employment
• Two      most significant (positive) times in their lives
• What      past hardship or loss has the client successfully negotiated in the past?
• Two      personal strengths
• Engage      them in identifying what is healthy versus non-healthy coping skills
  • Inquire       of 2 healthy coping skills they have used in the past and/or now
• Three      (3) pieces of advice they would give to their younger self if they could?
• Support      the client in taking the Geriatric Depression Scale.pdf
• Support      the client in taking the Fulmer SPICES Assessment.pdf
• Perform      a Mini Mental State Exam.pdf and Patient_Stress_Questionnaire.pdf (attach here)
• Perform      a Hall, Hall, and Chapman Article.pdf
• Report      the findings from the Geriatric Depression Scale, Fulmer Spices, Patient      stress questionnaire and the mini mental status exam
• Discuss      your older adult’s level of ego integrity vs. despair as described by      psychoanalyst Erik Erikson. If you had to rate them on a scale of 1-10,      with 1 representing a full state of despair and 10 representing full ego      integrity, what rating would you give your older adult?
• Describe      at least two nursing diagnoses for this client.  
• Create      a plan of care for the client to include at least three nursing goals with      two nursing interventions each.

The assignment should be written in an APA-formatted essay. The essay should be at least 1500 words in length and include at least two scholarly sources other than provided materials.

Record the time you spend interviewing the client and writing the assessment report as practice experience hours in Project Concert as ‘Older Adult Interview’ for Module 2. (Discussion Board work does not apply). It is expected to take you between 2-4 hours. Access Project Concert. Minimum required hours must be entered into Project Concert for Module 2. Some states/entities require hour logs for certification or employment. It is the student’s professional responsibility to ensure all hours are entered correctly in order to meet these requirements. Please see the Project Concert directions document in the Learning Materials on how to enter hours.

Topic: Negligence and Medical Malpractice

Reply prompt: Respond to threads posted by your classmates who reached a different conclusion than you did. Identify the points of difference in your analyses and explain how your sources and analysis led you to your conclusion.

The reply assignment asks you to respond to classmates who reached a different conclusion than you did. As often happens on this case, most of the initial threads agree on an overall finding of liability. If you look more closely, however, you will see differences among your threads.

Issues to examine as you write your replies:

• Look for differences in your analyses, how you reached your conclusions, etc.
• Where does liability lie? (just the doctor, just the hospital, other caregivers, some combination, etc.) Each entity that you are holding liable must meet all four of the elements.
• Is the hospital only vicariously liable through respondeat superior for employee negligence, or is it also directly liable for its own actions?
• If the hospital is liable through respondeat superior for the negligence of its employees, should it seek indemnification (reimbursement) from those employees for money it has to pay the Smiths for the employees’ negligence?
• How far does liability extend?
• liability for the initial staph infection is somewhat straight-forward, but was the autoimmune impact a reasonably foreseeable outcome from a breach (failure to change gloves, etc.)
• i.e., is there proximate/legal cause as well as factual cause for all of the injuries?

You might also consider options for the various parties at this point, including ADR, Biblical dispute resolution models, etc. 450 words . atleast 3 peer reviewed sources in APA format

Leadership Theories in Practice

A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.

However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations.

Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization.

To Prepare:

• Review the Resources and examine the leadership theories and behaviors introduced.
• Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
• Reflect on the leadership behaviors presented in the three resources that you selected for review.

By Day 3 of Week 4

Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.