1. Search the internet and learn about the cases of nurses Julie Thao and Kimberly Hiatt.
2. List and discuss lessons that you and all healthcare professionals can learn from these two cases.
3.  Describe how the principle of beneficence and the virtue of benevolence  could be applied to these cases. Do you think the hospital  adminstrators handled the situations legally and ethically?
4. In addition to benevolence, which other virtues exhibited by their colleagues might have helped Thao and Hiatt?
5. Discuss personal virtues that might be helpful to second victims themselves to navigate the grieving process.

Scholarly article, APA format, and no grammar error

Respond  to  your  colleagues by recommending at least one additional way you  would treat a  child or adolescent client differently than you would an  adult and at  least one additional way you would address the legal and  ethical issues  involved.  

(NOTE: Positive Comment)

                                                        Main Discussion

Psychiatric  emergencies are severe behavioral changes that may  result from  worsening mental illness. Psychiatric emergency is any  disturbance in  thoughts, feelings, or actions that require immediate  therapeutic  intervention (Stahl, S. M., 2014). The providers approach,  attitudes and  work environment may escalate the situation and interfere  with the  quality of care. Certain therapeutic measures can reduce the  intensity  of the situation and provide a more dignified way for  patients to  recover from the crisis. It is thus important that the  PMHNP understand  how to assess patient’s emergency status and address  their unique needs  while maintaining safety.

  Case selected.

Patient  is a 25-year-old AA male who presents to the emergency  department with  psychotic behavior in believing he should kill his  mother which led to  his attempt to stab his mother. Patient is admitted  for inpatient  psychiatric stabilization. Patient has a history of  schizoaffective  disorder and major depression that was managed with use  of clozapine  150mg twice a day and Zoloft 100mg daily. Family reported  that patient  has a history of medication non-compliant and had been on  different  psychiatric medications in the past but were not working for  him.  Additional reports by his parents shows that patient had missed  several  doses of his medication, decompensated and they had notices  some changes   recently including increase agitation, delusional  believes that he is  the savior in the family and God had directed him  to cast the demon in  his mother. Reports also that he had drawn a  picture of himself with  knives cutting a woman he portrayed as a demon  with blood flowing with a  man standing to the side, laughing. Patient  currently stated that he  participates in a meeting with angels from  which he gets directives on  how to attack his mother which led to his  attempt to stab his mother.  Because of this, patient was considered  dangerous to his mother per  admitting physician. Patients symptoms  include psychosis, extreme  agitation, paranoia, verbal outburst,  combative and very difficult to  redirect. Patient has no known drug  allergies per parents.  Verbal  restraint was used including letting  patient know what will happen if  he does not comply, respecting his  autonomy, empathetic listening,  decrease environmental stimulation,  reassure patient that they will be  safe, and maintain a safe  environment. The patient was given emergency  medications including  haloperidol lactate 5mg, lorazepam 2mg, and  diphenhydramine 50mg all IM  for severe agitation and danger to others.  To prevent  re-hospitalization within 12-24 hours of discharge, the  physician  ordered outpatient therapy and continued use of clozapine and  Zoloft  along with necessary lab work.

 How I would treat the client differently if he or she were a child or adolescent

Children and adolescent are usually brought for treatment when  their  behavior or thoughts come to the attention of parents, teachers,   social workers, or school.  For pediatric patients in a mental health   crisis, the typical chaotic nature of the situation may easily further   exacerbate an already traumatized state of the patient. Just like in   adults, as a PMHNP I would perform an evaluation to determine the type   of emergency and contributing factors in child and adolescent emergency   by assessing not just the child but also the entire family.   Additionally, safety and protection are essential mandate in  psychiatric  emergency evaluation especially when the patient pose  imminent threat  to self or others. What I will do different when  interviewing children  especially younger children is to assess the  underlying cause of the  violent behavior and delusional symptoms within  a developmental context. Specifically,  I would clarify that “bizarre  thinking ” or accounts of seeing or  hearing things that others do not  see or hear are different from  developmentally appropriate fantasy or  difficulty while distinguishing  inner voices from distressing  hallucinations. On like in adults where  they can provide information  during the interview, when it comes to  younger children, I would need  to obtain information from parents or  guardian. For adolescents,  I  would obtain information from the patient first then talk to their   parent or guardian if the adolescent is able to tell most of their own   story. This may also help to give a sense of autonomy and control to  the  adolescent which promote cooperation with the interview process.    However, information from family is very crucial particularly for a   child who is psychotic, frightened, unable, or unwilling to corporate   with the provider to help understand how the situation occurred and the   severity of the behavior. 

Same  interviewing strategies used in adult may be used including  speaking in  a soft voice respecting patients’ autonomy, assuring  safety, validating  feelings, offering distractions (like video games)  especially with very  young children, and clear limit-setting can be  helpful. However,  children should be evaluated in a carefully planned  setting with doors  closed for limiting access, and be sure appropriate  backup is available  (Margret, C. P., & Hilt, R., 2018).  

In  violent situations children may require a different approach in   deescalating the situation than adults. Safety is the essential mandate   in an aggression evaluation, with the interviewer specifically looking   for imminent threats, plans, targeted people, and access to means of   harm (Margret, C. P., & Hilt, R., 2018). Because adults are much   stronger, they may require physical restrain specially to administer   medication to calm the patient. Verbal restrain such as providing  verbal  directions in a nonthreatening manner, setting limits, and  assuring the  child that treatment may help them calm may be used for  children first.  However, if the child is dangerously out of control and  aggressive,  they may need medication to keep them calm and safe.

Legal or ethical issues I would consider when working with a child or adolescent emergency case

The  ethical issue I will consider when working with children and  adolescent  is respect for their autonomy, privacy, and confidentiality.  For very  young children parents must consent to treatment and the  health care  provider treating the child should make every reasonable  effort to  obtain and document informed consent. (American Academy of  Pediatrics,  2015). Just like adults, maintaining a patient’s  confidentiality is an  important ethical consideration when providing  care to children and  adolescents. However, when  a PMHNP is concerned  that the patient may be at imminent risk for harm  to self or others,  confidentiality requirements no longer apply (Chun,  T. H., Katz, E. R.,  & Duffy, S. J., 2013). This means that the PMHNP  in this situation  may disclose information collected  from patient to  caregivers or  others as needed and may obtain information from others  such as  friends, family members, school personnel, employers and other  without  obtaining consent from the patient or guardians (Chun, T. H.,  Katz, E.  R., & Duffy, S. J., 2013. Patient  autonomy is a major principle in  making decisions about an individual’s  health, and as a PMHNP we are  obligated to respect this right and allow  patients to practice their  autonomy in the course of their treatment  (Parsapoor, A., Parsapoor, M.  B., Rezaei, N., & Asghari, F., 2014).  However, a psychiatric  emergency and age may limit a child’s ability to  make such decisions.  Regardless, it is always important to involve the  child in informed  decision making even if the consent is signed by the  parents or  guardian.

References

Chun, T. H., Katz, E. R., & Duffy, S. J. (2013). Pediatric mental health emergencies and special 

health care needs. Pediatric clinics of North America, 60(5), 1185–1201. Retrieved from,

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3792398/

Da Silva, A. G., Baldaçara, L., Cavalcante, D. A., Fasanella, N. A., & Palha, A. P. (2020). The 

Impact of Mental Illness Stigma on Psychiatric Emergencies. Frontiers in psychiatry, 11, 

573. https://doi.org/10.3389/fpsyt.2020.00573

Margret, C. P., & Hilt, R. (2018). Evaluation and Management of Psychiatric Emergencies in 

Children. Pediatric Annals, 47(8), e328–e333. https://doi-

org.ezp.waldenulibrary.org/10.3928/19382359-20180709-01

Parsapoor, A., Parsapoor, M. B., Rezaei, N., & Asghari, F. (2014). Autonomy of children and 

adolescents in consent to treatment: ethical, jurisprudential and legal considerations. 

Iranian journal of pediatrics, 24(3), 241–248. Retrieved from, 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276576/

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New 

York, NY: Cambridge University Press.

 Your essay and power point assignment will be done as followed : Osteochondroma (Knee)

You will write an essay on the pathology that I assign you. The essay will be done in APA style. The essay will be comprised of the etiology of the pathology, symptoms, and treatment. You will go into detail explaining everything about the Pathology. You will also explain the X-ray procedure that will be used to diagnose the pathology. You will explain how to perform the x-ray procedure for you specific pathology. I do not care how long your essay is as long as you explain and do all I asked for in the instructions.

 Your Power Point assignment will be a presentation of your essay but concentrated including pictures of the pathology and the pictures of the x-ray procedure step by step from the beginning of symptoms ,to diagnosis, and treatment. If you have any questions e-mail me. There will be no copy and paste I want the assignment done I n your own words, if I see any signs of plagiarism I will take off points.  

Write an answer based on this assignment. Use at least 2 references but not the same that appears here.

1. Describe a situation in which the nurse manager would use problem resolution in the workplace. Describe a situation in which the nurse manager would use negotiation to resolve a conflict (or potential conflict) in the workplace. 

An exchange can be an option in contrast to settling struggle in the working environment particularly when the attendants differ on the methods for accomplishing the particular objective of the association. During the exchange cycle, nurture director asks the attendants to utilize a clear correspondence to alter their differences to eventually show up at an agreement.(Florida nurse. (n.d). Florida Nurses Association). Each attendant is permitted to share their objectives, needs, and the needs and afterward the whole nursing office is permitted to adjust to the requirements and needs so as to arrive at the shared objective of the association. The book clarifies that difficult goal is a cycle that inpatient care ought to be comfortable with. This critical thinking approach can be utilized at whatever point staff issues, for example, expanded outstanding task at hand, happen. The medical caretaker supervisor would utilize issue goal to initially distinguish the issue, create potential arrangements, actualize the picked arrangement lastly assess whether the issue has been understood.

2. Compare and contrast strategies for resolving a conflict, using first the informal negotiation method and then the formal negotiation method. 

Assertion includes the cycle whereby the contested gatherings present their contradictions to one referee. It is more affordable and more available than a preliminary. It includes the utilization of the formal and semiformal system and bits of proof. Then again, intercession is the place the third who is viewed as nonpartisan go between encourages the discourse cycle. Intervention is intentionally and non-restricting cycle instead of mediation which is automatic. This is a cycle that requires a lot of reasoning however it can lead the gatherings required to determine their contention by the methods for bargaining or consenting to the terms while additionally staying away from questions, differences and contending. Casual exchange technique is utilized when a difference has gotten too enormous, complex, and warmed for the difficult goal to be fruitful

3. Explore the American Nurses Association website for information on collective bargaining for nurses. Which states have nursing unions? Debate the issue of joining a union with another group of students. 

The states with nursing associations incorporate Minnesota, Massachusetts, Nevada, Texas, Maine, California, Michigan, Pennsylvania, Illinois, Kentucky, and Columbia locale. As an attendant, I trust it is important to join a nursing association on the grounds that there are numerous advantages to its individuals, associations allude to units that ensure and shield the privileges of the patrons. Along these lines, joining nursing associations one would get the chance to appreciate rights and opportunities, for example, better wages, aggregate dealing, better advantages, and individual portrayal with workers. Subsequently, it is essential to join a nursing association since it gives a dependable voice to individuals.

4. PART 1: Log onto the website of your state nurses association and search for information on collective bargaining. Search for news articles, union websites, and other recent information on collective bargaining for nurses in your state. Is there a great deal of collective bargaining activity in your state? If not, why? If yes, what are the primary issues under discussion?

The Florida Nurses Association is an affiliation that speaks to all enlisted medical caretakers for aggregate bartering. A cycle exists that realizes the appointment of authorities and the arrangement of agreements. Florida State has not experienced a lot of aggregate haggling movement since the state has a law that involves all workers reserve no option to strike, accordingly guaranteeing request and interference of government exercises. Florida is an option to work state; thusly, the privilege of a person to work can’t be denied dependent on participation or non-enrollment in any worker’s guild or association(Tappen, R. M. (2009). To guarantee the precise and continuous activities and elements of government, Florida’s state workers don’t reserve the privilege to strike. At present, there are seven work associations speaking to State Personnel System representatives whose classes are relegated to one of 13 aggregate haggling units.

PART 2: Review the pros and cons of becoming part of a collective bargaining unit. If you were a full-time staff nurse, would you want to join a union? Why or why not? 

I would join the union, I am in support of safeguarding the interests of people. Nursing isn’t a simple activity and it ought to be paid and celebrated all things considered. A master of joining an association would be the capacity to battle for what is correct, for example, compensation builds, extra advantages, downtime and advancement and continuation of expert practices. A con of joining an aggregate bartering is that it can make division from medical caretakers that don’t wish to join, for example, nurture directors or other staff individuals(Klug, M. (2018). This can make negative sentiments and can even advance a negative climate for all. It is important for the nursing professionals to consider the advantages and disadvantages resulting from unions, it opens doors for nurses to recognize whether the correct choice to make is to join or form a union.

References:

Florida nurse. (n.d). Florida Nurses Association. Retrieved from; https://www.floridanurse.org/page/LERC

America’s Unions. (n.d.). Collective Bargaining. Retrieved from: https://aflcio.org/what-unions-do/empower-workers/collective-bargaining 

Whitehead, D. K., Weiss, S. A., & Tappen, R. M. (2009). Essentials of nursing leadership and management. F A Davis Company.

Clay-Williams, R., Johnson, A., Lane, P., Li, Z., Camilleri, L., Winata, T., & Klug, M. (2018). Collaboration in a competitive healthcare system: negotiation 101 for clinicians. Journal of health organization and management.

SOAP Note Case , I uploaded an example, you can create your own case, with a person older than 21 years. Including patient name initials , date of birth and all the examples of personal and medical history provided in the example. I need all the information wrote  in the example, No require references, PLEASE everything must be related because is the same case.