1. you are educating your peers through this presentation regarding a federal bill you believe may be of interest to nurses.
2. Go to https://www.govtrack.us/congress/bills/subjects/health/6130 (Links to an external site.)
3. Choose a health-related federal bill of interest. Read through the bill and develop a summary in your own words. Include the bill number and name.
4. Here is a link to our U.S. legislative process (bill to law) for review, if needed: https://www.congress.gov/legislative-process

• Bill name and number (indicate either H.B. or S.B.)
• Bill summary (in your own words)
• Address how this bill might impact professional nursing practice standards if passed? If not passed?
• How might the bill impact your own nursing practice?
• How might you communicate your concerns about or support for this bill based on nursing practice, standards, or patient outcomes?
• How might this bill impact your community?
• References slide to include the Bill source in APA format.
• No more than 12 slides

Work #1:

Actual work where 2 students given their post on this:

Propose and defend a topic for your final project.  Write  500 words or more explaining why this topic is important for your peers to understand. Be focused and specific. Look into the general topic provided in the list in this folder to find something new and interesting to write about. You should do a deep dive into a topic. Do not do a survey. Use the Research Databases available from the Danforth Library not Google. 

You MUST make a statement saying exactly what your topic is. 

Use at least five sources. Include at least 3 quotes from your sources enclosed in quotation marks and cited in-line by reference to your reference list.  Example: “words you copied” (citation) These quotes should be one full sentence not altered or paraphrased. Cite your sources.

Copying without attribution or the use of spinbot or other word substitution software will result in a grade of 0. 

Write in essay format not in bulleted, numbered or other list format. 

Respond helpfully to two classmates’ posting in a paragraph of at least five sentences by asking questions, reflecting on your own experience, challenging assumptions, pointing out something new you learned, offering suggestions. Write to help them focus and say something that you think would help them say something that would be valuable.    

It is important that you use your own words, that you cite your sources, that you comply with the instructions regarding length of your post and that you reply to two classmates in a substantive way (not ‘nice post’ or the like).  Your goal is to help your colleagues write better. Do not use spinbot or other word replacement software. It usually results in nonsense and is not a good way to learn anything.

Work #2:

Actual work where 2 students given their post on this:

Discuss  500 words or more discuss why Security as a Service is a good investment.

Use at least three sources.  Use the Research Databases available from the Danforth Library not Google. Include at least 3 quotes from your sources enclosed in quotation marks and cited in-line by reference to your reference list.  Example: “words you copied” (citation) These quotes should be one full sentence not altered or paraphrased. Cite your sources using APA format. Use the quotes in your paragaphs.  Stand alone quotes will not count toward the 3 required quotes.

Copying without attribution or the use of spinbot or other word substitution software will result in a grade of 0. 

Write in essay format not in bulleted, numbered or other list format. 

Reply to two classmates’ posting in a paragraph of at least five sentences by asking questions, reflecting on your own experience, challenging assumptions, pointing out something new you learned, offering suggestions. These peer responses are not ‘attaboys’. 

It is important that you use your own words, that you cite your sources, that you comply with the instructions regarding length of your post and that you reply to two classmates in a substantive way (not ‘nice post’ or the like).  Your goal is to help your colleagues write better. Do not use spinbot or other word replacement software. It usually results in nonsense and is not a good way to learn anything. I will not spend a lot of my time trying to decipher nonsense. Proof read your work or have it edited. Find something interesting and/or relevant to your work to write about.  

Work #3:

Actual work where 2 students given their post on this:

1) Describe the purpose of the balance sheet and how this information is useful to the stakeholders of the corporation.  

2) Please describe the information presented on the statement of cash flows.  Why is this information important for the stakeholders of a corporation? 

Please find the three attachments. 

 I NEED A RESPONSE FOR THIS ASSIGNMENT

2 REFERENCES

Group Therapy with Older Adults

Psychotherapy, according to Wheeler (2014), can be used to treat varying psychological disorders throughout the lifespan of an individual. In general, psychotherapy must be adapted to address and fit the specific needs of the age groups. Researches have indicated in older group therapy that one can socialize with peers who share similar symptoms. It also creates an opportunity to increase one’s altruism and empathy and feel useful by helping others (Tavares & Barbosa, 2018). However, the elderly often may have neurological deficits and comorbidities that may affect their ability to fully participate and benefit from psychotherapy (Wheeler, 2014). Studies indicated that some of these older adults live in isolation and have lost their relationships, occupation, and capacity. Group therapy allows them to connect to people and be useful while receiving help (Wheeler, 2014). The discussion will include a description of a group therapy session with older adults, the group’s stage, any issues or resistances present, therapeutic modalities utilized, and challenges resulting from working with the group.

Group Description

This group includes ten members whose ages range from 64 to 80, including females and males, each with different diagnoses such as depression, sleep disorders, anxiety disorders, personality disorders, alcohol, drug use disorders, and neurocognitive disorders. Some of the patients were hyperactive, while some were depressed. Currently, the group comprises patients in different stages, such as forming, storming, norming, performing, and adjourning. The orientation stage still ongoing as new members joins the group while some are in their terminal adjourning phase. This group did not follow the predictable pattern of the average group staging. However, the patients introduce their names, ages, professions, and family backgrounds. The group went back and forth, elaborating on more background aspects of individual lives. Individuals were encouraged to share as much as they feel comfortable sharing. The group ran for 60 minutes, from 1030 to 1130 in the morning. It is modified to bring the best out of the patients. The therapy session time was divided and organized to allow note-taking, summarization, memory aids, and mnemonics devices to help in their recovery (Tavares & Barbosa, 2018).

Resistance or Issues Present

The cohesiveness of the group met a few resistances. One group member, a 70-years-old male, did comment on the newness of therapy. His comment was: “back in the day; people did not meet with each other to talk about everyday life hurdles; we dealt with it, that is what is expected of us as men.” I had a 65-year-old female who said she is not crazy and should not be in the group; this was her second day. She laughs, smiles, and shakes her head when others are speaking. She moved her chair further away from how the chairs were spaced-out due to the coronavirus pandemic. 

The compilation of both hyperactive and depressed patients made it often difficult for every patient to participate and achieve their expected goal at the same time. Some patients were hyperactive, intrusive, and monopolizing. They tried to control everything and respond to every question asked, which sometimes increased anxiety and tension to other group patients. While depressed and quiet, patients feel irritated, intimidating, and sad. 

Therapeutic Techniques

Cognitive-behavioral therapy (CBT) is a practical approach for a wide range of problems affecting older adults (Secker et al., 2020). As a therapeutic approach in group therapy sessions, CBT has proven to be beneficial to the elderly. It helps them build an interpersonal relationship with others, improve socializing skills, improve the symptoms of depression, and help manage stressful life events (Tavares & Barbosa, 2018). CBT aims to have the patients and the counselor in agreement on markers of progress in therapy. Domhardt and Baumeister (2018) stated that the CBT coping strategy helps the patient identify negative thoughts and replace more functional views. CBT equips the patients with internal resources and enhances their coping skills (Wheeler, 2014). In this manner, the individual’s symptoms reduce, and behaviors change as they learn to control their feelings.

Challenges

I encountered different challenges in conducting therapy with the age group. There was an issue with the seat arrangement; because of COVID-19, the patients were spaced six fits apart to maintain social distance. With some of the patients being intrusive and exhibiting poor boundary behavior, it became difficult to keep the space. Some patients had physical declines that affected therapy, some with cognitive impairment, hearing impairment, and decreased eyesight. Thus, requiring the facilitator to speak more slowly, louder and to explain more clearly. To accommodate those with low vision, I had to provide large print worksheets for the patients. Some patients remained in the forming and storming stages for a prolonged period due to their cognitive state. The group dynamic also affected this group outcome due to new admissions and discharges, which hinder the group’s progress.

No matter what population of people being counseled, it is necessary to recognize the challenges they face and change practices accordingly. CBT is feasible and highly effective in geriatric patients. Early diagnosis, good access to psychotherapy, and early intervention could improve care for older patients.

References

Domhardt, M., & Baumeister, H. (2018). Psychotherapy of adjustment disorders: current state and future directions. The World Journal of Biological Psychiatry, 19(sup1), S21-S35.

Hummel, J., Weisbrod, C., Boesch, L., Himpler, K., Hauer, K., Hautzinger, M., … & Dutzi, I. (2017). AIDE–acute illness and depression in elderly patients. Cognitive-behavioral group psychotherapy in geriatric patients with comorbid depression: A randomized, controlled trial. Journal of the American Medical Directors Association, 18(4), 341-349.

Secker, D. L., Kazantzis, N., & Pachana, N. A. (2020). Cognitive behavior therapy for older adults: Practical guidelines for adapting therapy structure. Journal of rational-emotive and cognitive-behavior therapy, 22(2), 93-109.

Tavares, L. R., & Barbosa, M. R. (2018). Efficacy of group psychotherapy for geriatric depression: A systematic review. Archives of gerontology and geriatrics, 78, 71-80.

Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

• Within your community, there has been a large increase in teenage smoking, and community leaders are developing a plan to decrease the incidence of smoking. To help them, you will:

A) Develop a research question to address the problem.
B) Determine what kind of study should be undertaken.
C) Design a study to decrease the incidence of smoking in teenagers.

2 

You are working in an ICU where a 16-year-old girl is in critical condition after an auto accident. Her mother comes in and begins to sing, sprinkle tobacco around the bed, hang eagle feathers and crystals around the room, and move her hands back and forth above the girl’s body. The girl’s nurse tells the mother that visiting time is over and that she should take all these dirty things out of the room. The mother insists on staying by the bedside and says that if she had placed rosary beads or Bibles in the room she would not have been questioned.

What cultural and spiritual issues are evident in this situation?

Cultural care is a type that involves the delivery of care in a non-conventional where care should be delivered in a way to accommodate the patient’s preference. The way that transcends cultural boundaries and considers a client’s culture as it affects health, illness and lifestyle, communication, dietary preferences, and dress are influenced. In this case, hang eagle feathers and crystals around the room can be accommodated if it will not interfere with scientific care.

Apply cultural competence to this case

Cultural competence is the ability of nurses to understand and address the entire cultural context of each client within the realm of the care they deliver. The nurse should be able to allow cultural exceptions for the patient and her mother. The patient’s mother’s faith was tied to the artifacts that she brought and will help the girl get better the moment she sees those things.

Discuss complementary therapies evident in this situation

In this situation, the mother is applying holistic/cultural care to the conventional scientific care the nurse is providing. This accommodation is will enhance nurse-patient interaction and relationships.

How would you incorporate spiritual care?

Nurses can provide spiritual care by attending to several important spiritual elements. This includes supporting the patient’s spiritual beliefs and needs and individualizing spiritual care to the patient. I would start by taking cues from the patient including but not limited to asking for the patient’s preferences. Also, supporting the patient within the limits of their faith and share encouraging thoughts or words.

How would you approach this situation?

I will approach this situation with caution and respect. I will create accommodations with the hospital policy in mind. By attending to the patient’s several important spiritual elements. The patient’s family acknowledges the higher powers and believes in the intervention of higher power. I will not stand in the way.

What principles would guide you?

I will base my guide on the ethical principles of patient-centeredness, holism, discretion, accompaniment, and tolerance. These are the core principles that guide spiritual care.

References

Hodge, D. R., & Limb, G. E. (2011). Spiritual assessment and Native Americans: establishing the social validity of a complementary set of assessment tools. Social Work, 56(3), 213–223.https://doi-org.resu.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=21848086&site=ehost-live

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