one paragraph with intext citation and reference follow up discussion for the above discussion. Further the dialogue by providing more information and clarification. Provide feedback on whether you agree or disagree with their criticism. Explain why. Build on their posts by providing additional insight of your own   

1. Summarize the concepts of floating that were addressed in the attached articles.

• This week’s provided articles discussed the entirety of nurses floating and the concerns, benefits, cost, stress, emotions regarding floating. To summarize, many nurses may feel overwhelmed or frustrated when being told to float to a unit other than their home unit. Most importantly, the plan of action regarding a floating nurse must be safe for all parties involved: the patient, all staff, the floating nurse. One article mentioned a nurse’s current procedure where floating nurses are only assigned “stable, easy patients” with full access to the charge nurse if needed (Magrath, 2016). This is a great tool that most units should follow to promote overall safety and ease of transitioning for all staff and the floating nurse.

2. What steps would you take in this scenario to ensure a safe transition into the unfamiliar unit?

• Safe transitions for floating nurses involve open communication between charge nurse of the unit and the floating nurse as well as involvement of other nurses working alongside the floating nurse. What must occur is appropriate planning from the charge nurse and the floating nurse by discussing the types of patients the nurse is certified and qualified to take care of. In this example, if the nurse is not certified to administer chemotherapy drugs or a patient undergoing radiating, then this nurse cannot care for a patient who is undergoing chemotherapy or radiation treatment.
• Other staff members will need to share the weight of the workload by caring for patients who the floater nurse is unable to care for. Should these discussions and planning take place and there ends up being an incident where the floating nurse has orders for a task that is inappropriate, the floating nurse must NOT complete the order and instead notify the charge nurse for reassignment.

3. Why are these steps important?

• These steps are important for the safety and protection of both the nurse’s license and of the patient.
• Secondly, the concept of planning is really important for clinical managers, charge nurses and staff nurses to master. This week’s discussion mentioned different types of planning involved in healthcare.

4. What are some of the legal ramifications that can occur if you accept an assigned that is out of your scope of practice?

• Medical malpractice can result from a nurse operating outside his or her scope of practice (Legal Rights and Responsibilities: NCLEX-RN2020). Patients can be injured, disabled, or die from improper care from an uncertified nurse if they operate outside of their scope. Those involved (i.e. charge nurse) could also be subpoenaed to court and may face legal ramifications as well if they had any involvement or awareness of a situation resulting in patient injury as well.

-LaurenReferences

Writers, R. N. S. (2020, August 23). Legal Rights and Responsibilities: NCLEX-RN. https://www.registerednursing.org/nclex/legal-rights-responsibilities/ (Links to an external site.).

Magrath, P. (2016, August 30). Nurses Are Talking About: Floating and Rapid Response Duty. http://blog.diversitynursing.com/blog/nurses-are-talking-about-floating-and-rapid-response-duty.

In this writing assignment, you will describe the current 21st century role of U.S. hospitals.

Step 1: Write a two to three page paper describing the current role of hospitals in the United States. In your paper, respond to the following questions.

• Briefly describe the history of hospitals in the United States.
• Briefly discuss the major changes hospitals have experienced over the past 20 years.
• Discuss how these changes have affected the delivery of health care in the United States.

Step 2: Save and submit your assignment.
When you have completed your assignment, save a copy for yourself in an easily accessible place and submit a copy to your instructor.

Cite any sources in APA format.

Locate a nursing article from a peer-reviewed journal which addresses an area of interest or concern you have.  

The article criteria are as follows:

-Must be from a peer-reviewed NURSING  journal

-Must be published within the last five years (2015 to present)

-You may access the article within one of the FAU online databases, or Google Scholar.

-You will utilize this article as the basis of your APA Scholarly Paper.

-Upload a copy of your article to the Discussion Board titled Library Assignment Articles! Provide an explanation in the discussion as to your rationale for selecting this article.  You must reply to at least two peers regarding their respective articles.

Submit the scholarly paper to the assignment drop box.

1. This paper is to be a reflection on a scholarly article that you found from a peer-reviewed nursing journal. (For guidelines regarding appropriate journals, please refer to the Library and APA resources posted in Unit 1).

The paper needs to meet the following criteria:

1. Addresses an area of nursing in which you have an interest (pediatric, community, nurse anesthesiology, etc.)
2. Review the article and determine if a holistic nursing theory grounded in caring science is evident, and if so, how it guides nursing practice.  Answer the following questions:
   1. Does the author identify nursing interventions that are guided by the theory?
   2. Are the nursing interventions holistic and caring?
   3. Why or why not?
   4. If there is no theory identified, you need to recommend a holistic theory grounded in caring science. Include your rationale for choosing this caring science theory.
   5. Identify two nursing interventions based on that theory (if the author has named nursing interventions), are these holistic and caring and could emerge from the theory you have identified?
   6. If the author has not identified nursing interventions or if those interventions presented in the article do not illustrate holism and caring, then you should recommend two nursing interventions). 
3. Applies Sister Roach’s 6 C’s, Mayeroff’s Caring Ingredients, and/or one theory of caring science to the article review (Examples include Boykin & Schoenhofer’s Nursing as Caring, etc.) OR the student may identify and apply a caring theory that could be applied to the paper with prior approval from the professor. All concepts within your selected theory must be utilized.  EACH concept from your selected theory must be applied.
4. Provides an article that has been written within the past five years
5. Adheres to APA 7th edition format throughout. Headers are to be utilized to organize your thoughts and provide guidance to the reader.
6. Please NOTE: APA/Scholarly papers do NOT support the use of first or second person.  For this assignment, you may use first person only in the first paragraph.  I highly suggest that you do not do this! My suggestion is to remain in the third tense (this author, this writer, an individual, one, a nurse, et cetera) throughout your paper.
7. Please remember to utilize citations throughout.  Also note that articles and studies do not produce themselves; therefore, there should be no references to an article or study in your paper-only the authors.

Rubric

APA Scholarly PaperAPA Scholarly PaperCriteriaRatingsPtsThis criterion is linked to a Learning OutcomeIntroductionExplain the rationale for choosing this article; what is your interest in the topic? TIP: Remember that APA does not use a header for the introduction; this is your first paragraph after the title of the paper. Suggested length; 1-2 paragraphs. (Use of first person “I” statement is acceptable for this section only      20 pts
This criterion is linked to a Learning OutcomeComprehensionSummarize the main ideas of the article with understanding, accuracy, and clarity. Mandatory maximum length; 1 page only. 20 pts
This criterion is linked to a Learning OutcomeApplication and SynthesisReview the article and determine if a holistic nursing theory grounded in caring science is evident, and if so, how it guides nursing practice. Does the author identify nursing interventions that are guided by the theory? Are the nursing interventions holistic and caring? Why or why not? If there is no theory identified, you need to recommend a holistic theory grounded in caring science. Include your rationale for choosing this caring science theory. Identify two nursing interventions based on that theory (if the author has named nursing interventions), are these holistic and caring and could emerge from the theory you have identified? If the author has not identified nursing interventions or if those interventions presented in the article do not illustrate holism and caring, then you should recommend two nursing interventions). Suggested length; 3-4 pages.    30 pts
This criterion is linked to a Learning Outcome  APA formatting This includes spelling, grammar, and punctuation. The paper should be a minimum of four pages with proper references, including citations in the body of the text with appropriately cited examples from article utilizing APA format to illustrate understanding of topic. Do not use more than one direct quote. Instead: Learn to paraphrase, then cite the author .20 pts
This criterion is linked to a Learning Outcome Scholarly Articlel Appropriate scholarly article from peer-reviewed journal, written within last 5 years.   10 pts
 

Week 4: Discussion on End-of-Life Decisions and Advanced Directives

Participation Requirement: You are required to post a minimum of three (3) times in each discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. on Wednesday.  On additional days, respond to your peers’ posts as well as additional faculty posts. Responses to peers must be posted by 11:59 p.m. on Sunday each week a discussion is due.

Step 1: Read attached article entitled, Advance Directives and Health Care Planning-Are all the pieces in place.pdf 

Step 2: Read the following article: Effect of Living wills on End of Life Care.pdf

Step 3: Watch the video, “Advanced Directives: Important Healthcare Tools for Supporting You and Your Family”https://www.youtube.com/watch?v=GOIrnjqP5_M (Links to an external site.)

Step 4: Watch the video, “How to Have an End of Life Discussion”https://www.youtube.com/watch?v=JtkgTzCSzqk (Links to an external site.)

An Advanced Directive is a document in which a client who is competent is able to express wishes regarding future acceptable health care. The document may include decisions including the desire for extraordinary lifesaving measures, such as resuscitation, intubation, and artificial hydration, and nutrition. The advanced directive may also be used to designate another person to make decisions when the client becomes physically or mentally unable to do so. The Patient-Determination Act requires all clients admitted to a health care facility be asked if they have advanced directives.

Planning guides for seriously ill clients includes:

1. Living will: Legal document that instructs health care providers and family members about what, if any, life-sustaining treatment an individual wants if at some time the individual is unable to make decisions.
2. Durable power of attorney for health care: Legal document that designates another person to make health care decisions for the client when the client becomes unable to make decisions independently.

Nursing intervention in these types of situations is to ensure to communicate to the interdisciplinary health care team that the client has provided and advanced directive and that it has been placed in the client’s medical record. Clients who do not have advanced directives must be given written information outlining rights related to health care decisions.

Initial Discussion scenario:

Mr. Gomez is a 73-year-old man who is estranged from his wife. Since he prefers that she doesn’t make any medical decisions for him should the need arise, he has filled out an advance directive naming his daughter Elena as his health care proxy. He has suffered from diabetes for many years and is adamant that he does not want dialysis, even if it would sustain his life. He does, however, wish to have tube feeding for however long it will sustain him.

One evening while at home with his daughter, Mr. Suarez has a seizure. He is taken to the hospital immediately, but never regains consciousness and doctors do not expect him to do so. Elena contacts her mother Mr. Gomez’s estranged wife and she quickly joins her daughter at the hospital. They want to put him on dialysis (as his diabetes is worsening) and a feeding tube (as there is no other way for him to receive nutrients). His daughter informs the doctors of her father’s end-of-life wishes. The doctors warn her that without dialysis her father will pass away more quickly, even with the feeding tube. Mr. Gomez’s estranged wife informs Elena that she needs to follow the advice received from the doctors in order to save her father’s life. Elena says that although she is aware of the consequences, she wants them to carry out her father’s wishes.

The clients estranged wife immediately has her attorney file an order to stop Elena from following her father’s wishes that are in his advanced directive. She feels that even though they are estranged, she still should have the right to make decisions regarding Mr. Gomez’s care. This action delays Elena’s ability to honor her father’s wishes and the doctors feel that it is necessary to inform the hospital’s ethics committee about the ongoing issue.

Assignment: Discuss the following questions

1. What is the role of the doctors in deciding whether or not to respect Mr. Gomez’s advanced directive?
2. Does Mr. Gomez’s estranged wife have the authority to step in and ignore Mr. Gomez’s advanced directive. Explain your reasoning while providing evidence-based solutions in your conclusion.
3. Gomez’s estranged wife has filed temporary order to ignore the advanced directive. If you were Elena, how would you handle this dilemma? What rights does Elena have that allow her to honor her father’s wishes?
4. What is the role of the ethics committee and how can they best support the client and his family?