Discussion Question

Respond to the following question:

.There are several vulnerable populations that have a chronic illness (older; homeless; and lesbian, gay, bisexual, and transgender populations) that face challenges when it comes to care. Choose one vulnerable population and discuss what can be done to help alleviate these challenges.

To support your work, use your course and text readings and also use outside sources. As in all assignments, cite your sources in your work and provide references for the citations in APA format. 

DEVELOPING A PERSONAL PHILOSOPHY

OVERVIEW:

Nursing, client, wellness, and environment are defined according the the personal attitudes, behaviors, beliefs and values of the professional nurse. State your personal philosophy about the profession of nursing.

PROCESS

1.  APA format 1-2 pages (minimum 1 page)

2.  Develop your personal philosophy based upon one of the Standards of Practice outlines by the American Nurses Assoc.(ANA). 

Standards of Nursing Practice.

i.e., Standards of Care for Critical Care Nursing/Standards of Care for Pediatric Nursing etc.

3. Identify at least three Standards and describe how your personal philosophy is 

congruent with the standards identified

4. Use PEER Reviewed articles from Nursing Journals.

Marquis & Huston (2017).Leadership Roles and Management Functions in Nursing Theory to Application (9th ed.) Wolters Kluwer/Lippincott

 Please react to this student post. remember references and plarigarism

Descending Spinal Tract

• Corticospinal, reticulospinal, and vestibulospinal
• Sends impulses from the brain to muscle groups
• Control muscle tone, posture, and motor movements
• Efferent

1. Ascending Spinal Tract
2. Spinothalamic and spinocerebellar
3. Sends sensory signals to accomplish complex tasks
4. Ascending tracts recognize exact stimulus and location
5. Contains fibers that discriminate rough from light touch, temperature and pain
6. Afferent

• If the spinal cord is completely severed, then complete loss of function below the point if injury is expected (Ball, Dains, Flynn, Solomon & Stewart, 2015).
• The nervous system is a group of nerves and neurons that transmit messages to different parts of the body. It is in charge of coordinating and controlling the body (Ball et al., 2015). The nervous system is divided into the central and the peripheral nervous system, further subdivided into autonomic, sympathetic and parasympathetic. The central nervous system is comprised of the brain. The peripheral nervous systems is comprised of the cranial and spinal nerves and the ascending and descending pathways (Ball et al., 2015). With all parts functioning properly the nervous system is able to receive and identify stimuli, control voluntary and involuntary body functions (Ball et al., 2015).
• The three major units of the brain are the cerebrum, the cerebellum and the brainstem (Ball et al., 2015).
• The difference between the ascending and descending tracts is that the ascending is sensory (afferent) because it delivers information to the brain and the descending tract delivers motor (efferent) information to the periphery (Ball et al., 2015)
• The pituitary gland regulates metabolic processes and controls growth, lactation, and vasoconstriction through hormonal regulation (Ball et al., 2015).
• The fourth cranial nerve is called trochlear and it is in charge of the downward and inward movement of the eye (Ball et al., 2015).
• Risk factors for cerebrovascular accidents include hypertension, obesity, sedentary lifestyle, smoking, stress, high cholesterol/triglycerides/lipoproteins, congenital conditions and family history of cerebrovascular accidents (Ball et al., 2015).
• The 5.07 monofilament test is used to test sensation in different parts of the foot in patients suffering from diabetes mellitus or peripheral neuropathy (Ball et al., 2015).  
• The 0 to 4+ scale is used to grade the response when testing the reflex. 0 indicates no response and 4+ indicates hyperactive reflex (Ball et al., 2015).
• Older adults may be taking medication for other conditions that can affect their balance, mental status and coordination and it is important know this in order to rule out whether a symptom is due to a side effect or a cause for concern (Ball et al., 2015).
• Meningitis that occurs during the first year may cause epilepsy later on in life, also any infection in the first year of life can impair brain functioning and development (Ball et al., 2015).
• Peripheral neuropathy is a loss of motor and sensory function due to diabetes mellitus, vitamin B12 deficiency, Lyme disease, HIV infection, poor blood circulation and altered lipid metabolism. In this case the cause of EI’s neuropathy is Diabetes Mellitus due to the elevated A1c (Ball et al., 2015).
• Objective data in peripheral neuropathy include reduced sensation in the foot, inability to feel sharp touch, diminished distal pulses, unable to stand on toes or heels, skin ulcers in extremities that are often not felt by the patient and decreased sensation below the knees (Ball et al., 2015).
• The best technique to assess for peripheral neuropathy is the 5.07 monofilament test because it assesses sensation in different areas of the foot (Ball et al., 2015).

Reference  

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidels guide to physical examination. St. Louis, MI: Elsevier Mosby.

RI..

The AHCA was written to solve a crisis that doesn’t exist and accordingly accepts sacrifices it doesn’t need to ( Q1,2018). It’s akin to a doctor who wants to amputate a patient’s leg, a reasonable solution if gangrene has set in, but disastrous in case of a botched diagnosis. Everyone will face the specter of getting priced of health insurance altogether if they lose coverage. For them this is functionally a mandate, except instead of a financial penalty the AHCA punishes them by withholding access to care. I think one of the somewhat surprising elements of the bill was the fact that they kept in the essential health benefits, the ten classes of benefits that need to be covered just because it’s covered doesn’t mean that you’re going to be able to afford them. For the people who have coverage, meaning they are in an insurance plan, what is the extent of the out of pocket exposure they have to get the care they need. As it turns out, studies showing better health outcomes for those with insurance looked at individuals having private insurance. On the other hand, multiple studies, assessing the effect of the Medicaid expansion, found no improvement in health outcomes for those on Medicaid.  In fact, other investigations have found worse outcomes for those with Medicaid as compared to those with no insurance at all.

There is no easy answer as to whether medical negligence cases should be handled in civil court or criminal court. It is my belief that medical negligence cases should start out in civil court, and if gross deviation from standard of care is found, it should move to criminal court. The first thing to consider is how to prove medical negligence in court. Medical negligence is proved in court after showing proof of four elements: 1. A professional duty owed to the patient, 2. Breach of such duty, 3. Injury caused by the breach, and 4. Resulting damages (Bal, 2008). This alone is difficult to do.

To take a case from civil to criminal court, proof must be found of “gross or flagrant deviation from the standard of care” (Barcus, n.d.). This is also difficult to do. Many issues arise while trying to prove this, such as jurors who are confused by medical jargon and jurors who overlook the standard of care while paying more attention to the physician’s state of mind (Barcus, n.d.). It is also difficult to figure out and prove whether the physician had prior knowledge of an important aspect that could cause harm unintentionally (Barcus, n.d.). 

So, although this is a difficult process that has a few flaws, it is important to hold physicians responsible for their actions, whether they were intentional or not. This can be done by utilizing both criminal and civil court.

References

Bal, S. (2008). An introduction to medical malpractice in the United States. Clinical orthopaedics and related research, 467(2), 339-47. https://dx.doi.org/10.1007%2Fs11999-008-0636-2

Barcus, H. A. (n.d.) When does medical negligence become criminal? Retrieved from: http://www.latlaw.com/index.php/firm-news-articles/articles-2010/88-when-does-medical-negligence-become-criminal

_____________

Medical negligence cases I believe should be handled in criminal court. The reason being so is because like stated in the article that is provided to us, “The prosecution of criminal medical negligence was once a relatively uncommon occurrence.” ( Barcus, H. A. (n.d.), 2010). Meaning that it used to be uncommon that criminal negligence went to court and was prosecuted. It has grown since the years of 1809-1981. Medical negligence is not a civil matter, it’s criminal. Yes there are some thing within criminal negligence that is civil, but the overall picture shows that it is criminal. Therefore, Criminal medical negligence should be handled within the criminal courts rather than the civil courts.

References:

Barcus, H. A. (n.d.) (2010):  http://www.latlaw.com/index.php/firm-news-articles/articles-2010/88-when-does-medical-negligence-become-criminal

______

To begin with, medical negligence is defined as an act or omission (failure to act) by a medical professional that deviates from the accepted medical standard of care (David Goguen, n.d.).  According to LawHelp.org (2018), in criminal court the government files a case against someone for committing a crime.  The person accused of committing the crime is called the defendant and if found guilty may receive jail time.  In civil court, a person or business files a case against another person or business because of a problem between them.  The judge can order the person who loses in civil court to pay money or a fine towards the other party.  People do not go to jail based off of civil court decisions (LawHelp.org, 2018).

I believe that in order for a medical negligence case to be handled in criminal court there must be a “gross or flagrant deviation from the standard of care”.  Another necessary reason is “practicing outside of one’s area of expertise” or “attempting to cover up a clinical mistake” (James A. Filkins, 2007).  These are all selfish acts that deliberately violate the principles of beneficence and non-maleficence.  Knowingly acts as such by medical “professionals” should be handled in criminal court and result in jail time.

According to Barcus, H. A. (n.d.), health care professionals should not be given a free pass from criminal liability for mistakes made in their treatment of patients (Barcus, H.A., n.d.).  I believe if a medical professional makes a genuine mistake, that the issue should be handled in civil court.  People are not perfect and no one deserves to be dragged away from their family because of a mistake.  If enough evidence is found in order to sincerely convey an action as a mistake, criminal court is not necessary.

LawHelp.org. (2018). The Differences between Criminal Court and Civil Court. Retrieved from https://www.lawhelp.org/resource/the-differences-between-criminal-court-and-ci

David Goguen, J.D. (n.d.). Medical Negligence. Retrieved from https://www.alllaw.com/articles/nolo/medical-malpractice/negligence.html

Barcus, H. A. (n.d.). When does medical negligence become criminal? Retrieved from: http://www.latlaw.com/index.php/firm-news-articles/articles-2010/88-when-does-medical-negligence-become-criminal

at least 250 words, must synthesis the 3 different posts.