Essay Instructions: Need a 5-7 page paper that addresses the question/subject listed below. You may take a position and defend it or look at it from different points of view. You must choose one of the four items listed below to write this paper.
1). Our bodies and appearance are morally significant.
2). Dementia ought not be a reason to limit medical treatment.
3). A "good old age" means being productive and engaged in one's community.
4). Families should bear the primary responsibility for taking care of older family members who need help with the activities of daily living.
Customer is requesting that (Cathii) completes this order.
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Essay Instructions: Characteristics of a Nurse Paper
Students will write a paper assignment about the professional characteristics/behaviors of a Baccalaureate nurse using the guidelines/rubric provided. The student will describe what he/she believes to be the necessary/ideal professional characteristics or behaviors of a Baccalaureate nurse. Additionally, the student will interview a Baccalaureate nurse and ask him/her to briefly describe his/her role, what he/she believes to be the difference in the preparation of Baccalaureate nurse as compared to other entry options. The student will also ask the nurse to describe a most memorable day or moment as a nurse and how this experience has affected the nurse personally and or professionally. The student will discuss those professional characteristics/traits and relate them to the story of the nurse you have interviewed. The student will discuss the development of professional characteristics/behaviors and how they begin in the professional nursing program. The student will provide examples and discuss the importance of the professional characteristic/behaviors to the student nurse.
Need an introduction of what is the paper about?
Describe the characteristics/traits of a Baccalaureate professional nurse. What are the differences in the preparation of Baccalaureate nurses as compared to other entry options? What are the skills required? What other qualities should the nurse have? and why?
Describe the role of the Baccalaureated professional nurse. What are her job duties? What is the setting? What is their most memorable day/moment? Why? What characteristics are reflective or demonstrated by the nurse's experience? How has this experience affected the nurse personally and or professionally?
Describe how and why the characteristics/behaviors role describe above are important to a nursing student?
What are your thoughts on the characteristics of a nurse now that you have researched it and/or spoken with a nurse? Does it affirm your decisions to become a nurse? Why or why not?
Interview question and answers
Describe your role briefly?
I work as a staff nurse at Brigham and Women’s Hospital in the Shapiro building on a vascular surgery and cardiology focused intermediate care unit. My role includes, but is definitely not limited to, understanding the health history and recent changes in health status of my patients during their admission; accurately assessing my patients’ current health status and making the covering MD aware of any changes throughout my shift; understanding my patients medications and administering them safely and accurately; monitoring telemetry and vital signs; performing patient-specific interventions such as dressing changes and wound care, chest physiotherapy, repositioning, etc.; providing emotional support (which is always needed when patients are hospitalized due to changes they all experience and need to cope with); delegation and knowing what tasks and to whom you can and feel comfortable delegating tasks to; teaching- both with my patients regarding new medications, tests and procedures and what to expect throughout hospitalization, changes in their health status/diet/lifestyle, etc.; and often my role also includes that of charge nurse….. which includes overseeing and making sure the unit is adequately staffed, awareness of all patient’s health status on the unit (including code status!!), resource to all staff on unit, maintaining safety and organization of unit, and a bunch of extra paperwork (lol). In both of these roles, it is also the responsibility of the individual nurse to notify the nurse manager of any potential problems (staff or patient related) that arise at any time on the unit.
What do you believe to be the difference in the preparation of Baccalaureated nurse as compared to other entry options?
I believe BSN prepared nurses are educated in a more holistic view and approach to patient care. BSN prepared nurses are educated in the background of both the art and science of nursing, and the education is standardized throughout BSN programs. The problem with having other degress such as LPN’s, diploma program nurses, associate degree-prepared nurses in addition to BSN prepared nurses is that there is too much variation in the education provided in the different programs, leading to varying levels of knowledge and competence in practice and different views/ approaches to patient care. The various nursing environments are becoming more sophisticated and technologically advanced, requiring nursing programs that can provide both a solid knowledge background as well as current issues and trends in nursing with a holistic and diverse view of patients and their families…. BSN programs provide this quality of nursing education for todays nurses and should be the expected standard of education (in my eyes).
Describe your most memorable day and how this experience has affected you professionally
Just this past weekend I had a very rewarding experience with a patient. I had come on to shift at 7pm on Friday night, and it was quite hectic. I had one patient in flash pulmonary edema who was requiring high-flow oxygen and just started diuresing, another patient was admitted with chest pain and awaiting cardiac catherization and was having active chest pain, and my 3rd patient came rolling by the nurses station at 705pm (new admission from an outside hospital) as I was waiting to get report from the day nurse.I felt slightly overwhelmed at the beginning of the shift, but quickly my patient having chest pain was brought down to cath lab….. so I could focus on my new admission and my patient having respiratory issues. I had a four-patient assignment that night but most of my time and energy was focused on this patient. The patient had 3 episodes of acute shortness of breath, with oxygen levels desaturating and labored breathing, with patient requiring high-flow humidified oxygen to maintain o2 sats. The patient was very anxious with each episode and noted to be tachycardic, requiring telemetry monitoring and 12-lead EKG, and a LOT of emotional support!! After spending two 12-hour night shift taking care of this patient, her respiratory status finally started to turn the corner for the better and I was able to wean patient to a nasal cannula and she told me that she felt her first deep breathe since surgery. Sparing you many unnecessary , although interesting, details to this story…. It was when the patient said to me, “you can go home to your family and know that you made a difference in a patient’s life. I wanted to die. I wanted to die, but you were there for me and helped me.” This made all of the work and stress of those past two nights more than worth it, and it reminded me of how much I love being a nurse!!
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Total Pages: 2 Words: 774 Works Cited: 4 Citation Style: APA Document Type: Essay
Essay Instructions: Writergrrl101, wizzy, writingptb, FLWriter2011,
Provide comments in own words and feedback on the following 2 separately.
1. The healthcare environment has evolved over the last couple of decades from physician dictated to big business drivers to a government run endeavor. Healthcare is all about treating members of society who are sick, ailing, or injured. Many segments of the healthcare environment play different roles in this mission of taking care of society. One of these segments is the pharmaceutical industry which has for over one hundred years provided medicines that treat disease and health conditions. However, as the healthcare environment has changed, the pharmaceutical industry has not adjusted and kept up with the ever evolving world of patient care. Pharmaceutical companies are faced with historically long research and development times lines which driven by a conservative business model that dates back over 100 years. These companies must look to new ways of conducting business in order to meet the demands of the external environment (Tjandrawanata & Simanjuntak, 2012).
It currently takes on average 12 years, with a range of 10 -15 years, and no less than 1 billion dollars to develop and bring a medicine to patients. These timelines and costs drive the cost of medicines to patients and payers higher and higher each year. In order to continue to provide healthcare providers with Evidnce based medicine (EBM) and Evidence based practice (EBP), these companies need to control costs to offset the losses associated with these patent expirations, but at the same time be able to continue to develop molecules for marketable drugs in the face of money constraints, and an every changing healthcare environment (Stach, 2006). Thus, the pharmaceutical industry must become innovative in their approach to drug discovery and development, they must control their expenses and become extremely focused on their key customers; that is the patient, prescriber, regulators and payers.
My project is about the what needs to change in the pharmaceutical industry, and how the pharmaceutical industry can use culture, organizational and behavior change, along with novel technologies to streamline drug development and bring medications to patients faster and with controlled cost.
Stach, G. (2006). Business alliance at Eli Lilly: A successful innovation strategy. Strategy and Leadership, 34.5, 28-33.
Tjandrawinata, R., & Simanjuntak, D. (2012). Factors affecting productivity of research-based pharmaceutical companies following mergers and acquisitions. Retrieved from http://mpra.ub.uni-muenchen.de/42514/
2. Capstone project: To educate healthcare professionals that patient simulation is a valid method to confirm competency and further propose the use of simulation as an educational method and solution to validate continued competency assessments of registered nurses, rather than the current method, lecture format.
1) What is the value of your project in your work setting?
As clinical situations continue to grow in complexity with an increase in patient co-morbidities, acuity, and the demand for safety, nurses must react with quick and appropriate clinical judgment (Galloway, 2009). Addressing specific learner needs and competencies, patient simulation facilitates active learning while providing an opportunity for repetition and evaluation. It enables nurses to develop, synthesize and apply their knowledge in a replica of real experience. In addition patient simulation encourages a learning environment to improve overall performance and communication skills for the learner, which in turn improves decision making, confidence, and enhances teamwork (Hagler & Wilson, 2013) and ultimately equates to the delivery of safe and quality care within my work setting.
2) What leadership skills do you feel you have gained from working on your project?
Olson (2013) conveys today?s healthcare system is faced with several issues including: social, political, and economic; all which subsequently present great challenges while placing a higher need for accountability. In addition Muller (2013) emphasizes professional practice within the 21st century revolves around accountability. While I hold myself accountability for my actions; I now view accountability in a new and broader manner. As the principal definition of accountability is to account for one?s action, the concept of accountability is multipart; for nurses have accountability to clients, themselves, the public, the institution, and other healthcare professionals (Iacono, 2013). To support a culture of accountability, O?Hagan and Persaud (2009) state, ?An organization must be able to access, create, manage, and use knowledge so as to improve organizational processes and allow organizational members to experience the benefits of accountability? (p. 125).
3) What are the outcomes that you achieved with your project?
Healthcare professionals on my unit are talking and are getting excited, excitement over learning and excitement that they may be able to practice skills in a safe and controlled environment in the near future. I have meant so many individuals over the past few weeks and the word is out that I?m trying to change how education and validation of competences are provided to registered nurses. I have scheduled meetings with various council committees within my organization and with help of a change theory, my thoughts are organized and I feel all ?bases? are covered to aid in the implementation of change. In addition I have support. I have support from my peers, my nurse manager, those overseeing the educational department, and local colleges/universities who are presently equipped with patient simulators.
Galloway, S.J., (2009). Simulation techniques to bridge the gap between novice and competent healthcare professionals. OJIN: The Online Journal of Issues in Nursing, 14(2), manuscript 3. doi:10.3912/OJIN.Vol14No02Man03
Hagler, D., & Wilson, R. (2013). Designing nursing staff competency assessment using simulation. Journal of Radiology Nursing, 32(4), 165-169. doi:10.1016/j.jradnu.2013.10.001
Iacono, M. (2013). The culture of accountability. Journal of PeriAnesthesia Nursing, 28(2), 107-109. doi:10.1016/j.jopan.2013.01.002
Muller, L. (2013). Integrity and accountability the omnibus final rule: Part 1. Professional Case Management, 18(4), 204-207. doi:10.1097/NCM.0b013e4
O? Hagan, J., & Persaud, D. (2009). Creating a culture of accountability in health care. The Health Care Manager, 28(2), 124-133. doi:10.1097/HCM.0b013e3181a2eb2b
Olson, L. (2013). Public health leadership development: Factors contributing growth. Journal of Public Health Management and Practice, 19(4), 341-347. doi:10.1097/PHH.0b013e3182703de2
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Essay Instructions: Utilizing the Community Health Needs Assessment data, design a hypothetical community health promotion project. Include the following elements:
-Introduce Aggregate / Special Emphasis Population and Community Agency
-Describe the results of the Needs Assessment, discussing sources of data and validity/reliability of the data. Emphasize if data gaps exist
-Categorize the data based on components of one of the conceptual models
-Select one community health need congruent with Healthy People 2020 or WHO Agenda
-Suggest a community health program that may be implemented
There is to be a minimum of three current (2002 to present day) peer reviewed journal references cited and no more than five Internet resources cited.
This paper must be a continuation of what I've written/submitted 2 weeks ago. My aggregate is caregiver of an Alzheimer patient.
Community Health Needs Assessment Paper
Alzheimer’s disease is not only one of the most common and debilitating ailments associated with individuals over the age of 65, but also its overall impact on society is projected to increase as the baby boomers start to retire in 2011. Indeed, according to statistics from the Alzheimer’s Association, Alzheimer’s is the sixth leading cause of death in the United States with over 5.2 million individuals currently suffering from the disease (Alzheimer’s Association, 2011). In addition, the burden of Alzheimer’s in the senior population is projected to increase: According to projections, the number of people aged 65 and older with Alzheimer’s disease is estimated to triple (16 million) by the year 2050 (Alzheimer’s Association, 2011).
Although general prevalence statistics may be relatively well known among those in the medical community, the devastating toll that Alzheimer’s imposes on family members living with Alzheimer’s patients is still being understood. According to a recent report, there are nearly 15 million unpaid caregivers in the United States that give care totaling roughly $202 billion annually to sufferers of Alzheimer’s (Alzheimer’s Association, 2011). The high standard of care needed for Alzheimer’s patients not only imposes monetary stress on family members, but also increases the overall stress level: The study found that 61% of caregivers cited high levels of stress as a by-product of care in a recent survey (Alzheimer’s Association, 2011).
With this background in mind, I chose to pick a survey instrument that would target the aggregate I chose: Family members living with an Alzheimer’s patient. This aggregate population, which has not been extensively analyzed in the medical literature, plays a key role in the process for a number of reasons including their closeness to the patient and ability to detect when the onset of disease may have occurred. That is, survey instruments aimed at family members might provide more accurate and earlier warning than a survey given to a parent or relative who is already in the early stages of cognitive decline. Although there are several instruments aimed at this aggregate, I chose an existing survey instrument that has proven to be quite valuable in assessing the needs of the aggregate population: The Margaret Blenkner Research Center (MBRC) Caregiver Strain Instrument.
The MBRC Caregiver Strain Instrument was developed in 1994 at the Margaret Blenker Research Center, as a result of the emergent phenomenon of family members taking care of relatives and spouses with Alzheimer’s disease. In particular, the developers of this survey tool were interested in developing a more comprehensive social care model that would include inputs not only from family/relatives, but also from community service providers that could help share the emotional and time burden that accompanies such care (Bass, McClendon, Deimling & Mukherjee, 1994). The MBRC instrument was developed as a means to assess how caregivers were faring from a number of different aspects- psychological, health, and socially.
There are many different permutations of the MBRC instrument; however, I have chosen a permutation commonly used by nursing homes and psychologists for assessment purposes. Overall, this version of the MBRC instrument reflects this concern as the survey includes 19 questions that can be broken down into four different analytical categories (Please see appendix 1 for the survey instrument). Questions one through four deal with how the family member feels in making care decisions for the individual with Alzheimer’s such as regarding the role of proper care and the need to do a “better job” in providing care. This analytical sub-category is known as “Caregiver Mastery Score.”
Questions five through nine deal with the overall relationship between the care giver and the individual with Alzheimer’s, particularly focusing on the existing relationship including feelings of manipulation and resent the caregiver may have based allocation of care. This
analytical sub-category is known as the “Relationship Strain Score.” Questions 10 through 14 deal with the physical health situation of the individual who is taking care of the individual’s with Alzheimer’s; this category covers a wide range of physical symptoms including the caregiver’s current state of energy, as well as the physiological state and psychological state. This analytical sub-category is known as the “Health Strain Score.” Finally, questions 15-19 deal with how the regular activities of the caregiver has been influenced by giving care for the individual with Alzheimer’s asking questions pertaining to participation in church/religious events, group events, and general activities.
While this survey instrument does a good job capturing of how different aspects of a caregiver’s life is affected, the one weakness (as far as this assignment is concerned) is the lack of demographic information it provides regarding the aggregate population. In order to make up for this lacuna, I propose that the following questions be added to the beginning of the survey (this is just an attenuated sample; all questions given on the website would be used): 1) Sex of caregiver (male/female); 2) Age of caregiver ( ); 3) Location of caregiver’s residence (urban/rural); 4) Race of caregiver; 5) Occupation of caregiver (if any).
The advent of the MBRC tool has proven critical in not only assessing the needs of the aggregate community, but also in creating a more holistic approach to providing care for Alzheimer’s patients outside the traditional nursing home setting that may not be palatable to certain individuals. Bass et al. (1996) develop this framework as they use results from the MBRC instrument to assess the current strain on the caregiver and also pull in different resources from community health providers in order to optimize care solutions for both the caregiver and the individual with Alzheimer’s (Bass, D.M., Noelker, L.S., & Rechlin, L.R., 1996). In this sense, the MBRC instrument serves a key assessment that can be used as the initial stepping off point in understanding what type of resources should be leveraged in order to provide adequate care for individuals with Alzheimer’s. In addition, the Instrument has also played an instrumental role in helping determine what educational programs may be useful in the initial stages of Alzheimer’s disease. Roberts et al. use the MBRC instrument in order to determine when education should be implemented for both caregivers and individuals with Alzheimer’s disease (Roberts & Silverio, 2009).
Overall, the MBRC Caregiver Strain Instrument is a valuable addition to better understand the burdens and challenges faced by individuals with Alzheimer’s and their caregivers. In addition to providing a holistic assessment of how caregivers’ life is impacted in a number of key areas, the survey instrument has also been used to initiate programs in education and therapeutic activities for caregivers.
Alzheimer’s Association. (2011). 2011 Alzheimer’s disease facts and figures. Accessed at: http://www.alz.org/alzheimers_disease_facts_and_figures.asp.
Bass, D. M., McClendon, M. J., Deimling, G. T., & Mukherjee, S. (1994). The influence of diagnosed mental impairment on family caregiver strain. Journals of Gerontology, 49, S146-S155.
Bass, D.M., Noelker, L.S., & Rechlin, L.R. (1996). The moderating influence of service use on negative caregiving consequences. Journal of Gerontology: Social Sciences , 51B, S121-S131.
Roberts, J.S. & Silverio, E. (2009). Evaluation of an education and support program for early-stage Alzheimer’s disease. Journal of Applied Gerontology, 28, 419-435.
MBRC Caregiver Strain Instrument
• • • •
Strongly agree = 3 Agree = 2 Disagree = 1 Strongly disagree = 0
National Chronic Care Consortium
During the past four weeks, because of helping the patient, I felt:
1. ____unsure whether he/she was getting proper care.
2. ____uncertain about how to best care for him/her.
3. ____that I should be doing more for him/her.
4. ____that I could do a better job of caring for him/her.
5. ____that he/she tried to manipulate me.
6. ____that my relationship with him/her was strained.
7. ____that he/she made requests over and above what he/she needed.
8. ____resentful toward him/her.
9. ____angry toward him/her.
10. ____my physical health was worse than before.
11. ____downhearted, blue, or sad more often.
12. ____more nervous or bothered by nerves than before.
13. ____I had less pep or energy.
14. ____bothered more by aches and pains.
Caregiver Mastery Score _________________ (Sum of items 1??"4)
Relationship Strain Score _________________ (Sum of items 5??"9)
Health Strain Score __________________ (Sum of items 10??"14)
Less often = 2 The same = 1 Strongly disagree = 0
During the past four weeks, because of helping the patient, I:
15. ____participated in church or religious activities.
16. ____visited with friends or family.
17. ____participated in group or organized activities.
18. ____engaged in volunteer activities.
19. ____went out to dinner, the theater, or a show.
Activity Restriction Score _________________ (Sum of items 15??"19)
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