(Trying to be Heard
Beneficence compounded by nurse-physician communication created ethical problems in this case. Mainly, Joanna’s assessment of Mrs. Kelly being ignored by the resident physician and the nursing supervisor. Joanna worked within the scope and standards of practice, she assessed, evaluated, and monitored her patient’s condition. She then reported her findings to the resident twice, and also sought nursing support from her shift supervisor. After Joanna’s first call to the resident, and her continued concern she needed to advocate in a proactive manner. Continuing her assessment of Mrs. Kelly to include palpation and auscultation could have offered additional clinical information enabling her to articulate the problem to the resident and nursing supervisor.
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The nurse unable to convince a physician of a patient’s failing health status, can result in harm to the patient. Nurses’ and physicians’ have different styles of communication and gender differences that play a primary role in this constraint (Burkhardt & Nathaniel, 2014). Another constraint would be nursing management’s lack of support for a staff member. The nursing supervisor could have assessed Mrs. Kelly with Joanna and suggested a more detailed assessment, and possibly contacting the house physician. She herself could have called the resident and insisted that he come evaluate Mrs. Kelly’s condition or contacted the house physician. Institutional constraints that may apply here is the hospital’s lack of shared decision making processes that promote and support the nurse as the patient’s advocate. Also, Management that does not support a culture of
References Discover credit # xxxx-xxxx-xxxx-1565 was never used, and there was balance on the Account. The account was closed on August 29, 2015.
In the year 2014, sixteen people were killed every week by train accidents. Chelsea is a small suburban town in the state of Alabama. It is located just miles south of one of Alabama's largest cities, Birmingham. There are many railroad crossings located in the city of Chelsea, but the crossing located on Highway 377 is not up to date on safety features. The plan is to use Chelsea’s Public Works leftover to build crossing gates and warning signals, and since there is money left a donation will be given to the Chelsea schools.
Sir, Mr. Perkins has advised S&S are required to do the following IOT provide the requested support:
The study will be a single-centered, crossover, randomized control trial which will aim to determine which foot condition, barefoot or shod, allows for best performance of the SEBT. The dependent variable is reach distance. The independent variable is the differing foot conditions, barefoot versus shod. The SEBT will produce continuous, ratio data measured in centimeters. A quantitative primary research approach will be used as quantitative measurements allow for statistical comparison between variables, which will allow the hypothesis to be accepted or rejected (Barker et al., 2016). 1:1 block randomization will be used in this study, with participant being randomly assigned to either barefoot or shod first groups of equal sizes using the crossover design. Randomization
4 – Jana is exceeding expectations for her work with WIC EBT tests and grocer system certifications. Jana has assisted with multiple certification events during this performance review period and was an essential component for completing certification tests for EBT Ops. Additionally, Jana has been successful in completing certification documentation timely and thoroughly. Furthermore, Jana’s work with creating WIC EBT certification cards and files is crucial for successfully completing certifications.
As is the case with any type of evidence seizure, what is fair game and what is off limits needs to be identified and set, preferably in writing before any work is done. (Nelson, Phillips, & Steuart, 2015). This ensures that the forensics team will be protected in the worst case scenario where the company could have an issue with what was taken, very similar to the protection ethical hackers require when performing a penetration test (##). Once this list is created, the team will interview the system administrators to provide any information allowed about the systems such as the equipment, system baselines, passwords that are allowed to be shared, and any special information that would need to be known before analyzing the system such as what information is logged and where would it be stored (Rowlingson, 2004). The entire purpose of this information gathering is to paint a clearer picture of the situation so a more detailed plan could be devised prior to any systems being touched.
The State Public Utility Commissions is represented by NARUC which is responsible for utility services (electricity, gas telephones) in different states.(4)
B) The intended purpose of Industrial or Economic regulation as applied to Oligopolies and Monopolistic market structures is used to reduce the market power of both! A government commission regulates the prices charged by “natural monopolists.” Industrial Regulation is necessary to prevent natural monopolies from charging monopoly rates which may harm consumers/ society. Industrial Regulation tries to establish pricing that will cover production costs and provide a fair amount of return to businesses. Price=Average Total Cost, where normal profit is accomplished. (governs pricing, output, & profits in specific industries).
The numbers of firms that produce identical products or goods which are homogenous are called market structure. Industrial regulation is the government regulation on an entire industry with the objective of keeping a close eye on the industry prices and take advantage of consumers. Rules set by government and agencies that help control the operations of businesses who may demonstrate monopoly power in their organization. Monopoly may lead to consumers being exploited (higher prices) and consumers paying way too much for a product.
I will approach the process of exploring more technologically advanced and interactive toys within the American Girl core brand by pulling a team of people to complete the strategic planning process (Ferrell & Hartline, 2014). A strategic plan is a roadmap to grow your business (Lavinsky, 2013). The roadmap will detail what it will take the implement the new technology and interactive product (Ferrell & Hartline, 2014). The team will explore the new technologies and understand the current status of interactive toys that the Mattel has had success with and the pain points. This will help the team understand what works and what has not worked. Research and analysis will be performed to understand the new technologically that is available
n building a good organization, good and effective communications are the cornerstone for success. Selecting members with great potential does not ensure that an effective team has been established. There must be a process of bonding and trust from all involved. The effective educational team will want to know where they are placed in the planning and executing of decisions. Leadership should build the organization on communications. The goals should be established by presenting the team with the opportunity to discuss the needs of the organization. Listening is a skill that has the potential to develop tremendous trust in an organization. Time should be allowed to allow members to give input in the decisions process. It is important to give an authentic perception of valuing everyone’s point of view. This process should never be viewed as an attack on the leader. The member should be politely acknowledged, and thanked for their valued opinion. The work must be performed by
During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to
A patient was admitted to the medsurg floor under my care. Her primary diagnosis was a chronic obstructive pulmonary disease. This patient has had this diagnosis for years, and although she continued to smoke, she was able to maintain her daily functions with little no interruptions. Upon initial assessment, the patient presented with low oxygen saturation, rapid shallow breathing and an overall panic. After treatment of medications, respiratory therapy and nursing intervention the patient showed signs of minor improvement. By this time a patient to nurse relationship has already been established with goals created and plan of care initiated. At this time the physician went to the patient’s bedside and knocked down the foundation that was created delivering a grim diagnosis. This physician, after only spending fifteen minutes with this patient, told her that she had less than six months to live due to end stage chronic obstructive pulmonary disease. Then he proceeded to inform her that he felt the need to place her within hospice care. This created severe anxiety for the patient, which in turn, increased her breathing
The patient has fluids running from the Emergency Room (ER). The nurse does the admission process, and finds out the patient has advance directives that have been verbally stated to the husband and son who will make decisions. The patient and family are also Albanian Muslims who practice faithfully. Past medical history include Sickle Cell Anemia, chronic migraines, asthma, chronic shortness of breath, and hypertension. The advance directives include not to resuscitate and no ventilator. The patient starts to complain of uncontrolled pain in her chest, feeling feverish, difficulty breathing, increase respiratory rate, decrease oxygenation 90%, and a strong wet cough. Doctors are notified of new onset of symptoms. The patient is diagnosed with Acute Chest Syndrome, and is treated appropriately with a bronchodilator, chest x-ray, antibiotics and fluids. No ventilator required, and patient states relief of pain. Education provided about crisis, with family at bedside. The husband stated he did not want any more interventions done now that she is stable and would like their medicine doctor to come see her. The patient refuses food provided by the cafeteria, due to the cafeteria tray having meat on the plate, and food is brought in to the patient by family and friends. The father or son is at the patient’s bedside at all times, and the patient’s medicine doctor visits to do a healing ceremony on the patient. The patient is
As a nurse, my ability to influence patient care outcomes depends on a variety of forces, each of which I must acknowledge in order to influence care outcomes in an ethically suitable approach. Ethically speaking, what should be done in an individual, patient-care situation is at the heart of many practice crisis nurses face on a regular basis. For example, if I received a discharge order for a 70 year old widow hospitalized for bilateral knee surgery. I know the patient needs further care that will not likely be delivered at home. The patient will need help with activities of daily living, regular therapy sessions and help to go for follow up, I know that the bottom financial line is that the patient has exhausted the days allotted for the this type of surgery and discharge is imminent. This example demonstrates the quandary associated to the ethical issue of the allotment of limited resources that occurs frequently within health care sector. The ethical principle of justice guides the fair and equal treatment of all people; yet, I may struggle with the outcome of limited organizational and societal financial resources. My knowledge and skill are significant forces that can add to the power to influence patient care in an ethical manner. This power comes from the health care team’s reliance on my knowledge and proficient skill. There is no alternate for the admiration that is earned by a nurse who gives reliable, outstanding, and holistic care. The reputation for excellence