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Physician-Patient and Hospital-Patient elationships
The importance of the physician-patient and hospital-patient relationships
There exists a quite recommendable potential in the alliance between a patient and a physician. A patient, who puts trust in the care of a physician, establishes moral responsibilities that are weighty and definite. When the patient and the physician work together, the possibility of pursuing intervention comes into place, and the health and quality life of the patient is bound to improve. Trust is very essential and critical in the bond between the patient and the physician in the process of diagnosis and therapy.
How contract principle and breach of warranty apply to the health care setting
In the healthcare setting, legal responsibilities to break discretion may result in difficult choices. The physician has the ethical responsibility of following the law but must know how to scale this with the responsibility to the patient. It is very…
References
Giesen, D. (2008). International medical malpractice law: A comparative law study of civil liability arising from medical care. Tu-bingen: J.C.B. Mohr.
Lemmens, T. (2006). Law and ethics in biomedical research: Regulation, conflict of interest, and liability. Toronto [u.a.: Univ. Of Toronto Press.
Mengel, B., Holleman, L., & Fields, A. (2007). Fundamentals of clinical practice. New York: Kluwer Academic/Plenum Publishers.
Miller, R.D. (2006). Problems in health care law. Sudbury (Mass.: Jones and Bartlett.
doctor and patient relationship behavior in a new light. The research documented in this article attempted to describe the effect of bedside case presentations vs. conference room style presentations. The impact of the medial care was interpreted through the patients perceptions of their medical care.
The research contained in this article was premised upon the idea that a significant difference may be noticed through different doctor presentations. The dichotomy presented here was bedside presentations may be more effective than the more rigid and academic style of the conference room presentation. They wrote "Despite the potential advantages of bedside presentations for students and physicians, there has been a trend to move clinical teaching away from the bedside and into the conference room. Concern about patients' discomfort with bedside presentations appears to be one reason for this change. Studies of such presentations have focused on patients' impressions and measurements of patients' anxiety.…
Key Finding
The researchers of this article found that there is much ignorance about the health benefits of exclusive breast feeding in Kenya. Many of the perceived ill health symptoms appeared to be associated with a lack of exclusive breast feeding practices. The authors suggested that more needed to be done in terms of educating young mothers and caregivers in this environment to practice exclusive breast feeding methods on their infants. Too much reliance is given to "their own backyard garden, and popular and folk medicines."
Matsuyama, A., Karama, M., Tanaka, J., & Kaneko, S. (2013). Perceptions of caregivers about health and nutritional problems and feeding practices of infants: a qualitative study on exclusive breast-feeding in Kwale, Kenya. BMC public health, 13(1), 525.
Ido Jean Orlando and analyzes how her contribution has impacted the nursing profession. It has 3 sources.
The field of nursing requires the utmost care on the part of nurses if they are to understand their patients. Nurses are an integral part of the medical care provision because they provide patients both physical and emotional care. Even doctors cannot succeed in reaching the level of emotional contact that nurses can achieve with their patients. According to Ida Jean Orlando, this kind of close relationship is dependent on the communication that nurses establish with the patients. This communication, whether verbal or non-verbal, plays a vital role in dealing out the most appropriate treatment as quickly as possible. Ida Jean Orlando's The Dynamic Nurse-Patient Relationship: Function, Process, and Principles, is a book that has had an immense impact on the field of nursing, popularizing Orlando's theory.
The Theorist:
Ida Jean Orlando was…
Sources:
Lego, S. (1999) One-to-One Nurse-Patient Relationship. Perspectives in Psychiatric Care.
Ida Jean Orlando Theorist (Accessed on 3-11-2003) http://www.uri.edu/nursing/schmieding/orlando/
Ida Jean Orlando Biography (2003) http://www.nurses.info/nursing_theory_midrange_theories_ida_orlando.htm
To wit, power is a huge influence in any social interaction, and in a study reported by the University of California Press (est, 2008, p. 87), men often interrupt women during conversations because men are generally viewed as the power in any male-female interaction. "Physicians interrupt patients disproportionately" in doctor-patient interactions, est writes, "except when the doctor is a 'lady'; then, "patients interrupt as much or more than physicians, and their interruptions seem to subvert physicians' authority" (est, p. 87). In other words, the stratification of male doctors having the power to interrupt is reversed when a woman is the doctor.
orks Cited
Blumer, Herbert. (1986). Symbolic Interactionism: Perspective and Method. Berkeley:
Breen, Catherine M., Abernethy, Amy P., Abbott, Katherine H., and Tulsky, James a. (2007).
Conflict Associated with Decisions to Limit Life-Sustaining Treatment in Intensive Care
Units. Journal of General Internal Medicine, 16(5), 283-289.
Donovan, Jenny L., and Blake,…
Works Cited
Blumer, Herbert. (1986). Symbolic Interactionism: Perspective and Method. Berkeley:
Breen, Catherine M., Abernethy, Amy P., Abbott, Katherine H., and Tulsky, James a. (2007).
Conflict Associated with Decisions to Limit Life-Sustaining Treatment in Intensive Care
Units. Journal of General Internal Medicine, 16(5), 283-289.
Patient-Centered Medical Home
Medical Home
How the Patient-Centered Medical-Home reducing cost and improving quality and safety for patients.
The patient centered medical home is a platform that fills a need in the current healthcare system. The U.S. healthcare system has been plagued for quite some time with a trend of substantially rising healthcare costs as well as another trend of slipping quality standards. These two trends are argued to be a phenomenon that has emerged at least partly from poor planning and ineffective use of resources. One solution to some of these issues can be found in the patient-centered medical home (PCMH) model of primary care. This model has been developed with the coordination of long-term physician-patient relationships in mind. Developing these relationships further can not only reduce costs in unnecessary procedures that are the result of the missed opportunity for preventive care, but also have been shown to improve…
References
Christensen, E., Dorrance, K., Ramchandiani, S., Lynch, S., Whitmeore, C., Borsky, A., . . . Bickett, T. (2013). Impact of a Patient-Centered Medical Home on Access, Quality, and Cost. Military Medicine, 135-141.
Ewing, M. (2013). The Patient-Centered Medical Home Solution to the Cost-Quality Conundrum. Journal of Healthcare Management, 258-266.
Kern, L., Dhopeshwarker, R., Edwards, A., & Kaushal, R. (2013). Patient Experience Over Time in Patient-Centered Medical Homes. American Journal of Managed Care, 403-410.
Nielsen, M., Olayiwola, J., Grundy, P., & Grumbach, K. (2014). The Patient-Centered Medical Home's Impact on Cost & Quality. Patient-Centered Primary Care Collaborative, 1-38.
These studies demonstrate that there are several factors associated with patient noncompliance, regardless of the disease being treated. Medication side effects represent only one of these issues. Nurse practitioners could help to resolve many of these issues by being proactive and asking questions about side effects in patients at risk for becoming noncompliant. They may also be able to predict noncompliance in patients that are prescribed medications with known side effects. By informing the patient of the side effects and giving them practical ways to cope with them, the nurse practitioner can play an active role in helping to eliminate patient noncompliance.
Education was found to play an important role in patient noncompliance. The overall educational level of the patient was found to be important. The nurse practitioner can take positive action by being aware of the patient's overall educational background. Extra care must be taken with those of low…
References
Barber, N., Parsons, J., Clifford, S., Darracott, R., & Horne, R. (2004). Patients' problems with new medication for chronic conditions. Quality and Safety in Healthcare. 13(3): 172-175.
Chatterjee, J. (2006). From compliance to concordance in diabetes. Journal of Medical Ethics. 32(9): 507-510.
Chisholm, M., Lance, C. & Mulloy, L. (2005). Patient factors associated with adherence to immunosuppressant therapy in renal transplant recipients. American Journal of Health- System Pharmacy. 62 (17): 1775-1781.
Eastern, J. "Dismissing Patients Properly." 1 Jun 2006. OB/GYN News. Accessed 11 Sept. 2008. http://findarticles.com/p/articles/mi_m0CYD/is_/ai_n26906768 .
Merrill, in the UK. Following his experience with heart surgery using innovating surgical techniques, the physician noted the problems he experienced in understanding all of his alternatives compared to a simpler earlier procedure, and finally trusted to the advice of his cardiologist to surgically intervene. In response to the experience, Dr. Merrill emphasized that, "As a physician talking to colleagues, I had the best information possible under the circumstances. But it wasn't the same as my hernia repair. The experience brought home to me the realization that the progress of medicine has made informed consent impossible -- even for me" (Merrill 1999: 190).
ationale of Study
Taken together, the foregoing issues indicate that there is an ongoing need for an assessment of knowledge levels of informed consent among perioperative nurses and operating department practitioners. Perioperative nurses and operating department practitioners, though, are frequently subjected to an enormous amount of stress…
References
Calloway, S.J. (2009) 'The Effect of Culture on Beliefs Related to Autonomy and Informed
Consent.' Journal of Cultural Diversity 16(2): 68-69.
Cobb, W.G. (2005) 'Defending the Informed Consent Case.' Defense Counsel Journal 72(4):
330-331.
Patient Centered Medical Homes (PCMH) are often confused as being actual "homes" for patients to be admitted in and given medical treatment and care. PCMH is actually a health care model based on which health care is provided to patients, under the supervision of physicians. The PCMH model of health care provides patients with continuous, comprehensive medical care, in order to increase the chances of achieving the goal of benefitting the patient with as much attention and medical care in order to maximize his/her health outcomes.
Over the years the PCMH model of health care has become widely adopted and preferred. This is because of the philosophy and approach that the model adopts in organizing and delivering the health care initiatives. The PCMH model is based upon delivering medical care and attention to patients with team-based health and medical experts that are focused strongly on the quality and the safety…
Bibliography
109-432, P.L. (2006, December 20). TAX RELIEF AND HEALTH CARE ACT OF 2006. Public Law 109-432 (109th Congress) .
Backer, L.A. (2009). Building the Case for the Patient-Centered Medical Home. Family Practice Management 16 (1), 14-18.
De Geest, S., Moons, P., Callens, B., Gut, C., Lindpaintner, L., & Spirig, R. (2008). Introducing advanced practice nurses/nurse practitioners in health care systems: a framework for reflection and analysis. Swiss Medical Weekly (138), 621-628.
NASHP. (2013, April). Medical Home & Patient-Centered Care. Retrieved from The National Academy for State Health Policy: http://www.nashp.org/med-home-map
Patient Perceptions of Maternal HIV Testing
Ob-Gyn Maternal HIV Testing Study
Coleman et. al., (2009) Patient Perceptions of Obstetrician-gynecologists' Practices Related to HIV Testing. Maternal Child Health Journal 13: 355-363.
The study objectives were to identify the percentage of women who had been tested for HIV, explore the perceptions of women patients about HIV testing and ascertain their knowledge about their own HIV risk status, to determine the primary reasons patients refuse to be tested for HIV, and to learn what patients recall about how their obstetrician-gynecologists' introduced the topic of HIV testing.
The authors hypothesized that pregnant women, women seeking preconception care, and women with risk factors for HIV infection would recall their obstetrician-gynecologists recommending HIV testing" (Coleman, et al., 2009)
Overall research goal & recommendation. The purpose of the study was to identify if patient-physician communication about HIV risks and testing to pregnant women is consistent with current…
There is also relevant information for specific sectors of society such as women and seniors. The MedlinePlus Magazine includes several links to asthma information. The bottom of the page includes links that contain information such as disclaimers, copyright, and privacy information. It also contains links that provide information on the contributors of information to the Website. The privacy statement clearly provides visitors and subscribers with the assurance that their information will not be shared. All the information on the site is therefore provided on the basis of full disclosure, both of the information itself and on information providers.
This Website is therefore very reliable, and also includes information on a myriad of other health topics, which will be helpful for Amy if she wants more information on her other conditions as well.
Suspicious Website: http://www.asthmaanswersonline.com/cures-asthma/
This Website indicates that asthma can in fact be cured. Prominently displayed at the top…
Most of the literature deals with healthcare issues experienced in the United States or Europe. hat small amount of literature there is available on healthcare in Malaysia seldom has anything to do with the clinic(s) in specific. This study could help, in some small measure, to alleviate that problem.
orks Cited
Chowdhury, N., (1999) the Power of Towers, Fortune, Vol. 139, No. 7, pp. 110-112
Kurokawa, I., Takami, M., Cheriex, H., (1999) Futuristic flight plan - the Kuala Lumpur International Airport was designed for the new millennium, Lighting Design + Application, Vol. 29, No. 8, pp. 42-45
Manson, L.A., Baptist, a.J., (2002) Assessing the cost-effectiveness of provider-based status, Healthcare Financial Management, Vol. 56, No. 8, pp. 52-59
Romano, M., (2006) Physicians in pain, Modern Healthcare, Vol. 36, No. 4, p. 40
Shameen, a., (2004) Malaysia: Coining it in Kuala Lumpure - Start-up ECM Libra has capitalized on strong markets, hard…
Works Cited
Chowdhury, N., (1999) the Power of Towers, Fortune, Vol. 139, No. 7, pp. 110-112
Kurokawa, I., Takami, M., Cheriex, H., (1999) Futuristic flight plan - the Kuala Lumpur International Airport was designed for the new millennium, Lighting Design + Application, Vol. 29, No. 8, pp. 42-45
Manson, L.A., Baptist, a.J., (2002) Assessing the cost-effectiveness of provider-based status, Healthcare Financial Management, Vol. 56, No. 8, pp. 52-59
Romano, M., (2006) Physicians in pain, Modern Healthcare, Vol. 36, No. 4, p. 40
elationship of Information Technology to Organizational Performance
Enterprises have continually invested in information technologies (IT) to gain competitive advantages by improving their business processes, integrating and aggregating diverse databases, and then transforming the data into a competitive advantage. The paradox of how to invest in IT for an optimal return however has been elusive (Brynjolfsson, Hitt, 1998). Traditional measures of eturn on investment (OI), metrics and key performance Indicators (KPIs) have failed to scale from the operational sides of a business to the data- and knowledge-based processes and functions (Ko, Osei-bryson, 2008). Analysis of information technology investments and their contributions to a firm's financial performance illustrate that the selective use of IT to supplement strategies, not its en masse adoption, is a critical success factor (Osei-Bryson, Ko, 2004). Studies have shown that in a market duopoly characterized by slow to moderate growth, the automating of processes and strategies has the…
References
Barrett, J.. (2007, November). Demand-Driven is an Operational Strategy. Industrial Management, 49(6), 14-19,5.
Brynjolfsson, Erik, & Hitt, Lorin. (1996). Paradox lost? Firm-level evidence on the returns to information systems spending. Management Science, 42(4), 541.
Erik Brynjolfsson, & Lorin M. Hitt. (1998). Beyond the productivity paradox. Association for Computing Machinery. Communications of the ACM, 41(8), 49-55.
Sanjeev Dewan, & Chung-ki Min. (1997). The substitution of information technology for other factors of production: A firm level analysis. Management Science, 43(12), 1660-1675.
elationships and expectations form one of the three main domains of the PEN-3 model. These three factors, perceptions, enablers, and nurturers, refer to the cultural component of health-seeking behaviors. The relationships and expectations domain can inform healthcare workers about how to encourage health-seeking behaviors in patients, and is a culturally sensitive approach. The PEN-3 concept shows how culture is a major determinant of both individual and public health.
Perceptions refer to the individual's perceptions about health, disease, medication, doctors, and healthcare systems. The perceptions are related directly to the cultural values, beliefs, and norms that are already embedded in the community. Individual and collective group health behaviors may be strongly determined by perceptions. For example, is there a perception that heart disease is not a serious problem in the African-American community? Or, is there a perception that healthcare is too expensive, or that doctors are too paternalistic? Perceptions might also…
References
Centers for Disease Control and Prevention. (2010) A Closer Look at African-American Men and High Blood Pressure Control: A Review of Psychosocial Factors and Systems-Level Interventions. Atlanta: U.S. Department of Health and Human Services. Retrieved November 1, 2011 from http://www.cdc.gov/bloodpressure/docs/African_American_Executive_Summary.pdf
Perez, M.A. & Luquis, R.R. (2008). Cultural Competence in Health Education and Health Promotion. John Wiley & Sons.
US Department of Health & Human Services [USDHHS], Maternal Child Health Bureau [MCHB] (2009). Core Concepts in Cultural Competence. Retrieved November 1, 2011 from http://support.mchtraining.net/national_ccce/case0/home.html
2).
A Patient's Rights
There are a number of lists to go by when it comes to the patient's "Bill of Rights," including a patient's rights under the Affordable Care Act. In the American Cancer Society "Patient's Bill of Rights" it begins with the right every patient has to "…accurate and easily-understood information about your health plan, health care professionals, and health care facilities' (www.cancer.org). Of course a patient also has the right to choose health care providers and when it comes to emergency services, a patient has a right to be "…screened and stabilized using emergency services" when injured or seriously ill; so that when one's health is in jeopardy, access to emergency services can be a vital and stabilizing experience (www.cancer.org).
A patient also has the right to be part of decisions regarding what treatment is appropriate, and a patient has a right to be respected and treated…
Works Cited
American Cancer Society. (2011). Patient's Bill of Rights: What is the Patient's Bill of Rights?
Retrieved July 31, 2012, from http://www.cancer.org .
Torrey, Trisha. (2010). Patient's Responsibilities. About.com. Retrieved July 31, 2012, from http://patients.about.com .
elationship Problems Support Group
Support groups are usually created to bring together individuals facing similar problems or issues such as relationship problems. The concept behind the formulation of a support group is that members can get help for their issues through talking with others in a similar situation. In this case, relationship problems support group exist so that people facing relationship issues can share their experiences and advice each other on how to handle them. Support groups help individuals deal with their problems through providing better ways of coping and making members feel less isolated as they make important connections with others in the same situation. While relationship problems support groups are not group therapy sessions, they help members to deal with relational issues through providing emotional support and shared experiences.
Historical Context
A support group is basically defined as a gathering of individuals who share similar interests or concerns…
References
Mayo Clinic Staff. (n.d.). Support Groups: Make Connections, Get Help. Retrieved August 22, 2016, from http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/support-groups/art-20044655
Peretti, A.G., Martins, P.P.S. & Guanaes-Lorenzi, C. (2013). The Management of Social Problems Talk in a Support Group. Psicologia & Sociedade, 25. Retrieved from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-71822013000500012
"Relationship Support Group."(n.d.). Divorce Dialogue. Retrieved August 22, 2016, from http://www.divorcedialogue.com/relationship-support-group-home.php
Sroufe et al. (2000). 5 Relationships, Development, and Psychopathology. In Handbook of developmental psychopathology (2nd ed). Arnold J. Sameroff, Michael Lewis, and Suzanne M. Miller (Eds). Retrieved August 22, 2016, from http://www.psychology.sunysb.edu/attachment/online/sroufe_rel_pathology.pdf
Nurse-Patient Relations
The main focus of this essay is going to concern the nurse-patient relationship idea, and why it is important. This was chosen because the researcher desired to achieve a better accepting of how a helpful nurse-patient relationship can be advanced and even from different theorists who have discovered this idea. In this essay, the researcher sets out to demonstrate what they have learnt regarding the nurse-patient relation concept and how this connection can utilized in the clinical practice setting. T The nurse patient connection, according to a study done by Press Gamey Associates Inc., creates the quality of the care experience and generates an influential influence on patient gratification. Nurses will a lot of their time with patients. Patients see nurses' relations with people among the care team and make their own conclusions about the hospital founded on what they are observing. Furthermore, nurses' approaches toward their vocation,…
Works Cited
Berdes, C. & . (2001). Race relations and caregiving relationships: A qualitative examination of perspectives from residents and nurses aides in three nursing homes. Research on Aging, 23(1), 109-126.
Biering, P. (2002). Caring for the involuntarily hospitalized adolescent: The issue of power in the nurse-patient relationship. Journal of Child and Adolescent Psychiatric Nursing, 16(2), 65-74.
Heijkenskjold, K.B. (2010). The patients dignity from the nurses perspective. Nursing Ethics, 6(3), 313-24.
LaSala, C.A.-B. (2007). The role of the clinical nurse specialist in promoting evidence-based practice and effecting positive patient outcomes. The Journal of Continuing Education in Nursing, 38(6), 262-70.
Care:
Issler is a patient who recently moved with his daughter-in-law who is no longer married to his son. As part of her interest in helping to take care of Mr. Issler, she noticed that he was pale and diaphoretic after a two and a half hour flight. The daughter-in-law took him to an emergency room where he was attended to by a cardiologist and set a follow-up check up for an echo cardiogram next week. Mr. Issler has complained of congestive heart failure and a history of deep vein thrombosis. The cardiologist recommended that he seeks out a primary care provider and check up of his thyroid. As the primary care provider, the patient has also expressed his uncertainties on whether he has hyper of hypo thyroidism though he has been under thyroid medication for several years. In addition to being very pale, he has a large bag of…
References:
Bray, D.L. (n.d.). Thyroid Storm and the AACN Synergy Model. Journal of Nursing. Retrieved from http://rnjournal.com/journal-of-nursing/thryoid-storm-and-the-aacn-synergy-model
Drewes at. al. (2012, October). The Effectiveness of Chronic Care Management for Heart Failure: Meta-Regression Analyses to Explain the Heterogeneity in Outcomes. Health Services Research, 47(5), 1926-1959.
Hardin, S. & Hussey, L. (2003, February). AACN Synergy Model for Patient Care Case Study of a CHF Patient. Critical Care Nurse, 23(1), 73-76. Retrieved from http://ccn.aacnjournals.org/content/23/1/73.full.pdf
Kaplow, R. & Reed, K.D. (2008). The AACN Synergy Model for Patient Care: A Nursing
(Hummelvoll, 1996, p. 13)
The professional relationship that the client has with the nurse is often one of the most fundamental of all the relationships the client has in his or her life. The nurse can act as an advocate between the client and other health care professional as well as an advocate for the client with his or her own family. The holistic needs of the client are often met through this and other relationships, when they are strong, consistent and productive.
A an authentic caring relationship between clients and nurses. This relationship stimulates mutual empowerment and helps the client pass through the conglomerate of not easily accessible helping systems in the United States. The purpose of this reciprocal and chosen partnership is to increase the client's safety and quality of life. Here too, empowerment is a means to better health, with the nurse acting as the client's advocate,…
Resources
Hummelvoll, J.K. (1996) "The Nurse-Client Alliance Model." Perspectives in Psychiatric Care. 32/4, pp.12-17.
Vuckovich, P.K. (2000) "The Ethics of Involuntary Procedures." Perspectives in Psychiatric Care. 36 / 4. p.111.
nursing client relationships and how the study is a valid research for practitioners. It has 26 sources in Harvard Style.
esearch titles must be limited to fifteen words. In this case the author has exceeded the limitation by one count which is negligible. The importance of relevance of the title to the body of the research is that it must collaborate with the core study area. In the first line the author has already specified the relationship of the nurse-client at the beginning and categorizes it as a "partnership" whereas the title of the study must not reveal the results or even the anticipated results.
Authors and Abstracts
The authors T. Hostick and F. McClelland both the authors indicate in their abstract that the article aim in establishing nursing behavior when they are engaged in a nurse-client relationship. The abstract though is limited in expressing the content of the study…
References
Hostick, T. & McClelland, F. 2002, Partnership: a co-operative inquiry between Community Mental Health Nurses and their clients. 2. The nurse-client relationship. Journal of Psychiatry and Mental Health Nursing 9, 111-117.
Beyea, S.C. 1997, Research utilization begins with learning to read research reports, Research Corner, AORN, February. Accessed on 29-9-2003 at http://www.aorn.org/journal/research/rc297.htm
Author not available, 2003, Reading Nursing Research to Critique a Study and to Summarize Findings for Use in Practice, Available at http://classes.kumc.edu/son/NURS460smith/460critiquingreseach.html
Forchuk, C. 1989, Establishing a Nurse-Client Relationship. Journal of Psychosocial Nursing vol.27,no.2. Available at http://willmar.ridgewater.mnscu.edu/library/338271.htm
Ethical Scenario: Skills as a Nurse Practioner
Nurses and other health care suppliers are the ones that are continuously confronted to make ethical choices in regards to things like life and death matters in giving out care to individuals, communities and families. To be pertinent and ethical, these choices need to be measured in the larger context of personal, societal, cultural and professional values and ethical ideologies. As scientific and medical technology advance, persons and society look at dilemmas and hard ethical choices. Nurses, as part of society and as frontline health care specialists, day-to-day face ethical dilemmas connected to life and death and fairness in health care. With that said, this paper examines the scenario of patient and nurse utilizing ethical principles.
As a nurse, the first thing to do is to understand that an unintended pregnancy further confuses the already confusing physical and mental changes of teens. Adolescents…
References
Begley A.M., 2. (2008). Truth-telling, honesty and compassion: a virtue-based exploration of a dilemma in practice. International Journal of Nursing Practice, 8, 336-341.
Lawlor, A. (2015, July 29). Morning-after pill poses moral dilemma for some MDs. Retrieved from http://www.consciencelaws.org/background/procedures/birth008.aspx
Marsh, B. (2015, July 29). Nurses' fear for morning-after pill. Retrieved from Daily Mail: http://www.dailymail.co.uk/health/article-179092/Nurses-fear-morning-pill.html
RN, M.S. (2013). The Ethical Component of Nursing Education: Integrating Ethics into Clinical Experiences. LWW; 1 edition.
Nursing Philosophy
Perhaps the most fundamental tenet of my nursing philosophy is the administration of care in an intrinsically empathetic manner which benefits the patient. I unequivocally believe in patient-centered care and that nurses who are able to maintain this component of their practice as their primary goal are able to produce the greatest efficacy in administering to patients. Moreover, with all of the concerns of the contemporary healthcare market, including various facets of financial and technological concern, the shortage of various practitioners, and innovations in precision medicine, it is easy to forget that the most vital component of the health care industry is the patients themselves. Quite simply, patients have the most to gain and lose from the health care system. Therefore, I readily believe that keeping those patients as the center of the care delivered by me and others within my profession is the best way we can…
References
Andrist, C., Nicholas, P. and Wolf, K. (2006). The Evolution of the Environment Paradigm in Nursing. A history of nursing ideas (pp. 97- 108). Sudbury, MA: Jones and Bartlett.
Bourdeau, M. Auguste Comte. The Stanford Encyclopedia of Philosophy. https://plato.stanford.edu/archives/win2015/entries/comte/
McEvoy, L., Duffy, A. (2008). Holistic practice -- a concept analysis. Nurse Education in Practice. 8, 412-419.
Zborowsky, T. (2014). The legacy of Florence Nightingale's environmental theory: nursing research focusing on the impact of healthcare environments. Health Environments Research & Design Journal. 7(4), 19-34.
patient's general health been? - The Patient, Mr. Jones has generally been good but with frequent cases of heart complications. The situation has been deteriorating over time.
Any colds in past years that required absences from work?-None
Most important things you do to keep healthy? -- regular jogging exercise and being a vegetarian
Accidents (home, work, driving)?-Twice when the patient experienced a heart attack
In past, has it been easy to find ways to follow suggestions from physicians or the nurses? Yes
F. If appropriate: what do you think caused the illness? I believe the illness was caused by the kind of lifestyle that I had (smoking and eating high cholesterol meals while also leading a sedentary life)
g. If necessary: outline the things important to you in your health care? How can we be most helpful? I require hypertensives and advice on how to live a healthy life
Examination…
References
Gordon, M. (2000). Manual of nursing diagnosis: 1995- 1996. St. Louis: Mosby.
Gordon, M. (1994). Nursing diagnosis: Process and application (3rd ed.). St. Louis: Mosby;
Patient Autonomy
The concept of patient autonomy, as opposed to medial paternity, is one that has gained much ground in recent years; "... about 30 years ago, issues began to appear that were difficult to solve using traditional ethics. New medical and reproductive technologies, research controversies, and a societal ethos that questioned all authority posed difficult questions." (Czaplyski, Larry, 2002)
At issue in this paper is the meaning and significance of patient autonomy and the way in which is relates to medical paternity. As the discussion will outline, the case for patient autonomy is not only ethically valid but also essential for the moral and practical balance in the medical profession. Underlying this view is the fact that the issue of patient autonomy does not exist in isolation or in the medical field alone - but relates to other issues and ethical problems in the society at large. These larger…
Bibliography
Bernstein Maurice, (2004) Social/Political Paternalism vs. Patient Autonomy.
Retrieved October 4, 2004 from Bioethics Discussion Blog: Web site: http://bioethicsdiscussion.blogspot.com/2004/07/socialpolitical-paternalism-vs.-patient.html
Bradley, Gerard V. (1989). "Does autonomy require informed and specific
Refusal of life-sustaining medical treatment." Issues in Law & Medicine, December 22, 1989. Czaplyski, Larry. (2002)
An efficacious preceptorship is centered on establishing a relationship and outlining expectations. This takes into account offering a strong basis to cultivate and sustain an effective level of mutuality for setting up a working relationship with the nursing practitioner student. It is imperative to note that this relationship is beneficial to both parties. On one hand, the preceptor attains greater competence in rendering service whereas for the NP student, he or she develops clinical expertise and leadership. Directed clinical learning experiences are vital to nurse practitioner education. The objective is to make certain that clinicians are prepared to manage care with ideal health results. The use of preceptors has substantiated to be a vastly beneficial approach for clinical education. It permits education to be customized, connects classroom knowledge to actual patient management issues and complications, and offers for role modeling as the student cultivates principles and approaches for practice (Burns…
Responsibilities of Nurses to Patients
Why is it important
The role of nurses has a direct implication on the patients. For example, nurses observe and provide direct care to the patients. The physicians give orders and thus are the role of the nurses to implement (Aiken et al., 2014). Often, the work of the physicians is not complete without the help of the nurses. The nurses are responsible for changing clothes and giving the medications to patients. Often, the patients are unable to do basic tasks, and therefore the roles of nurses become very important. Nurses keep medical records for the patients and therefore give medications to the patients in time and monitor their progress.
Another important role of the nurse is assessing the response of the patients to medications. Keep the records for the progress of patients is an invaluable practice. The records help the nurses to monitor how…
patient is a 35-year-old (male?), he was diagnosed with diabetes twenty five years ago at the age of ten years old, he claims that this is hereditary in his family. He has one sister who has Type 2 diabetes and a brother who has type 1 diabetes. He manages his diabetes and other illnesses from home and through a medical clinic; for most of his life he has known he has diabetes and manages to regulate it through insulin shots, glucose tablets as well as through the right nutrition, however he claims that this is difficult and there are most days where he experiences draw backs. Many complications have arisen from his diabetes. This patient was selected because of the certain case he has in regards to his diabetes and other complications which had developed from it. His treatment and management also includes an extensive study. At the young age…
Critique
The article was written quite comprehensively and gave enough information about the different aspects of history taking. The way all the different components of the history taking process were split up and explained in more detail was very helpful. It was noted that the entire information in this article was present in a rather organized way. This organized way of presenting the details helped in teaching the history taking process and left less ambiguity. One thing that could have been improved is that common mistakes in the history taking process should have been mentioned. Surely with the amount of research done on this topic, the common mistakes and questions would have been figured out. If the commonly made errors are highlighted in these articles, then those errors are less likely to be repeated by other nurses as well.
This article did interest me as it provided me with a…
References
Crumbie, A. (2006). Taking a History. In: Walsh, M. eds. (2006). Practitioners: Clinical Skiiis and Proffesional Issues. 2nd ed. Edinburgh: Butterworth-Heinemann, pp. 14-26.
Dougias, G., Nicoi, F. And Robertson, C. (2005). Madead's Ciinicoi Examination. 11th ed. Edinburgh: Churchill Livingstone.
Kurtz, S., Benson, J., Draper, J. And Silverman, J. (2003). Marrying content and process in clinical method teaching: enhancing the Calgary-Cambridge guides. Academic Medicine, 78 (8), pp. 802-809.
Lloyd, H. And Craig, S. (2007). A guide to taking a patient's history. Nursing Standard, 22 (13), pp. 42-48.
Part 1
Eliza, a patient aged eighteen, is enrolled at the City University and resides in a dorm with friends. The patient is currently seeking treatment for stress/anxiety and low self-image (Eliza Intake Document Provided by Customer). Eliza has not indicated any life stressors. Her father, Burt, drives a truck for a living, whereas her mom, Joan, is an elementary school secretary. While the father-daughter relationship appears to be quite strong, Eliza appears to have issues that need working on, when it comes to her relationship with her mother. As of now, Eliza is not taking any mental health medication.
Psychosocial assessment forms a key component of all nursing evaluation, as it aids nursing professionals by informing the disorder management and patient care plan. Individuals usually display diverse kinds of surgical or medical issues. Further, social or psychological aspects might impact their adherence to therapy and their recovery (Conducting…
patient was admitted due to a broken hip which required a total hip replacement (TH). This injury has required two weeks of in-hospital rehabilitation to this point, and Mr. Trosak will probably need more physical rehabilitation to completely recover from the injury. Since there are secondary concerns (such as some loss of cognitive function (text, 462)) after a fall, it will be necessary to monitor M. Trosak. The falling incident could also reoccur due to the fact that the patient resides on the second floor of his apartment building. It will be necessary to ensure that Mr. Trosak understands the risk of a recurrence, and that he has sufficient assistance.
Prior to being hospitalized for the fall, Mr. Trosak was not taking any prescription medication, and he has not had a physical examination for more than ten years. While admitted, the patient was found to have chronic hypertension, which is…
References
Smith, M., & Segal, J. (2011). Depression in older adults and the elderly. Retrieved from http://www.helpguide.org/mental/depression_elderly.htm
Vanwanseele, B. (2009). To rehab or not to rehab following a total hip replacement. Retrieved from http://sydney.edu.au/research/opportunities/opportunities/561
Text.
The purpose of effective communication is to co-ordinate efforts towards achieving team goals, enhancing quality of meetings for information to be shared, decisions collectively made, and for there to be shared understanding about the tasks to be performed. A necessary component of team work is establishing shared meaning of the work, and appropriate means of delivering high quality consumer care (Borrill et.al, 2000).
Effective healthcare centers heavily rely on effective communication for them to live up to their missions. Productivity at the workplace improves when information flawlessly flows from one level to another. It leads to more tasks completed, consequently leading to the fulfillment of goals. In the workplace too, effective communication usually has a positive effect on employee performance through increased morale, higher retention rates and the overall productivity at the workplace. According to Aramyan (2015), it also leads to reduced misunderstandings, increased empowerment and truthfulness, as well as…
1. Subjective
Patient’s chief complaint, reason for visit
Ms. Richards arrived complaining that she was experiencing severe anal pain, so much so that using a tissue was also proving impossible. She claimed the pain began a couple of days earlier and has aggravated considerably since.
History of Present Illness
Ms. Richards arrived complaining of anal pain which commenced a couple of days earlier and has aggravated since. With regard to her intimate relationships, Ms. Richards states that though she has a boyfriend, their relationship isn’t serious as the two are also seeing other people. According to internal assessment reports, patient has normal hair distribution, an intact perineum, and intact urethral meatus without any discharge or inflammation. However, patient experiences unbearable pain on vaginal opening palpation, redness, and edema. Further, a mass has been identified on the right, with spontaneous, dark-yellow, smelly secretion with palpation over the Bartholin's glands.
Physical examination…
Communication Discussion Board Response
I would have to respectfully disagree with the idea that communication is mainly about being clear in one's verbal and nonverbal language. A nurse can clearly communicate how to follow a healthy diet to a diabetic -- or the need to stay clean to a drug addict -- but unless the nurse comprehends the patient's own view of his or her situation, such as the real medical need to follow the diet or the dangers of drug abuse, communication has not transpired in an effectual fashion. It is just as important that the nurse understand the patient's body language, to assess whether he or she is listening, and to ask the patient to restate the treatment plan, and to repeat what he or she feels about his or her condition.
Discussion
You make a very important point that the process of communicating with patients isn't about…
Christy had some preconceived notions about Roamni people and their motivations, habits, and lifestyle. Being proactive rather than reactive is the best way to deal with different cultural practices and beliefs. Christy could educate herself regarding the cultural practices of bathing, cleanliness, eating etc. This information is available on the internet. Typically when faced with medical condition that a nurse, aide or physician is unfamiliar with it is a common practice to research it. This practice should extend to dealing with certain cultural groups one has not encountered. Obviously, she should have changed the water, sponge, and washed herself after touching the patient's lower body in clear view of the patient's relatives. Perhaps a better approach would have been to offer the patient's family the opportunity to participate in the care of the patient and perform some of these functions or to ask them how she should care for the…
Health Screening
Biographical Data
Cathy is a 17-year-old female. She is suffering from a certain amounts of loneliness and depression (DSM-IV). This is because her mother died in Iraq 10 years ago when serving in the Army eserves. She is currently living with her uncle and often deals with these issues from not being able to talk to her mother. She never knew her father and has no way to contact him. To account for them, she hides her feelings by turning to social networking sites as a way to connect with others. In the process, she places her entire life history for everyone to see and often takes pictures of herself. At the same time, she was elected class President and hides these feelings by being engaged in variety of activities (such as: Future Business Leaders of America and track). Yet, underneath it all, she feels like the world…
References
Ackley, B. (2013). Nursing Diagnosis Handbook. Maryland Heights, MO: Elsiever.
Ladwig, L. (2013). Mosby's Guide to Nursing Diagnosis. Maryland Heights, MO: Elsiever.
These suppositions allow the researcher to view the world from a certain perspective while ignoring other perspectives. The researcher in this study assumes that his subjects are logical human beings who have a rationale point-of-view. Their thinking is valid and reasonable and their approach is more or less along the lines of scientific thinking. In addition, we assume that commonsense thinking and scientific thinking are more or less identical in nature. With these assumptions in mind, we take a post-positivism philosophical foundation; as in line with Trochim (2000) post-positivism is the outright denial of positivism (which argues that the laws of the nature are perfunctory and therefore deductive reasoning can be the only suitable approach to comprehend nature) and presupposes that day-to-day human and scientific reasoning are more or less the same and in order to understand reality, researchers have to use not only deductive but also inductive reasoning (Trochim,…
References:
Bailer UF, Frank GK, Henry SE et al. (2005). Altered brain serotonin 5-HT1A receptor binding after recovery from anorexia nervosa measured by positron emission tomography. Archives of General Psychiatry, 62, 1032-1041.
Bloks H, Hoek HW, Callewaert I et al. (2004). Stability of personality traits in patients who received intensive treatment for a severe eating disorder. Journal of Nervous and Mental Disease, 192, 129-138.
Bulik CM, Klump KL, Thornton L. et al. (2004). Alcohol use disorder comorbidity in eating disorders: a multicenter study. Journal of Clinical Psychiatry, 65, 1000-1006.
Byrne, B. (2000) Relationships between Anxiety, Fear Self-Esteem, and Coping Strategies in Adolescence. Adolescence. 35. 137.
Introduction
Patient-centered care is the goal of many healthcare organizations, but the ability of an organization to deliver patient-centered care is influenced by a number of factors both internal and external. Business practices, regulatory requirements, and reimbursement all can impact patient-centered care in any healthcare organization. Promoting patient-centered care requires an organizational culture committed to this paradigm, which also needs to be embedded in the mission and values of the organization.
Executives and administrators create the organizational culture that promotes patient-centered care. All leaders in the organization are responsible for using patient-centered practices and communications styles in their interactions with patients and their families. Furthermore, administrators oversee the policies and procedures that directly impact the culture of care. Analyzing areas of weakness within the organizational structure and culture via established assessments like the Patient-and Family-Centered Care Organizational Self-Assessment Tool, it is possible to create multidisciplinary teams that promote the organization’s…
older patients over the age of 80 due to complications in health such as dementia and depressive symptoms, do not go for additional follow-ups. Yes, the authors explain repeated in person visits help better identify risk factors. There is no obvious research question however they do highlight the use of a study to confirm the hypothesis of whether or not repeated in person follow-ups help with problems experienced as patient's age. "We hypothesized that the type of visit would be related to key demographic, lifestyle, health and function characteristics and that the oldest aged participants would have the poorest retention for in-person visits, particularly clinic visits" (Strotmeyer et al., 2010, p. 697). This is a directional hypothesis because the retention rates are directly associated with increase in age. It is a simple hypothesis because it directly states a cause and effect. The hypothesis was tested and it revealed in-home visits…
References
Strotmeyer, E.S., Arnold, A.M., Boudreau, R.M., Ives, D.G., Cushman, M., Robbins, J.A., Newman, A.B. (2010). Long-Term Retention of Older Adults in the Cardiovascular Health Study: Implications for Studies of the Oldest Old. Journal of The American Geriatrics Society, 58(4), 696-701. doi:10.1111/j.1532-5415.2010.02770.x
Patient Protection and Affordable Care Act/Impact of ACA from the Organizational and the Patients view
Impact of the Affordable Care act (ACA) on the population that it affected
Impact of the economics of providing care to patients from the organization's point-of-view
How will patients be affected in relationship to cost of treatment, quality of treatment, and access to treatment?
Ethical implications of this act for both the organization and the patients
Impact of the Affordable Care act (ACA) on the population that it affected
The Affordable Care Act (ACA), as initially passed, mandated Medicaid expansion, for covering a majority of low-income, as-yet-uninsured American citizens and immigrants (with legal residency in the U.S. for a minimum duration of 5 years). The United States Supreme Court, however, in the historic National Federation of Independent Business v. Sebelius, 132 S. Ct. 2566 (2012), maintained that the obligatory Medicaid expansion proved to be unconstitutionally…
References
ACA. (2015). The Patient Protection and Affordable Care Act. Retrieved on 13th September, 2015 from http://www.dpc.senate.gov/healthreformbill/healthbill52.pdf
Howard, P. (2015). The Impact of the Affordable Care Act On the Economy, Employers, and the Workforce. edworkforce.house.gov. Retrieved on 13 th September, 2015 from http://edworkforce.house.gov/uploadedfiles/02.09.11_howard.pdf
Kengmana, R.T. (2015). An Ethical Perspective on the Affordable Care Act. MA: Psych Central. Retrieved on 13th September, 2015 from http://googleweblight.com/?lite_url=http://psychcentral.com/about/feedback&lc=en-IN&s=1&m=101&ts=1442202299&sig=APONPFlqjqQURNK5jFIewCvXRMJzyhz8zA
NCIOM. (2015a). Examining the Impact of the Patient Protection and Affordable Care Act in North Carolina. Chapter 7: Quality. Retrieved on 13th September, 2015 from https://www.google.co.in/url?sa=t&source=web&rct=j&url=http://www.nciom.org/wp-content/uploads/2013/01/Final-Ch7-Quality-FINAL.pdf&ved=0CCYQFjABahUKEwjv_JDfr_XHAhVIB44KHfLKAPg&usg=AFQjCNEdTlwW2QuvqN5Rn6qM31poi4lBUA
Dual elationships
The relationship between a service provider and their client is particularly sensitive because the circumstances that bring the two individuals into contact are usually necessitated by a state of mental unrest in the client. Accordingly, the issue of whether or not to engage in a dual relationship (when the doctor has a relationship with their patient distinct from the clinical context) with the client must be treated in a very sensitive manner; the therapist has a responsibility to not only operate in their own best interest but also that of the patient they are hired to assist. This paper examines the relationship between a therapist and an unhappily married Latin American female client, determining whether or not the therapist should advocate divorce and pursue a romantic relationship with his client. Although the therapist has decided that they will pursue the relationship and advocate divorce, this is not recommended.…
References
Dewane, C.J. (2010). Respecting boundaries -- the don'ts of dual relationships. Social Work Today, 10, 1, 18.
Freud, S., & Kreug, S. (2002a). Beyond the code of ethics, part II: Dual relationships revisited. Families in Society, 83(5), 483-492.
Difficult Patients
Mitigating isks from Dementia
Providing adequate care for an individual suffering from dementia presents many difficulties for nurses. Patients with dementia often have debilitating conditions such as Alzheimer's or similar neurologic diseases which are progressive, thereby making it challenging for them to remember, think lucidly, communicate effectively or complete activities of daily living. Furthermore, dementia can cause rapid variations in mood or even modify personality and behavior. With the tremendous number of elderly in society more and more nurses are required to care for patients with progressive dementias. It is imperative that a diagnosis be reached early in the course of the cognitive impairment and that the patient is closely monitored for coexisting morbidities. Nurses have a central role in assessment and management of individuals with progressive dementia. This essay provides some evidence-based practical strategies for managing the behavioral problems and communication difficulties often encountered in this population.…
Reference List
Aud, M.A., Oliver, D., Bostick, J. And Schwarz, B. 2011. Effectiveness of Social Model Care Units for Dementia. International Nursing Research Congress 2005.
Care, N.D. 2010. Teaching and Learning. Pulse. Winter Edition.
Fletcher, S. And Zimmerman, S. 2010. Trainee and trainer reactions to a scripted dementia care training program in residential care/assisted living settings and nursing homes. Alzheimer's Care. 11(1): 61-70.
Goodman, C. 2011. The organizational culture of nursing staff providing long-term dementia care is related to quality of care. Evidence-Based Nursing. 47:1274-1282.
Demographic Perception Survey of Patients with Atypical CP Who Present to Cardiac Care Doctors and Patient Outcomes
This study intends to examine gender differences in individuals who present to cardiac doctors with chest pain and specifically, atypical chest pain in women. The work of Debra L. Issac (2000) states that over the past ten years "there has been increasing awareness of both the importance of CAD in women and of the significant differences between men and women who have the disease. Potential gender biases, both within the medical community and within the general population of women themselves also have been identified. These gender differences and biases have the potential to influence investigation and management of suspected or confirmed CAD in women, and should be taken into consideration when faced with a woman with potential cardiovascular disease." (p.157)
Issac also states that chest pain in women is "common and often non-ischemic.…
References
Cayley, WE (2005) Diagnosing the Case of Chest Pain. American Family Physician. 15 Nob 2005. Retrieved from: http://www.aafp.org/afp/2005/1115/p2012.html
Gotzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database Syst Rev. (1):CD001877, 2011.
Issac, DL (2000) Women with Ischemic Heart Disease. Presented at the Canadian Cardiovascular Congress, Vancouver, British Columbia, October 2000. Retrieved from: http://www.stacommunications.com/journals/cme/images/cmepdf/oct01/womencv.pdf
Khan, JJ, Albarran, JW, Lopez, V, and Chair, SY (2010) Gender Differences on Chest Pain Perception associated with Acute Myocardial infarction in Chinese patients: A Questionnaire Survey. J Clin Nurs. 2010 Oct, 19 (19-20)2720-0. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/20846222
Treatment to Patients
The main objective of providing treatment to patients is to relieve symptoms along with decreasing the progression of the disease as well as the mortality or morbidity. However, in some cases, this objective is not fully achieved, especially in the case of the patients who are admitted to the ICU with some serious and almost always a terminal stage of the disease. For example, when old patients are admitted in the ICU, their immunity is extremely low and this is the perfect time for the opportunistic infections to make matters worse for these patients. There are many infections that are specifically associated with patients admitted in the hospitals. Pseudomonas Aurigeonosa is a micro-organism that is well documented to cause bacterial pneumonia and bacteremia in the patients who are terminally ill and are receiving treatment in the hospital setting. Since most of the patients in the ICU are…
Bibliography:
Beekmann, SE;Diekema, DJ; Chapin, KC;Doern, GV (2003) Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges.J ClinMicrobiol, 41:3119-3125.
Boussekey, N, Leroy, O, Georges, H, Devos, P, d'Escrivan, T, Guery, B (2005).Diagnostic and prognostic values of admission procalcitonin levels in community-acquired pneumonia in an intensive care unit.Infection, 33:257-263.
Charles, PE, Dalle, F, Aho, S, Quenot, JP, Doise, JM, Aube, H, Olsson, NO, Blettery, B: Serum procalcitonin measurement contribution to the early diagnosis of candidemia in critically ill patients. Intensive Care Med, 32:1577-1583.
Digiovine, B; Chenoweth, C; Watts, C; Higgins, M (1999)The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J. RespirCrit Care Med, 160:976-981.
Supervisory elationship in Psychology
In psychology, supervision is playing an important role in determining how effectively professionals are able to monitor their colleagues and ensure they are following the highest standards. This takes place by meeting with another associate inside the same discipline and field. The basic idea is to review the techniques that are utilized and seek out alternate avenues for enhancing professionalism. This occurs with both people serving as equals to understand how specific techniques and practices could have an impact on quality. During this process, there is an emphasis on engagement, uncertainty and formation. (Watkins, 2011, pg. 58, para. 2)
These models are serving as a foundation in understanding key challenges and the effects they are having on stakeholders. To fully comprehend this role requires examining how supervision is utilized. This will be accomplished by describing the attributes and the process for an optimal relationship. Together, these…
References
Bennett, S. (2008). The Interface Attachment. Smith College Studies in Social Work, 78 (2), 301 -- 317.
Farber, E. (2010). Introduction to the special section. Psychotherapy: Theory, Research, Practice, Training, 47(1), 1.
Landany, N. (2013). Effective and Ineffective Supervision. The Counseling Psychologist, 41 (1), 28-47.
Lyne, A. (2007). Empathetic Relational Bonds and Personal Agency is Psychotherapy. Psychotherapy, Theory, Research, Practice and Training, 44 (4), 371-377.
Doctors Drugs
Although the Affordable Health Care Act represents a step in the right direction towards encouraging all Americans to avail themselves of medical services, the bill fails to address the root causes of problems in the system. The American health care system is flawed because it is a for-profit model that places profits far ahead of patients. When profits come ahead of patients, the result is an inability to fulfill the ethical duties of being a health care worker. A progressive transformation of the American health care system would systematically undo the nefarious link between corporate interests and the interests of health care.
The relationship between doctors and drug companies has been well established and well documented. Major news media resources like The Atlantic, as well as professional peer-reviewed journals like the New England Journal of Medicine cover stories addressing the potential ethical conundrums inherent in a cozy connection…
References
Campbell, E.G. (2007). Doctors and drug companies -- Scrutinizing influential relationships. New England Journal of Medicine 2007;357: 1796-1797.
Carollo, K. (2010). Pay dirt: hundreds of doctors earned big money from drug companies. ABC News. 25 October, 2010. Retrieved online: http://abcnews.go.com/Health/Wellness/drug-companies-payments-doctors-revealed-database/story?id=11929217
"Let the Sunshine In," (2013). The Economist. Mar 2, 2013. Retrieved online: http://www.economist.com/news/business/21572784-new-efforts-reveal-ties-between-doctors-and-drug-firms-let-sunshine
Moynihan, R. (2003). Who pays for the pizza? BMJ 2003; 326:1189.
Nurse Patient atios and Quality of Care
This study reviews the broad level of issues that surround the nurse/patient ratio: a critical shortage of trained and experienced nurses; increased political and fiscal demands from all sectors of society; rising costs internally and externally combined with a rising number of under-insured; and the conundrum of nursing ethics and the ability to foster excellence in care and patient advocacy. We note that there remains an issue about hiring more nurses -- where will these nurses come from if the nursing schools do not increase their recruitment efforts and broaden their curriculum. In addition, we note that the large majority of patients and stakeholders primarily want two things when admitted to a healthcare facility: better paid nurses and more highly-trained professionals who are satisfied with their vocation.
Introduction
Modern nursing is, by necessity, a mixture of complex balance: patient care vs. staffing; procedures…
REFERENCES
More Nurses Make the Difference. (February 2012). The Lamp. 69 (1): Retrieved from: http://search.informit.com/au/documentSummary;dn=045435426132502;res=IELHEA
Safe Nurse Staffing: Looking Beyond the Numbers. (2009). Vantage Point, CNA. Retrieved from: https://www.nso.com/pdfs/db/newsletters/Safe_Nurse_Staffing_-_Looking_Beyond_the_Raw_Numbers_20094.pdf?fileName=Safe_Nurse_Staffing_ -_Looking_Beyond_the_Raw_Numbers_2009-pdf&folder=pdfs/db/newsletters
Aiken, L. (2001). The Hospital Nurse Workforce: Problems and Prospects."Draft
For the Council on the Economic Impact of Health System Change. Retrieved from: http://council.brandeis.edu/pubs/hospstruct / Council-Dec-14-2001-Aiken-paper.pdf
Ethics
Ensuring proper professional behavior
The nurse-client relationship is novel. No formula exists for judging the crossing of boundaries as good / bad, in the absence of considering the features of therapeutic relationship for every scenario. The suitable behavior must be measured with respect to professional's intent, respecting confidentiality, patient-client advocacy and corroborating the CAN Code of Ethics for egistered Nurses (Corey anad Callanan, 2007).
Violations of professional boundary
The crossings of boundaries are deemed as insignificant, but with the increase in frequency of such incidents of professional boundary violations, it could be serious. The nurse works on the patient-nurse relationship and fulfils the therapeutic needs of a patient and neglects his own. The professional boundary violation is not acceptable as it can spark other occurrences. The professional boundaries occur when conflict arises between client's needs and professional's needs. ationalization can be used to justify this behavior. The violation of…
References
Bond T, 1997, 'Standards and Ethics for Counselling in Action', pgs Sage Publications Ltd., London
Brammer LM & MacDonald G, 2003, 'The Helping Relationship, Process and Skills', pgs Library of Congress Cataloging-in-Publication Data, United States of America
Corey G & MS & Callanan P, 2007, 'Issues and Ethics in the Helping Professions', pgs Thomson Brookes/Cole, a part of The Thomson Corporation, United States of America
Egan G, 2007,'The Skilled Helper', pgs * Thomson Brookes/Cole, a part of The Thomson Corporation, United States of America
" (Giovacchini, 1996, pg. 2)
According to Giovachinni research into the psychodynamics of individuals in their experience of current adjustments and symptom formation is "much more interesting and fulfilling than monitoring surface behavior. processes are innately fascinating and their study creates dimensions and viewpoints that expand our appreciation of the versatility of the psyche as our in-depth understanding is increased, in itself, an aesthetic experience." (Giovacchini, 1996, pg. 2) Unconscious motivation is the "essence of the intrapsychic focus..." which serves to transform patients into "interesting human beings rather than the passive recipients of pharmacological ministrations. How the treatment procedures fits into the therapeutic relationship is taken into account, enabling patients to pursue autonomy and mastery of their emotions." (Giovacchini, 1996, pg. 2)
The work of Halil entitled: "Personality and Coping: A Multidimensional Research on Situation and Dispositional Coping" (2004) states that coping is defined "as a constantly changing cognitive and…
Bibliography
Intrapsychic (2008) Definition - Biology Online available at http://www.biology-online.org/dictionary/Intrapsychic
Intrapsychic (2008) Definition - the Free Library. Online available at http://www.thefreedictionary.com/intrapsychic
Giovachinni, Peter L. (1996) Intrapsychic Focus Can Have Lasting Benefits for Patients. 1996, December 1, Psychiatric Times, Vol. 13, No. 12. Online available at http://www.psychiatrictimes.com/display/article/10168/49006?pageNumber=2
Halil, EKSI (2004) Personality and Coping: A Multidimensional Research on Situational and Dispositional Coping. 2004 Egitim Danishmanligi ve Arastirmalari Iletisim Hizmetleri Tic. Ltd. Sti. (EDAM)
Customer relationship management (CM) is an essential component of organizational management. The purpose of this discussion is to focus on a CM strategy for United Behavioral Health a subsidiary of United Health Care . . United Behavioral Health is dedicated to presenting customers with high quality, cost-effective, managed mental health and substance abuse services to its customers. The investigation suggests that the company's core values have been successfully implemented into the company's CM Strategy. The current CM strategy utilizes technology to allow customers to voice their opinions. Currently the company's website ubhweb.uhc.com provides a page that offers help to members that are experiencing problems. In addition, it provides customers with "coaches" that can help whenever problems arise. The company's customers are currently divided into three different groups; the employer division, the health plan division and the public sector. We found testimonials of customers who were extremely satisfied with the care…
REFERENCES
Your Customers are Speaking To You. Do You Hear Them? 2002. 2 December 2004
http://www.jandlmarketing.com/pages/articles/article13.html
Gupta S. Binggeli U., Poomes C.D., CRM in the Air. The McKinsey Quarterly. Page Number: 6+.
Jacobs F.A., Claire Kamm Latham, Choongseop Lee. 1998. The Relationship of Customer Satisfaction to Strategic Decisions. Journal of Managerial Issues. Volume: 10. Issue: 2. Page Number: 165+.
Systems Theory
Discuss relationship systems theory healthcare deliver U.S. - What current concepts healthcare explained helped a system theory approach? - What system theory? - How researchers (Ludwig von Bertalanffy Everett M.
Systems theory and diffusion of innovation theory
Systems theory
Systems theory was not specifically designed to cope with the challenges of the U.S. healthcare system, although it has been frequently applied to some of its issues. Systems theory was originally coined by the scientist Ludwig von Bertalanffy to sum up his idea that the 'whole' of systems -- both biological and otherwise -- were larger than the sum of their parts. According to von Bertalanffy, "in the past, science tried to explain observable phenomena by reducing them to an interplay of elementary units investigable independently of each other, conceptions appear in contemporary science that are concerned with what is somewhat vaguely termed 'wholeness', i.e. problems of organization, phenomena…
Resources
Diffusion of innovation theory. (2013). University of Twente. Retrieved:
http://www.utwente.nl/cw/theorieenoverzicht/Theory%20clusters/Communication%20and%20Information%20Technology/Diffusion_of_Innovations_Theory.doc/
This website contains excerpts from E.M. Rogers' work on diffusion of innovation theory, along with a helpful graphical representation of how the information is disseminated.
Kaminski, J. (Spring 2011).Diffusion of innovation theory. Canadian Journal of Nursing.
Thus, if any of us was one of the "actors', we would be tempted to judge each alternative in a subjective manner. If we were the patients, the AECL board or the hospitals we would want Therac-25 to be approved. If we were the public or FDA we would want the equipment out of the market.
The main alternative to the reality would have been for AECL to take under consideration a software error. One other alternative would have been for the company to assign more accurate probabilities for hazard occurrence, while running the Fault Tree Analysis. Finally, the third alternative would have been to use a better method to determine hazard occurrence. A better method is a method that would have been capable to return higher risks associated with the use of Therac-25 and which would have determined AECL to adjust the equipment. The first alternative is superior to…
Reference List
Bentham J. (1996) "The Principles of morals and legislation," Oxford, England: Clarendon Press.
Griffin J. (1986), "Well Being," New York: Oxford University Press.
Margolis H. (1996), "Dealing with risk: why the public and the experts disagree on environmental issues," Chicago, IL: University of Chicago Press.
Roberts, M.J. & M.R.Reich (2002), "Ethical analysis in public health," the Lancet, Vol. 359: pp. 1055-1059.
Gonzalez (2007), discusses the company WellPoint Inc. that provides its members with the capability to develop their own personal health records, an option to receive test results online, provide a limited set of records to their providers and to allow other family members access to the information. In terms of security safeguards, WellPoint tracks who accesses information and has staff members to monitor the systems for potential breaches. This in turn offers users a certain level of security and quality in services rendered.
As pay-for-performance programs flourish, there is a fear that many EHs cannot accurately capture the data that is required to participate. The biggest obstacles for software makers are the sheer volume of performance measures and the lack of standardization among them. One pressing issue is that some EH systems are still text-based and are therefore not as powerful for reporting and extracting information. (McKinney, 2007)
Wilson (2007),…
References
Burda, D. (2007, June 4). Hey, you asked for it. Modern Healthcare, 37(23), p.25.
Cavolo, D.J. (2007, July). Electronic medical record system: know the cost of ownership. Nursing Homes, 56(7), pp. 17-19.
Evans, M. (2007, July 30). Push for Quality Starts with it. Modern Healthcare, 37(30), pp.22,24,28.
Freudenheim, M. (2005, September 19). Doctors collaborate to find less costly way to add electronic medical records. New York Times, p. C4.
Controlling Violent Health Care Patients and Employees
This is a paper discussion on the identification and control of violence amongst health care patients and employees. It has 11 sources.
An Introduction to Violence
Violence has become a common feature of our society found in every area of the nation from quiet neighborhoods in the suburbs to the urbanized cities of the U.S. To make the matter worse, the media including radio, TV, private cable networks, have become a part of the culture that promotes the concepts of violence, if there is no violence exhibited in either every day programs then these programs, including those of children are presumed to be a failure. Hence, it would not be wrong to assume that our entire culture has been virtually gripped in a sphere of violence to which there is no end.
This culture of violence continues despite the fact that the sociologists…
References
Erickson L. Williams-Evans SA. Attitudes of emergency nurses regarding patient assaults. J Emerg Nurs. 2000; 26(3):210-215.
Felton JS. Violence prevention at the health care site. Occup Med. 1997; 12(4):701-715.
Hegal MT, Ferguson RJ. Differential reinforcement of other behavior (DRO) to reduce aggressive behavior following traumatic brain injury. Behav Modif. 2000; 24(1):94-101.
Levin PF, Hewitt JB, Misner ST. Insights of nurses about assault in hospital-based emergency departments. Image J. Nurs Sch. 1998; 30(3):249-254.
Myra Levine
Nurses and patients are engaged in a "partnership of human experience," (Levine, 1977, p. 845). The ethical obligations and core values of nursing are rooted in this fundamental assumption about the relationship between nurse and patient. Nursing entails ethical obligations. "To be a nurse requires the willing assumption of ethical responsibility in every dimension of practice," (Levine, 1977, p. 845). The ethical obligations of a nurse are best explained by the belief that patients are holistic beings who constantly "thrive to preserve wholeness and integrity," ("Levine's Four Conservation Principles," 2012). Each patient is unique, too, and each seeks wholeness in a unique way. Nursing is defined as "a human interaction designed to promote 'wholeness' through adaptation." Myra Levine's theory is patient-centered, rather than disease-centered; the patient is treated and not just the disease. Because it offers specific guidelines within a rubric of ethical and philosophical tenets, Levine's conceptual…
References
Levine, M. (1966). Adaptation and assessment: A rationale for nursing intervention. The American Journal of Nursing 66(11): 2450-2453.
Levine, M. (1977). Nursing ethics and the ethical nurse. American Journal of Nursing 77(5): 845-849.
Levine, M. (2007). The rhetoric of nursing theory. Journal of Nursing Scholarship 27(1): 11-14.
"Levine's Four Conservation Principles," (2012). Nursing Theories. Retrieved online: http://currentnursing.com/nursing_theory/Levin_four_conservation_principles.html
" (South Australia, p. 8)
This demonstrates the balance which is necessary in protecting the rights of the patient and simultaneously ensuring that physicians have the freedom necessary to perform to the best of their abilities. In a respect, this underscores the nature of the strategies used for the protection of patients' rights. The intention is primarily to provide a basic forum for the constructive interaction of patient and physician with legal recourse serving as a failsafe. So is this implied by the LSCSA, which indicates that the demands of existing Patients' Rights standards are designed to make the physician actively accountable to the patient's interests. Therefore, the LSCSA indicates a strategy for preserving the right to consent, reporting that "although the first step usually should be to speak to the doctor or other health care provider who has treated the patient, if any doubts remain, a patient should not…
Works Cited:
Legal Services Commission of South Australia (LSCSA). (2010). Patients' Rights. Law Handbook.sa.gov.au.
South Australia (1995). Consent to Medical Treatment and Palliative Care Act 1995. Legislation Revision and Publication Act 2002.
South Australia1 (2009) Mental Health Act 2009. Legislation Revision and Publication Act 2002.
This was a clear gap in the research that was examined. The proposed research study will attempt to fill this gap by examining the importance of the adult child and parent relationship and its affect on the physical body.
Methodologies found
A number of different study methods were found amongst the studies in the literature review. Many of the studies that examined the use of psychotherapy with the treatment of a condition used a comparative study method. Clinical trials used a comparative study method in most cases. However, studies that were found to be theoretical in nature tended to use either a qualitative interview method or quantitative study methods.
No single method of study was found to be more prevalent in the group studied during the literature review. The method selected was highly dependant on the subject matter and the research question being asked in the study. no single method…
References
Baranek, G. (2002). Efficacy of Sensory and Motor Interventions for Children with Autism.
Journal of Autism and Developmental Disorders. 32 (5): 397-422).
Birditt, K., Miller, L., Fingerman, K., and Lefkowitz, E. (2009). Tensions in the parent and adult child relationship: Links to solidarity and ambivalence. Psychol Aging. 24(2):287-95.
Burkhardt a, Rudorf S, Brand C, Rockstroh B, Studer K, Lettke F, & Luscher K. (2007). When
"[4] (Bernall, 1992, p. 19)
Though historically this role could have strained the nurses professional relationships with other health care professionals, and especially doctors the modern medical industry has afforded a new way of understanding the role, including an emphasis of such a nursing role in medical school. (Bernall 1992, p. 22)
As this belief has proven to be a long-standing one, it is therefore important to explore a greater understanding of the application of its use in patient care. The particular example of the mentally handicapped / epileptic patient is important as the complicated nature of these possibly debilitating diseases often leaves patients feeling helpless to contribute to their own general health and wellness. In one study the application of a nurse, for the specific role of advocacy was used to study it effects of the patients health and wellness outcomes.
A nurse functioning as patient advocate for 21…
References
Baribeault J.J. "Clinical advocacy for persons with epilepsy and mental retardation living in community-based programs." Journal of Neuroscience Nursing, Dec 1996 28/6 pp. 359-67.
Bernal E.W. "The nurse as patient advocate." The Hastings Center Report, July-August
1992. 22/4, pp. 18-23.
The Hastings Center Report, July-August 1992 v22 n4 p18(6)
Keeping Patients Waiting? Not in My Office
This particular case is fascinating because so many doctors are not on time with their appointments. It is often surprising to find one that is. There are several ways that the doctor in this case ensures that a good time schedule is kept. The main reason that the schedule is kept to is that the scheduling is realistic. Instead of allowing the same amount of time for each patient, times for how long an appointment should take are determined based on what category the patient falls in when he/she calls the office to schedule a time. Extra time is also allotted for emergencies, patients that might show up late, walk-ins that need treatment that day, and other problems that may appear. This allows the doctor to see 20 to 30 patients a day, but the doctor can see 40 to 50 patients in…
Healthcare System -- Linkages and Alliances
The healthcare system is a complex but integrated system that allows patients, providers, pharmacists, insurance agencies, hospitals, and regulators to all come together so that the needs of each are met. This paper will select one healthcare delivery organization in the U.S. that provides care to patients and discuss the relationship between this organization and the other stakeholders in healthcare -- in particularly how it links and aligns with these stakeholders.
As the Institute of Medicine (2009) points out, "healthcare delivery organizations play a critical role because of their ability to drive practice trends, set standards, and influence smaller practices by sharing information, resources, and guidelines." This is something that Humana Care Delivery Organization is able to help achieve through its extensive network within the overall Humana family. By employing a balanced team, innovative pioneers, and using great locations to reach the population it…
However, this study was discredited and criticized by subsequent studies. Only one study directly addressed the use of untied mittens as restraints in the critical care unit. All other studies addressed other forms of restraint systems.
The results of this literature review indicate that studies regarding the use of restraints in the critical care unit is inconclusive. Only one study addressed the use of mittens as a restraint system, This is clearly an area that deserves further exploration. The use of mitten restraints may prove a more acceptable form of restraint than other restraint forms. This issue needs to be addressed in future research studies.
eferences
M. Bryan (2009). Use of Physical estraints From a Bedside Practice Perspective
Am. J. Crit. Care., March 1, 2009; 18(2): 101-102.
Chang, LY., Wang, KW., & Chao, YF et al. (2008). Influence of Physical estraint on Unplanned Extubation of Adult Intensive Care Patients: A…
References
M. Bryan (2009). Use of Physical Restraints From a Bedside Practice Perspective
Am. J. Crit. Care., March 1, 2009; 18(2): 101-102.
Chang, LY., Wang, KW., & Chao, YF et al. (2008). Influence of Physical Restraint on Unplanned Extubation of Adult Intensive Care Patients: A Case-Control Study. Am. J.
Crit. Care 17: 408-415.
There are various applications of the FID technology in the healthcare. These are explored by a HIBCC,(2006 ) report that studies the application of the FID technology in the healthcare setting with emphasis on its benefits, limitations as well as recommendations The report categorically pointed out that that the applications of the FID technology in the health care settings are numerous. They range from being used in the management of the hospital's supply chain to the management of the patients themselves. In terms of the supply chain management, the FID technology can be used in the organizing the delivery of supplies such as pacemakers, artificial limbs as well as defibrillators. This is because the supply chain of these crucial items is very complicated and requires the timely delivery of the consignments. The high degree of traceability that is needed to track the shipments from the supplier up to the time…
References
Anonymous (2004), RFID in the hospital, in RFID Gazette. July 15,
2004
Aarts, J., Doorewaard, H., and Berg, M.(2004), "Understanding implementation: the case of a computerized physician order entry system in a large Dutch university medical center," Journal of the American Medical Informatics Association, vol. 11, no. 3,
Chin-Yin,(2000)RFID-Enabled Analysis of Care Coordination and Patient Flow in Ambulatory Carpp. 207-216.