Class 1unit 4 comment 1

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An opinion leader is someone who is well respected, experienced, and patient (Hamric, Hansen, Tracy, & O’Grady, 2014, p. 277). This is a person who leads by example and is seen as leader because of the qualities they possess not by the position they hold. An opinion leader is often sought out by others for their advice and expertise (Hamric et al., 2014, p. 277). 

I see many characteristics of an opinion leader in myself. I have always been committed to continuing education and have attended several conferences and continuing education seminars. Due to this many of the nurses that I work with are eager to hear what I have learned in these conferences. My peers trust my clinical judgement and skills and often seek out my advice or my help with difficult skills. I feel I also show characteristics of an opinion leader when educating the certified nurse aids (CNAs). The CNAs I work with respond more effectively when I take my time to educate them why something is important rather than just telling them to do a task. 

An example of a time that I felt I was acting as an opinion leader was after attending an in-service put on by our local pharmacy. At that in-service, I learned that the use of Diphenhydramine in elderly patients drastically increases the risk of falls (J. Krichner, personal communication, January 21, 2015). Prior to this in-service, myself and the other nurses I worked with would routinely ask physicians for orders for Acetaminophen with Diphenhydramine when patients were having difficulties sleeping. After sharing this information with my peers all of the nurse stopped requesting Acetaminophen with Diphenhydramine as a first request to the physicians as a sleep aid. This continuing education allowed myself to make an important change to better care for my patients. 

References

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. (2014). Advanced practice nursing: 

            an integrative approach (5th ed.). St. Louis, MO: Elsevier/Saunders.

comment

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 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 150-200 WORDS

 

The ethos of scientism and postmodernism has exacerbated the perceived philosophical and cultural tension between science and religion. What is your perception of this tension? Use the lecture and the topic readings to support your response.

“Scientism is the belief that the best or only way to have any knowledge of reality is by means of the sciences” (Moreland & Craig, 2003, pp. 346-350). This does not mean that scientism and science are one in the same. Scientism lacks the ability to differentiate between making moral or ethical decisions due to science being based solely on testing and facts. Modernism “social scientists and health care professionals are calling for a more holistic view that brings humans into harmony with their environment” (Shelly & Miller, 2006). This type of method is based off of religions and philosophies.

Often in nursing there is tension between science and religion. In my nursing career, I have encountered patient conflicts related to science vs religion. Patients who have a strong religious and cultural backgrounds may opt out of treatments that are based on scientific evidenced based practice because of their beliefs. But as time has progressed I have noticed that religion and science are being incorporated more into patient care to achieve a better patient outcome. This is where the most important part of our job duties as a nurse becomes crucial which is education. We should give written literature and verbally explain to the patient the science rationale because this is what will help with treatment of the patient while incorporating their religious beliefs. After educating the patient and the treatment or procedure is still unacceptable in their religious beliefs, it will not be performed but at least the patient has gained knowledge and can then make their personal decision. I believe that if the healthcare team works with the patient and their families this can help reduce the tension between science and religion.  

 

References:
Moreland, J.P., & Craig, W.L. (2003). Philosophical foundations for a Christian worldview. Downers Grove, IL: IVP Academic.

 

Class 1 unit 5 Comment 1

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Team work is an essential part of nursing. In order for a team to succeed in achieving positive patient outcomes the team members must show mutual respect for one another, and have excellent communication and collaboration skills. Not all team members have to like each other, but they must show mutual respect for once another. If team members do not respect each other they will be less likely to share ideas and communicate effectively. When all team members show respect for one another the team members will be able to communicate more openly and share ideas to improve patient outcomes. 

It is essential that teams communicate effectively. For example, if a certified nurse’s aide does not communicate a new skin issue to a nurse in a long-term care facility the nurse will not know to asses this issue and contact the primary care provider if needed. This lapse in communication could lead to a negative patient outcome. Without proper communication, the whole picture of the patient is not seen. It is important that the primary care providers get the whole picture of the patient when making recommendations and when prescribing medications. 

Collaboration is also a very important part of a good clinical team. Hamric, Hansen, Tracy, and O’Grady (2014) explain that, “By definition, collaboration describes relationships that are positive and work well for professionals, patients, and communities” (p. 300). Collaborations is a partnership that promotes an open exchange of ideas (Hamric et al., 2014, p. 300). An effective team requires collaboration to promote open communication and exchange of ideas. When team members share ideas, they are able to brainstorm and put all of their expertise together to benefit their patients. I feel that respect, communication, and collaboration are all linked together and are all needed to make an effective team. 

Although team work is an essential part of nursing, it does not come without its challenges. Disagreements, conflicting personalities, lack of respect, and poor communication can all make team work very challenging. In every team, there are going to be disagreements. The important part is how a team handles those disagreements. Team members must be respectful to one another when discussing these disagreements and must be open to all ideas. Hamric et al. (2014) explains that teams must create strategies to handle disagreements in order to promote good collaboration (p. 300). 

Often in teams there will be conflicting personalities. Not all team members are going to get along. Not all team members need to be friendly on a personal level. The important part is that the team members are able to put personality differences aside and focus on the patient’s care. Similarly, team members must be able to put aside any personality conflicts and show respect for one another. When teams are able to work through differences and show respect for one another, all team members will feel more comfortable communicating with one another. This will allow for increases in positive patient outcomes. 

 

 

COMMENT EVE

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 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 150-200 WORDS

 

Management is a set of systems and processes designed for organizing, budgeting, staffing, and problem solving to achieve the desired results of an organization. Leadership defines the mission and vision; it inspires the team to embody the beliefs and behaviors necessary to take the actions needed to achieve those results. The most successful transformations occur when strong, visionary leadership converges with great management. Both are required to define a clear path, plan accordingly, and see the mission plan through to fulfillment (Gleeson, 2017). Management consists of controlling a group or set of entities to accomplish a goal. Leadership refers to an individual’s ability to influence, motivate, and enable others to contribute toward organizational success. Influence and inspiration separate leasers from managers not power and control (Nayar, 2014). When I worked in Alabama I had a manager that was all about the bottom line. She gave out write-ups every day. Before she came in to work she looked through all of the charting and if anything was missing she would write you up. In one way her method worked because our unit had the highest compliance rate, the highest customer service rating, and the lowest number of bad incidents. However, the staff was so unhappy that the turnover rate was the highest of any department. There was never enough staff and because there are no ratios in Alabama, many nurses often had nine or more telemetry patients. She did not allow the nurses to participate in “management decisions” and there was no communication between management and staff. My current director is the kind of leader that I hope to become. I remember the day I met her when I interviewed, I was impressed by the vision she had for this small L&D unit in an underserved community. She inspires us to come to work and do the best job we can with what we are given and she makes us feel like we are an important part of the team. We have meetings every morning where we can discuss what is going well and what could use some improvement. When we have issues with policies and even computer systems she is always willing to hear us out and often times sends emails to the CEO and CFO to bring about change. In the short six months that I have worked there we have accomplished so much including becoming officially baby friendly. I strive to be the type of leader and manager that she is. People always work harder and more diligently when they feel like they a part of something. I think that it is important to assert your authority while respecting each member of your team and that includes their opinions and recommendations.

Gleeson, B. (2017, February 23). The Fundamental Differences Between Leadership and Management. Retrieved June 28, 2017, from https://www.inc.com/brent-gleeson/the-fundamental-differences-between-leadership-and-management.html

Nayar, V. (2014, August 07). Three Differences Between Managers and Leaders. Retrieved June 28, 2017, from https://hbr.org/2013/08/tests-of-a-leadership-transiti

P2

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

Ijeoma Igbokwe 

 

3 posts

 

Re:Topic 3 DQ 1

 

You have an idea to improve patient care that you would like upper management to support and fund. What type of communication tool would you use to present your idea and why?

 

It is good to prepare yourself by researching almost everything about the ideas you have before formal presentation. Good and proper preparation and practice could help boost someone’s confidence. First, I would share my ideas with my colleagues, their feedback could give me a hint on how the management might react or the questions they might ask. One of the keys to a successful upward communication is the emphasize the benefits of the ideas to the patient’s care rather than the processes and background details, because when you speak upward (top management), the audience wants to address the questions that are most relevant to them, rather than how you get there, so it is important to be precise and clear when communicating (Grant, 2017)

 

Communication vary among groups, the tools, channels, and pattern used determines its effectiveness, communication could be transmitted through both verbal or non-verbal modes. Formal and informal methods also may be use when communicating. (Huber, 2014)

 

The communication tools I would use is the leaflets because information contained on it, is precise, clear and on point. It could contain some graphics that could engage and sustain the attention of the readers.

 

Email could also be used, because it is faster to disseminate information via emails and to a larger number of audience wherever they are, even people on vacation could access the information.

 

Presentation; Power-point presentation would be ideal because voluminous information can be compressed to a smaller, but concise, clear, and precise. There is an opportunity to answer questions asked and get feedbacks. There could be opportunity to have physical contacts with people.

 

Holding a meeting could also be beneficial as well, to better explain the ideas to the board members, especially to convince them to support and fund the ideas that would greatly benefit patient care delivery.  

 

 

 

References

 

Grant. A (2016) Your Guide to Communicating with Upper Management. Fast Company. Retrieved from https://www.fastcompany.com/3049998/your-guide-to-communicating-with-upper-management

 

Huber, D. (2014). Leadership and nursing Care Management (5th ed.). Maryland Heights, MO: Saunders Elsevier. ISBN-13: 9781455740710

 

 

 

comment ijeoma

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  I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT.BETWEEN 120-150 WORDS

 

A new director decides to reorganize the department you work in. This reorganization comes about without input from the employees and many of the nurses that you oversee are feeling resentful of the change. As a nurse leader, identify factors that may lead to conflict and ways you can manage them.

The fact that everyone is different, has different personality and opinions, there would always be conflict, but when this conflict arises, it is best to resolve it than to ignore it. (Cardillo, 2011) Some people quit jobs to avoid resolution of conflict at work, but this could lead to increased stress, unresolved feelings of anger, hostility, low esteem, and resentment. (Cardillo, 2011) The best option is to learn how to deal with the conflict and adjust to the change. (Cardillo, 2011) Change needed for progress, upgrade and transformation, the only thing that is not constant in life is “change”. As a healthcare providers, we should be ready for change as the world around us especially the world of technology changes and advances, almost every instrument and tools are going “high-tech”, so nurses must be part of that change, which in other words could mean “update” (Cardillo, 2011)

As a nurse leader, one need to be prepared to deal with peoples’ personalities and attitudes, it takes a lot of patience and self-discipline to handle conflicts, no leadership position is easy, especially in healthcare, a nurse leader would have to handle patients’ affairs, deal with other nurses, and healthcare teams’ attitudes.

 Identify factors that may lead to conflict and ways you can manage them

1)      Communication; A nurse leader must work on his/her communication skills, being able to express self clearly and respectively would help prevent some conflicts that could arise due to miscommunication or being misunderstood. A nurse leader must be professional while dealing with other nurses irrespective of how friendly they are outside the job. Some people may be resentful about reorganization because they lack information about the process, why it must be done and the benefits to both the patients and the staff. It is the role of a nurse leader to find out why they are resentful, and let the manager know their concerns. Effective communication would make it possible for everyone to be on the same page.

 

2)      Fair and bias; People take note and notice of how they are treated verses how others are treated in similar and different circumstances. As a nurse leader, I must avoid favoring people based on their race, personal preference, or other reasons. Everyone is important and must be treated fairly without bias. It is easy to judge people because they have different opinions or ways of handling things, it is important to know that everyone is entitled to his/her opinion, it is ok to be different. Nurses’ opinion must be considered and respected. A good leader must be able to accommodate other people even if they hesitate changes. It takes time to accept and absorb “changes”, some people transition faster and easily than others, and people should be able to tolerate that.  

 

3)      Compromising; In a situation, whereby the staff is reject the idea of reorganization, or does not agree with the management plan, compromising strategy should be used to resolve the conflict. Compromising strategy calls for both sides to give up some elements of their position or stand to accommodate others or establish an acceptable and agreeable solution. (Dontigney, 2017)

Reference

Cardillo. D (2011) 7 Strategies for Managing Conflict. Nurse.com. Retrieved from  https://www.nurse.com/blog/2011/11/28/seven-strategies-for-managing-conflict/

                       Dontigney. E (2017) 5 Conflicts Management Strategies. Chron. Retrieved from      http://smallbusiness.chron.com/5-conflict-management-strategies-16131.html

 

Class 2 Unit 6 COMMENT 1

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Purpose: Comment the Discussion

Thing to Remember:

•   Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

•   1 References, find resources that are 5 years or less

•   No errors with APA format 6 Edition

Discussion:

I really enjoyed reading about Florence Nightingales environmental model of nursing. I feel like this model speaks to my advanced practice nursing because it deals with observing the patient and asking many questions to understand the full picture (Butts, & Rich, 2018 p.427). This model puts the patient’s needs, and their environment first. 

Florence Nightingales theory emphasizes environmental factors that could affect the patient. “The Nightingale model involves nurses manipulating environmental factors that affect the patient’s health status, including noise, light, cleanliness, bedding, and ventilation (Butts et.al, 2018 p.427-428). “Observation is the primary method of data collection and evaluation of outcomes” (Butts et.al, 2018 p.428). 

I feel that working at the hospital while studying for APN has really opened my eyes to observe how other APN’s treat their patients. Many times, the APN’s can be just as rushed as the doctors are. However, some take their time to really get to know and assess the patient in detail. I want to be the kind of APN who takes their time, and really makes the patient feel comfortable in assessments and questioning. By making the patient feel comfortable in the environment they’re in, can cause the APN to observe the patient in a more natural state. “Nightingales model places an emphasis on relationships not regarded as revolutionary or complex” (Butts, et.al, 2018 p. 430).” “Three major relationships specified- environment to patient, nurse to environment, and nurse to patient (Butts et.al, 2018 p. 430). 

In conclusion, I would like to build a relationship with my patient’s and help them feel comfortable, in a not so comfortable environment. I would like to be the kind of APN that practices Florence Nightingales theory of always putting the patient’s needs first. I realize that every situation is different, but I will strive for these goals as an APN. 

References: 

Butts, J. B., & Rich, K. L. (2018). Philosophies and theories for advanced nursing practice. Burlington, MA: Jones & Bartlett Learning.

P1

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

Deactivated

 

Karan Kortlander 

 

1 posts

 

Re:Topic 1 DQ 1

 

The Scientific Management movement occurred with theorist Frederick Winslow Taylor. Taylor’s philosophy focused on the belief that making people work hard as possible was not as efficient as utilizing how the work was performed. According to Leading and Management book the scientific management theory is “based on the idea that there is one best way accomplish a task” (Yoder-Wise, 2011). Scientific Management states that all humans are motivated by money and that there should be separation between management and workers (Lecture 1, n.d).  This leads to management making decisions without input from employees and employees just doing what they are told.  This was believed to be the best and most productive way to manage. 

 

I have worked as a hospice nurse case manager out on the field and it can be very challenging at times. One of the things I saw inefficient while working out on the field was the lack of communication between per diem, on-call staff, and the assigned nurse case manager. Unfortunately, there was a time when I worked for a hospice company that did not supply per diem staff with computers. This problem would make it very hard for the assigned case manager and the per diem staff. The per diem staff was unable to retrieve records of the client and the assigned case manager was unable to know what was addressed or done with the client during the visit. The per diem staff failed to leave nursing notes in the client’s chart making it difficult once again to know what was assessed at time of visit. The per diem staff also had difficulties knowing what medications the client was on because it was prohibited to leave a medication list at the client’s home and the per diem nurse didn’t have a computer. The hospice company failed to include the per diem staff for regular interdisciplinary meetings that would have helped address many nursing problems.

 

I have worked for a couple of different hospices and I see progress being made. Currently the hospice I work for incorporates mandatory interdisciplinary bi-weekly meetings with the staff. The interdisciplinary meetings give opportunity for the staff to bring forth ways to communicate more efficiently as a team. The email system is also used and all staff including per diem is included when addressing client concerns. The per diem staff has been given computers to be able to have access to the client’s information and allow the nurse to chart. This process makes it easier for the assigned nurse case manager to see what problem/s was addressed in the plan of care. Communication is essential in all type of work but extremely essential when you are out in the field.

 

 

 

Reference:

 

 

 

Yoder-Wise, P. (2011). Leading and Managing in Nursing, 5th Edition. [VitalSource Bookshelf Online]. Retrieved from https://pageburstls.elsevier.com/#/books/978-0-323-06977-9/

Lecture 1 (n.d.). NRS-451V, Pheonix, AZ. Grand Canyon University

COMMENT DANILO

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 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 150-200 WORDS

 

In my field of work, they said losing someone is painful because we “do not want to be separated from our friends and family, even if it means moving on to a better life” (Shelly & Miller, 2006). According to Shelly & Miller, (2006), “regardless of how much we love and trust God, most of us fear death”. As for me, I don’t want to witness death, but in our line of work whether you like it or not, witnessing death is inevitable.

In my nursing career, I seldom encountered or witness death maybe 2 or 3 times. One that is lingering to my memory is the 80-year-old woman who was very pleasant and communicative. In my three days of taking care of her, every time I administered her medicine, she started to tell me a story and asked me how I am and my family, and then she started to tell me a story about her herself and her family. I don’t know why I enjoy hearing her stories and our conversation. That is why, I always put her at last list in giving medication. She said, she was ready to face her creator that why she doesn’t want any measures to revive her in case she is dying. I enjoyed listening to her stories because it reminds of my late grandmother who also loved to tell me stories when I was small kid. She has also had resemblance of my grandmother who was thin and skinny and always have smile on her face. On the third day of my shift, she said she was sad because she missed her son who lives in California, who cannot visit her because he was also sick, but she countered not to worry and continue her story about her family. That night, we ended our conversation with happy thoughts and smile on our face and I told her that she will home soon and see her son. At past midnight, our tele tech. called me to check Room 7 for asystole. I hurried went to the room and check on her and found that she was already gone. I was so sad and cannot explained the feeling as if I lose someone who was dear to me. I called her family to informed of them that she passed away. When her family came, I stood beside them and silently prayed for eternal repose of her soul. In the end, I know that she left this world in peace and smile on her face.

As a Christian, we often fear of death because it is painful and hard to lose our beloved, even though we know it is the end of their suffering and hardship. My experience in witnessing death, reminds me that life is short and anything can happen even in the midst of life, that is why we should love one another and enjoy our family and life because we never knew when death will come.

Reference:

Shelly, J. A., & Miller, A. B. (2006). Called to Care a Christian Worldview of Nursing (2 ed.). Retrieved from http://gcumedia.com/digital-resources/intervarsity-press/2006/called-to-care_a-christian-worldview-for-nursing_ebook_2e.php

WIKKI WEEK 1

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Week 1 Course Wiki: Click the link below to access the course wiki. Once you have accessed the Wiki, click Create Wiki Page on the action bar to create your own wiki page. Please add meaningful titles to your wiki pages so they are easy to scan in the side panel. You are able to edit any page you want. However, do not delete something any else has written. Feel free to use the Comments function also. After several pages are added, use a page’s contextual menu and select History to see how a page has been edited.

This is a graded, collaborative learning activity. Please add meaningful titles to your wiki pages so they are easy to scan in the side panel.

 

 

CPT Coding Week 1 Wiki Rubric:

 

 

 

A quality wiki page is created. The writing is clear and concise and relevant to the topic. The wiki page has a meaningful title page for ease of scanning in the side panel.  All questions in the “ICD-10”  topic are answered.   50 points

 

 

 

The writing is original and free of writing and spelling errors.  Citation and references are used appropriately using APA 6th edition format.   25 points

 

 

 

The wiki page includes a link to one credible site that has information on the topic.  25 points

 

 

ICD-10 (Improved Care Diagnosis) 10th Edition

 
  • When was it mandated to begin? Why were there delays? 
  • Why is the change being made to ICD-10?  
  • What are the advantages of this change? Are there any disadvantages?
  • What does it mean to physicians and other health care providers?

 

 

 

EXAMPLE

 

ICD-10 (Improved Care Diagnosis) 10th Edition

Created By Anonymous on Tuesday, August 6, 2013 3:28:04 PM EDT

last modified by Daniel Hornstein on Monday, June 12, 2017 1:16:20 AM EDT

 

  • When was it mandated to begin? Why were there delays? 
  •     ICD-10 was mandated to be in full use on October 1, 2015.  There were final delay to keep giving ample time for providers to all fall into compliance with the change, as well as makng sure that HIPPA is on the same page. 
  • Why is the change being made to ICD-10?  
  •      There are changes done for to comply and expand with current, treatments.. There are 1943 changes to  codes being used and being added as of 2017.
  • What are the advantages of this change? Are there any disadvantages?
  •     There is plenty of advantages as the freeze that was in place for new, and updated codes and there activity. There will be easier diagnosis as well as better communication. The changes are also helping a lot with fraud and abuse, of different patient accounts. There really isn’t any disadvantages that I am reading from the CDC website about ICD-10 and what it is doing to make healthcare coding and billing easier. 
  • What does it mean to physicians and other health care providers?
  •     These changes will better the treatment and diagnosis for the physicians and providers, it will have easier mortality,, and morbidity comparison, It will enhance the outcomes to the patients, with easier clinical decisions being made. All in all there will be better improved quality of data, received, better diagnosis of patient care and treatment. It will also provide a better tracking system all around to enhance the quality of patient care

 

 

Reference:

International Classification of Diseases, (ICD-10-CM/PCS) Transition – Background. (2015, October 01). Retrieved June 12, 2017, from https://www.cdc.gov/nchs/icd/icd10cm_pcs_background.htm