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Respond on two different days by sharing ideas for how shortcomings discovered in their evaluations and/or their examples of incivility could have been managed more effectively.

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Workplace Assessment

Prior to taking my last position in the hospital setting, I did some research on the organization.  I was leaving a hostile environment and wanted to make sure I was looking at organizations that aligned with my professional integrity, had good recommendations from staff and the patient population.  Clark (2019) discusses that “in the patient care environment, uncivil encounters can provoke uncertainty and self-doubt, weaken self-confidence, and compromise critical thinking and clinical judgment skills” (p.64).  At this time in my career, I needed stability and a healthy work environment that supported me both professionally and personally.              

Clark Healthy Workplace Inventory Results

            Based on the Clark Healthy Workplace Inventory results it appears that I made a good decision, I knew that myself within six months of starting there.  Scoring an 82 out of 100 this sets my workplace in the moderately healthy category.  Answering the question is my workplace civil or not?  I would have to say that from administration down my organization is civil.  Overall the organization is true to its proposed pillars of excellence and standards for patient care, outcomes, and employee satisfaction. No organization is perfect, but I have experienced growth and change with the organization and I feel like they are moving in the right direction.  In reflecting on workplace culture Clark (2105) notes that purposeful relationships and interactions with others facilitate the success of the individual, team, and organization (p.19).

Experience

            Unfortunately, I have experienced incivility in the workplace that is why I am with the organization I am with now. It was an unhealthy work environment where management was concerned, I shared the organization’s vision for patient care, but my manager did not. Often our ideas were shot down and then retaliated upon if she thought it might shade her as the manager. She was not a leader. The team I worked with was one of the only reasons I stayed as long as I did. We all experienced incivility at her hands collectively and individually.  It was not something that administration was unaware of, she had multiple complaints in previous years and prior to my group, her turnover rate was high. Communication had to be both verbal and in writing so that there was no miscommunication from all parties. We all could have been secretaries in our biweekly meetings. We were to add human resources (HR) to our communication when asked to do so. We worked along with HR to address issues and work on communication as a group as well as individuals. One might ask why I stayed with them as long as I did and to be honest it was the patient population.  I have since come to understand that it was not me individually or the team that was the issue, but that not all managers are leaders (Marshall and Bloom, 2017). 

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23. 

Clark, C. M. (2018). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator.

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer

 
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different types of anemia

Respond  on two different days who selected different types of anemia than you, in the following ways:

Share insights on how the anemia you selected is similar to or different from the one your colleague selected.

Discuss how genetic, gender, ethnic, age, and behavioral factors impact the diagnosis and prescription of treatment for anemic patients.

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                                           Anemia

Anemia is an insufficient amount of red blood cells that carry vital oxygen to the tissues. There are different types of anemia with unique pathological processes. This post will explore the pathophysiology of iron deficiency and folate deficiency anemia, including the impact of behavior on these disorders.

Iron deficiency anemia is like it sounds. The body has a deficiency of iron and cannot produce enough hemoglobin to oxygenate the tissues properly. The heme molecules that constitute hemoglobin need iron as it attracts oxygen to attach to the red blood cell (erythrocyte). When it is not available, hematopoiesis (red blood cell formation) cannot occur. The body has some reserves of iron, but it does not last because hematopoiesis happens throughout life. Red blood cells die or are lost through bleeding and need replacement. The causes of iron deficiency include inadequate dietary intake, chronic blood loss, and metabolic disorders via insufficient delivery or absorption. In all types of anemia, patients present with classic symptoms of weakness, fatigue, dyspnea, and paleness (Hammer & McPhee, 2019). Obtaining a serum ferritin level is the best way to measure iron deficiency as the iron binds to ferritin. Treatment includes increasing dietary intake of iron or giving supplemental iron after ruling out a chronic bleed (most often the gastrointestinal tract). If there is bleeding, this needs correction to resolve the anemia.

Folate deficiency anemia is an insufficient amount of folic acid. Folic acid is necessary for RNA and DNA synthesis in erythrocytes (Huether & McCance, 2017). Folate deficiency occurs more often in alcoholics or malnourished individuals. Symptoms that can present with this type of anemia include watery diarrhea, stomatitis, burning mouth syndrome, and ulcers in the mouth to name a few. Treatment requires an oral supplement of folic acid until blood levels rise to adequate levels. Although different in their pathology, both types of anemia effect hematopoiesis, and this is critical for oxygen delivery to the tissues.

Behavior

Adequate dietary intake of iron and folate can reduce these types of anemia. However, as mentioned above, with iron deficiency anemia, it is essential to determine the cause because it could be from bleeding. Odewole et al. (2013) conducted a study of folate deficiency anemia after the mandatory enrichment of folic acid into cereal grains in the United States. The researchers found only two individuals out of over 1500 surveyed, suggesting that this type of anemia is nearly nonexistent in the United States. (Odewole et al., 2013). 

References

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Odewole, O. A., Williamson, R. S., Zakai, N. A., Berry, R. J., Judd, S. E., Qi, Y., … Oakley Jr., G. P. (2013). Near-elimination of folate-deficiency anemia by mandatory folic acid fortification in older US adults: Reasons for Geographic and Racial Differences in Stroke study 2003-2007. The American Journal of Clinical Nutrition, 98(4), 1042–1047. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.3945/ajcn.113.059683 

 
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sharing ideas for how shortcomings discovered in their evaluations and/or their examples of incivility could have been managed more effectively.

Respond to at least two of your colleagues on two different days by sharing ideas for how shortcomings discovered in their evaluations and/or their examples of incivility could have been managed more effectively.

                                            Main Post

Workplace civility is linked to organizational excellence and creates an environment where employees respect and value one another through cooperation, fair resolution of disputes, teamwork, and non-discriminatory behavior (Department of Veteran Affairs, 2017). Organizational leaders and managers must create an environment that is respectful and inclusive of all people (Clark, 2015; Marshall & Broome, 2017).

Work Environment Assessment

According to the Clark Healthy Workplace Inventory results, my organization is a moderately healthy environment. Why my workplace is civil? The VA understands that civility is a significant determinant not only to employee outcomes ( job satisfaction, stress levels) but also to higher level outcomes directly connected to the organizational mission (quality of patient care, operational costs, ability to retain quality workforce ). The organization continues to create a healthy work environment and measures civility annually through the All Employee Survey (Department of Veteran Affairs, 2017).

Incidence of Incivility

A physician assistant (PA) ordered Versed, and  I was not comfortable giving this medication to my patient. I asked him to explain his rationale for ordering the medication because I knew this drug was not part of the ACLS chest pain protocol and although in pain morphine was the better drug of choice.  The PA pretending to understood my concern and contacted his pharmacist friend who works in our department, but was off duty. The pharmacist became enraged and began to text me with vulgar language and statements, feeling under attack, I  stood up for myself told the pharmacist and the PA I would not be bullied into unsafe practice, and it was my responsibility to advocate appropriately. I shared the messages with the supervising physician, management, and union representative. The pharmacist and PA both issued a formal apology and suspended for two weeks.

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

Department of Veteran Affairs. (2017). Civility, respect, and engagement in the workplace (crew). Retrieved from https://www.va.gov/ncod/crew.asp

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader. New York, NY: Springer Publishing Company.

 
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External Influences On Public Health

Your reading describes four major problems with the U.S. healthcare system: escalating costs due to technology, fragmentation of services, limited access to care, and quality of care. Which of these do you see as the primary problem? Why? What can be done to address the issues described? 

Reference your sources using apa format.

 
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Summary and Descriptive Statistics

Summary and Descriptive Statistics

There is often the requirement to evaluate descriptive statistics for data within the organization or for health care information. Every year the National Cancer Institute collects and publishes data based on patient demographics. Understanding differences between the groups based upon the collected data often informs health care professionals towards research, treatment options, or patient education.

Using the data on the “National Cancer Institute Data” Excel spreadsheet, calculate the descriptive statistics indicated below for each of the Race/Ethnicity groups. Refer to your textbook and the Topic Materials, as needed, for assistance in with creating Excel formulas.

Provide the following descriptive statistics:

  1. Measures of Central Tendency: Mean, Median, and Mode
  2. Measures of Variation: Variance, Standard Deviation, and Range (a formula is not needed for Range).
  3. Once the data is calculated, provide a 150-250 word analysis of the descriptive statistics on the spreadsheet. This should include differences and health outcomes between groups.

APA style is not required, but solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are not required to submit this assignment to LopesWrite.

AttachmentsHLT-362V-RS5-NationalCancerInstitutedata.xlsx
RUBRIC
Summary and Descriptive Statistics

There is often the requirement to evaluate descriptive statistics for data within the organization or for health care information. Every year the National Cancer Institute collects and publishes data based on patient demographics. Understanding differences between the groups based upon the collected data often informs health care professionals towards research, treatment options, or patient education.

Using the data on the “National Cancer Institute Data” Excel spreadsheet, calculate the descriptive statistics indicated below for each of the Race/Ethnicity groups. Refer to your textbook and the Topic Materials, as needed, for assistance in with creating Excel formulas.

Provide the following descriptive statistics:

  1. Measures of Central Tendency: Mean, Median, and Mode
  2. Measures of Variation: Variance, Standard Deviation, and Range (a formula is not needed for Range).
  3. Once the data is calculated, provide a 150-250 word analysis of the descriptive statistics on the spreadsheet. This should include differences and health outcomes between groups.

APA style is not required, but solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are not required to submit this assignment to LopesWrite.

AttachmentsHLT-362V-RS5-NationalCancerInstitutedata.xlsx
RUBRIC

 
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DNP: Scientific Underpinnings

I need 100 words for each question without any plagiarism and individual reference for each. 

Unit 2

Q2

Select a nursing model or theory described in your textbook. What are the key concepts and components of the example you selected, and how are they defined? Create an example describing the application to an area of nursing practice.

Unit 3

Q1

Compare and contrast a minimum of two middle range theories and discuss potential applications in your specific area of nursing practice.

Q2

Conduct a literature search in the Cumulative Index of Nursing and Allied Health Literature (CINAHL) using the terms middle range theory, mid-range theory, and nursing. Select one of the articles where the development of the middle range theory is the major focus of the paper. Share the article citation and describe how the theory was developed.

Unit 4

Q2

Consider yourself in a role in which you are accountable for allocation of scarce health care resources for a given situation. Discuss how ethical principles, virtues, and values affect your decision making. Describe your process for ethical decision making. How might a resolution cause conflicts between personal values and beliefs and the perspective of the community or organization?

Unit 5

Q1

Learning theories have implications for advanced practice nurses outside the classroom. Share an example describing the application of learning theory or theories to develop a program targeting change to a specific organizational issue, patient lifestyle, or specific unhealthy behaviors.

Q2

Health behavior change theories suggest behavior change as a “process,” not an “event.” How can you put this into action for developing an intervention for practice or research? Discuss how you would apply this in planning your DNP project.

Unit 6

Q1

Discuss “Envisioning Recovery” as an overarching framework for practice development and focus for all health care treatment.

Q2

How can the knowledge of economic theory be utilized by advanced practice nurses? How can economic theory be applied in analysis of interventions?

Unit 7

Q1

How can the DNP-prepared nurse apply the concepts of a complex adaptive system to individual patient care? Provide examples.

Q2

Research change theories in scholarly literature and on the Internet. Develop a scenario and describe application of a change theory from the perspective of an advanced practice nurse leader.

 
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DPI Project Proposal

DPI Project Proposal Chapter 2 – Literature Review Chapter 2 of the DPI Project Proposal is entitled “Literature Review” and expands upon work you completed in DNP-820 in the Develop a Literature Review assignment. Synthesis of the literature in the Literature Review (Chapter 2) defines the key aspects of the learner’s scholarly project, such as the problem statement, population and location, clinical questions, hypotheses or phenomena (if relevant to the project), methodology and design, purpose statement, data collection, and data analysis approaches. The literature selected must illustrate strong support for the learner’s practice change proposal. General Requirements: Use the following information to ensure successful completion of the assignment: 

• Locate the “DPI Proposal Template” in the PI Workspace of the DC Network. 

• Locate the Develop a Literature Review assignment you completed in DNP-820. 

• Locate the “Research Article Chart” resource in the Topic Materials. 

• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center. 

• This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

• You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center. Directions: Use the “DPI Proposal Template” and the Develop a Literature Review assignment from DNP-820 to develop a draft of a literature review (Chapter 2) for your DPI Project Proposal. The literature review (Chapter 2) is required to be a minimum of 30 pages. You have already completed some of this review in previous courses. No less than 85% of the articles must have been published in the past 5 years. Articles selected must further provide strong, relatable support for the proposal. Use the following guidelines to create your draft Literature Review (Chapter 2): 

1.Using the PICOT question format, identify at least three empirical or scholarly articles (25 articles total) related to the theme in the PICOT question. 

2. Use the “Research Article Chart” resource located in the Topic Materials as a guide to: (a) analyze and synthesize the literature into your paper, (b) state the article title, (c) identify the author, (d) state the research question(s), (e) identify the research sample, (f) explain the research methodology, (g) identify the limitations in the study, (h) provide the research findings of the study, and (i) identify the opportunities for practice implementation. For scholarly, nonempirical articles, state the article title and author, and provide a brief contextual summary of the article. 

3. Identify at least three subthemes that relate to each theme (six subthemes total). 

4. Identify at least three empirical or scholarly articles related to each subtheme (18 articles total). At least one article must demonstrate a quantitative methodology. Write statements that synthesize the three studies for each subtheme based on the information you stated above. You will write six synthesis statements.

 
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Nicotine Dependence

Northwestern State University

Department of Graduate Studies and Research in Nursing

PMHNP Program

NURG 5960

Psychopharmacology and Neurobiology

Professional Paper Guidelines and Grading Rubric

Select a class of drugs (i.e. – atypical antipsychotics) and a specific DSM-5 Disorder which the class of drugs is used to treat. Discuss the general indications for the drugs in the specific class chosen including diagnostic issues, screening tests, neurobiological effects and concerns (i.e. why this drug might treat a particular aspect of the disorder), prescribing/practice guidelines, documented off-label uses, black box warnings if applicable, any lab test monitoring necessary related to the drug class, evidence-based practice information and implications for your practice. This paper is worth 30% of your total course grade.

1. Introduction: 10 points

a. Include statement of the drug class and general indications as well as other pertinent introductory information.

2. Body: 50 points

a. Review diagnostic issues, screening tests

b. Review neurobiological effects and concerns related to the drug class

c. Discuss prescribing/practice guidelines related to the PMHNP

d. Discuss off-label uses

e. Discuss black box warnings

f. Discuss any necessary laboratory testing/monitoring

g. Discuss Evidence-based practice information

3. Conclusion: 30 points

a. Adequately summarize the information presented

b. Identify issues related to APRN practice

4. Form: 10 points

a. APA format is required. Spelling and grammar will be graded. A title page is required as well as a reference page, both of these should be separate from the body of the paper.

b. A minimum of five (5) references, which may include a combination of texts, journals, online texts, and websites, which are peer reviewed and from professional nursing and/or healthcare organizations must be utilized. References should be recent, 5 years or less. It is acceptable to include older references at times if appropriate but those more recent should primarily be utilized. Wikipedia is not a professional reference

TOTAL: 100 points

 
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For Domestic Violence And IPV

  1. Navigate the website www.womenshealth.gov to review the topics in Module 9 to gain an understanding of this type of threat to women, to include:
  • Conduct a self-assessment to identify potential risk for domestic violence:
http://www.womenshealth.gov/violence-against-women/index.html?from=AtoZ
  • Recognize the health implications strongly related to IPV:
http://www.womenshealth.gov/violence-against-women/types-of-violence/domestic-intimate-partner-violence.html
  • Identify factors that may contribute to domestic violence:
http://www.cdc.gov/violenceprevention/intimatepartnerviolence/index.html
http://www.cdc.gov/violenceprevention/pdf/ipv-factsheet.pdf
http://www.consultant360.com/article/intimate-partner-violence-silent-epidemic
  • Increase awareness of the healthcare community’s efforts to address violence:
http://www.cdc.gov/cdcgrandrounds/archives/2012/june2012.htm

You are only assigned the video section presented by Debbie Lee at the CDC Grand Rounds in 2012. This video portion is located from 39:05 through 51:27 (12 minutes). She is presenting interesting topics related to prevention, impact of AFA, and the partnership between numerous agencies to reduce domestic violence.

   ASSIGNMENT FOR YOUR GROUP DISCUSSION FORUM:

  1. Select one of the initiatives presented by Debbie Lee and explore the website for the selected plan for preventing violence to summarize the purpose of the program, the target population for the program, and does Georgia participate in the initiative.
  1. Explore your local community to identify resources that provide shelter, safety, and /or long term restoration for victimized women and briefly summarize your findings
 
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Critical Reasoning

Following are two passages from Florence Nightingale’s Notes on Nursing:

Passage 1
Now the medical man who sees the patient only once a day or even only once or twice a week, cannot possibly tell this without the assistance of the patient himself, or of those who are in constant observation on the patient. The utmost the medical man can tell is whether the patient is weaker or stronger at this visit than he was at the last visit. I should therefore say that incomparably the most important office of the nurse, after she has taken care of the patient’s air, is to take care to observe the effect of his food, and report it to the medical attendant. (1860, Section VII, para.14)

Passage 2
To be “in charge” is certainly not only to carry out the proper measures yourself but to see that everyone else does so too; to see that no one either willfully or ignorantly thwarts or prevents such measures. It is neither to do everything yourself nor to appoint a number of people to each duty, but to ensure that each does that duty to which he is appointed. This is the meaning which must be attached to the word by (above all) those “in charge” of sick, whether of numbers or of individuals. (1860, Section III, para.25)

Instructions
Answer the following:

  • Is passage 1 an argument or an explanation?
  • Is passage 2 an argument or an explanation?

You must answer both questions by making an argument for your position. Whichever type – argument or explanation – you find the passage to be, you must write an argument that will prove your answer to be correct.

 
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