1. Describe the pathology of a headache.   

Headaches can occur for a variety of reasons. They are frequently caused by irritation of the meninges, blood vessels, or other sites containing pain receptors. Headaches can be caused by blood vessel spasms, strokes (ischemic or hemorrhagic), trauma, infections (including meningitis), sinus infections, stress, caffeine, or vertebral, muscular, and nerve origins. Wei et al. (2014) discovered that applying lipopolysaccharide (LPS) significantly increased the action potential of neurons, implying that fibroblasts may also play a role in headache genesis.

1. Based on the different etiologies for headaches, which of those fit this patient’s situation?

Migraine without aura — Symptoms include one-sided discomfort, but no nausea, vomiting, or chilly hands. Allergy headaches are similar to nasal congestion and watery eyes, although they are more widespread. Cervicogenic headaches are characterized by discomfort on one side of the head and around the eyes, but no runny nose or weeping. Cluster headache — pain around the eye, nasal congestion, and tearing of the eyes, although no burning has been reported. The headaches last for days or weeks and can last up to a year, yet they only emerge at night, which does not match the client’s description. Based on the facts provided, this appears to be the best match for the client’s history.

1. What additional aspects of the history and physical examination could provide relevant information to help in the diagnosis?  

Is there a history of headaches in the client’s family, and if yes, when did they start? Is there a history of diagnosis? each headache’s onset, length, intensity, location, pain description, triggers, auras, and relieving elements, allergies to certain seasons in the past, caffeine, alcohol, and smoking history, is the client getting a good night’s sleep? do you use any illegal substances?, stress Levels, is there any history of trauma prior to the onset of the headaches?, the impact on Activities of Daily Living,  and Medications for headaches and other ailments currently in use

1. Based on the history provided and using the following diagnostic tool https://headaches.org/resources/the-complete-headache-chart/(Links to an external site.)(Links to an external site.) (Links to an external site.) as a quick reference of the guideline, you diagnose migraine without aura. List the evidence that supports your diagnosis.

Some of the symptoms match those of migraines without aura, but we don’t have enough information to be sure. Migraine without an aura is one-sided and is accompanied by nausea, vomiting, cold hands, and sound and light sensitivity. The client reported his or her pain as “burning,” with no mention of nausea, vomiting, or sensitivity to stimuli. In addition, the client stated that he was tearing up and had a runny nose, which does not appear to be consistent with the diagnosis.

In the United States (US), nursing turnover is a major challenge in the nursing industry with an averege turnover rate of about 14%  for registered nurses (Lindley & Cozad, 2017).  According to the American Hospital Association, 75% of all vacant positions are for registered nurses (Patricia, Sean, Jeannie, & Rosaly, 2004). The United States Department of Health and Human Services projects that the nursing shortage will soon reach a critical stage that will impact negatively on the healthcare industry  (Lindley & Cozad, 2017).  Nursing shortage has been adduced to a number of factors. Specifically, social factors and government policy have immensely contributed to the issue of nursing shortage and turnover. Government policy on the philosophy of free-market economy without adequate consideration for the assessment and compensation for quality care, the complex recruitment methods of new nurses and nurses

Competing Needs

Aging Population: Studies have reported that the United States has the largest number of nurses 65 years and over currently. This is coupled with a generally ageing population implies the need for more nurses to cope with this (Haddad et al, 2020).

Aging Work Force: The nurses are also becoming older like the populations they serve, the nursing workforce is also aging. By implication, one-third of the nursing workforce could be at retirement age in the next 10 to 15 years (Haddad et al, 2020)..

Nurse Burnout: High rate of burnout and job dissatisfaction is another competing need. Turnover in nursing seems to be leveling off, but only after years of steady climbing in rates. Currently, the national average for turnover rates is 8.8 % to 37.0%, depending on geographic location. (Haddad et al, 2020).

Growth: The high rate of job growth means a higher need is required seen in areas that have high retirement populations (Haddad et al, 2020)..

Competing Needs from the Economic Angle

Static Economic Shortages: This is based on the principle of demand and supply. Specifically nursing shortage depends on nurse availability in the face of actual budgeted slots at particular wage rates.  In a static economic shortage, the health organization has a budgeted position available but is unable to find suitable qualified candidate for employment at the wage being offered. That is, there is a shortage because the actual demand for nurses exceeds the actual supply of nurses who are available and willing to take these positions (Goldfarb, 2008).

Dynamic Economic Shortages: In this instance, demand and supply are equal, but suddenly the demand rises. Suppose that wages rise enough in response to call forth a sufficient increase in the number of nurses being supplied. The initial demand increase will then be met by rising supply (in response to the higher wage) and a moderating of the initial rise in demand because the higher wage makes adding nurses more expensive (Goldfarb, 2008).

How Policy Might Address These Competing Needs

Another important competing need is having adequate data on nursing. The question is: are nursing shortfalls large compared to other occupations. There is the need for organizations, policy makers and other stakeholders to have adequate data on nurse vacancy. A policy is required that will be driven in the direction of training enough nurses that will address the problem of nursing shortage in the US.

References

STEP 1: Think bout the three smartest people you know. Who are they? In what ways are they smart? What do they do that make sets them apart in intelligence?

STEP 2: Write a response between 150-250 words explaining why thes people are smart and, based on your readings, what psychological principles contribute to their intelligence. Were they born that way? Which type of intelligence would Gardner say they posses that most of? Are they also creative or do they do have high emotional intelligence? You essay should include an APA title and refernce page.

Please review the case presented and answer all the questions at the end of it.

CASE INTRODUCTION

Huddles are such an important part of nursing – they relay pertinent information, increase safety, offer team building opportunities, promote better outcomes for the patient, and ultimately can reduce costs.

Here is your scenario:

Your nurse manager identifies that the staff on your rehabilitation unit, and particularly that you as the evening charge nurse, are resistant and oppositional to an important new patient safety strategy of implementing huddles to improve staff communication.

BRIEF SUMMARY OF CASE 

Paragraph 1  Your nurse manager meets with you, the evening charge nurse, (and with you he had previously begun a disciplinary action process because you refused to implement huddles on the shifts when you was in charge).   You now understands that you (and the staff) were wrong, and you begin to explore with the manager how better to implement huddles on your shift.

Paragraph 2  In a quarterly staff development in-service for the rehab facility’s leaders, a group of nurses and charge nurses, including you, learn about implementing change using Lewin’s five-step Stages of Change (SCM) Model. The nurse manager and you apply this model to their failed implementation of huddles.

Paragraph  3 – You return to your unit and share with the staff that you—and they—were wrong to refuse to implement huddles. You begin to start the process as a change agent.

DISCUSSION GUIDE – QUESTIONS  Worth 2 points each (16 points)

Paragraph 1

1. How does your nurse manager know that you are ready to learn and be a part of the unit change?
2. How was the decision to implement the huddles handled?
3. What is the importance of a huddle?

Paragraph 2

1. What would you do prior to implementing a staff meeting to best communicate new information to the staff?
2. How would you describe Lewin’s Theory of Change? Can you give an example where you have used this theory?
3. What other theories of change are you familiar with, in addition to Lewin’s?

Paragraph 3

1. How would you manage conflict with the other unit staff?
2. How would you handle the resistance to change as noted by the unit staff?