Signature Assignment Title: What Makes a Good Leader?

Signature Assignment Description/Directions:

Choose one or more leadership topic(s) from your textbook or from a scholarly source from a previous discussion or assignment from this course and write about its application to nursing practice. Provide definitions, history/background, and major concepts of chosen topic.  Describe the topic’s function in nursing practice by examining at least three different nursing roles (for example, bedside nurse, public health nurse, CNO, unit manager, etc.). Discuss how the leadership topic can be used in your own practice. Discuss your personal growth in regard to your chosen leadership topic. Evaluate personal strengths, weaknesses, opportunities, and threats to your career advancement.

Then, discuss the top three traits you feel makes a good nurse leader. Support your statements with examples from your practice experience and scholarly sources.

Assignment Expectations:

Length: 1750 to 2000 words in length

Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.

References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three scholarly sources plus the textbook are required.

Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.

Format: Save your assignment as a Microsoft Word document (.doc or .docx) 

Case Study

Mrs. Smith is 82 years old and is diagnosed with hypertension, diabetes, and congestive heart

failure. Her two children live in California, whereas she lives in North Carolina in a small family

home on 10 acres of land in the Blue Ridge Mountains. Mrs. Smith has been in the hospital four

times in the last year because of congestive heart failure. As her eyesight and mobility get worse

with age, she has found it a challenge to stay on her medical plan and to do her shopping for the

right foods she knows she should be eating. Mrs. Smith’s health plan, Purple Cross of North

Carolina, assigned a nurse case manager to address her situation. Purple Cross provided a digital

scale and a remote monitoring device that record Mrs. Smith’s condition every day by uploading

her weight and transmitting the answers to a series of questions on a touch screen kiosk. The case

manager also coordinated delivery of Meals on Wheels, providing low-sodium, diabetic-compliant

dinners to Mrs. Smith on an ongoing basis. The case manager calls Mrs. Smith twice a week, taking

the time to educate her about her medications, her activities, and the disease-specific elements that

will keep her healthy and out of the hospital. When the case manager identifies that Mrs. Smith can

no longer organize her daily medications, a digital medication dispenser will be provided that will

keep her on her medication regimen. The medication dispenser will be preloaded with Mrs. Smith’s

medications and will issue a subtle doorbell tone when it is time to take her medicines. With the

combination of remote and real-time (telephonic) support persons and technologies, Mrs. Smith is

able to remain in her home and avoid further inpatient admissions.

Essay Questions

1. in 300 words elaborate on at least 5 components that are critical to Mrs. Smith staying safely in her home? 

2. in 300 words  Describe whether Mrs. Smith’s regimen might be augmented using telehealth

Applications and what measures can be taken. 

Use APA 7th format and at least 4 reference including the textbook 

 PLEASE FOLLOW THE INSTRUCTIONS BELOW

5 REFERENCES

Students will:

• Assess client families presenting for psychotherapy
• Develop genograms for client families presenting for psychotherapy

To prepare:

• Select a client family that you have observed or counseled at your practicum site.
• Review pages 137–142 of Wheeler (2014) and the Hernandez Family Genogram video in this week’s Learning Resources.
• Reflect on elements of writing a comprehensive client assessment and creating a genogram for the client you selected.

Assignment

Part 1: Comprehensive Client Family Assessment

Create a comprehensive client assessment for your selected client family that addresses (without violating HIPAA regulations) the following:

• Demographic information
• Presenting problem
• History or present illness
• Past psychiatric history
• Medical history
• Substance use history
• Developmental history
• Family psychiatric history
• Psychosocial history
• History of abuse and/or trauma
• Review of systems
• Physical assessment
• Mental status exam
• Differential diagnosis
• Case formulation
• Treatment plan

Part 2: Family Genogram

Develop a genogram for the client family you selected. The genogram should extend back at least three generations (parents, grandparents, and great grandparents).

Treatment of Psychiatric Emergencies in Children Versus Adults

The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations.

In this Discussion, you compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients.

Learning Objectives

Students will:

· Compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients

· Analyze legal and ethical issues concerning treatment of child or adolescent psychiatric emergency clients

To Prepare:

· Review the Learning Resources concerning emergency psychiatric medicine.

· Consider a case where an adult client had a psychiatric emergency. If you have not had a personal experience with an adult client who had a psychiatric emergency, you can conduct an internet or library search to identify.

Post:

· Briefly describe the case you selected.

· Explain how you would treat the client differently if he or she were a child or adolescent.

· Explain any legal or ethical issues you would have to consider when working with a child or adolescent emergency case.

 Required Readings ( Need 3 references)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

• “Bipolar and Related      Disorders”

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 23, “Emergency Psychiatric Medicine”      (pp. 785–790)
• Chapter 31, “Child Psychiatry” (pp. 1226–1253)

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell. 

• Chapter 50, “Provision of Intensive Treatment:      Intensive Outreach, Day Units, and In-Patient Units” (pp. 648–664)
• Chapter 64, “Suicidal Behavior and Self-Harm”      (pp. 893–912)

“Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for several weeks before her death. Her family was very anxious because of Mrs. Walsh’s unstable and deteriorating condition, and a family member was always with her 24 hours a day for the first few weeks.
The nurse became involved with this family while Mrs. Walsh was still in surgery, because family members were very anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac surgeon to better inform the family of their mother’s status.
One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with lists of questions. A consistent group of nurses who were familiar with Mrs. Walsh’s particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life.
The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She broke that tradition when she responded to the son’s and the daughter’s helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with families.
She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, “Why are you doing this? Nurse ‘So and So’ does it differently.” She commented that nurses learn to be flexible and to reset priorities. They should be able to let some things wait that do not need to be done right away to give the family some time with the patient. One of the things that the nurse did to coordinate care was to meet with the family to see what times worked best for them; then she posted family time on the patient’s activity schedule outside her cubicle to communicate the plan to others involved in Mrs. Walsh’s care.
When Mrs. Walsh died, the son and daughter wanted to participate in preparing her body. This had never been done in this unit, but after checking to see that there was no policy forbidding it, the nurse invited them to participate. They turned down the lights, closed the doors, and put music on; the nurse, the patient’s daughter, and the patient’s son all cried together while they prepared Mrs. Walsh to be taken to the morgue. The nurse took care of all intravenous lines and tubes while the children bathed her. The nurse provided evidence of how finely tuned her skill of involvement was with this family when she explained that she felt uncomfortable at first because she thought that the son and daughter should be sharing this time alone with their mother. Then she realized that they really wanted her to be there with them. This situation taught her that families of critically ill patients need care as well. The nurse explained that this was a paradigm case that motivated her to move into a CNS role, with expansion of her sphere of influence from her patients during her shift to other shifts, other patients and their families, and other disciplines”
Critical thinking activities
1. Discuss the clinical narrative provided here using the unfolding case study format to promote situated learning of clinical reasoning (Benner, Hooper-Kyriakidis, & Stannard, 2011).
2. Regarding the various aspects of the case as they unfold over time, consider questions that encourage thinking, increase understanding, and promote dialogue, such as: What are your concerns in this situation? What aspects stand out as salient? What would you say to the family at given points in time? How would you respond to your nursing colleagues who may question your inclusion of the family in care?
3. Using Benner’s approach, describe the five levels of competency and identify the characteristic intentions and meanings inherent at each level of practice.