Assignment: Developing Organizational Policies and Practices

Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.

Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.

Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.

To Prepare:

• Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
• Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
• Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (4-5 pages):

Developing Organizational Policies and Practices

Add a section to the paper you submitted in Module 1. The new section should address the following:

• Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
• Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
• Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
• Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
• Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.

Learning Resources

Required Readings

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. Retrieved from
https://www.nursingworld.org/coe-view-only
Note: Review all, with special attention to “Provision 6” (pp. 23–26).

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from
http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html  

Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved from
http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html

Required Media

Laureate Education (Producer). (2012). Ethical, Moral, and Legal Leadership [Video file]. Baltimore, MD: Author.
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

Laureate Education (Producer). (2009b). Working with Individuals [Video file]. Baltimore, MD: Author.
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

PLS REVIEW MY ASSIGN WK1 NURS 6053 BEFORE WORKING ON THIS PAPER.

Requirements: 

1. In order to prepare for this assignment, read the lessons as well as the assigned readings BEFORE attempting the self-assessment. 
2. Please use the following hyperlink to access and complete the survey: Week 2 Pre-TANIC Self-Assessment Survey    (Links to an external site.)
3. FAILURE TO COMPLETE THE SURVEY WILL RESULT IN A GRADE OF ZERO (0) FOR THE ASSIGNMENT. 
4. After completing the survey, navigate to the Week 2 Module in Canvas and respond to EACH of the q uestion s for your Reflection Post.    
5. The Reflection Posts DOES NOT require cross-posting to a peer or faculty .  
6. Scholarly sources: Only scholarly sources are acceptable for citation and reference in this course. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Your textbook and lesson are not considered to be an outside scholarly source. For the discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal.  You are encouraged to use the Chamberlain library and search one of the available data bases for a peer-reviewed journal article.  The following sources should not be used: Wikipedia, Wikis, or blogs.  These web  sites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality.  For example, the American Heart Association is a .com site with scholarship and quality.  It is the responsibility of the student to determine the scholarship and quality of any .com site.  Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years.  Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.  

ATTENTION: Students will not receive results following completion of this survey. For the reflection questions, please recall how you rated your proficiency/competency with the skills on the survey.

*IMPORTANT* Upon completing the TANIC self-assessment survey, please TAKE A SCREENSHOT of the last page of the survey using a program such as Snipping Tool and save as a PDF or JPG and for your records. If you are unable to take a screenshot, please inform your faculty.

Reflection Questions: 

Reflect upon your current or most recent clinical practice and answer the following:  

1. How is informatics used? 
2. Regarding the Pre-TANIC Self-Assessment for this week, how did your perceived competency level prior to the self-assessment compared to after the self-assessment? Explain in detail.  
3. What TWO competencies do you use in your current clinical role? Provide examples.  
4. Identify TWO resources to develop a strategic plan to enhance your competency skills.   
5. Which resources are suited to your needs and why?  
6. How do you intend to enact this improvement plan? 

 Discuss medications to treat asthma. What specifically should patients be taught about these medications to prevent adverse side effects? 

 to be included in your portfolio:

1. Nursing Philosophy (from prior course) as your personal statement. It is what it is your hallmark as an Advanced Practitioner.

Example as follow:

Personal statement or philosophy statement relating to your role as an APN

Nursing is an art that can never be defined in one word or way. I remember before I decided to enroll in nursing school, I cared for an old lady through a home health agency. She kept telling me how wonderful I was to her, how patient, compassionate and always willing to assist her with her daily activities. She kept saying it is not about doing it, it is how you do it. She made me realize how much I could enjoy being a nurse and she constantly encouraged me to pursue a career in nursing.

When I enrolled in nursing school, it was not a smooth journey either because it was a very hard and demanding program but I learned a lot. It was then I realized nursing was not all about giving medication and helping someone to the bathroom. I learned about the importance of establishing rapport with a patient as soon as you assume care with them.

I challenged Practical Nursing boards and started working as a LPN before I completed my BSN program and the idea of nursing grew even more. Working as an LPN made me realized at times I may have to provide care to the family member may be a little more than the patient him/herself. I learned daily that nursing is way more than just what you learn in books and school and completing the care plan interventions.

Nursing to me is all about the relationship you establish with your patients, understanding them from their perspective. Asking them what they think is going on with their health or what has been changing in their body. I like to ask, how do you feel? What do you think? Asking these questions to my patients gives me a door to see them in a holistic manner. It helps me as a nurse to understand if their symptoms are just physical or are psychological as well. Someone may be experiencing a lot of life stressor and not eating right, or not drinking a lot of water. As a result they start experiencing a lot of headache. Instead of thinking it is a migraine and heavily medicate them. It is fair to give this person a little does of Tylenol. Encourage them to perform some relaxation exercises, eat well and drink plenty of water. I have come to learn that, food, water and our brains is what makes us or breaks us. If we think positive, we excel and do better in every aspect of our lives including our health. If we think negative them the vice versa will occur.

Another thing I learned from being a nurse is that we should always be reminded that we are advocates for our patients both verbal and nonverbal patients, but we do not have the last say. Most times we know more things related to the healthcare field compared to our patients. Our patients look at us and establish a lot of trust before you decide to do anything to them like giving them medication, sticking a needle on them, putting them on some times of machine. They establish some kid nog trust. So we should always be willing to educate our patients on what we think is going on with them and why we are doing certain interventions on them. Advocacy also comes with utilizing the ethical principles in our nursing care like autonomy, respect, nonmaleficence, beneficence, and justice

 I currently work as a nurse in the emergency department, prior to that I word in medical surgical, home-health, rehab, and long term acute care. Nursing was not the same in all these areas. I took care of different kinds of patients in their different stages of life. While all was very interesting, I really love working in the Emergency room. The ER is the combination of all in one visit or sometimes in part of the visit. We do a lot of patient teaching, stabilizing, and referrals. We do not necessarily see the same patients every day, and that Is what makes me grow as a nurse. Prior to working in the ER, I never worked with the pediatric population. And I was amazed how wonderful working with all age groups can be. I am always curious and willing to learn more about nursing and wanting to do more for my patients. I decided to enroll in the Family Nurse Practitioner- Doctor of Nursing Practice (DNP) program because I knew the program will give me all what I mentioned and more

The DNP program will not only allow me to earn the knowledge of what will make me a great family nurse practitioner but also it has a research part that will allow me to research on the current issue related to health care and/ or the nurse practitioner role in the society. As nurse practitioners we see a lot of patients from hospital to home setting and understanding research is vital to improve the care we provide to the communities we serve. Research in nursing is what bring about evidence-based practice which is the best way of practicing our daily nursing activities.

I took a theory class in the spring 2016 when I began my DNP course and I was amazed how all the nursing theories were pretty much what makes modern nursing better today. One of my favorite theories was “the theory of goal attainment” by Dr. Imogene King. This theory talks about the importance of nurses and patients having mutual goals that will improve patients’ health (King & Fawcett, 2012). For example, if a patient comes to the ER with several symptoms, instead of only telling them this is what we are going to do and this is what you are going to do. It is best to say, this is what I think we should do and give them a chance to say what they want done and what they do not want done. This does not mean you should not explain the rationale of your interventions but allow the patients to participate in their own care by making decisions with you. This will make it easier for the both of you because you will not have to struggle trying to do something to a patient that she/he does not like or later get sued because you did something that the patient did not agree to.

The DNP class has also allowed me to learn the importance of cost effectiveness and how nurse practitioners can be more cost effective compared to primary care physicians in providing their care. Learning all this information also allows me later as a nurse practitioner to be a great mentor to staff nurses and student nurse practitioners as well. Encouraging them on the constant use of evidence-based practice during direct patient care. And explain all the whys that they may have so that they feel better and understand what they have to care for the patient(s) in a different way compared to what they are already used to base on the current evidence and research at the time.

Having all that said, I believe nursing is an art that can never be explained in one simple word. The art of nursing is fulling to both patients and nurses themselves. Being a nurse practitioner will allow me to continue to advocate for my patients and do more for them like diagnosing and treating their symptoms in a cost effective manner, adhering to the ethical principle and the holistic approach at all times. I will also continue to learn more about nursing, medicine and all the current evidence based studies to ensure I provide the best care to my patients.

                                           Reference

King, I. M., & Fawcett, J. (2012). Imogene King. interacting systems framework. [electronic resource (video)] :. Athens, OH : FITNE, 2012.

 PLEASE ANSWER THE QUESTIONS BELOW IN APA FORMAT

MUST HAVE AT LEAST 2 CITATIONS AND 2 REFERENCES

MINIMUM OD 250 WORDS

1-which of the following behaviors may be (1) ethical but illegal, (2) legal but unethical, (3) illegal and unethical, and (4) legal and ethical. 

A. Working in a clinic that performs abortions 

b. Respecting the wishes of a client suffering from ALS that he be permitted to die with dignity and not placed on “breathing machines”

c. Respecting the health surrogate’s wishes regarding termination of life support of her friend 

d. Observing a coworker take out two tablets of oxycodone as ordered for pain management for his patient but keeping one for himself, administering only one tablet to the patient. 

2-differentiate among the following: deontological theories, utilitarianism, and principlism. 

3-what do you think about health-care professionals disclosing information to clients about a poor prognosis, even though the information may cause severe distress.

4-What do they think about health-care professionals disclosing information to clients against family wishes? 

5. You see a colleague use another nurse’s password to access the medication administration system and take out a narcotic. What would you do? 

6.Your colleague’s child fell and was brought to the emergency department. She comes back up to the unit and tells you that they cleaned and debrided the wound, and she needs to change the dressings twice a day using a wet to dry method. You see her go into the supply system and remove the dressings and saline using a patient’s identification number. What would you do?

7. You are caring for a patient who has a terminal disease. He asks you if he is dying. Would you tell him? If yes, how? If no, what might you say? . 

8-You are administering hydromorphone to a patient. The patient asks you what you are administering. Would you tell the patient about the medication?