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 Discuss the tenets of nursing’s metaparadigm. Identify personal philosophy of nursing. 

Your paper should include the following:

– Discuss personal philosophy of nursing.
– Articulate changes in personal philosophy over time.
– Discuss factors that impacted change in personal philosophy of nursing.

Submission Instructions:

• The paper is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling.
• The paper should be formatted per current APA and 3-5 pages in length, excluding the title, abstract and references page. Incorporate a minimum of 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.

Case Study 

A 32-year-old African American mother of three toddlers who is 28 weeks pregnant is admitted to the high-risk pregnancy unit with regular contractions. She is concerned because the plans for her family are not finalized. She has many comfort needs, diagrammed in Table 33.1. When nurses assess for comfort needs in patients, they use the taxonomic structure, or comfort grid, to identify and organize all known needs. Using the comfort grid (see Fig. 33.1) as a mental guide, nurses design interrelated comforting interventions that can be implemented in one or two nurse–patient–family interactions. For this case, some suggestions to individualize the types of comfort interventions that might be considered are presented in 

Everything is in the document 

Respond to your colleague by providing at least two ways that their strategies may be expanded or improved.  

NOTE: Positive comment

                                                         Main Post

Treating Childhood Abuse

Psychiatric  Nurse Practitioners who work with children are mandatory reporters  (Child Welfare Information Gateway, 2019). Each state enacts specific  statutes that will clarify the guidelines/requirements about reporting  suspected child abuse, and it is the obligation of the PMH-NP to know  the law in his/her praciting state (Child Welfare Information Gateway,  2019).

Assessing for Abuse

Sadock,  Sadock & Ruiz (2014) identify certain vulnerability factors for  PTSD, including the presence of childhood trauma, inadequate support,  genetic predisposition to psychiatric illnesses, and recent stressful  life changes, all of which the patient in the case study displays. I  would keep those facts in mind as I assess any patient for the  possibility of abuse/trauma.

First  and foremost, establishing a therapeutic alliance is paramount; there  can be no self-disclosure without trust (Wheeler, 2014). I’m not sure if  this is a “strategy,” per se, but it is the foundation of any  relationship between the PMH-NP and her clients. 

As  I researched this topic, and I researched for hours because of the  gravitas of this topic, I found little conclusive evidence for specific  strategies. What I did find was a study from the WHO’s Mental Health Gap  Action Programme (2015) that concluded with, 

“Evidence  supporting the efficacy of strategies for detecting maltreatment of  children and youth within the context of mental health and developmental  assessment is sparse and inconclusive. No studies have evaluated the  performance of measures in predicting referrals and health outcomes.  However, it is generally agreed that it is important for health care  providers to detect child maltreatment. It is recognised that assessment  of child maltreatment requires a clinician who is competent enough to  ask the right questions and to respond appropriately’ (p. 17). 

While  this is disheartening, it is also a call to action. Not only do we need  to be attentive and alert with our younger patients, it is also clear  that we can and should be doing more to establish evidence-based  protocols for these situations. 

With  this particular case, considering this is a nineteen year old adult  presenting with a history of abuse versus current abuse (at least that  has been disclosed thus far), establishing trust and normalizing the  feelings of the client will be my priority. Also, I think it’s  imperative that we know our limits as clinicians and, while I might feel  competent to prescribe medications for this client, I am well aware  that bad therapy can worsen trauma for those with PTSD. I used to work  closely with our Trauma Stress Center at work and they consistently  drove home the importance of shoring up coping skills for these patients  before ever delving into the trauma, itself. I think too often some  clinicians overestimate their ability to help without taking into  consideration the possibility of doing harm.

Exposure to Social Media

As  with most things in life, exposure to social media has both pros and  cons, particularly when it comes to mental health/awareness/illness. On  the one hand, good information and resources are readily available;  however, there is also a glut of bad information. While there does seem  to be some evidence that social media can increase depression and/or  loneliness (Healthline, 2018) due to the tendency to compare oneself to  others, there are other studies which have not reached that same  conclusion. Instead, a study by Berryman, Ferguson & Negy (2018)  seem to suggest that the way social media is utilized is more important  than the mere use of social media. Certainly, at times social media can  increase connection with others.

Mandatory Reporting

As  previously referenced, the mandatory reporting requirements vary from  state to state (Child Welfare Information Gateway, 2019); however, in  the particular case, the client is nineteen years old. In the case of  adults, unless this is a elderly adult or adult with disabilities  (National Adult Protective Services Association, 2020). If Morgan is not  being currently abused and does not have a disability, mandatory  reporting is not required.

As  a side note, per the ANCC IQ practice questions for certification  (American Nurses Association, 2020), even if you suspect that an elderly  patient is being abused, if that patient is competent, you must respect  his/her wishes if they explicitly forbid you from reporting the abuse  to anyone. That surprised me but the rationale states, “The patient is  an adult. He has the right to make decisions for himself. Not all states  have mandatory elder abuse statutes or mandatory domestic abuse  statutes” (https://learning.ana-nursingknowledge.org/

d2l/le/content/8482/viewContent/40740/View, 2020). I would obviously double-check with state statutes to clarify state law. 

                                                                   References

American Nurses Association. (2020). Psychiatric Mental Health Nurse Practitioner 

Certification Practice IQ. Retrieved from https://learning.ana-nursingknowledge.org/d2l

home/8482

Berryman, C., Ferguson, C.J. & Negy, C.  (2018). Social Media Use and Mental Health 

Among Young Adults. The Psychiatric Quarterly 89(2), 307–14. doi:10.1007/s11126-017-9535-6.

Child Welfare Information Gateway. (2019). Mandatory reporters of child abuse and 

neglect. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau.

Healthline. (2018). The FOMO is Real: How Social Media Increases Depression and Loneliness.

Retrieved from https://www.healthline.com/health-news/social-media-use-increases-

depression-and-loneliness

National Adult Protective Services Association. (2020). What is Adult Protective Services?

Retrieved from https://www.napsa-now.org/get-help/how-aps-

helps/#:~:text=In%20most%20states%20in%20the,professionals%20to%20report%20their%20concerns.

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.

Wheeler, M. (Ed.) (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to

guide for evidence-based practice. New York, NY: Springer.

World Health Organization (WHO). (2015). Effective strategies for detecting maltreatment of 

Children and youth within the context of mental health and developmental assessment.

Retrieved from https://www.who.int/mental_health/mhgap/evidence/resource/child_q15.pdf

 Short answer

Less than 10 % similarity

References APA

Please note: i was born in Cuba. please do the work from Cuban Culture. thanks 

Chapter 10: Cultural Competence: Awareness, Sensitivity, and Respect

Think for a while about cultural practices and how they affect health or illness in your own family. They may be difficult to identify as such at first, but they do exist. What ideas about illness prevention does your family adhere to? What do you do when someone gets sick? What rituals does your family practice when someone dies?

HA3220D – Health Information Systems 

 Assignment 10: Optimizing Technology

(1) Create a workflow diagram to demonstrate a process in healthcare.

To construct your diagram, you can use symbols and shapes found in Microsoft Word. (If you aren’t familiar with using symbols and shapes in Word, the NAU Online Library’s Learning Express video tutorials can help, or you can view “Creating a Simple Flowchart in Microsoft Word,” a YouTube video hosted by Floyd Jay Winters, for a very quick introduction.)

Alternatively, you may wish to use a web-based mind mapping tool such as Coggle or WiseMapping. These tools are specially built to make web-based mind mapping easy, and give you the ability to export your work as a .PDF for upload to the dropbox.

If you’d like to draw your mind map by hand and scan it as a .PDF for upload, you can do that, too. Just make sure you have access to all the tools and know-how you need to get the job done (See Alan Henry’s LifeHacker article “5 Best Mobile Document Scanning Apps” for ideas).

(2) Review the steps in the diagram to determine how technology could impact the workflow. Then, create a revised diagram that integrates the use of technology.

(3) In a 1-page double-spaced report, compare the workflow in both diagrams. Summarize how the workflow can be maximized through the use of technology and outline steps of the work flow that can be redesigned to better accommodate the use of technology.

Directions

1. Please review the infographic as way to guide you in getting started with your assignment: Developing an Assignment with Integrity (Links to an external site.)
2. View a short tutorial with tips for completing this assignment: iCARE Paper Tutorial (Links to an external site.)
3. Getting Started: Interprofessional teams are part of practice trends we see developing in all aspects of care delivery. Consider you own work environment (or recent clinical setting).
   • For this assignment, consider the concept of interprofessional teamwork and patient outcomes.
   • Look to your current workplace as an example. (If you are not currently employed, look to a past workplace or clinical practice area.)
   • Apply the components of the iCARE concept to interprofessional teams in a short paper. (Body of the paper to be 3 pages, excluding the title page and references page)
   • iCARE components are:
     • C ompassion
     • A dvocacy
     • R esilience
     • E vidence-Based Practice (EBP)
   • How could you contribute to an interprofessional team and patient outcomes through nursing actions of: compassion, advocacy, resilience, and evidence-based practice?
4. Select one scholarly nursing article from CINAHL as a resource for your paper.
   • Additional scholarly sources can be used but are optional.
   • When searching in the CINAHL database, please limit your search word to one component of the paper you wish to emphasize, such as ‘Resilience’.  Searching for the term iCARE will not produce the results you need.
5. Elements of iCARE paper
   • Title page
   • Below are the headings to be used for this assignment.
     • Introduction: (No heading needed here in APA) Explain the type of work setting you are discussing and whether interprofessional teams are currently present. If interprofessional teams are present, indicate a team function that could be improved. If interprofessional teams are NOT present, indicate what type of team you think might be possible in the setting.
     • Describe a nursing action item for each component below that could contribute to: interprofessional team support; how this might impact the culture of your unit or organization; and possible impact on patient outcomes.
       • Compassion
       • Advocacy
       • Resilience
       • Evidence-Based Practice
     • Summary: Include a summary statement of how iCARE components can support interprofessional teams and patient outcomes. Address how you may be able to influence this process of support for interprofessional teams overall in your unit or organization.
     • References: List any references used in APA format.

Templates

The prepared paper template is RECOMMENDED for this assignment.

iCare Assignment Template (Links to an external site.) – APA 6th edition

iCare Assignment Template – APA 7th edition

Medication Errors Led to Disastrous Outcomes

 Julie Thao was licensed by the Wisconsin board of nursing as a nurse and worked in the birth unit at St Mary’s Hospital in Madison. She made a medication error when delivering care to a patient who was scheduled for labor induction by administering the wrong medication that was not prescribed. The 16-year-old Jasmine Gant delivered through cesarean section after suffering a cardiac attack and could not be rescued and this led to Thao losing her job and being charged with patient negligence (Treiber & Jones 2018). Kimberly Hiatt was also a registered nurse who did a medication error by administering an overdose of calcium chloride to an infant who had a heart problem. The baby died after 5 days and this led Kimberly to lose her job and could be hired anywhere else and this made her to commit suicide.

According to the two cases, healthcare professionals should learn that when a medication error occurs can have serious effects on patients’ health and well-being. Healthcare professionals should be very careful when administering medications to their patients to avoid such incidents (Cadwell & Hohenhaus 2011). They should avoid situations that inhibit delivery of safe and high-quality patient care such as attending to patients when they are fatigued to avoid making harmful errors.

The principle of beneficence and virtue of benevolence could have been applied by ensuring that the patients were given the correct medication according to their prescription to avoid hurting them. The hospital administration acted legally by making the nurses to be accountable for their actions, but the decisions were not ethical, it was not established that the nurses had the moral intent to make the errors.

Colleagues could have given them support by finding a quiet environment for them and let them relax. After creating a quiet place for them they would get an opportunity to ask questions which are open-ended and be more informed about the errors. Also, they could have given moral support through a show of compassion, sympathy, love, and truth-telling to help them cope with the impact of causing injury and death respectively.

Telling others how you feel about the situation can be very helpful to navigate through the whole process. Seeking support from family and friends who understands your pain can assist to go through the process (Ozeke et al., 2019). If one struggles with emotions elicited by the event, it is necessary to seek help from a health care professional to assist in developing coping skills. Also, seeking help is not a sign of weakness but it is a sign of strength.

References

Cadwell, S. M., & Hohenhaus, S. M. (2011). Medication errors and secondary victims. Journal of Emergency Nursing, 37(6), 562-563. https://doi.org/10.1016/j.jen.2011.07.010

Ozeke, O., Ozeke, V., Coskun, O., & Budakoglu, I. I. (2019). Second victims in health care: current perspectives. Advances in Medical Education and Practice, 10, 593. https://doi.org/10.2147/AMEP.S185912

Treiber, L. A., & Jones, J. H. (2018). Making an infusion error. Journal of Infusion Nursing, 41(3), 156-163. https://doi.org/10.1097/NAN.0000000000000273

Reply to Thread
 

 Respond to your colleague by providing at least two ways that their strategies may be expanded or improved.  

NOTE: Positive comment

                                                 Main Post

Clinicians  of all kinds tend to come into contact with victims of abuse many  times. This includes children who have been abused and molested in  different ways such as Morgan in the Case study. Victims of abuse are  susceptible to mental health issues such as anxiety, depression, and  PTSD. There is a very high connection between psychological outcomes in  adults and childhood maltreatment (Kisely et al., 2018). To put it  differently, childhood maltreatment is a major risk factor for mental  health issues in adulthood. This can be seen in Morgan’s case. he is  already 19 and an adult but he suffers from mental health issues because  he was molested as a child by his cousin. 

 Psychiatric  mental health nurse practitioners might interact with victims of child  abuse more than other clinicians because of the psychological outcomes  that are associated with child abuse and molestation. In some cases, the  victim may not be able to open up and point detailed information about  their past such as abuse and molestation. In such a case, the PMHNP  should have different strategies that can be used to make an assessment  and conclude that a client might be a victim of child abuse. For  example, during a client’s comprehensive assessment, physical assessment  must be done. During a physical assessment, a clinician should be able  to detect cases of physical trauma that the patient may find hard to  explain. An assessment also requires questions to be asked about trauma  history. Here, the client can be asked to point out ten most significant  disturbing events in their lives (Wheeler, 2013). This is an  opportunity to prompt the client to provide detailed information about  possible cases of child abuse. In order to be effective there is need to  make sure that the client can trust the process. A rapport should be  created from the very beginning of interacting with the client to make  sure that the client feels comfortable to share details that he would  rather not. Morgan has been silent about this for a long time and  therefore he has not been able to get over the trauma. This is an  opportunity to make sure that he is able to share as a way of helping  him face his disturbances. This will help in coming up with treatment  strategies that suit his needs. When it comes to psychotherapy,  communication is considered as the core element. It is the verbal and  non-verbal interaction between the PMHNP and the client that helps in  developing a fulfilling psychotherapeutic relationship (Del Giacco,  Salcuni & Anguera, 2019). 

 Thus,  in brief, the best ways of assessing a patient to determine a case of  abuse is through physical assessment and proper communication that  builds on trust. These are strategies that will push the client out of a  comfort zone where they feel not sharing keeps them safe. Communication  that builds on trust allows the client to feel like he is in a safe  place. This should be reinforced by the commitment from the PMHNP that  information shared during counselling cannot be shared with any other  person. Indeed, this might take time, but the client will eventually  learn to open up completely. 

 Being  exposed to the media and social media might be helpful or bad for the  client. This depends on the content that he views or reads online.  Social media might have content that allows him to cope with his  disturbances such as excessive worry and changes in mood. However,  reading or viewing the wrong content might exacerbate his distress.  During the counselling sessions, he should be asked what content he  consumes the most online. This is to allow the clinician to recommend  areas or content that he can focus on or completely avoid. Child  abuse should be reported in the United States. This is mandatory  requirement. The reporting should be done to a child protective service  agency or the police, depending on the requirements and policies in a  state. In this case, reporting will not be necessary because Morgan’s  cousin was already arrested and convicted for abuse and molestation.

                                                                References

Del  Giacco, L., Salcuni, S., & Anguera, M. T. (2019). The communicative  modes analysis system in psychotherapy from mixed methods framework:  introducing a new observation system for classifying verbal and  non-verbal communication. Frontiers in psychology, 10, 782

Kisely,  S., Abajobir, A. A., Mills, R., Strathearn, L., Clavarino, A., &  Najman, J. M. (2018). Child maltreatment and mental health problems in  adulthood: birth cohort study. The British Journal of Psychiatry, 213(6), 698-703

Wheeler, K. (2013). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. Springer Publishing Company

Student needs to know, compare and contrast the different categories of “shock” and the 

medicines used to treat “shock”

write two pages in APA stile with minimum of two referencies.