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Week 1 Discussion

Select one of the articles listed below and answer this question:

Do you think it is reasonable to expect nurses to stay current regarding new research/Evidence-Based Practice findings in their area of practice? Or is this an agency/organization responsibility?

search for one of the articles below:

· Friesen, M. A., Brady, J. M., Milligan, R., & Christensen, P. (2017). Findings from a pilot study: Bringing evidence-based practice to the bedside. Worldviews on Evidence-Based Nursing, 14

· Jae, Y. Y., Jin, H. K., Jin, S. K., Hyun, L. K., & Jung, S. K. (2019). Clinical nurses’ beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: the first step to creating an evidence-based practice culture. Plos One, 14

As you prepare to transition from an academic student to a newly graduated nurse in clinical practice, consider the following:

· What two provisions in the ANA’s Code of Ethics for Nurses may help you in this transition?

· Expand on your chosen provisions and describe how adopting them into your clinical practice will help you to be successful.

In order to receive full credit, you will need to clearly respond to both parts of the question using subtitles or bullets AND cite at least one scholarly reference in your response. You are required to participate on at least three (3) days of the week to receive full participation points.

Week 1 Interactive Case Study Journal

· Due

 

No Due Date

 

· Points 50

 

· Submitting a text entry box or a file upload

Click on this link to view the DNR Interactive Case Study.

After you view the case study, reflect upon what you have learned and how it is related to the learning materials. Compare the case study to your nursing practice and give a similar example from your experience in which you might have run into an ethical situation.

Submit your entry by Sunday, 11:59 p.m. (Pacific time). Your reflection content should be a minimum of 500 words, equal to five to six paragraphs, and is worth 50 points.

Rubric

NURS_440_OL – Case Study Rubric (2)

NURS_440_OL – Case Study Rubric (2)
Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeCritical Analysis	20 to >17.8 pts Meets or Exceeds Expectations Presents an exemplary articulation and insightful analysis of significant concepts and/or theories presented in the case. Offers detailed and specific examples for all questions. Makes keen observations, making note of essential information provided in the case. Ideas are professionally sound and creative; they are supported by scientific evidence that is credible and timely. Draws insightful and comprehensive conclusions and solutions. 17.8 to >15.0 pts Mostly Meets Expectations Presents an accurate analysis of significant concepts and/or theories presented in the case. Offers some detail and some examples for most questions. Makes occasional note of essential information provided in the case. Ideas are mostly supported by scientific evidence that is credible and timely. Makes some attempt to draw conclusions and solutions. 15 to >11.8 pts Below Expectations Provides insufficient explanations of significant concepts. Offers little or insignificant detail and no examples for most questions. Fails to address essential information provided in the case. Ideas are generally unsupported by scientific evidence, but some attempt has been made. Fails to draw conclusion. 11.8 to >0 pts Not Meeting Expectations Does not, or incorrectly, answers with insufficient explanations. Information is not scientifically sound.	20 pts
This criterion is linked to a Learning OutcomeContent	15 to >13.3 5 pts Meets or Exceeds Expectations Makes insightful, clear and accurate connections to key concepts and relevant theories. Response indicates a comprehensive, high-level understanding of the concepts presented in the case. 13.35 to >11.25 pts Mostly Meets Expectations Makes mostly accurate connections to key concepts and relevant theories. Response indicates a general understanding of the concepts presented in the case. 11.25 to >8.85 pts Below Expectations Provides several insufficient or inaccurate explanations, although attempts are made to address some key concepts. Response indicates an introductory understanding of the concepts presented in the case. 8.85 to >0 pts Not Meeting Expectations Information is inaccurate or inadequate. Response indicates little or no understanding of the concepts presented in the case.	15 pts
This criterion is linked to a Learning OutcomeMechanics	10 to >8.9 pts Meets or Exceeds Expectations Answers are well written throughout. Information is well organized and clearly communicated. Assignment is free of spelling and grammatical errors. 8.9 to >7.5 pts Mostly Meets Expectations Answers are well written throughout and the information is reasonably organized and communicated. Assignment is mostly free of spelling and grammatical errors. 7.5 to >5.9 pts Below Expectations Answers are somewhat organized and lacks some clarity. Contains some spelling and grammatical errors. 5.9 to >0 pts Not Meeting Expectations Answers are not well written and lack clarity. Information is poorly organized. Assignment contains many spelling and grammatical errors.	10 pts
This criterion is linked to a Learning OutcomeAPA Format	5 to >4.45 pts Meets or Exceeds Expectations Follows all the requirements related to format, length, source citations, and layout. 4.45 to >3.75 pts Mostly Meets Expectations Follows length requirement and most of the requirements related to format, source citations, and layout. 3.75 to >2.95 pts Below Expectations Follows most of the requirements related to format, length, source citations, and layout. 2.95 to >0 pts Not Meeting Expectations Does not follow format, length, source citations, and layout requirements.	5 pts

Nurses can be an integral part of designing public policy as political leaders. As a registered nurse, you have a professional commitment to improve health care. However, many nurses are not politically active and do not lobby for important aspects of their profession.

· What are the reasons many nurses do not actively engage in lobbying efforts?

· What actions can nurses take to encourage themselves and their peers to get involved politically and lobby for specific issues such as healthcare policy changes? Provide a detailed example.

Week 2 Interactive Case Study Journal

· Due

 

No Due Date

 

· Points 50

 

· Submitting a text entry box or a file upload

Click on this link to view the Staffing Issues Interactive Case Study.

After you view the case study, reflect upon what you have learned and how it is related to the learning materials. Compare the case study to your nursing practice and give a similar example from your experience in which you might have run into staffing issues.

Submit your entry by Sunday, 11:59 p.m. (Pacific time). Your reflection content should be a minimum of 500 words, equal to five to six paragraphs, and is worth 50 points.

Rubric

NURS_440_OL – Case Study Rubric (1)

NURS_440_OL – Case Study Rubric (1)
Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeCritical Analysis	20 to >17.8 pts Meets or Exceeds Expectations Presents an exemplary articulation and insightful analysis of significant concepts and/or theories presented in the case. Offers detailed and specific examples for all questions. Makes keen observations, making note of essential information provided in the case. Ideas are professionally sound and creative; they are supported by scientific evidence that is credible and timely. Draws insightful and comprehensive conclusions and solutions. 17.8 to >15.0 pts Mostly Meets Expectations Presents an accurate analysis of significant concepts and/or theories presented in the case. Offers some detail and some examples for most questions. Makes occasional note of essential information provided in the case. Ideas are mostly supported by scientific evidence that is credible and timely. Makes some attempt to draw conclusions and solutions. 15 to >11.8 pts Below Expectations Provides insufficient explanations of significant concepts. Offers little or insignificant detail and no examples for most questions. Fails to address essential information provided in the case. Ideas are generally unsupported by scientific evidence, but some attempt has been made. Fails to draw conclusion. 11.8 to >0 pts Not Meeting Expectations Does not, or incorrectly, answers with insufficient explanations. Information is not scientifically sound.	20 pts
This criterion is linked to a Learning OutcomeContent	15 to >13.3 5 pts Meets or Exceeds Expectations Makes insightful, clear and accurate connections to key concepts and relevant theories. Response indicates a comprehensive, high-level understanding of the concepts presented in the case. 13.35 to >11.25 pts Mostly Meets Expectations Makes mostly accurate connections to key concepts and relevant theories. Response indicates a general understanding of the concepts presented in the case. 11.25 to >8.85 pts Below Expectations Provides several insufficient or inaccurate explanations, although attempts are made to address some key concepts. Response indicates an introductory understanding of the concepts presented in the case. 8.85 to >0 pts Not Meeting Expectations Information is inaccurate or inadequate. Response indicates little or no understanding of the concepts presented in the case.	15 pts
This criterion is linked to a Learning OutcomeMechanics	10 to >8.9 pts Meets or Exceeds Expectations Answers are well written throughout. Information is well organized and clearly communicated. Assignment is free of spelling and grammatical errors. 8.9 to >7.5 pts Mostly Meets Expectations Answers are well written throughout and the information is reasonably organized and communicated. Assignment is mostly free of spelling and grammatical errors. 7.5 to >5.9 pts Below Expectations Answers are somewhat organized and lacks some clarity. Contains some spelling and grammatical errors. 5.9 to >0 pts Not Meeting Expectations Answers are not well written and lack clarity. Information is poorly organized. Assignment contains many spelling and grammatical errors.	10 pts
This criterion is linked to a Learning OutcomeAPA Format	5 to >4.45 pts Meets or Exceeds Expectations Follows all the requirements related to format, length, source citations, and layout. 4.45 to >3.75 pts Mostly Meets Expectations Follows length requirement and most of the requirements related to format, source citations, and layout. 3.75 to >2.95 pts Below Expectations Follows most of the requirements related to format, length, source citations, and layout. 2.95 to >0 pts Not Meeting Expectations Does not follow format, length, source citations, and layout requirements.	5 pts
Total Points: 50

Week 2 Discussion 350

Has anyone read a report of a qualitative study before reading the one in this chapter? Where did you encounter it? What can you tell us about it? The point of reading research reports at this point is to understand them and extract essential information. Appraisal will come later. 

Discuss Why–How–What of the qualitative study listed at the bottom and respond to the questions below:

· Why did the researchers think it was important to do this study?

· What did their study do that those other studies did not do?

search for the article below:

Qualitative Article from Chapter 4:

· Sibeoni, J., Picard, C., Orri, M., Labey, M., Bousquet, G., Verneuil, L., & Revah-Levy, A. (2018). Patients’ quality of life during active cancer treatment: A qualitative study. BMC Cancer, 18 

2

DNR Case Study

Student’s Name:

Course Title:

Course Number:

Professor’s Name:

Date:

DNR Case Study

Nurses are required to advocate for their patients while practicing the nursing profession. Patients, on the other hand, are encouraged to also speak out for themselves so that they can be involved in decision-making and meet their needs. Patients and their families are regarded as the parties with a better understanding of their problems. As a patient’s support system, the family is expected to have plans of their loved one in ensuring their wishes are achieved in case a disease progresses (Keeley, 2017). This guarantees the wishes of a patient will be met at end-of-life care.

Neglecting conversations concerning end-of-life decisions makes clinicians and families make choices for the patients that may not align with the patient’s unknown wishes. In the disease and treatment process, it is essential for a patient, the nurses, and the family to work together to ensure that transparency exists between them and best responses are sourced when there is a medical emergency (Nnate, 2021). When questions and explanations are requested, an understanding is established. Despite a patient’s capacity of consciousness, the focus of care should always be on them.

Planning ahead of time for the patient’s care is vital since it ensure that the care provided aligns with their wishes and ensures a mutual understanding between family members and nurses. Nurses should keep in touch with family members and keep a complete record of the patient’s status to facilitate planning (Keeley, 2017). Because a disease might have several stages and a patient may have other preferences on their care plans, communications should always continue even after an initial care plan is established. There should always be room for change since anything can happen in the course of the treatment process. As the disease progresses through several stages, nurses should always check in with the patient to protect their quality of life.

Nurses should not be reluctant to initiate end-of-life conversations even though it may seem difficult. Patient’s wishes in care and the dying process will not be known without such conversations. Nurses can learn how to deal with ethical difficulties that arise at the end of life by engaging in such dialogues with patients and their families. To minimize uncertainties, patients and their families must also be heartened to initiate end-of-life dialogues. End-of-life discussions are meant to empower patients by allowing them to let out their thoughts and feelings and be accorded their wishes during end-of-life (Keeley, 2017). Advanced care planning helps families and healthcare facilities to save time and finances by avoiding legal actions to be taken when a patient is already dead.

In their daily practice, nurses are confronted with ethical dilemmas. Nurses’ knowledge and abilities enable them to deal with ethical challenges (Nnate, 2021). A practical experience is when a patient was diagnosed with breast cancer and the patient informed the nurse not to tell her husband. The nurse was in a dilemma because he knew the best person to take care of the patient at home was her husband. The nurse had to convince the patient of the benefits of telling her husband to ensure that she receives the best care at home as there was no other close person identified. Patients’ autonomy and privacy should be respected, but nurses are obligated to ensure the decisions made are for the best interest of the patients.

References

Keeley M. P. (2017). Family communication at the end of life. Behavioral Sciences (Basel, Switzerland), 7(3), 45. https://doi.org/10.3390/bs7030045

Nnate, D. A. (2021). Treatment withdrawal of the patient on end of life: An analysis of values, ethics, and guidelines in palliative care. Nursing Open, 8(3), 1023-1029. https://doi.org/10.1002/nop2.777

2

Understaffing in Nursing

Student’s Name:

Course Title:

Course Number:

Professor’s Name:

Date:

Understaffing in Nursing

Understaffing in nursing comes with a lot of challenges to care delivery. Patients’ welfare can be jeopardized when healthcare institutions have insufficient nursing staff. Furthermore, overworked nurses may overlook nuances or fail to interact properly with patients, which may make patients may be unsatisfied with the nursing performance. Increased workloads are associated with burnout and fatigue since nurses end up working for long hours with inadequate rest (Griffiths et al., 2020). It is impossible to give the best patient care when a healthcare professional is stressed as it increases the risk of making errors. Understaffing can put nurses under pressure; thus, inducing stress and making it difficult to concentrate on their work. Medication errors are attributed to problems of understaffing (Haddad et al., 2020). It is easy for nurses to make mistakes when they are not in a good state of mind. As the nurse-patient ratio increase, the quality of care is more likely to decrease.

Since the healthcare sector is moving in the direction of patient-centered care, patient satisfaction is critical. Patients can help or harm the facility’s reputation by voicing their concerns and expressing their dissatisfaction with the services provided in a healthcare facility. Dissatisfied patients are less likely to refer others to a certain care facility or return, which may have an impact on healthcare organizations’ financial returns. Healthcare organizations must focus their efforts on retaining nurses by ensuring that they have effective and safe working circumstances (Glette et al., 2017). Employers should collaborate with registered nurses to implement flexible staffing strategies in their facilities.

The problem of understaffing is linked to the shortage of nurses in many countries. With healthcare facilities operating 24 hours a day and the increasing patient health care demands, more and more nurses are needed to help meet these demands round-the-clock (Haddad et al., 2020). Despite that, the nursing workforce itself is rapidly aging, and there is yet to be found a solution to fill these gaps with new young nurses. Nurses have to undergo professional training and prove to be competent to be recruited to the nursing workforce. As time passes by, more nurses should be trained to fill the gaps of the aging nurse population as well as helping to deal with the problem of nurse shortage. The importation of nurses has helped to try and resolve the issues of nurse shortage.

Patient outcomes are largely dependent on the care they receive from nurses (Griffiths et al., 2020). The care has to be consistent and effective from assessment to hospitalization to recovery. An experience observed in a clinical setting concerning understaffing is in a certain care facility where there was a shortage of nurses. The facility experienced long queues pf patients who had to wait for many hours before they were attended to. This resulted in violent behavior from some of the patients and their families leading to an injury to a nurse. The average waiting time was 6 hours, and a significant number of patients could leave without being treated. The problem exposed the few nurses in the facility to stress and burnout, as well as the risk of violence from impatient patients and visitors.

References

Glette, M. K., Aase, K., & Wiig, S. (2017). The relationship between understaffing of nurses and patient safety in hospitals-A literature review with thematic analysis. Open Journal of Nursing, 7(12), 1387-1429. http://dx.doi.org/10.4236/ojn.2017.712100

Griffiths, P., Saville, C., Ball, J., Jones, J., Pattison, N., Monks, T., & Safer Nursing Care Study Group (2020). Nursing workload, nurse staffing methodologies, and tools: A systematic scoping review and discussion. International Journal of Nursing Studies, 103, 103487. https://doi.org/10.1016/j.ijnurstu.2019.103487

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. StatPearls Publishing.