You are working in the ER when an older adult woman, of Arab heritage, is brought in for what appears to be a possible heart attack, She is coherent and keeps saying that she lives with her son and that you must contact the local Imam before she can be treated for any healthcare issues. There is a sense of urgency. How might you handle this situation in the most culturally competent manner?

Group B Word Pool

11. An approved list of physicians, hospitals, and other providers _______________________

12. A decision-making process used by managed care organizations; used to manage healthcare costs through case-by-case assessments of the appropriateness of care _______________________

13. The primary care provider in charge of a patient’s treatment; additional treatment, such as referrals to a specialist, must be approved by this person _______________________

14. A service provided by various insurance companies for providers to look up patient insurance benefits, eligibilit , claims status, and explanation of benefits ______________________

15. A designated person who receives funds from an insurance policy _______________________

16. A process required by some insurance carriers in which the provider obtains permission to perform certain procedures or services _______________________

17. The amount of time a patient waits for disability insurance to pay after the date of injury _______________________

18. A payment arrangement for healthcare providers; the provider is paid a set amount for each enrolled person assigned to them, per period of time, whether or not that person has received services _______________________

preauthorization
gatekeeper
provider network
capitation
utilization management
online provider insurance web
portal
waiting period
beneficiary

Case Presentation

Jane King is a 22 year old female who has just begun her BSN nursing program. She is in her first clinical experience, and although she has been taught about giving bed baths, she is not sure that she is at all comfortable doing this. Her patient today is a 78-year-old male renal failure patient with limited mobility. Within her 8-hour assignment, Jane will need to complete all of her patient’s personal care.

Although Jane has cared for young children in baby-sitting jobs since she was 11 years old, she has no experience caring for adults. She is particularly concerned about perineal care. Yes, Jane has had instruction—but what about the actual experience of doing peri care? This is new to Jane, and she doesn’t know what to do.

Case Analysis

This is a time when the learning experience isn’t solely about Jane. As she tries on her new identity, she hasn’t had any of these experiences, and doesn’t know what to do. Because this is her first semester in her nursing program, she hasn’t had much time to ‘feel, think, and act” like a nurse professional. However, this patient is in a difficult situation in which he needs her care.

Compassion and engaged role modeling from Jane’s clinical instructor will help her take the next step in her own professional identity formation. As one takes on a new identity, there can be some sadness in “letting go” of the person’s previous perception of him- or herself. The clinical instructor needs to be aware that just as the student is constructing a new sense of professional identity in nursing, this often occurs in crisis (as in this situation), and often “deconstruction”—grieving the loss of the previous identity—occurs as the person takes on this new understanding of self. This example illustrates how such a situation reaches beyond role or job title. This student is experiencing a formative moment, and it is likely that she will be able to re-tell the story years from now. This is precisely why positive, insightful role modeling is needed by the clinical instructor. The student needs to see what the instructor does, how she treats the patient and the student, and what it means to provide professional nursing care in difficult situations. Furthermore, the instructor needs to ask the student to reflect on this experience within the next few days and discuss the student’s thoughts and reactions with the instructor. Role modeling, reflection, feedback, and encouragement are important strategies to help students as they incorporate additional identities into their own sense of professional identity.

1.What statements or non-verbal cues might Jane be communicating to indicate that this situation is about professional identity?

2.What are examples of instructor behavior and interaction with Jane and her patient that would be helpful in this situation?

Suppose that you have been asked to present a speech to an elderly audience. What topic will you develop and what story will you present?

You must refer to the process of storytelling included in the learning

Discussion questions:

Florence Nightingale was one of nursing's greatest pioneers in holistic nursing using your Dossey book and readings:

• Compare and contrast the theories and principles of Florence Nightingale’s and Jean Watson’s work. Discuss their impact on the global field of Nursing.

• What attributes do I have that reflect the core values of holistic nursing? Give examples of environmental patterning.

PLEASE USE CITATION IF USING IT.

in a child.

Of the hormones secreted by the posterior pituitary, if you had to choice one to be in a "hypo" state which one would it be and why? What are the treatment options for this "hypo" state and what monitoring would need to be completed?

A child of four years fell inside a swimming pool, but was timely saved by the senior brother. You arrived at the scene as soon as the victim had been brought out of the water

a) What is Drowning?
b) Mention Six (6) possible causes of drowning
c) Describe the First Aid Management of a child who was rescued from a swimming pool;

You are a female student nurse assigned to care for Mr. Habib, a male patient who is Muslim. He is recovering from surgery for prostate cancer and has a suprapubic incision. He is from Iran and has some difficulty speaking English. You know very little about the Muslim faith. You have been told that his wife is always at the bedside, and she seems very nice. One nurse tells you that she cared for the patient yesterday and that he has “something on a string around his neck.”

1. How would you familiarize yourself with Muslim beliefs as they affect health care?
2. As a female, what questions might you ask the patient about the care you plan on providing?
3. How would you best meet his spiritual and cultural needs while you care for him?

Children often come to the ambulatory care setting reporting hip or knee pain and walking with a limp. Compare and contrast the three common hip disorders in children.

--->

Anita Alvarez, a nurse, is providing care to Mark Walton, a 27-year old man who has just been diagnosed with irritable bowel syn. drome (IBS). Anita is teaching Mr. Walton about the dietary changes that he will need to make to manage his condition. Anita asks a series of questions quickly, changing the subject rapidly and not allowing Mr. Walton to provide answers or ask clarifying questions. During the session, she reads directly off a computer screen. When Mr. Walton does get a chance to ask questions, Anita takes several seconds to respond because she is busy look ing at her phone. She focuses on herself for several minutes when Mr. Walton asks one question about her work. When Mr. Walton leaves, Anita says, "Everything's going to be all right" as she slams the door.

Critical Thinking Questions

1. Which mistakes or barriers to communication did Anita engage in?

2. What could Anita have done better or differently to ensure that Mr. Walton retained the information and to promote the therapeutic relationship?

Even after accounting for patient’s severity of illness and population demographics, there are significant variations in hospital outcomes. What are some of the actions that can be taken in order to reduce the outcome variation? Provide at least one example of a policy (state or national level) in recent history (passed in the last 15 years) which was introduced to reduce these variations. Provide a brief history of the policy and a brief summary of it, as well as key aspects of the policy.