What are sorts of problems, challenges, and limitations are you finding in organizational development; both now and projected into the future? What sort of impact will these have on healthcare organizations?

Lisa, a critical care nurse is caring or Rochelle a 73-year-old woman suffering from diabetes, TBI and multiple internal injuries following a serious motor vehicle accident. Most likely Rochelle will need substantial skilled nursing care for an indefinite period of time, likely the rest of her life. Rochelle is on medicare and her husband informed you they have no supplemental insurance. Although Rochelle had expressed to her husband and several friends a desire to not live in a situation as she is currently, her husband was persuaded by the children to do everything possible to sustain her life. Rochelle’s husband has privately expressed to you his concern that her wishes are not being followed but feels he cannot disregard the wishes of their children.

*Apply the ethical principles: autonomy, beneficence, nonmaleficence, fidelity and justice to this case study. What would you do in this situation?

VOCABULARY REVIEW
Using the word pool on the right, find the correct word to match the definition. Write the word on the line after the
definition.
Group A Word Pool
1. A document sent by the insurance company to the provider and
the patient explaining the allowed charge amount, the amount
reimbursed for services, and the patient’s financial responsibilities
_______________________

2. An online marketplace where you can compare and buy
individual health insurance plans; state health insurance
exchanges were established as part of the Affordable Care Act
_______________________

3. Low-income Medicare patients who qualify for Medicaid for their
secondary insurance _______________________

4. A formal request for payment from an insurance company for
services provided _______________________

5. System used to determine how much providers should be paid
for services rendered; used by Medicare and many other health
insurance companies _______________________

6. An order from a primary care provider for the patient to see a
specialist or get certain medical services _______________________

7. A written agreement between two parties where one party (the
insurance company) agrees to pay another party (the patient) if
certain specified ci cumstances occur _______________________

8. A list of fixed fees for services ______________________

9. An organization that processes claims and provides
administrative services for another organization; often used by
self-funded plans _______________________

10. Poor, needy, impoverished _______________________

policy
claim
indigent
resource-based relative value
scale (RBRVS)
explanation of benefits (EOB)
fee schedule
qualified Medica e
beneficiaries (QMBs)
third-party administrator
(TPA)
health insurance exchange
referral

Review the Diabetes section in both the Index and Tabular sections of the ICD-10-CM book and look at the many manifestations related to Diabetes and the instructional notes related to the sequencing of these codes. Create a post that discusses the various manifestations and how they are noted in the ICD-10-CM book. How are they the same? How are they different? What should coders look for in the medical record for each manifestation? Post must be at least 250 words

the leading causes of death in the world. Pretend you have been hired by the WHO to address one of these causes. Write a one-page, typed paper discussing the cause of death you have chosen to address, why you chose it, and three ideas you have for addressing it. You will need to do some additional reading to determine health promoting activities/strategies that reduce the risk of your choice.  

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;