How Doctors Tell Patients They're Dying/Being Mortal
First response
As the loved one, when I see that the medical condition of my patient is deteriorating I feel anxious, depressed, anger, fatigue, losing appetite and loneliness. As a normal human being, I start developing negative thoughts, I feel helpless and I have no joy at all. I expected my loved one to improve his medical condition but it seems like things are not good since the condition is deteriorating. As the doctors tell us openly and honestly that the condition is getting worse, I feel disheartened. I thought the illness is treatable since most hospitals' culture is set toward ‘cure' but in our case, there is no hope of improvement and recovery is uncertain. Rather than expecting false hope from the doctor, I appreciated whatever the doctor said, we build trust and accepted the reality.
Second response
As the caregiver, I believe that the act of communicating with the patient and the loved one about the deteriorating condition is the most stressful experience. Breaking the bad news is a very sensitive matter that needs special skills and courage. At this moment, I do not rely on the knowledge gained in the medical school but I use my own experience to inform them that the patient needs end-of-life care. As a physician, I feel that the patient and the loved one will find it hard to believe the bad news but I need compassion and kindness to help them accept the reality. As the condition deteriorates, I have the role and responsibility to help the family member face the reality. At this point, I find it a horrific circumstance and a terrible thing disclosing the bad news to the family. I feel distressed but at the same time, I need to gain strength and courage to deliver the news in an empathetic and professional manner. As a professional, I need to let the family know that death is an inevitable part of life.
Effects of caffeine consumption among college students
Introduction
In the U.S, a high percentage of college students consume caffeine on daily basis to stay awake and alert and, increase strength. In general, 80% of individuals globally consume caffeine on daily basis to increase alertness. Caffeine is readily available and it is extracted from various sources such as coffee beans, tea leaves, energy drinks, energy waters, pills and more. Today, people are consuming energy drinks and research has shown that the drink contains caffeine. Recent research has confirmed that consumers of energy drinks are young adults aged 18-43 and there is a need to find out the effects of caffeine on these young people. The purpose of this research paper is to study the effect of caffeine on college students. Authors such as Campsen & Buboltz (2017), Kerpershoek, Antypa & Van den Berg (2018) and Chaudhary et al, 2016 have reported that caffeine consumption is associated with insomnia and short sleep duration. However, it is important to figure out whether the poor sleep quality affects the student's academic performance. My concern in this research is to figure out the caffeine consumption and mental health, especially on college students. To begin the research, I will conduct a literature review to understand the history and current trend in caffeine consumption. I will research the health benefits (some studies such as the article by Capek & Guenther (2009) report that caffeine has memory-boosting effects) and harmful effects (some study report that caffeine decrease memory performance).The hypothesis of the research paper is that caffeine affects the students' performance in that it is associated with poor sleep quality which then affects the learning abilities, depressive symptoms, negative moods, physical illness, and lower academic performance. By reviewing the literature and research from recent journals, the paper will come up with a conclusion to support or refute the hypothesis.
In healthcare, the basic concepts of human resource management include supervising employees who work at different departments and ensuring the provision of training and education needs. Human resources managers focus on achieving organizational goals by employing strategies and activities. These strategies and activities are designed to ensure that employees who are the human resources- have the needed skill level and satisfaction for them to increase performance and the level of productivity (Niles, 2013).Thus, it is the role of the human resource manager to coordinate with the organization management to set strategic planning and engage in various roles. In the healthcare industry, the human resources manager provides employees with legal and ethical principles. Since the healthcare industry has many difficult situations, the human resource manager should state the ethical behaviors that both the healthcare provider and the patient should follow. In addition, the human resources manager should provide the employees with ethics and training where they will not only learn about ethics but also the employment-related legislation or laws that are passed by the federal and State (Niles, 2013). The human resource manager should also create a healthy work environment and provide training and education so that healthcare providers can understand the health and safety standards. Human resources manager is also responsible for job analysis and design, recruitment, selection, providing the employees with employees' benefits and motivating the workers so that they can provide the highest quality care (Niles, 2013). The human resource manager also needs to create programs for employee development to help employees improve performance.
Social and community service managers
Social and community service manager is one of the jobs I'm interested in. In the healthcare industry, this role consists of creating community initiatives with an aim of providing the community with social services and meet the public health needs (Niles, 2013). While in the health care field, I have done research and found that community is suffering from health issues such as cancers and diabetes which are caused by lack of activity and poor nutrition. The latter has also resulted in overnight and obesity and as a result, many people are suffering from respiratory problems, osteoarthritis, heart diseases and more. Tobacco, substance abuse and HIV-AIDS are also health issues which are causing premature death in many communities. Thus, the role of social and community service manager is to come up with a social service program designed to provide the public with social services. The manager does not work alone but rather he works with the community members and other stakeholders to identify the problem, the resources needed as well the best programs (Niles, 2013). In some cases, the manager may focus on a particular group such as older adults, people with mental problems, people who lack employment, homeless and more. The manager focuses on creating effective programs and services to help the target audiences with resources. They may also engage in recruiting new staffs, supervising programs, manage budgets and raise funds.
Practice managers
Given that there are many jobs that someone can work with a degree in health administration, the practice manager is one of the jobs I like. Today, the healthcare industry has a variety of healthcare practices which demand multidisciplinary care models. These many roles require the practice manager to run the multidisciplinary practices among other functions such as technology management and risk management. The health care industry is facing an increasing complexity and changes such as rising costs, new consumer expectations, technological change, need for quality assurance and more (Keagy & Thomas, 2004).These changing are impacting the healthcare and to avoid negative impacts, it is the role of the practice manager to ensure an effective management and best practices. In specific, practice manager acts as a change agent and play significant roles such as the implementation of processes, setting strategic planning, anticipate change, driving changes through creating staff cultures, offering training, changing systems and planning for risk management (Keagy & Thomas, 2004). .
Health insurance specialist
Today, the healthcare industry accept the filling of a health insurance claim. Health insurance specialist plays a significant role in reviewing the health-related claims and patient record documentation to view the diagnoses and services offered. The purpose of this role is to provide the patient's with insurance treatment plan so that the insurance can provide the benefits. This role also helps in improving care delivery and ensuring effective practices (Green, 2012). Another role that the practice manager play entails researching the insurance rules and regulations and ensuring that the insurance companies adhere to the rules. After reviewing the health-related claims, the manager posts charges to both patients and office accounts.
References
Niles, N. J. (2013). Basic concepts of health care human resource management. Burlington, Mass: Jones
& Bartlett Learning.
Keagy, B. A., & Thomas, M. S. (2004). Essentials of Physician Practice Management. New York, NY: John
Wiley & Sons.
Green A. Michelle. (2012). Understanding Health Insurance. Cengage Learning
Heart disease is one of the leading causes of death for many people in America; the disease associated behaviours are distributed all through the country. Stroke has also been listed as the fifth leading death cause and together, stroke and heart diseases are termed as the most costly health issues in the United States in the current day ("Heart Disease And Stroke | Healthy People 2020").
Health disparity
There is a high disparity in the quality of health care delivery across racial, ethnic, gender and social economic groups when it comes to heart diseases. Poverty and education have a great influence on health status and this affects the prevalence of heart diseases as well. The disease tend to affects some of the ethnic groups more than others especially those that are less educated as well as those who have lower incomes ("Heart Disease And Stroke | Healthy People 2020"). Some of the barriers to heart disease care that are experienced include; poor communication, perceived racism, cultural barriers and lack of provider parity with the patients. Most of the health care providers tend to be biased and thus do not offer treatment to those who really need it which lead to inadequate treatments for the minority groups. More people from the minority groups need to be trained in healthcare in order to help reduce the barriers to heart disease treatments.
Disparities in healthcare when it comes to heart diseases also lie in the awareness of and access to the knowledge about living a cardio protective life style. Hispanics and African Americans have about three times more hospital admissions for heart diseases and stroke as compared to other groups (Aspinal & Jacobson, p. 20). These groups have the worst outcomes from the heart diseases which include higher mortality rates all because of the unrecognized as well as the untreated heart disease risk factors.
Prevalence of risk factors
The risk factors for heart diseases and stroke can be classified as both controllable and uncontrollable.
The controllable risk factors for heart diseases include;
High cholesterol levels,
Smoking of cigarettes,
Diabetes,
High blood pressure
Obesity
These risk factors in cause some changes in the blood vessels of the heart which leads to heart failure, heart attacks and even strokes.
The uncontrollable risk factors include;
Age, where people who are over 65 have high chances of getting heart diseases
Gender, where men have higher rates of acquiring heart diseases than women
Family history, an individual from a family with heart disease reference has high chances of getting a heart ailment
Ethnicity, African Americans have a 40% higher chance of acquiring and dying from heart diseases as compared to the other groups. They are also twice likely to have stroke as well as higher rate of heart failure (Aspinal & Jacobson, p. 34). The Asians have higher Lipoprotein levels as compared to other groups which makes them highly vulnerable to heart diseases. They also tend to be insulin resistant which increases their risk factors to the diseases failure (Aspinal & Jacobson, p. 42).
Access to treatment
Treatment for heart diseases is neither cheap nor affordable to every one most especially the minority. Most people suffering from heart diseases go untreated which increases the mortality rates of the diseases (Ferdinand, p1). Most people in the minority groups do not get screened or even reach the correct therapeutic goals to help reduce cases of heart diseases because they do not have the facilities or enough knowledge regarding heart diseases. The African American and Asians have a 10% lesser chance of controlling their blood pressure as compared to the white people all because of lack of access (Ferdinand, p1).
The key element that can help improve heart disease treatment is education, heart diseases are mainly caused by controllable factors which can be eliminated through proper education. The society especially the minority should be enlightened about the risks factors of heart diseases and ways that they can control them (Aspinal & Jacobson, p. 54). Affordable health care should be provided for these groups in their various backgrounds to make it possible for them to access correct medical advice as well as treatment. Cardiovascular diseases and stroke are health issues that can be controlled and their impact reduced through provision of proper healthcare education.
Works cited
"Heart Disease And Stroke | Healthy People 2020". Healthypeople.Gov, 2018,
Healthy lungs keep the body healthy as one can breathe easily without discomfort. However, when the lung airways are affected, they are unable to supply oxygen. Aetiology or causation of this condition is that airways are unable to supply oxygen due to tobacco smoke, exposure to airborne pollutants, respiratory infections and other conditions such as rheumatoid arthritis (Shaw et al. 2002). The research finds that patients who undergo bone marrow and lung transplantation may develop airways disease. The pathogenesis or the development of airways diseases happens due to inflammation of the bronchi and bronchioles and also due to fibrosis. When this happens, the patient may experience pulmonary changes and suffer from asthma- inflammation of the airways and characterized by wheezing and shortness of breath. Chronic Obstructive Pulmonary Disease (COPD) - difficulty in exhaling which is characterized by wheezing and shortness of breath. Chronic Bronchitis- difficult in inhaling and exhaling due to inflammation of the bronchial tubes. Acute Bronchitis- this is an inflammation of bronchi associated with upper respiratory infections such as epiglottitis, rhinitis, sinus infection, nasopharyngitis, laryngitis and more. Cystic Fibrosis- inflammation of the bronchial tubes cause sticky mucus, coughing and lung infections (Shaw et al. 2002).
The research finds that the common pulmonary function tests cannot easily detect the airways obstruction. The best method is to examine the lung volumes and pulmonary ventilation distribution. Low lung volumes and nonuniformity in ventilation may indicate airways obstruction (Shaw et al. 2002). In general, the inflammation and fibrosis of the airways lead to functional abnormalities or a condition where the air creates resistance to flow. However, this condition can be managed through early diagnosis as the physician will examine the causative factors and prevent the condition from progressing to pulmonary disability (Shaw et al. 2002). Patients should also avoid smoking tobacco and exposure to dust to keep their lungs in a healthy condition.
Reference
Shaw, R. J., Djukanovic, R., Tashkin, D. P., Millar, A. B., Du Bois, R. M., & Corris, P. A. (2002). The role of
small airways in lung disease. Respiratory medicine, 96(2), 67-80.
As far as the End-of-life Care is concerned, healthcare education is regarded as being a multidisciplinary practice that enable physicians to design, implement, and evaluate various programs which enable communities, organizations, families, groups, and individuals to play an active role in protecting, enabling, and sustaining health. In order to enables APRN to provide effective care in end of life management, health education combines multiple learning experiences which are designed for the purpose of facilitating voluntary actions which are conducive to health (Matzo & Sherman, 2010). Research indicates that some of the patients nearing this stage always have progressive and life-threatening ailments which make them to have no opportunity of obtaining stabilizations, remissions, or modifications of the course of their ailment.
To enable APRN to provide valuable care in end of life management, there is the need of ensuring education is designed for the purpose of making these experiences more and more manageable not only by the patients, but also to their informal caregivers. Ideally, the essence of education is ultimately to increase an individual’s sense of self-control as well as the theoretical well-being of the patients nearing EoL and their families (Bushfield & DeFord, 2010). Since EoL is a complex task, the education offered by the health care providers to such patients is aimed at increasing their knowledge regarding the available care options.
Nevertheless, the clinical condition and the patients’ situation, together with the support their caregivers receive, is the one which impacts both the quality of their life and the quality of their health care. The manner in which caregivers and patients access education and variations in health care systems is the one which contributes to improving their contentment (Matzo & Sherman, 2010). Patient’s informal care providers, organization of care, health care options available and decision-making process also influences outcomes. As a whole, health education has the potential of improving the informal care providers’ quality of life and the symptom control of the patients (Young et al., 2005). In return, this has the capacity of improving the satisfactions of the caregiver.
References
Bushfield, S. Y., & DeFord, B. (2010). End-of-life care and addiction: A family systems approach. New York: Springer Pub. Co.
Matzo, M., & Sherman, D. W. (2010). Palliative care nursing: Quality care to the end of life. New York: Springer Pub. Co.
Young, C., Koopsen, C., Farb, D., & UniversityOfHealthCare. (2005). End of life care issues guidebook. Los Angeles, Calif: UniversityOfHealthCare.
In nursing, professionalization is having sufficient knowledge, self-discipline, and commitment, adhering to social values and executing standard activities in the provision of health care services to the patients. Shohani & Zamanzadeh (2017) states that development of professional or rather professionalization is influenced by factors such as official authority, research development, frequent training, resources, professional ethics, unity among members, nurses' support and, individual's actions. However, despite all these factors that influence professionalization, research has found that there is a weakness in professionalization or in other words, health care centers are experiencing insufficient professional nurses, higher rates of resignations, lack of job satisfaction and poor working environments (Shohani & Zamanzadeh, 2017). The research finds that professionalization has challenges which hinder the nurses from offering quality care. Nurses are unable to show professionalization due to lack of professional identity. The latter is hindered by technological, political, scientific and social factors.
The problem with professionalization since the professionalization is viewed through the lens of capabilities of nurses, professional ethics, frequent training, professional organizations, nursing license-confidence, managerial positions and more (Shohani & Zamanzadeh, 2017). On the other hand, clinical nurses' attitudes are not valued. The research article finds that the majority of nurses are women with a Bachelor of Science. On the other hand, men who enter in the nursing field with MSc degrees are less willing to stay on the job. In general, men and women hold different attitudes where some belief in the sense of commitment whereas as other belief on autonomy and organization unity. The main point is that professionalization needs to be supported in order to create satisfaction and provision of better services. Thus, as nurses hold their own beliefs, there should be a relationship between their attitudes and other variables such as nursing training for them to gain scientific knowledge (Shohani & Zamanzadeh, 2017). Nurses should know that education is not only about getting high degrees but also attending in-service training sessions to gain experience, job security and increase knowledge.
Professionalism in nursing
As a nurse, I understand that I have to demonstrate professionalism in order to offer high-quality services and create a healthy work environment. Nurses achieve professionalism through different practice such as adhering to ARNNL standards of practice, professional standards and demonstrating positive verbal and non-verbal behaviors (Huston, 2014). One situation in which I demonstrated professionalism in nursing is when I exercised ethical nursing practice. I was working in a community where the population was culturally diverse. I met patients of different races and backgrounds and I was able to avoid implicit stereotype and prejudices. I focused on my goals of providing an impartial care regardless of the diversity. I interacted with both white and black patients and I ensured a high standard of care to all patients. I focused on building professional relationships and acted as a moral agent in doing the good and right things. I was also interested in learning the cultures and this helped in providing cultural competency and sensitivity.
I can say that my behaviors in this situation (valuing and accepting diversity) is different than it would have been without my RN to BSN programs because these programs have provided me with higher proficiency in communication, critical thinking, adherence to ethical principles, showing repost, integrity, discipline, and compassion. These programs have also helped me gain cognitive skills, impersonal, and behavioral skills (Huston, 2014). By having the knowledge and skills required in nursing, I was able to value the different cultures, create rapport with patients, communicate effectively and offer culturally competent care to all patients. However, if I had not attained RN and BSN programs, there could be misunderstanding and miscommunication, unhealthy interactions, healthy disparities, lack of access to quality care and the minority would suffer from serious ailments (Huston, 2014). I would not value diversity but I would provide quality care to patients whom we have common cultures and show unfairness to the minority.
References
Huston, C. J. (2014). Professional issues in nursing: Challenges & opportunities. Baltimore, MD ;
Philadelphia, PA
Shohani, M., & Zamanzadeh, V. (2017). Nurses' Attitude towards Professionalization and Factors
Influencing It. Journal of caring sciences, 6(4), 345-357
Issues in Nursing: A Summary of Lessons from Various Scholars
Nursing Administration Article
Oppolo, Lloyd-Busby, Foreman and Richardson (2014) have discussed the changing environment in which nurse leaders operate in as they discharge their sensitive duties. In the article, the authors have documented that the nurse leaders have politically perceptive and be able to adapt to the fast changing conditions and chaotic in their environment of operation. The nurse leaders of the future have to be adept in their decision-making, be able to build effective teams and develop effective networks for collaboration. In this view, I learned that the nurse leader role requires extensive training and mentoring for effective nursing administrators of the current and future generations to be created.
Nursing Education Article
Gorski et al. (2015) have discussed in detail the nature of education required in the training of nurses for them to be able to meet the demands of the population of the country now and in the future. I have learned of the various challenges in the current nursing curriculum, which need to be addressed urgently for there to be more trained and effective nurses to deal with the emerging issues. The article has also helped me understand the need for all registered nurses (RN) to undertake further training and education for them to be effective in their service delivery.
Advanced Practice Nurse Article
Fagerström (2012) has documented the complicated nature of healthcare needs in the modern communities. Unlike in the past, nurses are required to be trained in multiple areas for them to be effective in providing nursing services in an advanced setting. I have learned from the article that the roles and duties of registered nurses globally have changed in a significant manner, which then requires those training to be nurses to be aware of the advanced practice expected of them once their begin offering nursing services as professionals.
References
Fagerström, L. (2012). The impact of advanced practice nursing in healthcare: Recipe for developing countries. Annals of neurosciences, 19(1), 1.
Gorski, M. S., Gerardi, T., Giddens, J., Meyer, D., & Peters-Lewis, A. (2015). Nursing education transformation. AJN The American Journal of Nursing, 115(4), 53-57.
Opollo, J. G., Lloyd-Busby, A., Foreman, K., & Richardson, D. (2014). Nursing administrative officer: Transforming nursing leadership in acute-care hospitals. Nurse Leader, 12(6), 84-90.
Frances Ballentine is the Vice President for Nursing Services at a hospital that has been found with various problems including inefficient process of medication errors’ reporting. The problems facing the hospital are ineffective leadership and quality issues. The ineffective leadership is indicated by the inconsistent process of reporting medication errors in the procedure manual for each floor, a problem that was identified after Frances carried out her investigation. In fact, Frances experienced difficulties while compiling her own monthly report on the number and causes of such errors. This lead to poor quality of healthcare services provided in the hospital. Therefore, the problems seen in the case include; incomplete reporting of medication errors, lack of monthly report on number and cause of errors, no timely incident reports from the hospital’s departments and the reports presented were most of the time incomplete. These issues majorly formed the secondary problems that resulted in poor quality of services. The primary problem experienced in the hospital was inconsistent application of reporting process after medication errors occurred, and these are attributed to lack of effective leadership across the various departments in the hospitals.
Key players identified in the case include the CEO, Frances as the VP for Nursing Services, Ally Ray as quality improvement director, the MEQI (Medication Errors Quality Improvement) team. The players embarked holding various meetings aimed at investigating of the reporting process of medication errors so as to identify the problems. The MEQI project team embarked on finding ways to improve the process and organized a special team that had knowledge of the process. The meeting between France and MEQI team members also decided to clarify the present knowledge of the entire process. The team established a Medication Error Reporting Chart as solution to the problems, and later embarked on implementing the improved process, which was supported by an online training to familiarize nurses with it. Coming up with a cause-and-effect program was an important step taken by the team.
Outcome
The adoption of the new medication error reporting policy, involving PDCA Cycle, and two check sheets is aimed at improving the process. The process requires improved leadership, especially in training and guiding the human resources on how the new policy is to be applied. The outcomes after the adoption of the new policy, including a cause- and –effect chart, should be improved quality of nursing services provided by the hospital. Outcomes in healthcare involve the resulting patients’ health status (Buchbinder, 2012). Quality involves the technical management of patient’s health and illnesses, and the interpersonal relationship management between healthcare providers and the patient (Buchbinder, 2012). The second aspect relates to the leadership quality among nursing management, a position that is occupied by Frances as the Nurses’ VP. The adoption of the new policy should ensure that the process of medication error reporting is consistent in the various departments of the hospital. The reporting of the errors should be complete and done on monthly basis so that to maintain consistency.
Moreover, the new policy should also be communicated throughout the hospital so that they the required quality of nursing health services is improved across board. The online training programs have to reach all the nurses in the department so that implementation process of the new policy achieves the required quality. Quality improvement team under the guidance of QI director should ensure that the health outcomes required are achieved in the hospital. The investigation done by the various teams in the hospital where the reporting process was shown to be inconsistent aligns with the need for combined efforts of various stakeholders and their views in understanding healthcare quality. Frances position as the VP for Nurses involved technical management and thus, the reason for being tasked by the CEO to oversee the improvement of quality especially while reporting medication errors. The meetings held by the MEQI project team whose members included the six hospital units and pharmacy representatives indicates the required integration of multiple stakeholders , since their divergent views would result to development of quality process of reporting in the organization. Health technical management pays attention to the clinical performance of providers of healthcare services while interpersonal relationship management highlights the combined efforts of patients and providers for improved services production (Buchbinder, 2012). These forms part of the required leadership related outcomes that
Solution
The major problems identified in the case involve leadership and quality. The solution for these problems has to be based on improved organizational effectiveness and healthcare quality in the various departments of the hospital. Leadership effectiveness will ensure that there is a continuous quality improvement to deal with inefficiencies in the medication error reporting process. This requires a strategy to be adopted by Frances with support of the CEO and other departments in the hospital. Strategy involves the philosophy or framework, various tactical processes and quality improvement tools. The strategy will ensure that the established framework considers the various problems identified in the investigation including lack of complete and timely reporting. The causes of such problems have to be identified early on before they greatly affect the healthcare outcomes in future. The medication error reporting process should incorporate a cause-and-effect diagram, before being adopted in the various departments in the hospital. A cause-and-effect diagram is an important tool since it enables nursing management in a hospital to identify the various problems and the probable causes in format that is well structured (Buchbinder, 2012). The application of a frequency chart in the framework such as Pareto chart will ensure that the number of occurrences of the medication errors is tracked, and this will be important in the process of data analysis. The quality improvement strategy to be adopted by the hospital management has to align with the desired health outcomes for the patient.
A framework that is not aligned with the continuous quality improvement cannot withstand the changes in patient’s health needs. The process of report compilation has to done within the set timelines, a month in this case, while ensuring that all the departments adhere to the various provisions of the process. For the best health outcomes to be achieved, the hospital leadership should ensure that Continuous Quality Improvement efforts are employed by nurses in all the departments if the hospital. Quality should be regarded as a major strategic priority in need of executive leadership and therefore, training the staff in quality methods should be part of the organizational culture (Buchbinder, 2012). Quality in health outcomes will be attained if the hospital management trains the nurses in all units about the improved process of reporting medication errors.
Reference
Buchbinder, S. B. (2012). Introduction to health care management. Burlington, Mass: Jones et Bartlett Learning.
As the administrator at Jonestown Medical Center, I understand that physicians should engage in professional activities and professional self-regulation in order to maintain medical profession integrity, maintain patients' safety and minimize professional risk. Given that Dr. Smith who works in the emergency room is intoxicated, there are chances of functional impairment or he may be unable to work due to his condition. I would take early interventions and appropriate actions to minimize the patients' injury and physician's criminal charges and loss of medical license (Buchbinder, 2012). First, I would do thorough investigation including alcohol test to obtain all evidence that the physician is intoxicated. If the results turn positive, I would advise him to review the Standards of Practice and admit whether he has violates the rules or not. Next, I would take a disciplinary action that is; warning with stipulations.
Case 2
As the CEO, I would apologize for the failure of pain medication. Second, I would discuss the matter with the physician who prescribed the pain medication to understand why the drug is not working. If the physician is guilty because he prescribed the wrong medication, I would give him or her a warning (Buchbinder, 2012). If the prescribed drug is not working, I would pay much attention to the patients by advising her to receive inpatient care in order to monitor her condition.
Case 3
In this case, it seems like the internists become defensive and angry because she is aware of the mistakes. In addressing the case, I would first inform her of the effects of upcoding to the hospital. The inaccurate billing code inflates the reimbursement causing higher hospital bills. This is an illegal practice that violates the False Claim Act (Buchbinder, 2012). After reviewing the pattern of upcoding, I expect the internist to accept the mistake and start using the correct billing codes. As a manager, I would impose fines since the act is unethical and illegal.
Case 4
As the assistant director, I would assess his clinical competencies and expertise to ensure that the physician looking for a job has 8 years of post-high school education and has attended the National Residency Matching Program. Since the ElSalvador medical school burned down, I would find his credentials and certifications and other details from a computer database (Buchbinder, 2012). Second, I will allow the physician to take a board certification examination to test his medical knowledge, skills to add areas of specialization.
Case 5
Since the hospital has a shortage of respiratory therapists, as a new administrator, I would collect information from the human resource manager regarding the hospital recruitment methods, meet the board of directors to discuss the issue and propose the best action, review the performance and reward of the workers and review how the physicians are motivated (Buchbinder, 2012). This information will help discuss how to reduce turnover, improve performance and quality services to the patients, increase patient satisfaction and prevent malpractice.
Case 6
As the administrator, I would call Dr. White and discuss with him the reasons as to why he offered a higher dose. We would also discuss the patient's history to ensure the safety of the patients. If the doctor confirms that the dosage is correct and no harm to the patient, then I would solve the conflict through negotiation where the parties involved would come to a mutually acceptable agreement (Buchbinder, 2012). If the doctor admits his mistakes of prescribing a higher dose, I would advise the doctor to prescribe the right dose.
Reference
Buchbinder, S. B. (2012). Introduction to health care management. Burlington, Mass: Jones et Bartlett
The Need for the Internet of Things (IoT) In Healthcare
The healthcare sector is in a state of intense misery. Healthcare related services are pricier than before, even as the universal aging population and chronic illnesses are increasing. We are, therefore, approaching a state where the primary healthcare will be out of reach for most individuals and more people will become more prone to long-term illnesses. For most people, a world with no accessible healthcare services is a reflection of the end of humankind. Fortunate enough, IoT development is the solution.
It is evident that technology cannot stop the global populace from aging and the spread of chronic illnesses immediately, but it can guarantee flexibility through reduced costs and accessibility. Despite the rapid development and adoption of technology across different sectors, it will never substitute humans since humans hold the final decision-making command. One can, however, in the process choose to settle for technological solutions that will make their work simple and create efficiency. IoT is best defined by the ability to bring about convenience, competence, and automation. IoT is the contemporary transformer technology that has been creating a thrill across industries but not yet embraced in the healthcare sector. IoT is an unrivaled innovation. Its primary objective in healthcare is to create reliable connections amid doctors and patients with zero restrictions. Such developments lead to health empowerment and the ability of the physicians to make informed choices centered on efficiency.
Why IoT is needed In Healthcare?
To Enhance Patient Care
IoT is the equipment that will enhance each aspect of care and change its managing across the healthcare range. The use of this technology will lead to better illness management that offers better patients encounter. In case of emergency, patients can contact their physicians immediately. In other words, the technology will bring mobility solution in the industry since the doctors can check on their patients regularly and identify their issues. Constant reporting and patients monitoring via the automated devices can save lives in emergent situations such as heart attack, high blood pressure and so on. Real-time responses help in the easy acquisition of data. The technology can serve as a preventative measure given that through research, some chronic illnesses can be prevented. Patients can access health management information from the devices easily which educates them on how to manage their conditions better.
Lower Healthcare Services Cost
With efficiency, expenses in accessing healthcare services are lower. Even though the issue of healthcare rising cost has been on the buzz over the last few years, it is widely agreed that the quality of care and efficiency are rather low. The situation is mainly driven by the fact that healthcare management needs are changing slightly rapidly thus, pressuring medics to respond instantly. Their decisions are less informed in most cases leading to inefficiency and illnesses intensification. With improved care then, patients will make fewer hospital visits as a whole resulting in less spending. This will, in turn, encourage quality and convenience given that one can access the services when needed with no hindrances. Thus, IoT will lower cost by reducing unnecessary hospital visits, quality utilization of resources and improved planning and allocation practices.
Transform Data and Increase Patient Engagement and Satisfaction
Measured health will be the healthcare sector’s future given that anything that is quantifiable can be upgraded. Thus, it is essential to take advantage of measured health technology in the provision of more regular services. It is without a doubt that data acquisition and use in health care affect the general performance and therefore the technology can provide reliable grounds for easy operation tracking for desirable outcomes. Through this technology, the response teams can gather more updated and accurate information that is in turn used in care provision. IoT can empower patients to engage more with physicians through the optimization of services accessibility and convenience. For example, constant informing of the patients about their health and treatment will increase their engagement by ensuring that patients interact more with their physicians directly.
Despite the overwhelming benefits of IoT in the healthcare system, there are significant barriers. The most common limitations to its adoption are related to data storage, management, and security. Currently, there is little awareness regarding the use of this technology. Reliability and data safety is dependent on training among the users since the smooth flow of data relies on human control. Besides, infrastructure is a necessity that is currently missing, and most healthcare providers are unaware of how to develop it. The innovation is not likely to benefit the vulnerable population, for instance, the elderly, low-income earners and illiterate persons. Such people are not exposed to the use of the internet and its application, while those with low education levels will face difficulties in the coordination and operating the devices. Such needs must be addressed for the successful adoption of IoT in healthcare.
Evidently, IoT will change the healthcare industry as it is associated with convenience, competence, and automation. The technologies will expand care management causing significant changes in the patient’s satisfaction, cost, illnesses prevention, services quality, and accessibility.
Elements of malpractice in professional nursing healthcare
Legal duty
In a healthcare setting, a patient is owed a duty of care by the nurse once the professional agrees to take care of the patient. The duty consists of interpretation the orders from physicians and following them so that care is undertaken appropriately (Raveesh, 2016). For instance, the professional owes his patient a safe treatment environment and to be provide medical care as per the orders from the physician.
Breach of duty
The nursing professional who owed the patient duty of care should have failed in their duty by not observing the level of medical skills or care that a reasonable nurse with similar specialty would be expected to use in an equal scenario (Raveesh, 2016). The duty, in this case, has been fulfilled. For instance, the nurse may have forgotten to put the bed rail in the right manner making the patient to fall.
Damages
The damages results from the professionals breach of duty. Thus, the breach of duty must have led to physical or emotional suffering to the patient while under the care of nursing practitioner (Raveesh, 2016). For instance, the fall by the patient from the bed can led to arm injury and thus, incur damages.
Causation
The patient or his attorney must provide solid proof which shows that the nursing practitioner’s breach of duty led to injury. It must be shown that the conduct of the nurse led to worsening of the health situation of the patient. In case of malpractice, the direct connection should be made by showing that the deteriorated condition would not have happened if the nurse was not negligent (Raveesh, 2016). For instance, administration of wrong drugs would lead to developmental problems to a child as determined by an expert.
In order to avoid legal cases in malpractices, the nursing practitioners should make follow ups, communicate effectively and prevent medical negligence. Follow ups ensures that nurse keeps tracks of the orders from the physicians , nothing is overlooked and that doctors are notified of any arising issues. Communication should be clear and effective so that the patient understand the medication and treatment plans are precise (Cruz, 2013). This ensures that physicians’ instructions are followed correctly. Preventing negligence involves avoiding mindlessly applying the care and treatment which may lead to injuries (Cruz, 2013).
Reference
Raveesh, B. N., Nayak, R. B., & Kumbar, S. F. (2016). Preventing medico-legal issues in clinical practice. Annals of Indian Academy of Neurology, 19(Suppl 1), S15.
ATECAR: Asian Tobacco Education and Cancer Awareness Research
Introduction
Asian Americans is among the minority groups in the U.S, and they consist of Chinese, Indian, Filipino, and Bangladeshi among other groups. The ethnic groups have lived in the U.S since the 1800s and immigration has changed the U.S demographic due to voluntary immigration, war, and imperialism which have increased the Asian-American demographics. Cancer is a threat to Asian Americans, and ATECAR (a community-based organization) was established in 2000 to control tobacco and cancer. The organization aims at developing programs and network for providing knowledge and skills and healthy behaviors related to prevention and intervention. Even though Asian Americans are overrepresented in higher education, they are the most underserved populations and encounter racial stereotypes.
Dhingra & Rodriguez (2014) asserts that race and ethnicity shapes society and Asian Americans are ethnic groups that lack the privileged of controlling their lives once they enter in U.S. Asians American encounter all kinds of sociological issues such as inequality and prejudice in the society. They encounter the deprivation of resources and unfair treatment in the labor market and in social institutions such as education and politics due to their gender, sex, age, and race. Since they lack the opportunity of participating in the institutions and social groups, they are unable to develop their self-identity due to limited choices. The inequality, underrepresentation in the social institution and lack of self-identify occur due to racism (Dhingra & Rodriguez, 2014). The racial formation theory states race shapes the society and whites use racial ideologies in defining the minorities. For example, Asian Americans are described as sexually deviant and apolitical among other terms that hinder the promotion of equality. It is essential to understand that race and ethnicity are social constructions where people define others by focusing on biological features such as skin color. White people use the physical differences to divide people between the society and social institutions (Dhingra & Rodriguez, 2014). Racial classification has become an issue of concern in modern societies in that rather than classifying people using biological bases; the community is using the political and social invention. For example, Irish Americans have phenotypic traits, but they were categorized as ‘racially white' until they socialized with whites in voting.
Having understood the social construction of race and the sociological issues that Asian Americans encounter, Ma et al. (2006) assert that health indicators in Asian Americans community shows the diversity. For example, the health indicators show that the rate of tuberculosis and hepatitis B Virus is higher in the Asian American community compared with other population such as white non-Hispanic and African Americans. Tobacco use is on rising in the Asian American community, and the high prevalence is leading to lung cancer. To address these issues, the ATECAR was established, and its role was to provide comprehensive prevention and control of tobacco and cancer. Primarily, the organization focused on taking collective actions and agreements with leaders of the Asian American community and later developed a National Cancer Institute (Ma et al. 2006). ATECAR collaborated with the Asian Community Cancer Coalition and established common goals and objective which enabled them to meet the social needs of Asian Americans.
Conclusion
Asian Americans are underrepresented in social settings, and they are discriminated and prejudiced due to the racial and ethnicity factors despite the higher education performance. Affirmative action and diversity programs have been developed to ensure that the group is not underrepresented. ATECAR has served a significant role in eliminating the diversity which the Asian Americans encounter in the U.S. As a community-based organization, it has developed sustainable partnerships with the community and ensured that the uninsured and underserved minorities can now access the health care. By implementing a comprehensive and cultural strategy, Asian population in the U.S has gained empowerment.
References
Dhingra P., & Rodriguez R.M.,(2014). Asian America: Sociological and Interdisciplinary Perspective. Polity
Press
Ma, G. X., Tan, Y., Toubbeh, J. I., Edwards, R. L., Shive, S. E., Siu, P., ... & Fang, C. Y. (2006). Asian tobacco
education and cancer awareness research special population network. Cancer, 107(S8), 1995-
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