Through communication—inquiry and dialogue—every person makes a contribution, and by being involved in the process, people can shift their attention and action away from a problem-oriented focus to dreams that are worthy to them and to productive possibilities for the future.

—Watkins & Mohr, 2001

Without a doubt, promoting health care quality and patient safety presents a meaningful aim.

To achieve this goal, nurse leader-managers need to be able to evaluate a situation from many different viewpoints and frame questions that elicit valuable insights. They must be able to promote skillful problem solving and interdisciplinary teamwork.

In this Discussion, you examine how you can use emotional intelligence and appreciative inquiry to facilitate positive changes that lead to improved quality and safety.

To prepare:

Review the information on emotional intelligence and appreciative inquiry presented in this week’s Learning Resources.

If you have not already done so, follow the instructions in the course text, Emotional Intelligence 2.0 to complete the online assessment.

Consider the results of the assessment. Review your strengths and opportunities for growth related to self-awareness, self-management, social awareness, and relationship management. What insights, questions, or concerns arise as you think about these results?

Think about how your identified emotional intelligence strengths and opportunities for growth relate to your current role as a leader-manager and to the professional contributions that you hope to make now and in the future. Give focused attention to patient safety and health care quality. How and why is emotional intelligence valuable for promoting optimal patient outcomes and creating systems-level change?

As indicated on pages 53–55 of the Bradberry and Greaves text, develop a plan for improving your skills in one area of emotional intelligence. Evaluate strategies for applying your strengths in the workplace. Identify at least two that you can use to add value to a team or workgroup to improve quality and safety.

Also review the information on appreciative inquiry in this week’s Learning Resources. Have you used appreciative inquiry before? If so, how? How does the application of appreciative inquiry relate to your role as nurse leader-manager and/or to efforts to promote health care quality?

Reflect on your experiences working in health care and identify an issue or problem that required, or requires, a change. Consider how you could apply emotional intelligence and appreciative inquiry strategies to this situation to facilitate positive results that lead to improved quality.

By Day 3

Post a brief description of an issue or problem in a health care setting that required, or requires, a change. Explain how you, as a nurse leader-manager, could apply both emotional intelligence and appreciative inquiry strategies to address this issue and facilitate positive results that lead to improved quality.

Read a selection of your colleagues’ responses.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Bradberry, T., & Greaves, J. (2009). Emotional intelligence 2.0. San Diego, CA: TalentSmart.

Chapter 1, “The Journey” (pp. 1–12)

Chapter 2, “The Big Picture” (pp. 13–22)

Chapter 3, “What Emotional Intelligence Looks Like: Understanding the Four Skills” (pp. 23–50)The first three chapters of this book introduce foundational concepts related to emotional intelligence, and provide the background for the online assessment that you will take in preparation for this week’s Discussion. In addition to these chapters, you should read the rest of the book once you have completed the assessment.

Note: You must purchase a new, unopened copy of this book in order to acquire the access code that you will need to complete the online assessment.

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.

Chapter 1, “Understanding the U.S. Healthcare System” (pp. 1–30)

This chapter sets the context for understanding quality-related issues within the U.S. health care system (macroenvironment). The authors discuss health care access and costs, which may be viewed as part of a triad with quality.

Ingram, J., & Cangemi, J. (2012). Emotions, emotional intelligence and leadership: A brief, pragmatic perspective. Education, 132(4), 771–778.

Retrieved from the Walden Library databases.

Nel, H., & Pretorius, E. (2012). Applying appreciative inquiry in building capacity in a nongovernmental organization for youths: An example from Soweto, Gauteng, South Africa. Social Development Issues, 34(1), 37–55.

Retrieved from the Walden Library databases.

This article examines how appreciative inquiry can be used to foster meaningful change in organizations. It outlines the principles of appreciative inquiry and the four phases: discovery, dream, design, and delivery.

Sadri, G. (2012). Emotional intelligence and leadership development. Public Personnel Management, 41(3), 535–548.

Retrieved from the Walden Library databases.

Emotional intelligence has been proposed as a key element of leadership. This article examines that argument, with attention to how and why it has been challenged.

Copperrider, D. L., & Godwin, L. N. (2010). Positive organization development: Innovation-inspired change in an economy and ecology of strengths.

Approximately 1 in 5 children and adolescents have a mental health disorder, which may lead to issues at home, school, and other areas of their lives (Prout & Fedewa, 2015). When working with this population, it is important to recognize that children and adolescents are not “mini adults” and should not be treated as such. Psychotherapy with these clients is often more complex than psychotherapy with the general adult population, particularly in terms of communication. As a result, strong therapeutic relationships are essential to success.

This week, as you explore psychotherapy with children and adolescents, you assess clients presenting with disruptive behaviors. You also examine therapies for treating these clients and consider potential outcomes. Finally, you develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

Photo Credit: [dolgachov]/[iStock / Getty Images Plus]/Getty Images

Learning Resources

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

Chapter 17, “Psychotherapy With Children” (pp. 597–624)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Note: You will access this text from the Walden Library databases.

Bass, C., van Nevel, J., & Swart, J. (2014). A comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment of adolescents. International Journal of Behavioral Consultation and Therapy, 9(2), 4–8. doi:10.1037/h0100991

Note: You will access this article from the Walden Library databases.

Koocher, G. P. (2003). Ethical issues in psychotherapy with adolescents. Journal of Clinical Psychology, 59(11), 1247–1256. PMID:14566959

Note: You will access this article from the Walden Library databases.

McLeod, B. D., Jensen-Doss, A., Tully, C. B., Southam-Gerow, M. A., Weisz, J. R., & Kendall, P. C. (2016). The role of setting versus treatment type in alliance within youth therapy. Journal of Consulting and Clinical Psychology, 84(5), 453–464. doi:10.1037/ccp0000081

Note: You will access this article from the Walden Library databases.

Zilberstein, K. (2014). The use and limitations of attachment theory in child psychotherapy. Psychotherapy, 51(1), 93–103. doi:10.1037/a0030930

Note: You will access this article from the Walden Library databases.

Required Media

Laureate Education (Producer). (2013a). Disruptive behaviors – Part 1 [Multimedia file]. Baltimore, MD: Author.

Laureate Education (Producer). (2013a). Disruptive behaviors – Part 2 [Multimedia file]. Baltimore, MD: Author.

Walker, R. (n.d.). Making child therapy work [Video file]. Mill Valley, CA: Psychotherapy.net.

Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 95 minutes.

Optional Resources

Bruce, T., & Jongsma, A. (2010a). Evidence-based treatment planning for disruptive child and adolescent behavior [Video file]. Mill Valley, CA: Psychotherapy.net.

Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 63 minutes.

Discussion: Counseling Adolescents

The adolescent population is often referred to as “young adults,” but in some ways, this is a misrepresentation. Adolescents are not children, but they are not yet adults either. This transition from childhood to adulthood often poses many unique challenges to working with adolescent clients, particularly in terms of disruptive behavior. In your role, you must overcome these behaviors to effectively counsel clients. For this Discussion, as you examine the Disruptive Behaviors media in this week’s Learning Resources, consider how you might assess and treat adolescent clients presenting with disruptive behavior.

Learning Objectives

Students will:

Assess clients presenting with disruptive behavior

Analyze therapeutic approaches for treating clients presenting with disruptive behavior

Evaluate outcomes for clients presenting with disruptive behavior

To prepare:

Review this week’s Learning Resources and reflect on the insights they provide.

View the media, Disruptive Behaviors. Select one of the four case studies and assess the client.

For guidance on assessing the client, refer to pages 137-142 of the Wheeler text in this week’s Learning Resources.

Note: To complete this Discussion, you must assess the client, but you are not required to submit a formal Comprehensive Client Assessment.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!

By Day 3

Post an explanation of your observations of the hyperactive adolescent in the case study you selected, including behaviors that align to the criteria in DSM-5. Then, explain therapeutic approaches you might use with this client, including psychotropic medications if appropriate. Finally, explain expected outcomes for the client based on these therapeutic approaches. Support your approach with evidence-based literature.

Read a selection of your colleagues’ responses.

W 2 Assignment 1 Discussion

The discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

For this assignment, make sure you post your initial response to the Discussion Area by Wednesday, October 19, 2016.

To support your work, use your course and text readings and articles from the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

To learn more about qualitative designs, please go to the following website:
http://health.prenhall.com/nieswiadomy/pdf/NIESWIADOMY10.pdf

For quantitative designs, please go to the websites:
https://explorable.com/research-designs 
http://www.researchproposalsforhealthprofessionals.com

Workforce Issues on Patient Safety

In this assignment, you will consider how workforce issues impact patient safety.

Based on your research, respond to one of the following discussion questions.

Discussion Question 1

Identify the methodology, design, and rationale of the following titles.

1. Exploring the rate of seasonal pattern depression in an Inuit community
2. Democracy in America
3. The relationship between compassion fatigue and burnout among critical care nurses
4. Two drugs for Alzheimer’s show promise
5. Evaluating technology with student success
6. Factors that influence weight control among women
7. The meaning of living with brain injury and stroke 10 years after the injury
8. Exploring the beliefs of healing among Aborigines

Discussion Question 2

Using the South University Online Library, research workforce issues and patient safety.

Based on your research, complete the following tasks:

• Identify and describe the research problems, purpose, objectives, and hypothesis of the research.
• Evaluate the credibility and validity of the study.

Suggested References:

Shisana, O., Rice, K., Zungu, N., & Zuma, K. (2010). Gender and poverty in South
           Africa in the era of HIV/AIDS: A quantitative study. Journal of Women’s
           Health (15409996), 19(1), 39–46.

Ko, E., Nelson-Becker, H., Park, Y., & Shin, M. (2013). End-of-Life decision making
           in older Korean adults: Concerns, preferences, and expectations.Educational
           Gerontology, 39(2), 71–81.

Witzke, J., Rhone, R., Backhaus, D., & Shaver, N. (2008). How sweet the sound:
           Research evidence for the use of music in Alzheimer’s dementia. Journal of
           Gerontological Nursing, 34(10), 45–52.

Sandvik, A., Melender, H., Jonsén, E., Jönsson, G., Salmu, M., & Hilli, Y. (2012).
           Nursing students’ experiences of the first clinical education: A nordic
           quantitative study. Nordic Journal of Nursing Research & Clinical Studies /
           Vård I Norden, 32(3), 20–25.

Cooper, C., Taft, L., & Thelen, M. (2004). Examining the role of technology in
           learning: An evaluation of online clinical conferencing. Journal of
           Professional Nursing, 20(3), 160–166.

Roulston, A., Bickerstaff, D., Haynes, T., Rutherford, L., & Jones, L. (2012). A pilot
           study to evaluate an outpatient service for people with advanced lung cancer.
           International Journal of Palliative Nursing, 18(5), 225–233.

Word count: 1,800 (+10% penalty will apply for non-adherence) – you cannot answer this paper in less than 1800 words. No work will be marked after 1980 words.

The purpose ofthisassignmenttaskis toidentifytheprinciplesofprofessional nursing practice, outlinetheethical andlegal frameworksforprofessional practice and apply the Ethical Decision Making Framework to a complex scenario to establish an ethically and legally sound decision. Remember toincorporate evidenced-basedpracticeinrelationtoquality patientcare.YouMUSTincludeinyourreferencing 4(four)ormore ofthefollowing;

·         Health PractitionerRegulation NationalLawAct 2010(WA)

·         NMBA Registered Nurse Standards for Practice 2016

·         NMBA NationalCode of Conduct for theRegistered Nurse2008

·         NMBA Codeof EthicsforRegistered Nurses2008

·         NMBA NationalFrameworkfortheDevelopmentof Decision Making Framework:  Scopeof Nursing Practice (2007)

·         NMBA ProfessionalBoundaries2010

Relevant Acts and Laws relating to the subject and health care practitioners – remember ALL your work must be referenced.

Use theModel for EthicalDecisionMaking (included in your instructions, available on Blackboard) to determine themost favorable outcome of your chosen scenario.

General Instructions

There should be attention to spelling grammar and punctuation, this work is an academic paper and needs to reflect your ability to analyse, reflect and articulate in the written form. Take time to study the marking guide to assist you with your focus. Note that there is no requirement for an introduction or a conclusion. There should be evidence of critical thinking. Citations within text and reference list should conform to APA 6^th ed format.

If you feel that you require assistance with your academic writing skills there are many facilities on campus and online to support you. Below is the link to access what is available.

http://life.curtin.edu.au/learning-support/writing-skills.htm

Include a marking guide with your work. Put your name in full on your uploaded document; Surname first.

Using theModel for EthicalDecisionMaking (Kerridge, Lowe and McPhee, p85 2005) to determine themost favorable outcome:

Modelfor EthicalDecision-Making

•     Pleaseusetheseheadingswhenwritingyourcasestudy

·         The word count provided is only an example – it also shows the weighting of the importance of each section.

1.Clearlystatetheproblem: this should not be any more than 150 words (this is like an introduction)

Considertheproblemwithinitscontext; ethical, medical,socialandlegal considerations.

This should be a very brief summary of the issues as you see it – extract the issues:

o   What is the ethical ISSUE-what is the decision about?

o   What is the medical condition, just state this in a few lines

o   What is the social situation of the patient -is the person dependent, do they have support?

o   What appear (prima facie) to be the legal issues? Is it assault; is it the application of an Advanced Directive or informed consent for example?

Example: The medical issues for this patient (Mr S) are; Diabetes type1, depression and Heart Failure. The ethical issue for Mr S is that he is concerned about the lack of autonomy and justice when he is in hospital. Mr S’s social situation is that he lives with his wife and one daughter, he states he is a Catholic. The legal issues for Mr S are namely consent, guardianship and refusal of treatment. These issues will be explored throughout this paper. (80 WORDS – you don’t have to put the word count in each section just at the end of your work – this is just an example for you).

2.Get thefacts: this should not be any more than 350 words

Here you need to find out what are the facts of the case;  – what is the medical condition & history, examination, relevant tests (investigations), define the medical condition what is the pathophysiology of the condition/s – use scientific references

o   What is the prognosis?

o   What are the implications of the condition/s -for example is it acute, chronic, and degenerative? What type of progression or prognosis might be expected?

o   Are there any alternative treatments?

o   What social factors might have an influence – family input, social interaction

3.Considerthefourprinciples: this should not be any more than 250 words

o   You need to define each principle and relate the principle to the patient

o   Autonomy: whatarethe patient’spreferences?

o   Beneficence:whatbenefitscanbe obtainedforthepatient?

o   Non-maleficence:whatarethe risksandhowcantheybeavoided?

o   Justice:howarethe interestsofdifferentpartiesto be balanced?

4.Identifyethical conflicts: this should not be any more than 200 words

What are the ethical conflicts? To promote autonomy are we in conflict with beneficence (Autonomy vs Beneficence).

Explainwhytheconflictsoccur relating this to the patient andhowtheymayberesolved.

Ref the NMBA Code of Ethics / ICN Code of Ethics in this section

5.ConsidertheLaw: this should not be any more than 450 words

Identifyrelevantlegal conceptsandlawsandhowtheymightguidemanagement.

·         Consider: the Practice Standards – how they apply to the case study ie (NMBA Registered Nurse Standards for Practice 2016).

o   How does duty of care apply to the patient?

·         How does the Practice Standards relate to the Act?

·         You need to use the Acts (legislation) that apply to the case study for example:

o   Consent to Treatment – Age of Majority Act

o   Human Tissue and Transplant Act

6.Makingthe ethicaldecision:this should not be any more than 250 words

o   Clearlystatethe clinical ethicaldecisionand justifyiteg:

o   Specifyhowguidingprincipleswere balancedand why (i.e.justifythe decision). Use the information that you have in the Law and Get the Facts section to support your decision. MUST Reference

o   Takeresponsibilityforthedecision&providealternativemanagement – reference this!

7. Evaluate the decision and discuss the legal relevance and importance of accurate documentation: this should not be any more than 150 words

·         Identify how you would evaluate your decision-what is our fundamental tool for establishing the efficacy/outcome of an action/decision? – here you will research what does the literature say about evaluation – also use the NMBA Registered Nurse Standards for Practice 2016

o   State where you would document and why it is a fundamental practice in healthcare. Here you will research what the literature say about evaluation – also use the NMBA Registered Nurse Standards for Practice 2016.

Tip for 7. – Review Kozier and Erb’s Fundamentals of Nursing 2008 Vol 1 – Evaluating p 245 and Documentation and reporting Chapter 15 p255

___________________________________________________________________________

Further information:

·         A minimum of 18 references are required for this assessment.

·         Review the marking rubric when doing your assessment.

·         Good luck

______________________________________________________________________________

CASE SCENARIOS

SELECT ONE CASE SCENARIO AND APPLY THE MODEL FOR ETHICAL DECISION-MAKING

Case Study 1                          Mr. Alphonse

Mr Alphonse Martinez[1] a retired Italian man, married, his wife also retired and they have two grown up sons who still live at home. They are a close family who go to church every Sunday. Mr Alphonse had just recently made an Advanced Health Directive (AHD) that stated if he had another serious heart attack that he was not to be resuscitated. His wife and two sons were opposed to his Advanced Directive and instructed the staff to take no notice of the AHD.

Alphonse has been discharged from the coronary care unit (CCU) and placed in a step-down cardiac ward following his myocardial infarction (MI). While he had been in CCU the staff had felt that he had exaggerated his chest pain. That is, when they asked him to rate his pain from 0 – 10 he sometimes stated that it was 12 or 14. In response staff reacted in a rather disapproving manner.

During the first evening on the cardiac ward Alphonse asked Mark, one of the student nurses on clinical practice, to contact the hospital priest to come and see him and give him the last rites. Mark did so immediately and then went back to sit with Mr Alphonse.

Later Mark’s clinical supervisor (RN) called him to one side and asked why he was sitting with Mr Alphonse. Mark (student nurse) replied that Mr Alphonse was anxious and so he was sitting with him. The RN asked Mark “do you think you could be making him more anxious by sitting with him?” Mark replied that he didn’t think so, and he was only doing so until the priest came.

The RN then asked why the priest was coming, and Mark said that Mr Alphonse had asked for the priest, and so he had contacted him to come. The RN then said to Mark, “did you not think you should have told me what you had done” With that Mr Alphonse’s buzzer went and, turning to go back into the room, the RN and Mark saw Mr Alphonse have a cardiac arrest.

Despite vigorous and sustained effort Mr Alphonse could not be resuscitated.

___________________________________________________________________________

Case Study 2                                   Miss Mary-Jane

Mary-Jane is 14 years old; her parents are newly separated and they both work. She has three younger siblings and Mary-Jane does a lot of the child minding. She has been complaining of abdominal pain, moderate now severe and has some vaginal spotting (bleeding) for the past 24 hours. She presents to the emergency department at her local hospital with her parents who are concerned that their daughter is so unwell. Mary-Jane is looking pale, sweaty, light headed, nauseated and has some stomach bloating. You have taken her base line observations on admission and they are: temperature 37.8C, pulse 118bpm, BP 90/50, Respirations 28bpm, shallow breathing.  A possible diagnosis would be an ectopic pregnancy, and to rule this out a pregnancy test is essential. As the student nurse together with the Registered Nurse caring for Mary-Jane consider the legal and ethical issues, one being consent and the other confidentiality, these and others will need to be considered for Mary-Jane.

What are the rules surrounding mandatory reporting of sexual abuse?

__________________________________________________________________________________

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[1]Alphonse Martinez (Hawley, G. (p 212, 2007). Ethics in clinical practice: An interprofessional   approach. London.   Pearson Education Ltd.

The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and acceptance of a diversity of faith expressions.

The purpose of this paper is to complete a comparative ethical analysis of George’s situation and decision from the perspective of two worldviews or religions: Christianity and a second religion of your choosing. For the second faith, choose a faith that is unfamiliar to you. Examples of faiths to choose from include Sikh, Baha’i, Buddhism, Shintoism, etc.

In your comparative analysis, address all the worldview questions in detail for Christianity and your selected faith. Refer to Chapter 2 of Called to Care for the list of questions. Once you have outlined the worldview of each religion, begin your ethical analysis from each perspective.

In a minimum of 1,500-2,000 words, provide an ethical analysis based upon the different belief systems, reinforcing major themes with insights gained from your research, and answering the following questions based on the research:

1. How would each religion interpret the nature of George’s malady and suffering? Is there a “why” to his disease and suffering? (i.e., is there a reason for why George is ill, beyond the reality of physical malady?)
2. In George’s analysis of his own life, how would each religion think about the value of his life as a person, and value of his life with ALS?
3. What sorts of values and considerations would each religion focus on in deliberating about whether or not George should opt for euthanasia?
4. Given the above, what options would be morally justified under each religion for George and why?
5. Finally, present and defend your own view.

Support your position by referencing at least three academic resources (preferably from the GCU Library) in addition to the course readings, lectures, the Bible, and the textbooks for each religion. Each religion must have a primary source included. A TOTAL OF SIX REFERENCES ARE REQUIRED ACCORDING TO THE SPECIFICATIONS LISTED ABOVE. Incorporate the research into your writing in an appropriate, scholarly manner. Prepare this assignment according to the guidelines found in the APA Style Guide

Read “End of Life and Sanctity of Life” in the American Medical Association Journal of Ethics, formerly Virtual Mentor (2005).