Overview/Description of Final Paper: The final written assignment will synthesize what you have discovered about the different advanced practice roles and scope of practice found in the master of nursing curriculum: APRNs, nurse educator, nurse informaticist, and nurse administrator/executive. You will review all roles and then examine the specialty for which you were admitted, focusing on the scope of practice, core competencies, certification requirements, and legal aspects of practice for that specific role. You will also identify the practice environment and population you will be working with, as well as peers and colleagues. In addition, you will discuss your future leadership role and participation in professional organizations.
Your paper is to be based on current literature, standards of practice, core competencies, and certification bodies for your chosen role. The paper should be 8-10 pages excluding the title and reference pages, and APA format is required.

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Criteria:
Advanced Practice Roles in Nursing:
Briefly define advance nursing practice and the roles in advanced practice nursing pertaining to clinical practice, primary care, education, administration, and health information. Distinguish between ANP and the APN.
Describe the advance nursing practice role you aspire and briefly share the experiences and/or qualities you have that have influenced your decision. Include your personal philosophy.
Selected Advanced Practice Role:
Identify the AP you interviewed and summarize the interview, which should/may include (if not in the interview, please address):
Examine regulatory and legal requirements for the state in which you plan to practice/work.
Describe the professional organizations available for membership based on your selected role.
Identify required competencies (domains), including certification requirements for your selected role.
Describe the organization and setting, population, and colleagues with whom you plan to work.
Leadership Attributes of the Advanced Practice Role:
Determine your leadership style
Define Transformational Leadership and as it relates to your identified leadership attributes that you possess or need to develop
Apply the leadership style you will embrace in AP to one of the domains
Health Policy and the Advanced Practice Role
Based on your program of study, review the literature and address the following:
FNP/AGNP:Medicare reimbursement for NPs is 85%for the same health care that MDs receive at 100% reimbursement? Please address questions below and state your position on this mandate.
FNP/AGNP:What states have NP Full Practice Authority and which states have limitations or restrictions? How does this apply to your state? Please address questions below and state your position on this regulation.
For the above category chosen, address the following:
Describe the current policy or trends and determine if it needs to change; if opposed to change state why
Provide the process required to make the change with key players and parties of interest; support opposition
Explain how you could lead the effort to make or influence the change in policy or keep the policy the same and the impact in healthcare quality.
Conclusion-Summarize your role paper by highlighting key points made in your paper.
Submission Details:
Support your responses with examples.
Cite any sources in APA format

Question 1 Statistics for 2008 to 2009 indicated that 20.7% of children lived in poverty. What health implications can be drawn from this statistic?

Select all that apply.

1. These children run a higher risk of poor overall health status.

2. Public health clinics can provide preventive care.

3. Medicaid assistance can enable these children to receive health care.

4. Increased funding for children’s health has resulted from these statistics.

Question 2 Which criterion limits access to health care?

1. No public transportation

2. Employment opportunities

3. Transition programs for newly arrived legal residents

4. Advocacy groups for immigrants

Question 3 A patient in the Emergency Department is concerned about the cost of treatment because of no financial income. What areas would the nurse include when assessing this patient?

Select all that apply.

1. Preventive care

2. Nutritional status

3. Number of accidents

4. Shelter

5. Status of current immunizations

Question 4 While taking the health history, a Black Hispanic patient tells the nurse about having difficulty finding employment. The nurse realizes that which is a factor that causes income disparity within this segment of the population?

1. Shift to labor requiring higher technological skills

2. Increase in the real minimum wage potential

3. Increase in traditional labor skills for these groups

4. Shift of skilled jobs to unskilled labor

Question 5 The nurse notes that a larger number of foreign-born patients are being seen in the hospital. From which countries are the majority of foreign-born legal permanent residents?

Select all that apply.

1. Mexico

2. China

3. India

4. Europe

5. South America

Question 6 A patient explains how a former job has been outsourced to another country. What impact has globalization had on the economy?

1. Increased income inequality for some groups in the United States

2. Improved income for all minority groups in the United States

3. Increased membership in labor unions

4. Decreased immigration

Question 7 Legal permanent residents tend to initially settle in urban areas. What can be inferred from this?

1. Employment may be found but will probably be in lesser-paying jobs.

2. Unemployment will not be a concern.

3. Employment is easy to obtain in urban areas.

4. Income earning potential is higher.

Question 8 A foreign-born patient tells the nurse about preparing for the naturalization exam. What kinds of questions will be on this exam?

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Select all that apply.

1. Questions about the Constitution

2. Parts of the US government

3. Who makes federal laws

4. The number of justices on the Supreme Court

5. Words of the US national anthem

Question 9 While shifts in the population profile are occurring, what is an important consideration to address in health care?

1. Cultural health needs of varying groups must be considered.

2. Health care needs to be streamlined for consistent care delivery.

3. More physicians need to be trained to deliver health care.

4. Health care providers need to be younger to care for an aging population.

Question 10 According to the 2010 Census, the percentage of the 65+ population of White non-Hispanics is at 13%. How will health planning needs be affected by this percentage?

1. This population will have greater demands on the health care system as it ages.

2. Planning needs for other segments of the population can be revised downwards.

3. There is no need to increase manufacture of childhood immunizations.

4. Cultural accommodations for other minority groups can be decreased.

Question 11 A patient tells the nurse that she lives in Section 8 housing. The nurse realizes that eligibility for this program is determined by:

1. Low-income guidelines

2. Family size

3. Geographic address

4. Employment history

Question 12 A patient, an immigrant from another country, is waiting to be seen in the Emergency Department. What difficulties is this patient dealing with since coming to a new country?

Select all that apply.

1. Learning a new language

2. Adapting to a new climate

3. Eating new foods

4. Fitting in with the new culture

5. Rejecting old customs in favor of new ones

Question 13 The nurse is comparing the patient population at a health care organization with the US Bureau of the Census population statistics. Which statement would the nurse use to make this comparison?

1. The percentage of US citizens who were people of color in 2010 was 36.3% of the population. 

2. The percentage of Black Americans dropped considerably between 2000 and 2010. 

3. People of color are the majority population within the United States.

4. People of color as a percentage of the overall US population are decreasing.

Question 14 Prior to completing an admission assessment, a foreign-born patient provides the nurse with a green card. What does this green card represent?

Select all that apply.

1. Proof of legal permanent residency

2. All rights of a US citizen with exceptions

3. Inability to vote

4. Restrictions to become a citizen

5. Automatic US citizenship

Question 15 When determining health care needs for a patient population, the health care organization analyzes the percentage of races represented within the organization with those of the US Census. What was the change in the White population between the 2000 and 2010 censuses?

1. 2.7%

2. 1.2% 

3. 0.3%

4. 3.8%

Question 16 While completing demographics for a new admission, the nurse notes that there are separate categories for race and Hispanic origin.What influenced this change to occur in demographic data  reporting?

1. Federal guidelines written in 1997 separated race and Hispanic origin as two separate concepts.

2. The number of people identified as non-White was increasing out of proportion to the population.

3. Identifies which health plans the patient is eligible to enroll in

4. Better differentiates categories within the African-American group

Question 17 How might immigration contribute to income inequality in the United States?

1. Many immigrants’ willingness to do jobs for less money than native-born residents

2. Being the primary income earners in the family

3. Advocating for higher minimum wages

4. A willingness to join labor unions as in previous immigrant trends

Question 18 Which characteristic would the nurse assess in a family experiencing multi-generational poverty?

1. Repeated cycles of decreased educational opportunities leading to poorer income potential and poorer health outcomes

2. Members not wishing to improve their life circumstances

3. Decreased interest by lawmakers in reducing poverty circumstances

4. Increased government efforts to provide money to improve incomes

Question 19 The health care administrator is comparing the 2000 Census Bureau data with patient demographic data. Which cultural group represented 12.5% of the population in 2000?

1. Hispanic or Latino 

2. Asian

3. African American

4. American Indian and Alaskan Native 

Question 20 What does the nurse identify as reasons why income influences health?

Select all that apply.

1. Increases access to health care

2. Enables people to live in better neighborhoods

3. Enables people to afford better housing

4. Enables people to live in areas without environmental hazards

5. Reduces despair

Complete each case study utilizing collegiate formatting (MLA or APA); typed in Cambria or New Times Roman 12 point font in ONE document. Citations required.

Case studies are case specific. Your answers should reflect the assessment and your analysis of the information in the case study… no generalized answers of all matter regarding the content.

QUESTION 1: Healthcare Delivery and Evidenced –Based Nursing Practice

The registered nurse working in the cardiac care clinic is tasked with implementing quality improvement measures. To educate the clinic staff, the nurse plans an in-service program to introduce concepts of quality improvement and evidence-based practice. Additionally, the role of the case manager will be included in the presentation. The nurse plans on using care of the patient with Congestive Heart Failure as a template, and prepares sample clinical pathways, care maps, and multidisciplinary action plans. (Learning Objective 3)

Describe how clinical pathways are used to coordinate care of caseloads of patients.

What is the role of the case manager in evaluating a patient’s progress?

What are examples of evidence-based practice tools used for planning patient care?

QUESTION 2: Community-Based Nursing Practice

Mrs. Johnson, a 67-year-old female patient, has recently been discharged from the hospital following an admission for COPD. She has a past medical history of a colon resection related to acute diverticulitis. She developed a surgical wound infection that requires daily wet to dry wound packing and IV Zosyn. Mrs. Johnson was discharged with home oxygen. To manage her care at home, home care visits were ordered. (Learning Objective 5).

What would be involved in setting up the first home care visit?

Describe the nursing assessments and management that would occur during the visit.

QUESTION 3: Case Study, Chapter 3, Critical Thinking, Ethical Decision Making, and the Nursing Process

1. Mrs. Elle, 80 years of age, is a female patient who is diagnosed with end-stage cancer of the small intestine. She is currently receiving comfort measures only in hospice. She has gangrene of her right foot and has a history of diabetes controlled with oral agents. She is confused and the physician has determined that she is unable to make her own informed decisions. The hospice nurse, not realizing that the weekly order for CBC and renal profile had been discontinued, obtained the labs and sent them to the nearby laboratory for processing. The abnormal lab results obtained later that day revealed that the patient needed a blood transfusion. The hospice nurse updated the patient’s medical power of attorney who was distressed at the report. The patient’s wishes were to die peacefully and to not have to undergo an amputation of her right foot. But if the patient receives the blood transfusion, she may live long enough to need the amputation. The patient’s physician had previously informed the medical power of attorney that the patient would most likely not be able to survive the amputation. The patient’s medical power of attorney had made the request to cease all labs so that the patient would receive comfort measures until she died. The patient has no complaint of shortness of breath or discomfort. (Learning Objective 4)

What ethical dilemma exists?

Who are the stakeholders and what gains or losses do each have?

What strategies should the hospice nurse take to resolve the ethical dilemma?

QUESTION 4:

Chapter 4, Health Education and Health Promotion

he community health nurse is planning a health promotion workshop for a high school PTSO (Parent-Teacher-Student Organization). The choice of topics was suggested by the high school’s registered nurse who has observed a gradual increase in student obesity. The two nurses have collaborated to develop this workshop to provide parents, students, and teachers with information about the importance of health promotion. (Learning Objectives 6, 8, and 9)

Describe the importance of a focus on health promotion.

According to the health promotion model developed by Becker (1993), what four variables influence the selection and use of health promotion behaviors?

c. Describe four components of health promotion.

QUESTION 5: Chapter 5, Adult Health and Nutritional Assessment

The registered nurse prepares to conduct a nutritional assessment on Mrs. Varner, a 52-year-old Caucasian female who describes herself as “overweight most of my adult life.” The client states that her health is good. She works part time as a receptionist and volunteers about 10 hours per week in her church. The nurse obtains Mrs. Varner’s height as 64 inches and her weight as 165 pounds. (Learning Objective 8)

What is the rationale for computing body mass index? What is Mrs. Varner’s BMI?

Calculate her ideal body weight. What is your assessment of her BMI and weight?

Based on Mrs. Varner’s BMI and weight, the nurse measures her waist circumference. Describe the proper procedure for this assessment.

Mrs. Varner’s waist circumference is 38 inches. What is your assessment?

What laboratory values would the nurse review to evaluate Mrs. Varner’s protein levels?

QUESTION 6: Chapter 6, Individual and Family Homeostasis, Stress, and Adaptation

Mary Turner stepped on a nail 5 days ago and sustained a puncture about 1 inch deep. She immediately cleaned the area with soap and water and hydrogen peroxide, and applied triple antibiotic ointment to the site. Today she comes to the clinic with complaints of increased pain and swelling in her foot. On assessment, the nurse notes that the puncture site is red and edematous, and has a moderate amount of yellowish drainage. (Learning Objective 9)

Describe the sequence of events that caused the local inflammation seen in Mary’s foot.

What is the role of histamine and kinins in the inflammatory process?

Which of the five cardinal signs of inflammation does Mary exhibit?

Because Mary’s injury occurred 5 days ago, the nurse should assess for what systemic effects?

QUESTION 7:

Chapter 7, Overview of Transcultural Nursing

The nurse manager of an ambulatory care clinic has noted an increased number of visits by patients from different countries and cultures, including patients from Mexico and other Latin American countries. Concerned about meeting the needs of this culturally diverse population, the nurse manager convenes a staff meeting to discuss this change in patient demographics, and to query the staff about any learning needs they have related to the care of these patients. (Learning Objective 3) FUNDAMENTAL OF NURSING ASSIGNMENT

What strategy to avoid stereotyping clients from other cultures should the nurse include in this meeting?

Identify culturally sensitive issues to be discussed in the staff meeting.

One technician on the staff complains that some patients never make eye contact, and this makes it difficult for him to complete his work. How should the nurse respond?

QUESTION 8: Chapter 8, Overview of Genetics and Genomics in Nursing

Mr. Wayne is a 38-year-old man with a significant family history of elevated cholesterol levels. His father died at age 42 from a massive heart attack secondary to elevated cholesterol and triglycerides, and two of his older siblings are currently taking medications to lower their cholesterol levels. Mr. Wayne makes an appointment to discuss his risk for hypercholesterolemia. The nurse recognizes that Mr. Wayne is at risk for familial hypercholesterolemia because this is an autosomal dominant inherited condition. (Learning Objective 2)

Describe the pattern of autosomal dominant inheritance.

Mr. Wayne asks what chance his children have of developing familial hypercholesterolemia. How should the nurse respond?

Explain the phenomenon of penetrance observed in autosomal dominant inheritance.

QUESTION 9: Chapter 9, Chronic Illness and Disability

Mr. Edwards is 20-year-old male patient who is admitted for treatment of recurring pyelonephritis (kidney infection) and surgical treatment of a urinary stricture, which has decreased the urinary stream. Mr. Edwards has paraplegia; he is paralyzed from the waist down secondary to an automobile accident when he was 16. He came by ambulance to the hospital, leaving his wheelchair and wheelchair pressure-relieving cushion at home. According to the nursing history, the patient is a nonsmoker and he does not drink alcohol or take any illegal drugs. (Learning Objective 5)

What nursing considerations should be made for Mr. Edwards related to his disability?

What health promotion and prevention education does Mr. Edwards need?

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QUESTION 10: Chapter 10, Principles and Practices of Rehabilitation

You are assigned to care for David Ramsey, a 22-year-old male patient who sustained a back injury secondary to being thrown from a motorcycle. He did not damage the spinal cord, but the computed tomography revealed a compression fracture at L-2 (lumbar area). David complains of severe lower back pain with numbness and tingling in the lower extremities. You identify the following nursing diagnosis: Impaired Physical Mobility.

(Learning Objective 4)

What assessments are indicated based on this nursing diagnosis?

List other major nursing diagnoses based on David’s clinical presentation.

QUESTION 11:

Chapter 11, Health Care of the Older Adult

The nurse working at the senior center notices Mrs. Jones, a 78-year-old, crying. The nurse approaches Mrs. Jones and asks if she needs help. Mrs. Jones states “I am so embarrassed. I had another accident and my pants are all wet. It’s like I’m a baby. I never should have come to the senior center.” (Learning Objectives 3 and 4)

What factors may be contributing to the urinary incontinence?

How should the nurse respond to Mrs. Jones?

QUESTION 12:

Chapter 12, Pain Management

Mr. Rogers is 2 days postoperative of a thoracotomy for removal of a malignant mass in his left chest. His pain is being managed via an epidural catheter with morphine (an opioid analgesic). As the nurse assumes care of Mr. Rogers, he is alert and fully oriented, and states that his current pain is 2 on a 1-to-10 scale. His vital signs are 37.8 – 92 – 12, 138/82. (Learning Objective 6)

What are benefits of epidural versus systemic administration of opioids?

The nurse monitors Mr. Rogers’ respiratory status and vital signs every 2 hours. What is the rationale for these frequent assessments?

The nurse monitors Mr. Rogers for what other complications of epidural analgesia?

Mr. Rogers complains of a severe headache. What should the nurse do?

Mr. Rogers’ epidural morphine and decreased mobility increase his chances of constipation. What interventions should be included in his plan of care to minimize constipation?

QUESTION 13:

Chapter 13, Fluid and Electrolytes: Balance and Disturbance

Mrs. Dean is 75-year-old woman admitted to the hospital for a small bowel obstruction. Her medical history includes hypertension. Mrs. Dean is NPO. She has a nasogastric (NG) tube to low continuous suction. She has an IV of 0.9% NS at 83 mL/hr. Current medications include furosemide 20 mg daily and hydromorphone 0.2 mg every 4 hours, as needed for pain. The morning electrolytes reveal serum potassium of 3.2 mEq/L. (Learning Objective 4)

What are possible causes of a low potassium level?

What action should the nurse take in relation to the serum potassium level?

What clinical manifestations might the nurse assess in Mrs. Dean?

Question 14:

Chapter 14, Shock and Multiple Organ Dysfunction Syndrome

Adam Smith, 77 years of age, is a male patient who was admitted from a nursing home to the intensive care unit with septic shock secondary to urosepsis. The patient has a Foley catheter in place from the nursing home with cloudy greenish, yellow-colored urine with sediments. The nurse removes the catheter after obtaining a urine culture and replaces it with a condom catheter attached to a drainage bag since the patient has a history of urinary and bowel incontinence. The patient is confused, afebrile, and hypotensive with a blood pressure of 82/44 mm Hg. His respiratory rate is 28 breaths/min and the pulse oximeter reading is at 88% room air, so the physician ordered 2 to 4 L of oxygen per nasal cannula titrated to keep SaO2 greater than 90%. The patient responded to 2 L of oxygen per nasal cannula with a SaO2 of 92%. The patient has diarrhea. His blood glucose level is elevated at 160 mg/dL. The white blood count is 15,000 and the C-reactive protein, a marker for inflammation, is elevated. The patient is being treated with broad-spectrum antibiotics and norepinephrine (Levophed) beginning at 2 mcg/min and titrated to keep systolic blood pressure greater than 100 mm Hg. A subclavian triple lumen catheter was inserted and verified by chest x-ray for correct placement. An arterial line was placed in the right radial artery to closely monitor the patient’s blood pressure during the usage of the vasopressor therapy. (Learning Objectives 6 and 7)

What predisposed the patient to develop septic shock?

What potential findings would suggest that the patient’s septic shock is worsening from the point of admission?

The norepinephrine concentration is 16 mg in 250 mL of normal saline (NS). Explain how the nurse should administer the medication. What nursing implications are related to the usage of a vasoactive medication?

Explain why the effectiveness of a vasoactive medication decreases as the septic shock worsens. What treatment should the nurse anticipate to be obtained to help the patient? FUNDAMENTAL OF NURSING ASSIGNMENT

QUESTION 15:

Chapter 15, Oncology: Nursing Management in Cancer Care

The oncology clinical nurse specialist (CNS) is asked to develop a staff development program for registered nurses who will be administering chemotherapeutic agents. Because the nurses will be administering a variety of chemotherapeutic drugs to oncology patients, the CNS plans on presenting an overview of agents, classifications, and special precautions related to the safe handling and administration of these drugs. (Learning Objectives 6 and 8)

What does the CNS describe as the goals of chemotherapy?

How should the CNS respond to the following question: “Why do patients require rounds of chemotherapeutic drugs, including different drugs and varying intervals?”

In teaching about the administration of chemotherapeutic agents, what signs of extravasation should the nurse include?

What clinical manifestations of myelosuppression, secondary to chemotherapy administration, should the CNS include in this program?

QUESTION 16:

Chapter 16, End-of-Life Care

Joe Clark, 79 years of age, is a male patient who is receiving hospice care for his terminal illnesses that include lung cancer and chronic obstructive pulmonary disease (COPD). He developed bilateral pleural effusion (fluid that accumulates in the pleural space of each lung), which has compromised his lung expansion. He states that he is short of breath and feels anxious that the next breath will be his last. The patient is admitted to the hospital for a thoracentesis (an invasive procedure used to drain the fluid from the pleural space so the lung can expand). The thoracentesis is being used as a palliative measure to relieve the discomfort he is experiencing. Low dose morphine is ordered to provide relief from dyspnea or discomfort. The patient is prescribed Proventil (albuterol) inhaler 2 puffs per day, as needed, and Flovent (fluticasone propionate) inhaler 2 puffs twice a day. The patient has 2 L/min of oxygen ordered per nasal cannula as needed for comfort. (Learning Objective 9)

a. What nursing measures should the nurse use to manage the patient’s dyspnea?

The patient complains that he has no appetite and struggles to eat and breathe. What nursing measures should the nurse implement to manage this physiologic response to the terminal illnesses?

QUESTION 17:

Chapter 17, Preoperative Nursing Management

The nurse in a gynecology clinic is completing preoperative teaching for a patient scheduled for an abdominal hysterectomy next week. The patient states that she is currently taking 325 mg of aspirin daily for chronic joint pain, along with a multivitamin. The patient has type 2 diabetes; she closely monitors her blood glucose levels. Currently, she is taking an oral hypoglycemic agent. The nurse advises her to ask the anesthesiologist whether she should take this medication the morning of surgery. (Learning Objectives 2 and 4)

The nurse instructs the patient to stop taking the aspirin. What is the rationale for this action?

Why is it important to assess the patient for use of herbal products prior to surgery?

c. The patient asks how surgery could affect her blood glucose; how should the nurse respond?

QUESTION 18: Chapter 18, Intraoperative Nursing Management

Pearl Richards, 69 years of age, is a female patient who is in the operating room for a repair of an abdominal aortic aneurysm. The patient has a history of hypertension controlled with medications, osteoporosis, chronic obstructive pulmonary disease, and has smoked two packs of cigarettes per day for 40 years. (Learning Objectives 2, 6, and 9)

What nursing interventions are instituted to reduce the surgical risk factors related to the patient’s age?

Explain the role of the nurse in providing patient safety measures during the intraoperative period.

QUESTION 19: Chapter 19, Postoperative Nursing Management

1. Rita Schmidt, 74 years of age, is a female patient who was admitted to the surgical unit after undergoing removal of a section of the colon for colorectal cancer. The patient does not have a colostomy. The patient has several small abdominal incisions and a clear dressing over each site. The incisions are well approximated and the staples are dry and intact. There is a Jackson-Pratt drain intact with minimal serous sanguineous drainage present. The patient has a Salem sump tube connected to low continuous wall suction that is draining a small amount of brown liquid. The patient has no bowel sounds. The Foley catheter has a small amount of dark amber-colored urine without sediments. The patient has sequential compression device (SCD) in place. The nurse performs an assessment and notes that the patient’s breath sounds are decreased bilaterally in the bases and the patient has inspiratory crackles. The patient’s cardiac assessment is within normal limits. The patient is receiving O2 at 2 L per nasal cannula with a pulse oximetry reading of 95%. The vital signs include: blood pressure, 100/50 mm Hg; heart rate 110 bpm; respiratory rate 16 breaths/min; and the patient is afebrile. The patient is confused as to place and time. (Learning Objectives 4 and 7)

Explain the assessment parameters used to provide clues to detect postoperative problems early and the interventions needed.

What gerontological postoperative considerations should the nurse make?

2. Mr. John Smith is admitted to the hospital for surgical incision and drainage (I&D) of an abscess on his right calf, which resulted from a farm machinery accident. The right calf has an area 3 cm × 2.5 cm, which is red, warm and hard to touch, and edematous. (Learning Objective 5)

Explain the wound healing process according to the phase of Mr. Smith’s wound?

The surgeon orders for wet-to-dry sterile saline dressing twice a day with iodoform gauze to the wound, covered with the wet-to-dry dressing. Explain how to perform this dressing change

REFERENCE TEXTBOOK:

Fundamentals of Nursing Second Edition Theory, Concepts and Applications by Judith M. Wilkinson, Leslie S Treas FUNDAMENTAL OF NURSING ASSIGNMENT.

Assignment: Application: Taking a Stand

Effective leaders have a high degree of self-awareness and know how to leverage their strengths in the workplace. Assessments are a valuable tool that professionals can use to learn more about themselves and consider how their temperament and preferences influence their interactions with others.

As you engage in this learning process, it is important to remember that everyone—regardless of temperament type or related preferences—experiences some challenges with regard to leadership. The key to success is being able to recognize and leverage your own strengths while honoring differences among your colleagues.

At some point in your leadership career, you will encounter an ethical or moral dilemma that requires you to take a stand and defend your position.

For this Assignment, you evaluate an issue and consider how you could act as a moral agent or advocate, facilitating the resolution of the issue for a positive outcome.

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To prepare:

• Consider the examples of leadership demonstrated in this week’s media presentation and the other Learning Resources.
• To further your self-knowledge, you are required to complete the Kiersey Temperament as indicated in this week’s Learning Resources. Consider your leadership style, including your strengths for leading others and include your results from Kiersey Temperament Sorter to describe potential challenges related to your leadership style.
• Mentally survey your work environment, or one with which you are familiar, and identify a timely issue/dilemma that requires you to perform the leadership role of moral agent or advocate to improve a situation (e.g., speaking or acting on behalf of a vulnerable patient, the need for appropriate staffing, a colleague being treated unfairly).
• What ethical, moral, or legal skills, dispositions, and/or strategies would help you resolve this dilemma? Define the differences between ethical, moral, and legal leadership.
• Finally, consider the values and principles that guide the nursing profession; the organization’s mission, vision, and values; the leadership and management competencies addressed in this course; and your own values and reasons for entering the profession. What motivation do you see for taking a stand on an important issue even when it is difficult to do so?

To complete:

By Day 7

Write a 4 to 5 page paper (page count does not include title and reference page) that addresses the following:

• Introduce the conceptual frameworks of the ethical constructs of ethics, moral, or legal standards and the purpose of the paper.
• Consider  an ethical, moral, or legal dilemma that you have encountered in your work environment and describe it.
• Analyze the moral, ethical, and legal implications utilized in this situation. Describe your role as a moral agent or advocate for this specific issue.
• Consider your leadership styles identified by your self-assessment and determine if they act as a barrier or facilitation during this dilemma. 

The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references.

challenges that the leaders of today’s health care organizations face

Choose two issues or challenges that the leaders of today’s health care organizations face. Select from among the following topics:

1. Staff Shortage (Physicians, Nurses, Allied Health Providers, Ancillary Services)
2. Reorganization in Response to Merger or Consolidation of Services
3. Layoffs as a Result of Declining Revenues
4. Influx of Registry, Part-Time, and Temporary Contract Staff
5. Poor Performance Outcomes Leading to a Reduction in Medicare Reimbursement Dollars
6. Poor Job Satisfaction Rates Resulting in Turnover challenges that the leaders of today’s health care organizations face

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You are the manager of an ancillary service department at a large, 500+ bed hospital. Develop a proposal (750-1,200 words) that is directed toward your staff, in which you address the following:

1. Inform the staff of the two issues (from the topics provided) your organization is facing.
2. Describe the impact of these issues on your department.
3. Describe how improved communication, collaboration, and teamwork can improve conditions in your department.
4. Identify at least two examples from the required or recommended readings of techniques found to foster inclusion and improve communication and collaboration.
5. A minimum of three academic references from credible sources are required for this assignment.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin. challenges that the leaders of today’s health care organizations face