The Law and License Investigation

 Have you encountered a situation similar to the scenario in the Self-Evaluation? If so, how did you handle it? (Throughout Modules 2-3, we will cover information pertinent to this scenario and your options.)

 How does your State Nurse Practice Act address Nursing Peer Review situations?

Post your responses to the questions above on the Discussion Board by 23:59, Wednesday of Module 2. Then respond to two or more of your colleagues’ responses by asking each colleague at least two probing questions. The probing questions may ask the person to clarify statements or provide more detail, or may ask the person to consider another viewpoint. Please respond to each of the questions you are asked by your colleagues during the onlinediscussion. You will be evaluated on the quality of your summaries, questions, and responses to colleagues’ questions The Law and License Investigation.

Basic APA format is required.

Please open up the “My Groups” option on the left navigation bar and click on your group discussion link to post.

I already did the self assessment let me know thanks

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Here is the scenario:

You, the RN, arrive early on your regular orthopedic unit. Your Charge Nurse comes to you and says that you need to go to the cardiac step-down unit. You protest, but she says she has no control over the situation and that you at least need to go to the step-down unit and see what is going on. You arrive at the step-down unit. The House Supervisor is present with the unit Charge Nurse. You are told that the unit is very understaffed that day and that you must take patients. You protest that you have worked only orthopedics for the past 10 years- that you do not know the current cardiac drugs and side effects, the current treatments and post-treatment care and that you have never had to read the type of cardiac monitoring strips that are generated on all the patients on this unit. The House Supervisor tells you to not worry. She explains as follows:

· There are monitoring techs who are responsible for reading the strips.

· You have access to a PDR and Pharmacy if you have questions about the drugs.

· A nurse with recent experience on this floor will be able to go around with you to orient you for about two hours. (That nurse must return to his regular floor in two hours.)]

You again express concerns that you are not qualified to take this assignment. The House Supervisor takes you aside and says, “We need you to step up and help out here. We need team players in situations like this. If you refuse, I’m going to have to discuss your refusal with the Director of Nursing and your unit manager — it may not be good for your career here at this hospital. Besides, do you think you are the first nurse who ever had to take patients in a less than perfect circumstance? The patients are worse off if you refuse.”

Reluctantly, you accept the assignment. About 5 hours into the 12-hour shift, you mis-titrate a cardiac drug. The patient codes, never regains consciousness and is transferred to ICU. The patient dies 3 hours after being transferred.

Two weeks later, you are called to Human Resources. Your unit manager, the House Supervisor, and an HR representative are there. You are told that you are being reported to the state’s Board of Nursing due to the negative outcome of your patient The Law and License Investigation.

                    Practicum Journal: Checkpoint for Certification Plan

Psychiatric/mental health nurse practitioners currently have only one choice for certification, which is through the American Nurses Credentialing Center (ANCC). The ANCC offers the “psychiatric/mental-health nurse practitioner (across the lifespan)” board certification (PMHNP-BC). In many states, board certification is needed as a prerequisite to being granted an NP license. Even if board certification is not a requirement for state licensure, it may be a requirement to receive privileges in various hospitals and other health care facilities. It may also be required by malpractice insurance providers prior to issuing coverage to NPs.

                                      Learning Objectives

Students will:

Evaluate progress on certification plans

Report your progress on the Certification Plan you completed in Week 4 (SEE ATTACHED WEEK 4 CERTIFICATION PLAN DONE)

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                                Assignment 

            Write a 2- to 3-page paper in which you do the following: 

1) What have you done to prepare for your certification?

2) Have you completed the scheduled tasks assigned on your timeline as you 

     noted in week 4 ? If not, what are your plans to stay on schedule?(SEE 

    ATTACHED WEEK 4 CERTIFICATION PLAN DONE)

                            INSTRUCTION

  NB: for this Assignment (Journal Entries)

· Include references  immediately following  the content.

· Use APA style for your journal entry and references less than 5 years old.

. PLEASE INCLUDE INTRODUCTION, CONCLUSION AND REFERENCES LESS 

 THAN 5 YEARS OLD

                                             Learning Resources

Required Readings

Barton Associates. (2017). Nurse practitioner scope of practice laws. Retrieved from https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws/

American Psychiatric Association. (2016). Practice guidelines for the psychiatric evaluation of adults. Retrieved from http://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760

Healing and Autonomy

Write a 1,200-1,500 word analysis of “Case Study: Healing and Autonomy.” In light of the readings, be sure to address the following questions:

1. Under the Christian narrative and Christian vision, what sorts of issues are most pressing in this case study?
2. Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James?
3. According to the Christian narrative and the discussion of the issues of treatment refusal, patient autonomy, and organ donation in the topic readings, how might one analyze this case?
4. According to the topic readings and lecture, how ought the Christian think about sickness and health? What should Mike as a Christian do? How should he reason about trusting God and treating James? Healing and Autonomy

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

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Case Study: Healing and Autonomy

Mike and Joanne are the parents of James and Samuel, identical twins born eight years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’ condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own, or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve.

The attending physician suggested immediate dialysis. After some time of discussion with Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago, and also had witnessed a close friend regain mobility when she was prayed over at a healing service after a serious stroke. They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet Mike and Joanne agreed to return to the hospital after the faith healing services later in the week, and in hopes that James would be healed by then. Healing and Autonomy

Two days later the family returned, and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier. Had he not enough faith? Was God punishing him or James? To make matters worse, James kidneys had deteriorated such that his dialysis was now not a temporary matter, and was in need of a kidney transplant. Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors. Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James. However, none of them were tissue matches.

James’ nephrologist called to schedule a private appointment with Mike and Joanne. James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’ brother Samuel.

Mike vacillates and struggles to decide whether he should have his other son Samuel lose a kidney, or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? “This time around, it is a matter of life and death, what could require greater faith than that?” Mike reasons.

© 2015. Grand Canyon University. All Rights Reserved. Healing and Autonomy

Remember to submit your work following the file naming convention FirstInitial.LastName_M01.docx. For example, J.Smith_M01.docx. Remember that it is not necessary to manually type in the file extension; it will automatically append.

Start by reading and following these instructions:

1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.

2. Read the required chapter(s) of the textbook and any additional recommended resources.  Some answers may require you to do additional research on the Internet or in other reference sources.  Choose your sources carefully.

3. Consider the discussion and any insights you gained from it.

4. Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

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Assignment:

1. Locate an article that discusses a bioethics issue. First, provide a summary of the article and the bioethics issue being presented. Next, discuss what ethical actions the nurse should take in relation to the issue being presented. Also, discuss possible legal issues that the nurse should be aware of. This section should include at least 1 outside reference and your textbook and should be at least 1 ½ pages long.

2. Analyze the following case study and then answer the following questions:

You are working on the Operating Room and the trauma alert goes off. You respond to the ER to provide support. Once in the ER, you receive report that an 89 year old male is coming in with a self-inflicted GSW (Gun Shot Wound) to the head.  You listen to the radio traffic between the ER and ambulance to get an idea what kind of surgery you need to set up for and what will be needed as far as lines and fluid.  Here is the report: Ethical Nursing

HR: 121

B/P: 60/45

Saturation: 93%

Patient is intubated and non-responsive. Right pupil is fixed and dilated. Paramedic also states there is a large extended family headed to the ER. The patient lost his wife of 60 years 1 week ago and left a note stating that he is too heartbroken to go on. The patient and family arrive. The neurosurgeon discusses that their father’s potential outcome, even with surgery, is not good. The family still insists that the neurosurgeon complete the surgery.

1. What are the ethical and legal issues in this case study. Be specific and support your response with references

Once you have the patient in the room and you are prepped and ready for surgery, the phone rings. You receive word that the patient signed DNR orders two days ago.

1. As the OR nurse what are your legal and ethical issues now? Was the patient of sound mind when he signed this order? Do you honor the DNR or the family’s wishes? Explain and support your response.  

Your response to this case study should be at least 2 pages and include 2 outside references and your textbook.

Please submit one paper which includes both assignments.

                              Hernandez Family Assessment

Assessment is as essential to family therapy as it is to individual therapy. Although families often present with one person identified as the “problem,” the assessment process will help you better understand family roles and determine whether the identified problem client is in fact the root of the family’s issues. As you examine the Hernandez Family: Sessions 1-6 videos in this week’s Learning Resources, consider how you might assess and treat the client family.

                                                             Learning Objectives

Students will:

· Assess client families presenting for psychotherapy

To prepare:

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

· View the Hernandez Family: Sessions 1-6 videos, and consider how you might assess the family in the case study.

Note: For guidance on writing a comprehensive client assessment, refer to pages 137–142 of Wheeler (2014) in this week’s Learning Resources.

                                                                 The Assignment

Address in a comprehensive client assessment of the Hernandez family the following:

· Demographic information

· Presenting problem

· History or present illness

· Past psychiatric history

· Medical history

· Substance use history

· Developmental history

· Family psychiatric history

· Psychosocial history

· History of abuse and/or trauma

· Review of systems

· Physical assessment

· Mental status exam

· Differential diagnosis

· Case formulation

· Treatment plan

Note: Any item you are unable to address from the video should be marked “needs to be added to” as you would in an actual comprehensive client assessment

                                                               Learning Resources

Required Readings

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

• Chapter      12, “Family Therapy” (pp. 429–468)

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

• Chapter 3, “Basic Techniques of Family Therapy” (pp.      29–48)
• Chapter      4, “The Fundamental Concepts of Family Therapy” (pp. 49–68)

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

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Note: It is highly recommended that you use this resource as a reference guide throughout the course. 

L’Abate, L. (2015). Highlights from 60 years of practice, research, and teaching in family therapy. American Journal of Family Therapy, 43(2), 180–196. doi:10.1080/01926187.2014.1002367

Mojta, C., Falconier, M. K., & Huebner, A. J. (2014). Fostering self-awareness in novice therapists using internal family systems therapy. American Journal of Family Therapy, 42(1), 67–78. doi:10.1080/01926187.2013.772870

Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207–215. doi:10.1111/famp.12025

Papero, D. V. (2014). Assisting the two-person system: An approach based on the Bowen theory. Australian & New Zealand Journal of Family Therapy, 35(4), 386–397. doi:10.1002/anzf.1079 family therapy.

                                                                         Required Media

Laureate Education (Producer). (2013a). Hernandez family> Sessions 1—6 [Video file]. Author: Baltimore, MD.

N.B: PLEASE ATTACH WITH THIS ASSIGNMENT IS THE 6 VIDEO TRANSCRIPT DOWNLOADED IN PDF FORMAT FOR THIS ASSIGNMENT SINCE THE VIDEO AND THE AUDIO IS NOT AVAILABLE AT THIS TIME, AND A SAMPLE FORMAT FOR THE ASSIGNMENT.

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Psychotherapy.net (Producer). (2006). Tools and techniques for family therapy. [Video file]. Mill Valley, CA: Author. 

 

Hernandez Family Episode 1

Hernandez Family Episode 1 Program Transcript

JUAN HERNANDEZ: But we didn’t do anything wrong. That woman, that social worker, who came to our house, I told her, me and Elena, we decide what’s best for our boys, not her. Telling us we punish to hard. She doesn’t know anything about us.

ELENA HERNANDEZ: We give our sons a good life. We love them very much. It’s not fair what she said about Juan and me. We’re good parents.

FEMALE SPEAKER: Mrs. Hernandez, I understand how difficult this is for you–

JUAN HERNANDEZ: I don’t think you do. Everything that we do, we do for them, everything. We work hard. We take care of them. And when they don’t follow the rules, they get punished, strictly. The old fashioned way.

ELENA HERNANDEZ: Shh. Quiet. I told you.

JUAN HERNANDEZ: Sometimes I’m not strict enough with them. Look, I punish my sons the way I see fit. That’s the only way they are going to learn. That’s how we learned from our parents, right? Nobody took parenting classes. That’s ridiculous.

FEMALE SPEAKER: I understand you’re angry. And you’re raising your children the way you were brought up to do. But ACS has required that you do this.

JUAN HERNANDEZ: What if I don’t want to be required?

ELENA HERNANDEZ: I have a question.

FEMALE SPEAKER: Of course.

ELENA HERNANDEZ: If we go through with this, the things we talk about with you, will it be private?

JUAN HERNANDEZ: But we have not agreed to do this.

ELENA HERNANDEZ: I don’t want to be here either. But I don’t want to loose our children. Would it be private, what we talk about?

FEMALE SPEAKER: The information we share is between us. The only exception to that is if one of you says you’re going to hurt yourself or hurt someone else. In that case, I have to report it to the ACS worker. But everything else is strictly confidential.

© 2017 Laureate Education, Inc. 1

Hernandez Family Episode 1

So how do you think we can work together to make this a positive experience for both of you?

JUAN HERNANDEZ: Parenting classes, really? What about the bills? I’m not going to be able to work overtime.

ELENA HERNANDEZ: If we do what we’re supposed to do, would it be OK with our family?

FEMALE SPEAKER: There are no guarantees. But here’s what I can say. We’ll all work together to create a plan based on what the ACS worker has required and recommended. Then it will be up to her what the outcome will be.

So shall we make a plan?

Hernandez Family Episode 1 Additional Content Attribution

MUSIC: Music by Clean Cuts

Original Art and Photography Provided By: Brian Kline and Nico Danks

© 2017 Laureate Education, Inc. 2

Hernandez Family Episode 2

Hernandez Family Episode 2 Program Transcript

FEMALE SPEAKER: It’s good to see all our parents again tonight. And I want to say thank you for being here these last few weeks. Today, we’re going to talk about child development, specifically the behavior of our children, and what are some realistic expectations we can have about how they behave, depending on how old they are.

Part of understanding human behavior is looking at where someone is in their life, as well at the impact of their environment, whether it’s school, home life, family, or friends.

MALE SPEAKER: What’s there to understand? I mean, come on. They’re kids. They shouldn’t be seen or heard, right?

FEMALE SPEAKER: We all want our children to behave. But throughout childhood, there are certain behaviors that come with certain ages that can be very challenging to deal with.

FEMALE SPEAKER: Tell me about it.

FEMALE SPEAKER: So let’s talk about some of your expectations about your children’s behavior.

MALE SPEAKER: Well, my son is nine. That age, I expect him to do his chores and listen to me. When I was nine, you better believe I was listening to my old man, or else, you know?

MALE SPEAKER: You’ve got that right. And I don’t understand why my son doesn’t listen to me when I tell them to do something. I mean, what if I didn’t listen and come to this class? We might lose our kids. How do I deal with this better? I mean, get him to listen and behave?

FEMALE SPEAKER: Well, Juan Junior is eight, and at that age, their attention can be really hard to not only gain, but–

Hernandez Family Episode 2 Additional Content Attribution

MUSIC: Music by Clean Cuts

Original Art and Photography Provided By: Brian Kline and Nico Danks

© 2017 Laureate Education, Inc. 1

Hernandez Family Episode 3

Hernandez Family Episode 3 Program Transcript

JUAN HERNANDEZ: Do you have any idea how hard it is for us to get to these classes?

ELENA HERNANDEZ: And there’s only one class a week. We don’t have a choice when to come.

FEMALE SPEAKER: That is why we offer the parenting class at night, to make it easier for working families to attend.

ELENA HERNANDEZ: That’s fine for some people, but that’s when Juan gets his overtime. He can’t do both. Every time we come here it costs us. We lose money. And the way things are, we can’t afford to lose a dime.

FEMALE SPEAKER: I understand that missing overtime is having a big impact on you financially. And I understand what you’re saying about the class only being offered one night a week. If we could offer it several times a week, that would probably be more helpful. But in the meantime–

JUAN HERNANDEZ: Look, let’s stop dancing around what’s really wrong here. We appreciate what you’re doing. You want to help parents do a better job with their kids. But we’re good parents. We love our kids. Yes, they get punished when they need to be punished, just Elena and I when we were growing up. But we don’t hit our boys. We don’t hurt them.

If anything, you hurt them by making us come here when I could be out there making extra money, money that the family needs. Do you hear me? This class this, whole policy is the real problem. That’s what needs to change, not us.

Hernandez Family Episode 3 Additional Content Attribution

MUSIC: Music by Clean Cuts

Original Art and Photography Provided By: Brian Kline and Nico Danks

© 2017 Laureate Education, Inc. 1

Hernandez Family Episode 4

Hernandez Family Episode 4 Program Transcript

FEMALE SPEAKER: So how’s your week going? What’s happening with that Hernandez family? That’s their name, right? You were having some challenges there?

FEMALE SPEAKER: They’ve missed four of their parenting classes, so far.

FEMALE SPEAKER: So they haven’t completed the parenting group?

FEMALE SPEAKER: I have to call the ACS worker and let her know. They’re probably going to have to take the classes over again, and that’s going to be tough. The father misses overtime to come to the classes, and they really rely on that money to make ends meet.

FEMALE SPEAKER: You have something else on your mind. Say it.

FEMALE SPEAKER: I should have discussed this with you earlier. I don’t know why I didn’t. But perhaps they weren’t the best candidates for this to begin with.

FEMALE SPEAKER: Because of their financial situation?

FEMALE SPEAKER: Yes, and something else. I remember the ACS worker. And when she talked about wanting Elena, she kept calling them Mexicans. It was really derogatory the way she said it.

FEMALE SPEAKER: So you’re saying she might have been biased into mandating that they take these classes?

FEMALE SPEAKER: Yes. The more I think about it, she never talked to me about trying to understand the way they’re raising their children. And that Mexican remark, it just really wasn’t respectful. It’s like she had already made up her mind about people from that culture, and now they’re paying the price for it family therapy.

Hernandez Family Episode 4 Additional Content Attribution

MUSIC: Music by Clean Cuts

Original Art and Photography Provided By: Brian Kline and Nico Danks

© 2017 Laureate Education, Inc. 1

Hernandez Family Episode 5

Hernandez Family Episode 5 Program Transcript

FEMALE SPEAKER: They’ve missed four of their parenting classes so far.

FEMALE SPEAKER: So they haven’t completed their parenting group?

FEMALE SPEAKER: I have to call the ACS worker and let her know. They’re probably going to have to take the classes over again, and that’s going to be tough. The classes caused the father to miss overtime at work, and they really rely on that money to make ends meet.

FEMALE SPEAKER: But they have to finish the program. They’re only allowed three missed classes. There’s another problem. You know the agency’s been conducting a study of our performance. Well, it lowers our completion numbers. Lower numbers put our funding at risk. Our bosses start questioning the credibility of what we’re trying to do here.

FEMALE SPEAKER: But I can’t give the Hernandez family the post test. They won’t be able to complete it.

FEMALE SPEAKER: No, that’s not why I brought this up. The agency needs data to determine how effective these parenting classes are. The more attrition we have when parents don’t finish the program, there’s no data. No data means no support for what we’re teaching or how it might benefit other populations.

FEMALE SPEAKER: Maybe we should account for the attrition then. Maybe there’s something we can learn from it?

Hernandez Family Episode 5 Additional Content Attribution

MUSIC: Music by Clean Cuts

Original Art and Photography Provided By: Brian Kline and Nico Danks

© 2017 Laureate Education, Inc. 1

Hernandez Family Episode 6

Hernandez Family Episode 6 Program Transcript

FEMALE SPEAKER: So last week I showed you how to make a genogram, like this one. Now, the idea behind making a genogram is to help you draw a picture of your family history. And then we use that to discuss the relationships and connections among your relatives. OK? So Juan, why don’t you start off and talk about what you came up with.

JUAN HERNANDEZ: So we’re starting with my family. My father, Hector, he’s still alive. And he married my mother, Freda. And she passed away two years ago. And then there’s their children, myself– I’m the oldest– and then there’s my three sisters, Marie, Senta, and Rose.

FEMALE SPEAKER: Good. And Elena, what about your family?

ELENA HERNANDEZ: Well, here’s my father, Anthony. He met and married my mother, Sofia. They are both still alive. They had five children. Firstborn was my brother Daniel, then my brother Tomas, then my sisters Martina and Camila, and there’s me, the baby.

And then I met Juan, and we started our own family. And we have two beautiful sons that you met, one, Junior, who is eight, and Alberto, who is six.

FEMALE SPEAKER: Good. So for the last several weeks we’ve been talking a lot about how you discipline your sons at home. And both of you mentioned how your parents used to punish you when you were growing up. Juan, why don’t you talk about that and point to anybody on the genogram as you mention them?

JUAN HERNANDEZ: Sure. So my dad, when he was mad at me he would send me to get books from the encyclopedia. And he’d make me hold them out, straight out like this, until he told me to stop. It caused so much pain in my arms, I mean, my arms felt like they would break off.

And my mom, she did basically the same thing. Except when she was really mad, when would make me get more books than my dad. I hated those books so much. I never went near them on my own. To me, they only meant one thing, misery. And now, I guess I inherited that from them.

FEMALE SPEAKER: Elena, how about you?

ELENA HERNANDEZ: Yes, misery. That’s what it was like for me, too.

© 2017 Laureate Education, Inc. 1

Hernandez Family Episode 6

Hernandez Family Episode 6 Additional Content Attribution

MUSIC: Music by Clean Cuts

Original Art and Photography Provided By: Brian Kline and Nico Danks

© 2017 Laureate Education, Inc. 2 family therapy