Describe an example of your leadership experience in which you have positively influenced others, helped resolve disputes, or contributed to group efforts over time.

Please answer any 3 questions

Responses to each question are limited to 350 words.

  1. Describe an example of your leadership experience in which you have positively influenced others, helped resolve disputes, or contributed to group efforts over time.
  2. Every person has a creative side, and it can be expressed in many ways: problem solving, original and innovative thinking, and artistically, to name a few. Describe how you express your creative side.
  3. What would you say is your greatest talent or skill? How have you developed and demonstrated that talent over time?
  4. Describe how you have taken advantage of a significant educational opportunity or worked to overcome an educational barrier you have faced.
  5. Describe the most significant challenge you have faced and the steps you have taken to overcome this challenge. How has this challenge affected your academic achievement?
  6. What have you done to make your school or your community a better place?
  7. Beyond what has already been shared in your application, what do you believe makes you stand out as a strong candidate for admissions to the University of California?

Please let me know which 3 questions you will be answering.

I want to enroll for a business administration major.

I am currently a 4.0 student.

Having completed the IGETC.

Will have 85 units upon competition.

Please message me here to ask any other personal questions that will help me with this.

 

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Problem of Evil

I will be attaching the prompt below but basically you have to how 1 of the 3 questions and read the readings that go along with with and write an essay on it.

BTW, I will be giving a tip accordingly,

When I get my grade back,

B+-A=$50 tip

B=$40 tip

  1. on the 3 questions for you to choose one from:

The final essay with unweighted 10 credit points (to be graded
in the 2nd group) is the platform where you get to exercise your
logical acumen and thinking abilities at the end of the course.
That is the ultimate purpose for the study of “informal” logic,
where there has to be a common substantive philosophical inquiry.
As might have been suggested along the way, given what we have
treated ourselves with Edutainment, it is concerned with the extent
to which a logical thinking can be applied to one of the most
vexing questions of human existence.

The object of subject matter in logic is “argument” defined as a
body of thoughts to be expressed in a structure, where the
conclusion is a function of the premises with the inference in the
middle. Our formal exercises with proof is a rigorous procedure to
ascertain only validity as a part of soundness; now you shall get a
chance to be thinking about argumentation with the whole ideal
properties by writing an essay on a substantive question that you
get to choose within an area.

Thus this final essay requirement can be met by submitting a
“substantive term paper” on one of the 3 questions posed below. The
Question 1 below is directly related to the theme of the
Edutainment; but there are also for two more questions as
alternatives; all in all, you have 3 questions to choose from.

Reading materials (5 pieces, from A to E) are attached to this
email; they are selected for readability and manageability; but you
don’t have to confine yourself to them, as you may look into any
other materials deemed as relevant.

Here are the three questions:


Question 1:

Is the so-call “Problem of Evil” strong enough to
dismantle the theistic view of the world? Is any of
“theodicies” convincing enough to uphold it?

Reading A…St. Thomas, Summa Theologica, Q.2,
esp., 3rd Article, Obj. 1 (p.5) & Reply (p.7)

Reading B…Zagzebski, “The Problem of Evil”

For those who might be more interested in rather “positive”
arguments for the Existence of God, as opposed to the above
defensive apologetic argument, here are two other alternatives:


Question 2:

Is the Cosmological Argument “sound”?
If so, how? If not, why not?

Reading A…St. Thomas, Summa Theologica, (the same one)
esp., “5 Ways” (pp. 5-6)

Reading C…Moreland, “The Kalam Cosmological Argument”


Question 3:

Is the Teleological Argument “sound”? Is it augmented
by modern sciences, especially “Anthropic” principle?

Reading D…Paley, “Natural Theology”

Reading E…Schlesinger, “Corroboration from Contemporary
Astrophysics…”


  1. on the “Reconstruction” as the “essential” requirement:

The final paper could be either (1) your own conclusive thought or
(2) your own critical examination of others’ arguments, or even a
mixture of both. Whether you’re inclined to be theistic or
atheistic, (or even in the middle, i.e., agnostic) is not my
interest as a professor teaching you logic. The key is to be as
logically clear as one can be, and as argumentative as one can be.
The “essential” requirement for that aspect of the essay is to do
“Reconstruction” whereby you specify the following two
indispensable components of an argument which your essay should be:

  1. the conclusion of your essay
  2. the premises which you employ to support the conclusion

In other words, “Reconstruction” refers to a precise restatement of
an argument, where the conclusion and the premises are clearly
articulated. The idea is to lay out its “inferential” structure as
clearly as possible. Indeed, that is what we have been studying
throughout the semester. (There is no need to be formally rigorous
to use letters for sentences as we have done in proof; rather
actual sentences for the conclusion and the premises will do.)

*the essay should have the cover page with the following
contents (besides your name):

  • “Abstract”:

NB: this is one-paragraph description of what the essay
is concerned with by you as the author of the essay

  • “Reconstruction”:

NB: of course, it refers to what is explained above

  1. the essay should have Bibliography at the end of the essay
  2. the length of the main text of essay should be at least 7 pages,
    “exclusive” of the above 1st-page cover and Bibliography. Of
    course, it could be longer, as one may wish.

NB: double-spaced with normal 12 points font size

 

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What Is Magical Realism

Question Description

 Research paper explaining Magical Realism. I suggest that you research what Magical Realism is, how it came about, the great authors of Magical Realism, and finally how it manifests itself today, that is to say, in what genres. Please include and quote three to five outside sources, use the MLA format, and in the process of the paper explain what magical realism is, how it developed, some of the great authors and works, and its international scope today.

In your research you might find very good articles such as What Is Magical Realism Anyway?” and many more. You will find that Harry Potter as well as the great Japanese writerMurakami and the Muslim writer Salman Rushdie all share in common that they represent Magical Realism. Find some aspect of Magical Realism that appeals to you and focus on that topic for your paper

An annotated bibliography is basically the same as any works cited or references page but, and this is the key difference, after the reference, there is a few brief sentences summarizing the contents of the item listed above it in the bibliography. The bibliography is still a list of sources in alphabetical order, but the difference is the summary of the article, book, or any other source appears immediately below the MLA reference. If you have any questions, you can Google annotated bibliography examples and look at one or more. To save time and be working on your documented essay at the same time, there is some logic to using the research items for Magical Realism. You will be working on your paper for next week as well as meeting the requirements for this week’s assignment. 

You must have three to five sources, all of which are quoted in the body of the paper consistent with MLA style. The paper uses parenthetical references and has a Works Cited, which, unlike the annotated bibliography, contains the reference but not the annotations. 

 

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Teaching Plan Project

Assignment 2: Teaching Plan Project

As part of the teaching plan you began in Week 3, this week you will create a 10-page paper (excluding the title page, references, and Appendices) considering a specific population and topic to be taught to the learners on a patient safety initiative from the IOM and QSEN competencies. This can be for a group of patients in a hospital setting, staff education, or a group of clients in a community setting (such as Planned Parenthood, adult education).

Lesson Planning and Teaching Strategies

In this section of the teaching plan, you are asked to research and discuss your selected teaching strategies taking into consideration the learning needs, learning styles, and cultural diversity of your target audience. Incorporate a variety of teaching strategies that includes innovative teaching strategies to promote an active learning environment. Integrate appropriate technology-based teaching strategies and evidence-based techniques into your teaching plan. In the Appendix, include the handouts that will be distributed and any other additional teaching aids.

Evaluation

In this section, you will create an assignment using technology in nursing education that is designed to evaluate students’ learning on the achievement of the objectives stated in your teaching plan.

To get started, visit:

http://www.cmu.edu/teaching/assessment/assesslearning/creatingassignments.html

This web page provides information on how to create effective assignments. Also, at the bottom of the page there is a checklist which can be used as a guide to ensure that you include all of the necessary components in the assignment you create.

Be sure to include the following:

  • The purpose of the evaluative assignment that uses technology in nursing education
  • A written description of the assignment (not a test, an evaluative assignment)
  • The assignment instructions, as they will appear to learners
  • Clear expectations regarding format and presentation, required citation style, due dates, and consequences for late submissions
  • Evaluation criteria (how you plan to grade the assignment, i.e., rubric)
  • Points or percentage value to pass

As you create your paper, be sure that you follow APA guidelines for writing style, spelling and grammar, and citation of sources. Submit this assignment to the W4: Assignment 2 Dropbox .

 

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Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

This paper is the final of attached documents. please make sure to meet the word count and APA format and references done correctly. ( i have attached the last 3 assingments i posted and again this is continuation and final draft)

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

PICOT Statement

Revise the PICOT statement you wrote in the Topic 1 assignment.

The final PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

Refer to “Research Critique Guidelines.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

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.

 

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Health Policy and Politics

For this Assignment, you will write a position paper in which you will choose and support a policy change which reinforces the role of the nurse as a leader in ensuring access to quality health care in developed and underdeveloped countries. You should approach this assignment from the perspective of your specialty track. Information which may be helpful in selecting a proposed policy change can be found in your textbook Health Policy and Politics: A Nurse’s Guide The word count for your position paper will be 1000 to 1600 words. You must support your work with at least eight scholarly peer reviewed articles. Your paper must include the following topics:

  • Current nursing issues related to globalization of healthcare
  • The proposed policy change
  • Agenda setting strategies (Process by which your proposal will gain attention of stakeholders and/or the public)
  • A model or theory that can be used to bring about the change
  • Design strategies
  • Implementation strategies
  • Evaluation strategies
  • Conclusion
 

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The Form and Function of the Family

Using the family structural theory (see the textbook as a model) how can families created following second marriages learn to function as one?

150-200 words.

NRS-429V Lecture 4

The Form and Function of the Family

Introduction

The family has an important place in the health promotion paradigm. The roles family members play in providing care to a loved one are crucial to the health and well being of the family system. In order to adequately assist families in achieving health, it is important for the nurse to assess the family as a whole as well as its individual members.

Family Evaluation

When providing care, nurses evaluate families within three domains. First, families are viewed in relation to caring for the individual, with the family as a support system for the person needing care. The perspectives and information provided by the family is important in clinical decision making. Ejaz, Straker, Fox, and Swami (2003) posited that assessing family members’ views on the quality of care provided gives a human face to care, which complements research obtained by statistical measures. Secondly, the family is considered the client, and care is aimed at all members collectively. Lastly, the family is viewed as a system within the community.

Family Function

Family members are the first influence on a person’s view of health. What people are familiar with seeing and experiencing at home is, typically, what they will continue to carry out on their own. Families function as support systems for one another; they assist with providing basic human needs and help younger members learn to socialize with one another and with the world around them. Therefore, families define both acceptable and unacceptable values and behavior.

Calgary Family Assessment Model

Lorraine Wright and Maureen Leahey (1994) developed a model for nurses to assess families within three specific aspects: structure, function and development. Internal and external forces affect the structure of the family. The nurse needs to gather enough information to get a more complete picture of these forces. Function of the family would include communication styles and how members interact with each other. Societal influence and life changes complete the developmental picture of the family. Nurses can assess these aspects through conversing with the patient and observing interactions among the family members.

Calgary Family Intervention Model

Wright and Leahey (1994) also developed the Calgary family intervention model to provide a basis for the nurse to assess interventions for the family based on strengths and resiliency. Previous interventions by the nurse tended to focus on dysfunction and shortcomings of the patient and the family. A more positive connotation can be the focus when strengths are emphasized and resiliency patterns are utilized. The nurse can assist the family in prioritizing these specific aspects that help in dealing with illness.

Family Developmental Theory

Nursing practice has a foundation of using developmental theory to assist patients through every stage of life. Duvall built upon the theoretical framework of Erikson in his eight stages of psychosocial development. Duvall also created eight stages in her family development theory. Stage one begins with the family as a married couple with no children. Stage two includes childbearing families with children up to 30 months of age. Stage three represents families with preschool children. Stage four is made up of those with school-aged children, 6 through 13 years old. Families with teenagers are at stage five, and those families assisting their young adults out into the world are at stage six. Stage seven is empty nest couples, and stage eight represents old age, from retirement to death (University of North Texas, n.d.).

In addition, Duvall’s theory utilizes a set of eight tasks that families move through in each stage (University of North Texas, n.d.). The successful completion of the task depends on building upon the previous developmental stage. Adaptation and new responsibilities come with each developmental stage and the tasks associated with it. The nurse uses this theory to analyze the family’s progress to anticipate opportunity for health promotion and intervention.

Systems Theory

With systems theory, the family is viewed as a whole unit through which the action of each member influences the others. Within this theory, it is assumed that the family unit is greater than the sum of its members. Nurses familiar with systems theory view the individual client as a functioning and contributing member of a larger family system whereby each member influences the other. Essentially, the nurse must focus attention of the family as a whole instead of only the individual. When there is a change in health status of any individual person, the entire family must adapt.

Gordon’s Functional Health Patterns

Gordon’s functional health patterns are founded on 11 principles that are incorporated within the nursing process. They serve as a framework for clinical assessment and can be applied to the individual, family, and community. Through this framework, data is collected and assessed, allowing for the application of nursing diagnoses and interventions that encompass a holistic view of the client. There are 11 patterns, and within each pattern there are four focal areas.

When used together, the 11 functional health patterns can formulate the basis for a comprehensive nursing assessment and allow for identification of actual or potential health concerns. These functional health patterns will promote holistic nursing care through the evaluation of many physical, social, environmental, and spiritual domains. In order to facilitate effective nursing interventions, it is necessary for the nurse to implement critical thinking skills. This allows for the adequate and accurate assessment of clients based on the data and cues provided by the client.

Provided below is a listing of Gordon’s (1994) functional health patterns (FHPs).

Pattern of Health Perception and Health Management

Nutritional − Metabolic Pattern

Pattern of Elimination

Pattern of Activity and Exercise

Cognitive − Perceptual Pattern

Pattern of Sleep and Rest

Pattern of Self Perception and Self Concept

Role − Relationship Pattern

Sexuality − Reproductive Pattern

Pattern of Coping and Stress Tolerance

Pattern of Values and Beliefs

Conclusion

Whether caring for individuals or for entire families, nurses must be cognizant of developmental and system theories that apply to family units. Having an understanding of the family as an integrated, living system provides the nurse with the tools needed to promote healthy living. In addition, recognizing the vital role that families play in ensuring the health and well being of children and family members of all developmental ages poises the nurse to promote a healthy community.

References

Ejaz, F., Straker, J., & Swami, S. (2003). Developing a satisfaction survey for families of Ohio’s nursing home residents. The Gerontologists, 43, 447-458.

Gordon, M. (1994). Nursing diagnosis: Process and application (3rd ed.). St. Louis, MO: Mosby.

University of North Texas. (n.d.). Center for parent education. Retrieved from http://www.unt.edu/cpe/module2/thrybase.htm

Vetere, A. (2001). Structural family therapy. Child Psychology and Psychiatry Review, 6(3), 133-139.

Wright, L. M., & Leahey, M. (1994). Calgary family intervention model: One way to think about change. Journal of Marital and Family Therapy, 20, 381. Retrieved from https://lopes.idm.oclc.org/login?url=http://search…

Wright, L. M., Leahey, M. (2012). Nurses and families: A guide to family assessment and intervention (6th ed.). F. A. Davis Company, Philadelphia, PA.

The Nurse’s Role

Nurses collaborate with families using a systems perspective to understand family interaction, family norms, family expectations, effectiveness of family communication, family decision-making, and family coping mechanisms. The nurse’s role in health promo- tion and disease prevention includes the following tasks:Become aware of family attitudes and behaviors toward health promotion and disease prevention.Act as a role model for the family. • Collaborate with the family to assess, improve, enhance, and

evaluate family health practices. • Assist the family in growth and development behaviors. • Assist the family in identifying risk-taking behaviors. • Assist the family in decision-making about lifestyle choices. • Provide reinforcement for positive health-behavior

practices. • Provide health information to the family. • Assist the family in learning behaviors to promote health and

prevent disease. • Assist the family in problem-solving and decision-making

about health promotion. • Serve as a liaison for referral or collaboration between com-

munity resources and the family. Nurses use family theoretical frameworks to guide, observe, and classify situations. Nursing roles for families in various stages of development are presented in Table 7-2.

FAMILY THEORIES AND FRAMEWORKS

Family theory stems from a variety of interrelated disciplines (Atkin et al., 2015). Family systems theory explains patterns of living among the individuals who comprise family systems. In systems theory, behaviors and family members’ responses influence patterns. Meanings and values provide the vital elements of motivation and energy for family systems. Every family has its unique culture, value structure, and history. Values provide a means for interpreting events and information, passing from one generation to the next. Values usually change slowly over time. Families process information and energy exchange with the environment through values. For example, holiday food traditions may be changed slightly by a daughter-in-law, whose own daughter may then adjust the traditional recipe within her own nuclear family. System boundaries separate family systems from their environment and control information flow. This characteristic forms a family internal manager that influences and defines interactions and relationships with one another and with those outside the family system. The family forms a unified whole rather than the sum of its parts—an integrated system of interdependent functions, structures, and relationships. For example, one drug- dependent individual’s health behavior influences the entire family unit.

Living systems are open systems. As living systems, families experience constant exchanges of energy and information with the environment. Change in one part or member of the family results in changes in the family as a whole. For example, loss of a family member through death changes roles and relationships among all family members. Change requires adaptation of every family member as roles and functions assume new meanings. Changes families make are incorporated into the system.

When the system is the family, issues can be clarified by family processes, communication interaction among family members, and family group values. In Bowen’s family systems theory, birth order is considered an important determinant of behavior. In addition, family patterns of behavior differentiate one family from another (Vedanthan et al., 2016; Vess & Lara, 2016). When an individual family member expresses behaviors that differ from the learned family pattern, differentiation of self occurs. Interac- tion among family members and the transmission of these interaction patterns from one generation to the next provide the framework for the family systems approach (Rothenberg et al., 2016).

The framework for health promotion introduced by Pender and colleagues (2014) recognizes the family as the unit of assessment and intervention because families develop self-care and dependent-care competencies; foster resilience among family members; provide resources; and promote healthy individuation within cohesive family structures. Furthermore, because the family often provides the structure for implementation of health promotion, family assessment becomes an integral tool to foster health and healthy behaviors (Pender et al., 2014)

THE FAMILY FROM A DEVELOPMENTAL PERSPECTIVE

Building on Erikson’s (1998) theory of psychosocial development, Duvall and Miller (1985) identified stages of the family life cycle and critical family developmental tasks. Although Duvall’s classification has been criticized for its middle class homogeneity and lack of diversity in family forms, this conceptual model helps to anticipate family events and has formed the basis for more contemporary developmental models (Duvall & Miller, 1985). Knowing a family’s composition, interrelationships, and particular life cycle helps nurses predict the overall family pattern. Box 7-2 lists characteristics of healthy families. From Duvall’s perspective, most families complete these basic family tasks. Each family performs these tasks in a unique expression of its personal- ity. Progression through the stages occurs in a linear fashion; however, regression may occur and families may experience tasks in more than one stage at a time (Duvall & Miller, 1985). Specific tasks arise as growth responsibilities during family development. Failure to accomplish a developmental task leads to negative consequences. For example, intimate partner violence or child abuse or neglect may result in intervention by police, welfare, health department, or other agencies. Life cycle tasks build upon one another. Success at one stage is dependent on success at an earlier stage. Early failure may lead to developmental difficulties at later stages.

As families enter each new developmental stage, transition occurs. Families move through new stages as a result of events ranging from marriage (heterosexual, homosexual), gay and lesbian relationships, childbirth, single-led families, joint custody or remarried families; to adolescents maturing into young adults and leaving the home; to the aging years.

Each new developmental stage requires adaptation with new responsibilities. Concurrently, developmental stages provide opportunities for families to realize their potential. Nurses anticipate change through analysis of progress through each stage. Each new stage presents opportunities for health promotion and intervention. Family developmental stages, although reflective of traditional nuclear families and extended family networks, also apply to nontraditional family configurations (Coyne et al., 2016; Edwards, 2009). A family systems approach addresses the interaction of these multiple family configurations. For example, couples may marry and bring children from a previous marriage to a blended family that works toward achieving developmental tasks of couples along with family stages for the children. Both the couple and their children possess values and beliefs from the past that must integrate within the present union. Childless couples present developmental tasks that are different from those proposed for couples with children. One family conceptual model proposed by Vedanthan and colleagues (2016) illustrates the multiple connections among interdependence among family systems, shared environment, parenting style, caregiver percep- tions, and genomics to promote cardiovascular health.

Nurses collect data to determine progress toward family developmental task attainment during the family assessment. Use of assessment tools that include gathering factors that strengthen and protect the family such as the Canadian Family Assessment Tool and the Family Development Matrix used in California. provides more robust information (Harper Browne, 2014). These newer assessment tools focus on the assessment of family assets and social network resources that families currently use. These kinds of assessments intend to build on strengths at particular developmental stages to promote healthy family environments. Assessment of family developmental stages entails use of guidelines to analyze progress toward developmental tasks, family growth, and health-promotion needs.

THE FAMILY FROM A STRUCTURAL-FUNCTIONAL PERSPECTIVE

Families consist of both structural and functional components. Family structure refers to family composition, including roles and relationships, whereas family function consists of processes within systems as information and energy exchange occurs between families and their environment.

 

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Spiritual care to me means acknowledging and addressing a patient’s spiritual worries, doubts, and questions.

please respond to the discussions with reference

Discussion 1

Spiritual care to me means acknowledging and addressing a patient’s spiritual worries, doubts, and questions. According to Shelly & Miller (2006, p264) “Spiritual care means putting people in touch with God through compassionate presence, active listening, witness, prayer, Bible reading and partnering with the body of Christ (the church community and the clergy). It is never coercive or rude.” “Christian spiritual care means facilitating a person’s relationship with God through Jesus Christ” (Shelly & Miller, 2006, p264). I have mixed feelings about witnessing to my patients because I am worried about being ‘coercive or rude’, and have seen witnessing done badly more often than not. I cringe at how some people come off. I have prayed with my patients, a Christian prayer to God, for guidance, wisdom, and peace. In a secular society, I watch what I say. I have asked leading questions about patient’s beliefs and if they believe in God/Jesus, then I will talk relatively openly to them, but if they do not, I do not witness to them.

According to Shelly & Miller (2006, p265), a compassionate presence means “we meet patients where they are, provide the assistance needed at the moment and constantly nudge them toward the goals God intends for them. Compassion means to feel with another person.” I can agree with this. I can give nudges, and comments, but not a lecture which only serves to turn them off. I like the example Shelly & Miller (2006) give about the angel coming along side of Elijah and helping him get back on his feet again so he could go on. That’s one of the reasons I went into nursing and how I would like to be remembered.

I wholeheartedly agree with active listening; “active listening includes hearing what a person is not saying as well as the actual thoughts and feelings articulated.” (Shelly & Miller, 2006, p266). I try to do this with everyone I come into contact with, not just in the nursing field. “After careful, active listening, there are times when a word of witness is appropriate and helpful.” (Shelly & Miller, 2006, p267). I fail at witnessing because I don’t know when it is ‘appropriate and helpful’.

I agree with the aspect of Christian community. “Partnering with the body of Christ—the church community and the clergy—is another important aspect of spiritual care (Shelly & Miller, 2006, p274). But this is mixed because sometimes it is just a cop out, as it is easier to just call the clergy than talk to the patient myself. I also will call clergy from other religions to give support for the patient according to their own beliefs.

Reference

Shelly, J. A., & Miller, A. B. (2006). Called to care: A Christian worldview for nursing (2 nd ed.). Downers Grove, Il. Inter Varsity Press. Retrieved from http://gcumedia.com/digital-resources

Discussion 2

All human beings experience deep, existential concerns that are intensified when we suffer. Questions such as, ‘why do I exist?’, ‘why am I ill?’, ‘will I die?’, and ‘what will happen to me when I die?’ are all examples of the concerns that connect us. Illness can drive us to make our lives meaningful, develop coping strategies, and experience hope. When we support others whose needs are finding meaning, purpose, and hope, we are providing spiritual care.

Shelly and Miller (2006) beautifully, and succinctly state that the definition of spiritual care is ‘giving hope to the hopeless’ (p. 262). Matthew 9: 2-8 tells us about Jesus healing a paralyzed man. Christ first addressed this man’s depression, saying, ‘Son, be of good cheer’ (King James Version). Jesus is giving this man spiritual care before anything else. He did not heal his paralysis first, he healed his depression first; he spoke kind words to him, and then told him his sins were forgiven. Christ addressed this man’s spiritual needs first, thus giving him hope. If God addresses our spiritual needs first, before physical needs, why don’t we? Shelly and Miller (2006) go on to explain that nurses who provide good spiritual care facilitate the ‘restoration of an individual’s relationship with God’ (p. 295).

This truth led me to consider what it means to provide spiritual care to patients who do not believe in God. Does it mean if I provide good spiritual care, it will help lead them to the Lord? Does it mean that I cannot hope to provide good spiritual care to an atheist? How do I support someone who is looking for meaning, purpose, and hope, if they don’t believe in God? If spirituality is the feeling of deep connection we have towards one another, and with the universe in general, then we all are spiritual, whether we believe in God or not. However, my Christian worldview leads me to understand that a sense of interconnectedness cannot exist without God. How can we be connected, if there is nothing that connects us? I think the provision of spiritual care for an atheist would have to include an assessment of the nature of what it is that gives them hope, comfort, meaning, and purpose.

I agree with Shelly and Miller (2006) that spiritual care means putting people in touch with God, by providing a supportive, compassionate presence. As an example, the nurse theorist, Jean Watson, explains that helping a patient with their toileting needs is a sacred act (https://www.watsoncaringscience.org/). Who or what is it that facilitates that compassionate, supportive presence, if not God?

Reference

Shelly, J. A., & Miller, A. B. (2006). Called to care: A Christian worldview for nursing (2 nd ed.). Downers Grove, IL: IVP Academic. Retrieved from http://www.gcumedia.com/digital-resources

Discussion 3

Spiritual care to me means ministering to a patients mind and spirit. It does not necessarily have to exist in conjunction with medical care. I feel like we can provide spiritual care to our friends and family in need. When one of my friends or family members “acts out” or is angry, I try to be calm and use a combination of empathy, compassion, and active listening to help them. In regards to my patients, they all deserve spiritual care. Regardless of their sin, we are to accept them as human beings made from God. I have found that using techniques that were mentioned in the readings, I can provide spiritual care to my patients. By having a compassionate presence, we are letting our patients know that we are feeling with them. By staying with them and holding their hand or listening to their fears, we let them share their most private emotions with us. That is how I feel about my prayers to God. There are times when I just need him to hear me. As God’s children, and as nurses, we can be there to listen to the scared patient before surgery or facing a terminal illness. Being an active listener also encourages spiritual care. Patients in the hospital are being given a lot of verbal and written information about their illness. They usually don’t feel comfortable asking questions because they know that doctors and nurses are busy. By giving a patient active listening time, they can express their concerns. Regardless of religious preference, the power of prayer is amazing. I feel as though it is like a “time-out” before a procedure. It is a time to bless the hands of the medical staff, the patient, and the family. A moment of prayer stops the hands of time for a moment and focuses on the spiritual needs of the patient.

We were created by God with a physical body and our own spirit. As medical treatments nurture our physical body, spiritual care through love and compassion nurture our spirits. I believe that if a person’s spiritual being is in peace, they can handle just about anything their physical needs are. I always thank my patients for allowing me to be a part of their care. I am present for some of the most private, emotional times in people’s lives. They trust and look to us for guidance and to help keep them calm. We can help extend the spiritual care beyond the hospital setting by reaching out to their community resources such as a pastor, church, or prayer group.

Discussion 4

I believe spiritual care encompasses caring for the individual holistically – mind body and soul/spirit. It means to aspire to provide care which will inspire hope to enable the patient/client to cope with an illness, trauma, or life change; being cognizant of the variant ways in which one may choose to seek a devout relationship with a higher power/God/Deity by displaying respect and appreciation for that presence regardless of one’s own religion. I feel as though my view is in accordance with the nursing Florence Nightingale implemented – without excluding or abandoning good actions, secular nursing seems best to be observed, as it leaves out the biases, to include diversified cultures and practices in an effort to execute for what nurses are meant – provision of a caring relationship that facilitates health and healing (Shelly and Miller, 2006).

Reference

Shelly and Miller. (2006). Nusing – Practice of Care. In J. Shelly & A. Miller, Called to Care: A Christian Worldview for Nursing, Second Edition (pp. 231 – 287). Downers Grove: Intervarsity Press.

Discussion 5

All people are made in the image of God, whether or not their beliefs tell them that is true, and therefore, all have value and are loved by God. Spiritual care is approaching every patient with that first thought in mind and providing them with care that goes beyond the task at hand. All of God’s children have a need to be connected with Him (to fill that God shaped hole in our hearts) and that can be accomplished in many ways. Allowing the love of God to shine through us is key. Whatever spiritual care you perform, the goal should be to show the love of Jesus. Shelly and Miller (2006) list spiritual interventions that can fall into the categories of compassionate presence, active listening, witness, prayer, scripture and Christian community. I agree with how they discuss spiritual care. I would be cautious in the area of witness and prayer unless that nurse is particularly gifted in discerning the appropriate time and patient while offering truth and hope with a huge helping of grace and love. Maybe I feel that way because of my area of practice in the ED and trauma world are most always fast paced and we don’t usually have time to build that kind of foundation. The other interventions can be easily incorporated into a fast paced ED, including offering to have the chaplain or their personal clergy contacted opening the opportunity for payer and witness.

References

Shelly, J. A., & Miller, A. B. (2006). Called to care A Christian worldview for nursing (2nd ed.). Downers Grove, IL: InterVarsity Press.

Discussion 6

Have you ever wondered why faith is listed first then hope and last love? A human does need to have faith in something greater than themselves. Hope is needed for the future and it takes love of others to reach out and care for those around us. Spiritual care is learning what the patient believes or the worldview held as truth and then respecting the view held by the patient. The nurse respects and responds to the patient at their level of need. The nurse does not have the answer but is available to listen, guide, and support the patient at whatever stage they are in.

Personally, I like several things in this week’s literature such as, spiritual care given in a spirit of gentleness and humility is usually well received (Shelley, 2006). This is because it is not judgmental in nature but can open the door for conversation. To be able to care for a patient without judgment no matter how their worldview differs from the one held by the nurse is true Christianity.

This has been a touchy subject with me after working in a hospital that was attempting to be politically correct after 9/11. The problem began when they okayed for the Muslim nurses to wear their head wraps but sent out a notice that any nurses who wore a crucifix would have to remove it or be sent home. This was a hospital that had a Catholic priest rounding on a regular basis, fixed fish every Friday along with performing Ash Wednesday. The thought was that the crucifix was offensive to the other faiths and we instructed that nurses were not allowed to pray with any patients. The nurses’ autonomy was being restricted, beneficence was being taken away by holding one religious view greater than another.

Is there a difference or an accord with the description of spiritual care?

A difference or harmony is according to the nurse giving care. If the nurse is combative, negative, pushy, or strongly opinionated this is destructive to the nurse patient relationship. This type of attitude will be detrimental to the healing process since it interferes with the mindset of the patient along with causing conflict with the worldview held as truth to the patient. Each patient is a different situation but each patient only wants someone to listen to their story. The nurses’ responsibility is to be careful not to try to give answers but to only be a receptive listener. The nurse should never be Job’s friends that only spoke death.

References

Shelley, J. &. (2006). Called to care: A Christian worldview for nursing. Downers Grove: IVP Academic.

 

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Planning for Data Collection

Discussion – Week 8

APA format

PART 1 DUE IN 12 HOURS – PART 2 (RESPONSE TO COLLEAGUES)DUE IN 36 HOURS

Top of Form

Planning for Data Collection

Data collection is an important part of both quantitative and qualitative research. Although the actual approach to gathering information may vary, for either research design, researchers need to plan in advance how the data will be gathered, reported, and stored, and they need to ensure that their methods are both reliable and valid. As nurses review research when considering a new evidence-based practice, it is important to be familiar with sound collection practices in order to ascertain the credibility of the data presented.

Consider the following scenario:

Nurses and other health care professionals are often interested in assessing patient satisfaction with health care services. Imagine that you are a nurse working in a suburban primary care setting that serves 10,000 patients annually. Your organization is very interested in understanding the patient’s point of view to help determine areas of care that can be improved. With this focus in mind, consider how you would create a survey to assess patient satisfaction with the services your organization provides. You may wish to consider variables such as the ease of accessing care, patient wait time, friendliness of the staff, or the likelihood that a patient would recommend your organization to others.

For this Discussion, you generate questions and an overall plan for data collection that would be appropriate for a patient satisfaction survey in relation to the above scenario.

To prepare:

  • Consider the guidelines for generating questions presented in this week’s Learning Resources.
  • Review the scenario and formulate at least five questions that you could use to evaluate patient satisfaction.
  • Reflect on the different methods or instruments that can be used for gathering data described in Chapter 13 and Chapter 22 of the course text. Which methods or instruments would work well for the scenario?
  • Determine an appropriate sample size for the scenario.

Post the questions that you created for gathering information about patient satisfaction based on the above scenario. Explain which method or instrument you would use to gather data. Describe the sample size appropriate for the population and how you would select participants. Provide a rationale for your choices, and explain how you can ensure high standard of reliability and validity.

AT LEAST 3 CITATIONS TO VALIDATE YOUR DISCUSSION

Read a selection of your colleagues’ responses.

Respond to at least three of your colleagues on three different days using one or more of the following approaches:

  • Ask a probing question, substantiated with additional background information, and evidence.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.
  • Validate an idea with your own experience and additional sources.
  • Make a suggestion based on additional evidence drawn from the readings or after synthesizing multiple postings.
  • USE AT LEAST TWO CITATIONS PER DISCUSSION TO VALID YOUR RESPONSE

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Colleague response #1

Main Discussion Post

Introduction

This weeks objective is to evaluate different methods of data collection, specifically for patient satisfaction and improvement methods. The Agency of Healthcare Research and Quality (2017) report a notable difference between patient satisfaction and patient experience. To determine if patients are satisfied with their care does not determine what their experience was like. It is with assessments of patient experiences that, variables can be analyzed and included or excluded into all patients care for consistency in quality, safety, and improve overall patient satisfaction. The data for collection is to determine the patient’s experience, which renders the data to be collected as qualitative in nature. I think a descriptive phenomenology qualitative design would be best for describing the patient’s experiences with with the health care services.

Sampling

The target populations is the patients of the suburban primary care center. The organization is interested in knowing all of the patient’s point of view, so essentially they are heterogeneous and no one patient’s experience is more important than the others. There is no inclusion or exclusion criteria. This maximum variation sampling will include ample diversity among the sample and increase the results ability to be generalized (Polit & Beck, 2017). The sample size that will be obtained from the facilities population of 10,000 people will be determined from how information rich the participants that are selected are (Malterud, Siersma, & Guasora, 2016; Polit & Beck, 2017). As data is collected, typically the analysis should be taking place along side of the collection process. At this point the sample size may be increased if the researchers realized that certain significant aspects that have been left out of the study and this will improve the validity ( Malterud, Siersma, & Guasora, 2016). Another aspect to consider with the sample is how the sample will be selected. Randomized sampling would be fitting for this scenario. A randomized computer program could select participants at random to determine their inclusion into the research. This will improve the qualitative designs rigor due to non-random sampling being criticized for having selected bias participants that will have similar or desired opinions (Gray, Grove, & Sutherland, 2017). 

Data Collection

Another criticized element of qualitative designs that tarnishes the studies rigor and validity is the bias of the researchers conducting the interviews and analyzing the data. The researchers must have reflexivity when conducting interviews. Having reflexivity means that the researcher is aware of their own opinions and beliefs and maintain intellectual honesty while conducting interviews, especially since they are the ones who will be analyzing the data (Gray, Grove, & Sutherland, 2017; Polit & Beck, 2017). Intellectual honesty and reflexivity will improve a studies rigor and validity. Because the scenario is set out to gather data about improvements for access to care, wait times, staff friendliness, and likelihood of facility being recommended to others, the interview must be semi-structured where there are a list of questions that will be asked of each participant without a prediction of responses (Polit & Beck, 2017). The guidelines would include to provide an environment where information can be discussed freely, questions are asked in a logical sequence, and the interviewer is attentive (Polit & Beck, 2017). The interviewer may also utilize probe questions to encourage the participants to explain richer details to explanations. The open-ended questions would be:

1. Describe to me the process of making an appointment at the office?

2. How often are you able to get an appointment within the time frame you are requesting?

3. When you arrive at the office, tell me about your wait time?

4. Tell me about your experience with each staff member?

5. What would your recommend to your family or friends about our office?

References

Agency of Healthcare Research and Quality. (2017). What is patient experience? [online] Available at: https://www.ahrq.gov/cahps/about-cahps/patient-exp…

Gray, J. R, Grove, S. K., & Sutherland, S. (2017). The practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Elsevier.

Malterud, K., Siersma, V. D., & Guassora, A. D. (2016). Sample size in qualitative interview studies: guided by information power. Qualitative health research26(13), 1753-1760.

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10thed.). Philadelphia, PA: Wolters Kluwer

Robinson, O. C. (2014). Sampling in interview-based qualitative research: A theoretical and practical guide. QUALITATIVE RESEARCH IN PSYCHOLOGY11(1), 25–41. https://doi-org.ezp.waldenulibrary.org/10.1080/147…

Colleague response 2

Introduction: Polit and Beck state that “Both the study and the participants and those collecting the data are considered during the collection of qualitative data. The goal is to achieve consistency in what is asked and how the answers are reported. This is done to reduce biases and facilitate analysis.” (Polit, Beck. 2017) I currently work in the surgical services unit and take part in patient satisfaction surveys daily. I will be asking questions regarding our patients experiences during their surgical experience with us.

My five questions are based off of patients who have been discharged from our surgical services unit after having a surgical procedure in our hospital. Upon discharged our patients will have experienced our preop, operating room, and post anesthesia care units. Some may have been admitted and spent some time on our medsurg unit. These questions are focused around how overall satisfied they were with our surgical services.

Questions:

  • How do you feel about the overall access to care in our surgical services unit?
  • How do you feel about the overall processing and wait time from admission to surgical start time?
  • How do you feel about the friendliness and care of our staff?
  • Do you feel like you and your loved ones were given good discharge instructions on how to care for yourself and manage your post op pain at home?
  • How likely are you to recommend us to your family and friends to receive care in our surgical services unit if ever needed?

These questions provide unbiased data from patients who have had a surgical procedure performed in the facility. i feel they follow the Poilt and Beck, (2017)guidelines and focus on a set population of patients.

As for the instrument to gather and collection of data, I would refer to Polit and Beck (2017) and use both closed and open ended questions. These questions and data will be collected through phone surveys and mail surveys. It’s important to stress that the survey is voluntary and the reason for the survey. The participant should also know that the survey in anonymous and that no identifiers will be used. (Polit, Beck. 2017)

This survey will have validity because of the population sample that will be used to gather the data. Participants will have experienced the same areas and many similar situations throughout their visit. Validity is achieved through larger sample populations with repetition.

In conclusion, as nurses we must be involved in the collection of the data. This helps to validate where the information should be gathered from and how. Using the guidelines of Polit and Beck (2017) will help to ensure that the questions in the survey are appropriate for the study.

Beck, C. T., & Polit, D. F. (2017). Nursing research generating and assessing evidence for nursing practice

(Tenth ed., pp. 32-34). Philadelphia, PA: Wolters Kluwer.

Colleague Post #3

Based on the above scenario, as a nurse working in primary care setting that serves 10,000 patients annually, quality of care and patient satisfaction are important. A satisfaction survey is needed to understand what satisfies our patients and what areas need improvement but to keep the quality of the study, careful selection of the sample is needed. To prevent biased and too small of a sample, statistics would be used to determine the sample size and length of the study. Convenience sampling might be a good place to start, it is easy and efficient (Polit & Beck, 2017). I would provide the patients with a link where they could go online and fill out five questions that rank 0-10 from extremely dissatisfied (1) to extremely satisfied (5), these are simple closed-ended questions that are easy to answer. From experience keeping surveys short and simple are going to have a better impact on responses. People are busy and don’t like taking surveys if they are too time consuming, so I picked five questions to rank.

Survey Questions

Research question drives the research methods, as noted in our assigned video (Laureate Education 2012). The five survey questions ranking 1-5 being extremely dissatisfied, very dissatisfied, satisfied, very satisfied, and extremely satisfied and at the end they can add comments if needed to explain any of the answers. The goal is to make the patients feel that they are being heard.

  • Wait time until seen
  • Friendliness of the office staff
  • Office environment
  • All issues & concerns were addressed
  • Understanding of discharge summary

Reliability and Validity

Survey research is flexible and can be used in large studies or small groups. The research question will be the most important step in the process, it should be measurable, clear and concise. Although there are some challenges to web-based method it is still easy to access, and the patients can respond in their own time. Sending out email reminders with the link may also be helpful if the patient misplaced the link. Conducting a power analysis to determine the amount of responses needed will add significance to the study. With the questions being asked are simple and the patients should be able to interpret them in the same manner which makes it more reliable (Keough & Tanabe, 2011). The results of this survey will be easy to identify by the researchers because they are very straightforward with easy ranking.

References

Keough, V. A., & Tanabe, P. (2011, January). Survey research: An effective design for conducting nursing research. Journal of Nursing Regulation1(4), 37-44. Retrieved from https://class.waldenu.edu/bbcswebdav/institution/USW1/201770_27/MS_NURS/NURS_5052/readings/USW1_NURS_5052_Keough%202011.pdf

Laureate Education. (Producer). (2012). Qualitative and mixed methods research designs. Baltimore, MD: Author

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kl

 

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