Nursing

Assignment: Footnotes and bibliography
Assignment: Footnotes and bibliography
Permalink:
Please the attached Rubric and Sample for the Capstone Essay
Summary
The final assignment for ETHC101 is a capstone essay that brings all of the knowledge and skills developed in this course to bear on a single ethical issue. Each student will write a paper of 2100 to 2400 words (total, including the title page, table of contents, quotations, footnotes, and bibliography), in current Turabian format, that combines the insights and arguments of the third and fourth discussion boards into a single carefully-articulated work. Assignment: Footnotes and bibliography
Content
Begin your paper with a brief introductory paragraph that clearly states what positions you are going to argue for. State what metaethic you will defend, the issue in applied ethics to which you will be applying it, and the conclusion(s) on that issue that you want to defend.
Next provide a lengthy and detailed explanation of your metaethic. This will likely reflect the metaethic that you argued for in your Discussion Board Three thread and the feedback that you received from the classmate or classmates who responded to your thread. Here you can go into much more detail than you could in the Discussion Board, which was limited to 600 words. If you use half of your paper to develop your metaethic, then it will contain approximately 1100 words, which means that it will be roughly twice as long as your Discussion Board thread was.
Once you have fully explicated and argued for your metaethic, proceed to an application of that metaethic to the applied ethics issue that you discussed in your Discussion Board Four thread. This discussion may end up being twice as long as your discussion board thread was. Add detail, nuance, and argumentation, providing a fairly complete and comprehensive argument for approaching the issue the way that you do. You may illustrate the issue with real-life examples, but please do not fill your paper with anecdotes. You should anticipate possible objections to your approach to the issue and respond to them in an objective and informed manner. (For ideas on how others might object to your approach, a good place to begin would be your classmate’s reply to your DB4 thread, but you needn’t stop there. Your own imagination and the many books and articles that have been published on issues in applied ethics can provide a wealth of possible arguments relevant to every issue.)
Your final paragraph(s) should reflect that you have accomplished your thesis. It should recap what you have accomplished and how you have accomplished it.
Research
This paper is not required to utilize any sources outside of those that were used in the class (the two textbooks, the videos, and the PointCast presentations), but use of additional resources is permitted and encouraged. At the minimum the paper should utilize the resources from the class. All resources used must be listed in the bibliography and any resources quoted, paraphrased, or alluded to must be documented via footnotes formatted according to Turabian.
While your footnotes and bibliography (if you had one) did not count toward the word count for your discussion boards, for this capstone essay both the footnotes and the bibliography count toward the word count. In other words, the 2400 word limit is all-inclusive. You will be penalized if you exceed the limit, so please do not.
Format
Your paper must begin with a title page that includes a paper title, your name, the date, and the course name and number. The second page of your paper must be a table of contents. The last page of your paper must be devoted to your bibliography. The paper must utilize 12 point Times New Roman font, double-spaced, with one inch margins. It must be double-spaced rather than triple-spaced between paragraphs and there should be only one space after the end of each sentence.
Any documentation in the body of your paper must be done via footnotes formatted according to Turabian. If you are not familiar with how to do this, simply look it up online. There are many websites that explain Turabian formatting. Footnotes should be single-spaced 10 point Times New Roman font.
Your paper must be submitted as a Microsoft Word document. If you submit it as a .pdf or anything other than a Microsoft Word document it will not be graded.
Format Example
Title Page
Table of Contents
Body of Paper:
· Introduction
· Metaethic
· Application
· Conclusion
Bibliography
Miscellany
Proofread your work before handing it in! Errors of spelling, grammar, syntax, and punctuation will affect your grade. This is a university-level writing assignment. Please write accordingly.
The deadline for this assignment is 11:59pm on Friday of Unit 8. Submit your finished paper via the SafeAssign link on Blackboard. SafeAssign is a program that checks your work for plagiarism. Plagiarism is immoral, unchristian, and will not be tolerated. The consequences for plagiarism are significant and SafeAssign makes it easy to detect. If you are not sure what plagiarism is, it is your responsibility to find out. Ignorance is no excuse. Do not plagiarize!
This assignment contributes to achieving and assessing the achievement of all four of the Course Learning Outcomes.
This assignment is due by 11:59 p.m. (ET) on Friday of Module/Week 8.

Assignment: Worksheet Measuring Disease
Assignment: Worksheet Measuring Disease
Permalink:
A causal relationship between cigarette smoking and lung cancer was first suspected in the 1920s on the basis of clinical observations. To test this apparent association, numerous epidemiologic studies were undertaken between 1930 and 1960. Two studies were conducted by Richard Doll and Austin Bradford Hill in Great Britain. The first was a case-control study begun in 1947 comparing the smoking habits of lung cancer patients with the smoking habits of other patients. The second was a cohort study begun in 1951 recording causes of death among British physicians in relation to smoking habits. This case study deals first with the case-control study, then with the cohort study. Assignment: Worksheet Measuring Disease
Data for the case-control study were obtained from hospitalized patients in London and vicinity over a four-year period (April 1948 – February 1952). Initially, 20 hospitals, and later more, were asked to notify the investigators of all patients admitted with a new diagnosis of lung cancer. These patients were then interviewed concerning smoking habits, as were controls selected from patients with other disorders (primarily nonmalignant) who were hospitalized in the same hospitals at the same time. Data for the cohort study were obtained from the population of all physicians listed in the British Medical Register who resided in England and Wales as of October 1951. Information about present and past smoking habits was obtained by questionnaire. Information about lung cancer came from death certificates and other mortality data recorded during ensuing years. Assignment: Worksheet Measuring Disease
Over 1700 patients with lung cancer, all under age 75 were eligible for the case-control study. About 15% of these persons were not interviewed because of death, discharge, severity of illness, or inability to speak English. An additional group of patients were interviewed by later excluded when initial lung cancer diagnosed proved mistaken. The final study group included 1,465 cases (1,357 males and 108 females). The following table shows the relationship between cigarette smoking and lung cancer among male cases and controls: Assignment: Worksheet Measuring Disease
Table 1
Cases Controls
Cigarette Smoker 1,350 1,296
Nonsmoker 7 61
Total 1,357 1,357
1. Accurately calculate the proportion of cases that smoked. Be sure to show your calculations.
2. Accurately calculate the proportion of controls that smoked. Be sure to show your calculations. Assignment: Worksheet Measuring Disease
3. Accurately calculate the odds ratio, with the correct equation. What do you infer from the odds ratio about the relationship between smoking and lung cancer? Assignment: Worksheet Measuring Disease
Table 2 shows the frequency distribution of male cases and controls by average number of cigarettes smoked per day.
Table 2: Daily cigarette consumption
Daily Number of Cigarettes Number of Cases Number of Controls Odds Ratio
0 7 61 Referent
1–14 565 706
15–24 445 408
25+ 340 182
All smokers 1350 1296
Total 1357 1357
4. Accurately calculate the odds ratios by category of daily cigarette consumption, comparing each category to nonsmokers. Be sure to show your calculations.
5. Interpret these results, and describe the trends or patterns you see in the data.
Part 2: The Cohort Study
Data for the cohort study were obtained from the population of all physicians listed in the British Medical Register who resided in England and Wales as of October 1951. Questionnaires were mailed in October 1951 to 59,600 physicians. The questionnaire asked the physicians to classify themselves into one of three categories: 1) current smoker, 2) ex-smoker, or 3) nonsmoker. Smokers and ex-smokers were asked the amount they smoked, their method of smoking, the age they started to smoke, and, if they had stopped smoking, how long it had been since they last smoked. Nonsmokers were defined as persons who had never consistently smoked as much as one cigarette day for as long as one year. Physicians were also asked whether or not they had a diagnosis of lung cancer. Usable responses to the questionnaires were received from 40,637 (68%) physicians, of whom 34,445 were males and 6,192 were females. The next section of this case study is limited to the analysis of male physician respondents, 35 years of age or older. Assignment: Worksheet Measuring Disease
The occurrence of lung cancer in physicians responding to the questionnaire was documented over a 10-year period (November 1951 through October 1961) from death certificates filed with the Registrar General of the United Kingdom and from lists of physician deaths provided by the British Medical Association. All certificates indicating that the decedent was a physician were abstracted. For each death attributed to lung cancer, medical records were reviewed to confirm the diagnosis.
Diagnoses of lung cancer were based on the best evidence available; about 70% were from biopsy, autopsy, or sputum cytology (combined with bronchoscopy or X-ray evidence); 29% were from cytology, bronchoscopy, or X-ray alone; and only 1% were from just case history, physical examination, or death certificate. In total, there were 355 cases of lung cancer during this 10-year time period, with 255 newly diagnosed cases of lung cancer. Assignment: Worksheet Measuring Disease
Of 4,597 deaths in the cohort over the 10-year period, 157 were reported to have been caused by lung cancer; in 4 of the 157 cases this diagnosis could not be documented, leaving 153 confirmed deaths from lung cancer.
The following table shows numbers of lung cancer deaths by daily number of cigarettes smoked at the time of the 1951 questionnaire (for male physicians who were nonsmokers and current smokers only). Person-years of observation (“person-years at risk”) are given for each smoking category. The number of cigarettes smoked was available for 136 of the persons who died from lung cancer.
Table 3: Number and rate (per 100,000 person-years) of lung cancer deaths by number of cigarettes smoked per day, Doll and Hill physician cohort study, Great Britain, 1951–1961.
Daily number of cigarettes smoked Deaths from lung cancer Person-years at risk Mortality rate per 1,000 person-years
0 3 42,800 0.07
1–14 22 38,600
15–24 54 38,900
25+ 57 25,100
All smokers 133 102,600
Total 136 145,400
6. Accurately calculates the lung cancer mortality rates for each smoking category. Be sure to show your calculations.
7. Describe the trends or patterns you see in the data about mortality, and explain what the trends or patterns mean.
8. Accurately calculate the incidence for lung cancer during the 10 year time period. Be sure to show your calculations.
9. Accurately calculate the prevalence for lung cancer during this 10 year time period. Be sure to show your calculations.
This worksheet was modified using information from the original case study found on the CDC website:
Centers for Disease Control. (2003). “Cigarette smoking and lung cancer.” Centers for Disease Control and Prevention Epidemiology Program Office Case Studies in Applied Epidemiology, 731-703. Retrieved from: https://www.cdc.gov/eis/downloads/xsmoke-student-731-703.pdf

Assignment: Gospel Essentials
Assignment: Gospel Essentials
Permalink:
In this assignment you will summarize and analyze the essential elements of the Christian worldview and reflect on implications for your own worldview.
Write a 1,250-1,500-word essay using at least two course resources (textbook, lectures, the Bible) and at least two other sources from the GCU Library to support your points. Remember, the Bible counts as one reference regardless of how many times you use it or how many verses you cite.
Begin your paper with an appropriate introduction, including a thesis statement to introduce the purpose of the paper.
Organize your paper with the following sections using the seven underlined titles for subheadings.
The Christian Worldview: Describe the beliefs of the Christian worldview with regard to the following components corresponding to Topics 2-5. Write at least one paragraph for each component using the underlined title for a subheading.
God: What is God like? What are God’s characteristics? What is his creation?
Humanity: What is human nature? What is human purpose? What is the root cause of human problems?
Jesus: What is Jesus’ true identity? What did Jesus do? Why is Jesus’ identity and work significant for the Christian worldview?
Restoration: What is the solution to human problems according to the Christian worldview? What role do grace and faith play in Christian salvation? How do Christians think that the transformation of self and society happens?
Analysis: Analyze the Christian worldview by addressing each of the following questions:
What are the benefits or strengths of Christian belief?
What is troublesome or confusing about Christianity?
How does Christianity influence a person’s thinking and behavior?
Reflection: Reflect on your worldview by answering one of the following questions:
If you are not a Christian, what similarities and differences are there between your worldview and the Christian worldview?
If you are a Christian, how specifically do you live out the beliefs of the Christian worldview?
Conclusion: Synthesize the main points, pulling the ideas of the paper together.
References
Prepare this assignment according to the guidelines found in the GCU Style Guide, located in the Student Success Center.
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.

Assignment: Stress Perception Levels
Assignment: Stress Perception Levels
Permalink:
Occupational Stressors, Stress Perception Levels, and Coping Styles of Medical Srugical RNs: A Generalized Perspective
(Wakim, 2014)
Your assigned article for critique is:
Wakim, N. (2014). Occupational stressors, stress perception levels, and coping styles of medical surgical RNs. Journal of Nursing Administration, 44(12), 632-639.
Instructions: A major skill that is learned in this course is how to critically read and critique nursing research articles. The purpose for critiquing an article is to critically evaluate the research process followed by the author(s) of the assigned article. This is an information-intensive, time-intensive process that is not learned overnight. To demonstrate your skill at critiquing an article, you will complete this open-book multiple choice assignment.
Here’s how you should approach completing this week’s assignment to finish critiquing an article:
1. First, do your assigned reading in Grove, Gray, and Burns (2015) and complete the reading worksheets early in the week. This will introduce you to the critique skills you will need for the week.
2. Skim the entire instructor assigned research article that has been posted on Blackboard for you so that you will have an idea of what it is about. Lightly cross out the abstract for the article (you won’t be using it). Then, for this week, re-read carefully from the study design section through the end of the article.
3. Print this document and find the best answer to each question below based on your Grove, Gray, and Burns (2015) assigned reading for the week and what you have read in the instructor assigned research article.
4. Some of the questions in the critique assignment below will seem unfamiliar to you. Look up key terms from the question in your textbook. Some examples of these terms might be: power analysis, inter-rater reliability, and generalization. You can also look in Chapter 12 for an example of a critical appraisal (or critique) of a quantitative research article.
5. Once you have completed this assignment “on paper”, go into blackboard and enter your answers by the assignment due date and time listed in the syllabus. Ignore any wording from Blackboard that indicates that “this is a test” and carefully enter your answers from this document.
6. You will have two access attempts to record your answers. This is given to you so that if you encounter technical difficulties on your first attempt, or you would like a second attempt to try to improve your grade, you may do so. You will not be able to see the questions that you missed when you submit your attempt. Blackboard will record the highest grade from the two submissions.
If you have questions about this assignment, you can post them to your group discussion board for help. Please do not post the exact question from the assignment below and ask the group for the answer as this would constitute academic dishonesty.
Questions 1 – 9: Sample. (For help with these questions, refer to chapters: 9 & 12)
1. What sampling method or plan was used by the authors in this study?
a. Simple random sampling
b. Systematic sampling
c. Convenience sampling
d. Network sampling
2. According to Grove, Gray, and Burns (2015), what are the potential biases of this sampling method?
a. This is a strong probability sampling method with very little potential for bias
b. This method is used when an ordered list of all members of the population are available, and provides a random but not equal chance for inclusion in the study.
c. This method provides little opportunity to control for bias because subjects are included in the study merely because they happen to be in the right place at the right time.
d. This method is specific to the individuals who were recruited and the information gained cannot be generalized to others who don’t share these types of experiences.
e. None of the above biases best describe the sampling method chosen by the author.
3. What was the final sample size reported by the authors for this study?
a. 200 participants
b. 84 participants
c. 159 participants
d. 161 participants
4. Was a power analysis conducted? If so, which statement best describes the results of the power analysis?
a. The authors mention that an a priori power analysis was conducted, and 200 subjects were
determined to be needed for the study.
b. The authors mention that a power analysis was conducted using four predictors and 1-way ANOVA using three independent groups for a needed sample size of 159.
c. The authors do not report that a power analysis was conducted.
5. Which of these statements would be considered an inclusion criterion for the sample in the research article?
a. English-speaking
b. Have at least two years of experience as a nurse
c. Work on a Medical Surgical unit
d. Be a member of the Medical Surgical Nurses Association
6. Which of these statements would be considered to be exclusion criterion specifically identified by the author for the sample in the research article?
a. The exclusion criteria were explained verbally during recruitment.
b. History of depression/ mental health issue.
c. Report of no stress related problems by the participant.
d. Participants only worked on the night shift.
7. What is the refusal rate for this study? (Hint: see page 253 in your text)
a. 161/200 X 100% = 80%
b. 84/159 X 100% = 53%
c. unknown / cannot be calculated.
d. 39/200 x 100% = 19.5%
8. Which of the following would be accurate for the attrition rate for this study?
a. 161/200 X 100% = 80%
b. 39/200 X 100% = 20%
c. 84/159 X 100% = 53%
d. 0%
9. What was the setting for this research study? Briefly describe the setting and indicate whether it was appropriate for conducting this study.
a. The setting for this study was a partially controlled setting and was appropriate for this study’s research design.
b. The setting for this study was not well described by the authors and therefore not appropriate for
conducting this study.
c. The setting for this study was a highly controlled setting and was appropriate for this study’s research design.
d. The setting for this study was a natural or field setting and was appropriate for this study’s research design.
Question 10 – 14: Measurement Methods. (For help with these questions, refer to chapters 10 & 12.)
10. Which ones of these questionnaires, scales, or physiologic measures is used in this research study?
(Select all that apply).
a. The Ways of Coping Questionaire (WAYS)
b. The Nursing Stress Scale (NSS)
c. The Perceived Stress Scale (PSS)
d. The Quality of Life Scale (QOLS)
11. How do the authors describe the reliability of the Nursing Stress Scale (NSS) in previous studies?
a. Two follow-up emails were sent to potential participants.
b. they compared the odd and even questions on the test to determine their equivalence.
c. a team of staff nurses was trained by the primary investigator to administer the questionnaire.
d. they tested a group of subjects twice using the same questionnaire (test-retest reliability).
e. they computed a Cronbach’s alpha on the Nurse Stress Scale that was administered to this group of subjects.
12. How do the authors describe the validity of The Ways of Coping Questionnaire (WAYS).
a. discriminant validity demonstrated that each subscale measured the same constructs.
b. evidence of validity from contrasting groups because they gave it to spouses of MS nurses.
c. no was no mention of determining the validity of WAYS questionnaire.
d. The authors had experience with administering this questionnaire.
13. What types of questionnaires or surveys were used in this research study? (Select all that apply.)
a. The authors developed the Professional Quality of Life Scale.
b. Interviews were reportedly used, but the authors do not explain what was included in them.
c. The authors developed their own questions to ask about demographic information.
d. The authors report adding a few of their own questions at the end of the demographic questionnaire.
e. This study did not use any questionnaires or surveys.
f. The authors used previously developed questionnaires or surveys to measure the study
variables.
14. Were any physiological measurements collected from the subjects for the purpose of this study?
a. Yes
b. No
Question 15- 16: Data Collection. (For help with these questions, refer to chapters 10 & 12)
15. Which one of the following best describes the data collection process used in this study?
a. questionnaires / surveys were completed via the telephone.
b. participants were given the questionnaires on enrollment in the study and asked to drop the sealed envelope in a locked box at the nurse’s station.
c. questionnaires / surveys were mailed to the prospective participants and returned in a self-
addressed stamped envelope.
d. nurse researchers interviewed the study participants in a focus group.
16. If there were more than one data collector for the study, would an estimation of inter-rater reliability be an important concept for the authors to report on for this study?
a. yes, and the authors reported their efforts to achieve inter-rater reliability.
b. yes, but the authors do not discuss any efforts to achieve inter-rater reliability.
c. no, the issue of inter-rater reliability does not apply here.
Question 17 – 19: Data Analysis. (For help with these questions, refer to chapters 11 & 12)
17. What descriptive statistics are used in this study? (Select all that apply).
a. mean
b. median
c. mode
d. standard deviation
e. z-scores
f. percentage distributions
18. What inferential statistics were used to examine the data obtained from the subjects? (Select all that apply)
a. Bivariate correlational analysis
b. Factor Analysis
c. t-Test
d. Chi-Square
e. ANCOVA
f. ANOVA
g. regression analysis
h. None of the above inferential statistics were used in this study.
19. What is the level of significance (alpha) set at for this study?
a. .05 or 5%
b. .10 or 90%
c .01 or 1%
d. an alpha level or level of significance chosen by the authors was not specifically mentioned in the text
of the article.
Question 20-25: Researcher’s Interpretation of the Findings. (For help with these questions, refer to chapters 11 & 12)
20. There are several statistically significant findings in this study. Which of these statements from the article would be considered a significant and predicted result? (select all that apply)
a. As MS nurses’ perceptions of their stress increases, their use of ways to cope increases (r = .357, P<.00) b. Younger nurses have lower levels of perceived stress, per post hoc Tukey analysis. c. Baby boomers tend to report higher use of self-controlling behaviors than Gen X and Gen Y nurses when dealing with occupational stressors. d. The stress perception level is thus determined by the type of occupational stressor that the nurse is exposed to. 21. Which of these statements from the article would be considered a non-significant result. (Select all that apply) a. The older the nurse, the higher the level of stress. b. There was no difference between the scores on ways of coping related to age cohorts (F2158 = 1.12, P=.33) c. Age, years of experience, and educational levels are not significant factors in levels of perceived stress among MS nurses. d. Baby boomers tend to report higher use of self-controlling behaviors than Gen X and Gen Y nurses when dealing with occupational stressors. 22. Which one of these statements from the article would be considered clinically important? a. According to this study results, a high level of occupational stress is not a known factor for nursing turnover in MS nurses. b. Younger nurses have better coping skills to combat perceived stress compared to more experienced nurses. c. Baby boomers reported higher use of self-controlling behaviors when dealing with occupational stressors compared with Gen X and Gen Y. d. Six participants were removed from the study due to incomplete surveys. 23. Which statements below implied from the article would be considered a limitation of the study? (Select all that apply) a. The researchers utilized a qualitative method in the research design. b. Lack of standardization of the conditions of administering the instruments. c. A small sample size with a low response rate. d. A measure of social desirability in giving responses as the participants worked with the researcher. 24. Which one of these statements would be considered a statement regarding generalization of these results? a. The results indicated that there were high levels of perceived stress in this group of MS nurses and can be generalized to all MS nurses in the United States. b. The survey was mailed only to MS nurses who were members of the Medical Surgical Nurses Association (MSNA). c. A convenience sample of MS nurses decreases generalizability. d. The use of a power analysis influenced the generalization of the results to all MS nurses. 25. Which one of these statements from the article would be considered a recommendation for future studies? (Select al that apply.) a. Future development of programs to help relieve the occupational stress in MS nurses. b. Research to discover why older nurses have a higher perceived stress compared to younger nurses. c. Sufficiently educating nursing leaders in generational differences. d. Identification of occupational stressors, perceived stress, and coping styles among generational cohorts.

Discussion: Responses to Immune Disorders
Discussion: Responses to Immune Disorders
Permalink:
Maladaptive responses to disorders are compensatory mechanisms that ultimately have adverse health effects for patients. For instance, a patient’s allergic reaction to peanuts might lead to anaphylactic shock, or a patient struggling with depression might develop a substance-abuse problem. To properly diagnose and treat patients, advanced practice nurses must understand both the pathophysiology of disorders and potential maladaptive responses that some disorders cause.
Consider immune disorders, such as HIV, psoriasis, inflammatory bowel disease, and systemic lupus E. What are resulting maladaptive responses for patients with these disorders?
To prepare:
Review Chapter 5 and Chapter 7 in the Huether and McCance text, as well as the Yi, et al, article in the Learning Resources. Reflect on the concept of maladaptive responses to disorders.
Select two of the following immune disorders: HIV, psoriasis, inflammatory bowel disease, and/or systemic lupus E (SLE).
Think about the pathophysiology of each disorder you selected. Consider the compensatory mechanisms that the disorders trigger. Then, compare the resulting maladaptive and physiological responses of the two disorders.
Consider the types of drugs that would be prescribed to patients to treat symptoms associated with these disorders and why.
Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Consider how your selected factor might impact the disorder. Then, reflect on how your selected factor might impact the effects of prescribed drugs, as well as any measures you might take to help reduce any negative side effects.
Questions to be addressed in my paper:
A brief description of the pathophysiology of the immune disorders you selected.
Explain how the maladaptive and physiological responses of the two disorders differ.
Then, describe the types of drugs that would be prescribed to patients to treat symptoms associated with these immune disorders and why.
Explain how the factor you selected might impact the pathophysiology of each disorder as well as the effects of prescribed drugs.
Explain any measures you might take to help reduce any negative side effects.
Summary with Conclusion
REMINDERS:
1) 2-3 pages (addressing the 5 questions above excluding the title page and reference page).
2) Kindly follow APA format for the citation and references! References should be between the period of 2011 and 2016. Please utilize the references at least three below as much as possible and the rest from yours.
3) Make headings for each question.
RESOURCES:
Readings
Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.
Chapter 5, “Innate Immunity: Inflammation and Wound Healing”This chapter examines how the body responds to injury and infection by exploring the first, second, and third lines of defense. It also covers wound healing and alterations of the wound-healing process.
Chapter 6, “Adaptive Immunity”This chapter examines the third line of defense, adaptive immunity. It also covers the roles of antigens and immunogens, the humoral immune response, cell-mediated immunity, and the production of B and T lymphocytes in the immune response.
Chapter 7, “Infection and Defects in Mechanisms of Defense”This chapter covers the epidemiology, clinical presentation, and treatment of disorders resulting from infection, deficiencies in immunity, and hypersensitivity. It also examines the pathophysiology of an important immune disorder: HIV/AIDS.
Chapter 8, “Stress and Disease”This chapter evaluates the impact of stress on various body systems and the immune system. It also examines coping mechanisms and disorders related to stress.
Chapter 39, “Structure, Function, and Disorders of the Integument”This chapter begins with an overview of the structure and function of skin. It then covers effects of aging on skin, as well as disorders of the skin, hair, and nails.
Chapter 40, “Alterations of Integument in Children”This chapter covers alterations of the integument that affect children. These include acne vulgaris, dermatitis, infections of the skin, insect bites and parasites, vascular disorders, and other skin disorders.
Poole Arcangelo, V., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
Chapter 8, “Principles of Antimicrobial Therapy”This chapter covers factors that impact the selection of an antimicrobial treatment regimen. It also examines the clinical uses, adverse events, and drug interactions of various antimicrobial agents, such as penicillin
Chapter 12, “Fungal Infections of the Skin”This chapter explores the pathophysiology of several fungal infections of the skin, as well as related drug treatments. It also examines the importance of patient education when managing these infections.
Chapter 14, “Bacterial Infections of the Skin”This chapter begins by examining causes of bacterial infections. It then explores the importance of selecting an appropriate agent for treating bacterial infections.
Chapter 32, “Urinary Tract Infection”This chapter covers drugs used to treat urinary tract infections. It also identifies special considerations when treating geriatric patients, pediatric patients, and women.
Chapter 35, “Sexually Transmitted Infections”This chapter outlines the causes, pathophysiology, and drug treatment of six sexually transmitted infections, including gonorrhea, syphilis, and human papilloma virus infection (HPV). It also examines the importance of selecting the proper agent and monitoring patient response to treatment.
Chapter 48, “Human Immunodeficiency Virus”This chapter presents the causes, pathophysiology, diagnostic criteria, and prevention methods for HIV. It also covers various methods of drug treatment and patient factors to consider when selecting, administering, and managing drug treatments.
Yi, H., Shidlo, A., & Sandfort, T. (2011). Assessing maladaptive responses to the stress of being at risk of HIV infection among HIV-negative gay men in New York City. Journal of Sex Research, 48(1), 62–73.
Retrieved from the Walden Library databases.This study assesses behaviors and attitudes toward HIV based on knowledge about infection and advances in medical treatment. It also examines the impact of maladaptive responses to the stress of HIV risk.
Scourfield, A., Waters, L., & Nelson, M. (2011). Drug combinations for HIV: What’s new? Expert Review of Anti-Infective Therapy, 9(11), 1001–1011. Retrieved from
This article examines current therapies and strategies for treating HIV patients. It also examines factors that impact the selection of therapy, including drug interactions, personalization of therapy, costs, management of comorbidities, and patient response.
Drugs.com. (2012). Retrieved from This website presents a comprehensive review of prescription and over-the-counter drugs, including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.
Media
Laureate Education, Inc. (Executive Producer). (2012b). . Baltimore, MD: Author.This media presentation outlines principles of antimicrobial therapy.
Optional Resources
Centers for Disease Control and Prevention. (n.d.). Retrieved August 10, 2012, from
Haymarket Media, Inc. (2012). Monthly prescribing reference [Online database]. Retrieved from
Institute for Safe Medication Practices. (2012). Retrieved from
Medscape. (2012). Retrieved from

principles of principlism assignment
principles of principlism assignment
Permalink:
This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles of principlism.
Based on the “Case Study: Healing and Autonomy” and other required topic study materials, you will complete the “Applying the Four Principles: Case Study” document that includes the following:
Part 1: Chart
This chart will formalize principlism and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice.
Part 2: Evaluation
This part includes questions, to be answered in a total of 500 words, that describe how principalism would be applied according to the Christian worldview.
Remember to support your responses with the topic study materials.
APA style is not required, but solid academic writing is expected.
You are required to submit this assignment to LopesWrite. Refer to the for assistance.
This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles of principlism.
Based on the “Case Study: Healing and Autonomy” and other required topic study materials, you will complete the “Applying the Four Principles: Case Study” document that includes the following:
Part 1: Chart
This chart will formalize principlism and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice.
Part 2: Evaluation
This part includes questions, to be answered in a total of 500 words, that describe how principalism would be applied according to the Christian worldview.
Remember to support your responses with the topic study materials.
APA style is not required, but solid academic writing is expected.
You are required to submit this assignment to LopesWrite. Refer to the for assistance.

Assignment: Assessing medication history
Assignment: Assessing medication history
Permalink:
Question 1 A patient has been prescribed a Scheduled 5 drug, an example of this drug is
Question 2 A nurse has just completed a medication history on a newly admitted patient In order to complete medication reconciliation for this patient the nurse will
Question 3 A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a
Question 4 A nurse works in a private hospital and needs to administer some narcotic drugs to one of her patients Which of the following should the nurse consider when administering narcotics to patients in a hospital setting?
Question 5 Drugs have a valid medical use but a high potential for abuse, both psychological and physiologic In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription These prescriptions cannot be refilled A new prescription must be written each time Examples include certain amphetamines and barbiturates This is scheduled drug
Question 6 A nurse receives an order to administer a critically ill patient two drugs immediately (stat) The nurse begins the process by
Question 7 A nurse working for a drug company is involved in phase III drug evaluation studies Which of the following might the nurse be responsible for during this stage of drug development?
Question 8 Federal legislation dictates a lengthy and rigorous process of testing for new drugs What is the primary purpose of this testing process?
Question 9 These drugs have a potential for abuse, but the potential is lower than for drugs on Schedule 2 These drugs contain a combination of controlled and noncontrolled substances Use of these drugs can cause a moderate to low physiologic dependence and a higher psychological dependence A verbal order can be given to the pharmacy and the prescription can be refilled up to five times within 6 months Examples include certain narcotics (codeine) and nonbarbiturate sedatives This is scheduled drug
Question 10 Which of the following patients should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?
Question 11 Drugs have a high potential for abuse There is no routine therapeutic use for these drugs and they are not available for regular useThey may be obtained for “investigational use only” by applying to the US Drug Enforcement Agency Examples include heroin and LSD Which scheduled drug is this?
Question 12 A patient has taken an overdose of a vitamin/mineral supplement containing magnesium The nurse will be sure to assess
Question 13 A nurse practitioner understands when prescribing a medication that there are certain questions to address Check all that apply
Question 14 A nurse is caring for a 46-year-old patient of Chinese origin who has bipolar disorder The physician has prescribed lithium carbonate (Eskalith) to treat the disorder The nurse is aware that the lithium dose will likely be given in a
Question 15 The nurse practitioner orders Amoxicillin 250 mg/5 ml tid for 10 days? The nurse practitioner would expect the pharmacist to fill the prescription bottle with how many ml?
Question 16 A patient will begin three new medications as part of her treatment plan The nurse practitioner understands that proper disposal of medications is key when the nurse practitioner states
Question 17 A nurse is providing a patient with a list of drugs as a part of the patient’s plan of care Which of the following drug nomenclatures should the nurse use to list the drugs?
Question 18 A nurse is providing care for a 71-year-old woman who was sponsored to emigrate from Mexico to the United States 6 months ago Earlier this week, the woman slipped while getting off a bus and fractured her hip How should the woman’s nurse best exemplify cultural competence in the care of this patient?
Question 19 Which of the following serves to protect the public by ensuring the purity of a drug and its contents?
Question 20 A nurse is admitting a Mexican woman to the hospital who cannot speak or understand English The patient is alone, and there is no interpreter available When trying to communicate with the patient the nurse will
Question 21 A patient comes to primary clinic for strep throat A throat swab culture is sent to lab What information is required for the nurse practitioner to disclose on lab transmittal?
Question 22 A Native American man who lives a traditional lifestyle is scheduled to have heart surgery The tribal chief has requested that the tribe’s medicine man perform a ritual before the patient goes to surgery The nurse’s response to this request should be
Question 23 A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine The nurse should inform the patient that
Question 24 A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins The nurse understands that white Americans usually receive
Question 25 A nurse is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up This area of study is called

Assignment: CONFLICT RESOLUTION PAPER
Assignment: CONFLICT RESOLUTION PAPER
Permalink:
Directions
1. Read Finkelman (2016), Chapter 13: Improving Teamwork: Collaboration, Coordination, and Conflict Resolution, section on Negotiation and Conflict Resolution, pp. 324-333.
2. Observe nurses in a care delivery setting. Identify a recurring conflict with the potential to negatively impact patient care. Decide if delegation was an issue in the conflict. This should be from your practice setting or prelicensure experiences.
3. Provide details of what happened, including who was involved, what was said, where it occurred, and what was the outcome that led you to decide the conflict was unresolved.
4. Identify the type of conflict. Explain your rationale for selecting this type.
5. Outline the four stages of conflict, as described in our text, and how they relate to your example.
6. Propose strategies to resolve the conflict. Search scholarly sources in the library and the Internet for evidence on what may be effective.
7. Discuss if delegation was an issue in the conflict. Be specific.
8. Describe how you would collaborate with a nurse leader to reach consensus on the best strategy to employ to deal with the conflict.
9. Describe the rationale for selecting the best strategy.
10. Provide a summary or conclusion about this experience or assignment and how you may deal with conflict more effectively in the future.
1. Follow APA format. Consult your APA manual, and consider using the APA resources provided by Chamberlain.
2. Write a 5-7 page paper (not including the title or References pages) using APA format that includes the following.
a. Describe an unresolved (recurring) conflict that you experienced or observed. Identify the type of conflict.
b. Provide details of what happened, including who was involved, what was said, where it occurred, and what was the outcome that led you to decide the conflict was unresolved.
c. Outline the four stages of conflict, as described in Finkelman, and how the stages relate to your example. Decide if delegation was an issue in the conflict. Be specific.
d. Describe the strategies for conflict resolution and how you would collaborate with a nurse leader to resolve the conflict. Cites the course textbook and two scholarly sources.
e. Provide a conclusion or summary about this experience and how you may deal with conflict more effectively in the future.
f. Submit by the end of Week 3.
Read Finkelman (2016), Chapter 13: Improving Teamwork: Collaboration, Coordination, and Conflict Resolution, section on Negotiation and Conflict Resolution, pp. 324-333.
BELOW
There are three types of conflict: individual, interpersonal, and intergroup/organizational ().
· Individual conflict. The most common type of individual conflict in the workplace is role conflict, which occurs when there is incompatibility between one or more role expectations. When staff do not understand the roles of other staff, this can be very stressful for the individual and affects work. Staff may be critical of each other for not doing some work activity when in reality it is not part of the role and responsibilities of that staff member, or staff members may feel that another staff member is doing some activity that really is not his or her responsibility.
· Interpersonal conflict. This conflict occurs between people. Sometimes this is due to differences and/or personalities; competition; or concern about territory, control, or loss.
· Intergroup/organizational conflict. Conflict also occurs between teams (e.g., units, services, teams, healthcare professional groups, agencies, community and a healthcare provider organization, and so on). Sometimes this is due to competition, lack of understanding of purpose for another team, and lack of leadership within a team or across teams within an HCO.
Gets Results
A leader’s ultimate purpose is to accomplish organizational results. A leader gets results by providing guidance and managing resources, as well as performing the other leader competencies. This competency is focused on consistent and ethical task accomplishment through supervising, managing, monitoring, and controlling of the work.
Prioritizes, organizes, and coordinates taskings for teams or other organizational structures/groups · Uses planning to ensure each course of action achieves the desired outcome.
· Organizes groups and teams to accomplish work.
· Plans to ensure that all tasks can be executed in the time available and that tasks depending on other tasks are executed in the correct sequence.
· Limits overspecification and micromanagement.
Identifies and accounts for individual and group capabilities and commitment to task · Considers duty positions, capabilities, and developmental needs when assigning tasks.
· Conducts initial assessments when beginning a new task or assuming a new position.
Designates, clarifies, and deconflicts roles · Establishes and employs procedures for monitoring, coordinating, and regulating subordinates’ actions and activities.
· Mediates peer conflicts and disagreements.
Identifies, contends for, allocates, and manages resources · Allocates adequate time for task completion.
· Keeps track of people and equipment.
· Allocates time to prepare and conduct rehearsals.
· Continually seeks improvement in operating efficiency, resource conservation, and fiscal responsibility.
· Attracts, recognizes, and retains talent.
Removes work barriers · Protects organization from unnecessary taskings and distractions.
· Recognizes and resolves scheduling conflicts.
· Overcomes other obstacles preventing full attention to accomplishing the mission.
Recognizes and rewards good performance · Recognizes individual and team accomplishments; rewards them appropriately.
· Credits subordinates for good performance.
· Builds on successes.
· Explores new reward systems and understands individual reward motivations.
Seeks, recognizes, and takes advantage of opportunities to improve performance · Asks incisive questions.
· Anticipates needs for action.
· Analyzes activities to determine how desired end states are achieved or affected.
· Acts to improve the organization’s collective performance.
· Envisions ways to improve.
· Recommends best methods for accomplishing tasks.
· Leverages information and communication technology to improve individual and group effectiveness.
· Encourages staff to use creativity to solve problems.
Makes feedback part of work processes · Gives and seeks accurate and timely feedback.
· Uses feedback to modify duties, tasks, procedures, requirements, and goals when appropriate.
· Uses assessment techniques and evaluation tools (such as AARs) to identify lessons learned and facilitate consistent improvement.
· Determines the appropriate setting and timing for feedback.
Executes plans to accomplish the mission · Schedules activities to meet all commitments in critical performance areas.
· Notifies peers and subordinates in advance when their support is required.
· Keeps track of task assignments and suspenses.
· Adjusts assignments, if necessary.
· Attends to details.
Identifies and adjusts to external influences on the mission or taskings and organization · Gathers and analyzes relevant information about changing situations.
· Determines causes, effects, and contributing factors of problems.
· Considers contingencies and their consequences.
· Makes necessary, on-the-spot adjustments.
Figure 13-1?Competency: Gets results and associated components and actions
Source: U.S. Army. (2006). Army leadership: Competent, confident, and agile. Retrieved from
When conflict occurs, something is out of sync, usually due to a lack of clear understanding of one another’s roles and responsibilities. Sometimes conflict is open and obvious, and sometimes it is not as obvious; this latter type may be more destructive as staff may be responding negatively without a clear reason. Everyone has experienced covert conflict. It never feels good and increases stress quickly. Distrust and confusion about the best response are also experienced. Acknowledging covert conflict is not easy, and staff will have different perceptions of the conflict since it is not clear and below the surface. Overt conflict is obvious, at least to most people, and thus coping with it is usually easier. It is easier to arrive at an agreement when overt conflict is present and easier to arrive at a description of the conflict.
The common assumption about conflict is that it is destructive, and it certainly can be. There is, however, another view of conflict. It can be used to improve if changes are made to address problems related to the conflict. The following quote speaks to the need to recognize that conflict can be viewed as an opportunity.
When I speak of celebrating conflict, others often look at me as if I have just stepped over the credibility line. As nurses, we have been socialized to avoid conflict. Our modus operandi has been to smooth over at all costs, particularly if the dynamic involves individuals representing roles that have significant power differences in the organization. Be advised that well-functioning transdisciplinary teams will encounter conflict-laden situations. It is inevitable. The role of the leader is to use conflicting perspectives to highlight and hone the rich diversity that is present within the team. Conflict also provides opportunities for individuals to present divergent yet equally valid views that allow all team members to gain an understanding of their contributions to the process. Respect for each team member’s standpoint comes only after the team has explored fully and learned to appreciate the diversity of its membership.
(, p. 83)
This is a positive view of conflict, which on the surface may appear negative. If one asked nurses if they wanted to experience conflict, they would say no. Probably behind their response is the fact that they do not know how to handle conflict and feel uncomfortable with it. However, if you asked staff, “Would you like to work in an environment where staff at all levels could be direct without concern of repercussions and could actively dialogue about issues and problems without others taking comments personally?” many staff would most likely see this as positive and not conflict. Avoidance of conflict, however, usually means that it will catch up with the person again, and then it may be more difficult to resolve. There may then be more emotions attached to it, making it more difficult to resolve.
Causes of Conflict
Effective resolution of conflict requires an understanding of the cause of the conflict; however, some conflicts may have more than one cause. It is easy to jump to conclusions without doing a thorough assessment. Some of the typical causes of conflict between individuals and between teams/groups are “whether resources are shared equitably; insufficient explanation of expectations, leading to performance being questioned; unexplained changes that disturb routines and processes and that team members are not prepared for; and stress resulting from changes that team members do not understand and may see as threatening” (, p. 336).
Two predictors of conflict are the existence of competition for resources and inadequate communication. It is rare that a major change on a unit or in an HCO does not result in competition for resources (staff, financial, space, supplies), so conflicts arise between units or between those who may or may not receive the resources or may lose resources. Causes of conflict can be varied. An understanding of a conflict requires as thorough an assessment as possible. Along with the assessment, it is important to understand the stages of conflict.
Stages of Conflict
There are four stages of conflict that help describe the process of conflict development ():
1. Latent conflict. This stage involves the anticipation of conflict. Competition for resources or inadequate communication can be predictors of conflict. Anticipating conflict can increase tension. This is when staff may verbalize, “We know this is going to be a problem,” or may feel this internally. The anticipation of conflict can occur between units that
Figure 13-2 ?Stages of conflict
accept one another’s patients when one unit does not think that the staff members on the other unit are very competent yet must accept orders and patient plans from them.
2. Perceived conflict. This stage requires recognition or awareness that conflict exists at a particular time. It may not be discussed but only felt. Perception is very important as it can affect whether or not there really is a conflict, what is known about the conflict, and how it might be resolved.
3. Felt conflict. This occurs when individuals begin to have feelings about the conflict such as anxiety or anger. Staff feel stress at this time. If avoidance is used at this time, it may prevent the conflict from moving to the next stage. Avoidance may be appropriate in some circumstances, but sometimes it just covers over the conflict and does not resolve it. In this case the conflict may come up again and be more complicated. Trust plays a role here. How much do staff trust that the situation will be resolved effectively? How comfortable do staff members feel in being open with their feelings and opinions?
4. Manifest conflict. This is overt conflict. At this time the conflict can be constructive or destructive. Examples of destructive behavior related to the conflict are ignoring a policy, denying a problem, avoiding a staff member, and discussing staff in public with negative comments. Examples of constructive responses to the conflict include encouraging the team to identify and solve the problem, expressing appropriate feelings, and offering to help out a staff member. ( highlights the stages of conflict.)
Prevention of Conflict
Some conflict can be prevented, so it is important to take preventive steps whenever possible to correct a problem before it develops into a conflict. A staff team or HCO that says it has no conflicts is either not aware of conflict or prefers not to acknowledge it. Prevention of conflict should focus on the typical causes of conflict that have been identified in this chapter. Clear communication, known expectations, appropriate allocation of resources, and delineation of roles and responsibilities will go a long way toward preventing conflict. If the goal is to eliminate all conflict, this will not be successful because it cannot be done.
Since not all conflict can be prevented, managers and staff need to know how to manage conflict and resolve it when it exists. It is important to identify potential barriers that can make it more likely that a situation will turn into a conflict or will act as barriers to conflict resolution. First and foremost, if all staff make an effort to decrease their tension or stress level, this will go a long way in preventing or resolving conflict. In addition to this strategy, it is important to improve communication, recognize team members as members with expertise, listen and compromise to get to the most effective decision given the available data, understand the roles and responsibilities of team/staff members, and be willing to evaluate practice and team functioning.
Conflict Management: Issues and Strategies
Conflict management is critical in any HCO. When conflicts arise, then managers and staff need to understand conflict management issues and strategies. The major goals of conflict management are as follows:
1. To eliminate or decrease the conflict
2. To meet the needs of the patient, family/significant others, and the organization
3. To ensure that all parties feel positive about the resolution so future work together can be productive
Powerlessness and Empowerment
When staff experience conflict, powerlessness and empowerment, as well as aggressiveness and passive-aggressiveness, become important. When staff members feel that they are not recognized, appreciated, or paid attention to, then they feel powerless. What happens in a work environment when staff feel powerless? First, staff members do not feel they can make an impact; they are unable to change situations they think need to be changed. Staff members will not be as creative in approaching problems. They may feel they are responsible for tasks yet have no control or power to effect change with these tasks. The team community will be affected negatively, and eventually the team may feel it cannot make change happen. Staff may make any of the following comments: “Don’t bother trying to make a difference,” “I can’t make a difference here,” and “Who listens to us?” Morale deteriorates as staff feel more and more powerless. New staff will soon pick up on the feeling of powerlessness. In some respects, the powerlessness really does diminish any effort for change. As was discussed in , responding to change effectively is very important today. In addition, when staff feel powerless, this greatly impacts the organizational culture.
Power is about influencing decisions, controlling resources, and affecting behavior. It is the ability to get things done—access resources and information, and use them to make decisions. Power can be used constructively or destructively. The power a person has originates from the person’s personal qualities and characteristics, as well as the person’s position. Some people have qualities that make others turn to them—people trust them, consider their advice helpful, and so on. A person’s position, such as a team leader or nurse manager, has associated power.
Power is not stagnant. It changes as it is affected by the situation. There are a number of sources of power. Each one can be useful depending on the circumstances and the goal. An individual may have several sources of power. The common sources of power include the following:
· Legitimate power. This power is what one typically thinks of in relation to power. It is power that comes from having a formal position in an organization such as a nurse manager, team leader, or vice president of patient services. These positions give the person who holds the position the right to influence staff and expect staff to follow requests. Staff members recognize that they have tasks to accomplish and job requirements. It is important to note that a leader must have legitimate power. This is a critical concept to understand about leadership and power. However, it takes more than power to be an effective leader and manager. The leader must also demonstrate competency.
· Reward power. A person’s power comes from the ability to reward others when they comply. Examples of reward power include money (such as an increase in salary level), desired schedule or assignment, providing a space to work, and recognition of accomplishment.
· Coercive power. This type of power is based on punishment initiated when a person does not do what is expected or directed. Examples of punishment may include denial of a pay raise, termination, and poor schedule or assignment. This type of power leads to an unpleasant work situation. Staff will not respond positively to coercive power, and this type of power has a strong negative effect on staff morale.
· Referent power. This informal power comes from others recognizing that an individual has special qualities and is admired. This person then has influence over others because they want to follow the person due to the person’s charisma. Staff feel valued and accepted.
· Expert power. When a person has expertise in a particular topic or activity, the person can have power over others who respect the expertise. When this type of power is present, the expert is able to provide sound advice and direction.
Box 13-3 Types of Power
· Legitimate
· Reward
· Coercive
· Referent
· Expert
· Informational
· Persuasive
· Informational power. This type of power arises from the ability to access and share information, which is critical in the Information Age.
· Persuasive power. This type of power influences others by providing an effective point of view or argument (). ( highlights the types of power.)
All HCOs experience their own politics, and this usually involves some staff trying to gain power, hold on to power, or expand power. As has been said, power can be used negatively, and this can also lead to the unethical use of power or not doing the right thing with the power. discusses examples of ethical issues. There is no doubt that there are managers who use their power to control staff, as well as staff who use power to control other staff, but this is not a healthy use of power. Rather, it is a misuse of power and does not demonstrate nursing leadership.
A self-appraisal of a person’s personal view of power allows the individual to better understand how the person uses power and how it then affects the person’s decisions and relationships. This can lead to more effective responses to change during planning and decision making, coping with conflict, and the ability to collaborate and coordinate.
Empowerment is often viewed as the sharing of power; however, it is more than this. “To empower is to enable to act” (). Power must be more than words; it must be demonstrated. Participative decision making empowers staff but only if staff really do have the opportunity to participate and influence decisions. Recognizing that one’s participation is accepted makes a difference. True empowerment gives the staff the right to choose how to address issues with the manager.
Should all staff be empowered? A critical issue to consider when answering this question is whether or not staff can effectively handle decision making. This implies that staff members need leadership qualities and skills to make sound decisions and participate together collaboratively. They need to be able to use communication effectively. When staff members are selected, all these factors become important. Empowerment is not gained just by being a member of the staff, but rather staff members become empowered because they are able to handle it. Management who want to empower staff must transfer power over to the staff, but management must first feel confident that staff can handle empowerment.
When staff are empowered, some limits or boundaries need to be set, or conflict may develop. Some of these boundaries are established by the HCO’s policies, procedures, and position descriptions; education and experience; standards; and laws and regulations (for example, state nurse practice acts). The manager must be aware of these boundaries and establish any others that may be required (for example, direct involvement of staff in the selection process for new equipment). If staff members are involved in the decision making, then they should first be given a list of several possible equipment choices that meet the budgetary requirements and criteria to use in the evaluation process. It is critical that the manager make clear the boundaries, or staff members will feel like their efforts are useless if their suggestions are rejected because they were not given the boundaries. Setting staff up by not giving them full information leads to poor choices and is not effective. What does this mean? Roles and responsibilities need to be clearly described, and if they change, they need to be discussed. At the same time, the nurse manager or the team leader must not control, domineer, or overpower staff. This type of response is usually seen in new nurse managers or team leaders who feel insecure. Ineffective use of empowerment can be just as problematic as a lack of empowerment.
Although empowering oneself may seem like an unusual concept, it is an important one. The amount of power a person has in a relationship is determined by the degree to which someone else needs what the other person has. Anger is related to expectations that are not met, and when these expectations are not met, the person may act out to gain power. It is the responsibility of the nursing profession to communicate what nurses have to offer to patient care and to the healthcare delivery system, but individual nurses also need to understand what they have to offer as nurses. To have an impact, this communication and development must be ongoing. Empowerment can be positive if the strategies that are used to gain empowerment are constructive (for example, gaining new competencies, speaking out constructively, networking, using political advocacy, increasing involvement in planning and decision making, getting more nurses on key organization committees, improving image through a positive image campaign, and developing and implementing assertiveness). There are many other strategies that can result in empowerment that improves the workplace and the nurse’s self-perception.
Aggressive and Passive-Aggressive Behavior
Aggressive and passive-aggressive behavior can interfere with successful conflict resolution and might even be the cause of conflict. When staff members are hostile to one another, the team leader, or the nurse manager, anxiety rises. Hostile behavior can be a response to conflict. It is important to recognize personal feelings. The first response should be to get emotions under control and communicate control to the hostile staff member. The nurse manager or team leader may be the one who is hostile, which makes it even more complex and requires assistance from higher-level management. It is hoped someone will recognize the need to bring the situation under control and try to move to a private place. Demonstrations of open conflict with hostility should not take place in patient or public areas. If the suggestion to move to a private area does not work and the situation continues to escalate, simply walking away may help set some boundaries. Cool down time is definitely needed.
There are many times when more information is really required before a response can be given. If this is the case, everyone concerned needs to be told that when information is gathered, the issue or problem will then be discussed. No one should be pressured to respond with inadequate information as this will lead to ineffective decision making and may lead to further hostility. It is critical that after further assessment is completed there be additional discussion and a conclusion.
When there are conflicts with patients and families, what is the best way to cope? Many of the same strategies mentioned earlier can be used. Safety is the first issue, as it must be maintained. It is never appropriate to allow patients or families to demonstrate anger inappropriately. When this occurs, someone needs to set reasonable limits that are based on an assessment of the situation. There may be many reasons for anger and inappropriate behavior, such as pain, medications, fear and anxiety, psychosis, dysfunctional communication, and so on. Staff need to avoid taking things personally as this will interfere with thoughtful problem solving. When one gets defensive or emotional, interventions taken to resolve a conflict may not be effective. Active listening is critical to cope with emotions. If a different culture is involved, then this factor needs to be considered. (For example, some cultures consider it appropriate to be very emotional, and others do not.) In the long term, clear communication is critical during the entire process.
How Do Individual Staff Members Cope With Conflict?
Not everyone responds to conflict in the same way, and individuals may vary in how they respond dependent on the circumstances. Four typical responses to conflict are avoidance, accommodation, competition, and collaboration ().
· Avoidance occurs when a person is very uncomfortable and cannot cope with the anxiety effectively. This person will withdraw from the situation to avoid it. There are times when this may be the most effective response, particularly when the situation may lead to negative results, but in many situations this will not be effective in the long term. This response might occur when a staff member is in conflict with a manager and disagrees with the manager. The staff member must consider whether it is worthwhile to disagree publicly. Typically avoidance occurs when one side is perceived as more powerful than the other. It is a helpful approach when more information is needed or when the issue is not worth what might be lost.
· A second response is accommodation. How does this occur? The person tries to make the situation better by cooperating. The critical issue may not be resolved or not resolved to the fullest satisfaction. The goal is just to eliminate the conflict as quickly as possible. Accommodation works best when one person or team is less interested in the issue than the other. It can be advantageous as it does develop harmony, and it can provide power in future conflict since one party was more willing to let the conflict deflate. Later interaction may require that the other party cooperate.
· A third response is competition. How does this work? Power is used to stop the conflict. A manager might say, “This is the way it will be.” This closes further efforts from others who may be in conflict with the manager.
· Collaboration is the fourth response, which has been discussed in this chapter. This is a positive approach, with all parties attempting to reach an acceptable solution, and in the end, both sides feel they won something. Collaboration often involves some compromise, which is a method used to respond to conflict.
Using the best conflict resolution style can make a difference in success. There are many ways that a conflict can be resolved. When conflict occurs, each person involved has a personal perspective of the issue and conflict. Today there is more conflict in the healthcare delivery environment with increased workplace stress that may lead to misunderstandings, ineffective communication, and reduced productivity and dysfunctional organizations, as noted in the Institute of Medicine reports (, ).
Gender Issues
Are there differences in the ways in which women and men negotiate? There are differences in how women and men approach leadership issues such as conflict (). Men tend to negotiate to win, while women focus more on what is fair. It is believed that this is related to the way children play through sports and activities. Women will make an effort to reach win-win solutions. Men will test the limits that have been set more overtly than women, so it is important for women to ensure that limits are set and maintained. It is important, despite the differences described, to avoid stereotyping.
Nurse-Physician Relationships
Though the nurse-physician relationship should be the strongest relationship that nurses have to meet the needs of the patient, it frequently is not. Both sides have a role in the inadequacies of this relationship. Conflict does occur and this conflict can act as a barrier to effective patient care. Collegial relationships are those where there is equality of power and knowledge. In contrast, collaborative relationships between nurses and physicians focus on mutual power, but typically the physician’s power is greater. The nurse’s power is based on the nurse’s extended time with patients, experience, and knowledge. In addition to power, this relationship requires respect and trust between the nurse and physician. Due to these factors, it is a complex relationship.
Nurses have long worked on teams, mostly with other nursing staff. However, the nurse-physician relationships have become more important in the changing healthcare environment with the greater emphasis on interprofessional teams. Nurse-physician interactions and communication have been discussed for a long time in healthcare literature.
Physicians, however, are not the only healthcare providers nurses must work with while they provide care. (For example, nurses work with other nursing staff, social workers, support staff, laboratory technicians, physical therapists, pharmacists, and many others.) There are also other members joining the healthcare team such as alternative therapists (massage therapists, herbal therapists, acupuncturists, etc.), case managers, more actively involved insurers, and so forth. The future will probably bring other new members into the healthcare delivery system. Nurses need to develop the skills necessary to participate effectively on the team, which requires collaboration, communication, coordination, delegation, and negotiation. Communication and delegation are discussed in other chapters. It is difficult to practice today in any healthcare setting without experiencing interprofessional interactions such as nurse to physician. Effective teams:
· work

Servant Leadership and World Values
Servant Leadership and World Values
A.
Think about Greenleaf’s principles of servant leadership and what you have learned about the biblical foundation of servant leadership. Identify specific principles of servant leadership that, when employed effectively, can proliferate respect for multiculturalism and diversity within the organizations and communities they serve? Provide specific examples to illustrate your ideas.
B.
Research an international servant leader or international servant leadership organization to examine the similarities and differences in the way servant leadership is executed in Western culture and Christianity when compared with other cultures and religions. Summarize the similarities and differences you discovered and discuss which principles of servant leadership you think are universal, regardless of religious and cultural differences. Provide examples to support your opinions.
RESOURCES
Electronic Resource
1. Effective Leadership Within a Multinational Environment
Read “Effective Leadership Within a Multinational Environment,” by Rentfrow, located on the Leadership Advance Online website (2007).
e-Library Resource
1. Servant Leadership and World Values
Read “Servant Leadership and World Values,” by Rubio-Sanchez, Bosco, and Melchar, from Global Studies Journal (2013).
Unit 7
A.
In the Topic Materials you read several examples of ways that servant leadership can be displayed through true volunteerism and acts of service to others. Research an historic or current servant leader who is a true volunteer in service to others. In what ways does the person inspire leadership while building his or her own character and integrity? How does this leader exemplify the moral obligation to lead through kindness, compassion, and justice?
B.
Share the servant leadership volunteer opportunity you are completing. Discuss how you think this experience will help you develop your own character and give you experience in leading through exhibiting kindness, compassion, and justice.
RESOURCES
2. When Servant Becomes Leader: The Corazon C. Aquino Success Story as a Beacon for Business Leaders
Read “When Servant Becomes Leader: The Corazon C. Aquino Success Story as a Beacon for Business Leaders,” by Udani and Lorenzo-Molo, from Journal of Business Ethics (2013).

Assignment: Functions of testosterone
Assignment: Functions of testosterone
Permalink:
Anatomy
Which of the following is true of the biological functions of testosterone?
A. Testosterone is not secreted by the ovaries.
B. Testosterone is needed for development of female secondary sexual characteristics.
C. Testosterone stimulates ovulation.
D. Testosterone is needed for development of male secondary sexual characteristics.
Anatomy
Which of the following is true of the biological functions of estrone?
A. Estrone is required for proper development of male secondary sexual characteristics.
B. Level of estrogen degreases if the egg is not fertilized.
C. Estrone is required for proper development of female secondary sexual
characteristics.
D. Estrone affects only the reproductive organs.
Biology
What is the function of hemoglobin?
A. Hemoglobin is the protein in red blood cells that is responsible for carrying oxygen to the cells of the body.
B. Hemoglobin is a lipid in red blood cells that is responsible for carrying oxygen to the cells of the body.
C. Hemoglobin is a protein in white blood cells that is responsible for carrying oxygen to the cells of the body.
D. Hemoglobin is a protein in red blood cells that is not responsible for carrying carbon dioxide to the cells of the body.
Biology
Why is heat an effective means of sterilization?
A. Heat is an effective means of sterilization because it destroys the proteins of microbial life forms, including fungi, bacteria, and viruses.
B. Heat is an effective means of sterilization because it destroys the proteins of anaerobic microbial life forms, including fungi, bacteria, and viruses.
C. Heat is an effective means of sterilization because it destroys the lipids of microbial life forms, including fungi, bacteria, and viruses.
D. Both (B) and (C).
Chemistry:
List the enzymes whose levels are elevated in the blood serum following an MI.
A. CPK, LDH, AST, and SGOT
B. LDH, AST, and SGOT
C. CRE, AST, and ALT
D. None of the above
Chemistry
What is the physiological function of gluconeogenesis?
A. Gluconeogenesis is production of glucose from noncarbohydrate molecules in times when blood glucose levels are low. This ensures proper function of brain and red blood cells, which only use glucose as fuel.
B. Gluconeogenesis is production of glucose from noncarbohydrate molecules in times when blood glucose levels are high. This ensures proper function of brain and white blood cells, which only use glucose as fuel.
C. Gluconeogenesis is production of glucose from carbohydrate molecules in times when blood glucose levels are low. This ensures proper function of brain and red blood cells, which only use glucose as fuel.
D. None of the above