Marquis and Huston 2014 critical thinking health and medicine homework help

Reflect upon a decision you have made or a problem you have solved in the past year. Apply one of the theoretical approaches to your problem/decision. According to Marquis and Huston (2014), critical thinking is sometimes referred to as reflective thinking (p.3). What would you have done differently, if at all? Identify if you were in a leadership or management position. How would this situation be different if you were in the other position?

 

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Systems Thinking in Health Care – Case study

Case Study

Your task

Write

a

case study

in the form of a short conference paper

of

2

,000 words that

presents

a

syst

ems thinking investigation

that you have completed

about

a problematical situation

of your choice

within a

health

care

domain

.

Your case study should follow an acceptable format for an academic conference paper

that presents “work in progress”, i.e. not a

full conference paper but one that follows the

same academic conventions such as having an

abstract

, referencing appropriate

literature and following clearly explained methods.

Your

case study

should

begin with a

n

introduction

describing

the problemati

cal

situation, its scope

,

boundaries and key emergent properties

. It should also explain the

purpose of your case study and

why

it

is interesting and relevant.

Your

methods

should

include

a variety of different

systems thinking

techniques including

a Soft

Systems

Methodology enquiry and the

use of

Thinking Differently techniques

and/or other

approaches and ideas covered in the course

.

The techniques you select should

be

justified and

help you

to

explore the current situation and identify the challenges and

opportunities of taking a more holistic perspective on the situation.

The out

puts

from the

tools and techniques should be presented as the

results

.

Based on these, the

discussion

of your findings

should include a

critical,

reflective evaluation of your o

wn

analysis. Your

conclusion

should summarise the key points

,

consider whether the work

undertake

n fulfilled the stated purpose

and make recommendations for further action

research or investigation.

You

may present some of the output of your work as diagr

ams or tables within the paper

but

should

also be prepared to

reference

and make use of

appendices

to show the

detailed work.

Reports marked “Confidential” will be kept securely and seen only by those involved in

the University assessment process.

You ma

y also change the name of the organisation

to a fictional one provided you make this clear in the introduction.

Assessment Criteria

Your

case study

should demonstrate

that you

can

:

•

Apply a range of

systems thinking

techniques

, attitudes and approaches

to a

health

care context.

•

Use

appropriate

modelling

and techniques to surface

issues and opportunities

and new ways of thinking.

•

Critically

asses

s

the techniques that

you

have used

in terms of their

ap

p

ropriat

e

ness

, evidence base and

effectiveness

.

•

D

em

onstrate an understanding of the strengths and weaknesses of

applying a

systems thinking approach

.

•

Demonstrate an ability to understand and work within healthcare domains

.

Your

case study

should:

?

Be l

ogical

ly

structure

d

with a coherent argument

.

?

Use e

vi

dence

from a

range of

relevant

sources to support your discussion

.

2

?

Use good English

with correct spelling and punctuation.

?

Include a

ccu

rate and consistent referencing

using the Harvard system

.

Word Count:

2

,000 words (exclu

ding

tables, graphs

,

abstract,

appendices

and

references)

Recommended reading

CHECKLAND, P. and J. POULTER. 2006.

Learning for action: a short definitive account of soft systems

methodology, and

its use for practitioners, teachers and students

. Wiley, UK

Top of page

Other interesti

ng reading

BEER, S. 1994.

The brain of the firm

. 2nd edition. Wiley, UK

BEYNON

–

DAVIES, P. 2010.

Significance : exploring the nature of information, systems and technology

.

Palgrave Macmillan, UK

CHECKLAND, P. 1999.

Systems thinking, systems practice

. Wiley, UK

DE BONO, E. 2009.

Lateral Thinking: A Textbook of Creativity

. Penguin, UK.

SENGE, P. 2006.

The fifth discipline: the art and practice of the learning organisation

. Century Business

SWEENEY, L. 2010.

The systems thinking playbook : exercises to stretch and build learning and systems

thinking capabilities

. Chelsea

Green Publishing Company, Vermont USA.

A selection of journal papers will accompany this course.

 

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Discuss disparities related to ethnic and cultural groups relative to low birth weight infants and preterm births.

Discuss disparities related to ethnic and cultural groups relative to low birth weight infants and preterm births. Describe the impact of extremely low birth weight babies on the family and on the community (short-term and long-term, including economic considerations, on-going care considerations, and co-morbidities associated with prematurity). Identify at least one support service within your community for preterm infants and their family. Provide the link for your colleagues to view. Does the service adequately aIDress needs of this population? Explain your answer

 

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The family of Mr. Holland Park was searching for a home care that would serve the needs of their grandfather. They needed a home that would offer impeccable services that would ensure the comfort of their relative. Mr. Holland Park is suffering from several complications, including dementia, hearing problems, challenging behaviour and visual problems. His family chose my practice after recommendation from friends and other family members. The reason for their choice is the immaculate outcomes of this nursing home in that it is versatile and works to deliver on individual needs. Introduction The emphasis on special and specific needs in social careprofession has evolved to encompass all activities relatedthe users of these homes stress on their delivery of service meaning that for any home to stay in business, it should provide quality services. Another twist to this story is that auditors are sent periodically by the government to check the operations of these homes and any home found operating contrary to the codes of conduct required of them is shut down. Task 1 The perceptions of health, disability, illness, and behaviour The way people view various health issues in the society is dependent on several factors including education, socio-economic background, and even political factors. This implies that the perception of different elements such as health, behaviour, illness, and During the process of admitting Mr. Holland Park several concepts related to Analysis of the concepts of health, disability, illness, and behaviour Different phrases, elements, and concepts in healthcare have different definitions and uses in various subsections of healthcare. This section strives to analyse and define various concepts related to special care. These concepts include Health Health For instance, if Mr. Holland did not suffer from all the ailments outlined above but still had social problems some would term him healthy. However, according to this definition, Mr. Holland is unhealthy until he is in a state of complete health. This underscores the importance of care homes for people with disabilities because these homes strive to put these people in a state of complete wellbeing as defined in the paragraphs above. Disability Disability can be described as any mental, physical, and emotional impairment that restricts an individual from undertaking regular activities like walking, working, driving, eating, and even going on vacations. Mr. Holland has various disabilities ranging from hearing, seeing, dementia and even behavioural problems. The care home defined above caters for all these disabilities. In fact, the essence of the home is to enable these people to lead a comfortable life. Illness In all aspects, illness is related to both health and disability in that illness involves the state of the body just like health and disability. In essence, an illness is a state of being unhealthy in body and mind. Illnesses inhibit a person from carrying out several activities done by a healthy person. In this case, scenario Mr. Park is suffering from several illnesses, and that is the reason it becomes necessary for him to be cared for in a home. Behaviour and behavioural issues Behaviour can be defined as an individual’s character. It is the way an individual acts and conducts towards his or her environment. Most of the time the way someone relates to others is very important to the comfort of their lives. Behavioural issues often arise due to old age as the mental and physical health deteriorates. This is perhaps the reason Mr. Park exhibits these problems. The fact that he suffers from several illnesses implies that his behavioural problems are prevalent. Over the decades, the perceptions of people from different lifestyles on disability have changed considerably. the number of private practices in the UK as opposed to the past where people depended on public healthcare institutions. Moreover, the quality of care is stressed by individuals and the concerned government institutions not like in the past where did not give much importanceMoreover, people’s attitudes towards people with special needs have changed over the years prompting increased focus on their wellbeing and comfort. Indeed, Mr. Park’s family wanted a care home that would treat him with respect and at the same time offer him impeccable services. They desired to see their relative being taken care of and living in a comfortable environment, a thing they were not able to do because of their limited capabilities and busy schedules. society, and culture Several laws governing the treatment of individuals with special needs exist in the UK. Perhaps the most important law in the UK relating to individuals with specific needs is the Health Act 1999, which stipulates pooling of resources and capabilities in order to enhance the quality of service. This implies that the adoption of this Act ensures that people like Mr. Park get better services than it was in the past. The impact of culture on the services for the disabled is less compared to economic and political factors in that the current UK is modernised. The perception of people towards disability has become better than it was in the past. For instance, buildings are now constructed Several initiatives have been established to cater for people with special needs. Reports suggest that the British government has increased its funding of disability benefits. Indeed, over the last decade government spending has increased to over 30 billion pounds. Task 2 Care needs of individuals with specific needs Special health care needs comprise any developmental, sensory, mental, physical, behavioural, emotional, or cognitive impairment requiring specialized medical attention and care. These conditions arise due to several factors including old age, congenital factors, diseases, trauma, or environmental factors. This condition limits the individuals suffering from it from leading a normal life. e facility. Most of Mr. Park’s conditions are not treatable but only manageable. This implies that the treatment plan will involve training him on ways of coping with these conditions. Moreover, Mr. Park’s behavioural issues implywhich is needed so that the treatment can continue as planned. Although Mr. Park’s condition is related to old age, the whole process will begin with the identification of the causes of his behavioural issues. The preceding steps will include eliminating these causes and training him to better ways of dealing with his condition. Mr. Park will be made to know that being in the home does not mean that the family is forsaking him but are minding the eventual state of his health. The process of treatment of the other disorders will only begin after the patient has been healed of the behavioural disorders. The process will continue with finding medical remedies for the visual and hearing problems. The treatment plan will include suggestions for the diet that fits his condition. As it is evident, dementia is often caused by old age; however proper diet helps to elevate some of these problems. The main aspect of the treatment will involve putting Mr. Park in a peaceful and familiar environment. This will ease his anxiety during the treatment allowing for a faster recovery. The services available in a chosen locality my private practice have tremendous support from the community. Indeed, the UK special care institutions have augmented their services with the help of the members of the community. For instance, the people around Manchester always act as volunteers in the practice while others visit the patients to offer moral support. This is not the only initiative that supports these individuals because the government has structured several interventions to support their cause. For instance, there are several welfares established to cater for their financial needs. One of the welfares is the disability living allowance, and the other one is the reform for incapacity benefit. The services available in a chosen locality There are several prejudices against people with special needs in the UK. These prejudices increase the problems that these people go through especially in urban centres. However, government intervention and that of the private sector have allowed for the improvement of their condition. Mr. Park. Task 3 Explanation of the approaches and interventions In response to the auditor’s question, I provided him with a catalog of approaches undertaken to meet the specific needs of Mr. Holland Park. These specific needs are stated with a brief explanation as shown below: the self-help approach and evidence-based practices. The former consist of self-approach towards improving the situation. The latter comprises of services that continuously display the efficiency of the people. Interventions used in this perspective are as follows: Education interventions Mr. Park needs relevant and specific health information. Appropriate communication between healthcare personnel and the individuals provides health information. This health linked information is of great significance. Physical interventions These comprise of suitable therapies and exercises for joint movements. In this kind of intervention, there is a stipulation for exterior appliances. It assists Mr. Park in sustaining the physical status and reinstating the lost functions so that he can live normal life that he used to enjoy before. Vocational interventions This kind of intervention aims at promoting the vocational training that is appropriate to the disability level. Once trained, Mr. Park can earn something for himself, which will assist him in living an independent life. Since this kind of training enables him to suit in a working environment, he will gain confidence for the job. Lastly, we have Psychological interventions Psychological intervention is significant for an individual like Mr. Park because he has a challenging behaviour. It assists him in building positive attitude towards life and hoisting his morale. This psychoanalysis assists in treating anxiety, personality changes, suicidal tendency, and depression. Evaluation of the effectiveness of intervention strategies Psychological intervention is necessary for physical intervention to succeed. The former will enhance Mr. Park’s morale and help him in building the affirmative attitude towards life. This psychotherapy helps in treating anxiety, personality changes, suicidal propensity Discussion of the potential impact of emerging developments in support for individuals with specific needs Some of the emerging developments are certain changes to the legislation and policies from international, national For instance, a green document that puts emphasis on the importance of social welfare by cooking healthy and good meals has been launched Numerous external agencies run the scheme to assist the people like Mr. Holland Park and promote the well-being and health of the society. With healthy care partnership, they try to maintain and arouse the proper environment with healthy care partnership. The theories of behavioural change explain the reasons behind certain health behaviours. It is easy to achieve strategies for social and health providers. In line with this, the people with certain conditions and their respective caretakers must have knowledge and skills for effective communication between them and health and social care providers. In aIDition, the workers of social and health care should be able to communicate effectively with the patients and provide a solution to their questions. For people with long-term conditions, the providers should use their best expertise and knowledge to design the personalized care plans. After a thorough and a well-organized discussion with the patient, a detailed plan should be created. When designing a care plan, there should be an integrated approach by which organizations are supposed to work together in a closer manner. Task 4 Explanation of the different concepts of challenging behaviour Challenging behaviours are behaviours of such duration, frequency or intensity that the physical safety of an individual or other people is likely to be put in risk. It can also be defineIDisabilities or physical impairment. The effects of these behaviours are the ones that make them abusive or challenging. These behaviours can be aggressive, and these may include; spitting, screaming, verbal abuse, throwing objects, hair pulling, grabbing, pinching, hitting, biting and scratching. Those that are non-person directed include withdrawal, lack of awareness of danger, incontinence, and destruction of clothing, inappropriately sexualized behaviour, stealing, hyperactivity and damage to property. Others included self-injuries and stereotyped. The former entails eating things that are not food, grinding teeth, picking, eye poking, pulling, scratching and head banging. The latter entails repetitive manipulation of objects, repetitive speech, rocking and repetitive movements. There are several combination of reasons or potential reasons leading the rise of challenging behaviour. Some are simple as that of an individual who runs away just because he or she cannot cope with crowds. Others entail a complex mix of factors such as biological causes. For example, Lesch-Nyhan syndrome is associated with self-injuring behaviour because of the difference in how the brain handles hormones and chemicals. Some individuals would want to sustain the level of arousal or stimulation they want hence developing a stereotyped behaviour like rocking. Another factor is that this challenging behaviour could result as a way of communication. For instance, the need for comfort, drink or food could the reason behind this behaviour. Response to the environment is another reason for challenging behaviour. This entails over- or under-stimulation, poor physical environment especially extremes in noisy or temperature levels, inconsistencies in staff that includes training, approach, awareness and staffing levels. Lastly, challenging behaviour could be as a sign of pain, discomfort, frustration, anger, distress or abuse. At mealtimes, for instance, withdrawal of cooperation may be the only way available for showing emotions to a highly physically dependent person. The aspects influencing challenging behaviour comprises of ill health, physical disability, alcohol and drugs, fatigue, sleep disturbance, sexuality, expectations and perceptions; social factors like ethnicity, culture and relationship The potential impacts of challenging behaviour on health and social care organisations. People suffering from challenging behaviour have the following impacts. These include memory problem, communication difficulty, alcohol and drug aIDiction. It also includes demand for more financial and emotional support, unable to get on with the carer, and they do not have contact with the neighbor, friend or family hence they are isolated. The following are some of the most important risk factors of challenging behaviour. These include depression among the caregivers, abuse of substances, social isolation, and illness among the elderly or intensity of dementia. It also includes inadequate support from the caregivers, the elder’s verbal and physical aggression Analysis of the Strategies for working with challenging behaviours associated with specific needs. In the bylaw of social care worker, the code of practices, procedures, policies. should be given to these social care providers on how to handle vulnerable groups that need assistance from them. In aIDition to respecting the rights of service users, their behaviour should not harm the emotions of service users.

Earnings sometimes called the bottom line are the most important element in the life ofbeing earned by an organization. The essence of the earnings is that they indicate the degree that the company has engaged in valued aIDed activities. Earnings are a good element for the company; however, they lead to uncontrollable ambition, which may lead to fraud. The term fraud can be defined as a criminal activity that exploits one’s position, bogus representation or taking someone else’s rights for personal financial or status gain. In essence, fraud is an act of trickery where a person or a company cheats another person or company in order to obtain an individual gain. The concept of earnings give rise to another phrase termed earnings management, which, in essence, implies the control of finances in such a way as to show a good position of a company. Indeed, it is it is a sensible and legal management reporting and decision-making anticipated to attain steady and feasible financial outcomes. Earnings management is a huge term that leads to other phrases such as “caveat emptor” that implies that a customer is responsible for any financial loss on his or her part. This only happens when the buyer has been informed of the situation of the stuff he or she is buying. In this regard, this essay will delve into earnings management particularly in exchange-listed companies. It will also assess whether it is an illegality or an instance of caveat emptor for an investor in such situations.

Earnings Management Literature Review

According to Weil (2009), earnings quality and quality of earnings have no particular meaning. However, they are utilized in accounting issues, reviewing earnings management, and in analyzing business issues such as timing of transactions. This implies that the two concepts are crucial in understanding the concept of earning management and its implications. Weil (2009) also dictates that the concept of earning management is not a complex phrase rather it is a simple and a vital term in accounting and finance. This concept occurs in two situations namely 1) during a situation when a firm has a chance of making accounting decisions and 2) when a firm takes advantage of these chances.

Bishop states that earnings are a pointer aiding the direction of resource allocation in capital markets (Bishop 2001). Indeed, the hypothetical value of a firm’s earnings is represented by the current state of its earnings. According to Bishop (2001), earnings become a crucial aspect of the firm especially when it comes to firms listed on the securities exchange. This is because the state of the earnings influences the decision of an investor. Indeed, a firm with better-looking earnings is sure to attract more investors than a company with a poor state of earnings. Bishop states that the importance given to earnings in every firm has lead to the phenomenon “earnings management.” h a huge importance, earnings management is sure to lead to several illegalities as the companies try to present a good image in the stock exchange. investor puts his or her money into a wrongly rated investment (Bishop 2001). Bishop states that several listed companies in the US and the UK fix their accounts due to a host of reasons, including the deferment of accruals and increase investor confidence.

Healy & Wahlen (1999) state that earnings management is very crucial for a company that wishes to get more investors, especially in the securities exchange. They assert that obtaining resources is a very crucial aspect in a firm and that it is very important for a firm to design ways that enable it to access these resources easily. However, they state that the existence of independent auditors and the government intervention implies that firms have limited allowance to fix their earnings to their liking. Indeed, several governments require that all financial reports reflect the real state of the company and not a fictional value. Healy & Wahlen (1999) assert that it is through these financial reports the government and hence the investors, assess the financial situation of the company. In truth, the existence of financial reporting standards implies that companies should provide correct reports in a timely manner unlike what is required in earnings management.

Healy & Wahlen (1999) state that the aspect of earnings management can only be legal if the investor is well informed of the financial situation of the company. This implies that an investor can make an informed decision on the viability and the feasibility of his or her investment. Only then, they argue, is the concept of earnings management legal and practical. In another instance, they state that earnings management for companies in the stock exchange is illegal in that the stock exchange depends on the valuation of the companies to value its shares. A wrong evaluation of a company’s earnings implies that the shares in the stock exchange will be valued wrongly too. This implies that the investors will put their money 1) into wrong investments and 2) bogus projects.

Burgsahler et al. (2004) state that the pressures and the requirements of the capital markets forced firms to operate in certain ways. They state that although the morality of earnings management is low, the firms often do it for the sake of financial gains. Several markets in the capital market strive to provide a healthy picture of its fina is different from the reality. Bugrsahler et al. (2004), however, state that the existence of financial reports implies that the investors have a better chance of investing in stocks of real value. This is because the government provides stipulations requiring the firms to provide true information in the financial reports according to financial reporting standards.

Nonetheless, Burgsahler et al. (2004) state that these standards give a considerable flexibility to companies. The reporting is often founded on private information. AIDitionally, the standards are based on personal judgments. In this way, the firms may decide to use this discretion afforded to them to satisfy their interests or provide a true picture of the finances of the firm. This implies that reporting incentives play an integral role in determining the truth of the financial reports projected. For this reason, the investors are likely to be dubbed in the process of investing in such businesses.

Hail et al. (2009) summarizes the argument by stating that there are positive and negative sides to earnings management. However, they state that the benefits accrued fall to the firms rather than the investors. Nonetheless, the investors can benefit from the deal but only if the company begins to profit after the investor has entered into the company. They, however, state that the concept is illegal considering the amount of information hiIDen from the investor.

Synthesis of the Literature

It is evident that most people regard the act of fixing accounts as illegal due to the amount of information given. The rules that govern business dealings stipulate that all the parties to the deal be informed of all the circumstances surrounding the deal. However, earnings management tends to hide these items implying that there is no fairness in the deal. The literature disagrees with the notion that the concept is legal and that it is an instance of caveat emptor in case an investor is caught in such a situation.

The US and UK Regulatory Framework

The US has several measures and regulations that govern financial reporting apart from IFRS. For instance, the United States Commission on Fraudulent Financial Reporting of 1987 describes counterfeit reporting as a deliberate or careless act of omission of information resulting in deceptive financial statements. This implies that earnings management is considered a fraud according to this commission. However, according to GAAP, these activities cannot be considered as fraud but management’s discretion.

In the UK, the Cadbury report and the Accounting Standards Board assert the need for transparency in any accounting reporting. The frameworks were designed to govern the companies from fixing their earnings. However, as it is in the US, the stipulations provided by the IFRS and GAAP influence the definition of fraud in this regard.

Conclusion

Several countries, inclusive of the US and the UK allow earnings management to a certain degree. However, the aggressive aspect of the concept is deemed illegal as the firms use it to obtain finances illegally. However, the importance of the concept comes when the company needs to push accruals to a later date. This, however, does not imply that the process is wholesomely legal. The fact that the investor is left with the responsibility of assessing the company does not also mean that the concept is legal. This is because these investors depend on these financial reports, which have been fixed, to make decisions.

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Identify two or more wellness nursing diagnosis based on your family assessment.

Family Health Assessment.  Assignment

due 12 ET noon this sunday, Feb 7

Select a family to complete a family health assessment. (The family can not student’s.)

Before interviewing the family, develop three open-ended, family-focused questions for each of the following health patterns.

1.Values, Health Perception

  1. Nutrition
  2. Sleep/Rest
  3. Elimination

5.Activity/Exercise

6 Cognitive

7 Sensory-perception

  1. Self-Perception
  2. Role Relationship
  3. Sexuality
  4. Coping.

Note: Your list of questions must be submitted with your assignment as an attachment.

After interviewing the family, complete the data and analyze the responses.

In 1000-1250 words, summarize the findings for each functional health pattern for the family you have selected.

Identify two or more wellness nursing diagnosis based on your family assessment. Wellness and family nursing diagnosis are different tha standard nursing diagnosis.

 

A list of wellness and family diagnosis, from J.R. Weber’s Nurses Handbook of health assessment (5th ed), can be found at the following link. http://web.archive.org

Prepare this assignment according to the guidelines found in the APA style guide.

 

 

GRADING RUBRIC

 

Excellent 90% – 100%

20% Open-Minded, Family-Focused Questions for Each of the 11 Identified Health Patterns

The development of two to three open minded, family-focused questions for each of the 11 Identified Health Patterns that are both thoughtful in content and in how they support each other in eliciting a holistic view of the patient.

30.0 %Summarizes the Findings for Each Functional Health Pattern

Brief summarization of the findings for each functional health pattern for your family is supported by accurate details along with thoughtful reflection.

30.0 %Wellness and Family Nursing Diagnoses

Identification of two or more wellness and family nursing diagnoses that you identified about your family based on your assessment are supported by accurate details along with thoughtful reflection.

5.0 %Thesis Development and Purpose

Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.

5.0 %Paragraph Development and Transitions

There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.

5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Writer is clearly in command of standard, written, academic English.

2.0 %Paper Format (use of appropriate style for the major and assignment)All format elements are correct.

All formats correct

3.0 %Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment)

 

In-text citations and a reference page are complete. The documentation of cited sources is free of error.

PLEASE USE TURNITIN  OR THIS FREE PLAGIARISM CHECKER WWW.smallseotools.com/plagiarism-checker/

 

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Describe the legal and ethical dilemma discussed in the case study. Analyze the key ways in which a patient’s right to die relates to this specific case.

Need a 6 page APA format paper based on the case study posted below. Need the paper completed by Tuesday, January 19th, 2016 at 13:00 EST (1pm).

 

Deciding to place a loved one into a long-term care facility can be extremely difficult. Even more difficult is the thought of your loved one’s rights being violated while in long-term care. Patient healthcare rights are not as clearly defined as one would expect, and there are long-term care and other healthcare facilities that create their own sets of patient rights. However, there are also certain indisputable rights afforded to patients across the board.

Read the case study titled “A Legal and Ethical Dilemma (Posted below)

Write a six (6) page paper in which you:

  1. Describe the legal and ethical dilemma discussed in the case study. Analyze the key ways in which a patient’s right to die relates to this specific case.
  2. From your research, specify the potential repercussions for failure to comply with the wishes of a patient who has requested to withhold a life-sustaining procedure. Next, take a position on whether the patient’s right to die or the patient’s right to be protected from harm should take precedence in this case. Provide a rationale for your position.
  3. Imagine that you are a part of the ethics committee investigating this case. Determine the main facts pertaining to the issue that the committee should consider. Suggest one (1) step that the facility should take next in order to resolve the dilemma. Provide a rationale for your response.
  4. Use at least three (3) quality academic resources. Note:Wikipedia and other similar websites do not qualify as academic resources.

Your assignment must follow these formatting requirements:

  • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format.

 

Case Study: A legal and Ethical Dilemma:

Background

Mary Evelyn Greene, who has memory impairment, lives in a private room at Shady Brook Skilled Nursing Facility located in a beautiful suburb of a major metropolitan city. She has resided at Shady Brook for the past 18 months. Before moving into Shady Brook, Mrs. Greene lived independently in her own home with assistance from a private-duty nursing assistant and a housekeeper. She and her husband had resided together in this home for more than 50 years. Mrs. Greene is 89 years old and suffers from several health problems associated with aging.

Mrs. Greene has one son, David Greene. David has the power of attorney to handle his mother’s health care and other personal affairs. David works as a trial attorney in one of the city’s largest and most prestigious law firms. He owns a large home in an upscale neighborhood and works hard to put two of his children through college and another one through medical school. His home is about an hour’s drive from his workplace and about 20 minutes from Shady Brook. David’s wife Barbara has never been close to her mother-in-law and has not shown much interest in her care. Hence, caring for his mother has become a major responsibility for David, and he is having a difficult time dealing with her declining health and the onset of mild dementia. It is becoming increasingly more difficult for David to leave his law practice or the court room to deal with issues related to his mother.

Mrs. Greene’s husband was a very successful land developer who left her with a substantial estate, which meets all of her financial needs. After her husband passed away, Mrs. Greene decided to remain in her home. She was able to maintain her independence until she was 87 years old, when she began to show signs of dementia. Shortly thereafter, David moved her to Shady Brook. David also hired a part-time “sitter” to keep her mother company because she was too weak to go out of her room on her own. Mrs. Greene seems to enjoy the sitter’s company and likes the attention she gets.

Upon entering Shady Brook, Mrs. Greene became depressed over losing her independence and her home and felt a growing frustration with forgetfulness. She gradually lost her appetite, and her desire to eat continued to decline. On the other hand, Mrs. Greene seems to enjoy the smell of certain foods. The associates monitor and document her food intake and her facial expressions when she is offered different foods. Mrs. Greene is particularly fond of Susan Brown, a certified nursing assistant (CNA), who sits with her and helps Mrs. Greene with whatever little she can eat. When this occurs, her appetite shows some improvement. Mrs. Greene also responds well to volunteers who carry out activities at the facility.

Frustrated Family Member

Mrs. Greene has become too weak to eat on her own. When no one is feeding her, she leaves most of her food on the tray. Recently, she has sustained a weight loss of more than 5 pounds per week. Her plan of care needs to be reevaluated, and her situation needs immediate attention.

David has been visiting his mother quite regularly. Recently, however, his visits have become less frequent, generally two to three times per week. The associates who work on Mrs. Greene’s nursing unit have reported some changes in David’s attitude. At one time he became angry with his mother, raised his voice, and spoke to her as if she were a bad child. Although no one was present in Mrs. Greene’s room at the time, the associates working at the nursing station heard David’s loud voice. When the charge nurse went into Mrs. Greene’s room to find out why David was angry, David told her that it was none of her business. On David’s subsequent visits, the associates observed that Mrs. Greene would become agitated during David’s visits. These issues were brought to the charge nurse’s attention, and they were documented in the patient’s medical record.

The Dilemma

One day David approached the charge nurse and exclaimed that his mother had expressed that she wished to die. On his next two visits, David also told the CNAs that his mother’s desire was not to eat anything so she could just die a quick death. This was the first time the CNAs had heard that Mrs. Greene had expressed a desire to die. The associates also believed that Mrs. Greene appeared to be happier when David was not there.

Before the week was over, David came into the facility early in the morning on his way to work. He handed a sealed envelope to the incoming charge nurse on the day shift. The envelope was aIDressed to Betty Wright, Shady Brook’s administrator. David said to the charge nurse, “I have been telling you people that my mother wishes a speedy death. Tell your administrator that I will be filing a lawsuit if my mother’s wishes are not carried out.” David left without visiting his mother.

Betty Wright decided to place the issue on the ethics committee’s agenda for that same afternoon. As a safeguard, Betty also notified the facility’s liability insurance carrier of the potential legal action.

Meeting of the Ethics Committee

That afternoon, Betty met with members of the ethics committee: chaplain, medical director, director of nursing, charge nurse, social worker, two CNAs, and the local ombudsman. Betty began the meeting with these remarks: “The man’s mother has been declining rapidly and eats very little. He wants his mother to die rather than prolong her suffering. I have learned that the son is the heir to his mother’s estate, and my overall concern is my trust in his decision or his motives. I think he needs the money to pay for the college expenses for his three children. Although it is not uncommon for some residents to be ignored by family after they are admitted, it is rare that they express the wish to enable the death of a relatively healthy person.” The ethics committee is faced with the issue of what is legally and ethically appropriate. The committee deliberates on whether or not to comply with David’s request to withhold food as well as the threat of a lawsuit.

 

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Discuss ways to solve health disaster management.

Topic: Health disaster management

 

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Nike Company wants to develop a cost formula for its maintenance costs to estimate such costs for the coming year….

Nike Company wants to develop a cost formula for its maintenance costs to estimate such costs for the coming year. The following data are available Month Direct Labor Hours Maintenance Costs Incurred January 4,000 $ 900 February 6,500 1,325 March 7,000 1,500 April 5,500 1,150 Using the high-low method, what is the cost formula for maintenance costs? a. $500 + $1.00 per direct labor hour b. $300 + $1.50 per direct labor hour c. $100 + $0.20 per direct labor hour d. $200 + $0.10 per direct labor hour 3. If sales are $80,000, variable costs are $50,000, and fixed costs are $20,000, the contribution margin ratio is a. 37.5% b. 12.5% c. 62.5% d. 25.0% 4. At the breakeven point a. Sales will be equal to variable costs plus target profit b. Sales will be equal to variable costs plus fixed costs c. Sales will be equal to fixed costs plus target profit d. Fixed costs will be equal to variable costs 5. An increase in the breakeven point can be caused by a. an increase in desired profit. b. an increase in selling price per unit. c. an increase in variable cost per unit. d. a decrease in total fixed cost. EXTRA CREDIT (Worth 2 points) 4. Acme, Inc. manufactures pencils which sell for $7.50 each. Acme expects to sell 82,000 pencils next quarter. At this level of sales, variable expenses will total $184,500 and fixed expenses will total $242,130. How many pencils will Acme have to sell next quarter to breakeven? Hint First determine the VC per unit. a. 32,284 pencils. b. 46,120 pencils. c. 56,884 pencils. d. 345,900 pencils.

 

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Nursing homes

Course Paper Instructions

Overview: In this assignment you will write an analytic essay that examines a social institution using your sociological imagination and the theoretical perspectives learned in our class. Please choose one of the following social institutions and follow the directions below to write your paper: Religion, Medicine/Healthcare, Family, Education, Government, Science/Technology, Sports, the Military. Due to extensive coverage in our regular class meetings, you may not choose the Economy or the Media as your main topic, however, bringing them into your analysis is appropriate, as the economy and media are connected to all of our institutions in many ways.

Instructions: After choosing an institution, do some background research to solidify your knowledge of the institution and its general features. If you choose an institution that is covered in our class text, the information in related chapter is a good place to start. After your background reading and reflection on your institution’s place in our society, you will be analyzing your topic using your sociological imagination and theoretical perspectives. It’s important to keep this in mind, as your paper should not be a typical “research paper.” Though I like creativity and I’m flexible in how you present your work, your paper should contain many of the following elements and analysis:

  1. Macro analysis of the institution from the Functionalist Perspective
  • What societal need does this institution fulfill? Manifest functions? Latent functions?
  • How is it integrated with other major institutions in our society? (Economy, Media, etc.)
  • How does this institution promote things like order, stability, value consensus, norms?
  • Provide and cite at least one media example in the above analysis to demonstrate application
  1. Macro analysis of the institution from the Conflict Perspective
  • Does this institution have internal conflicts or competing groups?
  • How does this institution conflict with other major institutions in society?
  • Does this institution support inequality, oppression, competition, or struggle?
  • Is this institution a source of value conflicts, competing ideologies, or other “dysfunctions?”
  • Provide and cite at least one media example in the above analysis to demonstrate application

III. Micro analysis of the institution from the Interactionist Perspective

  • How does this institution shape groups/people’s behavior and reality constructions?
  • What cultural scripts, norms, values, and statuses/role sets come from this institution?
  • What are some common symbols/interpretations associated with the institution and its groups?
  • Using theories of interaction like dramaturgy and exchange theory, how could you explain some of the

behaviors associated with this institution?

  • Provide and cite at least one media example in the above analysis to demonstrate application
  1. Summary analysis and concluding remarks.

AIDitional Requirements: In aIDition to using your text or other general sociological resources to analyze your institution, please use and cite a minimum of one media example for each theoretical perspective. News articles, documentary films, books, and realistic fictional sources are all acceptable examples. Real life, non-academic examples are preferred. Your paper should explain many of the above concepts as they apply to your institution, then it should demonstrate understanding of these concepts by applying them directly to examples in the articles. If you need clarification on this instruction and help selecting appropriate articles, please ask. You may use any standard citation format such as MLA, ASA, or APA. Papers should be 4 to 5 pages long, typed, double-spaced with an 11 or 12 font and 1? margins; your name and class info should be in the upper, right corner with a single staple in the left corner. No title pages or plastic protectors, please.

 

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