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After completing the reading, what are your thoughts on practice differences between the RN and the BSN-prepared nurse? What have you heard (if anything)? Think about the differences between the 2-year RN and the BSN… If you have no experience or contact to draw upon, ask someone! (a nurse you might know, someone else at the college, check online resources, etc.)
Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
Communication is so very important. There are multiple ways to communicate with me:
Value-based care in nursing refers to the quality of healthcare services offered to patients. It is a system of care that was introduced to tackle the problem of a shift in the demographics, rampant poor quality outcomes, and the ballooning cost of healthcare. In contrast, the fee-for-value system is where health outcomes/quality is measured based on what the customer can afford. In simple terms, value means that high-end customers get high-quality healthcare services whereas low-end customers get a lower quality of healthcare services. Fee for value is a highly controversial system because the model is simply a reward for expensive interventions.
Value-based care creates room for Interprofessional collaboration leading to improved patient outcomes. In the fee-for-value system, healthcare facilities work against each other to increase their profits. In this system, patients are merely seen as customers who bring in money. Thus, the more customers the higher the profitability. Based on this analogy, healthcare facilities work in competition against each other. Conversely, in a value-based system, the focus is on improving the health of patients which means that doctors and nurses from the same and different healthcare facilities collaborate with the view of improving patient outcomes.
Value-based care reduces costs for patients while it advocates for better outcomes. The words value and quality are the lifeblood of value-based care which means patients pay less for quality healthcare services. In most cases, the focus of value-based care is preventative care which is less costly compared to treating chronic ailments such as diabetes, hypertension, or cancer. Based on this analogy, value-based care aims to educate and sensitize members of the public to adopt a healthy lifestyle that would prevent them from contracting these chronic diseases.
Besides advocating for the members of the public to live healthy lifestyles, value-based care uses models of treatment that make patients spend less on medication as they get their health back on track. By focusing on prevention as its core modus operandi, value-based care ensures that patients use less money for medication because they are healthy. For example, value-based care helps to eliminate poor habits such as smoking, obesity, excessive alcohol consumption, and overeating. These factors are the biggest contributors to chronic conditions.
Value-based care promotes patient satisfaction which is a critical benchmark in the provision of quality healthcare. Healthcare facilities can use patient satisfaction as a measurement for their performance. Duly, healthcare facilities that satisfy their customers through high-quality healthcare get rewarded with a good reputation. Value-based care’s sole focus is the health of patients which means the overall long-term goal of this model is improving the quality of life of societies (World Health Organization, 2017).
This model of operation runs on the mantra that the healthier the nation, the less money is spent on healthcare. This statement is true because most developed countries today have a huge budgetary allocation for health especially for treating people suffering from chronic diseases that could have been prevented if people adopted a healthier lifestyle.
The model of value-based care has transformed the practice of medicine due to a reduction in medical errors. As mentioned earlier, the focus of value-based care is the quality of healthcare accorded to patients. For this reason, value-based care has adopted the core values of professional nursing that impact the quality of care (Gray, 2017). The core values of nursing practice used in value-based care include; altruism, autonomy, human dignity, integrity, and social justice. These core nursing practices define how nurses, physicians, and other medical professionals dispense their duties. These core values require medical professionals to dispense their duties with the utmost care, professionalism, justice, and knowledge.
In the fee-for-service model, physicians, nurses, and hospitals are paid based on the number of services provided each day. For example, if a doctor sees ten patients in a day, he gets paid for those ten patients based on the price of each treatment. In simple terms, doctors, nurses, and hospitals are paid based on the number of patients they attend each day, thus, the higher the number of customers, the better. The healthcare providers working under the fee-for-service model get compensated on the number of visits, tests, and medical procedures. Consequently, this model seeks to increase the number of patients/customers because they are profit-motivated.
On contrary, physicians and nurses under the value-based care model are compensated for the quality of care they provide, not quantity. This type of model is customer-centered and takes a more team-oriented approach where different health professionals and healthcare facilities collaborate to improve patient outcomes (Gray, 2017). Another critical feature of value-based care is that the health professionals under this model have more accountability because the expectations put on them concerning patient outcomes are much higher than their colleagues -for working in the fee-for-value model.
Value-based care boosts the reputation of healthcare facilities. Today, patient safety is one of the parameters for judging healthcare facilities. Patient safety is at the top of many hospitals because patients do not want to go to healthcare facilities that have a bad reputation concerning safety (World Health Organization, 2017). Many patients would rather pay more to get medication from hospitals with good quality patient care.
The quality of healthcare to patients is impacted by the environment where the care is given. The relationship between nurses and physicians directly impacts the quality of care to patients. Strained relationships between nurses and physicians adversely affect the quality of care whereas positive relationships between nurses and physicians result in positive patient outcomes. While tensions are common in any workplace, however, these can be solved through proper communication between co-workers. Proper communication between nurses and doctors can alleviate unnecessary conflicts and misunderstandings (Siedlecki, & Hixson, 2017). For example, doctors must make clear orders to nurses so that there are no misunderstandings when attending to patients. Most importantly, there must be mutual respect between physicians and nurses for a conducive work environment to prevail.
Physicians must treat nurses as equal partners in dispensing healthcare to patients. The truth is that doctors cannot operate without nurses and the reverse is also true. Based on this analogy, nurses and physicians must work closely together to offer quality healthcare to patients (Siedlecki, & Hixson, 2017). In terms of ranking, physicians rank higher than nurses in any healthcare-giving facility. However, in terms of dispensing their duties to patients, the two must work closely together sharing power, skills, and knowledge, in the effort to provide quality care to patients.
Shared power between nurses and physicians enhances patient safety. Patient safety in hospitals reduces risks of harm or injury. The objective of patient safety is to curb risks and harm that may happen to patients during their stay or visit to healthcare facilities (Burgener, 2020). Patient safety is a critical factor in quality care while reducing errors that harm both patients and hospitals (Burgener, 2020). Today, patient safety is a phenomenon that healthcare facilities cannot ignore. Facilities that do not take patient safety seriously suffer from costly lawsuits and damaged reputations.
Value-based care has numerous benefits to patients and healthcare facilities. To patients, the biggest advantage of this health model is improved outcomes, safety, and quality of care. Concerning quality, value-based care provides quality care to patients because all systems work together in collaboration for the benefit of patients. For healthcare facilities, the idea of patient satisfaction creates a good reputation which in turn translates into profitability. Another critical advantage of value-based care is that it reduces the cost of medication.
The fact that this model of healthcare emphasizes primary prevention means that people spend less money on health. In contrast, the fee-to-service health model emphasizes quantity rather than quality. This means that physicians and nurses are compensated based on the number of patients they attend. This type of care does not emphasize the quality of care provided. Its mode of operation is that customers get different quality of care depending on their pocket.
Value-based care in nursing refers to the quality of healthcare services offered to patients. It is a system of care that was introduced to tackle the problem of a shift in the demographics, rampant poor-quality outcomes, and the ballooning cost of healthcare. In contrast, the basis for fee-for-value system rests on measuring health outcomes/quality based on what the customer can afford. In simple terms, value means that high-end customers get high-quality healthcare services whereas low-end customers get lower quality of healthcare services. Fee-for-value is a highly controversial system because the model is simply a reward for expensive interventions.
Value-based care creates room for interprofessional collaboration leading to improved patient outcomes. In the fee-for-value system, healthcare facilities work against each other to increase their profits. In this system, patients are merely seen as customers who bring in money. Thus, the more customers the higher the profitability. Based on this analogy, healthcare facilities work in competition against each other. Conversely, in a value-based system, the focus is on improving the health of patients which means that doctors and nurses from the same and different healthcare facilities collaborate with the view of improving patient outcomes.
Value-based care reduces costs for patients while it advocates for better outcomes. The words value and quality are the lifeblood of value-based care which means patients pay less for quality healthcare services. In most cases, the focus of value-based care is preventative care which is less costly compared to treating chronic ailments such as diabetes, hypertension, or cancer. Based on this analogy, value-based care aims to educate and sensitize members of the public to adopt a healthy lifestyle that would prevent them from contracting these chronic diseases.
Besides advocating for the members of the public to live healthy lifestyles, value-based care uses models of treatment that make patients spend less on medication as they get their health back on track. By focusing on prevention as its core modus operandi, value-based care ensures that patients use less money for medication because they are healthy. For example, value-based care helps to eliminate poor habits such as smoking, obesity, excessive alcohol consumption, and overeating. These factors are the biggest contributors to chronic conditions.
Value-based care promotes patient satisfaction which is a critical benchmark in the provision of quality healthcare. Healthcare facilities can use patient satisfaction as a measurement for their performance. Duly, healthcare facilities that satisfy their customers through high-quality healthcare get rewarded with a good reputation. Value-based care’s sole focus is the health of patients which means the overall long-term goal of this model is improving the quality of life of societies (World Health Organization, 2017).
This model of operation runs on the mantra that the healthier the nation, the less money is spent on healthcare. This statement is true because most developed countries today have a huge budgetary allocation for health especially for treating people suffering from chronic diseases that could have been prevented if people adopted a healthier lifestyle.
The model of value-based care has transformed the practice of medicine due to a reduction in medical errors. As mentioned earlier, the focus of value-based care is the quality of healthcare accorded to patients. For this reason, value-based care has adopted the core values of professional nursing that impact the quality of care (Gray, 2017). The core values of nursing practice used in value-based care include altruism, autonomy, human dignity, integrity, and social justice. These core nursing practices define how nurses, physicians, and other medical professionals dispense their duties. These core values require medical professionals to dispense their duties with the utmost care, professionalism, justice, and knowledge.
In the fee-for-service model, physicians, nurses, and hospitals are paid based on the number of services provided each day. For example, if a doctor sees ten patients in a day, he gets paid for those ten patients based on the price of each treatment. In simple terms, doctors, nurses, and hospitals are paid based on the number of patients they attend each day, thus, the higher the number of customers, the better. The healthcare providers working under the fee-for-service model get compensated on the number of visits, tests, and medical procedures. Consequently, this model seeks to increase the number of patients/customers because they are profit motivated.
On the contrary, physicians and nurses under the value-based care model are compensated for the quality of care they provide, not quantity. According to Gray (2017), this model is customer-centered and takes a more team-oriented approach where different health professionals and healthcare facilities collaborate to improve patient outcomes.
Another critical feature of value-based care is that the health professionals under this model have more accountability because the expectations put on them concerning patient outcomes are much higher than their colleagues working under the fee-for-value model. Value-based care boosts the reputation of healthcare facilities. Today, patient safety is one of the parameters for judging healthcare facilities. Patient safety is at the top of many hospitals because patients do not want to go to healthcare facilities that have a bad reputation concerning safety (World Health Organization, 2017). Many patients would rather pay more to get medication from hospitals with good quality patient care.
A number of factors impact the quality of healthcare offered to patients, among them, the environment where the care is given. The relationship between nurses and physicians directly impacts the quality of care to patients. Strained relationships between nurses and physicians adversely affect the quality of care whereas positive relationships between nurses and physicians result in positive patient outcomes. While tensions are common in any workplace, it is possible to resolve them through proper communication between co-workers. Arguably, Siedlecki and Hixson (2017) contend that proper communication between nurses and doctors can alleviate unnecessary conflicts and misunderstandings. For example, doctors must make clear orders to nurses so that there are no misunderstandings when attending to patients. Most importantly, there must be mutual respect between physicians and nurses for a conducive work environment to prevail.
Physicians must treat nurses as equal partners in dispensing healthcare to patients. The truth is that doctors cannot operate without nurses and the converse is also true. Based on this analogy, nurses and physicians must work closely together to offer quality healthcare to patients (Siedlecki, & Hixson, 2017). In terms of ranking, physicians rank higher than nurses in any healthcare facility. However, in terms of dispensing their duties to patients, the two must work closely together sharing power, skills, and knowledge in the effort to provide quality care to patients.
Shared power between nurses and physicians enhances patient safety. Patient safety in hospitals reduces risks of harm or injury. The objective of patient safety, according to Burgener (2020) is to curb risks and harm that may happen to patients during their stay or visit to healthcare facilities. Today, patient safety is a phenomenon that healthcare facilities cannot ignore. Facilities that do not take patient safety seriously run the risks of encountering costly lawsuits and damaged reputations.
Value-based care has numerous benefits to patients and healthcare facilities. To patients, the biggest advantage of this health model are improved outcomes, safety, and quality of care. Concerning quality, value-based care provides quality care to patients because all systems work together in collaboration for the benefit of patients. For healthcare facilities, the idea of patient satisfaction creates a good reputation which in turn translates into profitability. Another critical advantage of value-based care is that it reduces the cost of medication.
The fact that this model emphasizes primary prevention means that people spend less money on health. In contrast, the fee-to-service health model emphasizes quantity rather than quality. This means that physicians and nurses are compensated based on the number of patients they handle. This type of care does not emphasize the quality of care provided. Its mode of operation is that customers get different quality of care depending on their pocket.
Please note: In the writing of this Capstone paper, avoid the use of first person. Examples of first person are the following: I, me, we, our, and us. You may refer to yourself as the author or the student.
Please identify a nursing problem within your specialty track: Nursing Education or Nursing Leadership and Management. Discuss why the problem requires an evidence-based practice change, quality improvement, or innovation. How did you identify the problem? Is it a nurse sensitive indicator that you or your peers have identified? What observations of your own or comments made by your peer group, management team, and other members of the transprofessional team help identify this problem?
For project ideas, please see your Field Experience Course of Study – Introduction section. The scope of your project must address all aspects included in the course evaluation rubric. The Field Experience Course is designed to guide you to the successful completion of your Capstone project planning. You will plan an evidence-based practice change, quality improvement, or innovation during the Field Experience course; this may require up to 12 weeks. Then you will implement your evidence-based practice change, quality improvement, or innovation within your Capstone course; this may require up to 6 weeks. Your project should be completed within 18 weeks from start to completion, including writing your project report. If you are considering a large-scale project within your work setting that will exceed these time frames, you should identify a way to narrow the scope of the project to meet these course requirements. Your project must be REASONABLE with the goal of graduation in mind.
This section will include a general description of the evidence-based practice change, quality improvement, or innovation that your organization is interested in, actively engaged in, or willing to support. This will provide a framework for your actual Capstone project, which is comprised of the action steps that you will actually, complete (or have completed) in support of your organization’s practice change, quality improvement, or innovation. You will need to be specific. For example, your organization may be interested in changing the policy or approach to patient triage in your emergency department. However, this policy change/process improvement will take several months and system wide resources to complete. You will not have sufficient time or resources to complete the entire policy change/process improvement within the scope of your Capstone project.
In addition, due to organizational constraints or your position in the organization, you may not have the capacity to effect the policy/process improvement in its entirety. Nevertheless, you are in a position to influence change by developing a specific component in support of changing the triage process. Therefore, your project will involve a smaller scope, which you must fully develop. Your part of the project may involve the following: 1) Developing a schematic for the new triage process, 2) Developing a new policy for implementing the new triage process, 3) Developing a new educational offering about the new triage process, and/or 4) Providing a presentation of the evidence that supports changing the triage process to stakeholders that are in a position to effect the change that you are advocating.
Your Capstone project will then focus on what you will do (or did) to influence change within your organization; your specific component can be part of the larger change that is taking place within your organization. The goal is for you to be succinct, yet provide sufficient detail to ensure readers have a clear understanding of what your specific contribution to the organization’s practice change, quality improvement, or innovation is all about.
This section includes a description of why the change, quality improvement, or innovation is required. Please respond in paragraph format. A paragraph contains a minimum of five sentences. Each paragraph supports a separate and distinct idea.
This section involves factors, issues, or phenomenon that helped to create the problem. Please respond in narrative paragraph format. Each paragraph supports a separate and distinct idea. What is the cause of the problem in your area of practice? What are you and/or your peers seeing in your practice setting? What factors contribute to the problem?
Your stakeholders are people internal or external to your organization that have a key interest in or can have a significant impact on your proposed change. Examples of stakeholders include, but are not limited to patients, nurses, physicians, administrators, support or ancillary care staff, family members, volunteers, etc. You will need to include the positions or roles each of the stakeholders hold in your discussion. For example, the CNO, unit manager, staff nurse, educator, quality improvement office, spouse, etc.
Stakeholders’ interest, power, and influence. This section involves a more detailed discussion about the specific interest, power, and influence (role) that each stakeholder has in relation to your proposed change. For example, hospital administration or the administration of a university can be stakeholders. They would have a heavy interest in any changes made within their facilities and have the power to approve or deny your project. Physicians, practitioners, or nurses may have a positive or negative influence on your project. Informal leaders also have power and influence. Your challenge is to identify the specific interest, power, and influence each of the identified stakeholders has in relation to your specific project. Please be sure to address all three aspects of interest, power, and influence for each stakeholder group identified.
This section should include a detailed description of what the proposed evidence-based practice change, quality improvement, or innovation will accomplish. What specific change will your project bring about? What do you hope to accomplish for the organization and/or stakeholders by implementing your proposed change?
This section involves presenting a succinct and clear description or statement of your proposed evidence-based practice change, quality improvement, or innovation. The description must include specific information about what you intend to do (change). Based on your current position within the organization, this may also involve what you plan to do to influence change. You may serve as a change agent within your organization. Your proposed solution should include who will be involved, what will be done, and where your proposed project will take place.
This involves a narrative discussion summarizing the five scholarly sources that were reviewed. The Evidence Summary should not be an Annotated Bibliography (separate critique) of the five sources. Instead, it should identify the areas where consensus among the various authors of the sources exists. The findings, positions, and recommendations included in your Evidence Summary should be consistent with the recommendations you are proposing for your Capstone project. This section will require the use of in-text citations using each of the five sources. A reference list for the evidence summary in APA format that includes five scholarly, peer-reviewed sources that were published within the last five years will be included in the References section of the paper. Remember, this evidence summary is your preliminary support for your project. Be sure your support is adequate.
Plan of Action
This section should provide a detailed plan of action. You will need to provide information about the specific steps that will be required to complete your Capstone project. This section may also include a description of meetings and agreements (support commitments or negotiations) in preparation for your project prior to actual implementation. You should include proposed meetings with your preceptor and/or stakeholders, plans for educating stakeholders (if necessary), goals, and any additional steps for the successful implementation of this project. While an exact step-by-step plan is not needed and may not be possible to include at this phase of your project development, you must provide a clear, succinct explanation of your proposed plan of action.
Timeline
Your proposed timeline should include general information about when the various milestones in your project are anticipated to be achieved. For example, Week 1 of the project will include…. Weeks 2-4 will involve….. Week 5 will involve…. Weeks 6 and 7 will provide for…. etc. The timeline can be displayed using a variety of options including tables, graphics, in addition to a narrative discussion of the milestones. You do not need to provide specific dates, however; you should provide an estimation of the time involved with each step.
Required Resources and Personnel
This section involves a narrative discussion about any resources required for the planning and implementation of your project. Resources may include financial support, time, classroom space, printing costs, equipment, personnel adjustments, or reallocation of staffing.
Proposed Change Theory
This discussion should identify the specific change theory you have chosen to guide and inform your project. You will need to include the details of the change theory you believe will be most effective in your area of nursing practice. This detailed discussion should correlate the actions/activities relevant to your project with each stage/phase/step of the Change Theory you identify. In-text citation(s) are required in this section.
Barriers to Implementation
This section involves a discussion about potential barriers you may encounter with the implementation of your project. This discussion may include ways you plan to address or mitigate the potential barriers.
NOTE: This section only applies to Education Specialty track students. This section requires a description of the learning objectives and anticipated outcomes associated with your Capstone project. For example, you will need to identify objectives and outcomes if you are planning an education offering, training module, simulation, training exercise, return demonstration activity, new or revised course or curriculum. Learning objectives and outcomes should be articulated in clear and concise terms. In-text citations may be required to support your chosen objectives and outcomes.
Please note that this document outline is only a guide. The written paper, including all in-text citations, must be written in proper APA style. All references (sources) should be identified using in-text citations in the body (narrative portion) of the paper. All of the included sources should be included in the References section.
A patient has filed a $3 million medical malpractice lawsuit against St. Patrick Hospital. In light of the patient’s litigious background and the facts of the case, hospital administration is adamant that it is not liable. It has instructed its legal counsel to proceed toward trial, where it may be absolved of liability.
Please number your responses so that I know which questions you are answering. Questions 1 and 3 probably only require one sentence. The remaining questions require a few sentences or a paragraph! Be sure to cite your sources!
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized.
Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
The approval by the project’s sponsor and host facility is complete. Approval was attained by reviewing the charter and signing against the titles of assigned parties. The scope and charter of the project consisted of implementing a standardized accurate integumentary informatics system for assessing and documenting Pressure Injuries, PrI. Reinventing the practicum site facility’s electronic medical records was mandatory. The first phase of intervention entailed educating physicians and nurses on approaches of utilizing CMS QRM in reporting PrI (Eslami, Sardar & Abbasabadi, 2020). The second phase was training the care providers on dual skin management and assessment via admitting the nurses and physicians in an accredited wound ostomy department.
All organizational governance processes were executed as required. Proper communication procedure were applied to convey information to all stakeholders, including the sponsors, project manager, IT manager, team members, nurses and physicians (Muszynska, 2016). Communication involved reporting the progress, alerting team members of upcoming events, serving as reminder for meetings and acting as reminder for training sessions during the processes of project initiation and implementation.
The defined project management processes were applied avidly. The Gantt Chart provided a graphical representation that assisted the process of planning, coordination and tracking the EMRA gateway project (Baim-Lance, Onwuegbuzie & Wisdom, 2020). The managers applied change management improvement via teams, measuring change processes, risk management and a reliable communication plan.
The parties involved completed the administrative closing of all procurements and contracts, while all contractual obligations toward each other were signed off. In addition, completion of the project was formally recognized including transition of operations. Significant components of the closure include monitoring and controlling measures as well as reviews. Worth-noting, the benefits of the projects were validated against the business case. The specific advantages of the project consist of augmentation of documentation and identification of PrI, with consequent increase in competency and accuracy in documentation and treatment (Eslami, Sardar & Abbasabadi, 2020). Also, integration of EMR will assist in identifying and documenting PrI.
Notable lessons were completed including the roles of teams in project implementation, establishment of adequate risk management strategies and assignment of tasks to project teams to meet the project schedule (Baim-Lance, Onwuegbuzie & Wisdom, 2020). Engagement of different stakeholders in the project could be done better, particularly the executive management such as the facility’s Chief Executive Officer and governmental agencies.
The project resources were disbanded, making them free for other projects. The resources included the Electronic Medical Record Algorithm, additional desktop computers and stationery for the health personnel to use during the training. Nonetheless, the facility had existing desktop computers with an EMR that has been running efficiently. The incorporated algorithm was added as an update to the latest version of the CMS QRM software.
The project deliverables to the consumer demonstrate seamless operations and support. Regular updates and trainings to the health care providers ensure that the Electronic Medical Record Systems are reliable and free from redundancy, besides other complications. Providing the required skills to the technical teams ensures proper running of EMR systems for a more satisfying patient experience.
Final Project Closure Assessment – Appendix A
Type of Project Closure _________ Project Manager____________ Date:
Health history and physical examination are integral in diagnosing patients. The questions asked during the two procedures determine the outcome and diagnosis made during an assessment. Nurses must be keen when taking the health history so that they do not miss important patient health details. This essay analyzes essential questions for a patient in health history and physical examination that informed a diagnosis and necessary confirmatory diagnostic tests.
The crucial questions include what is the duration of the cough? The question helps differentiate between chronic and acute cough because they have different etiologies. What are the cough characteristics? The severity, intensity, and characteristic of the sputum help determine the underlying cause.
In this case, thick phlegm could indicate other problems such as tuberculosis. A prolonged dry cough could be indicative of other problems such as asthma and pertussis (O’Grady et al., 2017). What are the aggravating and relieving factors? The question helps determine an already working therapy and informs patient education. They also help rule out other respiratory problems such as allergies
Have you had exposure to people with similar symptoms? Exposure to sick individuals coupled with poor hygiene leads to infection with communicable diseases. What are the associated symptoms? Different diseases have different symptoms associated with cough, and in this case, the symptoms are synonymous with PNA. Are you active? Diseases affect an individual’s activity level depending on the severity and virulence of the disease-causing microorganism.
Do you have ear problems? Ear, nose, and throat infections are often synonymous and quickly spread among the three organs. Family history of respiratory illnesses is another vital question. Some diseases carry some genetic predisposition, such as cystic fibrosis (Haga & Orlando, 2020). Family history helps rule out some of these diseases.
Diagnostics studies are integral as adjunct or confirmatory tests for specific diagnoses. These tests include radiologic and blood tests (Kosack, Page, & Klatser, 2017). The most common tests are blood tests. In this case, a complete blood count with white blood cells differentials is an important diagnostic test. A chest X-ray is also required to check for inflammation of the lungs. Pulse oximetry readings are also essential to determine if the patient is in any respiratory distress. These diagnostic tests also help determine severity of a disease and thus, inform treatment and other interventions.
Health history taking and physical examination reveal much information, as seen above. Nurses must be proactive in health history taking because it contains valuable health information. In addition, diagnostic tests are necessary in many conditions. The diagnostic tests also inform patient management, as seen.
A client presents with a chief complaint of a cough that has lasted for a while. The cough was accompanied by fever and green sputum. However, recenty, the sputum has been blood-stained. The presenting problems mainly stem from the respiratory system. For this patient with respiratory system problems, a focused respiratory system health history and a focused physical examination are integral to determine the diagnosis and prognosis.
A focused health history narrows down assessment to a specific system or organ/body region to detect possible errors without wasting time on non-affected areas (Wan & Zeng, 2020). According to the presenting problems, the patient has problems with the respiratory system; hence a focused respiratory system history is integral. The onset, duration, and frequency of the symptoms are integral in determining the primary diagnosis and severity of the condition. History of past respiratory illnesses such as asthma, tuberculosis, and pneumonia can be suggestive recurrence or etiology of current disease.
Tonsils and adenoids for this client were removed in her childhood Family history of respiratory illnesses, smoking history, and environmental exposures are also integral etiological factors. Additional information necessary in the patient’s history includes dyspnea, cough/sputum and its characteristics, fever, chills, chest pain for inflammation diagnosis, current and past medications, and exacerbating and relieving factors. The information is integral in informing the diagnosis and treatment.
The focused physical examination reveals finer details unknown to the patient, informing the diagnosis and treatment (Cox & Ham, 2017). The focused physical examination is divided into four:
Inspection: Inspect the use of accessory muscles and labored breathing which could indicate congestion. Chest symmetry with breathing could reveal any injuries to the chest and conditions such as pneumonia, atelectasis, and fractured ribs. Inspecting the rate and depth of breathing is also vital. The color of the face, lips, and hands indicates oxygen levels and respiratory compromise. In addition, inspect for nasal flaring and an anxious look, which would indicate respiratory distress. Measuring the peripheral oxygen concentration is integral at this point (Cox & Ham, 2017).
Auscultation: Auscultating reveals problems in the lungs and respiratory tract problems through abnormal breath sounds. These breath sounds include fine crackles (asthma and COPD), coarse crackles (pulmonary edema), wheezes (asthma, emphysema, and bronchitis), rhonchi (pneumonia), and creaking (pleurisy) (Cox & Ham, 2017). Auscultation should be on both the anterior and posterior chest.
Palpation: Palpation of the chest reveals tenderness (due to pain and inflammation), asymmetry (with injury or severe diseases), diaphragmatic excursion, crepitus (lung inflammation and exudate formation), and vocal fremitus. Vocal fremitus is vibrations with talking, and breathing and areas where it is higher than others may indicate denser tissues in cases such as pneumonia or malignancy.
Percussion: Chest percussion will help elicit sounds to determine the underlying tissue. The characteristic sound produced is the resonant sound. Hyper resonance/ tympanic sounds indicate pneumothorax. The techniques used in the focus examination reveal characteristics of the chest integral in making a diagnosis.
Patients at times present with symptoms specific to various organ systems and that require focused assessment. In focused assessment, the nurses do a comprehensive assessment of a patient’s system involved in the patient’s presenting problem to ascertain the specific diagnosis. In this case, Ms. Park presents with abdominal discomfort accompanied by moderate pain that she rates as 6/10. A focused gastrointestinal, renal, and partially reproductive systems assessment will ensue to ascertain the underlying condition in Ms. Esther Parks’ case. The focused examination includes inspection, palpation, percussion, and auscultations of the suspected affected organ system. The findings of the assessment shall determine the patient’s diagnoses and consequently inform the plan of care.
Ms. Park presents with complains of pain in the abdomen. She had experienced mild diarrhea 3 days ago, and bowel movement ceased with the cessation of diarrhea. She reports that the pain began five days ago. She has been with the abdominal discomfort for the past one week. The pain was initially mild but increased 2-3 days ago. She rates the pain she is experiencing right now as 6 on a scale of 1-10. She reports her pain to be dull and crampy. She rates her pain during onset of the pain at 1 or 2 out of 10. She is bloating and has reduced appetite. She was reluctant to seek medical attention due to low perceived severity of symptoms until her daughter insisted that she comes for checkup.
She reports a history of caesarian section and cholecystectomy during her early 40s. She has no history of inflammatory, bowel disease, GERD, or other GI disorders. She has not been previously admitted and does not report any known allergy. The patient is not currently on any medication and has not yet taken any medication for constipation nor abdominal pain.
For abdominal pain and discomfort, the patient might have underlying conditions from various body systems (GIT, renal, and partially the reproductive system). A focused review of systems was performed. The patient reports generalized abdominal discomfort and localized pain in the left lower quadrant. She has no nausea or vomiting. She denies blood or mucus in stool. She reports no rectal pain or rectal bleeding. She has had fever recently.
She reports no vaginal bleeding or any vaginal discharge. She reports a decreased appetite in the last few days and reports decreased water and fluid intake in the last few days. Ms. Park says her normal stool is soft and brown in color. Her micturition pattern is normal. She reports no blood in urine, no pain urinating, and no abnormal urine color. She reports no flank pain and reports no edema.
General Survey: Ms. Park is an elderly woman who exhibits mild distress, but she is relatively stable. She has a flashy appearance and she looks rather uncomfortable while seated on the examination table. She appears to grimace in pain at times.
HEENT: The mucous membranes are not dry (they are moist). Her skin has normal turgor without tenting.
Cardiovascular system: S1, S2 heart sounds present. She has no extra heart sound or any other abnormalities. No bruits over the abdominal arteries.
Respiratory: Respiratory system assessment reveals normal respirations, the patient can speak fluently without strain, and auscultation reveals clear breath sounds in all areas.
Abdomen: She has a scar in RUQ (cholecystectomy scar) and another scar (Caesarian scar) at the midline above the pubis. On inspection, there is no discoloration, bowel activity is normal, and bowel sounds are evenly distributed in all quadrants (normoactive). There are no bruits auscultated over spleen or liver. Tympanic sound elicited on abdominal percussion, and scattered dullness over the LLQ noted. The abdomen is soft on palpation. An abnormal oblong mass is palpated in the left lower quadrant. The abdomen is distended and tender with mild guarding. The abdominal organs are normal (no organomegaly). The liver is normally situated and exhibits no hepatomegaly. There is no abdominal herniation. On rectal examination, she has no hemorrhoids, no fissures or ulceration.
At this point, a focused physical examination of the three organ systems should be performed (Schoenwald & Douglas, 2017). On auscultation, normal bowel sounds in all quadrants are detected. There are neither bruits nor friction sounds auscultated. On percussion, scattered dull sounds are elicited in the LLQ. This is suggestive of scattered fecal matter in the colon. The abdomen, however, elicits a tympanic sound. The patient exhibited guarding suggestive of tenderness during palpation and an oblong mass was detected in the LLQ. The oblong mass prompted a digital rectal exam. After a digital rectal exam, fecal matter was found in the rectum. The patient exhibited no splenomegaly or hepatomegaly. The pelvic examination findings were normal thus ruling out pelvic inflammatory disease. Ms. Park had normal urinalysis findings thus ruling out renal system abnormalities and urinary tract infections. Ms. Park is not dehydrated and there are no detectable cardiovascular abnormalities. The physical examination findings coupled with the health history information are suggestive of constipation.
Differential diagnoses for this patient are Constipation, Diverticulitis, and intestinal obstruction. Constipation impacts negatively on the quality of life and should be managed promptly because it is not a complicated condition. A person with constipation presents with an inability to empty the rectum sufficiently, the presence of hard lumpy stool, abdominal pain, and few or absent bowel sounds (Lucak, Lunsford & Harris, 2017). A patient with Diverticulitis often presents with “pain in the left lower quadrant, fever, and leukocytosis” (Young, 2018). Mrs. Packs has no fever and only requires a CBC to rule out Diverticulitis. Imaging studies could also help rule out Diverticulitis. A patient with intestinal obstruction presents with “nausea, emesis, colicky abdominal pain, and cessation of the passage of flatus and stool” (Jackson & Cruz, 2018). Most of these signs and symptoms of intestinal obstruction are absent in the case of Mrs. Packs. Further, an ultrasound can be instrumental in ruling out intestinal obstruction.
Mrs. Park should be scheduled for diagnostic tests to rule out differential diagnosis: CBC to rule out Diverticulitis, electrolytes profile for fluid status, and a CT scan for intestinal obstruction. For management of diverticulitis, she can be started on intravenous fluids and bed rest. For management of an intestinal obstruction, the patient oral feeding should be withdrawn, and intravenous fluids initiated. The patient should also be considered for surgery. For management of constipation, fluids should be increased, the patient should take a high fiber diet and promote increased activity. Use of rectal enema in the event the client cooperates and when constipation does not resolve is recommended.
Analgesic administration, most preferably NSAIDs, to minimize pain and encourage bowel clearance because they are not known to cause constipation (Serra et al., 2017)
Encouraging fluid intake, which is much decreased in this patient to enhance bowel activity and reduce fecal impaction.
To reduce the impacted fecal matter, I will administer polyethylene glycol (an osmotic laxative), then docusate sodium (stool softener), and lastly, Bisacodyl, a stimulant laxative (Emmanuel et al., 2017). I shall closely monitor the patient for drug side effects.
Educating the patient on her condition to promote informed decision-making, minimizing anxiety, and fostering collaboration during care is also essential.
Routine assessment should be scheduled to assess the patient’s recovery and detect any complications during care delivery.
Management of Ms. Park requires a focused examination to determine the underlying condition and treat it accordingly. An in-depth assessment of the affected organ systems and focused management can be instrumental in the management of this patient. She must also be evaluated and necessary adjustments to care made to optimize therapy and ensure recovery. Several considerations such as age and cultural constructions have to be made during care of this patient. Care of a patient requires a collaborative effort between the patient and healthcare providers, and the recovery of the patient is also dependent on her cooperation during care.
Foundational issues in Christian spirituality and ethics are essential to understanding one’s worldview. The purpose of this assignment is to explore my worldview as a Christian by elaborating my understanding of ultimate reality, nature of the universe, human being, knowledge, basis of ethics, and purpose of existence.
According to Bogue and Hogan (2020), ultimate reality refers to the highest authority. In my Christian view, the ultimate reality is God. He is Supreme, Almighty, and creator of heaven and earth and all things visible and invisible. God is the unique source of all reality. He is supernatural. God is described as omnipresent, omniscient, eternal, omnipotent, and omnibenevolent (Bogue & Hogan, 2020). Consequently, we Christians believe that God, who exists as the trinity, created the world and was pleased with His creation. Additionally, God is the source of morality. For instance, He commanded man, “You may surely eat of every tree of the garden, but of the tree of the knowledge of good and evil you shall not eat, for in the day that you eat of it you shall surely die” (Genesis 2:16-17). God also demonstrates His supremacy through various miracles and powerful signs that are well documented in both the old and the new testaments of the Bible.
As a Christian, the universe was created by God, who rules over it. It is composed of both physical and spiritual worlds. Human beings have been given power over the physical world to be fruitful and multiply and explore the resources within the physical world. However, the spiritual world involves an interaction of the spirit of God and the spirits of human souls. As a result, human beings can communicate to God spiritually through prayer. The existence of the spiritual world is demonstrated by Christ himself when he teaches his disciples to pray, and He is also seen interceding on behalf of us.
As Christian, human beings are part of God’s creation and were made on the last day of creation. They are superior to other creatures, for they were made in the image and likeness of God (Genesis 1:27). Similarly, as human beings, we are blessed by the Almighty. But unlike God, human beings have sinned and fallen short of the glory of God (Roman 3:23). The sinful nature of human beings is also depicted during the call of Moses when God orders him to remove his shoes, for he was standing on holy ground. However, God forgives us whenever we repent. Given the valuable nature of human beings as the image of God, human life must be respected and protected at all costs (Baumeister & Bushman, 2020). Likewise, human beings must be treated with dignity and love. Finally, God values his creation. For instance, God became a human being in the person of Jesus Christ.
Knowledge is the sum of what is known. As Christians, knowledge is a gift from God. God (1 Corinthians 12:8). Additionally, Christians regard scientific knowledge as a consequence of the utilization of power that was given to them by God. Therefore, human beings must utilize knowledge as a service to humanity (Cuellar De la Cruz & Robinson, 2017). The Bible remains the main source of Christian knowledge. Christians also acknowledge the limited nature of human knowledge and its hindrance by sin. Finally, Christians can pray to God to obtain knowledge through faith since knowledge is directly connected to God’s revelatory acts.
Ethics refers to moral principles that govern an individual’s behavior. It encompasses systematizing, defending, and recommending the concepts of right and wrong behavior (Stanley et al., 2018). From a Christian point of view, God is the basis of morality. This is evidenced by the mentioning of the tree of knowledge of good and evil in the creation stories. Following the fall of mankind, human beings became aware of good and evil with an obligation to do good as evil doings are punishable. Subsequently, Christian ethics involves living a life pleasing to God that is guided by Christian scriptures and traditions. For instance, God issues commandments to the Israelites through Moses, which were to be followed, and these are later summarized into the two greatest commandments by Jesus Christ in the New Testament. Consequently, Christians rely on the Bible, a book penned down by human beings supernaturally inspired by God, as the most authoritative source of Christian morals and ethics.
The sole purpose of existence for Christians is to worship God and enjoy a relationship with Him forever. Christians exist to Love God and their fellow human beings, after which they will be rewarded with eternal life. Similarly, Christ encourages Christians to follow him and serve God through doing good deeds to the needy. Christ also redefines the purpose of life. For instance, He fights evil throughout His life, He is sentenced to death, resurrects and finally ascends into heaven, and finally promises to come back to judge the living and the dead. Consequently, Christians spend their life preparing for the second coming of Jesus Christ through service to God.
Foundational issues in Christian spirituality and ethics are core to understanding one’s worldview. For Christians, God is the ultimate reality, and they live to serve Him. Human beings are special and have dominion over other creatures.
Baumeister, R. F., & Bushman, B. J. (2020). Social Psychology and Human Nature. Cengage Learning.
Bogue, D. W., & Hogan, M. (2020). Practicing dignity: An introduction to Christian values and decision-making in health care. In Grand Canyon University. https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/1
Cuellar De la Cruz, Y., & Robinson, S. (2017). Answering the call to accessible quality health care for all using a new model of local community not-for-profit charity clinics: A return to Christ-centered care of the past. The Linacre Quarterly, 84(1), 44–56. https://doi.org/10.1080/00243639.2016.1274631
Stanley, S., Purser, R. E., & Singh, N. N. (2018). Ethical foundations of mindfulness. In Mindfulness in Behavioral Health (pp. 1–29). Springer International Publishing. https://doi.org/10.1007/978-3-319-76538-9_1
What would spirituality be according to your own worldview? How do you believe that your conception of spirituality would influence the way in which you care for patients?
Spirituality is the experience of one’s inner existence, a personal expression, and practice and how the person interprets the world and the inner universe (Bogue & Hogan, 2020). Spirituality is not synonymous of religion. Indeed, many regard themselves to be very spiritual and non-religious. Being spiritual does not need membership in a church, temple, or other religious organization, despite the fact that, many individuals express their spiritual needs via religion. How people connect with their spirituality is entirely up to them.
My spirituality, as a Christian, is based on the belief in the existence of only one God, creator of the finite and infinite, and the Trinity. God promotes love among people regardless of race, gender, religion, or social status. Human beings are children of God, who made us in his image and likeness and his spirit resides in each one of us. As children of God, we have received gifts of wisdom that allow us to develop abilities and skills. The gift of intelligence, the arts, science, and creativity allow us to apply knowledge to solve daily situations in our lives such as medical problems. In the tradition of Christian healthcare, acts of mercy are carried out under the guidance of a Christian spirit that upholds the principles of human dignity, solidarity, the common good, and subsidiarity (Cuellar De la Cruz & Robinson, 2017). As a Christian, as a nurse, as a former firefighter, as a volunteer, I have dedicated my life to the service of others, under the principles that govern nursing ethics such as justice, beneficence, and nonmaleficence (Gaines, 2021), following the command Jesus gave his followers “Amen, I say to you, whatever you did for one of these least brothers of mine, you did for me.” (Matt 25:25-40).
References:
Bogue, D. W., & Hogan, M. (2020). Foundational Issues in Christian Spirituality and Ethics. In Grand Canyon University (Ed). Practicing dignity: An introduction to Christian values and decision-making in health care. https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/1
Cuellar De la Cruz, Y., & Robinson, S. (2017). Answering the Call to Accessible Quality Health Care for All Using a New Model of Local Community Not-for-Profit Charity Clinics: A Return to Christ-Centered Care of the Past. The Linacre Quarterly, 84(1), 44–56. https://doi.org/10.1080/00243639.2016.1274631
Gaines, K. (2021). What is the nursing code of ethics? Nurse.org. https://nurse.org/education/nursing-code-of-ethics/
In 750-1,000 words, answer each of the worldview questions according to your own personal perspective and worldview:
What is ultimate reality?
What is the nature of the universe?
What is a human being?
What is knowledge?
What is your basis of ethics?
What is the purpose of your existence?
Support your reflection with the attached topic Resources.
What is the Christian concept of the imago Dei? How might it be important to health care, and why is it relevant?
In 250 words, answer the following question: What do the four parts of the Christian biblical narrative (i.e., creation, fall, redemption, and restoration) say about the nature of God and of reality in relation to the reality of sickness and disease? From where would one find comfort and hope in the light of illness according to this narrative? Explain in detail each part of the narrative above and analyze the implications.
From the beginning of time, Christians are guided by the teachings and directives from the bible. They also believe in the supreme God, a powerful Mighty. However, the presence of diseases, suffering, and pain bring temptations to Christians` faith beyond their imagination (Newbanks et al., 2018). As a result, understanding the biblical narrative from creation, fall, redemption, and restoration would help interpret various situations.
During creation, God created everything that exists systematically, all with purpose. Human beings are a special kind of creation, made in the image and likeness of God, each having intrinsic value and worth and mandated stewardship over God`s creations (Hoerhner, n.d.). God is the giver of human life. Furthermore, health is defined not merely by physical wellness but also includes spiritual, emotional, and communal dimensions of wellness of soul and body.
After creation, man was made the custodian of creation and placed in the Garden of Eden, and their relationship was good. However, a man sinned against God`s command. This led to the breakage of their relationship. The consequences of disobedience were pain, suffering, diseases, and death (Newbanks et al., 2018). However, this was not God`s original plan, man was supposed to enjoy his life.
Human hope is restored through redemption and restoration. God showed love by sending Jesus Christ to bring hope and mend the broken relationship with humans. Christ performed miracles to demonstrate God`s power over disease and illness. Christ suffered, died, and was resurrected to save humans from their sins. Christ`s suffering encourages man to endure suffering and hope to obtain God`s glory upon resurrection (Snyder, 2021). Furthermore, in restoration, there is a promise for new creation and eternal life upon the second coming of Christ. This will bring an end to human suffering, illness, pain, and death. Likewise, during sickness, humans find comfort in redemption and restoration. They persevere in suffering like Christ and hope to inherit eternal life free from suffering and death upon resurrection.
Hoerhner, P. J. (n.d.). Biomedical ethics in the Christian Narrative. http://file:///C:/Users/USER/Downloads/week_3_Practicing_Dignity__An_Introduction_to_Christian_Values_and_Decision_Making_in_Health_Care.pdf
Newbanks, R. S., Rieg, L. S., & Schaefer, B. (2018). What is caring in nursing?: Sorting out humanistic and Christian perspectives. Journal of Christian Nursing: A Quarterly Publication of Nurses Christian Fellowship, 35(3), 160–167. https://doi.org/10.1097/CNJ.0000000000000441
Snyder, J. (2021). Providing a sense of hope and relief during the pandemic. Journal of the American Pharmacists Association: JAPhA, 61(3), 230–231. https://doi.org/10.1016/j.japh.2021.03.017
Case Study: End of Life Decisions
George is a successful attorney in his mid-fifties. He is also a legal scholar, holding a teaching post at the local university law school in Oregon. George is also actively involved in his teenage son’s basketball league, coaching regularly for their team. Recently, George has experienced muscle weakness and unresponsive muscle coordination. He was forced to seek medical attention after he fell and injured his hip. After an examination at the local hospital following his fall, the attending physician suspected that George may be showing early symptoms for amyotrophic lateral sclerosis (ALS), a degenerative disease affecting the nerve cells in the brain and spinal cord. The week following the initial examination, further testing revealed a positive diagnosis of ALS.
ALS is progressive and gradually causes motor neuron deterioration and muscle atrophy to the point of complete muscle control loss. There is currently no cure for ALS, and the median life expectancy is between 3 and 4 years, though it is not uncommon for some to live 10 or more years. The progressive muscle atrophy and deterioration of motor neurons leads to the loss of the ability to speak, move, eat, and breathe. However, sight, touch, hearing, taste, and smell are not affected. Patients will be wheelchair bound and eventually need permanent ventilator support to assist with breathing.
George and his family are devastated by the diagnosis. George knows that treatment options only attempt to slow down the degeneration, but the symptoms will eventually come. He will eventually be wheelchair bound and be unable to move, eat, speak, or even breathe on his own.
In contemplating his future life with ALS, George begins to dread the prospect of losing his mobility and even speech. He imagines his life in complete dependence upon others for basic everyday functions and perceives the possibility of eventually degenerating to the point at which he is a prisoner in his own body. Would he be willing to undergo such torture, such loss of his own dignity and power? George thus begins inquiring about the possibility of voluntary euthanasia.
Based on the attached ”Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic Resources you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview. Provide a 1,500-2,000-word ethical analysis while answering the following questions: How would George interpret his suffering in light of the Christian narrative, with an emphasis on the fallenness of the world? How would George interpret his suffering in light of the Christian narrative, with an emphasis on the hope of resurrection? As George contemplates life with amyotrophic lateral sclerosis (ALS), how would the Christian worldview inform his view about the value of his life as a person? What sorts of values and considerations would the Christian worldview focus on in deliberating about whether or not George should opt for euthanasia? Given the above, what options would be morally justified in the Christian worldview for George and why? Based on your worldview, what decision would you make if you were in George’s situation? Please use the attached document titled ”Death, Dying and Grief” as one of the references.
PLEASE SEE THE ATTCHED DOCUMENTS. CHART FOR TOPIC 3 IS ATTACHED. PLEASE USE THE REFERENCES ATTACHED.
In addition to the topic Resources, use the chart you completed and questions you answered in the Topic 3 about ”Case Study: Healing and Autonomy” as the basis for your responses in this assignment. Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.
In 200-250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.
In 400-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?
In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?