ORGINAL Work Only!! APA- Nursing Essay- Scholarly- With References

APA NURSING Assignment:

HAVE A INTRODUCTION AND CONCLUSION IN ESSAY FORM SEE ATTACHMENT FOR APA EXAMPLE TO FORMAT

Answer all of the following questions using headers to separate topics.

  1. Attack or defend the following statement and then explain what you would do, in concrete terms, to improve things in your involvement or what you have observed. “It seems that the people behind the new computerized systems perceive that the people who work here and the roles they play are to make the computer’s job easier as opposed to the systems being here to help transform average healthcare workers into super workers.”
  2. It has been argued that getting nursing involved in the implementation of all of the computer systems in healthcare is a good thing, but doing that is in conflict with current patient care and the reality that many nurses are uncomfortable with some of the changes they see and would rather not be involved. To what extend does this resonate with your personal experience? What do you believe are the key prerequisites that must be addressed before enough of the right nurses and other key role players in the healthcare process and what concrete steps would you recommend to address these and why?
  3. Chapter 5 in the text provides a perspective for implementing Clinical Information Systems. From your experience, what are the more critical issues or concerns you have with the material presented in this chapter and what would you advocate should be done to improve the likelihood that such projects would be successful. (You can address technical issues, skill issues, change and fear issues, as well as business and/or leadership issues.)
  4. Chapter 6 focuses on the Electronic Medical Records and physician adoption and utilization. Reflect on your experiences with physicians and other key, scarce, and therefore costly healthcare professionals. How well do you believe these professionals would react to the kinds of changes and approaches covered in the chapter. Have the authors done a good job addressing the really key issues and concerns? If not what did they miss? To what extend do you believe what is advocated would work in your environment or healthcare facilities with which you are familiar? Sketch what you might propose be done differently, if anything.
 
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the impact of the ongoing development of the curriculum on educational leaders in Saudi Arabia. – GradSchoolPapers.com

the impact of the ongoing development of the curriculum on educational leaders in Saudi Arabia.
Essay: Your primary task is to respond to the topic below by exploring the relevant literature and critically interpreting, analysing and commenting on the major issues and arguments raised in that literature. The essay should be 4500 words in length, including references.
Consider the impact of a national or state initiative in curriculum. What are the implications of this initiative for educational leaders? What are the consequences for you in your current or future contexts? Your discussion should be based on a thorough literature search on this topic.
Grading Criteria and Feedback
Assessmentcriteria
• A good introduction which clearly identifies the initiative that has been chosen, gives a brief description of its context and significance and outlines the argument that will be made in the essay;
• Main issues are clarified, context and significance are clear;
• Interpretations are critical and analytical;
• Overview and discussion of the main issues and related arguments are properly substantiated;
• Personal views and comments (if any) are balanced and substantiated;
• A concluding paragraph that briefly states the main points discussed in the essay;
• Overall content is well organised and coherent;
• A wide range of appropriate literature has been consulted;
• Sound academic writing including use of the required APA 6th referencing style
An essay with this grade should demonstrate:
• Wide reading, well beyond that provided in the references list;
• An ability to conceptualise and to link the theoretical concepts addressed with topic area;
• An original analysis of the topic and related material;
• A clear, logical and creative approach to exploration of the topic; and
• An exceptional command of expression, argument and structure.

 
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two pages essay 2

in this essay you need to answer about five short questions including definitions and give example.

 
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Leadership Health Care Organizations Practicum

For clarification purposes, please submit each assignment with according to their unit numbers

Unit 1

Should all nurses be considered leaders? What characteristics of nurses make them leaders? How do your responses compare or contrast with the view of power according to servant leadership? Support your response with evidence from the textbook or Topic Materials.

RESOURCES

Electronic Resource

1. Guidelines for Graduate Field Experience Manual

Please refer to the Guidelines for Graduate Field Experience Manual. Students need to log hours in Typhon as a time log. The preceptor must approve time log entry by clicking on green box to lock entry. For questions, please contact typhon@gcu.edu or the Office of Field Experience.

http://students.gcu.edu/academics/college-of-nursing-and-health-care-professions.php

2. Issue of Power

View the “Issue of Power” video.

http://lc.gcumedia.com/zwebassets/courseMaterialPages/nur670_vpv01GUI.php

3. What Is the Difference Between Leadership and Management?

Read “What Is the Difference Between Leadership and Management?” by Murray, from The Wall Street Journal (2014).

http://guides.wsj.com/management/developing-a-leadership-style/what-is-the-difference-between-management-and-leadership/

e-Library Resource

1. The Role of Values in Servant Leadership

Read “The Role of Values in Servant Leadership,” by Russell, from Leadership and Organization Development Journal (2001).

https://lopes.idm.oclc.org/login?url=http://search.proquest.com/docview/226915965?accountid=7374

Other

1. Nurse Leadership Practicum Clinical Log

The “Nurse Leadership Practicum Clinical Log” is a pass/fail assignment due at the end of the course, but the instructor may ask at any time to review the document.

Students must update the “Nurse Leadership Practicum Clinical Log” each week.

NUR-670-RS-NurseLeadershipPracticumClinicalLog.docx

Unit 2

In the secular approach to leadership, there is an inherent belief that hard work will get you to the top and guarantee success. Think of a time in your professional life when this has proven to be true. What were the circumstances? How much influence did you have on the outcome? Based on the textbook, how do your responses compare to the views of servant leadership? How do your responses compare to the secular view of leadership?

Unit 3

You are in a place of influence in your professional life where you can help people be successful. Describe the relationship and what actions you have taken or could take to serve others. Based on the textbook, how does your response compare to the views of authority according to servant leadership? How does your response compare to the secular view of authority?

Unit 4

What is your given “authority” at your work place and/or professional life? Describe a time when you have exercised this authority in your journey as a professional nurse? How does your response compare to the secular view of power? How does your response compare to the secular view of authority? How does your response compare to the view of power according to servant leadership? How does your response compare to the view of authority according to servant leadership?

Unit 5

Describe a time in your professional life when you felt used and manipulated. What were the circumstances? Did you feel valued by the leader? Based on the textbook, explain how the issue of purpose, in the servant-leader paradigm, could have yielded a more beneficial outcome for the leader and yourself.

 
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PLEASE ANSWER ACCORDING THE ANSWER. WRITE AT LEAST 130 WORDS. REFERENCE (2013-2018). THANKS.

Comment 1

A colleague recently was diagnosed with breast cancer. The American Cancer Society (ACS) has an easy website to navigate for information. There is a search bar for questions that may be posed. One can begin with cancer from A to Z. Breast cancer has many headers such as about, risk and prevention, early diagnosis and prevention, understanding the diagnosis, treating, reconstruction surgery, living as a survivor, and non-cancerous breast conditions. A patient can even find easy reading for those with breast cancer. They have downloadable information under pdfs with similar headings. Related topics, news and stories, and more resources are available. Their site has a handy tool bar and toll-free phone number for those who prefer to use that resource. At the end of their page is another way to approach subjects. For example, to find information about rides to treatment one can just navigate to the bottom of the page, rather than using the search bar. Reach to Recovery is a phenomenal resource, allowing you to speak with a person that has survived breast cancer (Cancer Caregiver Support, n.d.).

Factors that are associated with cancer risk are tobacco use and secondhand smoke, inactivity, obesity, nutrition and diet, alcohol, ultraviolet light, and cancer-associated infections such as HPV. Six infections are listed. I live in Connecticut and it is estimated that there will be 21,240 new cases diagnosed and 6,590 deaths this year. In my state, there is a partnership with Center for Disease Control (CDC). State specific cancer issues are identified and a plan has been developed with goals and strategies for improvement. For example, at St. Francis Hospital, Men’s Health Institute has the goal of providing free services to the underinsured or uninsured and to address the disparities affecting African-Americans. I feel that research and medication and treatment trials will make an enormous impact in the future. The ACS is always trying to raise not only awareness but funding for further research. I think that statistics will change to percentages rather than number of people in diagnosis and mortality because we are living longer. I believe there will be some cures that will decrease certain kinds of cancers in the future as well as people being more aware.

ACS conducts Palliative Care Research. It has come to mean pain relief with treatments and management of side effects; it is not only specific to terminal cancers. According to the website, the ACS is funding more than $26 million for survivorship and quality of life research. Included is the improvement of lives of children with cancer and studies of survivors. The research has the goal of relieving cancer pain and managing side effects. I would imagine a person newly diagnosed would be most worried about prognosis and pain. This research is tantamount to cancer patients (American Cancer Society, 2018).

Comment 2

It was fascinating to learn of “liquid biopsy” as an emerging technology. I learned from the National Cancer Institute that liquid biopsy is “A test done on a sample of blood to look for cancer cells from a tumor that are circulating in the blood or for pieces of DNA from tumor cells that are in the blood. A liquid biopsy may be used to help find cancer at an early stage. It may also be used to help plan treatment or to find out how well treatment is working or if cancer has come back” (NCI, 2018). It is technically known as rapid plasma genotyping, and has a plausable rate of accuracy, according to researches from the study at Dana Farber Cancer Institute, where the study took place. According to the website from Dana Farber Cancer Institute, they are working on not only this technology, but target cancer therapy technology, where they pinpoint the origin of cancer, and create a tumor profile.

 
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MN577 Discussion Board: Common Causes Of Pelvic Pain – Peer Response

No plagiarism please.

Will need minimum of 150 words for each response, APA Style, double spaced, times new roman, font 12, and and Include: (1 reference for each response within years 2015-2018) with intext citation.

Peer Resp.#1

 

When it comes to women’s health, pelvic pain is a serious condition that needs to be examined carefully and seriously.  Pelvic pain is a common problem among women and in primary care office, and it is seen in approximately in one to two percentage of women (Dunphy et al., 2015).  The nature and intensity of the pain may fluctuate, and its cause is often unclear.  According to Dunphy et al., (2015) pelvic pain is characterized as acute, chronic or recurrent and reported in both pelvic or lower abdomen.  Speer, Mushkbar, & Erbele (2016) define Chronic Pelvic Pain (CPP) as a persistent, noncyclic pain perceived to be in structures related to the pelvis, lasting more than six months, and does not show any signs of improvement with treatment.  Due to the multiple possible causes to develop CPP, the diagnosis could be difficult and must be done with care.  The cause of the pelvic pain might stem from genitourinary, gastrointestinal, musculoskeletal system disease or dysfunction which could cause sudden acute pain. (Dunphy et al., 2015).  CPP is not a direct diagnosis, but rather a condition that is caused by numerous factors or another medical disease.   The most prevalent and medically significant causes are cancers, sexually transmitted diseases (STDs), and general medical issues with the intestines and reproductive organs (Passavanti, Pota, & Sansone, 2017).  Ovarian cancer, chlamydia, and ovarian cysts are all potential causes that could be extremely serious for the patient and could even be life threatening.  On the other hand, it could be simple ache or pain caused by relatively benign reasons (Speer, Mushkbar, & Erbele, 2016).  Chronic or recurrent pelvic pain is less urgent; and recurrent pain could be associated or not with menstruation (Dunphy et al., 2015).  The origin of CPP could be related to benign or malignant neoplasms or characterized as psychogenic. (Dunphy et al., 2015).

 

Pain is a subjective symptom, and healthcare professionals cannot experience the pain that the patient is experiencing.  However, there are procedures that can help with assessment and diagnosis.  First, when assessing pelvic pain, a solid interview with the patient should be conducted, including the use of pain scales, questionnaires, and direct statements from the patient (Passavanti, Pota, & Sansone, 2017).  Severe persisting pain that has been present for an extended period should be evaluated and taken as a potential cause for professional diagnosis.  Due to the sheer amount of potential conditions that could cause pelvic pain, being able to narrow down possible causes is extremely important.  Therefore, other factors must be put into consideration to make a good differential diagnosis.  Lifford & Barbieri (2002) state that evaluating potential pre-existing conditions such as depression, narcotic dependency, and physical, sexual, or emotional abuse is crucial when diagnosing pelvic pain.   In the case that patients state that the pain is unbearable and severely affects their everyday life, referral to emergency department must be recommended to get promptly treatment.  Overall, the diagnosis and evaluation of pelvic pain cannot be taken lightly and should be done with caution to implement an adequate treatment with good health outcomes, which could give to the patient a better quality of life.  The determination when and why one would refer a patient for diagnostics and second opinions is based upon by the physical exam and tests, treatments might include medicines, surgical procedures, physical therapy and pain management techniques.

References

Peer Resp.#2

 

There are many different causes of pelvic pain in women. Pelvic pain is defined as pain that is felt in the lower part of the abdomen or pelvis and can be caused from urinary, reproductive/sexual, musculoskeletal, or digestive issues (Mayo Clinic, 2018). One of the causes can be due to uterine fibroids. Uterine fibroids, also referred to as leiomyomas, are noncancerous growths in the uterus that can cause pain, abnormal bleeding, pelvic pressure, constipation, and back aches (Mayo Clinic, 2018). Uterine fibroids are most commonly seen in patients who are in child bearing years and they can vary in size, shape, and symptom severity. Fibroids do not generally interfere with conceiving; however, they can lead to placental abruption, preterm delivery, and fetal growth restriction if not managed properly. (Mayo Clinic, 2018).

This patient would be referred to a GYN specialist and surgeon, have a pelvic ultrasound obtained with results sent to both the primary and GYN. The GYN specialist, surgeon, and patient can discuss a treatment plan such as expectant management, laparoscopic myomectomy, or hysterectomy. (Mayo Clinic, 2018)

The steps to writing a referral involve the diagnosis and chief complaint, plan of care such as the ultrasound, and the NP should plan to see the patient in 2 weeks for ultrasound review and to discuss the patient’s plan going forward.

 
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Ethical And Legal Implications Of Prescribing Drugs

Ethical and Legal Implications of Prescribing Drugs

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to thispatient?

These are some of the questions you might consider when selecting a treatment plan for a patient. As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives on a daily basis. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. In this paper, you explore ethical and legal implications of the following scenario and consider how to appropriately respond.

Scenario:

You see another nurse practitioner writing a prescription for her husband who is not a patient of the nurse practitioner. The prescription is for a narcotic. You can’t decide whether or not to report the incident.

To prepare:

· Review  the following:

·

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach(4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

  • Chapter 1, “Issues for the Practitioner in Drug      Therapy” (pp. 3–14) 
         This chapter introduces issues relating to drug therapy such as adverse      drug events and medication adherence. It also explores drug safety, the      practitioner’s role and responsibilities in prescribing, and prescription      writing.
  • Chapter 59, “The Economics of Pharmacotherapeutics”      (pp. 1009-1018) 
         This chapter analyzes the costs of drug therapy to health care systems and      society and explores practice guideline compliance and current issues in      medical care.
  • Chapter 60, “Integrative Approaches to      Pharmacotherapy—A Look at Complex Cases” (pp. 1021-1036) 
         This chapter examines issues in individual patient cases. It explores      concepts relating to evaluation, drug selection, patient education, and      alternative treatment options.

As well as:

Drug Enforcement Administration. (n.d.). Code of federal regulations. Retrieved August 23, 2012, from http://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm

Anderson, P., & Townsend, T. (2010). Medication errors: Don’t let them happen to you. American Nurse Today, 5(3), 23–28. Retrieved from https://americannursetoday.com/medication-errors-dont-let-them-happen-to-you/

· Consider the ethical and legal implications of the scenario for all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family.

· Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario.

With these thoughts in mind:

Post an explanation of the ethical and legal implications of the scenario you selected on all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family. Describe two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario.

 
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Everyday Use

The requirements for this essay are:

1. 500-600 words; 5-paragraph structure (can have more than five).

2. Your idea about the story itself—the value of the story (at least a paragraph)

3. How it applies to life in general (at least a paragraph)

4. How it applies to you.  Write about an item that is important to you, one that has been passed down to you or one that you hope will be or an item that you have that you will plan to pass down to someone (at least a paragraph). .

5. Be sure to supply

a. A parenthetical reference

b. A Works Cited

I will wait for her in the yard that Maggie and I made so clean and wavy yesterday afternoon. A yard like this is more comfortable than most people know. It is not just a yard. It is like an extended living room. When the hard clay is swept clean as a floor and the fine sand around the edges lined with tiny, irregular grooves, anyone can come and sit and look up into the elm tree and wait for the breezes that never come inside the house.

Maggie will be nervous until after her sister goes: she will stand hopelessly in corners, homely and ashamed of the burn scars down her arms and legs, eying her sister with a mixture of envy and awe. She thinks her sister has held life always in the palm of one hand, that “no” is a word the world never learned to say to her.

You’ve no doubt seen those TV shows where the child who has “made it” is confronted, as a surprise, by her own mother and father, tottering in weakly from backstage. (A pleasant surprise, of course: What would they do if parent and child came on the show only to curse out and insult each other?) On TV mother and child embrace and smile into each other’s faces. Sometimes the mother and father weep, the child wraps them in her arms and leans across the table to tell how she would not have made it without their help. I have seen these programs.

Sometimes I dream a dream in which Dee and I are suddenly brought together on a TV program of this sort. Out of a dark and soft.seated limousine I am ushered into a bright room filled with many people. There I meet a smiling, gray, sporty man like Johnny Carson who shakes my hand and tells me what a fine girl I have. Then we are on the stage and Dee is embracing me with tears in her eyes. She pins on my dress a large orchid, even though she has told me once that she thinks orchids are tacky flowers.

In real life I am a large, big.boned woman with rough, man.working hands. In the winter I wear flannel nightgowns to bed and overalls dur.ing the day. I can kill and clean a hog as mercilessly as a man. My fat keeps me hot in zero weather. I can work outside all day, breaking ice to get water for washing; I can eat pork liver cooked over the open fire minutes after it comes steaming from the hog. One winter I knocked a bull calf straight in the brain between the eyes with a sledge hammer and had the meat hung up to chill before nightfall. But of course all this does not show on television. I am the way my daughter would want me to be: a hundred pounds lighter, my skin like an uncooked barley pancake. My hair glistens in the hot bright lights. Johnny Carson has much to do to keep up with my quick and witty tongue.

But that is a mistake. I know even before I wake up. Who ever knew a Johnson with a quick tongue? Who can even imagine me looking a strange white man in the eye? It seems to me I have talked to them always with one foot raised in flight, with my head fumed in whichever way is farthest from them. Dee, though. She would always look anyone in the eye. Hesitation was no part of her nature.

“How do I look, Mama?” Maggie says, showing just enough of her thin body enveloped in pink skirt and red blouse for me to know she’s there, almost hidden by the door.

“Come out into the yard,” I say.

Have you ever seen a lame animal, perhaps a dog run over by some careless person rich enough to own a car, sidle up to someone who is ignorant enough to be kind to him? That is the way my Maggie walks. She has been like this, chin on chest, eyes on ground, feet in shuffle, ever since the fire that burned the other house to the ground.

Dee is lighter than Maggie, with nicer hair and a fuller figure. She’s a woman now, though sometimes I forget. How long ago was it that the other house burned? Ten, twelve years? Sometimes I can still hear the flames and feel Maggie’s arms sticking to me, her hair smoking and her dress falling off her in little black papery flakes. Her eyes seemed stretched open, blazed open by the flames reflected in them. And Dee. I see her standing off under the sweet gum tree she used to dig gum out of; a look of concentration on her face as she watched the last dingy gray board of the house fall in toward the red.hot brick chimney. Why don’t you do a dance around the ashes? I’d wanted to ask her. She had hated the house that much.

I used to think she hated Maggie, too. But that was before we raised money, the church and me, to send her to Augusta to school. She used to read to us without pity; forcing words, lies, other folks’ habits, whole lives upon us two, sitting trapped and ignorant underneath her voice. She washed us in a river of make.believe, burned us with a lot of knowl edge we didn’t necessarily need to know. Pressed us to her with the serf’ ous way she read, to shove us away at just the moment, like dimwits, we seemed about to understand.

Dee wanted nice things. A yellow organdy dress to wear to her grad.uation from high school; black pumps to match a green suit she’d made from an old suit somebody gave me. She was determined to stare down any disaster in her efforts. Her eyelids would not flicker for minutes at a time. Often I fought off the temptation to shake her. At sixteen she had a style of her own: and knew what style was.

I never had an education myself. After second grade the school was closed down. Don’t ask my why: in 1927 colored asked fewer questions than they do now. Sometimes Maggie reads to me. She stumbles along good.naturedly but can’t see well. She knows she is not bright. Like good looks and money, quickness passes her by. She will marry John Thomas (who has mossy teeth in an earnest face) and then I’ll be free to sit here and I guess just sing church songs to myself. Although I never was a good singer. Never could carry a tune. I was always better at a man’s job. I used to love to milk till I was hooked in the side in ’49. Cows are soothing and slow and don’t bother you, unless you try to milk them the wrong way.

I have deliberately turned my back on the house. It is three rooms, just like the one that burned, except the roof is tin; they don’t make shingle roofs any more. There are no real windows, just some holes cut in the sides, like the portholes in a ship, but not round and not square, with rawhide holding the shutters up on the outside. This house is in a pasture, too, like the other one. No doubt when Dee sees it she will want to tear it down. She wrote me once that no matter where we “choose” to live, she will manage to come see us. But she will never bring her friends. Maggie and I thought about this and Maggie asked me, “Mama, when did Dee ever have any friends?”

She had a few. Furtive boys in pink shirts hanging about on washday after school. Nervous girls who never laughed. Impressed with her they worshiped the well.turned phrase, the cute shape, the scalding humor that erupted like bubbles in Iye. She read to them.

When she was courting Jimmy T she didn’t have much time to pay to us, but turned all her faultfinding power on him. He flew to marry a cheap city girl from a family of ignorant flashy people. She hardly had time to recompose herself.

When she comes I will meet—but there they are!

Maggie attempts to make a dash for the house, in her shuffling way, but I stay her with my hand. “Come back here, ” I say. And she stops and tries to dig a well in the sand with her toe.

It is hard to see them clearly through the strong sun. But even the first glimpse of leg out of the car tells me it is Dee. Her feet were always neat.looking, as if God himself had shaped them with a certain style. From the other side of the car comes a short, stocky man. Hair is all over his head a foot long and hanging from his chin like a kinky mule tail. I hear Maggie suck in her breath. “Uhnnnh, ” is what it sounds like. Like when you see the wriggling end of a snake just in front of your foot on the road. “Uhnnnh.”

Dee next. A dress down to the ground, in this hot weather. A dress so loud it hurts my eyes. There are yellows and oranges enough to throw back the light of the sun. I feel my whole face warming from the heat waves it throws out. Earrings gold, too, and hanging down to her shoul.ders. Bracelets dangling and making noises when she moves her arm up to shake the folds of the dress out of her armpits. The dress is loose and flows, and as she walks closer, I like it. I hear Maggie go “Uhnnnh” again. It is her sister’s hair. It stands straight up like the wool on a sheep. It is black as night and around the edges are two long pigtails that rope about like small lizards disappearing behind her ears.

“Wa.su.zo.Tean.o!” she says, coming on in that gliding way the dress makes her move. The short stocky fellow with the hair to his navel is all grinning and he follows up with “Asalamalakim, my mother and sister!” He moves to hug Maggie but she falls back, right up against the back of my chair. I feel her trembling there and when I look up I see the perspiration falling off her chin.

“Don’t get up,” says Dee. Since I am stout it takes something of a push. You can see me trying to move a second or two before I make it. She turns, showing white heels through her sandals, and goes back to the car. Out she peeks next with a Polaroid. She stoops down quickly and lines up picture after picture of me sitting there in front of the house with Maggie cowering behind me. She never takes a shot without mak’ ing sure the house is included. When a cow comes nibbling around the edge of the yard she snaps it and me and Maggie and the house. Then she puts the Polaroid in the back seat of the car, and comes up and kisses me on the forehead.

Meanwhile Asalamalakim is going through motions with Maggie’s hand. Maggie’s hand is as limp as a fish, and probably as cold, despite the sweat, and she keeps trying to pull it back. It looks like Asalamalakim wants to shake hands but wants to do it fancy. Or maybe he don’t know how people shake hands. Anyhow, he soon gives up on Maggie.

“Well,” I say. “Dee.”

“No, Mama,” she says. “Not ‘Dee,’ Wangero Leewanika Kemanjo!”

“What happened to ‘Dee’?” I wanted to know.

“She’s dead,” Wangero said. “I couldn’t bear it any longer, being named after the people who oppress me.”

“You know as well as me you was named after your aunt Dicie,” I said. Dicie is my sister. She named Dee. We called her “Big Dee” after Dee was born.

“But who was she named after?” asked Wangero.

“I guess after Grandma Dee,” I said.

“And who was she named after?” asked Wangero.

“Her mother,” I said, and saw Wangero was getting tired. “That’s about as far back as I can trace it,” I said. Though, in fact, I probably could have carried it back beyond the Civil War through the branches.

“Well,” said Asalamalakim, “there you are.”

“Uhnnnh,” I heard Maggie say.

“There I was not,” I said, “before ‘Dicie’ cropped up in our family, so why should I try to trace it that far back?”

He just stood there grinning, looking down on me like somebody inspecting a Model A car. Every once in a while he and Wangero sent eye signals over my head.

“How do you pronounce this name?” I asked.

“You don’t have to call me by it if you don’t want to,” said Wangero.

“Why shouldn’t 1?” I asked. “If that’s what you want us to call you, we’ll call you.”

.

“I know it might sound awkward at first,” said Wangero.

“I’ll get used to it,” I said. “Ream it out again.”

Well, soon we got the name out of the way. Asalamalakim had a name twice as long and three times as hard. After I tripped over it two or three times he told me to just call him Hakim.a.barber. I wanted to ask him was he a barber, but I didn’t really think he was, so I didn’t ask.

“You must belong to those beef.cattle peoples down the road,” I said. They said “Asalamalakim” when they met you, too, but they didn’t shake hands. Always too busy: feeding the cattle, fixing the fences, putting up salt.lick shelters, throwing down hay. When the white folks poisoned some of the herd the men stayed up all night with rifles in their hands. I walked a mile and a half just to see the sight.

Hakim.a.barber said, “I accept some of their doctrines, but farming and raising cattle is not my style.” (They didn’t tell me, and I didn’t ask, whether Wangero (Dee) had really gone and married him.)

We sat down to eat and right away he said he didn’t eat collards and pork was unclean. Wangero, though, went on through the chitlins and com bread, the greens and everything else. She talked a blue streak over the sweet potatoes. Everything delighted her. Even the fact that we still used the benches her daddy made for the table when we couldn’t effort to buy chairs.

“Oh, Mama!” she cried. Then turned to Hakim.a.barber. “I never knew how lovely these benches are. You can feel the rump prints,” she said, running her hands underneath her and along the bench. Then she gave a sigh and her hand closed over Grandma Dee’s butter dish. “That’s it!” she said. “I knew there was something I wanted to ask you if I could have.” She jumped up from the table and went over in the corner where the churn stood, the milk in it crabber by now. She looked at the churn and looked at it.

“This churn top is what I need,” she said. “Didn’t Uncle Buddy whittle it out of a tree you all used to have?”

“Yes,” I said.

“Un huh,” she said happily. “And I want the dasher, too.”

“Uncle Buddy whittle that, too?” asked the barber.

Dee (Wangero) looked up at me.

“Aunt Dee’s first husband whittled the dash,” said Maggie so low you almost couldn’t hear her. “His name was Henry, but they called him Stash.”

 

“Maggie’s brain is like an elephant’s,” Wangero said, laughing. “I can use the chute top as a centerpiece for the alcove table,” she said, sliding a plate over the chute, “and I’ll think of something artistic to do with the dasher.”

When she finished wrapping the dasher the handle stuck out. I took it for a moment in my hands. You didn’t even have to look close to see where hands pushing the dasher up and down to make butter had left a kind of sink in the wood. In fact, there were a lot of small sinks; you could see where thumbs and fingers had sunk into the wood. It was beautiful light yellow wood, from a tree that grew in the yard where Big Dee and Stash had lived.

After dinner Dee (Wangero) went to the trunk at the foot of my bed and started rifling through it. Maggie hung back in the kitchen over the dishpan. Out came Wangero with two quilts. They had been pieced by Grandma Dee and then Big Dee and me had hung them on the quilt ftames on the ftont porch and quilted them. One was in the Lone Stat pattetn. The other was Walk Around the Mountain. In both of them were scraps of dresses Grandma Dee had wotn fifty and more years ago. Bits and pieces of Grandpa Jattell’s Paisley shirts. And one teeny faded blue piece, about the size of a penny matchbox, that was from Great Grandpa Ezra’s unifotm that he wore in the Civil War.

“Mama,” Wangro said sweet as a bird. “Can I have these old quilts?”

I heard something fall in the kitchen, and a minute later the kitchen door slammed.

“Why don’t you take one or two of the others?” I asked. “These old things was just done by me and Big Dee from some tops your grandma pieced before she died.”

“No,” said Wangero. “I don’t want those. They are stitched around the borders by machine.”

“That’ll make them last better,” I said.

“That’s not the point,” said Wangero. “These are all pieces of dresses Grandma used to wear. She did all this stitching by hand. Imag’ ine!” She held the quilts securely in her atms, stroking them.

“Some of the pieces, like those lavender ones, come ftom old clothes her mother handed down to her,” I said, moving up to touch the quilts. Dee (Wangero) moved back just enough so that I couldn’t reach the quilts. They already belonged to her.

“Imagine!” she breathed again, clutching them closely to her bosom.

“The ttuth is,” I said, “I promised to give them quilts to Maggie, for when she matties John Thomas.”

She gasped like a bee had stung her.

“Maggie can’t appreciate these quilts!” she said. “She’d probably be backward enough to put them to everyday use.”

 

“I reckon she would,” I said. “God knows I been saving ’em for long enough with nobody using ’em. I hope she will!” I didn’t want to bring up how I had offered Dee (Wangero) a quilt when she went away to college. Then she had told they were old~fashioned, out of style.

“But they’re priceless!” she was saying now, furiously; for she has a temper. “Maggie would put them on the bed and in five years they’d be in rags. Less than that!”

“She can always make some more,” I said. “Maggie knows how to quilt.”

Dee (Wangero) looked at me with hatred. “You just will not under.stand. The point is these quilts, these quilts!”

“Well,” I said, stumped. “What would you do with them7”

“Hang them,” she said. As if that was the only thing you could do with quilts.

Maggie by now was standing in the door. I could almost hear the sound her feet made as they scraped over each other.

“She can have them, Mama,” she said, like somebody used to never winning anything, or having anything reserved for her. “I can ‘member Grandma Dee without the quilts.”

I looked at her hard. She had filled her bottom lip with checkerberry snuff and gave her face a kind of dopey, hangdog look. It was Grandma Dee and Big Dee who taught her how to quilt herself. She stood there with her scarred hands hidden in the folds of her skirt. She looked at her sister with something like fear but she wasn’t mad at her. This was Maggie’s portion. This was the way she knew God to work.

When I looked at her like that something hit me in the top of my head and ran down to the soles of my feet. Just like when I’m in church and the spirit of God touches me and I get happy and shout. I did some.thing I never done before: hugged Maggie to me, then dragged her on into the room, snatched the quilts out of Miss Wangero’s hands and dumped them into Maggie’s lap. Maggie just sat there on my bed with her mouth open.

“Take one or two of the others,” I said to Dee.

But she turned without a word and went out to Hakim~a~barber.

“You just don’t understand,” she said, as Maggie and I came out to the car.

“What don’t I understand?” I wanted to know.

“Your heritage,” she said, And then she turned to Maggie, kissed her, and said, “You ought to try to make something of yourself, too, Maggie. It’s really a new day for us. But from the way you and Mama still live you’d never know it.”

She put on some sunglasses that hid everything above the tip of her nose and chin.

Maggie smiled; maybe at the sunglasses. But a real smile, not scared. After we watched the car dust settle I asked Maggie to bring me a dip of snuff. And then the two of us sat there just enjoying, until it was time to go in the house and go to bed.

 
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Please Answer Based On These Answers As They Are Listed, Each One Must Be Answered In APAform And Not Less Than 150 Words

3-One area of nursing that seems to be an ongoing problem is nurse to patient ratio. I feel like when this subject is brought up to those in charge of staffing, they want to roll their eyes at me or whoever is asking about it. I understand that nurses have been wanting less patients for as long as I can recall. The problem is more than just floor nurses complaining. With the advancements in technology and medicine, patients are able to have their cares at home or surgeries on an outpatient basis. Those “walkie talkie” patients are becoming fewer and fewer in the hospital. The patients that we take care of on a daily basis are sick. And I mean they are sick. These patients that may have been ICU patients in the past are now on acute care floors and are being cared for by a nurse that has four other very sick patients. If they had been admitted to the ICU, their nurse may have only one more patient. Floor nurses are being pulled very thin which also leads to nurses feeling burnt out and can have those nurses looking for a different job, which leads to the nursing shortage (Garretson, 2004). We have continued to have the same nurse to patient ratio for years now even though the patients being seen are getting sicker. If nurses had less patients to care for, closer attention can be given to their patients and the risk of mortality can be decreased (Shekelle, 2013)

Garretson, S. (2004). Nurse to patient ratios in American health care. Nursing Standard, 19(14), 33-37. Retrieved 8 29,

2018, from

https://ncbi.nlm.nih.gov/pubmed/15633873

Shekelle, P. G. (2013). Nurse–Patient Ratios as a Patient Safety Strategy: A Systematic Review. Annals of Internal

 

5-I like your post. Of course Nurses play an important customer service role for hospitals, doctors offices and other medical facilities. Nurses are the ones with the most frequent, direct patient interaction. I just want to share  the best way to provide excellent customer services .

Be personable and connect with patients:

  • Listen
  • Use      touch when appropriate
  • Make      eye contact
  • Do      not rush interactions with patients
  • Acknowledge      that you are understanding the patients desires and concerns by      summarizing and stating them back to the patient and verifying that you      both are on the same page.

Use appropriate language:

  • Discuss      medical information in language that patients can understand

For example: If a patient has a fourth grade reading level do not use every big word and medical term possible when discussing medical information

Show that you care:

  • Ask      patients if they have any questions or concerns
  • Take      the time to listen to any questions or concerns that the patient may have
  • Show      empathy and acknowledge their issues
  • Address      their issues and keep them informed on actions being taken

Involve patients in their care:

  • Give      patients choices whenever possible
  • Take      their preferences into consideration and formulate a plan together
  • Be      knowledgable and considerate of the cultural, social or economic factors      that influence their care, decision making, and interation with the      healthcare team

 

6-Medication errors are one of the most common causes of unintended harm to patients. Med errors can lead to patient disability or even death. The problem is many nurses are in a hurry or don’t even realize they have administered the wrong medication. This can not only lead to possible further harm but does nothing to correct the error as it goes unnoticed. A patient returns from surgery, anxious and in pain, with several I.V. lines and intracranial pressure (ICP), monitor in place. The I.V. tubing used in the operating room differs from the tubing used in the intensive care unit (ICU). In her haste, the ICU nurse prepares to inject morphine into the patient’s ICP drain, which she has mistaken for the central line. She stops just in time when she realizes she is about to make a severe mistake.  The nurse did not complete her five rights before administration leading to a med error. With the new mandated law of electronic charting, we are required to scan our meds which may cut back on the number of errors, but I do not believe it will eliminate them. Technology is growing in hospitals and helping nurses to go right path and prevent medication errors, but unfortunately, med error still exists. Nurses can help further eliminate medication errors by following five rights and completing the appropriate checks before administering any medications. A possible benefit to help reduce medication errors may be to extend new grads internships as well. Education is the key to prevent the medication error. Medication administration is a complicated multistep process that encompasses prescribing, transcribing, dispensing, and administering drugs and monitoring patient response. An error can happen at any step. Although many errors arise at the prescribing stage, some are intercepted by pharmacists, nurses, or other staff.

References

American Nurses today-ANA:https://www.americannursetoday.com/medication-errors-best-practices/

Nurse Perceptions of Medication Errors: What We Need to Know for Patient Safety: https://www.nursingcenter.com/journalarticle?Article_ID=514523

 
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