Combatting Moral Distress

You have been given some tools to develop critical thinking skills, use ethical decision making models to strengthen and clarify your values. You will need to be on an intentional journey to use and leverage these skills to keep your nursing practice resilient and meaningful.

QUESTION

1. How do you see yourself cultivating moral resilience within yourself,  with your colleagues and the organizations where you will work?  

2. What specific interventions can you envision for yourself as you continue your journey in the socialization of becoming a nurse? 

3. What contributions do you intend to create to make meaningful and sustainable change in your role as a nurse?

 

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Essay  Contemporary Moral Issue 

 

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Evaluating and Sustaining Improvement

 The downfall of many quality improvement initiatives is the inability to sustain improvements. Last week, you considered the use of evidence-based practice models as a method for sustaining practice changes to improve quality. This week’s Discussion builds on those concepts of sustainability. You evaluate measurement mechanisms and explore strategies that leadership and improvement teams can use to sustain improvement efforts.
 

To prepare:

• Review      the evaluation tools presented in the Learning Resources and how the tools      can be used to promote sustainability.
• Select      a measurement mechanism that can be used to evaluate your quality      improvement initiative. You may wish to conduct additional research on the      use of measurement mechanisms to sustain outcomes of improvement      initiatives.
• Consider      the influence of leadership and improvement teams in sustaining      improvement efforts. Ask yourself: What specific strategies can leaders      and my improvement team use to sustain our improvement initiative?

By tomorrow Wednesday February 7, 2018 by 12 noon, post a minimum of 550 words essay in APA format with at least 2 references from the list below. Include the levels one headings as numbered below:

post a cohesive scholarly response that addresses the following:

1) Evaluate the influence of leadership and improvement teams in sustaining improvement efforts. 

2) Present a succinct analysis of three or more strategies leaders and teams can use in your response.

Required Readings

Richardson, A., & Storr, J. (2010). Patient safety: A literative review on the impact of nursing empowerment, leadership and collaboration [corrected] [published erratum appears in INT NURS REV 2010 Mar;57(1):158]. International Nursing Review, 57(1), 12–21. doi:10.1111/j.1466-7657.2009.00757.x 

This article analyzes how nurses can improve patient safety. It identifies certain knowledge gaps that inhibit nurses’ ability to improve patient safety that must be addressed before they can effectively make contributions.

Bigelow, L., Wolkowski, C., Baskin, L., & Gorko, M. (2010). Lean Six Sigma: Sustaining the gains in a hospital laboratory. Clinical Leadership & Management Review, 24(3), 1–14.

In this article, a health care organization uses Lean Six Sigma to improve performance, but it does not initially achieve the desired results. It then utilizes an Operational Performance Improvement office from within the organization to receive better training in Lean Six Sigma and it is finally able to improve performance.

Murphree, P., Vath, R. R., & Daigle, L. (2011). Sustaining Lean Six Sigma projects in health care. Physician Executive, 37(1), 44–48. 

The authors of this article consider ways to keep Lean Six Sigma projects operating instead of closing them. They distinguish between closing and controlling, the latter being the last phase in Lean Six Sigma. According to the authors, many organizations close Lean Six Sigma projects when they should be controlling them.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: Organizational change. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

This video examines factors that enhance and impede organizational change. Dr. Wooden and Dr. Freshman discuss change models that can be used to manage the change process and to assist individuals through the transition period 

 

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Review the attached. 

In this activity, we are going to review the assignment and response provided below and then analyze whether the Socratic Approach was applied adequately in the sample response provided below. Please provide separate numbered answers to the below questions in regards to assignment. 

Assignment:

In considering how personality develops, the impact of the child’s environment, as well as the child’s innate characteristics, must be taken into consideration. Assess the nature versus nurture controversy. Assess your views on how each affects a child’s personality and moral development. Provide supporting evidence or reasoning. Which theoretical perspective on personality and moral development most closely represents your view?

Sample Response:

In the context of the nature versus nurture controversy, nature means one’s genetic inheritance of traits such as intelligence, physical characteristics, and personality tendencies (Vander Zanden, Crandell, & Crandell, 2009). Nurture means the influence of environment, including parenting, schooling, physical environment, culture, and other factors (Vander Zanden et al., 2009). In the past, social scientists and others argued which factor—nature or nurture —was responsible in a given situation, but it is more common today to ask either how much is due to nature versus nurture, or how they interact (Vander Zanden et al., 2009). Vander Zanden et al. (2009) therefore characterize the current nature versus nurture controversy as asking either how or how much, rather than which.

While there are many theories that address the nature-nurture controversy, behaviorism most closely represents my view. Most of the behaviors needed to succeed in life are within the capabilities of most people, but some people’s environments make success unlikely for them. If a person is raised in an environment that does not support educational activities, that person is unlikely to become a physicist, even if he or she was born with the intelligence traits of an Einstein. Similarly, those raised in a violent environment are more likely to be violent, such as those who were abused as children may subsequently abuse their own children.

Reference: Vander Zanden, J. W., Crandell, T. L., & Crandell, C. H. (2009). Human development (9th ed.). Boston: McGraw-Hill Higher Education.

Step 1: Identify the elements of the problem, issue, or question. Did the response adequately include this step? Yes or No? If no, what was missing?

Step 2: Analyze/ define/ frame the problem, issue, or question. Did the response adequately include this step? Yes or No? If no, what was missing?

Step 3: Consider solutions, responses, or answers. Did the response adequately include this step? Yes or No? If no, what was missing?

Step 4: Choose a solution, response, or answer. Did the response adequately include this step? Yes or No? If no, what was missing?

 

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Discribe four characteristic/ test or blood patient readiness

  for ventilator.(weaning)
1)the ventilator change mode

2)MIP or NIF/ vital capacity test

3)RSBI(rapid shallow breathing index)

4) blood gas

 

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