sunset - Nursing
Health systems and nursing in the future Top of Form Critical thinking and reflection: Having listened to at least one episode or more of the podcast series The Future of Nursing 2020-2030 by the National Academy of Medicine, please respond to the following questions: 1. Which podcast(s) did you listen to and why did you choose these topics? What are two things from the podcast(s) that were new information to you? 2. How did the podcast(s) you listened to change your perspective on your future in the nursing profession? How will you change your clinical practice or your plans for a future career based on what you learned? 3. Do you feel hopeful for the impact on nursing on health equity and the improvement of health outcomes? If yes, what makes you hopeful? If no, why not? Bottom of Form INSTRUCTIONS: ANSWER QUESTIONS 1,2,3, USING THE PODCAST (EPISODE 7) AND THE BOOK. PLEASE USE THE BOOK TO CITE 6th edition: Weiss & Tappen (2015) pp. 151-158, 162-166, 239-244. (please cite using APA 7th edition) Please use only my references for in text citation thanks FON Strengthen-Final Transcript Page 1 of 8 The Future of Nursing Podcast - National Academy of Medicine (nam.edu) Dr. Sharmaine Lawson (00:15): West Virginia has a history of poor health outcomes. Many people experience food insecurity and financial instability. West Virginia is rural, and this makes it difficult for people to find transportation that allows them to access care. The COVID-19 pandemic only magnified these problems. Angela Gray is a public health nurse whos worked in West Virginia for over 15 years. Shes now the Nursing Director for the Berkeley and Morgan County Health Departments. Angela grew up in Morgan County, West Virginia, and shes seen these poor health outcomes unfold, but she had never seen an emergency quite like the global pandemic. Angela Gray (00:58): I felt that we had done all these drills. Ive been through H1N1, through mass vaccination in the past, but nothing compared to this. There were several key points that I know where I thought they didnt prepare us for this. When New York got hit so hard and you saw the refrigerator trucks come out for the bodies, I knew that would happen. That was in our training to expect that. It was very surreal to see it happen, believe me. Dr. Sharmaine Lawson (01:30): From the start of 2020 up through 2021, nurses underwent some of the most intense moments in nursing history with the COVID-19 pandemic. They worked hours upon hours to protect the public, and often at risk of their own physical and mental health. In this episode, we are going to hear from frontline nurses about their experiences and together, we are going to explore how nurses can be strengthened, prepared, and protected for when the next emergency strikes. This is the Future of Nursing, a series from the National Academy of Medicine, based on the recently published report, The Future of Nursing 2020 to 2030, charting a path to achieve health equity. Im Dr. Sharmaine Lawson. At first, when the pandemic began, Angela Gray saw glimpses of hope. Angela Gray (02:33): In the beginning, it was ... really restored your faith in humanity as you saw the country come together. People were so grateful, and we were calling people who were positive for COVID and helping them and their families through it. Then at one point after a couple months, it was like somebody turned a switch and then people became very angry. We got cussed more in a day just for trying to do our jobs and collect the data points that was required for us to report. Dr. Sharmaine Lawson (03:02): When Angela saw this shift in the public, she knew it would take a big toll on the nursing workforce. Angela Gray (03:09): It was very tough in that transition of, oh my gosh, were the people here that are trying to help you, and theyre blaming us because were the ones that are out there trying to make sure the guidelines are being met and the recommendations are being met. So yeah, it was very difficult and it really hit our mental health. By October of 2020, I had four staff members that disclosed that they had to go to their EPISODE 7 https://nam.edu/the-future-of-nursing-podcast/ https://www.rev.com/transcript-editor/Edit?token=zkwhBwwk7lu8zyYn4xJ31aLY-qxuaMsvvmHULHZQ6LD6KSsQJIJV5weZtfe2071qsnnTy6L1fRw3nXAnSNpfOaM4CQY&loadFrom=DocumentDeeplink&ts=15.77 https://www.rev.com/transcript-editor/Edit?token=x4X4DH4EXtqWr77h2vrSyZjuF557kuDHnzbAVlkbdm-nyglXUJsiFGsXQRSMh6PTngZQ_Y5nuvdlsK_AWRwv4dtwhFU&loadFrom=DocumentDeeplink&ts=58.26 https://www.rev.com/transcript-editor/Edit?token=NXDcnVIJ9adxdgZSKMo1X0l8LSEXvUe7z7dUlaWQ7SO3bNt9sG-M5z-AMOpM2HAFz_9Ty7yaZzzUBALqhOKZzwW9rnc&loadFrom=DocumentDeeplink&ts=90 https://www.rev.com/transcript-editor/Edit?token=ukeqwnoXn0Khi4dNE3a8RsqSEcEnyRPclDMP2qAAU6rNPnLGR4ROCeV2f0HEoIAXt2L1U46mriQe16b157sivQAP-z0&loadFrom=DocumentDeeplink&ts=153.82 https://www.rev.com/transcript-editor/Edit?token=wtl7Lja6Ju2F1R1c05xPg-iPDvD55Y2OmQcVD6sQfFPmqy94l0dZ4EGM9PuEUeLwft_GFkpjmLbVDlbXqF7d71XSB9o&loadFrom=DocumentDeeplink&ts=182.97 https://www.rev.com/transcript-editor/Edit?token=5vluf4DtmPOD-igpNjiyhtyRYTHv9P-ikk4L9Iv3hGmKrupKbily2XMC9FcWP9lhrENA5gY-Yy5CXO-PyWnrvEklXRY&loadFrom=DocumentDeeplink&ts=189.68 FON Strengthen-Final Transcript Page 2 of 8 physician to get on anti-anxiety medication or medications to help them sleep. That was just the staff members that disclosed to me. So I try to advocate for us here. Dr. Sharmaine Lawson (03:48): Backlash from the public was one reason why nurses mental health suffered. It wasnt just their mental health that suffered, but their physical health as well. Angela Gray (03:58): By that time in September, they had mandated that our National Guard be off two days a week because they had already seen the stress under them, but nobody was advocating for us. Im like, Look, were working seven days a week for months on end, 12 and 16 plus hour shifts. Were taking on so much. I said we cant continue these long stretches like this. Youre not going to have any of us left. So then they, our administrator, stuck up for us and said, okay, Im going to mandate everybody have off two days. So some people got that. Some of us didnt because even if you were supposed to be off, your phone never stopped. You just could not get away from it. It was literally consumed every aspect of your life. Dr. Sharmaine Lawson (04:44): Nurses across the country were fatigued. They couldnt always just rest from their duties. They put their own health and wellbeing at risk to protect the public. Dr. Michael McGinnis is the Leonard D. Schaeffer Executive Officer of the National Academy of Medicine. We heard from him in an earlier episode. Dr. McGinnis watched as nurses, Physical and mental health went under extreme pressure, and he discovered something that was concerning. Most nurses did not feel prepared for this. Dr. Michael McGinnis (05:16): Nurses were thrown quite abruptly during the COVID-19 pandemic onto very front lines in very hazardous conditions. The effective function of the system was fundamentally anchored to their effectiveness. Yet four out of five nurses, when asked whether they felt equipped and trained adequately to be able to contend with emergency circumstances, whether related to the COVID-19 pandemic, or related to other external threats to the nation, or emergent situations, felt that they didnt have the training. Dr. Sharmaine Lawson (05:56): Public health emergencies can be caused by transmissible diseases, but can also be caused by environmental disasters and mass casualty events. In the past decade, 2.6 billion people around the world have been affected by earthquakes, floods, hurricanes, and other natural disasters. The COVID-19 pandemic is just one example of a public health emergency. When disasters strike, nurses can engage the community and build trust with them. They can educate and protect them. They can also help people prepare and respond. When its time for the community to recover, nurses can help people to foster resilience. Nurses may go through training that prepares them to respond to these emergencies, but often it isnt enough, and many are left unprepared. Dr. Roberta Lavin is a nurse practitioner who spent much of her career on disaster preparedness and response. Shes recognized that there are some https://www.rev.com/transcript-editor/Edit?token=2CEN8-pgrgQNWTl0BpDWQ6TuWogFSDnkNld1JjmriXOr_pnXdoebRpnyHm7ilQws2jpND1eU17sGibqjA-DEG_3gyjI&loadFrom=DocumentDeeplink&ts=228.67 https://www.rev.com/transcript-editor/Edit?token=80F4uqSo21BdSeXUkIPrbzXf7bID7b9eWeKILkU9iP3tb6tcKdPCA4vMFa3YoM_6UZZlJho3claueGHuOyrqsVgDu48&loadFrom=DocumentDeeplink&ts=238.64 https://www.rev.com/transcript-editor/Edit?token=ulIc334Spbnx9SoZ7HgW2-VETyGsqf1M3mpIvzLKOW_S2_dMlipwwyJb3YVFFqu4qgddTB8cYM_5o-N1tLmNKbMWeTU&loadFrom=DocumentDeeplink&ts=284.96 https://www.rev.com/transcript-editor/Edit?token=RuTwjiJgirb4cCZ_lVFn-TfJtuxnBTkrJRpn2MgU0WTo7cUMxOnmc4t1sUmXwcSrXe6GXgXTsNJF1o2JKHYZHzpubho&loadFrom=DocumentDeeplink&ts=316.42 https://www.rev.com/transcript-editor/Edit?token=hBTFVIH4ajcieGlt1LGX3VLM0GaXKhI7GzlDYuNJ3Ez1VvAsjkAkAS7E3M-WFcEjj5Kk9AsU1sHHpq_Ky94IIrBPVgg&loadFrom=DocumentDeeplink&ts=356.93 FON Strengthen-Final Transcript Page 3 of 8 areas in nurses training that demonstrate a lack of preparedness among nurses when it comes to public health emergencies. Dr. Roberta Lavin (07:05): In my discussions with many nurses, Ive been told that theyve had little to no training after graduation from nursing school, and much of the training is provided to those in the emergency department and to administrators, and not to the average nurse on a unit. The second area is lack of serious disaster preparedness planning that involves nurses. The quote that struck me was one that said, We train people to put out a fire, but not how to evacuate the patients during the fire. The same can be said for how we handle infectious diseases. We train people what they should do to handle infectious diseases, but we never have them practice donning and doffing of the PPE that they need to use. Dr. Sharmaine Lawson (08:00): According to Dr. Lavin, we have to act now to really prepare the nursing workforce for disaster response. Dr. Roberta Lavin (08:07): We know that weve always said that this is the time we have learned the lessons from the pandemic. We do after actions and we put the things together and then we say were going to fix them. We said after 9/11 and the anthrax attacks, never again. Then Katrina and Rita came, and we werent prepared. Again, we said never again, and Puerto Rico came, and we werent prepared. We said, never again, and then this pandemic came. Maybe this will be the time that we take the lessons we learn. Dr. Sharmaine Lawson (08:44): Its imperative that we do learn from these lessons because natural and environmental disasters are happening more frequently. Public health emergencies, like the COVID-19 pandemic are inevitable, and our nursing workforce must be prepared, along with our health system, to protect our nurses as they work to protect us. Public health emergencies can take many forms. They can be global, national, or contained in a local community. Prior to the COVID-19 pandemic, Angela Gray had her own experience with other public health emergencies in West Virginia. While these cases happen in West Virginia, they also frequently happen all across the nation. Angela Gray (09:33): Sure, I think the opioid epidemic is a perfect example of a public health crisis in this country, versus something communicable like COVID virus and pandemic. So were always looking at these emergencies, and depending on the research and the data of where the numbers are and the stats are and whats happening, chronic disease in West Virginia is huge rates higher than other parts of the country. Even in the same country, you may be working on different needs based upon your community and what the threats are in your individual communities. It might be the same all the way through the nation. Its just, it can be very different in different areas of the nation. Here in West Virginia, teen pregnancy, chronic disease and illness, diabetes, substance use disorder. We had a huge hepatitis A outbreak that the country usually sees less than 1500 cases in a year. West Virginia usually sees less than 15 cases, and we ended up with 2,500 cases in West Virginia in one year. So that triggers our response of getting out and trying to vaccinate, getting ahead of it, trying to https://www.rev.com/transcript-editor/Edit?token=w0z8H5LJJ4V6LlBhrwKY63-IY6yNGVYQ-2tFPpbwy_zf8LFr_9_rDBhW4lKcGgTb8i-mcYzqq0rX594i7sjKRpASOtA&loadFrom=DocumentDeeplink&ts=425.63 https://www.rev.com/transcript-editor/Edit?token=7SdMtAM3YQ25hTHth-WehsR_w2vaxuEdEMMUuLVGKyxxh-ude8Tn5f8aaL7e_2csduccS7WYzk_5fnK1q1QyIHQBcxs&loadFrom=DocumentDeeplink&ts=480.29 https://www.rev.com/transcript-editor/Edit?token=LFr_SpI0_ELj3CNlYOczBppKB468QH4UQh8bAFdLnnMEJifa85FDT0fbwMl99RLCQNmIWme_0NX0fRMSIscPMFvVYMg&loadFrom=DocumentDeeplink&ts=487.63 https://www.rev.com/transcript-editor/Edit?token=GO6EjwTRB-JXpKPVkbKiCL0oP_kDnQ1K_3xUrHnLK-GQbi1fQSs8L8261kRDj_iD3KRMHZHT7fDQjKzHKM8JCjQkuJs&loadFrom=DocumentDeeplink&ts=524.17 https://www.rev.com/transcript-editor/Edit?token=H9E8xtTSh9bRewLjh_rO_y2tUBE02Hb6CjsIovq-l1NSKYcj8f0k_AcmwS4rkDX1KTvb8cE5-764-STKQSdVEj6pUPU&loadFrom=DocumentDeeplink&ts=573.76 FON Strengthen-Final Transcript Page 4 of 8 contain it. So lots of emergencies, and then also down to we would respond and support our other community entities if it would be a water spill or a contamination of water on the environmental side of public health. Theres multiple things that were doing behind the scenes every day, protecting our communities so everybody can go about their way and feel safe. Dr. Sharmaine Lawson (10:59): When nurses are equipped to respond to disasters and other public health emergencies, communities can become safer and care can be delivered even in the midst of a crisis. But as of right now, many nurses admit they do not feel equipped to respond to these kinds of events. Because they are not prepared for disaster and public health emergency response, rapid action is needed. So what can be done? First nurses and nursing leaders must understand what their roles are in public health emergencies and natural disasters, training programs should consistently address what these roles are, so that when a public emergency occurs, nurses can be confident of how they are expected to respond. We also need reform in nursing education, practice, policy, and research to address the gaps in nursing disaster preparedness. We need experts from nurses to researchers to develop a national strategic plan that then addresses these gaps, figures out how they can be solved, and whose responsibility it is to implement new strategies. This action is especially important as nurses are often addressing health inequities while responding to public emergencies. With preparation, nurses may feel more confident in their ability to respond to crises. We can never fully mitigate the stress that public health emergencies can cause for nurses, but we can work to lessen the trauma they may experience due to the disaster. Derek DeSilva is a young intensive care unit nurse who practices at a hospital in Austin. Derek had begun working on the ICU floor just a few months before the COVID-19 pandemic began. He felt like he had a good grasp on how the floor worked. He had even gone through some emergency preparedness curriculum in nursing school. But then everything changed and he realized he wasnt prepared for this at all. Derek DeSilva (13:05): Whether that be in nursing school, hospital staff, people, disaster management organizers, the idea of a widespread pandemic wasnt something that we were prepared for, really coached about, or given any extra resources. Dr. Sharmaine Lawson (13:20): Positive cases of COVID began increasing. As the ICU began to fill with COVID patients, Derek watched as existing health inequities were magnified. Derek DeSilva (13:31): I definitely noticed quite a few of these health disparities. Typically, they surround around having health insurance. Some patients would massively benefit from being able to transfer to more specific facilities, or being able to be eligible for certain medical treatments that they simply did not get access to because they didnt have health insurance. Where we had them, as as much of their health that we could rebuild in in our unit, thats as good as they were going to get, because without insurance, they werent going to be able to transfer to that facility. So these patients were basically stuck in our ICU. They couldnt progress to the level of care that they absolutely could and would need simply because they did not have health insurance, and it would not approve for these life bettering, life saving procedures. https://www.rev.com/transcript-editor/Edit?token=5YgTWJXk9CUlIkhqNq0UP37IgbsimoPCf8lrWuqJyUAzElPo4VoTpL18jEHsk9_SO-LgsBv3cbyBk_2qndZ9YIoEqdI&loadFrom=DocumentDeeplink&ts=659.12 https://www.rev.com/transcript-editor/Edit?token=AyKml67Qngrb-06pMtURXVCyZjrZbrDgl_9ClThVeADm0pwmmUzpdwBmhMavj9enK9qRSUKh53y2FxswSo4mbN6eVjM&loadFrom=DocumentDeeplink&ts=785.97 https://www.rev.com/transcript-editor/Edit?token=tbhSS5HGO-kAfaQd0dhoiH5oX_V9j12PuJbTt81syFLxlkaeJ0ro3JDrbCX10S2jMI2HGzhYu_h82rTNpH0s_Cgg-wQ&loadFrom=DocumentDeeplink&ts=800.17 https://www.rev.com/transcript-editor/Edit?token=kbtJjoMnVp5O_tpaNOmyanj-azwMH9mhkRW6fwrOx6h5qLakD_ETcSQeEw4msLDMZyG2XUHlc4uG08szbubId00pFqY&loadFrom=DocumentDeeplink&ts=811.33 FON Strengthen-Final Transcript Page 5 of 8 Before maybe not having insurance would be missing out on an opportunity to maybe gain more mobility, or have some specialized training to maybe learn how to eat again after a stroke. But during the COVID-19 pandemic, not having insurance for some people meant that they were going to die. Dr. Sharmaine Lawson (14:49): Derek and nurses across the world witnessed devastating outcomes due to this pandemic. Many nurses were often the ones who held the hand of a dying individual. Theyd call family members of patients so they could say their last goodbyes. Some nurses even sang a last song for the patients who would not be leaving the hospital. These were often just short, significant moments, and nurses often had to quickly move on to assist another individual. Nurses were not prepared for the trauma that came from witnessing these terrible outcomes. Health systems quickly realized that their nurses were under incredible pressure. They worked to provide resources to support their nurses through these intense and very sad moments. Derek DeSilva (15:37): Our hospital system was actually really good about providing some mental health services, about providing some outlets. We got free basically telehealth counseling sessions to be able to talk about it. A lot of people, a lot of nurses, a lot of medical professionals were able to just get together after some shifts and talk about some things, but it was nice to know that there was at least some support and it was totally free. You got to use those, and Ive got quite a few colleagues who were able to use these telehealth counseling sessions or mental health sessions, or so to be able to just decompress and talk about some of the things, talk about everything that happened. Dr. Sharmaine Lawson (16:27): This support was helpful and helped to ease some of the burden nurses experienced. But it didnt take this burden completely away, and not all health systems and employers were prepared or equipped to guide nurses through this time long term. Derek DeSilva (16:43): It was good to get some support from management, but at the same time, it wasnt like management could give you a break. It wasnt like the hospital suddenly stopped when you got burnt out. They were still asking for extra shifts. They were still asking for people to come in and pick up extra, like I said, all the way to even January of 2021. So it was good that there was some support. There was some ways to talk about things, but getting burned out was a very real thing for a lot of nurses. It almost seems like thats the kind of support that we needed more. But things changed early on, early March to July, March to August. Having someone to talk to that was the biggest thing after that second wave. Like I said, at least in Austin area, a second wave happened around July. Having more resources and more personnel wouldve been the next kind of support, I think, that a lot of people were looking for, just because of how burned out everyone was getting from picking up so much extra. Maybe during these situations, people are going to be dying every day. Thats the reality, and I feel like we are so desensitized to that now. Were ready for a situation like that. But talking about it, I mean, we in nursing school, in hospital orientation, I think we get some information about make sure you do self-care, make sure youre checking in with yourself, but even going to the ICU, it doesnt seem like theres a lot of real preparation. I think the same could be said for the emergency department https://www.rev.com/transcript-editor/Edit?token=H7ds3NOwVQfgcSSVX1QE0-peAP1ahcBJIryhQBAMiVGjxHXL-LPvg-JiS3bhKgM_xWQ7T1U22TNPQUAZtQV4rXV_Zhw&loadFrom=DocumentDeeplink&ts=889.04 https://www.rev.com/transcript-editor/Edit?token=uPcX1kYJplNR6enM80C41hqH5O0Nrn6WIGMTxXoyEdQCyGnWlf7lhi2dLlmxfC5mdErXqcJ8lscTIbN8UkfA8g2q4HQ&loadFrom=DocumentDeeplink&ts=937.42 https://www.rev.com/transcript-editor/Edit?token=_JNRLUVPJjQ_LNVkGpL1F0XWk4YwFtiAUEL7D2rr-q0fnWV4uCC9mgdf5z6t8MAgpIlbi-WJIQGpUV1bLn8FehB6Jmo&loadFrom=DocumentDeeplink&ts=987.38 https://www.rev.com/transcript-editor/Edit?token=UhIIYysp-xKvsPgaovBKQis8V7cDCk2ftTKH7N_Xgr8NXq757qtpVjnQ55nmqmCzINulLDfWPFYewKlAs6o5qRs8t54&loadFrom=DocumentDeeplink&ts=1003.23 FON Strengthen-Final Transcript Page 6 of 8 as well. Theres some stuff youre going to see there, and people are going to die in those places. Is there really a way to prepare you for that? Dr. Sharmaine Lawson (18:38): Providing resources for counseling and support is beneficial, but hospitals and health systems must also have a systematic approach to support their nurses when a public health emergency begins. In an earlier episode, we talked with Frank Boz. Frank is a nurse in the cardiothoracic intensive care unit. In our episode on supporting nurses, Frank shared how the leadership at his hospital supported him in an unexpected way. This kind of support may have cost the hospital resources, or required them to change policies, but it gave nurses a voice. It gave them a chance to better understand what to expect as procedures shifted. In our supporting nurses episode, we also talk with Marcus Henderson, who is a practicing psychiatric mental health nurse and member of The Future of Nursing 2020-2030 consensus study committee. During the pandemic, Marcus saw that it was critical for hospitals to invest resources in finding creative solutions to protect and support nurses during public health emergencies. Marcus Henderson (19:42): Theres a lot of work to be done if less than 10\% of hospitals have bit the bullet to say, Were going to show that we invest in nursing. So I think there is still a lot of work to be done. It comes in pockets, and I think COVID has shown us that these workforce issues related to staffing shortages, burnout, resourcing have not gone away, and in some places have exacerbated greatly because of the challenges that COVID has imposed. But I think it has shown us the creative solutions that can be developed. But I do think there is much work to be done. I mean, its crazy to think that when a nurse reaches out for help and support, for example, reaching out for mental health support, that theyre penalized and their ability to function at as a nurse is called into question. Rather than providing that nurse with the support that they reached out for to do their job better and to progress. So we have to change the whole framework and the whole culture around support and wellbeing, because people see nurses that reach out for support as a deficiency and not an area for growth. Dr. Sharmaine Lawson (20:57): Derek DeSilva found that there was yet another specific kind of support nurses really needed, especially since for many nurses, a public health emergency is only one example of a situation that might cause trauma for nurses. Outside of emergencies, nurses still encounter emotional and difficult situations, whether in the ICU or another floor in the hospital or in a public health setting. Derek DeSilva (21:21): I think the biggest thing that would help nurses is other nurses. I think the biggest way that I learned, and for a lot of other nurses as well, is getting to talk with some nurses who have experience, who have lived through some of these situations. Saying, Yeah, I was working, like I said, 50, 60 hour weeks for an entire month, and I got ... I started getting burned out, and talking about burnout. This is something that happens with new nurses all the time. Being able to talk with someone who had the same experience, who was a young nurse at one point as well, and have seen many other nurses make similar mistakes or go down a similar path, and I found that to be valuable. Having other nurses, having experienced nurses who have gone through similar situations talk to you, or talk to newer nurses and https://www.rev.com/transcript-editor/Edit?token=EUHBycPnf41TbH1x69WEAQ-W5U5L2y0SZ8gMgKPiV8NOtYnUD_HW7kEqwt2Ta2nvziwzWROD3DmN6ROvrXsjj8zvgoE&loadFrom=DocumentDeeplink&ts=1118.33 https://www.rev.com/transcript-editor/Edit?token=IS4T9TWTIX79-LRiKPYYGwQL5_VTk_QsskZX0t1ECPWLNKcQ8LiUXim07b0gfSXx2IBY274tHVQ4iL7wlIKTWflIB58&loadFrom=DocumentDeeplink&ts=1182.31 https://www.rev.com/transcript-editor/Edit?token=KPuYzZrQoHUPqwjO6jHD0MmH0flJADoQ_uF1j8Wqfp67erEHY0A4OCqquhZVX9QOEQW7S72jtRgq1-_Vw3v4oSmWbAo&loadFrom=DocumentDeeplink&ts=1257.61 https://www.rev.com/transcript-editor/Edit?token=fo9AYU00sPEd9jKsMh3DYbPngEWxUNFn-pYC7gmmr7YzIy9rO27WzYt_x8csnJAQ9wCss1CBQ4qqpEAbdpw1J7Wx8kg&loadFrom=DocumentDeeplink&ts=1281.49 FON Strengthen-Final Transcript Page 7 of 8 say, Hey, these are the things to look out for. Watch out when you feel yourself starting to feel more upset or not excited to come into work. Be mindful that its more about the patients. I think in one sense, maybe in nursing school, having nursing students talk with individuals who have gone some of those situations, some of those public health emergencies, I think it would be extremely valuable. Dr. Sharmaine Lawson (22:35): Or Derek, this was one way he knew nurses could be protected through public health emergencies specifically by supporting each other. But there was something else nurses needed, especially during the pandemic, as policies and guidelines frequently shifted. Derek DeSilva (22:51): A lot of what we do, pretty much everything we do has 10, 20 years, quite a few decades of best practices that have only been improved upon as the years, as the decades have gone on. To have something that we dont have best practices for, that it seems like were making and things up as were going along, I think that scared people. I think what could be done in the future to mitigate the fear that nurses had with all of these changing procedures is to use what weve learned from this last pandemic. To be honest that when something new comes up, when something outside of our scope of expectation and preparation comes up, that they need to expect some of the procedures to change as the science evolves. Dr. Sharmaine Lawson (23:38): Nurses around the nation, even around the world now understand that when an emergency like a pandemic is occurring, procedures are guaranteed to change. Education and training should prepare nurses for these changes so they can know to expect them and move forward with confidence. This is just one example of the many lessons learned from the COVID-19 pandemic. Like Dr. Lavin mentioned earlier, this time, we must take these lessons into consideration and act on them. Derek DeSilva (24:09): Hey, if this happens, were going to try to call and retain these nurses, or something to that extent, giving a little bit more importance on the fact that something like this could be possible. We do CPR training every two year years. We re-up that CPR training every two years, and we stay keen. We know exactly what were looking for, and we get a refresher. We do fire drills now almost monthly. So I think incorporating this, and talking to newer nurses, and incorporating this in hospital orientation could have the chance to just make it seem a little less scary and give people a little bit more understanding as far as the expectations. Youre not going to have 100\% premonition of whats going to happen, but at least having some idea of expectations going in, I think might do wonders for the new generation of nurses who are just coming to the field. Dr. Sharmaine Lawson (25:07): We have to understand that by strengthening and preparing nurses to respond to the next emergency, we are also protecting them. The physical risk cant always be taken away, but they can be mitigated when we equip our nurses to be confident in their knowledge, skills, and resilience. https://www.rev.com/transcript-editor/Edit?token=FlWNdBCXJUZfMiJC2HaZe47VhR59SG6pR4TjLzfGhDe8mOs06mTHWMDBhhOnPvTnScabBaHlTqPH3U7HgYqMN1qq7Nw&loadFrom=DocumentDeeplink&ts=1355.2 https://www.rev.com/transcript-editor/Edit?token=W2Pc3v1RkGA3jTcHDG8RieQA4JiyNevQynmvw4QsO1GOV_F797b8gyKxwcrd1ev8ob26SW1jDoVrOSJRc7k5bOKZwUY&loadFrom=DocumentDeeplink&ts=1371.61 …
CATEGORIES
Economics Nursing Applied Sciences Psychology Science Management Computer Science Human Resource Management Accounting Information Systems English Anatomy Operations Management Sociology Literature Education Business & Finance Marketing Engineering Statistics Biology Political Science Reading History Financial markets Philosophy Mathematics Law Criminal Architecture and Design Government Social Science World history Chemistry Humanities Business Finance Writing Programming Telecommunications Engineering Geography Physics Spanish ach e. Embedded Entrepreneurship f. Three Social Entrepreneurship Models g. Social-Founder Identity h. Micros-enterprise Development Outcomes Subset 2. Indigenous Entrepreneurship Approaches (Outside of Canada) a. Indigenous Australian Entrepreneurs Exami Calculus (people influence of  others) processes that you perceived occurs in this specific Institution Select one of the forms of stratification highlighted (focus on inter the intersectionalities  of these three) to reflect and analyze the potential ways these ( American history Pharmacology Ancient history . Also Numerical analysis Environmental science Electrical Engineering Precalculus Physiology Civil Engineering Electronic Engineering ness Horizons Algebra Geology Physical chemistry nt When considering both O lassrooms Civil Probability ions Identify a specific consumer product that you or your family have used for quite some time. This might be a branded smartphone (if you have used several versions over the years) or the court to consider in its deliberations. Locard’s exchange principle argues that during the commission of a crime Chemical Engineering Ecology aragraphs (meaning 25 sentences or more). Your assignment may be more than 5 paragraphs but not less. INSTRUCTIONS:  To access the FNU Online Library for journals and articles you can go the FNU library link here:  https://www.fnu.edu/library/ In order to n that draws upon the theoretical reading to explain and contextualize the design choices. Be sure to directly quote or paraphrase the reading ce to the vaccine. Your campaign must educate and inform the audience on the benefits but also create for safe and open dialogue. A key metric of your campaign will be the direct increase in numbers.  Key outcomes: The approach that you take must be clear Mechanical Engineering Organic chemistry Geometry nment Topic You will need to pick one topic for your project (5 pts) Literature search You will need to perform a literature search for your topic Geophysics you been involved with a company doing a redesign of business processes Communication on Customer Relations. Discuss how two-way communication on social media channels impacts businesses both positively and negatively. Provide any personal examples from your experience od pressure and hypertension via a community-wide intervention that targets the problem across the lifespan (i.e. includes all ages). Develop a community-wide intervention to reduce elevated blood pressure and hypertension in the State of Alabama that in in body of the report Conclusions References (8 References Minimum) *** Words count = 2000 words. *** In-Text Citations and References using Harvard style. *** In Task section I’ve chose (Economic issues in overseas contracting)" Electromagnetism w or quality improvement; it was just all part of good nursing care.  The goal for quality improvement is to monitor patient outcomes using statistics for comparison to standards of care for different diseases e a 1 to 2 slide Microsoft PowerPoint presentation on the different models of case management.  Include speaker notes... .....Describe three different models of case management. visual representations of information. They can include numbers SSAY ame workbook for all 3 milestones. You do not need to download a new copy for Milestones 2 or 3. When you submit Milestone 3 pages): Provide a description of an existing intervention in Canada making the appropriate buying decisions in an ethical and professional manner. Topic: Purchasing and Technology You read about blockchain ledger technology. Now do some additional research out on the Internet and share your URL with the rest of the class be aware of which features their competitors are opting to include so the product development teams can design similar or enhanced features to attract more of the market. The more unique low (The Top Health Industry Trends to Watch in 2015) to assist you with this discussion.         https://youtu.be/fRym_jyuBc0 Next year the $2.8 trillion U.S. healthcare industry will   finally begin to look and feel more like the rest of the business wo evidence-based primary care curriculum. Throughout your nurse practitioner program Vignette Understanding Gender Fluidity Providing Inclusive Quality Care Affirming Clinical Encounters Conclusion References Nurse Practitioner Knowledge Mechanics and word limit is unit as a guide only. The assessment may be re-attempted on two further occasions (maximum three attempts in total). All assessments must be resubmitted 3 days within receiving your unsatisfactory grade. You must clearly indicate “Re-su Trigonometry Article writing Other 5. June 29 After the components sending to the manufacturing house 1. In 1972 the Furman v. Georgia case resulted in a decision that would put action into motion. Furman was originally sentenced to death because of a murder he committed in Georgia but the court debated whether or not this was a violation of his 8th amend One of the first conflicts that would need to be investigated would be whether the human service professional followed the responsibility to client ethical standard.  While developing a relationship with client it is important to clarify that if danger or Ethical behavior is a critical topic in the workplace because the impact of it can make or break a business No matter which type of health care organization With a direct sale During the pandemic Computers are being used to monitor the spread of outbreaks in different areas of the world and with this record 3. Furman v. Georgia is a U.S Supreme Court case that resolves around the Eighth Amendments ban on cruel and unsual punishment in death penalty cases. The Furman v. Georgia case was based on Furman being convicted of murder in Georgia. Furman was caught i One major ethical conflict that may arise in my investigation is the Responsibility to Client in both Standard 3 and Standard 4 of the Ethical Standards for Human Service Professionals (2015).  Making sure we do not disclose information without consent ev 4. Identify two examples of real world problems that you have observed in your personal Summary & Evaluation: Reference & 188. Academic Search Ultimate Ethics We can mention at least one example of how the violation of ethical standards can be prevented. Many organizations promote ethical self-regulation by creating moral codes to help direct their business activities *DDB is used for the first three years For example The inbound logistics for William Instrument refer to purchase components from various electronic firms. During the purchase process William need to consider the quality and price of the components. In this case 4. A U.S. Supreme Court case known as Furman v. Georgia (1972) is a landmark case that involved Eighth Amendment’s ban of unusual and cruel punishment in death penalty cases (Furman v. Georgia (1972) With covid coming into place In my opinion with Not necessarily all home buyers are the same! When you choose to work with we buy ugly houses Baltimore & nationwide USA The ability to view ourselves from an unbiased perspective allows us to critically assess our personal strengths and weaknesses. This is an important step in the process of finding the right resources for our personal learning style. Ego and pride can be · By Day 1 of this week While you must form your answers to the questions below from our assigned reading material CliftonLarsonAllen LLP (2013) 5 The family dynamic is awkward at first since the most outgoing and straight forward person in the family in Linda Urien The most important benefit of my statistical analysis would be the accuracy with which I interpret the data. The greatest obstacle From a similar but larger point of view 4 In order to get the entire family to come back for another session I would suggest coming in on a day the restaurant is not open When seeking to identify a patient’s health condition After viewing the you tube videos on prayer Your paper must be at least two pages in length (not counting the title and reference pages) The word assimilate is negative to me. I believe everyone should learn about a country that they are going to live in. It doesnt mean that they have to believe that everything in America is better than where they came from. It means that they care enough Data collection Single Subject Chris is a social worker in a geriatric case management program located in a midsize Northeastern town. She has an MSW and is part of a team of case managers that likes to continuously improve on its practice. The team is currently using an I would start off with Linda on repeating her options for the child and going over what she is feeling with each option.  I would want to find out what she is afraid of.  I would avoid asking her any “why” questions because I want her to be in the here an Summarize the advantages and disadvantages of using an Internet site as means of collecting data for psychological research (Comp 2.1) 25.0\% Summarization of the advantages and disadvantages of using an Internet site as means of collecting data for psych Identify the type of research used in a chosen study Compose a 1 Optics effect relationship becomes more difficult—as the researcher cannot enact total control of another person even in an experimental environment. Social workers serve clients in highly complex real-world environments. Clients often implement recommended inte I think knowing more about you will allow you to be able to choose the right resources Be 4 pages in length soft MB-920 dumps review and documentation and high-quality listing pdf MB-920 braindumps also recommended and approved by Microsoft experts. The practical test g One thing you will need to do in college is learn how to find and use references. References support your ideas. College-level work must be supported by research. You are expected to do that for this paper. You will research Elaborate on any potential confounds or ethical concerns while participating in the psychological study 20.0\% Elaboration on any potential confounds or ethical concerns while participating in the psychological study is missing. Elaboration on any potenti 3 The first thing I would do in the family’s first session is develop a genogram of the family to get an idea of all the individuals who play a major role in Linda’s life. After establishing where each member is in relation to the family A Health in All Policies approach Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum Chen Read Connecting Communities and Complexity: A Case Study in Creating the Conditions for Transformational Change Read Reflections on Cultural Humility Read A Basic Guide to ABCD Community Organizing Use the bolded black section and sub-section titles below to organize your paper. For each section Losinski forwarded the article on a priority basis to Mary Scott Losinksi wanted details on use of the ED at CGH. He asked the administrative resident