sunset - Nursing
Health systems and nursing in the future
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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?
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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
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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/
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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
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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
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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.
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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
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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
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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.
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od pressure and hypertension via a community-wide intervention that targets the problem across the lifespan (i.e. includes all ages).
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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.
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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
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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
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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
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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
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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
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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