Assignment 2: Evolution of Professional Nursing and Culturally Diverse Workforce Analysis
of RA1:
In this module, we looked at the evolution of the nursing profession and how it relates to the continued issue of achieving a culturally diverse workforce. Despite our progress in moving toward a culturally diverse nursing workforce, efforts are needed to achieve nursing workforce diversity to meet patient care needs. The report produced by the Sullivan Commission on Diversity in the Healthcare Workforce (2004) provided a framework from which one can understand nursing workforce diversity issues. In particular, it provided a way to systematically review issues surrounding the historical context of nursing workforce diversity, why increasing workforce diversity is important, how we might achieve a more diverse workforce and how it may be paid for, and who is accountable for achieving the diversity goal.
Tasks:
Use the derived Sullivan Commission Report framework to describe and analyze nursing workforce diversity in a workplace of your choice. The framework is given in the bulleted list below.
Support your analysis with references. You must reference at least three nursing journal articles that are not from your reading assignment. Additionally, you may cite documents from the Module 1 reading assignments.
Protect workplace and personal identifiers in the completion of your assignment

In your third meeting with the CIO, she explains that she must make a presentation to her peers on the executive team, including the chief operating officer, chief medical officer, chief nursing officer, chief financial officer, and CEO. The purpose is to teach them about the importance of rigorous and structured risk management.
They believe they worry too much about risk and issues that may not occur. However, the CIO has found that when unexpected events occur, especially events related to IT, she is asked, “How could this have happened?” She would like you to prepare a presentation describing the reasons for risk management planning and high-level steps in performing risk management.
Create a 7 slide Microsoft® PowerPoint® presentation describing the reasons for risk management planning and high-level steps in performing risk management. Your presentation should:

Analyze the steps in identifying risks in a health care IT project.
Explain the stakeholders involved in the project.

Explain the benefits to the company upon completion of this project.
Analyze the risks that may affect the project.

Analyze the characteristics of the risks.
Analyze why it is important to consider these risks throughout the project.
Analyze how to correct the identified risks.
Explain how the project will be implemented.
Explain how the project will be monitored for ongoing risks.

Cite at least 3 reputable references. One reference must be your textbook, Managing Risk in Information Systems. Reputable references include trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality.
Format your presentation according to APA guidelines. Include a title page, detailed speaker notes, and a references page.

For these discussions, I need between 150-200 words for each. Kindly separate each discussion according to their numbers.
Discussion 1
How will accomplishing research objectives support your success in management? What risks or challenges might a health care manager encounter if he or she has not mastered these objectives? Explain.
Discussion 2
Explain your proposed approach for conducting research necessary to develop quality deliverables and explain how the information gleaned will support your career development in health care management. 
Discussion 3
Reflecting on the focus and content of this course (Research Methods for Healthcare), what is an important challenge facing management of health care organizations today, and how would you go about addressing it? Explain
Discussion 4
Collaboration leverages the collective knowledge of a health care team. Peer evaluation and support, provided in the spirit of continuous improvement and organizational success, result in higher quality deliverables than are generally possible by the efforts of an individual. Describe the process that you plan to use to conduct research, identify findings, and develop the Comprehensive Project due in Unit 5, and present a brief outline indicating how you intend to organize the project deliverable.
NOTE: I will assign the project exclusively to you alone so that you know what the project is about.
Discussion 5
What competencies were you able to develop in researching and writing the Comprehensive Project due in Unit 5? How did you leverage feedback from your peers in the Discussion Board for Units 1–4 in completing the Project? How will these competencies and knowledge support your career advancement in management?
NOTE: I will assign the project exclusively to you alone so that you know what the project is about.

Question 2

A nursing home in Iowa, whose residents were all English-speakers and all over the age of 80, instituted a rule that required that all employees speak English while working since the residents of the nursing home were elderly and not able to understand any language other than English. Several of the employees of the nursing home were Latino and spoke Spanish fluently. The nursing home informed all employees, both verbally and in writing, of the English-only rule and gave verbal and formal, written warnings to several of the Latino employees who were overheard by management speaking Spanish in the presence of residents of the nursing home. After several such warnings, the nursing home discharged Catalina for continuing to speak Spanish in the presence of residents after she had been given several warnings not to speak Spanish while she was working.

Did the discharge of Catalina for the reason given constitute national origin discrimination? Why, or why not? What factors must be considered in deciding whether an employer can legally require that only English be spoken by employees while working?

Q2

Wilson Hospital, a nonprofit hospital affiliated with Wilson College, had the following cash receipts for the year ended December 31, 2005:

The dividends received are restricted by the donor for hospital building improvements. No improvements were made during 2005. On the hospital’s statement of cash flows for the year ended December 31, 2005, what amount of these cash receipts would be included in the amount reported for net cash provided (used) by operating activities?

1. $ 880,000
2. $ 800,000
3. $1,050,000
4. $ 750,000

Directions: Carefully read each scenario describing an ethical dilemma in health care. SelectTWOscenarios for which you will write a thorough response to not exceedONEcomplete paragraph for each. Responses will vary based on an individuals cultural upbringing ideology and educational knowledge; however you must support your position with appropriate theory and principle.In Clinical Ethics three clinical ethicists (a philosopher -Jonsen a physician -Siegler and a lawyer -Winslade) developed a method to work through difficult cases. The process can be thought of as the ethics workup similar to the History and Physical skills that all medical students use when learning how to workup a patient’s primary complaints. While this method has deep philosophical roots clinicians who use this method like the way it parallels the way they think through tough medical cases.Medical Indications- All clinical encounters include a diagnosis prognosis and treatment options and include an assessment of goals of carePatient Preferences- The patients preferences and values are central in determining the best and most respectful course of treatment.Quality of Life- The objective of all clinical encounters is to improve or at least address quality of life for the patient as experienced by the patient.Contextual Features- All clinical encounters occur in a wider social context beyond physician and patient to include family the law culture hospital policy insurance companies and other financial issues and so forth.Scenario 1At your last office staff meeting the rising cost of rent and overhead was discussed. One of your partners mentioned that he had been approached by a large pharmacy chain with an offer of space adjacent to their new pharmacy that is only one block from your current offices. The cost per square foot is half of what you are currently paying and there was a suggestion that the rent could be lowered if the volume of prescriptions from your office were substantial. Although this offer is very tempting you have reservations about the potential conflict of interest. One of your partners is pushing to explore this option. You are wondering if you could manage the conflict by refusing to engage in any reduction in rent based on prescription volume but still take the space at the reduced lease costs. Another partner feels that this arrangement will compromise her autonomy and feels that it will look as if the office is associated with the pharmacy even if it is not. Everyone agrees that the overhead costs need to be reduced. What is the right thing to do?Scenario 2You are the training director for a residency program. Recently several residents have come to you reporting that a physician frequently makes disparaging comments to residents and to patients about the work of other physicians. The physicians latest comment was to a patient in which he said he would not allow a particular physician to treat his pets. Other comments attributed to this physician involved telling the residents that a surgeon is a butcher and a psychiatrist a mindless twit. The residents have attempted to speak to him about this practice to which the physician responded by saying he only speaks the truth adding that patients and residents have a right to know. The residents report the comments appear to be unwarranted and they seem to be scaring the patients. Is this physician behaving unethically? Should physicians question the work of their colleagues? How should this be done?Scenario 3You are nearing the end of your practice career and many of your patients are older. Several of them have developed mild dementia and youve been discussing their wishes should they continue to lose mental capacity. The other day an elderly gentleman arrived for his appointment with his middle-aged son who reported that his father is becoming increasingly forgetful. The son would like to have his father moved to a facility rather than continue to live on his own. While examining your patient you note he has multiple bruises on his upper arms that suggest he has been grabbed by someones hand. When you discuss with him the idea of moving to an assisted living facility he becomes very upset and says his son wants to get his hands on his money and that is why he wants him to move from his own home. The patients Mini Mental Status examination is within the normal limits and he reports that his multiple bruises are the result of a friend grabbing his arm while they were out walking. You would like to respect your patients autonomy to make his own decisions but have some concerns that he may be at risk. You are not sure what the ethical principles are and approach your colleague for advice. What advice would you give to this colleague if you were approached?Scenario 4You have been treating a 24-year-old man for many years in your family practice. He has an anxiety disorder and had some trouble with substance abuse in his teens but has been doing well and attending university. After his last visit for a minor injury you noted that a prescription pad was missing. A few weeks later you received a call from a pharmacy asking you to verify a prescription for Lorazepam 1mg bid 300 tablets and acetaminophen with codeine 300 tabs written for this patient. You report that this is a forgery and ask the pharmacy not to fill it. Your colleague urges you to report this to the police and states this is allowed under the Health Information Act. You are very angry with the betrayal of trust with your patient but you have never reported a patient to the police and wonder what you should do. The CMA code of ethics advises you to keep patients personal health information private and only consent to release to a third party with consent or as provided for by the law such as when the maintenance of confidentiality would result in a significant risk of substantial harm. You are wondering if your patient has a substance abuse problem and whether he could be selling this medication. You have called the patient to come in for an appointment but he has refused. Should you notify the police?Scenario 5A patient has rheumatoid arthritis for which she should be taking drugs to control the disease and prevent further joint damage. However she tells the doctor that she has stopped because she does not like the look of the side effects listed on the leaflet in the packet and would like a treatment she found on the internet. The doctor disagrees with her preferred treatment. What issues does this raise? How should the doctor handle this scenario?Scenario 6A newly hired nurse is being given orientation and training in the hospital by a senior member of the nursing staff. Assigned to a medical -surgical unit the nurse receives instructions on procedures. The nurse is instructed to push Heparin IV through a tube in the person’s arm. The nurse when being trained in nursing program was instructed not to do so such a thing as it could have serious consequences. When the newly hired questioned the procedure that nurse was told by the senior nurse: Look that is how we do it here missy. We are understaffed and do not have the time to do it intravenously. If you want to work here that is how you will do it too. What should the response of the new nurse be to this situation? Why?Scenario 7John a 32 year-old lawyer had worried for several years about developing Huntington’s chorea a neurological disorder that appears in a person’s 30s or 40s resulting in uncontrollable twitching and contractions and progressive irreversible dementia. It typically leads to death in about 10 years. John’s mother died from this disease. Huntington’s is autosomal dominant and children of an affected person have a 50% chance of inheriting the condition. John had indicated to many people that he would prefer to die rather than endure the progression of the illness. He was anxious drank heavily and had intermittent depression for which he saw a psychiatrist. Nevertheless he was a productive lawyer. John first noticed facial twitching 3 months ago and 2 neurologists independently confirmed a diagnosis of Huntington’s. He explained his situation to his psychiatrist and requested help committing suicide. When the psychiatrist refused John reassured him that he did not plan to attempt suicide any time soon. But when he went home he ingested all his antidepressant medicine after pinning a note to his shirt to explain his actions and to refuse any medical assistance that might be offered. His wife who did not yet know about his diagnosis found him unconscious and rushed him to the emergency room without removing the note. How much weight should Johns preferences (especially his attempt to end his life) carry in managing his emergency and subsequent clinical care? Scenario 8Mrs. Jones has signed a donor card indicating that she is willing to donate her body to science without notifying her husband and son. She gets into an accident and it is determined she is brain dead. The family doctor who is on call that afternoon reviews the chart and determines that she would be perfect for medical students to practice the removal of organs for transplantation purposes. The doctor then talks to the family to discuss the procedure and to confirm their consent. They both oppose the procedure and refuse to allow their doctor to move forward. The doctor points out that Mrs. Jones could be helping hundreds of people by educating the medical students and that technically consent has already been provided. The husband understands how beneficial the educational experience is but is too emotional to allow them to continue. The son a medical student refuses because he knows the bodies are not treated with dignity. If you were the doctor how would you proceed? Why?