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DQ1: Tatiana

Julie is a 35-year-old with bipolar II disorder. After her third child was born, she had a severe depressive episode. She attempted suicide by taking 25 Xanax pills. She is back in the hospital with depression after having a 2-week hypomanic episode. She has not been taking her medications.

a. What responsibility does the health care organization have to Julie?

The health care organization staff, such as the nurses, doctors, pharmacists, social workers, psychologists, and nutritionists, partner with Julie in shared decision making, cooperation, and coordination on the management or treatment of Julie’s bipolar disorder. Hence, the health care organization has a collaborative practice responsibility toward Julie. The collaborative practice saves time, improves communication, improves working relationships, reduces duplication, and enhances the better experience of clients such as Julie, who use the organization’s social and healthcare services.

b. What structures are needed at a hospital to ensure that Julie will get the care she needs?

Julie’s condition is manageable through the outpatient department. If the condition worsens or she experiences manic, depressive, or panic attacks, she will be admitted to the medical word for close observation until she is proven stable by the doctor. Julie’s family, guardian, or caregiver should take part in her treatment process to help in decision making, especially when July cannot communicate or is medically unfit to make decisions. Management of bipolar disorder involves medication such as antipsychotics, mood stabilizers, anti-depressants, and psychological and ECG intervention.

c. What is the nurse’s responsibility regarding the health promotion activities directed toward Julie?

The nurse’s responsibility is to provide holistic care to Julie by ensuring that all her needs are met to ensure positive health outcomes. For example, Julie’s nurses should provide psychological support and a peaceful environment free from distractions to the patient. To meet the patient’s nutritional needs, the nurses should ensure Julie adheres to treatment and medication and is provided with a balanced diet to meet all the nutritional demands and ensure positive health outcomes. The nurse should also motivate and help Julie do regular exercises and attending ensure she is safe at all times.

Stephane, a 15-year-old Haitian refugee who is living at a center for children of refugees, has a severe cough and fever. She is curled up in a corner of the community room wrapped in a towel. She looks like she has been crying.

a. How can the nurse ensure culturally competent care?

The nurses observe cultural competency by:

1. They are preventing communication barriers to improve communication. Besides, poor communication between the patient and the nurse makes it difficult to guarantee the success of the treatment; hence, if the patient cannot understand the nurse, the nurses should use symbols, pictures, sign language, facial expressions, and gestures to communicate effectively.

2. Participate in online media platforms to support and show respect for diversity and different cultural perspectives. This can help influence positive views for diversity and enhance cultural awareness.

3. Participate in direct cross-cultural interaction with the patient and understand the patient’s values, beliefs, and needs to enhance the effective relationships with them.

4. Take part in cultural competence self-assessment to understand their cultural competence abilities and be informed with trending information on cultures, taking part in cultural competence training and reading primary sources on cultural competence.

b. List three priorities for the nurse regarding the cultural values, beliefs, and possible practices Stephane may have.

These are priorities about cultural beliefs and values, including practices, which Stephanie may have:

1. Affection and belonging to a group, whereby the nurses should ensure that Stephanie is taken to a children’s home, where she can feel at home ad be shown love and care during her lowest times.

2. Safety needs include ensuring Stephanie is safe from danger and lives or stays in a peaceful environment, where she is secure and can call it home.

3. Physiological needs include nurses’ provision of needs such as clothes and food when attending to Stephanie.

DQ2: Flor

1.         Nurses can take several actions if they believe that the OSHA guidelines are not being followed in the workplace. One of the actions that the nurses can take is that they can report the problems to their supervisors and/or managers. This is something that would allow the nurses to express what they feel and any concerns that they might have. In case the managers do not respond, the nurses can then report the issue to the higher management. If the higher management also does not respond, then the nurses must file an official report with OSHA to let them know that there are violations that are being conducted so that they can be rectified (Surber, 2021). 

2.         Positive patient outcomes depend on several aspects of the work environment. This can include both safeties as well as security issues. In this regard, if the nurses notice that another nurse is drinking alcohol or doing drugs while on duty, it would be something that would lead to negative patient outcomes. Other than that, if the nurses are being overworked and are not being given enough time to rest in between their shifts, it would mean that they would be exhausted and fatigued and this is something that would also result in negative patient outcomes (Melnyk et al., 2018). 

3.         The characteristics of healthcare organizations that may lead to burnout amongst nurses include a negative and/or hostile work environment, the nurses being made to work long hours without any break, the nurses not being paid enough, as well as the nurses being made to care for more patients than they can handle. All of these can be changed by having proper policies that would ensure that the nurses are working in a positive working environment (Khatatbeh et al., 2022). 

DQ3 IGOR

 A workplace culture is the shared values, belief systems, attitudes, and the set of assumptions that people in a workplace share. A positive workplace culture improves teamwork, raises the morale, increases productivity and efficiency, and enhances retention of the workforce. Job satisfaction, collaboration, and work performance are all enhanced. And, most importantly, a positive workplace environment reduces stress in employees (White, Aiken, Sloane, McHugh, 2020).

         Why is it important? Working environment has a positive impact on the job satisfaction of employees.

         Better work environments were associated with lower odds of negative nurse outcomes, poor safety or quality ratings, and negative patient outcomes, but higher odds of patient satisfaction (Al Sabei,2019).

         Job satisfaction is a reliable and relevant predictor of employee retention

Ways to create a positive work environment. Hire the Right People: Find the right candidates that are a good fit for your work culture, Listen to Ideas: Leadership has an "open door policy”, Encourage employees to give solutions to areas of improvement that they identify, don’t be afraid of change, True collaboration: There should be multiple opportunities to share ideas and work together toward a solution.

Effective decision-making: Nurses should have a say in the matters that affect them, such as policy and care decisions, and be given opportunities to lead. Strong Lines of Communication: Clear and concise messaging. Set clear expectations (Ulrich, Barden, Cassidy,Varn-Davis, 2019)