A DNP and a PhD in nursing are both advanced practice nursing degrees, but can be very different. One degree is not considered higher in education than the other, but the requirements for each can greatly differ. For example, a DNP student, “must complete a clinical project that demonstrates intimate knowledge of evidenced-based practices. PhD programs, however, most often have a focus on original research and research methodology, which results in a final research project and defense of a dissertation” (What’s the Difference, n.d.). But the main difference between the two degrees is, “…the DNP, or Doctor of Nursing Practice, is a clinical practice degree while the PhD, or Doctor of Philosophy, in nursing is a research-focused degree” (What’s the Difference, n.d.). A DNP focuses on different aspects of clinical patient care including: translating research evidence into nursing practice, healthcare policy, and cultivating practice expertise; while, in a PhD the curriculum focus is topics such as research methodologies, theories of nursing research, and faculty development. In a DNP program, the student is required to acquire up to 1000 hours in clinical work, while in a PhD program clinical work is minimal.
If I were to choose to pursue one of the two previously discussed degrees were I to continue my education to the doctoral level, I would strive to obtain a Doctor of Nursing Practice over a PhD, or Doctor of Philosophy in nursing. The reasoning is simply that mastering my practice skills, understanding of the nursing profession and all its aspects, and applying research evidence into actual practice in my community is far more appealing to me than that of theories of nursing and research methodologies. I enjoy being at the bedside, and even if I moved on to where my specific job does not require me to be at the bedside, I would still want my work to go towards improving bedside nursing.
Thanks for your informative post. It is interesting to know that, there is truly a correlation between the level of education in nursing and patient’s safety. Like you pointed out there are many studies with the evidence that linked patient’s safety outcome to ADN and BSN nurses. A study published by the American Association of Colleges of Nursing in 2014 revealed that there is a more than 12% increase in the number of student enrolling into the RN to BSN program from 2013 – 2014. Nursing is in high demand among students, as well as patients, and one main reason for this increase is the recognition of the role higher education plays in improving patient safety (stmary.edu, 2017). This implies that nurses with ADN and BSN are more valued than those with only RN, by their educational curriculum, they are more prepared with all the knowledge that has been acquired from the program to handle the patient with better outcome. Nice Post.

Health insurance began in the early part of the twentieth century as a means to protect an organization’s assets, either its financial assets or its manpower. Since the early days, health insurance evolved into a system of managed care in order to control issues such as overutilization, skyrocketing costs, limited restrictions, and low-quality care.
Using the Internet, search for articles on health insurance and managed care. Based on your research, summarize your findings and answer the following questions:
Examine the main events in the history of health insurance from the mid-twentieth century to the present. Explain how these events led up to the evolution of managed care organizations.
Evaluate the purpose of health care insurance in the early days.
Evaluate the evolution of health insurance and managed care. What is the relationship between the two and how has managed care risen to prominence in today’s health care market?
Explain how the perspective of health insurance has or hasn’t changed in today’s managed care environment.
Analyze the public policy and market forces leading to the growth of managed care.
Analyze the current trends in managed care and its future in the context of health care reforms.
Based on your understanding, create a 4 page Microsoft Word document that includes the answers to the above questions.
Support your responses with examples.

When I first started working in my current role as an educator, leadership determined there was a patient safety concern related to the moderate sedation practices in the gastrointestinal (GI) lab. Leadership wanted to send the message to the caregivers that the current sedation practices were not compliant with policy and patients were receiving large doses of sedation, which they worried would eventually lead to patient harm or even patient death. The director of surgical services asked me to communicate the change in practice via a power point presentation at the GI caregivers meeting. According to Gifu, Dima, & Teodorescu (2014), “communication requires a sender, a message, a medium and a recipient” (p. 47). In this scenario nurse management is the sender, the message is the need to change moderate sedation practices, the medium is the power point presentation, and the recipients are the GI lab caregivers.
Caregivers Perceptions
While the message seemed like it was a simple message, management did not take into account the external climate when they chose to address the sedation issues. Management asked me to deliver the message during a transition time where caregivers were upset with the changes taking place in the department. The GI caregivers were also worried about their jobs during this time because they heard rumors about the meeting with leadership and understood the purpose of the meeting was to scold the nurses for not following policy and possibly fire policy offenders. Marquis & Huston reported that “perception of the message is altered greatly depending on the climate that exists at the time the message was sent or received” (p. 439).
During the sedation talks, caregivers were visibly upset and even verbally raised concerns of being fired for not following policy or working outside their scope of practice. I took the feedback from the meeting to nursing leadership and follow-up meetings were scheduled to communicate to caregivers that the only reason for the change was to be compliant with policy and create a safe environment for the patients. While the message was clear, management did not choose a great time to deliver the message. “Effective communication requires paying attention to an entire process, not only the content of the message” (Benjamin, 2016, para 3). Management did not pay close attention to the current climate in the GI lab when deciding when to deliver the message to the caregivers.
Making Communication More Effective
There are two things I think that could have made the initial delivery of the message better. The first is management should have delivered the message or been present at the staff meeting to answer questions and reassure the purpose of the message. I also think management should have been more aware of the climate in the GI lab and not presented the changes to current practice during the time caregivers were already upset with other issues within the department.

The ideal composition of a healthy community is one that has an overall physical, mental, and social well-being. An example of where this has broken down is in Puerto Rico after Hurricane Maria. Viewers see on television that communities are without power and even access to clean drinking water. This natural disaster has affected every community on every level and they will need months of recovery before achieving a healthy state again. According to the CDC (2014), a strong community is one that establishes and improves both its physical and social environments, helps people support one another in conditions of daily life, and enhances their fullest potential. Some examples of a healthy community include being clean and safe for all citizens. There should be access to food, water, shelter, income, and recreation in the community. Availability to access health care services that are culturally competent is vital. There should be opportunities for a large amount of the population in decision-making and where there is peace, equality, and justice for all. As communities grow, emphasis needs to be on a safe environment where people have breathable air and no toxic exposures. Healthy places have in common the fact that they are designed and built to better the quality of life for all the citizens who live, work, worship, learn, and play within their borders. This also includes low crime rates, excellent schools, a hearty economy, transportation, housing, civic involvement, good weather, recreation, and reasonable taxes. (Maurer & Smith, 2013).
Nurses must first begin by researching and studying the community by reading newspapers and statistical facts. One goal of providing care would be to empower the people, families, organizations in the community, and other healthcare professionals to contribute to creating a healthy community. Often community/public health nurses can offer insight about health care that others may not think is possible. “Nurses can educate and speak about visions of health and specific commitments that can increase the likelihood of particular health possibilities.” (Maurer & Smith, 2013). They have unique commitments to community/public health including:

PUBLIC HEALTH, EPIDEMIOLOGY, AND HEALTH STATISTICS
PUBLIC HEALTH, EPIDEMIOLOGY, AND HEALTH STATISTICS
Submit a paper summarizing the history of tuberculosis and take this information up to tuberculosis today. Include a graph of statistics (specific to your home state) to show if tuberculosis cases have increased or decreased in your state since 1980. Discuss why you feel this is significant and explain why you think these numbers are so high or low. Length: 3-4 pages, excluding title page and references. Required Reading Fojo, A. T., Stennis, N. L., Azman, A. S., Kendall, E. A., Shrestha, S., Ahuja, S. D., & Dowdy, D. W. (2017).
Current and future trends in tuberculosis incidence in New York City: a dynamic modelling analysis. Lancet Public Health, 2(7), e323-e330. Obtained from Trident Online Library. Lewinsohn, D. M., Leonard, M. K., LoBue, P. A., Cohn, D. L., Daley, C. L., Desmond, E., … & Woods, G. L. (2017 January 15). Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention clinical practice guidelines: Diagnosis of tuberculosis in adults and children. Clinical Infectious Diseases, 64(2), 111-5. Accessed from https://academic.oup.com/cid/article/64/2/111/2811357 Shrestha, S., Hill, A. N., Marks, S. M., & Dowdy, D. W. (2017 October 15).
Comparing drivers and dynamics of tuberculosis in California, Florida, New York, and Texas. American Journal of Respiratory and Critical Care Medicine, 196(8), 1050-1059. Obtained from Trident Online Library. Stewart, R.J., Tsang, C.A., Pratt, R.H. Price, S.F., & Langer, A.J. (2018). Tuberculosis – United States, 2017. Morbidity and Mortality Weekly Report, 67, 317-323. Retrieved from https://www.cdc.gov/mmwr/volumes/67/wr/mm6711a2.htm World Health Organization. (2017). Ethics guidance for the implementation of the End TB strategy. Retrieved from http://apps.who.int/iris/bitstream/10665/254820/1/9789241512114-eng.pdf?ua=1