Tag Archive for: nursing

range of contemporary issues teenagers face today

Research the range of contemporary issues teenagers face today. In a 500-750-word paper, choose one issue (besides teen pregnancy) and discuss its effect on adolescent behavior and overall well-being. Include the following in your submission:

  1. Describe the contemporary issue and explain what external stressors are associated with this issue.
  2. Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient. Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian.
  3. Discuss support options for adolescents encountering external stressors. Include specific support options for the contemporary issue you presented.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Antibiotic Stewardship

Construct a professional paper that outlines the advanced practice role – a nurse practitioner – to advance the CDC’s antibiotic resistance initiative.

Assignment Requirements

  1. Introduction that identifies your advanced practice role and your view of how that role will be able to impact the antibiotic resistance dilemma.  Support your discussion with at least two references from the literature.
  2. Review the CDC’s goals and identify one of the CDC’s key strategies that you will be able to promote/support in your advanced practice role. Support your discussion with at least two references from the literature.
  3. Discuss three activities/actions that you will develop to support the promotion of the key strategy that you identified in item 2 above.  Each action/activity needs to be well designed and supported with at least one reference from the literature. For example, if you are a:
    • nurse practitioner student – what prescribing practices, patient education practices, monitoring programs, etc., will you engage with, and provide justification for your strategies, etc.

Instructions 

  • Prepare and submit a minimum of a 6 page paper pages [excluding title and reference pages].
  • Format consistent with APA style without an abstract page.
  • Answer all the questions above.
  • Support your position with examples.
  • Please review the rubric to ensure that your assignment meets criteria.
  • Submit the following documents to the Submit Assignments/Assessments area:
    • Assignment: Antibiotic Stewardship

health care services

Write a 5–6 page, APA-formatted report that explains the responses to a global event, how issues of race, class, and gender may have affected the response, and the role of international and altruistic organizations in providing health care services related to the event.

Describe barriers to receiving health care services related to the event, and explain the role of the professional nurse in providing health care services related to the global event.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

 

  • Competency 1: Explain the factors that affect the health of communities.
    • (IMPORTANT) -Explain the response to a global event at the local and national levels.
    • (IMPORTANT) -Explain how social attitudes and issues of race, class, and/or gender may impact the response to a global event.
    • (IMPORTANT) -Explain the role of international and altruistic organizations in providing health care services during a global event.
  • Competency 2: Apply evidence-based interventions to promote health and disease prevention and respond to community health issues.
    • (IMPORTANT) -Explain the role of the professional nurse in providing health care services related to global events.
  • Competency 3: Develop an evidence-based nursing response for providing health care services related to community crises.
    • (IMPORTANT) -Describe barriers to health care services during a global event.
  • Competency 4: Communicate in a manner that is scholarly, professional, and consistent with expectations for a nursing professional.
    • (IMPORTANT) -Write content clearly and logically with correct use of grammar, punctuation, and mechanics.
    • (IMPORTANT) -Correctly format paper, citations, and references, using current APA style.

Assessment Instructions

 

Preparation

Suppose that within your health care organization there is no formal process or structure for health care professionals to volunteer time and services in times of global need. You would like to develop a proposal for establishing a process that would allow nurses and other health care professionals to secure time off to work with a specific worldwide organization, to provide health care services during global events. As part of the proposal, you would need to provide background research to support your request.

Conduct background research on either one of the following to support the proposal you would develop:

  • Choose one worldwide epidemic, such as the 2009 flu pandemic, 2009 mumps outbreak, 2012 Middle East respiratory syndrome coronavirus outbreak, the recent Ebola virus epidemic, or another epidemic. Research articles that focus on how the initial outbreak was handled; the role of social attitudes and issues of race, class, and gender in responding to the outbreak; barriers to people receiving proper health care; and the role of nursing in providing health care services related to the epidemic.
  • Choose one natural disaster, such as the earthquakes in Haiti, Pakistan, or Nepal; Cyclone Nargis in Myanmar; the Indian Ocean earthquake and tsunami, or any other natural disaster that brought a worldwide response. Research articles that focus on the initial response to the disaster; the role of social attitudes and issues of race, class, and gender in responding to the disaster; barriers to survivors receiving health care; and the role of nursing in providing health care services related to the disaster.

Requirements

For this assessment, develop background research that would support a proposal for an organizational process allowing health care professionals to volunteer time and services when global events happen. First, identify the global event you will be using in your research, and then:

  • Explain how the local and national (meaning the nation in which the event took place) communities responded to the event. Who responded? How long did the first response take? How did health care providers respond?
  • Explain how social attitudes, as well as issues of race, class, gender, or other factors may have influenced the response to the event. Be sure you consider not only the response of the home country, but the global response as well.
  • Describe barriers to health care services for the people impacted by the event. Some barriers may be obvious, and other barriers less obvious; try to consider multiple aspects.
  • Explain the role of international health organizations and altruistic organizations in providing health care services related to the global event.
  • Explain the role of the professional nurse in providing health care services related to the global event. Consider scope of practice when working professionally out of one’s area of license—either nationally or globally.

Additional Requirements

Complete your assessment using the following specifications:

  • Title page and reference page.
  • Number of pages: 5–6 (not  including the title and reference pages).
  • At least 4 current scholarly or professional resources.
  • APA format for the entire document, including citations and references.
  • Times New Roman font, 12-point, double-spaced.

Skin trauma

Question 1.                

A female patient is suspected of having psoriasis. Which of the following aspects of the woman’s history and her care provider’s assessment would be potential contributors to her health problem?

The woman takes an angiotensin-converting enzyme inhibitor for the treatment of hypertension. She has been diagnosed with arthritis.

The woman has a family history of diabetes.

Skin trauma of any kind often precedes an outbreak.

The woman has dark skin.

 

 

Question 2.                

Which of the following pathophysiologic phenomena would be most indicative of ankylosing spondylitis?

Loss of motion in the spinal column and eventual kyphosis

A progressive loss of range of motion in knee and hip joints

A facial “butterfly rash” and multiorgan involvement

Decreased bone density in long bones

 

Question 3.                

The father of an 18-month-old girl noticed a small vesicle on her face several days ago. The lesion ruptured and left a straw-colored crust that remained on the girl’s face. The eruption of new vesicles has prompted him to bring the child to the emergency department. Which of the following treatments for the child’s skin problem is most likely?

A topical antifungal ointment

An oral corticosteroid

An antiviral ointment

A topical antibiotic

 

Question 4.                

Which of the following statements best conveys an aspect of the process of keratinization?

Keratin cells synthesized in the dermis migrate to the surface over 20 to 30 days.

Mitosis that begins with the cells of the stratum granulosum results in a continual supply of new keratinocytes.

The stratum germinativum continuously produces new keratinocytes to replace losses.

The basal cells of the epidermis migrate to the skin surface at a rate that matches superficial losses of skin cells.

 

 

 

 

Question 5.                

A 35-year-old woman who has been in recovery from alcoholism for 2 years presents at her primary care nurse practitioner’s office with chronic hip pain. She reports that as part of her commitment to her recovery, she began exercising regularly about a year earlier. After a month or two, her hip began to hurt when she ran on the treadmill. She stretches, has had a physical trainer check her form to ensure that it is correct, and rests adequately between each workout. Six months ago the pain began awakening her at night, and now it is constant. She is not aware of any injury to her hip and has no other outward symptoms. Which of the following is most likely to be the cause of her pain?

Hematogenous osteomyelitis

Osteomyelitis with vascular insufficiency

Tuberculosis of the bone

Osteonecrosis

 

 

Question 6.                

Clinical investigation of a 40-year-old female patient with diverse dermatologic signs and symptoms has focused on the woman’s basement membrane. Which of the following skin functions would a clinician most likely attribute to a region of the integument other than the basement membrane?

Lack of sensory nerve impulse conduction

Formation of blisters on various skin surfaces

Lack of adhesion between the dermis and epidermis

Large immunoglobulin deposits

 

 

Question 7.                

An 80-year-old female with a diagnosis of osteoporosis receives daily supplements of calcitonin in the form of a nasal spray that she instills each morning. Which of the following phenomena would her care providers expect to result from her supplementation?

Decreased serum calcium levels

Increased bone resorption

Acceleration of osteoclast action

Increased bone formation

 

 

Question 8.                

A 41-year-old woman has been diagnosed as having a loose body of cartilage in her left knee. What data would be most likely to lead clinicians to this conclusion?

A visible hematoma is present on the anterior portion of the knee.

The woman experiences intermittent, painful locking of her joint.

Computed tomography indicates a complete tear of her knee ligament.

An X-ray shows that her femoral head and tibia are no longer articulated.

 

Teaching Experience Paper 

Community Teaching Plan: Teaching Experience Paper

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.

Note: This is an individual assignment. In 1,500-2,000 words, describe the teaching experience and discuss your observations. The written portion of this assignment should include:

  1. Summary of teaching plan
  2. Epidemiological rationale for topic
  3. Evaluation of teaching experience
  4. Community response to teaching
  5. Areas of strengths and areas of improvement

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Community Teaching Plan: Teaching Experience Paper – Rubric

No of Criteria: 10 Achievement Levels: 5CriteriaAchievement LevelsDescriptionPercentageUnsatisfactory0.00 %Less than Satisfactory75.00 %Satisfactory83.00 %Good94.00 %Excellent100.00 %Content80.0     Comprehensive Summary of Teaching Plan 15.0Summary of community teaching plan is omitted.Summary of community teaching plan is incomplete. Overall, the teaching plan is unclear. Summary of community teaching plan is offered, but some elements are vague. Some rationale or evidence is needed for clarity and support.Community teaching plan is clear with a detailed summary of each component. Minor rationale is needed for clarity or support.Focus of community teaching is clear, consistent with community teaching plan, detailed, and well supported. The presentation demonstrates an ability to create effective teaching plans relative to a population. Epidemiological Rationale for Topic15.0Epidemiological rationale for the topic is omitted.Epidemiological rationale is unclear or incorrect.Epidemiological rationale is summarized and provides some support for the topic. More information or evidence is needed for support.Epidemiological rationale is provided and provides general support for the topic. Some detail is needed for clarity.Strong epidemiological rationale is provided and demonstrates support for the topic presented.Evaluation of Teaching Experience20.0Evaluation of teaching experience is omitted or incomplete.Evaluation of teaching experience is unclear or underdeveloped. The narrative is not written in a manner that evaluates the experience. Evaluation of teaching experience is summarized. Some aspects are vague. More detail is needed to fully illustrate an assessment of the experience.Evaluation of the teaching experience is generally presented. Some detail is needed for clarity. A comprehensive evaluation of teaching experience is presented. Insight into self-appraisal in regard to teaching is demonstrated. Community Response to Teaching Provided15.0Community response to teaching is omitted.Community response to teaching is partially summarized. More information is needed.A summary of the community response to teaching is presented. Some areas are unclear. More information is needed for support or clarity.A description of community response to teaching is generally presented. Some information is needed for support or clarity.A detailed description of community response to teaching is presented. Areas of Strength and Improvement 15.0Areas of strength and improvement are omitted.Areas of strength and improvement are partially discussed.Areas of strength and improvement are generally discussed. Areas of strength and improvement are discussed.Areas of strength and improvement are thoroughly discussed. The author demonstrates insight into personal strengths and areas where improvement would be beneficial.Organization and Effectiveness 15.0     Thesis Development and Purpose5.0Paper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed and/or vague; purpose is not clear. Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.Argument Logic and Construction5.0Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.Mechanics of Writing (includes spelling, punctuation, grammar, language use)5.0Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English.Format5.0     Paper Format2.0Template is not used appropriately or documentation format is rarely followed correctly.Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style.All format elements are correct. Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)3.0Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.Total Percentage  100

parenthetical reference

The requirements for this essay are:

1. 500-600 words; 5-paragraph structure (can have more than five).

2. Your idea about the story itself—the value of the story (at least a paragraph)

3. How it applies to life in general (at least a paragraph)

4. How it applies to you.  Write about an item that is important to you, one that has been passed down to you or one that you hope will be or an item that you have that you will plan to pass down to someone (at least a paragraph). .

5. Be sure to supply

a. A parenthetical reference

b. A Works Cited

I will wait for her in the yard that Maggie and I made so clean and wavy yesterday afternoon. A yard like this is more comfortable than most people know. It is not just a yard. It is like an extended living room. When the hard clay is swept clean as a floor and the fine sand around the edges lined with tiny, irregular grooves, anyone can come and sit and look up into the elm tree and wait for the breezes that never come inside the house.

Maggie will be nervous until after her sister goes: she will stand hopelessly in corners, homely and ashamed of the burn scars down her arms and legs, eying her sister with a mixture of envy and awe. She thinks her sister has held life always in the palm of one hand, that “no” is a word the world never learned to say to her.

You’ve no doubt seen those TV shows where the child who has “made it” is confronted, as a surprise, by her own mother and father, tottering in weakly from backstage. (A pleasant surprise, of course: What would they do if parent and child came on the show only to curse out and insult each other?) On TV mother and child embrace and smile into each other’s faces. Sometimes the mother and father weep, the child wraps them in her arms and leans across the table to tell how she would not have made it without their help. I have seen these programs.

Sometimes I dream a dream in which Dee and I are suddenly brought together on a TV program of this sort. Out of a dark and soft.seated limousine I am ushered into a bright room filled with many people. There I meet a smiling, gray, sporty man like Johnny Carson who shakes my hand and tells me what a fine girl I have. Then we are on the stage and Dee is embracing me with tears in her eyes. She pins on my dress a large orchid, even though she has told me once that she thinks orchids are tacky flowers.

In real life I am a large, big.boned woman with rough, man.working hands. In the winter I wear flannel nightgowns to bed and overalls dur.ing the day. I can kill and clean a hog as mercilessly as a man. My fat keeps me hot in zero weather. I can work outside all day, breaking ice to get water for washing; I can eat pork liver cooked over the open fire minutes after it comes steaming from the hog. One winter I knocked a bull calf straight in the brain between the eyes with a sledge hammer and had the meat hung up to chill before nightfall. But of course all this does not show on television. I am the way my daughter would want me to be: a hundred pounds lighter, my skin like an uncooked barley pancake. My hair glistens in the hot bright lights. Johnny Carson has much to do to keep up with my quick and witty tongue.

But that is a mistake. I know even before I wake up. Who ever knew a Johnson with a quick tongue? Who can even imagine me looking a strange white man in the eye? It seems to me I have talked to them always with one foot raised in flight, with my head fumed in whichever way is farthest from them. Dee, though. She would always look anyone in the eye. Hesitation was no part of her nature.

“How do I look, Mama?” Maggie says, showing just enough of her thin body enveloped in pink skirt and red blouse for me to know she’s there, almost hidden by the door.

“Come out into the yard,” I say.

Have you ever seen a lame animal, perhaps a dog run over by some careless person rich enough to own a car, sidle up to someone who is ignorant enough to be kind to him? That is the way my Maggie walks. She has been like this, chin on chest, eyes on ground, feet in shuffle, ever since the fire that burned the other house to the ground.

Dee is lighter than Maggie, with nicer hair and a fuller figure. She’s a woman now, though sometimes I forget. How long ago was it that the other house burned? Ten, twelve years? Sometimes I can still hear the flames and feel Maggie’s arms sticking to me, her hair smoking and her dress falling off her in little black papery flakes. Her eyes seemed stretched open, blazed open by the flames reflected in them. And Dee. I see her standing off under the sweet gum tree she used to dig gum out of; a look of concentration on her face as she watched the last dingy gray board of the house fall in toward the red.hot brick chimney. Why don’t you do a dance around the ashes? I’d wanted to ask her. She had hated the house that much.

I used to think she hated Maggie, too. But that was before we raised money, the church and me, to send her to Augusta to school. She used to read to us without pity; forcing words, lies, other folks’ habits, whole lives upon us two, sitting trapped and ignorant underneath her voice. She washed us in a river of make.believe, burned us with a lot of knowl edge we didn’t necessarily need to know. Pressed us to her with the serf’ ous way she read, to shove us away at just the moment, like dimwits, we seemed about to understand.

Dee wanted nice things. A yellow organdy dress to wear to her grad.uation from high school; black pumps to match a green suit she’d made from an old suit somebody gave me. She was determined to stare down any disaster in her efforts. Her eyelids would not flicker for minutes at a time. Often I fought off the temptation to shake her. At sixteen she had a style of her own: and knew what style was.

I never had an education myself. After second grade the school was closed down. Don’t ask my why: in 1927 colored asked fewer questions than they do now. Sometimes Maggie reads to me. She stumbles along good.naturedly but can’t see well. She knows she is not bright. Like good looks and money, quickness passes her by. She will marry John Thomas (who has mossy teeth in an earnest face) and then I’ll be free to sit here and I guess just sing church songs to myself. Although I never was a good singer. Never could carry a tune. I was always better at a man’s job. I used to love to milk till I was hooked in the side in ’49. Cows are soothing and slow and don’t bother you, unless you try to milk them the wrong way.

I have deliberately turned my back on the house. It is three rooms, just like the one that burned, except the roof is tin; they don’t make shingle roofs any more. There are no real windows, just some holes cut in the sides, like the portholes in a ship, but not round and not square, with rawhide holding the shutters up on the outside. This house is in a pasture, too, like the other one. No doubt when Dee sees it she will want to tear it down. She wrote me once that no matter where we “choose” to live, she will manage to come see us. But she will never bring her friends. Maggie and I thought about this and Maggie asked me, “Mama, when did Dee ever have any friends?”

She had a few. Furtive boys in pink shirts hanging about on washday after school. Nervous girls who never laughed. Impressed with her they worshiped the well.turned phrase, the cute shape, the scalding humor that erupted like bubbles in Iye. She read to them.

When she was courting Jimmy T she didn’t have much time to pay to us, but turned all her faultfinding power on him. He flew to marry a cheap city girl from a family of ignorant flashy people. She hardly had time to recompose herself.

When she comes I will meet—but there they are!

Maggie attempts to make a dash for the house, in her shuffling way, but I stay her with my hand. “Come back here, ” I say. And she stops and tries to dig a well in the sand with her toe.

It is hard to see them clearly through the strong sun. But even the first glimpse of leg out of the car tells me it is Dee. Her feet were always neat.looking, as if God himself had shaped them with a certain style. From the other side of the car comes a short, stocky man. Hair is all over his head a foot long and hanging from his chin like a kinky mule tail. I hear Maggie suck in her breath. “Uhnnnh, ” is what it sounds like. Like when you see the wriggling end of a snake just in front of your foot on the road. “Uhnnnh.”

Dee next. A dress down to the ground, in this hot weather. A dress so loud it hurts my eyes. There are yellows and oranges enough to throw back the light of the sun. I feel my whole face warming from the heat waves it throws out. Earrings gold, too, and hanging down to her shoul.ders. Bracelets dangling and making noises when she moves her arm up to shake the folds of the dress out of her armpits. The dress is loose and flows, and as she walks closer, I like it. I hear Maggie go “Uhnnnh” again. It is her sister’s hair. It stands straight up like the wool on a sheep. It is black as night and around the edges are two long pigtails that rope about like small lizards disappearing behind her ears.

“Wa.su.zo.Tean.o!” she says, coming on in that gliding way the dress makes her move. The short stocky fellow with the hair to his navel is all grinning and he follows up with “Asalamalakim, my mother and sister!” He moves to hug Maggie but she falls back, right up against the back of my chair. I feel her trembling there and when I look up I see the perspiration falling off her chin.

“Don’t get up,” says Dee. Since I am stout it takes something of a push. You can see me trying to move a second or two before I make it. She turns, showing white heels through her sandals, and goes back to the car. Out she peeks next with a Polaroid. She stoops down quickly and lines up picture after picture of me sitting there in front of the house with Maggie cowering behind me. She never takes a shot without mak’ ing sure the house is included. When a cow comes nibbling around the edge of the yard she snaps it and me and Maggie and the house. Then she puts the Polaroid in the back seat of the car, and comes up and kisses me on the forehead.

Meanwhile Asalamalakim is going through motions with Maggie’s hand. Maggie’s hand is as limp as a fish, and probably as cold, despite the sweat, and she keeps trying to pull it back. It looks like Asalamalakim wants to shake hands but wants to do it fancy. Or maybe he don’t know how people shake hands. Anyhow, he soon gives up on Maggie.

“Well,” I say. “Dee.”

“No, Mama,” she says. “Not ‘Dee,’ Wangero Leewanika Kemanjo!”

“What happened to ‘Dee’?” I wanted to know.

“She’s dead,” Wangero said. “I couldn’t bear it any longer, being named after the people who oppress me.”

“You know as well as me you was named after your aunt Dicie,” I said. Dicie is my sister. She named Dee. We called her “Big Dee” after Dee was born.

“But who was she named after?” asked Wangero.

“I guess after Grandma Dee,” I said.

“And who was she named after?” asked Wangero.

“Her mother,” I said, and saw Wangero was getting tired. “That’s about as far back as I can trace it,” I said. Though, in fact, I probably could have carried it back beyond the Civil War through the branches.

“Well,” said Asalamalakim, “there you are.”

“Uhnnnh,” I heard Maggie say.

“There I was not,” I said, “before ‘Dicie’ cropped up in our family, so why should I try to trace it that far back?”

He just stood there grinning, looking down on me like somebody inspecting a Model A car. Every once in a while he and Wangero sent eye signals over my head.

“How do you pronounce this name?” I asked.

“You don’t have to call me by it if you don’t want to,” said Wangero.

“Why shouldn’t 1?” I asked. “If that’s what you want us to call you, we’ll call you.”

.

“I know it might sound awkward at first,” said Wangero.

“I’ll get used to it,” I said. “Ream it out again.”

Well, soon we got the name out of the way. Asalamalakim had a name twice as long and three times as hard. After I tripped over it two or three times he told me to just call him Hakim.a.barber. I wanted to ask him was he a barber, but I didn’t really think he was, so I didn’t ask.

“You must belong to those beef.cattle peoples down the road,” I said. They said “Asalamalakim” when they met you, too, but they didn’t shake hands. Always too busy: feeding the cattle, fixing the fences, putting up salt.lick shelters, throwing down hay. When the white folks poisoned some of the herd the men stayed up all night with rifles in their hands. I walked a mile and a half just to see the sight.

Hakim.a.barber said, “I accept some of their doctrines, but farming and raising cattle is not my style.” (They didn’t tell me, and I didn’t ask, whether Wangero (Dee) had really gone and married him.)

We sat down to eat and right away he said he didn’t eat collards and pork was unclean. Wangero, though, went on through the chitlins and com bread, the greens and everything else. She talked a blue streak over the sweet potatoes. Everything delighted her. Even the fact that we still used the benches her daddy made for the table when we couldn’t effort to buy chairs.

“Oh, Mama!” she cried. Then turned to Hakim.a.barber. “I never knew how lovely these benches are. You can feel the rump prints,” she said, running her hands underneath her and along the bench. Then she gave a sigh and her hand closed over Grandma Dee’s butter dish. “That’s it!” she said. “I knew there was something I wanted to ask you if I could have.” She jumped up from the table and went over in the corner where the churn stood, the milk in it crabber by now. She looked at the churn and looked at it.

“This churn top is what I need,” she said. “Didn’t Uncle Buddy whittle it out of a tree you all used to have?”

“Yes,” I said.

“Un huh,” she said happily. “And I want the dasher, too.”

“Uncle Buddy whittle that, too?” asked the barber.

Dee (Wangero) looked up at me.

“Aunt Dee’s first husband whittled the dash,” said Maggie so low you almost couldn’t hear her. “His name was Henry, but they called him Stash.”

 

“Maggie’s brain is like an elephant’s,” Wangero said, laughing. “I can use the chute top as a centerpiece for the alcove table,” she said, sliding a plate over the chute, “and I’ll think of something artistic to do with the dasher.”

When she finished wrapping the dasher the handle stuck out. I took it for a moment in my hands. You didn’t even have to look close to see where hands pushing the dasher up and down to make butter had left a kind of sink in the wood. In fact, there were a lot of small sinks; you could see where thumbs and fingers had sunk into the wood. It was beautiful light yellow wood, from a tree that grew in the yard where Big Dee and Stash had lived.

After dinner Dee (Wangero) went to the trunk at the foot of my bed and started rifling through it. Maggie hung back in the kitchen over the dishpan. Out came Wangero with two quilts. They had been pieced by Grandma Dee and then Big Dee and me had hung them on the quilt ftames on the ftont porch and quilted them. One was in the Lone Stat pattetn. The other was Walk Around the Mountain. In both of them were scraps of dresses Grandma Dee had wotn fifty and more years ago. Bits and pieces of Grandpa Jattell’s Paisley shirts. And one teeny faded blue piece, about the size of a penny matchbox, that was from Great Grandpa Ezra’s unifotm that he wore in the Civil War.

“Mama,” Wangro said sweet as a bird. “Can I have these old quilts?”

I heard something fall in the kitchen, and a minute later the kitchen door slammed.

“Why don’t you take one or two of the others?” I asked. “These old things was just done by me and Big Dee from some tops your grandma pieced before she died.”

“No,” said Wangero. “I don’t want those. They are stitched around the borders by machine.”

“That’ll make them last better,” I said.

“That’s not the point,” said Wangero. “These are all pieces of dresses Grandma used to wear. She did all this stitching by hand. Imag’ ine!” She held the quilts securely in her atms, stroking them.

“Some of the pieces, like those lavender ones, come ftom old clothes her mother handed down to her,” I said, moving up to touch the quilts. Dee (Wangero) moved back just enough so that I couldn’t reach the quilts. They already belonged to her.

“Imagine!” she breathed again, clutching them closely to her bosom.

“The ttuth is,” I said, “I promised to give them quilts to Maggie, for when she matties John Thomas.”

She gasped like a bee had stung her.

“Maggie can’t appreciate these quilts!” she said. “She’d probably be backward enough to put them to everyday use.”

 

“I reckon she would,” I said. “God knows I been saving ’em for long enough with nobody using ’em. I hope she will!” I didn’t want to bring up how I had offered Dee (Wangero) a quilt when she went away to college. Then she had told they were old~fashioned, out of style.

“But they’re priceless!” she was saying now, furiously; for she has a temper. “Maggie would put them on the bed and in five years they’d be in rags. Less than that!”

“She can always make some more,” I said. “Maggie knows how to quilt.”

Dee (Wangero) looked at me with hatred. “You just will not under.stand. The point is these quilts, these quilts!”

“Well,” I said, stumped. “What would you do with them7”

“Hang them,” she said. As if that was the only thing you could do with quilts.

Maggie by now was standing in the door. I could almost hear the sound her feet made as they scraped over each other.

“She can have them, Mama,” she said, like somebody used to never winning anything, or having anything reserved for her. “I can ‘member Grandma Dee without the quilts.”

I looked at her hard. She had filled her bottom lip with checkerberry snuff and gave her face a kind of dopey, hangdog look. It was Grandma Dee and Big Dee who taught her how to quilt herself. She stood there with her scarred hands hidden in the folds of her skirt. She looked at her sister with something like fear but she wasn’t mad at her. This was Maggie’s portion. This was the way she knew God to work.

When I looked at her like that something hit me in the top of my head and ran down to the soles of my feet. Just like when I’m in church and the spirit of God touches me and I get happy and shout. I did some.thing I never done before: hugged Maggie to me, then dragged her on into the room, snatched the quilts out of Miss Wangero’s hands and dumped them into Maggie’s lap. Maggie just sat there on my bed with her mouth open.

“Take one or two of the others,” I said to Dee.

But she turned without a word and went out to Hakim~a~barber.

“You just don’t understand,” she said, as Maggie and I came out to the car.

“What don’t I understand?” I wanted to know.

“Your heritage,” she said, And then she turned to Maggie, kissed her, and said, “You ought to try to make something of yourself, too, Maggie. It’s really a new day for us. But from the way you and Mama still live you’d never know it.”

She put on some sunglasses that hid everything above the tip of her nose and chin.

Maggie smiled; maybe at the sunglasses. But a real smile, not scared. After we watched the car dust settle I asked Maggie to bring me a dip of snuff. And then the two of us sat there just enjoying, until it was time to go in the house and go to bed.

Unlicensed Assistive Personnel and the Registered Nu

Please answer the following Discussion Question. Please be certain to answer the two questions on this week DQ and to provide a well-developed and complete answer to receive credit. Also, please ensure to have read the assigned chapters for the current week.

Case Study, Chapter 8, Unlicensed Assistive Personnel and the Registered Nurse

The increased use of unlicensed assistive personnel presents both opportunities and challenges for the American health care system. The nurse manager has to deal with the challenge that unlicensed assistive personnel only be used to provide personal care needs or nursing tasks that do not require the skill and judgment of the RN.

1. The nurse manager reviews the national effort to define the scope of practice for unlicensed assistive personnel. In 2007, the American Nurses Association made recommendations for a national and/or state policy for nursing assistive personnel. What are the six actions that should be taken to create a national and/or state policy agenda about the educational preparation of unlicensed assistive personnel and the competencies they should have for safe practice?

2. The need in health care today is for today’s nurses to have highly developed delegation skills in working effectively and efficiently with unlicensed assistive personnel. This is critical to ensure the clients’ needs are met and their safety is not jeopardized. What are the key general principles that the nurse manager needs to review with professional registered nurses in delegating to unlicensed assistive personnel?

health problem

Due in 24hrs

I am attaching Assignment 1. This is a follow up of assignment 1. Kindly use table template attached/below to complete the assignment.

Build on Assignment #1. You will cover the same health problem and the same policy unless otherwise indicated by your instructor.  Some remedial action on Assignment #1 may be required in order for students to proceed to Assignment #2. Complete the following using the format provided. Except for titles, narrative format is expected with complete sentences. The table should be single spaced maximum 2 pages. Also include a cover page and a reference page in APA Format.

 
Student Name: Type your name here.
Assignment #2 Title: Provide a short name and the official title of the legislation.
Agency Responsible: Identify the agency and subunit (such as a bureau or office) responsible for implementing the policy.  If multiple agencies are involved indicate who is responsible for what.
Enforcement: What federal or state agency is responsible for enforcement? What are the key areas for enforcement?
Implementation: How is the legislation implemented? What federal or state agency is charged with its implementation?  Are local public health departments involved? Are collaborating organizations engaged to achieve the aims of the policy?  Are citizen’s involved? Are health provider organizations? Are grants awarded?
Impact on Health Service Organizations: What does a Health Care Manager need to know about this legislation and the related implementation?  Include five bullets of how this legislation impacts health services organizations operating in your home state.
Resource: What resource would a health organization utilize to find updates regarding the impact policies have on them?

All sections of Assignment #2 are required.

The grading rubric for this assignment appears below, if you opened the Assignment in the Assignment Folder, or can be opened by clicking on the ‘Written Assignment Rubric’ tab in the lower right corner of the screen, if you opened the Assignment in Content.

financial analysis methods

Organizations rely on financial statements to carry out important business decisions. The statements are typically compiled into a cohesive document, which allow managers to evaluate, based on various financial analysis methods. This process involves a comparison of ratio outcomes from the financial statements. Collectively, the ratios are used to execute financial analysis of business operations, to assess profitability and viability. This portion of the project requires you to apply financial analysis methods, choose the best method to evaluate financial outcomes for your case, and explain why this method should be used over other methods.

Submit a minimum 2-page report that:

  • Defines and describes various financial analysis methods, such as vertical and horizontal analysis.
  • Explains how and why each method would be used in an organization’s financial review process.
  • Compares the similarities and differences among the methods.
  • Using the financial statements for your case, examine how at least one of the methods can be used.
    • Support your position with the actual ratio outcome(s).
    • Explain WHY this method should be used over the others, based on case financial challen

approaches to decision-making

Write a formal paper of 750-1,000 words that addresses the following: 1.Discuss the differences in competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level. 2.Identify a patient care situation in which you describe how nursing care or approaches to decision-making may differ based upon the educational preparation of the nurse (BSN versus a diploma or ADN degree). For additional help finding research on this topic, refer to the GCU Library tutorial located at in the Student Success Center. Refer to the “American Association of Colleges of Nursing (AACN) Fact Sheet: Creating a More Highly Qualified Nursing Workforce” as a resource. Refer to the assigned readings for concepts that help support your main points. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Students should review the rubric prior to beginning the assignment to become familiar with the criteria and expectations for successful completion.

Requirements:

1.Differences in competencies between nurses based on degree level are accurate and supported with detail, while demonstrating deeper understanding by incorporating prior learning.

2.Use of patient care situation to describe differences in approach to nursing care based upon formal educational preparation in nursing is accurate and supported with detail, while demonstrating deeper understanding by incorporating prior learning.

3.Thesis and/or main claim are comprehensive. The essence of the paper is contained within the thesis. Thesis statement makes the purpose of the paper clear.

4.Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

5. Writer is clearly in command of standard, written, academic English.

6.In-text citations and a reference page are complete and correct. The documentation of cited sources is free of error