Complete the following:

• Amish case study
• Jewish Case study #1
• JEWISH CASE STUDY #1
  Selecting a “typical” Jewish cl
  ient is difficult. An ultra-Or
  thodox Jew has a particular set
  of special needs. Yet, it is more common
  to see a Jew who is a middle-of-the-road
  Conservative.
  Sarah is an 80-year-old woman who is
  a first-generation American. She was
  raised in a traditional Conservative home. Her husband died after 50 years of a strong
  marriage. She has three children. Although her home is not kosher, she practices a
  variation of kosher-style eating, avoiding por
  k and not making dishes that combine
  meat and milk.
  Two months ago, she was diagnosed w
  ith pancreatic cancer. Surgery was
  attempted, but the cancer was already in an advanced stage. Chemotherapy was started,
  but the cancer has progressed and is not re
  sponding to the medications. She is having
  difficulty eating because of the pressure of
  the tumor on the gastrointestinal tract.
  Discussions are being held to determine
  whether or not treatme
  nts should be stopped
  and whether hospice care should be initiated.
  Her hospital room is always filled with visitors.
  Study Questions
  1.    What must you anticipate in discussi
  ng with Sarah her wi
  shes regarding the
  continuation of medical care?
  2.    How would you respond to
  her initial decision to ha
  ve surgery and initiate
  chemotherapy?

  3.    What questions do you need to ask in
  the initial patient interview to assess her
  degree of religious practice? How will
  you determine her spirituality needs?
  4.    What is your understanding of the reas
  on she has so many visitors in her room?
  5.    Is hospice care appropriate for this patient?
  6.
  Sarah dies with her family at her bedsid
  e. What interventions can you take at the
  time of death to demonstrate religious sens
  itivity to the family? What questions do
  you need to ask the family?
  7.    Describe three genetic or heredita
  ry diseases common with Ashkenazi Jews.
  8.    Describe Jewish burial
  rituals and grieving process.
  9.    Discuss the laws of Kashrut in regard to
  food practices for observant Jewish clients.
  10.
  What should the health-care provider keep
  in mind when entering a Jewish home to
  provide care?
  11.   Distinguish between the terms
  Sephardic
  and
  Ashkenazi
  .
  12.   How might a non-Jewish and a Jewish cowo
  rker share holidays in the workforce?
  13.   What is the official language
  the Jewish people use for prayer?

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AMISH CASE STUDY
Elmer and Mary Miller, both 35 years old, liv
e with their five children in the main
house on the family farmstead in one of th
e largest Amish settlements in Indiana.
Aaron and Annie Schlabach, aged 68 and 70, live in the attached grandparents’
cottage. Mary is the youngest of their ei
ght children, and when she married, she and
Elmer moved into the grandparents’ cottage
with the intention that Elmer would take
over the farm when Aaron wanted to retire.
Eight years ago, they traded living space.
Now, Aaron continues to help with
the farm work, despite increasing pain in hi
s hip, which the doctor advises should be
replaced. Most of Mary’s and Elmer’s sibli
ngs live in the area, though not in the same
church district or settlement. Two of Elmer’s brothers and their families recently
moved to Tennessee, where farms are less expensive and where they are helping to
start a new church district.
Mary and Elmer’s fifth child, Melvin,
was born 6 weeks prematurely and is 1
month old. Sarah, aged 13, Martin, aged
12, and Wayne, aged 8, attend the Amish
elementary school located 1 mile from thei
r home. Lucille, aged 4, is staying with
Mary’s sister and her family for a w
eek because baby Melvin has been having
respiratory problems and their physician told
the family he will need to be hospitalized
if he does not get better within 2 days.
At the doctor’s office, Mary suggested
to one nurse, who often talks with Mary
about “Amish ways,” that Menno Martin, an
Amish man who “gives treatments,” may
be able to help. He uses “warm hands” to
treat people and is
especially good with

babies because he can feel what is wrong. Th
e nurse noticed that Mary carefully placed
the baby on a pillow as she prepared to leave.
Elmer and Mary do not carry any hea
lth insurance and are concerned about
paying the doctor and hospital bills associat
ed with this complicated pregnancy. In
addition, they have an appointment for Wayne
to be seen at Rile
y Children’s Hospital,
3 hours away at the University Medical Cent
er in Indianapolis, for a recurring cyst
located behind his left ear. Plans are being
made for a driver to take Mary, Elmer,
Wayne, Aaron, Annie, and two of Mary’s sist
ers to Indianapolis
for the appointment.
Because it is on the way, they plan to stop in
Fort Wayne to see an Amish healer who
gives nutritional advice and does “treatment
s.” Aaron, Annie, and Elmer have been
there before, and the other women are considering having treatments, too. Many
Amish and non-Amish go there and tell others
how much better they feel after the
treatments.
They know their medical expenses seem minor in comparison to the family
who last week lost their barn in a fire
and to the young couple whose 10-year-old child
had brain surgery after a fall from the hayl
oft. Elmer gave mone
y to help with the
expenses of the child and will go to the barn raising to help rebuild the barn. Mary’s
sisters will help to cook for the barn raisi
ng, but Mary will not help this time because
of the need to care for her newborn.
The state health department is concer
ned about the low immunization rates in
the Amish communities. One community-health nurse, who works in the area where
Elmer and Mary live, has volunteered to talk
with Elmer, who is on the Amish school
board. The nurse wants to learn how the health
department can work more closely with

the Amish and also learn more about what
the people know about immunizations. The
county health commissioner thinks this is a wast
e of time and that what they need to do
is let the Amish know that they are creating
a health hazard by ne
glecting or refusing
to have their children immunized.
Study Questions
1.
Develop three open-ended questions or
statements to guide you in your
understanding of Mary and Elmer and what
health and caring mean
to them and to
the Amish culture.
2.    List four or five areas of perinatal
care that you would want to discuss with Mary.
3.    Why do you think Mary placed the baby
on a pillow as she was leaving the doctor’s
office?
4.     If you were the nurse to whom Mrs. Mill
er confided her interest in taking the baby
to the folk healer, what would you do to le
arn more about their simultaneous use of
folk and professiona
l health services?
5.     List three items to discuss with the M
illers to prepare them fo
r their consultation at
the medical center.
6.    If you were preparing the reference fo
r consultation, what would you mention about
the Millers that would help to promote cu
lturally congruent ca
re at the medical
center?
7.    Imagine yourself participa
ting in a meeting with state
and local health department
officials and several local physicians and nur
ses to develop a plan to increase the

immunization rates in the
counties with large Amish
populations. What would you
suggest as ways to accomplish this goal?
8.
Discuss two reasons why many Old Orde
r Amish choose not to carry health
insurance.
9.
Name three health problems with genetic
links that are prevalent in some Amish
communities.
10.
How might health-care providers use the
Amish values of the three-generational
family and their visiting patterns in pr
omoting health in the Amish community?
11.   List three Amish values to consid
er in prenatal education classes.
12.
Develop a nutritional guide for Amish wome
n who are interested in losing weight.
Consider Amish values, daily lifestyl
e, and food production and preparation
patterns.
13.   List three ways in which Amish express caring.

APPALACHIAN CASE STUDY #1
William Kapp, aged 55 years, and his wife, Gloria, aged 37, have recently moved from an
isolated rural area of northern Appalachia
to Denver, Colorado, because of Gloria’s
failing health. Mrs. Kapp has had pulmonary t
uberculosis for several years. They decided
to move to New Mexico because they heard that the climate was better for Mrs. Kapp’s
pulmonary condition. For an unknown reason, they stayed in Denver, where William
obtained employment making machine parts.
The Kapp’s oldest daughter, Ruth, ag
ed 20, Ruth’s husband, Roy, aged 24, and
their daughter, Rebecca, aged 17 months, moved with them so Ruth could help care for
her ailing mother. After 2 months, Roy return
ed to northern Appalachia because he was
unable to find work in Denver. Ruth is 3 months’ pregnant.
Because Mrs. Kapp has been feeling “mor
e poorly” in the last few days, she has
come to the clinic and is accompanied by her husband, William, her daughter Ruth, and
her granddaughter, Rebecca. On admission, Glor
ia is expectorating greenish sputum,
which her husband estimates to be about a teac
upful each day. Gloria is 5 ft 5 in. tall and
weighs 92 pounds. Her temperature is 101.4°F,
her pulse is regular at 96 beats per
minute, and her respirations are 30 per minute
and labored. Her skin is dry and scaly with
poor turgor.
While the physician is examining Mrs. Kapp, the nurse is taking additional
historical and demographic da
ta from Mr. Kapp and Ruth. Th
e nurse finds that Ruth has
had no prenatal care and that her first chil
d, Rebecca, was delivered at home with the
assistance of a neighbor. Rebecca is pale and
suffers from frequent bouts of diarrhea and
paper needs to be written in a paper format-not just a list of the questions and replies.

Read Chapter 12

1. What are three questions you should ask yourself when you begin your job search?

2. What are the most common mistakes people make in preparing their résumés?

3. What should you know about your prospective employer before the job interview?

4. What should the interviewee try to achieve during a job interview? What should you look for? What red flags should you watch for?

5. What can you do in advance to prepare for the changes during the first year of employment?

6. Create your own SWOT analysis. How would you respond to your personal strengths and weaknesses if you were a prospective employer? How can you enhance your strengths and improve in areas of weakness?

7. Draw a career path for yourself, beginning with the present year and extending to the age of retirement. Be sure to include any “twists and turns” of the path you expect to experience along the way and any barriers you expect to encounter. How will you handle these experiences?

Do an online nationwide search for information about current job prospects in nursing.Compare opportunities in various regions of the country. Why do you think these opportunities are the same or different?

5. Develop a list of questions that you should ask a potential employer. What “homework” will you need to do to prepare for an interview?

The field of nursing has changed over time. In a 750-1,000 word paper, discuss nursing practice today by addressing the following:

1. Explain      how nursing practice has changed over time and how this evolution has      changed the scope of practice and the approach to treating the individual.
2. Compare      and contrast the differentiated practice competencies between an associate      and baccalaureate education in nursing. Explain how scope of practice      changes between an associate and baccalaureate nurse.
3. Identify      a patient care situation and describe how nursing care, or approaches to      decision-making, differ between the BSN-prepared nurse and the ADN nurse.
4. Discuss      the significance of applying evidence-based practice to nursing care and      explain how the academic preparation of the RN-BSN nurse supports its      application.
5. Discuss      how nurses today communicate and collaborate with interdisciplinary teams      and how this supports safer and more effective patient outcomes.

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.

Anne Kolsky    3 posts   Re: Topic 10 DQ 2  Importance of EBP for BSN-RN  Sustainability of evidence-based practice has waned. One thing I have noticed in my workplace is that people (including myself) tend to take the path of least resistance. “It’s easier to…” My mentor and I have had many conversations about this. It’s easier to just give a ‘Band-Aid or bag of ice’ then take the time to assess the situation and treat appropriately. Another example, comparing my last workplace to current, one striking difference is stock medications. We did not give out or stock any kind of medication in the former. My new workplace not only stocks but does not require a doctor’s order to administer. Although it is more work, I insist on an order for stock medications. I also call the parent before giving, as appropriate. It is my license and it is for the safety of the students that are at stake.  I have already had conversations with staff and nursing staff about these practices.  Although they know the risks, they are choosing to keep status quo for themselves.  Of 6 nurses on staff, there is one other that holds similar practice.  She stated at our last meeting that “Kids come down asking for a Tylenol, just to get out of class.”  She made it clear that without an order and parent permission, she will not give out any medications.     Another difference noted is charting practices. Currently, other nurses use a one word drop down menu to chart. SOAP notes are not done consistently. I will continue to make notes. I will continue to chart more fully. It has saved my skin more than once when a student, a teacher, or even a parent will claim that “the nurse didn’t do anything.” It gives such good data for what is trending with that student, why wouldn’t one want to do that? I understand that the office is super busy, but so is the courtroom. I’m not here to make friends, I’m here to do my job.   Another practice I will continue to implement, but with a new perspective, are the various screenings given to students. I will make a more concerted effort to make sure the student and family is aware of all the services available. In my former workplace, I compiled a list of resources for families. I need to make a new one for this community. I have a new perspective towards screenings and a fuller understanding of how important these are in the bigger picture.  In the study by Meyer, et al., (2019) of 1,600 clinicians only 51 reported no obstacles to implementing new treatments. The biggest obstacles reported related to time, cost, location for training, demographic mismatch with resources and difficulty finding resources. New trainees are not given evidence-based training nor supervision experiences, either. Participants in the study requested greater access to existing resources. Handouts, journals, training modules, and workshops (Meyer, et al., 2019).   Meyer, A. E., Reilly, E. E., Daniel, K. E., Hollon, S. D., Jensen-Doss, A., Mennin, D. S., … Teachman, B. A. (2019). Characterizing evidence-based practice and training resource barriers: A needs assessment. Training and Education in Professional Psychology. doi:10.1037/tep0000261.supp (Supplemental)