...was the idea to implement nurse residency programs. This is specifically, a “planned, comprehensive periods of time during which nursing graduates can acquire the knowledge and skills to deliver safe, quality care that meets defined (organization or professional society) standards of practice” (IOM, 2011). It gives the first year nurse the ability to develop clinical decision making skills, clinical autonomy in providing patient care, blend evidence based practice into their practices, and can increase commitment to nursing as a career (IOM, 2011). I feel that this recommendation is extremely important, not only for newly licensed RNs but also advanced practice nurses. I remember when I came out of nursing school and received by nursing license I was scared out of my mind and did not think I was capable of providing the best quality care. I was grateful enough to be provided with a five month orientation with preceptors who took the time to teach me the ropes of the emergency room and also how to use everything I learned in nursing school. Following completion of my orientation, I felt fully competent to take care of patients who need immediate attention from me. I do not know how I would have handled myself if I only had a few weeks worth of orientation and got thrown to the wolves. The nursing profession can meet these recommendations by providing financial assistance to hospitals who provide longer orientations times or residency programs. Hospitals that...
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...| The High Costs of Medical Education Impacting Future Physicians | Module 5 Essay | | | 3/9/2014 | Jacquelyn Q | Summary Thousands of recent college graduates with medical educational loans to pay off are putting their plans for better lives on hold. Medical education tuition and medical student debt have increased dramatically during the past two decades, even though loans and grants are available on conditional terms, students continue to find it impossible to receive a medical education. As an investment, medical education is an excellent choice; its net present value is more than a million dollars. Cost is nevertheless a strong deterrent to potential physicians, such as myself. If tuition and indebtedness continue to increase while physician incomes does not, medical schools may have increasing difficulty recruiting qualified medical students. If tuition continues its rapid increase, potential physicians may find it extremely difficult to repay their medical school debts, and some students may be deterred from attempting a career in medicine. These decisions could have a devastating impact on our health care system. Recent increases in medical education tuition and high levels of indebtedness among graduates are matters of concern to me. Although concern about rapidly increasing costs is seen throughout higher education, the situation in medicine appear especially troubling in view of the much higher levels of indebtedness and the lengthy...
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...Discuss the conflict that is occurring at General Hospital. Conflict is a process in which one party (person or group) perceives that its interests are being opposed or negatively affected by another party (Hellriegel/Slocum, 2011). There are four primary levels of conflict: intrapersonal, interpersonal, intragroup, and intergroup (Hellriegel/Slocum, 2011). Intrapersonal conflict occurs within an individual and usually involves some form of goal, cognitive, or affective conflict (Hellriegel/Slocum, 2011). General Hospitals’ CEO Mike Hammer experiences intrapersonal approach-avoidance type conflict since he is trying to devise a master plan to cut costs, increase revenues, expand current services, and add new services. Interpersonal conflict occurs when two or more individuals perceive that their attitudes, behaviors or preferred goal are in opposition (Hellriegel/Slocum, 2011). Once Hammer presented his ideas to Dr. Mark Williams, Director of Medicine an intrapersonal conflict was shown since he felt that all physicians act in the practice of good medicine and forcing them to adhere would make it harder to keep and attract new physicians. Intragroup conflict refers to disputes among some or all of a group’s members, which affects a group’s dynamics and effectiveness (Hellriegel/Slocum, 2011). Although Marge Harding’s father and brother are medical doctors, she isn’t wowed by their positions, doesn’t mind challenging physicians, and views them as one dimensional. This represents...
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..."MUMBAKI" In the world we live in, each kind of people has their own kind of culture, each one differing one from another. The people under the same culture shares their own set of beliefs, practices, rituals, goals and values. Though there may be some that members that may go astray from the others. Anyway from the movie Mumbaki we can see the culture of the Ifugao wherein their belief in their so-called 'baki' or gods is so strong that they would even forgo the medicine putting their whole trust in the mumbaki, fearing that if ever they would not follow him their pagan god would bring them diseases and plagues. In the movie also we saw here how that in just a small argument a war might erupt just like the dispute of the Alimit and the Lidum tribe. From there it can also be said that revenge always happen once again because their god might bring them incurable sicknesses and even death thus when the epidemic diseases already experienced by some has transferred to many refusing the medicine given by their attending physician. For my own personal standpoint I must say they are all idiots, I have been to Banaue been born there and had my childhood there and in there I have seen adults carrying pigs in bamboo stalks even in the early morning or late at night, they always perform this ritual whenever they need the guidance of their pagan gods such as looking for a lost person in the forest, an offering to their gods for a newlywed but the most common time you see it is in the...
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...On-Line Medicaid Billing-Nursing Home Access the Texas Medicaid website, www.tmhp.com to bill Nursing Home claims. Select Providers link (top of screen) and then select Access TexMedConnect (right side of screen). 1. Medicaid a. If pt is utilizing hospice services and has Medicaid, we have to bill and pay for their room and board b. You will receive an email with new admitted patient information from each location c. The nursing home bills a patients private insurances for services d. only bills Medicare for hospice skilled services and Medicaid for Room and Board e. Drew and Troy took over Nursing home billing in July f. A folder for each location is called Medicaid, each office has its own folder, each office folder has a spreadsheet for each Nursing home i. There is also a spreadsheet for Medicaid Primary g. Medicaid hospice pays for different levels of rooms at different rates i. Tile or RUG rates: ranges from $100 to $250 a day depending on the level of care h. There are 25 levels of facilities (25 being the low end facility) i. deals with level 5-12 facilities i. Ex: tile level CA2 = $114 (refer to cross legend) j. Texas Medicaid Website is: www.tmhp.com – Below are features of the site i. MESAVE lets you check patient eligibility ii. Look for NURSING FACILIITY ROOM AND BOARD iii. NEED...
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...of Darling v. Charleston Community Memorial Hospital. This is a case in which the Illinois Supreme Court ruled in favor for the plaintiff showing that the hospital failed to give due process to the injured individual. Hospital facts presented shown that the young patient had a fracture of the tibia and fibula. A time frame of three years had passed since the attending physician treated a fracture. A consultation from a trained orthopedic physician was not obtained by the general practitioner and the attending physician set the plaster cast from the groin to toes on the plaintiff. The hospital failed to render adequate care to the patient for not having trained staff to notice and report the condition of gangrene, and the failure of the nurses not reporting the condition to the appropriate staff to rectify the condition, (Pozgar, 2010). The hospital was found liable by the jury because it fail to oversee and provide the necessary proper care for the patient. Define Respondeat Superior Respondeat Superior is a legal doctrine that...
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...Ethical Decision Making Lisa Stanley Grand Canyon University: HLT 305 April 18, 2012 Ethical Decision Making The ethical dilemma here is about a six year old child rush to the hospital for medical treatments. The six year old symptoms consist of convulsions and violent vomiting while attending school. The attending physician made a diagnosis of Meningitis and suggested medical treatment. However, being the parents are both Christian Scientists and decided against medical treatment, but the attending physician initiate medical treatment anyway causing a lawsuit by the parents against the and hospital. Since both parents are Christian Scientists, practicing Christian Science, It would be in the physician best interest to respect their wishes. Christian Science teaches Christian Science teaches that it’s never God's will for anyone to suffer, be sick, or die. Instead, it shows how God is entirely good, and therefore his will for each of us is only health and life (Christian Science, 2012).If I was in the position of the physician and hospital, I would respect the parent’s wishes. We should respect others beliefs and or religions because we never know when we may be put into a position to utilize our religion or belief, and besides it may save us a lawsuit in the long run. In this particular situation Contextual Features would be appropriate for use, because it covers all grounds for the parent’s wishes to be follow among other things that may have hin-dered them...
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...PUB 195 NC (7-10) FACT SHEET Identification and Legal Presence Requirements for Non-United States Citizens As part of a nationwide effort to enhance the issuance of secure identification credentials, Pennsylvania requires the following documentation from Non-U.S. Citizens applying for a PA Driver’s License, Learner’s Permit and/or Identification (ID) Card, or transferring an out-of-state driver’s license. A minimum of one year legal presence is required by Pennsylvania law. PennDOT determines the expiration date of products based on your length of stay documents (typically the I-94) along with information from the Department of Homeland Security (DHS). PennDOT verifies immigration documents electronically with DHS. This verification may not be able to be completed on the day of your visit and may require additional verification which can take up to 3 weeks to complete. Please take this time into account when planning to get a product. Age Requirements for Non-U.S. Citizens Individuals must be at least 16 years of age to apply for or, 16 1/2 years of age to transfer a Non-Commercial Driver’s License and/or Non-Commercial Learner’s Permit. Out-of-State Learner’s Permits can not be transferred to Pennsylvania. Individuals applying for or transferring a Commercial Driver’s License must be at least 18 years of age for intrastate driving or 21 years of age or older for interstate driving. Individuals must be at least 10 years of age to apply for a Photo Identification (ID) Card...
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...Records Organization The similarities that I found for the organizations of patient files are that most of the paper files between the small and medium facilities are handled the same way. With the demographics and administrative filed on the left and medical on the right. Such as reports of labs, patient progress notes, prescription documentation, and any miscellaneous reports. Some of the small and medium facilities seem to use this filing method. This filing works well in a small to medium facility because there are not many files for the staff members to handle on a daily basis. I believe this system would not work with large facilities because the large facilities will need to use a filing system that is beneficial to the facility to keep track of patient’s files. The difference that I saw with the patient files are there organized by different departments and chronological, oldest to newest in small facilities and also organized using filing alphabetically this filing system will work because it will help keep these facilities organized and help maintain the patients records efficiently. In large facilities numerical filing will work to keep track of all patient files. The similarities I found with all three facilities are that loose documentation remains loose until the attending physician or the patient signs the required documentation needed. All this is done before anchored into patient files. Any remaining administrative documentation is anchored when found loose....
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...The conclusion endorsed in this argument is that the woven baskets, which are previously thought to be unique in Palean, are found to be not conform to its reputation as "Palean baskets". To substantiate(bolster) this assertion, the arguer points out evidence that archaeologists has discovered such a "Palean" basket in Lithos which is an ancient village across a river from Palea. Furthermore, he indicates that the ancient Paleans have no ability to cross this river. At first glance, the author's argument seems to be cogent, but close scrutiny reveals that it is unconvincing in many aspects. In the first place, the author unfairly assumes that no Palea's residents have ever been to Lithos for there is a river across them. While the arguer doesn't provide us sufficient materials such as geographical data or certain historical recordings to prove Palean was seperated from Lithos. Maybe they can just walk or tramp over hill and dale to Lithos. Even if the only way from Palean to Lithos is across the Brim river, the author's inference rests on the poor assumption that during thousands of years this river is always deep and broad. It is highly possible that this river is shallow and narrow or just not exit in prehistoric era. What is more, the author gratuitously mention that the ancient Paleans could have crossed the river only by boat and no Palean baskets have been found. Why should they have to come to Lithos by boat? A small raft or a simple drawbridge could be more convenient...
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...(Additions in black bold font, proposed deletions with strike-thru) Two-Midnight Rule CMS adopted the Two-Midnight rule for admissions beginning on or after October 1, 2013. The rule states: Inpatient admissions will generally be payable under Part A if the admitting practitioner documents the patient to require a hospital stay that is expected to cross two midnights, and the medical record supports that reasonable expectation. Medicare Part A payment is generally not appropriate for hospital stays (acute, LTAC, and psychiatric) not expected to span at least two midnights. Purpose Because of the structure of Medicare, payment for hospital services is distributed differently for inpatient status versus outpatient status. When a patient is admitted to a hospital as an Inpatient, the reimbursement falls under the Inpatient Prospective Payment System (IPPS). In contrast, when a patient is admitted to the hospital as Observation, Medicare pays the hospital under the Outpatient Prospective Payment System (OPPS). The care provided is the same regardless of the Inpatient or Observation status assigned. The doctor must decide whether it is suitable to admit the patient as an Inpatient or Outpatient based on the 2 MN Rule criteria provided by CMS. The beneficiary is responsible for a one-time deductible if admitted (and billed) as Inpatient, but conversely will be responsible for a copayment on each individual hospital service if admitted (and billed) as Observation. CMS states the...
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...Ethics and Tarvydas Model Laura Garcia PSYC 410 Dr. Lane October 26, 2014 Ethics and Tarvydas Model 1. The counselor receives an intake for an attending physician, whom has worked with the agency in the past. This intake call is inquiring on a personal matter regarding his 17 year old daughter with an eating disorder / exhibited symptoms of Borderline Personality Disorder. It is relayed during the call; the physician will continue the medication management portion of treatment, while the agency provides counseling services. It was presented during the intake he was concern with being well-known doctor that would like to keep this information private from others and would like to pay cash for service. Phase 1: The counselor is aware of the physician’s rights to keep his daughters condition private, however providing medication to a family member is cause for concern when there may not have been a proper assessment completed or if it is not being documented properly. The influence the medication can influence the process of therapy; especially when there may be no medical documentation of initial symptoms can cause various problems with treatment. It is important in determining if there is medical documentation supporting the diagnosis/medication and what types of tools were used in determining those findings. Determine why she was not referred to an agency earlier, and why is it in the best interest for the physician to continue medication when the counselor would...
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...business environment, the questions that arise whether current existing law regrading residence and source is no longer fitting and whether its application may be conducive for cases where misappropriation is intentional. This paper considers some of the questionable reasoning used today by the courts in determining residence and source on companies incorporated overseas. The case of Crown is not dissimilar to that of Malayan Shipping Co, whereby an Australian resident (Mr Sleigh) the majority shareholder of a taxpayer company incorporated overseas, was considered to be the managing director and agent who alone could decide upon the entering of contracts by the company in Australia. The company was found to derive its income and have tax residency in Australia “despite the directors being non-resident and meeting outside Australia” due to central management and control being held by an Australian resident. Similarly in Crown several indicators of absolute authority held by an Australian resident were presented, including “All of the proposals were prepared by Mr. Pattenden on his lap top” and “Mr. Pattenden prepared a group insurance proposal and prepared and issued a policy”, these statements seemingly present Mr. Pattenden as being ‘the brains behind operation’. The commissioner pursued this as it had been in Malayan shipping, however several factors prevented the same decision being applied, in particular central management and control was not considered to be in Australia due...
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...pneumonia. Marion immediately becomes disoriented and attempts to remove her intravenous and oxygen tubing. Since she tries to climb out of bed, her daughters must remain at her side. The attending physician tells the daughters that in addition to treatment for pneumonia, Marion will also need to have a pacemaker inserted to regulate her heartbeat. However, Marion would then be unable to return to the nursing home, since the facility is not equipped to care for someone recovering from surgery. After thoughtful discussions with other family members, Marion’s daughters tell the physician that they do not want to put their confused mother through the surgical procedure. The physician seems to be understanding of this decision. However, the floor nurses take the daughters aside on several occasions to tell them that this is not a dangerous procedure and they need to sign a permit for the surgery. In fact, the daughters are made to feel that they are not acting in their mother’s best interests by refusing to sign the permit. Marion...
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...Personal differences and preference can greatly impact organizational ethics especially in medical field. Many times, medical decision such as courses of treatment is based on the treating physician experience which sometimes includes physician’s preference of certain medication over another. Pharmaceutical companies often visit hospital and clinic in hope of encouraging physician to prescribe their line of medication over their competitor. The encouragement may include free sample of the medication, notepad, pen, or even an out of town seminar. The seminar is often paid for by the pharmaceutical company that may include a few hours of actual seminar and the rest of the weekend free to leisure activities, according to Carollo (2010), “pharmaceutical companies paid out more than $250 million to some 17,000 doctors and nursed across the country in 2009 and 2010”. Most if not all drugs have side-effect and drugs used to treat the same symptom may have different side effect depending on its ingredient. A physician preference of one type of drug over another, whether it’s due to pass experience of prescribing the drugs or other benefit provided by the pharmaceutical company that come along with prescribing the drugs. Two physicians treating the same symptoms may prescribe two different course of treatment or medication based on the different experience each physician have. Physician A may have prescribed Medication 1 to a patient in pass. That patient may have reacted badly to medication...
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