Select one of the discussion prompts below and respond to it with an initial post by Day #4 of the unit week. Your initial post needs to thoroughly address all parts of the selected prompt and be supported by at least one scholarly source. Then, respond to at least two threads on two additional days to drive the weekly discussions. All posts must demonstrate critical thinking and effective written communication including proper spelling, grammar, professional language, and APA formatting of references and in-text citations. All posts must also be submitted no later than the last day of the unit week.

Discussion 

1

Discuss a time when you may have had difficulty discussing an issue related to oppression, privilege, or intersectionality due to struggles with using the terminology. In this situation, what sort of uncertainty or struggle did you face? What was the outcome? What did you learn during this unit that can help you overcome the struggle with discussing the issue?

(USLO 2.1) 

2

Please watch the following video that is comprised of several short clips demonstrating stereotypes, microaggressions, and instances of prejudice and discrimination: “Power of One” (Thomas, 2007).

After you’ve watched the short video, answer the following questions:

1. Have you or someone you have known ever experienced or witnessed similar instances of what happened in the clips?
2. How did it feel to witness someone else act against the instances of prejudice and discrimination?
3. Do you think you could combat these prejudices, microaggressions, and stereotypes as the people did in the clips? Would you feel comfortable doing this with a family member? A friend? What if you heard an older person make a stereotypical or prejudiced statement?
4. What advice would you give to someone who has experienced stereotyping, discrimination, and prejudice?

(USLO 2.3)

4

What does it mean to be an “American?” Is there an overriding definition of what it means to be an American? How would we encompass the multitude number of races, ethnicities, cultures, religions, and various more identities into one single national identity? Is that even possible? What is the danger behind pushing for a single “story?” Reflect on these questions critically in your answer.

(USLO 2.4)

5

Discuss the privileges ‘natural’ born U.S. citizens enjoy that people with different immigrant and migrant identities do not. What institutional or systemic factors give rise to nationalism for in-groups and oppression of the non-citizen groups?

(USLO 2.6)

6

Immigrants, migrants, and asylum seekers belong to various race, gender, age, religion, and more identities. How does the intersectionality of multiple identities affect these non-citizen groups? Provide a couple of examples and discuss ways to mitigate the detrimental effects and trauma these groups face in the host country.

(USLO 2.4)

7

In recent times, there is a growing fear of diversability regarding people with immigrant identities. Historically, the U.S. is a nation formed with groups of people who fled their countries due to various threats to their lives and safety. Then, on what basis is the current fear of immigrants, migrants, and refugees, justified? How would you change the narrative to mitigate such fears?

(USLO 2.5)

8

Despite the immigrant, migrant, and undocumented workers’ contributions to the U.S. economy, the groups experience various socio-economic, political, and legal barriers to inclusion. Why is immigrant inclusion vital to a nation? What are the critical challenges to inclusive practices for these groups? And as a society, what can we do to ensure equitable access to resources for the immigrant groups?

Original Work, No Plagiarism, Cite and Reference

Joanna, a psychiatrist, has a busy clinical practice. She is widely recognized as a leader in reducing the number of psychotic episodes that patients with schizophrenia experience. Her treatment modalities are largely informed by her research. She has performed numerous clinical trial studies combining various antipsychotic and other medications to achieve longer intervals without episodes. She has cultivated a trusting relationship with her patients as many have seen her for more than five years as she has provide hope and relief to a great number of them.

Joanna is enrolling participants into a randomized placebo-controlled study with a promising new drug to treat schizophrenia. Although two other psychiatrists in her practice are referring patients to the study, she also decides to offer the protocol to patients in her practice that meet the inclusion criteria.

As part of the consent process, she explains to patients that there is a 50-50 chance whether they are placed in the group receiving the investigational drug or in the group that receives the placebo (sugar pill). She tells them that those who are given placebos will not be offered standard-of-care medicine so that important drug-placebo differences can be identified. Joanna also tells them that rational decision-making does not seem to be affected during short periods of medication-free intervals, according to the most recent research. She does acknowledge that studies have had mixed results about the increased risk of suicidality, however.

One of Joanna’s patients, a potential participant named Duncan, asks how long the study is supposed to last. Joanna knows that Duncan has failed other attempts of reducing the length and severity of his schizophrenic episodes. She also believes that he may be a good candidate for the study—as long as he’s not in the placebo group.  There’s no guarantee that he’ll receive the treatment, or do well on it. If he doesn’t enroll, then his clinical care will go on uninterrupted. If he does enroll, this new experimental drug may be his best shot at receiving an effective treatment so that he can lead a more normal life.

Joanna asks if Duncan is interested. Duncan responds, “Whatever you think is best. You’re the doc.”

Questions:

1. How many different kinds of conflicts of interest does Joanna have?

2. How concerned should she be that her patient(s) might not grasp the risks of participating in a drug trial?

3. In your own words, what is a therapeutic misconception?

4. What do you think motivates patients like Duncan to respond “Whatever you think is best”?

5. Should clinical researchers be allowed to enroll their own patients in a study?

 The patient is a 71-year-old widowed man who is seen regularly in the clinic for health maintenance and follow-up of his chronic insomnia and anxiety. He has regular prescriptions for triazolam (Halcion) and clonazepam (Klonopin) for these problems. Recently he has been reporting frequent episodes of losing his balance and falling, and eight weeks ago was hospitalized for a hip fracture sustained during one of these falls resulting in hip surgery. On this visit, he also complains of becoming increasingly confused. 

After studying Module 2: Lecture Materials & Resources, discuss the following:

1. Define psychiatric interview and its importance to the psychiatric nurse practitioner’s role.
2. Compare the phases and critical tasks involved in performing the initial interview.
3. Explain the on going process of the psychiatric assessment.

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
• All replies must be constructive and use literature where possible.
• Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
• Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
• You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

Assignment: National Patient Safety Goal

This assignment will be done in the classroom with discussion to follow.

1.  Read the following chapter from the book, “Patient Safety and Quality: An Evidence-Based Handbook for Nurses” and provide a brief overview.

https://www.ncbi.nlm.nih.gov/books/NBK2681/

2.  List the National Patient Safety Goals from the Joint Commission’s website appropriate to the long-term care environment and what precautions should the nurse take relative to EACH safety goal? 

https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2022/npsg_chapter_alc_jan2022.pdf

3.  From the book, “Patient Safety and Quality: An Evidence-Based Handbook for Nurses,” select one other chapter to read and provide a brief overview.  Apply the main concepts to the long-term care facility environment.  This could be a situation from work or from school or a personal experience. 

http://www.ahrq.gov/qual/nurseshdbk/

4.  Select a Speak Up brochure developed by The Joint Commission. Follow this link to the proper website: https://www.jointcommission.org/topics/speak_up_campaigns.aspx and answer the following questions.

a.  Identify the brochure you chose and the demographic it applies to. Who else can utilize this information?

b.  Why is the brochure you chose important?

c.  What was done well? What could be improved?

d.  How will patient safety be improved from the chosen brochure?

e.  Discuss how current nursing or healthcare-related research supports the information presented in the brochure.

Title

Assignment:  National Patient Safety Goal

Put X in box to correspond with the SLO (s)

Put X in box to correspond with the Competency (s)

Knowledge/Practice/Ethical Comportment

K

P

E

Student Learning Outcome(s)

Patient-Centered Care

Communication Skills

 

Nursing Process

Learning Needs

Technology

Documentation

Informatics

Nursing Judgment

Prioritization

Nursing Judgment

Professionalism

Professionalism

Ethical/Legal

Quality Improvement

Patient Care Concerns

Systems

Safety

x

Patient Complications

Safe Nursing

x

x

x

Teamwork/Collaboration

Communication

Conflict Recognition 

Managing Care 

Managing Care of the Individual Patient

Assign/Monitor 

Where should this assignment be used:

Classroom

X

Clinical Setting

X

Independent Study

X

Online/Web Based

X

Skills Lab

Simulation

 

Revised from Linda Caputi © (What type of assignment is this?)

Patient Care Assignment

Non-Patient Care Assignments

Patient Care

The assignments are related to the student while providing patient care in the clinical setting.
Example:  Concept mapping care for one or multiple patients. 

Thinking Focused
Assignments encourages critical thinking and clinical reasoning and teaches students to think like a nurse.

Patient Focused

The student focuses on specific aspects of patient care such as safety, falls, diabetes, other diseases, etc.

Systems Focused

Assignments help the student understand the clinical world, the nurse’s work therein, and the effect of the system on the nurse and the patient.
Example:  How the system completes medication administration from order to delivery to patient.  

x

x

x