2. Assignment 1: “What Makes ______ the Best Place to Work and Why?”
   Due Week 3 and worth 100 points
   Choose one (1) company that you believe would be an ideal company to work for based on working conditions, salary, opportunity for advancement and work involved. Use the Internet to research.
   Write a four to six (4-6) page paper in which you:

   1. Evaluate the fundamental driving forces that shape the organizational environment of the selected company. Be sure to address the following: competing in a global marketplace, workforce diversity, ethics and morality, and technological innovation.
   2. Examine the selected company’s specific practices or policies. Speculate on the major influences that these practices or policies have on individual and organizational outcomes.
   3. Determine which practices related to work attitudes in U.S. organizations are most strongly affected by diversity and suggest a strategy to address the effects.
   4. Use at least three (3) quality references. Note: Wikipedia and other Websites do not quality as academic resources.

   Your assignment must follow these formatting requirements:

   • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA. Check with your professor for any additional instructions.
   • Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

   The specific course learning outcomes associated with this assignment are:

   • Evaluate human behavior in organizations and the forces shaping the behavior.
   • Analyze individual differences within organizations and their impact on organizational behavior.
   • Use technology to research issues affecting organizational behavior in order to deliver assignments which are clear, concise and have proper writing mechanics.
   • Write clearly and concisely about operations management using proper writing mechanics.

Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”

References:

• Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.

Words Limits

• Response posts: Minimum 100 words excluding references
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• Discussion 1

The purpose of this discussion is to identify key issues to consider when delegating and assigning care, dimensions of power and conflict in the case study, the problems presented, and possible solutions.

As Leadership and Nursing Care Management (2014) explains, when delegating and assigning care there are five Rights; Right task, Right circumstance, Right Person, Right Direction/communication, and Right supervision and evaluation. The delegator and the delegate should agree on the task assigned. The delegator should assess the delegate’s experience and skills of the task. The delegate should be comfortable and confident in completing the said task.

Some problems presented in the case are; the patient is non-verbal with James, is it because there is a language barrier or does the patient not speak/ like male caregivers, James has never prepared a patient for a mastectomy surgery, and the charge nurse gives minimal instruction without concern or review with James.

Two workable solutions are for the charge nurse to evaluate what James knows and educate him on missing components or to do the task with him, so he can see the steps and feel comfortable for the next time he has a mastectomy patient going for surgery. I feel since the patient is not verbally responsive to James, the charge nurse should assume the care of the patient to see if that helps and since the charge nurse is experienced she should do the preparation for such an invasive surgery. If the staff refuses to accept the delegated task, the charge nurse should assess the reason why the staff refuses and go from there with demonstration and instruction or to have the staff observe the task for better knowledge and understanding for next time. Ultimately, the task weather it is complete correctly or incorrectly will fall back on the delegating charge nurse. Delegation errors are a primary factor in malpractice lawsuits against nurses (Anderson, 2016).

Reference:

Huber, D. (2014). Leadership & Nursing Care Management. St. Louis, Missouri: Elsevier Inc.

Anderson, P. (2016). Delegating without Doubts. American Nurse Today. November 2016, Vol. 1 Num. 2.

Discussion 2

Delegation is a nursing skill that takes time to acquire and practice to do effectively. Every successful nurse must learn this skill to be able to provide the best quality and most efficient care to patients. Although delegation is taught in nursing school, the lack of practice in the clinical environment creates challenges for nurses coming into the field. In addition, unsuccessful delegation can create conflict and resentment inside the nursing unit (Huber, 2014).

In the critical thinking exercise, the key issues to consider when delegating and assigning care to the patient are the patient’s feelings and level of comfort with James, James lack of education regarding pre-operative protocol/preparation for mastectomies, and Julie’s training regarding patient pre-operative preparation. Also depending on the unit’s acuity and operating room schedule, time could play a significant role in this situation. Currently, the problems facing that unit are that there is a patient who needs to be prepped for a surgery and is assigned to a nurse who does not have experience with that type of surgery and that the patient has not established a good rapport with the assigned nurse and has stopped communicating (Huber, 2014).

In this situation, the relational aspect of power, the dependency of power, and the sanctioning of power are all present. In the relational aspect of power, the charge nurse has enough power of the staff nurse that he may prep the patient for surgery although he does not have education on that process and the patient may not want him involved. In terms of dependency power, the surgical unit is dependent on the oncology unit preparing the patient for surgery. Lastly, in the sanctioning aspect of power, the charge nurse may punish the staff nurse for not completing the preparation on his own or reward him for finishing the task. The relationship between the patient, staff nurse, and charge nurse can quickly create conflict resulting from the lack of familiarity of the process by the staff nurse. The patient and nurse may experience intrapersonal conflict arising from unmet needs. Whereas the charge nurse may experience intrapersonal conflict while being pulled to handle this patient’s situation while her patients wait for care (Huber, 2014).

There are a few solutions the charge nurse can choose to remedy this situation. First of all, she could use collaboration to work with the staff nurse and the nursing assistant to complete the surgical preparation while teaching him for future patients. She could also compromise with him and swap the patient for one of her patients. By working together, the team could problem solve the situation together and the patient could be persuaded to allow him to complete the preparation by using active listening and allowing her to voice her concerns (Huber, 2014).

In this situation, the best solution would be to collaborate and prepare the patient for surgery. The nursing assistant could help with the physical tasks of preparing the patient such as bath, gown, removal of jewelry, etc. Since the staff nurse is not able to oversee the preparation himself, the delegation should come from the charge nurse since she is familiar with the process and can supervise and evaluate the care. Then the charge nurse and staff nurse could work together to complete the pre-operative assessment and forms. By working together, the staff nurse will have an opportunity to experience the mastectomy preparation and will be prepared in the future. In the event the staff refuses to accept the delegated tasks, the charge nurse should use the chain of command to address the situation. The most important issue at the moment is addressing the patient’s concerns and getting her to surgery. While delegation can create conflict, an experienced and effective delegator can use communication to solve the conflict and strengthen the care team (Huber, 2014). In conclusion, successful delegation requires effective communication, collaboration within the healthcare team, competence by both parties, and defined roles. Delegation is a skill which when done effectively, benefits patient care (National Guidelines for Nursing Delegation, 2016).

References

Huber, D. (2014). Leadership and nursing care management. Saint Louis, MO: Elsevier Health Sciences.

National Guidelines for Nursing Delegation. (2016). Journal of Nursing Regulation, 7(1), 5-14.

Respond to one of the following three “news clippings” related to virtue ethics from your Pozgar text. Write a 1- 2 page essay addressing the discussion questions posed for the one you selected. Be sure to clearly identify the news clipping you selected.

Adhere to APA formatting and cite all sources. Review the rubric for further information on how your assignment will be graded.

Points: 40

Watch the following 3 videos and choose one to address for your assignment.

CASE SELECTED:
#1. Wrong-Operation Doctor ( LINK: http://www.insurancejournal.com/news/southcentral/… )

Assignment Discussion Questions

1. Discuss the issues of integrity in this case.

2. Should criminal charges be considered in this case, if accurately reported? Discuss your answer.

3. Why did you choose to respond to this story?

4. How is integrity displayed in your clinical setting?

HISTORY:

Judgment Upheld in Arkansas Brain Surgery Lawsuit

The Arkansas Supreme Court has upheld an $11 million judgment in a medical malpractice lawsuit against an insurer for Arkansas Children’s Hospital (ACH), in a suit brought by a Mabelvale couple after a doctor operated on the wrong side of their son’s brain.

The Dec. 13 ruling rejected appeals by by Proassurance Indemnity Co. and of the parents of Cody Metheny.

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The Metheny’s wanted the court to restore the original $20 million judgment after it was reduced by a judge to $11 million. The insurance company argued for a new trial so a jury could consider whether doctors involved in the surgery should share blame.

The court rejected both arguments.

Cody Metheny was 15 when he underwent surgery in an effort to end seizures that originated in the right side of his brain. The surgeon, Dr. Badih Adada, who performed surgeries at ACH but was employed by the University of Arkansas for Medical Sciences (UAMS), operated on the wrong side of the brain at first, the left side, and destroyed brain tissue in the process, according to documents released by the Court. After realizing his mistake, Dr. Adada proceeded to operate on the correct side of the brain.

After the surgery, Dr. Adada admitted to Metheny’s parents he had initially started the operation on the left side of the brain but said he had not harmed it, and had successfully removed the right-side lesion, according to Court documents.

Metheny now lives in a rehabilitation center.

Some 15 months after the surgery, the Methenys found out that tissue had wrongly been removed from the left side of the boy’s brain.

In their original suit against the hospital and the surgeon, the Methenys “sought both compensatory and punitive damages based on two counts of medical negligence, as well as one count of outrage,” the Court noted.

The circuit court dismissed the outrage claim. Dr. Adada and other physicians named in the lawsuit settled with the Methenys but the case proceeded against ACH.

At trial the jury found in favor of the Methenys and awarded the $20 million in damages, which the circuit court reduced to $11 million, “an amount consistent with ProAssurance’s liability coverage for ACH,” according to the Court’s opinion, written by Associate Justice Donald L. Corbin.

ProAssurance in its appeal asserted that the circuit court failed to “instruct the jury in a manner that would allow it to apportion liability among it and certain physicians who were sued in a prior case but ultimately settled;” refused to “allow ProAssurance to present evidence of fault attributable to the settling physicians; and “denied denying ProAssurance’s motion for judgment notwithstanding the verdict (JNOV) where the evidence supporting Cody’s future damages was based on improperly bundled calculations.”

Rejecting ProAssurance’s appeal, the Court noted that it found no errors in the actions of the circuit court.

As we have seen in our reading, evidentiary issues can be very challenging. Because I realize that evidentiary rules discussed in our textbook can be rather confusing, I think it is important to construct a few fact patterns to illustrate the concepts at work.

In the following three fact patterns which are drawn from the Instructor’s Edition of the text-book, I would like you to play the role of a “judge” for a day and make a ruling on these three fact patterns. In ruling on these three fact patterns, please refer to the text-book and provide an initial response of 500 words and two responses of 250 each.

1.Quincy sued Edwards for injuries suffered in a fall on the sidewalk of Edwards’ home. Quincy’s complaint alleged that the walk was covered with a thick sheet of ice, which had been negligently left there for several days by Edwards. In his answer, Edwards set forth that the ice formed overnight and that Quincy fell before Edwards had a chance to remove it. During the trial, Dr. Carter, a physician who treated Quincy after the fall and whose office was next door to Edwards’ home, testified that he saw Quincy fall and that the ice, which had been there for several days, was at least two inches thick. On cross-examination, counsel for Edwards asked Dr. Carter the following question: “During your treatment of Quincy on the day in question, is it not true that he told you his fall resulted from a loss of equilibrium after he suffered from dizziness?” Quincy’s attorney objects to this line of question ON THE GROUND THAT THE STATEMENT ON HEARSAY GROUNDS. How would you rule?

2.Quincy sued Edwards for injuries suffered in a fall on the sidewalk of Edwards’ home. Quincy’s complaint alleged that the walk was covered with a thick sheet of ice, which had been negligently left there for several days by Edwards. In his answer, Edwards set forth that the ice formed overnight and that Quincy fell before Edwards had a chance to remove it. Quincy’s housekeeper testified that Quincy was on bed rest and unable to work for a month because of the sprained back which he suffered when he fell. About two months after Quincy returned home from the hospital, she stated that he told her, “My back was really killing me after the fall. The pain was excruciating. I thought it would be a miracle if I ever stood up again.” Edwards’ counsel then moved to strike the housekeeper’s testimony ON HEARSAY GROUNDS. How would you rule?

3.In a suit between Peters and Daniels arising out of an automobile accident, Barnett, a bystander, was called to the stand to testify that Daniels had driven through a red traffic light immediately before the collision. On cross-examination, Daniels’ attorney wants to get Barnett to admit that he made a prior statement to Franklin, a friend, that he was not sure if the traffic signal was yellow or red when Daniels drove through the intersection. How should the trial court rule ON A HEARSAY OBJECTION TO THE ADMISSIBILITY OF THE PRIOR STATEMENT?