To complete this discussion, you will be logging into The Neighborhood.Click Accessing and Using The Neighborhood for directions to enter the virtual community.Select the link watch the video for further instruction on The Neighborhood.Click Neighborhood to access the neighborhood simulation.As a nurse, you can influence policy-making and change decisions at many levels. The process of policy development or change begins by identifying a topic of interest that you are seeking to change or enhance.Step 1: In The Neighborhood, read the following:Hospital Nursing IssuesNeighborhood hospital nursesPat RichmanSeason 2, Episodes 5 and 6 (mandatory overtime)Season 2, Episodes 13 and 14 (employee drug testing)School Nursing IssueViolet BrinkworthSeason 3, Episodes 13 and 14 (emergency response)Senior Center Nursing IssueKaren WilliamsSeason 3, Episode 6 (increase in funding)Step 2: Decide which of the four issues from The Neighborhood readings interests you most. Determine what you can do to advocate for enhancing or changing the policy involved in that situation.Step 3: Post to the discussion forum.In an initial post of approximately 150 words, discuss the policy issue you would like to see enhanced or changed and explain how you would implement the enhancement or change.Step 4: Read other students’ posts and respond to at least two of them by Friday at 11:59pm MT.Respond to your classmates by discussing any potential barriers you can foresee during the implementation of their policy recommendation. List some strategies to resolve these problems.
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Pat Richman Season 2 Episode 5 and 6 (Mandatory Overtime)
The Neighborhood forest fire has made the entire hospital crazy. There are far more
patients needing hospital beds than are available, and the nurses in the Emergency
Department keep calling to the unit, demanding that they make beds available.
Pat becomes really angry when he attends an administrative meeting in which the
managers are informed that mandatory overtime will be instituted at the hospital beginning
the next pay period. He can’t believe how bad their timing is.
Pat holds a staff meeting that he has been dreading the whole week. He announces
mandatory overtime to the staff and can feel the tension in the room. He has brought
muffins and coffee to try to improve the staff’s mood, but he can see that this clearly has not
helped. The person he thought would be most negative about the news was Bobby. Pat is
surprised that Bobby says little during the meeting.
Episode 13 and 14 (Employee Drug Test)
Pat continues watching Bobby. He has not actually caught Bobby doing anything wrong, yet
he strongly suspects he is taking narcotics. Pat knows what he must do, but is feeling
overwhelmed with all that has been going on lately. Pat contacts his supervisor, the area
director of nursing, and the human resources department, to make sure he handles this
Pat’s To Do List
Bobby Schofield and quality of care:
Signs of drug use while working:
Several nurses have complained about him in the past several months
Physical signs of disheveled dress, diaphoresis, unsteady gait, slurred speech, fatigue, and
Zainah, the charge nurse, and several other staff have reported him to have unpredictable
behavior, unprofessional dress, and unexpected diaphoresis.
Bobby always denies responsibility for any issue that may occur while he is working.
Jacob McCain complained to his instructor about unpredictable behavior from Bobby.
Increased narcotic sign-outs, wasting, and lack of pain relief in assigned patients:
Several complaints from patients and family members about substandard care provided by
Complaints include poor pain control while under his care.
Contact supervisor and Human Resources for assistance with handling the situation.
Check Union guidelines for employee substance abuse.
Pat receives a phone call from Zainah Kattan at 7 a.m., informing him that she thinks Bobby
is “messed up.” After observing Bobby for a few minutes, Pat relieves him of his duties and
orders Bobby to submit a urine sample for a drug screening. Pat is extremely disappointed,
but not surprised, when he is notified that Bobby tests positive for several types of drugs. In
addition to having to deal with this, Pat is now down yet another nurse. Because Bobby
belongs to the nursing union, he also fully expects they will get involved. He just hates
having to deal with that.
Pat’s To Do List
List of Bobby’s shifts through next week.
Ask admin for help getting coverage.
Call home; may be working extra hours; cancel out dinner plans?
Violet Brinkworth Season 3 Episode 13 and 14
While working at Neighborhood High School, a student comes running into Violet’s office
and tells her that one of the students is sick in the hall outside the girls’ locker room. Violet
hurries out and finds Amy Price, a student with alleged drug and alcohol problems, lying on
the floor awake. When Violet asks her what happened, Amy does not respond. Violet
notices that Amy’s pupils are dilated, and she has labored breathing. Violet checks Amy’s
pulse and notes it is very weak and rapid. She sends a student to the main office to tell
someone to notify the principal and then Violet calls 9-1-1 on her cell phone. She asks Amy
if she has taken any medicine or drugs recently. She does not respond, but Amy’s friend
tells Violet that she took a “whole bunch” of pills but nobody knows what the pills were. The
paramedics arrive and take Amy to Neighborhood Hospital. Violet writes up a detailed
incident report and submits it to the office.
Violet is called into the principal’s office at Neighborhood High School and is reprimanded
for calling an ambulance to come to the school. The principal tells Violet that in the future
she needs to allow her to decide whether or not an ambulance is needed and make the call.
Violet has a heated exchange at this point, telling the principal that there was no time to try
to find her, and that she used her professional judgment and decided to call an ambulance
based on her assessment of the situation. She also tells the principal that she is very willing
to inform her of the need to call for emergency help if she is easy to find, but will not put a
student’s life in jeopardy to appease her need to control the situation. The principal tells
Violet that she is expected to follow the school policy. Violet responds that emergency
situations trump policies, and that in the future she will continue to use her professional
clinical judgment to prioritize actions needed in emergency situations. It is on days like this
that Violet wonders if she would be better off working at Neighborhood Hospital.
Violet Brinkworth’s Memo
To: High School Principal J. Camp
From: Violet Brinkworth RN
Subject: Calling for emergency assistance
This is in response to our meeting yesterday in which you indicated to me that it was
inappropriate for me to call an ambulance for a seriously ill student. While I do understand
there are school policies for emergency situations, there has to be room for the use of
professional clinical judgment. I am a healthcare professional with many years of nursing
experience. When I came upon the student situation, I assessed the situation and
recognized the signs of a serious drug overdose. This was also confirmed by another
student that this was indeed the situation. In this particular case, my judgment was correct.
The student is currently in the ICU at Neighborhood Hospital in critical condition. Any delay
in getting her there could have resulted in her death. I was in touch with the student’s
mother and was told by her that her daughter is expected to recover, but she will have a
long road ahead of her. I suggest we work together on amending this policy so that it has
the student’s best interests at its core.
Karen Williams Season 3 Episode 6 (increase in funding)
With the permission of the Senior Center project director, Karen writes a letter to the City
Council requesting an increase in funding for the Senior Center Nursing Clinic, specifically
to hire another nurse to assist her during the busiest hours and to extend the hours of
service. Karen also encourages the seniors who regularly visit the center to write letters.
Karen explains to Jennifer, the nursing student, that it is often a challenge to get adequate
resources for publicly funded clinics.
Mary Martin announces to everyone at the Senior Center that Betty O’Dowd, one of the
seniors frequently seen in the clinic, just died of cancer. Karen recalls that the last time
Betty was in the center, she said she had been experiencing abdominal pain for about a
month. Karen is very sad to hear of that outcome, as Betty was one of her favorite people.
She attends Betty’s funeral a few days later.
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