Windshield Survey Essay

Windshield Survey Essay.

This windshield survey is a simple observation of a community. It involves collection of data to help define the community, the trend within the community, stability of the community and changes that may define the health of the community. Many dimensions of the community can be observed from a car drive observing the community life, and environment. Common characteristics to be noted are the people walking the street, gathering places in the community, quality of houses, community life rhythm, and geographic boundaries (Stanhope & Lancaster, 2012, p.

409-410). Community is defined widely by (Stanhope & Lancaster, 2012). According to the World Health Organization (WHO) community is a group of people, living in a specific geographical area. They may share a common culture, norms and values. Members of the community gain their social and personal identity by sharing their common beliefs, norms and values which has been developed by the community (Stanhope & Lancaster, 2012, p. 397). Community health is the meeting of the community collective needs by identification of the community problems, managing the behaviors in the community and between the larger society and community (Stanhope & Lancaster, 2012, p. 401).

The community partnerships helps to bring about the changes necessary to fulfill the vision of Healthy People 2020. A foundation is provided by Healthy People 2020 for national health promotion and disease prevention. It is necessary to have community partnerships in order for the lay community members to have vested interest in the community success to improve the community health Stanhope & Lancaster, 2012, p 402). Community as client is the community as the nurse client. The community is only the client when the focus of the nurse is on the common or collective good of the community instead of the health of one individual (Stanhope & Lancaster, 2012, p. 398). The community chosen for this windshield survey is the city I currently reside in, Virginia Beach. It is located in the state of Virginia and a part of the Hampton roads. Hampton Roads consist of seven cities which are Virginia Beach, Norfolk, Chesapeake, Hampton, Newport News, Suffolk and Portsmouth. In my city of Virginia Beach I live in the Ocean Front Community.

We have a large military community related to the Naval Base Oceana Naval Air Weapon station. Virginia Beach is 249.02 square miles and the persons per square miles are 1,758.9. The population estimate in 2013 is 48,479. Persons under 5 years of age is 6.7%. The percentage of Persons under 18 years of age is 23.1%. Persons 65 years of age or older is 11.8%. Female percentage is 50.9%. The percentage of Whites alone is 68.9%, Blacks are 20.0%, Alaska native and American Indian 0.5%, Asians 6.6%, Native Hawaiian and other pacific Islander is 0.2%, persons with two or more races is 3.9% and Hispanics are 7.5%. Persons residing in the same home greater than a year is 82.2% of the population. High school graduates or person with a higher education makes up 93.6%. The veteran population for 2009-2013 is 61,100. The median value of homes are $267,600 with 2.62 persons per household. The median household income is $65,219. Persons living below the poverty level is 7.9% (United States Census Bureau. n.d.). Virginia Beach is located alongside the Atlantic Ocean on the east and the Chesapeake Bay to the north.

The average elevation of the city is 12 feet ( VB GeoFacts and Information, n.d.). VB GeoFacts and Information. (n.d.). The homes in the community are mostly two story homes colonial style, or brick and aluminum side homes and one story homes. Homes in the community are well kept with manicured lawns. There are some condominiums and apartments in the area. There is no signs of abandoned buildings in the areas observed for the windshield survey. Virginia Beach is known for its tourism especially in the summer months. Not many pedestrians were noted walking along the street in the community during the current winter month. Joggers were noted early morning and evenings in the ocean front area of the community. Public transportation available in the city of Virginia Beach are buses and taxi cabs. There is no light rail system or train system that provides transportation. There are numerous attractions such as the aquarium, the botanical garden, the boardwalk, ocean breeze Water Park. There are many open body of water around in the community for fishing besides the Atlantic Ocean.

There are two malls located in the community Pembroke mall and Lynnhaven Mall. Many restaurants are available with a healthy choices. Only five fast food restaurants were noted on an 8 mile drive. There was 3 ABC stores noted selling liquor, and 2 Totally Wine stores noted. There are two super Walmart stores, one regular Walmart, and a Walmart Neighborhood. Food Lion and Farm Fresh are the other main grocery stores. Farm fresh provides a fresh salad bar daily. There are many Consumer Value Stores (CVS) with 24 hours pharmacy available. Patient First is chain of urgent care facilities available within the community. They are open 7 days a week until 10pm. Sentara is the name of the group of hospitals in the community.

There is Sentara Princess Anne Hospital and Sentara Virginia Beach General.

There are many doctor offices, dentist office and other medical specialties available in the community. The schools average rating is 6 out of 10. Virginia Beach schools have many academic programs such as the Global studies & World language, health sciences Academy, Legal Studies, Technology, Visual & Performing Arts, International Baccalaureate program and mathematics & Science for high school students. Middle school children has advance academic programs available such as the middle years International Baccalaureate program (About Us, n.d). The community provides parks and recreation centers. There are numerous trails for outdoor hiking, sporting leagues for children and adults and fitness and wellness. There are a number of religions noted in the community catholic, united Methodist, southern Baptist and Jewish.

Healthy People 2020 Health Indicators

The Healthy people 2020 health indicator chosen for this community is the transmission of sexually transmitted diseases. Per Healthy People 2020 there is an estimated 19 million new sexually transmitted disease cases each year in the United States (, n.d). Hampton roads area has a higher average of sexually transmitted disease, this eastern region had the highest rates in the state for gonorrhea, syphilis and chlamydia. State statistics showed in the region there were 2,620 girls’ ages 3 to 19 diagnosed with chlamydia comparing to 528 boys in the same age range. A study completed showed the rate of STD was much higher among blacks girls compared with 20 among the white race and Hispanic girls. The CDC has a difficult time comparing the statistics to Virginia reported figures because the health care providers are not required to report Herpes, Human Papillomavirus (HPV) and trichomoniasis to the local health department. This causes the state numbers to be less than reality. Another barrier that prevents the actual numbers is many people infected with STDs may not exhibit symptoms. Meaning STD is transmitted from one person to the other without realizing transmission of the disease.

There is an estimate of 70 to 80 percent of girls with chlamydia with no symptoms. Untreated these STDs causes infertility. HPV is another infection that often does not manifest symptoms. Virginia has a new law in place requiring sixth grade girls to receive HPV vaccines unless they opt out (Simpson, 2008). Virginia Beach Department of Public of Health clinic provides free, confidential education, counseling and testing for HIV. They provide Nurses and health counselors at their Virginia Beach clinic for clients found to be HIV positive. The clinic operates on a walk in basis for testing. They offer services for the patients to contact other sexual partners that may need testing and treatment (Clinic, n.d.). Virginia Beach does not have a large immigration population with many ethnicities. There are however many resources available to address different cultures within our community. Yearly the city has a Latin festival and reggae festival. I do not encounter many people of different cultures from Latin countries or Caribbean countries in the community. It is mostly whites or blacks, there is very minimal encounters with other races.

It can present a problem in the community if there should be a rise in a specific ethnicities from a different parts of the world such as Africa, or Asia. Nurses and other health care providers would definitely need conferences on cultural diversity. The most I have been exposed to diversity is while working as charge nurse for a correctional facility for the Common Wealth of Virginia. Immigration and Customs Enforcement held many immigrants there for a period of time at correctional facility. Aspects of the community that can affect residents’ health were not visible to myself from a windshield point of view. Virginia Beach government website gave more insight on the aspects that affect residents in the community.

Three aspects listed are teenage pregnancies, low birth weight babies and child abuse. In conclusion Virginia Beach is a wonderful community. It is not congested, we have large areas that still trees, wild animals and fishing areas. It is a family oriented community in my opinion with many resources within the community to meet the needs of individuals. Crime is at minimal, the people in the community are genuinely polite, and there are many programs in the community provided by the city or YMCA promoting health and wellness.

About Us. (n.d.). Retrieved February 8, 2015, from CIty of Virginia Beach Community Indicators. (2011, September 1). Retrieved February 8, 2015, from

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Windshield Survey Essay

Chick Growth Enhancer Essay

Chick Growth Enhancer Essay.


The study is entitled “Aloe Vera as Chick Growth Enhancer”. Specifically, it sought to find out the efficacy of Aloe Vera as a growth enhancer in broiler chicks. The study aims to produce a low-priced but high quality growth enhancer by using Aloe Vera as a main component. Twenty-one day old straight run broiler chicks were used in the study and were distributed to a cage with a dimension of (33 x 57). The cage was further subdivided into two cages for the different treatments with two birds per cage.

Fresh leaves of Aloe Vera were then extracted, 5ml per liter of water. Feeding troughs and waters were also provided for each cage. The set up was composed of experimental and control group.

The experimental group was being provided with water containing the Aloe Vera gel. In the other hand, the control group was being provided with only pure water. Data were collected to gather relevant information. The results obtained regarding performance of the broilers showed that Aloe Vera gel groups brought about higher body weight gain, growth, quality of feathers and immune system compared to the control group.

From the investigation, the researchers would like to recommend this study to the people of the poultry business who would pursue the Aloe Vera as Chick Growth Enhancer to improve the performance of broiler chicks. Also, further research should be made especially on the right amounts of Aloe Vera in water to achieve a better mixture and produce a better product.


This study would have been impossible without the support and encouragement of many individuals who have given their time, efforts and advice to this study: Mr. Ronel Deloso, their adviser, for having encouraged the researchers to pursue this project, having assisted them in the process of their experiment and for having shared his knowledge in writing this study; Their parents, Mr. and Mrs. Rony Vasquez, Mr. and Mrs. Stewart Ong, and Mr. Malvin Tan and Mrs. Mildred Nakila for the financial and moral support and for believing in them in all their endeavors; also to their friends, classmates and teachers for motivating them to continue this study;

Their brothers, Gabrielle, Keith and Joshua for endlessly inspiring them and for offering their help, regardless if it’s big or small; Mr. Raffy K. Fortun, for assisting them in taking care of the chicks and for providing the cages needed for the experiment, for sharing them his expertise and for his suggestions and recommendations to improve the study; Mr. Glenn R. Galendez, for his undying support and faith in them that they were capable of accomplishing this study; and To Almighty God for the wisdom and perseverance that He has bestowed upon them and for endlessly showering them with blessings of strength and confidence to finish this study.


Broiler production is regarded to be one of the biggest and most progressive animal enterprises in the Philippines today. It represents 85 percent of poultry meat that Filipinos consume. As human population increases, the demand for poultry and poultry by products continue to rise. It is therefore advisable to source alternative ways to enhance and hasten animal’s growth. Aloe Vera is found helpful to this cause because it contains vitamins and minerals essential to improve the growth of broiler chicks. In this study, Aloe Vera is used as a growth enhancer substitute.

Background of the Study

Chicks are young chickens. They require special brooding and temperatures, as well as unique feed and care until they reach a more self-sufficient age. Furthermore, there is a high demand of chickens in the world not only in the Philippines but in the entire world. “Poultry production is considered one of the most common and very promising agricultural enterprises especially for low income farm families.” It offers several advantages to the raisers. Vitamins A, B and vitamin E, among other vitamins and minerals, are needed by chicks to grow. Aloe Vera is a house plant which comes from the family of lily. It is native to the eastern and southern part of Africa but it has spread throughout many of the warmer regions of the world like the Philippines. Physically, it is a short-stemmed plant that could grow from 80 to 100 cm tall, spreading by offsets and root sprouts. The leaves are lanceolate, thick and fleshy with thorny edges and with color ranging from deep green to grey- green.

“Aloe vera is rich in vitamins and minerals. Specific vitamins include: Vitamin A (Beta-Carotene), Vitamin B1 (Thiamine), Vitamin B2 (Riboflavin), Vitamin B3 (Niacin), Vitamin B5, Vitamin B6 (Pyridoxine), Vitamin B12, Vitamin C, Vitamin E, Choline, and Folic Acid. The vitamins A, C, and E are responsible for the aloe’s antioxidant activity while vitamin B and choline are involved in amino acid metabolism and vitamin B12 is required for the production and development of blood cells. Among the important minerals found in Aloe Vera are: calcium, chromium, copper, iron, magnesium, manganese, potassium, phosphorous, sodium, and zinc. These minerals are essential for good health and are known to work in synergistic combinations with each other, with vitamins and other trace elements.”

Objective of the Study

This investigatory project primarily aims to test the efficacy of Aloe Vera (Aloe barbadensis miller) as a substitute growth enhancer in chicks. More specifically, the study espouses the following objectives:

1. To determine if there is a difference in:

a. weight
b. growth
c. feathers
d. immune system
Scope and Limitation

The study will be conducted at a small poultry farm where the chicks will be observed for 21 days. Fresh leaves of Aloe Vera will serve as the source of extract that will be used in this study. The sample will be freshly collected before extracting. The study focuses on how Aloe Vera (Aloe barbadensis miller) leaves extract give potential as a substitute growth enhancer in chicks.

Significance of the Study

The study would answer the effectiveness of Aloe Vera (Aloe barbadensis miller) as Chick Growth Enhancer. The result of this study will provide information not only to the researchers but also to the people of the poultry business.

Review of Related Literature

Lorenzo said that Aloe Vera leaf extract contains nutrients which enhance the growth of animals and even boost their immunity ( Chung (2003) stated that vitamins must be present in sufficient quantities in the diet to ensure efficient utilization of carbohydrates, protein, fats, minerals, and water for health and maintenance and production function such as growth development and reproduction. Poultry Raising Guide (1975) cited that in the presence of stressful condition like the movement of the birds, the presence of infection, sudden change of weather and feeding practices, vaccination, deworming and debeaking birds need to be supplemented with vitamins. Aloe gel contains substances known as glycoproteins and polysaccharides. Glycoproteins speed the healing process by stopping pain and inflammation, while polysaccharides stimulate skin growth and repair. These substances may also stimulate the immune system.

This is according to University of Maryland (2013) Bejar and Colapo (2005) said that Aside from vitamins and minerals, aloe vera is rich with enzymes (help the breakdown of food sugars and fats), hormones (aid in healing and anti-inflammatory activities), sugars (i.e. glucose and fructose that provide anti-inflammatory activity), anthraquinones or phenolic compounds (aid absorption from gastro-intestinal tract and have antimicrobial and pain killing effects), lignin (increases the blood circulation), saponins (provide cleansing and antiseptic activity), sterols (antiseptic and analgesic), amino acids (basic building blocks of proteins in the production of muscle tissue), and salicylic acid (works as a pain killer).”

Olupona et al. (2010) reported that Aloe Vera gel added to water (15, 20, 25 and 30 cm3/dm3) resulted in significant final body weight gain as well as in weekly body weight gain compared to control group. Several studies have shown antimicrobial properties of herb extracts (Cowan, 1999; Hammer et al., 1999) which can improve intestinal microflora population and enhance health in birds’ digestive systems through reduction in number of disease-making bacteria (Mitsch et al., 2004). Intestinal health is of great importance in poultry for improved performance and reduced feed conversion ratio (Montagne et al., 2003). Previous studies discovered different properties of Aloe Vera gel, including wound healing, anti-parasitic, anti-viral, anti-fungal and anti-bacterial properties (Boudreau and Beland, 2006; Reynolds and Dweck, 1999).


A total of twenty-one (21) day old straight run broiler chicks were used in the study and were distributed to a cage with a dimension of (57 x 33). The cage was further subdivided into two (2) cages for the different treatments with two (2) birds per cage. 3 days prior to the arrival of the chicks the cages were prepared thoroughly and provided with electric bulb as heaters up to 3 weeks 21 days of age and until their feathers were fully developed. Fresh leaves of Aloe Vera were then extracted, 5ml per liter of water. Feeding troughs containing chick pellets and waterers were provided for each cage.

The set up was composed of experimental and control group. The experimental group was being provided with water containing the Aloe Vera gel. On the other hand, the control group was being provided with only pure water. The observations in weight, growth, feathers and immune system was made weekly by the researchers. A digital weighing scale was used to measure the weight while a tape measure was used to determine the growth. The chicks were observed as starters (4-10 days), growers (10-15 days), and finishers (15-21) days. However, the final observations were made at the total experiment period.

Results and Discussion

Table 1 presents the results on the experiments on body weight gain. As seen in the table, the larger body weight gain was observed in the Aloe Vera group in the starter, grower and finisher, as well as the total experiment period. In the starter period, significant increase in body weight gain was observed in the both the Aloe Vera and control groups. However, in the grower and finisher periods, the larger body weight gain was observed in the Aloe Vera group compared to the control group. Finally, the results on body weight gain in the total period (day 21) showed a significant difference among the Aloe Vera and control group. In addition, the Aloe Vera gel groups experienced enhanced body weight gain compared to the control group.

The results of the experiments on growth are shown in Table 2. Here, the Aloe Vera group showed higher level of growth in broilers. During the starter period both groups had the same measure of height in centimeters. Significant differences were observed in the grower and finisher periods that Aloe Vera indeed has an effect in the growth of broilers.

Table 3 shows the results of treatments on feathers in broilers. As shown in the table, there was a significant difference observed between the two groups. In the starter and grower periods, both groups had the same quality and color of feathers. It was observed however; in the finisher periods the control group had pale-looking feathers while the Aloe Vera group had a golden yellow color.

The differences on immune system are presented in Table 4. During the starter period, there was no significant difference between the two groups. However, the stronger immune system was observed in the Aloe Vera group in the grower and finisher periods compared to the control group, which showed minor cases of skin lesions in the body.

Table 1 (Weight)

Total Experiment Period
Aloe group
100 g
148.3 g
175 g
200 g
Control group
100 g
145 g
170.5 g
160 g

Table 2 (Growth)

Total Experiment Period
Aloe group
8 cm
12 cm
15 cm
18 cm
Control group
8 cm
10.5 cm
13 cm
16 cm

Table 3 (feathers)

Total Experiment Period
Aloe group
Yellowish, Dry and fluffy
Feathers are clean and yellowish, covers the entire body
Yellowish, fluffy feathers
Golden-yellow, healthy feathers
Control group
Yellowish, Dry and fluffy
Signs of bald patches
Visible bald patches
Pale yellow, with bald patches

Table 4 (Immune System)

Total Experiment Period
Aloe group
No diseases
Little skin lesions
Control group
Skin lesions begin to appear
Skin lesions have spread
Lack of nourishment

Summary, Conclusion and Recommendation

The study is entitled “Aloe Vera as Chick Growth Enhancer”. It focused on making a low priced but high quality growth enhancer in broiler chicks. It was conducted for the main purpose of evaluating and comparing the quality of Aloe Vera as a growth enhancer in terms of body weight gain, growth, feathers, and immune system.

A total of twenty-one (21) day old straight run broiler chicks were used in the study and were distributed to a cage with a dimension of (57 x 33). The cage was further subdivided into two (2) cages for the different treatments with two (2) birds per cage. 3 days prior to the arrival of the chicks the cages were prepared thoroughly and provided with electric bulb as heaters up to 3 weeks 21 days of age and until their feathers were fully developed. Fresh leaves of Aloe Vera were then extracted, 5ml per liter of water. Feeding troughs containing chick pellets and waterers were provided for each cage. The set up was composed of experimental and control group. The experimental group was being provided with water containing the Aloe Vera gel. On the other hand, the control group was being provided with only pure water.

The observations in weight, growth, feathers and immune system was made weekly by the researchers. . A digital weighing scale was used to measure the weight while a tape measure was used to determine the growth. The chicks were observed as starters (4-10 days), growers (10-15 days), and finishers (15-21) days. The results obtained regarding performance of the broilers showed that Aloe Vera gel groups brought about higher body weight gain, growth, quality of feathers and immune system compared to the control group. The differences were then illustrated in a table. From the investigation, the researchers would like to recommend this study to the people of the poultry business who would pursue the Aloe Vera as Chick Growth Enhancer to improve the performance of broiler chicks. Also, further research should be made especially on the right amounts of Aloe Vera in water to achieve a better mixture and produce a better product.


Finally, it can be concluded that the group treated by Aloe Vera gel showed better performance compared to the control group. Furthermore, among the two groups, the Aloe Vera group experienced higher level of body weight gain, growth, quality of feathers, and immune system. Recommendation

From the investigation, the researchers would like to recommend this study to the people of the poultry business who would pursue the Aloe Vera as Chick Growth Enhancer to improve the performance of broiler chicks. Also, further research should be made especially on the right amounts of Aloe Vera in water to achieve a better mixture and produce a better product.

Bejar, Feliciano R.; Colapo, Remedies P. (2005) Growth Performance and Sensory Evaluation of Broilers Supplemented with Aloe Vera ( Aloe barbadensis miller) Extract in Drinking Water. Boudreau, M.D., Beland, F. A., 2006. An evaluation of the biological and toxicological properties of Aloe barbadensis (miller), Aloe vera. J. Environ. Sci. Heal. C 24:103-154. Cowan, M.M., 1999. Plant products as antimicrobial agents. Clin. Microbiol. Rev. 12: 564-582. Darabighane, Babak (2011) Effects of different levels of Aloe vera gel as an alternative to antibiotic on performance and ileum morphology in broilers. Italian Journal of Animal Science. Licensee PAGEPress, Italy Vol 10, No 3 [eISSN 1828-051X] Dela Cruz, Rita T. (2006) Extracts from Aloe: Not Only a natural Healer also a Poultry Growth Enhancer. BAR Digest. Vol. 8 No. 2. Hammer, K.A., Carson, C.F., Riley, T.V., 1999. Antimicrobial activity of essential oils and other plants extracts. J. Appl. Microbiol. 86:985-990. Ehrlich, Steven D. (2013) Aloe Medical Reference Guide. University of Maryland Medical System. MD 21201
Lorenzo, Elias (unknown) Aloe Vera Found Beneficial to Poultry. Davao Agri Biz. Mitsch, P. (2004). The effect of two different blends of essential oil components on the proliferation of Clostridium perfringens in the intestines of broiler chickens. Poultry Sci. 83:669-675. Montagne, L. (2003) A review of interactions between dietary fibre and the intestinalmucosa, and their consequences on digestive health in young non-ruminant animals. Anim. Feed Sci. Tech. 108:95-117. Olupona, J.A. Effect of Aloe Vera Juice Application Through Drinking Water on Performance pp 42-43 in Proc. Reynolds, T., Dweck, A.C., (1999). Aloe vera leaf gel: a review update. J. Ethnopharmacol. 68:3-37.

Chick Growth Enhancer Essay

LPN Scope of Practice Essay

LPN Scope of Practice Essay.

The Nurse is defined by the University of North Carolina as “the leader in providing compassionate, quality care, focusing on the unique needs of patients and their families.” It goes on to define the Nurse as someone who “collaborates with patients families and other health team members to plan and provide Nursing care that will achieve an optimal level of health and wellness, or when this is not possible, support the experience of loss and death.” I completely agree with these statements.

Deciding to take on the role of a Nurse shows the selflessness of the person. It is making the decision to put someone else before one’s self. It is the act of transforming from whatever type of person they are on the outside of the work place, and becoming someone who is non-judgmental, optimistic, positive, caring, empathetic and has the understanding ability to be able to provide care while respecting the patient’s wishes and beliefs. I feel as if certain characteristics of the Nurse are not taught.

These are personality traits that we are born with and whether or not we utilize them, is up to us. Other Characteristics of the Nursing role, I feel are obtained by training and education.

For example, inserting a Foley catheter, or any sterile procedure for this matter, training has to take place for the Nurse to properly insert the catheter. We have to be trained how to properly open the package, how to move so that sterility isn’t broken and know proper techniques to insert the catheter. The Nurse must be trained on how to do this skill but unless she is educated, then the skill is useless. The Nurse is educate on rationales to each step, i.e.: Why am I doing this?, What am I looking for? What do I do If this happens? How will this affect the patient? Nursing is an incredibly interesting field with many doors of opportunity. It is a field that interests me greatly. There are so many different areas of nursing which makes the learning process never ending. While pursuing my Nursing license, I find it extremely comforting to know that if I ever feel “burnt out” on a specific area of the field, I can move on to different areas. I am not obligated to do the same type of Nursing for the rest of my life. My options are endless. While comparing the roles of the Licensed Practical Nurse in North Carolina versus South Carolina, I was a little surprised at some of the differences. I had a very hard time finding specific skills that an LPN in NC could perform.

We are directed straight other pages which don’t necessarily directly state do’s and don’ts. Some skills with both North Carolina and South Carolina can be performed by the LPN if, and only if, the employer has documentation of proper training, continuing educations courses, verification of skill competency by at least an RN, and frequent evaluation of the Nurse’s competency of completion with the skill being performed, on file. Both states have set rules on how much continuing education is necessary or how frequent the skill competencies should be evaluated. Both States allow the Licensed Practical Nurse to assist in preforming the initial assessment but are not allowed to make nursing diagnoses. They both allow the LPN to verify blood with an RN but LPNs are not allowed to hang blood. Neither state allow the LPN’s to do any pulmonary artery pressure or pronounce death. Also, in South Carolina the Licensed Practical Nurse cannot evaluate or stage pressure ulcers, they can only document on the observations of the ulcer once the RN have evaluated and staged it. In North Carolina, the LPN can first assess and size the wound or ulcer or even change the dressing under a specific order and a Registered Nurse will verify the LPN’s evaluation.

South Carolina does not allow LPNs to do any arterial punctures, but they can manage the site; LPN’s in North Carolina can complete arterial punctures for the collection of blood. The two differences that fascinated me the most dealt with acupuncture and cosmetic procedures. In North Carolina, the LPN, or the RN, cannot practice acupuncture. It is prohibited, unless an individual has completed a 3 year postgraduate acupuncture college or training program verified by the state. In South Carolina, an LPN can practice acupuncture under a Licensed Acupuncturist as long as he/she has been trained under the employer, it is documented, and a request to practice has been approved by the state. With cosmetic procedures, in South Carolina a Licensed Practical Nurse can only apply chemical peels with less than twenty percent acid solutions and they may also do a microdermabrasion under a dermatologist. In North Carolina, a Licensed Practical Nurse can do a broad range of skills in the cosmetology field. He/She may give a microdermabrasion, chemical peels, give Botox, collagen injections and laser hair removal. With Botox and Collagen injections affecting the appearance so greatly, it is hard to believe that this is a skill that an LPN can become properly trained on.

The Charge Nurse role is defined by the North Carolina Board of Nursing as “an RN who supervises and manages patient care delivery settings or groups of clients, usually for designated time periods.” It also defines the Nurse-In-Charge role as “the assigned role and responsibility of an LPN who participates in assuming the implementation of established health care plans for a designated number of clients under RN supervision.” Basically how I interpreted this was, the LPN can be the Manager when the Manager is away. The Licensed Practical Nurse will continue to work in the appropriate scope of practice and report to the Registered Nurse. The LPN will call to report updates or for guidance in certain situations. If the task at hand is not in the scope of practice for the LPN, the RN will be called to come in to make decisions or perform the tasks. Working in a long term care facility has helped me better understand the difference between the two, although we do not use the term Nurse-In-Charge as often as we should. On weekends we have two specific Nurses who work opposite weekends of each other and are delegated the responsibility of being the Nurse-In-Charge. On Fridays, before our Charge Nurse leaves for the weekend, she will do a quick run through with the Nurse-In-Charge for the weekend.

They go through and talk about the “what if’s?” for the weekend, and what to do and not to do. These Nurses also know when a phone call needs to be placed to the Charge Nurse. Throughout the weekend, they call with updates and notify the Charge Nurse of any changes that have or are occurring with any health statuses of the Residents. Depending on the situation, the RN delegates appropriate tasks in the LPN’s scope of practice over the phone or, if another RN is not in the building, she will come into work if needed. It is said that we, ourselves, are our biggest critics. For me this is extremely true, so when it came to trying to determine my strengths, it took a while. Based on what others have told me, I’ve got an abundance of patience and I also have good communication skills. I’ve always had strong relationships with my residents and their family members. When trying to decide what my strengths were, I had to ask myself “Why do they like me?”, “Why do they treat me as if I’m a part of their family?” “Why do they trust me?”. What came to mind was the way I talk to them.

I speak to residents and families the way I would hope to be spoken to, if the roles were reversed. I believe that good communication skills, including the ability to listen, would be something positive I could bring to the role of the LPN. I hope to be an influence to other Nurses who come in with bad attitudes and forget that their patients are humans too. To remember that even though they may be a “frequent flyer”, they are still human, they still make mistakes, and more than likely are in desperate need of kind words. I hope to influence others when it comes to being open minded and influence them when they go to pass judgment. I hope to bring more compassion, optimism, acceptance and leadership to the LPN Role. My weaknesses are my confidence in my decisions and my abilities.

I second guess myself a lot and I constantly double check myself. This could work both ways, good and bad. I look for reassurance from others to ensure that I am right and I know that I won’t always be in a position where I can be reassured. I want to gain the confidence without becoming “the know it all.” A good quality Nurse is one who’s always willing to learn. Another weakness I have is my inability to handle the emotions of the family members during the harder times. Times like these are very awkward for me and I would like to get stronger in my ability to be comforting and supportive. I usually try to avoid these situations as much as possible because the wall that holds my emotions in during these times, is very thin. I need to learn how to be emotionally professional while still remaining to be human.

NURSE–IN-CHARGE ASSIGNMENT TO LPN Position Statement for RN and LPN Practice. (1996, January 2). Retrieved November 23, 2014, from

LPN Scope of Practice Clarification. (2010, January 1). Retrieved November 23, 2014, from trees/lpn-position-statement.pdf

Mission and Philosophy. (n.d.). Retrieved November 23, 2014, from
Infusion Therapy/ Access Procedures. (1998, May 1). Retrieved November 23, 2014, from
South Carolina Board of Nursing. (1989, November 1-Revised 2014, July 1). Retrieved November 23, 2014, from

LPN Scope of Practice Essay

Hospitals and Long-Term Care Facilities Essay

Hospitals and Long-Term Care Facilities Essay.


Hospitals can be set up as nonprofit or for-profit facilities. The differences between the nonprofit and for profit hospitals will be discussed. Hospitals have experienced different trends in the last thirty years. This paper will identify at least three major trends that have occurred within the hospital sector. Three examples that describe and differentiate the roles of hospitals and nursing homes are providing long-term care. The conclusion of this paper will be a brief critiquing of the current state of long-term care policy in the United States.

Hospitals and Long-Term Care Facilities

The differences between nonprofit and for-profit hospitals: A characteristic as stated by Williams and Torrens (2008) of nonprofit hospitals is that these hospitals do not function under the realm of regular corporate law but under a special provision of the corporate law in each state. It is also noted that nonprofit hospitals also function under special federal and state tax provisions because of recognition of their community service function.

Other characteristics of nonprofit hospitals are they do not have owners and their governing body is a community based board that has complete authority over operations. Nonprofit hospitals, in general, are not required to pay most of the taxes at federal, state and local levels. Under section 501C (3) of the federal tax code, the non-profits are exempt. Due to this exemption status donations made by individuals are tax deductible. Nonprofit entities are not only expected to care for the destitute and poor but they are also expected to provide a variety of services to the community (Williams & Torrens, 2008).

Now that the characteristics of the non-profit have been outlined the for-profit entities make-up will be discussed. For profit entities, unlike nonprofit ones, have owners. The owners are issued stocks and these stocks reflect the owner’s equity position. “For- profit entities, including hospitals, may be publicly or privately held” (Williams & Torrens, 2008, p. 186). Stocks for entities for-profit that are publicly held are made available for anyone to purchase. Publicly held for-profit entities are plagued with various accountability and regulation rules that are supervised by the Securities and Exchange Commission at both federal and state level. Williams and Torrens (2008) state that privately held for-profit entities issue stock but the difference in public versus private issuing of stock is that the private for-profit stock is not available for purchase by the general public. For-profit hospitals, in the past, have been owned by the physicians who work in them but due to the astronomical costs of such expenditures as: building, maintaining and operating a hospital in today’s market the trend of physician owned for-profit hospitals is almost extinct. The majority of for-profit hospitals in the United States are part of a large multihospital chain.

The multi chains of hospitals as stated by Williams & Torrens (2008) are publicly traded. For-profit hospitals do not serve only the community but they are also expected to operate at a profit so that the equity investors receive a return on their capital (Williams & Torrens, 2008). Three major trends that have occurred within the hospital sector. One of three major trends that have occurred within the hospital sector is the increase in specialty hospitals. The specialty hospitals focus on such areas as cancer and heart disease as well as profitable fields like orthopedic surgery. The specialty hospitals as stated by Williams & Torrens (2008) show an increase of being owned partially by the physicians who practice in them. Some would make the argument that the specialty hospitals provide the best care while others see these hospitals as entities that “siphon off insured and relatively healthier patients leaving the less profitable and more complicated cases to community general hospitals” (Williams & Torrens, 2008, p. 194).

Concerns raised by the physicians’ ownership of the specialty hospitals include but not limited to are that the financial incentives will affect the treatment decisions (i.e. diagnostic services) and also that the physicians will treat the less complicated but yet more profitable health care cases and leave the biggest burden of caring for the less fortunate, financially challenged and uninsured individuals to the community and public hospitals (Williams & Torrens, 2008) Another trend that has occurred within the hospital sector is in the field of technology. “Technology has shaped the physical and operational structures of hospitals, has affected the lives of patients and families, and has provided a delivery vehicle for physicians in clinical practice” (Williams & Torrens, 2008, p. 195). It is technological research that allows for the services hospitals provide for example anesthesia and antisepsis laid the ground work for surgical care and imaging technology has impacted effective intervention for individuals seeking care in a hospital atmosphere. Technology has affected a vast array of individuals: obstetric patients, those in need of pediatric care and terminally ill patients just to name a few.

Advanced technology has led to development “increased specialization, clinical practices, expansion of specialized services, new medical and surgical specialties, and treatments for many diseases for which little curative or other care could be provided” (Williams & Torrens, 2008, p. 195). While continued advance technology leads toward continuous improved health care it also brings along with it problems, especially for the hospitals. The hospitals are immensely gratified by the increased technology and its application to improve overall general health but along with the benefits comes complications. Hospitals are expected to provide the most up to date technology but at the most effective pricing to please their customers, patients and physicians. This presents a major challenge to hospitals (Williams & Torrens, 2008) Academic medical centers are another trend that has occurred within the hospital sector. Academic medical centers are composed of medical schools and their primary teaching hospitals. The “academic medical centers provide tertiary, secondary, and primary care but have a principal focus on biomedical research, teaching of medical residents and medical students, and often an array of other professional training, research, and services activities” (Williams & Torrens, 2008, p. 196).

Unlike other hospitals, the academic medical center does not have top priorities of financial efficiency and customer satisfaction. Great demands are placed on these facilities by physicians and researchers to provide the latest technology and staffing for the assurance of teaching and clinical investigation. According to Williams and Torrens (2008) the long-term strengths and successes of our health care systems depends largely on the success of the academic medical centers to achieve their mission. Three examples that describe and differentiate the roles of hospitals and nursing homes in providing long term care. The nursing home facility is for patients who need extended care because they are very sick or unable to function without continued nursing and supportive services in a formal health care facility. These patients are sick and/or are in need of assistance but they are not ill enough that they require the intense treatment and care offered at a hospital. According to Williams and Torrens (2008) about forty-seven percent of all nursing home facility care is paid for by Medicaid and residents and their families pay approximately one-third of the cost for the facility services. In recent years the length of time one stays at a nursing home has greatly decreased.

Even with the decrease in stay there is still a fifty percent chance of an individual in his/her lifetime having to spend some time in a nursing facility. Both of these previous mentioned trends is reflective of the nursing facilities moving toward becoming more technologically sophisticated as well as being able to function as more of a short term temporary residence for patients in between the hospital and going home (Williams & Torrens, 2008). Hospitals are designed to take care of the more acute problems and emergencies. Hospitals provide a wide array of outpatient services. The outpatient services range from “rehabilitation to mental health counseling to outpatient surgery” (Williams & Torrens, 2008, p. 205). Unlike the nursing home facility the primary source of payment for hospital stay and services is Medicare and private insurance and very little payment comes from individuals. The current state of long-term care policy in the United States.

Medicare provides financing for medical care for nearly all elderly Americans and others with certain disabilities but this does not hold true for long-term care. The majority of individuals needing long term must depend on family and friends and sometimes the community they live in. There is a lot of work to be done in the United States as it relates to the financing of long term care for every needy individual (Williams & Torrens, 2008). There is no clear and precise policy in the United States for long-term care but there are different provisions within Medicare and Medicaid that provide for long-term services for some (not all) individuals in need of it. While the financing of long-term care has been and continues to be a challenge for the United States there have been strives in the care coordination of long-term patients.

The care coordination that has emerged through the years for long term care patients appears to be relatively effective. “Quality is enhanced when information is communicated among all the professionals caring for a person, and efficiencies are achieved when duplication of services is avoided” (Williams & Torrens, 2008, p. 211). Case management, which is a process that encompasses the following: case identification, assessment, care planning, service arrangement, monitoring and reassessment enables one professional individual to work with the family to coordinate and obtain all of the services that the long term care patient may need. Case management has proven to have one of the most positive effects of improving long-term care (Williams & Torrens, 2008).


Williams, S. J., & Torrens, P. R. (Eds.). (2008). Introduction to health services: 2010 custom edition (7th ed.). New York: Cengage Delmar Learning.

Hospitals and Long-Term Care Facilities Essay

Graded Unit Essay

Graded Unit Essay.

As a HNC Health Care student I am required to provide evidence of the following principal aims and objectives: to integrate knowledge, theory and practice, to develop and apply a broad knowledge and skills and to have an individual patient/client focus in my practice. To achieve all of the above I am required to complete project in a form of Graded Unit which consists of three stages: planning, development and evaluation.

After consultation with my work experience mentor and lead lecture (appendix 1 and 2) it was agreed, the project will be a nursing activity, weighing a patient , which will be carried out within an ambulatory care settings which is my current placement .

This will take place on Monday the 22nd of April. The chosen activity is a part of the patients’ treatment care plan and its aims maintaining patient’s safety related to correct medicine administration as well as to detect potential side effects associated with pharmacological treatment. In accordance with applicable law (Data Protection Act 1998) and to maintain patient confidentiality and privacy the name of the patient has been changed.

I will be referring to the patient as Cinderella. The patients’ personal information had been obtained with her consent and knowledge (NMC Code of Conduct 2008).

Cinderella is a 26 years old patient attending the Peter Burnt Centre at Aberdeen Royal Infirmary where she has been receiving Hepatitis C (HCV) treatment since November 2012. Cinderella lives alone in high rise block of flats in one of Aberdeen City Council estate. She left school at the age of sixteen with no qualifications and used drugs for several years. She was brought up by single parent – her mother, and has no siblings. With the help from local drug rehabilitation team she managed to stop using drugs for five years. Currently she works as a housekeeper on a part time bases in one of the hotels in the city centre. Recently, she has reduced the number of working hours due to the side effects of medication which make her feel very tired. She also complains of an upset stomach and lack of appetite. After having a chat with Cinderella she has told me that her social life and circle of friends is quite limited as her income is now much lower. She also mentioned that is quiet difficult to make new friends while you have drug use history.

When speaking to Cinderella it became evident to me that being HCV positive makes her feels worse than others and reminds her of when she was using drugs. It is well evidenced that people who have both; history of drug use and disease which can be sexually transmitted such is HCV, are likely to experience stigma and discrimination in their life (Gilman 1999).Stigma and discrimination are socioeconomic factors which have a damaging health, social and financial consequences (Nursing Standard 2008). It is believed that those who are stigmatised and discriminated are more likely to have a lower income and due to this cannot afford to purchase better quality food, better housing, live in safer environments and have worse access to healthcare and education. Cinderella’s low socioeconomic status and negative social attitudes evidently put her physical and mental wellbeing at risk. Stigma and discrimination may relate to Social Symbolic Interaction Theory and in particular to the idea of labelling and its negative impact on people behaviour and self- concept (Miller J, Gibb S 2007).

This would also fit with Carl Rodgers Person- Centred Theory and his idea of self- concept. Self –concept in other words is how we perceive and value our self. Rogers believes that humans need a positive environment to achieve fulfilment in their lives. In Cinderella’s case both her socioeconomic status and unfavorable social attitudes may make her feel negatively about herself and stop her from social integration. I also believe that Abraham Maslow’s Hierarchy of Needs can be applied to the patient situation. According to this psychological perspective every person is motivated by their needs and cannot achieve his/he full potential (self-actualization) if some of these are not met.

I feel that this may relate to Cinderella’s safety, love and belongings needs. Limited social contacts, stigma and fear caused by her illness may stop her from moving on to the next level personality development. To support people in similar to Cinderella’s circumstances the Scottish Government launched the Hepatitis C Action Plan in 2006. The aim of this policy is to improve health care services for people living with HCV and to tackle HCV- related social stigma, by rising public awareness and changing the way HCV is portrayed in media.

I have decided to use Roper Logan and Tierney twelve activities of daily living (A DLs) to asses Cinderella’s needs. The reason for this is that I find it to be the nursing model which is very effective in assessing basic day to day activities which have its own importance to the survival of life; also it follows the objectives of my graded unit. For the purpose of this project I will focus on maintaining safe environment in relation to Cinderella’s HCV antiviral therapy. Cinderella had been referred to Peter Brunt Centre at Aberdeen Royal Infirmary by her GP due to the result of blood test which revealed Hepatitis C antibodies. After a number of blood tests and liver biopsy Cinderella had been diagnosed with Chronic Hepatitis C with genotype 1 and mild liver damage. HCV is a disease caused by blood – borne virus Hepatitis C, which infects the liver and causes its inflammation (British Liver Trust 2010). The term chronic describes illnesses that last for a long period of time (more than six months) or for the whole life. The liver is an organ which is a part of the digestive system and carries out numerous important jobs’ such as; detoxification, aiding digestion or extracting nutrients.

These play a vital role in maintenance of equilibrium of the body internal environment, known as a homeostasis. Due to prolonged liver inflammation scaring of liver tissue occurs (fibrosis) and permanent liver damage is likely to occur (cirrhosis, liver cancer). As a result liver work capacity become impaired and the whole body may become poisoned (WHO 2011). There are several effective HCV treatment options available however none of them gives a one hundred percent guarantee. Nevertheless, adequately matched therapy can permanently clear the virus from blood and prevent liver from further damage. Cinderella after consultation with liver specialist doctor and liver specialist liver nurse decided to undergo HCV treatment known as a ‘triple therapy’ which is recommended by National Institute for Health and Clinical Excellence (NICE) The effectiveness of treatment among other factors lay in an adequate dosage and duration of medicine intake.

Both too low or too high dosage as well as side effects of medication may negatively impact Cinderella’s physical health and put her life at risk. To maintain the patient safety it was agreed that Cinderella will be visiting PBC every Monday for blood tests and weight checks. To ensure Cinderella’s safety I will follow appropriate NHS procedures and policies (NHS Procedure guidelines: Weighing the patient 2008) in line with the Health and Safety at Work Act (1974). To perform chosen activity I will require specific resources which I listed in Appendix 3 and project timescale (see Appendix 4). I have obtained consent from a different patient who is also visiting PBC this day if for some reason I will not be able to complete it with Cinderella.


Health Protection Scotland – a division of NHS National Services Scotland. (2009). Blood Borne Viruses & Sexually Transmitted Disease . Available: Last accessed 25yh March 2013. The Scottish Government (2011). The Sexual Health and Blood Borne Virus Framework 2011-15 . Edinburgh: Scottish Government. p31- 42. Grundy G, Beeching N . (2004). Understanding social stigma ii women with hepatitis C. Nursing Standard. 19 (4), 35-39. Gilman S (1999) Disease and stigma. Lancet. 354, Suppl, SIV15. World Health Organization. (2012). Hepatitis C . Available: Last accessed 5th April 2013. Nicole Cutler. (2007). Breaking the Hepatitis C Social Stigma. Available: Last accessed 7th April 2013. British Liver Trust. (2011). Facts and functions of the liver. Available: Last accessed 11th April 2013. Maslow, A. H. (1970). Motivation and Personality. New York: Harper & Row Rogers, Carl. (1951). Client-centered Therapy: Its Current Practice, Implications and Theory. London: Constable. Miller,J and Gibb, S (2007). Care in practise for Higher Second Edition. Paisley: Hodder gibson. 202-204. Nursing and Midwifery Council (2008). The code: Standards of conduct, performance and ethics for nurses and midwives. London: NMC. p2- 8. Roper, Logan, Tierney (1980). The elements of nursing. Edinburgh: Churchhill livingstone. 141.

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Graded Unit Essay

Skilled Care Pharmacy Essay

Skilled Care Pharmacy Essay.

I. Background of the Case

Skilled care Pharmacy, located in Mason, Ohio, is a $25 million privately held regional provide of pharmaceutical products delivered within the long-term care, assisted living, hospice, and group home environments. The following products are included within the service: Medications and related billing services

Medical records
Information systems
Continuing education

Consulting services to include pharmacy nursing, dietary, and social services The key customer groups the Skilled Care provides services to include the senior population housed within the extended and long-term care environments.

Customers within this sector depend on Skilled Care to provide their daily pharmaceutical needs at a competitive rate. Because of the high risk factor of its business, these needs require that the righht drug be delivered to the right patient at the right time. Moreover, depending on the environment being served, different medication dispensing methods maybe used such as vials, multidose packaging, or unit dose boxes. Also, depnding on the customer ttype, specific delivery requirements may be implemented to better serve the end user.

Skilled Care’s dedication and commitment to continuoud quality improvement is evident throughout its internal and external operations.

By reflecting on the principles needed to attain quality success across all level of customers. Skilled Care’s employee population includes the culturally diverse associates committed to a substance free workplace. The team includes associates with all levels of educational training representing many of the following disciplines: pharmacists, pharmacy technicians, medical data entry, accountants, billing especialists, nurse, human resources, sales/marketing, purchasing, etc. At times, multifaceted work teams are formed through cross-functional approaches to complete the tasks at hand. Skilled care’s deliverables are generated from its sole 24,000-square foot location in mason, Ohio. The pharmacy, which is open 24 hours a day, 365 days a year, is secured by a Honeywell alarm system.

The company’s primary technology rests within its pharmacy software, Rescot. This system enables Skilled Care to process, bill, and generate partinent data critical to the overall operations of the company. Other partnership have also been established within Skilled Care’s multidosed packaging capabilities and wholesaler purchasing interface. SCP utilizes the Internet for publishing partinent information and news as well as hosts a web-enabled customer service application called Trck-It to report specific information about customer issues for companywide resolution. Advantages of e-commerce include quicker customer service response time for all areas of service including placing the order, pharmacist’s review, delivery, and billing of the product.

II. Problems

Skilled Care Pharmacy faces key strategic challenges that are follows: Is the financial structure of the health care is rapidly evolving? Is there a shortage of licensed pharmacist personel at the Skilled Care Pharmacy? How does the constant evolution of medical practice affect the Skilled Care Pharmacy? How can the Skilled Care Pharmacy decrease their employee retention at all levels? These, as well as future challenges, are always balanced with the responsibility to the stakeholders.

III. Areas of Consideration

This case of Skilled Care Pharmacy considered (4) four factors can be a cause of their problems and this are:
Global Respnsibility
Consumer Awareness
Work Place of the Future

IV. Alternative Courses of Action

In this case, I created at least (3) three alternative solution to solve the problems of Skilled Care Pharmacy. a.) The SCP must be fully aware of the global impact of its local decisions and realize that as demand grows for the planet’s finite sources, waste is increasingly unacceptable. It involves human rights, labor practices, fair operating practices, consumer interests and contributions to society. b.) The SCP must be quick when responding to their customer’s concerns and match their products to customers’ wants and needs, or risk having their customers defect to a competitors.

c.) SCP have to contend with a growing number of competitors and sources of lower-cost labor and assume risks associated with global supply chains. They will need to become more flexible with how and where their workforces operate. They will need a greater investment in training and education, and a place greater emphasis on professional certifications, which will evolve based on their demands for demonstrated competemcy from its employees.

V. Conclusions

I therefore conclude that the SCP has their edge in terms of customer service as well as in the inventory of their medicines. But I also found out that there is a shortage of licensed pharmacist personel and the growing number of competitors is evolving, lastly the pharmacy increases their employee’s retention.

VI. Recommendation

Within the review of the findings I recommended the ‘letter c’ in my alternative courses of action, because it is the most helpful solution and the best way to solve the Skilled Care Pharmacy, it says that “SCP have to contend with a growing number of competitors and sources of lower-cost labor and assume risks associated with global supply chains. They will need to become more flexible with how and where their workforces operate. They will need a greater investment in training and education, and a place greater emphasis on professional certifications, which will evolve based on their demands for demonstrated competemcy from its employees.”

Skilled Care Pharmacy Essay

Affordable Care Act Essay

Affordable Care Act Essay.


The Affordable Care Act Health coverage was developed to provide and guarantee coverage for sickness, injury and preventable health measures. Many people suffer from illness’ that go untreated because they have no health insurance or cannot afford it. The Patient Protection and Affordable Care Act allows everyone to have health insurance. In this case study I will explain how the affordable Care Act in North Carolina has improved.

The impact of the Affordable Care act on the population that it affected The Patient Protection and Affordable Care Act (ACA) is the most comprehensive reform of the United States.

The Affordable Care Act (ACA) also called Obama Care transforms the non-group insurance market in the United States, mandates that all residents will have health insurance, significantly expands public insurance and subsidizes private insurance coverage, raises revenues from a variety of new taxes, and reduces and reorganizes spending under the nation’s largest health insurance plan, Medicare. Many people are opposed to Obama Care, simply because their high Republican beliefs won’t allow them to participate in any program put in place by a Democrat.

Participating in a Healthcare program shouldn’t be chosen by whichever political party you believe in, it should be determined by carefully thought out plans and weighing the pros and cons of whichever coverage best suits you and your family’s needs. The Affordable Care Act does not affect people or families currently covered with adequate health insurance. Those who already have Heath Care in place are protected by the “Grandfather Policy”. However, it does affect lower income Americans without health care making below 138% of the Federal Poverty Level (FPL). They may qualify for Medicaid under Medicaid expansion, if they meet all of the policies requirements.

This puts health care within reach of many people denied health care in the past. The President of the United States put laws in place that all people participate in the Affordable Care Act and get health care insurance or be penalized and pay monthly fines. This legislation ensures that all people be treated equally… the rich, poor or anywhere in between, you must have health insurance. To some this program seems very beneficial, but we as Americans do not like the government controlling our Medicare choices.

These newly enacted Affordable Care Acts were set in place to help all Americans receive health care and medical treatment. This act wasn’t put in place to provide care to people living in the United States illegally; undocumented immigrants and people who have been in the United States for less than five years do not qualify. The uninsured people, who gain insurance coverage in 2014, will obtain their coverage through the state’s Medicaid program. Beginning in 2014, the Affordable Care Act requires that states expand Medicaid coverage to most uninsured adults with modified adjusted gross income no greater than 138% of the federal poverty limit. Children in families with incomes no greater than 200% FPL will continue to be eligible for Medicaid or North Carolina Health Choice (North Carolina’s Child Health Insurance Program (CHIP). Other people will gain coverage through private insurance offered through the Health Benefit Exchange (HBE). (Milstead, 2013, p. 199).

The impact of the economics of providing care to patients from the organizations view In the case study, the impact of the affordable care act on North Carolina uninsured population in 2011 showed childless, non-disabled, nonelderly adults could not qualify for Medicaid. Being poor, unemployed or homeless did not qualify a person for Medicaid. People, who are uninsured, are more likely to delay care and less likely to receive preventive services, primary care, or chronic care management. As of 2014, The Affordable care Act adults will be able to qualify for Medicaid if their income is no greater than 138 percent of the Federal Poverty Level. That income level was set at $30,429 for a family of four in 2010. However, some states do allow a family of four to have higher incomes and still qualify. The case study also showed that providing Medicaid to all people across the chart insured total coverage to all people and the FPL (Federal Poverty Level) had risen to a level where all people were nearly identical to one another.

Suggesting that if health care is provided equally throughout the nation there will be a lull in infectious diseases and untreated illnesses because everyone would seek treatment since they have coverage. Some of the economic growth and plans involve tax credits to individuals and families participating in Affordable Care Act, helping to keep participation affordable to all. Doing so helps to promote membership to all, thus keeping costs at a minimum and entices more families to participate. Another planned impact would be the cap placed on insurance company’s expenditures, careful monitoring of costs to provide service will eliminate overcharging by insurance companies and its affiliates.

The government understands that it will take a number of years before the Affordable Care Act will show how much of a positive impact this program has on its participants. However, the government promises that keeping health care costs affordable will eventually lower rates and spending across the board. It says that with health care more available to all, more people get better and employees will come in to work reducing sick days and create better productivity, and financial gain for everyone.

The Affordable Care Act also keeps families from financial ruin now when a family member becomes sick or unable to work they can still have health coverage through policies of their own or coverage provided through a participating family member. Before when a family member got sick they had to worry about being cut off of coverage if they lost their jobs. Families also had the added worry of escalating medical expenses while they were suffering through their sicknesses. Many feared losing their homes to pay for medical expenses.

How the patients will be affected in relationship to the cost of treatment, quality of treatment, and access to treatment

The Residents of North Carolina’s will have access to quality, affordable health care under the updated health insurance reform. The Affordable Care Act of 2014 will have a positive effect on patient safety and outcomes. It will provide many resources to allow patients easier access to insurance for health care costs and preventive care such as cancer screenings and vaccines. It will give incentives to health care facilities to improve the care being given. It is also mandated for all healthcare facilities to use electronic health record systems to keep track of all patient information to minimize errors. Doing this will also ensure that all patients receive the same care and treatment at all facility’s and that hospitals can share new developments or procedures.

Reducing costs and prolonged hospital stays and long drawn out treatments, patients in need of specialized treatments can be sent to facilities better equipped to treat them with records of their treatments already in the system. (R. Kocher, J. Emanuel, M. Deparle, 2014, pp. 536-540) The Affordable Care Act provides medical coverage for families and children and is required to continue to make such coverage available for an adult child who is not married until the child reaches age 26. However, the Affordable Care Act is not obligated to make coverage available for a child of a child receiving dependent coverage. These people are considered parents themselves, and are expected to work and provide health care for their dependent children themselves.

The ethical implications of this act for both the organization and the patients

Since the beginning of 2010 adults, can qualify for Medicaid if their income is not greater than 138 percent of the Federal Poverty Level. Gaining strength over the last couple of years as of 2014 everyone is qualified to get Affordable Health Care as long as they meet the plans restrictions and verifications. As everyone in North Carolina gains health coverage, the state and county governments could potentially reduce some of the expense to safety net providers currently used to help pay for services to the uninsured. Under this new mandated health reform, hospitals and medical providers will be assured funding and payment since this program is to be funded by the federal government. Thus providing a system where medical facilities can focus on patient care, and not worry about the un or under insured not being able to pay for the care they receive.

When organizations across the entire United States are given enough funding to cover the expense of new equipment and supplies, it allows more opportunities for hiring more educated staff members, and lets health providers focus on patient care. The state of North Carolina may eventually experience a decrease in unnecessary use of the emergency department and reduced hospitalizations as more people gain coverage and access to preventive and primary care services.

Once health care is made more readily available and affordable to more people and families, the risk of fraud and abuse of services would be greatly reduced. These worries and concerns will all but be eliminated because health care would now be available to all Americans. Even Americans who were once refused treatment due to pre-existing health problems can now be seen by a physician. The Affordable Care Act prohibits pre-existing condition exclusions, refusals of treatment and all other discriminations based on health status by group health plans.


Milstead, J. A. (2013). Health policy and politics: A nurse’s guide (Laureate Education, Inc., custom ed.). Sudbury, MA: Jones and Bartlett Publishers.

Kocher, R., Emanuel, E. J., & DeParle, N. M. (2010). The Affordable Care Act and the Future of Clinical Medicine: The Opportunities and Challenges. Annals Of Internal Medicine, 153(8), 536-W.190 Kovner, A. R., & Knickerman, J. R. (2011). Health care delivery in the United States. (10th ed.). New York, NY: Springer.

2014, 01). Impact of Affordable Care Act on North Carolina Uninsured Population. Retrieved 01, 2014, from

(P.L. 111-152 Summary of patient protection and affordable care act (P.L.
111-148, H.R. 3590), with amendments of the health care and education reconciliation act of 2010, H.R. 4872). (2010). Tax Management Tax Practice Series Bulletin, 22(7), 12-31. Retrieved from

Affordable Care Act Essay

Facilitate Coaching And Mentoring Essay

Facilitate Coaching And Mentoring Essay.

1 Understand the benefits of coaching and mentoring practitioners in health and social care or children and young people’s settings 1.1 Analyse the differences between coaching and mentoring 1.2 Explain circumstances when coaching would be an appropriate method of supporting learning at work 1.3 Explain circumstances when mentoring would be an appropriate method of supporting learning at work 1.4 Explain how coaching and mentoring complement other methods of supporting learning 1.5 Analyse how coaching and mentoring at work can promote the business objectives of the work setting 1.

6 Evaluate the management implications of supporting coaching and mentoring in the work setting 1.7 Explain how coaching and mentoring in the work setting can contribute to a learning culture 1.8 Explain the importance of meeting the learning needs of coaches and mentors 2 Be able to promote coaching and mentoring of practitioners in health and social care or children and young people’s settings

2.1 Promote the benefits of coaching and mentoring in the work setting 2.2 Support practitioners to identify learning needs where it would be appropriate to use coaching 2.

3 Support practitioners to identify learning needs where it would be appropriate to use mentoring 2.4 Explain the different types of information, advice and guidance that can support learning in the work setting 2.5 Demonstrate a solution­focused approach to promoting coaching and mentoring in the work setting 3 Be able to identify the coaching and mentoring needs of practitioners in health and social care or children and young people’s settings 3.1 Use different information sources to determine the coaching and mentoring needs of practitioners in the work setting 3.2 Plan coaching and mentoring activities

4 Be able to implement coaching and mentoring activities in health and social care or children and young people’s settings 4.1 Support the implementation of coaching and mentoring activities 4.2 Select the most appropriate person to act as coach or mentor 4.3 Explain the support needs of those who are working with peers as coaches or mentors 4.4 Provide coaching in a work setting according to the agreed plan 4.5 Provide mentoring in a work setting according to the agreed plan 5 Be able to review the outcomes of coaching and mentoring in health and social care or children and young people’s settings 5.1 Review how the use of coaching and mentoring in the work setting has supported business objectives 5.2 Evaluate the impact of coaching and mentoring on practice 5.3 Develop plans to support the future development of coaching and mentoring in the work setting

Facilitate Coaching And Mentoring Essay