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Essential V: Healthcare Policy, Finance, and Regulatory Environments

Carlos Jaen

Frostburg State University

Essential V: Healthcare Policy, Finance, and Regulatory Environments

The American Association of Colleges of Nurses (AACN) essential V: Healthcare policy, finance, and regulatory environments, This essential discusses the importance of healthcare policies, including financial and regulatory policies, how these policies directly and indirectly influence nursing practice as well as the nature and functioning of the healthcare system and how they affect the way nursing is practiced.

In a society laws are created to regulate human behavior, provide order, prevent harm, and protect our individual right (Pozgar, 2013). In a healthcare setting, healthcare policies are created with these same principles because they regulate the practice and behavior of all healthcare professionals who work in that place, each institution creates its own set of rules and standards which regulate one’s conduct within the organization.

Healthcare policy shapes the nature, quality, and safety of the practice environment and all professional nurses have the responsibility to participate in the political process and advocate for patients, families, communities, the nursing profession, and changes in the healthcare system as needed. (AACN, 2008).

Exemplar

This assignment consisted of the use of one’s ethical viewpoint to render social justice and apply ethical responsibilities. For this assignment we were given the scenario that after a meteor strikes the earth we had to choose six of the fifteen surviving individuals to return to earth to repopulate it, the remaining survivors would die.

Each group member had the ethical responsibility to choose the six best individuals that would help to start life on earth once their space shuttle returns to earth from out of space. I selected this exemplar because it promotes ethical responsibility, as well as advocacy. “Advocacy for vulnerable populations with the goal of promoting social justice is recognized as moral and ethical responsibilities of the nurse”. (AACN, 2008). Many of our group members for this assignment chose not to advocate for the older individuals and discriminated against their age. As a registered nurse, one must advocate for the entire population, including the most vulnerable; the young and the elderly. The American Nurses Association, states that “The registered nurse advocates for equitable healthcare consumer care”.

This group assignment demonstrated the need for advocacy in our society, someone who would speak up and protect an individual’s rights; someone who would not discriminate against one sex, creed, and age. The group members for this assignment did not speak up for the rights of the older individuals because not a single one was considered to return to earth.

One of the most difficult parts of this assignment was the selection of the best six candidates who would make it back to earth. My rationale for choosing those six individuals was based on cultural diversity because the group of individuals that I chose was composed of younger, middle-aged, and mature individuals from diverse cultures who would interact with one another, and bring their different life experiences to the table. The ethical viewpoint that I utilized to narrow down to the six individuals that I chose was based on the theory of Ethical Relativism, this theory implies that morality is relative to the norms of the culture because what's considered morally right for one culture might not be acceptable in another culture ( Pozgar, 2011). I believe that this would help individuals maintain their own cultural identity and it would also help individuals appreciate and respect other’s cultures, values and beliefs, thereby eliminating cultural biases. What I learned from this project was that the solution to an ethical dilemma would vary from one individual to the next because of our differences in personal values and beliefs that influences our ethical decision.

Reflection

The Meteor Strikes People Survival relates to the AACN essential because it describes rules, and regulations that authorize and define professional nursing practice. Every professional organization has its own set of rules and standards that regulate the way people should behave and practice, the nursing profession has its own scope and standards of practice that defines the nursing profession. The American Nurses Associations (ANA) is the professional nursing organization that develops the scope and standards that apply to the practice of all professional nurses and serve as a template for nursing specialty practice. (ANA, 2010).

My exemplar also relates to the essential use of an ethical framework to evaluate the impact of social policies on health care, especially for vulnerable populations. Nurses use a code of ethics to assist them with ethical decisions, this same code of ethics, delineate the rules, duties and responsibilities on individuals’ conduct. These rules, duties, and responsibilities have their roots from ethical principles that guide ones behaviors and decision making. “Ethical principles assist caregivers in making choices based on moral principles that have been identified as standards” ( Pozgard, 2013). For my exemplar ethical decision needed to be made in order to keep civilization alive, social justice was rendered when only six individuals were chosen to continue to live, while the rest were left to die. Advocacy for consumers and the nursing profession is an AACN essential that the Meteor Strikes People Survival exemplar relates to because as a professional registered nurse, when one abides and follows the code of ethics for nursing one becomes an advocate for that patient. The code of ethics for nurses outlines my responsibilities to the patients, their families, other healthcare professionals, and the community. Advocating for others is a nurse duty; the nursing profession is about caring and helping others, and it's based on the Deontological ethics principle because "it focuses on one's duties to others and others' rights" (Pozgard, 2013,p.28).

Reference:

Pozgar, G.D. (2011). Legal and ethical issues for health professionals (3rd ed.).

Burlington, MA: Jones and Bartlett.

American Association of Colleges of Nurse. (2008). The essentials of baccalaureate education For Professional Nursing Practice. Washington, DC, USA: American Association of Colleges of Nursing.

American Nurses Association (2010). Scope and standards of practice (2nd. ed.). Silver Spring, Maryland.

Meteor Strikes People Survival Worksheet (Individual)

Fifteen (15) people are aboard the international space station when a large asteroid strikes the earth with the force of 1 Trillion tons of TNT. After four days, there are no signs of survivors on the Earth and all efforts communicate with the planet have failed. There is a large layer of smoke and dust surrounding the planet and thus, for the time being, there is no way for the attached space shuttle to return to Earth without guidance and support from the surface. You must assume that the 15 people described below are the only humans known to be alive.

The problem

There are 15 people on the space station, but if all of them stay on the station, they will run out of oxygen and food in approximately two months. However, computer projections indicate that the dust in the Earth’s atmosphere will not be able to be penetrated for at least six months, at which time it may be possible to navigate a safe return to Earth. Based on the oxygen-producing capacity of the station, only a crew of 6 people would be able to stay alive for six months.

Your task is to decide, based on the information you have been given, which six people should be allowed to remain on the space station (and live) and who should be selected to leave. There is only one shuttle capable of returning to Earth. We will assume that the people selected to leave the station will do so peacefully. At stake is the survival of humans on Earth. The repopulation of humans on Earth will begin with the survivors selected.

Carefully evaluate all of the information provided and then decide who will survive and who must leave. Write down your list of six survivors and nine who must be sacrificed. State your reasons for your selections.

The people

Michelle is 42, married, and the mother of 17-year-old twins. She is an avid runner and the daughter of a famous Chinese scientist. She is also a breast cancer survivor and the author of more than 40 articles in her field of molecular biology.

Caroline is 31 and single. She has no children. She was the co-pilot on the space shuttle that is docked to the space station. She was one of the first people to receive an experimental laser treatment to correct severe near sightedness— something she had to do to qualify for the space program. She is the daughter of a coal miner from West Virginia.

Sumiyo is a 48-year-old physician who came to the space station to carry out medical experiments on the crew. She is the divorced mother of one 24-year-old son. She is in excellent health, but her father died from a heart attack when he was 54. She is the first Japanese woman to serve on the space station.

Natasha, age 27, is the youngest person on the space station. She is divorced and has no children (though she had one miscarriage when she was 23). She is a computer expert and her primary role is to oversee the technical aspects of the 300 separate experiments that are currently being conducted on the space station. She is from Moscow.

Addrienne is the first woman from sub-Saharan Africa to voyage to the space station (she is from Zimbabwe). She is 34 and married. She is the mother of two young boys. She is a botanist, studying how a variety of plant species respond to micro-gravity.

Alexandra is 51, single, and has no children. She is the Captain of the crew that last arrived on the space station. She is a veteran of more than 12 shuttle missions and has served as both pilot and navigator of previous shuttle flights. Her mother is a US Senator and her father, now deceased, was a World War Two fighter pilot. She is in excellent health and was raised in Washington DC.

Sergei is 44 and serves as a payload specialist on the crew. He is married and has no children. He is a former Olympic hockey player from Russia. At 6’ 4” and 220lbs., he is in excellent physical condition. His father died from the effects of alcoholism, but his mother is still doing well at age 74.

Max is a 32-year-old physician and the divorced father of six children. He is the flight surgeon for the crew. He is from Australia. He is a serious runner, but hypertension runs on both sides of his family and he takes medication to control his blood pressure. He also takes medicine to control his allergies to molds, dust, and pollen.

Hiro is a 41-year-old Japanese businessman and the father of two children. He is the owner of a vast exporting company and is fulfilling his life-long dream to go into space. Through his donation of $15 million, he is responsible for funding more than 100 experiments on the space station. He is slightly over-weight, and with exception of poor vision, he is in generally good health.

Rahim is the first Iranian to visit the space station. He is 38 and is the most decorated pilot in the Iranian airforce. He is the father of five children. He was the pilot of the original shuttle to the space station, and has been on board the station for five months. Though very slender, he is in good health.

Kerry is 57 and has spent more time in space than any other astronaut. This is his 17th mission. He is married and has three grown children. He was looking forward to retiring from NASA at the conclusion of the mission, returning to California, and pursuing his hobbies of gardening and woodworking. He is also contemplating a post-retirement return to school to become a minister. He is the highest-ranking member of the crew and serves as the chief administrator of the space station. He is slightly overweight, but is in generally good health.

Steven is 41 and is from Nigeria. He is single and has no children. He is an exercise physiologist, a former professional soccer player, and is studying the effects of weightlessness on muscle density. He has developed a series of exercise machines for the crew and works out for more than three hours every day. He was adopted as a child and has no information about his biological parents.

Jorge is a 29-year-old astrophysicist from Mexico City. He is the father of one two-year-old daughter. He is studying deep space quasars using the station’s powerful telescope. He is not athletic and dislikes exercise, but is in generally good physical condition. He is widely regarded as one of world’s most brilliant young astronomers.

Dimitri is the 32-year-old son of the president of Greece. His mother is the former Miss Universe. He is single and has no children. He was a professional model in his early 20s, and then decided to pursue a career in graphic design. He developed a three-dimensional graphics program that allows the computers on board the station to map the surfaces of any object with incredible precision. Other than wearing contact lenses to correct severe myopia, he is in excellent health.

Angelo is 43 and single. He has no children. He is an Italian cartographer who is working on developing the most comprehensive map of deep space ever created. He is the son of poor farmers and grew up raising all of the food he ate. His parents –now in their 70s-- are both still living on their family farm. He has a slight limp from an accident as a child, but otherwise has no health problems.

Six Choices and Rationale:

1) Natasha 27 years old and the youngest of the group who never had children and is a computer expert.

2) Alexandra 51 years old crew captain, although not a politician her mother was a US Senator. She also provides leadership, maturity and has good life experience.

3) Addrienne 34 years old botanist a mother of two, her background as a mother and a botanist can be an asses when the crew returns to earth because they need to use the land to feed themselves.

4) Jorge 29 years old astrophysicist is a father and he is young and he is also regarded as a brilliant person.

5) Max 32 years old flight surgeon who takes meds to control his blood pressure. The crew will need a doctor to take care of them when someone gets ill.

6) Kerry 57 years old who brings administrator experience, maturity, and good life experience. He also enjoys gardening, wood working and can become a religious leader.

Ethical Viewpoint/Framework and Rationale from Text Context:

My rationale for choosing those six individuals to return to earth was to foster a learning environment in which a culturally diverse group including younger, middle-aged, and mature individuals would interact with one another, bringing their different life experiences to the table.

My ethical viewpoint for my conclusion was based on the theory of Ethical Relativism, this theory implies that morality is relative to the norms of the culture because what's considered morally right for one culture might not be acceptable in another culture ( Pozgar, 2011). I believe that this would help individuals keeping their own identity and it would also help individuals appreciate and respect other cultures' values and beliefs, thereby eliminating cultural biases.

Reference:

Pozgar, G.D. (2011). Legal and ethical issues for health professionals (3rd ed.).

Burlington, MA: Jones and Bartlett.

Meteor Strikes People Survival Worksheet Group

Fifteen (15) people are aboard the international space station when a large asteroid strikes the earth with the force of 1 Trillion tons of TNT. After four days, there are no signs of survivors on the Earth and all efforts communicate with the planet have failed. There is a large layer of smoke and dust surrounding the planet and thus, for the time being, there is no way for the attached space shuttle to return to Earth without guidance and support from the surface. You must assume that the 15 people described below are the only humans known to be alive.

The problem

There are 15 people on the space station, but if all of them stay on the station, they will run out of oxygen and food in approximately two months. However, computer projections indicate that the dust in the Earth’s atmosphere will not be able to be penetrated for at least six months, at which time it may be possible to navigate a safe return to Earth. Based on the oxygen-producing capacity of the station, only a crew of 6 people would be able to stay alive for six months.

Your task is to decide, based on the information you have been given, which six people should be allowed to remain on the space station (and live) and who should be selected to leave. There is only one shuttle capable of returning to Earth. We will assume that the people selected to leave the station will do so peacefully. At stake is the survival of humans on Earth. The repopulation of humans on Earth will begin with the survivors selected.

Carefully evaluate all of the information provided and then decide who will survive and who must leave. Write down your list of six survivors and nine who must be sacrificed. State your reasons for your selections.

The people

Michelle is 42, married, and the mother of 17-year-old twins. She is an avid runner and the daughter of a famous Chinese scientist. She is also a breast cancer survivor and the author of more than 40 articles in her field of molecular biology.

Caroline is 31 and single. She has no children. She was the co-pilot on the space shuttle that is docked to the space station. She was one of the first people to receive an experimental laser treatment to correct severe near sightedness— something she had to do to qualify for the space program. She is the daughter of a coal miner from West Virginia.

Sumiyo is a 48-year-old physician who came to the space station to carry out medical experiments on the crew. She is the divorced mother of one 24-year-old son. She is in excellent health, but her father died from a heart attack when he was 54. She is the first Japanese woman to serve on the space station.

Natasha, age 27, is the youngest person on the space station. She is divorced and has no children (though she had one miscarriage when she was 23). She is a computer expert and her primary role is to oversee the technical aspects of the 300 separate experiments that are currently being conducted on the space station. She is from Moscow.

Addrienne is the first woman from sub-Saharan Africa to voyage to the space station (she is from Zimbabwe). She is 34 and married. She is the mother of two young boys. She is a botanist, studying how a variety of plant species respond to micro-gravity.

Alexandra is 51, single, and has no children. She is the Captain of the crew that last arrived on the space station. She is a veteran of more than 12 shuttle missions and has served as both pilot and navigator of previous shuttle flights. Her mother is a US Senator and her father, now deceased, was a World War Two fighter pilot. She is in excellent health and was raised in Washington DC.

Sergei is 44 and serves as a payload specialist on the crew. He is married and has no children. He is a former Olympic hockey player from Russia. At 6’ 4” and 220lbs., he is in excellent physical condition. His father died from the effects of alcoholism, but his mother is still doing well at age 74.

Max is a 32-year-old physician and the divorced father of six children. He is the flight surgeon for the crew. He is from Australia. He is a serious runner, but hypertension runs on both sides of his family and he takes medication to control his blood pressure. He also takes medicine to control his allergies to molds, dust, and pollen.

Hiro is a 41-year-old Japanese businessman and the father of two children. He is the owner of a vast exporting company and is fulfilling his life-long dream to go into space. Through his donation of $15 million, he is responsible for funding more than 100 experiments on the space station. He is slightly over-weight, and with exception of poor vision, he is in generally good health.

Rahim is the first Iranian to visit the space station. He is 38 and is the most decorated pilot in the Iranian airforce. He is the father of five children. He was the pilot of the original shuttle to the space station, and has been on board the station for five months. Though very slender, he is in good health.

Kerry is 57 and has spent more time in space than any other astronaut. This is his 17th mission. He is married and has three grown children. He was looking forward to retiring from NASA at the conclusion of the mission, returning to California, and pursuing his hobbies of gardening and woodworking. He is also contemplating a post-retirement return to school to become a minister. He is the highest-ranking member of the crew and serves as the chief administrator of the space station. He is slightly overweight, but is in generally good health.

Steven is 41 and is from Nigeria. He is single and has no children. He is an exercise physiologist, a former professional soccer player, and is studying the effects of weightlessness on muscle density. He has developed a series of exercise machines for the crew and works out for more than three hours every day. He was adopted as a child and has no information about his biological parents.

Jorge is a 29-year-old astrophysicist from Mexico City. He is the father of one two-year-old daughter. He is studying deep space quasars using the station’s powerful telescope. He is not athletic and dislikes exercise, but is in generally good physical condition. He is widely regarded as one of world’s most brilliant young astronomers.

Dimitri is the 32-year-old son of the president of Greece. His mother is the former Miss Universe. He is single and has no children. He was a professional model in his early 20s, and then decided to pursue a career in graphic design. He developed a three-dimensional graphics program that allows the computers on board the station to map the surfaces of any object with incredible precision. Other than wearing contact lenses to correct severe myopia, he is in excellent health.

Angelo is 43 and single. He has no children. He is an Italian cartographer who is working on developing the most comprehensive map of deep space ever created. He is the son of poor farmers and grew up raising all of the food he ate. His parents –now in their 70s-- are both still living on their family farm. He has a slight limp from an accident as a child, but otherwise has no health problems.

Six Choices and Rationale:

Our Mission: Ensure survival of the human race. Must repopulate, so young females are a must. Need at least one pilot to land the shuttle. Prefer at least one physician. Should choose those in good health and those with skills to enhance the group’s chances of survival.

Our 6 Choices:

1. Caroline, 31 y.o. F

a. Young age. Can possibly bear many children.

b. Co-pilot to assist in safely landing space shuttle.

2. Addrienne, 27 y.o. F

a. Young age. Can bear children.

b. Botanist skills useful for finding, identifying, and cultivating plants for consumption.

3. Natasha, 27 y.o. F

a. Young. Can possibly bear many children.

4. Sumiyo, 48 y.o. F

a. Can possibly still bear children until reaches menopause.

b. Physician. Can tend to the group’s medical needs and pass on her medical skills to others.

c. Excellent health.

5. Angelo, 43 y.o. M

a. Farming skills. Cultivate crops as an important food source.

b. Cartography skills to re-map Earth’s land.

c. Can impregnate females, assuming he is able to. He has not had children in the past.

d. No health problems except a slight limp.

6. Rahim, 38 y.o. M

a. Pilot. Will safely land the space shuttle.

b. Can impregnate females. Has had children in past.

c. Leadership skills.

d. Good health.

We decided on four females and two males because more females are necessary to repopulate the race more quickly. We decided to have Sumiyo as our last female selection because of her medical expertise. We struggled between Rahim and Kerry as our group’s sixth and final survivor selection. Although Kerry has excellent leadership skills, gardening and woodworking skills, and a passion for ministry, he is much older than Rahim. Kerry is 57 and slightly overweight. Rahim is 38, slender, in good health and also has leadership skills. Unlike Kerry, Rahim is a decorated pilot and the best equipped of the group to safely land the space shuttle. Rahim has fathered five children and can father many more children than Kerry could based on age. Although Kerry’s woodworking skills may have come in handy, Rahim and Angelo are healthy and intelligent to build adequate shelters if not from experience, than through trial and error. Kerry’s gardening skills is not as important to the survival group because we already selected a farmer and a botanist. After much discussion, a consensus was reached that Rahim would benefit the survival group moreso than Kerry.

Ethical Viewpoint/Framework and Rationale from Text Context:

Our group used utilitarianism, consequential ethics and situational ethics for this assignment. The idea of killing nine people would not be acceptable except in an extreme survival-of-the-human-race scenario such as this where there are only enough resources (oxygen) to keep six out of 15 crew members alive. If the crew cannot get down to six members, all those aboard would run out of oxygen and the human race would become extinct. According to Pozgar’s (2013) explanation of situational ethics, “the ends justify the means” (p. 52). Sometimes a person’s beliefs and values change as circumstances change (p. 52). In other words, sometimes good people take bad actions (murder or human sacrifice) for the greater good.

Utilitarianism is a form of consequential ethics. The consequential ethics theory, as explained by Pozgar (2013), states that “the morally right action is whatever action leads to the maximum balance of good over evil" (p. 7). This means that an action that provides the most good to the greatest number of people is the action chosen over other options. In this scenario, the six survivors our group chose are healthy and strong enough to survive a post-apocalyptic earth. These survivors possess qualities/skills that the entire group may benefit from. Each of the six chosen are capable of producing offspring which is of utmost importance when repopulating the human race.

When collaborating on Blackboard’s Elluminate for this assignment, our group used the following values: cooperation because we worked together to make our decisions; kindness and respect in listening to other's viewpoints without being critical or personally attacking others; and we were conscientious in our decision making process, trying to do what is right.

Reference

Pozgar, G. D. (2013). Legal and ethical issues for health professionals (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

Names:

Carla Blaney, Jennifer Brewer, Megan Brooksbank, Melissa Deptol, Carlos Jaen, Edith Lopez

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