Weekly Challenge – Meditation

Spend some time this week exploring aspects of mindfulness

What mindfulness activity I did this week:

The mindfulness activity I did this week is a form of meditation known as walking meditation. Accordingly, this activity involves focusing the mind on what it feels like to walk by paying all attention to every movement involved in walking (Donatelle & Thompson, 2011). Such movement includes lifting the foot, moving the foot forward, placing the foot on the floor, and shifting body weight from one leg to the other. This activity helps a person get out of their head, relax, and fully engage with the world around them.

How often did I do this activity?

Because of this assignment, I came to know of walking meditation, and after I practiced it and liked it, I started doing it almost every day when I found myself with some free time.

How does this mindfulness activity impact my physical, emotional and spiritual wellness?

Since I have been doing this activity for a short while, I have noticed no physical wellness so far. However, my emotional and spiritual wellness has improved. Lately, my anxiety and moodiness have reduced, and so has my stress. In addition, I feel more mindful and have a new sensation of life satisfaction, which makes me happy.

What new insights have I gained?

A major insight I gained from this experience concerns my mind and how it is chaotic. I realized how I constantly and obsessively follow old thoughts and constantly get distracted, unable to focus on one thing for a long time. This lack of attention then leads to me missing out on many things in the present moment because I am thinking about something else.

Additional thoughts, reflections and comments

With the current age of the internet, modern technologies are constantly embedded into people’s everyday lives at an increased rate. Studies have shown that the generations growing up in the Internet age have a lot of anxiety and little life satisfaction, which are all linked to Internet addiction (Kvintová et al., 2020). As such, I feel that practices like walking meditation are important for everyone, especially the young generation, and schools should find a way to incorporate such lessons.

References

Donatelle, R. J., & Thompson, A. M. (2011). Health: the basics. Benjamin Cummings.

Kvintová, J., Cakirpaloglu, S. D., & Hájková, R. (2020). Relationship between internet addiction, life satisfaction and anxiety in pre-service teachers of generation Z. In EDULEARN20 Proceedings (pp. 5843-5849). IATED.

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

---

WHAT IS MINDFULNESS?
Mindfulness is a type of meditation in which you focus on being intensely aware of what you’re sensing and feeling in the moment, without interpretation or judgment. Practicing mindfulness involves breathing methods, guided imagery, and other practices to relax the body and mind and help reduce stress. Spending too much time planning, problem-solving, daydreaming, or thinking negative or random thoughts can be draining. It can also make you more likely to experience stress, anxiety and symptoms of depression. Practicing mindfulness exercises can help you direct your attention away from this kind of thinking and engage with the world around you.

Spend some time this week exploring aspects of mindfulness

1. What mindfulness activity I did this week:
2. How often did I do this activity
3. How does this mindfulness activity impact my physical, emotional and spiritual wellness?
4. What new insights have I gained?
5. Additional thoughts, reflections and comments

The Physician Shortage

From the article, we learn that in the US, more is spent on healthcare than in any other nation, but still, citizens are less healthy compared to other high-income countries that spend less amount. Additionally, the number of physicians has reduced over the last 12 years. This shortage of physicians across the country has been attributed to other factors such as American diet and lifestyle, health care system incentives that have led to overuse and underuse of services, and inappropriate health outcome measurement. However, different measures have been introduced to help solve the physician shortage. These measures include increasing the number of physicians to meet the demand for care and increasing the number of physician assistants that offer primary care services, such as practical nurses.

Increasing the number of physicians to meet the demand for care and increasing the number of physician assistants that offer primary care services is expensive and will see the healthcare cost increase and diminish in the returns. The most appropriate measure to curb the physician shortage is to address the demand for health care services by controlling individual and group variables which are the top 10 causes of mortality in the US. Group variables targeting involves improving management and access to chronic disease services, using information and financial incentives, implementing health information technology, and improving care coordination. Individual variables targeting, on the other hand, involves individual determinants such as financial decisions, diet, exercise, and substance use. Legislators should consider strategic policy formulation to ensure that targeting individual and group variables is official and mandatory (Ahmed & Carmody, 2020).

References

Ahmed, H., & Carmody, J. B. (2020). On the Looming Physician Shortage and Strategic Expansion of Graduate Medical Education. Cureus, 12(7). https://doi.org/10.7759/cureus.9216

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

---

Read “The Physician Shortage: A Red Herring in American Health Care Reform,” by Corso, Dorrance, LaRochelle, and LaRochelle, from Military Medicine (2018).
What are your key takeaways in the article?

Stress and Depression

Stress is a neglected factor in day-to-day events of life, and it plays a vital role in the mental health of a being. It is a physiological response to any physical, emotional, or psychological strain (Cassidy, 2017). Stress may have a positive or negative impact, but for the essay below, we will focus on the negative part of stress causing depression. To others, stress acts as a defence mechanism, and if it becomes chronic, it can lead to depression. Depression is a significant health determinant during healthcare delivery. It is also a common mental illness whose manifestations include loss of interest, feelings of guilt, low concentrations, and loss of appetite. Stress is closely associated with depression. With chronic stress, one is likely to go into depression. The essay below will discuss the short and long-term effects of depression on health, treatment, and prevention strategies and how one can avoid disorders related to stress. It will also give an insight into how stress contributes to depression.

Stress Contribution to Depression

Life events full of stress contribute to the origin and, more so, the development of pressure through the interaction of factors such as environmental stressors, psychological factors, and neurotrophic factors. Psychological vulnerability, which is determined by the strength, duration of impact, and intensity of life events, can lead to depression (Yang et al., 2015). When a person is exposed to stressors that are uncontrollable and unavoidable, this may interfere with their cognitive functioning. Especially cases where resources to cope with these stressors are unavailable. When these people are unable to make proper judgments on how to handle stressful life events, they begin to feel useless and helpless.

Environmental stressors such as traumatic events experienced by a person during childhood could cause vulnerability and trigger depression. Adverse life events such as extreme poverty, loss of a close relative, abuse by peers, and neglect have a direct way of forming dysfunctional and negative attitudes. So, exposure to additional environmental stressors that are not favourable could lead to depressive symptoms.

Neurotrophic factors play a role in neural processes in the brain. These include the brain-derived neurotrophic elements, neurotrophins 3, 4, 5, and 6, and nerve growth factors. Research has shown that any drop in the levels of the brain-derived neurotrophic factor may cause depression symptoms (Phillipe., 2017). However, an increased level of this helps to speed up healing during a clinical process. Chronic stress can damage the central neurons, decreasing the stories of the brain-derived neurotrophic factor and causing depressive symptoms.

Effects of Depression on Health

Depression causes endocrine abnormalities, which result in endocrine disorders. The most common condition associated with depression is the increased activity of the HPA (Hypothalamic-pituitary-adrenal) axis (Kim et al., 2016). It results in the diseases of parathyroid, adrenal glands, and thyroid glands and also causes diabetes mellitus, which involves insulin secretion. Some long-term effects are the unresponsive treatment of the thyroid, adrenal and parathyroid glands.

Short-term effects on the nervous system include slowed-down neurological functions, irritability, sudden intense mood swings, disorientation, lethargy, and muscle weakness. The long-term effects of depression on this system include migraines, pains unresponsive to pain medications, prolonged body aches, and loss of memory.

Depression causes diarrhoea or increased intestinal motility in the gastrointestinal system. Prolonged duration of depression may cause regurgitation, leading to chronic ulcers. It can lead to a build-up of acid in the respiratory system, leading to respiratory acidosis.

Depression is treated after a holistic assessment. This holistic assessment includes clinical assessment, identification of stressors, presence of underlying disorders, looking at the patient’s preference, and weighing on the prognosis if they have had one before. Medications are given, which include antidepressants and other drugs, to manage the clinical manifestations of an individual (Olfson et al., 2016).

Depression can be prevented by creating awareness of the effects of an excellent early childhood upbringing. It can also be controlled by educating the caretakers and parents on how to handle those who have had depression before to minimize the strength of stressors. Advocating for the implementation of government policies on mental health and encouraging psychotherapeutic talks can help prevent depression.

Stress-related disorders such as depression can be avoided by seeking immediate help. Early medical attention, such as attending cognitive and behavioural psychotherapy, helps to minimize the weight of stress and the number of stressors on an individual. The decreased number of stressors on an individual is directly proportional to the improved health status of an individual.

Conclusion

In conclusion, there is a close association between stress and depression. Stress contributes to depression via environmental stressors, psychological stressors, for example, psychological vulnerability, and neurotrophic factors, such as brain-derived neurotrophic factors. A decrease in brain-derived neurotrophic factors causes depressive symptoms. Still, depression affects the endocrine system, nervous system, gastrointestinal system, and respiratory system. It causes endocrine abnormalities and diseases of the glands. These glands include the thyroid, adrenal and parathyroid. However, there are ways to treat and prevent depression, for example, the administration of antidepressants. Apart from these two, depression can be avoided.

References

Cassidy, T. (2017). Stress, cognition and health. Routledge. https://doi.org/10.4324/9781315800103

Kim, Y. K., Na, K. S., Myint, A. M., & Leonard, B. E. (2016). The role of pro-inflammatory cytokines in neuroinflammation, neurogenesis and the neuroendocrine system in major depression. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 64, 277-284. https://doi.org/10.1016/j.pnpbp.2015.06.008

Olfson, M., Blanco, C., & Marcus, S. C. (2016). Treatment of adult depression in the United States. JAMA Internal Medicine, 176(10), 1482-1491. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2546155

Phillips, C. (2017). Brain-derived neurotrophic factor, depression, and physical activity: making the neuroplastic connection. Neural plasticity, 2017. https://doi.org/10.1155/2017/7260130

Yang, L., Zhao, Y., Wang, Y., Liu, L., Zhang, X., Li, B., & Cui, R. (2015). The effects of psychological stress on depression. Current neuropharmacology, 13(4), 494-504. https://www.ingentaconnect.com/content/ben/cn/2015/00000013/00000004/art00011

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

---

Module 2 – Case

THE PHYSIOLOGY OF STRESS

Assignment Overview

Scientists have known for some time that stress can aggravate physical or mental illnesses. We also know that stress is also associated with an increased risk for psychological and physical diseases such as:

Depression
Irritable Bowel Syndrome (IBS)
Breast Cancer ( I chose breast Cancer because my Aunt Passed away from it.)
Headache
During the normal stress response, the nervous system and endocrine systems respond. Chronic stress can result in the continued comeback of these systems, especially regarding hormone release, which can impact other body systems.

Case Assignment
Choose one of the disorders below to research.

Depression
Irritable Bowel Syndrome (IBS)
Breast Cancer
Headache
Describe the current research that supports how stress contributes to the effects of the disorder (3 well-developed paragraphs).

How does your chosen stress-related disorder affect short- and long-term health? Consider the impact on endocrine, nervous and other body systems (3 well-developed paragraphs).

What can be done to prevent and treat your chosen stress-related disorder? (2 well-developed paragraphs).

Conclude how to avoid these stress-related disorders (1 well-developed paragraph).

Public Choice Theory

The public choice theory posits that politicians and the general public behave in a manner that fosters their personal interests over the interests of the public. To that end, politicians are motivated by their personal interests while formulating public policies and laws (Schuster, 2018). One of the main motivations driving legislative action is the politicians’ desire to retain their income by being voted in. The desire is explicit when legislators support popular policies regardless of their soundness to get votes. Politicians leverage the public’s lack of knowledge to support popular bills that may not benefit the general public in the long run.

Rivalry and excludability characteristics are associated with private (non-public goods). A good example of a rival and excludable good is healthcare. The consumption of healthcare by one individual excludes another from consuming those healthcare services. For instance, when patients are admitted to a public healthcare facility, they occupy bed space that someone else may have occupied (Dewar, 2017). Dewar (2017) also avers that healthcare provision is uncertain to a large extent. Although some healthcare issues, such as pregnancies, may be predicted, many healthcare issues occur suddenly and quickly, hence highly unpredictable. Healthcare possesses distinct characteristics from public goods, so it is left to the private sector.

Healthcare funding management is also in the realm of the private sector to ensure there is efficiency. If the sector were to be administered through the public sector, it would likely fail due to inefficiency (Higbea & Cline, 2021). Public officials and politicians do not have a profit incentive when managing public goods; hence they may not put enough effort into ensuring these services work. The rivalry and excludability of healthcare make it a non-public good.

References

Dewar, D. M. (2017). Essentials of health economics. Burlington, Ma Jones & Bartlett Learning Burlington, Ma Jones & Bartlett Learning.

Higbea, R., & Cline, G. (2021). Government and policy for U.S. health leaders. Jones & Bartlett Learning.

Schuster, W. (2018). Public Choice Theory, the Constitution, and Public Understanding of the Copyright System. https://lawreview.law.ucdavis.edu/issues/51/5/Articles/51-5_Schuster.pdf.

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

---

Using both your textbook and at least one other peer-reviewed source, discuss the public choice theory or model. How does it relate to rivalness and excludability?

Performance Improvement Plan

Employee’s Name

Delores

Job Position

Director of Nursing

Position Roles and Responsibilities

As the director of nursing, you are responsible for managing and overseeing all functions of the facility’s nursing staff. You are also responsible for care services provided to all patients within the facility, including other administrative roles related to nursing care, such as supervision of nurses, and ensuring the nursing department has its set goals, objectives, policies, and roles clearly outlined. You are also expected to ensure that all department records are up-to-date and be constantly in touch with the nurses to determine and resolve any issues within nursing care. You are also expected to check on the nurses’ performance and ensure they meet the facility’s ethical and operational quality standards regarding patient care. Most importantly, you are responsible for maintaining a strict budget within the set limits of your department.

Date: 16 February 2023

Reason for Performance Improvement Plan

This performance improvement plan aims to define the issues in your current behavior as the facility’s director of nursing and provide you with an opportunity to address these behaviors, improve your work behavior, and meet the roles and responsibilities as a senior employee of the facility.

Situations and Concerns Identified in Your Work Behavior and Performance

As we had discussed in our previous meeting with you and the Human Resources manager, this PIP will allow you to improve the below situations and concerns about your roles and responsibilities:

Concern/Situation 1: You spent all your days in your office and did not make any environmental rounds.

Concern/Situation 2: You do not interact with Nursing or other staff members.

Concern/Situation 3: The following deficiencies have been identified in your nursing department from the annual NYSDOH survey: infection control, care planning, abuse and neglect, and medication administration.

Concern/Situation 4: The facility has received three complaint surveys related to serious patient incidents in the past month.

Concern/Situation 5: Your department’s overtime expenses exceeded $50,000 above the facility’s limit.

Performance Improvement Goals and Objectives

• Achieve daily and hourly environmental rounds and assess and do a situational analysis of the facility with full reports filled daily.
• Improved and reported interactions with the other nurses and employees within the facility.
• Improved interaction with the clients within the nursing home.
• Improved reporting on the safety of infection control, care planning, abuse and neglect, and medication administration.
• Reduction to net zero of severe patient incidents.
• Management of the nursing department’s budget and staff planning to reduce expenditure on overtime.

Action Items to Improve Work Behavior and Performance

For you to be able to achieve the above-listed goals and objectives of this PIP:

• You are expected to do daily and hourly environmental rounds and assess the situation within the facility. At the end of each day, you will expect to file a report with a full analysis of the facility’s situation.
• You are expected to interact daily with the nurses and other workers within the facility and make daily reports on the interactions and what issues you may have found. You will be required to commit a total of 3 hours a day to interact with the facility’s staff and other individuals within the facility.
• You are expected to interact with the clients within the nursing home and identify any issues with the care provided. A total of 2 hours are required to be committed to interacting with the clients, and a full report is filed with your assigned supervisor.
• You are expected to develop, implement, and report on progress on the safety of infection control, care planning, abuse and neglect management, and safety of medication administration.
• You are expected to develop and implement a program that will lead to a reduction to net zero of severe patient incidents within the next three months.
• You are expected to develop and implement a working duty rotation plan for all nurses to ensure the existing staff’s availability and efficiency to reduce overtime expenditure.

Resources and Support

As a leader, you are expected to develop an awareness of efficient resource allocation, especially intellectual capital, to improve performance and competitiveness (Alfiero et al., 2021). The facility will provide you with any resources needed for this PIP and throughout the PIP. Additionally, additional training, including outside resources and learning materials, will be available to support your improvement. You will also be trained in leadership skills to support your roles and improvement. A leader is expected to be strongly committed to achieving and facilitating breakthroughs in organizational performance (Ahn et al., 2021).

Expectations and Consequences

It is our best belief that you will be able to achieve the goals and objectives of this PIP and meet the improvement expectations. Failure to meet the expectations will lead to removal from your position, and we are awaiting committee confirmation for the full termination of your employment.

Action Plan with Timeline

You will be assessed every Friday at 4:30 PM with a full report expected at the end of the day for the next 90 days. Your progress will be fully reviewed on the fourth Friday of every month.

 

Employee’s Signature:

Supervisor’s Signature:

Management 1:

Management 2:

References

Ahn, C., Rundall, T. G., Shortell, S. M., Blodgett, J. C., & Reponen, E. (2021). Lean Management and Breakthrough Performance Improvement in Health Care. Quality Management in Health Care, 30(1), 6–12. https://doi.org/10.1097/QMH.0000000000000282

Alfiero, S., Brescia, V., & Bert, F. (2021). Intellectual capital-based performance improvement: a study in the healthcare sector. BMC Health Services Research 2021 21:1, 21(1), 1–15. https://doi.org/10.1186/S12913-021-06087-Y

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

---

Now that you have reviewed the notes provided and considered life experience, please respond to the following scenario: You are the CEO of a 300-bed Nursing Home in a small town in Westchester. Delores was hired 3 months ago as a Director of Nursing. The following situations have arisen since hire:
She stays in her office all day and doesn’t make environmental rounds.
She doesn’t interact with nursing staff or other staff members.
The nursing home completed an annual NYSDOH survey and received 12 deficiencies, which was way above the state average. Deficiencies included infection control, care planning, abuse and neglect, and medication administration.
The facility has received three complaint surveys related to serious patient incidents in the past month.
Overtime expenses have increased by $50,000.

You may want to terminate Delores. However, you have been advised by Human Resources to develop a performance improvement plan to assist her in becoming successful. In 3 months, you will re-evaluate her progress. Develop a carefully thought out performance improvement plan to address the issues identified as problematic.