Lecture 4: RN, SW, HA, and Decision Making

Question 1

What are the three main roles of a nurse?

Answer 1

1. care for patients, educate patients, provide advice and emotional support to patients and families
2. Record medical histories/symptoms, administer treatments and medications
3. Teach about illnesses, explain post-treatment home care needs

Question 2

What are the different levels of education for nursing techs, LPN/LVN, RN?

Answer 2

1. Nursing attendant/tech: certificates for hospital training programs (under 1 year)
2. LPN/LVN: 1 year of training in a technical school or community college
3. RN: AA diploma or bachelor degree (only one that’s considered professional nursing)
4. Nurse practitioners, midwives, nurse anesthetists, clinical nurse specialists: train 1-2 years beyond the baccalaureate level and attain master’s degree

Question 3

What is the common requirement for nurses in all states?

Answer 3

They must graduate from an approved program and pass the NCLEX-RN (national licensing exam)

Question 4

What is the role of a nurse practicioner?

Answer 4

They act in the same way as a PCP and have prescribing privileges that are derived from the physician they are working with

Question 5

What is the role of a DNP (Nurse doctorate-practice focus)?

Answer 5

DNP’s have more leadership and administrative roles

Question 6

What are the three main values of nursing?

Answer 6

1. patient care and advocacy
2. optimizing the patient’s experience of illness and health care
3. focusing on care opposed to the physician’s focus on cure

Question 7

What are qualities that nurses should possess?

Answer 7

detail orientation, compassion, critical thinking, patience, compassion, speaking skills

Question 8

What O*NET category to nurses fall under?

Answer 8

Social interest

Question 9

What fields do healthcare social workers work in?

Answer 9

Substance abuse, mental health, gerontology, hospice, and palliative care

Question 10

What are the main three roles of a social worker?

Answer 10

1. Provide psychosocial support needed to cope with illness
2. Help with payment arrangements and locating long-term care or residential placements for people with disabilities or the elderly
3. Advise family care givers, provide patient education and counseling, and make referrals for other services (housing, hospice, transportation, home health, security)

Question 11

What is the education required to become a social worker?

Answer 11

• bachelor’s degree in social work
• master’s degree usually required for clinical social workers
• licensure varies from state to state

Question 12

What are the two main values of social workers?

Answer 12

1. value attention to psychological response to illness and social context of illness, emphasize improving mental health, remain attentive through whole experience of illness
2. mindful of place of the patient in respect to societal, legal, and governmental rules

Question 13

What qualities should a social worker possess?

Answer 13

compassion, listening skills, people skills, time-management, organizational, problem-solving skills

Question 14

What O*NET category to social workers fall under?

Answer 14

Social

Question 15

What are the two main roles of health administrators?

Answer 15

1. Lead and manage healthcare organizations
2. Set and monitor organizational strategy, monitoring performance of organization, implementing business functions of finance, human resource management, information management, marketing, and environmental management

Question 16

What is the educational requirement to be an HCA?

Answer 16

• MHA, MPH or MBA in standard credential

- to become a head of a department may need a degree in the appropriate clinical field and required work experience

Question 17

What are the three main values for Health Administrators?

Answer 17

1. have a systems view of their work (attention to micro-level decisions on the larger organization)
2. comfortable working in a chain of command and value interpersonal skill and organizational political skill
3. practical, look for solutions that work

Question 18

What is the primary interest of healthcare administrators on O*NET?

Answer 18

Enterprising

Question 19

What are recent changes in roles taking place in healthcare?

Answer 19

• physicians no longer the only dominant figures in healthcare
• nurses able to take more assertive roles through increasing educational opportunities
• pharmacists able to carry out medicational therapy management previously restricted only to physicians

Question 20

What motivation forms alliances between nurses and physicians vs. social workers, pharmacists and administrators?

Answer 20

an emphasis on patient care considerations from nurses and physicians vs. cost considerations from social workers, pharmacists and administrators

Question 21

What issue forms alliances between nurses and social workers vs. physicians, pharmacists and administrators?

Answer 21

Nurses and social workers see themselves as attending to the person rather than the disease

Question 22

What issue forms alliances between pharmacists and physicians vs. nurses and social workers?

Answer 22

Pharmacists and physicians place a greater importance on the timely administration of drugs

Question 23

What issue forms alliances between social workers and administrators vs. nurses, physicians, and pharmacists?

Answer 23

Social workers and administrators place a greater emphasis on community and population health concerns and resources.

Question 24

Which professions conflict on focusing on the patient experience vs. focus on the disease?

Answer 24

Nurses vs. physicians

Question 25

Which professions conflict on who has greater expertise in prescribing drugs?

Answer 25

Physicians vs. pharmacists

Question 26

Which professions conflict on having a greater breadth of community interventions?

Answer 26

Social workers vs. nurses

Question 27

Which professions conflict on resource constraints?

Answer 27

Administrators vs. physicians/nurses

Question 28

What is quality healthcare defined as?

Answer 28

(2001): “health care should be safe, effective, patient-centered, timely, efficient and equitable”

Question 29

What defines patient-centered care?

Answer 29

Satisfying patient’s needs along with their wants; care defined by patients’ interests as defined by them not by the professional provider

Question 30

What paradigm shift occurred concerning patient-centered care?

Answer 30

• moving away from paternalistic medicine

- recognizing the autonomy, dignity, sensibility, and self-awareness of the individual patient

Question 31

What are the three primary strategies in patient decision making?

Answer 31

1. paternalism by permission
2. partnership
3. patient in charge

Question 32

What is paternalism by permission?

Answer 32

Patient asks someone else to make decisions on their behalf; deferring decision to another family member or to a provider
Ex. Engaging a surrogate to act on behalf of patient

Question 33

What is an example of paternalism by permission by a physician?

Answer 33

If pt cedes decision making to physician, physician talks to patient and gains understanding of patient values and goals, then handles course of action accordingly

Question 34

What is patient autonomy?

Answer 34

The right of the patient to make decision about their medical care without their health care provider trying to influence the decision

Question 35

What are main factors in patient-physician partner decision making?

Answer 35

• patient participates in care but is not in charge
• provider provides treatment options that are consistent with patient’s values and goals
• frequent discussion on risks and benefits
• patient genuinely works with providers in making decisions
• both patient and provider maintain veto power

Question 36

What are the main aspects of the patient in charge model?

Answer 36

• patient wishes to make decision themselves after being properly informed
• involves discussion with professionals but only patient makes definite decision
• no shared decision making
• healthcare professional is not obliged to do what a patient dictates
• healthcare professional retains veto

Question 37

What is an example of a patient in charge?

Answer 37

A patient who makes decisions by themselves and seeks no input on their choices from healthcare professionals beyond scientific facts