Instructions

The purpose of this connection is to practice our paragraph writing, so we can make sure those paragraphs are strong when it is essay time.

For this activity, please review what you learned about PIE paragraph structure last week (you can go back to Week 2 module and review), and write a PIE paragraph. For the paragraph, choose one student from First Generation and argue whether or not that student has a fixed or growth mindset.

Here is a sample structure you may find helpful: PIE Structure for First Generation Paragraph.

Requirements:

• Your paragraph should be at least 300 words long.
• It should be formatted in Times New Roman/12 pt font and double spaced.
• It should have a Point, 2 pieces of Information and 2 pieces of explanation (see the structure example above).
• It should be formatted in MLA.

 

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What was Pablo Neruda’s most notable work? Which one do you prefer? Explain your answers in 300-500 words.

 

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this is a 8 page exploratory essay i dropped all the requirements in the bottom and i will also provide a example paper here in the note section. however it says on one of the papers i provided that one source must be a peer review from my library databases. this is the link for it right here. http://sks.sirs.com.proxy4.athensams.net/webapp/le…

another good search too bar that you can use is http://web.a.ebscohost.com/ehost/search/basic?vid=… it provides you with many sources

if you have any question email me at yasser.elmatari95@gmail.com i need this done latest by saturday. thank you

Grace K.

Professor Ganeshan

COM 102

–

008

13 November 2017

Exploratory Essay First Draft

About year and a half ago, my life changed completely when my fiancé decided to enlist

in the military. At the time, we had been together for just about four years and him deciding to

enlist was a total shock for me. In the years past, he talked about wan

ting to go to college to

pursue a career in video game programming; however, that completely changed when he spoke

to a United States Marines recruiter at our high school career fair. He started going to the

recruitment office close to his house to speak w

ith a recruiter about joining. As soon as he

expressed interest in possibly joining, his recruiter was determined to deter his mind away from

going to college and stress that he should join the Marines instead. I questioned this since he was

only eighteen

at the time and did not really have a clear idea of what he wanted to do with his

life. I felt like his recruiter was pushing him into making a decision that he was not totally sure

of. However, his recruiter’s job was to get him to enlist by whatever mean

s necessary, so that is

exactly what she did. On July 25th, 2016, my fiancé officially enlisted into the Marines and

hopped on a plane to head to three months of military boot camp at Marine Corps Recruit Depot,

San Diego. After he was gone I was left wond

ering, are eighteen year olds really mature enough

to make a decision that will greatly impact their lives and the people around them? This

experience has caused me to ask the question, should the United States military be allowed to

target teenagers in it

s recruitment efforts?

The first source I decided to look at was an academic journal I found in the library

databases. The journal title immediately caught my eye, so I figured that it would be a good

place to start. The article titled, “Should We End Mi

litary Recruiting in High Schools as a Matter

of Child Protection and Public Health?”, was written by Amy Hagopian and Kathy Barker. It

was published in

the

American Journal of Public Health

in January of 2011. Amy Hagopian has

her PhD and works in the Dep

artment of Global Health at the University of Washington.

Hagopian was also the president of the Garfield High School Parent Teacher Association from

2004 to 2006. Kathy Barker has her PhD as well and is a science writer. Along with Hagopian,

Barker is als

o on the board of the Garfield High School Parent Teacher Association in Seattle,

Washington. Considering these credentials, I knew these writers would be trustworthy sources of

information.

In this article, the authors start by explaining the public heal

th issues for young recruits.

Hagopian and Barker explain how “the bulk of newly enlisted military personnel are

developmentally in late adolescence

—

a time of relatively robust physical health but not

necessarily complete brain development or a wise tim

e to introduce high levels of stress” (19). It

is scientifically proven that a person’s brain is not fully developed until the age of twenty

–

five,

therefore, introducing eighteen year olds to this kind of stress can cause major problems. The

authors explai

n how high levels of stress can cause adolescents to be more likely to develop

mental disorders, like alcohol abuse, anxiety syndromes, depression, and post

–

traumatic stress

disorder. Studies have shown that “younger soldiers had 30% to 60% more substance

abuse

disorders than did older soldiers, and younger women in particular had the highest incidence of

attempted suicide or self

–

inflicted injuries” (19). This statistic presents a vital problem with

recruiting young people who are still maturing physically

and psychologically. The article also

talks about the efforts of the Garfield High School Parent Teacher Association. Hagopian and

Barker, along with other members of this association, tried to put a stop to military recruiting in

Garfield High School. On

ce the press got ahold of this news, the story spread like wildfire.

Ultimately, the Seattle school board worked with students and activists to come up with a

handful of rules to be put in place. The school board and these activists decided that “recruiter

visits were limited to one per semester, visits were to be announced in advance, and military

recruiters were no longer free to roam through the school building” (21). Although Garfield High

School worked hard to try and stop military recruiting, it is so

mething that can not be easily

avoided.

While reading this source, I was intrigued by the topics Hagopian and Barker brought up.

I am currently majoring in psychology, so all of the psychological aspects they brought up in this

article were ones that I wa

s familiar with. It is important to know that at eighteen a person is in

their peak stage of development and their brain is still maturing. I agree with the fact that

introducing high levels of stress to young people who are still maturing can cause proble

ms. The

statistics they put in the article about the rates of mental illnesses on young and old soldiers

definitely helps reinforce this belief as well. I appreciate how the authors took a stand in their

own community to try and warn Garfield High School a

bout the health issues that military

recruiting can have on young adolescents. Their efforts to try and ban military recruiting to keep

their students out of harm’s way was definitely inspirational to me.

Although I believe a lot of the important informa

tion shared in this article, there are some

points brought up that I question. I question the point Hagopian and Barker make about recruiters

being like predators. The authors explain how the behaviors of recruiters are remarkably similar

to those of child

predators who use “predatory grooming” to gain a child’s trust. While child

predators and recruiters may both use persuasion, I would not go as far to say that the words

should be used in conjunction. In my opinion, I feel like comparing the two terms is

a little far

fetched. Although recruiters do use persuasive measures to try and make people enlist, they are

not doing so in an illegal or abusive manner.

Overall, this source helped contribute many important ideas to my research question. I

learned more

about the health effects that can be caused by high stress environments at a young

age. Also, I was able to see statistics of how many young soldiers end up with mental health

issues, which was far more than that of the older soldiers. I enjoyed how the ar

ticle talked about

Garfield High School’s efforts to try and ban military recruiters from coming to their school. It

was interesting to see the outcome of a school who took a stand to make sure their students were

not being taken advantage of. For my next

source, I would like to look into more of the

psychological issues and health issues that can be caused by enlisting at such a young age when a

person’s brain is not completely developed.

Works Cited

Hagopian, Amy and Kathy Barker. “Should We End Mil

itary Recruiting in High Schools as a

Matter of Child Protection and Public Health?.”

American Journal of Public Health

, vol.

101, no. 1, Jan. 2011, pp. 19

–

23. EBSCOhost, doi:10.2105/AJPH.2009.183418.

 

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1. Discuss the reproduction of social class, using several examples to identify the structural

and institutional processes that support it. (3 points)

2. Discuss the poverty line, its origins, purpose, strengths, and weaknesses. (5 points)

3. Identify and discuss several means through which government influences the social class

experiences of American families. (2 points)

 

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Please respond to the discussions APA format with reference

DQ1

Nursing shortage has been a talked about issue for some time now and becomes increasingly urgent as baby boomers age and healthcare continues to become more complex and demanding. The Bureau of Labor Statistics stated that, “the RN workforce is expected to grow from 2.7 million in 2014 to 3.2 million in 2024, an increase of 439,300 or 16%” (Hogan, 2015). With the nursing staff shortage comes higher nurse to patient ratios, leaving an impact on both the staff and the patient experience and outcomes. Many studies have revealed the negative impact that this issue may result in. One study revealed that the more patients to one nurse, over 4 specifically, revealed a significant increase in readmission rates (AACN, 2017). Other studies have shown that this also leads to increased patient mortality rate, shorter hospital stays, and decreased infection rates. Overall, the high workload for nurses pose a risk to the patients, hindering them from being able to spend the time needed with each provide the high-quality care. Nursing is also experiencing high turnover rates and burnt out rates which are associated by the high stress increased even more by the work load due to staffing shortages. I know I have seen many nursing say they cannot do their job to the standard they want to due to not having the time and resources to fulfill their workload, as well as suffer from stress and fatigue associated with it.

There are some strategies put into place to work towards solving this issue. One focus has been on increasing the amount of education opportunities for the nursing career, funding for more nursing programs, increasing the student capacity, and nursing educators. Foundations such as the Institute of Medicine and RWJF have pushed nursing education to expand to higher degrees like bachelors and graduate programs, creating more opportunity and incentive to drive people to enter the field. Many health care facilities are trying to stress the importance of employee retention, working to enhance employee satisfaction.

References

American Association of Colleges of Nursing (AACN). Nursing Shortage Fact Sheet. Received from http://www.aacnnursing.org/News-Information/Fact-S…

DQ2

With regards to the nursing shortage there is a shown to be an increased level of mortality within given patient populations. Studies have shown that according to the American Association of Colleges (AAC) of Nursing, “According to a study published in the October 23/30, 2002 issue of the Journal of the American Medical Association, more nurses at the bedside could save thousands of patient lives each year. Nurse researchers at the University of Pennsylvania determined that patients who have common surgeries in hospitals with low nurse-to-patient ratios have an up to 31% increased chance of dying”. One way that the government is trying to help combat this problem is by passing legislation to help fund nursing schools and give support to staff and students. According to the ACC of Nursing (2018), “The Title VIII Nursing Workforce Reauthorization Act of 2017 (H.R. 959) provides critical support to nursing students, faculty, and programs, which ensures access to care across the continuum and in every community”. This passing could help provide support for many programs and help get students to the next level. This way we are able to replace the soon to be retiring work force of nurses over the next several years.

Reference:

ACC of Nursing. (2018, July 23). Policy & advocacy. Retrieved August 14, 2018, from American Association of Colleges of Nursing website: http://www.aacnnursing.org/Policy-Advocacy

ACC of Nursing. (n.d.). Impact of the nursing shortage on patient care. Retrieved August 14, 2018, from American Association of Colleges of Nursing website: http://www.aacnnursing.org/News-Information/Nursin…

DQ3

The nursing shortage is very much a reality as the “baby boomers” turn 60, the hospital census continues to grow due to ACA and healthcare is surviving the population into their advanced years. Supply and demand combined with the number of current nurses reaching retirement age is posing a severe problem for the future of nursing. “According to the National Council of State Boards of Nursing, 55% of the RN workforce is 50yrs or older” (American Association College of Nursing, 2017). By 2020, the nursing deficit will reach 285,000, which exceeds the shortage of the 1960’s (Buerhaus, 2008).

“The effects of the nursing shortage have been demonstrated by less than favorable outcomes in recent studies regarding patient safety, infection rates, failure to rescue, and mortality rates” (AACN, 2017). These facts are significant as they dispute the cost/base theory supported by hospital administration regarding a lean “nurse/patient matrix”. Another impact seen of the nursing shortage is the influence it has on new graduates entering the nursing profession. This is noted in areas such as decrease staffing which leads to insufficient orientation, lack of mentoring and a failure of support for the “new” staff nurses.

To resolve the nursing shortage, it is important for all parties vested, such as the state along with the health care industry to collectively focus on addressing this issue. Many of the states have adopted the Nurse Residency programs to help acclimate the new BSN nurses into the workforce of the hospital (AACN, 2017). These programs will help the hospital and the nursing community by providing longevity within the profession. Nursing leadership is instrumental in facilitating positive practice environments which enhances nurse retention and facilitates quality patient care. “Nursing leadership should also be at the forefront of evidence-based change with the ability to impact the work force and reduce turnover” (Twigg & McCullough, 2014).

Reference:

American Association of Colleges of Nursing. (2017, May 18). Nursing Shortage Fact Sheet. Retrieved from http://www.aacnnursing.org/News-Information/Fact-S…

Buerhaus, P. (2008, November 26). Current and Future State of the US Nursing Workforce. Retrieved from http://jamanetwork.com/journals/jama/article-abstr…

Twigg, D., & McCullough, K. (2014). Nurse retention: A review of strategies to create and enhance positive practice environments in clinical settings. International Journal of Nursing Studies, 51(1), 85-92. http://dx.doi.org/10.1016/j.ijnurstu.2013.05.015

DQ4

When I was a child I remember hearing about the shortage of nurses, and this is one of the reasons I decided to become a nurse. Forty years later the nursing shortage still exists, and it is projected to become worse as time passes. Turnover is a significant contribution to the nursing shortage, and the inability to retain nurses profoundly impacts patient care.

In 2014, Marshall University researchers completed a study to determine the root problems contributing to nursing turnover and the underlying factors driving the nursing shortage in the United States of America (Coustasse, Cox & Willis, 2014). The study determined several factors “explain the cause of the nursing turnover and the lack of available skilled nurses within the U.S.; job dissatisfaction, RN age increases, demographic changes in patients, insufficient staffing, recent turnover, and supervisor control” (Coustasse, Cox & Willis, 2014, p.1).

“High turnover rates are a growing problem for healthcare providers and is causing increased expenses and draining financial assets for every open position within a facility, with an estimated $10,000 to $60,000 cost per vacancy depending on the specificity of the nursing position” (Cleary & Rice, 2005). Cutting costs means we are sacrificing the care we provide to our patients. Purchasing cheaper equipment that is less reliable is sacrificial. Hiring fewer nurses to save money means higher nurse/patient ratios, and this can lead to missed diagnosis, healthcare acquired infections and workplace violence (Syed, L., Atif, B., Samreen, B., Zoya., & Saif, U., 2018).

Sadly, I often leave work wondering if I have done my best. I work on a renal, palliative and oncology unit. I am a resource nurse, but I also have a full patient module. I have had as many as 7 patients, run a unit of 28 patients, managed RRT’s and Code Blues and dealt with unhappy staff and patients all in one shift. Those are the days I ask myself, “why do I do this”? Those days are perfect examples of what leads to turnover. Cimiotti, Aiken, Sloane and Wu, summed it up perfectly: “Due to the decreased staffing of nurses, it is becoming more difficult for current active nurses to affectively provide quality patient care to their patients. If nurses are required to service more patients due to a lack of staffed nurses it has been shown to increase infection rates in hospitals” (Cimiotti, Aiken, Sloane, & Wu, 2012).

Studies indicate that turnover contributes to the nursing shortage but what are we doing about the issue? New Graduate Residency programs allow new nurses the opportunity to learn, grow and gain experience with a mentor. Nurse residency programs have been shown to improve retention through mentoring, education and experience (Ackerson & Stiles, 2018). Residency programs help new graduates find a position in an acute care environment. When I graduated from nursing school residency programs were not available. The only RN position I was able to find for the first two years of my career was in a long-term care facility. Out of 20 applications I filled out, 19 stated, “you do not have the required one year of experience”. A residency program allows new grads to bypass rejection due to lack of experience and obtain the experience in the environment they choose and enhances nurse retention at the same time.

Ackerson, K., & Stiles, K. (2018). Value of Nurse Residency Programs in Retaining New Graduate Nurses and Their Potential Effect on the Nursing Shortage. Retrieved from: https://doi.org/10.3928/00220124-20180517-09

Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nursing Staffing, Burnout, and Health Care-Associated Infection. American Journal of Infection Control, 40(6), 486490.

Coustasse, A., Cox, P., & Willis, W. (2014). The U.S. Nursing Shortage and Turnover Problem. Marshall University. Retrieved from: http://mds.marshall.edu/cgi/viewcontent.cgi?articl…

Cleary, B., & Rice, R. (2005). Nursing Workforce Development: Strategic State Initiatives. New York: Springer Publishing Company

Syed, L., Atif, B., Samreen, B., Zoya., & Saif, U. (2018) How Patient-Perpetrated Workplace Violence Leads to Turnover Intention Among Nurses: The Mediating Mechanism of Occupational Stress and Burnout, Journal of Aggression, Maltreatment & Trauma, 27:1, 96-118, DOI: 10.1080/10926771.2017.1410751

DQ5

One of the most predicted changes promised under healthcare reform is a greater allowance and accessibility to wellness and prevention programs. These programs have often been treated as a minimally important service of the insurance and provider industry. As more and more clinical studies are starting to disclose, many of the chronic conditions that require long term and acute care services can be prevented, managed, and even reversed through use of wellness and prevention programs. Florence Nightingale’s theory supports wellness by addressing the whole patient and affirming his or her positive qualities and strengths.

Nurses are the crucial interface between health care services and the lives and health of the people who are served by them. Nightingale, believed that nurses should work to prevent disease and care for healthy patients, with the same approach as caring for sick patients. With more than three million nurses in America, nursing has the capacity to provide wellness coaching where it is needed. The new focus on wellness and disease management will require the guidance of a profession that has always adapted to change. Nurses have an important role in educating patients. The most common theme about how nurses promote health is giving information about healthy lifestyles to patients with specific health conditions. Nursing education, nursing research, and nursing administration need to work together to make wellness a priority before nurses can value their role as wellness promoters.

Reference:

Benjamin, M. R. (2011). The National Prevention Strategy: Shifting The Nation’s Health-Care System. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC31853…

Strout, K. (2012). Wellness Promotion and the Institute of Medicine’s Future of Nursing Report: Are Nurses Ready? Retrieved from http://www.nursingcenter.com/journalarticle?Articl…

DQ6

According to Salmond & Echevarria (2017), “Factors driving healthcare transformation include fragmentation, access problems, unsustainable costs, suboptimal outcomes, and disparities. Cost and quality concerns along with changing social and disease-type demographics created the greatest urgency for the need for change”. While they look at the smaller picture, that being the costs of healthcare to the sick population, or those who cannot afford it. The larger picture is that if people take management over their health they are less likely to be sick. The goal of healthcare now is prevention. Taking care of the human condition before there is any illness. Also having fully informed patients who understand how disease processes work they are less likely to utilize emergency services or have smaller hospital stays. Where nursing fit into this change is where they always have as the patient’s advocate and educator. The nurse needs to teach the patient everything they need to know whether it is about a test, scan, disease process, and medications. The nurse needs to make sure that their patient is as well informed as possible and understands what is going on in their own care. This is primarily why now nurses are required to give handoff report at the bedside and let the patient be involved. By having nurses educate patients and give patients the resources to be successful the initiative to move healthcare to be more of wellness and prevention could be successful.

Reference:

Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic Nursing, 36(1), 12-25. https://doi.org/10.1097/NOR.0000000000000308

 

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