assignment 7 advanced health assessment

Assignment:After having read the websites cited in the introduction and
other relevant references, write an essay of 1500 to 2000 words in APA style
with at least two references, on the following case study:A victim of interpersonal violence presents to you as a patient,
wanting help to be safe. Describe the case from the victim’s viewpoint, as though you
interviewed the patient to lay a foundation for the intervention. Then discuss how you
would intervene—what education would you give the patient and from what sources?
How would you follow up to see that your patient was safe?
How would you deal with the moral distress that you feel if you cannot do
anything to help or if your patient is later injured?
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Telling Amy’s Story: A Case Study in Domestic Violence
SCIENCE
SC
Four years after Amy Homan McGee first fell in love with her husband, he killed her while her children
waited for her outside their home.
“Someone call 911. I just shot Amy,” said Vincent McGee, as he stumbled out the door, but she was
already dead. She was 33.
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Their love affair started in 1997 in State College, Pennsylvania, where she worked in a home store; he
drove the armored truck that picked up money from the shop. And shortly after they met, they had
their first son.
Before they had a child, McGee started driving her to work and picking her up every day. He called the
store incessantly. He checked her schedule to make sure she wasn’t working alone with men. Then
there were the bruises that came from “softballs” and “falling boxes.”
But there was no way to connect the dots at the time. Amy’s co-workers noticed strange behavior,
going so far as to draft a fake schedule to throw McGee off track. Amy’s parents drove her to the police
station to get a protection order. But the incidents seemed disjointed, and no one realized that it would
lead to murder.
Until Detective Deidri Fishel came along, albeit after the fact, and made a documentary about Amy’s
experience. Fishel took Amy’s story and turned it into a cohesive timeline that clearly showed the
danger signs in Amy’s abusive relationship—and more important, the number of times that police or
other services could have intervened. Something that seems so obvious in hindsight wasn’t when Amy
was in the depths of it.
Fishel now uses this story, which was funded by the Verizon Foundation, to train others to detect and
help women who are being beaten.
Fishel brought Amy’s story to New York City last night to kick off “It’s Time to Talk Day,” a day started
by Liz Claiborne to help raise awareness about domestic violence, emphasizing that it is far more
prevalent than most think.
Hosted by Meredith Vieira of the Today show, the night began with a revelation of Vieira’s own.
“I know what it’s like to be beaten. I’ve probably avoided talking about it because it’s embarrassing,”
said Vieira. “I’m an intelligent woman. How could I get in that situation?”
That seems to be the question on most people’s minds about domestic violence. Why didn’t she leave?
The question irks domestic-abuse advocates to no end.
“‘Why doesn’t she leave?’ needs to be ‘why does he beat her?’” said Fishel. “You can’t put the burden on
the victim.”
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At times, it seemed that Amy herself was the only person who could pull it all together and make a
change. But between their deeply intertwined lives and the sheer terror, she was in no place to take on
that burden, even if it was hers to begin with.
And the terror, as it turns out, was founded. Vincent killed her when she went home to gather her
things for the final time.
“I know what it’s like to be beaten. I’ve probably avoided talking about it because it’s embarrassing,”
said Meredith Vieira.
Three of four people know someone who has been a victim of domestic abuse (whether they know it or
not), suggesting that there’s a missing link somewhere when it comes to intervention.
Fishel had just become a detective when she came across Amy’s story and decided to use it as a case
study. Amy had been murdered three years prior, but her story struck a chord in Fishel. They were
both in their early thirties when Amy was killed. They both had a young son at the time. And Fishel has
two sisters who were abused.
“This could literally have been me,” said Fishel.
Telling Amy’s Story, which was created by Penn State Public Broadcasting, was funded by the Verizon
Foundation, which trains its employees in domestic-violence awareness, and has programs for victims,
much like Liz Claiborne Inc., which started its program in 1991.
Roja Heydarpour is an editor at The Daily Beast. She has reported for the The New York Times and
The Times-Tribune.
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Trump Rage-Tweets That Michael Cohen Won’t Snitch on Him.
Privately, He Tells Folks: ‘We’ll See.’
President Donald Trump woke up on Saturday morning at his Florida estate and club Mar-a-Lago. His
wife, First Lady Melania Trump, was preparing to attend the Texas memorial service for Barbara Bush,
the recently departed matriarch of the Bush political dynasty. And there was nothing pressing—in fact,
nothing at all—on his own public schedule.
So Trump went golfing. But on his way to Trump International Golf Club in suburban West Palm
Beach, he checked his phone first, looking down into the device as he sat in the back of his motorcade.
And then, as is his want, he rage-tweeted.
“The New York Times and a third rate reporter named Maggie Haberman, known as a Crooked H
flunkie who I don’t speak to and have nothing to do with, are going out of their way to destroy Michael
Cohen and his relationship with me in the hope that he will ‘flip,’” President Trump posted to Twitter.
“They use……..non-existent ‘sources’ and a drunk/drugged up loser who hates Michael, a fine person
with a wonderful family. Michael is a businessman for his own account/lawyer who I have always liked
& respected.”
Two Trump associates and one White House official who The Daily Beast asked about these Saturday
morning posts all deduced, based on interactions with the president, that the “drunk/drugged up loser
who hates Michael” to whom Trump referred was Sam Nunberg, a former political adviser and aide
who was prominently quoted in the recent Times article that irked the president. Nunberg did not
respond to inquiries from The Daily Beast. Neither did the White House press shop.
President Trump concluded his tirade by tweeting, “Most people will flip if the Government lets them
out of trouble, even if……..it means lying or making up stories. Sorry, I don’t see Michael doing that
despite the horrible Witch Hunt and the dishonest media!”
While public outbursts are hardly new for this president, the one that took place on Saturday was
uniquely loaded in its legal and political implications. The tweets may have been directed at
Haberman. But their intended audience was largely Cohen.
Trump’s personal attorney and notorious fixer finds himself in legal crosshairs after his office and
residence were raided by the feds. And over the past week, there have been several reports that close
Trump allies and senior White House aides are actively concerned about, and trying to game out, what
to do if Cohen flips.
Jay Goldberg, one of Trump’s longtime legal advisers, even told The Wall Street Journal that he spoke
with the president in recent days about Cohen and specifically cautioned Trump about putting his
trust in Cohen to stay loyal if there are criminal charges.
Three different officials and associates in Trumpworld independently expressed worry to The Daily
Beast this month that Cohen could quickly become just another “snitch.”
The premise that there is something to “snitch” about was simply taken for granted. And it’s infused
public commentary about the issue too.
“Is [Michael Cohen] wilting under the feds’ pressure tactics? Why is he giving [interviews] to news
outlets hostile to @realDonaldTrump? We address that & much more—10p ET @FoxNews,” host
Laura Ingraham—a close ally to the Trump family who interviewed for the job of Trump’s White
House press secretary—tweeted on April 10.
Multiple sources who have spoken with Trump about this insisted to The Daily Beast in recent days
that the president is not completely losing his faith in Cohen’s loyalty. At least not yet.
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In private conversations, Trump has emphasized his deep annoyance and fury over federal
investigators and authorities who he believes have gone beyond the pale in probing his inner circle, his
business empire, and his family. When it comes to how Cohen will stand up—or fall down—under
pressure, several people close to President Trump have noticed him uttering a familiar refrain and
vocal tic: “We’ll see.”
Cohen, for his part, has long held himself out as an unbreakable ally to the president, even though
there are numerous questions about how the president treats and feels about him.
“I’d rather jump out of a building than turn on Donald Trump,” Cohen reportedly said earlier this
month.
Those close to the president—as well as, and perhaps especially, the president himself—are watching
closely to see how strongly that statement holds.
“How tall is the building?” one senior White House official asked.
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Page 1 of 3
Overview
Incivility, bullying and violence is rampant in the culture of nursing. This module will examine incivility and
violence in the home and workplace, and its effect on nurses and patients.
Provision One of the American Nurses Association (ANA) Code of Ethics stated : “The nurse, in all professional
relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every
individual, unrestricted by considerations of social and economic status, personal attributes, or the nature of
health problems (Fowler, 2013, p. 1).” What does this mean to you? What does this mean to our profession of
nursing? If this is the first tenet in the nursing Code of Ethics, why is incivility so rampant in nursing venues
today?
Incivility in the health care venues was so rampant that the Joint Commission issued a Sentinel Event alert,
requiring every health care venue they accredit to have mechanisms in place to stop the incivility. Read the
Joint Commission’s Sentinel Event Alert Number 40
at http://www.jointcommission.org/sentinel_event_alert_issue_40_behaviors_that_undermine_a_culture_of_safet
How does incivility in the workplace affect the culture of nursing and the delivery of care to the patients who
depend on us? If you have experienced incivility in your workplace, how did it affect patient outcomes, staff
retention, and your loyalty to the workplace? Read Stokowski’s article
athttp://www.medscape.com/viewarticle/739328 and think about where your workplace is on the incivility line.
Do managers seem aware of bullying and incivility in your workplace?
Incivility is not limited to the clinical setting. It is also present in nursing academia. Read this
article http://www.nsna.org/portals/0/skins/nsna/pdf/imprint_aprmay08_feat_incivility.pdf
Then, ask yourself if you have ever been incivil in the academic setting or tolerated incivility when you saw it,
Students are another vulnerable population that need to have role models of appropriate professional behavior.
Faculty also are often bullied by students or other faculty which leads to a very hostile work environment. What
mechanisms should be in place to change this culture? The ANA discusses the moral distress in modern
nursing academia at http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Courage-andDistress/Moral-Distress-in-Academia.html
Do you think that this moral distress comes from incivility in the workplace? Do you think that this might have
contributed to the faculty shortage and to students leaving nursing as a major of study? Do incivil educators
then actually teach through example new nursing graduates to be incivil in the workplace?
On an individual level, are you contributing to an incivil environment at work or at home?
Readhttp://www.theamericannurse.org/index.php/2014/02/27/toward-civility/ and determine how you plan to
change the workplace or home to make a difference.
However, you do not have control over all environments, including where your patients live. Why do you think
interpersonal or domestic violence is so common? “Interpersonal violence and abuse refers to violence and
abuse that occurs between people who know each other. It can occur within or outside a family setting.
https://classroom.aspen.edu/content/enforced/30922-N495-DP8-03-06-18/Module%20Eig…
4/21/2018
Page 2 of 3
Violence is when there is an unlawful exercise of physical force that may result in criminal charges or physical
and/or sexual abuse. Abuse is when someone in a caring relationship does or says things to gain control over
another person by hurting that person or causing feelings such as fear, anxiety, nervousness, guilt,
helplessness or worthlessness” (Government of Saskatchewan, n.d.). Read the World Health Organization
statement on violence
at http://www.who.int/violence_injury_prevention/violence/interpersonal/ipv2/en/index3.html
Determine what you can do to decrease interpersonal violence in your community. Do you know what
resources are available in your community? For some ideas of how to help in your community,
see http://us.reachout.com/facts/factsheet/interpersonal-violence/
The activities in this module require that you read these materials and reflect on your role in decreasing
incivility.
References
• American Nurses Association. (2015). Toward civility: ANA, nurses promote strategies to prevent
•
•
•
•
•
•
•
•
disruptive behaviors. The American Nurse.Retrieved from
http://www.theamericannurse.org/index.php/2014/02/27/toward-civility/
Fowler, M. D. M. (2013). Guide to the Code of Ethics for nurses (7th ed.). Silver Spring, MD: American
Nurses Association.
Ganske, K. Moral distress in academia. Retrieved
from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Courage-and-Distress/MoralDistress-in-Academia.html
Government of Saskatchewan. Definition of interpersonal violence and abuse. Retrieved
from http://www.justice.gov.sk.ca/DIVA
Luparell, S. (2011). Incivility in nursing education: Let’s put an end to it. Retrieved
from http://www.nsna.org/portals/0/skins/nsna/pdf/imprint_aprmay08_feat_incivility.pdf
Reach Out. (n.d.). What is interpersonal violence? Retrieved from
http://us.reachout.com/facts/factsheet/interpersonal-violence/
Stokowski, L. A. (2011). The downward spiral in nursing: Incivility in nursing. Retrieved
from
http://www.medscape.com/viewarticle/739328
The Joint Commission. (2008). Sentinel event alert, issue 40: Behaviors that undermine a culture
of safety. Retrieved
from http://www.jointcommission.org/sentinel_event_alert_issue_40_behaviors_that_undermine_a_cultu
World Health Organization. (n.d.). Injuries and violence prevention. Retrieved
from http://www.who.int/violence_injury_prevention/violence/interpersonal/ipv2/en/index3.html
Goals
After completing this module, you will be able to do the following:
• Discuss incivility in the nursing workplace and patient homes
• Describe interventions to reduce incivility in the workplace and home
Learning Materials:
Online articles:
• Ganske, K. Moral distress in academia. Retrieved
from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Courage-and-Distress/MoralDistress-in-Academia.html
https://classroom.aspen.edu/content/enforced/30922-N495-DP8-03-06-18/Module%20Eig…
4/21/2018
Page 3 of 3
• Government of Saskatchewan. Definition of interpersonal violence and abuse. Retrieved
from
http://www.justice.gov.sk.ca/DIVA
• Luparell, S. (2011). Incivility in nursing education: Let’s put an end to it. Retrieved
from http://www.nsna.org/portals/0/skins/nsna/pdf/imprint_aprmay08_feat_incivility.pdf
• Reach Out. (n.d.). What is interpersonal violence? Retrieved
from http://us.reachout.com/facts/factsheet/interpersonal-violence/
• Stokowski, L. A. (2011). The downward spiral in nursing: Incivility in nursing. Retrieved
from http://www.medscape.com/viewarticle/739328
• The Joint Commission. (2008). Sentinel event alert, issue 40: Behaviors that undermine a culture of
safety. Retrieved
from http://www.jointcommission.org/sentinel_event_alert_issue_40_behaviors_that_undermine_a_culture
• World Health Organization. (n.d.). Injuries and violence prevention. Retrieved
from http://www.who.int/violence_injury_prevention/violence/interpersonal/ipv2/en/index3.html
https://classroom.aspen.edu/content/enforced/30922-N495-DP8-03-06-18/Module%20Eig…
4/21/2018

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