Category: Questions

Group Dynamics and Teams

We will continue our experiential approach to the study of Organizational Behavior by engaging in a personal applied case on the topic of group dynamics and teams. As in Module 1, use the following outline to structure your 4- to 6-page paper. You may use the subtitles as headings for your paper.

Introduction: Discuss the topic of the paper and how you will approach it. It is best to write this section after you have written the rest of the paper.

Concrete Experience: Begin with a specific situation/event. Describe an experience with a group or team that was meaningful to you. It may have been an extraordinarily good experience – or it may have been an experience that did not work out very well at all! The important point is that it should be an experience which you would like to understand better. Be objective and focus on just the facts: who, what, where, when, and how – as if you were composing a newspaper article.

Reflective Observation: Reflect upon that experience from multiple perspectives of persons involved or affected in the experience. Step back from the situation, look at the experience from your own viewpoint, and from the perspective of all other parties involved or affected. You want to look at the circumstances surrounding the experience from every relevant point of view. Why did you behave the way that you did? Why did others behave the way that they did? Did others have the same positive (or negative) experience? Explain. (Note: your discussion of theories and models from your module materials belongs in the following section.)

Abstract Conceptualization: (This Abstract Conceptualization section is the “heart” of your paper.) Use critical thinking skills to understand and interpret the experience at a deeper, more generalizable level. Interpret and understand the events you have described by drawing on the concepts, theories, and models in the background material from this module. Explain how they apply to your experience. For example, what behavior patterns can you identify in yourself and others that are similar to the ones described in the material on communication, teams, and conflict management? Does the model of Force Field Analysis (home page) help you better understand why people behaved the way they did? Be sure to apply at least three concepts, theories, and/or models and cite all references to concepts, ideas, and/or quotes that you use from any outside source.

Active Experimentation: Identify ways to respond to the next occurrence of a similar experience. What have you learned about the way groups work from this analysis? What have you learned from your mistakes? How are you going to put what you have learned to use? What actions will you take to build more effective work teams in your job?

Conclusion: Sum up the main points of your analysis and the key learning you are taking from it.

Reference List: List all references that you have cited in the paper using APA formatting. References include materials from the required background readings as well as any outside internet or library sources you used in researching and writing your paper. If you have APA questions, refer to the optional listings on the background page.

Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1 page)

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision Point One
Select what you should do:

Zolpidem: 10 mg daily at bedtime

Trazodone 50 mg po at bedtime

Hydroxyzine: 50 mg daily at bedtime.  

Decision Point One

Trazodone 50 mg po at bedtime
RESULTS OF DECISION POINT ONE
• Patient returns to clinic in 2 weeks
• Patient states medication works well but gives him an unpleasant side effect of an erection lasting approximately 15 minutes after waking
• Patient states this makes it difficult to get ready for work or go downstairs and have coffee with his girlfriend and daughter in the morning
• Patient denies auditory/visual hallucinations and is future oriented

Decision Point One

Trazodone 50 mg po at bedtime
RESULTS OF DECISION POINT ONE
• Patient returns to clinic in 2 weeks
• Patient states medication works well but gives him an unpleasant side effect of an erection lasting approximately 15 minutes after waking
• Patient states this makes it difficult to get ready for work or go downstairs and have coffee with his girlfriend and daughter in the morning
• Patient denies auditory/visual hallucinations and is future oriented
Decision Point Two
Select what you should do next:

Explain that an erection lasting 15 minutes is not considered a priapism and should diminish over time, continue with current dose

Discontinue trazodone. Initiate therapy with suvorexant 10 mg daily at bedtime

Decrease trazodone to 25 mg daily at bedtime.  
Decision Point Two

Decrease trazodone to 25 mg daily at bedtime

RESULTS OF DECISION POINT TWO
• Patient returns to clinic in 2 weeks
• Patient states trazodone is very effective for sleep
• Patient states sometimes the 25 mg dosage isn’t quite enough to help him sleep through the night
• Patient denies auditory/visual hallucinations and is future oriented

Decision Point Three
Select what you should do next:

Discontinue trazodone. Initiate therapy with ramelteon 8 mg nightly at bedtime. Follow up in 4 weeks

Continue dose. Encourage sleep hygiene. Follow up in 4 weeks

Discontinue trazodone. Initiate therapy with hydroxyzine 50 mg nightly at bedtime. Follow up in 4 weeks

Decision Point Three

Continue dose. Encourage sleep hygiene. Follow up in 4 weeks

Guidance to Student

Since the patient is already showing a partial response from trazodone, it may not be prudent to switch therapy. A thorough sleep hygiene analysis should always be performed prior to initiation of pharmacotherapy as well as at reassessments. If you find the patient isn’t practicing proper sleep hygiene, you may continue the dose and encourage sleep hygiene. If the patient is practicing good sleep hygiene, you may consider discontinuing trazodone and initiating hydroxyzine. Although there are some negative side effects associated with hydroxyzine such as Xerostomia and Xerophthalmia, it is still a safer medication to prescribe than ramelteon.

As a psychiatric nurse practitioner, you will likely encounter patients who suffer from various mental health disorders. Not surprisingly, ensuring that your patients have the appropriate psychopharmacologic treatments will be essential for their overall health and well-being. The psychopharmacologic treatments you might recommend for patients may have potential impacts on other mental health conditions and, therefore, require additional consideration for positive patient outcomes. For this Assignment, you will review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.

Photo Credit: Getty Images/Collection Mix: Sub

To Prepare
Review the Learning Resources for this week.
Reflect on the psychopharmacologic treatments that you have covered up to this point that may be available to treat patients with mental health disorders.
Consider the potential effects these psychopharmacologic treatments may have on co-existing mental health conditions and/or their potential effects on your patient’s overall health.
To complete:
Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.

1. Mental health stigma is negatively judging someone and discriminating against them for having a mental illness. It is a barrier to people with mental illness in seeking help for their problem, because of the shame and embarrassment they feel if they do. We all need to stop the stigma of mental illness. Read the information at the National Alliance on mental Illness site below. Go to our discussion board and post an example of the stigma of mental illness that you have had or seen toward someone else. If you have not seen this, make up an example. Also, list 2 actions you can do to reduce stigma in our society. Post on discussion by midnight January 21. A minimum of one paragraph for the example and another paragraph for the actions. (Don’t forget to do the second part of Lesson 1 assignment at the bottom of Lesson 1 module. It is worth 25 points, also)

9 Ways to Fight Mental Health Stigma | NAMI: National Alliance on Mental Illness
Every day, in every possible way, we need to stand up to stigma. If you’re not sure how, here are some ways our Facebook community responded to the question: “How do you fight stigma?”

In this file “Magic Foods Pattern Recognition Data (Student).xls” you will see these variables in the Data tab of the file: (I will attach excel file to this order)

No. of Shops (in hundred) No. of Dealers (in hundred) No. of Popular Brands Population (in thousands) Sales (in $millions).

You will also see two correlations between sales and population and sales and stores with interpretations that have already been done for you. Use the Excel file to generate correlations, R-squared values, and scatter diagrams

To generate correlations, use:

(Excel > Data Analysis > Correlation OR Excel > Formulas > More Functions > Statistical > CORREL).

To generate scatter diagrams, use:

Excel> Insert > Scatter (Diagrams).

Please calculate the remaining correlations and construct scatter diagrams for the remaining variables. In this exercise, our dependent variable (that we want to predict) is sales. The other variables are considered independent, or predictors.

You will also see two other tabs with scatter plots for Sales v Population and Sales v Stores that have been done for you as an example.

When we look at scatterplot, we should be able to describe the association we see between the variables. A quick description of the association in a scatterplot should always include a description of the form, direction, and strength of the association, along with the presence of any outliers.

Form: Is the association linear (more or less a straight line) or nonlinear?
Direction: Is the association positive or negative?
Strength: Does the association appear to be strong, moderately strong, or weak?
Outliers: Do there appear to be any data points that are unusually far away from the general pattern?
It’s also important to include the context of the two variables in the description of these features.

Follow the instructions in the Individual Case Study Instructions New.docx ( I will attach to this order)

In your report, make sure you explain each scatter diagram (Excel > Insert > Charts > Scatter), each correlation (Excel > Formulas > More Functions > Statistical > CORREL), and interpret your r values (correlation coefficients). Also in your report, make a recommendation as to which of the independent variables you would focus on to increase sales.

Insomnia is one of the most common medical conditions you will encounter as a PNP. Insomnia is a common symptom of many mental illnesses, including anxiety, depression, schizophrenia, and ADHD (Abbott, 2016). Various studies have demonstrated the bidirectional relationship between insomnia and mental illness. In fact, about 50% of adults with insomnia have a mental health problem, while up to 90% of adults with depression experience sleep problems (Abbott, 2016). Due to the interconnected psychopathology, it is important that you, as the PNP, understand the importance of the effects some psychopharmacologic treatments may have on a patient’s mental health illness and their sleep patterns. Therefore, it is important that you understand and reflect on the evidence-based research in developing treatment plans to recommend proper sleep practices to your patients as well as recommend appropriate psychopharmacologic treatments for optimal health and well-being.
Reference: Abbott, J. (2016). What’s the link between insomnia and mental illness? Health. https://www.sciencealert.com/what-exactly-is-the-link-between-insomnia-and-mental-illness#:~:text=Sleep%20problems%20such%20as%20insomnia%20are%20a%20common,bipolar%20disorder%2C%20and%20attention%20deficit%20hyperactivity%20disorder%20%28ADHD%29

For this Discussion, review the case Learning Resources and the case study excerpt presented. Reflect on the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat the patient’s health needs.  

Case: An elderly widow who just lost her spouse. 

Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications: 

Metformin 500mg BID 
Januvia 100mg daily 
Losartan 100mg daily 
HCTZ 25mg daily 
Sertraline 100mg daily 
Current weight: 88 kg

Current height: 64 inches

Temp: 98.6 degrees F

BP: 132/86 

By Day 3 of Week 7
Post a response to each of the following:

List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions. 
Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why. 
Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used. 
List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why. 
List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other. 
For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on ethical prescribing or decision-making. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals based on ethical prescribing guidelines or decision-making?
Include any “check points” (i.e., follow-up data at Week 4, 8, 12, etc.), and indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen.

Case Scenario

BACKGROUND
The client is a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an “arranged” marriage (her husband was selected for her when she was 9 years old). She presents following a 21-day hospitalization for what was diagnosed as “brief psychotic disorder.” She was given this diagnosis as her symptoms have persisted for less than 1 month.
Prior to admission, she was reporting visions of Allah, and over the course of a week, she believed that she was the prophet Mohammad. She believed that she would deliver the world from sin. Her husband became concerned about her behavior to the point that he was afraid of leaving their 4 children with her. One evening, she was “out of control,” which resulted in his calling the police and her subsequent admission to an inpatient psych unit.
During today’s assessment, she appears quite calm and insists that the entire incident was “blown out of proportion.” She denies that she believed herself to be the prophet Mohammad and states that her husband was just out to get her because he never loved her and wanted an “American wife” instead of her. She says she knows this because the television is telling her so.
She currently weighs 140 lbs., and she is 5’ 5.

SUBJECTIVE
Client reports that her mood is “good.” She denies auditory/visual hallucinations but believes that the television talks to her. She believes that Allah sends her messages through the TV. At times throughout the clinical interview, she becomes hostile towards you but then calms down.
A review of her hospital records shows that she received a medical workup from a physician, who reported her to be in overall good health. Lab studies were all within normal limits.
Client admits that she was tolerating her Risperdal well but stopped taking about a week after she got out of the hospital because she thinks her husband is going to poison her so that he can marry an American woman.

MENTAL STATUS EXAM
The client is alert and oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is slow and, at times, interrupted by periods of silence. Self-reported mood is euthymic. Affect is constricted. Although the client denies visual or auditory hallucinations, she appears to be “listening” to something. Delusional and paranoid thought processes as described above. Insight and judgment are impaired. She is currently denying suicidal or homicidal ideation.
You administer the PANSS which reveals the following scores:
-40 for the positive symptoms scale
-20 for the negative symptom scale
-60 for general psychopathology scale
Diagnosis: Schizophrenia, paranoid type

For this Competency Assessment, you will respond to the following prompts based on the case study that is related to a particular health issue: HIV partner notification.
Scenario: You are a nurse in the surgical unit of a large metropolitan hospital. A young woman has been admitted for an ovarian cyst removal later the same day. As you are taking her health history, she reveals that she has recently been diagnosed as HIV positive. In response to a query from you, she acknowledges that she has not yet seen a healthcare provider regarding this diagnosis. She also quickly adds that she hasn’t disclosed this condition to her new boyfriend, who is in the waiting room, or to any other family members or friends.
Respond to the questions below from your perspective as the nurse providing care for this patient. Support your thoughts and ideas with appropriate citation of scholarly references.
With this patient’s right to privacy and confidentiality in mind, identify those whom you need to inform about her HIV-positive status. Provide support from scholarly references for your response. (1–2 paragraphs)

[Insert response here]
During the health assessment, your patient has revealed that her boyfriend does not know about her HIV-positive status. Briefly explain how you might explore the patient’s understanding of how her HIV positive status may impact her relationship and the health of her partner. Explain why you would take this approach. Support your approach with scholarly references. (1–2 paragraphs)

[Insert response here]
Identify two actions you would take—or ensure are taken—in this scenario to preserve patient confidentiality. Support your response with reference to the ANA’s position paper on privacy and confidentiality. (1–2 paragraphs)
[Insert response here]

The Code of Ethics for Nurses was developed to provide guidance for administering quality and ethical care while upholding standards and obligations of the profession. Select one of the provisions of the Code and explain how you might apply this provision to guide your responses to the health assessment described in the scenario. Support your response with appropriate citations from scholarly references. (2–3 paragraphs)
[Insert response here]

Once your patient has revealed her HIV-positive status to you, what else do you need to think about and do in providing quality care? With a holistic approach to this woman’s care in mind, describe one subsequent action you might take. Explain how this action is in alignment with the Code of Ethics for Nurses. Support your response with appropriate citations to scholarly references. (2–3 paragraphs)
[Insert response here]

Soon after revealing her HIV-positive status to you during the health history, the patient appears to regret bringing it up. She is clearly worried and asks you if any of this information will be sent to her home, which she shares with her parents, or to her employer. Briefly explain how you would respond to her. Support your response with scholarly references. (2–3 paragraphs)
[Insert response here]

Discussion posts will be assessed according to the following criteria found on the discussion rubric:

Quality of initial posting (first post): Initial posting reveals a clear understanding of all aspects of the treated discussion question; uses factual and relevant information; and demonstrates full development of concepts.
Quality of responses to classmates: Responds to the required number of students and to the professor, if appropriate. Demonstrates analysis of others’ posts; extends meaningful discussions by building on previous peer posts; and offers alternative perspectives.
Reference to supporting readings/information literacy: Refers to and properly cites either course and/or outside sources in posts, as required.
Critical thinking: Demonstrates mastery conceptualizing the problem; viewpoints and assumptions of experts are analyzed, synthesized, and evaluated; and conclusions are logically presented with appropriate rationale.
A. Consider a job you have held that you did NOT find motivating. What job characteristics were missing? How do you think that job could have been redesigned to enhance one or more job characteristics and increase its motivating properties

B. Critically compare and contrast the Job Characteristics Model with Herzberg’s Motivation-Hygiene theory. What factors leading to satisfaction (motivators) can be aligned with Job Characteristics or Critical Psychological States? Do you think any of Herzberg’s dissatisfiers (hygiene factors) align with Job Characteristics or Critical Psychological States? If not, what, if anything, does this tell you?

Mental health stigma is negatively judging someone and discriminating against them for having a mental illness. It is a barrier to people with mental illness in seeking help for their problem, because of the shame and embarrassment they feel if they do. We all need to stop the stigma of mental illness. Read the information at the National Alliance on mental Illness site below. Go to our discussion board and post an example of the stigma of mental illness that you have had or seen toward someone else. If you have not seen this, make up an example. Also, list 2 actions you can do to reduce stigma in our society. Post on discussion by midnight January 21. A minimum of one paragraph for the example and another paragraph for the actions. (Don’t forget to do the second part of Lesson 1 assignment at the bottom of Lesson 1 module. It is worth 25 points, also)

9 Ways to Fight Mental Health Stigma | NAMI: National Alliance on Mental Illness
Every day, in every possible way, we need to stand up to stigma. If you’re not sure how, here are some ways our Facebook community responded to the question: “How do you fight stigma?”