the patient will not always improve in all nursing plan of care -

two periods

in delegation the RN as well as...do you mean evaluating if the patient outcome was met

Can this be said a different way if this is not a direct quote? the in some way seems out of place. The kinds of errors involving nurses and endangering patient safety over a board territory ( this reminds me of the game of Risk- smile) instead of territory could we say covers many ????

and/or patient representative can be present

... should be given to the effects of disease processes, the patients mental status, pain , and cultural beliefs on the ability ... to reach outcomes . A time frame set by the patient i conjunction with the nurse should encompass a time frame that is reflective of limitations of the patient.

Is cultural a condition? Maybe physical, mental , spiritual condition and any cultural limitations? attributes? in relation to . I don't see cultural as a condition

Can this be made larger for ease in reafing?

should employer really be first? It doe snot supersede the state practice act nor federal guidelines...

be able to

Nurses need to have strong inductive reasoning.... and be able to

need

and is seems like a better fit

excellent video I use in fundamentals class

means same without your. I think it makes it read better

talents?

what are you grateful for ?

what about for non religious folks- is this the olny opportunity chaplain?

This statement is hard to understand. Nurses must be aware of the Practice Act in their state and the legalities and ethical challenges of nursing actions surrounding complex issues such as assisted suicide, active euthanasia, and abortion

It is well recognized that the grief cycle is not ordered and does not flow , can you show a visual of this as well?

Suggestion use film clip at graveside of Steel Magnolias. Sally Field shows all of the stages in one scene that takes about 3 minutes https://www.youtube.com/watch?v=iZx1W6cHw-g

are you also able to modify original to include fathers of the still born child because the focus is usually on the mother who has had the loss?

This is not true for all cultures of the United States and therefore is grouping all Americans into the same category which is not true . Please be careful with this- it undermines all work taught on cultural differences and biases

This is an excellent concept to introduce as fundamentals thank you!

the patient Considers to be the problem,

I am having trouble understanding this sentence. could it be reversed for greater clarity? Nurses should perform a cultural assessment when caring for all patients. and leave out with culturally responsive care principles in mind

I do not understand this sentence

nice touch to reflect, could also be used to have students reflect on their biases and how they believe that their own bias can influence how they will deliver health care to homeless, drug users, Blacks, Mexicans, abusers, prisoners?

and the financial burden of continued social inequity that creates homelessness, poverty unemployment, and uncontrolled chronic illnesses.

can lead to

Can we say minorities or persons who are underserved, or vulnerable populations? The word culturally diverse is not addressing the problem directly here

contributes to health???? health care outcomes favorable for a particular population but health care disparities for others, because

lack of adherence - just a thought

and family. The family mistrust of the nurse and health care system is vital for the student nurse to understand

Good stuff here- thank you very clear!

**define please NIH does a nice job cultural competency refers to the ability of healthcare providers to recognize and respect patients with diverse values, beliefs, behaviors and linguistic needs. The National Institutes of Health (NIH) describes it as “the combination of a body of knowledge, a body of belief and a body of behavior” because it requires healthcare professionals to understand cultural differences and respond accordingly. The intersection of knowledge, beliefs, and behavior is where patient care can be affected.

The American Hospital Association says that “a culturally competent healthcare system is one that acknowledges the value of culture, incorporates the assessment of cross-cultural relations, recognizes the potential impact of cultural differences, expands cultural knowledge, and adapts services to meet culturally unique needs.” It may sound like a tall order, but each of these action items is achievable. More importantly, they are necessary for healthcare systems to meet the demand of a diverse population.

Who in the family is the decision-maker and the balance of roles or you could say ( power)

my understanding of implicit is unexpressed except when dealing with bias , then it is unconscious, is this a swipe at unconscious implicit bias or do you really meaning implicit as in "The definition of implicit refers to something that is suggested or implied but not ever clearly said. An example of implicit is when your wife gives you a dirty look when you drop your socks on the floor. Without reservation or doubt; unquestioning; absolute."

Hummm. could this be better stated Health care practices are impacted by the culture in which the health care setting is located. For example.....

The reason I say this is hopefully nurses are made u of many heterogenous groups of individuals that adhere to the American health care system if trained here. Western medicine influences our practice here. But the culture of nursing is what you are talking about ad to reference nurses makes it seem inconsequential

is a life-long process that begins with cultural desire and applies .....

Could we just start with Nurses provide holistic care when they address their patients physical , mental spiritual and cultural perspectives and beliefs ( referred to as holism)

I am unsure that it flows well using the term better, better and better

Optimal patient outcomes?

This is too broad. Please consider adding that ethical principles are applied contextually and holds a nurses responsibility to all stakeholders in each case, including themselves in accordance with the law and the societal expectations that stem from the role of the nurse- something to that effect. Maybe consider adding "An ethical principle is a general guide, basic truth, or assumption that can be used with judgment to help determine a course of action.12 Principles have long been used in bioethics and clinical ethics to describe the most common ethical concerns one must consider in most cases. Although all of the principles are important, they can conflict with each other in certain situations. The four principles most often cited are respect for persons, nonmaleficence, beneficence, and justice.12 Less often mentioned, but equally important, is the principle of fidelity." Jean Giddens 3 rd edition

I wonder if a simpler word can be chosen for reading level. Perhaps limitations to the rule instead of caveats.

I feel like this is a colloquial term and may not be understood by students with ESL, clips diversity angle off when we use colloquial terms

Is it important to note , for professional development reasons that the NCLEX is developed by surveys of newly graduated nurses collected and collated by experts of the NCSBN . The NCLEX is reviewed constantly and undergoes change every three years to be relevant and up to date with evidenced based practice? I think it is important but it may be more than the intent of the authors

by the UAP.

does it make as much sense without the that are? It does make it clearer to me without the that are

Nursing practice occurs , instead of it

Completely agree with above statement. This is a great place to put State and Local which should be before any employer guidelines as they cannot supersede the state law or local laws

Nice and up to date information. very well explained!

Use the word Nurses rather than They

I dont understand the phrasing "placing a patient in a state" For my ESL students they may interpret this as a literal state such as Ohio or Utah. Is there a better word or phrase that can be used

Rather than start sentence with Essentially, I believe it is clearer to repeat the subject. I would start "A scope of practice provides