PNUR-203 Lecture Notes - Registered Nurse, Incident Response Team, Informed Consent

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midnightnoon

11 May 2023

School

Centennial College

Department

PNUR

Course

PNUR-203

Professor

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Document Summary

K is a registered nurse who became depressed after the death of her 16 year old daughter one year ago. She found herself unable to go to work at the general hospital where she held a permanent part-time position for 12 years. Her husband became extremely angry with her, began abusing alcohol, and ended the marriage. Mrs. k does not have any family in the country. Eventually mrs. k lost her apartment because she could not pay rent. The police found mrs. k standing on a bridge ready to jump onto the highway below because she felt she had nothing else to live for. The police take mrs. k to the nearest general hospital and she is made involuntary. The emergency response team responds and confines her to a locked safe room (seclusion). She receives a form 30 letting her know that a form 3 has been initiated.

Related Questions

Case Study: Mental Health Parity

Presenting to the board, Chris spoke with passion. Our insurance plan should provide the same coverage for mental health services as for other medical services. It's the right thing to do, and it's good business. If our employees or their dependents have untreated mental health problems, the employees become less productive and waste money getting treated for other stuff. Thank you, Chris, said Kerry, the company's CEO. This is an important question for us, and the Benefits Committee will carefully consider it. After Chris left the room, Kerry turned to Jordan, the director of human resources, and said, Jordan, what's your take on this? There are actually two questions here, said Jordan. First, how elastic is the demand for ambulatory mental health services? How much will the use of mental health services increase if coverage improves? Second, how effective is mental health care? This second question is the more important one because good mental health care can have such powerful effects. Now, a number of studies have concluded that the use of mental health services is more price-sensitive than the use of other ambulatory care. Analyses of ambulatory mental health services have found elasticities ranging from 0.44 to 1.00. These results could be statistical flukes. Consumers who expect to use mental health services may choose insurance plans that offer generous coverage for those services. However, the RAND Corporation researchers Keeler, Manning, and Wells in 1988 used data from the RAND Health Insurance Experiment, which randomly assigned respondents to insurance plans, to resolve this issue. The RAND analysis generally confirmed that the demand for mental health services is more price-sensitive than the demand for general ambulatory medical services. Demand for each is inelastic, but the elasticity for mental health services is 0.8 and the elasticity for other outpatient services is 0.3. Most consumers will not use any mental health services, but plans that offer generous mental health benefits will cost more. We can't ignore this. I'm confused, said Addison, an internist on the board. In 2012 McConnell and colleagues published a study showing that Oregon's law requiring mental health parity in commercial insurance plans had little effect on spending. How could that be? Real-life appears to be contradicting the RAND study. I'm sure the plans for federal employees used managed care techniques to control spending, Jordan jumped in. And mental health spending isn't the issue. The issues are what happens to other healthcare spending and what happens to our workers. I'm pretty sure there's good evidence showing that effective mental health treatment can reduce other costs and improve productivity.

Discussion questions:

Why does it matter whether demand for mental health services is more elastic than demand for other services?

The price elasticity of demand for ambulatory mental health services appears to be about 0.8, and the price elasticity for general ambulatory medical services appears to be about 0.3. How much would spending increase for each type of care if copayments were cut from $40 to $25?

What managed care techniques do insurers use to control spending?

Is there evidence that better treatment of mental health problems reduces other spending?

Is there evidence that better treatment of mental health problems improves productivity?

What is your recommendation to the Benefits Committee?

cyanseal60

Mark Miller, CEO of Jefferson General Hospital, has some tough decisions to make in the future. Jefferson General is a stand-alone, not-for-profit hospital that has a long and proud tradition of serving the community in which it operates. It was founded in the midst of the great depression as Jefferson County Hospital and remained under public control for over 50 years. Then, in 1986, after years of losses, the county decided that it could no long afford to operate the hospital, and it subsequently converted the hospital from a public to a private entity.At that time, Mark was brought in as the CEO. After a shaky start, he was able to turn the hospital into a moneymaker. Still, he was very aware of the hospital’s roots, and he made sure that the hospital continued its original mission of providing healthcare services to the needy regardless of their ability to pay.Jefferson General is the smallest of the three hospitals that serve Jefferson and surrounding counties; the other two are St. Vincent’s Hospital and Northwest Regional Medical Center. St. Vincent’s has religious roots, but it is now operated as a not-for-profit, non sectarian hospital. Northwest Regional is owned and operated by a large for-profit chain. The combined capacity of the three hospitals is over 950 beds,but none of the three operates above 60 percent occupancy. Further-more, managed care is starting to take hold locally, and hospital utilization trends indicate that the service area will need only 600 beds as utilization rates are squeezed down.The most logical solution to the county’s changing healthcare market conditions is a merger between two of the three hospitals, and Jefferson General is the hospital most likely to be acquired. Mark has been approached by the CEOs of both St. Vincent’s and Northwest Regional concerning his interest in a merger. Although it was too early to speculate on the exact terms that might result if a merger takes place,past mergers in the region provide some insights into what might hap-pen to Mark should a merger occur.If the hospital were acquired by St. Vincent’s, Mark would prob-ably continue as CEO of the hospital, at about the same compensation as he currently receives. However, he would lose much of his autonomy and authority because he would now have to report to the system CEO,who most likely would be the current CEO of St. Vincent’s. If the hospital were acquired by Northwest Regional, Mark would probably relocate to a CEO position at some other not-for-profit hospital because the for-profit chain usually brings in its own management team when it makes an acquisition. But Mark would not go away empty handed. He would probably receive a large “golden parachute” as a result of his job loss, which might include lucrative stock options, a lump sum payment,and a consulting contract. The aggregate amount of such payments could easily be worth many times his current annual salary.Although the ultimate decision regarding the fate of Jefferson General rests in the hands of its board of trustees, the members of the board were chosen more on the basis of their community ties than on their business acumen. Thus, all those involved are aware that Mark’s recommendations regarding the hospital’s future will carry a great deal of weight in the final decision.

What do you think about the dilemma facing mark miller? Does this case present an ethical issue? If so, to which party (or parties)? If you could act as the ultimate authority on this situation, what would you do?

burgundygoldfish154

Mark Miller, CEO of Jefferson General Hospital, has some toughdecisions to make in the future. Jefferson General is astand-alone, not-for-profit hospital that has a long and proudtradition of serving the community in which it operates. It wasfounded in the midst of the great depression as Jefferson CountyHospital and remained under public control for over 50 years. Then,in 1986, after years of losses, the county decided that it could nolong afford to operate the hospital, and it subsequently convertedthe hospital from a public to a private entity.At that time, Markwas brought in as the CEO. After a shaky start, he was able to turnthe hospital into a moneymaker. Still, he was very aware of thehospitalâs roots, and he made sure that the hospital continued itsoriginal mission of providing healthcare services to the needyregardless of their ability to pay.Jefferson General is thesmallest of the three hospitals that serve Jefferson andsurrounding counties; the other two are St. Vincentâs Hospital andNorthwest Regional Medical Center. St. Vincentâs has religiousroots, but it is now operated as a not-for-profit, non sectarianhospital. Northwest Regional is owned and operated by a largefor-profit chain. The combined capacity of the three hospitals isover 950 beds,but none of the three operates above 60 percentoccupancy. Further-more, managed care is starting to take holdlocally, and hospital utilization trends indicate that the servicearea will need only 600 beds as utilization rates are squeezeddown.The most logical solution to the countyâs changing healthcaremarket conditions is a merger between two of the three hospitals,and Jefferson General is the hospital most likely to be acquired.Mark has been approached by the CEOs of both St. Vincentâs andNorthwest Regional concerning his interest in a merger. Although itwas too early to speculate on the exact terms that might result ifa merger takes place,past mergers in the region provide someinsights into what might hap-pen to Mark should a merger occur.Ifthe hospital were acquired by St. Vincentâs, Mark would prob-ablycontinue as CEO of the hospital, at about the same compensation ashe currently receives. However, he would lose much of his autonomyand authority because he would now have to report to the systemCEO,who most likely would be the current CEO of St. Vincentâs. Ifthe hospital were acquired by Northwest Regional, Mark wouldprobably relocate to a CEO position at some other not-for-profithospital because the for-profit chain usually brings in its ownmanagement team when it makes an acquisition. But Mark would not goaway empty handed. He would probably receive a large âgoldenparachuteâ as a result of his job loss, which might includelucrative stock options, a lump sum payment,and a consultingcontract. The aggregate amount of such payments could easily beworth many times his current annual salary.Although the ultimatedecision regarding the fate of Jefferson General rests in the handsof its board of trustees, the members of the board were chosen moreon the basis of their community ties than on their business acumen.Thus, all those involved are aware that Markâs recommendationsregarding the hospitalâs future will carry a great deal of weightin the final decision.

What do you think? Does this case present an ethical issue? Ifso, to which party (or parties)? If you could act as the ultimateauthority on this situation, what would you do?

in jefferson general hospita mergers,acquisitons,and agency.what do you think about the dilemma facing mark miller? Does thiscase present an ethical issue? if so to which party? if you couldact as the ultimate authority in this situation what would youdo?

PNUR-203 Lecture Notes - Registered Nurse, Incident Response Team, Informed Consent

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