RLG205H5 Lecture : RLG205 - Lecture 5

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scarletllama3

27 Sep 2011

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Mahabharta 75 000 verses, the longest poem in the world. Different tradition (opposite) than the rg veda. Interpolation, cretion : the text continues to grow: no longer the same degree of rigidity and constraints to the text, (in contrast to veda, which is strict) The mahabharta considered to be a text of ithihasa ( this is how it happened , a legendary account, like history (not history: narration of events (ithihasa) Composition of the text itself: northwestern india (versus the raymana which is northeastern) The mahabharta talks about jaya (the first version, 7000 verses, means victory) A dynastic struggles of war (between pandanas [semi-divine] and dhrasthra) Late vedic world still slightly maintained: dharma, gods, sacrifice. Renunciation is apart of something else, something bigger. Basic issue: arajunak doesn"t want to fight, krsna makes arugments trying to convince him of the reason he should fight (talks about yoga, bhakti: araj.

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Discussion: Assessing the Ears, Nose, and Throat Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment. Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes, but would probably perform a simple strep test. In this Discussion, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions. Note: By Day 1 of this week, your instructor will have assigned you to one of the following case studies to review for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case. Case 1: Nose Focused Examination Richard is a 50-year-old male with nasal congestion, sneezing, rhinorrhea, and postnasal drainage. Richard has struggled with an itchy nose, eyes, palate, and ears for 5 days. As you check his ears and throat for redness and inflammation, you notice him touch his fingers to the bridge of his nose to press and rub there. He says he's taken Mucinex OTC the past two nights to help him breathe while he sleeps. When you ask if the Mucinex has helped at all, he sneers slightly and gestures that the improvement is only minimal. Richard is alert and oriented. He has pale, boggy nasal mucosa with clear thin secretions and enlarged nasal turbinates, which obstruct airway flow but his lungs are clear. His tonsils are not enlarged but his throat is mildly erythematous. To prepare: Review this week's Learning Resources and consider the insights they provide. Consider what history would be necessary to collect from the patient. Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient's condition. How would the results be used to make a diagnosis? Identify at least 10 possible conditions that may be considered in a differential diagnosis for the patient. Note: Before you submit your initial post, replace the subject line (âWeek 5 Discussionâ) with âReview of Case Study ___,â identifying the number of the case study you were assigned. Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient's differential diagnosis and justify why you selected each.

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?

RLG205H5 Lecture : RLG205 - Lecture 5

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