Can you please write 4 responses to the 4 different post-discussion? One response to post #1 and one response to post #2 and so on. The response to posts should be a minimum of 50 words. Whether you agree or disagree explain why with supporting evidence and concepts from the reading or related experience. Include a reference, link, or citation when appropriate. Thank you
Post #1
A range of liabilities characterizes nurses working in acute care and community health settings. Nurses in acute care settings are liable for offering patient care that requires them to understand a range of complex illnesses and machines. Therefore, nurses are responsible for providing safe and competent care, recognizing potential issues, and identifying risk areas during practice. Hence, a nurse in an acute setting is liable for overseeing the patient’s safety, communicating intent to harm, and protecting them from related incidences. Others include liability for improper injection technique, incorrect administration time, failure to note the patient’s allergies, and poor medication knowledge and associated side effects.
Conversely, a community health nurse should oversee significant changes in the patient’s conditions and determine whether they require further interventions. The nurses’ responsibility is to communicate any changes and indicate the need for treatment (Guido, 2014). Nurses are also liable for their failure to take up further interventions, such as persuading a patient or family members on the importance of treatment. Therefore, nurses who fail to escalate their concerns can be liable for negligence. Liability may also ensue due to the nurses’ failure to meet appropriate care standards and ensure that prescribed treatments are undertaken and completed (Guido, 2014). Failure to offer at prescribed rates may also result in liability. Thus, nurses in acute and community care settings can ensure positive patient health and safety.
The expectation to offer quality and safe care for nurses working in long-term health care settings is not realistic. A fundamental problem is a requirement that these nurses provide quality care services in an environment characterized by diminished resources (Guido, 2014). Thus, nurses in these settings suffer the potential for the most significant liability despite the limitations in the work environment.
Most of the expectations that guide the work of nurses in long-term care settings are a result of legal frameworks such as the nursing home reform act of 1987. The Act serves as the basis of agreeable standards of care for patients residing in nursing facilities. Various provisions of the Act allow inspectors to make impromptu visits to the facility to check on patient care.
Individuals working in long-term care settings must first become licensed practical nurses. They may also opt to become a registered nurse. Once individuals complete the NCLEX exams and earn a practice license from the respective state, they can work in long-term care settings.
Conversely, individuals working in long-term care settings must have acquired an associate nursing degree or BSN. They can later get registered in the respective states, which is only possible after completing the NCLEX-RN exam. Thus, acute care nurses undergo rigorous training compared to their long-term care setting counterparts.
Magnet status played a role in the composition of the nursing workforce. Long-term health care facilities hardly qualify for the magnet status due to the unrealistic expectations placed on them. Therefore, they hardly attract competent and passionate employees as most persons seek to work in hospitals with a magnet status. Hence, more qualified personnel apply for work in acute care other than in long-term care settings.

Post #2
• Are the expectations to provide quality and safe care for nurses in long term care settings realistic? Compare and contrast educational preparation and backgrounds of health care professionals in long term settings versus the acute care settings; explain these differences.
o I do not think that mandating quality care that will assist in the Pt reaching and maintaining the highest possible level of physical, mental, and psychosocial well being is too much to ask. Where I think the issue lies is in staffing. Sadly, the current model of long-term care is not the money maker that hospitals have, therefore standards must be moved in other places. In IL LPNs are almost nonexistent, except in nursing homes. This is allowed to some degree because of the nursing shortage as a whole and the inability of the long-term living facilities to meet the requirements to be attractive places of employment for ADN and BSN nurses. I do not have a fix for this, but these are the observations I have made.
• Where do these expectations come from (legal, ethical, standards of care, etc)?
o The Omnibus budget reconciliation act of 1987
• Has Magnet status played a role in the composition of the nursing workforce in these two settings?
o Yes, it has. A BSN is all but useless as a working RN with 1-2 classes remaining in my BSN program. The sole reason I am even getting my BSN is because of Magnet status and most travel agencies required a BSN. Then covid hit and the nursing shortage was all too common everywhere and this frivolous requirement is ignored. At the hospital I am currently employed at we are a Magnet hospital, but I’d wager but just a hair. Having your BSN v ADN does not make you a better nurse or better in your specialty. The problem with the BSN is that it is far too broad and does not cover anything related to most nursing positions. Most nurses provide Pt care, they are not manager or leaders or the CEO of the hospital. Yes, these people exist but by far and away most nurses are at the bed side.
o What my recommendation has been for quite some time now is that BSN programs should be a Bachelor of Nursing with the requirement to focus in an area of study. An example would be BSN w/ a concentration in Intensive care. Some or most of your classes would be composed of what are currently certifications, such as CCRN or TNCC. With that being said I’m sure this idea has massive repercussions too. Being a nurse right now means I can do almost anything, but if the BSN becomes more specialized that may remove my eligibility from certain specialties because I don’t have the correct degree for that floor or specialty. An example, let’s say I got my BSN w/ a concentration in gerontology, I may now not be eligible for ICU positions because I did not get my BSN w/ a concentration in Intensive care.

Post#3
Discuss differences in liability issues for nurses working in the community and acute care settings.
Community nurses may work in areas such as home health, where there are contracts and different legal obligations. But in a home health situation it is important to properly assess your patients because the nurse would see them multiple times a week and would get to know them. This would make it easier to know when something has changed. Also with community settings there are more people involved and there needs to be signed release for sharing information. For instance Acute care would be in a hospital where there is a bigger chance that something could go wrong because they are in a more serious situation. I think in acute care situations there is a greater chance for med errors.
Are the expectations to provide quality and safe care for nurses in long term care settings realistic?
Honestly I do not think so. Many nursing homes have 25+ patients per nurse. I know of some that they can have 35-45 residents for 1 nurse. How is it possible to be able to know what is going on with every wound, and be able to document and care for every one. They end up getting substandard care. Pressure ulcers form so quickly, people get up and ambulate when they cant get to the bathroom in time, which results in falls and even more work to do. It is no wonder one of the top malpractice suits involves decubitus ulcers.
Where do these expectations come from (legal, ethical, standards of care, etc)?
The expectations come from an ethical stand point and from standard of care.
Compare and contrast educational preparation and backgrounds of health care professionals in long term settings versus the acute care settings; explain these differences.
I feel like in an acute care setting a higher education is necessary. In long term care people are stable, and there are more LPNs working in long term care. My DON reminded me that in Illinois, LPNs cannot do assessments, cannot triage, cannot phone in prescriptions, they cant do IVs hang meds, flush and IV lines etc. So RNs will end up working in more acute care settings because they have the skill set to do so. I was also told that there has to be an RN in the building, and that facilities get higher reimbursement if RNs are working. I cant find any information to back that up though.
Has Magnet status played a role in the composition of the nursing workforce in these two settings?
I suppose so, because magnet staus is a big deal, and hospitals want the best, and if it is a good place to work then nusres are not going to leave.

Post#4
• Discuss differences in liability issues for nurses working in the community and acute care settings.
Liability issues commonly occur in home health settings when it comes to practicing within the scope of practice, obtaining consent, honoring the patient’s right to refuse, respecting patient’s privacy and confidentiality, following standing orders and protocol, patient education, documentation, and delegation. The one area I see being a problem is the nurse’s risk of malpractice and negligence when working in the home setting. Because of the lack of supervision, nurses may be more prone to be negligent and not constantly have eyes on the patient. Also, the nurse may fail to report a fall or change of condition. In the acute care setting, there are many members of the healthcare team around to monitor the patient in case of an accident or quick decline in health.
• Are the expectations to provide quality and safe care for nurses in long term care settings realistic?
It does depend on the facility and the resources and staffing the facility provides its nurses. When the facility is well-staffed and given up-to-date technology and resources, it allows nurses and staff to better provide quality and safe care. When you start to see a deviation from this, there is something lacking in the facility’s system.
• Where do these expectations come from (legal, ethical, standards of care, etc)?
Most expectations are driven by the Joint Commission. This committee holds long-term care facilities accountable for meeting performance expectations and the standards of care to assure patients receive safe, high-quality care.
• Compare and contrast educational preparation and backgrounds of health care professionals in long term settings versus the acute care settings; explain these differences.
Nursing employees of nursing homes include “unlicensed assistive personnel (UAPs) and LPN/LVNs working with minimal supervision” in addition to RN’s. It’s common to see an LPN act as a registered nurse and being assigned to more than 20 patients on a unit. You wouldn’t usually see this in an acute care setting like a hospital (Guido, 2010, p. 506).
• Has Magnet status played a role in the composition of the nursing workforce in these two settings?
Magnet status plays a huge role in the composition of the nursing workforce in these two settings. This status is the highest recognition of nursing excellence and supports “education and development through every career stage, which leads to greater autonomy at the bedside. To patients, it means the very best care, delivered by nurses who are supported to be the very best that they can be” (Magnet recognition). Because Magnet status supports educational growth, many CNSs, LPNs, and UAPs would be encouraged to become RNs which would help advance both acute and long-term settings.