Nursing shortage is a problem in many countries. It is often difficult to get trained nurses. While nurses are an integral part of the health care system, a shortage of trained nurses leaves an impact on the health care system. Due to the shortage of nurses there is often a heavy workload on the serving nurses.

One of the major concerns about the shortage of nurses and the consequent workload on serving nurses is that effect on the safety of patients. Overworked nurses or nurses who have to attend more patients within a limited period of time, they are not able to give the adequate importance to each patient as is warranted for proper nursing care. Hence the safety of patients is affected.

The job satisfaction of the nurses are affected which leads to high turnover and creates further nursing shortage. This also leads to deteriorating morale and lack of motivation which reduces the quality of service of nurses. The hospitals reduced their nursing staffs and implemented mandatory overtime policies to meet unexpectedly high demands in response to the increasing costs of health care since the 1990s which is an indirect fall out of shortage of nurses (Hughes, 2008).

The only way that this problem can be tackled is through wider nursing proper education and proper planning by the health care system in utilizing the available nurses to obtain the best results of care from them.

1B)

The nurses have a new opportunity to deliver care and play an integral role in leading change according to the 2010 healthcare reform act (Patient Protection and Affordable Care Act, or PPACA.

Nurses first need to understand the opportunities and know how nurses can be part of the solution to achieve better patient outcomes at more reasonable costs. In the spirit of the change and the act, nurses need to do more to prevent disease; provide chronic care management to an aging, sicker, and more diverse population; and offer end-of-life care that emphasizes comfort and compassion.

Nurses have the role of expanding access to care and improving the quality of health care at lower costs. Nursing led innovation like nurse-managed health clinics, home visiting programs for low-income mothers and the Transitional Care Model are some of the innovations that nurses can take part in.

Nurses can also play an important role in innovation and help shape quality and safety. Collection and tracking of data to improve their own practice as part of broader efforts to improve care is one of the opportunities for the nursing community as prescribe by the health care reform act. This act of the nurses would help in the building of the scientific foundation for clinical practice, prevention, and improved patient outcomes.

The nursing education also needs to be redesigned and nurses, with practical experience can help in the formation and reengineering of the nursing education courses (American Nurse Today, 2010).

2A)

According to Section 5208 of the Patient Protection and Affordable Care Act states that grants would be given to NMHCs that provide comprehensive primary care or wellness services without any regard to income or insurance status for patients. This has a significant bearing on the nursing community. This is a scope for the nursing community to bring health care services to the underprivileged and those who do not have money to avail the facilities of the established health care system.

This section of the act also gives an opportunity to the nurses to get associated with academic department of nursing, qualified health center or independent nonprofit health or social services agency and to get work experience. The nurses can, with the help of grants from the government, run these NMHCs and eliminate the shortage of nurses to an extent.

Students of nursing would also be able to take advantage of the provision under Section 5204 of the Patient Protection and Affordable Care Act. This allows students of nursing to take a loan from the government or banks against an assurance of to accept employment with a public health agency for at least three years. The government would in turn repay one-third of loans incurred by the public health or health professions student. The government...

This is an opportunity for the nursing community where they can now study at reduced costs and the expenditure of the studies would be reduced. In addition, the nurses would get employment soon after they pass out form nursing colleges (Rnaction.org, 2015).
2B

The development of innovative health care models is being forced by a number of factors. A rapidly expanding uninsured and underinsured population has been created due to the excessive increase of health costs and insurance premiums. The greater use of community clinics and the high utilization of emergency department are the other reasons. The problems an exemplified by rising shortage in nursing staff.

One such model of innovative health care that involves interdisciplinary care delivery team is the mobile health clinics. This innovative model of health care delivers comprehensive primary health care to patients through the development of partnerships between patients, families and personal physicians.

Through this model of health care, it is possible to reduce the health care disparity. This is possible by moving the health care facility to the patients rather than the patients coming to the health care centers. This model enables health care reach the homeless and underserved populations who most often do not have transportations and other necessary resources to reach the health care facilities.

Such mobile health clinics, which can comprise of nurses, doctors and pharmacists, encourage preventive screenings and immunization that result in the decreasing use of the emergency department.

Such mobile health clinics add value to the safety net clinics and enhance the capacity of the health care system to address to patient's needs in remote and rural areas (Maeda, 2015).

3A

Current research has shown that lower mortality rates, fewer medication errors, and positive outcomes are all linked to a nurse's education and the degree that is possessed. Authorities believe that education has a strong impact on a nurse's ability to practice. Several researches have linked patient care outcome to the nursing education (Blegen, Goode, Park, Vaughn & Spetz, 2013).

A study by Olga Yakusheva from the University of Michigan and her colleagues claims that a 10% increase in the proportion of baccalaureate-prepared nurses on hospital units was associated with lowering the odds of patient mortality by 10.9%. The research is titled "Economic Evaluation of the 80% Baccalaureate Nurse Workforce Recommendation." Published in Medical Care on October 2014, the research claimed that increasing the amount of care provided by BSNs to 80% would result in significantly lower readmission rates and shorter lengths of stay. The study concluded that these translate din reduced costs of health care.

Another research found that a 10% increase in baccalaureate-prepared nurses was associated with a 9% decrease in patient deaths in South Korean hospitals. This research was conducted by a team of researchers from several nursing schools in South Korea and the University of Pennsylvania. The research paper was posted online by the International Journal of Nursing Studies in August 2014. The number of in-hospital deaths would be reduced by increasing the number of nurses with degrees, the research concluded.

Patients experiencing complications after surgery are more likely to live if treated in hospitals with adequate nurse staffing levels and higher numbers of BSN nurses was the conclusion of another research that was published in The Lancet in May 2014 (Aacn.nche.edu, 2015).

3B

The primary difference between a DNP and a PhD in nursing is the approach. While DNP degree is a practice doctorate, PhD is a research doctorate. The students who pass a PhD program would engage in independent research and disseminate their findings while those graduating DNP program would acquire the requisite skills and tools necessary to assess the evidence gained through nursing research and out the evaluations into practice. Both the degrees however have provisions for scholarships.

The aim of DNP is to create nursing leaders in interdisciplinary health care teams who would be able to translate evidence gained through nursing research into practice by the application of the tools and skills necessary so as to improve systems of care and measure outcomes of patient groups.

On the other hand, PhD programs are aimed to prepare nurse scientists to develop new knowledge for the science and practice of nursing which are evaluated and put to practice by DNP students. PhD graduates generally dispense the duty of leading interdisciplinary research teams and the designing and conduction of research studies and the dissemination of knowledge of nursing and related disciplines particularly in the areas of chronic illness and care systems (Duke School of Nursing, 2011).

I would choose the PhD stream as it would give the opportunity to research and create new systems for health care especially in critical care.

4A)

For this question we choose Congressman Diane Black who has been a registered nurse for over 40 years. The importance of high-quality care and the obstacles faced by both patients and provider, echoed…