Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment. Include the following: Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse's role and responsibility. Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations. Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings. Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.

FULL QUESTION:  There is a common phrase in business: "Cash is king." "Cash flow is the life-blood of a company. Without it, a company will fail" (Hicks, 2012). Yet, companies often have to take risks that could potentially jeopardize their cash flow (e.g., new projects, growth, capital budgeting, etc.). Assume you are the CFO of a struggling company. While you do have a positive cash flow, it is minimal at best. If something does not change soon, the company will go under. Fortunately, your product development team has just created a new product that will not only save the company from financial demise but will also revolutionize how the industry does business. The problem is that the product is still 2 years away from being able to be sold to the public, and you will run out of cash within the next 6 months. How would you propose obtaining the funds needed to keep the company alive and thriving for the next 2 years until you are able to see a return on the product development? How would you keep the stakeholders happy? 

Answer the Primary Questions (250 words). Respond to 3 classmate post (250 words each)the following questions: Also remember these comprise what is referred to as the "primary post", i.e., these should be posted in a single post with one response on top of the other. Each should be numbered to clearly show where the response to #1 ends and the response to #2 starts. 1.Select a more recent Supreme Court decisions (less than 2 years old) that had a significant impact on law enforcement. What are the facts of the case and what are the impacts of the decision on the police administrator? 2.Describe the relationship between the police agency/police administrator and the media. In what ways are there conflicts? In what ways are there partnerships? Classmate 1 Lauren: You are led to believe that the media sway our stance on law enforcement. When studied, there are no significant effects of exposure to an image of police officers interacting with civilians on respondents' perceptions of police misconduct, police bias, or evaluation of how police complete routine tasks and responsibilities. That public opinion about the police is primarily shaped by personal experiences with the police, unique demographic and ideological characteristics, and routine, self-selected news consumption habits. That group identities maybe even more important than personal experiences with the police, as political partisanship, political ideology, race/ethnicity, and age were the most consistent predictors of variation on attitudes toward the police in our regressions (Wozniak, Drakulich, & Calfano, 2021). It would seem social learning theory is in place for people's perceptions of police. As we become more inundated with social networks, that media could sway people's perceptions of police. Social media is still not heavily regulated, and people can write whatever they want to, and others will believe them. The U.S. Supreme Court extended the capability of people to sue police for excessive force. The 5-3 decision allowed Roxanne Torres to pursue her lawsuit, blaming the New Mexico State Police. The court determined that to sue for excessive force under the Fourth Amendment, it is not essential for a plaintiff to have been tangibly detained by law enforcement. (Hurley, 2021). The ability to sue for excessive force makes law enforcement more accountable for their action. No one should be above the law, police officers included. Everyone has a right to a trial not to be hurt or possibly killed by police officers. If someone is running away and the police officer can not catch them, they should radio in the description of the offender. Show the body cam footage to their department. They should put a warrant out for their arrest not, a bullet to the chest. Bibliography Hurley, L. (2021, March 25). U.S. Supreme Court widens ability to sue police for excessive force. Retrieved from Reuters: https://www.reuters.com/article/us-usa-court-polic... Wozniak, K. H., Drakulich, K. M., & Calfano, B. R. (2021). Do photos of police-civilian interactions influence public opinion about the police? A multimethod test of media effects. Journal of Experimental Criminology, 17, 239-265. doi:10.1007/s11292-020-09415-0 Classmate 2 Michael: 1. Select a more recent Supreme Court decisions (less than 2 years old) that had a significant impact on law enforcement. What are the facts of the case and what are the impacts of the decision on the police administrator? On May 8, 2020 the Fourth Circuit of Appeals, made a decision in the case of United States v. Ruffin distinguishing the levels of officer’s encounters under the Fourth Amendment and how it applies and progresses during police encounters (Batterton, 2020). This impacts law enforcement greatly, as it establishes the required Reasonable Articulable Suspicion (RAS) that is needed for a detention beyond a mere Casual Encounter. The facts of this case are interesting and evolved quickly. The Fourth Circuit, which is in my jurisdiction, I believe made the right call in reference to the decision and based on the facts that transpired. In the early morning hours of November 24, 2016 Tiffany Farmer of Wilson, North Carolina discovered that her vehicle was broken into and several items stolen, including her cell phone. Officers arrived on scene and noticed several of the stolen items belonging to Farmer was scattered in a grassy area nearby. K-9 Officer Emory responded to the scene with his partner Jaxx who was duel-trained in Controlled Dangerous Substance (CDS) detection and Human Tracking. Officer Emory and Jaxx conducted a “track” and Jaxx led officers on a scent through the woods and into a nearby neighborhood. Upon emerging from the woods, officers spotted Ruffin hunched over near a wheelchair ramp in the apartment complex. Ruffin stood up and attempted to walk away from the ramp when officers spotted numerous objects under the ramp where Ruffin was observed. Ruffin was bending down near the ramp at this time. Officers inherently believed that Ruffin was the scent that Jaxx was tracking, and that the items observed were associated with the Theft From Motor Vehicle (TFMV) incident. It should be noted that Ruffin was the only person in the area at this time. Officer Ochoa approached Ruffin and spoke to him, who was nervous and failed to provide his name. Ruffin stated that he did not live in the area and he was waiting for his child to use the bathroom in the woods, at which he kept staring at and looking around suspiciously. It was ultimately untrue about his child and the stuttering was indicative that this was as a lie. Ruffin consented to a “Pat Down” or Terry Frisk for weapons, as Ruffin appeared to be looking for an escape route for an opportunity to flee. Ruffin was informed by Officer Ochoa advised Ruffin he was not free to leave and was being detained. Officer Ochoa retrieved his handcuffs and attempted to place Ruffin in handcuffs to detain him, preventing him from running. Ruffin stiffened his arm and pulled away and a struggle ensued. Ochoa was successful in placing Ruffin in handcuffs and radioed other officers to respond, and Ruffin was placed under arrest for Obstructing a Public Officer, N.C Gen Stat. 14-233 (Batterton, 2020). Ruffin’s person was searched Incident to Arrest and numerous denominations of $2,082.37 in U.S currency was recovered. The area underneath the wheelchair ramps was also searched and a white grocery bag and black sock were located. Hundreds of grams of cocaine, a digital scale, and other paraphernalia were contained within. Ruffin contested being charged with federal drug charges and sought to suppress the evidence. The court ruled that the Fourth Amendment was not violated during the detention throughout the incident. It was determined that Ruffin was formally detained when RAS was achieved to do so, subsequent to the initial Casual Encounter. The arrest was ruled to be lawful, including the subsequent search incident to arrest. The impacts of this case is beneficial for police officers and will impact police administrators in several ways. General Orders (G.O.’s) and Standard Operating Procedures (SOP’s) will need updated and revised. In addition to policy changes, training standards and implementation will also have to take place in order to prepare officers for practical application. This is a difficult aspect of these changes that require a timely and thorough approach. In the case of Ruffin, there are four stages of Ruffin’s detention and distinctions as to what they mean for officers. The court ruled that stage one occurred when Officer Ochoa initially encountered Ruffin and began questioning. This is where Ochoa received consent to “Pat Down” Ruffin for weapons and did not initiate a “Terry Frisk” based on RAS as it was not required at this stage. Stage two was the portion of the encounter where the court determined that a seizure occurred under the Fourth Amendment. This is when Officer Ochoa physically placed his hand on Ruffin to place him in handcuffs and verbally informed him he was being detained. The court ruled that there was sufficient RAS to detain Ruffin at this stage. Facts considered were the time of day, the location of Ruffin in reference to the original TFMV call, Ruffin being the only person in the area, Ruffin’s constructive possession of the CDS located underneath the wheelchair ramp where he was observed, Ruffin’s behavior exhibiting nervousness, and Ruffin’s deceit and physical separation from the wheelchair ramp where the CDS was located. These facts are important elements of the case law, as they will be the foundation of detention training. Some key points to note from stage two is that handcuffing does not elevate a detention into an arrest and was reasonable based on the circumstances and officer safety in this case. Stage three involved the arrest of Ruffin for Obstructing a Public Officer, N.C Gen Stat. 14-233 (Batterton, 2020). The court ruled that Officer Ochoa had ample suspicion to detain Ruffin for the TFMV incident previously reported, Officer Ochoa verbally advised Ruffin he was being detained, and Ruffin physically struggled attempting to prevent being handcuffed. The key points of this stage for training is that Ruffin’s “resistance” to a lawful detention, authorized an arrest under the North Carolina Statute, Obstructing a Public Officer, N.C Gen Stat. 14-233 (Batterton, 2020). This is extremely important as it establishes that “resistance” of a lawful detention is considered a violation of the above statute. This statute is comparable to other state legislation, similar to Maryland’s obstructing and hindering law. This case is out of the Fourth Circuit which incorporates Maryland, setting precedent for and a groundwork for the judgement to Fourth Amendment standards. Lastly, stage four was considered to be the search incident to arrest. To make it simple, the arrest was good, therefore, the search Incident to Arrest is good as well. This is a sound standard that has been established through judgements regarding the “Fruit of the Poisonous Tree”. There was nothing poisonous about this case and the ruling is actually fruitfully delicious. The search Incident to Arrest is a “warrantless exception” to the warrant requirement to recover evidence and weapons that may pose a threat to officer safety. The court addressed the “constructive possession” standard as well, in reference to the Incident to Arrest. This exception includes the search of the arrestee and the area within their immediate control (Batterton, 2020). In this case specifically, it was the area of the wheelchair ramp where Ruffin was observed bending down near. When implementing the training aspect of this stage, refresher training and re-emphasis on the important elements of the above topics should be addressed as well. Case law is rapidly changing and a daunting task for police administrators and trainers. It is important for command-level officers and leadership to be informed and well versed on changing trends, topics, and legislation. Creating a culture of experts and “practitioners” in policing is beneficial for the entire agency and profession as a whole. 2. Describe the relationship between the police agency/police administrator and the media. In what ways are there conflicts? In what ways are there partnerships? The relationship between police agencies and the media, is solely based on police administrators and direction of the Chief of Police. Public Information Officers are assigned as the liaison between the police department and the media. The media comprises many representations of news, fiction, and entertainment, causing police sensitivity about their public image (Huey & Broll, 2012). The political ideology of the police department’s culture and the associations of the media outlet plays a huge role. Media outlets are overwhelming in favor of the left and at its core, democratic policing involves public involved decision making (Bonner, 2020). This is a dangerous realm as media outlets are businesses interested in making money, and will do so by any means. In order to make money, the media has to be entertaining and spark interest in their audience. Like the media, government administrations express views and make decisions reflective of political sacrifices in the interest of, essentially, the popular vote (Bonner 2020). What this means is, especially today, is that whatever is trendy or controversial, these stances will be taken whether the person or group actually believes in the message or not. This affects police-media relations and rightfully so, as it is compared to a “stormy marriage” or love-hate relationship (Huey & Broll, p.385, 2012). There are positives and negatives involving the relationship between the media and police. The mass media portrayal of policing is extremely important, as media is the primary source of information to the public (Huey & Broll, 2012). Depending on how the police are portrayed in the news, movies, TV, and music, this is likely to influence public perception whether the information is accurate or not (Stefanovska, 2015). As a response, police agencies may exclude information to protect the integrity of investigations and police operations, or sometimes just to discourage the media, knowing the public has an insatiable desire for crime related stories (Huey & Broll, 2012). Without the police and providing the information, the business aspect of the media source is jeopardized. It is difficult to find a balance when the average of media publications contain ninety percent (90%) of articles containing discriminatory and unfair actions of police involving the public (Stefanovska, 2015). In recent years, this contemporary culture has exacerbated this stance and public viewpoint. The partnership is an unnecessary evil to promote a positive image and share information with the public. With social media and departments being selective of which media outlets information is shared, a balance can be made. Social media and the internet make it possible for police agencies to control the media release of information and become the sole proprietor of that information ( Live Press Releases, Website Releases, and use of PIO’s). Transparency occurs with the most current and factual information. This information is controlled solely by the agency to ensure the most accurate information is being shared and it is coming from the “horse’s mouth”. There is no business interest involved and depending on the political climate of the agency, it may very well allow for a fair assessment of the facts being disseminated. -Murph References Batterton, B. (2021). Fourth Circuit Discusses The Three Levels Of Officer Citizen Encounters - LLRMI - Training and Expert Services for Law Enforcement, Jails & Corrections, Insurance Pools, Risk Managers, and Attorneys. Retrieved July 12, 2021, from https://www.llrmi.com/articles/legal_updates/2021_us_v_ruffin/ Bonner, M. D. (2020). What Democratic Policing Is?...?And Is Not. Policing & Society, 30(9), 1044–1060. https://doi.org/10.1080/10439463.2019.1649405 Huey, L., & Broll, R. (2012). “All It Takes Is One TV Show to Ruin It”: a Police Perspective on Police-Media Relations in the Era of Expanding Prime Time Crime Markets. Policing & Society, 22(4), 384–396. https://doi.org/10.1080/10439463.2011.641556 Stefanovska, V. (2015). The Image of the Police in the Printed Media. Balkan Social Science Review, 6, 75–91. Classmate 3 Hannah: 1. Select a more recent Supreme Court decisions (less than 2 years old) that had a significant impact on law enforcement. What are the facts of the case and what are the impacts of the decision on the police administrator? In the case, Lange v. California, Mr. Arthur Lange asserted that his Fourth Amendment right was violated by a California highway patrol member when the latter entered the former's garage without a warrant, yet the First District Court of Appeals has ruled that the search was legal because the officer demonstrated their intent to investigate while Mr. Lange was still on public property and the officer had probable cause. When a Mr. Lange was observed driving his vehicle while behaving in an eradicate manner, the highway patrol member pursued the car and signaled for Mr. Lange to pull over by turning on the overhead lights. Mr. Lange refused to pull over, and instead proceeded to drive to his home garage. When both parties arrived at the house, the patrol member entered the suspect's garage where they observed indications that Mr. Lange was under the influence, and so a field sobriety test was initiated. After Mr. Lange failed the field test, the patrol member noticed that there were containers of alcohol in the vehicle, and Mr. Lange was put under arrest for driving under the influence and another misdemeanor related to his loud music. This case is of importance in how it relates to the balance between a police officer's pursuit of justice and a civilians's right to privacy and protection from undue searches. Mr. Lange and his attorney called upon the ruling of another Court case, United States v. Santana, in which Ms. Santana was arrested within her private residence after attempting to retreat into her home when she realized the individuals she was selling heroin to were undercover officers (1976). As a result of Ms. Santana entering into a sale of heroin from her doorway, which was deemed by the Court to be a public space, and the officers had begun the arrest prior to Ms. Santana's withdrawal into the house, the officers acted under "hot pursuit," and so the arrest was justified. Mr. Lange argued that Ms. Santana was being arrested for a felony whereas he was only being charged with a misdemeanor, and he should therefore fall outside of the range of the "hot pursuit" doctrine (Crabb Brown James Team, 2021). Ultimately, the Court did not decide to bind the "hot pursuit" doctrine to a specific category of crime, but instead purported that the following need to occur for a legal warrantless arrest on private property: 1. the police officer's expression of intent to pursue and/or investigate a suspect while both parties are still in a public space; 2. a failure on the suspect's part to adhere to or acknowledge the lawful orders of the police officer; 3. the officer pursues the suspect into their private residence in "hot pursuit" (meaning reason to believe violence and/or destruction of evidence will follow if a warrant must first be administered) (CBJ Team, 2021). The Lange v. California ruling allows for police officers to be more flexible while also requiring them to be booksmart - in keeping up with recent cases such as this one and knowing how it affects their job - and also to be able to critically analyze each scenario as they are presented. It is imperative that police officers maintain a firm grip on legal literature so that they can justly uphold the balance between order and privacy. Moreover, to be able to apply such rulings in the plethora of scenarios that a member is faced with is a necessity. Meaning, law enforcement officers need not only be up to date on the most recent rulings, but thoroughly conceptualize the laws so that they can aptly apply them in their everyday life. CBJ Team. (2021 March 02). Case Watch: Lange v. California - Supreme Court Revisits the Hot Pursuit Doctrine.Crabb Brown James. https://cbjlawyers.com/case-watch-lange-v-california-hot-pursuit-doctrine/ Lange v. California, 20 U.S. 18 (2021). https://www.supremecourt.gov/opinions/20pdf/20-18_cb7d.pdf United States v. Santana, 427 U.S. 38 (1976). https://supreme.justia.com/cases/federal/us/427/38/ 2. Describe the relationship between the police agency/police administrator and the media. In what ways are there conflicts? In what ways are there partnerships? Police agencies and the press have utilized one another over the years, and the advancements in technology over the past several decades has resulted in the creation of a position within the police department: the Public Information Officer (PIO). Motschall and Cao speak of an PIO's role as being "designed to inform the media and the general public about agency operations, events, and activities," (2002, p. 153). The PIO is a liaison of sorts between the police department and the news media. The police and the news media are described by Kääriäinen, Isotalus, and Thomassen (2016) as being engaged in a mutually beneficial relationship, which allows for the news to be pumped full of highly entertaining stories of criminals while shining the police in the image that they seek for public approval. Further into their survey, the authors found that news coverage of a case of police misconduct does not have sway over the individual's perception, but that the news sources (which tends to be related to an individual's political party) may have a much stronger pull. This makes sense, as news outlets, regardless of whether they claim to be unbiased and fair, tend to cater to one of the two largest political parties of the United States or the other. And so, the individual consuming the coverage has already subscribed to a biased retelling of the scenario, and a spin that matches the individual's perception of the world will be included. Therefore, those more concerned with safety will be relieved by accounts relating to police officers being tough on crime, whereas their counterparts who are more concerned with human rights will be more and more disturbed with the state of the police (Fine, Rowan & Simmons, 2019). With this in mind, it is understandable that there would be instances of both partnership and conflict within the relationship between police agencies and the news media, as the consumers of the media will usually already have a preconceived idea of a policing failure or success. Furthermore, while these news media sources are catering to their intended audience, the story will be sensationalized either way. Such an example of this occurring can be found in the aftermath of George Floyd's death. News media outlets on both sides of the political spectrum acknowledged that George Floyd should not have been killed, and rioting and looting is criminal, yet what was focused on most often depended on the political affiliation of the news source (Phillips, 2020). Thus, those who lean more conservative were supportive of the police officers who were fighting against the burning of cities, while those who lean more liberal were angered and distraught over the killing of an innocent man. Even with the same overall story being covered, there are both instances of partnership and conflict between police agencies and the news media. Fine, A., Rowan, Z., & Simmons, C. (2019). Do politics Trump race in determining America's youths' perceptions of law enforcement? Journal of Criminal Justice, 61, 48-57. Kääriäinen, J., Isotalus P. & Thomassen, G. (2016). Does public criticism Erode trust in the police? The case of Jari Aarnio in the Finnish news media and its effects on the public's attitudes toward the police. Journal of Scandinavian Studies in Criminology & Crime Prevention, 17(1), 70-85. Motschall, M. & Cao, L. (2002). An analysis of the public relations role of the police public information officer. Police Quarterly, 5(2), 152-180.