Barriers that hinder the effective application of hospice/palliative care in the current society Palliative care revolves around improving the quality of life for patients and families exposed to long-term diseases. It remains one of the crucial approaches in the healthcare sector. Despite its relevance, most people fail to acquire vital services or do so in the last phase of their illnesses (Hawley, 2017). This limitation denies patients and their families an opportunity to develop quality health and overall well-being. Poor communication, inadequate provision of information about palliative care services, and unequal access to care services remain some of the crucial barriers to palliative care. Failure to integrate viable communication tactics between patients, family members, and clinicians is a threat to hospice care delivery. Also, some community members fail to receive information on palliative care and thus do not access these services. Lastly, socioeconomic, racial, and ethnic characteristics play a vital role. Minority underserved populations are less likely to receive palliative care services compared to the majority populations. Appropriate nursing roles and strategies in end-of-life decision making in acute care, ICU, and pediatric populations Nurses have a pivotal role in the decision-making process surrounding acute care, ICU, and pediatric populations. There is a dire need for the nurses to understand the effectiveness of respective strategies and activities. As Adams et al. (2011) state, exposure to processes linked to end-of-life decisions (EOL) helps patients and families make viable choices. The role of nurses in ELO is to act as an information broker, supporter, and advocate. They provide information to physicians, provide patient and family preference, and deliver emotional readiness. They also build trust, meet practical needs, and provide details about patient care daily. They integrate strategies such as engaging in the shared decision-making process, receive essential and truthful information, and develop trusting relationships with patients and their families. The role of the nurse in promoting concepts of hospice/palliative care Nurses initiate interventions that help patients counter pain and other prevailing symptoms in their dying process. One of the key considerations is that nurses act in line with the expected standards. They are not expected to act in a manner that directly insinuates the intent of ending a patient’s life. They monitor the patients and provide pain management perspectives (Hawley, 2017). Notably, nurses provide medications, manage tools and equipment, and also provide personal care. Overall, the central focus is to deliver quality care and attention service in the dying process. Three significant elements of learning over the course Trust, empathy, and effective communication are crucial insights that I have gained in the course. I will integrate these vital elements to deliver quality services to patients and their family members. I believe that being an effective communicator and in a position to understand other people’s feelings puts me in a better place to develop a trusting relationship. I will utilize these three elements to understand patients’ issues, attitudes, perceptions, and expectations. For example, forming a trustworthy relationship with a patient will enable me to learn about their experiences and expectations. Provision of self-care in times of stress, sadness, and loss If I experience stress, sadness, and loss, I will surround myself with positive people and a supportive environment. For example, I can spend more time with family members and friends who I believe can provide me with a shoulder to lean on. I would also visit an aesthetic environment such as the park or a garden to relieve off the stress, sadness, or loss.   References Adams, J. A., Bailey, D. E., Anderson, R. A., & Docherty, S. L. (2011). Nursing roles and strategies in end-of-life decision making in acute care: A systematic review of the literature. Nursing Research and Practice, 2011. Hawley, P. (2017). Barriers to access to palliative care. Palliative Care: Research and Treatment, 10, 1178224216688887.

Question One

The detailed analysis by Bjelopera and Finklea (2012) demonstrates the evolving nature of Transnational Organized Crime (TOC) and how it affects law enforcement agencies’ efforts to control its spread. The authors indicate TOC’s evolution through the adoption of structural approaches that hinder the efficiency of combat operations initiated by law enforcement agencies. Likewise, the criminal groups have internationalized their operations through their ability to utilize technological systems that allow them to morph into the modern community and evade the measures implemented by authorities around the globe. Incorporating technology in their criminal operations has provided gangs with an opportunity to bypass the government’s long-arm because of their ability to conduct their activities without any detection from the law enforcement agencies. Internet connectivity plays a significant role in executing different criminal operations because of the anonymous aspect that allows gangs to remain undetected. Cybercrime cases are on the rise because of criminal groups’ ability to mask their identity and execute their activities remotely.

Unlike the traditional approaches used by criminal gangs that exposed their vulnerabilities to U.S. enforcement agencies, modern groups rely on cellular and networked structures to avoid the sting operations embraced by global authorities. This operation mode has eliminated the hierarchy of leadership that made it easier for law enforcement agencies to cripple a criminal group’s operations by eliminating their leaders. From this realization, globalization has played a significant role in criminal activities’ evolution because of the increased demand for illegal products worldwide. Besides, the reward for engaging in TOC has risen exponentially, a move that has seen a rise in the number of criminal activities worldwide.

Question Two

Even though many people believe that treating all gangs like mafia kingpins overemphasizes their importance, criminal activities’ impact continues to be felt. I’m afraid I have to disagree with the notion that many gang members are petty delinquents because of their ability to expose individuals to a risky environment where they cannot control outcomes in their immediate environment. Narrowing down on gang members’ identity presents an opportunity for law enforcement agencies to develop viable strategies that can be used to counter the criminal operations by crippling their networks and weakening their links with the outside world (Papachristos, 2009). The approach used by U.S. law enforcement agencies demonstrates the impact of preparing to counter the sophisticated mechanisms deployed by criminal gangs and their ability to overcome challenges caused by their ability to remain undetected.


I believe criminal gangs have affected the nature of interactions on the internet because of the rise in cybercriminal cases reported worldwide. Many internet users are always exposed to illegal activities because of the vast chunks of information they deposit on their social media accounts. Creating a system that hinders criminal gangs from taking advantage of internet users can cripple their operations and weaken their networks (Arsovska, 2016). In the same vein, the approaches used by U.S. law enforcement agencies have a significant impact on their efforts to counter the criminal operations because of the numerous changes that have taken place in the trans-organizational crime. Overestimating criminal gangs prompts the relevant authorities to develop viable mechanisms that can respond to the gangs’ threats in the U.S. and beyond.




Arsovska, J. (2016). Culture, Migration, and Transnational Crime: Ethnic Albanian Organized Crime in New York City.

Bjelopera, J. P., & Finklea, K. M. (2012). Organized Crime: An Evolving Challenge for US Law Enforcement. Washington, DC: Congressional Research Service.

Papachristos, A. V. (2009). Gang world. Foreign policy, (147), 48.

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