Kim works as a charge nurse in the Alzheimer's unit at a not-for-profit assisted-living retirement community. She loves her patients, believing that she connects to the older adult population. Kim believes that her role as a patient advocate requires her to make the needs of the unit known to the administrator, so she schedules a meeting. During the meeting, Kim approaches the following topics:

• Inadequate staffing. The unit acuity has increased over the past 6 months, and staffing has not kept up with the changes. The extra staff could affect patient outcomes. Kim asks for one more nurse per shift.

• A monitoring system. The Alzheimer's unit requires some form of monitoring to identify where patients are during the day. Having such a system would provide safety by tracking patients to make sure they are not wandering where they should not be.

• Change to the acuity system. The current method does not take into account the severity of Alzheimer's disease.

The acuity system is antiquated and needs to be updated to reflect the current understanding of the patients' needs. The administrator says the budget is too tight at this time to consider any of Kim's requests.

1. How could Kim strengthen her arguments for the requests?

2. How is Kim demonstrating fiscal responsibility to the patient?

3. Which actions can Kim take to increase fiscal responsibility to the institution and the patient?