...SB 89(BR-1094) According to Kentucky law (KRS 314.011), Advanced Practice Registered Nurses (APRNs) have been authorized to prescribe non-scheduled legend drugs and controlled substances to their patients after acquiring a written collaborative agreement with a physician licensed in Kentucky (KBN, 2018). The author of this paper resides in the state of Kentucky. The proposed Senate bill addressed in this paper amends the current practice of prescriptive authorities for APRNs in that state. The Bill proposes an expansion of the APRNs role in prescribing medication. Proposed Benefit SB 89(BR-1094) was introduced in the Senate on Wednesday, January 17, 2018. The Bill was sponsored by Senator Paul Hornback, from Senate district 20. The Bill...
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...Nurse Management and Leadership Case Study Nurse Management and Leadership Case Study Introduction Good leadership is necessary in every business organization. When it comes to nursing, every health center must have a good leadership that supports the nurses so that they can maximize their performance. However, for leadership to be of good quality there needs to be a good working environment in all aspects (Pinelli et al., 2004). The following is a case study illustrating an ideal working environment that supports good nurse leadership in health institutions. Type of Organization The organization that I would like to work in is a medium sized health care center. The facility is equipped with all the necessary gear needed to deliver quality healthcare services. There are over fifty doctors and seventy qualified nurses in the organization. The healthcare center serves over five hundred outpatient patients daily. It has enough facilities to cater for approximately 250 in-patients at any particular point. This health facility has taken into consideration the guidelines that make it professionally fit for an advanced nursing role. The development and implementation of good governance in this facility has been taken seriously in order to promote the nursing role. The following are some of the principles that have been implemented in order to promote good governance in this health facility. The organization looks at all the aspects of service delivery to promote good decision...
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...Nursing Roles and Values Task One Western Governors University State Regulations and Nursing Standards The State of Tennessee Board of Nursing’s Rules and Regulations of Registered Nurses, Rule # 1000-01-.13-1r states that unprofessional conduct is defined in part by "failing to take appropriate action in safeguarding the patient from incompetent health care practices" (State of Tennessee, 2011). There are a number of arguments in this case study that incompetent health care practices are being performed, from the decision to place a patient on a ventilator for an oxygen saturation of 88%, circumventing the patient’s written and verbal advanced directives, utilizing an unauthorized family member to get consent for a medical procedure, and discussing confidential medical information in a public location and with and unauthorized family member. The nurse clearly violated this rule because the nurse did not take any action at any point to stop the physician from taking these incompetent actions. Implications Rule # 1000-01-.13-1r applies because, as mentioned above, the nurse failed to take any action to prevent the physician from performing a number of incompetent acts related to the healthcare of the patient. First and foremost, the patient likely does not even need to be placed on the ventilator. The physician’s decision to place the patient on the ventilator is based on an oxygen saturation of 88%. Although the patient’s oxygen saturation does need...
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...GENETIC COUNSELING IN NURSING AND ETHICS Hyang Ko Azusa Pacific University Abstract The current development of genetic information and technique leaves us assignments. It is included ethical issues, roles of nurses, and the responsibilities in healthcare professionals. In order to understand nurses’ role and responsibilities and to provide genetic counseling, two research article with text books were reviewed. There were conflicts within ethical principles and nurses’ obligation. Each principle is important but one principle is superior to others when healthcare professionals make a decision in a certain context. It is necessary that genetic counseling is provided to patients and their family when healthcare professionals deal with genetic information. The two research articles empathized that experienced nurses are excellent candidates in genetic counseling within healthcare professionals by being educated, trained about genetic information. Genetic Counseling in Nursing and Ethics Definitions of Genetics and Genetic Counseling Officially, the terms of Genetics and genetic counseling is defined by Wekipidia as below: Genetics, a discipline of biology, is the science of genes, heredity, and variation in living organisms (http://en.wikipedia.org/wiki/Genetics). Genetic counseling is the process by which patients or relatives, at risk of an inherited disorder, are advised of the consequences and nature of the disorder, the probability of developing or transmitting...
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...Question Post: Week 4: Discussion – Clinical Challenges for the NP Case Study One: Dismissing the non-compliant patient. Gwen, a 52-year-old Caucasian LPN, recently joined your practice as a new patient. She currently has a BMI of 32, B/P of 142/88. Pulse is 89, the Respiratory rate is 22, Pulse Ox is 96% on Room Air. She is taking Lisinopril 10mg PO daily (when she can remember), Metformin 1000mg PO BID and refuses lab work. Her physical exam is unremarkable and foot exam is normal. She refuses all vaccinations including Prevnar and Influenza. Gwen’s last mammogram and Pap smear were “years ago.” The case study above is a description of health scenario of Gwen an LPN whose health is at peril. According to Westrick and Jacob (2016), this is a description of health care advice of patient non-compliant behavior. Gwen is an LPN who indeed understand her health conditions, however, fails to comply with the appropriate medical process, problem conforming to treatment care modality thus Gwen fails to accede to what is properly related to negligence. The Legal Implication and Key Component of Malpractice Policy in this Case There are indeed two components of malpractice policy related to...
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...Legal Issues Faced with ethical and legal decisions on a daily basis, nurses must at times make some pretty tough decisions including how to proceed with care for an incapacitated patient with no advanced directive or how to proceed when called upon to testify against a current employer. The American Nurses Association Code of Nursing Ethics is one of the main tools available for the nurse to utilize when it comes to making these tough decisions. The nurse may apply personal values as well as societal values to these cases in order to come to a sound, ethical decision. The legal aspects of each of these cases can have a profound effect on the continuing career of the nurse, a thorough evaluation is necessary to protect all involved. Finally, the nurse also carries a legal responsibility to her profession, workplace, patients, and self. Ethical and legal decision-making are complex but after a thorough assessment, the nurse can continue to make an ethically and legally sound judgment on how to proceed. Influence of the ANA Code of Nursing Ethics The ANA Code of Nursing Ethics is the first reference when deciding how to proceed with an incapacitated patient who has no advanced directive or how a nurse should react when called upon to testify against an employer in a negligence or malpractice case. This code, designed to assist the nurse in maintaining his or her ethical integrity as well as protect the nurse and patient during ethical dilemmas, is the foundation for ethical decision...
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...CASE STUDY Included in section 1300.360 RN Scope of Practice, Title 68 Professions and Occupations of the Nurse Practice Act it clearly states that nurses will advocate for patients. What this means to me is that if a patient is not of sound mental or physical state, that the nurse will act as the patients advocate in any situation that could or would affect the patient’s medical status. In this case in particular, the patient has an “advanced directive” in place that states his medical wishes. The patient also has a diagnosis of a mild mental retardation condition. The case study does not elaborate on the extent to the mental retardation; however he does have the legal advanced directive. Title 68: Professions and Occupations, Section 1300.350: Standards or Professional Conduct for Registered Professional Nurses in Illinois states several items. In reference to this case study, the most important would be to “report unsafe, unethical or illegal health care practice or conditions to appropriate authorities”. In my opinion, Dr. G is overriding the wishes the patient has listed in his “advanced directive”. What good is a document of this nature if a physician can make the choice to override it at anytime? The patient also has a “durable power of attorney”, which is Mr. B. This was also overridden by Dr. G. Both of these instances are unethical and could be challenged in a court of law. This would be a hard situation to be faced with. If I were placed in this situation...
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...Advance Practice Nurse Role for Legislators/Government Officials What is a Nurse Practitioner? According to the American Association of Nurse Practitioners (AANP 2016), nurse practitioners (NPs) are licensed, autonomous clinicians focused on managing people’s health conditions and preventing disease. As advanced practice registered nurses (APRNs), NPs often specialize by patient population, including pediatric, adult-gerontological, and women’s health. NPs may also subspecialize in areas such as dermatology, cardiovascular health, and oncology. NPs take health histories and provide complete physical examinations; diagnose and treat many common acute and chronic problems; interpret laboratory results and X-rays; prescribe and manage medications...
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...nursing skills class several decades ago up to the philosophy’s degree in nursing practice today. Since nursing is the holistic care of a human being, as caregivers, we must continue to invest time and effort into providing more advanced nursing to our holistic beings for their better health. According to the Institute of Medicine (IOM), nurses must be 80 % baccalaureate prepared RN workforce by 2020 (AACN Face Sheet, 2015). Therefore, nurses must endeavor to achieve the Bachelor of Science in nursing (BSN) for more competencies in their lifetime working field. Needless to say, patients will receive highly qualified care based upon enhanced education. Thus, BSN education preparation should be differentiate in order to meet these expectations. Different Competencies between the Associate-Degree Versus the Baccalaureate Degree Level The enlightened preceding nurses through many experimental years have developed many characteristics for a professional nursing. Currently educated nurses utilize their competencies that acquired from school in many different clinical setting environments. Compare to Associated degree level (ADN) focused on learning basic clinical skills within two years, BSN programs broadened learning realm along with the education centered on the art and science of nursing in four years (Walters & Kluwer, 2012). For example, ADN nurses tend to have better grasp on nursing skills and tasks such as IV insertion and Foley...
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... In the case study, the nurse is facing ethical as well as professional dilemma regarding the patient’s rights. The nurse’s role in this case study is to, work according to the Maryland state regulations and nursing standards; But as per Maryland nursing standards, she is not working as an advocate for her patient, Mr. E at this situation (Code of Ethics - the Division of State Documents, 10.27.19.02). The patient already signed advanced directive against life saving measures almost seven years ago, at the time of admission to a nursing home, with the help of patient advocate; but Dr G. is planning patient care in opposition to Mr.E’s active advance directive and his expressed objections to the medical care. There are numerous issues to consider in this case study. The nurse has to review her professional role according to code of ethics and nursing standards in relation to advance directives and medical power of attorney. The nurse also has to consider the patient’s right to privacy and confidentiality according to HIPPA Policy. The issues in contemporary healthcare facilities are sometimes the statues can be vague, and issues can be in conflict with own personal beliefs in most areas. A) State Regulations and Nursing Standards of practice There are specific Maryland state regulations and nursing standards regarding patient rights in this case study. However, the most relevant regulation is that, the nurse promotes, advocates for,...
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...Differences in Competency between ADN and BSN Nurses Angela G. Strickland Grand Canyon University NRS-430V August 15, 2012 Differences in Competency between ADN and BSN Nurses Presently if a person chooses to be a registered nurse they can follow three different pathways; diploma, associate degree, or baccalaureate degree. Diploma nurses obtain their education through a hospital based program. Associate degree programs are similar to baccalaureate degree programs except not as in-depth because of this they are more fast-paced. The Bachelor of Science degree in nursing is a four year academic degree that depending on which school and program can be very pricey. All three of these pathways will qualify the nurse to sit for the National Council Licensure Examination (NCLEX). The NCLEX only tests for the minimum competency in order to work as a safe nurse. According to the American Association of Colleges of Nursing (AACN) “The NCLEX-RN is only one indicator of competency, and it does not measure performance over time or test for all of the knowledge and skills developed through a BSN program” (Rosseter, 2012). In this paper only the competency of the ADN and BSN nurses will be discussed. A large percentage of nurses take the associate degree pathway, it is an attractive option because of the shortened amount of time it takes to graduate and begin work as a registered nurse, plus it takes half the amount of money. The associate degree programs were developed in order to...
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...education preparation argues that baccalaureate-degree level nurses are better prepared to provide safe, competent care than associate-degree level, and diploma-degree level nurses. Nursing is an ever evolving practice. Throughout the history of nursing, practices have changed, medicine has advanced, and the need for higher education among clinicians has increased. There has been ongoing research related to nursing practice, comparing the care provided by both baccalaureate-degree level nurses and associate-degree and diploma-degree level nurses to analyze the safety, and level of care that is being provided. Research has provided evidence that nurses with baccalaureate degree have fewer errors with medication administration, have a lower rate of mortality, and have also proved a better overall outcome (Rosseter, 2012). Baccalaureate-degree nurses have an advantage over associate-degree and diploma-degree nurses related to their advanced educational preparation. Nurses who have graduated with an associate’s degree or with a bachelor’s degree have both studied: the fundamentals of nursing; pathophysiology; pharmacology; the history of nursing; nursing across the lifespan, and physical and mental health. Both courses of study have also included: math, psychology, sociology, and multiple science courses. The difference between the four year Bachelors of Science in nursing BSN, and the two year associate-degree nurse ADN, is the in-depth training that the BSN learns and the ADN...
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...DIFFERENCE BETWEEN NURSES PREPARED AT THE ASSOCIATE DEGREE LEVEL VERSUS BACCALAUREATE DIFFERENCE BETWEEN NURSES PREPARED AT THE ASSOCIATE DEGREE LEVEL VERSUS BACCALAUREATE Different levels at which a nurse is prepared have a strong impact on the nurse`s ability to practice in a health care setting. In the nursing profession, nurses are prepared at different levels. A baccalaureate nurse is a nurse who has completed a four years formal training in a university or senior college and has completed a 120 hours college and has acquired broader understanding in physical and social sciences, nursing research, public and community health, political, economic and social issues. While an associate degree nurse is a nurse who has completed a two years program in a community college and has completed a 60 hours college credit and only acquired understanding of fundamentals of nursing and sometimes lacks some basic knowledge to handle critical issues as they arise in patient care. Although both Educational levels took the same licensure exam after completing their program and have registered nurse license to practice as a registered nurse, there are still some enormous difference between the quality of their work in terms of positive patient outcome, lower mortality rates, quality patient care, clinical competency, administrative/leadership role, critical thinking and decision making. These roles are also incorporated in the GCU college of nursing philosophy where it states” the...
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...research. British Journal of Nursing, 16(11), 658-663. This article provides a step-by-step approach to understanding research terminology and provides the nurses with a basis for understanding quantitative research. The article points out that being able to read nursing research is the first step in incorporating evidence based best practices into nursing care. As referred to in the article, each stage of the process must be thoroughly examined and this article walks the inexperienced nurse through the process. Duffy, J. R. (2005). Critically appraising quantitative research. Nursing & Health Sciences, 7(4), 281-283. doi:10.1111/j.1442-2018.2005.00248.x Critical appraisal of quantitative research is important to evidence-based practice. It allows a clinician to determine whether a study is scientifically rigorous. This article describes critical appraisal as a careful process of judging the worth of a quantitative study that guide clinical decisions, as well as a structured approach for understanding the strengths and weaknesses of a study. The author describes the process of implementing research appraisal. The author also provides multiple links to critical appraisal tools. Flemming, K. (2010). Synthesis of quantitative and qualitative research: an example using Critical Interpretive Synthesis. Journal Of Advanced Nursing, 66(1), 201-217. doi:10.1111/j.1365-2648.2009.05173.x This...
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...would like to begin my career as an active duty army nurse. I am currently in the Army Reserve; however, I am not in the ROTC program. Because I am not in the ROTC program, which may inevitably make becoming a nurse in the army more of a difficult task. If by some unfortunate chance I cannot become a nurse in the army, I would like to begin my career in critical care or the emergency department. However, my preference would be the emergency department. I think...
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