...NURS 6565 - Main 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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...FAQ: 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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...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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...profession as an Advanced Practice Nurse. The course has allowed my growth and has equipped me with the tools to become more comfortable in the practice setting. Even though I have cared for hundreds of patients before, during my initial contact in the clinical setting I was a bit nervous possible because of my soon to be new role as a provider who will be liable for making safe and appropriate decision in caring for patients. The different case studies provided in the course and learning about the differential diagnoses has also helped me to pinpoint the main diagnosis before initiating a treatment plan....
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...Do X-rays Requested By Triage Nurses Decrease Waiting Times? Research in Health and Social Care Introduction: Since 1991 when the patient’s charter (Department of Health 1991) was introduced, Accident and Emergency (A&E) departments have been under pressure to see, treat and discharge patients within a certain time period. In 1991 75% of walking wounded who presented to the department had to be discharged within one hour. It was subsequently changed in 2004 when the government decided that 98% of all patients attending an A&E department should be in the department no longer than four hours (Department of Health 2004). And again in 2011 when the department of health introduced the clinical care indicators that relaxed the target to 95% seen, treated and discharged or admitted in 4 hours (Department of Health 2011). Triage nurses within the accident and emergency department are one of the first people to assess the patients who present with an injury or illness. The patient’s condition is assessed and their need for how quickly they require treatment is prioritised. Triage nurses are usually experienced A&E nurses who have many years A&E experience (Dolan et al 2007). Patients are then placed in queues to await assessment by a Doctor or Emergency Nurse Practitioner. Once seen they are then put in another queue to await x-ray if necessary before waiting again to see the doctor/ENP that will interpret their x-ray and decided on the best course of treatment...
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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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...inter-professional collaboration with MD? Nurse practitioners are registered nurses who have an advanced education (Master’s Degree at minimum) and the ability to provide a wide range of health services, similar to those of physicians. These services allow preventative and acute healthcare services to patients of all ages. An NP’s services can include, performing physical examinations, diagnosing and treating common and chronic acute health issues, ordering and interpreting x-rays and laboratory tests, and prescribing and managing medications. NP’s also provide health education and promote healthy lifestyle behaviors and illness prevention. An NP’s scope of practice can very from state to state depending on the state laws that govern their practices; some of the most rigorous laws and restrictions being from California. (Buppert, C. 2012). A Clinical Nurse Specialist is a clinical expert who also has an advanced education and shares some of the same abilities and practices of an NP. They can also provide direct patient care services including, health assessment, health promotion, and prevention, as well as the management of health issues. However, CNS’s specialize in areas of nursing that improves nursing care through education, consultation, and research. The roles of CNS’s contain five major components consisting of expert clinical practice, clinical leadership, consultation, education, and research. (Buppert, C. 2012). A Clinical Nurse Specialist (CNS) is an expert clinician...
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...flexibility, visibility and relevance) (Whetten & Cameron, 2011). From the team setting provided, the six roles can be divided into two groups; surgeon, general practitioner and radiographer in one (high-ranking) and theater nurse, ward nurse and ward clerk in another group (low-ranking). Generally high-ranking personnel have more authority (formal power) than lower-ranking personnel (Mechanic, 1962). As such sources of power for surgeon, general practitioner and radiographer are mainly coming from the personal power group; their professional qualification background-expertise power, effort power where they have to be responsible on patients’ condition and expectations from others, plus legitimate power that they possess to save lives which is congruent with health care system objectives. Oppositely, the lower-ranking group (theater nurse, ward nurse and ward clerk) obtains much of its power in the form of positional power. The group’s broad network of both vertically and horizontally in tasks and interpersonal relationships provides great centrality power by having access to information. Furthermore, the famous Doctor-Nurse Game by Stein (1967) shows that flexibility and visibility are another two main sources of power resulting from the dependency of high-ranking on low-ranking groups. These two powers are well illustrated when nurse provides recommendation or...
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...difference between nurses prepared at the baccalaureate degree level and nurses prepared at the associate degree level. Abigail Fosu Grand Canyon University: NRS 430V 11/08/2015 The associate degree and the baccalaureate degree nurses are both RNs who have taken and passed the NCLEX proficiency test and are licensed to practice nursing. They both have in most cases the same job titles and duties. However the difference between these two nurses are the educational levels attained. The BSN nurses has educational background that prepares them to be ready for the demands of the job. As they take more core classes which shape and build their skills as nurses. Education and training. The commitment require to become a baccalaureate degree nurse is more than that of an associate degree nurse, BSN nurses are in school for four years where as an associate degree program takes two years. They take more humanitarian and social science classes, as well as classes expanding deep into theory, evidence based practice, nursing research and patient care. The baccalaureate students also are able to build and learn leadership and managerial skills through team projects that they are required to participate in during their study. They are able to develop strong critical thinking skills and problem solving skills within the four year period. Unfortunately ADN programs focus directly on the basic nursing skills, how to perform, duties, techniques and procedures as nurses. . Job opportunities...
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...The readings this week discussed Milstead (2013) six case studies regarding the roles and scopes of APN’s. Case study four reflected upon Medicare and Medical Home Health Services (HHS) with regard to the APN’s scope of practice. NPP’s are all subjected to the same financial restrictions as physicians under the HHS guidelines (Center of Medicare and Medicaid Services, 2015). Chapter seven explained the Medicare policy manual and the regulations related to patient eligibility for home health services and physician certifications. Section 30.5.1.1 described the qualifications of a non-physician practitioner (NPP) for patient face-to-face encounter. The policy revised and implemented in May 2015, stated nurse practitioners, clinical nurse...
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...Kolotylo, C. (2010). A questionnaire for assessing community health nurses' learning needs. Western Journal of Nursing Research, 32(8), 1055-1072. This journal covers the important stages of the Learning needs assessment and how it impacts every educational process that is aimed to inform changes in practice and policy for continuing professional development. Professional opportunities have been widely used as a basis for the development of learning needs assessment. This article reports on the development of a learning needs assessment questionnaire for Community Health Nurses (CHNs). Exploratory and confirmatory factor analyses were conducted to examine the consistency of factors underpinning the Canadian Community Health Nursing (CCHN) Standards. Also, validity and reliability of the questionnaire were evaluated using appropriate techniques. This process resulted in a valid and reliable CHN learning needs assessment questionnaire to measure learning needs of large groups of practitioners, where other forms of measurement cannot be feasibly conducted. Aydin, A.K., & Karadaq, A. (September-October 2010). Assessment of nurses knowledge and practice in prevention and management of deep tissue injury and stage 1 pressure ulcer. Journal of Wound, Ostomy, and Continence Nursing, 37(5), 487-494. This is a good overview from a well-known nursing journal that focuses on a descriptive study on how to determine a nurses knowledge and usual practice and prevention of deep tissue injuries...
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...("Report," 2010). The message of the Institute of Medicine (IOM) in regards to the future of nursing clearly states that changes should be made in its field in order to meet these emerging demands. As stated in the IOM report on The Future of Nursing: “A number of barriers prevent nurses from being able to respond effectively to rapidly changing health care setting and an evolving health care system. These barriers need to be overcome to ensure that nurses are well-positioned to lead change and advance health” ("Report," 2010). Because of this, focus in the changes in education, nursing practice, nursing role, and leadership are the key requirements for nurses today. If changes are not started at this time, then the future of quality and safe nursing care is at risk. Knowledge is power, and quality education is needed to acquire knowledge. “A more educated nursing workforce would be better equipped to meet the demands of an evolving health care system, and this need could be met by increasing the percentage of nurses with a BSN” ("The Need for Highly-Educated Nurses," 2011, p. 1). The goal of the IOM report on the future of nursing, with respect to education, is to increase the number of nurses with baccalaureate degrees from 50% to 80% by 2020. A solid educational background is a foundation of a strong...
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... All nurses practice acts include two essential purposes. First each act includes statements that refer to protecting the health and safety of the citizens in the jurisdiction. The second purpose is to protect the title of the RN. The legal title RN is reserved for those meeting the requirements to practice nursing. (Contemporary Nursing, 2014) The scope of practice for RN’s is to provide individuals and groups nursing care, requiring specialized knowledge, judgment and skill derived from the principles of biological, physical, behavioral, social and nursing science. Such nursing care includes: 1. Indentifying patterns of human response to actual or potential health problems amendable to a nursing regimen. 2. Executing a nursing regimen through the selection, performance, management and evaluation of nursing actions.’ 3. Assessing health status for the purpose of providing nursing care. 4. Providing health counseling and health teaching. 5. Teaching administering, supervising, delegating and evaluating nursing practice. (Law regulating the practice of nursing, dialysis care and community health workers., 2013) (Ohio Board of Nursing) An advanced practice RN is a registered nurse who has completed and advanced graduate-level education program and has passed a national certification examination in order to practice in one of four APRN (advanced practice registered nurse) roles, such as: clinical nurse specialist, nurse midwife, nurse practitioner, and...
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...The Nurses Role in Transforming Healthcare Grand Canyon University: NRS-430 Professional Dynamics November 10, 2012 The Institute of Medicine (IOM), developed in 1970, is as self- governing, non-profit organization that provides informed health decisions for decision makers and the public. The IOM’s advice and decisions are based on expert committees’ discussions, discoveries and cross disciplinary thinking. The IOM asks and answers the nation’s most pressing questions about health and health care (Institute of Medicine, 2010). One of the questions that commonly arises is, what is the nurses’ position and responsibility to ensure the ability to carry out the increasing demand for quality health care? Health care is ever changing. With advanced technology and new research, nurses must have the ability to adjust to frequent change and often overcome complex situations. In order for new practices and advancement in healthcare to be successful, nurses must remain educated and involved. The IOM report focuses on the impact of education, nursing practice and leadership and their significance in the future of health care delivery. As healthcare advances, unfortunately, the number of people living with chronic illness rises as well. In order for healthcare members to be able to accommodate and care for these patients it is pertinent that healthcare workers, particularly nurses at the entry level or Associates degree level (ADN) consider continuing education toward the Baccalaureate...
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...Differences in Competencies between Nurses Based on Degree Level Introduction Nurses usually start their training as generalists and then pursue various specialties as they advance their education. Principally, there are three types of nurses based on their levels of education and responsibilities. The first type is the Registered Nurse (RN), who holds a diploma in Practical Nursing (ASN) after two years of study in either a college or a hospital. Based on their education level, RNs are competent enough to deal with some complex issues. Consequently, they mostly deal with patients who are stable and predictable. The second type is the Registered Nurse (BSN). The RNs with a baccalaureate degree in Bachelor of Science in Nursing (BSN). RNs undertake comprehensive studies; hence, they possess superior knowledge and skills in critical thinking, research, and clinical practice. Notably, the BSN are competent to handle patients with complex problems and unpredictable conditions. The third type is the Nurse Practitioners (NPs), who are Registered Nurses with advanced education. NPs specialize in adult care, primary health care, anesthesia, or pediatric care (Klein and Fowles 117). Competence and Advanced Education Notably, the competence of nurses increases as they advance their level of education. Indeed, some states have laws that require nurses to continue with their education as a condition for the renewal of their licenses. The reason that nursing demands continued education is...
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