...opportunistic infections. As a nursing student, I am responsible for making sure that I do not cause cross contamination. My question is “What are evidence based methods to prevent opportunistic infections in patients with a compromised immune system?” Since one of my sources addresses neutropenia, it is necessary to explain the disorder and how it relates to my question. Information about neutropenia was obtained from an article named Neutropenia: A Diagnostic Approach from the Western Journal of Medicine. The two authors are doctors and this article is based on evidence-based case review. Neutropenia is a somewhat common condition in which the level of neutrophils in the blood is abnormally low (Montgomery and Munshi, 2000, para. 1). An immune system becomes compromised when it does not have an adequate number of neutrophils and my question concerns patients who have a compromised immune system. Some causes of neutropenia include chemotherapy, viral or bacterial infections, adverse drug reactions and autoimmune disorders, such as AIDS (Montgomery and Munshi, 2000). Another source is a peer reviewed article named Neutropenia: State of the Knowledge Part II. The main author of this article is Nirenberg, but she had input from five other authors. This article is from the Oncology Nursing Forum which is property of the Oncology Nursing Society. The Oncology Nursing Society (ONS) is a professional oncology association composed of registered nurses and...
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...Failure Unit * Provided direct patient care to patients requiring continuous telemetry monitoring including LVAD, transplant, and medical patients on the heart failure unit * Participated in coordinating discharge planning and home care with doctors, social workers, case managers, physical therapists, nutritionists * Served as a patient advocate and recognized for patient satisfaction * Monitored daily weights, intake and output, and reported symptoms and changes in patients’ condition * Actively participated in codes and rapid responses on the unit * Participated in Performance Improvement projects and activities * Provided written and teaching/demonstration skills for extensive patient education * Counseled patients a family members on the promotion and maintenance of health and disease prevention through health teaching EDUCATION College Name, City, State Bachelor of Science Degree in Nursing LICENSES/CERTIFICATIONS * New Jersey Registered Professional Nurse * New York Registered Professional Nurse * Basic Life Support for Health Care Professionals * IV Certified PROFESSIONAL ASSOCIATIONS Member – American Association of Critical Nursing OTHER EXPERIENCES Volunteer, Somerset Medical Center (Summer 2011) * Extend patient comfort care and staff support by answering call lights, refreshing water, assisting patients with meal trays and feeding, and listening to patients and family...
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...please e-mail pubpermissions@ons.org. FEATURE ARTICLE Building Comfort With Ambiguity in Nursing Practice Kalli Stilos, RN, MScN, CHCPN(C), Shari L. Moura, RN, MN, CONC(C), CHCPN(C), and Frances Flint, RN, MN Current nursing literature recognizes the need to honor the concept of ambiguity. Nurses experience uncertainty with handling or honoring complexity and ambiguity when confronted with times of struggle. Traditional models of care fall short as patients and families define their expectations of the healthcare system. Nurses bear witness to the discomfort caused by the unknown in their daily practice. They are challenged to address their feelings, unsure of what to anticipate, what to say, or how to respond to their patients. Uncertainty diminishes the opportunity for meaningful dialogue between nurses and other people. Nurses attempting to ease the discomfort of ambiguity by providing patients or families with reassurance, offering advice on how to fix problems, or avoiding talking about situations often express dissatisfaction. Nurses should be invited to explore ambiguity and seek understanding through dialogue and nursing knowledge. Encouraging nurses to define the meaningfulness in nursing practice that embraces human science theory will help relieve some of the ambiguity that exists in current practice. This article will explore the concept of ambiguity, highlight how nursing theory based on human science can support practice, and propose recommendations for practice...
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...pancreatic cancer. He is married with two children and had previously worked as a solicitor- he has been admitted to the local hospice. For the purpose of this assignment the focus will be on pain, the importance of being pain free and what this would mean for Charles will be discussed through-out this case study. The World Health Organization (2008) say that freedom from cancer pain must be regarded as a human rights issue. Charles's pain was poorly controlled on admission so it took several hours for the nurse to assess and come to an agreement with Charles about how to manage his pain. The End of Life Care Strategy, written by the Department of Health have published the following guideline; " Ensure that pain amongst people approaching the end of life are kept to an absolute minimum with access to skilful symptom management for optimum quality of life." (Department of Health, 2008, p33). Historically, pain was seen as an emotion rather than a sensation that was experienced by the heart and not the brain (Meldrum, 2003). Pain in today’s society is seen as an unpleasant sensory and emotional experience associated with actual or potential tissue damage (International Association of the Study of Pain, 2011). Therefore, pain is not only experienced on a physical level such as intensity, location and quality but also with emotional feelings such as anxiety, frustration and depression. Pain is a multidimensional phenomenon and many health care professionals today adapt a more practical...
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...Kolcaba’s Comfort Theory Katherine Kolcaba is the founder of the comfort theory in nursing. She was born in Cleveland, Ohio; where she has spent most of her life. In 1965 she became a graduate of St. Luke’s school of nursing obtaining a nursing diploma. After working for many years in the areas of medical surgical nursing, long-term care, and home care. She had a promotional offer that required an academic degree. After completing the required prerequisites she went to Case Western Reserve University and in 1987 graduated in the first RN to MSN class with specialty in gerontology. During her years of work as a head nurse, she began to see comfort in a theorical context. She advanced her education and in 1997 obtained a PhD in nursing from Case Western University. Dr. Kolcaba is an associate professor at the University of Akron, Ohio, where she teaches an undergraduate course titled Nursing Care of Older Adults and graduate courses in research, theory, professional roles, and domains of nursing knowledge. Her areas of expertise include gerontology, end- of- life, long-term care interventions, comfort studies, instrument development, nursing theory, nursing research, and magnet status. (Kolcaba, Tilton, & Drouin, 2006, p. 648). Components of the theory The back bone of the comfort theory is the taxonomic structure grid of 12 cells. It intercalates the three types of comfort with the four contexts of human experience. The three types of comfort are; relief is the state of...
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...Running Head: Research Critique Part 1 1 Research Critique Part 1 CLABSI in the Pediatric Oncology Population Cathy Frederick Grand Canyon University NRS-433V Introduction to Nursing Research October 11, 2015 Research Critique Part 1 2 Purpose of the Research This paper will perform a research critique on a qualitative research study published in the Infection Control and Hospital Epidemiology, March 2013, Vol. 34, No.3. The study was presented with contributions from multiple individuals, Dr. A. Gaur, Dr. D, Bundy, C. Gao, PhD, Dr. E. Werner, Dr. A. Billett, Dr. J. Hord, Dr. J. Siegel, Dr. D. Dickens, C. Winkle, RN., and Dr. M. Miller. The research was to identify the host and organism characteristics of the hospital-acquired condition, central line-associated bloodstream infections (CLABSIs) in pediatric hematology/oncology patients. Problem Statement CLABSIs increase the risk for increased mortality and morbidity, extended hospital stays, and raises the overall cost of healthcare. Children’s Hospital Association Hematology-Oncology Quality Transformation Collaborative Project (CHAHQTCP), was a qualitative research project that began on November 1, 2009 and ended July 31, 2011. This project was initiated to identify the contributing factors to blood stream infections (BSI) in pediatric hematology patients. The goal of this research was to reduce CLABSIs by 50%. To be included, the CLABSI needed occur 48 hours after being hospitalized or...
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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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...NRS-430V November 20, 2015 In the nursing profession, nurses have evolved along with advances in education and practice. Throughout the profession’s history, nurses have functioned as advocate for a better, safer health care system, and for public guidelines that promote the health of the population. Nurses have the option of choosing from two levels of college education in other to achieve their goals and become professional nurses, an associate degree or a baccalaureate degree. Their purpose is training nurses to function independently, collaborate with the others team members, and implement critical thinking skills in providing high quality nursing care. Both degrees fulfill the requirements to become an RN, however the main differences in competencies are length of the program, educational level and finances. National League of Nursing had a complete study about todays nursing schools. The study gave detailed description of the schools, described their curricula, and made recommendations for professional nursing collegiate education. Mildred Montag is the originator of ADN programs in the states. She dedicated herself to educate “technical nurses” to assist professional nurses. Her further goal was all nurses to possess a baccalaureate degree and achieve higher education. An Associate degree in nursing is typically two years college degree program which emphases on clinical nursing skills, disease conditions and bedside nursing with no evidence-based practice. I consider...
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...How do competencies vary between ADN and BSN? March 25, 2015 How do competencies vary between ADN and BSN? I am very proud of my accomplishment of obtaining my license as a Registered Nurse as this was my lifelong dream. I chose a very common route to achieve this, through a community college. This program offered a low cost and rather short timeframe to reach my goal of becoming a RN. The ADN program was rumored to be one of the best in Wisconsin so I chose it, with plans of pursuing my BSN right after I graduated. Unfortunately, like most get their ADN, this just doesn’t happen. A person gets a nursing job and deals with work, life and family stressors, who needs to go back to school for a BSN? A BSN does not generally pay better, the job description is the same for both degrees, why would one possible waste their time? During my first class at the community college, the students were told that the ADN graduates generally performed higher on their NCLEX exams than did the BSN graduates. Another point taught was that this ADN degree was more desirable to perspective employers because ADN’s had greater clinical skills and got hired faster. This information seemed to be true, I was hired at a desirable facility and so began my career as an ADN. My career was going great, I was living my dream, having everything I always wanted. Then policies changed, nurses could no longer hold management positions unless they returned to school to earn their BSN. ...
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...take the NCLEX-RN and get an RN license. The American Association of Colleges of Nursing (2010) believes that “education has a significant impact on the knowledge and competencies of nurses”. The healthcare environment and the nursing world today are constantly changing. The economy is getting worse and competition is getting fiercer. As a result there is an escalating demand for better-quality and efficient patient care providers and independent decision making nurses. The registered nurse today is expected to do much more than just follow physician’s orders, administer medications on time and wound dressing changes. The nurse nowadays must be able to make important judgment decisions, must be able to politely query a doctor when orders seem not appropriate and help patients and family members make difficult decisions that will affect their lives. The associate degree RN and the bachelor’s degree RN have the same RN license, but the baccalaureate degree nurse studied more subjects in the physical and social sciences, nursing research, public and community health and the humanities. These additional courses further enhances the RN’s professional development and provides the nurse with a holistic understanding of the social, economic and political issues that influence the patient and is more prepared to assist them in making decisions that will affect their lives. The American Association...
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...influence of Florence Nightingale there was no formal education for nurses and their work and social status was considered very low. Now partly because of the work of our nursing pioneers nurses are respected and educated professionals. In the United States there are currently three recognized routes to becoming a Registered Nurse. There are Diploma Schools which are hospital based and rely on the apprentice model, the Associate Degree, started by Mildred Montag in response to a post World War II nursing shortage and the Baccalaureate degree. According to the American Association of Colleges of Nursing, Fact Sheet: Creating a More Highly Qualified Nursing Workforce:” The fact that new nurses pass the licensing exam at the same rate does not mean that all entry-level nurses are equally prepared for practice. The NCLEX tests for minimum technical competency for safe entry into basic nursing practice.” The test does not differentiate between the ADN and BSN educational backgrounds. The ADN graduates from a two year program most often in a Community College setting that prepares nurses to provide safe nursing care at the bedside following facility protocols to carry out procedures and to provide education to patients and families but it does not thoroughly investigate the theory and science of the nursing profession. The ADN is also expected to supervise the Patient Care Technicians and Licensed Practical Nurses. The BSN is a four year program in a...
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...1 Searchable Clinical Question (graded) Read the assigned case study and formulate one searchable, clinical question in the PICO(T) format. There are several potential questions that could be asked. Identify if the focus of your question is assessment, etiology, treatment, or prognosis. Remember to integrate references. DQ 2 Role of Research (graded) Why should nurses incorporate research? What trends have created a push for nursing practice based on evidence? Remember to use references. Devry NR439N Week 2 Discussion DQ 1 & DQ 2 Latest 2016 Jan. DQ 1 Describe a Significant Nursing Clinical Issue (graded) Reflect on your practice and identify a significant nursing clinical issue that you would like to search for evidence in online sources. This issue will be the basis for the Research Database Assignment that you will submit in Week 3. Formulate searchable, clinical questions in the PICO(T) format for your nursing clinical issue. Remember to integrate references. DQ 2 Share a Research Database Description (graded) Review the guidelines and grading rubric for the Research Database Assignment due in Week 3. Search for ONE research database that is relevant to your nursing clinical issue, briefly describe the issue you are investigating, and use the instructions on the form provided in Doc Sharing to write your review. Briefly describe your process for locating databases that contain relevant research studies. Did you have any difficulties or face any challenges? Devry...
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...the demand for a more educated, skilled, resourceful practitioner is required (Smith, 2009). Personal Experience Example of how an ADN versus BSN nurse would treat a CHF patient. A specific patient case I reviewed, was readmitted to a hospital again within thirty days with a diagnosis of congestive heart failure. The ADN trained nurse could administer drugs, perform daily weights, ensure that the patient followed a cardiac diet, but was strictly task oriented (The Future of the Associate Degree in Nursing Program, 2013). The BSN trained nurse, would base the care provided using a more integrated system (Why the Push for BSN Nurses?, 2012). The focus of the BSN trained nurse would encompass more teaching, measuring compliance of instructions that were given, and ensure core measures would be met prior to discharge. The follow up care would include determining if the patient had access to meds, home health, understood the need to maintain dietary restrictions, and instruct the patient on keeping a daily weight log to ensure that weight trends would be monitored and recorded. ADN AND BSN DIFFERENCES 3 The college system today has defined an ADN nurse as technical and a BSN nurse as a professional nurse (The Future of the Associate Degree in Nursing Program, 2013). A nurse with an ADN degree, although important, can look at the degree as a stepping stone to advancing their career to attain the BSN. The ANA has been pushing for nurses to obtain their...
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...the demand for a more educated, skilled, resourceful practitioner is required (Smith, 2009). Personal Experience Example of how an ADN versus BSN nurse would treat a CHF patient. A specific patient case I reviewed, was readmitted to a hospital again within thirty days with a diagnosis of congestive heart failure. The ADN trained nurse could administer drugs, perform daily weights, ensure that the patient followed a cardiac diet, but was strictly task oriented (The Future of the Associate Degree in Nursing Program, 2013). The BSN trained nurse, would base the care provided using a more integrated system (Why the Push for BSN Nurses?, 2012). The focus of the BSN trained nurse would encompass more teaching, measuring compliance of instructions that were given, and ensure core measures would be met prior to discharge. The follow up care would include determining if the patient had access to meds, home health, understood the need to maintain dietary restrictions, and instruct the patient on keeping a daily weight log to ensure that weight trends would be monitored and recorded. ADN AND BSN DIFFERENCES 3 The college system today has defined an ADN nurse as technical and a BSN nurse as a professional nurse (The Future of the Associate Degree in Nursing Program, 2013). A nurse with an ADN degree, although important, can look at the degree as a stepping stone to advancing their career to attain the BSN. The ANA has been pushing for nurses to obtain their...
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...Nurse Burnout and Its Impact on Patient Safety Georgetown University Foundations of Health Systems and Policy NURO-624 September 12, 2013 Nurse Burnout and Its Impact on Patient Safety Patient safety encompasses the application of best practices that are geared towards achieving positive outcomes and promoting safety, and can serve as an indicator of quality in healthcare institutions; sustainable nursing workloads improve the quality of health care by reducing unsafe conditions, as well as reducing mortality and morbidity. Several literature reviews have clearly identified the consequences for patients when nurses are overtaxed or over utilized to bridge the gap of nursing shortages. According to Mckee et al, each patient added to nurses’ workloads (beyond four patients) is associated with a seven percent increase in mortality following common surgical procedures (McKee, M. 1999). Recent health reform legislation has further stimulated increased awareness and focuses on patient centered care, and emphasizes on the importance of the patients’ experience. Moreover, patients’ expectations of their caregivers to be positively engaged in their work and performing efficiently and effectively in a supportive environment are prudent. However, several challenges are being encountered by nurses, as they strive to meet the mandates of the aforementioned health care reform. Challenges resulting from unfavorable working conditions that are not conducive to the provision of patient...
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