...Anne Johnston-Silverberg, MS, FNPc September 14, 2012 The Affordable Care Act: The Role of the Nurse Practitioner The recent implementation of the Affordable Care Act (ACA) has had a significant impact on the American health care delivery systems. The passage of this bill mandates that all Americans must have health care coverage and that insurance companies cannot disqualify applicants due to preexisting conditions (National Council of State Boards of Nursing, 2014). These changes will undoubtedly lead to an increase in the number of people seeking medical care, particularly those with chronic diseases. It is estimated that this influx in the number of patients will result in a primary care provider shortage of 20% by the year 2025 (Poghosyan, Boyd & Knutson, 2014). With many new physicians choosing to pursue specialties due to the promise of a larger salary, hospitals and clinics will need to start looking to other health care providers, such as nurse practitioners, to fill this role. The purpose of this paper is to discuss the role nurse practitioners play with regards to the Affordable Care Act by examining the history and qualifications of nurse practitioners, the current practice of nurse practitioners, the basics of the Affordable Care Act legislation, and potential nursing challenges. History of Nurse Practitioners The role of the modern day nurse practitioner emerged in the late 1960’s out of necessity for more primary care providers. When Medicare and Medicaid...
Words: 3789 - Pages: 16
...or others in the context of delegation" (NCSBN, 2009). This is in reference to the nurse's legal liability for the actions taken and patient outcomes. Accountability and responsibility are different, as responsibility belongs to the person doing the task and accountability belongs to the person who assigned the task. The nurse is both accountable for the task being completed and is also responsible for the patients in their care. (RCN, 2010) Accountability and responsibility are two essential parts of delegation. DeWits and O’Neill (2014) define delegation as "transferring the authority to perform a selected nursing task in a selected situation to a competent individual ". When delegating, the registered nurse (RN) allocates nursing tasks to health care assistants (HCAs) while still remaining accountable for the patient and the task that was assigned. Delegating is a management technique that is used to provide more efficient care to patients. (NCSBN, 2009) Permitting HCAs to take on nursing responsibilities allows the nurse to complete other tasks that need to be completed; however, delegation is done at the nurses' discretion and is a personal choice. Nurses need to make careful decisions regarding delegation, taking into account the skill and training of the HCA, the difficulty and risk of the task, and the patient's condition. The expected outcomes, a time frame for completion, and any limitations should be explained to the HCA at the time that the task was delegated. (NHS...
Words: 1804 - Pages: 8
...Cindy Johnson Grand Canyon University: NRS-430-V 03-26-15 Differences in Associate Degree prepared Nurse and Baccalaureate prepared Nurse Competencies. The rise in morbidity and mortality rates among hospitalized patients in the United States heightens concerns about professional competency. Nurses and other healthcare professionals are under increased pressure to provide safe, effective patient care. Research has shown that lower mortality rates, fewer medication errors, and positive outcomes are all linked to nurses prepared at the baccalaureate and graduate degree levels. This paper will compare the differences between an Associate degree prepared nurse (ADN) and a Baccalaureate degree prepared nurse (BSN). Education Differences An ADN or associate degree nurse is as a nurse with two to three years training, usually at a community college or technical school. The curriculum usually consists of fundamentals, the basics of nursing and clinicals. A BSN or baccalaureate prepared nurse is a nurse with four or five years of training usually at a University. With the BSN, a nurse will have to think outside the box, use credible research, theory, leadership skills, all of which will make the nurse a better critical thinker, and in turn her patients will be safer. Both ADN and BSN will be qualified to take the NCLEX exam upon graduation from either community college or a university and become RNs. ADNs get primarily fundamental education in school consisting...
Words: 1131 - Pages: 5
...Article 1 Quimby, Erin L. "The use of herbal therapies in pediatric oncology patients: treating symptoms of cancer and side effects of standard therapies."Journal of Pediatric Oncology Nursing Jan.-Feb. 2007: 35+. Academic OneFile. Web. 20 Nov. 2014. Summary: Erin L. Quimby graduated from the University of Pennsylvania with her Masters of Science in Nursing. She currently works for Penn State as a Nurse Practitioner caring for pediatric oncology patients. Throughout the article she explains many aspects of using herbal therapies along with chemotherapy. Quimby gives us positive and negative notations on these affects. According to Quimby, the use of complementary and alternative medicine (CAM) has increased in the pediatric oncology community. CAM is the use of herbal therapies to minimize the side effects of chemotherapy. Complementary and alternative medicine is commonly used, but is not always discussed with the health care provider. Not consulting a health care provider before using prescription drugs, with non-prescription drugs can be very harmful towards a child. According to Quimby “a study conducted by Friedman et al. (1997) showed that 64% of children with cancer use some type of CAM, where only 22% of them told their health care provider. These results suggested that families with chronically ill children are more likely to disclose information about herbal therapy usage in their homes. “ When asked by a health care provider, parents often times only...
Words: 1305 - Pages: 6
...The role of senior nurses is dynamic and multifaceted. Nurse leaders in practice settings have unique opportunities to influence and even create the environment in which professional nursing practice can flourish. Marriner-Tomey (1993) suggested that, in this highly influential role, nurse leaders have a major responsibility to change behaviour to provide an environment that supports the preparation of competent and expert practitioners. It is part of nurse leaders’ role to serve as a model in providing effective socialisation experiences that impart the appropriate values, beliefs, behaviours and skills to staff. In the nursing profession, a nurse manager's personal style of leadership impacts multiple aspects of a healthcare facility's operations and can have far-reaching implications. This piece will define and discuss several different styles of nursing leadership. First and foremost, the autocratic style of leadership typically involves a leader or nurse manager who makes all pertinent decisions, gives specific orders, and issues directives to subordinate employees who must obey under watchful supervision. Sorensen et al (2008) advocate autocratic leaders strongly discourage workers from questioning the validity of any directives. Constable and Russell (1986) showed that the autocratic style of leadership is appropriate for workplaces such as jails, prisons, the military, and highly structured settings with routinized operations because, in these places, the lives of masses...
Words: 2057 - Pages: 9
...heavily * * DAY 1 Jack was born by caesarean section because they were concerns with the Zoe. Zoe was unwell – she had a heart valve problem. Jack was admitted to the intensive care unit, needing ventilation support for six hours 12pm * Safeguarding midwife aware that Jack been born, states that all people who needed to be aware of baby being born are. Informed us that her current partner and father of baby are not allowed to visit. Security, front desk at the main entrance of unit and nurses made aware * Urine virology/toxicology sent * Morphine started as Jack was Ventilated due to the respiratory distress 15pm * Out of hours social worker called inquiring about baby and mum 1630pm * Maternity support worker visited unit, updated on baby’s condition. Mum had her surgery – she will go and update mum 1830pm * Nurse looking after mum on ITU informed us on mum’s condition. Nurse informed us of name of mum’s current partner who is aware baby is born – nurse said he sounded concerned DAY 2 15pm * No signs of withdrawal DAY 3 14pm * Duty social worker given us the details of named social worker who is aware baby is born. Asked how long baby is expected to be an inpatient – informed likely 2 – 3 weeks possible...
Words: 4847 - Pages: 20
...Immediate Post Operative Care 2 The following essay will use a systematic approach to critically evaluate the care and treatment delivered to a non-elective paediatric orthopaedic patient within the Post Anaesthetic Care Unit (PACU) by a student Operating Department Practitioner at a local trust hospital. The assessment and management of the patients care will be examined and rationale provided for strategies employed during delivery of individualised patient care. In accordance with Health and Care Professional Council’s standards of conduct, performance and ethics (HCPC, 2012) the confidentiality of the service user will be up held at all times. The service user shall be referred to as “Daisy” to protect her confidentiality. Daisy was received to the PACU after surgical stabilisation of her left fibula and tibia with flexible intramedullary nails following a fall. A specified paediatric bay was utilised enabling the patient to be cared for separately from the adults in the PACU (RCOA, 2013). Anaesthetic and surgical handover was received (RCOA, 2013) which detailed that she was 14 years old with no known allergies. She had no significant medical history. She had a general anaesthetic with 140mfg of Propofol used on induction followed by Sevoflurane as a maintenance agent. 30mg of Atricurium, 4mg Dexamethasone, 4mg Ondansatron, 10mg Morphine and 1g Paracetemol had been administered intraoperatively. 1 litre of Hartmanns solution had been administered during surgery and...
Words: 3025 - Pages: 13
...Knowledge Area Module VI Contemporary Issues and the Ethical Delivery of Health Services Student: Harold Taitt, harold.taitt@waldenu.edu Student ID # A00293212 Program: Ph.D. Health Services Specialization: Health Management and Policy Faculty Mentor: Dr. Robert Hoye, robert.hoye@waldenu.edu Faculty Assessor: Dr. Jim Goes, jim.goes@waldenu.edu Walden University May 10, 2013 Abstract Breadth Component In this age of rapidly evolving technological advances, many of the legal and ethical issues that are challenging the delivery of health care and the health care profession are new. As we confront the legal, moral, and ethical aspects of health care, we are seldom faced with decisions that require or are resolved by simple right or wrong answers (Edge & Kreiger, 1998). In the Breadth component of KAM VI, I focus on several ethical theories and how those theories influence the way ethical issues and concerns are addressed and managed in the allocation and delivery of health care services. I critically assess and evaluate those theories, concepts, and derivative principles as they impact important decisions and the implications of those decisions within the context of social change and with special emphasis on health care management and policy. In addition, I discuss the key assumptions on which the selected theories are constructed, compare and contrast the writers’ interpretations across theories, and conclude by providing a critical commentary on the merits of the selected...
Words: 34918 - Pages: 140
...conclusions supported by the data. The concept of profesional journal as a means of developing reflective practice has become a popular topic in classrooms, professional journals, conferences, and continuing education programs (Boud & Walker, 1998). Many other names for profesional journal appear in nursing literature, including log, journaling, narrative pedagogy, dialogue journals, reflective practice, and reflective writing. Whatever people says, reflective profesional journal requires writing, a great deal of it. However, journals are an integral part of the teaching/learning in many nursing programs as well as in allied health programs and education in general. The purpose of this essay is to review the literature related to profesional journal and reflective practice and how it can be beneficial in the teaching/learning process. Reflective practice is a means of self-examination that involves looking back over what has happened in practice in an effort to improve performance or to encourage professional growth (Ruth-Sahd, 2003). Profesional journal is a method that is frequently used in nursing education as an active learning technique to enhance reflective practice. Why is reflective practice so important? The literature cites numerous reasons for utilizing profesional journal/reflective practice in the academic setting. According to Pinkstaff (1985), students find that ideas become clearer when...
Words: 3686 - Pages: 15
...National League for Nursing Evaluation and Learning Advisory Committee (ELAC) ANNOTATED BIBLIOGRAPHY ON ASSESSMENT AND EVALUATION ELAC Members: Marilyn H. Oermann (Chair) Karen Saewert (Chair-elect) Pamela Rutar Suzanne Yarbrough Sub-committee Members: Reba Childress Dawne-Marie Dunbar Sally Erdel Barbara Haas Evelyn Hayes Debra Hurd Sheila Kyle Gayle Preheim, Chair Linda Siktberg Gale R. Woolley, Chair A comprehensive literature review was completed, reflecting best practices in assessment, evaluation, and grading in nursing. This annotated bibliography of the literature is organized into four areas: assessment and evaluation in (a) the classroom, (b) the online environment, (c) clinical practice, and (d) learning and simulation laboratories. There is a fifth section that provides references on the assessment of psychomotor learning and performance; that section is not annotated. This work was completed by members of ELAC and its subcommittees as noted above. 1 CLASSROOM ASSESSMENT Ahmad, N. (2002). Evaluation of teaching: Through eyes of students. Plano: Institutional Research Office, Collin County Community College District. This article reviews the student evaluations instruments used to evaluate learning and faculty in the classroom. The purpose of this article was to search for come standardized instruments of student evaluations. Instruments used are: Individual Developmental and Educational Assessment (IDEA), Student Assessment of...
Words: 20999 - Pages: 84
...Praise for The Spirit Catches You and You Fall Down “Fadiman describes with extraordinary skill the colliding worlds of Western medicine and Hmong culture.” —The New Yorker “This fine book recounts a poignant tragedy…It has no heroes or villains, but it has an abundance of innocent suffering, and it most certainly does have a moral…[A] sad, excellent book.” —Melvin Konner, The New York Times Book Review “An intriguing, spirit-lifting, extraordinary exploration of two cultures in uneasy coexistence…A wonderful aspect of Fadiman’s book is her even-handed, detailed presentation of these disparate cultures and divergent views—not with cool, dispassionate fairness but rather with a warm, involved interest that sees and embraces both sides of each issue…Superb, informal cultural anthropology—eye-opening, readable, utterly engaging.” —Carole Horn, The Washington Post Book World “This is a book that should be deeply disturbing to anyone who has given so much as a moment’s thought to the state of American medicine. But it is much more…People are presented as [Fadiman] saw them, in their humility and their frailty—and their nobility.” —Sherwin B. Nuland, The New Republic 3/462 “Anne Fadiman’s phenomenal first book, The Spirit Catches You and You Fall Down, brings to life the enduring power of parental love in an impoverished refugee family struggling to protect their seriously ill infant daughter and ancient spiritual traditions from the tyranny of welfare bureaucrats and intolerant...
Words: 134140 - Pages: 537
...CROSSROADS When I read the first draft of this manuscript it provided a genuine " aha" experience. I felt that "tempered radicalism" was a concept that had been waiting to be invented. Meyerson and Scully, in my view, have grasped an important idea and have written about it in a careful and an illuminating way. It's one of those papers, I suspect; that some people will react to by thinking: "I wish I had written that!" Further, I can see others I know well in the field as fitting'the description of the tempered radical, at least in some circumstances and at different times. The reviewers, while suggesting changes, as reviewers do, were also very taken with the paper. It is intellectually interesting, and evocative. It provides us with a perspective on organizational issues that is typically glossed. It opens an arena for organizational analysis that is missed in r most theoretical frameworks. Tempered radicals, Meyerson and Scully argue, are individuals who identify with and are committed to their organizations and also to a cause, community or ideology that is fundamentally different from, and possibly at odds with, the dominant culture of their organization. Their radicalism stimulates them to challenge the status quo. Their temperedness reflects the way they have been toughened by challenges, angered by what they see as injustices or ineffectiveness, and inclined to seek moderation in their interactions with members closer to the centre of organizational values and orientations...
Words: 30873 - Pages: 124
...The DO s Dr. Andrew Taylor Still, 1828 –1917 THE DOS OSTEOPATHIC MEDICINE IN AMERICA Second Edition NORMAN GEVITZ The Johns Hopkins University Press Baltimore & London © 1982, 2004 The Johns Hopkins University Press All rights reserved. Published 2004 Printed in the United States of America on acid-free paper 246897531 The Johns Hopkins University Press 2715 North Charles Street Baltimore, Maryland 21218-4363 www.press.jhu.edu Library of Congress Cataloging-in-Publication Data Gevitz, Norman. The DOs : osteopathic medicine in America / Norman Gevitz.–2nd ed. p. ; cm. Rev ed. of: The D.O.’s. c1982 Includes bibliographical references and index. ISBN 0-8018-7833-0 (alk. paper) — ISBN 0-8018-7834-9 (pbk. : alk. paper) 1. Osteopathic medicine—United States—History. [DNLM: 1. Osteopathic Medicine—history—United States. WB 940 G396d 2004] I. Gevitz, Norman. D.O.’s. II. Title. RZ325.U6G48 2004 615.5′33′0973—dc21 2003012874 A catalog record for this book is available from the British Library. Frontispiece courtesy of the Still National Osteopathic Museum, Kirksville, Missouri. For Kathryn Gevitz This page intentionally left blank CONTENTS Preface & Acknowledgments ix Chapter 1 Andrew Taylor Still THE MISSOURI MECCA IN THE FIELD 39 1 22 Chapter 2 Chapter 3 Chapter 4 STRUCTURE & FUNCTION EXPANDING THE SCOPE 54 69 85 Chapter 5 Chapter 6 THE PUSH FOR HIGHER STANDARDS A QUESTION OF IDENTITY The California Merger 101 115...
Words: 99946 - Pages: 400
...2012 Catalog Volume 20 Issue 1 March 5, 2012 – December 31, 2012 This Catalog contains information, policies, procedures, regulations and requirements that were correct at the time of publication and are subject to the terms and conditions of the Enrollment Agreement entered into between the Student and ECPI University. In keeping with the educational mission of the University, the information, policies, procedures, regulations and requirements contained herein are continually being reviewed, changed and updated. Consequently, this document cannot be considered binding. Students are responsible for keeping informed of official policies and meeting all relevant requirements. When required changes to the Catalog occur, they will be communicated through catalog inserts and other means until a revised edition of the Catalog is published. The policies in this Catalog have been approved under the authority of the ECPI University Board of Trustees and, therefore, constitute official University policy. Students should become familiar with the policies in this Catalog. These policies outline both student rights and student responsibilities. The University reserves the right and authority at any time to alter any or all of the statements contained herein, to modify the requirements for admission and graduation, to change or discontinue programs of study, to amend any regulation or policy affecting the student body, to increase tuition and fees, to deny admission, to revoke an offer...
Words: 130938 - Pages: 524
...OFFICIAL CATALOG This Catalog contains information, policies, procedures, regulations and requirements that were correct at the time of publication and are subject to the terms and conditions of the Enrollment Agreement entered into between the Student and ECPI University. In keeping with the educational mission of the University, the information, policies, procedures, regulations and requirements contained herein are continually being reviewed, changed and updated. Consequently, this document cannot be considered binding. Students are responsible for keeping informed of official policies and meeting all relevant requirements. When required changes to the Catalog occur, they will be communicated through catalog inserts and other means until a revised edition of the Catalog is published. The policies in this Catalog have been approved under the authority of the ECPI University Board of Trustees and, therefore, constitute official University policy. Students should become familiar with the policies in this Catalog. These policies outline both student rights and student responsibilities. The University reserves the right and authority at any time to alter any or all of the statements contained herein, to modify the requirements for admission and graduation, to change or discontinue programs of study, to amend any regulation or policy affecting the student body, to increase tuition and fees, to deny admission, to revoke an offer of admission and to dismiss from the...
Words: 149595 - Pages: 599
