Want help to write your Essay or Assignments? Click here
Provide your thoughts about the process used to guide the policy process AND explain how the APN/RN could impact this particular policy process.
This reading is meant to provide an extensive example of policy process AND motivate students to think about how they could be a part of the policy process, even a small component.
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
An example of agenda setting in 2014 was an effort by the Nebraska Nurse Practitioners (NNP), a state nursing association, to find a state senator who would introduce a bill into the Nebraska unicameral legislative session to eliminate the Integrated Practice Agreement (IPA) from the Nurse Practitioner Practice Act (Nebraska Legislature, 2014).
The public hearing for the bill was held on January 31, 2014; the sponsoring state senator’s goal was for the bill to emerge from the seven-member Health and Human Services Committee with support from all or most of the members (Senator S. Crawford, personal communication, January 2014).
Spring 2014 Nebraska Unicameral Legislature
Prior to the bill’s introduction, the NNP had to undergo review by the Nebraska Credentialing Review (407) Program. This state-level review program had been created to evaluate current Nebraska health professionals who are seeking to expand their scope of practice or to evaluate the scope of practice of a new type of provider (Nebraska Department of Health and Human Services, n.d.).
As part of its review, the NNP submitted extensive documentation to three review bodies—an ad hoc Technical Review Committee appointed by the director of the Nebraska Division of Public Health, a second review by the State Board of Health, and a third review by the director of the Division of Public Health. These reviews represented input from the Department of Health and Human Services (DHHS) about possible concerns for Nebraskans in either public health or safety.
Spring 2014 Nebraska Unicameral Legislature
Want help to write your Essay or Assignments? Click here
Although the recommendations at the three levels are advisory, they serve to inform state senators when considering and voting on proposed legislation (D. Wesley, lobbyist, personal communication, June 2013). The NNP proposal received support at the first two levels; at the second level, the vote was 12–5 to eliminate the IPA requirement (Whitmire, 2013).
There also were recommendations with this second vote to (1) have practice requirements for the new graduate nurse practitioner (NP) and (2) have ongoing competency evaluations of all NPs. At the third level of review, the director and chief medical director of the DHHS were strongly opposed to the NNP proposal (Ruggles, 2013).
APRNs in Nebraska set the agenda with four goals in mind:
Decrease barriers to their full scope of practice
Provide more and needed access to health care (especially primary care and mental health care) in rural parts of the state
Meet the emerging primary healthcare needs associated with an increased Nebraska population having health insurance because of the Affordable Care Act
Decrease the exodus of APRNs to contiguous states that did not have such IPA agreements (Sundermeier, 2013/2014)
Spring 2014 Nebraska Unicameral Legislature
Want help to write your Essay or Assignments? Click here
In seeking passage of this bill, Nebraska NPs wanted to join the 17 other states and the District of Columbia that had facilitated full scope of practice availability for nurse practitioners. As noted by Bobrow and Dryzek (1987), this case study underscores the importance of contextual dimensions furthering agenda setting. As noted previously, there were four important contexts in setting this agenda topic at this time in this state.
This agenda, which was based on evidence-based practice studies and the promotion of all nurses working to their full potential, is also advocated by the National Academy of Medicine (Institute of Medicine, 2010). By providing legislative language to a state senator to introduce a bill, APRNs set the agenda in Nebraska.
A variety of strategies were implemented to further the agenda goal. This chapter’s author served as chair of the Nebraska Nurses Association’s Legislative Advocacy and Representation Committee (LARC). This committee worked in unison and collaboratively with the NNP, its lobbyist, the NNA lobbyist, and the sponsoring state senator to serve as the lead strategists and voices.
APRNs used public media to promote their perspectives. For example, following a negative review from the Nebraska DHHS, one APRN educated the public via an op-ed article about APRNs in the state’s largest newspaper (Holmes, 2013). She noted several of the previously made arguments as support for why APRNs wanted the IPA eliminated.
Spring 2014 Nebraska Unicameral Legislature
Want help to write your Essay or Assignments? Click here
The bill passed by a 43–0 vote during the last day of the 2014 unicameral session. However, the governor vetoed the legislation, and there was not time for the unicameral legislature to enact an override.
In early 2015, the bill was reintroduced, passed, and signed by the new governor on March 5, 2015 (Lazure, Cramer, & Hoebelheinrich, 2016). Other factors facilitating its passage included
(1) education regarding APRN capabilities along with advocacy during the campaigns of 17 new state senators;
(2) obtaining commitments from both gubernatorial candidates that they would not veto the bill if reintroduced in 2015;
(3) ongoing advocacy by the earlier noted nursing groups; and
(4) interprofessional health groups that both supported the bill and said they would testify at a public hearing. Nebraska is now one of 21 states in which nurse practitioners have full practice authority (Pohl, Thomas, Barksdale, & Werner, 2016).
Read the Case Study above to Answer the Questions Below:
1: How does the Kingdon model apply to the Nebraska case study?
2: How can all healthcare providers support one another and further some of the IOM goals or Healthy People 2030 goals using the Kingdon Model to get the policy process started?
Spring 2014 Nebraska Unicameral Legislature
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
• Find an organization that coincides with your specialty
• Explain the advocacy priorities of the organization you have chosen.
• Focus on one of the issues from the organization’s advocacy priorities.
o Explain the issue you have chosen in depth and why it is important to you using an example from a clinical experience or work situation. Do not support your choice with a personal story.
o From the viewpoint of an Advanced Practice Nurse, discusses challenges and opportunities envisioned for the advanced practice registered nurse related to the issue and examples provided.
o Identify who the stakeholders are related to the issue. Discuss why they are impacted by the advocacy priority and how they influence policy. Include both formal and informal stakeholders (ie: healthcare providers and patient advocacy groups).
o Describe needed revisions in local, state, federal, or organizational regulations or policies to attain the desired outcome/revision.
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
Instructions:
A policy brief is a concise summary of an issue, event, or a problem. There may be supporting documents, but these are used sparingly and selectively; most often they are not submitted with the “brief.” Be aware that while policy briefs are shorter than papers or reports, they are not any less scholarly or rigorous. In fact, some individuals find them harder to write, as decisions have to be made about what content to include and what not to include.
The author has to be concise yet document and substantiate points. So, while the basic write-up of this “brief” is short, one should not underestimate the analysis that underpins it. Assertions have to be supported with logical arguments, data, or expert opinions. Use standard sized margins and a 11 or 12 point font.
Directions
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
From the assessment, my leadership style is participative type of leadership. This fits in my leadership believes in that the leaders must listen to followers inputs when solving problems or making decisions. This is because it motivates the group members, encouraging them to remain focused to the organization. I believe in that involvement decision making as it improves the understanding of the critical issues by the group people who will undertake the tasks.
This includes the involvement of the subordinate staff, superiors, stakeholders and peers. This helps the individuals become committed with their actions, become less competitive and instead, they become more collaborative towards working together. These processes of making decisions collectively ensures that there are social commitment, which makes them become committed to the decision established (Lam & Chan, 2013).
This type of leadership has a lot of attributes that are vital for the graduate level nurses. To start with, it is based on mutual respect as it involves increased participation between the leaders and the nurse staff. The other attribute of participative leadership includes the issue of involvement. This increased collaborative work and involvement among the staff to contribute to ideas, support ethical decision making.
This type of leadership is always open to suggestions. The leader is humble enough to accept other people’s contribution and ideas. This makes the leader remain respected as the input benefits all the staff. This attribute increases collaborative work, which promotes teamwork (He, 2013).
Leadership and the Graduate Nursing Role
Want help to write your Essay or Assignments? Click here
The leader appreciates the concepts of diversity and cultural competence. This discussion of the most effective strategies results sometimes with conflicting ideas or methods of achieving the set strategies. The leader ensures that they use these differences to ensure that the team work effectively and more efficiently. The participative leadership ensures that others have been empowered.
The leaders ensure that they invest on the employees’ values by supporting them when they have committed mistakes, or help them in solving issues. This enables the workers become more optimistic, proficient and making them become more motivated (Arnold & Loughlin, 2013).
Evidence based practice indicates that participative leadership ensures that the nurse satisfaction because it ensures that positive work environment is promoted. This improves employee retention. It is identified as a crucial element that can be used to improve quality of care as it is effective in implementing change towards improving the patient safety.
This type of method is adopted in most healthcare facilities as it has been associated with reduced medical errors. This is because it strengthens the relationships between the healthcare providers such as patients, colleagues and physicians. This is because positive relationships are key issues towards success (Lam & Chan, 2013).
The key issues that help me as family nurse practitioner is the fact that it helps when making decisions that are critical. The healthcare is undergoing numerous changes, which requires new visions to be implemented regularly. This type of leadership ensures that my fellow employees acquire new skills and knowledge, which enables them understand the best way to manage their work. They are able to make reflections of their work, and understand what would influence their contribution to work. This will also help them perform even in absence of their leaders (He, 2013).
Leadership and the Graduate Nursing Role
Want help to write your Essay or Assignments? Click here
Other attributes that increase the advantages of this attributes includes my increased ability to understand my authority as well as my responsibility. I possess effective communication and interpersonal skills. This helps in communicating responsibilities to the team members and in the delegation of challenging responsibilities, which improves the confidence of the team members. Additional skills include self-monitoring, listening skills, and legitimate power and assertiveness skills (Arnold & Loughlin, 2013).
Some of the challenging attributes is conflict management skills, which negatively affects the satisfaction of the team members. I sometimes tend to side with team members that we have close relationship, which results to biased response. This results to reduced motivation and has one time resulted to resistance to change. This issue must be addressed in order to improve the quality of the decisions, and team member’s performances.
In some cases, this has resulted in splitting of groups, which results to more internal conflicts. Learning to be impartial when solving internal conflicts will facilitate smoother implementation of the proposed change, and improve the quality of care being delivered (Lam & Chan, 2013).
Leadership and the Graduate Nursing Role
Want help to write your Essay or Assignments? Click here
Other challenges that neutralise the effectiveness of this type of leadership includes when we are faced with urgent emergency incidences. Most of the time, these incidences has shorter deadlines which may not allow facilitate participation of every team members. It has also been found that charismatic character tends to overcome the passive people, whose voices are often overlooked.
In this context, it is important to build group harmony, and increase formal rules as well as procedures that describe ways to deal with internal conflicts, and ways to handle emergencies that have shorter deadlines. In some cases, it may require redesigning of tasks to improve interdependence between the team members (Arnold & Loughlin, 2013).
References
Arnold, K., & Loughlin, C. (2013). Integrating transformational and participative versus directive leadership theories. Leadership & Organization Development Journal, 34(1), 67-84. http://dx.doi.org/10.1108/01437731311289974
He, H. (2013). Participative Leadership and Follower Creativity: Do Different Types of Trust Play Different Roles?. Academy Of Management Proceedings, 2013(1), 12324-12324. http://dx.doi.org/10.5465/ambpp.2013.12324abstract
Lam, C., & Chan, S. (2013). “Leadership Threshold: Participative Leadership, Information Sharing, and Performance”. Academy Of Management Proceedings, 2013(1), 15706-15706. http://dx.doi.org/10.5465/ambpp.2013.15706abstract
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
Question 1
In the recent course, the core principles that have been applied are andrology. This aspect was developed by Malcolm Shepherd Knowles (1913-1997) which was used synonymously as adult education. The core aspect of andrology is that it is both an art and a science of adult learning (Iwasiw, Goldenberg, & Andrusyszyn, 2008).
This term is sometimes viewed to be equivalent to pedagogy, which is a Greek word that refers child leading (Kearsley, 2010). The principles of andragogy are based on four assumptions. To start with, it points out the issue of self-concept, which indicates that as a person matures, they shift from becoming dependent personality to being self-directed persons (Atherton, 2013).
Additionally, andragogy assumes that as human beings mature, they accumulate experience reservoirs, which become the resources of learning (Iwasiw, Goldenberg, & Andrusyszyn, 2008). Additionally, this increases readiness to acquire knew knowledge, which increases their developmental responsibilities. This also improves their orientation learning (Atherton, 2013).
This is because a nature person’s perspective continues to change by the adoption of immediacy application of the learnt knowledge rather than postponing of the knowledge, thus shifting the learning orientation from subject centeredness to that of the problem solved approach. Additionally, the matured adult gets the motivation to learn increases (Kearsley, 2010).
Nursing Education Theory
Want help to write your Essay or Assignments? Click here
The core principles of andragogy that have been observed in this course include the principle of planning and evaluation of the instruction given (Iwasiw, Goldenberg, & Andrusyszyn, 2008). Additionally, in this learning process, all experiences and mistakes are viewed as effective and form the basis of learning as it broadens an individual’s way of thinking (Atherton, 2013).
Additionally, the learning by the adults is important if it gives immediate relevance or benefits to person’s lives or their jobs (Kearsley, 2010). Additionally, the adult learning problem centred as compared to content oriented. This is effective way of interacting learning and improving the knowledge as well as critical thinking skills of the learner (Iwasiw, Goldenberg, & Andrusyszyn, 2008).
The effectiveness of this learning method is based by the fact that in each of the aspect being taught must be elaborated extensively giving the specific reasons behind the concept (Kearsley, 2010). Additionally, this learning process ensures that instructions are task oriented, thus ensuring that the concepts are understood rather that memorization as compared pedagogy (Atherton, 2013).
Additionally, this learning method puts into considerations the diversity of the learners, thus allowing integration of different materials and learning methods according to each person’s experiences (Kearsley, 2010). The learning method assumes that learning instructions is self-directed, thus the learners will enable them discover new knowledge without actually depending on other people (Iwasiw, Goldenberg, & Andrusyszyn, 2008).
Nursing Education Theory
Want help to write your Essay or Assignments? Click here
Question 2
There is high diversity in nursing career. This includes diversity in students, contents being taught and the tutors teaching these contents. The learning method chosen must be delicate enough to accommodate this diversity (Kearsley, 2010). The diverse learning theories include the Leon Festinger’s cognitive dissonance where the students are seeking to balance between their behaviour and their attitudes (Iwasiw, Goldenberg, & Andrusyszyn, 2008). This is often important where a person seeks to choose between the learning issues that are culturally competent from those that are not.
This method is not popular in nursing because it inhibits acquisitions of new ideas that conflict the persons attitudes or even behaviours (Atherton, 2013). Carl Rogers experiential learning theory focuses on the applied knowledge which improves (Kearsley, 2010), despite the popularity, this learning method is still not widely used in nursing process. This trend is similar to Albert Bandura social learning theory (Iwasiw, Goldenberg, & Andrusyszyn, 2008).
Nursing Education Theory
Want help to write your Essay or Assignments? Click here
The learning theory foundation for nursing course is the adult learning theory (Iwasiw, Goldenberg, & Andrusyszyn, 2008). This is because this learning theory incorporates the aspects of the other learning theories aforementioned (Atherton, 2013). Additionally, this learning theory integrates the use of case studies, simulations, role playing as well as self-evaluation by the students (Kearsley, 2010). The students are involved during the planning as well as evaluation. The learning methods promote learning activities based on experiences (Iwasiw, Goldenberg, & Andrusyszyn, 2008).
Additionally, this learning method puts into considerations the diversity of the learners, thus allowing integration of different materials and learning methods according to each person’s experiences (Kearsley, 2010). The learning method assumes that learning instructions is self-directed, thus the learners will enable them discover new knowledge without actually depending on other people (Atherton, 2013). This helps in promoting the nursing processes principles of leadership and cultural competence.
This method also increases the student’s attentions, through the incorporation of modelled events as well as the use of observation characteristics (Iwasiw, Goldenberg, & Andrusyszyn, 2008). This learning method ensures that knowledge is retention through use of symbolic learning and improvement of motor reproduction, thus ensuring that self-reinforcement. This learning method integrates other learning methods which ensures that the student attention, motivation, memory, behavioural frameworks and cognitive abilities (Iwasiw, Goldenberg, & Andrusyszyn, 2008).
References
Atherton J S. (2013). Learning and Teaching; Knowles’ andragogy: an angle on adult learning [On-line: UK] retrieved 1 December 2015 from http://www.learningandteaching.info/learning/knowlesa.htm
Iwasiw, C., Goldenberg, D., & Andrusyszyn, M. A. (2008). Curriculum development in nursing education. Boston, MA: Jones & Bartlett
Kearsley, G. (2010). Andragogy (M.Knowles). The theory Into practice database. Retrieved from http://tip.psychology.org
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
Nursing is pragmatically considered to be a profession that is within the Medicare division of the overall concern of diverse families, individuals and the communities so the communities can achieve, sustain or even improve their finest health and the eminence life. Nursing can be distinguished from diverse further Medicare providers because of their aspect of work, their work technique to patient’s care, guidance and the extent of performance as the nurses usually carry out work in a broad range of performance areas that has diverse scope of performance and an intensity of the prescribed influence in every practitioner.
Nursing can be said to be a promotion, safety, and even the optimization of abilities and health, impediment of the illness and improvement of pain by the analysis and the treatment of human reaction.
Nursing as a worldwide community is normally for its professional to ensure that there is quality care for everybody as they maintain their diverse credentials, standards, code of ethics a competencies. For an individual to work in the nursing as a professional, all the nurse or the nurses practitioners holds one or even more credentials that normally depends on their scope of practice and their education.
Nurses are usually considered as not truly doctor’s assistants because nurses more often are independently caring for their patients or even assisting other nurses in the healthcare centre. Registered Nurses are mandated to treat patients, provide emotional support, record their medical history, and even provide follow-up care because nurses assist doctors in performing some of the diagnostic tests.
Want help to write your Essay or Assignments? Click here
Advanced Practice Roles in Nursing
Nurse educators are registered nurses who have advanced education that includes advanced clinical training in a health care specialty because they combine expertise and also a passion for teaching into rich and rewarding careers selection. Nurse educators normally plays a paramount role in the aspect of strengthening the overall nursing workforce who serves as a role models in providing needed leadership skill so as to implement evidence based practice.
The nurse educators are similar with nurse practitioners in the aspect of health care provision but majorly differ in their work place because a nurse practitioner is in the health care room while a nurse educator can work from school to school so as to educate diverse people on the importance of nursing as a profession.
Nursing Informatics is considered to be a discipline and practice that incorporates the aspect of nursing, its data and diverse awareness, with the diverse administration of data and the communication skills so as to uphold the fitness of communities. A nurse informatics usually work as developers of information and communication technologies, researchers, the principal information and nursing officers and also as software engineers who advance the healthcare facilities.
Center area of work for nurse informaticians includes the perception illustration and standards so as to sustain the evidence-based performance, education, and research. The nurse informaticians are similar with other advanced roles of nursing in the aspect of health care provision and health care improvement but majorly differ in their work place because a nurse informaticians is in the health care control room such as data centre so as to ensure that sophisticated deices and softwares are installed in the health care for improved efficiency.
Advanced Practice Roles in Nursing
Want help to write your Essay or Assignments? Click here
Nurse administrator is an advanced role in nursing professional who are knowledgeable of the aspect of guidance practices as they have relation to the nursing professionals. This particular aspect may refer to a number of managerial supervisory and diverse tittles that assist the health care facilities in carrying on their esteemed functions. The multifaceted and complex character of contemporary healthcare facilities needs nursing guidance professionals who can craft efficient facility-wide systems and intra-departmental of healthcare delivery as they lead to a useful and proficient employees.
Nurse administrator permits for best possible patient care in any health care environment, from private hospices and hospitals to big medical care centers. Nurse administrator is similar to other advanced roles of nursing professionals in that all of the foster the aspect of healthy environment and the general provision of efficient health care services. Conversely, nurse administrator differ with other advanced roles of nursing profession in that they ensure that all the roles are efficient so as to provide a unity and productive workforce.
Selected Advanced Practice Role
Nurse Practitioner
Nurse practitioner is a sophisticated practice of registered nurses who are usually knowledgeable and vigorously skilled so as to offer health support and diverse protection by the aspect of medical analysis and the handling of severe illness and the persistent conditions (Hamric, 2013). A nurse practitioner normally has maximum capability to provide health care to all people even those who are perceived mental challenge because of their scope of work and advanced training.
Nurse practitioner differs with other advanced roles of nursing because nurses are mandated to carry out his or her duties in the health care room such as recording data and diverse healthcare services to the patients. A nurse practitioner is similar to other advanced roles of nursing as all of them involve the service that will prevent illness and promote health (Speziale, 2011).
Advanced Practice Roles in Nursing
Want help to write your Essay or Assignments? Click here
Nurse Practitioners regulatory and legal requirements for North Carolina
Nurse Practitioners are considered to be the principal group of highly skilled practice and roles in North Carolina State. The licensure law and state practice usually provide for all the nurse practitioners to assess all the sick people, order, analyze, and then interpret the diagnostic tests with physician supervision so as to instigate and then manage treatments that incorporate recommending medications in the special licensure power of the state panel of nursing (Munhall, 2012).
The supervision physician should provide written instructions that orders medication, tests and the treatment which in turns assesses the information of Nurse Practitioners within a logical time. In North Carolina Nurses are normally taken care by a Joint Subcommittee of the North Carolina Medical Boards and the North Carolina Board of Nursing who promulgates rules so as to control the work of nurse practitioners, that then should be accepted by both panels prior to finishing the rulemaking procedure and then becoming effectual.
North Carolina Organization of Nurse Leaders (NCONL) usually exists to promote the nursing management excellence, shape general population guidelines and also toughen the leaders in nursing profession through teamwork and learning (Speziale, 2011). To become a member of the North Carolina Organization of Nurse Leaders, one is supposed to fill out the membership application that can be downloaded from the website. Membership fees dues are normally paid after January 1st is usually prorated on a quarterly basis because prorated membership dues are commonly considered only after a 12-month lapse in membership.
Advanced Practice Roles in Nursing
Want help to write your Essay or Assignments? Click here
Required competencies for North Carolina
In North Carolina, nurse practitioners are normally required to possess high level of education so as to provide great nursing services to the public at large (DeNisco, 2012). Diverse exams are conducted so as to determine the level of competence that an individual contain. Nursing profession is considered to be a profession that needs adequate and necessary skills and knowledge because of its nature and the aspect that the profession deals with life-saving matters.
The required competencies for a nurse practitioner include pass in a nursing exams with high grades as the profession usually offers for all the nurse practitioners to assess all the patients, order, analyze, and then understand the diagnostic assessments with physician supervision so as to instigate and administer treatments that incorporates recommending prescriptions in the special licensure power of the state panel of nurses (Panel, 2011).
Some of the organizations are deemed best in working as I plan to work in North Carolina State Hospital because I feel that the medical facility environment possesses exceptional characteristics that support nursing profession. The state has a lot of people because the profession needs large population so as to embrace efficiency and experiences.
Advanced Practice Roles in Nursing
Want help to write your Essay or Assignments? Click here
Early childhood social and economic conditions are considered to directly affect their respective health conditions. Diverse education and income, their neighbors resources and economic and the social factors affects their health at each stage of their life but the impacts on the young children is usually dramatic. Hamric et al (2013), the children early ages have the full potential to set up a path they are leading towards a good health or far away.
The diverse impact of these obstacles and opportunities along with diverse health effects that are accumulated over a long period of time can be transmitted in across generations as the children grow up to become parents because some of the social disadvantage in childhood such as a chronic stress can lead to a health disadvantage in adulthood. The effects of these is that, every parent want the best for all their children but it is usually considered that not all the parents have the same resources so as to assist their young ones to grow up healthy.
The policy needs to change the aspect of health care provision in that all the parents should try having the best practice and education for their children. Children should receive good education earlier so that they can embrace their good health from diverse school education that enhances good health. According to Robert Wood Jonson Foundation, nurse practitioners need diverse health policy attributes that will assist him or her ensure that the policies are helpful because as the number of negative childhood experiences increases it also increases the aspect of negative health outcome.
Advanced Practice Roles in Nursing
Want help to write your Essay or Assignments? Click here
The process required to make the changes in the health policy should be instrumental so as to embrace productivity as a nurse practitioners have the capability to conduct numerous campaigns so as to preach the good parts of early childhood experience as it shapes health and the aspect of well being throughout the life of a child. According to Robert Wood Jonson Foundation, interested parties are normally the health practitioners, government and parents who have the responsibility to ensure that the children have a positive environment that will assist them shape the livelihood of their children.
Nurse practitioners need to be very intelligent in what they are doing so as to reveal any confidential matter that concerns a patient (Hamric, 2013). What I could that may lead the efforts to influence the change in policy is conducting numerous training so as to promote and ensure that the children have a positive environment that will assist them shape the livelihood of their children. I will attain and evaluate those missing attributes by continuous practice because this is considered to be the best way to add knowledge for a nurse practitioner.
If the particular changes are implemented, children will have a better life when the attain an adulthood age because of the aspect that they have been shaped because nurse practitioners have diverse responsibilities to ensure that the children have a positive environment that will assist them shape the livelihood.
Advanced Practice Roles in Nursing
Want help to write your Essay or Assignments? Click here
According to Robert Wood Jonson Foundation, nursing is considered to be one of the professions that promotes, protects, protection of the poor health and injuries, assistance of healing, and lessening of the affliction by the analysis and management of human reaction (Parahoo, 2014). Nurse practitioners use their leadership attributes to ensure that the nursing profession continues providing quality services to the whole world because nurse practitioners normally have maximum capability to provide health care to all people even those who are perceived mental challenge because of their scope of work and advanced training.
DeNisco, S. M. (2012). Advanced practice nursing: Evolving roles for the transformation of the profession. .
Hamric, A. B. (2013). Advanced practice nursing: An integrative approach. . Elsevier Health Sciences.
Munhall, P. (2012). Nursing research. .
Panel, I. E. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel.
Parahoo, K. (2014). Nursing research: principles, process and issues.
Speziale, H. S. (2011). Qualitative research in nursing: Advancing the humanistic imperative.
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
The nursing metaparadigm is defined as the sole source of the development of many nursing concepts. Ideally, many of the conceptual models in nursing seem to have developed from the meta-paradigm of nursing. These theoretical models are defined as a given set of statements and concepts that eventually integrate the concepts into an exact configuration (Meleis, 2011). In other words, a meta-paradigm is considered as the most conventional or global perspective of a discipline and acts as a framework in which the most important structures are developed. The nursing meta-paradigm involves the following concepts; nursing, person, environment and health (Meleis, 2011).
The four concepts integrate to give an exact configuration. As such, a person is therefore defined as the primary recipient of nursing care. The nursing concept comes in to manage or alter the external environment to successfully implement the natural law of health. The environment is defined as the internal or external factors that affect the surroundings in which the patient exists (Fawcett et al., 2012). This includes factors like food, medication, water, ventilation, bedding and temperature. Health is defined as having harmony, comfort and peace. The significance of the concepts is their integration in ensuring that there is a satisfactory outcome from the exact configuration that ensues from the integration of the central concepts of the nursing meta-paradigm.
Want help to write your Essay or Assignments? Click here
In conclusion, the nursing meta-paradigm gives a significant association between different crucial notions of the fundamental conceptual models related to nursing and health care. Essentially, in understanding how the meta-paradigm works ensures that the provision of nursing care becomes a fully understood process. The reason being that the concepts are fully understood thus the specific components involved in the process of patient recovery are integrated into a given configuration that will ensure successful healing process.
Reference
Fawcett, J., & Desanto-Madeya, S. (2012). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories. FA Davis.
Meleis, A. I. (2011). Theoretical nursing: Development and progress. Lippincott Williams & Wilkins.
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
Children are brought by their parents to the clinic with complaints that seems to be straightforward, with most being treated appropriately. However, as advanced nurse practitioner, I am faced by the responsibility to ensure that the patient is diagnosed correctly and the disease is managed effectively. However, making of correct diagnosis can be elusive and in most cases, it will require the APN to carefully consider the possible differentials as well as identifying the most appropriate strategy to manage the problem (Burn et al., 2013).
During the practicum, a 9 year old boy of Hispanic origin reported to the clinic with sore throat and higher fever (1030F), malaise headache and general body weakness. The patient Lymph nodes were swollen. The patient had attended a local clinic where she was diagnosed with streptococcal pharyngitis and was administered with Omnicef 14 mg/kg/day. However the patient condition worsened after 3 days, and the mother was concerned that the child could be suffering from something else (Murray & Chennupati, 2012).
Practicum Journal Entry
Want help to write your Essay or Assignments? Click here
To identify the core area of the child current situation, I employed helpful tool of the pneumonic NEEDS. NEEDS is an acronym that stands for Nutrition, Elimination, Environment/Education, Daycare/ Development and Sleep/ Sexuality (Murray & Chennupati, 2012). In this context, nutritionally, the patient reported difficulty in swallowing but was able to drink cool liquids. The patient elimination was normal as she voided normal stool at least four times a day.
The assessment of the patient education and environment indicated that the patient was doing fine, and that she had not been exposed to sick friends or family friends. The patient general care was good and was involved in Drama club, although the patient missed practice this week. Patient rest is adequate as the she sleeps approximately for 9 hours a night, but have been sleeping for more than 12 hours since the onset of the disease. The patient reported that she had ensured medication adherence, and denied presence of persistent illness in the past (Murray & Chennupati, 2012).
In some cases, when making differential diagnoses, there could be loop holes that can make diagnoses be missed. In this case, specific and sensitive diagnostic tests should be done to facilitate accuracy, cost and precision. In this case, the poor response to antibiotics and patient clinical manifestation of persistent fever, fatigue, tonsillitis and lymphadenopathy made me consider presence of other infections such as infectious mononucleosis (IM). Other differential diagnoses that were considered included acute leukaemia, tumours of the neck, Hodgkin’s disease. Allergies are also associated with throat pain and pharyngeal tickling (Thompson, 2015).
Practicum Journal Entry
Want help to write your Essay or Assignments? Click here
I conducted patient physical examination, where the patient weight, Bp, BMI and height were on the 50th percentile for the patient. The remarkable physical observations were +3 erythematous tonsils that had no exudate. Tonsillar nodes were swollen. The nodes were tender and soft. Patient chest was clear and the heart sounds were normal. All other systems were reviewed and were intact. The laboratory findings were positive for IM (Burn et al., 2013).
However, the diagnosis process posed some challenges. This is because I relied in the initial impression of the clinical diagnostic, and had failed to reconsider the new data obtained during the revaluation. This is because my confidence was low, and was not keen to work with the results that I had gathered from patient assessment. It took the intervention of my preceptor, who helped me reconsider the new data gathered to frame the diagnostic options. My preceptor cautioned against this behaviour. I was also warned about premature closure, where the APN may prematurely close other potential diagnostic possibilities (Thorburn, 2010).
The final diagnosis was IM; however, there is no direct treatment for this disease. The treatment plan was to control patient clinical manifestation. This includes controlling patient fever; maintain patient body hydrated, adequate rest, and the treatment of secondary infections. Treatment is symptom based. The patient was given antipyretics to manage the patient fever. The patient was advised to be in light clothes to facilitate the dissipation of heat.
Practicum Journal Entry
Want help to write your Essay or Assignments? Click here
Appropriate foods as well as liquids were suggested to the mother so as to avoid irritation of the throat. This was done putting consideration of cultural sensitivity to ensure that the food selected would be tolerated by the family. I did not see the need for the patient to continue with Omnicef, but my preceptor advised that group A streptococcus is a secondary infection for patients diagnosed with IM, so the patient should continue with the mediation (Murray & Chennupati, 2012).
As an APN, it was my responsibility to educate the family about the disease, causes, symptomatic and treatment. I educated the patient on importance of finishing the dosage for fever and to avoid use of multiple blankets. The patient is taught the benefits of completing medication to manage the secondary bacterial infections even if it fails to make other clinical manifestation such as sore throat, fatigue and fever to disappear. The benefits of hydration were also monitored (Burn et al., 2013).
References
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care(5th ed.). Philadelphia, PA: Elsevier.
Murray, R., & Chennupati, S. (2012). Chronic Streptococcal and Non-Streptococcal Pharyngitis. IDDT, 12(4), 281-285. http://dx.doi.org/10.2174/187152612801319311
Thompson, A. (2015). Infectious Mononucleosis. JAMA, 313(11), 1180. http://dx.doi.org/10.1001/jama.2015.159
Thorburn, K. (2010). Case Studies in Pediatric Critical Care. Critical Care, 14(1), 301. http://dx.doi.org/10.1186/cc8836
Practicum Journal Entry
Want help to write your Essay or Assignments? Click here