Health workforce issues e.g. rural General Practitioner training; expanded scope of practice for paramedics in rural locations; working hours for junior doctors; nurse practitioners in emergency departments; inter-professional practice.
The purpose of this assignment is to develop your written and database searching skills.
You are to search for three (3) published journal articles* by three (3) different authors from three (3) different journals on one (1) of the listed topics.
You will write a short summary of each of the articles.
*This does NOT include: newspaper articles, news reports or editorials or web pages.
Structure : 50- 75
Introduction: 50 -75
Provide a brief overview of the topic and what you intend to discuss with the reader in the following 3 articles.
Article 1
200 words Full reference here (Harvard or APA) as a heading.
Description
Tell the reader the main concepts, purpose and outcomes of the article. What was the author intending to demonstrate with this article.
Identify methods
Briefly tell the reader what methods were used to collect the data (information) used in the article ? did these include descriptive (interview, focus
group), or statistical (survey, questionnaire), how many people were involved, who were the participants (male, female, children, ages)?
Relationships with other health professionals
From the information found identify any (actual or potential) relationships with other health professionals.
Future practice reflection
Reflect on your future health professional practice.
What ideas and thoughts does the information provided in the article stimulate in relation to how you might practice as a health professional?
Be specific here about you and your future practice.
Article 2 200 words Reference
Description of the article
Identify methods
Relationship with other health professionals Future practice reflection.
Article 3 200 words
Reference
Description
Identify methods
Relationship with other health professionals Future practice reflection.
Conclusion 50-75 words
Make a brief statement that connects the 3 articles to the intention provided in your introduction
Self Assessment 50 words
Reflect on how you felt in completing this task, what were the challenges, what do you need to improve before the next task and identify what support you
need.
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Evidence based practice on nursing with their definition and under each word the definition then under that the reference for example :
1 – Primary Nursing
Primary Nursing is a system in which one nurse is responsible for overseeing the total care of a number of clients. It is a method of providing
comprehensive, individualised and consistent care (Gonda & Hales 2016, p122).
Gonda, J & Hales M 2016, ‘Health care Delivery Systems’, Kozier and Erb’s Fundamentals of Nursing Care, Vol 1, Pearson Australia, French Forest, NSW.
2- Primary Research
Primary research is the initial research which has been conducted between any of the following; health professionals, patients and or medical students (Daly, Speedy, Jackson 2014, p.g 141).
Daly J, Speedy S, Jackson D 2014, Contexts of Nursing, 4th edn, Elsevier, Australia.
* each definition has to be no more than 30 words
* No plurals words
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One and a half page will be acceptable
Below is requirement and an example of my classmate.
For this part of the project, you will need to utilize the library database of scientific journal articles to:
a.search for 2 primary research papers regarding one of the topics listed below,
b.obtain a copy of the FULL paper (NOT just the abstract),
c. read it, and
d. summarize the research papers in a way that would make sense to the general public
You must use 2 different primary research papers (not review articles) as references. The two papers should be on the same topic so as to compare the two.
Summarize your findings in 250-500 words (excluding references). Cite all of your references using appropriate citation style such as APA, MLA, or AMA within the summary and your references at the end (see book references for examples).
IMPORTANT: Please use original words and be careful not to plagiarize. You must include your summary in this document AND post it on the ‘Iron project’ forum on the discussion board for full credit. (You can copy and paste into a discussion posting). ). If you have questions about what peer reviewed primary research papers are, please ask. The purpose is for you to find two different papers that did an experiment on the same topic. And give me your conclusions based on these two papers. What is your take home message?
Topics to choose from:
· Iron deficiency during pregnancy
· Iron and cognitive function in children
· Iron status in vegans
· Most effective form of oral iron supplementation
Grading Guidelines:
· Primary research paper appropriately chosen (i.e., primary research paper, published in scientific journals, NOT review articles, etc). No credit
if papers are not primary research.
· 2 pts: appropriate reference within summary and citations
· 1: posting on discussion board
· 4 pts: quality of summary. This should be adequately summarized so that the general public could understand the implications.
Example :
The purpose to the Prevalence of Iron Deficiency Anemia among Iranian Pregnant Women was to detect the average iron status for women who were in their 20- 40’s living in Iran. The study was limited to healthy individuals who were not refugees, had cancer, or were undergoing hemodialysis as these groups would stand as outliers and skew the data. A total of 11,037 participants were entered into the analysis (Barooti, et al., 2010). Of these, 42% regularly saw a physician to be tested every month while pregnant. The other 58% had regular house visits from the physician. Hematocrit tests and urine samples were taken for each visit. The maximum percent of pregnant women who had anemia was 95%. Out of those, 67% were in their second or third trimester. The percentage of anemia in Iranian women during pregnancy is considerably highter than that of most EMRO countries (Barooti, et al., 2010).
The second article, Screening for Iron Deficiency Anemia-Including Iron Supplementation for Children and Pregnant Women was a case study based on a 25 year old female who has a family history of anemia and is currently in her first trimester of pregnancy. Regular checkups were done throughout the entire pregnancy. Regular iron testings were done. During the first trimester, the iron levels based on the hematocrit testings were at a normal range of 40%. By the second trimester, the numbers have dropped significantly to 26%. Iron supplements were added to the diet and increased the iron level to 54% by the end of the third trimester (Mabry-Hernandez, 2017).
To summarize for patients, during the first trimester of pregnancy, iron levels remained relatively steady. The body is able to store enough eaten iron for
the body and the growing fetus. Begining the second and third trimesters, the fetus is growing and is in need of a larger iron supply which promotes normal
development. The iron input is less than the iron required which causes anemia. Anemia is the most common hematological disorder during pregnancy which causes complications for the mother and fetus (Barooti, et al., 2010). Eating a well balanced diet, including lean meats, beans, and fresh vegetables are a good source of iron. Iron supplements are also recommended to aquire enough iron to sustain the mother and fetus.
Works Cited
Barooti, E., Rezazadehkermani, M., Sadeghirad, B., Motaghipisheh, S., Tayeri, S., Arabi, M., et al. (2017, June). Prevalence of Iron Deficiency Anemia among
Iranian Pregnant Women. Retrieved June 26, 2017, from US National Library of Medicine National Institutes of Health: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719272/
Mabry-Hernandez, I. R. (2016, May 15). Screening for Iron Deficiency Anemia-Including Iron Supplementation for Children and Pregnant Women. Retrieved June
26, 2017, from American Family Physician: http://www.aafp.org/afp/2016/0515/p897.html
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Reports information from three relevant sources, at least one of which is a text source.
paper has a two part thesis statement that takes a stand or expresses an opinion. argue position through evidence. must have topic sentences and transitions.
Use at least three (3) quality references Note: Wikipedia and other related websites do not qualify as academic resources.
Your assignment must follow these formatting requirements:
Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.
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Reading The Theory of Nursing Research Literature Order Instructions: Please, let the writers follow the guidelines for this other Project.
Reading The Theory of Nursing Research Literature
Also, I am attaching 1 file of the Project that my friend made for the same class.
Please, let the writer include the book in the reference
Houser, J. 2015. Nursing research: Reading, using and creating evidence (3rd ed.). Sudbury, MA: Jones & Bartlett.
Reading The Theory of Nursing Research Literature Sample Answer
Reading Research Literature #2 – Week 6
(3 Pages)
Type your answers to the following questions using complete sentences and correct grammar, spelling, and syntax. Click Save as and save the file with your last name and assignment, e.g., NR439_RRL2_Smith.Submit to the Reading Research Literature #2 basket in the Dropbox by 11:59 p.m. MT Sunday at the end of Week 6. The guidelines and grading rubric for this assignment may be found in Doc Sharing.
Title: RRL#2
Name:[replace this text with your name]
The following questions pertain to: Sanford, J., Townsend-Rocchicciolli, J., Horigan, A., &Hall, P. (2011). A process of decision making by caregivers of family members with heart failure.Research & Theory for Nursing Practice, 25(1), 55–70.
What methods were put in place to ensure that the subjects were giving true informed consent?
The population of this study consisted of a total of 20 participants (care givers) of family members with Heart failure (HF). The population was selected randomly in-patient hospitals, adult care facilities and cardiology offices. In each of the four stages, five care givers participated in open-ended interviews which lasted for 45minutes-2 hours (Sanford et al, p. 59, 2011).
What was the setting for the study?
The investigation set varied according to each participant location including the caregivers home, in hospitals and offices. The locations were mutually agreed.
Was the sample adequate for the research design that was selected?
Qualitative studies often require small sample size to represent the population(Houser, p133, 2013). In this regard, the 20 participants were adequate for the investigation. However, there was potential for biasness as all the participants originated from the same locality i.e. South East America. The biasness could have resulted from environmental and cultural allied variables. Therefore, different conclusions could be deducted if the same research is repeated in different locations.
Describe the data collection procedure.
Data was collected through open-ended interviews which were not structured. The interviews were conducted at mutually agreed private locations. The interviews were recorded using an audiotape. Additionally, the researchers kept short notes and memos in order to record key points which would require further clarification. Some of the variables studied included the nonlinear actions involved in decision-making process including support, evaluation, and reflection and seeking input. These variables were also associated with the participant’s gender, socioeconomic status and participant-patient relationship. Demographic data was also collected (Sanford et al., p.59, 2011).
What did the authors say about the reliability and validity of their data collection and analysis?
The data collection and analysis was reliable. The researchers applied the triangulation method to ensure validity in their research. This method involves use of more than two approaches to gathering data relating on the same topic. This ensures that data is cross-validated through capturing of various dimensions of the same phenomenon being evaluated. In a qualitative study, rigor is defined through use of open data which scrupulously adhere to specific perspective and increased thoroughness in data collection. Rigor concept is often applied in qualitative study to ensure that investigations comply with trustworthiness fundamentals of naturalistic studies.
What demographic information was reported?
Demographic information collected included gender, marital status, racial and ethnic identity, socio-economic status and the participant’s relationship with the HF family member (Sanford et al., p.60, 2011).
What were the variables that were studied?
Some of the variables studied included the nonlinear actions involved in decision making process including; what support care giver have; how care givers evaluate decision made; decision reflection and seeking input. These variables were also associated with the participant’s gender, socio economic status and participant-patient relationship (Sanford et al., p.55, 2011).
How were the data analyzed after collection? Was there any special software used?
Researchers coded data collected line by line and independently after every interview conducted; focused coding was done later to establish a more salient data categorization. Core categories identified were analyzed to generate theoretical categories. As the data was analyzed, pertinent data was theoretically sampled to refine the categories until fine refinement/saturation was reached. Through these efforts, theoretical model was completed which described caregivers process of decision making.
Special statistical software programs were used. Data collected was transcribed in verbatim. To ensure reliability, the data accuracy was checked. Data analysis was done using Nvivo program. Theoretical sampling of the data was also done to refine categories in the theory until saturation was reached. A theoretical model was developed to describe the decision making process (Sanford et al., p.60, 2011).
Discuss the use of any figures, graphs, and tables. Was the information conveyed in an understandable and meaningful way?
The researchers use a flow chart diagram to describe the theoretical model of care givers decision making process (p.61). The flow chart indicates that decision making process involves actualization of the problem, seeking input support, seeking validation, making decision choice and evaluation of the decision made.
Table1 on page 59 lists interview questions used for study. The questions include probes on history of the family member’s illness, their influences, their advice to other people and how care givers make decisions.
Table 2 on page 60 of the article is a tabulated summary of the frequency demographic distribution of care givers. From the table, 75% were males, 25% female. The highest rate of participants was married at 85%, divorcee at 5% and widowed 10%. There was huge disparities between white and African American participants; 75% and 25% respectively. The relationship between patient and care givers results indicated that 65% were spouses to the HF patients and 35% were HF children.
Graphs, tables and figures capture and summarize data in a way that enhances the approval of the researcher’s argument. One can grasp the author’s argument at a glance.
Discuss the authors’ conclusions. Do you feel these conclusions are based on the data that they collected?
The researchers concluded that decision making by care givers of HF family members was a nonlinear cognitive process which required actualization of the problem, seeking of input or support, reflecting on the choice made and evaluating the decision to validate the choice. Based from the data collected, there are factors that determine decision making ranging from individual attributes to the environment. Understanding these factors would significantly impact the care giving decision making and improve the patient’s health.
The conclusions were based on study’s data.
The following questions pertain to: Schwarz, K., Mion, P., Hudock, D., &Litman, G. (2008). Telemonitoring of heart failure patients and their caregivers: A pilot randomized controlled study. Progress in Cardiovascular Nursing, 23(1), 18–26.
What methods were put in place to ensure that the subjects were giving true informed consent?
The physicians provided a written permission to their patients to be identified and get enrolled for the study. Potential participants about the research and obtained verbal permission for PI to contact them before they were discharged from the hospital. The PI obtained oral consent from the patients. Patients also provided their contacts during discharge. Care givers and patients provided HIPAA authorization and written informed consents during the first interview (10 days after discharge).
What was the setting for the study?
The setting was at 537 bed tertiary teaching hospital located in Northern Ohio. Ten days after discharge, interviews were conducted and 90 days after discharge. Interview investigation setting varied according to each participant location but were generally mutually private location (patients home) agreed upon but data collection and all other study methodologies were conducted at the teaching hospital in Northern Ohio.
Was the sample adequate for the research design that was selected?
In quantitative study, sufficient sample size is the least number of subjects required to statistically evaluate/indicate if variations actually exists. Before sample size calculations, researchers should establish what they consider statistically significant for the proposed investigation; then a sample size is estimated. Elements which influence sample size are put into consideration. These include effect of the sample size, sample homogeneity , risk error and anticipated study attrition.
In this framework, study sample was adequate for the study. A hundred and two patients randomized into two groups for 84 days. The study design was well structured and executed.
Describe the data collection procedure.
Approval was obtained by the researchers. Physicians and cardiologists provided written permission to their patients who potentially matched screening eligibility. HF manager identified potential participants during routine rounds. The potential participants were informed study particulars and care managers obtained verbal consent; the PI was informed. PI explained further the study particulars to both the HF and care giver and issued the potential participants a letter of explanation. Eligible patients gave their telephone and contact numbers after discharge. Randomization of participants to usual hospital they were admitted by drawing from an already prepared envelops which was sealed.
After discharge, participants were interviewed ten days immediately and 90 days after discharge by RN. After the first interview, participants received telemonitoring facilities which were removed 90days later. The data collector (RN) placed a weight scale in the patients home which were connected via the homestead’s telephone line to a computerized monitoring system at the hospital. Therefore, most of the data pertaining to physiological status of the patient was collected by the computerized system. Additionally, the manager of the HF care and APN monitored the device and recorded the information. The physician recorded the number of hospital visits and ED visits(Schwarz et al., p.21, 2008).
How did the authors addressthe reliability and validity of their data collection and analysis of the instruments used?
The data collection and analysis was reliable. The researchers conducted periodical checks throughout the investigation and ensured they maintained more than 90% of the agreement(Schwarz et al., p.20, 2008).
Hospital readmission in this study referred to unplanned hospital within 90 days after discharge. Days of re-admission referred to days between the discharge and readmission.
Functional status was evaluated using IADL’s baseline. The ADL tool consisted of eating, bathing, toileting, movements/transfers and incontinence. The scores for the tool ranged from 0 (Totally independent – 2 (Totally dependent). The IADL scale is very reproducible with co-efficient of 0.96 and 0.87 inter-rater reliability . ADL &IADL ranges are 0-26; and have been shown to be feasible and valid by Spector and Fleishman.
Depressive symptomatology was evaluated by Center for epidemiological studies Depression Scale (CES-D). Twenty items were rated using 4 point Likert scale; ranging from 0( “rarely”) -3(“most/ all the time”). It represented the CES-D psychometric excellent properties.
Quality of life was recorded using 18 items from Minnesota Living With HF questionnaire (MLWHF). The 18 items were rated using 6 point Likert Scale where 0=no and 5=very much. Cronbach’s coefficient at time 1&2 was 0.91. Rector & Cohn identified MLWHF as a valid self-assessment on therapeutic strategies.
Care giver mastery was given using Philadelphia Geriatric Center Caregiving Appraisal Scale (PGCCAS) at baseline and at 90 days. The six items assessed included uncertainty of caregiver, caregiver’s reassurance that he is giving right care, feeling of satisfaction that they are doing the right care, care giver decision making process and perception. The six items were rated on 5 point Likert Scale where 1=never and 5= nearly always. The study reliability and validity was measured using Cronbach’s coefficients ranging from 0.61- 0, 73 at time 1 and time 2 respectively.
Informal social support was measured using tangible subscale from Modified Inventory of Socially Supportive behaviors Scale (MISSB). It used 9 items using 4point Likert scale where 1=never and 4=very often, To measure reliability and validity Cronbach’s coefficient of 0.71-0.92 were used.
What limitations did the authors face in data collection? How could these have been lessened or minimized?
One of the major weaknesses of random controlled trials is the limited external validity. In this context, the findings were limited to patient classified in NYHA AS II; III&IV. Replication of the study could yield different conclusions using less ill participants. Using a large cohort could reduce biasness due to sampling.
Secondly, there was reduced and unwillingness to record vital findings such as specific number of hospital visits. This could have introduced bias. Researchers should ensure they participate in data collection. Further studies should introduce control over usual care provider; and should integrate EHM (Schwarz et al., p.25, 2008).
There lacked a formalized monitoring system put in place to determine whether patients complied to medication. Again, there were variations during medication prescription and administration which could have led to study biasness. Future studies should put standardized procedure on subjects medication prescription and processes in order to reduce study heterogeneity.
What demographic information was reported by the authors?
Demographic information collected included gender, education background, age, racial and ethnic identity, , and socio-economic status, perceived health status of the participant and care givers (Schwarz et al., p.21, 2008).
What were the variables that were studied?
The variables used included the hospital readmission, emergency visits, days to readmission were used to evaluate readmission risk. Additionally, physiologic health status was assessed. These included but not limited to blood pressure, patients weight, the apical pulse and oxygen concentration. Functional status, informal support, cost of care and depressive symptomatology was also evaluated (Schwarz et al., p.21, 2008).
Were there any inferential tests used in the analysis of data in this study? If so, what were they?
Descriptive analysis and comparative statistical tools were used to analyze data collected using SPSS Inc. version 13. Descriptive analysis included measures of central tendencies (mean, median and mode), frequencies and measures of dispersion. Inferential tests used includes Using Pearson correlation of co-efficient, the variables association was evaluated(Schwarz et al., p.22, 2008).
Discuss the use of any figures, graphs, and tables. Was the information conveyed in an understandable and meaningful way?
The researchers use a flow chart diagram to describe the alogarithm of cohorts who were to be selected for eligibility(Schwarz et al., p.20, 2008).
Table 1 on page 22 of the article is a tabulated summary of the participants and care givers attributes as indexed during hospital visits. From the table, 43% were females for IG and 31% for control group; p=0.07. The highest rate of participants was married at 71% and 55% for control group;p=0.56. NYHA class II, III & IV subjects were 24%, 45% and 31% respectively for intervention group and 18%, 51% and 31% consecutively; p=0.74. Commodities p=0.14 current medication p=0.79. About 64% of participants were spouses of HF, 13% were children and 10% were other distant relations (not specified).
Table 2 (p.23) summarizes the ED visits, cost of care and hospital readmission frequencies.
IG hospital readmission was 0.32 whereas the control group was recorded 0.33; p=0.9; ED visits for IG was 0.34 and control group 0.39; p=0.73 and cost of care for IG was 12,017 and control group 6,673; p=0.28
Table 3 (Schwarz et al., p.24, 2008) summarizes other variables including the depressive symptomatology, quality of life and days of admission by group. Depressive symptoms value at baseline was 8.7 in Intervention group (IG) and 6.8 for control group(p=0.32). At 90 days after discharge IG depressive symptoms changed whereas the control group depressive symptom maintained at 6.6 (p=0.44). Days to re-admission, IG group had lengthier days at 31.3 whereas the control group were shorter recorded at 24 (p=0.96). The patients quality of life was influenced by care giver mastery(p=0.05 at baseline; p=0.38 90 days after discharge).
Graphs, tables and figures capture and summarize data in a way that enhances the approval of the researcher’s argument (Creswell, p. 36, 2009). One can grasp the author’s argument at a glance because the information is presented in a neat and meaningful way.
Reading The Theory of Nursing Research Literature References
Creswell, J. (2009). Research design: qualitative, quantitative and mixed method approaches (3rd ed.)Thousand Oaks, CA: sage publications
Houser, J. 2013. Nursing research: Reading, using, and creating evidence (3rd ed.). Sudbury, MA: Jones & Bartlett.
Schwarz, K., Mion, P., Hudock, D., & Litman, G. (2008). Telemonitoring of heart failure patients and their caregivers: A pilot randomized controlled study. Progress in Cardiovascular Nursing, 23(1), 18–26.
Sanford, J., Townsend-Rocchicciolli, J., Horigan, A., & Hall, P. (2011). A process of decision making by caregivers of family members with heart failure. Research & Theory for Nursing Practice, 25(1), 55–70.
The role of the NP is a challenging, complex, dynamic and rewarding role! Reflect on the level of insight you feel you have gained in the course. Do you have a better understanding of the role of the NP? How has this course impacted your perspective on the role of the NP?
SAMPLE ANSWER
Role of NP
Nursing practitioners have a critical role in providing extensive primary and specialty health care. NP job is challenging as every practitioner must remain abreast in nursing technologies advancements. They are also being encouraged to get acquainted in billing and coding systems. Through the program, I was privileged to care for patients and it is gratifying. The program have positively changed my perception of nursing health care by reinforcing the vital role nurses play when providing health care services. Through interaction with the nurses, I observed care and hard work the nurses undergo on daily basis to make the world a better place. For instance, they have to consult and work with other health care practitioners in order to attain their objectives. They have to document their report completely and with the highest order of clarity on every encounter with the patients (Ridenour, 2009).
Additionally, registered nurses offer public health care to populations from diverse cultures; each with unique cultural and religious spirituality. It is nurse’s responsibility to understand patient cultural background because they impact significantly on the patients’ health and illness. Nursing profession is a caring profession. Nurses must reflect on cultural values of the society especially in this era of globalization and massive international movement (HRSA, 2012). To become a Nursing practitioner, one has to be a registered nurse who is certified by the board and their scope of practice is expanded within specialty. Good health care practices entail the provision of quality care through changing risky behavior that hallmarks various misunderstandings. These misunderstandings are obstacles in responding to the growing quality health care demands. More so, they are expected to be healthy living models, but putting into consideration of the nature of their work, this expectation is quite demanding (CNO, 2012).
Cultural competence: Registered Professional Nurse Responsibility
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To be done by writer: 111969
Its a research paper not essay
The M6A3: Cultural Competence: Registered Professional Nurse Responsibility Paper counts as 30% of your grade for this course.
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Week 2: Begin developing an outline for your paper.
Week 3: You should have your outline completed.
Week 4: You should be using your outline to write your paper.
Week 5: Continue work on your paper.
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linked item M6A3: Cultural Competence: Registered Professional Nurse Responsibility Paper
Using APA format, write a six (6) to ten (10) page paper (excludes cover and reference page) that examines culturally sensitive nursing care. The paper consists of two (2) parts and must be submitted by the close of week six (6).
A minimum of three (3) current professional references must be provided. Current references include professional publications and valid websites dated within five (5) years. Additionally, a textbook that is no more than one (1) edition old may be used.
Part 1 – Introduction
Address the following:
Using your own words, define culturally competent nursing care. Support the definition with a professional literature citation.
Identify four (4) guidelines the registered professional nurse may use to enhance the ability to provide culturally competent nursing care. Provide one example the culturally competent nurse applies to each of the four (4) selected guidelines. At least one example must address care of patient not occurring in an acute care hospital.
Describe how the registered professional nurse evaluates if the patient’s cultural needs have been met?
Describe whether cultural practices must be accommodated in all aspects of health care? Provide a specific example and rationale to support your response.
Part 2- Demonstrating Culturally Competent Nursing Care
Address the following:
Select one of the following cultures:
Asian
Native American
Hispanic
Select four (4) cultural features, associated with the selected cultures that influence the provision of nursing care for patients with chronic illness and at the end of their lives. Describe how the four (4) cultural features influence the provision of care to the patients.
Provide two (2) examples that demonstrate nursing care, which reflects the respect for the dignity and uniqueness of those cultural features for patients experiencing chronic illness and at the end of their lives.
Compose your work using a word processor (or other software as appropriate) and save it frequently to your computer. Use a 12 font size, double space your work and use APA format for citations, references, and overall format. Assistance with APA citations and references is available through the free resource Citation Machine™. Assistance with APA format, grammar, and avoiding plagiarism is available for free through the Excelsior College Online Writing Lab (OWL). Be sure to check your work and correct any spelling or grammatical errors before you submit your assignment
NB
This task is 7 pages.
SAMPLE ANSWER
Registered Professional Nurse Responsibility
Cultural competence: Registered Professional Nurse Responsibility
Today, registered nurses offer public health care to populations from diverse cultures; each with unique cultural and religious spirituality. Culture is defined as shared values and character, transmitted from one generation to another, which distinguish individuals of one group from another. Therefore, it is vital to understand patient cultural background because they impact significantly on the patients’ health and illness (Astrid et al, 2010). Cultural diversity is recognizes individual uniqueness in terms of their socio economic status, physical attributes, ethnicity, political and religious beliefs. The cultural diversity concept entails respecting person’s cultural background in order to relate with them i.e. cultural competence. According to The Primary care Access Network (PCAN) of central Florida, culture competence refers to all activities geared towards effective and sensitive delivery of quality health care. It entails a set of attitudes and regulatory policies that work together in ensuring that health care practitioners function effectively and sensitively across the board. Becoming culturally competent requires self-awareness and commitment to give safe and quality health care services to everyone irrespective of their backgrounds (CDC, 2014).To provide competent health care, the following four guidelines are followed; a) Acknowledge and respect diverse cultural influence b) Cultural care accommodation c) Widen knowledge on cultural diversity and d) Culture care preservation
To start with, the practitioner should acknowledge and respect the cultural influence in personal and professional way of life. The guideline supports patient centered model; where the nurse focuses on the patient rather than treating the illness. According to this guideline, illness is interpretation of individual’s ailment interpreted by their sociocultural factors. For instance, some cultures may associate mental disorder such as Schizophrenia as being inhabited by evil spirit. It is the nurse’s obligation to listen the disease description according to the patient’s perspective. Secondly, health practitioner should be vigilant regarding the dynamics of cross cultural relations to enhance communication. Cross cultural interaction brings forth the possibility of misjudging other people’s actions or intentions. More insights on patient’s cultural background minimize stereotyping incidences; and develop mutual beneficial relationship between the parties. The medical practitioner should Listen to patient’s description of the problem; explain the perception into medical terms and prescribe the treatment (Norton &Marks-Maran, 2014).
Thirdly, The practitioners should broaden their cultural diversity knowledge, and incorporate it into their profession. The increased knowledge about the person’s sociocultural concepts enhances the relationship especially during physical examination processes i.e. facilitate in identifying what questions to ask, avoid, modify and how to put them across. For instance, questioning sexual behavior among Hispanic community is disrespectful, and patients may not collaborate. Some religion does not permit vaccination, and therefore, may exempt their new born from getting immunization. Nurses should get acquainted on the relevant sociocultural beliefs of the ethnographic local communities. Lastly, Nurses should develop and adapt to the identified culturally sensitive interventions which will enhance better relation between patients’ needs and clinicians needs (Dudas, 2012).
An Islam Imam (spiritual leader) suffered mild dementia while visiting his son in Toronto. He was physically examined, and all cultural questions posed were answered by his son. The patient condition deteriorated and was transferred to the ICU. After several interventions, the nurse in-charge decided to help the elderly man in grooming and personal hygiene. The first step was to clean shave the long and unkempt beard. In the process, the nurse let the man know that she was going to shave his beard; the man seemed to nod, and the nurse concluded that he agreed with the entire hygiene Practices. The nurse went home very happy and proud to have provided such good comfort and care for the elderly. When the son visited the following morning, he was horrified at the sight of his father. He rushed out of the room and reprimanded the nurse. Apparently, the father was a holy man so his beard had never been cut. The family had to make new arrangements of how to sacrifice for this taboo. The nurse was charged with negligence of cultural beliefs Therefore, it is important to identify all practices and beliefs by designing assessment questions elicit to provide more information. The healthcare institution should involve political, religious and non-religious experts when designing such assessments. This will ensure that health care services are delivered in a way that respects and values cultural practices. From this example, it is obvious that cultural competent care is very important in providing quality and satisfying patients care (CNO, 2009).
Nursing scholars have debated on ways to ensure cultural competence in nursing. Cultural assessment interview plays vital role when evaluating patient cultural needs. This is done by asking relevant but open-ended questions to the patient, and giving them opportunities to elaborate on them (Mareno & Hart, 2014). Patients become more co-operative if a nurse shows interest in learning more their cultural back ground. The nurse should make the comfortable enough to make the open up about everything they have done prior to seeking medical attention. Georgetown University have established Cultural competence Health practitioner Assessment program which can be downloaded from their website. Generally, The nurse must listen and must not misjudge or stereotype the patient. Some of the questions that could be integrated to gather clients culture include; asking the patient to explain what could have caused the ailment; letting the patient explain what they think the disease does to them; enquiring on the major problem the patient thinks could have been caused by the illness; what steps or precautions they have taken since commencement of the illness; enquire what kind of treatment they expect or their overall expectation; and asking for other information that seems culturally important (Mcclimens et al, 2014).
Nursing profession is a caring profession. Nurses must reflect on cultural values of the society especially in this era of globalization and massive international movement. The only way to ensure that cultural competent services are offered is by acquiring more about transcultural nursing practices, especially by conducting comparative analysis of various cultures nursing care, values and beliefs. (Mareno & Hart, 2014). However, noting the broad differences across culture is not enough, relying on data only risks generalization and stereotyping because even two individuals from the same community or ethnic group, may have different experiences and expectations from the same illness, influenced by their education and socio economic background. Language barriers are the most common obstacle when delivering health care services which impedes clear communication between patient and the health practitioner. Most common law suits are miscommunication related cases. Understanding cultural diversity will improve patient treatment and safeguard them from malpractice (Rily, Tish &Nancy, 2014). The world is a global village. Citizens from any particular part of the world are from all sorts of backgrounds. This presents challenges to the health sector during service delivery to patients. Therefore, cultural competency and sensitivity program must be incorporated in medical schools. Leaving cultural disparities in health care unattended could lead to high turnover rate, mortalities and disease burden in certain geographic locations. This will directly or indirectly impact on every person in the US. Therefore, every health practitioner has unique opportunity to take leadership to improve quality of life through culturally competent health care (Mcclimens et al, 2014).
Part 2
Good health care practices entail the provision of quality care through changing risky behavior that hallmarks cultural miscommunications and misunderstandings. These misunderstandings are obstacles in responding to the growing health care demands for Hispanics. Hispanics represents approximately 55% of US total population. Hispanic culture upholds family institution, and it comprises of the extended relatives including grandparents, uncles, aunts, cousins, god parents and family’s siblings. When ill, Hispanic person mostly consult with their family members, and frequently ask the members to accompany them to the hospital. Hispanic culture entails provision of love and support to the ill; which could be opposed by institutional rules such as limit of patient’s visitors (Antonio, 2014).
Additionally, Hispanic culture emphasizes on interdependence and cooperation. Therefore, the patient’s relatives will be actively involved in decision making and treatment processes which may not be entertained by most health institutions. Hispanic culture is mediated by respect. Respect involves appropriate behavior based on individual’s age, gender, and socio economic status. Thus, the elderly demands respect from the young, men demands respect from women and so on. Hispanics show respect by avoiding eye contact to the authority which could be misinterpreted as lack of interest. Due to their medical expertise, health practitioners are afforded great respect; most Hispanic patient will regard the physician advice. Respect is highly valued in this culture and a patient may terminate treatment if any signs of disrespect are perceived. Family information remains confidential and must remain within the family. Therefore, questions on health related problems such as sexual practices, alcoholism and mental disorders are perceived as embarrassing and disrespectful. To gather this kind of information, registered nurse should ask them indirectly (CNO, 2009).
As a registered nurse, having some culture insights facilitate communication. Therefore, working in ethnographic regions whose larger local population is Hispanics; the health practitioner should retrieve secondary data analyzed by CDC databases. Due to their collectivistic tendency, registered nurse should allow collective responsibility during decision making. Most Hispanics are group oriented. The family has a right to make decisions regarding health care interventions necessary and in most cases, they are actively involved in decision process in order to allow the patient to rest and recover peacefully. The nurse can request the patient to identify the family’s spokesman. If they are out of country, the nurse should be patient and wait to get consent for the therapy. To accord respect to the patient, the nurse can address them using their language formal titles such as, Mr., Mrs., Miss, Senöra or Senör. In most cases, Hispanics nod out of respect to the authority (health practitioner), that does not necessarily imply that they agree with the nurse. In this case, the registered nurse should pay attention to the non- verbal communication, and attempt to clarify further if required. In most cases, silence is a sign of respect; the nurse should be patient for a response. If need be, the nurse can ask for an interpreter. Additionally, most Hispanic is religious and beliefs that illness and death are natural life processes. Because of this belief, the patient tends to neglect health acre attention until their health worsens significantly. In some cases, the family may want the patient spend end of life at home. The patient may associate the setting impersonal and disrupts their family relationship (CDC, 2014).
Nurses are privileged to meet people during the period of crisis in their lives when they are required to provide their expertise. People attitude toward death and bereaved are influenced by their cultural, religious and socioeconomic background. The nurse should always remember that there are aspects within every cultural grouping which could be solved through competent cultural care and comprehensive communication. For instance, a client from Hispanic community requests for sweet-grass ceremony as her last wish. The ceremony is a part of cultural treatment, which involves burning of incense stick and prayer chanting, and will be conducted in the hospital. Heeding to the patient’s request implies that the nurse will break the institutional policy. What is the solution to this case scenario? In this case, other options should be explored by consulting the relevant authorities in other departments. If the activity is determined as risky to other patients, then the client can be transferred to private room where the ceremony can be conducted. Inexperience’s and fear are the most common obstacles to providing cultural competence care. Through consultation with higher authorities, the nurse is able to address the issue (CNO, 2009).
References
Antonio, MA. 2014. Latin American culture: A deconstruction of stereotypes. Studies in Latin American Popular Culture Vol 32, 73-100
Dudas, K. (2012) Cultural competence: An evolutionary concept analysis. Nursing Education Perspectives 33; 5,317-321
Norton, D. & Marks- Maran, D (2014) Developing cultural sensitivity and awareness in nursing overseas. Nursing standards, 28, 44, 39-44
Mareno, N. & Hart, PL (2014) Cultural competency among nurses with undergraduate and graduate degrees: Implications for nursing education. Nursing education perspective 35, 2, 83-90
Mcclimens, A. Et al (2014) Recognizing and respecting patient’s cultural diversity. Nursing standard, 28; 28, 45-52
Riley, D., Tish, S., & Nancy, Y. (2012) Cultural competence of practicing nurses entering an RN-BSN program. Nursing education perspective 33, 6, 381-385
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The writer should take note that the prefer area of practice is clinical settings , and it is very important that the writer pay attention to all the components of this paper and incorporate everything that is been asked.
NP Career Trajectory.
For this paper, you will develop your plan to become a NP. First, take time to examine the roles of the advanced practice nurse within the context of the United States healthcare delivery system.
Identify your preferred areas of practice (clinical settings) and necessary steps to reach this goal (including acquiring licensure, certification, DEA numbers, etc.).
Identify who you will draw upon for professional support.
Further, identify areas of involvement, such as research, policy, etc., that you would like to be involved in and create your plan for lifelong learning and professional development. Be sure to use the grading rubric as an outline for developing your paper!
Your paper should be 7 pages (excluding the title and reference pages).
Resources
Textbooks, read the following:
Advanced Practice Nursing:
Emphasizing Common Roles
• Review previously assigned chapters
Please review the following web resources:
• Reel, S. (2011). Developing a Business Plan
• Australia North Territory Department of Health – Evidence Portfolio (Australian based resource but wonderful for stimulating ideas!)
• RNDegrees. Net (2006-2011) Why become a nurse practitioner?
• NHS Career Planner for Nurses (United Kingdom resources, but wonderful, again, for stimulating ideas!)
SAMPLE ANSWER
Nursing Practitioner Career Trajectory
Introduction
One area of the socio-economic landscape of the United States that has changed dramatically over the past 50 years is healthcare. Improvements in technology, changes in population, advancements in science and also policy development among others have had a direct impact on how healthcare services are delivered to the general population across the country. While physicians continue to be seen as the key decision makers in this sector of the economy, the impact that nurses have had throughout this period cannot be overlooked. The sheer amount of contact hours that nurses have with patients means that their role has also evolved over the years (ANA, 2014).
The term nurse is often associated with the act of a person of the female gender taking care of an ill individual. This is because the origins of nursing as a profession lie in women taking up the position in the formative years of healthcare due to their perceived nurturing nature. This meant that there was little training if any on standardized practices to be adhered to by nurses. This however changed in the middle of the 20th Century in the United States when it was realized the a swelling national population would demand a more structured form of service delivery by nurses. This led to the formulation and development of academic programs that would be used to compliment and improve the work of nurses (RNDegrees, 2011).
Over the past half century these academic programs have diversified and led to the development of positions such as Nursing Practitioner and also Advanced Practice Nurses. In this exercise the dynamics surrounding this position will be illustrated as I elaborate on my desired career trajectory in this profession.
My Preferred Areas of Practice
As stated above, the duties of Advanced Practice Nurses have a scope that spans across the entire healthcare sector. For one to practice however it is important that he or she specialize in one of these areas. Personally I would like to pursue the areas of Geriatric care as well as Palliative care. While the two are different areas of specialization, they are closely related given the fact that they are both primarily aimed at the more elderly patients who have relatively similar healthcare needs.
Geriatric healthcare encompasses the provision of healthcare-related services to individuals whose health is compromised by the natural process of ageing. Unlike conventional healthcare which aims to cure diseases, geriatric care is more of a continuous process given that ageing is not a reversible process. It therefore entails the treatment of a number of terminal illnesses as well as other healthcare complications that come from ageing. These include the inability of some patients to take adequate care of themselves. Demand for geriatric care is only set to increase in the near future as a result of improved healthcare which gives individuals a chance to live longer than they do today; an increase in the life-expectancy. The elderly are often plagued by a host of mental problems such as dementia, reduced immunity and also severely limited mobility.
Palliative care on the other hand is the delivery of healthcare services to individuals who are perceived to be nearing the end of their lives due to the diagnosis or advancement of a terminal illness. These include cancer, cardio-vascular ailments and also select respiratory conditions. It seeks to improve the life of the patient as well as his or her family who have to psychologically take in the fact that their loved one has a relatively short time to live. It mainly involves the management of pain. A large number of the consumers of this healthcare service also happen to be the elderly in society. This is the reason why I would like to pursue a nursing career in this area in the future. Such a career path will enable me to work in a hospice or home for the elderly in a practical as well as administrative position.
The Steps Necessary for Pursuing Geriatric and Palliative Care Nursing Careers
For an individual to become an advanced practice nurse who is specialized in the provision of Geriatric healthcare services it is imperative that he or she acquire the right mix of academic credentials, practical experience and also official accreditation through licensing. The manner in which these are acquired needs to be in tandem with the set of standards that have been set within the country an individual wishes to practice this form of nursing. In the United States, an APRN who is specialized in nursing needs to have undertaken undergraduate education in nursing, attained a degree then combined it with post graduate certification in the area of geriatrics (ANCC, 2014). At the same time it is necessary for this individual to have a license for him or her to practice as a nurse.
At graduate level the individual needs to undertake an undergraduate degree course that all nurses have to undertake. This will provide him or her with industry knowledge, best-practices, theoretical information and also practical skills that are required of nurses. There is little or no specialization in careers for those undertaking nursing at an undergraduate level. The most that one can specialize in is adult-gerontology which is basically the study of how nursing is relevant to individuals who are in their early stages of ageing as well as those in the more advanced stages. This means there is a wide scope with regard to the ages considered (RNDegrees, 2011).
For one who is interested in practicing geriatric healthcare at an Advanced Practice Nurse Level it is essential that he or she participate in a program that provides adequate clinical as well as didactic experience for the students. This means that from an early stage the prospective APRN has a higher skill and knowledge level than the conventional nurse. The graduate education of an APRN not only prepares him or her for the technical dynamics of the healthcare sector. These nurses also get to be prepared emotionally and psychologically for a higher level of accountability and emotional preparedness for the increased level of responsibility. These undergraduate programs take three to four years to complete (Niagra College Canada, 2014).
Post Graduate Degree in Geriatric Nursing
Following the graduation from an undergraduate program it is also important that the prospective APRN undertakes a Master’s Degree program. This provides the nurse with administrative skills as well as more specialized education on how to resolve health problems of the elderly through advanced nursing. The programs take between two and three years. They are more oriented towards problem-solving than the undergraduate degrees. The title of the specific courses varies greatly from university to university. It may therefore have a prefix of Masters of Science.. or other similar titles.
Certification
In addition to the acquisition of academic credentials, it is necessary for APRNs to have a certificate that has been issued by the American Nurses’ Credentialling Center, ANCC. This allows the individual to work as a nurse practitioner. The certificate awarded is highly course specific. One also requires a certificate in one of the areas of Geriatric Nursing. There are different sub-sections of geriatric nursing and these include health promotion, emerging issues, the management of chronic health challenges and also the theories that scholars have formulated in relation to Nursing. It is also important to note that some institutions of learning will insist on a set of academic credits coupled with a number of clinical practice hours before allowing an individual to enroll in their post-graduate nursing programs. An exam set by the Nursing board needs to be passed prior to the issuance of this certificate (AACN, 2014).
One also needs to have a Nursing Practitioner’s license and this is awarded following an application for the same in the specific region, state or territory he or she would like to work in as a nurse (RNAO, 2014).
Professional Support
For professional support I will have to rely on a mentor who is more advanced than myself in terms of experience, exposure and possibly academically in the area of Geriatric Nursing. This will most likely be a professor or an individual who plays a supervisory role in the healthcare institution that I will be attached to. This will help me in consultations about the challenges I face on a day to day basis in clinical practice as well as personal development in the field. I will also register as a member of the local APRN nurses association. Here I will have a lot of peer to peer interactions and networking. Having a formal membership in the association will also enable me to benefit from collective bargaining that may arise from time to time in the course of my work.
Further professional support will be drawn from my former colleagues who studied with me during the undergraduate and post graduate nursing programs. This will mainly be in the form of comparing notes with them as we exchange our unique experiences.
Areas I would like to be involved in in the future
In a bid to ensure that my career involves life-long learning and professional development I would like to be involved in policy development, research and also ethics. These areas have been singled out because of their relatively high potential with respect to the objectives I have.
Policy development stands out because it is an ever-continuous process that goes hand in hand with the work of APRNs. The past half century has seen changes to policy with an effort to ensure nurses have a much larger impact in improving healthcare for the swelling population of the country. Through legislation nursing has become more of a profession due to the introduction of academic programs which led to the standardization of the practices. The legal framework governing the work of Nursing Practitioners in Geriatric Clinics as well as those in hospices is constantly undergoing transformation subjective to the different territories and the most pressing issues that arise (Discover Nursing, 2014). As such it is important for individuals with ground knowledge on the dynamics of nursing to be involved in the formulation of these laws. Projected changes in the cultural as well as economic landscape of the country has profound implications for the nursing practitioner profession.
Ethics in nursing mainly involves the pursuit of systems, procedures and clinical environments that will ensure the greatest good and this basically means improvements on the well-being of patients. As medical technology and scientific knowledge increase over time, approaches used in the tendering of healthcare services to elderly patients also changes. These changes however need to be constantly evaluated with the mind of prioritizing the healthcare needs of the patient among other needs that may arise such as the comfort of healthcare workers or financial objectives of private clinics. This too is another area that I would like to pursue.
I may also be interested in the area of Research and Development of new techniques of healthcare delivery to Geriatric patients. This involves a lot of study, bench-marking and also comparison. Wide travel too may be a component of this aspect of healthcare. As such it promises to not just add to my knowledge but also help me develop professionally (Hamric et al, 2000).
Conclusion
From the above it is evident that the path to being an Advanced Practice Registered Nurse is long and demanding. This is occasioned by the ever changing healthcare landscape and the emergence of needs that were relatively isolated in the past. The advancements in healthcare and quality of life are leading to larger populations of the elderly. This motivates me to want to be an advanced practice nurse who has specialized in Geriatric healthcare. I therefore have to commit to a rigid academic schedule as well as practical experience if I am to succeed in this endeavor.
RNDegrees. Net (2006-2011) Why become a nurse practitioner?NHS Career Planner for Nurses (United Kingdom resources, but wonderful, again, for stimulating ideas!)
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The Demand for Healthcare in the U.S. and the Role of the NP ;The Role of Nurse Practitioners in the Future
Order Instructions:
SECTION A (1.5 pages)
The Demand for Healthcare in the U.S. and the Role of the NP
The role and scope of practice of the NP is ever changing, particularly in our contemporary U.S. Healthcare system. Evaluate the impact of public demand for healthcare in the U.S. and the impact this has on the changing scope of practice and the role of the NP.
Include a reference list at the end of this section (4 references minimum).
SECTION B (1.5 pages)
Sustainable Practice for the NP
How might the NP establish a sustainable practice in our contemporary U.S. Healthcare system? Identify components to take into consideration and appraise the impact of these components on the development of a sustainable practice.
Include a reference list at the end of this section (3 minimum).
Resources
From your textbooks, read the following:
Advanced Practice Nursing: Emphasizing Common Roles
• Chapters 8, 16
Please review the following web resources:
IOM – Future of Nursing Report Leading Change, Advancing Health
Advanced Practice Nurse Outcomes 1990-2008: A Systematic Review
Health Resources and Services Administration
SAMPLE ANSWER
The Role of Nurse Practitioners in the Future
SECTION A
Nurse practitioners have existed and provided services in healthcare for over 40 years. These NP have become essential in primary healthcare delivery system. NP are expected to have masters, advanced practice registered nurses possessing advanced academic and clinical experiences that enable them to provide care to various populations.
The services of NP have widened even as the nurses shortage looms. Healthcare in US face a NP shortage if adequate measures are not taken. The number of NP available in healthcare facility has continued to reduce as the number of patients increases. This therefore leaves a gap that requires immediate addressed (Yang, 2014). Demand of healthcare is high especially with these amendments of healthcare policies such as the coming into place of this Affordable Health Care Act of 2010. Many people are now able to access medical care (Yang, 2014).
NP plays various roles in healthcare. They provide primary and acute care to patients in need. They as well contribute in offering a comprehensive healthcare and as well emphasize overall health and wellness of patients. Nurse practitioners provide this healthcare to all patients of all ages. They can work on their own as well as collaboratively with healthcare teams.
The Nurse practitioners provide other services such as physical examination, diagnosis services as well as treatment to patients that suffer from acute and chronic problems. They have the skill to interpret laboratory results, x-rays and even prescribe medication as well as manage various patients’ conditions and therapies (Mayo clinic, 2014). They as well teach and counsel and offer supported healthy lifestyle behaviors to patients on prevention of diseases. They as well can refer patients to other qualified and specialized health professionals for medication.
They help to promote equality and fairness in healthcare service provision. They render high quality, and cost effective individualized care to patients, communities as well as families. Even as the role and scope of NP continues to change, healthcare in US has to ensure that the public demand for healthcare is met (Institute of Medicine (U.S.) & Robert Wood Johnson Foundation, 2011). They must ensure that these nurses receive sufficient education, are a credited and posted to deliver quality healthcare. They also should provide grants to encourage people to join the professional to reduce the gap between the providers and the patients. This has as well some impacts on the changing scope of practice and the role of NP. One impact is that it will lead to poor quality healthcare, as nurses will be few and overstretched. Training of nurse will equip them with skill improving quality. Nurses are also expected to have knowledge in informatics to provide better services (Edelstein, 2013). This will require training in these areas to equip them with these skills.
Institute of Medicine (U.S.)., & Robert Wood Johnson Foundation. (2011). The future of nursing: Leading change, advancing health. Washington, D.C: National Academies Press.
NP plays a key role in healthcare delivery and therefore require support from the government to enhance their service delivery. NPs have a duty to establish a sustainable practice in the contemporary US healthcare system. They should take the leading role to meet the Institute of medicine recommendations to remain competitive. They should be committed to delivering of high quality healthcare to their patients in their environment. They should as well ensure that they pursue higher education to get masters and doctorate degrees to become proficient. This is important, as they will be required to deliver healthcare to the ever-increasing population (Institute of medicine, 2014). It is through higher training that these nurses can be able to remain competent and address the ever-changing health issues in the society (Yang, 2014). Training is also very important in this age of technological advancement. Healthcare nowadays has embraced technology and informatics in delivery of healthcare. Therefore, they must be trained in this area to equip themselves with these skills to be in a position to provide superb healthcare to their customers.
To achieve this sustainability it is important that various components are taken into consideration. These components include availability of nurses, the attitude of the nurses, the availability of finance to support the training, availability of the training institutions and professionals, demand of the healthcare among many others (Institute of medicine, 2014). For instance, it is important to determine whether credible institutions are in place to provide these training services to these nurses. If these are not in place, it becomes important to ensure that they are put in place at the commencement of training. The demand of the healthcare facility should as well be considered to determine the number of new enrolment.
These components impact on the development of a sustainable practice. If of nurses are few, they work under a lot of pressure and these compromises on the quality of care. Many of them may not be able to provide quality healthcare while others may opt to move to other careers (Yang, 2014). The work done should consummate with the amount of pay. NP should be well paid to motivate them to work hard. Availability or absence of training centers and professionals will also affect the quality of training. Many of the nurses may not be enrolled in the facility or those that enroll and fail to get high quality training will negatively affect delivery of quality healthcare.
It is therefore important to ensure that initiatives are in place to sustain NP. They play key role in promoting of healthcare and their services cannot be ignored even for a single second. The government must therefore work closely with them to provide them with assistance to ensure they remain committed to their duty.
References
Bourgeois, S et al., (2014). Nurse practitioner work: A case study. Contemporary Nurse: A Journal for the Australian Nursing Profession, 47 (1/2):p61-68.
SECTION A ( 1.5 pages )
Code of Ethics for Nurses, Encountering Challenging Dilemmas and Mentorship
The role of the NP is quite rewarding. However, it can be wrought with challenges, as well. Review the Code of Ethics for Nurses and examine potential challenges the NP may encounter in practice and create potential solutions. Share this in your paper.
Might the availability of other NPs as mentors impact how the novice NP manages challenges? Evaluate the pros and cons of mentorship and the novice NP in negotiating challenges encountered in the role.
Include a reference list at the end of this section 4 minimum.
SECTION B (1.5 pages)
Professional Development and Lifelong Learning.
NPs must invest in lifelong learning strategies for professional development, to maintain licensure and certification and for personal enrichment. Fortunately, numerous options and opportunities for lifelong learning and professional development exist. NPs may engage in research, policy and decision making, writing for publication, continuing educational opportunities, teaching and mentoring novice NPs, to name a few. Identify and discuss a few of your own professional interests and areas you envision focusing on for ongoing professional development and lifelong learning.
Include a reference list at the end of this section, 4 minimum
Resources.
Required Activities
Reading
From your textbooks, read the following:
Advanced Practice Nursing: Emphasizing Common Roles
• Chapters 8, 10, 14
Please review the following web resources:
ANA – Code of Ethics for Nurses
Salaries for Nurse Practitioners
Medscape News (Nurse Practitioners)
SAMPLE ANSWER
Ethics in Nursing
Introduction
The role of Nursing Practitioners is to enhance the work that conventional nurses have been doing over the years. Their increased qualifications automatically result in increased responsibility in the healthcare sector. While this will increase their contribution to the restoration and maintenance of public health, it also introduces new challenges that Nursing Practitioners have to overcome in their quest to deliver quality services while concurrently maintaining a good ethical standing. A nursing practitioner may encounter challenges while he or she is trying to adhere to some sections of the Code of Ethics that is prescribed for all those employed in the nursing sector. These include the patient’s right to self-determination, acceptance of accountability and responsibility and the protection of participants of research (American Nursing Association, 2011; Kunyk and Austin, 2012).
In as far as the “Patient’s right to self-determination” goes, a nursing practitioner will face the challenge of having to accept that the patient has the final say in regard to the medical interventions that will be carried out on him or her. The difference in knowledge gives the nursing practitioner relative to the patient creates a scenario where it is tempting to manipulate the patient into accepting a given treatment. The manipulation may be in the form of the registered nurse exaggerating potential consequences of refraining from the named medical treatment or procedure. In such situations the most a nursing practitioner can do is make the patient fully aware of the actual risks and also the potential benefits of agreement to the medical advice being dispensed.
Acceptance of accountability and responsibility can also be a challenge to a registered nurse due to the profound implications that this new-found responsibility has. Unlike nurses whose scope of work is highly dependent on physician’s instructions, nursing practitioners have a relatively elevated position with respect to the influence they have in decisions about medical interventions that patients need to be subjected to. In the event that a patient has a condition that is unique or uncommon, the registered nurse will have difficulty in making the decision since counter-productive interventions will at best lead to the worsening of the patient’s condition and at worst lead to death. These issues can at times lead to public inquests or lawsuits which taint a professional’s name and even lead to a license being revoked. In such situations, a registered nurse needs to consult widely prior to making a decision on the way forward for the patient (Robinson et al, 2014).
The main advantage of mentorship is that it facilitates for the monitoring of progress on a one on one basis making it easier to deal with subjective challenges. The main disadvantage of mentorship however is the fact that it creates a possibility for the mentor’s flaws to be passed down to the individual under mentorship and this could become part of a cycle therefore making a problem ingrained within a healthcare organization (Butts and Rich, 2013).
References
American Nurses Association. (2011). ANA Code of ethics for nurses with interpretive statements. 2001.
Butts, J. B., & Rich, K. L. (2013). Nursing ethics: Across the curriculum and into practice. Jones & Bartlett Publishers.
Kunyk, D., & Austin, W. (2012). Nursing under the influence A relational ethics perspective. Nursing ethics, 19(3), 380-389.
Robinson, E. M., Lee, S. M., Zollfrank, A., Jurchak, M., Frost, D., & Grace, P. (2014). Enhancing moral agency: clinical ethics residency for nurses. Hastings Center Report, 44(5), 12-20.
Section B
As an individual the key areas that I am interested in pursuing for my sustained professional development in the field of nursing are the pursuing of continuing education opportunities as well as participation in policy making for the formulation of decision making guidelines. I believe that these two areas provide me with the best chance of making a sustainable positive difference in this field (Hamric et al, 2013).
Continuing education that is currently available exists in the form of post-graduate courses and numerous training seminars on different aspects of the work of a nursing practitioner. The field of academia is one that is knowledge oriented and this comes from the heavy reliance on research materials for the passage of theoretical and practical knowledge to others in this field (Fairman et al, 2011). The lectures, assignments, projects and presentations will improve my aptitude on relevant matters pertaining to the position of registered nurses in the healthcare system. I also stand the chance to interact with a large number of people who have had unique experiences as nursing practitioners in different parts of the country and possibly the world. The presentations and assignments that I will participate in will also expose me to aspects of nursing that I was not familiar with, in the process making me more resourceful (Lawrence and Murray, 2013).
I also have an inclination towards participation in providing advice on policies that are being made or adjusted to accommodate the work of registered nurses. I believe that ethics need to be heavily applied to these policies in such a manner that ensures the public is the greatest beneficiary of the work of nursing practitioners. It is of no use if nursing practitioners are accommodated in a healthcare sector but they have limited capacity to perform. In this light I believe my participation in policy making will help in bridging the gap that exists between people most in need of basic healthcare services and the increasing number of registered nurses. I believe that engaging in policy development will also make my services relevant to other countries whose healthcare systems are also undergoing development (Mason et al, 2013).
References
Fairman, J. A., Rowe, J. W., Hassmiller, S., & Shalala, D. E. (2011). Broadening the scope of nursing practice. New England Journal of Medicine, 364(3), 193-196.
Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (Eds.). (2013). Advanced practice nursing: An integrative approach. Elsevier Health Sciences.
Lawrence, B., & Murray, L. (2013). Practitioner-Based Enquiry: Principles and Practices for Postgraduate Research. Routledge.
Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2013). Policy and Politics in Nursing and Healthcare-Revised Reprint. Elsevier Health Sciences.
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