Tag Archive for: nursing

Personal Philosophy of Nursing

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Personal Philosophy of Nursing
In a 6- to 7-page paper in APA format describe your personal approach to professional nursing practice. Be sure to address the following:

Which philosophy/conceptual framework/theory/middle-range theory describes nursing in the way you think about it? Discuss how you could utilize the philosophy/conceptual framework/theory/middle-range theory to organize your thoughts for critical thinking and decision making in nursing practice.
Formulate and discuss your personal definition of nursing, person, health, and environment.
Discuss a minimum of two beliefs and/or values about nursing that guide your own practice.
Analyze your communication style using one of the tools presented in the course. In your paper, discuss the strengths and weaknesses associated with your style of communication and the impact on your ability to collaborate as part of an interdisciplinary team.
On a separate references page, cite all sources using APA format.
Use this APA Citation Helper as a convenient reference for properly citing resources.
This handout will provide you the details of formatting your essay using APA style.
You may create your essay in this APA-formatted template.

    Psychiatric Assessment of the Adult and Older Adult

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    Psychiatric Assessment of the Adult and Older Adult

Many assessment principles are the same for children and adults; however, with adults/older adults, consent for participation in the assessment comes from the actual client and not parents or guardians. The exception to this is adults/older adults who have been determined incapacitated by a court of competent jurisdiction. Some adults may be easier to assess than children/adolescents as they are more psychologically minded. That is, they have better insights into themselves and their motivations than children/adolescents (although this is not universally true).

Older adults present some of their own unique assessment challenges in that they may have higher levels of stigma associated with seeking psychiatric care. Additionally, there are higher rates of neurocognitive disorders superimposed on other clinical conditions such as depression or anxiety, which creates additional diagnostic challenges.

This week, you will develop your own personal format for initial interviews of mental health clients. You also will explore the restrictions and limitations for practice as a PMHNP in your home state and create a plan for passing the national certification exam.

Week 1-developing skills in interviewing and diagnostic reasoning

As we begin Week 1, the module is focused on developing an interview format that provides you with questions/responses that you will use in your work-ups and diagnostic assessments or some call them Psychiatric H & P. By now, you have seen many different formats and ways that providers conduct interviews.

For this document, I encourage you to think of your personal style as well as assure that all relevant information is collected in the first interview. Do not use a template that you find online or that your preceptor uses in the office. The purpose of this assignment is for you to think through how you interview patients. There are many examples online to use as a guide. The key elements are similar to a medical H &P, HPI, PPH, PMH, FH, SH, ROS (psychiatric), MSE, Clinical Assessment and Formulation, Diagnosis, and Plan. This will be your ‘bread and butter’, so to speak for your entire career. It is worth spending some time and effort on this. If you put in a canned template, I will not accept your work.
My personal style is what I would call ‘conversational’. I try to engage in some social conversation to get the visit started and then as the patient talks, I make notes on follow-up questions. I keep a list of the basic things that I need for my write-up: HPI, PPH, PMH, Soc/Dev, Substance use, Medication history, Stressors, coping abilities, therapy history. At the end of what I consider ‘the interview’ I review my list to make sure that I have all the information and I sometimes say to patients, “let me make sure that I got all the information that I need to make an accurate diagnosis and develop a treatment plan”. Then, I will say to the patient, “do you have anything that you’d like to add?”

This conversational style is not for everyone and I know many providers that use more of a ‘checklist’ style. Think about what you want and how you will feel most comfortable. Feel free to provide feedback to your colleagues –there are no right or wrong styles.

Instructions- Week 1:

Despite what you may believe (or may have been told), there is no such thing as one “right” way to do an interview. In fact, there are numerous books written about the various ways of conducting the clinical interview. In actual clinical practice, you will find the format that “works” best for you and addresses your unique strengths and the needs of the client.

In this Discussion, you will practice finding the interview format that works for you and share those ideas with your colleagues for feedback.

Learning Objectives

Students will:

  • Develop formats for initial interviews of mental health clients

To prepare for this Discussion:

  • Review  the Learning Resources.
  • Develop an interview format you would use for an initial interview of a client.

                                                           ASSIGNMENT

  • Attach  the interview format document you would use for an initial interview of a client.
  • Describe      what interview format your preceptor uses for the initial interview of a  client.
  • Describe      which element of your interview format is most helpful in your practice.

                                               Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

  • Section 5.1, “Psychiatric Interview, Mental Status      Examination” (pp. 192–211)
  • Section 5.2, “The Psychiatric Report and Medical      Record” (pp. 211–217)
  • Section 5.3, “Psychiatric Rating Scales” (pp. 217–236)
  • Section 5.5, “Personality Assessment: Adults and      Children” (pp. 246–257)
  • Section 5.7, “Medical Assessment and Laboratory Testing      in Psychiatry” (pp. 266–275)
  • Chapter      6, “Classification in Psychiatry” (pp. 290–308)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

  • “Cautionary Statement for Forensic Use of DSM-5”
  • “Assessment Measures”
  • “Cultural Formulation”
  • “Glossary of Technical Terms”
  • “Glossary of Cultural Concepts of Distress”

Barton Associates. (2017). Nurse practitioner scope of practice laws. Retrieved from https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws/

American Psychiatric Association. (2016). Practice guidelines for the psychiatric 

evaluation of adults. Retrieved from http://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760

Required Media

Laureate Education (Producer). (2017b). Working with Adults and Older Adults” [Video file]. Baltimore, MD: Author.

Hagen, B. (Producer). (n.d.-a). Conducting a mental status exam [Video file]. Mill Valley, CA: Psychotherapy.net.

Optional Resources

American Psychological Association. (2008). Assessment of older adults with diminished capacity. Retrieved from https://www.apa.org/pi/aging/programs/assessment/capacity-psychologist-handbook.pdf 

Rosen, S. L., & Reuben, D. B. (2011). Geriatric assessment tools. Mount Sinai Journal of Medicine, 78(4), 489–497. doi:10.1002/msj.20277

Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). TIP 59: Improving cultural competence. Retrieved from http://store.samhsa.gov/product/TIP-59-Improving-Cultural-Competence/SMA15-4849

interprofessional collaboration

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Write a 3–4-page article that addresses the topic of interprofessional collaboration and teamwork in health care organizations.

The majority of health care leaders today state that  interprofessional collaboration is essential for effective and efficient  health care delivery. But this type of collaboration rarely occurs  (Bankston & Glazer, 2013). In this assessment you will consider what  it takes to develop truly effective interprofessional collaborative  teams.

When six Navy pilots step into their F/A-18 fighter jets, they become  the Blue Angels, and the world sees a synchronized display of precision  flight formation. During their aerial acrobatics, the 28-ton jets form a  diamond shape with a mere 18 inches between the wing of one jet and the  canopy of another, travelling at more than 300 miles per hour. How do  the pilots achieve such precision? In addition to hours of practice,  intense focus, clear communication, and mutual trust, “at the door, each  [pilot] checks his or her ego, exchanging it for a soul-deep commitment  to ‘The Team'” (Scott, 2005, para.1).

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Teams and collaborative groups are at the heart of many great  achievements and are common in health care and familiar to nurses. But  what defines a team, and how do teams achieve great outcomes? There are a  number of elements that must come together in order to build effective  teams. Many teams are in a state of constant flux as they build and  dissolve, based on the needs of the organization. Nurses are often  involved in several teams at the same time, and many of these teams are  multidisciplinary in nature.

So, what factors determine the effectiveness of a  multidisciplinary team? Do the same factors affect different teams  working within different areas of health care?

Reference

Scott, W. (2005). Blue angels. Aviation Week & Space Technology, 162(12), 50–57.

Preparation

Search the Capella library and Internet to locate scholarly and  professional journal articles on the elements of an effective  interprofessional health care team to use as support in this assessment.

Requirements

You have been asked to submit an article to be published in your  organization’s newsletter. After careful deliberation, you have decided  to address the topic of interprofessional collaboration and teamwork in  health care organizations, and how teams can be successful. Your article  should be 3–4 pages in length, not including the title page and  references page. Format this assessment following APA guidelines.

Complete the following in your article:

  • Explain what is meant by the term interprofessional collaboration from a nursing perspective. (Do not simply copy a definition from a dictionary or other resource!)
  • Describe the characteristics and qualities of effective interprofessional teams in terms of patient care and safety.
  • Describe the benefits and limitations of interprofessional teams for health care organizations, members of a team, and patients.
  • Explain the challenges of working in an interprofessional team.
  • Describe strategies to help people come together to function effectively as a collaborative team.
  • Explain how interprofessional teams define success. Consider how  the definition might change based on the types of situations the team  was formed to handle.

Additional Requirements

  • Include a separate title page and references page.
  • Reference at least three current scholarly or professional resources.
  • Use APA format.
  • Use Times New Roman font, 12 point.
  • Double space.

Medical Education

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Due tomorrow Monday at 1:00 PM Central

Discussion Board #5 Options Menu: Forum

HCA 340

Discussion Board Assignment #5

Chapter 6 – Medical Education and the Changing Practice of Medicine

Answer the following questions:

  1. The Flexner Report of 1910 is described by the authors as “an accurate and searing description of abuses in the medical schools.” Describe some of the major shortcomings of medical education cited by the Flexner report and the corrective measures that resulted.
  2. Academic medical centers were formed by the union of medical schools through affiliations with hospitals that provided clinical experience for medical students. These affiliations were later broadened into academic health centers. Describe the components of the academic health centers and their significance to the evolution of the university-based health professional education complex.
  3. The health care delivery system now with ACA mandates, places increased emphasis on maintaining wellness and on promoting disease avoidance through healthy behaviors and lifestyles. What are some challenges this new orientation poses for our existing system of medical education and training?
  4. In what ways did physicians’ relationships with hospitals change as a result of health care industry reforms? Discuss the consequences of these changes for physicians’ roles and responsibilities in relationship to hospitals.
  5. The dispute over exposing the comparative performance of physicians on a wide spectrum of variables has been resolved in favor of the consumers of health care with requirements such as “Physician Compare.”  A number of states have passed legislation that gives the public access to physician information, including disciplinary records, malpractice actions, and whether a physician has lost hospital privileges. Are these fair and balanced bases on which consumers should make decisions about their choice of physicians?
  6. Given the new role of hospitalists in patient care, identify some issues raised by this new brand of physician for the primary physician and patient.

Common Cardiovascular and Neurologic Conditions

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Discussion:

 Diagnosing and Managing Common Cardiovascular and Neurologic Conditions

Cardiovascular and neurologic conditions are among the leading causes of death and hospitalization of women in the United States (Centers for Disease Control and Prevention, 2008a). As an advanced practice nurse, you must routinely monitor patients at risk of these conditions and recommend the appropriate health screenings and preventive services. When assessing patients for these conditions, it is important to keep in mind that while some female patients might present with typical signs and symptoms, others might present with atypical signs and symptoms that are unique to women. For this Discussion, consider signs and symptoms presented by the women in the following case studies and develop differential diagnoses:

                                                      Case Study 2: Due  10.30.17

You are seeing a 63-year-old African American female for a two-week history of intermittent chest pain. The pain varies in intensity and resolves with rest. She does not believe it has increased over time. She is a nonsmoker with a history of hypertension treated with Lisinopril 10 mg once daily. She had an exercise stress test one year ago that was within normal limits. Her physical exam findings are as follows: HR–90, BP–150/92, R–22, O2Sat 98% RA; lungs: clear to auscultation bilaterally; cardiovascular: apical pulse of 90 RRR, no rubs, murmurs, or gallops. Chest wall mildly tender to palpation that reproduces her complaint of pain. Extremities include no clubbing, cyanosis, or edema. The remainder of the exam is within normal limits.

To prepare:

· Review Chapter 8 of the Tharpe et al. text and the McSweeney et al. article in this week’s Learning Resources.

· Analyze the patient information on case study # 2

· Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.

· Reflect on the appropriate clinical guidelines.

· Think about a treatment and management plan for the patient.

· Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.

· Consider strategies for educating patients on the treatment and management of the disorder you identified as your primary diagnosis.

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Then, based on the appropriate clinical guidelines, explain a treatment and management plan for the patient, including proper dosages for any recommended treatments. Finally, explain strategies for educating patients on the disorder.

                                             Please use these resources/references:

 

Required Readings

Tharpe, N. L., Farley, C., & Jordan, R. G. (2017). Clinical practice guidelines for midwifery & women’s health (5th  ed.). Burlington, MA: Jones & Bartlett Publishers.

Chapter 8, “Primary Care in Women’s Health” (pp. 457-616)
This chapter explores health promotion and disease prevention in women’s health. It also describes the presentation, assessment, diagnosis, and management of various systemic conditions, including cardiovascular and neurologic conditions.

McSweeney, J. C., Pettey, C. M., Souder, E., & Rhoads, S. (2011). Disparities in Women’s cardiovascular health. Journal of Obstetric, Gynecologic & Neonatal Nursing, 40(3), 362–371.
Note: Retrieved from the Walden Library databases.

This article explores health disparities in cardiovascular disease, including gender and racial disparities related to the diagnosis, treatment, and outcomes of patients with this disease.

Department of Health and Human Services, National Institutes of Health, & National Heart, Lung, and Blood Institute. (n.d.). Women’s Health Initiative: WHI background and overview. Retrieved March 20, 2013, from http://www.nhlbi.nih.gov/whi/background.htm

This website outlines details of the Women’s Health Initiative (WHI) and introduces the various health issues addressed by the WHI.

Optional Resources

Centers for Disease Control and Prevention. (2012b). Women’s health. Retrieved from http://www.cdc.gov/women/

National Institutes of Health. (2012). Office of Research on Women’s Health (ORWH). Retrieved from http://orwh.od.nih.gov/

U.S. Department of Health and Human Services. (2012a). Womenshealth.gov. Retrieved from http://www.womenshealth.gov/

subcodes

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Prepare a draft of a zero-based operational budget that includes the following based on your selected nursing unit:
Operating expenses with subcodes
Description of subcodes
Prior-year expenses of subcodes
Original budget allocations for subcodes
Annualized expense for subcodes
Budget adjustments for subcodes
Approved budget for subcodes
Personnel costs for one nursing unit
Personnel Costs for One Nursing Unit—Components
The nursing personnel budget is based on the total number of hours of care needed, which is determined by patient-acuity levels. Complete the following budget calculations using the information given and add these to the zero-based operational budget as a line item and subcode. https://onlinenursingpapers.com/zero-based-budget/ is the link to the full assignment instructions

Epidemiology Paper Requirements

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Write a scholarly paper in which you apply the concepts of epidemiology and nursing research to a communicable disease. Choose one communicable disease.

Epidemiology Paper Requirements

Include the following in your assignment:

1.  A thorough description of the disease including causes, mode of transmission, symptoms, treatment and complications. Discuss the demographic most affected-incidence, prevalence, morbidity and mortality.

2.  What are the determinants of health affecting this disease? https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health.

3.  Identify the epidemiologic triad including host, agent and environmental factors as related to this disease.

4.  Discuss the role of the public health nurse in relation to this disease. How is the public health nurse involved in finding, reporting, collection and analysis of data and follow up?

A minimum of three references is required. The written essay should be at least 1250 words in length.

breast cancer.

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As an advanced practice nurse, you will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend to help address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?

For this Discussion, you will be assigned a patient case study and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, safe, and quality patient care for positive patient health outcomes.

Post a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.

A 46-year-old, 230lb woman with a family history of breast cancer. She is up to date on yearly mammograms. She has a history of HTN. She complains of hot flushing, night sweats, and genitourinary symptoms. She had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms. She has a history of ASCUS about 5 years ago on her pap, other than that, Pap smears have been normal. Home medications are Norvasc 10mg qd and HCTZ 25mg qd. Her BP today is 150/90. She has regular monthly menstrual cycles. Her LMP was 1 month ago.

Workplace Environment Assessment

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Workplace Environment Assessment

The Assignment (3-6 pages total):

Part 1: Work Environment Assessment (1-2 pages)

  • Review the Work Environment Assessment Template you completed for this Module’s Discussion.
  • Describe the results of the Work Environment Assessment you completed on your workplace.
  • Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed.
  • Explain what the results of the Assessment suggest about the health and civility of your workplace.

Part 2: Reviewing the Literature (1-2 pages)

  • Briefly describe the theory or concept presented in the article(s) you selected.
  • Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.
  • Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.

Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1–2 pages)

  • Recommend at least two strategies, supported in the literature, that can be implemented to address any shortcomings revealed in your Work Environment Assessment.
  • Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment.

Leading Change, Advancing Health

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Details:
Review the Institute of Medicine’s 2010 report “The Future of Nursing: Leading Change, Advancing Health.” Write a 750-1,000 word paper discussing the influence of the IOM report on nursing practice. Include the following:

Summarize the four messages outlined in the IOM report and explain why these are significant to nursing practice.
Discuss the direct influence the IOM report has on nursing education and nursing leadership. Describe the benefits and opportunities for BSN-prepared nurses.
Explain why it is important that a nurse’s role and education evolve to meet the needs of an aging and increasingly diverse population.
Discuss the significance of professional development, or lifelong learning, and its relevance in caring for diverse populations across the life span and within the health-illness continuum.
Discuss how nurses can assist in effectively managing patient care within an evolving health care system.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.