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For this assignment I have chosen to use a qualitative research analysis. This approach is best for my area of interest because the PICo question will be answered with patient’s personal life experiences, views, and opinions. The PICo question I have created asks, “In sickle cell patient’s experiences(P) how effective are non-opioid medications and non-pharmacological interventions compared to opioid medications (I) in decreasing sickle cell disease pain (Co)?” My practice questions seeks to find best practices for managing pain in patients with sickle cell disease. Currently in the 

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As the nurse executive in an acute care hospital, I welcome collaboration among advanced practice nurses (APN) and the clinical staff for many reasons. Advanced practice nurses can take on acute services, be readily available and in all honesty are far more approachable, accessible and can provide a sense of trust into our patient population when being compared to a PGYI or newer medical student. Often times our medical residents or surgical residents lack empathy and lack a collaborative effort that makes our admissions and discharges flow in less than desired manner. As a whole, the unit gravitates toward reaching out to the APRN for effective communication when placed in a position to communicate between families, patients and our medical teams.

         An organizational chart could absolutely be utilized to enhance and improve collaborative communication and facilitate trust among different departments through reflexivity. From the article Margaret Archer, Modes of Reflexivity: The Structured Agency of Nursing Action, communicative reflexivity is said to be our inner conversations which required confirmation and communication with others before we act. A nurse who predominantly uses communicative reflexivity will consider what their peers are thinking and will want to act in such a way as to fit in (Goodman, 2017). Although the nursing profession especially as a clinical provider we tend to use our professional critical thinking skills and act on our best nursing judgement, we tend to disconnect from our peers and resources such as the APNs to confirm our actions before we act. Although working together as a team is essential for the unit to function properly in crisis situations, I often times see nurses perform on “auto-pilot”, working independently without collaborative efforts that could be in the best interest of our patient population. Facilitating collaboration between available APNs and clinical staff is essential to improving patient outcomes and building a higher self-esteem among staff. Being validated that our critical thinking, assumptions and interventions are correct from someone with higher level education can be very empowering.

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Health Systems: Daniel, a DNP prepared ED NP identified that patients seen in the ED for various reasons had undiagnosed HTN. He observed that the patient’s chief compliant was well addressed but the HTN was not. He has approached the hospital system about the problem and suggested an outpatient clinic adjacent to the ED to address the HTN and other coincidentally found problems. What AP roles, core competencies and support are needed to make this happen?

I am a nurse manager and discuss what roles are needed to make this outpatient clinic happen.

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Weekly project, For week 2, I will ask for you to submit a small 1 page paper, using APA format on the following (Do NOT include a cover page): Many patients ask for nonprescription medications to use for various health problems, such as insomnia, depression, pain, memory, anxiety… Select one patient complaint (for example, insomnia) and review the major herbs that have been recommended for treatment, focus your paper one ONE of those herbs. Review their possible mechanism of action, discuss the intended benefit, document possible adverse effects and interactions and provide a dialogue indicating if you will be recommending that as a treatment in your practice or not and Why? Do not forget to finish the paper with a conclusion/summary of the new information reviewed within the paper.

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• As the nurse executive, how would you manage relationships with advanced practice nurses (APN) in your setting? Do you feel an organizational chart may enhance collaboration between departments through reflexivity (one of the person-centered leader attributes)? How could you facilitate staff nurses acceptance and understanding of the APN role? Share specific examples.

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