Response 1 19472579

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Respond one of your colleagues’ posts by offering a possible resolution to their  questions/concerns with supporting documentation.

at least 2 references in each peer responses! 

  

The protection of those who receive nursing care is the responsibility of the State.  Each state’s rules and regulations, along with with their Nurse Practice Act guide competent and safe practices.  Although each state is dedicated to quality care for all patients, some regulations may vary from one State to the next (NCSB. 2019).

In each state, there are regulations that pertain directly to Advanced Practice Registered Nurses.  These rules specify the criteria that a Registered Nurse must meet in order to practice as an APRN.  In Missouri, an RN must pass an advanced pharmacology course.  This course offers education related to the pharmacokinetics and pharmacodynamics of various commonly used medications.  It also provides information pertaining to the use of medications for disease treatment or health promotion (NCSB. 2019).

The state of Iowa does not specify a requirement for an advanced pharmacology course within their ARPN rules and regulations.  Both states require an active RN license and graduation from an accredited program (NCSB. 2019).  There are many more regulations related to the requirements of licensure for an APRN in Missouri than an ARNP in Iowa. 

In Missouri, an APRN can apply for a certificate enabling them to prescribe controlled substances.  They could then prescribe drugs from a schedule III to V, omitting schedule I and II.  These certificates are obtained through the Missouri State Board of Nursing by applying with the Missouri Bureau of Narcotics and Dangerous Drugs as well as the Drug Enforcement Agency.  This certificate requires collaborations between the APRN and a physician  (NCSB. 2019).

Iowa also has State Regulations related to Advanced Registered Nurse Practitioners (as it is so named in Iowa) related to the prescription of controlled substances.  Just as it is in Missouri, Iowa ARNPs may only prescribe schedule II through V of narcotics (NCSB. 2019).  Both states require that this nurse register with the DEA, only in Iowa must this nurse maintain an active Controlled Substances Act to allow them to dispense, prescribe, or administer medications that are deemed a controlled substance (Weinberg, K. 2019). After reading the regulations for an ARPN in Iowa, versus an APRN in Missouri, it seems that there are more rules, and better detail within each rule, related to these nurses’ ability to prescribe scheduled medications.

The APRN in Missouri must complete an advanced pharmacology course.  This may be very useful for these nurses to assist in the treatment of various diseases and the promotion of health.  An ARPN can specialize as a nurse anesthetist, a family nurse practitioner, a nurse-midwife, or a clinical nurse specialist (Hoebelheinrich, K. 2018). In any one of these roles, this nurse may need pharmacology knowledge to prescribe the right medications, and to monitor for side effects related to their use.  APRNs are becoming increasingly vulnerable to liabilities related to inappropriate prescribing of medications that lead to medication errors (White, C. 2011).  These errors can cause loss of life for the patients.  It is important that APRNs are properly educated in pharmacology to reduce the risk of these life-altering errors. 

To ensure adherence any nurse who wants to further their education to become an APRN in Missouri should research all possible universities and programs and select one that provides an advanced pharmacology course.  It is important for a nurse to seek advice from an advisor who is employed at these schools as they will know what courses are required.  To ensure that any APRN is prescribing appropriately within the regulations of Missouri laws they should familiarize themselves with all laws and regulations related to APRN roles.  They should be aware of all requirements for obtaining certification to prescribe controlled substances and then comply with them fully. 

 
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Response 19400885

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Re: Topic 5 DQ 2

The video clip was an eye opener and took me through a rollercoaster of emotions. It was evident that the country of Haiti was not prepared for a large-scale disaster like the earthquake that occurred in 2010. The earthquake claimed the lives of more than 200,000 people and injured thousands more (World Health Organization, 2019). Their health care infrastructure including hospitals and health facilities were put to the ultimate test as thousands of people lined up for care. Many lessons of disaster preparedness can be learned through this devastating event.

Disaster or emergency management can be separated into four phases: Prevention or Mitigation, Preparedness, Response, and Recovery, each phase having its own set of activities. The mitigation phase includes actions to prevent or reduce the cause, impact, and consequences should a disaster occur. Public health nurses (PHN) can educate the community with planning for emergency situations such as practicing preparation drills. The preparedness phase includes planning and training to develop the capacity to respond quickly and efficiently to disasters and emergencies. Activities include developing plans to include what, where, and who to call for assistance. Health care facilities may practice through drills and exercises or educate the public with creating disaster kits. The next phase is the response phase which is the phase immediately following a disaster to provide safety for the community such as search and rescues, providing shelter, food, and medical care. The last phase is the recovery phase where restoration efforts occur (Falkner, 2018).

Disasters are unpredictable and impossible to stop and therefore, preventative measures must be taken to decrease the impact in the event of a disaster (Falkner, 2018). The primary phase involves planning prior to the onset of a disaster. PHN can assist families with creating plans for emergencies such as a making a first-aid kit, having at least a three-day supply of nonperishable goods, or preparing a gallon of water per person per day for at least three days. Another important message for the public is having an evacuation plan 9Falkner, 2018). There were no evacuation or safety plans in place for emergencies. Haiti was not prepared at for mass casualty. Having necessary supplies for developing countries can be challenging. Therefore, worldwide efforts with building emergency shelters should be in place. A good place to start are hospitals and clinics with adequate supply of water and food. Secondary prevention occurs within the onset of a disaster such as providing emergency assistance and emergency shelters (Falkner, 2018). As said in the video clip, people were lined up everywhere for medical services. Preventing infections from wounds, providing necessities or proper shelter was an impossible task due to lack of supplies and inadequate infrastructure. While there were worldwide efforts to provide secondary aide, it was an absolute chaos. Boxes were everywhere and emergency supplies could not be located. Perhaps in an event such as this, a point person can be designated to coordinate supplies so that it is more assessible to the health care team. Tertiary prevention occurs once the disaster has ceased with a focus on recovery (Falkner, 2018). The time for recovery will vary but there is hope with worldwide effort. This could come from donations and missions from volunteers to assist with financial and emotional distress such as the American Red Cross. The American Red Cross is a non-profit organization that has been providing life-saving services to the members of the American armed forces as well as providing emergency assistance in the United States and worldwide.

Reference

 
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Response 19399521

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Peer 1 

Nurses influence through engaging in activism act as a drive to health care policy changes enhancing improvement of the quality of care by increasing accessibility of the necessary resources as well as opportunities. Political activism skills are considered essential for the nurses as it enables them to protect the nursing profession as well as their practice (Buck-McFadyen & MacDonnell, 2017). Nurses can serve in elected positions within the state or the national levels to present the broad healthcare aspects of concern and ensure they are integrated within the healthcare policies.  

         Unionization of nurses is considered to be pertinent as the union offers the nurses the strength and power to bargain on the enforceable contracts such as the acceptable ratio of nurse to patient, their specific roles in maintaining quality of care as well as nurses overtime working hours and pay scale. Besides, joining nursing union provides an opportunity for the nurses to engage in political activism by lobbying private bodies and the government to advocate for policy changes that enhance improved patient care as well as participating in campaigns to create awareness on the importance of nurses thereby improving patient outcome (Ulrich & Kear, 2014). Nursing unions incorporate strategies that not only increase the nurse’s voice in advocating for improved care practices but also encourages nurses’ effective involvement in patient care through making informed decisions thereby creating a workforce culture of safety. One of the Masters of Science in nursing essential is the ability of the nurses to positively influence health policy and advocacy. The masters nursing program ensures that the nurses can effectively integrate nursing concepts at the system level to not only participate in the policy development process but also utilize advocacy strategies to impact change in health care policies.   

  

Peer 2 

Unionized nurses refer to nurses who belong in labor organizations that are meant to protect the nurses’ welfare and advocate for the improvement of the healthcare system. Nurses should be provided with the opportunity to join work environment unions at will. Work environment unions range from large national unions to smaller organizations created to address specific issues in specific healthcare facilities (Dube, Kaplan, & Thompson, 2014). 

Nurses’ organizations come with the benefits of coming together to address matters relating to healthcare and welfare of nurses such as proper wages, job security, benefits, staffing ratios, and patient rights (Dube, Kaplan, & Thompson, 2014). Nurses account for a significant proportion of any health facility’s budget, which makes them an easy target especially during the economic restructuring. Large budget for nurses often creates workforce shortages and unconventional staffing ratios. Unions can also advocate for motivational benefits such as medical and dental insurance, educational leave, sick pay and vacation. We can, therefore, argue that unions are an essential tool in enhancing the safety of nurses through negotiating for better wages, worker protection benefits, against unfair laying offs and terminations and proper amount of workload for the nurses (Higgins, 2016).  

Similar to the nurses’ welfare, unions can be instrumental in advocating for a proper health system that enhances patient care (Giovanetto, 2017).  Advocating for proper staffing ratios, for example, advances the interest of patients. Proper staffing ratio is key improving patient outcome because nurses can make proper follow up on patients even after discharge. Benefits such as educational leave also facilitate lifelong learning which is key in strengthening the skills possessed by nurses and hence the quality of healthcare and safety of patients. Nurses’ unions can also engage in advocacy relating patient safety by seeking change in management practices that relate to health care equipment, patient diet, hygiene, and patient rights such as privacy and informed consent (Higgins, 2016).  In conclusion, unions provide nurses with enhanced strength in numbers that can be used to advocate for nurses and patient safety. 

Response must be minimum 150 words each, doble space, APA(6th) no more than 5 years.

 

Bellow is the original activity if you needed: 

As an advanced practice nurse, one can engage in activism in order to achieve desired policy change at various levels including their own organization. Examine the following questions, should nurses be unionized and how does being unionized impact a workforce culture of safety? Be sure to include one MSN Essential in your discussion that relates to this topic. 

 
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Response 19398351

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4 postsRe: Topic 5 DQ 2

Based on the script from Haiti hurricane 2010 my thoughts are:

       Phase 1, the pre-disaster phase, is characterized by fear and uncertainty. The specific reactions a community experiences depend on the type of disaster. Phase 2, the impact phase, is characterized by a range of intense emotional reactions. As with the pre-disaster phase, the specific reactions also depend on the type of disaster that is occurring. Phase 3, the heroic phase, is characterized by a high level of activity with a low level of productivity (Substance Abuse and Mental Health Services Administration (2018).

       Primary prevention would be having volunteers appropriately vaccinated before leaving. After landing in Haiti, have the Hatians vaccinated against airborne and vector-borne diseases such as malaria. Ensure safe and proper sanitation such as making sure hands are washed before and after personal hygiene and patient care. Have clutters cleaned and cleared and make tracks for stagnant water to flow to avoid breeding mosquitos and encourage infestation of bugs. Shelters should be adequate and not overcrowded. Educate about diarrhea, what symptoms to look for and how to handle it.

        Secondary prevention depends on how devastating things are. Triage casualties according to acute, urgent, emergent. Initiate search and rescue efforts in wreckages, but not until damaged structures are deemed safe to enter or dismantle. Have a plan to manage casualties so that there will be no chaos. This could be done by using tents and designated signs with volunteers directing traffic. Teach the Hatians how to cope by asking for help from friends and families not badly affected by the disaster. Set-up an area where they can get emotional support to deal with their loss and address future community educational needs, such as disaster preparedness.

        Teritary prevention entails looking at long-term needs after the resolution of the disaster. Things such as healing and how to cope. Stress related issues such as rebuilding, that could be dealt with by the government and outside organizations such as the Salvation Army and other charitable organizations.

        I would work with Adventist Disaster Relief Agency (ADRA) because they are a branch of my church, the Seventh Day Adventist Church.  They have been helping with the organization of outreach world wide.  They are always on the ground in every disaster alongside the Canadian Red Cross and the Salvation Army organizations. Here’s a link for ADRA if interested to know more: www.adra.ca/connections

        Prevention includes a wide range of activities — known as “interventions” — aimed at reducing risks or threats to health. For many health problems, a combination of primary, secondary and tertiary interventions are needed to achieve a meaningful degree of prevention and protection, (Institute for Work and Health 2015). 

        Based on the script, this nurse is at the preimpact stage which falls under primary prevention, as she is planning to reduce the impact of the hurricane on the population and what damage may have occurred.  This could only be assessed on her arrival.

References

GCU. (2010). “Diary of a medical mission trip.” Retrieved from Grand Canyon University: http://lc.gcumedia.com/nrs427v/diary-of-medical-mission-trip/v2.1/

Institute for Work and Health (2015). Primary, Secondary and Teritary Prevention. Retrieved from: https://www.iwh.on.ca

Substance Abuse and Mental Health Services Administration (2018). Phases of Disaster. Retrieved from https://www.samhsa.gov

 
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Response 19398341

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1 postsRe: Topic 5 DQ 2

On a large scale the preparation and planning for a disaster, before it happened would be a primary prevention in disaster management. In the video about the catastrophic earthquake in Haiti in 2010, the primary prevention was mentioned while the narrator described the use of hand sanitizer and gloves to ensure their own safety on the scene of a disaster (Falkner, 2018). Also, we can assume that the medical staff have received immunization shots against infectious diseases which are prevalent in the Haiti prior to leaving the U.S.

The secondary prevention, during a disaster, would have measures aimed to maintaining and saving lives, and supporting victims and their health (Falkner, 2018). For example, an appropriate wound care to prevent development of a local infection. And, if the wound infection is already happening, the antibiotic treatment would be an example of the tertiary prevention of systemic infection or sepsis, as a complication. For disasters in general, the tertiary prevention would take place after an event has ceased and the interventions focus on recovery and may take months or years (Falkner, 2018). Also, in this phase the learned lessons should be reviewed and collected, in order to be considered for preparation for possible future disasters (back to primary prevention). The agencies, which would be involved in planning, creating policies and making changes to the existing policies would be Federal Emergency Management Agency, it offers the National Disaster Recovery Framework which is a

guide that enables effective recovery support to disaster-impacted States, Tribes, Territorial and local jurisdictions. It provides a flexible structure that enables disaster recovery managers to operate in a unified and collaborative manner. It also focuses on how best to restore, redevelop and revitalize the health, social, economic, natural and environmental fabric of the community and build a more resilient Nation (FEMA, n.d.). Retrieved from https://www.fema.gov/national-disaster-recovery-framework

Falkner, A. (2018). Disaster management. In Grand Canyon University web services. Community & public health: The future of health care (ch. 5). Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/#/chapter/5

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Response 19398335

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3 postsRe: Topic 5 DQ 1

Whether natural or manmade, disasters take a toll on the communities they hit and those who are caring for them, physically, psychologically, and spiritually. However, natural and manmade disasters may have different impacts psychologically and spiritually. In the context of a natural disaster there are stresses from injury/loss of life, the potential damaging of a community, and a feeling of disbelief or stress related to coping with a loss. Depending on the cause of the manmade disaster, there could be slightly different stresses including loss of trust in people or anger if the disaster was intentional. Regardless they both have an impact on the individuals, community, and health care providers effected.

In order for health care providers to be able to care for people and communities affected by disaster, they must first ensure they care for themselves spiritually in order for them to focus on the needs of others. Once this is taken care of community health nurses can assist individuals in many ways including building rapport and relationship with them and having therapeutic conversations, they can also utilize the resources in the community such as chaplains and social work. Chaplains are trained and able to provide counseling and comfort to those impacted by the shock and grief of a disaster (Falkner, 2018). Another way in which community health nurses could assist would be with preparation of the community prior to the disaster occurring. By assessing and knowing the community’s spiritual needs and resources pre-disaster they will know who to turn to after an event even quicker. In working with colleagues during disaster response the community health nurse can monitor their mental and spiritual health and reach out if they see them slipping at all.

Resources

Falkner, A. (2018). Disaster management. In Grand Canyon University (Ed.), Community & public health: The future of health care. Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/#/chapter/5

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Response 19398329

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1 postsRe: Topic 5 DQ 1

Disaster usually involves causing great damage that often results in extensive loss of property and loss of life. These catastrophic events can be man-made or natural disaster. Nurses are always at the fore front and playing crucial role in responding to disasters. For nursing care to be holistic, the need for spiritual care is very important to be accomplished, particularly in the event of disaster. However, nurses are using not well equipped to be involved in spiritual work. This is due to the lack of training in the nursing curriculum and this has resulted in the lack of competent in implementing this very important part of care in promoting health and wellbeing. According to (Zehtab, & Adib-Hajbaghery, 2003), not proving spiritual support to patient is neglecting the opportunity to improve patient’s care.

Spiritual aspect of care is now more central throughout healthcare. A person’s health is looked at physical, mental social and spiritual wellbeing (Who Health Organization, 2007). Spiritual care has a positive effect on the wellbeing of the individual’s stress responses, and it is important for patients during illness and hospitalization (Cavendish et al., 2003).

Nurses serve as an essential resource and can play a wide range of responsibilities related disaster preparedness and response. One of the key roles is providing education to individuals, community, self and colleagues about how to keep self during a disaster. This knowledge shared will help in alleviating anxiety and fear. Nurses have also volunteer during disaster through various organizations such as American Red Cross, the Federal Emergency Management Agency and the United State Public Health Service (the Role of the Nurses in Providing Spiritual Care to Patients, n.d). They can be directly involved in assisting in disasters such as first aid and medication, assessing the state of victims and monitoring the mental health of victims. Nurses have family and themselves, preparing the family with emergency plan and emergency supplies can help ensure the nurse and family are safe in time of disaster.

 
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Response 19408761

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3 postsRe: Topic 1 DQ 2

Servant leadership is a type of leadership in which the main goal of the leader is to serve and place the needs and interests of their followers and organization over their own self-interest and needs (Greenleaf Center for Servant Leadership, 2016). “Servant leadership is a philosophy and set of practices that enriches the lives of individuals, builds better organizations, and ultimately creates a more just and caring world,” states the Greenleaf Institute for Servant Leadership. The phrase “servant leadership” was coined by Robert K. Greenleaf in The Servant as Leader and in his thesis he makes several strong statements including the philosophy that, “caring for persons, the more able and the less able serving each other, is the rock upon which a good society is built” (Greenleaf Center for Servant Leadership, 2016). This type of leadership style is set up to serve each member in the group. In a diverse workplace, this type of leadership would be beneficial in that it allows for personalized management and can help to establish cohesiveness in a team environment (Root, 2007). In other forms of management styles, the needs and visions of the company are often put ahead of the needs of the staff. In the servant leadership setting, all input and opinions are taken into consideration which helps to build loyalty from staff, can improve feelings of teamwork, and increase staff morale (Root, 2007). When employees are satisfied with their jobs and their company, workplace productivity tend to rise.

Transformational leaders work with their employees to implement change. This type of leadership involves creating a vision for followers and guiding changes through inspiration and motivation. This theory was developed by James Burins in the 1970s with the basic assumptions that, “Both leaders and followers have the ability to “raise each other to the highest levels of motivation and morality” (Marquis & Huston, 2017, p. 50).” (Grand Canyon University, 2018). “In Burns’ view, transformational leadership has the potential to motivate followers to satisfy higher-level needs, such as self-esteem and self-actualization. Those influenced by transformational leaders find meaning and value in their work, make significant contributions to the success of their employing organization, and become leaders’ themselves” (Rose O. Sherman, 2019). Transformational leaders use the following four elements when leading others; idealized influence, inspirational motivation, intellectual stimulation, and individual consideration. “Transformational leadership focuses on empowerment, viewing errors as learning opportunities, and valuing innovation which means staff members have a means of continually providing input about how to improve care. As a result, transformational leadership can revitalize healthcare from the point of patient care and more” (Rose O. Sherman, 2019). This can be a very powerful approach, but the visionary, big-picture aspect can distract the leader from the day-to-day tasks. It works best when the leader has a detail-oriented subordinate to keep him things grounded.

Grand Canyon University (Ed). (2018). Nursing leadership & management: Leading and serving. Retrieved from https://lc.gcumedia.com/nrs451vn/nursing-leadership-and-management-leading-and-serving/v1.1/

Greenleaf Center for Servant Leadership. (2016). The Servant as a Leader. Retrieved from What is Servant Leadership: https://www.greenleaf.org/what-is-servant-leadership/

Root, G. N. (2007). The Advantages of the Servant Leadership Style. Retrieved from Leadership: https://smallbusiness.chron.com/advantages-servant-leadership-style-11693.html

 
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Response 19373463

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 In response to two of your peers, identify the strengths and weaknesses of the discussed research design related to evidence-based practice. 

Please respond individually to peers response attached below.

 
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Response 19406509

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3 postsRe: Topic 1 DQ 1

A manager is the member of an organization with the responsibility of carrying out the four important functions of management: planning, organizing, leading, and controlling. The managers may react to specific situations and more concerned with short term problem solving. Management is regarded as related to people working in a structured organization and with prescribed roles (R, Lopez. 2014).

A leader doesn’t have to be an authority figure in the organization and a leader can be anyone. The most important aim of a manager is to maximize the organizational output through managerial performance. But leader always seeks new possibilities and understand new possibilities in organization. Most of the workgroups are more loyal to leaders than managers (Essays, UK. 2018).

Leadership and management are interrelated, and they go hand in hand. They have same goals. For example, managing conflicts. At my work setting, if there is a situation or conflict between staff, it goes though the leaders who will work with the individual involved to manage a conflict and if it doesn’t solve than the leader takes to managers and they both work together to solve the issue .

Being a leader once must have a basic leadership skill. I will make sure I am knowledgeable, I am known how to do time management, I have a visionary sight for the benefits of the company and be able to motivate the team for their tasks.

Reference

Essays, UK. (November 2018). Relationship Between Management and Leadership Management Essay. Retrieved from https://www.ukessays.co

 
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