There are multiple differences between leaders and managers. According to Clarke, L. (n.d), the difference between leader and manager can be drawn on the following grounds:

1. A leader influences his subordinate to achieve a specified goal, whereas a manager is a person who manages the entire organization.
2. A leader possesses the quality of foresightedness while a manager has the intelligence
3. A leader sets directions, but a manager plans details.
4. A manager takes decision while a leader facilitates it.
5. A leader and the manager is that a leader has followers while the manager has the employees.
6. A manager avoids conflicts. On the contrary, a leader uses conflicts as an asset.
7. The manager uses transactional leadership style. As against this, transformational leadership style is used by the leader.
8. Leaders promote change, but Managers react to the change.
9. A leader aligns people, while a manager organizes people.
10. A leader strives for doing the right things. Conversely, the manager strives for doing the right things.
11. The leader focuses on people while a manager focuses on the Process and Procedure.
12. A leader aims at the growth and development of his teammates while a manager aims at accomplishing the end results.

However, (Gillikin, n.d.) states that managers are often considered to be the members of an organization that are more interested in executing goals and objectives rather than creating new visions and missions for their organizations. With this, Arruda (2016) writes that leaders are often the ones promoting full scale change within their organizations while managers are more interested in maintaining the status quo. So, the main difference between leadership and management largely lie in philosophy and the practical execution of one’s role. While the philosophical differences strongly contrast from one another, some of the practical aesthetics of management and leadership overlap. Many managers are called to create plans and objectives for their organization that can encourage long term growth and budgeting over time. While these long term changes are not designed to be visionary, a practical manager may end up optimizing or changing major operational practices that have been used for some time in a company.

In addition, by its very nature, the professional nurse role is one of leadership. Across the healthcare continuum, regardless of our role or practice setting, we are looked to as leaders. The call to leadership moves all of us to a higher plane of responsibility and accountability, with or without a management title; it is inherent in all nursing positions from staff nurse to CEO. We all have similar goals and responsibilities for patient care. With all the changes currently underway in our healthcare delivery system and the nursing profession, all nurses must strive to emulate the hallmarks of good management and leadership and never stop working on our professional growth. We all need to stay informed and be politically saavy; we need to know what our professional journals and nursing organizations are saying and advance our education. In the end, all nurses must be visionaries, critical thinkers, skilled communicators and teachers. And the good news is you do not need a formal manager or leader title required to do any of these things (Williamson, E. 2017).

Nurse leaders that want to encourage change in their organizations should do so by being proactive managers that want to increase the value of the services their facilities offer. Thew (2018) writes that nurse managers can take advantage of the industry’s shift to value based care by looking at how they can optimize the use of their fellow nurses in the field. Rejecting some of the financial reimbursements that come with solely focusing on fee based services means that nurse managers will create more optimal business strategies.

References:

Clarke, L. (n.d.). Key Differences Between Leader and Manager. Retrieved from https://inside.6q.io/whats-the-difference-between-manager-and-leader/

Gillikin, Jason. (n.d.). Management vs. leadership in a healthy organizational culture. Small Business – Chron. Retrieved from http://smallbusiness.chron.com/management-vs-leadership-healthy-organ

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1 postsRe: Topic 5 DQ 2

This catastrophic earthquake took place on January 12, 2010, in the country of Haiti. With a magnitude of 7.0. on the Richter scale, this earthquake took many lives. An international relief operation was initiated soon after the earthquake happened. The United States sent thousands of military troops to Haiti to provide resources, help with finding lost loved ones and friends and help sustain peace.

According to Green (2018), “Primary prevention in disaster management involves planning prior to the disaster.” Thinking of the situation that is taking place and planning how to overcome the obstacles to help treat and save people. For instance, access to surgical, medical and emergency equipment, plans set in place to handle burns, trauma or other issues that might occur. Access needs to also be available to medications like antibiotics and IV fluid. Additionally, Green (2018) adds that “Secondary prevention may occur when the onset of the disaster has occurred or within hours of its impact; this is when the response occurs during a disaster.” This could be priority immunizations, including mass vaccination campaigns for tetanus immunization as part of wound care. This happens in the second phase to insure that once people are not in danger, they do not get an infection from a secondary situation. Secondary situations to educate on would be wound care and proper dressing change Finally, Green (2018 ) describes the last stage as “Tertiary prevention occurs after the offending event has ceased and the focus is on recovery.” This stage is when the recovery process begins. The duration of the recovery phase varies and can focus on the mental health of persons involved in the tragedy. Spiritual guidance and prayer are highly recommended at this stage to help people cope with the disaster.

There are many organizations that manage a crisis to this magnitude. One organization that I would work with is FEMA. FEMA is trained to respond to crisis situations and has a protocol already in place to follow to ensure the safest and most effective rescue and treatment for the public. I would also work with the American Red Cross. This organization is also highly trained to deal with disaster situations and getting proper supplies to people in need. I would also work with community churches and faith-based organizations to help people spiritually and mentally.

References

Community and Public Health: The Future of Health Care. (2018). Retrieved from Grand Canyon University (Ed.): https://lc.

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I need a reply for this 2 peers. 

A minimum of 2 paragraphs is required for all posts  

Support all posts with at least 2 cited peer review references within 5 years of publication (references cannot be older than 5 years). 

All posts are to be written in APA 6th edition format  

Peer 1 

The Role of Advanced Practice Nursing in Safe Prescribing 

The s. 893.03 Florida Statutes mandate the APRNs to prescribe controlled substances in line with the supervisory standards. The professionals have to engage in three-hour training sessions on safe prescribing and the effective implementation of the related strategies (Florida Board of Nursing, 2016). The APRNs have to evaluate and define the patients’ health issues to offer the right prescriptions. They should also equip patients with relevant information about warnings as well as how one should take the prescribed drugs (Pigman et al., 2016). Additionally, the practitioners monitor the patients regularly to make sure they receive the intended benefits of the prescriptions at hand. According to the state requirements, the APRN practitioners have to meet the same prescription standards as physicians. 

Prescribing Barriers for APRNs 

Various barriers limit the APRN practitioners from undertaking their prescription roles effectively. First, state licensure restricts the APRNs from engaging in full practice in line with their educational qualifications. The practitioners can only engage in one of the NP roles based on collaborative agreements. Secondly, APRN training programs may fail to equip learners with advanced skills for delivering high-quality health care services. Negative perceptions of the existing working conditions and inadequate knowledge also limit the practitioners from performing their prescription roles effectively (Jun, Kovner, & Stimpfel, 2016). Additionally, certain payer policies deter the APRN from engaging in health care delivery activities to the full extent of their training as well as licensure. For instance, some scope-of-practice policies restrict practitioners to specific roles. Job satisfaction issues also hinder practitioners from undertaking their prescription roles in a way that impacts significantly on patient outcomes. Some practitioners experience unfavorable working conditions, which reduce their productivity. 

Peer 2 

ARNPs have in their hands a high level of responsibility when prescribing medications. The degree of responsibility depends on whether they can or not prescribe medicines that rely on the state’s laws related to the prescriptive authority given to APRNs. There are twenty-one states that are fully independent prescribing by nurse practitioners (Teri, & Marylou, 2015). The responsibility for the final decision on which drug to use and how to use it depends on the APRN prescriber. To be a safer prescriber, it is important that APRN assume the higher level of legal responsibility that is required. Also, the knowledge of medicine, pharmacology, determine the diagnose for which the drug will be ordered, prescribe the appropriate drug, monitor the outcome, and educate the patient about the medication and possible adverse effects. 

Despite many positive expansions to the APRN role that include caring for ethnically diverse, underserved populations within an aging society and across many healthcare settings, there are a lot of barriers requiring attention. Prescribing medications is one of the main components of the APRN role and essential to his/her practice. One of the barriers is the restrictions on prescriptive authority that limit the ability of NPs to provide comprehensive health care services. AANP recommends that NP prescribing authority be solely regulated by state boards of nursing and in accordance with the NP role, education and certification. This process of license and regulation exclusively by the nursing board promotes public safety and competent practice (Hain, D., & Fleck, L., 2014). 

The Florida Board of Nursing states that ARNP may only prescribe or dispense a controlled substance as defined in s. 893.03 Florida Statutes if the ARNP graduated from a program with a master’s or doctoral degree in a clinical nursing specialty area with training in specialized practitioner skills. However, all ARNPs and PAs are required to complete at least three hours of continuing education on the safe and effective prescribing of controlled substances. Also, Under the new law, an ARNP’s prescribing privileges for controlled substances listed in Schedule II are limited to a seven-day supply and do not include the prescribing of psychotropic medications for children under 18 years of age, unless prescribed by an ARNP who is a Psychiatric Nurse. The bill also clarifies that only allopathic physicians licensed under chapter 458, Florida Statutes, or osteopathic physicians licensed under chapter 459 Florida Statutes may dispense medications or prescribe controlled substances in a registered pain management clinic (Florida Board of Nursing, 2016).In addition, every person who prescribe controlled substances must register and obtain a registration number with the US Drug Enforcement Administration. Also, they have to maintain and keep on file for a minimum of 2 years accurate records of controlled drugs they purchase, distribute, administer, and dispense.  (Teri, & Marylou, 2015). 

This is the original assignment if you needed: 

Discuss the role of advanced practice nursing in safe prescribing and 3  prescribing barriers for APRNs. 

https://www.flsenate.gov/Committees/BillSummaries/2016/html/1424 

http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-2014/No2-May-2014/Barriers-to-NP-Practice.html 

https://floridasnursing.gov/new-legislation-impacting-your-profession/ 

https://www.aanp.org/advocacy/advocacy-resource/position-statements/nurse-practitioner-prescriptive-privilege 

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Discussion Assignment:

Respond to the following Case study:

Explain how you might apply knowledge gained from the Response case studies to your own practice in clinical settings.

· Share additional interview and communication techniques that could be effective with your colleague’s selected patient.

·  

· Suggest additional health-related risks that might be considered.

·  

· Validate an idea with your own experience and additional research.

·  

· Explain your reasoning using at least TWO different references from current evidence-based literature in APA Format.

Case Study: Knee Pain

Patients Initial:  JD       Age: 15    Genders:  Male

S.
CC: “Knee pain”.
HPI: A 15 year old male who presents with dull pain started about 2 months in his both knees. Sometimes one or both knees click, and he also describes a catching sensation under the patella.  He is young soccer player.

· Location: One or both knees bilaterally

· Onset: Pain and other symptoms goes and comes back for about 2 months

· Character: Dull pain

· Associated signs and symptoms: Click and catching sensation under patella

· Timings: comes and goes

· Relieving factors: Rest

· Severity: 8/10 pain scale

Current Medications:  One Tylenol over the counter, 325 mg 6 hours for pain control

Allergies: No known allergies of medications, food or latex materials.

PMHx: JP has received all of the vaccines recommended to protect him from life-threatening diseases, meningococcal and papillomavirus vaccines per pediatrician’s recommendation. No major illnesses and surgeries in the past. His major issue is knee pain which bother him during soccer ball practice.

KNEE PAIN                                                                                                                                                                               3

Soc Hx:  JP is 9th grade first year of high school. He plays soccer when knee pain permits; does not smoke, no alcohol, lives with parents no siblings. He uses school bus to and from school. He uses seat belt while rides motor vehicles, does not use cell phone while driving. They have working smoke detectors in the house, help parent with house chores.

Fam Hx. JP’s mother (40 years old), father (46 years old), paternal grandfather (70 years old), PGM (66 yrs old), MGM (64 yrs old) MGF (71 yrs old). They all are healthy but little overweight.  MGF has minor joints pain; he takes extra strength 1 Tylenol at night so he can sleep well. JP is the only child (Ball et al., 2019).

ROS:

GENERAL: No fever, chills, weakness or fatigue

Musculoskeletal: Bilateral knee pain, click, and catching sensation under the patella. 

Skin: Intact around the knees bilaterally

Objective

Physical exam:

• Vital signs: BP 140/80, P      72, RR 16, temp  36.9C, O2 sat 100,  Wt 134.5 lbs, Ht       70”  BMI: 24.4
• General: Patient is      AA&Ox4, moderately appears ill because of knee pain otherwise appears      strong and healthy, genital are at adult size with pubic hair and spread      to the inner thigh’s, has deeper voice, weighs 170 lbs, ht. 70”, no fever,      no chills, no weakness, was happy to give information (Coguen, 2019).
• HEENT: Normocephalic, no      visual loss, pupils are normal in size and reactive to light, no ocular      discharge noted. No hearing loss. N o sneezing, congestion, no runny nose.      No sore throat (Ball et al., 2019).

KNEE PAIN                                                                                                                                                                          4

• Mouth: He has all teeth      without evidence of carries. There are no lesions present in the oral      cavity (Hui, 2015).
• Neck: On auscultation no      carotid bruits. No tracheal deviation noted. No masses palpated.  His      neck is supple and able to move all directions without resistant. There is      no erythema or tenderness of the nodes (Ball et al., 2019).
• Skin: JP’s skin is clear      of rash and lesions, it is warm to touch. There is no cyanosis of his      skin, lips, blond thin hair combed; he has good skin turgor on examination      (Ball et al., 2019).
• Nails: Pink, smooth, flat      with smooth edges and rounded (Ball et al., 2019).
• Cardiovascular: Regular      heart rate and rhythm, no murmur, gallops or rubs (Balls et al., 2019).
• Respiration:  Breath      sounds clear to auscultation in all lung fields. Diaphragmatic excursion      is symmetrical. No increased AP diameter (Ball et al., 2019).
• Abdomen: Soft, nontender.      No masses or organomegaly. Bowel sounds physiological in all four      quadrants. No guarding or rebound noted (Ball et al., 2019).
• Rectal/GU: Normal male      genitalia with full puberty. No burning on urination (Ball et al., 2019).
• Neurological: CN 11-X11      grossly intact. No focal neurological deficit noted (Ball et al., 2019).
• Musculoskeletal: No      clubbing, cyanosis, or edema, muscles are too tight below knees      bilaterally; upper extremities have good muscle bilaterally tone in all      extremities. Has full range of motion of all extremities without pain      except knees (Ball et al., 2019).
• Hematologic: No complaint      of bleeding, no bruises noted on the body (Ball et al., 2019).
• Lymphatic: There is no      erythema or tenderness of the nodes (Ball et al., 2019).
• Psychiatric: Appears      happy, no sign of depression, anxiety, nor autism (Ball et al., 2019).

KNEE PAIN                                                                                                                                                                          5

• Endocrinologic: HE denies      of sweating, cold or heat intolerance, polyuria or polydipsia (Ball et      al., 2019).
• Allergies: Not known of      any medication, food, and environmental allergies at this time (Ball et      al., 2019).

Assessment:

           JP’s complaint pain in front of knee pain bilaterally with squat, kneel, going down stairs. He feels of popping, grinding, slipping, or catching in knee cap when he bends or straighten his legs.  His thigh muscles bilaterally are slightly weak. His muscles are too tight, have a trace of edema bilaterally and he is overweight. JP’s knee cap are slightly misaligned; with palpitation femoral pulses are 2+ regular normal bilaterally with knee flexion, at the middle of posterior knee at popliteal fossa with tight hand (Sullivan, 2019).  

Diagnostic Results: MRI, Labs, x-rays might not show soft tissues of the knees, CT scan (black, 2016).

Treatment:  Often begins with simple measures. Rest the knees as much as possible. Avoid or modify activities that increase the pain, such as climbing stairs, kneeling or squatting.   Physical therapies will be ordered by physician upon diagnostic findings (Black, 2016).

Differential diagnoses
1. Patellar tracking disorder (PTD): PTD means that the knee cap (patella) shifts out of the leg bends of straightens. The knee cap sits in a groove at the end of the thigh bone. The thigh weak muscle, tendons, ligaments, or muscles in the legs that are too tight. The activities that stress the knee again and again, especially those with twisting motions (Black, 2015)

KNEE PAIN                                                                                                                                                   6

2. Patellar tendonitis (PT): PT is a common overuse injury, caused by repeated stress on your patellar leading to injury to the tendon connecting your knee cap to your shinbone and pain is found in between that area. It is most common in athletes whose sports involve frequently jumping such as basketball and volleyball. At first be present only as you begin physical activity or just after an intense workout (Black, 2015).
3. Patellofemoral joint syndrome: It is one of the most common knee complaints of both the young active sports athlete and the elderly. It can be caused by overuse of the knee joints, physically trauma, or misalignment of the knee cap.  Patients may report a painful catching sensation and a painful giving way of the knee and is mainly due to overuse or a change in exercise intensity (Black, 2015).
4. Osteoarthritis: Obesity in children and adolescents has been linked to   musculoskeletal disorders, loss of flexibility, bone spurs, swelling, grating sensation. High-impact, high-intensity, and repetitive athletics have a strong association with the occurrence of osteoarthritis in teenagers (Black, 2015).
5. Bursitis:  Sudden inability to move a joint, excessive swelling, redness, bruising or rash in the affected area, sharp  or shooting pain, especially on exert. Bursa reduces friction and cushion pressure between your bones, tendons, muscles, and skin near your joints and inflamed pain is felt with activity or rest (Black, 2016).

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I need a response for each peer. Response posts must be minimum 100 words each. Word document , double space, APA 6th

Peer 1  

Antimicrobial resistance is an important issue the public health center is battling with presently. The resistance occurs after the mutation of microorganisms following the continuous exposure to antimicrobial drugs and antivirals. The resistance threatens the health of humans and animals with the resistant organisms increasing the infectious diseases. WHO’s suggestion is that the world may be heading to a post-antibiotic era in the 21st century where minor injuries and common infections can kill (“How to stop antibiotic resistance? Here’s a WHO prescription”, 2015). 

Nurses can help with practical contributions by seeing to a reduction of inappropriate prescription of antibiotics and professionally backing of antimicrobial stewardship. The latter is an approach for promoting and monitoring if antimicrobials are used judiciously for the preservation of their effectiveness in the future (Beović et al., 2017. Since nurses play significant roles in inpatient care aspects, they can hence be influential in the use and prescription rates during varying patient care stages. 

Both Global disease and domestic disease surveillance entails tracking, detection, assessment, and response to health events.  However, domestic disease surveillance involves systematic data collection, comprehensive analysis, and interpretation of data from households (Nsubuga et al., 2006).  Global disease surveillance, countries, and public health entities across the globe gang up efforts to ensure capacity building to ensure preparedness for global health emergencies (“Global Health Surveillance”, 2012) 

Early detection of diseases averts the occurrence and re-occurrence of such infectious diseases, thus minimizes global health threats. Family nurse practitioners have the capability of making long-lasting relationships with patients. These nurses, therefore, empower individuals to make positive health choices as well as influence them to adopt healthy lifestyle practices that help in the prevention of non-communicable diseases such as diabetes. They also ensure that the surveillance programs cover the most remote at-risk population. 

Peer 2

Nurses can improve Policies in the use of Antibiotics  

Nurses and nursing organizations can improve policies and encourage the judicious use of antibiotics in humans. Nurses implement most of the policies in the health care sector because they deal with patients directly. They also administer antibiotics to patients, and thus, they can get first-hand feedback from patients (Malani et al., 2012). Therefore, nurses should collect data about the effectiveness of different antibiotics and their side effects from patients. They can use their organizations to channel the information to policymakers, who can respond appropriately. Consequently, policymakers can stop the use of certain antibiotics or increase the dosage, among other changes. Nurses and nursing organizations should also conduct scientific studies about different antibiotics to identify their effectiveness and drawbacks (Malani et al., 2012). The findings of these studies can enable policymakers to make policies that can help humans to use antibiotics cautiously.  

Disease surveillance refers to the process of monitoring the spread of a disease to identify its progression and spread patterns. It involves collecting, analyzing, and interpreting data about a condition, especially during an outbreak (Lombardo & Buckeridge, 2012). The gathered information can help in identifying the risk factors of a disease, its impacts on members of the society, and the population that is at risk. Global disease surveillance refers to the process of monitoring the spread and progression patterns of disease worldwide. Conversely, domestic disease surveillance refers to the process of monitoring the spread and progression patterns of a disease locally. There is a correlation between the two because the information that is obtained in domestic disease surveillance can be used in global disease surveillance (Lombardo & Buckeridge, 2012). More importantly, Family Nurse Practitioners play a crucial role in both domestic and global disease surveillance. They interact with patients at a family level and collect useful data about the spread and progression patterns of certain diseases, locally and globally. 

Below is the original homework if you need it:

Examine how might nurses and nursing organizations improve policies to encourage the judicious use of antibiotics in humans? Identify the correlation between global disease surveillance and domestic disease surveillance, and the significant role the family nurse practitioner plays. 

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