Your Nursing Philosophy as an ARNP

 

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  Your Nursing Philosophy as an ARNP

 

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Week 1
Hi class,

Topics to review during our first week of the course:

· How Healthcare reform is impacting primary care https://www.ajmc.com/contributor/sophia–bernazzani/2016/03/how–healthcare–reform–is–impactingprimarycare 

• Healthcare reform 101: What the health is going on in 2018? https://www.youtube.com/watch?v=cwTWhwWLzHQ  

• Healthcare Transformation and Changing Roles for Nursing https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266427/pdf/ornur3612.pdf 

Frequently when the shortage of primary care providers is mentioned with regard to healthcare reform, insurance companies and other institutions forget to factor in the impact nurse practitioners can have on increasing access. How do you think we can improve this understanding of the nurse practitioner role?

Discussion 1: Susana Castellanos

Top of Form

    As listed in the articles provided, there are many barriers to health care access for patients to receive primary care services from a family nurse practitioner. Among them are the annoyingly-varied scope of practice regulations that are different from state-to-state, health care reimbursement from insurance companies, misinformation regarding the roles of the nurse practitioner in health care, and the unvoiced stigma towards nurse practitioners that might exist (Bernazzani, 2016). These are all factors that impede our ability to practice as primary care providers. These barriers do not decrease the burden on primary care providers, despite the fact that more nurses are graduating from these graduate programs to become nurse practitioners. I believe that if the scope of practice for family nurse practitioners can be more standardized across the United States, rather than varying state-by-state, it would have a huge positive impact on the other barriers. A standardized scope of practice for a family nurse practitioner may reduce confusion regarding the role the FNP has in primary care (Altman, 2016). This will allow easier collaboration between other primary care providers. In addition, reimbursement from insurance companies may be better able to recognize the FNP as a primary care provider. If scope of practice is standardized, perhaps patients can accept care in an easer fashion from an FNP and may promote better access to health care.

References:

Altman, S. H. (2016, February 22). Removing Barriers to Practice and Care. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK350160/

Bernazzani, S. (2016). How Healthcare Reform Is Impacting Primary Care. Retrieved from https://www.ajmc.com/contributor/sophia-bernazzani/2016/03/how-healthcare-reform-is-impacting-primary-care

Week 2

The main post in this class was in week 1, that show before NOW this discussion only I need to do a peer response Week 2

Note por the professor:

Hello class,

Please refer to your APA format in your postings. The journal name and volume is italicized font. Ex.

…The American Nursing Journal,7(9),,,,

Discussion Board 1 Health Care Reform and NP role

Please update your APA to reflect doi or retrieved point, next time I will deduct points if missing. Refer to your APA manual.

Again missing to include the doi or retrieved from .. as on your initial post. This time -0.25 (correction on private evaluation note here) 

 

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My initial post:

End of Life

The advancement of elderly case has been determined to encompass assistance that is able and informed on the diseases prone to such age groups. It is crucial to determine the challenges and expectations required to efficiently perform those duties. This can only be properly accomplished with the right set of information accompanying the act and practice itself. It creates the need for research to accurately as possible find out what proper care can be applied. 

This can be accomplished by integration of the evidence obtained throughout all the sectors and levels concerned with that healthcare plan. This will allow seamless treatment and end of life care as it has properly seen and enforced expected conditions. This will lead to the development of newer methods that may be deemed efficient to handle such circumstances. This will lead to the promotion of the best quality practices across the dimensions and will include the assessment of physical, psychological, spiritual and interpersonal practices. It will ensure the use of the best to provide care.

In regard to decision making, the use of evidence based ethical practices will be used to avoid mistreatment of certain elderly patients. As such research ought to indicate their best interests in ensuring which manner of care being used is deemed ethical or respectable to the senior citizens. Support decision making is also encouraged to ensure their participation in whatever decision that they may come across.

In light of ethics, a measure of best practices should be placed to show quality and effectiveness of the care being provided and whether family is involved in treatment and decision making. It should also indicate the satisfaction rate of the patients, their families in the use of healthcare amenities to provide proper end-of-line care. Such research should be given the maximum support by the various stakeholders and beneficiaries of such programs for proper utilization. 

References:

Floyd J. & Buckle J., (1987), Nursing Care of The Elderly Journal of Gerontological Nursing Vol. 13, No. 2, 20-25 accessed at: https://doi.org/10.3928/0098-9134-19870201-07

PROFESSOR QUESTION

Can you give us an example of a case when evidence base practice and establish end of life ethics helped your team to solve an end of life issue?

Thank you

Note of the professor:

Hello class,

Please refer to your APA format in your postings. The journal name and volume is italicized font. Ex.

…The American Nursing Journal,7(9),,,,

Please update your APA to reflect doi or retrieved point, Refer to your APA manual, include the doi or retrieved from .. 

 

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Week 4 End of Life 

Hi class,

End of life issues. 

With our aging population living longer with, in many cases, multiple chronic diseases, it is important we feel confident identifying and addressing end of life challenges and expectations.

Choose 1 focal point from each subcategory of practice, education, research and administration and describe how the APRN can provide effective care in end of life management, using the American nurses association position statement, recommendations for improvement in end of life management focuses on practice, education, research and administration. Listed below are steps that nurses can take to overcome barriers in healthcare practice.

Practice

1. Strive to attain a standard of primary palliative care so that all health care providers have basic knowledge of palliative nursing to improve the care of patients and families.

2. All nurses will have basic skills in recognizing and managing symptoms, including pain, dyspnea, nausea, constipation, and others.

3. Nurses will be comfortable having discussions about death and will collaborate with the care teams to ensure that patients and families have current and accurate information about the possibility or probability of a patient’s impending death.

4. Encourage patient and family participation in health care decision-making, including the use of advance directives in which both patient preferences and surrogates are identified.

Education

1. Those who practice in secondary or tertiary palliative care will have specialist education and certification.

2. Institutions and schools of nursing will integrate precepts of primary palliative care into curricula.

3. Basic and specialist End-of-Life Nursing Education Consortium (ELNEC) resources will be available.

4. Advocate for additional education in academic programs and work settings related to palliative care, including symptom management, supported decision-making, and end-of-life care, focusing on patients and families.

Research

1. Increase the integration of evidence-based care across the dimensions of end-of-life care.

2. Develop best practices for quality care across the dimensions of end-of-life care, including the physical, psychological, spiritual, and interpersonal.

3. Support the use of evidence-based and ethical care, and support decision-making for care at the end of life.

4. Develop best practices to measure the quality and effectiveness of the counseling and interdisciplinary care patients and families receive regarding end-of-life decision-making and treatments.

5. Support research that examines the relationship of patient and family satisfaction and their utilization of health care resources in end-of-life care choices.

Administration

1. Promote work environments in which the standards for excellent care extend through the patient’s death and into post-death care for families.

2. Encourage facilities and institutions to support the clinical competence and professional development that will help nurses provide excellent, dignified, and compassionate end-of-life care.

3. Work toward a standard of palliative care available to patients and families from the time of diagnosis of a serious illness or an injury.

4. Support the development and integration of palliative care services for all in- and outpatients and their families.

Note por the professor:

Hello class,

Please refer to your APA format in your postings. The journal name and volume is italicized font. Ex.

…The American Nursing Journal,7(9),,,,

Please update your APA to reflect doi or retrieved point, Refer to your APA manual, include the doi or retrieved from .. 

 

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