Category: Nursing

  • NRNP 6552: Advanced Nurse Practice in Reproductive Health Care

    NRNP 6552: Advanced Nurse Practice in Reproductive Health Care

    Week 1: Health and Health Promotion

    Much like archaeologists sift through sand to identify artifacts of interest, nurse practitioners must devote time and effort to interviewing patients, sifting through facts to identify relevant information that can be pieced together to create a relevant patient history. These efforts have their own unique challenges and approaches based on the characteristics of the patient, including sex, age, culture, and more.

    Female patient interviews have their own unique characteristics. Sensitive matters related to sexual health, physical and/or emotional abuse, pregnancy, menstruation, and other topics may leave patients uncomfortable and create challenges to productive conversations NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    For this week, you will examine the role of the patient interview in health promotion. You also will practice approaches to building a patient history by interviewing a volunteer by creating a script which you use to conduct a mock patient interview with the volunteer.

    Learning Objectives

    Students will:

    Analyze professional interests of study

    Analyze the different roles related to the a CRNP (certified registered nurse practitioner), a CNM (certified nurse midwife), and a PA (Physician Assistant)

    Create scripts for taking a health history to include difficult questions

    Develop patient health histories related to difficult questions

    *These Learning Objectives are introduced this week and assessed in Week 2 NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Optional Resources
     (click to expand/reduce)

    Discussion: Different Roles of the Nurse Practitioner

    The term ‘history” is broad in meaning. Within that broad framework archeologists tend to focus their careers on various specialties and areas of interest, such as specific historical eras or geographical areas.

    So it is with nurses. Within the broad framework of healthcare, nurse practitioners focus their careers on various roles. These roles may in part be based on narrower areas of interest such as women’s health. Careers also focus on selected technical nursing specialties NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    Photo Credit: Getty Images/Blend Images

    For this Discussion, you will explore your professional interests and those interests are addressed in specific guidelines and competencies. You also examine the different nurse practitioner roles related to women’s health and how these roles might impact the way you work.

    To prepare:

    Review the modular structure of this course and reflect on how each module defines the specific skills needed as an advanced Nurse Practitioner (NP).

    Review the ANA guidelines, NP competencies, and the Ethic resources found in this week’s Learning Resources and consider how they impact the work of the NP.

    By Day 3

    Post a brief explanation about the differences in roles related to a CRNP, a CNM, and a PA and how each of these roles might impact the how you practice as a FNP. Be specific and provide examples.

    Read
     a selection of your colleagues’ responses.

      Providers present with many different education backgrounds. Some credentials one may see within a women’s health care setting include: certified registered nurse practitioner (CRNP) or advanced practice nurse practitioner (APNP), certified nurse midwife (CNM) and physician’s assistant (PA). This discussion will look at the different roles of an individual based on their educational background NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    When looking at providers one area to discuss includes scope of practice. For nurse practitioners (NPs) in the United States, state level practicing laws vary from state to state despite educational preparation for independent patient care, prescribing practices and diagnostic procedures (Poghosyan, Liu, & Norful, 2017, Kraus & DuBois, 2017). The scope of practice for an NP in Ohio falls under a reduced practice. APNPs, including a CNM, in the state of Ohio must collaborate with a licensed physician with a written agreement for prescribing practices per the Ohio Revised Code (NCSL, 2021, McCleery, et al., Freeman, 2019).  Limitations for CNM is also addressed in the state laws.  For example, a CNM in Ohio is unable to deliver breech babies or perform version (Legislative Service Commission, 2020). Prescribing practices and scope of practice for PAs also differs in the Ohio revised Code. A supervision agreement between the PA and an appropriate physician that addresses prescriptive authority for schedule II-V controlled substances along with a scope of practice agreed upon by both parties must be submitted to the State Medical Board (NCSL, 2021). As an advanced practice provider, it is important to know the scope of practice within the state, practicing guidelines within the facility, and the agreement with the supervising physician.

    Another difference in these three provider roles includes their approach to care. An individual who takes the nursing path, such as a CNM or APNP, directs care with a patient-centered approach to disease prevention and education. An individual who takes the medical school approach, such as a PA, follows a disease-centered approach to health care. Clinical approaches to healthcare vary based on scope of practice, education, and practice influence (Freeman, 2019). These differences in approaches are important in team management planning NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    In conclusion, healthcare is changing rapidly in how care is provided with an emphasis on a team approach to management. As a practitioner, it is important to know the differences between the roles of different advanced practice providers. Knowing an individual’s own scope of practice within their state and surrounding states is an important aspect of providing safe care. As a provider it is also important to ensure safe care is provided to all individuals. Knowing roles of other providers is important when delegation is required.

    References

    Freeman, J. (2019). Family Physicians, Nurse Practitioners, Physician Assistants, and Scope of Practice: Who Will Decide? 
    Family Medicine, 51
    (4): 305-307. doi: 10.22454/FamMed.2019.356702

    Kraus, E. & DuBois, J. (2017). Knowing your limits: A qualitative study of physician and nurse practitioner perspectives on NP independence in primary care. 
    Journal of General Internal Medicine, 32
    (3): 284-290. doi: 10.1007/s11606-016-3896-7

    Legislative Service Commission. (2020). Section 4723.43 | Scope of specialized nursing services. Retrieved from 
    https://codes.ohio.gov/ohio-revised-code/section-4723.43
    .

    NCSL. (2021). Scope of Practice Policy. Retrieved from https://scopeofpracticepolicy.org/states/oh/

    Poghosyan, L. Liu, J. & Norful, A. (2017). Nurse practitioners as primary care providers with their own patient panels and organizational structures: A cross-sectional study.
     International Journal of Nursing Studies, 74
    : 1-7. doi: 10.1016/j.ijnurstu.2017.05.004 NRNP 6552: Advanced Nurse Practice in Reproductive Health Care

    By Day 6

    Respond to at least 
    two
     of your colleagues’ posts on 
    two different days 
    andprovide additional insight to your colleagues related to issues and topics they may want to also consider. Use the Learning Resources and/or the best available evidence from current literature to support your explanation.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    I enjoyed reading your post as it highlights the fact that the fundamental differences that exist between a CRNP, CNM, and a PA assistance, lies in their scope of practice. A Family nurse practitioner or APRN has a wide variety of specialties which in some cases, is conducive to the patients. Most patients believe that as an APRN, you can prescribe any medication as long as a diagnosis is established. The APRN profession encompasses a wide variety of advanced nursing specialties; hence a wide variety of scope of practices issues is associated with this profession (Citizen Advocacy Center). This is because sometimes patients believe that as a nurse practitioner you can provide any services they need. At my clinical site today we had a patient who came in for a  regular pap smear but while checking her vital signs and doing her labs, her blood pressure was so elevated and the urine dipstick indicated a glucose level of greater than 2000. The patient was referred to the ER and she started crying and requesting to know why they could not prescribe her blood pressure medications. The NP is WHNP and can not prescribe medications for blood pressure and diabetes but it was difficult for the patient to understand NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    The scope of practice for APRNs is also very dynamic as they can acquire new knowledge through education and take on new roles. “The scope of the advanced practices evolves through experience, acquisition of knowledge, evidence-based practices, technology development, and changes in the health care delivery system. Therefore, advanced practice registered nurses may need to practice in new settings, perform new procedures, and develop new skills during their professional careers” (Texas Board of Nursing).

    Reference

    Citizen Advocacy Center (CAC): Scope of Practice FAQs for Consumers. Advanced Practice Registered Nurse (APRNs). Retrieved from; www.ncsbn.org/APRNS_Scope_of_practice_FAQs_for_Consumers.pdf

    Texas Board of Nursing: Practice-APRN scope of practice. Retrieved from; https://bon.texas.gov/practice_scope_of_practice_aprn.asp

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 1 Discussion Rubric

    Post by Day 3 and Respond by Day 6

    To Participate in this Discussion:

    Week 1 Discussion NRNP 6552: Advanced Nurse Practice in Reproductive Health Care

    Module 1 Assignment: Taking a Health History: Building a Health History: Asking Difficult Questions

    Much of an archeologist’s work is done under the mantra “proceed with caution.” Archeologists must dutifully secure permissions to access sites. They also must exercise extreme caution when excavating or analyzing in a lab to avoid potential damage to historical artifacts.

    Likewise, nurse practitioners must proceed with caution when building a patient’s health history. Important questions can be difficult for both nurse and patient. Care must be taken to approach such questions with dignity, tact, and respect to create an environment conducive to productive conversations.

    For this Assignment, you will develop a script to be used to interview a volunteer serving in the role of patient.

    To prepare:

    Review the Ewing (2004) questionnaire found in this week’s Learning Resources and consider the difficult questions you might have to ask when you take a patient’s health history.

    Review the screening tools found in the Learning Resources and consider how you might use an app or tool to assist in screening.

    Review the media programs related to a vaginal exam, pap test, and breast exam.

    Review the health history guide presented in Chapter 7 of the Schuiling & Likis (2022) text and consider how you would create your own script for building a health history. (
    Note:
     You will also find the Health History Form in Chapter 7)

    Describe the components of a complete gynecologic health history.  Include  considerations for special populations such as  LGBTQ+ individuals NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    What health maintenance guidelines should be  included for initial and follow up  might be needed for follow-up assessments?  (i.e., bone density test, Gardasil vaccine, shingles, etc.)?

    What questions would you consider in your patient’s assessment? For example

    What is your patient’s living situation?

    Do they have stairs?

    Do they live by themselves?

    Do they have a working refrigerator?

    Create your own script for building a health history and use the Health History Template for guidance (consider the type of language you would use to help your patient be more comfortable). As you create your script, consider the difficult questions you want to include in your script.

    Assignment: 
    (1- to 2-page reflection)

    In addition to your script for building a health history for this assignment, include a separate section called “Reflection” that includes the following:

    A brief summary of your experiences in developing and implementing your script during your health history.

    Explanations of what you might find difficult when asking these questions. What you found insightful and what would you say or do differently.

    Reminder:
    The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

    No Assignment submission due this week.

    By Day 7 of Week 2

    Submit
     your Module 1 Assignment by 
    Day 7 of Week 2.

    What’s Coming Up in Week 2?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    Next week, you continue to explore common health screening but more specifically, how technology tools can support your screening process when working with women and/or LGBTQ+ individuals. You also examine the elements of gynecologic history and the recommended screenings NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    Week 2: Knowledge Check

    In Week 2, you will experience your first Knowledge Check which covers the topics from Weeks 1 and 2 of Module 1. Please refer to the Week 2 Knowledge Check Assignment for further details related to the topics covered. Plan your time accordingly.

    Practicum – Upcoming Deadline

    In the Nurse Practitioner programs of study (FNP, AGACNP, AGPCNP, and PMHNP) you are required to take several practicum courses. If you plan on taking a practicum course within the next two terms, 
    you will need to submit your application via 
    Meditrek
     .

    For information on the practicum application process and deadlines, please visit the 
    Field Experience: College of Nursing: Application Process – Graduate
     web page.

    Please take the time to review the 
    Appropriate Preceptors and Field Sites
     for your courses.

    Please take the time to review the practicum manuals, FAQs, Webinars and any required forms on the 
    Field Experience: College of Nursing: Student Resources and Manuals
     web page.

    Field Experience: College of Nursing Quick Answers

    Field Experience: MSN Nurse Practitioner Practicum Manual

    Student Practicum Resources: NP Student Orientation

    To go to the next week:

    Week 2 NRNP 6552: Advanced Nurse Practice in Reproductive Health Care

    Week 2: Common Health Screenings

    Archeologists do not begin their work by simply selecting a site and digging for historical finds. Their initial steps involve laying the groundwork through research to apply expertise in their historical areas of focus, combined with best practices for excavation and analysis.

    Similarly, nurse practitioners do not simply develop a treatment plan for patients. They methodically construct a patient’s history and apply best practices to conduct health screenings that help inform treatment. For practitioners of women’s healthcare this means applying expertise in specialized areas such as gynecology and gynecologic history taking and screening.

    For this week, you examine the elements that comprise a patient’s gynecologic history.  As part of your Module 1 assignment, you will describe elements of a complete gynecologic history.

    Learning Objectives

    Students will:

    Analyze the elements of gynecologic history and recommended screenings for individuals (i.e., LGBTQ+)

    Analyze health maintenance guidelines when conducting patient assessments

    Create scripts for taking a health history to include difficult questions

    Develop patient health histories related to difficult questions

    Identify key terms, concepts, and principles related to the primary care of individuals, families, and communities NRNP 6552: Advanced Nurse Practice in Reproductive Health Care

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Optional Resource
    (click to expand/reduce)

    Module 1 Assignment: Taking a Health History: Building a Health History: Asking Difficult Questions

    Much of an archeologist’s work is done under the mantra “proceed with caution.” Archeologists must dutifully secure permissions to access sites. They also must exercise extreme caution when excavating or analyzing in a lab to avoid potential damage to historical artifacts.

    Likewise, nurse practitioners must proceed with caution when building a patient’s health history. Important questions can be difficult for both nurse and patient. Care must be taken to approach such questions with dignity, tact, and respect to create an environment conducive to productive conversations NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    For this Assignment, you will develop a script to be used to interview a volunteer serving in the role of patient.

    To prepare:

    Review the Ewing (2004) questionnaire found in the Week 1 Learning Resources and consider the difficult questions you might have to ask when you take a patient’s complete health history.

    Review the screening tools found in the Learning Resources and consider how you might use an app or tool to assist in screening.

    Review the media programs related to a vaginal exam, pap test, and breast exam.

    Review the health history guide presented in Chapter 7 of the Schuiling & Likis (2022) text and consider how you would create your own script for building a complete health history. (
    Note:
     You will also find the Health History Form in Chapter 7)

    Include considerations for special populations such as LGBTQ+ individuals.

    What health maintenance guidelines should be included for initial and follow up might be needed for follow-up assessments? (i.e., bone density test, Gardasil vaccine, shingles, etc.)?

    Create your own script for building a health history and use the Health History Template for guidance (consider the type of language you would use to help your patient be more comfortable). As you create your script, consider the difficult questions you want to include in your script. There is no sample template to provide to you. You are the one to develop the script. Think of it as you are writing a movie and you need to write the script for the movie. What lines would you provide for the actor to utilize when sitting down with a patient to perform a COMPLETE Medical History which also entails those DIFFICULT GYN questions. You do not need to provide the answers to the questions however, if you find that beneficial, you may do so NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    Assignment: 
    (1- to 2-page reflection)

    In addition to your script for building a health history for this assignment, include a separate section called “Reflection” that includes the following:

    A brief summary of your experiences in developing and implementing your script during your health history.

    Explanations of what you might find difficult when asking these questions. What you found insightful and what would you say or do differently.

    Reminder:
    The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

    By Day 7 of Week 2

    Submit
     your Module 1 Assignment by 
    Day 7 of Week 2.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “M1Assgn+last name+first initial.(extension)” as the name.

    Click the 
    Module 1 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Module 1 Assignment 
    link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “M1Assignment+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
     button to complete your submission.

    Grading Criteria

    To access your rubric:

    Module 1 Assignment Rubric NRNP 6552: Advanced Nurse Practice in Reproductive Health Care

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Module 1 Assignment draft and review the originality report.

    Submit Your Assignment by Day 7

    To participate in this Assignment:

    Module 1 Assignment

    Knowledge Check: Module 1

    In this exercise, you will complete a 20-question Knowledge Check to gauge your understanding of this module’s content.  You will have 1 attempt for each question. Each question is worth 1 point.

    Possible topics to be covered from Weeks 1 and 2:

    Adult Gerontology

    Women’s Health and Health Promotion

    Gynecologic Health care for Sexual and Gender Minorities

    Using Evidence to Support Clinical Practice

    Role of women’s health NP

    Gynecologic Anatomy and Physiology

    Gynecologic History and Physical Exam

    Gynecologic Screening and Health Maintenance

    Sexual Violence

    Women’s Health Care Across the Life Span

    Well-Woman Exam

    Osteoporosis

    Tobacco Cessation NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    Photo Credit: kyoshino / iStock / Getty Images Plus / Getty Images

    By Day 7

    Complete
     and 
    submit
     your Knowledge Check.

    Submission Information

    Submit Your Knowledge Check by Day 7

    To submit your Knowledge Check:

    Module 1 Knowledge Check

    What’s Coming Up in Module 2?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    In Module 2, you explore important aspects of gynecologic health. You will examine common gynecologic conditions through a variety of case studies. You also will complete a Knowledge Check covering the topics from Weeks 3 through 5, and you will complete a Midterm Exam to assess your understanding of the content examined in Weeks 1 – 6 of the course.

    Week 5: Knowledge Check

    In Week 5, you will complete your next Knowledge Check which covers the topics from Weeks 3, 4 and 5 of Module 2. Please refer to the Week 5 Knowledge Check Assignment for further details related to the topics covered. Plan your time accordingly NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

      ORDER A PLAGIARISM FREE PAPER NOW

    To go to the next module:

    Module 2

    Week 3: Gynecologic Health

    Western movies often portray dusty old towns with limited available resources that include a single general store, a single saloon, and a single sheriff. Within these settings, healthcare is revealed to be the responsibility of the single town doctor.

    Unlike these theatrical towns of old, most modern developed communities enjoy the luxury of diverse choices in shopping, entertainment, and more. Thankfully, this includes healthcare options that extend the concept of the “old west” town doctor to diverse specialty areas of practice, including those focused on women’s health care and wellness, such as gynecology.

    For this week, you will use a case study to analyze information obtained from well-woman examinations. You also will consider and propose treatment plans for diagnoses.

    Learning Objectives

    Students will:

    Analyze pertinent patient information obtained from a comprehensive well-woman exam

    Formulate differential diagnoses

    Recommend diagnostics to support differential diagnoses

    Develop treatment and management plans

    Develop additional questions to support patient assessments NRNP 6552: Advanced Nurse Practice in Reproductive Health Care

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Optional Resources
    (click to expand/reduce)

    Case Study Discussion: Gynecologic Health

    Case studies provide the opportunity to simulate realistic scenarios involving patients presenting with various health problems or symptoms. Such case studies enable nurse learners to apply concepts, lessons, and critical thinking to interviewing, screening, diagnostic approaches, as well as the development of treatment plans.

    Photo Credit: Teodor Lazarev / Adobe Stock

    For this Case Study Discussion, you will review a case study scenario to obtain information related to a comprehensive well-woman exam and determine differential diagnoses, diagnostics, and develop treatment and management plans.

    To prepare:

    By Day 1 of this week, you will be assigned to a specific case study scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your case study assignment from your Instructor.

    Review the Learning Resources for this week and pay close attention to the media program related to the basic microscope skills. Also, consider re-reviewing the media programs found in Week 1 Learning Resources.

    Carefully review the clinical guideline resources specific to your assigned case study.

    Use the Focused SOAP Note Template found in the Learning Resources to support Discussion. Complete a SOAP note and critically analyze this and focus your attention on the diagnostic tests. You are NOT to post your SOAP note. This is for your information only to help you develop your differential diagnosis and additional questions NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    By Day 3

    DO NOT POST A SOAP NOTE. Post
     your differential diagnosis. Include the additional questions you would ask the patient. Be sure to include an explanation of the tests you might recommend, ruling out any other issues or concerns and include your rationale. Be specific and provide examples. Use your Learning Resources and/or evidence from the literature to support your explanations.

    Read
     a selection of your colleagues’ responses.

    By Day 6

    Respond to at least 
    two
     of your colleagues’ posts on 
    two different days 
    and explain how you might think differently about the types of tests you might recommend and explain why. Use your Learning Resources and/or evidence from the literature to support your position.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 3 Case Study Discussion Rubric

    Post by Day 3 and Respond by Day 6

    To Participate in this Discussion:

    Week 3 Case Study Discussion NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    What’s Coming Up in Week 4?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    Next week, you will explore common gynecologic conditions as they relate to sexually transmitted infections (STIs), and contraceptive issues, as well as other conditions through a specific case study.

    To go to the next week:

    Week 4

    Week 4: Common Gynecologic Conditions, Part 1

    Patients can present a variety of symptoms including breast or vaginal discomfort that may indicate gynecologic conditions. These conditions may range from minor and easy- to-treat infections to more serious issues related to cancer or sexually transmitted diseases.

    Nurse practitioners must apply expertise and best practices to early interventions to contribute to diagnoses of issues and plans for treatments. These activities typically begin with analysis of findings from interviews and screenings.

    For this week, you will practice these approaches by considering circumstances of case study. You will analyze a patient history and symptoms presented and recommend tests and treatment options.

    Learning Objectives

    Students will:

    Identify key symptoms consistent with a medical diagnosis

    Analyze the health history and presentation of a patient

    Analyze patient diagnoses

    Apply case-specific clinical guidelines

    Recommend diagnostic tests and treatment options NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Optional Resource
    (click to expand/reduce)

    Case Study Discussion: Common Gynecologic Conditions, Part 1

    Case studies provide the opportunity to simulate realistic scenarios involving patients presenting with various health problems or symptoms. Such case studies enable nurse learners to apply concepts, lessons, and critical thinking to interviewing, screening, and diagnostic approaches, as well as to the development of treatment plans.

    Photo Credit: Teodor Lazarev / Adobe Stock

    For this Case Study Discussion, you will once again review a case study scenario to obtain information related to a comprehensive well-woman exam and determine differential diagnoses, diagnostics, and develop treatment and management plans NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    To prepare:

    By Day 1 of this week, you will be assigned to a specific case study scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

    Review the Learning Resources for this week and specifically review the clinical guideline resources specific to your assigned case study.

    Use the Focused SOAP Note Template found in the Learning Resources to support your Discussion. Complete a SOAP note and critically analyze this and focus your attention on the diagnostic tests. You are NOT to post your SOAP note. This is for your information only to help you develop your differential diagnosis and additional questions.

    By Day 3

    DO NOT POST A SOAP NOTE.
     
    Post
     your primary diagnosis. Include the additional questions you would ask the patient and explain your reasons for asking the additional questions. Then, explain the types of symptoms you would ask. Be specific and provide examples. (
    Note:
     When asking questions, consider sociocultural factors that might influence your question decisions.)

    Based on the preemptive diagnosis, explain which treatment options and diagnostic tests you might recommend. Use your Learning Resources and/or evidence from the literature to support your recommendations.

    Read
     a selection of your colleagues’ responses.

    By Day 6

    Respond to at least 
    two
     of your colleagues’ posts on 
    two different days 
    and explain how you might think differently about the types of diagnostic tests you would recommend and explain your reasoning. Use your Learning Resources and/or evidence from the literature to support your position NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 4 Case Study Discussion Rubric

    Post by Day 3 and Respond by Day 6

    To Participate in this Discussion:

    Week 4 Case Study Discussion

    What’s Coming Up in Week 5?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    Next week, you will continue to explore common gynecologic conditions as they relate to reproductive health issues as well as other conditions.

    Specifically, for next week’s Discussion, you will propose a case study scenario for instructor approval. Please review the Week 5 Discussion instructions and be ready to submit your proposed case study scenario by Day 1 of Week 5. Plan your time accordingly.

    Week 5: Knowledge Check

    In Week 5, you will complete your next Knowledge Check which covers the topics from Weeks 3, 4 and 5 of Module 2. Please refer to the Week 5 Knowledge Check Assignment for further details related to the topics covered. Plan your time accordingly. NRNP 6552: Advanced Nurse Practice in Reproductive Health Care

  • tina jones gastrointestinal shadow health subjective data

    tina jones gastrointestinal shadow health subjective data

    Subjective Data Collection: 29 of 31 (93.5%)

    Hover To Reveal…

    Hover over the
    Patient Data
    items below to reveal important information, including
    Pro Tips
    and
    Example Questions
    .

    Found:

    Indicates an item that you found.

    Available:

    Indicates an item that is available to be found.

    Category

    Scored Items

    Experts selected these topics as essential components of a strong, thorough interview with this patient.

    Patient Data

    Not Scored

    A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case.

    Chief Complaint

    Finding:

    Established chief complaint tina jones gastrointestinal shadow health subjective data

    Finding:

    Reports frequently occurring stomach pain

    (Found)

    Pro Tip: Initially establishing a chief complaint allows the patient to express their reason for seeking care, primary concerns, or condition they are presenting with.

    Example Question:

    How are you feeling? tina jones gastrointestinal shadow health subjective data

    History of Present Illness

    Finding:

    Asked about onset of pain

    Finding:

    Reports noticing pain for “at least a month”

    (Found)

    Pro Tip: By establishing a timeline of Tina’s abdominal pain, you’re soliciting information that can help you to understand the nature and extent of her stomach pain.

    Example Question:

    How long have you had abdominal pain?

    Finding:

    Reports that pain increased gradually

    (Found)

    Pro Tip: By establishing a timeline of Tina’s abdominal pain, you’re soliciting information that can help you to understand the nature and extent of her stomach pain.

    Example Question:

    Did the abdominal pain start suddenly?

    Finding:

    Asked about frequency of pain

    Finding:

    Reports pain occurs every day

    (Found)

    Pro Tip: By establishing a timeline of Tina’s abdominal pain, you’re soliciting information that can help you to understand the nature and extent of her stomach pain.

    Example Question:

    Do you have abdominal pain every day?

    Finding:

    Reports 3 to 4 episodes a week that are more severe

    (Found)

    Pro Tip: By establishing a timeline of Tina’s abdominal pain, you’re soliciting information that can help you to understand the nature and extent of her stomach pain.

    Example Question:

    How many times a week do you have abdominal pain?

    Finding:

    Asked about duration of pain

    Finding:

    Pain begins right after finishing a meal

    (Found)

    Pro Tip: Soliciting information about what triggers Tina’s stomach pain can allow you to understand the nature of her symptoms and most effectively treat her.

    Example Question:

    How long after a meal does the pain start?

    Finding:

    Each episode lasts “a few hours”

    (Found)

    Pro Tip: Soliciting information about the duration of Tina’s stomach pain can allow you to understand the nature of her symptoms and most effectively treat her.

    Example Question:

    How many hours does the abdominal pain last?

    Finding:

    Asked about severity of pain on a scale

    Finding:

    Rates present pain as 1 or 2 out of 10

    (Found)

    Pro Tip: Pain severity might change over time for a variety of reasons. Asking Tina to rate the severity of her pain on a scale of 1-10 will provide a quantified and relative measurement of her condition.

    Example Question:

    Can you rate your current stomach pain on a scale of 0 to 10?

    Finding:

    Rates worst pain after eating as 5 out of 10

    (Found)

    Pro Tip: Pain severity might change for a variety of reasons. Asking Tina to rate the severity of her pain on a scale of 1-10 after she eats will provide a quantified and relative measurement of her condition tina jones gastrointestinal shadow health subjective data.

    Example Question:

    Can you rate the stomach pain after you eat on a scale of 0 to 10?

    Finding:

    Rates pain when supine as a 6 or 7 out of 10

    (Available)

    Pro Tip: Pain severity might change for a variety of reasons. Asking Tina to rate the severity of her pain when she’s lying down, on a scale of 1-10, will provide a quantified and relative measurement of her condition.

    Example Question:

    Can you rate the stomach pain when you’re lying down on a scale of 0 to 10?

    Finding:

    Asked about character of the pain

    Finding:

    Describes the pain as similar to heartburn

    (Found)

    Pro Tip: Follow-up questions will enable Tina to more fully and specifically describe her condition, experience, or symptoms.

    Example Question:

    Does the pain feel like heartburn?

    Finding:

    Denies crushing pain

    (Found)

    Pro Tip: Follow-up questions will enable Tina to more fully and specifically describe her condition, experience, or symptoms.

    Example Question:

    Is the pain crushing?

    Finding:

    Denies gnawing pain

    (Found)

    Pro Tip: Follow-up questions will enable Tina to more fully and specifically describe her condition, experience, or symptoms.

    Example Question:

    Is the pain gnawing?

    Finding:

    Denies cramping pain

    (Found)

    Pro Tip: Follow-up questions will enable Tina to more fully and specifically describe her condition, experience, or symptoms.

    Example Question:

    Does the stomach pain feel like cramps?

    Finding:

    Denies that abdomen is tender to the touch

    (Found)

    Pro Tip: Follow-up questions will enable Tina to more fully and specifically describe her condition, experience, or symptoms tina jones gastrointestinal shadow health subjective data.

    Example Question:

    Is your stomach tender to the touch?

    Finding:

    Asked location of the pain

    Finding:

    Pain is in center of upper stomach, below breastbone

    (Found)

    Pro Tip: Specifying the location of pain can narrow and define where Tina’s pain is occurring. Soliciting this information allows you to more accurately treat her symptoms.

    Example Question:

    Where is your stomach pain the worst?

    Finding:

    Pain does not radiate

    (Available)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina to describe what her pain feels like specifies the way that her symptoms and pain manifest.

    Example Question:

    Does the stomach pain radiate?

    Finding:

    Denies shoulder pain

    (Available)

    Pro Tip: Determining where Tina’s pain is occurring will allow you to most effectively treat her symptoms. Asking Tina if she has shoulder pain will help you to determine precisely where her pain is located.

    Example Question:

    Do you have shoulder pain?

    Finding:

    Denies back pain

    (Available)

    Pro Tip: Determining where Tina’s pain is occurring will allow you to most effectively treat her symptoms. Asking Tina if she has back pain will help you to determine precisely where her pain is located.

    Example Question:

    Do you have back pain?

    Finding:

    Denies arm pain

    (Available)

    Pro Tip: Determining where Tina’s pain is occurring will allow you to most effectively treat her symptoms. Asking Tina if either arm hurts will help you to determine precisely where her pain is located.

    Example Question:

    Does either arm hurt?

    Finding:

    Denies flank pain

    (Available)

    Pro Tip: Determining where Tina’s pain is occurring will allow you to most effectively treat her symptoms. Asking Tina if she has flank pain will help you to determine precisely where her pain is located tina jones gastrointestinal shadow health subjective data.

    Example Question:

    Do you have flank pain?

    Finding:

    Denies pain on right side of abdomen

    (Found)

    Pro Tip: Determining where Tina’s pain is occurring will allow you to most effectively treat her symptoms. Asking Tina if she has pain on the right side of her stomach will help you to determine precisely where her pain is located.

    Example Question:

    Do you have pain on the right side of your stomach?

    Finding:

    Asked about aggravating factors

    Finding:

    Pain occurs after eating

    (Found)

    Pro Tip: By determining what factors aggravate Tina’s pain you can develop a treatment plan for her. Asking if her pain is worse after she eats will help you to most effectively treat Tina’s symptoms.

    Example Question:

    Do you feel the pain after you eat?

    Finding:

    Pain worsens with larger meals

    (Found)

    Pro Tip: By determining what factors aggravate Tina’s pain you can develop a treatment plan for her. Asking if her pain is worse after she eats larger meals will help you to most effectively treat Tina’s symptoms.

    Example Question:

    Is the pain worse with larger meals?

    Finding:

    Reports that spicy foods increase the pain

    (Found)

    Pro Tip: By determining what factors aggravate Tina’s pain you can develop a treatment plan for her. Asking if her pain is worse after she eats spicy food will help you to most effectively treat Tina’s symptoms.

    Example Question:

    Does spicy food make the pain worse?

    Finding:

    Denies high-fat foods as an aggravating factor

    (Available)

    Pro Tip: By determining what factors aggravate Tina’s pain you can develop a treatment plan for her. Asking if her pain is worse after she eats greasy food will help you to most effectively treat Tina’s symptoms.

    Example Question:

    Does greasy food make the pain worse?

    Finding:

    Pain worsens when supine

    (Found)

    Pro Tip: Pain severity might change for a variety of reasons. Asking Tina if her pain is worse when she is supine will provide a relative measurement of her condition.

    Example Question:

    Is the pain worse when you lay down?

    Finding:

    Pain worsens when bending over

    (Found)

    Pro Tip: Pain severity might change for a variety of reasons. Asking Tina if her pain is worse when she bends over will provide a relative measurement of her condition.

    Example Question:

    Is the pain worse when you bend over?

    Finding:

    Asked about relieving factors

    Finding:

    Pain improves between meals

    (Found)

    Pro Tip: Pain might change over time for a variety of reasons. Asking Tina if her pain improves between meals establishes a timeline of when her symptoms are most aggravated.

    Example Question:

    Does your pain improve between meals?

    Finding:

    Pain improves when upright

    (Found)

    Pro Tip: Pain might change for a variety of reasons. Asking Tina if her pain improves when she is standing will solicit information about which positions are least uncomfortable for Tina.

    Example Question:

    Does your pain improve when you sit up?

    Finding:

    Asked about effects of pain on diet and appetite

    Finding:

    Reports decreased appetite

    (Found)

    Pro Tip: Pain can have a substantial effect on diet and appetite. Asking Tina how her appetite has been will illustrate the ways in which her symptoms are manifesting.

    Example Question:

    How has your appetite been?

    Finding:

    Describes not wanting to eat out of anticipation of pain

    (Found)

    Pro Tip: Pain can have a substantial effect on diet and appetite. Asking Tina why she has been eating less will illustrate the ways in which her symptoms are manifesting.

    Example Question:

    Why have you been eating less?

    Finding:

    Reports eating smaller meals

    (Found)

    Pro Tip: Pain can have a substantial effect on diet and appetite. Asking Tina if she has been eating smaller meals will illustrate the ways in which her symptoms are manifesting.

    Example Question:

    Have you been eating smaller meals?

    Finding:

    Reports avoiding spicy foods

    (Found)

    Pro Tip: Pain can have a substantial effect on diet and appetite. Asking Tina if she still eats spicy foods will illustrate the ways in which her symptoms are manifesting.

    Example Question:

    Do you still eat spicy foods?

    Finding:

    Asked about increased burping

    Finding:

    Reports burping

    (Found)

    Pro Tip: Increased burping can be a result of heartburn, acid reflux, or indigestion. Asking Tina if she’s been burping more would indicate that Tina has been swallowing more air recently.

    Example Question:

    Have you been burping?

    Finding:

    Burping occurs after eating

    (Found)

    Pro Tip: Increased burping can be a result of heartburn, acid reflux, or indigestion. Asking Tina when she burps the most would indicate that Tina has been swallowing more air recently.

    Example Question:

    When do you burp the most? tina jones gastrointestinal shadow health subjective data

    Finding:

    Asked about changes in weight

    Finding:

    Denies recent weight loss

    (Available)

    Pro Tip: Foundational questions about general health and wellbeing can help you to determine how your patient perceives her health. Asking Tina if her weight changed recently can indicate whether Tina has concerns about recent weight loss.

    Example Question:

    Have you lost weight recently?

    Medical History

    Finding:

    Confirmed use of medications

    Finding:

    Confirms medications (no new medications reported)

    (Found)

    Pro Tip: Determining what, if any, medications a patient is taking is a crucial element of a thorough health history and will help you avoid unwanted drug interactions.

    Example Question:

    What medications do you take?

    Finding:

    Reports occasional antacid use

    (Found)

    Pro Tip: Tina’s response to a question about pain management will reveal the severity of her pain, her health literacy, and the way she’s managing her symptoms.

    Example Question:

    Have you been taking antacids?

    Finding:

    Denies frequent Advil (ibuprofen) use

    (Available)

    Pro Tip: The medication that a patient takes reveals a current treatment plan and healthcare access. Asking Tina how frequently she is taking the Ibuprofen will illustrate the extent of her pain and how effectively OTC medication works for her injury.

    Example Question:

    How often do you take ibuprofen?

    Finding:

    Followed up on use of antacids and relieving factors

    Finding:

    Antacid brand is Tums

    (Found)

    Pro Tip: The medication that a patient takes reveals a current treatment plan and healthcare access. Asking Tina what kind of antacids she takes will illustrate the extent of her pain and how effectively OTC medication works for her pain.

    Example Question:

    What kind of antacids do you take?

    Finding:

    Takes antacids every few days

    (Available)

    Pro Tip: The medication that a patient takes reveals a current treatment plan and healthcare access. Asking Tina how often she takes an antacid will illustrate the extent of her pain and how effectively OTC medication works for her pain.

    Example Question:

    How often do you take an antacid?

    Finding:

    Takes between 2 and 4 antacid tablets at a time

    (Found)

    Pro Tip: The medication that a patient takes reveals a current treatment plan and healthcare access. Asking Tina how many antacids she takes at a time will illustrate the extent of her pain and how effectively OTC medication works for her pain.

    Example Question:

    How many antacids do you take at a time?

    Finding:

    Reports that antacids offer partial relief

    (Found)

    Pro Tip: The medication that a patient takes reveals a current treatment plan and healthcare access. Asking Tina if the antacids have been helping will illustrate the extent of her pain and how effectively OTC medication works for her injury.

    Example Question:

    Do the antacids help?

    Finding:

    Confirmed allergies

    Finding:

    Confirms allergies (no new allergies reported)

    (Found)

    Pro Tip: It’s best practice to ask a patient about her allergies each visit, even with an established patient, to uncover any new allergy triggers or symptoms.

    Example Question:

    Have you had any new allergies?

    Finding:

    Asked about past gastrointestinal history

    Finding:

    Denies past history of ulcers

    (Found)

    Pro Tip: Soliciting a relevant medical history from your patient will aid in effectively treating your patient’s symptoms. Asking Tina if she ever had any ulcers will allow her to describe any historical concerns or problems she’s had.

    Example Question:

    Have you ever had any ulcers?

    Finding:

    Denies gastrointestinal disease

    (Found)

    Pro Tip: Soliciting a relevant medical history from your patient will aid in effectively treating your patient’s symptoms. Asking Tina about her gastrointestinal history will allow her to describe any historical concerns or problems she’s had.

    Example Question:

    Do you have any gastrointestinal diseases?

    Finding:

    Denies past history of GERD

    (Available)

    Pro Tip: Soliciting a relevant medical history from your patient will aid in effectively treating your patient’s symptoms. Asking Tina if she’s ever been diagnosed with GERD will allow her to describe any historical concerns or problems she’s had.

    Example Question:

    Have you ever been diagnosed with GERD?

    Finding:

    Denies past gastrointestinal surgery

    (Found)

    Pro Tip: Soliciting a relevant medical history from your patient will aid in effectively treating your patient’s symptoms. Asking Tina if she’s had any gastrointestinal surgeries will allow her to describe any historical concerns or problems she’s had.

    Example Question:

    Have you had any gastrointestinal surgeries?

    Finding:

    Denies past history of appendicitis

    (Found)

    Pro Tip: Soliciting a relevant medical history from your patient will aid in effectively treating your patient’s symptoms. Asking Tina if she’s had appendicitis will allow her to describe any historical concerns or problems she’s had tina jones gastrointestinal shadow health subjective data.

    Example Question:

    Have you had appendicitis?

    Finding:

    Denies past history of cholecystitis

    (Available)

    Pro Tip: Soliciting a relevant medical history from your patient will aid in effectively treating your patient’s symptoms. Asking Tina if she ever had her gallbladder removed will allow her to describe any historical concerns or problems she’s had.

    Example Question:

    Have you ever had your gallbladder removed?

    Finding:

    Denies past history of stomach cancer

    (Found)

    Pro Tip: Soliciting a relevant medical history from your patient will aid in effectively treating your patient’s symptoms. Asking Tina if she ever had stomach cancer will allow her to describe any historical concerns or problems she’s had.

    Example Question:

    Have you ever had stomach cancer?

    Finding:

    Denies past history of liver disease

    (Found)

    Pro Tip: Soliciting a relevant medical history from your patient will aid in effectively treating your patient’s symptoms. Asking Tina if she’s ever been diagnosed with liver disease will allow her to describe any historical concerns or problems she’s had.

    Example Question:

    Have you ever been diagnosed with liver disease?

    Finding:

    Denies past history of kidney disease

    (Available)

    Pro Tip: Soliciting a relevant medical history from your patient will aid in effectively treating your patient’s symptoms. Asking Tina if she’s ever had any kidney diseases will allow her to describe any historical concerns or problems she’s had.

    Example Question:

    Have you ever had any kidney diseases?

    Finding:

    Denies past history of bladder disease

    (Found)

    Pro Tip: Soliciting a relevant medical history from your patient will aid in effectively treating your patient’s symptoms. Asking Tina if she’s ever had a bladder disease will allow her to describe any historical concerns or problems she’s had.

    Example Question:

    Have you ever had a bladder disease?

    Finding:

    Asked about typical bowel movements

    Finding:

    Reports bowel movement every 2 days

    (Found)

    Pro Tip: GERD and IBS often occur together. Asking Tina about her bowel movements is significant in understanding her gastrointestinal symptoms.

    Example Question:

    How often do you have a bowel movement?

    Finding:

    Denies pain during bowel movements

    (Found)

    Pro Tip: GERD and IBS often occur together. Asking Tina about her bowel movements is significant in understanding her gastrointestinal symptoms.

    Example Question:

    Do you have any pain with your bowel movements?

    Finding:

    Denies bloody or tarry stools

    (Found)

    Pro Tip: GERD and IBS often occur together. Asking Tina if there are any abnormalities in her stools is significant in understanding her gastrointestinal symptoms.

    Example Question:

    Do you have dark colored stools?

    Finding:

    Denies mucus in stool

    (Found)

    Pro Tip: GERD and IBS often occur together. Asking Tina if there are any abnormalities in her stools is significant in understanding her gastrointestinal symptoms tina jones gastrointestinal shadow health subjective data.

    Example Question:

    Do you notice mucus in your stools?

    Finding:

    Describes consistency of bowel movements

    (Available)

    Pro Tip: GERD and IBS often occur together. Asking Tina about her bowel movements is significant in understanding her gastrointestinal symptoms.

    Example Question:

    Are your bowel movements consistent?

    Finding:

    Asked about typical urination

    Finding:

    Reports increased urination

    (Found)

    Pro Tip: Bladder dysfunction can indicate a GI problem. Asking Tina if she has been urinating more than usual can help you to determine the cause of Tina’s symptoms.

    Example Question:

    Have you been urinating more than usual?

    Finding:

    Reports urine is a clear or light-yellow color

    (Found)

    Pro Tip: Bladder dysfunction can indicate a GI problem. Asking Tina what color her urine is can help you to determine the cause of Tina’s symptoms.

    Example Question:

    What color is your urine?

    Finding:

    Reports nocturia

    (Found)

    Pro Tip: Bladder dysfunction can indicate a GI problem. Asking Tina if she has to wake up to urinate can help you to determine the cause of Tina’s symptoms.

    Example Question:

    Have you had to wake up to urinate?

    Finding:

    Denies pain during urination

    (Found)

    Pro Tip: Bladder dysfunction can indicate a GI problem. Asking Tina if it is painful when she urinates can help you to determine the cause of Tina’s symptoms.

    Example Question:

    Is it painful when you urinate?

    Finding:

    Describes urine character as normal

    (Found)

    Pro Tip: Bladder dysfunction can indicate a GI problem. Asking Tina what her urine looks like can help you to determine the cause of Tina’s symptoms.

    Example Question:

    What does your urine look like?

    Finding:

    Denies pink or bloody urine

    (Found)

    Pro Tip: Bladder dysfunction can indicate a GI problem. Asking Tina if her urine is ever red can help you to determine the cause of Tina’s symptoms.

    Example Question:

    Is your urine ever red?

    Finding:

    Denies incontinence

    (Available)

    Pro Tip: Bladder dysfunction can indicate a GI problem. Asking Tina if she ever has trouble holding her urine in can help you to determine the cause of Tina’s symptoms.

    Example Question:

    Do you ever have trouble holding your urine in?

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    Finding:

    Asked about menstruation and sexual activity

    Finding:

    LMP was 3 weeks ago

    (Found)

    Pro Tip: Gynecologic disorders appear to be more common in people with IBS. Soliciting information about Tina’s menstrual patterns can indicate whether her menstrual patterns are normal tina jones gastrointestinal shadow health subjective data.

    Example Question:

    When was your last menstrual period?

    Finding:

    Denies sexual activity

    (Found)

    Pro Tip: Some sexually active people with IBD report pain and bloating during sex. Asking Tina if she is sexually active can help you to determine the extent of her gastrointestinal symptoms.

    Example Question:

    Are you currently sexually active?

    Social History

    Finding:

    Asked about most recent meal

    Finding:

    Most recent meal was breakfast this morning

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina when she most recently ate will illustrate her dietary recent patterns.

    Example Question:

    When was your most recent meal?

    Finding:

    Most recent meal was toast with butter and honey and orange juice

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina what she ate for breakfast will indicate how she has been eating recently.

    Example Question:

    What did you eat for breakfast?

    Finding:

    Asked 24-hour diet recall

    Finding:

    Yesterday’s breakfast was cereal

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina what she had for breakfast yesterday will illustrate her recent dietary patterns tina jones gastrointestinal shadow health subjective data.

    Example Question:

    What did you have for breakfast yesterday?

    Finding:

    Yesterday’s lunch was pizza

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina what she had for lunch yesterday will illustrate her recent dietary patterns.

    Example Question:

    What did you have for lunch yesterday?

    Finding:

    Yesterday’s dinner was a baked potato

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina what she had for dinner yesterday will illustrate her recent dietary patterns.

    Example Question:

    What did you have for dinner yesterday?

    Finding:

    Asked about typical diet

    Finding:

    Reports typical intake is 3 meals a day plus snacks

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina how many means she typically eats in a day will illustrate her recent dietary patterns tina jones gastrointestinal shadow health subjective data.

    Example Question:

    How many meals do you eat in a typical day?

    Finding:

    Typical breakfast is cereal, bread, or a muffin

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina what she typically has for breakfast will illustrate her recent dietary patterns.

    Example Question:

    What is your typical breakfast?

    Finding:

    Typical lunch is a sandwich and chips

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina what she typically has for lunch will illustrate her recent dietary patterns.

    Example Question:

    What is your typical lunch?

    Finding:

    Typical dinner is chicken, a vegetable or potatoes, and bread

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina what she typically has for dinner will illustrate her recent dietary patterns.

    Example Question:

    What is your typical dinner?

    Finding:

    Reports fast food intake 3 times a week

    (Available)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina how often she eats fast food will illustrate her recent dietary patterns.

    Example Question:

    How often do you eat fast food?

    Finding:

    Typical snack is pretzels, French fries, crackers or chips

    (Available)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina what she typically has for a snack will illustrate her recent dietary patterns.

    Example Question:

    What is a typical snack for you?

    Finding:

    Asked about typical beverages

    Finding:

    Last alcoholic drink was 2 weeks ago

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina when she last had an alcoholic drink will illustrate her recent dietary patterns.

    Example Question:

    When did you last have an alcoholic drink?

    Finding:

    Typical alcohol frequency is 2 – 3 times a month tina jones gastrointestinal shadow health subjective data

    (Available)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina how many drinks she typically has in a month will illustrate her recent dietary patterns.

    Example Question:

    How many times a month do you drink alcohol?

    Finding:

    Typical alcohol intake is 2 – 3 drinks at a time

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina how many alcoholic drinks she typically has at a time will illustrate her recent dietary patterns.

    Example Question:

    How many alcoholic drinks do you typically have at one time?

    Finding:

    Reports that alcohol intake bothered her stomach

    (Available)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina if the alcohol makes her stomach pain worse will indicate whether alcohol is causing some of her GI symptoms.

    Example Question:

    Does alcohol make your stomach pain worse?

    Finding:

    Reports drinking soda

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina if she drinks soda will illustrate her recent dietary patterns.

    Example Question:

    Do you drink soda?

    Finding:

    Reports drinking 3 – 4 diet cokes a day

    (Available)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina how many diet cokes she drinks a day will illustrate her recent dietary patterns.

    Example Question:

    How many diet cokes do you drink in a day?

    Finding:

    Reports that she hasn’t noticed a connection between soda intake and pain

    (Available)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina if the diet coke makes her stomach pain worse will indicate whether diet coke is causing some of her GI symptoms.

    Example Question:

    Does the diet coke make your stomach pain worse?

    Finding:

    Reports drinking 6 – 8 glasses of water a day tina jones gastrointestinal shadow health subjective data.

    (Found)

    Pro Tip: Because diet is such a large part of the GI system, asking Tina questions about her diet can be particularly informative. Asking Tina how many glasses of water she has a day will indicate her current patterns of diet and consumption.

    Example Question:

    How many glasses of water do you drink each day?

    Finding:

    Asked about recent dietary and life experiences

    Finding:

    Denies recent travel

    (Found)

    Pro Tip: Recent dietary or new life experiences can result in digestive problems. Asking Tina if she’s traveled recently might point to something new that is triggering digestive problems for Tina.

    Example Question:

    Have you traveled recently?

    Finding:

    Denies food poisoning

    (Found)

    Pro Tip: Recent dietary or new life experiences can result in digestive problems. Asking Tina if she thinks she could have food poisoning might indicate what’s triggering Tina’s digestive problems.

    Example Question:

    Do you think you could have food poisoning?

    Finding:

    Asked about substance use

    Finding:

    Denies illicit drug use

    (Found)

    Pro Tip: Drug use can cause damage to the cells of the digestive tract and inhibit the secretion enzymes needed for digestion. Asking Tina if she currently uses and illicit drugs might indicate whether drug use is causing problems for her digestion.

    Example Question:

    Do you currently use any recreational drugs?

    Finding:

    Denies cigarette smoking

    (Found)

    Pro Tip: Smoking or inhaling substances can have adverse effects on the digestive system. Asking Tina if she currently smokes can help you to discern whether smoking was a factor in Tina’s recent digestive problems.

    Example Question:

    Do you smoke cigarettes?

    Social Determinants of Health

    Finding:

    Asked about food access tina jones gastrointestinal shadow health subjective data.

    Finding:

    Reports living near grocery store

    (Available)

    Pro Tip: Asking a patient about Social Determinants of Health (SDOH) can unearth underlying social, political, or economic barriers to their health and wellbeing. Recognizing a patient’s SDOH can lead you to provide more informed and empathetic care for your patients, because you will have a greater understanding of the challenges they face.

    Example Question:

    How far away is the grocery store from where you live?

    Finding:

    Reports access to fresh foods

    (Available)

    Pro Tip: Asking a patient about Social Determinants of Health (SDOH) can unearth underlying social, political, or economic barriers to their health and wellbeing. Recognizing a patient’s SDOH can lead you to provide more informed and empathetic care for your patients, because you will have a greater understanding of the challenges they face.

    Example Question:

    Do you have access to fresh produce?

    Review of Systems

    Finding:

    Asked about general symptoms

    Finding:

    Denies fever

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like fever, details the way her individual symptoms and pain manifest.

    Example Question:

    Have you had any fever recently?

    Finding:

    Denies chills

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like getting chills, details the way her individual symptoms and pain manifest tina jones gastrointestinal shadow health subjective data.

    Example Question:

    Have you been feeling chills?

    Finding:

    Denies fatigue

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like fatigue, details the way her individual symptoms and pain manifest.

    Example Question:

    Have you been fatigued?

    Finding:

    Denies night sweats

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her injury, like night sweats, details the way her individual symptoms and pain manifest.

    Example Question:

    Have you had night sweats?

    Finding:

    Asked about review of systems for mental health

    Finding:

    Reports occasional feelings of anxiety

    (Found)

    Pro Tip: Anxiety can manifest in symptoms like heartburn or acid reflux. Asking Tina if she’s experienced anxiety would suggest a cyclical relationship between her physical symptoms and anxiety.

    Example Question:

    Have you been experiencing anxiety?

    Finding:

    Reports feelings of stress

    (Found)

    Pro Tip: Anxiety can manifest in symptoms like heartburn or acid reflux. Asking Tina about her recent stress levels would suggest a cyclical relationship between her physical symptoms and anxiety.

    Example Question:

    How is your recent stress level? tina jones gastrointestinal shadow health subjective data.

    Finding:

    Asked about review of systems for gastrointestinal

    Finding:

    Denies nausea

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like nausea, details the way her individual symptoms and pain manifest.

    Example Question:

    Have you had any nausea?

    Finding:

    Denies vomiting

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like vomiting, details the way her individual symptoms and pain manifest.

    Example Question:

    Have you been vomitting?

    Finding:

    Denies diarrhea

    (Available)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like diarrhea, details the way her individual symptoms and pain manifest.

    Example Question:

    Have you had any diarrhea?

    Finding:

    Denies constipation

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like constipation, details the way her individual symptoms and pain manifest.

    Example Question:

    Have you been constipated?

    Finding:

    Denies flatus

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like gas, details the way her individual symptoms and pain manifest.

    Example Question:

    Have you had gas?

    Finding:

    Denies bloating

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like feeling bloated, details the way her individual symptoms and pain manifest.

    Example Question:

    Have you felt bloated tina jones gastrointestinal shadow health subjective data?

    Finding:

    Asked about review of systems for respiratory

    Finding:

    Denies sore throat

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like throat pain, details the way her individual symptoms and pain manifest.

    Example Question:

    Do you have any throat pain?

    Finding:

    Denies coughing

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like coughing, details the way her individual symptoms and pain manifest.

    Example Question:

    Have you been coughing?

    Finding:

    Denies dysphagia

    (Available)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like difficulty swallowing, details the way her individual symptoms and pain manifest.

    Example Question:

    Do you have difficulty swallowing?

    Finding:

    Denies difficulty breathing

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like difficulty breathing, details the way her individual symptoms and pain manifest.

    Example Question:

    Have you had difficulty breathing?

    Finding:

    Denies chest pain

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like chest pain, details the way her individual symptoms and pain manifest.

    Example Question:

    Have you had any chest pain?

    Finding:

    Denies palpitations

    (Available)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like palpitations, details the way her individual symptoms and pain manifest tina jones gastrointestinal shadow health subjective data.

    Example Question:

    Have you had any palpitations?

    Finding:

    Denies change in sense of taste

    (Found)

    Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her pain, like change in her sense of taste, details the way her individual symptoms and pain manifest.

    Example Question:

    Has there been any change to your sense of taste?

    Family History

    Finding:

    Asked about relevant family history

    Finding:

    Reports family history of colon cancer

    (Found)

    Pro Tip: Family histories can suggest genetic predispositions to certain conditions. Asking if Tina has a family history of colon cancer might reveal a predisposition to gastrointestinal issues.

    Example Question:

    Do you have a family history of colon cancer?

    Finding:

    Denies family history of GERD

    (Found)

    Pro Tip: Family histories can suggest genetic predispositions to certain conditions. Asking if Tina has a family history of GERD might reveal a predisposition to gastrointestinal issues.

    Example Question:

    Do you have a family history of GERD?

    Finding:

    Denies family history of IBS

    (Found)

    Pro Tip: Family histories can suggest genetic predispositions to certain conditions. Asking if Tina has a family history of irritable bowel syndrome might reveal a predisposition to gastrointestinal issues.

    Example Question:

    Do you have a family history of irritable bowel syndrome?

    Finding:

    Denies family history of cholecystitis

    (Found)

    Pro Tip: Family histories can suggest genetic predispositions to certain conditions. Asking if Tina has a family history of cholecystitis might reveal a predisposition to gastrointestinal issues.

    Example Question:

    Do you have a family history of cholecystitis?

    Finding:

    Denies family history of liver disease

    (Found)

    Pro Tip: Family histories can suggest genetic predispositions to certain conditions. Asking if Tina has a family history of liver disease might reveal a predisposition to gastrointestinal issues.

    Example Question:

    Do you have a family history of liver disease?

    Finding:

    Denies family history of kidney disease

    (Found)

    Pro Tip: Family histories can suggest genetic predispositions to certain conditions. Asking if Tina has a family history of kidney disease might reveal a predisposition to gastrointestinal issues.

    Example Question:

    Do you have a family history of kidney disease?

    Finding:

    Denies family history of bladder disease tina jones gastrointestinal shadow health subjective data

  • Connecticut Nursing Certification and Licensure Essay

    Connecticut Nursing Certification and Licensure Essay

    In Connecticut, in order to practice as a nurse practitioner without a Collaborative Agreement, a  Connecticut licensed APRN who has maintained his or her Connecticut license for at least three (3) years and who has performed advanced practice level nursing activities in collaboration with a Connecticut licensed physician for at least three (3) years and for at least two thousand (2,000) hours may practice alone or in partnership with a physician or another licensed health care professional in this state. Any APRN who chooses to practice without a collaborative agreement is required to keep documentation of advanced practice level nursing activities performed in conjunction with a Connecticut licensed physician. Such APRN must keep such documentation for at least three (3) years after fulfilling such requirements and must provide it to the Department of Public Health for examination no later than forty-five (45) days after the department makes a request for such documentation Connecticut Nursing Certification and Licensure Essay. After fulfilling the criteria outlined above and before to practicing without a collaborative agreement, APRNs must provide written notification to the Department of their intention to practice without one.

    In order to practice as a nurse practitioner requiring a Collaborative Agreement an APRN must work in cooperation with a Connecticut-licensed physician for the first three (3) years after receiving their license. “Collaboration” refers to a mutually agreed-upon working relationship between an APRN and a physician who is educated, trained, or has relevant expertise in the advanced practice registered nurse’s field of practice. A fair and adequate degree of consultation and referral, covering for the patient in the absence of an APRN, a means to assess patient outcomes, and a method of disclosing the connection to the patient are all part of the cooperation. The collaboration between such advanced practice registered nurse and a physician, in relation to the exercise of prescriptive authority, shall be in writing and shall address the level of schedule II and III controlled substances that such APRN may prescribe, as well as a method to review patient outcomes, including, but not limited to, the review of medical therapeutics, corrective measures, and diagnostic studies Connecticut Nursing Certification and Licensure Essay. The Department of Public Health will not collect copies of collaborative practice agreements on a regular basis. APRNs must, however, furnish the Department with a copy of the collaboration agreement upon request (
    Aprn practice
    . CT.gov, 2021).

    To be eligible for advanced practice registered nurse licensure in Connecticut, a person must have a current Connecticut registered nurse license and hold and maintain current certification as a nurse practitioner, clinical nurse specialist, or nurse anesthetist from one of the recognized national organizations, such as American Nurses Credentialing Center, National Certification Corporation for the Obstetric, Gynecologic and Neonatal Nursing Specialties, Pediatric Nursing Certification Board, American Association of Nurse Anesthetists, American Academy of Nurse Practitioners, Oncology Nursing Certification Corporation, or American Association of Critical-Care Nurses (
    Aprn practice
    . CT.gov, 2021) Connecticut Nursing Certification and Licensure Essay.

    The documents for the APRN application may be found at http://www.ct.gov/dph/cwp/view.asp?a=3121&q=389400&dphNav GID=1821 on the Department of Public Health’s website. A number of original source papers will be required by DPH. Official transcripts from the issuing institution must be used to demonstrate post-basic nursing education. The dean or director of the program must verify pharmacology courses; the Board has provided a form for this purpose. Applicants who respond “yes” to any question concerning a negative professional background (for example, suspensions, investigations, or criminal convictions) must provide supporting proof. A personal statement as well as formal documentation such as court records will be requested by the licensing agency. Notarization is required on the application form. A current photograph will be taped to the applicant’s resume. The Commissioner of Public Health must be notified by an advanced practice nurse who has fulfilled the cooperation criteria and desires to practice independently. The Department of Public Health oversees the Connecticut Board of Examiners in Nursing. The Connecticut Department of Health has information on advanced practice nursing at http://www.ct.gov/dph/cwp/view.asp?a=3121&q=389400&dphNav GID=1821. The licensing agency can be reached at (860) 509-7603 or through email at dph.nursingteam @ ct.gov (
    Connecticut APRN LICENSE Requirements: Become a nurse practitioner in CT
    . NursingLicensure.org – A more efficient way to find nursing license requirements in your state, 2021) Connecticut Nursing Certification and Licensure Essay.

    Instead of a licensed physician, NPs practice under the jurisdiction of the State Board of Nursing. The NP must work with a physician for the first three years following first licensure. A fair and acceptable degree of consultation and referral, covering for the patient in the absence of such an advanced practice registered nurse, a means to assess patient outcomes, and a method of disclosing the connection to the patient must all be addressed in the written agreement. The NP can practice independently after three years. Prescriptive authority is given three years following first license, a written cooperation addressing the degree of Schedule II and III restricted drugs that an NP can prescribe is needed. A strategy for reviewing patient outcomes must be included in the partnership. After three years, the NP is free to prescribe on her own. State policy recognizes NPs as primary care professionals. A patient’s main care provider might be a participating, in-network physician or a participating, in-network advanced practice registered nurse (
    Connecticut scope of Practice policy – State Profile
    . Scope of Practice Policy, 2021) Connecticut Nursing Certification and Licensure Essay.

    Controlled Substance Practitioner Registration allows practitioners to distribute, dispense, conduct research, administer, or purchase restricted drugs in the course of their professional practice if the Department of Public Health or another regulating entity has granted them permission. A valid active registration with the Department of Public Health is required of anybody seeking for this registration. If you have been convicted of a felony or if your license has been surrendered, revoked, suspended, limited, or refused, or if any such action is underway, no further proof is necessary. In Connecticut, licensed medical staff who prescribe restricted drugs must meet this criterion. In order to proceed with the Controlled Substances Registration application, all applicants will be required to have an application on file with the Department of Public Health. The application fee is $40 at first. ALL PRACTITIONERS WHO POSSESS A CONNECTICUT CONTROLLED SUBSTANCE REGISTRATION MUST REGISTER IN THE CONNECTICUT PRESCRIPTION MONITORING AND REPORTING SYSTEM*** at 
    https://connecticut.pmpaware.net
    (
    Controlled substance practitioner registration
    . CT.gov, 2021) Connecticut Nursing Certification and Licensure Essay.

    The DEA application is divided into six components. Personal/business information, activity, state license(s), history, payment, and confirmation. The DEA Form-224 is now available online (recommended), or you can fill out and submit a paper version. Other forms for new registration (Forms DEA-225, DEA-363, and DEA-510) are also now accessible online or can be mailed. For assistance with registration, contact the DEA Registration Service Center at 1-800-882-9539 (8:30 a.m. to 5:50 p.m. ET) or send an email to DEA.Registration.Help@usdoj.gov. In your email, be sure to mention your DEA registration number. Alternatively, you may speak with a Local Registration Specialist (Registration, 2021). In CT controlled-substance prescriptive authority and drug schedules nurse practitioners are authorized to prescribe, Dispense, Administer, and procure Schedule II/IIN substances (2/2N), Schedule II/IIN substances (2/2N), Schedule IV substances (4), and Schedule V substances (5) (CSA registration tools, 2021).

    Our Regional 1 Director has been honored with the AANP State Advocacy Award for Excellence, which honors committed advocates in each state who have made substantial contributions to raising NP knowledge and recognition. Improving Access for Patients Who Need Cardiac and Pulmonary Rehabilitation Services, Improving Medicare Patient Access to Needed Therapeutic Shoes, and Introducing/Reintroducing ourselves to our Members of Congress to educate them on the high-quality health care that NPs provide are just a few of the activities that our states are involved with (
    AANP regional directors and state representatives
    . American Association of Nurse Practitioners, 2020) Connecticut Nursing Certification and Licensure Essay.

    Reference:

    AANP regional directors and state representatives
    . American Association of Nurse Practitioners. (2020).
    https://www.aanp.org/about/about-the-american-association-of-nurse-practitioners-aanp/your-aanp-region/regional-directors-and-state-representatives
    .

    Aprn practice
    . CT.gov. (2021).
    https://portal.ct.gov/DPH/Practitioner-Licensing–Investigations/APRN/APRN-Practice
    .

    Connecticut APRN LICENSE Requirements: Become a nurse practitioner in CT
    . NursingLicensure.org – A more efficient way to find nursing license requirements in your state (2021).  
    https://www.nursinglicensure.org/np-state/connecticut-nurse-practitioner/
    .
     

    Connecticut scope of Practice policy – State Profile
    . Scope of Practice Policy. (2021).
    https://scopeofpracticepolicy.org/states/ct/
    .

    Controlled substance practitioner registration
    . CT.gov. (2021).
    https://portal.ct.gov/DCP/License-Services-Division/All-License-Applications/Controlled-Substance-Practitioner-Registration
    .

    CSA registration tools: Login. (2021).
    https://apps.deadiversion.usdoj.gov/webforms2/spring/main?execution=e1s1
    .

    Registration. (2021). https://www.deadiversion.usdoj.gov/drugreg/index.html#2 Connecticut Nursing Certification and Licensure Essay.

  • Nursing Certification and Licensure in Pennsylvania Sample Essay

    As I enter my final quarter at Walden, I am incredibly excited at the prospect of finally becoming a nurse practitioner. Unfortunately, the regulations for APRN’s can be very confusing, as each state sets its own laws with regard to the practice authority of NP’s. It is important that every aspiring NP understands the regulations of their state and has a clear outline of the next steps regarding licensure and practice.

    Certification and Licensing in Pennsylvania

                To become a certified and licensed nurse practitioner in Pennsylvania, one must first achieve a master’s degree from an accredited university (Pennsylvania Department of State, 2021). Next, the prospective NP must pass a certification exam from a recognized organization, such as the AANP or ANCC. 3 hours of CE training on child abuse is also required, along with a $100 or $140 licensing fee, depending on whether the student was educated within or outside of Pennsylvania. Once all of the requirements have been met, nurses can apply for licensure with the state through Pennsylvania’s online licensing system, PALS (State Board of Nursing, 2019). PAL’s is the primary licensure office website for Pennsylvania, and allows nurses to apply and renew licenses, file complaints, and conduct mandatory reporting.

    Practice Restrictions

                Pennsylvania limits nurse practitioners to collaborative practice, in which they are bound to a collaborative agreement between themselves and a physician (Commonwealth of Pennsylvania, 2021). This agreement is to define the details of what the nurse practitioner is authorized to do and which medications he or she is authorized to prescribe. The physician must also be immediately available for communication while the NP is practicing, a plan for emergency care must be laid out, and the physician must regularly review the NP’s protocols, records, and practices.

             This is the area of my research that I found most surprising, as the exact definition of “communication” and “supervision” is never clearly outlined. I have looked into these questions in the past, as this sort of gray area is also very prevalent in my industry of aesthetics. The level of supervision required seems to be left up to the physician’s comfort level and  what can be justified as standard practice, but as someone who likes clear rules, I definitely wish these regulations were more clearly defined.

    Prescriptive Authority

             Nurse practitioners must obtain a DEA number through the DEA’s Diversion Control Division website in order to prescribe controlled substances (Drug Enforcement Agency, 2021a). The registration costs $888 and is valid for three years. In Pennsylvania, NP’s are allowed to prescribe schedule II drugs for up to a 30 day supply and schedule III, IV, and V drugs for up to a 90 day supply, so long as this is also authorized in their collaborative agreement (Drug Enforcement Agency, 2021b, p.8; Commonwealth of Pennsylvania, 2021).

    Nursing Organizations in Pennsylvania

             There are multiple large organizations in Pennsylvania that advocate for APRN’s and push for more autonomy. These groups include the Alliance of Advanced Practice Nurses (The Alliance), the Pennsylvania Coalition of Nurse Practitioners (PCNP), and the Pennsylvania State Nurses Association (PSN) (Carthon et al., 2016, p. 103). All three currently advocate for and ask members and supporters to contact their legislators to encourage them to vote for legislation that promotes APRN autonomy. For Pennsylvania specifically, the PCNP has been strongly backing bill SB25, which would allow for full practice authority (Pennsylvania Coalition of Nurse Practitioners, 2021).

    References

    Carthon, J., Wiltse Nicely, K., Altares Sarik, D., & Fairman, J. (2016). Effective strategies for achieving scope of practice reform in pennsylvania.
    Policy, Politics, & Nursing Practice
    ,
    17
    (2), 99–109.
    https://doi.org/10.1177/1527154416660700

    Commonwealth of Pennsylvania. (2021).
    Chapter 21: Subchapter C: Certified Registered Nurse Practitioners
    .
    http://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/049/chapter21/subchapCtoc.html&d=reduce

    Drug Enforcement Agency. (2021a).
    Application for registration under Controlled Substances Act of 1970
    .
    https://apps.deadiversion.usdoj.gov/webforms2/spring/main?execution=e1s1#

    Drug Enforcement Agency. (2021b).
    Mid-level practitioners authorization by state
    .
    https://www.deadiversion.usdoj.gov/drugreg/practioners/mlp_by_state.pdf

    Pennsylvania Coalition of Nurse Practitioners. (2021).
    Breaking: Senate committee passes SB25
    .
    https://www.pacnp.org/news/570100/Breaking-Senate-Committee-Passes-SB25.htm

    Pennsylvania Department of State. (2021).
    Certified Registered Nurse Practitioner: Pennsylvania licensure requirements
    .
    https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Pages/Certified-Registered-Nurse-Practitioner-Licensure-Requirements-Snapshot.aspx

    State Board of Nursing. (2019).
    Apply online for certified registered nurse practitioner certification
    .
    https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Documents/Applications%20and%20Forms/CRNP%20App%20Online%20Instructions.pdf

  • West Virginia Pursing Practice Certification and Licensure

    West Virginia Pursing Practice Certification and Licensure

    Application Processes and Regulations in West Virginia

    The application process for state boards differs from state to state and depends on the state’s specific regulations. State regulations for prescriptive authority also lack uniformity.

    In some states, prescriptive authority is granted to APRN’s only while working in collaboration with a physician. In contrast, other states allow the APRN to work and prescribe independently with specific stipulations (Buppert, 2019).

    State Board Application Process

    The application process for the APRN to sit for boards in West Virginia involves several steps. First, the APRN candidate must complete an accredited graduate program (Nursinglicensure, n.d.). Upon successful completion of the accredited graduate program, the APRN candidate may submit a completed application, along with the required fees, to the state board of nursing via an online portal (Nursinglicensure, n.d.) West Virginia Pursing Practice Certification and Licensure. The APRN candidate will need to furnish the state board with supporting documents such as official transcripts (Nursinglicensure, n.d.). Additionally, if the APRN candidate answers yes to any application questions regarding criminal convictions, professional discipline, drug use, or conditions that may cause impairment, he or she will need to explain and provide supporting documentation (Nursinglicensure, n.d.). Once the completed application is submitted, required fees are paid, and the board receives all supporting documentation, they will schedule the APRN candidate a date and time to test (Nursinglicensure, n.d.) West Virginia Pursing Practice Certification and Licensure.

    Application for Prescriptive Authority

    In West Virginia, the APRN may apply for and be granted prescriptive authority, either in collaboration with a physician or independently, depending on the APRN’s level of experience (Buppert, 2019). For both independent and collaborative prescriptive authority, the APRN must have completed at least 45 hours of board-approved, graduate-level advanced pharmacology contact hours, have a license in good standing, submit a completed application, and pay all required fees (Buppert, 2019). For the first three years of his or her practice, the APRN may apply for and be granted collaborative prescriptive authority (Buppert, 2019). To apply for and be granted collaborative prescriptive authority, the APRN must be able to show documentation of the use of pharmacotherapy in clinical practice, during his or her educational program (Buppert, 2019). The APRN will need to provide written verification of the collaborative agreement with a physician licensed in West Virginia, who holds an unencumbered license for prescriptive practice (Buppert, 2019). After the three years of collaborative prescriptive authority, the APRN may apply for and be granted independent prescriptive authority (Buppert, 2019). In addition to the completion of the three-year collaborative agreement, the APRN must provide documentation of 15 contact hours in advanced pharmacology completed within two years before the application (Buppert, 2019) West Virginia Pursing Practice Certification and Licensure.

    Impact of Prescriptive Authority

    The restrictions and stipulations placed on the APRN related to prescriptive authority are in place to help ensure patient safety. States such as West Virginia that require the APRN to complete a specific period of collaborative prescriptive authority, before granting independent prescriptive authority, are taking steps to maintain patient safety. Completing a required collaborative period will help to ensure patient safety by allowing the APRN to gain hands-on experience while being supervised by a licensed physician.  Mandating collaboration between the APRN and physician, allows the APRN to prescribe medications under the supervision of a licensed physician.

    Impact of Prescriptive Authority, Credentialing, and Clinical Privilege

    Regulations and criteria requirements for prescriptive authority, credentialing, and clinical privilege are in place to ensure patient safety. The criteria requirements and regulations are there to confirm that the APRN has met the minimum requirements of eligibility and competence. Without regulation and criteria requirements, there would be no way to verify that the APN has completed the necessary education or determines the extent of the APRNs ability, knowledge, and skills West Virginia Pursing Practice Certification and Licensure.

      ORDER A PLAGIARISM FREE PAPER NOW

    Prescriptive Authority

    Prescriptive authority is defined as the APRN’s ability and authority to prescribe medications (Scope of Practice Policy, 2020). There is a lack of uniformity across the United States regarding the APRN’s ability to prescribe medications. Additionally, several professional nursing organizations offer varying position statements regarding prescriptive authority for the APRN. For example, the American Association of Nurse Practitioners (2020) position is that the state board of nursing, in accordance with the APRN’s role, education, and certification, should solely regulate prescriptive authority. In contrast, the American Nurses Association position is that all APRNs should be granted full practice authority, including the ability to prescribe medications (NursingWorld, n.d.) West Virginia Pursing Practice Certification and Licensure.

    Credentialing

    Credentialing refers to the mechanisms of regulation, collection, and verification of the APRN’s professional qualifications (Hamric et al., 2018). National level credentialing for the APRN is achieved by meeting the standards for eligibility and then passing a national certification exam (Hamric et al., 2018). Likewise, state-level credentialing for the APRN is obtained with licensure, after eligibility criteria are met (Hamric et al., 2018). Eligibility criteria for state-level APRN credentialing include the completion of required graduate education and successful results on a national certification exam (Hamric et al., 2018).

    Clinical Privilege

    Clinical privilege can be described as an authorization granted to the APRN to provide treatment or specific care in a particular setting (Summers, 2017). Clinical privileges for the APRN are based on licensure, training, education, health status, judgment, competence, and experience (Summers, 2017). Authorization of clinical privilege is granted to the APRN by authorities such as human resources or medical staff (Summers, 2017) West Virginia Pursing Practice Certification and Licensure.

    References

    Advanced practice registered nurse (APRN) requirements in West Virginia. (n.d.).
    Nursinglicensure.org
    ,
    https://www.nursinglicensure.org/np-state-/west-virginia-nurse     practitioner.html

    Buppert, C. (2019).
    Nurse Practitioner’s Business Practice and Legal Guide
    , 5
    th
    Edition       [Bookshelf Ambassadored].         
    https://ambassadored.vitalsource.com/#/books/9781284143003/

    Hamric, A., Hanson, C., Tracy, M., & O’Grady, E. (2019). Advanced Practice Nursing: An    Integrative Approach. Fifth Edition.
    Elsevier
    . ISBN 978-1-4557-3980-6.

    Keeling, A. W. (2015). Historical perspectives on an expanded role for nursing. 
    The Online Journal of Issues in Nursing, 20
    (2), Manuscript 2.                                                               Doi: 10.3912/OJIN.Vol20No02Man02

    Nurse practitioners overview. (2020).
    Scope of Practice Policy
    ,
    https://scopeofpracticepolicy.org/pratitioners/nurse-practitioners/

    Nurse practitioner prescriptive authority. (2020). American Association of Nurse Practitioners,           
    https://www.aanp.org/advocacy/advocacy-resource/position-statement/nurse-practitioner            prescriptive-privilege

    Summers, L. (2020). Clinical privileges: Opening doors for APRNs.
    American Nurse, 44
    (1): 10 West Virginia Pursing Practice Certification and Licensure.

  • Nursing Certification and Licensure in Maryland Essay

    Nursing Certification and Licensure in Maryland Essay

    In Maryland, “Nurse practitioner” means a registered nurse who is certified by the Board to practice as a nurse practitioner in accordance with state regulations and bye laws (Buppert, 2021). The Maryland board of Nursing issues certifications to those who qualify to work as advanced practice registered nurses (APRN) in the state. Maryland is a compact state meaning that you are declaring the state in which you live as your permanent address and that state is part of the Registered Nurse Compact. For example, if you reside in Virginia and hold a Virginia Compact license, you will provide a copy of your Virginia RN license with your NP application Nursing Certification and Licensure in Maryland Essay.

    The application process for certification in the state of Maryland is based on your RN licensure status. One must provide the following information to the Maryland Board of Nursing: If you have or ever had a Maryland RN number; whether it is current, inactive or nonrenewed you must submit the following: Certification application, declaration of residence form, sealed official transcript(s), copy of current national certification or letter of eligibility to take the certification exam as well as complete the NP certification application in its entirety. If one is currently licensed in a Compact State, then they need to attach a copy of their current registered nurse license Nursing Certification and Licensure in Maryland Essay.

    An NP must also have their fingerprints taken and ran through the Criminal Information Justice System (CJIS) to confirm their suitability for the practice. In addition to the above, all nurse practitioner programs must be approved by the Maryland Board of Nursing. One’s program of study must be approved before the application will be processed. You therefore must submit your transcript(s) which must show proof of having completed the following along with other course work: Advanced Pharmacology, Advanced Pathophysiology as well as Advanced Physical Assessment Nursing Certification and Licensure in Maryland Essay.

    If applying for Graduate NP status, you need to complete the GRADUATE AGREEMENT as part of your Attestation document by accessing the following website to complete the Graduate Supervision forms:
    http://mbon.maryland.gov/Documents/graduate

    In Maryland, Nurse practitioners renew their license every year on the 28th day of their birth month. There are no CE requirements, but they must maintain national certifications.

    Maryland by designation is a full practice state where licensure laws permit all NPs to evaluate patients; diagnose, order, and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing. This is the model recommended by the National Academy of Medicine and the National Council of State Boards of Nursing.

    Three dynamic components influence the practice environment for nurse practitioners (NPs) in Maryland is. These are: Clinical practice, political system, and professional relationships. The NP role has evolved and developed over the years based mainly on these three components interacting with each other to create the setting for NP practice in the state Nursing Certification and Licensure in Maryland Essay.

    Clinical practice in Md has also been influenced by the educational standards adopted by national associations like National Organization of Nurse Practitioner Faculties (NONPF), American Association of Colleges of Nursing (AACN), National Council of State Boards of Nursing (NCSBN), American Association of Nurse Practitioners (AANP) Nursing Certification and Licensure in Maryland Essay.

    In the sphere of professional relationships, Nurse practitioners have collaborative and cooperative relationships with a wide variety of health care practitioners and professionals. Nurse practitioners are not limited to where they can practice. They provide their services in any setting wherever health care is needed, and these can be in schools, within the community in which they reside, prisons, occupational health centers, as well as other state and federal institutions.

    The environment in which nurse practitioners practice their craft is not devoid of political influence. Nurse practitioners in Maryland have been politically organized, legislatively active, and widely effective. NPs have returned to the legislature to wage strong campaigns to increase the NP role so that they might more fully advocate for patients and increase access to health care. Maryland Nurse Practitioners have a strong legislative committee that meets with legislators to educate them about the important role they play in the society as well as helping members to respond to critical issues by contacting legislators across the state.

    In a nutshell, requirements for NPs in Maryland are rigorous and flexible regards the opportunities available to them to practice in any health care setting. I also think, being a full practice state, nurse practitioners will be tasked with a big obligation to provide excellent services to keep their licensure. Any negligent response to patients’ health care needs can jeopardize the maintenance of their licenses. This situation will improve services rendered to patients by providing them with the best of health care Nursing Certification and Licensure in Maryland Essay.
     

    References

    Buppert, C. (2021).
    Nurse practitioner’s business practice and legal guide (7
    th
    ed
    . Jones & Bartlett Learning.

    University of Maryland. (n.d.).
    DEA license information
    . DEA License Information | Division of Research. https://research.umd.edu/dea-license-info.

    State practice environment
    . American Association of Nurse Practitioners. (n.d.). https://www.aanp.org/advocacy/state/state-practice-environment.

    https://www.npamonline.org/page/34

    sample essay 2

    The Summary of the Practice Guidelines for Nurse Practitioners in Maryland

    The state of Maryland does not require physician collaboration or supervision for nurse practitioners. Nurse practitioners in Maryland can practice independently.  A registered nurse degree and a nurse practitioner graduate degree are required to get licensed as a nurse practitioner in Maryland (Buppert, 2021; Maryland Board of Nursing, 2020) Nursing Certification and Licensure in Maryland Essay.

    Nurse practitioners must apply to the Board of nursing to get certified according to their desired specialization. Requirements needed to get a nurse practitioner license include earning a master’s degree in an accredited nursing school. The nurse must also have an active registered nurse license and hold a national certification from the AANPNCB or other national certifying body recognized by the Board. The applicant must demonstrate written and oral competency in the English language and must pay all required fees to become certified as a nurse practitioner. All the specific requirements can be found on the Maryland board of nursing website: 
    https://mbon.maryland.gov/Pages/adv-prac-nurse-practitioner-index.aspx
     (Buppert, 2021; Maryland Board of Nursing, 2020).

    A nurse practitioner may independently perform comprehensive physical assessments of patients, complete a birth or death certificate, witness an advanced directive, diagnose common acute or chronic problems, prescribe drugs and many other functions listed under COMAR regulation 10.27.07.03, listed on the Maryland board of nursing website (Maryland Board of Nursing, 2020) Nursing Certification and Licensure in Maryland Essay.

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    Regulations and barriers to nurse practitioner independent practice in Maryland

    A nurse practitioner may obtain a DEA license by first getting a Maryland State Controlled Dangerous Substances Registration (CDS) with the Office of Controlled Substances Administration (OCSA).  After the state of Maryland has approved registration for prescribing controlled substances, the nurse practitioner will then use the state license to apply for a DEA license online at 
    https://www.deadiversion.usdoj.gov/online_forms_apps.html
     (USDOJ Drug Enforcement Administration, 2021).

    Nurse practitioners can only prescribe schedule II to V controlled substances. They must also keep a record of all their prescriptions up to five years. Nurse practitioners in Maryland has come a long way to gain independent practice.  The two nurse practitioner associations found on the Board of nursing website in Maryland are the Nurse Practitioner Association of Maryland, Inc. and the Maryland Academy of Advanced Practice Clinicians.  The main objective that these associates stand for are continuing education for nurse practitioners and being a voice for the nurse practitioners in the legislative arm and the public (Buppert, 2021; Maryland Board of Nursing, 2020) Nursing Certification and Licensure in Maryland Essay.

    Surprise Findings during Research

    As a resident in Maryland, I can practice as a nurse in Virginia under the compact nursing license.  Therefore, I decided to research the laws governing nurse practitioners in the state of Virginia. I was surprised to find out that there was a huge difference between the nurse practitioners in Maryland versus Virginia.  Nurse practitioners in Virginia cannot practice independently until after 5 years of collaborative practice with a physician that will attest to that experience before being deemed worthy to practice independently. I was also surprised that a nurse practitioner could be certified by the Board of medicine or the Board of Nursing in Virginia, unlike Maryland, where the only certifying body is the Board of nursing (Buppert, 2021; Maryland Board of Nursing, 2020).

    References

    Maryland Board of Nursing (2020). Advanced Practice Registered Nursing: Nurse Practitioners https://mbon.maryland.gov/Pages/adv-prac-nurse-practitioner-index.aspx

    Buppert, C. (2021).
    Nurse practitioner’s business practice and legal guide
    (7th ed.). Jones & Bartlett.22

    USDOJ Drug Enforcement Administration. (2021). DEA Forms & Applications. https://www.deadiversion.usdoj.gov/online_forms_apps.html Nursing Certification and Licensure in Maryland Essay

  • Pennsylvania nursing Certification and Licensure

    Pennsylvania nursing Certification and Licensure

    Pennsylvania is considered a reduced practice state, which means that a nurse practitioner must practice under a physician with a collaboration agreement outlining their joint practice (ANA,2021). Under a collaboration agreement, a nurse practitioner can deliver many health care services such as diagnose medical conditions, develop and implement treatment plans, order and perform diagnostic tests, and order and manage medications (Pennsylvania Coalition of Nurse Practitioners, 2021). Physician availability must be also outlined in the agreement. However, recently the PA senate passed bill 717 trying to change current practice. The proposed bill would allow nurse practitioner’s the ability to practice independently in the state after participating in at least a 3-year collaboration agreement with a physician (Phillips, 2019). This bill has a lot of support but has also met resistance by the house and is still in process of potentially becoming Pennsylvania law. Although nurse practitioners cannot practice independently currently, they are recognized in the state as primary care providers Pennsylvania nursing Certification and Licensure.

    A nurse practitioner in Pennsylvania must have an RN license, successfully complete a master’s degree or post master’s certificate nurse practitioner program, and obtain national certification before applying for a Pennsylvania state license (Nursinglicensure.org, 2020). Application can be completed online with the Pennsylvania licensing system (PALS) and is approved by the state board of nursing. License renewal is every two years with a 30 continuing education hours requirement (AANP, n.d.).

    A nurse practitioner in Pennsylvania can prescribe drugs, devices and Schedule II-V controlled substances (Pennsylvania Coalition of Nurse Practitioners, 2021). Buprenorphine-containing products can be administered by a nurse practitioner if both the nurse practitioner and collaborating physician are certified and trained accordingly (Pennsylvania Coalition of Nurse Practitioners, 2021). Prescriptive authority must also be outlined in the collaboration agreement between the physician and nurse practitioner. To obtain a DEA number, one must apply online through the U.S. Department of Justice, Drug Enforcement agency. Once issued, it will need renewed every three years.

    There are multiple nurse practitioner organizations specific to Pennsylvania. Some are location specific within the state but share similar goals and mission statements. These organizations are there to support and promote practice through legislative and regulatory processes, provide continuing education, and advocate the roles of nurse practitioners in today’s health care (Pennsylvania Coalition of Nurse Practitioners, 2021).  The Pennsylvania Coalition of Nurse Practitioners (PCNP), Nurse Practitioner Assoc of Southwestern Pennsylvania (NPASP), Nurse Practitioners of Central Pennsylvania (NPCP), and Nurse Practitioners of Northeastern Pennsylvania (NEPA) are just some examples of the organizations available to Pennsylvania nurse practitioners Pennsylvania nursing Certification and Licensure.

    References

    AANP. (n.d.). Pennsylvania State Policy Fact Sheet. American association of nurse practitioners. Retrieved August 31, 2021, from
    https://www.aanp.org/advocacy/state/state-practice-environment/state-policy-fact-sheets/pennsylvania-state-policy-fact-sheet

    AANP. (2021). State practice environment. American Association of Nurse Practitioners. Retrieved August 31, 2021, from
    https://www.aanp.org/advocacy/state/state-practice-environment

    U.S. Department of Justice- Diversion control division. (n.d.). General information. Registration Procedures. Retrieved August 31, 2021, from https://www.deadiversion.usdoj.gov/drugreg/index.html

    Nursinglicensure.org. (2020, November 4). Pennsylvania crnp requirements – how to become a nurse practitioner in pa. NursingLicensure.org – A more efficient way to find nursing license requirements in your state. Retrieved August 31, 2021, from https://www.nursinglicensure.org/np-state/pennsylvania-nurse-practitioner/

    Pennsylvania Coalition of Nurse Practitioners. (2021). Scope of practice. Retrieved August 31, 2021, from
    https://www.pacnp.org/page/ScopeofPractice

    Phillips, J. (2019, June 13). Pa senate bill to expand role of nurse practitioners – rcpa. RCPA. https://www.paproviders.org/pa-senate-bill-to-expand-role-of-nurse-practitioners/ Pennsylvania nursing Certification and Licensure

    Discussion: Certification and Licensure

    Now that you are in your final course in your program, it is time to turn in earnest to preparing for certification and licensure. You will need to take and pass a national AGPCNP certification exam.  Once certified, you will then be eligible to apply for licensure as an advanced practice registered nurse (APRN) in the state desired. It will be up to you to ensure you are knowledgeable about the practice agreements, scope of practice, and prescriptive authority in your state.

    Photo Credit: Getty Images/iStockphoto

    Although there is a movement called the APRN Consensus Model to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement Pennsylvania nursing Certification and Licensure.

    Another important area to consider and plan for is prescriptive authority. Prescriptive authority is granted under state law by the appropriate board. The board granting prescriptive authority may be the medical board, state board of pharmacy, or nursing board for the appropriate state licensure being pursued. The authority to write for a 
    controlled substance
     is granted at a federal level and is verified through the Drug Enforcement Administration (DEA) by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.

    Finally, the legal landscape for NPs is constantly changing as the status of NPs as providers improves on a national level. Legislative changes may occur annually, bi-annually, or during an emergency legislative meeting at the state or federal level. These legislative sessions and any subsequent changes will significantly impact your scope of practice as a nurse practitioner.

    For this Discussion, you examine professional issues for your state, including certification and licensure, scope of practice, independent practice, prescriptive authority, and legislative activities.

    To prepare:

    Review practice agreements in your state.

    Identify whether your state requires physician collaboration or supervision for nurse practitioners and, if so, what those requirements are.

    Research the following:

    How do you get certified and licensed in your state?

    What is the application process for certification in your state?

    What is the primary nurse licensure office resource website in your state?Pennsylvania nursing Certification and Licensure

    How does your state define the scope of practice of a nurse practitioner?

    What is included in your state’s practice agreement?

    How do you get a Drug Enforcement Agency (DEA) license?

    How does your state describe a nurse practitioner’s controlled-substance prescriptive authority and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?

    In what legislative and advocacy activities are your state nurse practitioner organization(s) involved?

    By Day 3

    Post
     a summary of your findings on your state based on the questions listed above. Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research.

    Read
    a selection of your colleagues’ responses.

    By Day 6

    Respond
     to at least 
    two
     of your colleagues on 
    2 different days
     in one or more of the ways listed below.

    Share an insight from having viewed your colleagues’ posts.

    Suggest additional actions or perspectives.

    Share insights after comparing state processes, roles, and limitations.

    Suggest a way to advocate for the profession.

    Share resources with those who are in your state.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

     

    In the state of Pennsylvania, nurse practitioners are recognized as Certified Registered Nurse Practitioners (CRNPs) once licensed. CRNPs must have a master’s degree as well as have passed the certification exam. Once licensed, CRNPs must renew their license biannually (Pennsylvania Department of State, 2021) Pennsylvania nursing Certification and Licensure.

    In order to become certified as a CRNP in the state of Pennsylvania, the student must apply through the Pennsylvania State Board of Nursing. The Pennsylvania State Board of Nursing is the entity responsible for all nursing licensing in Pennsylvania. Once the student has completed all of their MSN coursework, official transcripts must be sent to the state BON. The student must also have current standing as a licensed registered nurse in the state. Finally, prescriptive authority approval must be obtained by completing required pharmaceutical education and submitting a separate application to the board (Buppert, 2021). Additional steps to the application process include child abuse clearance, criminal history check, educational verification and national certification.

    Pennsylvania is a restricted practice state in that it does require collaboration with a supervising physician (Pennsylvania Coalition of Nurse Practitioners, 2021). CRNPs are also required to have a collaborative agreement in order to prescribe. CRNPs may prescribe schedule II-V controlled substances as outlined in the prescribing agreement with the supervising physician.

    In Pennsylvania, a CRNP is defined as,

     “A professional nurse licensed in this Commonwealth who is certified by the Board in a specialty and who, while functioning in the expanded role as a professional nurse, performs acts of medical diagnosis or prescription of medical therapeutic or corrective measures in collaboration with a physician licensed to practice in this Commonwealth and in accordance with the act and this subchapter. Nothing in this subchapter is to be deemed to limit or prohibit a professional nurse from engaging in those activities which constitute the practice of professional nursing as defined in section 2 of the act (63 P.S. § 212). (Buppert, 2021) Pennsylvania nursing Certification and Licensure.
     

    One of the biggest barriers to being a CRNP in PA, as in many other states, is the requirement to collaborate with a physician. I grew up in MA where NPs can practice independently of physicians. Massachusetts is one of twenty-three states to enforce this regulation. The requirement of nurse practitioners to work with collaborating physicians is beneficial, especially as a new nurse practitioner, to provide a resource to the new CRNP. However, this can limit patient access to care, especially in rural areas. Nurse practitioners who wish to branch out on their own are unable to do so without having standing practice agreements with a collaborating physician.

    References

    Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett.

    Pennsylvania Department of State. (2021). Board of Nursing. Retrieved from
    https://www.dos.pa.gov

    Pennsylvania Coalition of Nurse Practitioners. (2021). Scope of Practice Pennsylvania nursing Certification and Licensure. Retrieved from
    https://www.pacnp.org

    NRNP_6565_Week1_Discussion_Rubric

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    Grid View

    List View

    Excellent

    Point range: 90–100

    Good

    Point range: 80–89

    Fair

    Point range: 70–79

    Poor

    Point range: 0–69

    Main Posting:

    Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

    Points Range:
    40
    (40%)
    – 44
    (44%)

    Thoroughly responds to the discussion question(s).

    Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

    No less than 75% of post has exceptional depth and breadth.

    Supported by at least 3 current credible sources.

    Points Range:
    35
    (35%)
    – 39
    (39%)

    Responds to most of the discussion question(s).

    Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

    50% of the post has exceptional depth and breadth.

    Supported by at least 3 credible references.

    Points Range:
    31
    (31%)
    – 34
    (34%)

    Responds to some of the discussion question(s).

    One to two criteria are not addressed or are superficially addressed.

    Is somewhat lacking reflection and critical analysis and synthesis.

    Somewhat represents knowledge gained from the course readings for the module.

    Post is cited with fewer than 2 credible references.

    Points Range:
    0
    (0%)
    – 30
    (30%)

    Does not respond to the discussion question(s).

    Lacks depth or superficially addresses criteria.

    Lacks reflection and critical analysis and synthesis.

    Does not represent knowledge gained from the course readings for the module.

    Contains only 1 or no credible references.

    Main Posting:

    Writing

    Points Range:
    6
    (6%)
    – 6
    (6%)

    Written clearly and concisely.

    Contains no grammatical or spelling errors.

    Further adheres to current APA manual writing rules and style.

    Points Range:
    5
    (5%)
    – 5
    (5%)

    Written concisely.

    May contain one to two grammatical or spelling errors.

    Adheres to current APA manual writing rules and style.

    Points Range:
    4
    (4%)
    – 4
    (4%)

    Written somewhat concisely.

    May contain more than two spelling or grammatical errors.

    Contains some APA formatting errors.

    Points Range:
    0
    (0%)
    – 3
    (3%)

    Not written clearly or concisely.

    Contains more than two spelling or grammatical errors.

    Does not adhere to current APA manual writing rules and style.

    Main Posting:

    Timely and full participation

    Points Range:
    9
    (9%)
    – 10
    (10%)

    Meets requirements for timely, full, and active participation.

    Posts main discussion by due date.

    Points Range:
    8
    (8%)
    – 8
    (8%)

    Posts main discussion by due date.

    Meets requirements for full participation.

    Points Range:
    7
    (7%)
    – 7
    (7%)

    Posts main discussion by due date.

    Points Range:
    0
    (0%)
    – 6
    (6%)

    Does not meet requirements for full participation.

    Does not post main discussion by due date.

    First Response:

    Post to colleague’s main post that is reflective and justified with credible sources.

    Points Range:
    9
    (9%)
    – 9
    (9%)

    Response exhibits critical thinking and application to practice settings.

    Responds to questions posed by faculty.

    The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

    Points Range:
    8
    (8%)
    – 8
    (8%)

    Response has some depth and may exhibit critical thinking or application to practice setting.

    Points Range:
    7
    (7%)
    – 7
    (7%)

    Response is on topic, may have some depth.

    Points Range:
    0
    (0%)
    – 6
    (6%)

    Response may not be on topic, lacks depth.

    First Response:

    Writing

    Points Range:
    6
    (6%)
    – 6
    (6%)

    Communication is professional and respectful to colleagues.

    Response to faculty questions are fully answered, if posed.

    Provides clear, concise opinions and ideas that are supported by two or more credible sources.

    Response is effectively written in Standard, Edited English.

    Points Range:
    5
    (5%)
    – 5
    (5%)

    Communication is mostly professional and respectful to colleagues.

    Response to faculty questions are mostly answered, if posed.

    Provides opinions and ideas that are supported by few credible sources.

    Response is written in Standard, Edited English.

    Points Range:
    4
    (4%)
    – 4
    (4%)

    Response posed in the discussion may lack effective professional communication.

    Response to faculty questions are somewhat answered, if posed.

    Few or no credible sources are cited.

    Points Range:
    0
    (0%)
    – 3
    (3%)

    Responses posted in the discussion lack effective communication.

    Response to faculty questions are missing.

    No credible sources are cited.

    First Response:

    Timely and full participation

    Points Range:
    5
    (5%)
    – 5
    (5%)

    Meets requirements for timely, full, and active participation.

    Posts by due date.

    Points Range:
    4
    (4%)
    – 4
    (4%)

    Meets requirements for full participation.

    Posts by due date.

    Points Range:
    3
    (3%)
    – 3
    (3%)

    Posts by due date.

    Points Range:
    0
    (0%)
    – 2
    (2%)

    Does not meet requirements for full participation.

    Does not post by due date.

    Second Response:

    Post to colleague’s main post that is reflective and justified with credible sources.

    Points Range:
    9
    (9%)
    – 9
    (9%)

    Response exhibits critical thinking and application to practice settings.

    Responds to questions posed by faculty.

    The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectivesPennsylvania nursing Certification and Licensure.

    Points Range:
    8
    (8%)
    – 8
    (8%)

    Response has some depth and may exhibit critical thinking or application to practice setting.

    Points Range:
    7
    (7%)
    – 7
    (7%)

    Response is on topic, may have some depth.

    Points Range:
    0
    (0%)
    – 6
    (6%)

    Response may not be on topic, lacks depth.

    Second Response:

    Writing

    Points Range:
    6
    (6%)
    – 6
    (6%)

    Communication is professional and respectful to colleagues.

    Response to faculty questions are fully answered, if posed.

    Provides clear, concise opinions and ideas that are supported by two or more credible sources.

    Response is effectively written in Standard, Edited English.

    Points Range:
    5
    (5%)
    – 5
    (5%)

    Communication is mostly professional and respectful to colleagues.

    Response to faculty questions are mostly answered, if posed.

    Provides opinions and ideas that are supported by few credible sources.

    Response is written in Standard, Edited English.

    Points Range:
    4
    (4%)
    – 4
    (4%)

    Response posed in the discussion may lack effective professional communication.

    Response to faculty questions are somewhat answered, if posed.

    Few or no credible sources are cited.

    Points Range:
    0
    (0%)
    – 3
    (3%)

    Responses posted in the discussion lack effective communication.

    Response to faculty questions are missing.

    No credible sources are cited.

    Second Response:

    Timely and full participation

    Points Range:
    5
    (5%)
    – 5
    (5%)

    Meets requirements for timely, full, and active participation.

    Posts by due date.

    Points Range:
    4
    (4%)
    – 4
    (4%)

    Meets requirements for full participation.

    Posts by due date.

    Points Range:
    3
    (3%)
    – 3
    (3%)

    Posts by due date.

    Points Range:
    0
    (0%)
    – 2
    (2%)

    Does not meet requirements for full participation.

    Does not post by due date.

    Total Points: 100

    Name: NRNP_6565_Week1_Discussion_Rubric

     

    Nurse Practitioner Practice Agreement, Certification, and Licensure in Pennsylvania

    In the state of Pennsylvania (PA), advanced practice registered nurses are given the title certified registered nurse practitioner [CRNP] (Buppert, 2021). CRNPs in PA practice under a reduced practice agreement; state practice and licensure laws require them to have a collaborative agreement with a physician who holds a current license to practice in PA, to provide patient care, and prescribe medications (American Association of Nurse Practitioners, 2019). This collaborative agreement must outline the availability of the physician to the CRNP directly or by phone, an emergency services plan, and the regular review of the CRNP’s patient charts by the physician (Buppert, 2021).

    To obtain CRNP certification in PA, students must graduate from an accredited, Board-approved master’s or postmaster’s nurse practitioner program and meet the minimum clinical hour requirement of 500 hours (Pennsylvania Department of State, 2021). CRNP students then must pass a Board-recognized national certification exam in their given specialty (Pennsylvania Department of State, 2021). Applicants must complete at least 45 hours of advanced pharmacology coursework within five years before applying for prescriptive authority (Buppert, 2021). To obtain licensure, the student must pay a $100 licensing fee for in-state schools or a $140 fee for an out-of-state education and pay a $50 application fee for prescriptive authority (Pennsylvania Department of State, 2021). Applicants then must complete three hours of child abuse recognition and reporting continuing education for initial licensure (Pennsylvania Department of State, 2021). Established CRNPs must complete 30 hours of continuing education every two years, consisting of at least 16 hours of pharmacology and two hours of child abuse education (Pennsylvania Department of State, 2021). They also have to pay a biennial renewal fee of $81 along with a $41 biennial prescriptive authority renewal fee (Pennsylvania Department of State, 2021).The primary nurse licensure office resource for CRNPs is the Pennsylvania Department of State website, which provides comprehensive details and resources about PA’s State Board of Nursing requirements Pennsylvania nursing Certification and Licensure.

    Nurse Practitioner Scope of Practice in PA

    When collaborating with a licensed physician in the Commonwealth of Pennsylvania, CRNPs may perform comprehensive patient assessments and establish medical diagnoses, order and perform diagnostic testing, initiate patient referrals to other licensed healthcare professionals, develop and implement treatment plans, implement pharmaceutical treatments if they have prescriptive authority, and complete admission and discharge summaries (Buppert, 2021). Also, CRNPs may order blood products, dietary plans, home health and hospice care, and durable medical equipment for patients (Buppert, 2021). CRNPs can refer patients for physical, occupational, respiratory, and dietary therapies (Buppert, 2021). Lastly, the scope of practice for a CRNP in PA includes performing disability assessments, making initial methadone treatment assessments, issuing homebound schooling certifications, and issuing verbal orders to the extent allowed by a healthcare facility’s policies (Buppert, 2021). CRNPs have a broad scope of practice in the state of PA; however, they are restricted by needing to have a collaborative agreement with a physician to carry out their scope of practice Pennsylvania nursing Certification and Licensure.

    Obtaining a Drug Enforcement Agency License and PA Regulations

    To prescribe and dispense controlled substances, CRNPs must register with the United States Department of Justice Drug Enforcement Administration (DEA) as a mid-level practitioner and obtain a DEA number (Pennsylvania State Board of Nursing, 2019). Pennsylvania does not require a separate state registration for prescribing controlled substances (Pennsylvania State Board of Nursing, 2019). In PA, CRNPs can prescribe a Schedule II controlled substance for up to a 30-day supply and a Schedule III or IV controlled substance for up to a 90-day supply, as identified in their collaborative agreement (Buppert, 2021). CRNPs cannot prescribe or dispense gold compounds, heavy metal antagonists, radioactive agents, oxytocics, and Schedule I controlled substances (Buppert, 2021).

    Legislative and Advocacy Activities

    The Pennsylvania Coalition of Nurse Practitioners (PCNP) is a state organization that protects and advocates for the practice of CRNPs in PA (Pennsylvania Coalition of Nurse Practitioners [PCNP], n.d.). PCNP is currently advocating to make PA a full-practice authority state for CRNPs (PCNP, n.d.). Senate Bill 25 and House Bill 100 have passed legislation in the Senate and are now undergoing evaluation in the House (PCNP, n.d.). These bills would grant CRNPs full practice authority after completing 3,600 hours and three years in a collaborative agreement (PCNP, n.d.). Advocating for CRNP full-practice authority legislation will help solve the primary care provider shortage in PA, expand services to areas with limited access to healthcare in the state, and help reduce the cost of healthcare for patients (PCNP n.d.) Pennsylvania nursing Certification and Licensure.

    Restrictions and Barriers Impacting Nurse Practitioner Independent Practice in PA

    The nurse practitioner workforce is the most rapidly growing primary care provider workforce in the United States, potentially reducing healthcare costs and improving patient access to quality healthcare services in Pennsylvania (Poghosyan, 2018). However, reduced practice constraints in PA leads to less efficient and more expensive patient care (Ortiz et al., 2018). Restrictions impede patient access to healthcare in medically underserved urban and rural areas of the state and the three million PA residents with Medicaid insurance (PCNP, n.d.). Additionally, with COVID-19 increasing the demand for healthcare services, restricted practice authority limits the ability of the PA healthcare system to respond to and meet patient needs (Moore et al., 2020). My research surprised me to discover that 2.5 million PA residents, or 22% of the PA population, live in a designated medically underserved area (PCNP, n.d.). Also, research by the PCNP demonstrates that Medicare and Medicaid patients experience 50% more unnecessary hospitalizations in a restricted practice state like PA, compared to states with full practice authority (PNCP, n.d.). Although CRNPs in PA have the practice authority to provide quality care to patients, healthcare policy reform is necessary to grant CRNPs full practice authority and subsequently expand patient access to affordable, quality care throughout the entire state of PA (Poghosyan, 2018).

    References

    American Association of Nurse Practitioners. (2019).
    State practice environment.

    https://www.aanp.org/advocacy/state/state-practice-environment

    Buppert, C. (2021).
    Nurse practitioner’s business practice and legal guide
    (7
    th
    ed.). Jones &

    Bartlett.

    Moore, C., Kabbe, A., Gibson, T.S., & Letvak, S. (2020). The pursuit of nurse practitioner

    practice legislation: a case study.
    Policy, Politics, & Nursing Practice, 21
    (4), 222-232. https://doi.org/10.1177/1527154420957259

    Ortiz, J., Hofler, R., Bushy, A., Lin, Y.L., Khanijahani, A., & Bitney, A. (2018). Impact of nurse

    practitioner practice regulations on rural population health outcomes.
    Healthcare, 6
    (2), 65. https://doi.org/10.3390/healthcare602065

    Pennsylvania Coalition of Nurse Practitioners (PCNP). (n.d.).
    Full practice authority for nurse Pennsylvania nursing Certification and Licensure

    practitioners expands care for PA.
    https://careforpa.com/improving-care

    Pennsylvania Department of State. (2021).
    Certified registered nurse practitioner Pennsylvania

    licensure requirements.
    Commonwealth of Pennsylvania. https://dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Pages/Certified-Registered-Nurse-Practitioner-Licensure-Requirements-Snapshot.aspx

    Pennsylvania State Board of Nursing. (2019, July).
    Instructions for certified registered nurse

    practitioner (CRNP) prescriptive authority application.
    https://dos.pa.gov/ProfessionalLicensing/BoardsCommisions/Nursing/Documents/Applications%20and%20Forms/Prescriptive-Authority-Application.pdf

    Poghosyan, L. (2018). Federal, state, and organizational barriers affecting nurse practitioner

    workforce and practice.
    Nursing Economics, 36
    (1), 43-45 Pennsylvania nursing Certification and Licensure.

  • Academic Success and Professional Development Plan Part 1: Developing an Academic and Professional Network

    Academic Success and Professional Development Plan Part 1: Developing an Academic and Professional Network

      Success and Professional Development Plan Part 1

    Indeed, no one can single-handily live a successful life either socially or professionally. We need each other for us to achieve our personal, professional, and academic goals. In real-life situations, most of the world’s entities are made up of different people with different capabilities of undertaking various duties and responsibilities. For instance, military personnel are grouped in battalions, brigade, or other fighting units (Hede, 2010). In the academic and professional arena, the situation is the same. To succeed, he or she has to be a good team player who is ready to partner and learn from others.

    My academic journey has not been a walk in the park. There have been countless challenges and shortcomings that had almost drained my energy Academic Success and Professional Development Plan Part 1: Developing an Academic and Professional Network. However, I have remained intense and moving through the assistance and help from various academic and professional partners. My educational journey at Walden University as I pursue my MSN program and later on as a practicing nurse would have been challenging. However, I decided to identify two academic and two professional individuals to be close to me to help me achieve my goals.

    BUY A PLAGIARISM-FREE NURSING PAPER NOW 

    Taking the MSN program is a very involving process that requires a lot of dedication and commitment. To facilitate a smooth learning process at Walden University, I identified two significant academic individuals who would partner with me in my epic educational journey. xxx-RN-BSN and xxxxxx MSN-RN would be my able academic partners through my MSN program at Walden. One of the core elements prioritized at Walden is the spirit of corroboration and teamwork (College of Nursing, n.d.). Learners at the institution are assigned various research assignments that they need to work on as groups. My academic individuals will be of great help since they will help me develop solutions to different educational and research questions Academic Success and Professional Development Plan Part 1: Developing an Academic and Professional Network. Through their partnership, I will be better positioned to withstand and overcome multiple setbacks and challenges that might arise in my journey towards completing my MSN program.

    In addition to the academic individuals, I will have another team of professional individuals on my side. xxxx. MSN-RN and xxx-MSN-RN will be my close and essential professional partners. Both of them are highly experienced healthcare providers in different fields, with xxxx been a charge nurse/educator and xxxx been a Clinical Supervisor. Both of them will be my close mentors to guide me through the nursing profession. The nursing profession is classified as one of the occupations requiring healthcare providers to be unselfish and ready to sacrifice both time and resources (Wijdicks, 2020). They will also be a source of guidance on psychological factors such as balancing work and life (Khaira, 2018). Being experienced professionals, they have already gone through many personal and professional setbacks, which have molded them to be stronger. Through this experience, the team will offer me emotional support during times of hardship and crisis. I will be an all-rounded healthcare provider thanks to the help of both the academic and professional partners Academic Success and Professional Development Plan Part 1: Developing an Academic and Professional Network.

    References

    College of Nursing. (n.d.). Walden University: Accredited Online University | Online Degree Programs.
    https://www.waldenu.edu/about/colleges-schools/college-of-nursing

    Hede, K. (2010). Making team science work: Advice from a team.
    Science
    .
    https://doi.org/10.1126/science.caredit.a1000083

    Khaira, G. (2018). Nurse practitioners: Struggle for professional identity role of mentors/coaches in professional socialization.
    Advanced Practices in Nursing
    ,
    03
    .
    https://doi.org/10.4172/2573-0347-c11-047

    Wijdicks, E. F. (2020). The nursing profession.
    Cinema, MD
    , 25-46.
    https://doi.org/10.1093/med/9780190685799.003.0002

    Assignment: Academic Success and Professional Development Plan Part 1: Developing an Academic and Professional Network

    When was the last time you read 
    Devotions Upon Emergent Occasions and Several Steps in my Sickness—Meditation XVII
    ?

    Unless you are a student of 17th-century poetry, you may not be all that familiar with this piece by author John Donne. However, you may be much more familiar with one of its well-known phrases: “No man is an island.”

    As you begin your journey toward achieving your academic and professional goals, you have a great opportunity to network with academics and professionals who can help ensure you do not travel alone. This network can help to clarify your own vision for success and can help guide you now and in the future. To paraphrase Donne, no one is an island Academic Success and Professional Development Plan Part 1: Developing an Academic and Professional Network.

    Begin creating an academic and professional network by identifying which academic and professional connections and resources you need to collaborate with to be successful in your MSN program and as a practicing nurse.

    To Prepare:

    Consider individuals, departments, teams, and/or resources within Walden University and within your profession that you believe can support your academic and professional success.

    Identify at least two academic and at least two professional individuals, colleagues, or teams to collaborate with to help you be successful in your MSN program and as a practicing nurse.

    Download the 
    Academic Success and Professional Development Plan Template
    .

    The Assignment:

    Academic and Professional Network

    Complete Part 1 of your 
    Academic Success and Professional Development Plan Template
    . Be sure to address the following:

    Clearly and accurately identify 
    at least two
     academic individuals or teams to collaborate with to be successful in the MSN program and as a practicing nurse.

    Clearly and accurately identify 
    at least two
     professional individuals or teams to collaborate with to be successful in your MSN program and as a practicing nurse.

    Clearly and thoroughly explain in detail why the academic and professional individuals/teams were selected to support success in the MSN program and as a practicing nurse.

    Clearly and accurately explain how the academic and professional individuals/teams will support success in the MSN program and as a practicing nurse Academic Success and Professional Development Plan Part 1: Developing an Academic and Professional Network.

  • New Jersey Nursing Practice Certification and Licensure

    New Jersey Nursing Practice Certification and Licensure

    NRNP 6565: Synthesis in Advanced Nursing Practice Care of Patients in Primary Care Settings

    Discussion: Certification and Licensure

    Week 1 Main Post

    Advanced Practice Nurses (APNs) are registered nurses who obtain a graduate level nursing education and advanced level preparation which affords them the knowledge to diagnose and treat acute and chronic medical conditions across populations (“New Jersey Nurse Practitioners,” 2021). The New Jersey Board of Nursing (BON) is the regulatory body that has authority over APN practice in the State of New Jersey (Phillips, 2020) New Jersey Nursing Practice Certification and Licensure. To practice as an APN in the State of New Jersey, the New Jersey BON requires a licensed registered nurse to graduate from an accredited master’s or doctorate level program geared towards the education of APNs as well as to successfully pass an advanced practice state board exam in their specialized area of study (“New Jersey Board of Nursing Advanced Practice Nurse Certification,” 2015). APNs in New Jersey are considered independent practitioners and they are permitted to diagnosed and treat without the supervision of a physician (“New Jersey Board of Nursing Advanced Practice Nurse Certification,” 2015). APN practice in NJ is limited however, in that they are only authorized to prescribe if they concomitantly associate themselves with a New Jersey licensed physician and collaboratively consult with them before prescribing any medication or device (“New Jersey Board of Nursing Advanced Practice Nurse Certification,” 2015). As a resident of the State of New Jersey, the author anticipates practicing as an APN in NJ upon completion of her studies.

    Application process in New Jersey:

    Request the application to the BON by email with personal information, Highest college/university degree related to Advanced Practice Nursing, specialty and type of certification. The type of application: Initial certification, Endorsement or Re-instatement. Proof of a current New Jersey registered professional nurse license in good standing New Jersey Nursing Practice Certification and Licensure.

    A completed, application form and nonrefundable, application fee of $100.00 payable by money order or check only.  (After the application process is completed, there is also a certificate fee of $80.00/$160.00 depending on the expiration our Registered Professional Nurse License.)

    Original Official Transcript(s) as proof of compliance with the Board’s education requirements.

    Proof of passing the highest level national Advanced Practice Nurse Examination in the area of clinical specialty.  (Certification information must be sent directly to the Board of Nursing from the Certifying Body.) Proof that all advanced nursing practice certification(s)/licensure(s) which have held in other states are in good standing, expired, or in some other status (New Jersey Board of Nursing, 2021). APNs must obtain a New Jersey CDS registration number as well as a federal Drug Enforcement Administration (DEA) certification number before they have the ability to prescribe a CDS and they must include their DEA number on any CDS prescription (“New Jersey Board of Nursing Advanced Practice Nurse Certification,” 2015). To prescribe a CDS, the APN must have completed prior pharmacology education and confer with a supervising physician prior to prescribing (“New Jersey Nurse Practitioners: Prescriptive Authority,” 2021). APNs licensed in NJ are permitted to prescribe CDS Schedules II through V provided that the above requirements are met (“Mid-Level Practitioners Authorization by State,” 2021; “New Jersey Board of Nursing Statutes and Regulations: Chapter 37,” 2020). (New Jersey Board of Nursing, 2021) New Jersey Nursing Practice Certification and Licensure.

      ORDER A PLAGIARISM FREE PAPER NOW

    New Jersey are involved in many legislative advocacy activities true NJSNA, between others are:

    Pronouncement of Death Act, Advanced Practice Nurse Act, Death Certification Bill (2015), etc.

    References:

    New Jersey Division of Consumer Affairs, Office of the Attorney General (2021). https://www.njconsumeraffairs.gov/nur/Pages/APN-Certification.aspx

    American Psychological Association. (2020). Publication manual of the American Psychological

    Association: The official guide to APA Style (Seventh ed.). American Psychological

    Association.

    Advanced Practice Nurses (APNs) care for patients in New Jersey. (n.d.). New Jersey State

    Nurses Association. Retrieved on April 18, 2021, from, https://njsna.org/policy-and-

    advocacy/apns-in-nj/

    Advanced Practice Nurses of New Jersey (2021). https://njsna.org/policy-and-advocacy/njsna-legislative-successes/New Jersey Nursing Practice Certification and Licensure

  • NURS 6002 /3 week 1 Discussion: Networking Opportunities

    NURS 6002 /3 week 1 Discussion: Networking Opportunities

    PMHNP are needed across the country in both rural and urban areas. Underserved populations often have difficulties accessing health care due to many factors, and mental health tends to take a backseat to primary care. Another thing to consider is that our current Covid pandemic will have a major impact on the mental health field. Patients recovering from covid, patient families that were left to deal with the loss of a family member or the loss of income in the family are experiencing all-time high stress. Health care workers are at an all-time high risk of experiencing mental health problems while working in health care. This pandemic has unknown long-term effects on people’s health, neurological wellbeing, and mental health. Being stuck in a room with minimal contact with others, gowned up from head to toe for months, can be extremely traumatic NURS 6002 /3 week 1 Discussion: Networking Opportunities. Health care workers treating covid patients that are seeing its effects first hand are having mental health issues related to PTSD and the fear of the unknown including contacting the virus while working. The aftermath of Covid to healthcare workers can be high anxiety, PTSD, and even suicidal behavior at a higher rate than ever before. (Cosic, Popovic, Sarlija, Kesedzic & Jovanovic, 2020) I believe that we need to improve our mental health programs and awareness to meet this new demand.

    BUY A PLAGIARISM-FREE NURSING PAPER HERE 

    Reference

    Ćosić, K., Popović, S., Šarlija, M., Kesedžić, I., & Jovanovic, T. (2020). Artificial intelligence in prediction of mental health disorders induced by the COVID- 19 pandemic among health care workers. 
    Croatian Medical Journal
    , 
    61
    (3), 279–288. https://doi-org.ezp.waldenulibrary.org/10.3325/cmj.2020.61.279

     

    response

    really liked your presentation and I totally agree with you when you refer to the need that exists, both in rural and urban areas, for qualified mental health professionals. On the other hand, the health situation generated by Coronavirus 19 on a global scale, without a doubt, has marked a before and after, having a negative impact in dissimilar areas, being one of the most affected, precisely, emotional health and mental of the people. I believe that programs such as the one offered at Walden University, allow the training and improvement of health professionals in the area of mental health and hopefully in the coming years many more nurses will make the decision to improve professionally in this field of specialization NURS 6002 /3 week 1 Discussion: Networking Opportunities.

    References

    Chapman, S.A., Toretsky, C., Phoenix, B.J.(2019). Enhancing Psychiatric Mental Health Nurse Practitioner practice: Impact of state scope of practice regulations. 
    Journal of Nursing Regulation 
    10
    (1):35–43
    .

    Shigemura, J., Ursano, R.J., Morganstein, J.C., Kurosawa, M., Benedek. D.M.(2020). Public responses to the novel 2019 coronavirus (2019 – nCoV): mental health consequences and target populations. 
    Psychiatry Clin. Neurosci. 
    doi: 10.1111/pcn.12988.

    Walden University. (2020). Master of Science in Nursing. Retrieved from 
    https://www.waldenu.edu/online-masters-programs/master-of-science-in-nursing/msn-nurse-practitioner-family
    Walden University. (2020).

    Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C.S., Ho, R.C.(2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. 
    Int. J. Environ. Res. Public Health,
    17
    (5):E1729 NURS 6002 /3 week 1 Discussion: Networking Opportunities.

    Discussion: Networking Opportunities

    This week you begin to lay the foundation for your academic and professional success. Your efforts begin with a vision, which includes your own definition of success. Your vision may vary from those of your colleagues, but this does not mean you have to take these first steps alone.

    Walden University and the College of Nursing also have a vision and mission, which include helping you to make your own vision a reality. Members of your new academic community, such as faculty, support teams, and fellow students, can also be helpful. Current practitioners and other members of the professional community can also help you to clarify your vision.

    This week’s Discussion asks you to think about how the Walden mission and vision and the College of Nursing mission and vision apply to your professional and academic goals. You will also begin to identify individuals and teams that can help you along the way, as you begin to design the “blueprint”—your Academic Success and Professional Development Plan—that will guide you toward your own vision for academic and professional success NURS 6002 /3 week 1 Discussion: Networking Opportunities.

    To Prepare:

    Review the Walden and the College of Nursing mission and vision statements, Walden’s goals and University Outcomes, and the MSN Program Learning Outcomes presented in this week’s Learning Resources.

    Reflect on your professional and academic goals as they relate to your program/specialization.

    Consider how the information in these resources fit with your own goals and to your becoming a scholar-practitioner.

    Also consider academic and professional individuals and teams that you may collaborate with in support of your efforts as a student at the University and as a professional within your organization and career.

    By Day 3

    Post
     a brief post introducing yourself to your colleagues. Include an explanation for how Walden’s vision, mission, goals, and social change initiatives relate to your professional and academic goals and to your becoming a scholar-practitioner. Also include an explanation for how the Walden MSN program outcomes and perspectives relate to your professional and academic goals and to your becoming a scholar-practitioner.

    Support main post with 3 of more current, credible sources and cite source within content of posting and on a reference list in proper APA.

    By Day 6

    Respond
     to at least 
    two
     of your colleagues 
    on two different days
    , by suggesting additional individuals and/or teams with whom to collaborate or by offering additional networking strategies.

    Be sure to offer support from at least 2 current, credible sources in each required response to classmates’ main post and cite per APA NURS 6002 /3 week 1 Discussion: Networking Opportunities.

    BUY A PLAGIARISM-FREE NURSING PAPER HERE 

    sample discussion 2

    Hello, my name is xxx  I am an RN with a BSN degree. I began long ago as a C.N.A., it was always my desire to become an RN. However, it was a long road and after completing school as a nursing assistant; I had to work then went on to earn my degree as an LPN. I found a job I truly loved in a pediatric office. I could take my children to work with me during my weekend shifts and with three children it was perfect to work in that area and be close to my children.

    I worked in multiple areas as an LPN and following the loss of my oldest child to a motor vehicle accident, a divorce, and becoming a single parent to my youngest child. I was not planning on giving up. I worked as a home health nurse and an orthopedic nurse while raising my daughter alone. I began preparing for my RN degree through Excelsior College and I made it with persistence and determination.  I later began working on my BSN degree which was also through Excelsior College I completed the program with honors.

    Now, I am back in pursuit of a degree as an FNP. While my youngest child is in RN school after having a family of her own and inspired me to go back to school. I had to find the right college. I wanted to attend a college that had similar values, goals to help get their students to meet their dreams. I found that school at Walden University. Walden has multiple programs for Master’s degree nurses at first, I wanted to complete the Adult-Gerontology Acute Care program. After, careful consideration the program that felt right for me was as a Family Nurse practitioner and a Primary Care Provider. I felt being an older student it would be most sensible NURS 6002 /3 week 1 Discussion: Networking Opportunities.

    Walden University had the vision I thought and believed could meet my needs and those I could serve. They understood that graduates could be worthy and the solution in a society critically challenged in the 21
    st
     Century, therefore progressing toward the advancement of the “greater global good (Walden University, 2020a).” The Vision statement and Mission were impressive due to the influence of social change. Walden states through “Positive social change,” as intentional development by creating and utilizing ideas, actions, strategies to stimulate worthy with dignity for communities and individuals as well as organizations, and different cultures (2020a).

    Society and individuals are facing some challenges that are forcing change. These individuals and communities who need a voice and healthcare workers to meet their needs as an FNP I believe I can reach many who are often forgotten such as vulnerable populations we need to meet their needs, who are they? They are people who are often forgotten; homeless patients, and older patients living alone, pregnant women and children, prisoners or people living in shelters (victims of Domestic Violence), disabled, mentally or physically challenged, veterans and unserved individuals (no or limited income) (Stanhope, 2014).

    Walden has become committed to specialized advancement and values nursing as an autonomous field with, dignity, integrity who are accountable legally and ethically responsible (Walden, 2020b). The vulnerable population as mentioned depends on those of us who are willing to learn to help them. The ANA Code of ethics believes nurses should practice with respect, compassion, and dignity, values, unique to every individual. They are committed to integrity and competence that, advocate for patient rights, and promote health and protect the health, and safety of the patients (ANA, 2015) NURS 6002 /3 week 1 Discussion: Networking Opportunities.

     

    I am thoroughly interested in becoming an FNP or advanced practicing nurse, excited, and still nervous with the road ahead. I have faced challenges in the past and succeeded. I know I can do it again because Walden is as determined to help its student success as we are to accomplish our goals.  They believe in promoting positive change, this is a must in helping others as Specialists, and through professionalism roles, we can promote the health and wellbeing of others with quality care (2020a).

    Reference:

    American Nurses, A. (2015). Code of Ethics for Nurses with Interpretive Statements. Silver

    Spring, Maryland: American Nurses Association.

    Stanhope, M. & Lancaster, J. (2014) Public Health Nursing. Population-Centered Health Care in

    the Community (8th ed.) Maryland Heights MO: Elsevier Mosby

    Walden University. (2020a) Vision, Mission, and Goals.  Retrieved October 13, 2020, from

    https://catalog.waldenu.edu/content

    Walden University. (2020b) Master of Science in Nursing (MSN). Retrieved October 13.2020

    from https://catalog.waldenu.edu/preview_program.

     

     

    another sample

    My Goals and University Vision and Mission

    I started my nursing career in 2014 after completing my associate’s degree from San Jacinto College in Pasadena, Texas. My first nursing unit was an adult telemetry unit in which I worked for a little over a year before transitioning to the pediatric emergency room. I have worked at Texas Children’s Hospital in the Texas Medical Center for 5 years this month. When I started at Texas Children’s, I kept a supplemental position at my first facility in the adult emergency room and have worked in a per-diem role in adult emergency settings since. I was drawn to Walden because of the flexibility of their program for working nurses who want to make a difference in the field. When starting my nursing education at the community-college level, I was intrigued by the mission of the institution. San Jacinto College (2020) established they are centered around students’ success and their academic advancement that improves the lives of people in their communities. I thought of this when I was researching schools to pursue a graduate degree. Walden’s mission and vision aligned with what I had taken away from my previous academic institutions. Walden University (2020) addresses challenges that practitioners may face and prepares students to make positive societal changes for the world today.

    Incorporation of Social Change

    Having worked with patients from across the lifespan, I came to the ultimate decision that a Family Nurse Practitioner degree would be ideal to give me the opportunity to care for patients at any stage in their lives. In addition to working as an advanced practice provider, as a Master’s-prepared clinician, it would also qualify me for a position as an adjunct professor to teach future nurses, which has also been a goal of mine. According to the American Association of Colleges of Nursing (2011), “Master’s-level nursing graduates must have an advanced level of understanding of nursing and relevant sciences as well as the ability to integrate this knowledge into practice” (p. 4). The Master of Science in Nursing at Walden University prepares students to commit to professional development of improve the future of nursing standards of patient care (Walden University, 2020). The expected outcomes of the program at Walden aligns with my personal goals to not only to provide quality holistic care for patients, but to work on my own professional development as well as educating future nurses to do the same NURS 6002 /3 week 1 Discussion: Networking Opportunities.

    References

    American Association of Colleges of Nursing. (2011). 
    The essentials of master’s education in nursing
    . 
    https://www.aacnnursing.org/portals/42/publications/mastersessentials11.pdf

    San Jacinto College (2020). 
    Our vision, mission and values.
     
    https://www.sanjac.edu/about-san-jac/our-vision-mission-and-values#:~:text=San%20Jacinto%20College%20is%20focused,in%20the%20communities%20we%20serve

    Walden University (2020). 
    2019-2020 Walden university catalog (March 2020). 
     https://catalog.waldenu.edu/preview_program.php?catoid=172&poid=67151&returnto=62482 NURS 6002 /3 week 1 Discussion: Networking Opportunities