Category: Nursing

  • Essay Title Generator

    Has it ever happened to you that you have a topic for your essay and the content but can’t come up with a catchy title? An excellent and brief essay title attracts the reader’s attention and hints at what the text is all about. With the help of an essay title generator, you can catch your instructor’s attention from the moment they look at your project.

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    Impact of
    social media
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    Role of Education in Society

    Benefits of eating a balanced diet

    The Role of Nurse Leader

    Importance of culture

    Patient Education in Nursing

    Effects of Technology on youth

    Importance of Family

    Benefits of an exercise

    Ways to make money

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  • LEADERSHIP THEORIES IN PRACTICE

    BY DAY 3 OF WEEK 4

    Post
     two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.

    BY DAY 6 OF WEEK 4

    Respond
     to at least 
    two
     of your colleagues 
    on two different days
     by explaining how the leadership skills they described may impact your organization or your personal leadership, or by identifying challenges you see in applying the skills described.

    Transitional Leadership

    Transformational leadership motivates followers by appealing to higher ideas and moral values, where the leader has a deep set of internal values and ideas (Doody & doody, 2012). This form of leadership leads to followers to sustain the greater good, rather than their own interests, and creates supportive environments where responsibility is shared (Doody & doody, 2012).

    Transitional leaders aim to ensure that everyone on the team understands the importance of their work, and the value that they bring to the environment (Doody & Doody, 2012). This empowers and engages the team (Doody & doody, 2012) to not only share their ideas, but also grants them the ability to communicate their thoughts and ideas with the expectation that their ideas are worth being considered.

    ORDER A PLAGIARISM-FREE ESSAY HERE

    James MacGregor Burns was a political scientist and historian and is the one who introduced this leadership theory (Collins et al., 2019). He was fascinated by the styles of Mahatma Gandhi, Franklin Roosevelt, and John F. Kennedy (Collins et al., 2019). Burns description of transformational leadership as two or more persons engaging with each other in such a way that the leader and followers raise one another to high levels of motivation and morality (Collins et al., 2019).

    One leader that I will always cherish is the nurse manager that I worked with in a PACU setting. This manager exemplified transitional leadership and went above and beyond to ensure that her staff was well prepared. Fifty percent of her staff were travel nurses, yet she treated us like we were her established team. If one of us did not have experience in pre-op, phase 1, phase 2, critical care recovery, or procedure experience, she ensured that we were not pigeonholed, performing the same duties each day. She believed that each of us should gain skills that would propel us in our profession.

    She would come in to work and before placing her things in her office, she would inquire about our day and if there was anything that she could do for us. She always kept an open-door policy and was never bothered with interruptions. She included us in team building activities outside of the office, and she would also include us in with her staff meetings, and any other required in-service/training that she provided for her staff.

    Each travel nurse was so in awe of her transformational leadership approach, so much so, we continued to renew our contracts, until the pandemic flipped our lives upside down. But that did not stop her from reconnecting with us once the restrictions were lifted. She requested for me and five other nurses to return, and we gleefully accepted. This may not seem like much to most, but when you come from a rigid, autocratic form of leadership, transformational leadership is very refreshing. It was like being in a warm hot spring, where I was able to detox my soul from the previous regime I was employed with. In summary, Meg was adaptable, inspiring, accountable, and extremely honorable (Morales, 2020). All of the ingredients for an exceptional transformational leader.

    References:

    CM, D. O. D. (2012, November). 
    Transformational leadership in nursing practice
    . British journal of nursing (Mark Allen Publishing). Retrieved December 13, 2022, from https://pubmed.ncbi.nlm.nih.gov/23132001/

    Collins, E., Owen, P., Digan, J., & Dunn, F. (2019, December 16). 
    Applying transformational leadership in nursing practice
    . Nursing standard (Royal College of Nursing (Great Britain) 1987). Retrieved December 13, 2022, from https://pubmed.ncbi.nlm.nih.gov/31840443/

    Morales, M. (2020, May 1). 
    Characteristics and examples of transformational leadership in nursing
    . Relias. Retrieved December 13, 2022, from https://www.relias.com/blog/transformational-leadership-in-nursing

     
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    Jessica Velez

    Jessica Velez

    Dec 23, 2022
    Dec 23, 2022 at 9:37pm

    Manage Discussion Entry

    hello Jada,

    I find transformational leadership to be an essential trait of leaders in the accelerated healthcare industry. The pressures of every day work and intense schedules, coupled with the pressures of pace-of-care, collaborating with providers, and educating lay-nurses are all types of leadership that demand your time and attention (Chung & Li2021). If I were to see a leader that exemplified transformational leadership, I would give them a standing ovation, handing them the leadership award of their career, and encouraging others to learn from their example. Powerful leaders do not make their followers feel like pawns. Rather, leaders empower the followers to take charge and engage in utilizing the talents of all of their colleagues. Great leaders today make a name for themselves by being innovative, heroic, and heartfelt, while in their position. Give up your self-centered ways and join in a movement that will change your world (Gull et al., 2022).

    References

    Chung, D. S., & Li, J. M. (2021). Curvilinear effect of transformational leadership on innovative behavior among R&D teams in South Korea: Moderating role of team learning. [Curvilinear effect of transformational leadership] Journal of Organizational Change Management, 34(1), 252-270. https://doi.org/10.1108/JOCM-01-2017-0017

     

    Gull, S., Bukhari, S. N. Z., Qamar, U., & Tanvir, A. (2022). Is transformational leadership instrumental to environmental sustainability? A perspective of Pakistani textile sector. [Este leadership-ul transformational important în sustenabilitatea mediului? O perspectivă a sectorului textil din Pakistan] Industria Textila, 73(4), 411-419. https://doi.org/10.35530/IT.073.04.202157

     
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    Sherwin Jackson

    Sherwin Jackson

    Dec 14, 2022
    Dec 14, 2022 at 8:35pm

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    Effective nurse executives combine a range of leadership styles, theories, and approaches in order to pursue a set of goals and objectives. Research has shown that leadership behaviors can have an impact in the creation of a healthy work environment. Some of the most common leadership theories employed in nursing include transformational leadership theory, and participative leadership theory (Alloubani & Akhu-Zaheya, 2018). Gobbi (2017) explained that transformational leadership is focused on how the vision of a leader can influence the followers to attain a set of goals. As such, the transformational nurse leader stands out as an individual with the capacity to motivate the entire team by encouraging them to adjust their inspirations, opinions and expectations in line with the set vision. The participative leadership theory calls for enhanced involvement of team members in the problem-solving and decision-making processes. In the nursing sector, some of the key behaviors associated with participative leadership include acting as a facilitator as opposed to a dictator, information-sharing tendencies, inspiring participation and engaging the followers in key decision-making processes (Alloubani & Akhu-Zaheya, 2018).

    Dr. Fauci is the leader that exhibits the behaviors associated with both the transformational and participative leadership theories. Neff Newitt (2020) explained that Fauci is a leader who radiate gravitas, communicate powerfully, establishes credibility, and exhibits a distinct charisma that played to his success when leading in uncertain and turbulent times during the COVID-19 pandemic. Ideally, the leadership behaviors exhibited by Dr. Fauci proved instrumental in raising public awareness regarding the COVID-19 pandemic and inspired renewed hope into the adoption of the safety guidelines and procedures to curb the spread of the coronavirus disease 2019. Moreover, the leader’s capacity to delegate responsibility and authority in a more effective manner makes him to stand out as a leader who exemplifies executive presence.

     

    References

    Alloubani, A., & Akhu-Zaheya, L. (2018). Leadership styles and theories. 
    Leadership Styles and Nursing Care Management
    , 1-23. 
    https://doi.org/10.2174/9781681087450118010003
    Links to an external site.

    Gobbi, M. (2017). Global issues for nursing leadership. 
    The Essentials of Nursing Leadership
    , 94-108. https://doi.org/10.4135/9781529714821.n7

    Neff Newitt, V. (2020). Lessons on COVID-19 from Anthony Fauci, MD. 
    Oncology Times
    , 42(16), 1,9-10. 
    https://doi.org/10.1097/01.cot.0000696416.98393.6a
    Links to an external site.

     

     
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    Jada Sewell

    Jada Sewell

    Dec 19, 2022
    Dec 19, 2022 at 3:59pm

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    Sherwin,

    I am a transformational leader and am grateful that this gift rest within. I state that it is a gift because I have attempted to train others to be transformational leaders in the ER environment where frequently all hell breaks loose, with no success. It was because they misused this style of leadership (as it was not inherent to their nature), thus it was a manipulation tool for self-gain/self-promotion (Iqbal et al., 2019), which ultimately backfired because their true nature always returned. These charge nurses were used to ruling with an iron fist and were dumbfounded when they attempted to utilize my leadership style and did not get the same results from the staff as I did. This comment is not meant for self-praise, I genuinely valued everyone on the team, and utilized them based on their strengths, and either helped them to strengthen their weaknesses, or did not utilize them in a capacity where they would fail.

    Transformational leadership is not a “you can catch more flies with honey approach,” but moreover a process of raising others to higher levels of morality and motivation (Collins eyt al., 2019). Nurses were exhausted in my previous ER, yet, when I needed them due to staffing shortages, they were willing to stay and do overtime to help me. Some even asked daycare providers to keep their children past the designated time to assist me. This is in part because I too was exhausted by giving them everything that I had to give, but also, I engaged them fully in every decision that pertained to their assignments and welcomed feedback whether positive or negative. We were in the trenches together, and I wanted them to know that I did not see them, or would I treat them any differently than I wanted to be treated.

    References

    Collins, E., Owen, P., Digan, J. q, & Dunn, F. (2019, December 16). 
    Applying transformational leadership in nursing practice
    . Retrieved December 19, 2022, from https://journals.rcni.com/nursing-standard/cpd/applying-transformational-leadership-in-nursing-practice-ns.2019.e11408/full

    Iqbal, K., Fatima, T., & Naveed, M. (2019, December 9). 
    The impact of transformational leadership on Nurses’ organizational commitment: A multiple mediation model
    . European journal of investigation in health, psychology and education. Retrieved December 19, 2022, from https://pubmed.ncbi.nlm.nih.gov/34542484/

     

     
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    Carolyn Hart

    Carolyn Hart

    Dec 21, 2022
    Dec 21, 2022 at 3:37pm

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    Jada,

    You touch on an important topic that is often overlooked: authenticity. Being authentic means that you are true to yourself and you always abide your basic principles – you do not try to be something that you are not! Bill George started writing about authentic leadership in the early 2000’s and identified characteristics about a leader who is authentic.

    Authentic leaders have a sense of purpose, but are also real and approachable. It can be accompanied with a sense of passion.

    Authentic leaders have clear values and they do not compromise. In other words, they have integrity and expect high ethical standards

    Authentic leaders build relationships and establish connections. They share things but they also listen.

    Authentic leaders have goals and self-discipline. they know what is needed to move forward and they consistently (and calmly) focus on that!

    Authentic leaders show compassion and are sensitive to the needs of others.

    Dr. Hart

     
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    Julia Said

    Julia Said

    Dec 22, 2022
    Dec 22, 2022 at 7:30pm

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    Sherwin,

    I appreciate that you mentioned nurses being involved in the decision-making process with their leaders. In my recent healthcare policy class, we discussed nurse involvement in policymaking. In that class, I learned that nurses of all levels should be involved in policymaking or decision-making processes within their organization. Research has found that when nurses are involved in shared governance, patient outcomes improve and employee satisfaction increases (Bartmess et al., 2022). When leaders do not allow their staff members to partake, they are sending the message: “I do not care what you think” or “Your opinion is not valued here.” Transformational leaders welcome and encourage their staff to reach out and express concerns with processes or policies. Not only do they encourage speaking up, but they actually do something about it. Good leaders listen 
    and
     react, to show they do value others’ opinions (Bartmess et al., 2022). This engages and empowers nurses, which improves employee satisfaction and can positively impact burnout and turnover (Bartmess et al., 2022). When nurses do not believe they have a leader they can turn to or look up to, they tend to feel higher levels of stress and burnout. A lack of wellbeing has been associated with absenteeism, turnover, and reduced productivity (Ahmed et al. 2019).  Organizations need employees to be at optimal levels of health and wellness in order to provide the highest quality care (Ahmed et al., 2019). This responsibility falls on leaders to encourage a positive work environment where nurses and other staff have a voice and the freedom to express concerns and get involved with policy change.

    References:

    Ahmed, O. M., Ishak, A. K., & Kamil, B. A. M. (2019, February 2). 
    Transformational leadership and employee psychological wellbeing among faculty staff: the mediating role of self-efficacy
    . International Journal of Management, Accounting and Economics.

    Bartmess, M. P., Myers, C. R., & Thomas, S. P. (2022). Original Research: ‘It Would Be Nice to Think We Could Have a Voice’: Exploring RN Involvement in Hospital Staffing Policymaking. 
    AJN, American Journal of Nursing
    , 
    122
    (10), 22–31. https://doi.org/10.1097/01.naj.0000884564.75005.a9

     
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    Jessica Velez

    Jessica Velez

    Dec 24, 2022
    Dec 24, 2022 at 1:13pm

    Manage Discussion Entry

    hello Sherwin,

    Dr Fauci as a leader, who has proven to be a definitive factor in the prevention of the virus from sparking a pandemic epidemic and the rise of the antiviral drugs. Dr Fauci is a man who stands out when meeting him in person; he is charismatic, smart, and mostly tends to let his appearance do the talking rather than speaking himself (Kerfoot, 2022). Dr. Fauci is an effective nurse executive who exhibits a range of leadership styles, theories, and approaches as he leads the battle to protect the American public from the deadly COVID-19 pandemic.

    The above notwithstanding, Dr. Fauci makes some decisions that in the short-run seem to be right, but in the long-run may prove to have been the wrong decisions especially in the event the COVID-19 pandemic proved to have been more deadly than anticipated. His leadership behaviors underpinned his position as the leader of the healthcare team in the wake of the COVII pandemic in the spring of 2019 (Wiapo & Clark, 2022).

    Reference

    Kerfoot, K. (2022). Chaos, Teamwork, Compassion, and Leadership: Disasters and Nursing’s Finest Hours. Pediatric Nursing, 48(4), 205. https://www.proquest.com/scholarly-journals/chaos-teamwork-compassion-leadership-disasters/docview/2709976924/se-2

    Wiapo, C., & Clark, T.,PhD.R.N. (2022). Weaving together the many strands of Indigenous nursing leadership: Towards a whakapapa model of nursing leadership. [Te tuitui i ngā whenu maha o te hautū mahi tapuhi iwi taketake: Te tarei tauira hautū mahi tapuhi iwi taketake i takea mai i te whakapapa] Nursing Praxis in New Zealand, 38(2), 4-11. https://doi.org/10.36951/27034542.2022.08

     
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    Shawntel Wright

    Shawntel Wright

    Dec 24, 2022
    Dec 24, 2022 at 10:54pm

    Manage Discussion Entry

           Sherwin, I could not agree with your post any more than what you have explained. It takes effective leadership to create and keep a healthy work environment. Being able to align the vision and goals of the facility with the staff is especially important. According to Coursera, “Setting goals establishes a process for evaluating and monitoring progress toward your nursing career objectives.” (N.A., N.D.). I am a transformational leader, and attempting to lead a cohort of peers is not an easy task. Speaking from personal experience, it is challenging to lead and be an effective leader when the facility does not have the required staff. “Transformational leadership is a process that changes and transforms individuals. (N.A. 2001). At the facility in which I am employed, transformational leadership styles are effective most of the allotted time and there is an efficient number of staff present. Leaders cannot do what is required when pulled in several different directions. I also loved how you mentioned involving staff in the decision-making process.  Staff seems to feel more appreciated when they have input on how their facility will be run. Sherwin, overall great weekly post!

     

     

     

     

     

    References

    Examples of professional nursing goals: Skills, education, earnings
    . Coursera. (n.d.). Retrieved from https://www.coursera.org/articles/examples-of-professional-nursing-goals

    HR020/HR020: Transformational leadership: The transformation of managers and associates. (n.d.). Retrieved from https://edis.ifas.ufl.edu/publication/HR020

     
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    Jacqueline Keener

    Jacqueline Keener

    Dec 20, 2022
    Dec 20, 2022 at 10:56am

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    Leadership Theories in Practice

    Everyone who has worked in healthcare has had interactions with at least one of the nursing leadership theories or behaviors. Having been in healthcare for 18 years, I have experienced a number of different leadership styles in various environments. A transformational leadership style has been the most beneficial to personal and professional growth! Broome & Marshall (2021) show different examples of behavioral and trait theories for leadership that have helped lead to transformational leadership.

    Scholarly Resource Examples

    One key insight that stuck out to me by Jumoke Ajanaku & Lubbe (2021) is the importance of building healthy relationships to inspire team members to feel empowered and inspired. There are multiple elements to a healthy, working relationship that begin with healthy communication. A leader who inspires others, leads by example, and encourages the heart. I am blessed to have a current nurse manager (Brandi) who exemplifies these traits. She often encourages us to try and find a solution on our own, and guides us to appropriate resources. She is also filled with passion and love for the job and our patients. Jumoke Ajanaku & Lubbe (2021) is the first example I’ve come across that talks about encouraging the heart, and this is a beautiful concept that will benefit staff and patients. I had an issue with an on-call provider not completing tasks that were sent, and when I was problem solving with her, she suggested completing a 4C to look at the issue. I had never completed a 4C, but she explained the process and ensured I had examples to follow. I felt accomplished and proud when I completed my 4C, and can look forward to helping improve practice by completing more when applicable. By completing this 4C, I was able to help address a practice weakness and ensure faster, safer patient responses as a direct result of Brandi practicing this leadership behavior.

    Broome & Marshall (2021) also list emotional intelligence as a nurse leadership consideration. Alshammar et al. (2020) explains “emotional intelligence is the prerequisite of leadership.” This is another key concept to understand that leadership behaviors and effectiveness can be determined by a leader’s level of emotional intelligence. My first experience with a transformational leadership nurse manager was Maria. One of the first gifts she gave me when I joined her team was the book Emotional Intelligence 2.0, and explained how that book was gifted to her, and helped shape the way she leads and interacts with people. Maria taught me through example and explanation how being aware of my own emotional intelligence can help me to more positively interact with coworkers and peers. Because of her leadership style, I was able to grow personally and professionally in the way I interact with others. I learned to assume positive intent and be more patient with others, positively impacting organizational interactions.

    References

    Alshammari, F., Pasay-an, E., Gonzales, F., & Torres, S. (2020). Emotional intelligence and authentic leadership among Saudi nursing leaders in the Kingdom of Saudi Arabia. 
    Journal of Professional Nursing
    , 
    36
    (6), 503–509. https://doi.org/10.1016/j.profnurs.2020.04.003

    Broome, M., & Marshall, E. S. (2021). 
    Transformational leadership in nursing: From expert clinician to influential leader
     (3rd ed.). New York, NY: Springer.

    Jumoke Ajanaku, O., & Lubbe, W. (2021). Applying Transformational Leadership in Nursing through the Lens of Kouzes and Posner Leadership Practices. 
    Gender & Behaviour
    , 
    19
    (2), 17788–17794.

     
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    Carolyn Hart

    Carolyn Hart

    Dec 20, 2022
    Dec 20, 2022 at 3:51pm

    Manage Discussion Entry

    Jacqueline,

    Thank you for a very thoughtful post! I loved your statement: 
    One key insight that stuck out to me by Jumoke Ajanaku & Lubbe (2021) is the importance of building healthy relationships to inspire team members to feel empowered and inspired
    . As a new leader, I found I needed to improve on my ability to inspire others; I used the book by Kouzes and Posner and learned a lot from the 
    leadership model
     
    Links to an external site.
    that they developed.

    Jacqueline and Class, Take a look at the leadership challenge. What traits do you already have and where do you think you can improve?

    Dr. Hart

     
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    Jacqueline Keener

    Jacqueline Keener

    Dec 21, 2022
    Dec 21, 2022 at 8:04am

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    Dr. Hart,

    Thank you for sharing this leadership model! I am still fairly new to leadership, but because of the incredible nurse leaders that I’ve had the privilege to work with, I believe I do have many of these traits. I model the way, most recently in precepting a new employee in my department. It would have been easy to teach her the “work arounds” in this department to help with on-call provider issues, but instead I helped her to work through the process correctly. This also helped me to challenge the process, because we were able to identify some areas for improvement. I also believe I inspire a shared vision, as I am passionate about our department and the work that we do. We are also looking to expand and create an outpatient injection clinic! I still have much room for improvement and will work on my confidence and ability to enable others to act. I can also improve in my ability to encourage the heart, as I am still stepping into my confidence as a nurse leader. Thank you for this great addition to this week’s discussion!

    Jackie K.

     
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    Julie Baker

    Julie Baker

    Dec 23, 2022
    Dec 23, 2022 at 12:41am

    Manage Discussion Entry

    Jackie,

    I loved your response to precepting the new employee. Its important for new nurses to learn correctly right from the start. They can later choose what ways might work better for them as work arounds or shortcuts but if they start with the correct instructions they can always utilize that background as they evolve.  According to Ferguson and Day (2007), “nurse managers are in the ideal position to create supportive practice environments that facilitate new nurse integration into the setting”. From the things you have said, I imagine you would make an excellent leader in your setting and building your confidence is a great way to start with a leadership plan that will allow you influence collaborators, or followers, to build task-specific self-confidences that can strengthen their job performance (Axelrod, 2016).

     

    Axelrod, R. H. (2016, August 1). 
    Leadership and self-confidence
    . SpringerLink. Retrieved December 23, 2022, from https://link.springer.com/chapter/10.1007/978-3-319-31036-7_17

    Ferguson, L., & Day, R. (2007). 
    Challenges for new nurses in evidence-based practice
    . Retrieved December 22, 2022.

     
    Reply
    Reply to Comment

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    Yvonne Oglesby-Moore

    Yvonne Oglesby-Moore

    Dec 23, 2022
    Dec 23, 2022 at 10:04pm

    Manage Discussion Entry

    Response #1

    Jacqueline thank you for your post. I agree leaders need to keep communication open to establish a rapport.  Authentic leadership is the leadership I would like to exhibit. Broome and Marshall (2021), describe the authentic leadership model as one that emphasizes relationships between leaders and followers to accomplish goals. Both authors explain that authentic leadership is optimistic and hopeful and they demonstrate honesty (Broom & Marshall, 2021). It is important for leaders to understand their staff and their needs to be effective. Deveau and McGill (2016), explain that frontline management is important to mentor and educate staff to have positive outcomes.

     

    Broome, M., & Marshall, E. S. (2021). 
    Transformational leadership in nursing: From expert clinician to influential leader
     (3rd ed.). New York, NY: Springer.

    Deveau, R. & McGill, P. (2016). Impact of practice leadership management style on staff experience in services for people with intellectual disability and challenging behaviour: a further examination and partial replication
    . Research in Development Disabilities
    . (56) 160-164.

     
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    Harmon Mann

    Harmon Mann

    Dec 24, 2022
    Dec 24, 2022 at 11:08am

    Manage Discussion Entry

    Great post Jacqueline. You made a great point that it’s important for leaders to motivate their staff in order to form a healthy relationship with them. A transformational leadership style is a great example of the type of leader that works to motivate others. They “inspire and motivate their workforce without micromanaging-they trust trained employees to take authority over decisions in their assigned jobs” (White, 2022). They will typically state the goals to the patients and then motivate them to reach the goals. When help is needed they will assist their staff and help them work towards their goals. These types of leaders know how to communicate with their staff and are reliable and approachable. “Transformational leadership has positive results for patients, professionals and institutions” (Ferreira, et.al, 2020). Since these leaders are good communicators they are able to get the staff to work together and create a good working environment.

     

    Ferreira, T., Mesquita, G., & Oliveria, M. (2020, March 30). 
    The influence of nursing leadership styles on the outcomes of patients, professionals and institutions: An integrative review
    . Journal of nursing management. https://pubmed.ncbi.nlm.nih.gov/35293055/

    White, S. K. (2022, October 10). 
    What is transformational leadership? A model for motivating innovation
    . CIO. https://www.cio.com/article/228465/what-is-transformational-leadership-a-model-for-motivating-innovation.html

     
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    Morayo Oloidi

    Morayo Oloidi

    Dec 20, 2022
    Dec 20, 2022 at 1:41pm

    Manage Discussion Entry

    Leadership Theories in Practice

    Leadership entails guiding, motivating, directing and inspiring others towards meeting a common goal (Marshall, 2021). Every organization has goals or objectives that they intend to achieve.  Staff need to be guided and inspired towards meeting these goals, and this is the major role of a leader. I have had experience with different types of leadership styles, but the two that stands out for me are transaction and transformational styles of leadership.

     Leadership behaviors and the creation of a healthy work environment

    After my review, two key insights were the crucial role of leaders regarding the creation of a positive work environment for staff, and the ensuing health as well as job-related outcomes.  There are certain traits that a leader must possess to enable them create a positive work environment. They must be self-aware, honest, have clarity of thought, be a person of integrity and also empathetic to those whom they lead.

    A leader should focus on ensuring that the welfare and needs of the staff are well addressed. They should also ensure that staff are provided with adequate resources to be able to seamlessly perform their work. They need to apply strategies that lessens burnouts, dissatisfaction, and turnover (Mudallal et al, 2017). Job satisfaction, commitment among nurses, and focus on delivery of high standards of care can be inspired with positive leadership behaviors. Staff need to be empowered to effectively utilize their skills and knowledge for better organization outcomes. Being concerned and caring towards staff as a leader helps to reduce feelings of depersonalization as well as emotional exhaustion. It makes staff to trust more in their leaders and the organizations they work for. Leadership styles like transformational leadership helps to establish a positive work environment where staff feel empowered to be able to deliver optimally.

    Employees can be helped to realize their full potentials in making change within the organization possible through positive leadership behaviors. Leaders who are able to inspire teamwork among staff, incorporate staff in decision-making, fairly reward staff for excellent performance, and also motivate, are in a better position of improving satisfaction and work-life quality of their employees (Suratnoet al, 2018).  One trait of a transformational leader is to inspire those whom they lead by motivating them, which encourages loyalty to the organization (Elewa, 2021). A leader who uses that style of leadership is also known to be delegative, which inspires professional growth among employees.

    A situation where the behavior and skills have been used

    I have seen my in charge use transformational leadership to inspire us to be more committed and productive to the organization. She is also concerned about our professional development, and always delegate most of her responsibilities to us, as a learning opportunity. She always encourages us to go back to school to gain knowledge and skills that will enable us deliver care that is based on evidence. She also has a positive approach towards nurses who sometimes fail to perform their roles as required. She always calls them aside, have a talk and encourage them to remain focused with their work. She does not criticize staff, but make them understand how their work is very important.

    There was a recent situation where she had to reprimand me for leaving work early. She called me to her office and asked me to explain why I had to end my shift earlier than usual. She gave me a good opportunity to explain myself, after which she advised me never to repeat such a mistake again. My in charge made me understand what could have gone wrong by me ending my shift early ad not notifying the management. She made me realize my mistake in a positive way, saving me from any punishment. We have since become very close friends, and she delegates some of her duties to me. She has also given me the duty to guide students on attachment, which is an opportunity for me to grow my leadership skills.

    Extent of effectiveness and how the practice of the skills have impacted the workplace

    The skills that the in-charge nurse used to handle my situation amicably were greatly effective in ensuring that I recognize my mistake and never to repeat the same. Though this is a mistake I only committed once, I have learned about its repercussions. Any time I will be leaving work, be it early or on time, I must ensure that I have handed over my shift to someone else. I also need to communicate with the management on time so that they can get someone to stand in for me. The in charge used very important skills to address my case effectively. These were open communication ad active listening.

    I felt that she was understanding and respectful, but at the same time interested on accountability from every staff. She did not criticize me, but made me realize the magnitude of the mistake I made. We managed to establish a positive connection between us, which translated to her also being concerned about my professional growth. From the duties she has been delegating to me, I have managed to learn a lot especially on leadership and accountability. I can now effectively inspire and guide others to positively contribute to the success of the organization. This experience has enabled me to also effectively guide students on attachment, and to ensure that they are responsible enough for their actions. My dedication at the workplace has since improved significantly.

    References

    Elewa, A. H. (2021). Nurse Manager’s Leadership Practices and its Relation to Staff Nurses

    Motivation and Intention to Leave. 
    Egyptian Journal of Health Care, 12(3),
     146-160.

    Manning, Jennifer, DNS, APRN & CNS, CNE. (2016). The Influence of Nurse Manager

    Leadership Style on Staff Nurse Work Engagement. 
    Journal of Nursing Administration
    ,

    46, 438-443. 
    https://doi.org/10.1097/NNA.0000000000000372
    Links to an external site.

    Marshall, E., & Broome, M. (2021). 
    Transformational leadership in nursing:
     
    From expert

    clinician to influential leader
     (2nd ed.). New York, NY: Springer.

    Mudallal, R., Othman, W., & Hassan, N. (2017). Nurses’ Burnout: The Influence of Leader

    Empowering Behaviors, Work Conditions, and Demographic Traits. INQUIRY: 
    The

    Journal of Health Care Organization, Provision, and Financing, 54
    (1), 1-10.

    Suratno, K., Kusrini, K., &Ariyanti, S. (2018). The Relationship between Transformational

    Leadership and Quality of Nursing Work Life in Hospital.  
    International Journal of

    Caring Sciences, 11
    (3), 1416-1420

  • ASSESSING, DIAGNOSING, AND TREATING ADULTS WITH MOOD DISORDERS Focused SOAP Note

    ASSESSING, DIAGNOSING, AND TREATING ADULTS WITH MOOD DISORDERS Focused SOAP Note

    Introduction

    In young adults, identification and management of mood symptoms can be challenging for clinicians. Tolliver & Anton (2015) claim the prevalence of comorbid mood disorders among these individuals increases. Thus, a thorough family and medical history assessment are often critical to implementing an optimal treatment plan. Failure to identify mood disorders increases the rates of relapse, recurring mood disorders, and suicidal rates. This paper aims to develop a focused soap note of a young-adult patient with a mood disorder, assess and develop a differential diagnosis list, and implement a treatment plan.

    Chief complaint:
    The patient is visiting the clinic for a mental health assessment.

    HPI:
    Petunia Park is a 24-year-old patient who presents to the clinic for a mental health assessment. She reports having a history of taking medications and stops as she feels she doesn’t need them, and they squash her. Ms. Park also says she has hypothyroidism and is currently under medication.

    Past Psychiatric History

    General statement:
    The patient first encounter with mental health was when she was a teenager, and after, she went for five days without sleep. She is unsure of what her mental condition was at that time.

    Caregiver:
    She lives with her boyfriend when she is not at home with her mother. He has been somewhat of a support system for her.

    Hospitalization:
    She reports previous hospitalizations four times before; the last time was during the past spring. She says her hospitalization in 2017 was due to a Benadryl overdose. The Patient denies any detox or residential rehabilitation.

     ORDER A PLAGIARISM-FREE PAPER HERE

    Medication trial:
    Ms. Park reports she tried Zoloft, which made her feel high, risperidone and Seroquel, which made her gain significant weight, and Klonopin, which slowed her down. She also reports an uncertain medication that “squashed” her creativity ASSESSING, DIAGNOSING, AND TREATING ADULTS WITH MOOD DISORDERS Focused SOAP Note.

    Previous psychiatric diagnosis:
    She reports a history of depression, anxiety, and bipolar disorder.

    Substance Use History:
    The Patient reports smoking about a pack a day, admits to taking alcohol at 19, and tried marijuana, which caused paranoia. Denies using cocaine, stimulants, inhalants, sedative medication, and synthetic substances.

    Family psychiatric/substance use history
    : Pt’s mother has a history of bipolar and suicidal attempts. The father went to prison for drugs and claimed his brother is a little ‘schizo’ but has never visited a doctor.

    Social History:
    The client was raised by her mother and older brother. She has one older brother and lives partially with her boyfriend. The client is single with no children. She is currently in vo-tech school for cosmetology and enjoys writing and painting as her hobbies. She works part-time at her aunt’s bookstore. She reports having been taken by police to the hospital once. The client denies any traumatic or violent experiences.

    Medical History:
    The client has hyperthyroidism, and she takes medication. She reports having depression that prevents her from working in the bookshop. During her depression episode, she has no energy or motivation, does not want to get out of bed, and feels unworthy after being up and working for five days.

    Current Medication: Medication for hypothyroidism.

    Allergies:
    Denies allergy.

    Reproductive Hx:
    Client reports she is heterosexual, has regular menses, has no pregnancy, is not lactating, and takes a birth control pill for polycystic ovaries. She admits to having multiple sexual partners.

    ROS

    GENERAL:
    The Patient is alert and oriented but agitated with some questions. Denies fever, chills, weakness, and fatigue.  She reports having a good appetite and sleeping 5-6 hours on average.

    HEENT:
    Denies headache and dizziness. No visual loss, blurred vision, or double vision. No ear pain or loss, no sinus allergies and infection. No neck stiffness, pain, or injury. No past dental examination.

    SKIN:
    No skin rash, itchiness, or wounds.

    RESPIRATORY:
    No chest pains, breath shortness, hemoptysis, congestion, coughs, or edema.

    CARDIOVASCULAR:
    No palpitations, wheezing, murmurs, or chest pains.

    GASTROINTESTINAL:
    No abdominal pains, nausea, diarrhea, or anorexia.

    GENITOURINARY:
    No burning urination, urgency, odor, or discoloration.

    NEUROLOGICAL:
    Patient reports episodes of abnormal sleep patterns, decreased energy, and feeling of worthlessness ASSESSING, DIAGNOSING, AND TREATING ADULTS WITH MOOD DISORDERS Focused SOAP Note.

    MUSCULOSKELETAL:
    No muscle cramps, muscle weakness, painful joints, or stiffness.

    HEMATOLOGY:
    No anemia or bleeding.

    LYMPHATIC:
    No nodes enlarged and no splenectomy.

    ENDOCRINE:
    No sweating, heat, or cold intolerance.

    Objective

    Physical exam:
    Temp 98.2, Pulse 90, Respiration 18, B/P 138/88.

    The Patient is alert and oriented but seems agitated when some questions are asked. She is appropriately groomed and gives information adequately.

    Diagnostic Results:
    Urine drug and alcohol screen negative. CBC within normal ranges, CMP within normal ranges. Lipid panel within normal ranges. Prolactin Level 8; TSH 6.3 (H).

    Assessment

    Mental Health Examination

    The Patient is a 24-year-old female who appears anxious and easily agitated. She is alert and oriented to place and time. She is appropriately groomed and maintains eye contact throughout the interview.  Her speech was clear but pressured at times; however, during the interview was able to comprehend what she was verbalizing. She can express thoughts and feelings without hallucination, delusion, or paranoia. Patient reports having depressed mood episodes after five days of working hard. During the episodes, she has no energy or motivation, does not want to get out of bed, and feels unworthy.

    Differential Diagnosis

    Manic Depression:
    Calabrese et al. (2017) cite the diagnostic criteria for bipolar disorder as the Patient must experience abnormal and persistent elevated or irritable mood, goal-directed energy lasting for one week and present most of the day, during mood disturbances, the Patient present with increased energy and at least four of the following decreased sleep, inflated self-esteem, more talkative than usual and excessive involvement in pleasurable activities. The Patient reports having depressed mood episodes after five days of working hard. During the episodes, she has no energy or motivation, does not want to get out of bed, and feels unworthy.

    Major depressive disorder: 
    The DSM-5 diagnostic criteria for MDD is the Patient must present with either depressed mood or loss of interest for at least two weeks and have at least five other symptoms, including loss of interest, depressed mood, weight loss, insomnia, suicidal thoughts, decreased concentration, fatigue, and retardation (Tolentino & Schmidt, 2018). The Patient reports a depressed mood and loss of interest, which elapses after one week.

    Premenstrual dysphoric disorder:
    According to Reid (2017), the diagnostic criteria is the Patient, during or before their menstrual cycle, must present with at least marked affective lability and irritability and at five of depressed mood, anxiety, decreased interest in activities, difficulty in concentration, change in appetite and insomnia.

    The accurate diagnosis for the Patient is manic depression. This is because the Patient presents with depression episodes when she feels she has no energy or motivation, does not want to get out of bed, and feels unworthy, which happens after she has had lots of energy and done a lot of work. She reports the episodes last for a week.

    Treatment Plan

    The treatment plan is based on several patient factors, including current medication, previous drug reactions, and existing comorbidities will guide the implementation of a treatment plan. In addition, the treatment plan should be re-evaluated and modified as needed. The treatment option for the Patient is initiating Valproate 250mg BD rather than lithium as she has hyperthyroidism which may be worsened by lithium. According to Shah et al. (2017), Valproate has been studied and proven effective in treating acute mania. The medication is associated with less severe side effects but educating the Patient on possible signs of hepatic and hematological dysfunction is significant. It is essential to monitor serum valproate levels and reduced symptoms of mania to determine whether to increase or discontinue the medication (Shah et al., 2017). It is also necessary to recommend the Patient develop a consistent and healthy daily routine that effectively stabilizes moods.

    Reflection

    The case study was very insightful as I identified that diagnosis of mood disorders involves a thorough evaluation to arrive at the correct diagnosis. Different mood disorders share common signs and symptoms; thus, a diagnostic tool is essential in ruling out possible differential diagnoses. In addition, I learned that treatment is guided by the diagnosis while considering other patient factors. What I would do differently is involve the Patient’s caregiver, as I believe their information would be insightful. Ethical considerations include informed consent and confidentiality. Specific social determinants of health might increase the risk for a mood disorder, including ethnicity, gender, and sexual orientation, low income, and low educational status. ASSESSING, DIAGNOSING, AND TREATING ADULTS WITH MOOD DISORDERS Focused SOAP Note Thus clinicians must consider all factors when recommending health promotion strategies.

    References

    Calabrese, J. R., Gao, K., & Sachs, G. (2017). Diagnosing mania in the age of DSM-5.
    American Journal of Psychiatry
    ,
    174
    (1), 8–10. https://doi.org/10.1176/appi.ajp.2016.16091084

    Reid RL. Premenstrual Dysphoric Disorder (Formerly Premenstrual Syndrome) [Updated 2017 Jan 23]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Table 1, Diagnostic Criteria for Premenstrual Dysphoric Disorder (PMDD) Available from: https://www.ncbi.nlm.nih.gov/books/NBK279045/table/premenstrual-syndrom.table1diag/

    Shah, N., Grover, S., & Rao, G. P. (2017). Clinical practice guidelines for management of bipolar disorder.
    Indian Journal of Psychiatry
    ,
    59
    (5), 51. https://doi.org/10.4103/0019-5545.196974

    Tolentino, J. C., & Schmidt, S. L. (2018). DSM-5 criteria and depression severity: Implications for clinical practice.
    Frontiers in Psychiatry
    ,
    9
    . https://doi.org/10.3389/fpsyt.2018.00450

    Tolliver, B. K., & Anton, R. F. (2015). Assessment and treatment of mood disorders in the context of substance abuse.
    Dialogues in Clinical Neuroscience
    ,
    17
    (2), 181–190. https://doi.org/10.31887/dcns.2015.17.2/btolliver

     

    ASSESSING, DIAGNOSING, AND TREATING ADULTS WITH MOOD DISORDERS

    It is important for the PMHNP to have a comprehensive understanding of mood disorders in order to assess and accurately formulate a diagnosis and treatment plan for patients presenting with these disorders. Mood disorders may be diagnosed when a patient’s emotional state meets the diagnostic criteria for severity, functional impact, and length of time. Those with a mood disorder may find that their emotions interfere with work, relationships, or other parts of their lives that impact daily functioning. Mood disorders may also lead to substance abuse or suicidal thoughts or behaviors, and although they are not likely to go away on their own, they can be managed with an effective treatment plan and understanding of how to manage symptoms.

    In this Assignment you will assess, diagnose, and devise a treatment plan for a patient in a case study who is presenting with a mood disorder.

    RESOURCES

     

    Be sure to review the Learning Resources before completing this activity.

    Click the weekly resources link to access the resources.

    WEEKLY RESOURCES

    TO PREPARE

    Review this week’s Learning Resources. Consider the insights they provide about assessing, diagnosing, and treating mood disorders.

    ASSESSING, DIAGNOSING, AND TREATING ADULTS WITH MOOD DISORDERS
    Focused SOAP Note

    Review the Focused SOAP Note template, which you will use to complete this Assignment. There is also a Focused SOAP Note Exemplar provided as a guide for Assignment expectations.

    Review the video, 
    Case Study: Petunia Park
    . You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar.

    Consider what history would be necessary to collect from this patient.

    Consider what interview questions you would need to ask this patient.

    Consider patient diagnostics missing from the video:
    Provider Review outside of interview:
    Temp 
    98.2
      Pulse  
    90
     Respiration 
    18
      B/P  
    138/88

    Laboratory Data Available
    : Urine drug and alcohol screen negative.  CBC within normal ranges, CMP within normal ranges. Lipid panel within normal ranges. Prolactin Level 8; TSH 6.3 (H)

    THE ASSIGNMENT

    Develop a Focused SOAP Note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:

    Subjective: 
    What details did the patient provide regarding their chief complaint and symptomatology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?

    Objective: 
    What observations did you make during the psychiatric assessment?

    Assessment:
     Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest to lowest priority. Compare the 
    DSM-5-TR
     diagnostic criteria for each differential diagnosis and explain what 
    DSM-5
     criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.

    Plan:
     What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy.

    Reflection notes:
     Reflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), social determinates of health, health promotion, and disease prevention that takes into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

    BY DAY 7 OF WEEK 4

    Submit
     your Focused SOAP Note.

    SUBMISSION INFORMATION

    Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the 
    Turnitin Drafts
     from the 
    Start Here
    area ASSESSING, DIAGNOSING, AND TREATING ADULTS WITH MOOD DISORDERS Focused SOAP Note.

    To submit your completed assignment, save your Assignment as 
    WK1Assgn+last name+first initial.

    BUY A PLAGIARISM-FREE ESSAY HERE

    Then, click on 
    Start Assignment
     near the top of the page.

    Next, click on 
    Upload File
     and select 
    Submit Assignment
     for review.

    Rubric

    NRNP_6665_Week4_Assignment_Rubric

    NRNP_6665_Week4_Assignment_Rubric

    Criteria

    Ratings

    Pts

    This criterion is linked to a Learning Outcome
    Create documentation in the Focused SOAP Note Template about the patient in the case study. In the Subjective section, provide: • Chief complaint• History of present illness (HPI)• Past psychiatric history• Medication trials and current medications• Psychotherapy or previous psychiatric diagnosis• Pertinent substance use, family psychiatric/substance use, social, and medical history• Allergies• ROS

    15
     
    to >
    13.0
     pts

    Excellent

    The response throughly and accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis.

    13
     
    to >
    11.0
     pts

    Good

    The response accurately describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis.

    11
     
    to >
    10.0
     pts

    Fair

    The response describes the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis but is somewhat vague or contains minor innacuracies.

    10
     
    to >
    0
     pts

    Poor

    The response provides an incomplete or inaccurate description of the patient’s subjective complaint, history of present illness, past psychiatric history, medication trials and current medications, psychotherapy or previous psychiatric diagnosis, pertinent histories, allergies, and review of all systems that would inform a differential diagnosis. Or the subjective documentation is missing.

    15
     pts

    This criterion is linked to a Learning Outcome
    In the Objective section, provide:• Review of Systems (ROS) documentation and relate if pertinent to the chief complaint, HPI, and history• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses

    15
     
    to >
    13.0
     pts

    Excellent

    The response thoroughly and accurately documents the patient’s ROS for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented.

    13
     
    to >
    11.0
     pts

    Good

    The response accurately documents the patient’s ROS for pertinent systems. Diagnostic tests and their results are accurately documented.

    11
     
    to >
    10.0
     pts

    Fair

    Documentation of the patient’s ROS is somewhat vague or contains minor innacuracies. Diagnostic tests and their results are documented but contain minor inaccuracies.

    10
     
    to >
    0
     pts

    Poor

    The response provides incomplete or inaccurate documentation of the patient’s ROS. Systems may have been unnecessarily reviewed. Or the objective documentation is missing.

    15
     pts

    This criterion is linked to a Learning Outcome
    In the Assessment section, provide:• Results of the mental status examination, presented in paragraph form• At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.

    20
     
    to >
    17.0
     pts

    Excellent

    The response thoroughly and accurately documents the results of the mental status exam. Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides a thorough, accurate, and detailed justification for each of the disorders selected.

    17
     
    to >
    15.0
     pts

    Good

    The response accurately documents the results of the mental status exam. Response lists at least three distinctly different and detailed possible disorders in order of priority for a differential diagnosis of the patient in the assigned case study, and it provides an accurate justification for each of the disorders selected.

    15
     
    to >
    13.0
     pts

    Fair

    The response documents the results of the mental status exam with some vagueness or innacuracy. Response lists at least three different possible disorders for a differential diagnosis of the patient and provides a justification for each, but may contain some vagueness or innacuracy.

    13
     
    to >
    0
     pts

    Poor

    The response provides an incomplete or inaccurate description of the results of the mental status exam and explanation of the differential diagnoses. Or the assessment documentation is missing ASSESSING, DIAGNOSING, AND TREATING ADULTS WITH MOOD DISORDERS Focused SOAP Note.

    20
     pts

    This criterion is linked to a Learning Outcome
    In the Plan section, provide:• Your plan for psychotherapy• Your plan for treatment and management, including alternative therapies. Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan. • Incorporate one health promotion activity and one patient education strategy.

    25
     
    to >
    22.0
     pts

    Excellent

    The response provides an evidence-based, detailed, and appropriate plan for psychotherapy for the patient. The response provides an evidence-based, detailed, and appropriate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. A strong rationale for the plan is provided that demonstrates critical thinking and content understanding. … The response includes at least one evidence-based health promotion activity and one evidence-based patient education strategy.

    22
     
    to >
    19.0
     pts

    Good

    The response provides an evidence-based and appropriate plan for psychotherapy for the patient. The response provides an evidence-based and appropriate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. An adequate rationale for the plan is provided. … The response includes at least one health promotion activity and one patient education strategy.

    19
     
    to >
    17.0
     pts

    Fair

    The response provides a somewhat vague or inaccurate plan for psychotherapy for the patient. The response provides a somewhat vague or inaccurate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. The rationale for the plan is weak or general. … The response includes one health promotion activity and one patient education strategy, but it may contain some vagueness or innacuracy.

    17
     
    to >
    0
     pts

    Poor

    The response provides an incomplete or inaccurate plan for psychotherapy for the patient. The response provides an incomplete or inaccurate plan for treatment and management, including pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. The rationale for the plan is inaccurate or missing. … The health promotion and patient education strategies are incomplete or missing.

    25
     pts

    This criterion is linked to a Learning Outcome
    • Reflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), social determinates of health, health promotion, and disease prevention that takes into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

    5
     
    to >
    4.0
     pts

    Excellent

    Reflections are thorough, thoughtful, and demonstrate critical thinking.

    4
     
    to >
    3.5
     pts

    Good

    Reflections demonstrate critical thinking.

    3.5
     
    to >
    3.0
     pts

    Fair

    Reflections are somewhat general or do not demonstrate critical thinking.

    3
     
    to >
    0
     pts

    Poor

    Reflections are incomplete, inaccurate, or missing.

    5
     pts

    This criterion is linked to a Learning Outcome
    Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).

    10
     
    to >
    8.0
     pts

    Excellent

    The response provides at least three current, evidence-based resources from the literature to support the assessment and diagnosis of the patient in the assigned case study. The resources reflect the latest clinical guidelines and provide strong justification for decision making.

    8
     
    to >
    7.0
     pts

    Good

    The response provides at least three current, evidence-based resources from the literature that appropriately support the assessment and diagnosis of the patient in the assigned case study.

    7
     
    to >
    6.0
     pts

    Fair

    Three evidence-based resources are provided to support the assessment and diagnosis of the patient in the assigned case study, but they may only provide vague or weak justification.

    6
     
    to >
    0
     pts

    Poor

    Two or fewer resources are provided to support the assessment and diagnosis decisions. The resources may not be current or evidence based.

    10
     pts

    This criterion is linked to a Learning Outcome
    Written Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list.

    5
     
    to >
    4.0
     pts

    Excellent

    Uses correct APA format with no errors

    4
     
    to >
    3.5
     pts

    Good

    Contains a few (one or two) APA format errors

    3.5
     
    to >
    3.0
     pts

    Fair

    Contains several (three or four) APA format errors

    3
     
    to >
    0
     pts

    Poor

    Contains many (five or more) APA format errors

    5
     pts

    This criterion is linked to a Learning Outcome
    Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and punctuation

    5
     
    to >
    4.0
     pts

    Excellent

    Uses correct grammar, spelling, and punctuation with no errors

    4
     
    to >
    3.5
     pts

    Good

    Contains a few (one or two) grammar, spelling, and punctuation errors

    3.5
     
    to >
    3.0
     pts

    Fair

    Contains several (three or four) grammar, spelling, and punctuation errors

    3
     
    to >
    0
     pts

    Poor

    Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding

    5
     pts

    Total Points: 
    100 ASSESSING, DIAGNOSING, AND TREATING ADULTS WITH MOOD DISORDERS Focused SOAP Note

  • ANALYSIS OF A PERTINENT HEALTHCARE ISSUE – Nurse Staffing ESSAY

    Analysis of a Pertinent Healthcare Issue – Nurse Staffing Essay

    Analysis of Pertinent Healthcare Issues

    With a rising number of people insured by government-sponsored health insurance schemes, concern has emerged regarding how to meet the nation’s healthcare demands. Although financial investments have increased, human resources have not kept pace with the growing number of patients who require healthcare services (Carthon et al., 2019). This is especially true given the growing elderly population eligible for Medicare and Medicaid. This problem has spread to healthcare facilities, including where I work.

    Nurse staffing is essential to patient outcomes, especially the quality of care provided to patients. Several studies have been conducted to investigate the impact of nurse staffing on patient outcomes, with the majority claiming that decreased nurse staff numbers resulted in missed care, an upsurge in nursing errors, and poor patient outcomes (Carthon et al., 2019) Analysis of a Pertinent Healthcare Issue – Nurse Staffing Essay. Similarly, inadequate nurse staffing levels lead to relatively low satisfaction and higher burnout among nurses.

    ORDER A PLAGIARISM-FREE ESSAY HERE

    The rising number of patients in the organization where I work has steadily put pressure on the nurses, with an increase in the frequency of floating in even more than one unit. However, handling an expanded range of patients employing short-term approaches such as floating will not be appropriate in the long run, necessitating the development of a more definite solution. Data collected in the previous year at the facility where I work revealed an increase in the instances of missed nursing care. Although some cases did not result in tragic consequences, they did represent a risk to the patient’s general well-being. The next part uses two chosen articles to illustrate the scope of the problem and show how other healthcare institutions have addressed the shortage of nurses amid the rising patient population.

    Summary of Studies On the Healthcare Issue

    The first article chosen was a study by Griffiths et al. (2018) that found an apparent connection between low nurse staffing and poor patient outcomes, such as mortality in inpatient institutions. The researcher continued by arguing that using missing care could be a more accurate way to determine if nurse staffing levels are acceptable or that it could be a valuable way to determine the causal relationship between nurse staffing levels and their effects. Low staffing numbers resulted in a high rate of missed care, which, according to the study, caused poor patient outcomes. According to the study’s findings, missing care was thought to be a reliable measure for determining nurse staffing levels in a healthcare facility.

    The second research was carried out by Cho et al. (2016). The article’s main goal was to establish a link between nurse staffing, the workplace, and patient outcomes. The observed elements that affected the level of job satisfaction among the nursing staff were primarily connected to the independent variables identified. According to the report, there are more instances of incorrect medicine administration, missing care, and impaired patient safety due to insufficient nurse staffing and a poor working environment Analysis of a Pertinent Healthcare Issue – Nurse Staffing Essay.

    Other organizations tackle nurse staffing concerns in various ways, including ensuring that there is as little employee turnover as possible within the health institution. Nurses are in high demand because of the increasing number of patients requiring their services (Boamah et al., 2018). As a result, most are eager to work for firms that will provide improved working conditions. This is when organizational leadership plays a role.

    Working circumstances for healthcare staff will be excellent with good leadership, resulting in high work satisfaction and minimal nurse turnover. This indicates that the number of employees will remain the same. Another strategy for dealing with nurse staffing difficulties is developing a formal staffing plan with nursing personnel. A rigid staffing structure is not appropriate in an ever-changing environment, and a more flexible employment plan will assist the hospital in dealing with unequal nurse-to-patient ratios.

    Strategies Used to Address the Healthcare Issue

    Several recommendations were made based on the research chosen to address the issue of inadequate nurse staffing ratios. One suggested method is to develop successful techniques for increasing nurse staffing and improving working conditions, which will also address the issue of nurse turnover (Cho et al., 2016). Implementing this method will benefit the business by allowing nurses to work more effectively and with less burnout, resulting in better patient outcomes. The negative effect is that the organization will most likely need to increase its labor spending, which may need more resources.

    Another technique was to utilize missing care as an indicator to determine changes in policy in nurse staffing ratios. This was thought to be a more practical unit of measurement for raising the sufficiency of nurse staffing ratios (Griffiths et al., 2018). Analysis of a Pertinent Healthcare Issue – Nurse Staffing Essay This strategy is advantageous because the institution will alter its case-by-case staffing basis instead of having a fixed system of analyzing nurse staffing needs. The disadvantage of this method is that it’s more reactive than proactive.

    Conclusion

    To sum it up, nurse staffing is a critical healthcare issue that must be addressed at national and corporate levels to ensure better patient outcomes.

     

    References

    Boamah, S. A., Laschinger, H. K. S., Wong, C., & Clarke, S. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. 
    Nursing Outlook
    , 
    66
    (2), 180-189.

    Carthon, J. M. B., Davis, L., Dierkes, A., Hatfield, L., Hedgeland, T., Holland, S., … & Aiken, L. H. (2019). Association of nurse engagement and nurse staffing on patient safety. 
    Journal of nursing care quality
    , 
    34
    (1), 40.

    Cho, E., Chin, D. L., Kim, S., & Hong, O. (2016). The relationships of nurse staffing level and work environment with patient adverse events. 
    Journal of Nursing Scholarship
    , 
    48
    (1), 74-82.

    Griffiths, P., Recio‐Saucedo, A., Dall’Ora, C., Briggs, J., Mariotti, A., Meredith, P., … & Missed Care Study Group. (2018). The association between nurse staffing and omissions in nursing care: a systematic review. 
    Journal of advanced nursing
    , 
    74
    (7), 1474-1487.

     

    To Prepare:

    Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.

    Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected Analysis of a Pertinent Healthcare Issue – Nurse Staffing Essay.

    Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.

    The Assignment (2-3 Pages):

    Analysis of a Pertinent Healthcare Issue

    Develop a 2 to 3 page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:

    Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).

    Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.

    Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively Analysis of a Pertinent Healthcare Issue – Nurse Staffing Essay. Be specific and provide examples.

  • Off-label prescribing FOR CHILDREN AND ADOLESCENTS : NRNP-6665 WEEK 3 Assignment

    Off-label prescribing FOR CHILDREN AND ADOLESCENTS : NRNP-6665 WEEK 3 Assignment

    Prescribing Medications for Children and Adolescents with Major Depressive Disorder (MDD)

    Major depressive disorder, or MDD, is a depressive disorder characterized by feelings of worthlessness, suicidality, low self-esteem, depressed mood, and a lack of enjoyment of pleasurable activities that were previously enjoyed (APA, 2022). Listings are diagnostic criteria in the fifth edition of the
    Diagnostic and Statistical Manual of Mental Disorders
    or DSM-5-TR that must exist for the diagnosis. Its treatment in children and adolescents involves using pharmacotherapy and psychotherapy or other nonpharmacologic strategies (Pataki & Carlson, 2016). The pharmacologic treatment makes use of FDA-approved and non-FDA-approved (off-label) medications.

    An FDA-Approved, an Off-Label, and a Nonpharmacologic Intervention for MDD

    One of the FDA-approved medications for treating MDD is fluoxetine (Prozac). It is a selective serotonin reuptake inhibitor or SSRI (Stahl, 2017). It is the drug I would recommend for the treatment of MDD in children and adolescents. It is supposed to be given to children and adolescents aged eight years and above. According to Braüner et al. (2016) found that about 32.3% of all psychiatric prescriptions for children and adolescents are off-label. Sertraline (Zoloft) which is another SSRI, is the off-label medication I would recommend for treating major depression in children and adolescents.

    BUY A PLAGIARISM-FREE ESSAY HERE

    Nonpharmacological interventions are also evidence-based, just like medications. Usually, they include psychoeducation and psychosocial treatments. A proven psychotherapeutic modality for managing MDD in children and adolescents as in adults is cognitive behavioral therapy or CBT (Shrestha et al., 2020). It encompasses the cognitive remodeling of restructuring, which is about changing the thought process.

    Risk Assessment

    Figuring out the effectiveness and safety of medications, particularly those not endorsed by the FDA, is a key component of the risk analysis that will be carried out to guide therapeutic results. Additionally, in-depth discussions with peers who have used it and had greater expertise are required. The risk analysis for the FDA-approved one will include assessing the likelihood of negative effects. The FDA-approved medication fluoxetine and the off-label sertraline have the advantage of being effective at treating MDD. Its risks, together with the off-label sertraline, include the possibility of agitation and insomnia, amongst other adverse effects (Stahl, 2017). These are taken into account in the risk assessment.

    Clinical Practice Guidelines

    There are indeed clinical practice guidelines in the management of depression. The guidelines recommend treatment with a dual approach of medications and psychotherapy (Gautam et al., 2017). In the guidelines, SSRIs are ideal because of their low side effects, effectiveness, and tolerability. Then again, CBT is preferred because of its proven effectiveness in resolving symptoms in those on medications. However, even with the guidelines prepared, treating depression, especially in children and adolescents, still requires careful critical clinical decision-making for each patient.

    Conclusion

    Major depressive disorder, or MDD, is a depressive disorder with a high morbidity and mortality rate in the general population. Its treatment can occasionally be challenging, especially in children and adolescents. However, the use of off-label prescriptions and nonpharmacologic strategies on top of FDA-approved drugs has proven effective. Available clinical practice guidelines support these recommendations Off-label prescribing FOR CHILDREN AND ADOLESCENTS : NRNP-6665 WEEK 3 Assignment .

     

    References

    American Psychiatric Association [APA] (2022).
    Diagnostic and Statistical Manual of Mental Disorders-Text Revision (DSM-5-TR), 5
    th
    ed
    . Author.

    Braüner, J.V., Johansen, L.M., Roesbjerg, T., & Pagsberg, A.K. (2016). Off-label prescription of psychopharmacological drugs in child and adolescent psychiatry.
    Journal of Clinical Psychopharmacology, 36
    (5), 500–507. 
    https://doi.org/10.1097/jcp.0000000000000559

    Gautam, S., Jain, A., Gautam, M., Vahia, V.N., & Grover, S. (2017). Clinical practice guidelines for the management of depression.
    Indian Journal of Psychiatry, 59
    (Suppl. 1), S34-S50.
    https://doi.org/10.4103/0019-5545.196973

    Pataki, C., & Carlson, G. A. (2016). Major depressive disorder among children and adolescents.
    FOCUS, 14
    (1), 10–14. 
    https://doi.org/10.1176/appi.focus.20150037

    Sadock, B.J., Sadock, V.A., & Ruiz, P. (2015).
    Synopsis of psychiatry: Behavioral sciences clinical psychiatry, 11
    th
    ed
    . Wolters Kluwer. Off-label prescribing FOR CHILDREN AND ADOLESCENTS : NRNP-6665 WEEK 3 Assignment

    Shrestha, M., Lautenschleger, J., & Soares, N. (2020). Non-pharmacologic management of attention-deficit/hyperactivity disorder in children and adolescents: A review.
    Translational Pediatrics, 9
    (S1), S114–S124. 
    https://doi.org/10.21037/tp.2019.10.01

    Stahl, S.M. (2017).
    Stahl’s essential psychopharmacology: Prescriber’s guide, 6
    th
    ed
    . Cambridge University Press.

     

    PRESCRIBING FOR CHILDREN AND ADOLESCENTS

    Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

    —Agency for Healthcare Research and Quality

    Psychotropic drugs are commonly used for children and adolescents to treat mental health disorders, yet many of these drugs are not FDA approved for use in these populations. Thus, their use is considered “off-label,” and it is often up to the best judgment of the prescribing clinician. As a PMHNP, you will need to apply the best available information and research on pharmacological treatments for children in order to safely and effectively treat child and adolescent patients. Sometimes this will come in the form of formal studies and approvals for drugs in children. Other times you may need to extrapolate from research or treatment guidelines on drugs in adults. Off-label prescribing FOR CHILDREN AND ADOLESCENTS : NRNP-6665 WEEK 3 Assignment  Each individual patient case will need to be considered independently and each treatment considered from a risk assessment standpoint. What psychotherapeutic approach might be indicated as an initial treatment? What are the potential side effects of a particular drug?

    For this Assignment, you consider these questions and others as you explore FDA-approved (“on label”) pharmacological treatments, non-FDA-approved (“off-label”) pharmacological treatments, and nonpharmacological treatments for disorders in children and adolescents.

    Reference:

    Agency for Healthcare Research and Quality. (2015). 
    Off-label drugs: What you need to know.
     
    https://www.ahrq.gov/patients-consumers/patient-involvement/off-label-drug-usage.html
    Links to an external site.

    RESOURCES

     

    Be sure to review the Learning Resources before completing this activity.

    Click the weekly resources link to access the resources.

    WEEKLY RESOURCE

    TO PREPARE

    Your Instructor will assign a specific disorder for you to research for this Assignment.

    Use the Walden library to research evidence-based treatments for your assigned disorder in children and adolescents. You will need to recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating this disorder in children and adolescents.

    THE ASSIGNMENT (1–2 PAGES)

    Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.

    Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?

    Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.

    Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.

    BY DAY 7 OF WEEK 3

    Submit
     your Off-label prescribing FOR CHILDREN AND ADOLESCENTS : NRNP-6665 WEEK 3 Assignment  Assignment.

    SUBMISSION INFORMATION

    Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the 
    Turnitin Drafts
     from the 
    Start Here
     area.

    BUY ESSAY HERE

    To submit your completed assignment, save your Assignment as 
    WK3Assgn1+last name+first initial.

    Then, click on 
    Start Assignment
     near the top of the page.

    Next, click on 
    Upload File
     and select 
    Submit Assignment
     for review.

    Rubric

    NRNP_6665_Week3_Assignment1_Rubric

    NRNP_6665_Week3_Assignment1_Rubric

    Criteria

    Ratings

    Pts

    This criterion is linked to a Learning Outcome
    In 1–2 pages, address the following: • Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.

    25
     
    to >
    22.0
     pts

    Excellent

    The response accurately and concisely explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents.

    22
     
    to >
    19.0
     pts

    Good

    The response accurately explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents.

    19
     
    to >
    17.0
     pts

    Fair

    The response somewhat vaguely or inaccurately explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents.

    17
     
    to >
    0
     pts

    Poor

    The response vaguely or inaccurately explains interventions that would be appropriate for treating the assigned disorder in children and adolescents. Interventions may not represent the three types of interventions required, or response may be missing.

    25
     pts

    This criterion is linked to a Learning Outcome
    • Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?

    25
     
    to >
    22.0
     pts

    Excellent

    The response accurately and concisely explains the risk assessment you would use to inform your treatment decision making. A concise and accurate explanation of the risks and benefits of each pharmacological intervention is provided.

    22
     
    to >
    19.0
     pts

    Good

    The response accurately explains the risk assessment you would use to inform your treatment decision making. An adequate explanation of the risks and benefits of each pharmacological intervention is provided.

    19
     
    to >
    17.0
     pts

    Fair

    The response somewhat vaguely or inaccurately explains the risk assessment you would use to inform your treatment decision making. The explanation of the risks and benefits of each pharmacological intervention is somewhat vague or inaccurate.

    17
     
    to >
    0
     pts

    Poor

    The response vaguely or inaccurately explains the risk assessment you would use to inform your treatment decision making. The risks and benefits of each pharmacological intervention is vague or inaccurate. Or, the response is missing.

    25
     pts

    This criterion is linked to a Learning Outcome
    • Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.

    25
     
    to >
    22.0
     pts

    Excellent

    The response accurately and concisely uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.

    22
     
    to >
    19.0
     pts

    Good

    The response accurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.

    19
     
    to >
    17.0
     pts

    Fair

    The response somewhat vaguely or inaccurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.

    17
     
    to >
    0
     pts

    Poor

    The response vaguely or inaccurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations. Or, the response is missing.

    25
     pts

    This criterion is linked to a Learning Outcome
    • Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Be sure they are current (no more than 5 years old). Attach the PDFs of your sources.

    10
     
    to >
    8.0
     pts

    Excellent

    The response provides at least three current, evidence-based resources from the literature to support the intervention recommendations. The resources reflect the latest clinical guidelines and provide strong justification for decision making.

    8
     
    to >
    7.0
     pts

    Good

    The response provides at least three current, evidence-based resources from the literature to support the intervention recommendations Off-label prescribing FOR CHILDREN AND ADOLESCENTS : NRNP-6665 WEEK 3 Assignment .

    7
     
    to >
    6.0
     pts

    Fair

    Three evidence-based resources are provided to support the intervention recommendations, but they may only provide vague or weak justification.

    6
     
    to >
    0
     pts

    Poor

    Two or fewer resources are provided to support the intervention recommendations. The resources may not be current or evidence based.

    10
     pts

    This criterion is linked to a Learning Outcome
    Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

    5
     
    to >
    4.0
     pts

    Excellent

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

    4
     
    to >
    3.5
     pts

    Good

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

    3.5
     
    to >
    3.0
     pts

    Fair

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.

    3
     
    to >
    0
     pts

    Poor

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time. No purpose statement, introduction, or conclusion were provided. 5  pts This criterion is linked to a Learning Outcome Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation 5   to >
    4.0
     pts

    Excellent

    Uses correct grammar, spelling, and punctuation with no errors

    4
     
    to >
    3.5
     pts

    Good

    Contains one or two grammar, spelling, and punctuation errors

    3.5
     
    to >
    3.0
     pts

    Fair

    Contains several (three or four) grammar, spelling, and punctuation errors

    3
     
    to >
    0
     pts

    Poor

    Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding

    5
     pts

    This criterion is linked to a Learning Outcome
    Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/narrative in-text citations, and reference list.

    5
     
    to >
    4.0
     pts

    Excellent

    Uses correct APA format with no errors

    4
     
    to >
    3.5
     pts

    Good

    Contains one or two APA format errors

    3.5
     
    to >
    3.0
     pts

    Fair

    Contains several (three or four) APA format errors

    3
     
    to >
    0
     pts

    Poor

    Contains many (five or more) APA format errors

    5
     pts

    Total Points: 
    100 Off-label prescribing FOR CHILDREN AND ADOLESCENTS : NRNP-6665 WEEK 3 Assignment

  • Patient Portals Essay

    Patient Portals Essay Main Post

    Within the healthcare world, there are many different problems and stressors facing the healthcare community at any given time. One issue that I feel has recently affected my practice is the creation of patient portals in response to a new national requirement dictating that patients have live access to their charts. The purpose of this Patient Portals Essay discussion post is to further describe this healthcare issue and how it has impacted my work setting as well as detail what changes have been implemented at my setting in response to this issue.

    In skilled nursing facilities or long-term care, patients have always had eventual access to their charts, but not immediate, live access. Historically, they have had to submit an official request for documents and wait a period of time before receiving paper copies. However, as healthcare technology has advanced further and further, patient charts have become almost completely electronic. It was inevitable, then, that the way patients interacted with their health records also change. Then, in 2016, a new regulation was passed called the 21
    st
     Century Cures Act (Arvisais-Anhalt et al., 2022). This regulation, in part, contained a requirement that by October 6, 2022, healthcare organizations give all patients live access to their electronic medical records (Durieux et al., 2022). As all healthcare organizations work towards the all-important Quadruple Aim, including the aim of improving patient experiences and outcomes, the hope is that patient portals can assist in this by encouraging patient involvement in their own care (Park et al., 2018).

    BUY A CUSTOM WRITTEN ESSAY HERE

    This new issue of patients having live access to their charts can impact long-term care facilities in a few different ways. First, it will be important for nurses and physicians to understand that patients are now going to be able to read their notes immediately after they are entered. This can potentially have an impact on the provider/patient relationship if a patient reads something in their chart that they disagree with or read a hard truth they are not ready to hear. For example, a provider charts on a diabetic patient who has the potential to lose their foot because they are failing to follow their diet or because they continue to smoke. Even though this documentation is true, if the patient reading it is not ready to hear this, they can respond negatively. Patient portals can also can affect facilities in a financial way. The development of patient portals and the software and manpower required to create and maintain them costs a significant amount of money. Organizations will have to factor this in as a new cost of doing business in healthcare that was not present before Patient Portals Essay. Smaller organizations may struggle to find the funds to comply.

    In response to this new regulation my organization has made numerous changes. First, they have had to work with a company to create patient portals for the facility, including the ability to create patient logins and passwords for access to their charts. Second, we have had to create new policies to encompass the use of these patient portals, and how to ensure that patient information is protected and HIPPA is followed. We have also had to add new documents to the patient admission packets that include information on patient portals and gives patients the option to participate or opt out. We have found that many older patients do not wish to have access to the portals while younger patients who are more used to this sort of technology are much more likely to participate Patient Portals Essay.

    Overall, even with all the struggles that have accompanied this new regulation, I feel that patients having live access to their charts is a positive change. One of our most significant roles as nurses is that of patient advocate and with the development of patient portals we must advocate for patients by encouraging them to participate in their own care and therefore advocate for themselves. The more a patient is able to understand and learn about their own disease process and plan of care, the more they are able to make informed decisions about it and anything that encourages this is certainly a worthy endeavor.

    References

    Arvisais-Anhalt, S., Lau, M., Lehmann, C. U., Holmgren, A. J., Medford, R. J., Ramirez, C. M.,

    & Chen, C. N. (2022). The 21st Century Cures Act and Multiuser Electronic Health

    Record Access: Potential Pitfalls of Information Release. 
    Journal of Medical Internet

    Research, 24
    (2), e34085. 
    https://doi.org/10.2196/34085
    Links to an external site.

    Durieux, B. N., DeCamp, M., & Lindvall, C. (2022). 21st Century Cures Act: ethical

    recommendations for new patient-facing products. 
    Journal of the American Medical

    Informatics Association, 29
    (10), 1818–1822. 
    https://doi.org/10.1093/jamia/ocac112
    Links to an external site.

    Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment

    models influence primary care and its impact on the Quadruple Aim. 
    Journal of the

    American Board of Family Medicine, 31
    (4), 588–604.

    https://doi.org/10.3122/jabfm.2018.04.170388
     
    Links to an external site.

     

    Patient Portals Essay response

    Good post!

    I have mixed feelings about patient portals. They became increasingly popular during the Covid-19 pandemic and allowed us to better serve our patients in unprecedented times. I know that they promote patient-centered care and allow our patients to be more actively involved in their plan of care, but I also believe they can cause a negative patient-provider relationship. I work in the mental health field, so I have also thought many times about patients seeing what I chart about them. There are times that I mention my patients being psychotic, delusional, or paranoid. If my patients were to read this as I am actively working with them, they may feel that they cannot trust me. So while these portals are meant to improve patient satisfaction, they may also jeopardize it. We must also consider health literacy when discussing the pros and cons of patient portal access. Health literacy describes how easily a patient can obtain, process, and understand basic health information (Yulong et al., 2015). If they read the information we chart, but do not understand it or know how to interpret the results, patients may make poor health-related decisions Patient Portals Essay. To tag along with your example, if their chart states that their A1c is 7.2mg/dL and they believe this to be within range, they may not change their dietary or exercise habits. As providers, it is important we remain diligent about educating our patients and do not rely on technology to explain everything.

    What I enjoy about the patient portals is the easy access to appointment reminders and medication information. In my experience, psychiatric patients struggle with compliance. Many of them forget about their appointments or do not have a way to organize their schedules/calendars. With the patient portal, patients are able to see when their next appointment is (Leung et al., 2019). Some portal systems even send notification reminders to the patients. Patient portals also allow our patients to review their medications to see what they are taking, what dosage is prescribed, how often they should be taking it, and when they are due for a refill. However, many patients stated they would not request a refill via their portal, and are more likely to call their pharmacy or physician’s office (Leung et al., 2019). With easy access to this information, patients are more likely to remain compliant with their medications. This will improve patient outcomes significantly.

    References:

    Leung, K., Clark, C., Sakal, M., Friesen, M., & Strudwick, G. (2019). Patient and Family Member Readiness, Needs, and Perceptions of a Mental Health Patient Portal: A Mixed Methods Study. 
    Studies in Health Technology and Informatics
    , 
    257
    , 266–270.

    Yulong, G., Orr, M., & Warren, J. (2015). Health literacy and patient portals. 
    Journal of Primary Health Care
    , 
    7
    (2), 172–175. https://doi.org/10.1071/hc15172 Patient Portals Essay

  • ETHICAL AND LEGAL FOUNDATIONS OF PMHNP CARE

    ETHICAL AND LEGAL FOUNDATIONS OF PMHNP CARE

    BY DAY 3 OF WEEK 2

    Briefly identify the topic you selected. Then, summarize the articles you selected, explaining the most salient ethical and legal issues related to the topic as they concern psychiatric-mental health practice for children/adolescents and for adults. Explain how this information could apply to your clinical practice, including specific implications for practice within your state. Attach the PDFs of your articles.

    Week 2 Discussion

    Ethical and Legal consideration of constraints

     

    Restraints is a clinical treatment method used in hospitals for many reasons, such as protecting manic patients from harming themselves or others and preventing demented patients from pulling out their tubes. There are three types of restraints: physical restraints, chemical restraints, and environmental restraints. It is usually the last resort for healthcare providers after all other interventions such as verbal de-escalation failed.

    Ethical Consideration of Restraints for Adult Patients

    Restraints usually happen in emergencies, healthcare providers will apply them against the patient’s will, which caused considerable ethical dilemmas in clinical. Considering the patient’s safety and autonomy, providers have to weigh the outcome of its use against the outcomes of not using it. Healthcare providers have to receive professional training about the protocols of restraints, familiar with evidence-based guidelines, and legal problems associated with restraints. When restraints are used, they should only limit the movements that may cause harm to the patients or others. Restraints should never be used for the caregiver’s convenience or threatening. If all other less restrictive treatments are failed, restraints are inevitable, providers will make sure that the patients still have their rights during the restraints. Also, the further need for restraints should be assessed continually by healthcare authorities, so, the restraints can be discontinued as soon as possible (Salehi, & others, 2019).

    BUY ESSAY HERE

    Legal Consideration for Restraints for Adult Patients

    Restraint should be used as a last choice and only be imposed when necessary to protect the patient from harming themselves or others. Patients’ rights should be always protected and promoted during the restraint period. Such as privacy, safety, and the right to be free from all forms of abuse or harassment. The attending physician must be consulted as soon as possible. Providers should debrief with the patient and family to discuss the previous interventions and alternatives to restraints. Each restraint order may only be renewed 4 hours later for adults, and it will expire within 24 hours. The restraint order must be discontinued at the earliest possible time (Public Health, 2018). The Code of Regulation also listed many other legal considerations related to restraints and seclusions.

    Ethical Consideration of Restraints on Children/Adolescents

    Physical restraint used for children and adolescents in mental health facilities requires particular ethical and legal consideration, it is often used as a reactive behavior management strategy for aggressive behaviors. We all realize that restraints limit the patient’s physical movement, and may cause some physical injuries if it is not used appropriately, but we can’t ignore that they could cause severe and long-term psychological consequences for children or adolescents who experienced restraints and seclusions (Nielson, 2021) ETHICAL AND LEGAL FOUNDATIONS OF PMHNP CARE.

    Providers need to understand the consequences of physical restraint on a child’s physical and mental well-being. Children and adolescents are mentally immature, they may feel defended, and they will experience anger, fear, anxiety, and many other negative emotions. According to some patients’ retrospect reviews, being physically restrained is a severely traumatic experience, it caused physical injury as well as psychological damage. Also, reports suggested that the use of restraint within mental health facilities can damage the therapeutic relationship between patients and healthcare providers.

     

    Legal Consideration to Restraints on Children/Adolescents

    Due to the tension between the patient’s right to freedom and the healthcare provider’s duty, healthcare providers may face potential claims of improperly detaining patients, false imprisonment, or harming children when restraints are applied. The use of restraints is among the most controversial practices in mental health care, especially for children and adolescents. Children and adolescents are considered the most vulnerable population among mental health patients. Federal and state law shared a desire to provide minor patients with the greatest protections regarding the usage of restraints and seclusion. Providers are mandated to notify the parents and legal guardians of the use of restraints as soon as possible, they will supply a copy of the restraint policy and obtain a written acknowledgment of the policy from the parents. (Neiman, Pelkey, & Holloway, 2016).

     

     

    References

    Nielson, S., Bray, L., Carter, B., & Kiernan, J. (2021). Physical restraint of children and adolescents in mental health inpatient services: A systematic review and narrative synthesis. Journal of child health care: for professionals working with children in the hospital and community, 25(3), 342–367. https://doi.org/10.1177/1367493520937152

    Neiman, E., Pelkey, E., & Holloway, M. (2016). An Analysis of Legal Issues-Child and Adolescent Behavioral Health, Part III: Patient Safety- Identifying and Addressing Legal Issues Involved When Treating Pediatric Patients with Behavioral Health Needs Teaching Hospitals and In-House Counsel Practice Groups, AUTHORS. https://lewisbrisbois.com/assets/uploads/email-files/Child_and_Adolescent_Behavioral_Health%2C_Part_III_-_Patient_Safety.pdf

    Public Health. (2018, October 1). Code of Federal Regulations. Www.govinfo.gov. https://www.govinfo.gov/content/pkg/CFR-2018-title42-vol5/xml/CFR-2018-title42-vol5-sec482-13.xml

    Salehi, Z., Najafi Ghezeljeh, T., Hajibabaee, F., & Joolaee, S. (2019). Factors behind ethical dilemmas regarding physical restraint for critical care nurses. Nursing Ethics, 27(2), 598–608. https://doi.org/10.1177/0969733019858711

     

    ETHICAL AND LEGAL FOUNDATIONS OF PMHNP CARE RESPONSE 1

    Your discussion piece on Restraints was informative. It got me thinking about recent and emerging trends in restraint use and isolation. I know that in my hospital there is a plan to move from restraining patients in a chair to using a bed. We are yet to see this change. This notwithstanding, studies have shown that seclusion and restraint use can be traumatic to patients (Chieze et al., 2019). The comprehensive systematic review by Chieze et. al. (2019) highlighted the negative physical and psychological impact of restraints on this patient population, especially those with a history of trauma. I remember working with a patient who was very disruptive and was pulling out all devices attached to him including extubating himself. He was subsequently physically restrained and placed in an enclosure bed. However, when the family was informed per protocol, they noted that the patient was a prisoner of war, and we were only traumatizing him further. This important part of the patient’s history should have been reflected in his plan of care and the use of physical restraints should have been contraindicated in this patient. As noted by this review, seclusion and restraint were associated with negative effects and they noted problems with arriving at any benefits. The study suggests a more robust patient-staff interaction and relationship which also makes me think of staffing ratios – are healthcare facilities adequately staffed to provide adequate patient-staff interaction to ameliorate or decrease the use of restraints? Meanwhile, I have observed that in my facility, the use of physical restraints is short (about two to four) as they are combined with chemical restraints (e-meds). The ideal for practice is non-malfeasance (do no harm).

    Thanks for provoking my thoughts with your discussion piece.

    Reference

    Chieze, M., Hurst, S., Kaiser, S., & Sentissi, O. (2019). Effects of Seclusion and Restraint in Adult Psychiatry: A Systematic Review. 
    Frontiers in Psychiatry
    , 
    10
    (491). https://doi.org/10.3389/fpsyt.2019.00491

     

     

    ETHICAL AND LEGAL FOUNDATIONS OF PMHNP CARE POST 2

    WEEK 2 DISCUSSIONS – Initial Post

    JUSTICE

    After reading 
    Just Mercy
    , I understood the meaning of justice as not being limited to the judiciary system and all the attending laws but the hope that the system can and will work equally for everyone (Stevenson, 2014), age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status (“Ethical Principles of Psychologists and Code of Conduct,” n.d.) notwithstanding. This is the essence of the Ethical Principles of Psychologists and Code of Conduct (Principle D). The principle of Justice, as noted by the Code of Conduct, is geared towards ensuring fairness and equitable access to competent psychiatric care for all. The other principles (Beneficence and Nonmaleficence,
     
    Fidelity and Responsibility, Integrity, and Respect for People’s Rights and Dignity) make sense in a paradigm where fairness and access is available to ensure that no harm is done, and patients are able to trust their providers (therapeutic alliance) to provide confidential and culturally sensitive evidence-supported care.

    Ethical Considerations for Adults

    While factors like income security, comorbid health conditions, the need for long-term care, nutrition, housing, abuse, neglect, and age discrimination are some of the ethical issues impacting care for the elderly, the issue of ethical considerations has loomed large in the area of consenting for genetic testing for this population. Lawrie et al. (2019) noted that early detection has not been linked to greater efficacy of treatment. However, they also note that the ethical considerations here are confidentiality, communicating, and sharing of research findings. On the issue of communication, they note that stigma associated with mental illness is a barrier to both delivering the result to the patient/family and disseminating pertinent significant research findings to the provider community. These considerations also apply to children and adolescents as parental consent are required – sometimes by adolescent patients deferring to parents and/or legal guardians, in most cases, to carry out research.

    Ethical Considerations for children/adolescents

    Adolescence is a period rife with gender issues and emerging gender identity. Kimberly et al. (2018) noted a disparity in the treatment outcomes of cisgender youths and youths with gender dysphoria. The authors urge for a more cautious approach to ensure access and equitable care for this population. Specifically, they advocate for ethical considerations for this population to be gender-affirming and tailored to achieve optimal treatment outcomes (beneficence), with minimal harm (nonmaleficence). The ethical considerations should have a focused treatment plan that supports autonomy for even children during times of rapid development with an emphasis on justice to provide that hope for the future with assured access to care.

    Legal Considerations for Adults

    As noted above, income security, health care decisions, long-term care, nutrition, housing, utilities, protective services, defense of guardianship, abuse, neglect, and age discrimination are some of the factors that come with adulthood and become even more significant with age. Bipeta (2019) cautions that the mentally ill have the same right as everyone else and must be treated with respect to the principles enshrined in the Code of Ethics ETHICAL AND LEGAL FOUNDATIONS OF PMHNP CARE. He warns of the need to treat each patient as a legal entity by understanding the unique aspects of each individual patient. He also recommends patience and learning over time for the practitioner to ensure that no harm comes to the patient in the process of care delivery to a mentally impaired patient.

    Legal Considerations for Children/Adolescents

    The issue of informed consent also looms large in caring for minors. Levin et al. (2022) note barriers to these include erroneous and biased professional assumptions, and inadequate initial assessments, which may lead to a paucity of information shared with the patients and their parents. They note that this is especially so with the gender dysphoric patient. At work, I noted that some children/adolescents have consented to treatment but have not shared their preferred gender identity with their parents/legal guardians. This limits the provider’s ability to share with the parents. According to Levin et al. (2019), this disagreement or disconnection from parents is a legal barrier to care. They also note that the presence of mental health problems may impair cognition and creates doubt about the minor’s ability to understand and be informed enough to consent to care.

    Application to Clinical Practice in Colorado

    It is important to practice within the Nurse Practitioner Scope of practice in Colorado. While the NP has full practice rights, it is important to have in mind the ethical and legal considerations noted above as they impact care. The age of consent for minors in CO has been lowered to 12 by the passing of Bill # HB17-1320. Even children as young as 10 can obtain psychotherapy treatment without parental consent. While the provider of care is protected by law, it is pertinent to have the Code of Conduct in mind to ensure that the principles of Beneficence and Nonmaleficence,
     
    Fidelity and Responsibility, Integrity, and Respect for People’s Rights and Dignity, and of course Justice are not compromised in the delivery of care to minors or the cognitively impaired mental patient ETHICAL AND LEGAL FOUNDATIONS OF PMHNP CARE.

     

    References

    Bipeta R. (2019). Legal and Ethical Aspects of Mental Health Care. 
    Indian journal of psychological medicine
    , 
    41
    (2), 108–112. 
    https://doi.org/10.4103/IJPSYM.IJPSYM_59_19
    Links to an external site.

    Ethical principles of psychologists and code of conduct. (n.d.). 
    Https://Www.apa.org
    . 
    https://www.apa.org/ethics/code/?item=3
    Links to an external site.

    Kimberly, L. L., Folkers, K. M., Friesen, P., Sultan, D., Quinn, G. P., Bateman-House, A., Parent, B., Konnoth, C., Janssen, A., Shah, L. D., Bluebond-Langner, R., & Salas-Humara, C. (2018). Ethical Issues in Gender-Affirming Care for Youth. 
    Pediatrics
    , 
    142
    (6), e20181537. 
    https://doi.org/10.1542/peds.2018-1537
    Links to an external site.

    Lawrie, S. M., Fletcher-Watson, S., Whalley, H. C., & McIntosh, A. M. (2019). Predicting major mental illness: ethical and practical considerations. 
    BJPsych Open
    , 
    5
    (2). 
    https://doi.org/10.1192/bjo.2019.11
    Links to an external site.

    Levine, S. B., Abbruzzese, E., & Mason, J. M. (2022). Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults. 
    Journal of Sex & Marital Therapy
    , 1–22. 
    https://doi.org/10.1080/0092623x.2022.2046221
    Links to an external site.

    Stevenson, B. (2014). 
    Just Mercy
    . Delacorte Press.

    ‌ Wiesen, K. (2022). 
    Nurse Practitioner Scope Of Practice By State – 2021
    . Www.nursingprocess.org. 
    https://www.nursingprocess.org/nurse-practitioner-scope-of-practice-by-state.html

     

    ETHICAL AND LEGAL FOUNDATIONS OF PMHNP CARE SAMPLE 2

    This
    discussion
    aims to discuss the ethical and legal considerations of involuntary hospitalization, the due process of civil commitment in adolescents and adults, and explain how this topic concerns psychiatric-mental health practice for children, adolescents, and adults.

    Involuntary hospitalization and due process of civil commitment

    In the United States, involuntary hospitalization, also known as civil commitment, is a legal intervention where individuals who pose a danger to themselves or others or are gravely disabled (unable to provide basic needs for food, clothing, or shelter) due to a psychiatric illness or substance abuse can be detained in a psychiatric hospital or receive supervised outpatient treatment for some length time (Gi Lee & et al., 2021).

    Under California law, short-term emergency detention often referred to as a “5150”, is when a person is held in legal custody for 72 hours. Only designated personnel, such as deputy officers, members of a mobile team, or mental health workers for psychiatric evaluation, can place a person on a 5150 legal hold.  After the 72-hour legal hold, a psychiatrist will evaluate the individual, after which the individual may be placed on a 14-day ‘5250’ involuntary hold or can agree to be admitted or discharged. The subsequent step is expected to continue if a court or psychiatrist orders a commitment extension for up to 14 days, subject to legal review (Gi Lee & et al., 2021).  Within four days after the patient is placed on a 14-day involuntary hold, there must be a certification evaluation hearing, also called a probable cause hearing.  The hospital/facility must present a substantiation as to why the patient necessitates further psychiatric management.  The patient is aided by a patient’s rights advocate who can rationalize why there is no need for an additional hospital stay.  A hearing deputy will decide whether or not there is probable cause to hold the patient in the hospital/facility against their will for a period not exceeding 14 days.

    Suppose the hearing officer decides there is probable cause, and the patient disagrees with the decision. In that case, the patient has the right to request a Writ of Habeas Corpus and have a hearing in the Superior court of the county where the patient is being held. The hospital may keep a patient for 180 days after the 5250 legal hold if they are still a danger to themselves or others.  In tremendous cases, when an adult has an extensive history of mental illness and non-adherence, family members or professional personnel may request an LPS (mental health) conservatorship; this gives an adult legal authority to make choices for a seriously mentally ill individual who cannot care for themselves.

    The purpose of commitment is to guarantee treatment for individuals who need treatment to alleviate the symptoms of psychiatric disorders that contribute drastically to an individual’s higher risk of harm to self or others (Nussbaum, 2020). A psychiatric patient with involuntary hospitalization often has overlapping vulnerabilities of language, sexual orientation, religion, and disrupted education. These vulnerabilities may either withhold vital services or deliver services coercively (Nussbaum, 2020).  Mental illness affects a person’s ability to make rational decisions and live a normal life. Sometimes, a patient’s capability to make choices is so incapacitated by a psychiatric illness that practitioners manage them against their will to restore their ability to make reasonable choices (Nussbaum, 2020).

     

    Applications to clinical practice and the specific implications for practice within California

    Practitioners are profoundly challenged to be ethical when a patient is involuntarily hospitalized due to civil commitment. When patients are held against their will, they are also intensely vulnerable to illness and social structure.  These situations obligate our profession to provide evidence-based patient care and advocate for better care of people with psychiatric disorders.  Civil commitment has obtained punitive legal criticism. The hearing process is criticized for being a “charade” for lacking a specific, meaningful chance for vulnerable individuals to dispute the liberty restriction they face (SAMSHA, 2020).

    In California, under the Lanterman-Petris Short Act (LPS), patients admitted under 5150 retain all their rights when hospitalized or receiving services, except for freely leaving the facility where they are admitted (SAMSHA, 2020).  Patients have all rights given to a voluntarily admitted patient.

    BUY ESSAY HERE

    The practitioners define the decision to commit a patient as resolving the pressure between the ethical principle of nonmaleficence and autonomy (Evans & et al., 2020).  They are obliged to predict the occurrence of a patient causing harm to themselves or others, consider when to intervene to avoid harm, and protect and warn those who may be harmed by the patient’s behavior.  As practitioners, we are guided to respect a patient’s ability to make choices and to neither unduly influence nor coerce a patient we are treating simultaneously. We should also act in ways not to cause harm to patients (SAMSHA, 2020).

     

    Ethical and legal issues concerning psychiatric-mental health practice for children/adolescents and adults

    In an article explored by Rice, Xing Tan & Li.  2021, adolescents navigated their treatment from admission to discharge.  Adolescents brought to the hospital by law enforcement officials after being placed under involuntary psychiatric hold because of the danger to themselves have a sense of shame that leads to tagging themselves negatively. The patient’s perceptions of their psychiatric mental health were too severe to be managed within standard community-based settings. Consequently, they were transferred to a locked psychiatric hospital for treatment.  The legal concern is that the patient has the right to privacy, human care, and dignity and cannot be denied this right as a situation of admission or as part of a treatment strategy.  In this study, it was established that practitioners should advocate an appropriate treatment intervention to meet the adolescent’s needs and revealed significant insight into ways of engaging and explaining the treatment to avoid rehospitalizations.

    In another article researched by Jones & et al., 2021 adolescents who experience involuntary hospitalizations positively and negatively impact their mental health treatment.  In this study, the participants describe the negative impact of involuntary hospitalization.  The participants reported distrust and inability to disclose their suicidal feelings as the environment was more punitive than therapeutic. Others suggested examination and evaluation be constantly incorporated into the clinical practice and addressed the need to evaluate interventions intended to promote patient-centered practices in hospitals (Jones & et al., 2021). Any time a right is denied under a “good cause,” it must be acknowledged in the patient’s medical record and clarified to the patient ETHICAL AND LEGAL FOUNDATIONS OF PMHNP CARE.

    In an article by Gather & et al., 2019 an adult patient who is actively psychotic and dangerous to themself and others is no longer considered competent to evaluate their need for psychiatric health services. The article substantiates that a commitment promotes the ethical obligation of the practitioner to encourage beneficence to the patient.  Involuntary hospitalization during this course becomes essential to treating the adult patient and initiating preventive services to promote patient and public safety (Gather & et al., 2019).

    According to the article “Incidences of Involuntary Psychiatric Detentions in 25 U.S. States,” involuntary hospitalization in adults improves the patient’s clinical condition and overall well-being and protects their safety and others while valuing their rights (Gi Lee & et al., 2021).

    It is imperative to balance the significance of self-determination and the social responsibility to care for a person with a lessened capacity to act in their best interest (Gi Lee & et al., 2021).

     

    References

     

    Evans, E. A., Harrington, C., Roose, R., Lemere, S., & Buchanan, D. (2020).  Perceived Benefits and Harms of Involuntary Civil Commitment for Opioid Use Disorder. 
    The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics
    , 
    48
    (4), 718–734.  
    https://doi.org/10.1177/1073110520979382
    Links to an external site.

    Gather, J., Kalagi, J., Otte, I., & Juckel, G. (2019). Interviewing a Person with Bipolar Disorder Under Involuntary Commitment: A Case Report. 
    Journal of Empirical Research on Human Research Ethics: JERHRE
    , 
    14
    (5), 472–474.  
    https://doi.org/10.1177/1556264619847322
    Links to an external site.

    Gi Lee, M. S. W., & David Cohen, M. (2021).  Incidences of Involuntary Psychiatric Detentions in 25 U.S. States. 
    Psychiatric Services
    , 
    72
    (1), 61–68.  
    https://doi.org/10.1176/appi.ps.201900477
    Links to an external site.

    Jones, N., Gius, B. K., Shields, M., Collings, S., Rosen, C., & Munson, M. (2021).  Investigating the impact of involuntary psychiatric hospitalization on youth and young adult trust and help-seeking in pathways to care. 
    Social Psychiatry and Psychiatric Epidemiology
    , 
    56
    (11), 2017–2027.  https://doi.org/10.1007/s00127-021-02048-2

    Nussbaum, A. M. (2020). Held Against Our Wills: Reimagining Involuntary Commitment. 
    Health Affairs (Project Hope)
    , 
    39
    (5), 898–901.  
    https://doi.org/10.1377/hlthaff.2019.00765
    Links to an external site.

    Rice, J. L., Tan, T. X., & Li, Y. (2021).  In their voices: Experiences of adolescents during involuntary psychiatric hospitalization. 
    Children and Youth Services Review
    , 
    126
    .  
    https://doi.org/10.1016/j.childyouth.2021.106045
    Links to an external site.

    SAMSHA.  (2021).  Civil Commitment and the Mental Health Care Continuum: Historical Trends and Principles for Law and Practice.  
    https://www.samhsa.gov/sites/default/files/civil-commitment-continuum-of-care.pdf
    Links to an external site.

    D2.In their voices_ Experiences of adolescents during involuntary psychiatric hospitalization _ Elsevier Enhanced Reader.pdf
     
    Download D2.In their voices_ Experiences of adolescents during involuntary psychiatric hospitalization _ Elsevier Enhanced Reader.pdf

    D2.Held_Against_Our_Wills_Reimag.pdf
     
    Download D2.Held_Against_Our_Wills_Reimag.pdf

    D2.Investigating the impact of involuntary psychiatric hospitalization on youth and young adult trust and help-seeking in pathways to care.pdf
    Download D2.Investigating the impact of involuntary psychiatric hospitalization on youth and young adult trust and help-seeking in pathways to care.pdf

    D2.Incidences of Involuntary Psychiatric Detentions in25 U.S. States.pdf
     
    Download D2.Incidences of Involuntary Psychiatric Detentions in25 U.S. States.pdf

    D2.Interviewing.pdf
     
    Download D2.Interviewing.pdf
    ETHICAL AND LEGAL FOUNDATIONS OF PMHNP CARE

  • Nursing staffing shortage essay

    Nursing staffing shortage essay

    Post
     a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

    An ongoing national healthcare issue is the nursing staffing shortage. This has been a known and growing healthcare issue that has drastically worsened with the COVID-19 pandemic. The impacts of the COVID-19 pandemic brought increased attention to the long-standing staffing issues, which affect the quality and safety of patient care. These issues have been ongoing for decades and can result in many adverse outcomes. In March 2022, 28% of nursing facilities reported at a staffing shortage. (Ochieng, et. al., 2022). Nursing staffing shortage essay Fewer nurses means that more patients are assigned to each nurse, which can lead to patient safety issues. The pandemic placed a larger strain on healthcare, but it did not create the nursing shortage issue. (Zhavoronkova, 2022).

    BUY A CUSTOM WRITTEN ESSAY HERE

    This healthcare issue continues to impact my work setting in multiple ways. I currently work in outpatient thoracic cancer research. Due to staffing shortages, patients are experiencing delays in being started on research studies. These delays are in regards to not having the appropriate staff to complete necessary documents and scheduling to begin treatment. With these delays, this fragile oncology patient population can face adverse outcomes such as cancer growth, complications, and mortality while waiting for potential life-saving treatments. The infusion center that administers chemotherapy also continues to face staffing shortages, which means that they are sending all patients with urgent needs to the emergency room and do not have enough nursing time slots to schedule chemotherapy infusions without delays.

    My workplace has responded to critical staffing shortages by offering sign-on bonuses to new staff members and referral bonuses to current staff members. My facility has also been asking current staff members if they know of anybody who may be interested in a job, which can streamline the hiring process. The charge nurse in the infusion center has been taking a full patient assignment. Nursing staffing shortage essay This allows more patients to be scheduled and treated, but arises safety concerns as this ties up resources and takes focus away from training new staff, creating daily nursing schedules, and administrative duties. The facility has also allowed overtime to decrease patient acuity and allow for more infusions.

    References

    Ochieng, N., Chidambaram, P., Musumeci, M. (2022). Nursing Facility Staffing Shortages During the COVID-19 Pandemic. 
    KFF. 
    Retrieved November 29, 2022, from

    Nursing Facility Staffing Shortages During the COVID-19 Pandemic


    Links to an external site.

     

    Zhavoronkova, M., Custer, B., Neal, A. (2022). How to Ease the Nursing Shortage in America. 
    Center for American Progress. 
    Retrieved November 29, 2022, from

    https://www.americanprogress.org/article/how-to-ease-the-nursing-shortage-in-america/

     

    Nursing staffing shortage essay response

    Respond
     to at least 
    two
     of your colleagues 
    on two different days
     who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

    Response

    Heather, great post this week! I agree that staffing shortages are probably the most significant issue facing healthcare today. During the Covid-19 pandemic, the Department of Health and Human Services reported that approximately twenty-four percent of hospitals in the U.S. were experiencing some type of staffing shortage (Bourgault, 2022). As you stated, fewer staff means that patient loads rise to the point of being unsafe. In your field of thoracic cancer research, it sounds as though staffing shortages can mean that patient treatment gets delayed, and as we know, when it comes to cancer, time is of the essence.

    It sounds as though your organization has at least taken the proper steps to try and alleviate the shortage. Incentives such as sign on bonuses and referral bonuses have helped companies recruit new staff, although the market is more competitive than ever Nursing staffing shortage essay. Interestingly, the unprecedented nursing shortage has likely been partially affected by nurses such as ourselves furthering our careers. Between 2010 and 2017, for example, nurses obtaining graduate degrees such as their Nurse Practitioner’s license were responsible for the loss of approximately 80,000 RNs from the workforce (Buerhaus, 2022). Unfortunately, as you and I and the rest of our class continue our education, we will contribute to the nursing shortage when we eventually leave our positions. But at least we can serve our communities in other ways. Great job!

    References

    Bourgault, A. M. (2022). The Nursing Shortage and Work Expectations Are in Critical

    Condition: Is Anyone Listening? 
    Critical Care Nurse, 42
    (2), 8–11.

    https://doi.org/10.4037/ccn2022909
    Links to an external site.

    Buerhaus, P. I. (2021). Current Nursing Shortages Could Have Long-Lasting Consequences:

    Time to Change Our Present Course. 
    Nursing Economic$, 39
    (5), 247–250.

     

    Nursing staffing shortage essay sample post 2

    One of the national healthcare issues we are facing is the national nursing shortage. Although there are many schools and programs everywhere teaching nursing students, we often hear of a nursing shortage in many places, especially after the COVID-19 pandemic. Even at my workplaces, they recently hired a group of new nurses because they had been chronically short-staffed for quite a while. Many reasons for the national nursing shortage include that baby boom nurses began retiring in 2010’s, which resulted in a loss of 60,000 nurses each year, and the interest in becoming advanced practice nursing, nurse practitioners (NP’s), has grown quickly in the past few years. Wyngeeren and Stuart pointed out that the reasons for newly graduated nurses’ turnover are stressful work environments and lack of support (n.d.).

    In this case, because we cannot stop people from retiring, advancing their careers, or changing their career goals, retaining newly graduated nurses is essential for organizations to save money and have quality and safety of patient care. “Organizations must be cognizant of the transition required of new graduate nurses merging into professional practice and implement strategies to support their transition, which can result in increased retention rates” (Buerhaus, 2021). One way to help new graduate nurses with transitioning into professional practice is to provide orientation programs, “such as a preceptor model, and found this to have a positive impact on new graduate nurse retention” (Wyngeeren & Stuart, n.d.).

    However, I think most of the time, it is solely focused on new graduate nurses. At the facility I used to work, because they wanted to retain new graduate nurses, they advertised high starting pay, gave comparably easy patients to them, and provided a longer orientation program, which caused the senior nurses to complain that they did not feel like being cared as much as new graduate nurses. They got paid not as much as they deserved with their years of experience and had to take care of patients who were more acute and harder to deal with. We need experienced nurses to train and support new nurses, so supporting them is also important. “Some strategies to support preceptors include strong, evidence-based preceptor development courses; leadership support; collaborative partnerships; and continuing education with a career path” (Bodine, 2022).

     

    Bodine, J. (2022). Supporting Preceptors Through the Nursing Shortage. Journal for Nurses in Professional Development, 38 (5), 316-318. doi: 10.1097/NND.0000000000000928.

    Buerhaus, P. I. (2021). Current Nursing Shortages Could Have Long-Lasting Consequences: Time to Change Our Present Course. 
    Nursing Economic$
    , 
    39
    (5), 247–250.

    Wyngeeren, K. & Stuart T. (n.d.). Increasing new graduate nurse retention from a student nurse perspective. 
    Journal of Nursing.
     
    https://rn-journal.com/journal-of-nursing/increasing-new-graduate-nurse-retention-from-a-student-nurse-perspective
      Nursing staffing shortage essay

  • Healthcare Cost in the US Essay

    Healthcare Cost in the US Essay

    BY DAY 3 OF WEEK 1

    Post
     a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

    The Healthcare Cost 

    Healthcare expenditure is a major national concern in the America. In 2020, healthcare expenditure accounted for 20% of the nation’s GDP, up from 5% in 1960 (Health System Tracker). Moreover, the WHO (2021) reports that US healthcare spending constitutes more than 40% of the global healthcare expenditure. Healthcare Cost in the US Essay These costs do not translate to more or better healthcare services. Rather, Americans pay more for each healthcare interaction. Hence, it is necessary to understand the underlying factors, the impact on care settings, and the potential responses to the issue.

    Issue Description

    Healthcare is more expensive in the USA due to multiple administrative costs. For instance, there is the department of human and health services, Medicare, and Medicaid at the federal level. These agencies have representation in all the states, plus state-level boards, agencies, and legislative authorities. Coordinating all these entities is costly. Meanwhile, the country lacks effective control over drug pricing. Suppliers base their prices on the demand-supply metrics, resulting in the highest bearable price at any particular location. Lastly, healthcare costs are higher since providers focus on avoiding legal exposure, causing many potentially unnecessary procedures. Consequently, physicians order more tests per consumer than their counterparts in other parts of the world. These tests are also more expensive, such as the CT scan (97 dollars in Canada, 896 in the US) (Knox, 2018). Therefore, healthcare becomes a bigger financial burden Healthcare Cost in the US Essay.

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    Impact on Care Setting

    The exorbitant prices impede healthcare service delivery. First, psychiatric care practitioners struggle to promote mental well-being due to the prohibitive prices. Mental well-being is one of the more expensive healthcare routines in America. For instance, depression can cost up to ten thousand dollars annually. Comparatively, an insulin-dependent diabetes patient will spend 4,800 dollars (Nguyen & Mui, 2020). Hence, fewer people are unwilling to seek treatment. The steep prices also fuel the general disregard for psychiatric health. Some people see it as a profit-oriented sector, discouraging engagement. The reluctance is unfortunate since the population is struggling with multiple issues, including trauma, substance abuse, etc., that require specialized care. Therefore, healthcare costs impede the actual and potential delivery of clinical services to address individual and collective psychiatric needs.

    Response to Issue

    Psychiatric Healthcare professionals are responding to the cost-based challenge by developing more clinical solutions. For instance, Melnyk (2020) developed the Creating Opportunities for Personal Empowerment (COPE) program to enable teenagers to deal with mental health issues, such as anxiety and depression. The intervention resulted in fewer hospitalizations, reducing patient-specific costs by over 14,000 dollars. Additionally, caregivers are integrating digital tools, such as cognitive behavioral therapy apps and game-like experiences for individuals with less severe needs (Blumenfield & Levin-Scherz, 2020). The result is that more people can afford basic mental healthcare at a low cost. Additionally, these tools prevent psychiatric deterioration, resulting in fewer cost-intensive needs.

     Conclusion

    According to Park et al. (2018), the ideal payment model for primary care are to be determined, lessons learned from existing payment models can help guide the shift from volume-based to value-based care. Caregivers are unable to reach many people due to these costs. Also, the high prices cause the general public to develop a negative attitude towards psychiatric health treatment, exacerbating the problem.

    However, there is still the need to develop more sustainable and systematic solutions to make fundamental mental health treatment more affordable Healthcare Cost in the US Essay.

    References

    Blumenfield, S., & Levin-Scherz, J. (2020, Dec. 03). Digital Tools Are Revolutionizing Mental Health Care in the US 
    https://hbr.org/2020/12/digital-tools-are-revolutionizing-mental-health-care-in-the-u-s
    Links to an external site.

    Health System Tracker. (2022). Health expenditures 1960 – 2020. 

    National Health Spending Explorer


    Links to an external site.

    Knox, R. (2018, Mar. 13). Why Are US Health Costs the World’s Highest? Study Affirms ‘It’s The Prices, Stupid.’ 
    https://www.wbur.org/news/2018/03/13/us-health-costs-high-jha
    Links to an external site.

    Melnyk, B. M. (2020). Reducing healthcare costs for mental health hospitalizations with the evidence-based COPE program for child and adolescent depression and anxiety: a cost analysis. 
    Journal of Pediatric Health Care, 34
    (2), 117–121. 
    https://doi.org/10.1016/j.pedhc.2019.08.002
    Links to an external site.

    Nguyen, A., & Mui, K. (2020, Apr. 07). The Staggering Cost of Controlled and Uncontrolled Diabetes. 
    https://www.goodrx.com/conditions/diabetes-type-2/annual-cost-of-managing-diabetes-and-treating-uncontrolled-diabetes
    Links to an external site.

    Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). 
    How evolving United States payment models influence primary care and its impact on the Quadruple Aim Links to an external site.
     
    Links to an external site.
    . 
    Journal of the American Board of Family Medicine, 31
    (4), 588–604 Healthcare Cost in the US Essay.

    World Health Organization [WHO]. (2021). Global expenditure on health: Public spending on the rise? [PDF File]. 
    https://www.who.int/publications/i/item/9789240041219

     

    BY DAY 6 OF WEEK 1 – Healthcare Cost in the US Essay

    Respond
     to at least 
    two
     of your colleagues 
    on two different days
     who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

    Healthcare Cost in the US Essay response 1

    Thank you for your discussion and input regarding the costs of healthcare. This is another major concern than effects just about everyone! I was aware that healthcare is more expensive in America, but I didn’t realize that American providers were ordering more tests than other countries for legal reasons. I have found that even with good health insurance, the cost of healthcare has had an impact on my likeliness to seek medical care for myself. I always enjoy seeing how topics impact the mental health population in medicine, and I was not surprised to see that mental health ranked highly among the most expensive routines. Kan, et al. (2021) looked at the world-wide cost of major depressive disorder (MDD) and found that it’s “expected to be among the top three diseases with the highest global burden of disease in 2030. So many factors are involved in the cost and treatment of mental health. Even in the facility I work now there are discrepancies in cost for outpatient and inpatient services. Once I transitioned to an outpatient role and started to see how challenging it was to get care for patients, it was explained to me that outpatient doesn’t make the money for the company, inpatient is where they make profit. I find it disturbing that we put so much emphasis on the inpatient population rather than trying to prevent inpatient stays with outpatient services. Healthcare Cost in the US Essay Himmelstein & Woolhandler (2021) describe how healthcare systems are “big investors in hedge funds and private equity.” I agree that we have made some strides in combating the high costs of care, but much work needs to be done to bring population health and wellbeing to the forefront of consideration. Thank you for a great discussion post!

    Reference:

    Himmelstein, D. U., & Woolhandler, S. (2021). Health Care Crisis Unabated: A Review of Recent Data on Health Care in the United States. 
    International Journal of Health Services
    , 
    51
    (2), 182–187. https://doi.org/10.1177/0020731420981497

    Kan, K., Lokkerbol, J., Jörg, F., Visser, E., Schoevers, R. A., & Feenstra, T. L. (2021). Real-World Treatment Costs and Care Utilization in Patients with Major Depressive Disorder With and Without Psychiatric Comorbidities in Specialist Mental Healthcare. 
    PharmacoEconomics
    , 
    39
    (6), 721–730. 
    https://doi.org/10.1007/s40273-021-01012-x
    Links to an external site.

    Healthcare Cost in the US Essay response 2

    Healthcare costs are incredibly high. I had an X-ray when I hurt my back, and my copay was $350 at a rural hospital in the Midwest. X-Rays cost $600 and up. I also had to purchase a prescription savings plan to lower costs. I take two medications for high blood pressure and have allergies and back issues. Without the prescription savings plan, my medications would be about $300 a month. My copay for doctors’ visits is $20, and I pay half the cost of any procedure, including surgery and childbirth. The copay on an emergency room visit is $100.

    While working in a medical unit, I noticed that patients with insulin-dependent diabetes are admitted to the hospital to receive insulin they cannot afford at home. The nurse caseworkers assist them with costs to prevent future admissions Healthcare Cost in the US Essay.

    Blue cross blue shield (2022) reports that healthcare spending in the United States is 3 trillion yearly and rising. The factors causing high health insurance costs are prescription drug prices, chronic diseases, unhealthy lifestyles, and an aging population. Hospital systems use technology that monitors patients for risk factors using artificial intelligence to lower costs (Wolters Kluwer, 2022).

    I had the opportunity to do light duty at my hospital corporate office after I hurt my back. The department I worked in discussed the price of healthcare and why they had to exclude certain benefits from the health plan because adding them would increase the cost of the healthcare plan for the employees. At my hospital, some departments monitor healthcare costs and determine the best way to ensure everyone is insured at the lowest cost. However, the copays are still high and burden the employee.

    References

    Blue Cross Blue Shield. (2022). 
    Why does healthcare cost so much?
     
    https://www.bcbs.com/issues-indepth/why-does-healthcare-cost-so-much
    Links to an external site.

    Wolters Kluwer. (2022). 
    Reducing healthcare costs | Healthcare challenges
    . Retrieved December 3, 2022, from 
    https://www.wolterskluwer.com/en/know/healthcare-challenges/reducing-healthcare-costs
    Links to an external site. 
     Healthcare Cost in the US Essay

  • GCU RN-to-BSN Domains & Competencies and NRS-493 Individual Success Plan

    GCU RN-to-BSN Domains & Competencies and NRS-493 Individual Success Plan

    APPENDIX A:

    GCU RN-to-BSN Domains & Competencies

    University’s Mission Critical Competencies

    How does this Individual Success Plan support the GCU Mission?

    MC1: Effective Communication:
    Therapeutic communication is central to baccalaureate nursing practice. Students gain an understanding of their ethical responsibility and how verbal and written communication affects others intellectually and emotionally. Students begin to use nursing terminology and taxonomies within the practice of professional and therapeutic communication. Courses require students to write scholarly papers, prepare presentations, develop persuasive arguments, and engage in discussion that is clear, assertive, and respectful GCU RN-to-BSN Domains & Competencies and NRS-493 Individual Success Plan.

    BUY A PAGIARISM-FREE PAPER HERE

    MC2: Critical Thinking:
    Courses require students to use critical thinking skills by analyzing, synthesizing, and evaluating scientific evidence needed to improve patient outcomes and professional practice.

    MC3: Christian Worldview:
    Students will apply a Christian worldview within a global society and examine ethical issues from the framework of a clearly articulated system of professional values. Students will engage in discussion of values-based decisions made from a Christian perspective.

    MC4:

    Global Awareness, Perspectives, and Ethics:
    The concept of global citizenship is introduced to baccalaureate students in the foundational curriculum. Some courses will focus on the human experience across the world health continuum. The World Health Organization (WHO) definitions of health, health disparities, and determinants of health are foundational to nursing practice.

    MC5: Leadership:
    Students are required to develop skills and knowledge associated with their professional role. Courses require students to develop self-leadership skills such as time management, setting priorities, self-control, and evaluation of their abilities and performance.

     

    Domains and Competencies

    How does this Individual Success Plan support the Program Domains and Competencies?

    Domain 1: Professional Role

    Graduates of Grand Canyon University’s RN-BSN program will be able to incorporate professional values to advance the nursing profession through leadership skills, political involvement, and life-long learning.

    Competencies:

    1.1:
          Exemplify professionalism in diverse health care settings.

    1.2:
          Manage patient care within the changing environment of the health care system.

    1.3:
          Exercise professional nursing leadership and management roles in the promotion of patient safety and quality care.

    1.4:
          Participate in health care policy development to influence nursing practice and health care.

    1.5:
          Advocate for autonomy and social justice for individuals and diverse populations.

    GCU RN-to-BSN Domains & Competencies and NRS-493 Individual Success Plan

     

    Domain 2: Theoretical Foundations of Nursing Practice

    Graduates of Grand Canyon University’s RN-BSN program will have acquired a body of nursing knowledge built on a theoretical foundation of liberal arts, science, and nursing concepts that will guide professional practice.

    Competencies:

    2.1:
          Incorporate liberal arts and science studies into nursing knowledge.

    2.2:
          Comprehend nursing concepts and health theories.

    2.3:
          Understand and value the processes of critical thinking, ethical reasoning, and decision making.

    Domain 3: Nursing Practice

    Graduates of Grand Canyon University’s RN-BSN program will be able to utilize the nursing process to provide safe quality care based on nursing best practices.

    Competencies:

    3.1:
          Utilize the nursing process to provide safe and effective care for patients across the lifespan

    3.2:
          Implement patient care decisions based on evidence-based practice.

    3.3:
          Provide individualized education to diverse patient populations in a variety of health care settings.

    3.4:
          Demonstrate professional standards of practice.

    Domain 4: Communication/Informatics

    Graduates of Grand Canyon University’s RN-BSN program will be able to manage information and technology to provide safe quality care in a variety of settings. In addition, graduates will be able to communicate therapeutically and professionally to produce positive working relationships with patients and health care team members.

    Competencies:

    4.1:
          Utilize patient care technology and information management systems.

    4.2:
          Communicate therapeutically with patients.

    4.3:
          Promote interprofessional collaborative communication with health care teams to provide safe and effective care.

    Domain 5: Holistic Patient Care

    Graduates of Grand Canyon University’s RN-BSN program will be able to provide holistic individualized care that is sensitive to cultural and spiritual aspects of the human experience.

    Competencies:

    5.1:
          Understand the human experience across the health-illness continuum.

    5.2:
          Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups.

    5.3:
          Provide culturally sensitive care.

    5.4:
          Preserve the integrity and human dignity in the care of all patients.

     

    NRS-493 Individual Success Plan

    REQUIRED PRACTICE HOURS: 100 Direct Clinical Experience (50 hours community/50 hours leadership) – 25 Indirect Clinical Experience Hours.

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    Complete Contact Information

    Student Information

    GCU

    Name:

     

    E-mail:

     

     

    Phone Number:

     

     

    Course Faculty Information

    GCU

    Name:

    GCU RN-to-BSN Domains & Competencies and NRS-493 Individual Success Plan

    E-mail:

     

     

    Phone Number:

     

     

    Practicum Preceptor Information

    Practice Setting

    Name:

     

    E-mail:

     

     

    Phone Number:

     

     

     

     

     

    ISP Instructions

    Use this form to develop your Individual Success Plan (ISP) for NRS-493, the Professional Capstone and Practicum course. An individual success plan maps out what you, the RN-to-BSN student, needs to accomplish in order to be successful as you work through this course and complete your overall program of study. You will also share this with your preceptor at the beginning and end of this course so that he or she will know what you need to accomplish.

    In this ISP, you will identify all of the objectives and assignments relating to the 100 direct clinical practice experience hours and the 25 indirect clinical practice hours you need to complete by the end of this course. Use this template to specify the date by which you will complete each assignment. Your plan should include a self-assessment of how you met all applicable GCU RN-to-BSN Domains & Competencies (see Appendix A).

    General Requirements

    Use the following information to ensure successful completion of each assignment as it pertains to deliverables due in this course:

    Use the Individual Success Plan
    to develop a personal plan for completing your clinical practice experience hours and self-assess how you will meet the GCU RN-to-BSN University Mission Critical Competencies
    and
    the Programmatic Domains & Competencies (Appendix A) related to that course.

    Show all of the major deliverables in the course, the topic/course objectives that apply to each deliverable, and lastly, align each deliverable to the applicable University Mission Critical Competencies and the course-specific Domains and Competencies (see Appendix A).

    Completing your ISP does not earn clinical practice experience hours, nor does telephone conference time, or time spent with your preceptor.

    Within the Individual Success Plan,
    ensure you identify all graded course assignments and indirect clinical assignments listed in the table on the next page.

     

     

     

     

     

     

    Topic

    Graded Assignment

    Indirect Clinical Assignments

    Topic 1

    1.     Individual Success Plan

    2.     Reflection Journal Entry

    1.     List of potential topics for the change proposal

    Topic 2

    1.     Topic Selection Approval Paper

    2.     Reflection Journal Entry

    1.     Search the literature for supporting journal articles

    2.     Summary of topic category; community or leadership

    Topic 3

    1.     PICOT Question Paper

    2.     Reflection Journal Entry

    1.     List of objectives

    GCU RN-to-BSN Domains & Competencies and NRS-493 Individual Success Plan

    Topic 4

    1.     Literature Evaluation Table

    2.     Reflection Journal Entry

    1.     List of measurable outcomes

    Topic 5

    1.     Reflection Journal Entry

    1.     Summary of the strategic plan

    2.     Midterm Evaluation Tool

    Topic 6

    1.     Literature Review Table

    2.     Reflection Journal Entry

    1.     List of resources

    Topic 7

    1.     Reflection Journal Entry

    1.     Summary of the evaluation plan

    2.     Remediation-if required

    Topic 8

    1.     Benchmark Written Capstone Project Change Proposal

    2.     Reflection Journal Entry

     

    Topic 9

    1.     Reflection Journal Entry

    1.     Professional Presentation

    Topic 10

    1.     Finalized ISP

    2.     Scholarly Activity Summary

    3.     Benchmark-Reflection Journal Summary

    1.     Summary of presentation

    2.     Final Clinical Evaluation Tool

    3.     Practice Clinical Evaluation Tool-Agency

    4.     Practice Clinical Evaluation Tool-Preceptor

     

    Application-based Learning Course Assignments

    List of Current Course Objectives

    Assignment

    Date Due

    Self-Assessment:

    Programmatic Domains & Competencies

    (see Appendix A)

    Self-Assessment:

    GCU RN-to-BSN

    University Mission Critical Competencies

     (see Appendix A)

    Date

    Assignment

    Completed

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    GCU RN-to-BSN Domains & Competencies and NRS-493 Individual Success Plan

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    By typing in his/her signature below, the student agrees to have read, understood, and be accountable for the instructions, assignments, and hours shown above and that all questions have been satisfactorily answered by the faculty.

    Preceptors will sign upon initial receipt and at the end of the course to confirm that assignments have been complete with your guidance.

     

    Student Signature

    Name:

     

    Date:

     

    Preceptor Signature [Upon Initiation of Course]

    Name:

     

    Date:

     

    Preceptor Signature [Upon Completion of Course]

    Name:

     

    Date:

    GCU RN-to-BSN Domains & Competencies and NRS-493 Individual Success Plan

    .