Tag: Clinical-Nursing

Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Culturally Competent Care in Home Health Care issue essay

Review of Current Healthcare Issues

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption? Social Determinant such as environment/community, education, access/quality to healthcare?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

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 the Resources and select one current national healthcare issue/stressor to focus on.

Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

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. Which social determinant(s) most affects this health issue? 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.

By Day 6 of Week 1

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.

Culturally Competent Care in Home Health Care Issue Essay

Culturally Competent Care in Home Health Care

Culturally competent care is essential in-home health care, where patients come from diverse backgrounds. It ensures respectful and effective care, improving communication and patient trust (Shepherd et al., 2019). Without cultural competence, misunderstandings can occur, leading to poor health outcomes Culturally Competent Care in Home Health Care issue essay

Impact on Home Health Care

Home health providers work with patients from different cultures, languages, and beliefs. If caregivers lack cultural awareness, patients may struggle to follow treatment plans. For example, a Muslim patient may need dietary accommodations, while a Spanish-speaking patient may require a translator (Purnell & Fenkl, 2019). Often, our nurses encounter multiple challenges when patients struggle to follow doctors’ orders after hospitalization. This issue is most evident in patients for whom English is a second language or those with low literacy skills.

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Key Social Factors Affecting Culturally Competent Care

Language barriers
: Patients with limited English may misunderstand instructions.

Economic status
: Low-income patients may have trouble accessing culturally appropriate care.

Education and health literacy
: Different cultural beliefs affect how patients understand health conditions.

Bias and discrimination
: Implicit bias can lead to unequal treatment.

How Home Health Care Agencies Are Responding

To address these challenges, home health organizations are:

Providing Cultural Competency Training
: Staff receive education on cultural awareness and communication.

Offering Language Support
: Agencies use bilingual staff, interpreters, and translation apps.

Tailoring Care to Patient Needs
: Care plans respect cultural and religious preferences.

Updating Policies
: Agencies follow national standards for culturally appropriate care.

Culturally Competent Care in Home Health Care issue essay

For example, some agencies such as my workplace match Spanish-speaking patients with bilingual caregivers or adjust meal plans to fit religious diets.

Conclusion

Culturally competent care is vital for quality home health care. Addressing language barriers, training staff, and respecting cultural preferences improve patient outcomes and satisfaction.

References

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

Purnell, L. D., & Fenkl, E. A. (2019). Transcultural diversity and health care. In L. D. Purnell & E. A. Fenkl (Eds.), Handbook for culturally competent care(pp. 1–15).

Springer. https://doi.org/10.1007/978-3-030-21946-8_1

Shepherd, S. M., Willis-Esqueda, C., Newton, D., Sivasubramaniam, D., Paradies, Y., & Dunn, K. (2019). The challenge of cultural competence in the workplace: Perspectives

of healthcare providers. BMC Health Services Research, 19(1), 135. https://doi.org/10.1186/s12913-019-3959-7 Culturally Competent Care in Home Health Care issue essay

Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Heart Disease National Healthcare Issue 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. Which social determinant(s) most affects this health issue? 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.

Heart Disease National Healthcare Issue Essay

National Healthcare Issue: Heart Disease

Cardiovascular disease is a significant national health concern that continues to impact millions of people across the United States. Cardiovascular diseases (CVD), being the leading cause of death, account for about one in four deaths each year (Tsao et al., 2022). The occurrence of conditions such as coronary artery disease, heart failure, and arrhythmias imposes a significant strain on the healthcare system. However, the impact of heart disease extends beyond the healthcare system. It affects society’s social and economic structure, leading to decreased productivity due to illness and increased healthcare costs. Heart disease burdens healthcare providers, facilities, and resources, from initial diagnosis and prevention to efficient management and prolonged care.

Impact on the Work Setting

Heart disease significantly impacts daily operations in healthcare settings, particularly in telemetry departments. Telemetry units, which monitor patients with acute cardiac conditions, are experiencing increased patient volumes due to the rising rates of cardiovascular disease. The continuous monitoring of patients’ vital signs, such as heart rate and rhythm, blood pressure, and oxygen levels, is essential in managing those with heart disease. Nonetheless, as the need for this type of care rises, telemetry units encounter difficulties sustaining adequate staffing and handling a patient surge. This may result in extended wait times for admission, a higher patient-to-nurse ratio, and increased pressure on healthcare professionals to deliver prompt interventions. Furthermore, managing patients with multiple comorbidities common in individuals with heart disease adds complexity to their care, requiring multidisciplinary teams to collaborate effectively (Batchelor et al., 2023) Heart Disease National Healthcare Issue Essay.

Social Determinants Affecting Heart Disease

Several social determinants of health (SDOH) significantly influence the onset and advancement of heart disease. Socioeconomic status (SES) is one of the most significant factors, as individuals with lower SES are more likely to experience poor cardiovascular health due to limited access to healthcare, lower-quality diets, and increased stress levels (Yong et al., 2023). Additionally, individuals residing in low-income areas may lack access to healthcare facilities or preventive care, leading to delayed diagnoses and inadequate management of heart conditions. Access to healthcare is another key determinant, as individuals without insurance or with insufficient coverage may not have regular check-ups or timely interventions, leading to a deterioration of their health (Kris-Etherton et al., 2020). Health habits also impact heart disease, with poor lifestyle choices such as smoking, physical inactivity, and an unhealthy diet contributing significantly to cardiovascular risks. Environments that limit access to healthy foods or safe spaces for exercise exacerbate these factors, increasing the overall burden of heart disease, especially in disadvantaged communities.

Healthcare System Response and Changes Implemented

Healthcare systems have made several adjustments in response to the growing burden of heart disease. One significant change has been integrating advanced monitoring technologies in care settings. These technologies, such as continuous ECG monitors and remote patient monitoring systems, allow for real-time monitoring of patients, enabling healthcare providers to identify early signs of deterioration, such as arrhythmias before they become life-threatening. This proactive approach has improved patient outcomes by enabling timely interventions (Kuan et al., 2022) Heart Disease National Healthcare Issue Essay.

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Expanding telehealth services is another response to the increased demand for heart disease management. Telehealth allows healthcare providers to monitor patients remotely, which has been particularly beneficial for individuals with chronic heart conditions who may not require hospitalization but still need frequent monitoring. By utilizing telehealth platforms, healthcare systems can extend care beyond the hospital setting, offering greater patient convenience and reducing the burden on in-person resources (Kuan et al., 2022).

Additionally, healthcare systems have emphasized the importance of multidisciplinary care teams in managing heart disease. In these teams, cardiologists, nurses, dietitians, physical therapists, and pharmacists collaborate to provide comprehensive care that addresses the multiple aspects of heart disease management, from medication adherence to lifestyle modifications and rehabilitation. This approach has been particularly effective in improving long-term outcomes for patients with heart disease, as it ensures holistic care and fosters patient education and empowerment. The effectiveness of these teams in providing comprehensive care reassures patients and their families that they are receiving the best possible treatment, enhancing their confidence in the healthcare system (Batchelor et al., 2023).

In response to socioeconomic barriers to heart disease management, many healthcare organizations have worked to improve access to care through programs such as community health initiatives, mobile clinics, and expanded insurance coverage. These initiatives aim to bridge gaps in healthcare access, ensuring that individuals from underserved communities can receive timely interventions and preventive care. In addition, hospitals have implemented patient education programs to raise awareness about heart disease prevention, focusing on healthy lifestyle choices such as improved diet, regular exercise, and smoking cessation. These programs provide valuable information and empower individuals to take control of their health, fostering a sense of responsibility and encouraging proactive health behaviors. These programs also empower individuals to make informed decisions and take an active role in their well-being by equipping them with the knowledge and tools to manage their health (Kris-Etherton et al., 2020).

Heart disease remains a significant
healthcare issue
in the United States, with far-reaching consequences for individuals, healthcare providers, and systems. The increasing demand for care has highlighted the need for advanced technologies, expanded access to care, and interdisciplinary treatment approaches. While social determinants such as socioeconomic status and access to healthcare significantly affect the prevalence and outcomes of heart disease, healthcare systems have implemented strategies aimed at improving care and reducing disparities. These efforts are essential in addressing the ongoing challenges of heart disease and improving the quality of life for individuals affected by this condition (Tsao et al., 2022).

References

Batchelor, W. B., Anwaruddin, S., Wang, D. D., Perpetua, E. M., Krishnaswami, A., Velagapudi, P., Wyman, J. F., Fullerton, D., Keegan, P., Phillips, A., Ross, L., Maini, B., Bernacki, G., Panjrath, G. S., Lee, J., Geske, J. B., Welt, F., Thakker, P. D., Deswal, A., … Holmes, D. (2023). The multidisciplinary heart team in cardiovascular medicine: Current role and future challenges. 
JACC: Advances, 2
(1). 
https://doi.org/10.1016/j.jacadv.2022.100160
Links to an external site.

Kris-Etherton, P. M., Petersen, K. S., Velarde, G., Barnard, N. D., Miller, M., Ros, E., O’Keefe, J. H., Williams, K., Sr, Horn, L. V., Na, M., Shay, C., Douglass, P., Katz, D. L., & Freeman, A. M. (2020). Barriers, opportunities, and challenges in addressing disparities in diet-related cardiovascular disease in the United States. 
Journal of the American Heart Association, 9
(7), e014433. 
https://doi.org/10.1161/JAHA.119.014433
Links to an external site.

Kuan, P. X., Chan, W. K., Fern Ying, D. K., Rahman, M. A. A., Peariasamy, K. M., Lai, N. M., Mills, N. L., & Anand, A. (2022). Efficacy of telemedicine for the management of cardiovascular disease: A systematic review and meta-analysis. 
The Lancet Digital Health, 4
(9), e676–e691. 
https://doi.org/10.1016/S2589-7500(22)00124-8
Links to an external site.

Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., Boehme, A. K., Buxton, A. E., Carson, A. P., Commodore-Mensah, Y., Elkind, M. S. V., Evenson, K. R., Eze-Nliam, C., Ferguson, J. F., Generoso, G., Ho, J. E., Kalani, R., Khan, S. S., Kissela, B. M., … Martin, S. S. (2022). Heart disease and stroke statistics-2022 update: A report from the American Heart Association. 
Circulation, 145
(8), e153–e639. 
https://doi.org/10.1161/CIR.0000000000001052
Links to an external site.

Yong, C., Palaniappan, L., Ibebuogu, U., Tran, A., Bacong, A. M., Lundberg, G., & Watson, K. (2023). Assessing and addressing social determinants of cardiovascular health: JACC state-of-the-art review. 
Journal of the American College of Cardiology, 81
(14), 1368–1385. 
https://doi.org/10.1016/j.jacc.2023.01.042
Links to an external site.
Heart Disease National Healthcare Issue Essay

By Day 3 of Week 1 – Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Vascular Access Disparities on Dialysis Care 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. Which social determinant(s) most affects this health issue? 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.

 

Vascular Access Disparities on Dialysis Care Essay

The Impact of Vascular Access Disparities on Dialysis Care

One of the biggest challenges in healthcare today, especially for patients with kidney disease, is vascular access for dialysis. For patients who require hemodialysis, their access type can make a significant difference in their overall health. Ideally, an arteriovenous fistula (AVF) or graft (AVG) should be placed before starting dialysis, but many patients, particularly those from underserved communities, begin treatment with a central venous catheter (CVC) instead. Unfortunately, catheters come with serious risks, including a higher chance of infection, blood clots, and hospitalizations (Allon et al., 2018).

Social Determinants of Health and Vascular Access

It’s easy to assume that vascular access issues are just a medical problem, but in reality, social determinants of health (SDOH) play a major role. Many patients don’t receive early kidney care because of financial barriers, transportation issues, or a lack of awareness about their condition. Research shows that individuals from lower-income backgrounds are significantly more likely to start dialysis with a catheter rather than a fistula or graft, which increases their risk for complications (Pisoni et al., 2018). Additionally, education is a key factor—patients who don’t fully understand their condition and the importance of vascular access may not seek care in time, leading to last-minute catheter placements.

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How does this issue affect my work?

As a Clinical Educator RN, I see the consequences of vascular access disparities every day. When a patient starts dialysis with a catheter instead of a fistula or graft, it often leads to frequent hospitalizations due to infections or clotting. I’ve worked with patients who return to the clinic multiple times with bloodstream infections, requiring antibiotics, hospital stays, and sometimes even surgical interventions. This not only impacts patient quality of life but also strains healthcare resources, increasing costs and workload for providers (Ravani et al., 2013).

How is my organization addressing the issue?

Recognizing the serious impact of vascular access complications, my organization has taken several steps to improve outcomes:

Early Patient Education:
 We’ve expanded pre-dialysis education efforts, ensuring that patients and families understand why AVF placement is important.

Vascular Access Coordinators:
 Specialists now work closely with nephrologists and surgeons to schedule access procedures before dialysis starts.

Telehealth and Mobile Clinics:
 To address transportation barriers, we’ve increased telehealth options and set up mobile clinics for patients who struggle to reach appointments (Crews & Novick., 2018).

Community Partnerships:
 We collaborate with local health programs to identify at-risk patients early and connect them to the right care before they reach kidney failure.

Vascular Access Disparities on Dialysis Care Essay

These efforts have already made a difference—more patients are receiving timely AVF placements, and fewer are starting dialysis with a catheter. However, there’s still work to be done. Reducing health disparities requires continued advocacy, policy changes, and additional resources to ensure every patient has access to optimal vascular care.

Addressing social determinants of health isn’t just about
improving clinical outcomes
—it’s about improving lives. By tackling these barriers head-on, we can create a healthcare system that gives every patient the best chance for a healthier future.

References

Allon, M., Imrey, P. B., Cheung, A. K., Radeva, M., Alpers, C. E., Beck, G. J., Dember, L. M., Farber, A., Greene, T., Himmelfarb, J., Huber, T. S., Kaufman, J. S., Kusek, J. W., Roy-Chaudhury, P., Robbin, M. L., Vazquez, M. A., Feldman, H. I., & Hemodialysis Fistula Maturation (HFM) Study Group (2018). Relationships Between Clinical Processes and Arteriovenous Fistula Cannulation and Maturation: A Multicenter Prospective Cohort Study. 
American journal of kidney diseases: the official journal of the National Kidney Foundation, 71
(5), 677–689. 
https://doi.org/10.1053/j.ajkd.2017.10.027
Links to an external site.

Crews, D. C., & Novick, T. K. (2019). Social Determinants of CKD Hotspots. 
Seminars in nephrology, 39
(3), 256–262. 
https://doi.org/10.1016/j.semnephrol.2019.02.003
Links to an external site.

Pisoni, R. L., Zepel, L., Fluck, R., Lok, C. E., Kawanishi, H., Süleymanlar, G., Wasse, H., Tentori, F., Zee, J., Li, Y., Schaubel, D., Burke, S., & Robinson, B. (2018). International Differences in the Location and Use of Arteriovenous Accesses Created for Hemodialysis: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). 
American journal of kidney diseases: the official journal of the National Kidney Foundation, 71
(4), 469–478. 
https://doi.org/10.1053/j.ajkd.2017.09.012
Links to an external site.

Ravani, P., Palmer, S. C., Oliver, M. J., Quinn, R. R., MacRae, J. M., Tai, D. J., Pannu, N. I., Thomas, C., Hemmelgarn, B. R., Craig, J. C., Manns, B., Tonelli, M., Strippoli, G. F., & James, M. T. (2013). Associations between hemodialysis access type and clinical outcomes: a systematic review. 
Journal of the American Society of Nephrology: JASN, 24
(3), 465–473. 
https://doi.org/10.1681/ASN.2012070643
Links to an external site.
  Vascular Access Disparities on Dialysis Care Essay

Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Medicare reimbursement essay – National healthcare issue/ stressor 

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. Which social determinant(s) most affects this health issue? 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.

Medicare reimbursement essay – National healthcare issue/ stressor

Medicare reimbursement

Before 2011, home health agencies could bill Medicare for separate services such as therapy, nursing, or supplies. Medicare changed to bundled payment models in 2011. This created a single payment system where all costs of services and supplies are placed into one payment. The provider is then expected to cooperate with other disciplines and consider how to contain their cost for services and supplies into the new single payment. This payment is based on a case mix depending on the patient’s diagnosis and functional data. The more ill patients are, the higher the reimbursement. This was to prevent overutilization of services like therapy in previous payment systems. This change in payment has caused significant stress in the home health world.

How this has impacted my work setting

 
In the previous PPS system, the home health agency was paid for each service or supply needed.  For example, the agency had a tracheostomy patient with a gastrostomy and a urinary catheter and wounds. The nurse went out thrice weekly for wound care and managed the other medical needs. The home health agency was paid for the nurse’s visits and reimbursed for all wound supplies, catheter supplies, and tracheostomy supplies, from saline bullets to tracheostomy inner cannulas. The nursing payment didn’t matter if the nurse went daily fifty miles away or once a week, they received the same payment based on the patient condition. An additional payment was added for the therapy care if therapy was needed. The agency was paid half upfront and the other half once the care was given at the end of the sixty days. Example: Nursing costs $1200, therapy $2300, and supplies $3000 Medicare reimbursement essay – National healthcare issue/ stressor .

Today, here is an example of one of my current patients with bundled payment based on case mix. $2000 per 30-day period for everything, and this is a high payment. Some are less than $1000. So the nurse goes three times a week for wound care for a stage IV with a wound vac, PICC line care for IV therapy, a Gastrostomy tube, pure wick, and tracheostomy.  That payment must cover nursing, mileage, and supplies. Home health must order each monthly tracheostomy replacement, closed suction systems, inner cannulas, etc, through agencies like Medline. This is due to the higher reimbursement due to patients leaving the hospital. The MD then orders PT, OT, speech, MSW, and aide because of the complexity of care. This is not possible with the reimbursement if just the PT  evaluation is $90 plus mileage. This is why many agencies went under over the last 10 years, and many more closed when PDGM hit. There is no extra for an in-house biller, QA nurse, or marketer. Many agencies are barely surviving.

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The goal of home care when it comes to Medicare is to treat them, get them better then discharge them. What about this patient? These are chronic, long-term, or lifetime illnesses. The longer they stay on services, the less money you get. Outcomes-based reimbursement. Based on functional skills, if this patient is paralyzed, how do I get them better to discharge from services?

Most case mix prospective payment models rely on functional assessment and health-related data to project payment for home health care. This offers only a limited view of the patient’s needs and care in the home. One study used home nurses and health insurers to look at case mix characteristics in the home and found holistic care, such as social networking and mental functioning, to be important indicators of successful home health care (Van den Bulck 2022) Medicare reimbursement essay – National healthcare issue/ stressor .

Many countries are utilizing case-mix models for home health payment. Different models are used, and no one system is the most effective (Van den Bulck et al., 2020).

A study with cardiac patients in the hospital and ninety days post-discharge noted changes in spending costs, care utilization, or improvements by using a bundled payment model. Medicare reimbursement essay – National healthcare issue/ stressor

What social determinants affect this issue?

Fewer agencies are even willing to take complex patients like this because their payment is in the negative. They cannot discharge the patient either due to the patient’s needs.
Healthcare access
and quality is compromised. Different patients have different healthcare payments. They have more difficulty finding providers to care for them if they live in a rural area. Many therapy companies in my area will not travel to surrounding towns due to their decreased payment and use. Agencies must buy generic supplies due to cost Medicare reimbursement essay – National healthcare issue/ stressor .

Many of these patients are low-income or even middle-income, and cannot afford in-home care from providers, and do not qualify for state services. They cannot afford payments on DME like a hospital bed or a shower chair, so they do without. Patient safety is compromised. Patient outcomes are not improved. The bundled payment is a great idea for utilizing services more efficiently, but the payment is not enough to cover patient needs and expenses, much less for an agency to stay afloat. This is with zero profit for the agency.

How has my agency responded

My agency cannot accept medically complex patients like the one described. We cannot afford their supplies much less extra services. We purchase generic wound care supplies and ask for cheaper alternatives to expensive treatments that may have been used in the hospital. We have downsized staff to the bare minimum, and everyone wears multiple hats. Small companies are dying out in this system Medicare reimbursement essay – National healthcare issue/ stressor . These mom-and-pop shops give great personalized care. Hospitals are enduring the same and cutting costs wherever possible. The patient and the agencies giving their care are the ones paying the extra cost.

References

Shashikumar, S. A., Jie Zheng, Orav, E. J., Epstein, A. M., & Maddox, K. E. J. (2023). Changes in Cardiovascular Spending, Care Utilization, and Clinical Outcomes Associated With Participation in Bundled Payments for Care Improvement – Advanced. 
Circulation
, 
148
(14), 1074–1083. https://doi.org/10.1161/CIRCULATIONAHA.123.065109

Van den Bulck, A. O. E., de Korte, M. H., Elissen, A. M. J., Metzelthin, S. F., Mikkers, M. C., & Ruwaard, D. (2020). A systematic review of case-mix models for home health care payment: Making sense of variation. 
Health Policy (Amsterdam, Netherlands)
, 
124
(2), 121–132. 
https://doi.org/10.1016/j.healthpol.2019.12.012
Links to an external site.

Van den Bulck, A. O. E. 
et al.
 Identifying client characteristics to predict homecare use more accurately: a Delphi-study involving nurses and homecare purchasing specialists. 
BMC Health Services Research
, 
[s. l.]
, v. 22, n. 1, p. 1–10, 2022. DOI 10.1186/s12913-022-07733-9. Disponível em: https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=rzh&AN=155953624&site=eds-live&scope=site. Acesso em: 26 fev. 2025. Medicare reimbursement essay – National healthcare issue/ stressor

Walden University NURS-6053 Module 1: Discussion
– Opioid use disorder (OUD) Essay – National healthcare issue discussion post

Review of Current Healthcare Issues

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption? Social Determinant such as environment/community, education, access/quality to healthcare?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a
national healthcare issue
and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

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 the Resources and select one current national healthcare issue/stressor to focus on.

Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

Opioid use disorder (OUD) Essay – National healthcare issue discussion post

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. Which social determinant(s) most affects this health issue? 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.

 

Opioid use disorder (OUD) Essay – National healthcare issue discussion post

Opioid use disorder (OUD) is characterized by the persistent consumption of opioids resulting in clinically significant suffering or impairment. The symptoms of this sickness encompass an intense compulsion to utilize opioids, heightened opioid tolerance, and withdrawal syndrome upon cessation of opioid use. Consequently, OUD may encompass a spectrum from opioid dependency to addiction. Opioid Use Disorder (OUD) impacts more than 16 million individuals globally and exceeds 2.1 million in the United States. Opioid dependency and addiction result from a multitude of biochemical, environmental, genetic, and psychological influences. The majority of opioids in circulation are prescribed; however, a significant quantity is acquired unlawfully. Following a reasonably short duration, several people utilizing opioids exhibit opioid dependency Opioid use disorder (OUD) Essay – National healthcare issue discussion post. Opioid dependency may be present as physical dependence, psychological dependence, or a combination of both. Patients reliant on opioids will have withdrawal symptoms if opioids are discontinued suddenly. Consequently, numerous opioid-dependent individuals may want ongoing access to opioids, through either lawful or unlawful channels, to avert withdrawal symptoms. Persistent opioid dependency can result in addiction and unregulated opioid use (Dydyk et al., 2024).

 Impact On Work Setting.

Opioid Use Disorder has a significant impact on my work environment, affecting both healthcare professionals and patients. Patients often who have opioid use disorder sometimes resort to self-injurious behaviors to obtain prescriptions, which leads to a heavier workload and high emotional demands on staff. This can result in burnout and fewer healthcare providers, as many patients require complex, long-term care. Additionally, the high emotional demands and frequent exposure to trauma can contribute to fatigue and secondary traumatic stress among staff. According to Gabriel and Aguinis (2021), burnout arises from prolonged work-related stress. Individuals experiencing burnout are emotionally exhausted and exhibit negativity and detachment from their jobs, resulting in diminished performance, stifled creativity and innovation, workplace accidents, absenteeism, and both physical and mental health issues.

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Which social determinant(s) most affects this health issue

Opioid Use Disorder affects individuals across all educational and socioeconomic strata. Individuals at heightened risk for opioid use disorder include those with neurotransmitter deficiencies, particularly in dopamine, or those with first-degree relatives who have a drug use issue. Individuals exposed to an environment including opioid use may exhibit a heightened propensity for developing opioid use disorder. Environmental hazards for opioid use disorder (OUD) including peer consumption of opioids or exposure to opioid analgesics resulting from a prior injury. Individuals with a history of untreated depression, post-traumatic stress disorder, anxiety, or early trauma are at increased risk for opioid use disorder (Dydyk et al., 2024).

How  work setting has responded to the healthcare issue/what changes may have been implemented

In my workplace, healthcare providers have been using medications, including opioids in reduced dosages, to prevent withdrawals along with behavioral skills to treat patients with opioid use disorders; this increased patient recovery as well as discharge, reducing workload. According to Common Comorbidities with Substance Use Disorders Research Report (2020), behavioral treatment, whether administered independently or in conjunction with pharmacotherapy, is fundamental to achieving favorable long-term results for numerous persons afflicted with substance use disorders or other mental health conditions. Multiple treatments have demonstrated efficacy in addressing particular comorbid disorders.  Cognitive Behavioral Therapy (CBT) aims to alter detrimental attitudes and maladaptive behaviors, demonstrating significant effectiveness for people with drug use problems. Cognitive Behavioral Therapy is the most efficacious treatment for children and adolescents with anxiety and mood problems. Dialectical Behavior Therapy is particularly formulated to mitigate self-harm behaviors, encompassing suicidal ideations, attempts, self-injury, and substance abuse. This is one of the few therapies beneficial for patients diagnosed with borderline personality disorder.  Opioid use disorder (OUD) Essay – National healthcare issue discussion post

References

Common Comorbidities with Substance Use Disorders Research Report. (2020). National Institutes on Drug Abuse (US). https://www.ncbi.nlm.nih.gov/books/NBK571451/

Dydyk, A. M., Jain, N. K., & Gupta, M. (2024). Opioid Use Disorder. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK553166/

Gabriel, K. P., & Aguinis, H. (2021). How to prevent and combat employee burnout and create healthier workplaces during crises and beyond. Business Horizons, 65(2), 183–192. https://doi.org/10.1016/j.bushor.2021.02.037  Opioid use disorder (OUD) Essay – National healthcare issue discussion post

Advanced Pathophysiology of Acute Myelogenous Leukemia (AML) – NURS-6501 Week 2 Case Study Scenario

Week 2 Case Study Scenario

Case Study 2: Advanced Pathophysiology of Acute Myelogenous Leukemia (AML
)
A 45-year-old male presents to the hematology clinic with symptoms of progressive fatigue,
frequent bruising, and recurrent nosebleeds over the past few weeks. On physical examination,
he appears pale and has petechiae on his lower extremities. Blood tests reveal a white blood cell
count of 50,000/mm³ with 60% blasts, hemoglobin of 8.5 g/dL, and platelets of 25,000/mm³. A
bone marrow biopsy confirms the diagnosis of AML, showing hypercellularity with 70%
myeloblasts. Cytogenetic analysis reveals a FLT3-ITD mutation, placing him in the intermediate-
risk category.

In 1 -2 pages, answer the questions below in detail. You must use current evidence-based
resources to support your answers. Follow APA guidelines. Follow the grading rubric.

Questions:
1.
What is the primary cellular abnormality in AML?
2.
How does the accumulation of leukemic blasts affect normal hematopoiesis?
3.
What role do genetic mutations play in the development of AML?
4.
Why do patients with AML often present with symptoms like fatigue, infections, and
bleeding?
5.
What is the significance of Auer rods in the diagnosis of AML?
6.
What is the impact of AML on the immune system?
7.
How do treatment strategies target the pathophysiological mechanisms of AML?

 

Advanced Pathophysiology of Acute Myelogenous Leukemia (AML) – NURS-6501 Week 2 Case Study Scenario

Case Study Analysis

The severe blood malignancy known as acute myelogenous leukemia (AML) impairs the bone marrow’s capacity to produce healthy blood cells.  The symptoms of a 45-year-old male patient include increased fatigue, easy bruising, and frequent nosebleeds.  Laboratory tests show low hemoglobin levels, decreased platelet counts, and an increased white blood cell count with notable blast cells.  The diagnosis of AML is confirmed by a bone marrow biopsy, which shows hypercellularity with a significant proportion of myeloblasts.  He is classified as intermediate-risk due to the FLT3-ITD mutation, which is revealed by additional genetic investigation.  Understanding the anomalies in AML cells, as well as their genetic causes and immunological effects, is essential for the diagnosis and treatment of this illness.

Myeloblasts are immature white blood cells that do not go through the normal maturation processes, and their unrestrained multiplication is the cause of AML.  The development of these immature cells is disrupted by this shortage; as they aggregate in the bone marrow, they prevent the generation of healthy platelets, white blood cells, and red blood cells (Döhner et al., 2022).  Patients suffer from a range of symptoms as a result, from fatigue to heightened susceptibility to infections and bleeding episodes.  Hematopoiesis, the process by which blood cells normally grow, is severely disrupted by the quantity of leukemic blasts.

The excessive accumulation within investors obstructs adequate production rates for regular blood cell types leading to anemia which often causes lethargy due to decreased oxygen transport capabilities in the body. Furthermore, neutropenia results from insufficient functional white blood cell quantity contributing greatly to susceptibility toward infections while thrombocytopenia makes avenue for bruising easily despite minimal trauma hence explaining phenomena such as petechiae or recurrent nasal hemorrhages observed in this patient case (Borthakur & Kantarjian, 2021).

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Genetic mutations play a key role in AML development. The FLT3-ITD mutation found in this patient is associated with increased cell proliferation and poor prognosis. This mutation causes continuous activation of signaling pathways that promote cancer cell survival and growth. Other mutations, such as NPM1 or RUNX1, may also contribute to disease progression and treatment resistance (Williams et al., 2021).  Identifying these mutations helps in selecting the best treatment approach.

Patients with AML often experience fatigue, infections, and bleeding due to the shortage of normal blood cells. Fatigue results from anemia, as fewer red blood cells are available to carry oxygen throughout the body. Frequent infections occur because leukemic blasts replace normal white blood cells, which weakens the immune system. Bleeding problems arise from the lack of platelets, leading to symptoms like easy bruising, nosebleeds, and petechiae, as seen in this patient (Döhner et al., 2022).

Auer rods are important in diagnosing AML. They are rod-shaped structures found inside myeloblasts and are made up of fused lysosomes containing myeloperoxidase, an enzyme specific to myeloid cells. The presence of Auer rods confirms AML and helps differentiate it from other types of leukemia.

AML significantly affects the immunological system.  A shortage of healthy white blood cells weakens the immunological response.  This makes infections more likely, even from little wounds or common microorganisms.  Infections become more severe and more difficult to treat when the body’s defenses against viruses and fungi are compromised (Barrett, 2020).  Inflammation linked to AML can also further impair immunological function.

The molecular level of AML is the focus of treatment.  Chemotherapy is a common treatment used to destroy leukemic blasts and restore normal blood cell production.  One kind of targeted drug used to slow the disease’s progression and stop abnormal FLT3 signaling in patients with the FLT3-ITD mutation is midostaurin.  In order to reestablish normal hematopoiesis and increase survival prospects, some patients may need a bone marrow transplant to replace damaged cells with healthy donor cells (Döhner et al., 2022).

Conclusively, AML is a serious blood malignancy brought on by myeloblasts growing out of control.  Fatigue, infections, and bleeding are some of the symptoms caused by the disease’s disruption of normal blood cell synthesis.  Genetic abnormalities like FLT3-ITD are important in the development of AML and have an impact on therapy choices. The presence of Auer rods confirms AML diagnosis, and the immune system is severely weakened due to a lack of functional white blood cells. Treatment strategies focus on eliminating leukemic cells through chemotherapy, targeted therapy, and bone marrow transplantation. Understanding the underlying cellular processes in AML is crucial for effective management and patient education Advanced Pathophysiology of Acute Myelogenous Leukemia (AML) – NURS-6501 Week 2 Case Study Scenario.

 

References

Barrett, A. J. (2020). Acute myeloid leukaemia and the immune system: Implications for immunotherapy. British Journal of Haematology, 188(1), 147-158.
https://doi.org/10.1111/bjh.16310

Borthakur, G., & Kantarjian, H. (2021). Core binding factor acute myelogenous leukemia-2021 treatment algorithm. Blood Cancer Journal, 11(6).
https://doi.org/10.1038/s41408-021-00503-6

Döhner, H., Wei, A. H., Appelbaum, F. R., Craddock, C., DiNardo, C. D., Dombret, H., Ebert, B. L., Fenaux, P., Godley, L. A., Hasserjian, R. P., Larson, R. A., Levine, R. L., Miyazaki, Y., Niederwieser, D., Ossenkoppele, G., Röllig, C., Sierra, J., Stein, E. M., Tallman, M. S., … Löwenberg, B. (2022). Diagnosis and management of AML in adults: 2022 recommendations from an international expert panel on behalf of the ELN. Blood, 140(12), 1345-1377.
https://doi.org/10.1182/blood.2022016867

Williams, L., Doucette, K., Karp, J. E., & Lai, C. (2021). Genetics of donor cell leukemia in acute myelogenous leukemia and myelodysplastic syndrome. Bone Marrow Transplantation, 56(7), 1535-1549.
https://doi.org/10.1038/s41409-021-01214-z. 
 Advanced Pathophysiology of Acute Myelogenous Leukemia (AML) – NURS-6501 Week 2 Case Study Scenario

CASE: A 45-year-old male presents to the clinic with fatigue, unexplained bruising, and frequent nosebleeds. Blood tests reveal leukocytosis, anemia, and thrombocytopenia. A bone marrow biopsy confirms the diagnosis of acute myelogenous leukemia (AML)

Alterations in Cellular Processes

At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.

Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.

For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts. You must use current evidence-based resources (Primary and secondary) to support your initial posting and all responses to your colleagues.

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:

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

by day 3 of Week 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

Which genetic mutations are commonly associated with the disease?

Why is the patient presenting with the specific symptoms described?

Discuss the pathophysiological mechanisms of the disease in detail.

What do the blood test results tell us about the disease and disease progression?

CASE: A 45-year-old male presents to the clinic with fatigue, unexplained bruising, and frequent nosebleeds. Blood tests reveal leukocytosis, anemia, and thrombocytopenia. A bone marrow biopsy confirms the diagnosis of acute myelogenous leukemia (AML)

Which genetic mutations are commonly associated with the disease?

There are an abundant number of genes associated with Acute myelocytic leukemia (AML). There are four categories of driver mutations—transcription factor mutations, signaling protein mutations, epigenome mutations, and TP53, or genes that help regulate p53. FLT3, NPM1, and CEBPα are three specific gene mutations that can occur with AML that are well studied (Makkar et al., 2023).

Why is the patient presenting with the specific symptoms described?

The genetic alteration in the myeloid stem cell disrupts the production of specialized myelocytic blood cells, affecting the resulting blood components (Rogers, 2022).  Myelocytic blood cell specializations are red blood cells, platelets, and myeloblast. Myeloblast cells are precursor cells that create granulocytes—white blood cells. A common characteristic of AML is that white blood cells are abundant in the blood, specifically called leukocytosis. The overabundance of blast cells crowd out the other cells in the blood. Lack of red blood cells or malformation of red blood cells causes anemia, and would be the cause of the fatigue. Lastly, the platelets are affected like the red blood cells, either crowded out by blast cells or mutated. Due to this process, thrombocytopenia occurs, and the body cannot clot the blood effectively—explaining the nose bleeds and bruising.

Discuss the pathophysiological mechanisms of the disease in detail.

AML occurs when one or more gene mutations disrupt the hematopoiesis pathway within the bone marrow (Rogers, 2022). An example of a transcription mutation is the gene RUNX1. RUNX1 is a protein used for many cellular processes, and mutations in this gene disrupt the pathway for hemopoiesis, which can cause malformations (Kellaway et al., 2022). Some RUNX1 mutation formations are more serious than others, but all give a high risk for AML if AML does not occur from the gene mutation alone. PTPN11 is a signaling protein that regulates cells, cell growth, and differentiation (Makkar et al., 2023). The next mutation category is epigenome mutations, TET2 is an example, and this protein’s primary function is to be a catalyst for 5-methylcytosine to 5-hydroxymethylcytosine (Makkar et al., 2023).  The final category of mutations is TP53, or genes that help regulate p53. TP53 is a code for the P53 tumor suppressor protein, and disrupting either of these proteins would no longer allow the gene’s function (Rogers, 2022).

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All of the gene mutations that can occur in the many cellular pathways in the body lead to a disruption of cell function. There are a few different ways mutations can occur—chemotherapy or other toxins, Down syndrome or other hereditary conditions, and another cause is an underlying condition such as bone marrow disease (Rogers, 2022).

The cell mutations lead to an overproduction of immature myeloblasts that cannot undergo granulopoiesis or become granulocytes (Rogers, 2022). Overproduction of blast cells takes resources, energy, and space from the other cell production, causing leukocytosis, anemia, and thrombocytopenia.

What do the blood test results tell us about the disease and disease progression?

Lab values show that the progression of the patient’s AML is not far along; this disease progresses rapidly and is similar to all types of leukemia (Vakiti et al., 2024). The white blood cell count is low. At this stage, the patient has yet to have formed enough mast cells to fill the bone marrow and start leaking into the blood or the accompanying bone pain to indicate that the bone marrow is full of blast cells (Rogers, 2022). There is dysfunction in apoptosis with ALM, so rapid production with no apoptosis means the build-up of mast cells happens quickly. Once Mast cells start leaking out of the bone marrow, Leukopenia will shift, resulting in leukocytosis even though the WBCs cannot function like proper cells and undergo hematopoiesis.

However, the disease process is far enough to show anemia and thrombocytopenia. With no intervention, the disease would progress, leading to extreme neutropenia because there is very little functional WBC. Indicating an increased risk of a fatal infection (Rogers, 2022).  If infection does not occur, the mast cells can build up high, causing hyperleukocytosis and leukemic cell infiltration (Döhner et al., 2022). Skin conditions can occur in all types of epithelial cells. Petechiae and ecchymosis, along with bruising or bleeding of any kind.  Another progression that can occur, most likely with chemotherapy, is Tumor lysis syndrome (TLS) (Adeyinka et al., 2024). TLS occurs when calls burst, causing a dump of cell contents that cause damage to the kidneys.

 

References

Adeyinka, A., Kaur, A., & Bashir, K. (2024, October 5). Tumor Lysis syndrome. StatPearls – NCBI Bookshelf. 
https://www.ncbi.nlm.nih.gov/books/NBK518985/
Links to an external site.

Döhner, H., Wei, A. H., Appelbaum, F. R., Craddock, C., DiNardo, C. D., Dombret, H., Ebert, B. L., Fenaux, P., Godley, L. A., Hasserjian, R. P., Larson, R. A., Levine, R. L., Miyazaki, Y., Niederwieser, D., Ossenkoppele, G., Röllig, C., Sierra, J., Stein, E. M., Tallman, M. S., . . . Löwenberg, B. (2022). Diagnosis and management of AML in adults: 2022 recommendations from an international expert panel on behalf of the ELN. Blood, 140(12), 1345–1377. https://doi.org/10.1182/blood.2022016867

Kellaway, S. G., Coleman, D. J., Cockerill, P. N., Raghavan, M., & Bonifer, C. (2022). Molecular basis of hematological disease caused by inherited or acquired RUNX1 mutations. 
Experimental Hematology
, 
111
, 1–12. 
https://doi.org/10.1016/j.exphem.2022.03.009
Links to an external site.

Makkar, H., Majhi, R. K., Goel, H., Gupta, A. K., Chopra, A., Tanwar, P., & Seth, R. (2023). Acute myeloid leukemia: novel mutations and their clinical implications. 
American journal of blood research
, 
13
(1), 12–27.

Rogers, J. (2022). 
McCance & Huether’s Pathophysiology
 (9th ed.). Elsevier Health Sciences (US). 
https://mbsdirect.vitalsource.com/books/9780323789899
Links to an external site.

Vakiti, A., Reynolds, S. B., & Mewawalla, P. (2024, April 27). 
Acute myeloid leukemia
. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK507875/ CASE: A 45-year-old male presents to the clinic with fatigue, unexplained bruising, and frequent nosebleeds. Blood tests reveal leukocytosis, anemia, and thrombocytopenia. A bone marrow biopsy confirms the diagnosis of acute myelogenous leukemia (AML)

CASE: A 45-year-old male presents to the clinic with fatigue, unexplained bruising, and frequent nosebleeds. Blood tests reveal leukocytosis, anemia, and thrombocytopenia. A bone marrow biopsy confirms the diagnosis of acute myelogenous leukemia (AML).

First, what is acute myelogenous leukemia (AML)? AML is a type of cancer that begins in the bone marrow and affects the production of blood cells. This type of cancer changes the development and growth of immature white blood cells (myeloblasts) (Z, 2024).  This results in the myeloblasts replacing normal blood cells.  The white blood cells are not allowed to mature and becoming functioning white blood cells (Z, 2024). This can lead to abnormalities in a complete blood count. For example, the patient in this case study has a low white blood cell count of 3.3 THOUS/uL, a low platelet count of 70 THOUS/uL, a low hemoglobin count of 7.9g/dL, and a low red blood cell count of 2.39 MIL/uL. These blood test results would also explain why the patient feels fatigue, is having nosebleeds, and is bruising easily. The over production of immature myeloblast cells affect the production of platelets, red blood cells, and white blood cells (Z, 2024).

There are several different pathophysiological mechanisms that are associated with AML. One mechanism would be genetic mutations. The genetic mutations affect genes that aid in cell survival, growth, and differentiation (Alom, 2023). The common mutated genes found are CEBPa, RUNX1, and PML-RARa (DiNardo, 2016). Mutation is also found in the signal transduction pathway with active mutated genes FLT3, NRAS, and KIT. One of the most common genetic abnormalities in AML is FLT3 (DiNardo, 2016). Rapid growth in these active mutated genes is due to the dysregulated signaling pathways (DiNardo, 2016). Another genetic component found in AML is the rearrangement of chromosomes. The rearrangement of chromosomes results in the fusion of certain genes resulting in the formation of a tumor (Zhang, 2017). Lastly, what occurs in the bone marrow is the key component in AML. The interaction between stromal cells and leukemia cells plays a critical part in aiding in the resistance to therapy, survival, and their growth rate (DiNardo, 2016).

The patient with AML is dealing with nosebleeds, bruising and the feeling of fatigue. These symptoms can best be explained due to the leukemia cells affecting the production of healthy blood cells in the bone marrow (Alom, 2023). The bone marrow crowding and rapid growth of leukemia cells causes the push out of healthy blood cells such as platelets and red blood cells (DiNardo, 2016). Platelets play a key role in the body’s ability to clot blood. The patient with a low platelet count would experience nosebleeds and bruising due to the inability to have an adequate about of platelets to aid in blood clotting (DiNardo, 2016). Another, healthy blood cell produced in the bone marrow are red blood cells. Due to the accumulation of abnormal leukemia cells in the bone marrow, there is a lack of production of healthy red blood cells which can cause the patient to experience fatigue. This is due to the blood cells ability to care oxygen throughout the body (DiNardo, 2016).

Ultimately, AML is due to the mutations in stem cells which causes an overpopulating growth of abnormal cells that hinders the production of normal healthy cells (Alom, 2023). Consequently, several different complications result from these mutations such as anemia, infection, hypermetabolism, and hemorrhage (DiNardo, 2016). After reviewing the patients’ lab results, AML with a low white blood cell count can indicate that the disease state is active (Z, 2024). The leukemia cells are actively replacing healthy blood cells in the bone marrow (DiNardo, 2016). The progression of the disease is based on the growth rate of the leukemia cells and the bone marrows inability to produce platelets and healthy red blood cells (DiNardo, 2016). As the leukemia cells continue to grow, the blood will become thick and sticky. This final stage of the disease will increase the patients’ risk for clots, tissue damage, strokes and heart attacks (DiNardo, 2016).

 

References:

Alom, M. M., Faruqe, M. O., Molla, M. K. I., & Rahman, M. M. (2023). Exploring Prognostic Biomarkers of Acute Myeloid Leukemia to Determine Its Most Effective Drugs from the FDA-Approved List through Molecular Docking and Dynamic Simulation. 
BioMed Research International
, 1–26. https://doi.org/10.1155/2023/1946703

DiNardo, C. D., & Cortes, J. E. (2016). Mutations in AML: prognostic and therapeutic implications. 
Hematology. American Society of Hematology. Education Program
, 
2016
(1), 348–355. 
https://doi.org/10.1182/asheducation-2016.1.348
Links to an external site.

Z, Hu., Y, Yang., J, Li., & Z, Hu. (2024). Genetic mutations and immune microenvironment: unveiling the connection to AML prognosis. 
Hematology (Amsterdam, Netherlands)
, 
29
(1), 2346965. 
https://doi.org/10.1080/16078454.2024.2346965
Links to an external site.

Zhang, Haiguo., Zhang, Chengfang., Feng, Rui., Zhang, Haixia., Gao, Min., & Ye, Ling. Investigating the microRNA-mRNA regulatory network in acute myeloid leukemia. 
Oncology Letters
, 
14
(4), 3981–3988. https://doi.org/10.3892/ol.2017.6686

 

 

CASE: A 45-year-old male presents to the clinic with fatigue, unexplained bruising, and frequent nosebleeds. Blood tests reveal leukocytosis, anemia, and thrombocytopenia. A bone marrow biopsy confirms the diagnosis of acute myelogenous leukemia (AML)

Acute myeloid leukemia (AML) is the expansion of leukemic stem cells that have acquired self-renewal capacity. An aggregation of leukemic blasts in bone marrow, peripheral blood, and extramedullary tissue will result in AML. AML induces the accumulation of leukemic blasts in bone marrow, peripheral blood, and extramedullary tissues.  (Koolivand et al., 2025).  These changes cause the myeloid cells to make a lot of immature white blood cells called myeloblasts. The myeloblasts can build up in the bone marrow, crowding out healthy blood cells. (Mayo Clinic, 2025). When these aggressive immature myeloid cells expand in the bone marrow, the result is hematologic compromise. (Kurzer & Weinberg, 2023). Without enough healthy blood cells circulating through the patient’s bloodstream, patients experience low oxygen levels in the blood, easy bruising and bleeding, and frequent infections. (Mayo Clinic, 2025). The symptoms the patient is presenting with are fatigue, unexplained bruising, and frequent nose bleeds. The blood tests reveal leukocytosis, anemia, and thrombocytopenia. Frequent nose bleeds and unexplained bleeding are a result of thrombocytopenia, and fatigue is a result of anemia.

According to Kurzer & Weinberg (2023), the World Health Organization Classification of Hematopoietic Neoplasms and The International Consensus Classification System now define a variety of AML subsets based on mutation in the deriver genes such as NPM1, CEBPA, TP53, ASXL1, BCOR, EZH2, RUNX1, SRSF2, STAG2, U2AF1, and ZRZR2. Although several studies have been performed to detect genetic mutations responsible for AML pathogenesis, the treatment methods have not significantly changed in the past two decades, as most genetic defects are still unknown. (Koolivand et al., 2025).   The primary variable used by physicians to assess the disease prognosis for AML is the karyotype. (Koolivand et al., 2025).  Mean platelet volume can be considered a predictive or prognostic marker in patients with AML. (Albayrak, et al. 2021).  The patient has a high mean platelet volume of 13.5 fl. Patients with higher mean platelet volumes at the time of diagnosis should be evaluated carefully. (Albayrak, et al. 2021).

References

Albayrak, M., et al. (2021). Mean platelet volume is a predictive and prognostic marker for patients with acute myeloid leukemia: a two-center retrospective analysis. Leukemia & Lymphoma. 62(11). Retrieved from http://doi.org/10.1080/10428194.2021.1929962

Koolivand, Z. et al. (2025). Inducing apoptosis in acute myeloid leukemia; mechanisms and limitations. 
Heliyon. 11.
 Retrieved from: 
https://doi.org/10.1016/j.heliyon.2024.e41355
Links to an external site.

Kurzer, J. & Weinberg, O. (2023). Updates in molecular genetics of acute myeloid leukemia. 
Seminars in Diagnostic Pathology. 40
(3). Retrieved from: 
http://doi.org/10.1053/j.semdp.2023.01.002
Links to an external site.

 

CASE: A 45-year-old male presents to the clinic with fatigue, unexplained bruising, and frequent nosebleeds. Blood tests reveal leukocytosis, anemia, and thrombocytopenia. A bone marrow biopsy confirms the diagnosis of acute myelogenous leukemia (AML)

Acute Myelogenous Leukemia

Genetic mutations disrupt normal gene processes due to multiple factors. One will examine specific symptoms, pathophysiological mechanisms, and laboratory results of genetic mutations in acute myelogenous leukemia.

Patient X

A 45-year-old male was recently diagnosed with
acute myelogenous leukemia (AML)
. The patient’s symptoms, frequent nosebleeds, bruising, and fatigue, represent a dysfunction of the bone marrow’s production and maturation of myeloid cells. The laboratory results confirm the states of cytopenias (e.g., anemia, infections, and/or bleeding or bruising), which may also be associated with abnormal values like metabolic abnormalities, thrombocytopenia, and leukocytosis (Schiffer & Gurbuxani, 2023). One will further investigate the genetic mutation of AML.

Genetic Mutation

Hu, Yang, Li, and Hu (2024) expressed that the instability of haematopoietic stem/progenitor cells by stem cell mutations can hinder the differentiation of the bone marrow. Usually, these differentials are classified as blast cells and can be further categorized by precursors (Rogers, 2022). Specific cellular alterations like mutations of the nucleophosmin 1 (NPM1) gene represent the most frequent molecular alteration in acute myelogenous leukemia (AML), especially in patient’s with AML who have a normal karyotype (Kongta, Panyasit, Jansaento, & Duangmano, 2022). Now, one will discuss the presentation of symptoms.

Presentation of Symptoms and Laboratory Results

Common symptoms of AML are due to the clonal expansion of immature “blast cells,” which results in the inefficient circulation of erythropoiesis (Debnath & Nath, 2024). Unfortunately, the body can not maintain homeostasis because of the accumulation of leukemia-stimulating cells. One will notice that the patient’s lab results reflect a cellular quiescence, resulting in uneven distribution of cells, decreased WBC, red blood cells, increased mean platelet volume, and corpuscular hemoglobin.

Pathophysiological Mechanisms

Acute myeloid leukemia involves an acquired somatic mutation and epigenetic changes in the bone marrow microenvironment (Schiffer & Gurbuxani, 2023). The process incorporates the mutation of cellular regulation, proliferation, differentiation, and survival by altering gene encodes, rewriting transcription and signaling pathways of proteins, and changing cell cycles (growth and apoptosis). AML is a complex disease that causes myeloid blast corruption, which makes treatment difficult.

Conclusion

Genetic mutations disrupt the normal functions and pathways of the cellular process. Acute myeloid leukemia results in multiple disorders that contribute to the immature production of circulating cells.

 

Reference
s

Debnath, A., & Nath, S. (2024). Prognosis and treatment in acute myeloid leukemia: a comprehensive review. 
Egyptian Journal of Medical Human Genetics
, 
25
(1), 1–15. 
https://doi.org/10.1186/s43042-024-00563-w
Links to an external site.

Hu Z, Yang Y, Li J, & Hu Z. (2024). Genetic mutations and immune microenvironment: unveiling the connection to AML prognosis. 
Hematology (Amsterdam, Netherlands)
, 
29
(1), 2346965. 
https://doi.org/10.1080/16078454.2024.2346965
Links to an external site.

Kongta, R., Panyasit, N., Jansaento, W., & Duangmano, S. (2022). Development of E-ice-COLD-PCR assay combined with HRM analysis for Nucleophosmin1 gene mutation detection in acute myelogenous leukemia. 
PLoS ONE
, 
17
(9), 1–15. 
https://doi.org/10.1371/journal.pone.0274034
Links to an external site.

Rogers, J. (2022). 
McCance & Huether’s Pathophysiology
 (9th ed.). Elsevier Health Sciences (US). 
https://mbsdirect.vitalsource.com/books/9780323789899
Links to an external site.

Schiffer, C. A., & Gurbuxani, S. (2023, December 19). Acute Myeloid Leukemia:  Classification. (R. A. Larson & A. G. Rosmarin, Eds.). Retrieved February 26, 2025,.

 

 

CASE: A 45-year-old male presents to the clinic with fatigue, unexplained bruising, and frequent nosebleeds. Blood tests reveal leukocytosis, anemia, and thrombocytopenia. A bone marrow biopsy confirms the diagnosis of acute myelogenous leukemia (AML)

AML Description
 

AML is characterized by the clonal proliferation of undifferentiated myeloid precursors, known as blasts, within the bone marrow compartment (Vakiti, et al., 2024). This disease can be genetic in nature or acquired due to changes in a person’s genetic structure caused by various environmental factors, smoking, radiation, therapy, and being immunocompromised.
 

Genetic Mutations Associated with Disease
 

Genetic abnormalities that characterize favorable risk disease include chromosomal translocations t(8;21)(q22;q22.1) or inv(16)(p13.1q22). Patients who lack FLT3-ITD (internal tandem duplication) mutations without mutated NPM1 or with CEBPA (bZIP in-frame) mutations are also categorized as favorable risk (Vakiti, et al., 2024).
 

Why is Patient Presenting with Specific Symptoms Described
 

Fatigue can be caused by anemia due to a low red blood cell count. There are not enough red blood cells to assist in carrying oxygen throughout the body, therefore causing fatigue. Platelets are not being formed due to the stem cells lack of differentiation thus causing frequent nose bleeds and bruising. 
Platelets maintain hemostasis by adhering to the vascular endothelium, aggregating with other platelets, and initiating the coagulation cascade, leading to the production of a fibrin mesh, which effectively prevents significant blood loss (Fountain, et al., 2023)
 

Pathophysiological Mechanisms of Disease
 

Transcription factor mutations (e.g., CEBPA) prevent normal myeloid cell maturation, causing an accumulation of undifferentiated blasts (Döhner et al., 2022). Leukemic blasts overpopulate the bone marrow, suppressing normal hematopoiesis and leading to anemia, neutropenia, and thrombocytopenia.
 

Blood Test  Results and Disease Progression
 

This person’s white blood cell count is low, possibly due to bone marrow suppression does putting this person at risk for infectio . Additionally, the red blood cell count and hemoglobin is low, causing anemia. The platelet count is also low, thus causing thrombocytopenia. The disease progression is aggressive, due to risk for infection, anemia, and bleeding.
 

References
 

Döhner, H., Weisdorf, D. J., & Bloomfield, C. D. (2022). Acute myeloid leukemia. The New England Journal of Medicine, 386(12), 1082-1094. 
https://doi.org/10.1056/NEJMra2200579
Links to an external site.
 

Fountain, J. H., & Lappin, S. L. (2023). Physiology, platelet. In StatPearls. StatPearls Publishing. Retrieved from 
https://www.ncbi.nlm.nih.gov/books/NBK470328/
Links to an external site.
 

Vakiti, A., Reynolds, S. B., & Mewawalla, P. (2024). Acute myeloid leukemia. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK507875/
 

CASE: A 45-year-old male presents to the clinic with fatigue, unexplained bruising, and frequent nosebleeds. Blood tests reveal leukocytosis, anemia, and thrombocytopenia. A bone marrow biopsy confirms the diagnosis of acute myelogenous leukemia (AML)

Acute myeloid leukemia (AML) Essay

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

Which genetic mutations are commonly associated with the disease?

Why is the patient presenting with the specific symptoms described?

Discuss the pathophysiological mechanisms of the disease in detail. 

What do the blood test results tell us about the disease and disease progression?

 

Acute myeloid leukemia (AML) Essay

Genetic mutations commonly associated with the disease.

The genetic cancer acute myeloid leukemia (AML) starts in hematopoietic stem cells and has problems with the genome, epigenetics, microRNAs, and gene mutations that happen repeatedly. If not treated, AML can spread quickly and result to death. Transcription factor mutations, commonly seen in t (8;21) and inv (16), are among the prevalent genetic mutations in AML. Both interfere with normal myeloid development by disrupting the genes RUNX1 and CBFB (Singh et al., 2023).

The FLT3 gene is another common gene mutation in AML. In a healthy state, this gene controls the survival and reproduction of white blood cells. When it changes, it leads to uncontrolled cell proliferation that starts in the bone marrow and affects the blood. This is what causes AML. The tumor suppressor gene TP53 that controls the p53 gene, which is essential for repairing DNA damage. Mutations in this gene can lead to AML resulting in severe dysplasia and complicated karyotypes (Rogers, 2023) Acute myeloid leukemia (AML) Essay.

 Why patient presented with the specific symptoms described.

The case study shows symptoms caused by AML, a type of cancer that affects bone marrow blood cells and causes a drop in healthy white blood cells, red blood cells (RBC), and platelets (Rogers, 2023). Myeloblast cells overcrowd healthy cells, lowering white blood cells, red blood cells, and platelets and causing the patient’s fatigue and low RBCs. Anemia results from the affected oxygen-carrying capacity and hematocrit. Insufficient delivery of oxygen to the body can cause fatigue. Blood clotting factors are low in people with thrombocytopenia, which makes them more likely to bruise and bleed easily and causes unexplained bruising and nosebleeds (Singh et al., 2023).

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Pathophysiology mechanism of Acute Myelogenous leukemias.

Acute myeloid leukemia (AML) is a rapidly growing, aggressive, and highly heterogeneous disease affecting the bone marrow (Rogers et al., 2023). It is marked by too many myeloblasts that won’t divide into promyelocytes, which are the next step in becoming mature white blood cells, causing the bone marrow to be crowded. AML is a condition where leukemic cells take over the bone marrow. This condition reduces the production of normal blood cells, which leads to blood cell imbalance, causing anemia, fatigue, increased bleeding, and bruising. Additionally, a high number of abnormal white blood cells malfunction, weakening the immune response. The myeloblast takes up a significant amount of space and inhibits the replication of red blood cells (RBC) and platelets. As a result, the patient may experience symptoms such as anemia, fatigue, and an elevated risk of bleeding due to the insufficient clotting factors in their blood. The patient’s risk of infection increases due to the immature WBC (Vakiti et al., 2024).

What the blood test tells us about AML and Its progression.

Medical professionals use bone marrow biopsy and complete blood count (CBC) analysis to detect acute myeloid leukemia (AML). In this instance, the lab results only showed low platelet, WBC, and RBC counts; myeloblast levels were not disclosed. However, to better understand the AML prognosis and choose the best course of therapy, appropriate testing is crucial for AML patients (Leukemia & Lymphoma Society, n.d.).

References

Rogers, J. (2023). 
McCance & Huether’s pathophysiology
 (9th ed.). Elsevier – Evolve.

Leukemia & Lymphoma Society (n.d.) Acute Myeloid Leukemia (AML)

https://www.lls.org/leukemia/acute-myeloid-leukemia/diagnosis
Links to an external site.

Singh, H., Kumar, M., & Kanungo, H. (2023). Role of Gene Mutations in Acute Myeloid Leukemia: A Review Article. 
Global medical genetics
, 
10
(2), 123–128. 
https://doi.org/10.1055/s-0043-1770768
Links to an external site.

Vakiti A, Reynolds SB, Mewawalla P. Acute Myeloid Leukemia. (2024). In: StatPearls [Internet].  
https://www.ncbi.nlm.nih.gov/books/NBK507875/

 

 

Acute myeloid leukemia (AML) Essay 2

Acute Myelogenous Leukemia

Leukemia in its own right is a serious disease which can often lead to death in many Americans. Thru this discussion we will be talking about one of the most common leukemias called Acute Myelogenous Leukemia or AML. Acute myelogenous leukemia (AML) is an immensely heterogeneous disease characterized by the clonal growth of promyelocytes or myeloblasts in bone marrow as well as in peripheral blood or tissue (Singh H, Kumar M, Kanungo H., 2023). As early symptoms and blood work such as a complete blood count can lean towards the diagnosing of AML, a bone marrow biopsy test can truly give a correct diagnosis. Understanding different genetic risk factors, genetic mutations and the pathophysiology of AML can sometimes assist in the overall treatment.

Genetic Mutations

Over the years, with the enhanced study of cells and DNA sequencing in relation to AML has showed the many genetic risk factors and its relationship. Many genetic risk factors have been identified, such as Klinefelter and Down syndromes, ataxia telangiectasia, Bloom syndrome, and telomeropathies such as Fanconi anemia, dyskeratosis congenita, and Shwachman-Diamond syndrome; germline mutations in RUNX1, CEBPA, to name a few (Chennamadhavuni A, Lyengar V, Mukkamalla SKR, Shimanovsky A., 2023). Although, the genetic mutations in regard to DNA sequencing stands as a precursor to many individuals assuming the disease AML there are other factors along with the mutations that can increase the chances. One correlation of the disease and its underlying harm is related with smoking. Many studies have showed along with the genetic mutations along with smoking has seen to cause a perfect storm for AML.

Pathophysiological Mechanisms and Specific Symptoms

There are usually two types of mechanisms that can be looked at in determining the pathophysiology of AML. Leukemogenic mechanisms can be broadly classified into two types-cell-intrinsic and cell-extrinsic (Chakraborty S, Park CY., 2022). Cell intrinsic looks at the genetic side of the cell and the way it can mutate and take form in the cell causing the mutation to transform. Cell extrinsic tends to take form in a certain way that can cause the cell to survive and form with strength to inhabit causing the leukemia to lay havoc on the body. Some symptoms that are help diagnose AML can be anemia, leukocytosis, bruising due to low platelet count and fatigue. These are usually found during a complete blood count lab that looks at hemoglobin, platelets and white blood cell count which will all be low due to attack of the cell. Early recognition and diagnosing with a bone marrow biopsy are key to possible survival with treatment to fight the disease.

References:

Chakraborty S, Park CY. Pathogenic Mechanisms in Acute Myeloid Leukemia. Curr Treat Options Oncol. 2022     Nov;23(11):1522-1534. doi: 10.1007/s11864-022-01021-8. Epub 2022 Oct 3. PMID: 36190670.

Chennamadhavuni A, Lyengar V, Mukkamalla SKR, Shimanovsky A. Leukemia. 2023 Jan 17. In: StatPearls [Internet].        Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 32809325.

Singh H, Kumar M, Kanungo H. Role of Gene Mutations in Acute Myeloid Leukemia: A Review Article. Glob Med Genet. 2023 Jun 23;10(2):123-128. doi: 10.1055/s-0043-1770768. PMID: 37360004; PMCID: PMC10289861

 

 

Acute myeloid leukemia (AML) Essay 3

1.  Which genetic mutations are commonly associated with the disease?

Several genetic mutations and translocations are associated with acute myelogenous leukemia (AML). According to the National Human Genome Research Institute (n.d.), chromosomal translocation is when a chromosome breaks and attaches itself to a different chromosome. Common translocation is found in CBFB-MYH11 and RUNx1-RUNx1T1, changing the normal development of blood cells (Swart & Heidenreich, 2021). Another common mutation is FLT3, where the body overproduces immature white blood cells (Rogers, 2022). Mutation of TP53 is also common in AML; this cell repairs DNA, but mutations inhibit that ability (Rogers, 2022).

 

2. Why is the patient presenting with the specific symptoms described?

Cancer cells attack the body, interfering with normal body systems and causing cellular destruction. Fatigue, bruising, and nosebleeds are all symptoms of AML. According to the patient’s labs, the red blood cell and platelet count are very low, with RBCs at 2.39 MIL/uL and platelets at 70 THOUS/uL. In AML, the process of creating red blood cells is disrupted, leading to severe anemia, which causes fatigue, bruising, and nosebleeds (Makkar et. al, 2023). Thrombocytopenia is a condition characterized by low platelet count and leads to a bleeding risk that can be both internal and external (U.S. Department of Health and Human Services, n.d.). The patient’s low platelets and low RBC explain the frequent fatigue, bruising, and nosebleeds. The patient is also experiencing fatigue as he is likely immunocompromised, with a low WBC count leading to increased fatigue Acute myeloid leukemia (AML) Essay.

 

3. Discuss the pathophysiological mechanisms of the disease in detail.

AML is a heterogeneous blood disease that is the result of the rapid development of undifferentiated myeloid precursors, also referred to as myeloblasts (Rogers, 2022). These blasts are immature white blood cells that rapidly develop in the bone marrow and take the place of healthy bone marrow, not involving B or T cells (Rogers, 2022). The immature cells interfere with the bone marrow’s ability to create red blood cells. Genetic and cellular mutations can lead to AML, as mutations lead to changes in the cell’s DNA.

 

4. What do the blood test results tell us about the disease and disease progression

The blood test results reveal that the patient has leukopenia as the white blood cells are very low. During the first phase of AML, the white blood count is often high, and there is a low blood count (Teixeira et al., 2023). The white blood count is low at 3.3, which may indicate disease advancement. The labs show a reduction in red blood cells and platelet production. The patient is likely immunocompromised and at risk for both infection and bleeding. The labs align with the diagnosis of AML, and the patient does not need a blood transfusion based on the current lab results. As the disease progresses, the patient may require a blood product transfusion.

 

References

Makkar, H., Majhi, R. K., Goel, H., Gupta, A. K., Chopra, A., Tanwar, P., & Seth, R. (2023). Acute myeloid leukemia: novel mutations and their clinical implications. 
American journal of blood research
, 
13
(1), 12–27.

National Human Genome Research Institute. (n.d.). 
Translocation
. Genome.gov. https://www.genome.gov/genetics-glossary/Translocation

Rogers, J. (2022). McCance & Huether’s Pathophysiology (9th ed.). Elsevier Health Sciences (US). 
https://mbsdirect.vitalsource.com/books/9780323789899
Links to an external site.

Swart, L. E., & Heidenreich, O. (2021). The RUNX1/RUNX1T1 network: Translating insights into therapeutic options. 
Experimental Hematology
, 
94
, 1–10. https://doi.org/10.1016/j.exphem.2020.11.005

Teixeira, A., Carreira, L., Abalde-Cela, S., Sampaio-Marques, B., Areias, A. C., Ludovico, P., & Diéguez, L. (2023). Current and emerging techniques for diagnosis and MRD detection in AML: A comprehensive narrative review. 
Cancers
, 
15
(5), 1362. https://doi.org/10.3390/cancers15051362

Wachter, F., & Pikman, Y. (2024). Pathophysiology of acute myeloid leukemia. 
Acta Haematologica
, 
147
(2), 229–246. https://doi.org/10.1159/000536152

U.S. Department of Health and Human Services. (n.d.). 
Thrombocytopenia
. National Heart Lung and Blood Institute. https://www.nhlbi.nih.gov/health/thrombocytopenia

 

Acute myeloid leukemia (AML) Essay 4

Which genetic mutations are commonly associated with the disease?

The development and outcome of
acute myelogenous leukemia (AML)
are affected by certain genetic alterations. Among the most prevalent mutations is FLT3-ITD, which stands for FMS-like tyrosine kinase 3. This mutation causes the constitutive activation of signaling pathways that encourage the unchecked proliferation of leukemic cells. According to Döhner et al. (2017), this mutation is associated with a more severe course of the illness and worse survival rates. Nucleophosmin 1 (NPM1) mutations are also common; these mutations impact cellular stress responses and ribosomal biogenesis. A better prognosis is linked to NPM1 mutations when FLT3 mutations do not accompany them. Having a CEBPA (CCAAT/enhancer-binding protein alpha) mutation on both alleles improves survival rates and disrupts normal myeloid differentiation. In addition, chromosomal abnormalities including t(8;21), inv(16), and t(15;17) impact how AML is classified and treated. The molecular heterogeneity of AML is influenced by these genetic alterations, which also affect therapy responses and help doctors choose targeted medicines (Newell & Cook, 2022).

Why is the patient presenting with the specific symptoms described?

Fatigue, unexplained bruises, and frequent nosebleeds are symptoms of acute myeloid leukemia (AML), which disrupts normal bone marrow hematopoiesis. Leukocytosis, anemia, and thrombocytopenia result from an overproduction of leukemic blasts, which inhibits the normal formation of blood cells. Fatigue and pallor are symptoms of anemia, which is caused by a decrease in the number of red blood cells in the body. This is because tissues do not receive enough oxygen. Thrombocytopenia, a condition characterized by a low platelet count, makes it more difficult for the body to form clots, which in turn makes bruising and nosebleeds more common. The paradoxical increase in white blood cell count known as leukocytosis is made up of immature leukemic cells that aren’t ready to fight off infections just yet. According to Estey and Döhner (2020), these dysfunctional cells can exacerbate the patient’s symptoms by adding to systemic inflammation, which in turn increases metabolic stress Acute myeloid leukemia (AML) Essay.

Discuss the pathophysiological mechanisms of the disease in detail.

Mutations in hematopoietic stem cells cause myeloid progenitor cells to proliferate uncontrollably and fail to differentiate properly, which in turn causes AML to develop. Myeloid stem cells typically alter their cellular composition to produce various blood cell types, including RBCs, WBCs, and platelets. Nevertheless, acute myeloid leukemia (AML) develops when mutations in genes interrupt signaling pathways and transcription factors that control differentiation. This leads to an overabundance of undifferentiated leukemic blasts in the blood and bone marrow. Bone marrow failure results from this process because anemia, thrombocytopenia, and neutropenia are caused by the suppression of normal hematopoiesis by the excessive proliferation of blasts. Fever and loss of weight are additional symptoms of systemic inflammation caused by leukemic cells’ dysregulation of cytokines. The spleen, liver, or gums can all be infiltrated by leukemia in rare instances, resulting in hepatosplenomegaly or gum hypertrophy. The patient becomes more vulnerable to opportunistic infections as a result of the profound immunosuppression caused by this disease progression (De Kouchkovsky & Abdul-Hay, 2016).

What do the blood test results tell us about the disease and disease progression?

The patient’s blood test results reveal important information about the progression of their disease, including the hallmarks of AML—leukocytosis, anemia, and thrombocytopenia. Leukocytosis is a sign of an overabundance of cancer cells, which interfere with normal blood cell production and lead to immune system malfunction. Fatigue and oxygen shortage can result from anemia, which is a condition in which the bone marrow’s capacity to create red blood cells is impaired. Thrombocytopenia, which is a result of impaired platelet formation, explains why the patient bruises more easily and has episodes of prolonged bleeding. One diagnostic requirement for AML is an elevated percentage of blasts, which is often more than 20%, as shown in a bone marrow biopsy that confirms the diagnosis. Blast counts, cytogenetic findings, and molecular markers track the development of AML; these metrics inform prognosis and treatment decisions (Döhner et al., 2022). Patients with AML may be offered chemotherapy, targeted therapy, or hematopoietic stem cell transplantation.

References

De Kouchkovsky, I., & Abdul-Hay, M. (2016). Acute myeloid leukemia: A comprehensive review and 2016 update. 
Blood Cancer Journal, 6
(7), e441. https://doi.org/10.1038/bcj.2016.50

Döhner, H., Weisdorf, D. J., & Bloomfield, C. D. (2017). Acute myeloid leukemia. 
New England Journal of Medicine, 377
(12), 1135-1148. https://doi.org/10.1056/NEJMra1406184

Estey, E. H., & Döhner, H. (2020). Acute myeloid leukemia. 
The Lancet, 396
(10260), 693-706. https://doi.org/10.1016/S0140-6736(20)31266-9

Newell, L. F., & Cook, R. J. (2022). Advances in acute myeloid leukemia. 
BMJ, 376
, e064542. https://doi.org/10.1136/bmj-2021-064542 Acute myeloid leukemia (AML) Essay

Angie is a new NP who just finished her FNP program. She is having a difficult time finding an FNP position in the rural area where she lives. So, since she was an ER nurse prior to her graduate program she decides to go back to the ER as an APRN. Does she meet the competency requirements for such a position?

 

Yes

 

No

Examining Nursing Specialties

You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.

Decisions are often not so easily inspired. Perhaps you discovered this when choosing a specialty within the MSN or PMC program. This decision is a critical part of your plan for success, and you no doubt want to get it right. This is yet another area where your network can help, as well as other sources of information that can help you make an informed choice.

Note
: Unless otherwise noted, initial postings to Discussions are due on or before Day 3, and response postings are due on or before Day 6. You are required to participate in the Discussion on at least three different days (a different day for main post and each response). It is important to adhere to the weekly time frame to allow others ample time to respond to your posting. In addition, you are expected to respond to questions directed toward your own initial posting in a timely manner.

 

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:

Reflect on your decision to pursue a specialty within the MSN or PMC program, including your professional and academic goals as they relate to your program/specialization/certification.

By Day 3 of Week 10

Post
 an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member.

By Day 6 of Week 10

Respond
 to at least 
two
 of your colleagues’ posts by sharing your thoughts on their specialty, supporting their choice or offering suggestions if they have yet to choose.

This topic is closed for comments.

AG

Allison George

Oct 30, 2024 11:06pm
| Last reply Nov 2, 2024 10:59am

Reply from Allison George

Module 6 Discussion Main Post

Nurse practitioners (NP) play a vital role in communities by providing care in various areas of healthcare. NP practices include assessments, ordering, performing, supervising, and interpreting lab and diagnostic testing, making diagnoses, and initiating and managing treatments. NPs can prescribe non-pharmacological treatments and medications, coordinate care, council and educate patients, their families, and communities (American Association of Nurse Practitioners, 2022). Family nurse practitioners (FNP) are nurse practitioners who have received either their Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) and receive a certification from either the American Nurses Credentialing Center (ANCC) or Academy of Nurse Practitioners (AANP) (Walden University, n.d.). Family nurse practitioners can care for a large spectrum of people from infants to geriatric patients. Depending on the state, some FNPs can work independently and serve as primary care providers. In my state, Illinois, FNPs can practice independently and prescribe anything but controlled substances independently. FNPs need an overseeing physician to prescribe narcotics and controlled substances. To open an independent practice, FNPs must reach certain criteria to apply for an independent practice license, but they still need an overseeing physician for controlled substances and narcotics (Illinois General Assembly, 2018). FNPs can work in many different settings including private practice, community health centers, universities, and health care systems. FNPs can also receive specialization certifications in areas including diabetes, pain, and obesity management (American Association of Nurse Practitioners, 2022).

I knew I wanted to advance my education after receiving my associate’s degree and working in a burn intensive care unit and a community hospital medical-surgical unit. I felt I could provide a unique perspective at a master’s level but I was stuck between nurse anesthetist and family nurse practitioner. After looking more into the professions and what the schooling would be like, I found that an online program that allowed me to do my preceptorship locally would work better for me and my family. I have a three-year-old daughter at home and my husband owns his own hauling business. The closest school for nurse anesthetists was almost two hours away and class was on campus. I chose Walden University because of its’ Accelerated into Masters (AIM) program. I still needed my bachelor’s and I liked that I could incorporate some of the master’s classes in my bachelor’s program and get a head start on my FNP. After looking more into the role of a FNP, I found a new motive to provide care for my rural community. Walden University’s website discussed how there aren’t as many physicians graduating to provide care for the increasing number of baby boomers, therefore FNPs play a vital role in these rural communities. Since pursuing this degree, I have already had three different offers to take over other FNPs practices as they wish to retire soon. I found that very promising and validated my choice.

Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member.

One professional organization that would help me be an up-to-date, competent practitioner is the National Association of Family Nurse Practitioners. This organization provides many incentives to members, including advocating for FNPs and broadening their scope of practice nationwide, providing clear and consistent FNP education, providing guidance and education for new FNPs, and establishing standards for educational programs (National Association of Family Nurse Practitioners, n.d.). To become a member of this association, there is an annual fee that’s dependent on the type of membership one is getting and an application to fill out.

References

American Association of Nurse Practitioners. (2022). 
Scope of Practice for Nurse Practitioners
. American Association of Nurse Practitioners; AANP Website. 
https://www.aanp.org/advocacy/advocacy-resource/position-statements/scope-of-practice-for-nurse-practitioners
Links to an external site.

Illinois General Assembly. (2018, January 1). 
225 ILCS 65/ Nurse Practice Act.
 Ilga.gov. 
https://ilga.gov/legislation/ilcs/ilcs4.asp?DocName=022500650HArt%2E+65&ActID=1312&ChapterID=24&SeqStart=16500000&SeqEnd=17850000
Links to an external site.

National Association of Family Nurse Practitioners. (n.d.). 
Home
. Nafnp.memberclicks.net. 
https://nafnp.memberclicks.net/
Links to an external site.

Walden University. (n.d.). 
The Varied Roles of a Family Nurse Practitioner | Walden University
. 
Www.waldenu.edu
Links to an external site.
. 
https://www.waldenu.edu/online-masters-programs/master-of-science-in-nursing/resource/the-varied-roles-of-a-family-nurse-practitioner
Links to an external site.

 

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Justina Chinyere Ibe

Oct 30, 2024 9:33pm
| Last reply Nov 2, 2024 12:32pm

Reply from Justina Chinyere Ibe

Main Question Post. 

An Explanation and Description to Specialization Choice.

A few years of my nursing career was in long and short term skilled nursing, and Rehab nursing. The majority of my nursing years have been in Acute care hospital. I enjoy being an acute care RN. This made it easy for me to choose to continue my nursing career as Adult Gerontology Acute care nurse Practitioner (AGACNP). I currently work in a level III trauma hospital as a resource RN. Being a resource RN has given me the opportunity to work in all the units (ED, ICU, surgery units and med/surg units). I have had the privilege of taking care of my patients (young adults to older adults) in their trauma, acute, critical and chronic health situations. I want to continue doing what I am doing, with improved education and skills. “AG ANCNPs are prepared to provide services ranging from disease prevention to critical care to stabilize the patient’s condition, prevent complications, restore maximum health and/or provide palliative care” (NONPF, 2016).

Choosing to be an AGACNP was not difficult for me because I enjoy what I am doing, and want to continue in this field. My second reason for choosing to be an AGACNP is because I plan to obtain my doctorate in acute care nursing and transfer my knowledge and skills to serve my community in my birth country, where qualified doctors and nurses are in shortage.

Professional Organization in Selected Specialization and Membership Details. 

American Nurses Association (ANA) is an umbrella organization that includes American Nurses Credentialing Center (ANCC). One of the services of ANCC is to provide nursing specialty certification, including AGACNP certifications. Any nurse, whatever the level can become a member of ANA. Some of the benefits of membership include

State association newsletter

Representation in the state house on critical issues

Local networking opportunities

Education and career development

Career center and job networking ( ANA Member Benefits, n.d.)

According to American Nurses Association (2019) publication, some of the competencies of a gerontological nurse is to demonstrate a commitment to lifelong learning, mentor, maintain a professional portfolio, etc. Any nurse can become a member by registering and paying monthly dues.

References

Adult-Gerontology NP Competencies Work Group. (2016). 
Adult-gerontology acute care and primary care NP competencies
 
https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/NP_Adult_Geri_competencies_4.pdf
Links to an external site.

American Nurses Association. (2019). 
Gerontological nursing: scope and standards of practice.
 American Nurses Association

https://www.nursingworld.org/membership/member-benefitss/
Links to an external site.

 

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Marie Christine Magadan Franco

Oct 30, 2024 9:09pm
| Last reply Nov 1, 2024 10:47am

Reply from Marie Christine Magadan Franco

Choosing a nursing specialty has been difficult because it reflects my professional goals and personal interests. My interest lies in becoming a Family Nurse Practitioner (FNP) due to its flexibility and broad scope of care. The ability to manage a variety of patient populations, including children and adults, appeals to my desire to promote holistic health. However, I am also drawn to the Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) role because of my current position in the Emergency Department (ED), where I witness the complexities of acute care firsthand. The challenge lies in balancing my aspiration for broad family-focused care with my acute care interests, leading to an ongoing internal debate about which path to pursue.

One of the primary factors influencing my decision is my experience in the ED.  I enjoy the fast-paced environment and the critical thinking skills required to manage acute cases effectively. Research indicates that acute care settings necessitate advanced competencies in patient assessment and management (Mackey & Bassendowski, 2017). I am motivated by the idea of applying these skills in a hospital or urgent care setting. However, I also envision a future where I can integrate wellness practices through a potential wellness clinic. An FNP role would allow me to blend traditional and alternative modalities, providing comprehensive care focusing on preventive health measures (Zaccagnini & Pechacek, 2019).

An important consideration is the professional organizations affiliated with my specialties. The American Association of Nurse Practitioners (AANP) is a prominent organization for FNPs, providing valuable resources for professional development, advocacy, and networking (AANP, 2023). Membership offers access to continuing education opportunities, clinical practice guidelines, and various tools to support FNP practice. To become a member, I need to complete an online application and pay an annual fee, granting me access to a wealth of resources to enhance my knowledge and future career as an FNP.

This reflection highlights the importance of aligning professional goals with personal values and experiences. While I am inclined towards the AGACNP because of my experiences in acute care, I am deeply interested in the FNP role for its versatility and the potential to open a wellness clinic. I plan to integrate my experience in acute care and continue my path into a holistic wellness nursing practice.

References

American Association of Nurse Practitioners. (2023). 
About AANP
. Retrieved from 
https://www.aanp.org
Links to an external site.

Mackey, S. P., & Bassendowski, S. (2017). The role of nurse practitioners in acute care settings. 
Journal of Nursing Practice
, 13(5), 12-18. https://doi.org/10.1016/j.nurpra.2017.02.005

Zaccagnini, M. E., & Pechacek, J. M. (2019). 
The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing
. Jones & Bartlett Learning.

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Sheena Chambers

Oct 30, 2024 7:57pm
| Last reply Nov 2, 2024 10:29pm

Reply from Sheena Chambers

Main Post

Reflection on Choosing a Nursing Specialty

I have never been the person who had the ‘story’ as to why they became a nurse. However, I believe the universe had me become a nurse to overcome the challenges that I have faced, and to have the knowledge to handle many personal life decisions. I want to pursue a career in becoming a Psychiatric-Mental Health Nurse Practitioner (PMHNP). I have struggled with mental health all of my life, along with close family members, and had to self-teach majority of the information I now know about the different tribulations that come with it. I would love to be able to help others that suffer from mental health issues, and to guide them into how to cope and manage it. Not only for the patient, but for families as well. As someone who grew up in southern Appalachia, mental health was a taboo subject, and was mostly brushed off. As I got older, and accepted my own diagnosis, I found the beauty in educating and caring for others that have the same. The patience, empathy and work it takes to get well and take care of those with it, is immeasurable. I want to somehow fix that heavy burden and help anyone I can that has dealt with mental health ailments. We all deserve to be kind to our minds, but being validated and educated on the how is important too.

Challenges and Influencing Factors in the Decision

There are a few factors that are influencing my choice. One of the major reasons is the responsibility of prescribing medication. The biggest challenges in that are looking at medication treatment adherence, decision making, and monitoring symptom related outcomes (Mangano et al., 2020). Looking out for those who take psychiatric medication is a huge responsibility, and if patients don’t have family to help support and observe, the responsibility is on the provider who prescribed those medications. Many psychiatric medications can have severe side effects, including black box warnings, so knowing you stuff and being a competent provider is crucial.

Another challenge for me is having the confidence to complete my degree and have that confidence to one day become a provider. Self-reflection is something I can work on as a current nurse, and on day provider. Being able to reflect on ones practice and be willing to give oneself grace important to retain that confidence and strength to keep showing up and making improvements. Ways I can improve my confidence are being kind to myself, saying positive words of affirmation, practice saying no to others, and avoid comparing myself to others. Keeping positive mindsets, accepting compliments, and writing things I love about myself are other ways I can hold myself accountable and remain positive (Mind, 2022).

Professional Organizations Related to My Chosen Specialty

The professional organization I chose would be the American Psychiatric Nurses Association. This website and organization have an open-ended acceptance for those who have an associates, bachelors, masters, or doctorate degree. These settings also include inpatient, community, academic, research, health institutions and high-level administration positions at the state or federal level. The purpose of this organization is to help identify mental health issues, prevent mental health problems, and caring and treating those with mental health issues. The stakeholders promote recovery, assessment, diagnosis, treatment and evaluation of those with mental health disorders (Mind, 20220.  I love that this is an open community, and willing to include all those who care about mental health and can come together as one to find a solution to mental health disorders.

 

References

American Psychiatric Nursing Association. 2024. Welcome to Your Psychiatric Mental Health Nursing Community. Retrieved from: https://www.apna.org

Mangano, E., Gonzalez, Y., & Kverno, K. S. (2020). Challenges Faced by New Psychiatric-Mental Health Nurse Practitioner Prescribers. Journal of psychosocial nursing and mental health services, 58(10), 7–11. Retrieved from: https://doi.org/10.3928/02793695-20200915-01

Mind. 2022. Self-esteem. Retrieved from: https://www.mind.org.uk/information-support/types-of-mental-health-problems/self-esteem/tips-to-improve-your-self-esteem/

 

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Donna Hopkinson

Oct 30, 2024 7:51pm
| Last reply Nov 3, 2024 1:20pm

Reply from Donna Hopkinson

Hello Professor and Class,

After careful consideration, I have selected to specialize in pediatric nursing. My desire to work with children and their families considers it important and provide early healthcare interventions to shape their lives. Pediatric nursing will allow me to show my love for children with the opportunity to provide critical care. “Pediatric nursing is very different from adult nursing. The primary aim of a pediatric nurse is to provide continuity of care along with the family of the child through the family-centered care approach” (Kaya & Isler-Dalgic, 2020). My profession will involve support for patients who are often vulnerable and need sympathetic care. One of the major difficulties that I faced in choosing this specialty was the large range of nursing fields. This makes the selection typical for me as I was drawn to several areas. “Pediatric nurses can lead policy initiatives and policy changes in several ways. Participating in activities that advance the SDGs is part of their responsibilities by engaging and influencing policy” (Moreland et al., 2023). The common areas that I was considering are including emergency nursing and oncology. Each of these has unique challenges and rewards. However, I understood that my desire lies in nurturing strong development in children. I also struggled with the emotional characteristics of pediatric nursing. I consider that caring for sick children can be important and needed. I understand that sympathy and resilience are the key strengths that will help me navigate these emotional challenges.

The selected professional organization for pediatric nursing is the Society of Pediatric Nurses (SPN). I would prefer to become a member of this organization as it holds strong and effective information. Becoming a member of SPN will bring several benefits like access to educational resources, and networking opportunities. “Excellence in pediatric nursing is characterized by the use of research to enable practice-based evidence for providing safe and effective nursing care to children and their families” (Harrison et al., 2020). It will allow me to have the latest research in pediatric nursing. Membership provides chances for professional growth through conferences and workshops. These workshops are crucial for staying updated in the field.

References

Harrison, T. M., Steward, D., Tucker, S., Fortney, C. A., Militello, L. K., Smith, L. H., Thrane, S., Tubbs-Cooley, H. L., & Pickler, R. H. (2020). The future of pediatric nursing science. 
Nursing Outlook
, 
68
(1), 73–82. https://doi.org/10.1016/j.outlook.2019.06.020

Kaya, A., & Isler-Dalgic, A. (2020). Evaluating the Job Satisfaction of Nurses Working in Pediatric Clinics in Terms of Eleven Dimensions and the Influencing Factors. 
Florence Nightingale Journal of Nursing
, 
28
(3), 312–320. https://doi.org/10.5152/fnjn.2020.19101

Moreland, P. J., Rosa, W. E., & Mukeshimana, M. (2023). Enhancing the education of paediatric nurses: A positive step towards achieving sustainable development goals. 
Enhancing the Education of Paediatric Nurses: A Positive Step towards Achieving Sustainable Development Goals
, 
10
(8), 5017–5023. https://doi.org/10.1002/nop2.1816

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Eloisa Solarana Almaguer

Oct 30, 2024 7:43pm
| Last reply Nov 3, 2024 9:03pm

Reply from Eloisa Solarana Almaguer

Module 6: Discussion

Since the beginning of my career, I have had a steady interest in the field of psychiatry, which has been a driving force guiding my professional decisions. I feel a genuine calling to help people face and overcome emotional and mental challenges. By choosing the specialization as a Psychiatric Mental Health Nurse Practitioner (PMHNP), I envision a unique opportunity to apply my nursing knowledge in an area as essential as mental health, with a comprehensive and patient-centered approach (Walden University, 2024). Among my primary objectives are to develop advanced clinical competencies in the diagnosis and treatment of mental disorders, particularly in highly vulnerable populations; to foster emotional and psychological well-being in my geriatric patients through psychiatric interventions tailored to their individual needs; and to contribute to the community by providing accessible, high-quality psychiatric care, thereby improving access to specialized mental health services (Adult-Gerontology NP Competencies Work Group, 2016).

Choosing a specialty in psychiatry has involved facing several challenges. During the decision-making process, I identified some difficulties, including insecurities about my ability to handle the inherent complexities of mental health, especially when treating patients who may have traumatic backgrounds or severe disorders (Walden University, 2024). Psychiatry requires a compassionate and rigorous approach and represents both a personal and professional challenge. It has become necessary to balance my current work responsibilities with the academic demands of the specialization, making effective time management essential to performing well in both areas. I have also recognized the emotional demands of mental health work, as it requires developing personal resilience and self-care strategies, given that constant interaction with psychiatric patients can be emotionally taxing. These challenges have reaffirmed my commitment to the specialization, motivating me to continue and strengthen my coping skills. I believe this choice will not only enhance my professional growth but also prepare me to make a meaningful difference in the lives of my patients.

A relevant association for this specialization is the American Psychiatric Nurses Association (APNA). According to Shea (2024), this organization plays a vital role in promoting mental health and well-being through the professional development and ongoing education of nurses in the psychiatric field. Membership in APNA offers access to educational resources, networking opportunities, and continuing education programs, which are fundamental for professional advancement in psychiatric nursing. The steps to join APNA include visiting the APNA website to review the membership benefits and requirements, completing the online application form by providing information about my academic background and professional experience, and paying the corresponding annual fee, which will allow me to keep my membership active and access all association resources (Johnson et al., 2024). By joining APNA, I hope to enrich my knowledge and contribute to the development of psychiatric nursing practice, supporting the organization’s mission of promoting mental health care in the community.

My decision to specialize in mental health through the PMHNP program stems from a deep calling to serve and a genuine interest in positively impacting the lives of my geriatric patients. Despite the challenges this path may present, I am committed to the values of the profession and motivated by the opportunities for personal and professional growth this specialization offers.

References

Adult-Gerontology NP Competencies Work Group. (2016). 
Adult-gerontology acute care and primary care NP competencies
. Adult-Gerontology NP Competencies Work Group . https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/NP_Adult_Geri_competencies_4.pdf

Johnson, C., Delaney, K. R., Cirpili, A., Marriott, S., & O’Connor, J. (2024). American Psychiatric Nurses Association Position: Staffing Inpatient Psychiatric Units. 
Journal of the American Psychiatric Nurses Association
, 
30
(5), 886–895. https://doi.org/10.1177/10783903231198247

Shea J. M. (2024). Psychiatric-Mental Health Nurses: Providers of Care Excellence. 
Journal of the American Psychiatric Nurses Association
, 10783903241291071. Advance online publication. https://doi.org/10.1177/10783903241291071

Walden University. (2024). Master of Science in nursing (MSN). Walden University. https://www.waldenu.edu/online-masters-programs/master-of-science-in-nursing

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Leticia Ariel Hernandez
 (She/Her)

Oct 30, 2024 7:31pm
| Last reply Nov 2, 2024 11:07am

Reply from Leticia Ariel Hernandez

Examining Nursing Specialties

Choosing a nursing specialty always involves weighing personal and professional goals. An MSN concentration in the role of Psychiatric Mental Health Nurse Practitioner defines my commitment to providing care for patients, both psychologically and holistically, to make a change in their lives. Among all these academic interests and career objectives, PMHNP is a perfect match for my enthusiasm for patient-centered practice and advocacy. Working off these challenges, factors that influenced me to become a dental hygienist, and the importance of professional organizations will help me to learn and identify the importance of this pathway toward my long-term goals.

Challenges in Choosing Psychiatric Mental Health as a Specialty

It was not an easy task to decide upon PMHNP as my specialty. It took work to choose between the areas of interest within the nursing profession. Because of the large number of nursing professions within the field, with each having its scope, competencies, and practice standards, I had a hard time going through the process (Walden University, n.d.). I was really torn between Psychiatric Nursing and Adult-Gerontology Primary Care because both practice areas involve pressing health concerns among diverse populations. I considered my long-term career goals, passion for mental health, and increased demand for psychiatric services because of greater awareness of psychiatric concerns in our society today.

This decision also required profound detail regarding the role and responsibilities of a PMHNP. Knowledge application regarding mental health disorders, therapeutic intervention, and clinical skills in terms of holistic care is actually necessitated by the American Nurses Association for psychiatric nurses (American Nurses Association, 2015). I was not so sure that I would handle such work, considering the many complexities and emotional challenges that usually come with those who have real mental health crises.

Factors Driving My Decision

Some of the reasons that kept me knowing that I should specialize in PMHNP include increased rates of mental health disorders such as anxiety, depression and substance use disorders, whose demands make it very necessary to have many psychiatric caregivers. For example, Echevarria (2018) stated that the mental health profession is one of the biggest and rapidly expanding areas in health care today. It does; more of the patients are being diagnosed with the diseases than there are caregivers out there.

My academic and professional goals also aligned with PMHNP. I want to learn psychiatric nursing comprehensively in order to provide holistic health services regarding mental and physical health. Other academic interests include evidence-based practice, therapeutic communication, and psychopharmacology, which steered me toward this path since PMHNPs are trained to integrate these aspects into their practice (Echevarria, 2018). My desire to belong to a growing network of professionals dedicated to enhancing mental health services was also of great significance.

Professional Organization: American Psychiatric Nurses Association (APNA)

In choosing psychiatric nursing as a specialty, I became a member of the American Psychiatric Nurses Association. APNA is one such organization that plays a vital role in promoting the specialty through excellence in practice, advocacy, and leadership (Bickford et al., 2015). Benefits of being an APNA member include access to all research publications, discounts on certification programs, and networking with other psychiatric nurses. It also offers the opportunity for continuing one’s education in emerging trends and best practices that come with changes in mental health care.

To join APNA, one needs to complete the application form available on the association’s website, send a document proving nursing credentials, and pay a yearly fee. Because they are PMHNPs, at the discretion of their organization, specialized resources such as clinical practice guidelines about mental health and advocacy will be provided (Cherry et al., 2019). This membership has given me a vast opportunity to enhance my knowledge of psychiatric nursing standards in a way that equips me to actively contribute to shaping the desired changes toward better mental health in my community.

In conclusion, a decision on the nursing specialty is thus quite critical, as it has numerous implications for one’s academic and professional life. Although not every journey toward my dream of psychiatric mental health nursing was devoid of challenges, my professional goals fell in place with my passion for mental health care, aside from the dire need for specialized psychiatric service provision. It was by joining professional organizations like APNA that I was able to gain valuable resources and a supportive community for my growth as a psychiatric nurse.

 

References

American Nurses Association. (2015). Nursing informatics: Scope and standards of practice (2
nd
 ed.). 
Silver Spring

Bickford, C. J., Marion, L., & Gazaway, S. (2015). Nursing: Scope and standards of practice, third edition – 2015

Cherry, B., Caramanica, L., Everett, L. Q., Fennimore, L., & Scott, E. (2019). Leveraging the power of board leadership in professional nursing organizations. 
JONA: The Journal of Nursing Administration
, 
49
(11), 517-519.

Echevarria, I. M. (2018). Make connections by joining a professional nursing organization. Nursing, 48(12), 35–38.

Walden University. (n.d.). Master of Science in Nursing (MSN). Retrieved October 30, 2024, from 
https://www.waldenu.edu/online-masters-programs/master-of-science-in-nursing
Links to an external site.

 

 

 

 

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Qurita Powell

Oct 30, 2024 5:48pm
| Last reply Nov 2, 2024 11:06pm

Reply from Qurita Powell

     The specialty that I chose for this program is Psychiatric Mental Health Nurse Practitioner. My choice is driven and motivated by a desire to contribute positively towards mental health needs across underserved populations. Over the past 15 years, I have worked in various mental health care settings. I have witnessed and felt the urgent demand that exists now for skilled practitioners who can offer empathetic, informed care to those with mental health challenges (Walden University, n.d.). Through my experience of working in this field, I have learned the importance of determining one’s overall health through their mental health. In many cases, stigmas arise from a lack of education regarding mental health and how to care for it. I chose this specialty because I truly have a passion for working with those that struggle with mental health issues and providing education and resources to those individuals as well as their support system on how to care for it.

Though everyone may or may not struggle with maintaining good mental health, we all know someone who has struggled with some form of mental health issues such as depression, anxiety, PTSD etc. I have not been faced with many difficulties in choosing PMHNP as my specialty because due to my passion and drive to help the mental health population. As I have mentioned in many of my posts, the mental health community is an underserved population of people with limited resources and access to them. One professional organization I wish to become affiliated with the American Psychiatric Nurses Association as it supports PMHNP professionals by providing critical resources such as standards of practice, educational mentorship, and professional development opportunities (Tierney, 2020). Membership with APNA gives each PMHNP relevant tools and resources through study curricula and certifications that reflect ever-changing best practices. Further, APNA’s mental health advocacy promotion deepens my clinical expertise and enhances my networks in the psychiatric nursing community. These resources will foster and guide my ability to effectively advocate for mental health needs and be meaningfully involved in the reduction of stigma for the same to ensure broader accessibility to mental health services

 

References

Tierney, M. (2020). Psychiatric-Mental Health Nurses: Revolutionizing Access to Person-Centered Care. 
Journal of the American Psychiatric Nurses Association
, 
26
(6), 595–597. https://doi.org/10.1177/1078390320965245

Walden University. (n.d.). 
Master of Science in Nursing (MSN)
. 
https://www.waldenu.edu/masters/master-of-science-in-nursing
Links to an external site.

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Debra Stone

Oct 30, 2024 5:42pm
| Last reply Nov 3, 2024 9:27pm

Reply from Debra Stone

Main Post

Reflection on Choosing a Nursing Specialty

Choosing to specialize as a Family Nurse Practitioner (FNP) in the Walden MSN program was a challenging and fulfilling decision stemming from my experiences as an emergency department (ED) nurse. In the fast-paced and high-pressure emergency department environment, I am exposed to a wide range of cases that enhance my clinical skills and decision-making abilities. According to the Population-Focused Competencies Task Force (2013), the FNP’s role includes long-term patient management, health promotion, and disease prevention beyond urgent and emergent care. The FNP role emphasizes health promotion and disease prevention, which resonates with my belief in the importance of proactive healthcare. My experience as an ED nurse both posed challenges and provided valuable insight that influenced my decision.

Challenges and Influencing Factors in the Decision

A significant challenge for me is letting go of my identity as an emergency department (ED) nurse. That role has shaped me both personally and professionally, and transitioning to a new identity as an FNP involves a period of adjustment and self-reflection. As a nurse in the ED, I have thrived in fast-paced and high-pressure situations and encountered a wide range of medical conditions, from minor injuries to life-threatening emergencies. It is challenging to adjust my primary focus from acute care to the FNP role and embrace a more holistic, long-term approach. Also, transitioning from RN to FNP may be difficult because of transitioning from an experienced RN to an inexperienced, new NP (Pituskin et al., 2022). I must learn to embrace this change while utilizing the valuable knowledge, experiences, and skills I have acquired while working in the ED.

My experience working in the emergency department has also helped to drive my decision to choose the FNP specialty. Working in a fast-paced setting reveals the importance of quick decision-making and comprehensive patient assessments. FNPs provide comprehensive healthcare services to patients of all ages and can work in various settings, including private practices, clinics, and hospitals. Transitioning to the FNP specialty allows me to leverage my extensive clinical experience while focusing on preventive care and health promotion. Also, if I shift my focus from primary care to emergency care, the FNP specialty will allow me to do that. As an FNP, I can work in urgent care and emergency departments and obtain additional emergency specialty education, such as becoming an emergency nurse practitioner (ENP) (American Association of Nurse Practitioners, n.d.-a).

Professional Organizations Related to My Chosen Specialty

Joining a professional organization like the American Association of Nurse Practitioners can be highly beneficial in staying informed, connected, and supported by other nurse practitioners (Echevarria, 2018). AANP provides a platform for nurse practitioners to connect, exchange ideas, and collaborate with peers nationwide. AANP members can access various continuing education opportunities, including webinars, conferences, and online courses, which help maintain certification and expand clinical knowledge (American Association of Nurse Practitioners, n.d.-b). Membership with AANP offers career resources and professional development tools that assist nurse practitioners in maintaining certifications and expanding clinical knowledge, which are essential for success as FNPs.

Conclusion

The decision to pursue a career as a Family Nurse Practitioner is both an exciting and challenging time. Given the increased demand for primary healthcare providers, the role of the FNP has never been more vital. As I navigate this transition, I am committed to embracing the opportunities for growth and learning while striving to make a meaningful impact on the health and well-being of the patients, families, and communities I serve.

 

References

American Association of Nurse Practitioners. (n.d.-a). 
Are you considering a career as an emergency nurse practitioner? 
https://www.aanp.org/news-feed/are-you-considering-a-career-as-an-emergency-nurse-practitioner
Links to an external site.

American Association of Nurse Practitioners. (n.d.-b). 
Membership
. 
https://www.aanp.org/membership
Links to an external site.

Echevarria, I. M. (2018). Make connections by joining a professional nursing organization. 
Nursing
, 
48
(12), 35–38. 
https://doi.org/10.1097/01.nurse.0000547721.84857.cb
Links to an external site.

Pituskin, E., Albert, M., & Norris, C. (2022). Facilitating successful role transitions from registered nurse to nurse practitioner. 
Texto & Contexto – Enfermagem
, 
31
. 
https://doi.org/10.1590/1980-265x-tce-2022-e001-en
Links to an external site.

Population-Focused Competencies Task Force. (2013). 
Population-focused Nurse Practitioner competencies. 
https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/Competencies/CompilationPopFocusComps2013.pdf
Links to an external site.

 

 

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Cenda Hemingway

Oct 30, 2024 5:13pm
| Last reply Nov 2, 2024 10:59pm

Reply from Cenda Hemingway

 

For over 19 years, I have been continually intrigued by the opportunity to learn new concepts as a nephrology nurse. My primary goal as a nurse is to provide the best possible care to my patients. Working as a dialysis nurse in an outpatient facility challenges me to operate independently, enhancing my clinical skills and learning capacity. I must think critically and make sound decisions regarding patient care, especially since I do not have a rounding physician in the facility at all times. The outpatient dialysis setting has sharpened my thinking and communication abilities when coordinating care with providers.

During the COVID-19 pandemic, there was an intense demand for more nephrology advanced practice family nurse practitioners in our area. The staggering number of patients who experienced kidney failure became overwhelming for the providers, prompting them to experience fatigue and burnout (Mc Keaveney et al., 2021). This increased need sparked my interest in expanding my knowledge and specializing in nephrology as a family nurse practitioner. I witnessed our outpatient dialysis clinic’s admission rates surge, prompting our company to hire full-time nurse practitioners to enhance patient care. Consequently, there is a growing demand for providers, and I am eager to play a significant role in problem-solving and delivering optimal healthcare to all patients. I am excited about expanding my knowledge to become an exemplary clinician. I find it fascinating to understand how processes interconnect, and I take pride in going the extra mile to collaborate with physicians in delivering the best patient care.

Therefore networking is important and continuing to thirst for knowledge is pertinent in this profession which makes it essential to collaborate with other nurse practitioners and providers. The opportunity to participate in organizations that advocate for the profession to ensure we are prepared to offer exceptional patient care is critical to elevating patient care. This collaboration allows for networking with others who share similar goals. The American Association of Nurse Practitioners (AANP) offers memberships to certified nurse practitioners and students enrolled in nurse practitioner programs. The membership fee for certified nurse practitioners is $150 (American Association of Nurse Practitioners. (n.d.). This organization provides educational resources, advocacy information, information about upcoming meetings supporting nurse practitioners’ roles, and in-depth research information. The organization’s goal is to continue to empower nurse practitioners to be leaders and scholars in their profession (Arends et al., 2024).

American Association of Nurse Practitioners. (n.d.). 
Membership
. AANP. Retrieved October 29, 2024, from 
https://www.aanp.org/membership 
Links to an external site.
Links to an external site.
Links to an external site.

Arends, R. , Austin-Ketch, T. , Covelli, A. , Davis, L. , Hallas, D. , Kalmakis, K. , Kirkland-Kyhn, H. ,  Melillo, K. , O’Reilly-Jacob, M. , Parish, A. , Rawlett, K. , Ricciardi, R. , Tracy, C. , Winkelman, C. & Whitehouse, C. (2024). American association of nurse practitioners research agenda, 2023–2028. Journal of the American Association of Nurse Practitioners, 36 (5), 257-261. doi: 10.1097/JXX.0000000000001011.

Mc Keaveney C, Reid J, Carswell C, Bonner A, de Barbieri I, Johnston W, Maxwell AP, O’Riordan J, Strini V, Walsh I, & Noble H. (2021). Experiences of renal healthcare practitioners during the cOVID-19 pandemic: A multi-methods approach. 
BMC Nephrology
, 
22
(1), 301. 
https://doi.org/10.1186/s12882-021-02500-0
Links to an external site.

 

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Qiana Felder

Oct 30, 2024 12:56pm
| Last reply Nov 2, 2024 5:26pm

Reply from Qiana Felder

An Explanation and Description of Specialization Choice

Over the past ten years, I have worked in juvenile corrections, and every time I left, my heart pulled me back.  This was confounding because it was never my goal to work in corrections while in nursing school. However, I believe everything happens for a reason, and I am where I need to be. I chose to advance my career to become a PMHNP due to the urgent and growing number of youths I have seen who need support. One in seven adolescents aged 10 to 19 is affected by a mental disorder, contributing to 15% of the disease burden within this age group (WHO, 2024)

Factors that drove this decision include the lack of providers, especially in underserved communities, and the continued negative mental health stigma that still exists. Stigma can create fear and reluctance toward mental health services, leading to significant delays in seeking help, even when a person urgently needs support (Ahad, 2023). One of my goals is to reduce the mental health stigma by educating and empowering families to be open-minded and understand that mental health is an essential part of overall health. One difficulty I faced was deciding whether to pursue FNP and then get my PMHNP certificate after working for a few years because of the broader scope of practice that would be available. I am more passionate about mental health, so I first pursued this degree.

 

Professional Organization in Selected Specialization and Membership Details

The American Psychiatric Nurse Association (APNA) is a professional organization I would love to be part of, as it is a community that welcomes all psychiatric mental health nurses, from advanced practice nurses to student nurses. APNA is committed to enhancing mental health care in communities and influencing health policy to improve mental health service delivery (American Psychiatric Nurse Association, 2020). The organization offers various resources, opportunities for certification, and support. To become a member, one needs to fill out an application, which can be emailed or mailed to the addresses listed on the website. There is also a yearly membership rate associated with this organization, ranging from $35-$145, depending on the chosen membership.

 

References

Ahad, A., Gonzalez, M., & Junquera, P. (2023). 
Understanding and addressing mental health stigma across cultures for improving psychiatric care: A narrative review
. Cureus, 
15
(5), 1–8. https://doi.org/10.7759/cureus.39549

American Psychiatric Nurses Association. (2020). 
American Psychiatric Nurses Association
. Apna.org. https://www.apna.org/

World Health Organization. (2024, October 10). 
Mental health of adolescents
. World Health Organization; World Health Organization. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health

 

 

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Joan Chikaodi Clement

Oct 30, 2024 5:23am
| Last reply Oct 31, 2024 12:37pm

Reply from Joan Chikaodi Clement

             The nursing specialty that I chose is psychiatric-mental health nurse practitioner (PMHNP). A factor that drove me into selecting the PMHNP is my desire to address the shortage of mental health having witnessed a close relative struggling with access to mental health.  Statistics indicate that as of 2023, approximately 160 million Americans lived in areas with mental health professional shortages with more than 8000  mental health professionals needed to address the shortage.  The shortage of mental health providers is hindering the ability to get timely care.  For instance, in 2021, fewer than half of people with a mental illness were able to access timely care and those with substance use disorders were even less likely (Substance Abuse and Mental Health Services Administration, 2023). The rate of unmet needs is high and this has been worsening mental health.  Statistics also indicate that about 7.6 out of 29.3 million adults aged 18 and above with any mental illness in the past year perceived an unmet need for mental health services in 2021 (Health Resources and Services Administration, 2023). These unmet needs drive me to address the gap and provide behavioral health care to underserved areas like rural settings.

I experienced difficulty between PMHNP and family nurse practitioner.  This is because FNP has a wide scope of practice as they are trained to provide care across the lifespan and address both acute and chronic illnesses. On the other hand, PMHNPs are restricted to mental health and managing psychiatric conditions which seems like a restricted scope of practice (Kumar et al., 2020).  One organization that I can join as a PMHNP is the American Psychiatric Nurses Association (APNA). To become a member, one is required to download a form and mail it to email it to 
membership@apna.org
.There are various types of membership such as regular membership which costs $145 per year, student members for $35, and $75 for the retired member (American Psychiatric Nurses Association, n.d.).

 

References

American Psychiatric Nurses Association. (n.d.). APNA member application. https://myaccount.apna.org/i4a/ams/public/member_start.cfm?mbrAppID=1&pageid=3278&showTitle=1

Health Resources and Services Administration. (2023). 
Behavioral Health Workforce Projections, 2023.
 
https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/Behavioral-Health-Workforce-Brief-2023.pdf

Kumar, A., Kearney, A., Hoskins, K., & Iyengar, A. (2020). The role of psychiatric mental health nurse practitioners in improving mental and behavioral health care delivery for children and adolescents in multiple settings. 
Archives of Psychiatric Nursing
, 
34
(5), 275–280. https://doi.org/10.1016/j.apnu.2020.07.022

Substance Abuse and Mental Health Services Administration. (2023). 
2021 National Survey on Drug Use and Health (NSDUH)
.. https://www.samhsa.gov/data/report/2021-nsduh-detailed-tables

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Mishay Brooks

Oct 29, 2024 11:25pm
| Last reply Oct 30, 2024 1:15pm

Reply from Mishay Brooks

Choosing to pursue a specialty in Psychiatric Mental Health Nurse Practitioner (PMHNP) as part of my MSN program represents a carefully considered step in advancing both my professional and personal goals. Driven by an intense desire to bridge gaps in mental health care, particularly for underserved populations, I view the PMHNP role as a unique opportunity to provide compassionate, holistic care. My goal in this specialization is to develop the clinical expertise necessary to support patients dealing with a range of mental health disorders, from anxiety and depression to more complex conditions such as schizophrenia and bipolar disorder, offering not just symptom management but comprehensive, patient-centered treatment. The knowledge I gain in this program will equip me to empower patients through individualized care plans that promote mental well-being and resilience, aligning closely with the core values of the PMHNP role and with the growing recognition of mental health as a critical component of public health (Phoenix, 2019).

Choosing PMHNP as a specialty was not without its challenges. Initially, I debated whether to specialize in family practice, where I have a strong clinical background, or focus on mental health, which has always been a deep-seated interest. Ultimately, my decision was influenced by the escalating demand for mental health providers and the unique interpersonal aspects of mental health nursing that allow for building long-term therapeutic relationships. As a psychiatric nurse, I am often involved in complex cases requiring an understanding of both physical and mental health. This integrative approach aligns with my aspiration to advocate for patients in a meaningful, holistic way. Mental health is deeply stigmatized and under-resourced, especially in marginalized communities, and I am passionate about contributing to a field where more providers can mean better patient outcomes (Johnson et al., 2023).

A crucial factor influencing my choice was the pressing need for specialized mental health care. With nearly 1 in 5 adults in the U.S. experiencing mental illness, the demand for psychiatric professionals is high, and gaps in access to mental health care persist, especially in rural and underserved areas. The shortage of mental health providers makes it essential to fill this void with skilled professionals who understand the complexities of psychiatric treatment and who can provide compassionate, evidence-based care (Johnson et al., 2023). My goal is to not only support individual patients but also contribute to public health initiatives, potentially even policy advocacy, that strive to make mental health services more accessible.

The American Psychiatric Nurses Association APNA is a leading professional organization for psychiatric nurses and provides excellent resources, continuing education, and networking opportunities that will be invaluable throughout my career (Delaney et al., 2019). Membership with APNA offers access to resources tailored specifically to PMHNPs, including journals, practice guidelines, and conferences, which help members stay informed of the latest evidence-based practices. Membership costs vary by level and include options for students, providing a flexible pathway to engage with the community of psychiatric nursing professionals. This network of peers and mentors is essential for career development and provides a platform to advocate for mental health reform at both the local and national levels (Delaney et al., 2019).

References

Delaney, K. R., Drew, B. L., & Rushton, A. (2019). Report on the APNA national psychiatric mental health advanced practice registered nurse survey. 
Journal of the American Psychiatric Nurses Association
, 
25
(2), 146-155. 
https://journals.sagepub.com/doi/abs/10.1177/1078390318777873
Links to an external site.

Johnson, C., Delaney, K. R., Cirpili, A., Marriott, S., & O’Connor, J. (2023). American psychiatric nurses association position: Staffing inpatient psychiatric units. 
Journal of the American Psychiatric Nurses Association
, 10783903231198247. 
https://journals.sagepub.com/doi/abs/10.1177/10783903231198247
Links to an external site.

Phoenix, B. J. (2019). The current psychiatric mental health registered nurse workforce. 
Journal of the American Psychiatric Nurses Association
, 
25
(1), 38-48. 
https://journals.sagepub.com/doi/abs/10.1177/1078390318810417
Links to an external site.

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Nicole Greco Carl

Oct 29, 2024 10:57pm
| Last reply Nov 2, 2024 6:12am

Reply from Nicole Greco Carl

The specialty I have chosen to pursue is psychiatric mental health nurse practitioner. Most of my life, I have been guided on what to do, and becoming a nurse was one of the things I was pushed to do and not decided on my own. Choosing to become a nurse practitioner and further my education is my own choice and has not been influenced by anybody else in my life. I want to be a “Nurse who takes advantage of continuing-education opportunities to gain professional breadth, broadening their knowledge regarding local and national nursing issues and going beyond the walls of their facilities” (Echevarria, 2018).

 

So far, as a nurse, I have been given great opportunities to interact with nurse practitioners in every specialty. Based on the ones that I have interacted with and what they have told me about their specialty, I found the most interest in psychiatric mental health. When they explained to me their plan of care and logic when helping patients, it made sense and connected for me. Also, when talking to practitioners and other specialties, I have had some tell me not to go in their specific specialty and, if they did it over again, wish they picked psychiatric mental health.

 

One challenge I have faced when making my decision is making sure I pick a specialty that I can say “I love my career”. As a current ER nurse, I love the excitement and the ever-changing experiences every day. As a PMHNP, I have options on the type of patient population I want to deal with: either impatient patients who are in manic states or switching to an outpatient job dealing with patients who need help with anxiety and depression and going about their daily lives.

 

The professional organization that I would like to be affiliated with is the California Association for Nurse Practitioners. This organization can help you “Find inspiration from a supportive network of peers. Add to CANP’s collective voice at the State Capitol. Access events, education, legal advice, and discounts tailored to NPs” (CANP, 2024). To become a member, you must fill out their online membership application. They also have many types of memberships that you can apply for; one being a student meant for ship and another being a membership for nurse practitioners just out of school. Also, another professional organization, the American Psychiatric Nurses Association, offers “APNA members connect with a dynamic community of psychiatric-mental health nurses, exceptional resources and educational programs, and opportunities to advance the PMH nursing profession” (APNA, 2024), with a similar application process of filling out a form and paying a member fee.

 

 

References:

 

APNA. (2024, October 16). 
American Psychiatric Nurses Association
. https://www.apna.org/

 

CANP. (2024). 
Membership
. https://canpweb.org/membership

 

Echevarria, I. M. (2018). 
Make connections by joining a professional nursing organizationLinks to an external site.
Links to an external site.
. 
Nursing
, 48(12), 35–38.

 

 

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Lenore Louise Benton-Bey
 (She/Her)

Oct 29, 2024 7:34pm
| Last reply Nov 1, 2024 6:31pm

Reply from Lenore Louise Benton-Bey

Initial Post

An Explanation and Description to Specialization Choice

I have chosen the family nurse practitioner program. I knew from the beginning that the end goal was to become a family nurse practitioner as I can work with a broader population in full to meet the needs of all stages of life. A family nurse practitioner can work with the population through out their stages of life, from newborns to geriatrics. I enjoy working with people of all ages as a registered nurse, however I find myself wanting to advance given back more to the community. As I am practicing in the current fields I am working in my fields of urgent care and OB/GYN. I know two different world but I cannot leave neither fully behind. I have experience in the cardiovascular world which is a plus as that is an advanced field but I have contemplated about one or the other in a true advancement in but I could not come to just sticking with one and with a FNP I can have more flexibility with so much more in practice.

Being an Iowan alleviates my worries of me not practicing to my full potential as there is not limitations and full practice for the state of Iowa. I will not only because to practice my cares but I can contribute to being cost effective in my state and for our country. Supported by a growing body of evidence of the safe and cost-effective provision of care by APRNs (ANA, 2024). There are hopes that the limitations for other states will be put in to place because of the cost effectiveness of the nurse practitioner. Advancing and protecting the scope of practice for nurses, particularly advanced practice registered nurses, is a major initiative at ANA. ANA is working together with our state/territorial affiliates (nurses associations) to remove barriers and secure full practice authority (ANA, 2024).

Professional Organization in Selected Specialization and Membership Details

The main reason professional organizations exist is to further the profession (Echevarria, 2018). Furthermore, this is why I chose to discuss the professional orgazation of the American Nurses Associations. I am a current member and I have explore their resources of what they offer for the advanced practicing nurse and the registered nurses. I am confident in the credentialing and the certifications that they offer for the advancement of my career of an advanced professional.I have access to certifications and articles that can help me stay updated with current evidence-based practices and continuing education. There is access to certifications, where to sign up for testing locally or near by your location. And much more to explore will advancing or in the career as the ARNP. Lastly,  I am looking to join the American Women’s Health, Obstetrics, and Newborn AWHONN. These associations will be an excellent resource to follow up on and keep up to date with resources and certifications in this field as well for my newborn and postpartum families.

 

References

American Nurses Association. (2024). Advanced Registered Nurse Practitioner (ARNP). Retrieved from 
https://www.nursingworld.org/practice-policy/aprn/
Links to an external site.
 on October 29, 2024.

Assoication of Women’s Health, Obestric, Newborn. (2024). 

AWHONN- Association of Women’s Health, Obstetric and Neonatal Nurses

Links to an external site.

Echevarria, I. M. (2018). 
Make connections by joining a professional nursing organization
Links to an external site.
. Nursing, 48(12), 35–38.

 

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John Kirby Tompkins

Oct 29, 2024 1:04pm
| Last reply Nov 1, 2024 8:24pm

Reply from John Kirby Tompkins

Module 6
 

Discussion Initial Post
 

An Explanation and Description to Specialization Choice
 

Ten years as an RN serving adults and children in inpatient mental health crisis settings. Ten more years as a Family Nurse Practitioner reaching the limits of that training trying to meet the needs of a rural underserved population. For example, for ten years there was only one child-adolescent psychiatrist in our county, and now he has retired. So, my choice for further specialization has been made by the logical progression of service to my local population.
 

The Walden PMHNP specialization program claims to be number 1 in enrollment in the USA and confers expertise in the care for mental and emotional well-being of patients throughout the lifespan, treating psychiatric disorders, brain disorders, and substance abuse issues. (Walden, n.d.).   
 

 
 

Professional Organization in Selected Specialization and Membership Details
 

During my family practice years, I comfortably relied on membership in the American Academy of Pediatrics. This enabled an alignment between my academic and professional development. I expect a similar benefit with membership in the Association of Psychiatric Mental Health Nurse Practitioners. Specifically addressing alignment with ANA Nursing Scope and Standards of Practice are six values explicated by Echevarria (2018.):” professional development, career growth, networking, mentorship, service to the profession, and advocacy”.
 

 
 

References
 

Echevarria, I. M. (2018). 
Make connections by joining a professional nursing organizationLinks to an external site.
Links to an external site.
. 
Nursing
, 48(12), 35–38.
 

Walden University. (n.d.).
Master of Science in Nursing (MSN)Links to an external site.
Links to an external site.
. Retrieved October 23, 2024, from 
https://www.waldenu.edu/masters/master-of-science-in-nursing
Links to an external site.
 

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Veronica Monono

Oct 29, 2024 1:03pm
| Last reply Nov 1, 2024 10:49am

Reply from Veronica Monono

An Explanation and Description to Specialization Choice
 

Choosing a nursing specialty within the program can be challenging due to the vast number of fields available, each offering unique opportunities for growth and development. A common difficulty is balancing personal interests with career goals, job market demand, and the time commitment required for advanced expertise. My choice of specialty is PMHNP, I have always wanted to further my education in Psychiatric nursing and my second choice was public health, but I decided to pursue my MSN in Psychiatric nursing because mental health illnesses are real and have been neglected by many because of lack of education concerning the reality of mental health crisis and also they have limited access to care, especially those living on underserved areas and they might not have enough mental health facilities in their locality to care for their needs. The community must be educated about the reality of mental health, how it can be recognized in a loved one and the communities and when to seek help. (National Alliance on Mental Illness, 2024)
 has been a cornerstone of addressing the challenges faced by millions of Americans living with mental health conditions, through Mental Health Awareness Month which is the month of May. NAMI actively participates in this national movement, dedicated to eradicating stigma, extending support, fostering public education, and advocating for policies that prioritize the well-being of individuals and families affected by mental illness.
 

Furthermore, the key factors driving my decision include personal interest, career opportunities, work-life balance, skills, and strengths. Concerning Personal interest, I have always had a passion for helping people suffering from mental health illnesses my goal is for the communities to be aware of the reality of mental health, how to recognize it in loved ones and communities, and when to seek help from mental health institutions. In career opportunities, PMHNPs are well paid, and career opportunities are always available in every sector of the health care system. You can work from home, in hospitals, clinics, and community centers, just to name a few. This career opportunity helps to balance work and life, especially working from home or in other settings, which can give you flexible working hours. This career path helps you align your clinical skills in areas of strength with the specialty that would best utilize them. (Psychology Jobs, 2024) states that 
Psychiatric Nurse Practitioners can choose to work with adults, adolescents, or children in a variety of settings based on his/her specialty. Many Psychiatric Nurses work in private practice or behavioral health clinics. Other settings include residential treatment centers or general practitioners’ offices. Working alongside other health professionals often means creating an interdisciplinary treatment plan to address patients’ health and wellness.
 

Professional Organization in Selected Specialization and Membership Details
 

One of the professional organizations that I would like to be affiliated with, will be the American Association of Nurse Practitioners (AANP
)
.  According to (
the American Association of Nurse Practitioners, 2024)
 to become a member, I would have to choose a membership level either a student, regular, or an associate, and I will have to pay the membership fee, student memberships are often discounted. I can apply online with proof of student status if applicable. Membership benefits include access to educational resources, networking opportunities, conferences, and professional development tools. In (Cherry et al., 2019) an important factor essential to a nurse’s professional development is active membership in at least one professional organization. And that membership provides exposure and access to educational resources and rewarding networking opportunities with peers and colleagues. Professional organizations provide nurses with a network of experts to share clinical and administrative challenges and gain new ideas and knowledge.
 

 

References 
 
 

American Association of Nurse Practitioners. (n.d.). 
Membership
. AANP. Retrieved October 26, 2024, from 
https://www.aanp.org/membership
Links to an external site.
 

Cherry, B., Caramanica, L, Everett, L. Q., Fennimore, L., & Elaine, S. (2019).
Leveraging the power of board leadership in professional nursing organizationsLinks to an external site.
Links to an external site.
. 
JONA: The Journal of Nursing Administration, 49
(11), 517-519.
 

National Alliance on Mental Illness. (n.d.). 
Mental Health Awareness Month
. NAMI. Retrieved October 26, 2024, from 
https://www.nami.org/get-involved/awareness-events/mental-health-awareness-month/
Links to an external site.
 

PsychologyJobs. (2024). 
Psychiatric nurse practitioner career guide
. PsychologyJobs.com. Retrieved October 26, 2024, from 

PMHNP / Psych NP Jobs – Psychiatric Nurse Practitioner Career Guide 2026

Links to an external site.
 

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Leaticia Onyeise

Oct 29, 2024 1:53am
| Last reply Oct 31, 2024 6:18pm

Reply from Leaticia Onyeise

Reflection on my decision to pursue a specialty in the PMHNP Certification Program

As a registered nurse, I have worked in various areas of the nursing care units. During this journey, I have passionately cared for psychiatric and mental health disorder patients, including clients with depression, schizophrenia, and substance abuse. However, it has been an exciting journey providing services to help alleviate the pains and sufferings these categories of patients face in trying to get adequate care services. Especially those patients from rural and poor communities in our society; they suffer more when there is a lack of providers or disparities and discrimination in the system. As a result, I was motivated to pursue an advanced degree specialty in the psychiatric mental health nurse practitioner program to qualify as a PMHNP. I want to be a catalyst for change in my community in this area of healthcare practice by playing a large role in raising awareness of mental health issues and the disparities in the system through advocacy and education to help close the gaps that exist in the service throughout the communities and society at large.

An Explanation and Description of Specialization Choice

Completing this program with a mental health nurse practitioner certification will be a big achievement and milestone for me.  A psychiatric mental health nurse practitioner (PMHNP) is an advanced practice registered nurse specializing in mental health care, providing comprehensive assessments and diagnoses, creating treatment plans, and medication management for patients with psychiatric disorders, including the ability to prescribe medications, depending on the state of regulations (Walden University, n.d.). Other vital facts about a psychiatric nurse practitioner include the scope of practice, educational training, conducting therapy sessions, prescribing medications, performing physical and psychosocial assessments, and developing treatment plans. It also involved engaging in further academic and continuing education training and certifications. Nurse practitioners
 
may collaborate with psychiatrists, maintain private practice, and work in schools and community mental health centers. Notwithstanding specialty, every nurse practitioner must maintain their continuing education, competency requirements, and license with their state board of nursing to continue and sustain practice.

Professional Organization in Selected Specialization and Membership Details

Professional nursing organizations are key in nursing and patient advocacy (Echevarria, (2018).  A professional association can assist nurses in meeting performance competencies, enhancing professional knowledge and skills, continuing education, achieving career growth and promotion, and providing research, mentoring, and networking tools. After my program, I plan to join a professional organization like the American Psychiatric Nurses Association. It is a membership organization dedicated to psychiatric-mental health RNs and APRNs who work in various settings, including inpatient, outpatient, research, education, administration, private practice, military, and more (APNA, n.d.). The association prides itself on being an inclusive organization where all psychiatric-mental health nurses can find a home for the education, resources, and support they need to provide crucial mental healthcare services.  In addition, its mission and vision align with my planned practice goal. According to (ANA, n.d.), the APNA membership values are professional development, career growth, networking, mentorship, professional service, and advocacy. These values align with my own values and the nursing scope and standards of practice.

References

Echevarria, I. M. (2018). 
Make connections by joining a professional nursing organizationLinks to an external site.
Links to an external site.
. 
Nursing
, 48(12), 35–38.

Walden University. (n.d.).
Master of Science in Nursing (MSN)Links to an external site.
Links to an external site.
. Retrieved November 14, 2018, from 
https://www.waldenu.edu/masters/master-of-science-in-nursing
Links to an external site.

American Psychiatric Nurses Association. (2024). 
About APNA
. 
https://www.apna.orgLinks to an external site.
Links to an external site.

 

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Deco Tanjong

Oct 28, 2024 5:47pm

Reply from Deco Tanjong

                      Examining Nursing specialties

My decision to persuade my post-master certification in psychiatric mental health nurse practitioner is a journey that took me  years to finally make up my mind  and follow this route . At the beginning of my nursing career I worked in a nursing home , later on move to a mental health facility where my initial idea was to gain more experience and continue my pathway in to my psychiatric nurse practitioner . At the facility I faced some challenges like one of my patient spilled milk on me when I was trying to guide and correct her. So I left to the Hospital working on a medical and surgical unit where I have been working for the last four to five years.

Choosing to go back to the same pathway of becoming a psychiatric nurse practitioner was because of the rise in the need of metal health providers, and the believe that some people still have, that mental health is not  a challenge that a lot of people are facing in live and just sometime  need someone to give them a listening ear. Department of Health (n,d).

My goal is to educate people that even though you are a drug addict you still deserve the opportunity to make things right, if you became stressful and depressed the best option is not to commit suicide or kill people you still deserve the right to live and be given the opportunity to make the right choices. And no suicide attempt should ever be dismissed. Mental Health America (n,d).

My prominent professional organization I want to be a member is the American psychiatric Nurse practitioner(APNA) which will help connect me with nurses who understand what I will be doing because they do it too. American psychiatric nurse Association (n,d). Also the APNA will keep me up to dates  with every evidence based practice changes as healthcare is a field of change .

Reference:

Bickford, C. J., Marion, L., & Gazaway, S. (2015). 
Nursing: Scope and standards of practice, third edition – 2015Links to an external site.
Links to an external site.
. Retrieved from 
http://ebooks.iospress.nl/publication/12524
Links to an external site.
.

 

Scope of practice
. American psychiatric nurse practitioner . (n.d.).

 

 

 

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Lucia Almeida

Oct 28, 2024 11:30am
| Last reply Nov 2, 2024 10:24pm

Reply from Lucia Almeida

Examining Nursing Specialties

Upon much contemplation, I chose Family Nurse Practitioner (FNP) as this option gives more opportunities to address the patient’s unique needs. The scope of practice of FNP includes broader categories in healthcare and the ability to take care of patients of all ages children, adolescents, adults, and the elderly (American Association of Nurse Practitioners [AANP], 2024). Planning entailed reflecting on my previous interactions within the nursing sphere which included aesthetics, IV therapy, and case management – and recognizing patient-centered care as an essential FNP component.

I also changed my mind about choosing Adult-Gerontology Primary Care over FNP because of the higher employment rate and ability to treat an extensive diversity of health problems. At first, I was drawn to adult care because of my responsibilities for handling medical and surgical cases, which provided me with knowledge about the requirements for the main adult groups. Yet, as I gathered information with the help of other experienced practitioners and thought about the needs in my community area, I realized that FNP gave a wider scope for advancements (American Psychiatric Nurses Association [APNA], 2024).

The American Association of Nurse Practitioners (AANP) is a comprehensive online source that provides up-to-date information on FNP practice, current literature and research, and current educational offerings. Through its membership, the AANP offers networking avenues, clinical tools, and advocacy initiatives that support the FNP practice throughout the United States (AANP, 2024). Additionally, the U.S. Bureau of Labor Statistics provides insight into employment rates and the growth potential within the FNP field, indicating a robust demand for FNPs nationwide (U.S. Bureau of Labor Statistics [BLS], 2023). This source highlights that an increasing number of healthcare facilities rely on FNPs to meet diverse health needs, validating my choice in specializing in FNP.

As I researched the FNP path, I encountered several difficulties in transitioning into advanced practice nursing roles, which were more accentuated when identifying courses and clerkships to undertake. Nonetheless, the faculty members and support staff have provided crucial advice on how to proceed, including competencies that still need to be developed and important resources that will be required to become a competent FNP.

References

American Association of Nurse Practitioners. (2024). 
American association of nurse practitioners
. American Association of Nurse Practitioners; AANP Website. 
https://www.aanp.org/
Links to an external site.

American Psychiatric Nurses Association. (2024). 
About APNA
. 

Home

Links to an external site.

U.S. Bureau of Labor Statistics. (2023). 
Nurse practitioners: Occupational outlook handbook
. U.S. Bureau of Labor Statistics. https://www.bls.gov/ooh/healthcare/nurse-practitioners.htm

An Explanation and Description to Specialization Choice

My decision to pursue a post-master’s certificate to earn my Psychiatric Mental Health Nursing Practitioner (PMHNP) is a journey shaped by personal experiences, professional encounters, educational pursuits, and clinical exposure.  The program is designed to prepare registered nurses to support individuals experiencing mental health issues.  The focus is on assessment, diagnosis, and treatment of mental health disorders across a variety of settings.  Students get advanced training in therapeutic communication, psychopharmacology, and evidence-based practices, alongside gaining practical experience through clinical rotations in mental health facilities.

Choosing to pursue the specialization of PMHNP can present several challenges.  It can be daunting to navigate the complexities of mental illnesses, including the stigma associated with them that takes an emotional toll.  The rigorous academic and clinical demands of the program have the potential to be overwhelming; therefore, strong time management and self-care practices are needed to avoid burnout. There are a variety of career paths within mental health nursing, such as opening up a private practice, inpatient care, or community health.  Weighing options and determining where my passion lies can be a significant source of stress.

Some factors that contributed to my decision to pursue a PMHNP program include a desire to make a difference in the population being cared for, coupled with my experiences working in mental health, which has allowed me to witness the impact of mental health issues on society at large.  According to (
van Dusseldorp et al., 2023
) research in somatic health care has shown that patients perceive nurse practitioners as dependable, supportive, and compassionate. They report feeling empowered, calm, and in control when receiving care from PMHNP.  The awareness and acceptance highlight the demand for qualified professionals in this area.  The evolving field that allows providing holistic care and patient advocacy is also a compelling reason to pursue this specialty (
Questions About Advanced Practice Psychiatric Nurses
, n.d.
).

 

Professional Organization in Selected Specialization and Membership Details

One prominent professional organization that supports and serves the interests of psychiatric-mental health nurses is the American Psychiatric Nurses Association (APNA).  There are various benefits a membership offers, including access to educational resources, networking opportunities, and advocacy initiatives aimed at advancing psychiatric nursing (
Apna Membership Benefits – Join the Apna Community
, n.d.
).

Membership typically requires an annual fee, which grants access to resources such as continuing education courses and professional development programs that include access to journals and publications.  Individuals can visit their official website and fill out an online membership application (
Apna Membership Benefits – Join the Apna Community
, n.d.
).

In conclusion, the PMHNP program offers a rewarding yet challenging path for those interested in specializing in mental health nursing.  The decision-making process can be complex, but support from professional organizations provides valuable resources for aspiring psychiatric nurses who are often influenced by personal motivations and the realities of the profession (
Aanp Communities
,n.d.
).

​

References

Aanp communities
. (n.d.). American Association of Nurse Practitioners. Retrieved September 1, 2024, from 
Links to an external site.
https://www.aanp.org/membership/aanp-communities
Links to an external site.

Apna membership benefits – join the apna community
. (n.d.). APNA. 
Links to an external site.

Why Join APNA?

Links to an external site.

Questions about advanced practice psychiatric nurses
. (n.d.). APNA. 
Links to an external site.

Questions about Advanced Practice Psychiatric Nurses

Links to an external site.

van Dusseldorp, L., Groot, M., van Vught, A., Goossens, P., Hulshof, H., & Peters, J. (2023). How patients with severe mental illness experience care provided by psychiatric mental health nurse practitioners. 
Journal of the American Association of Nurse Practitioners
, 
35
(5), 281–290. 
Links to an external site.
https://doi.org/10.1097/jxx.0000000000000867
Links to an external site.

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Caitlin J Mcelhaney

Oct 28, 2024 10:37am
| Last reply Oct 31, 2024 2:30pm

Reply from Caitlin J Mcelhaney

An Explanation and Description to Specialization Choice

In choosing to specialize as a psychiatric nurse practitioner (Psych NP), my journey stems from a deep desire to merge my nursing background with my academic foundation in forensic psychology. My work as a registered nurse in a behavioral hospital exposed me to the realities of mental health care, showing me the critical need for psychiatric professionals trained not only in mental health but also in the complex nuances of patient care across diverse and challenging settings. By integrating these two fields, I aim to address mental health issues with a holistic approach, acknowledging the complex interactions between mental health, trauma, and broader sociological factors.

Although the decision felt natural, I faced challenges in committing fully to this specialty, largely due to the intense demand, high levels of responsibility, and emotional toll involved in psychiatric nursing. The need to stay resilient in the face of difficult cases and patient experiences often requires sustained emotional and professional commitment, which can be daunting (Hammarström et al., 2019). However, my background in forensic psychology and passion for mental health care have consistently reaffirmed my choice. I am committed to fostering a supportive, empathetic, and evidence-based approach to care that aligns with patient-centered goals (American Psychiatric Nurses Association [APNA], 2024).

Professional Organization in Selected Specialization and Membership Details

One of the professional organizations I find valuable in supporting this journey is the American Psychiatric Nurses Association (APNA). This organization is dedicated to advancing psychiatric-mental health nursing through ongoing education, practice resources, and professional development. Membership in APNA requires an active RN license, granting access to a wealth of resources including specialized training, conferences, and certification preparation. These offerings not only foster personal growth but also build the competencies necessary to address the demands of psychiatric nursing (APNA, 2024).

References

American Psychiatric Nurses Association. (2024). 
About APNA
.
 https://www.apna.org
Links to an external site.

Hammarström, L., Häggström, M., Devik, S. A., & Hellzen, O. (2019). Controlling emotions—nurses’ lived experiences caring for patients in forensic psychiatry. 
International Journal of Qualitative Studies on Health and Well-Being
, 
14
(1), 1682911. https://doi.org/10.1080/17482631.2019.1682911

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Cynthia Ngozika Ekenta

Oct 28, 2024 8:39am
| Last reply Nov 1, 2024 5:26pm

Reply from Cynthia Ngozika Ekenta

An Explanation and Description of Specialization Choice

From the beginning of my nursing career, I anticipated working with elderly adults and aimed to specialize as an Adult-Gerontology Primary Care Nurse Practitioner. I was attracted to the complexities of aging and the opportunity to address their health issues and enhance their quality of life. However, my current experience on the observation unit has marked a significant transformation in my nursing path.

In my interactions with some psychiatric patients who frequently visit the emergency room, I listened attentively to their narratives. I observed the significant difficulties they encountered, including stigma, access to care, treatment adherence issues, co-occurring conditions, lack of social support, economic challenges, and navigating a complex healthcare system. Their courage in confronting these obstacles resonated profoundly with me. I recognized that mental health is a crucial component of overall well-being, and many individuals, particularly the elderly, often contend with mental health challenges alongside physical ailments (Simmons et al., 2017). This enlightening experience shifted my perspective on nursing and encouraged me to reconsider my career path.

I developed a strong belief in the necessity for specialized mental health care and acknowledged that I could make a significant impact as a psychiatric-mental health nurse practitioner (PMHNP). My goal is to advocate for individuals struggling with mental illness, offering them the essential support and resources they need. The shortage of psychiatrists and other mental health providers has become a major challenge in our communities. Currently, forty percent of individuals with serious mental illness in the United States receive no treatment for their symptoms within one year due to this shortage (Costa & Olfson, 2016).

By choosing to become a psychiatric-mental health nurse practitioner, I aim to assess, diagnose, prescribe treatments, and educate individuals with mental illness and their families, helping to reduce the stigma they face in their communities and within mental health facilities.

Professional Organization in Selected Specialization and Membership Details

To support my professional development in this specialty, I plan to join the American Psychiatric Nurses Association (APNA). This organization is dedicated to the practice of psychiatric-mental health nursing. It promotes health and wellness through the identification of mental health issues, prevention of mental health problems, and the care and treatment of individuals with psychiatric disorders (APNA, n.d.). Membership in the APNA will provide me with valuable networking opportunities, access to continuing education, and resources on evidence-based practices related to assessing, diagnosing, and treating mental health disorders. I will either email the organization about my interest in becoming a member or visit their website to complete the membership form and pay the required fees.

In conclusion, my journey has led me to understand the vital role of mental health in patient care. I am committed to becoming a Psychiatric Nurse Practitioner to advocate for those struggling with mental illness and to make a meaningful difference in their lives.

 

References

APNA. (n.d.). Your resource for psychiatric mental health nursing. Retrieved from  
https://www.apna.org/i4a/pages/index.cfm?pageid=1
Links to an external site.

Costa, C., & Olfson, M. (2016). Shortage of mental health professionals providing mental health care: The author replies. 
Health Affairs
, 35, 1934. DOI:10.1377/hlthaff.2016.0933

Simmons, L., Jones, T., & Bradley, E. (2017). Reducing mental health stigma: The relationship between knowledge and attitude change. 
European Journal of Mental Health, 12
(1), 25–40. 
https://doi.org/10.5708/EJMH.12.2017.1.2
Links to an external site.

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Rebecca Blair Manges

Oct 28, 2024 8:05am
| Last reply Oct 30, 2024 12:46pm

Reply from Rebecca Blair Manges

An Explanation and Description to Specialization Choice

I am pursuing a post master’s certification in Adult Gerontology Acute Care Nurse practitioner. 12 years ago, I graduated from a family nurse practitioner program. I remember contemplating between the FNP and AGACNP program in 2009. During that time NP’s and PA’s were not used in an inpatient setting in my area except as a surgical assistant.  I ultimately decided on an FNP program as it made me more marketable. I do not regret my choice as I have had a wide variety of experiences in the primary care arena. I went back to the acute care setting in 2020, and I have found my clinical interest as a hospitalist. I am planning to use my clinical hours to gain more experiences in specialties to enhance my clinical knowledge. These areas include neurology, cardiology and infectious disease. I am also planning some clinical hours in a hospital that I am not professionally affiliated with.

 

Professional Organization in Selected Specialization and Membership Details

The American Nurse’s Credentialing Center (ANCC) is the one the certifying boards for the AGACNP certification. To obtain the AGACNP-BC certification one must complete a master’s or post master’s program and complete an initial 175 question exam (ANCC, 2020.). This certification is good for 5 years and requires the provider to meet several certification requirements to be eligible or renewal (ANCC, 2020). The American Associations of Nurse Practitioners (AANP) offer a acute care specialty practice group for nurse practitioners with a clinical interest in acute care. This program suggests that the provider have an acute care certification and requires a membership to the AANP (Acute Care Specialty Practice Group, N.D.). I have found involvement in professional organizations is a great way to make professional connections that promote growth and development.

 

References

Acute Care Specialty Practice Group
. (N.D.). American Association of Nurse Practitioners. https://www.aanp.org/membership/aanp-communities/acute-care

Adult-Gerontology Acute Care Nurse Practitioner Certification (AGACNP-BC) | ANCC
. (2020). ANA. https://www.nursingworld.org/our-certifications/adult-gerontology-acute-care-nurse-practitioner/

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Barbara A Shannon

Oct 28, 2024 7:32am

Reply from Barbara A Shannon

My choice to pursue a nursing specialty in Psychiatric Mental Health stems from a strong desire to address the growing need for mental health services and make a meaningful impact on individuals struggling with mental health challenges. Mental health is a crucial yet often underrepresented area of healthcare, and there is a significant shortage of mental health professionals, particularly in underserved communities (Finley, 2020). Becoming a Psychiatric Mental Health Nurse Practitioner allows me to contribute to filling this gap and providing compassionate, evidence-based care to those who need it most.

Additionally, the holistic approach of the psychiatric mental health specialty aligns with my passion for treating the whole person addressing both mental and physical health needs (Kumar et al., 2020). Psychiatric mental health nursing focuses not only on diagnosing and treating mental health disorders but also on promoting mental wellness, educating patients and families, and advocating for those with mental illness (Kumar, 2020). This comprehensive approach to care resonates with my values as a nurse, as it allows me to build meaningful, long-term relationships with patients and provide continuous, integrated care.

Another reason for choosing this specialty is the growing recognition of mental health as an integral part of overall health. Mental health conditions like depression, anxiety, substance use disorders, and severe psychiatric illnesses are increasingly prevalent, yet many individuals still face barriers to accessing effective care (Kumar et al., 2020). By becoming a Psychiatric Mental Health – Nurse Practitioner, I can be part of the solution, advocating for mental health services, reducing stigma, and contributing to positive change in how mental health is viewed and treated in society.

In choosing to specialize in Psychiatric Mental Health, I encountered a few challenges and considerations that required careful thought. One of the difficulties was balancing my interest in various nursing specialties. As someone with a perioperative nurse background, I initially considered other advanced practice roles such as Pediatric Nurse Practitioner because of my experience with pediatrics. The decision to focus specifically on mental health involved reflecting on the most pressing needs within healthcare and where my skills could make the greatest impact. A major factor driving my decision was the growing recognition of mental health as an essential component of overall wellness and the significant shortage of mental health professionals, particularly in underserved populations (Mangano et al., 2020). Mental health disorders are rising, and more individuals are seeking mental health services than ever before (Mangano et al., 2020). Seeing how much these issues impact communities pushed me toward a role where I could actively contribute to improving mental health access and outcomes. Ultimately, these factors helped me clarify that specializing in Psychiatric Mental Health would allow me to combine my desire for long-term patient relationships, advocacy for vulnerable populations, and commitment to holistic care.

The American Psychiatric Nurses Association (APNA) is a professional organization focused on advancing care for individuals with psychiatric and mental health disorders and supporting the development of psychiatric-mental health nurses (PMHNs). APNA promotes education, research, and policy advocacy to improve mental health care and represents psychiatric nurses at all levels, including Psychiatric Mental Health Nurse Practitioners. It offers resources such as continuing education, webinars, conferences, and certifications to enhance professional development.

To become a member of the American Psychiatric Nurses Association you can go to the website where there are various membership categories based on professional status. Full membership for registered is for registered nurses and advanced practice nurses who are working in psychiatric-mental health nursing. Affiliate membership is for individuals who are registered nurses but have an interest in psychiatric mental health nursing. International membership is for nurses who practice outside the United States. Student membership is for those who are enrolled in a nursing program. Once you select the appropriate membership type, you can fill out the membership application online at the American Psychiatric Nurse Association website. You will need to provide personal and professional information such as contact details, nursing credentials, and employment information. Depending on the membership category you chose, membership dues are due at the time of application completion. Payments can also be made online at the website. The benefits of the membership allow access to various continuing education courses, clinical resources, research publications, conferences, networking opportunities, and advocacy efforts. The membership also comes with a subscription to the Journal of the Psychiatric Nurses Association. By joining APNA, you become part of a professional community that supports psychiatric-mental health nurses and contributes to advancing mental health care.

Finley B. A. (2020). Psychiatric Mental Health Nurse Practitioners Meeting Rural Mental Health Challenges. 
Journal of the American Psychiatric Nurses Association
, 
26
(1), 97–101. https://doi.org/10.1177/1078390319886357

Kumar, A., Kearney, A., Hoskins, K., & Iyengar, A. (2020). The role of psychiatric mental health nurse practitioners in improving mental and behavioral health care delivery for children and adolescents in multiple settings. 
Archives of psychiatric nursing
, 
34
(5), 275–280. 
https://doi.org/10.1016/j.apnu.2020.07.022
Links to an external site.

Mangano, E., Gonzalez, Y., & Kverno, K. S. (2020). Challenges Faced by New Psychiatric-Mental Health Nurse Practitioner Prescribers. 
Journal of psychosocial nursing and mental health services
, 
58
(10), 7–11. https://doi.org/10.3928/02793695-20200915-01

 

 

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Romel Suason

Oct 27, 2024 8:02pm

Reply from Romel Suason

Examining Nursing Specialties

After deciding on the specialty that I wanted to be part of with my MSN degree, I knew that it was the most important move toward taking my career and professional goals in nursing to a higher level. I decided to become an Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) based on substantial thinking over my interest in clinical aspects and the prevailing needs within healthcare. I have always been passionate about caring for the aging population, particularly managing chronic conditions. The role of an AGPCNP aligns with my commitment to improving the healthcare status among the aged population through the prevention, education, and management of chronic diseases (Echevarria, 2018). The specialty also meets my needs because it provides an avenue to deliver patient-centered care, a concept central to my nursing philosophy.

However, it was not an easy choice. Firstly, I needed to narrow my choices within nursing. Two roles that first came to mind were Family Nurse Practitioner and Psychiatric-Mental Health Nurse Practitioner, which had a variety of associated populations and settings. However, weighing my long-term goals with my interest in adult care, I found that the specialty of AGPCNP was best for my career goals. Another obstacle was balancing career growth goals against pragmatic realities like time investment, hard work, and financial burdens related to pursuing a higher degree. Besides the need to continue conducting my current responsibilities, such graduate studies also required a lot of planning and commitment. However, the fact that it offers quality, personalized care within a community I have been especially interested in proved a major aspect that kept me focused.

Several factors guided me toward taking this course. The first influence was the development of the need for primary health care nationwide, especially for the aging population. With the population aging, there comes a dire need for medical practitioners with the appropriate expertise in handling such patients. The AGPCNPs come in handy in meeting these gaps with holistic and evidence-based health care (Bickford et al., 2015). What attracts me to this position is the flexibility it allows a nurse practitioner to practice in various settings, be it outpatient, hospitals, or long-term care. Facilitated by this role, there are provisions for both acute and chronic care management, which further encourages me to establish a long-term relationship with patients and help them through several stages of their illness. What finally inspired me was the independence and leadership role accompanying the position of an AGPCNP. With each passing day, a nurse practitioner is recognized as a leader in health care, thus opening opportunities for me to manage health teams and advocate for policy change that promotes improved accessibility of care for older adults.

One of the large professional organizations associated with the AGPCNP specialty is the Gerontological Advanced Practice Nurses Association (GAPNA). The mission of GAPNA is to promote excellence in advanced practice nursing for older adults (Truant & Chan, 2017). A membership to GAPNA confers a number of benefits ranging from a plethora of continuing education resources to networking with other NPs and policy-supporting quality care of older adults. An active RN license and enrollment or completion of an advanced practice program in gerontology is requisite for being a member (Cherry et al., 2019). Membership includes but is not limited to students, currently practicing AGPCNPs, and other health professionals interested in or committed to caring for older adults. The available resources and support through GAPNA meet my professional goals of enhancing knowledge in caring for older adults and staying current on the best available evidence for practice.

In a recap, though a few factors have been considered when choosing a specialty, the growth in demand and the passion for improving the quality of care for the older population have factored into making it the correct path for me.

 

 

References

Bickford, C. J., Marion, L., & Gazaway, S. (2015). Nursing: Scope and standards of practice, third edition – 2015Links to an external site. Retrieved from 
http://ebooks.iospress.nl/publication/12524
Links to an external site.

Cherry, B., Caramanica, L, Everett, L. Q., Fennimore, L., & Elaine, S. (2019). Leveraging the power of board leadership in professional nursing organizations Links to an external site. JONA: The Journal of Nursing Administration, 49(11), 517-519.

Echevarria, I. M. (2018). Make connections by joining a professional nursing organization Links to an external site. Nursing, 48(12), 3538.

Truant, R., & Chan, R. J. (2017). Future ready: Strengthening oncology nursing leadership in the context of professional oncology nursing organizations Links to an external site. Canadian Oncology Nursing Journal, 27(1), 2-4.

 

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Erin Roecker

Oct 27, 2024 4:03pm
| Last reply Nov 2, 2024 2:47pm

Reply from Erin Roecker

I have been a registered nurse for over five years and have done everything from travel ICU to PACU to now being a diabetes nurse educator. I received my BSN online a year after graduating from nursing school. I have always had a personal goal to obtain a master’s degree and finally decided to bite the bullet this year. This was not an easy decision to make as a full-time working parent of two toddlers and now taking on school on top of work and parenting. I decided on the MSN-FNP route because I work closely with FNPs daily as a nurse diabetes educator. Being a family nurse practitioner makes a lot of sense for me not only because of the broad range of patients and disease processes ill see, but also time wise. I’ve always envied critical care NPs or those NPs that specialize in emergency medicine or midwifery, but I can’t go back to the 12-hour shifts that comes with those specialties. FNP provides more of a work-home life balance that better fits my family and achieves my personal goal of an MSN and FNP. Another driving factor for me was how desperately needed both physicians and midlevel’s are in primary care now. “Current research shows that there is a shortage of practicing primary care providers. This predicament is projected to worsen as the United States experiences an unprecedented growth of its elderly population and federal healthcare reform aims to extend access to primary care to millions of new patients. Recent reports indicate that the system will need more than 50,000 additional primary care providers by 2025 (Miner, 2019).” By becoming an FNP I am also helping the provider shortage that is happening nationwide but particularly burdens the rural areas of Alaska. According to an article regarding FNP’s and provider shortages, “Patients are benefiting now more than ever before from the high quality, comprehensive, patient-centered health care services provided by nurse practitioners (PR Newswire, 2019).”

A professional organization that advocates for APRN’s is the American Association of Nurse Practitioners (AANP). According to the AANP website, “A membership gives you the opportunity to receive two digital journals, the latest news on topics that matter, access to a comprehensive library of continuing education (CE) activities for all specialties and experience levels at discounted pricing, advocacy at the state and national level, practice tools and so much more (American Association of Nurse Practitioners, n.d.).” Joining a professional organization like AANP is beneficial for APRN’s because they offer advocacy and support, continuing education, certification support and networking opportunities.

 

References:

American Association of Nurse Practitioners. (n.d.). 
Membership
. 
https://membership.aanp.org/start
Links to an external site.

Miner, M. A. (2019). Physicians, Nurse Practitioners, and the Shortage in Primary Care Providers: Professional Autonomy in the Public Discourse. 
Sociological Imagination
, 
55
(1), 51–67.

PR Newswire. (2019, January 28). Nurse Practitioner Role Continues to Grow to Meet Primary Care Provider Shortages and Patient Demands. 
PR Newswire US
.