Tag: Clinical-Nursing

Discussion: Networking Opportunities Introduction

My name is xxxx. I am a native of xxx. I have been living in America with my family for the past eleven years. This year in May mark my five years of becoming a nurse. I love my being a nurse, and I find so much happiness and passion in it. I have worked in various settings in the last five years, and I have enjoyed taking care of every kind of population. I want to learn more in-depth about the disease process and medications with advanced degrees and training. Hence the Family Nurse Practitioner is something that incorporates all my clinical experiences at an advanced level.

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My Goals and University Vision and Mission 

 
As a nurse, I think it is important to have a career goal to progress and succeed. According to the American Nurses Association’s (ANA) 2015 Code of Ethics for Nurses with Interpretive Statements, it is the nurse’s responsibility to maintain competence and incorporate fundamental values and duties beyond individual patient interactions to practice within an ever-changing healthcare environment. Nursing requires ongoing training and education, and there are many specialties in healthcare to learn and grow. Discussion: Networking Opportunities

My ultimate goal is to become a Family Nurse Practitioner (FNP). I looked into several universities to obtain my degree in Family Nurse Practitioner. Among all the universities, I found Walden University to be one that meets my career goal. According to Walden University (WU) of Nursing’s vision statement, the degrees offer diverse specialization and an opportunity for growth (University, Vision, Mission, and Goals, 2020). From WU’s vision statement, the degree from them will be useful and relevant to help the graduate try to solve society’s problems around the world. Discussion: Networking Opportunities

 
Our country is very diverse, and we are increasingly getting patients from all different religious backgrounds. Walden University’s (2020) mission is to “provide a diverse community of career professionals with the opportunity to transform themselves as scholar-practitioners so that they can effect positive social change.” I want to be able to provide essential care with mutual respect and evidence-based knowledge to all those from different backgrounds.

WU’s goals and outcomes match my academic and professional goals. Upon completing the program, I hope to have a deeper understanding of nursing theories and emphasize ethical and critical decision-making skills.

I hope to learn to apply my leadership skills in the provision of high-quality nursing care.

Incorporation of Social Change 

WU wants its graduates to obtain knowledge and skills that will help them make the world a better place. Professional nursing is defined as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations” (Epstein, B., Turner, M. 2015). For me, nursing is the holistic care of all kinds of patients, regardless of their age, gender, race, and religion, in a comfortable environment with full confidentiality, right, and respect of a patient. I plan to bring positive change into practice settings, meet the patient’s unique, holistic needs, and make an incredible difference in the patient’s healthcare experience. Discussion: Networking Opportunities

Academic and professional collaboration

English is my third language. Due to the language barrier, I often struggle with academic and professional development. I will be taking advantage of Walden’s writing center and academic skills center to help to grow academically. My professional goal is to continue to work full time as a float pool nurse. Discussion: Networking Opportunities

 

References

 

Epstein, B., Turner, M., (May 31, 2015) “The Nursing Code of Ethics: Its Value, Its

History” 
OJIN: The Online Journal of Issues in Nursing
. Retrieved from 
http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-20-2015/No2-May-2015/The-Nursing-Code-of-Ethics-Its-Value-Its-History.html

 

Fowler, M. D. M. (2015). 
Guide to the code of ethics for nurses with interpretive
 

statements: development, interpretation, and application
. American Nurses Association. Retrieved from 
http://search.ebscohost.com.ezproxy.coloradomesa.edu/login.aspx?direct=true&db=cat01465a&AN=cmu.b54440063&site=eds-live&scope=site

 

Walden University
. (2020). Vision, Mission, and Goals. Retrieved June 1, 2020,
 

from 
https://catalog.waldenu.edu/content.php?catoid=172&navoid=59420

 

 

 

response

Hi xxx, in response to your comment about the need of culturally competent professionals to address our ever-changing society, I believe it’s an important component in today’s healthcare system so each patient gets the best care they deserve. There is an overwhelming evidence which suggests that providing sensitive care using patient-centered culturally sensitive care yields better outcomes for patients and the healthcare system overall, as it was published in the journal of Health Psychology. This article titled, “Patient-Centered Culturally Sensitive Health Care: Model Testing and Refinement”, presents a model to improve care for ethnically diverse patients seen in community-based primary care clinics (Tucker, Marsiske, & Rice, 2011).

Choosing Walden’s university was the right step toward your goal, becoming FNP. As you’ve mentioned, graduating to a diverse society requires professionals equipped with a new set of skills. Discussion: Networking Opportunities. As we all know, America’s diversity will continue growing each year and the health disparities will grow along with it, as predicted. However, if nurses and other healthcare providers take action in culturally and socially competent ways, then health disparities may be “altered, and the mandate to reduce and ultimately eliminate disparities may be realized sooner” (Giger et al, 2007). I look forward collaborating with you!

References

Giger, Joyce & Davidhizar, Ruth & Purnell, Larry & Harden, J & Phillips, Janice & Strickland, Ora. (2007). American Academy of Nursing Expert Panel Report. Journal of transcultural nursing : official journal of the Transcultural Nursing Society / Transcultural Nursing Society. 18. 95-102. 10.1177/1043659606298618.

Tucker, C. M., Marsiske, M., Rice, K. G., Nielson, J. J., & Herman, K. (2011). Patient-centered culturally sensitive health care: model testing and refinement. Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 30(3), 342–350. 
https://doi.org/10.1037/a0022967

 

Discussion: Networking Opportunities

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

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

This Module’s Discussion asks you to consider how the Walden mission and vision as well as the College of Nursing’s mission and vision apply to your professional and academic goals. You will also begin to identify individuals and teams who can help you along the way as you begin designing the “blueprint”—your Academic Success and Professional Development Plan—that will guide you toward your own vision for academic and professional success.

To Prepare:

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

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

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

Also consider academic and professional individuals and teams with whom you may collaborate in support of your efforts as a student at the university and as a professional within your organization and career. Discussion: Networking Opportunities

By Day 3 of Week 1

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

By Day 6 of Week 1

Respond
 to at least 
two
 of your colleagues’ posts by suggesting additional individuals and/or teams with whom you wish to collaborate or by offering additional networking strategies.

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Hello my name is xxx and I am enrolled in the Post Masters Psychiatric NP program.  I reside in Virginia Beach Virginia and I am a traveling nurse.  I enrolled in the Post Master Psychiatric program in hopes to  address and identify problems and challenges within communities.

Walden University was founded on the platform and need for social change in the community by expanding access to higher education. The mission of the University is to provide a diverse community of career professionals with the opportunity to transform themselves as scholar- practitioners to effect positive social change (Walden University, 2020). Discussion: Networking Opportunities This is especially significant to me as I am on the path to becoming a psychiatric nurse practitioner, and I understand the need for knowledgeable and skilled practitioners to practice in the community and effect change. Through the program at Walden, I expect that I will be equipped with the skills that will enable me translate research and knowledge into practice, to address the issues affecting the psychiatric patients in the community. This is also in line with the vision of the University where the aim is to ensure that the knowledge gained can be applied by the graduates to address key issues in the society (Walden University, 2020) Discussion: Networking Opportunities. As a graduate psychiatric nurse practitioner, I expect that with the combination of the knowledge and skills gained, I will be able to identify challenges in the community and apply the same to develop solutions (Kverno, 2016). I also expect that I will be able to improve practice by applying knowledge based on the context and needs of the patients to advance social change and improve patient outcomes.

The Walden MSN program outcomes have a focus on meeting the demand for mental health providers who are equipped with advanced skills and practicum training for the provision of care. Through these, I will be able to meet my professional and academic goals by becoming knowledgeable and equipped in the use of evidence based practice in the provision of care. This will require me to be able to engage in and utilize research in my practice to identify new output and interventions that have been identified through research, and apply them to my clinical context while considering the needs of the patient (Kverno, 2016). Through this, I will be on the way to becoming a scholar practitioner by translating evidence into practice to ensure improved patient outcomes. Discussion: Networking Opportunities

References

Kverno, K. (2016). Promoting access through integrated mental health care education. 
The Open Nursing Journal
, 
10
, 73.

Walden University. (2020). About Walden. Retrieved from: 
https://www.waldenu.edu/about
 Discussion: Networking Opportunities

Yale-Brown Obsessive-Compulsive Scale

Psychiatric Interview Components

One important component of the psychiatric interview is gathering the history of present illness (HPI) (Carlat, 2017). One piece of the HPI is gathering information on the current and premorbid level of functioning (Carlat, 2017). I find this component important because it establishes which symptoms of the illness may be interfering with the patient’s daily activities. For example, a patient may state that their anxiety has gotten to the point where they are no longer able to participate in family gatherings, which is something they once enjoyed. In addition, this establishes a baseline for the patient (Carlat, 2017). This information may establish treatment goals for the patient. Yale-Brown Obsessive-Compulsive Scale

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A second component of the psychiatric interview is obtaining a family psychiatric history (Carlat, 2017). I find this component of the interview important because oftentimes psychiatric illnesses, or risk of substance use disorders, have a familial tie. For example, for a patient presenting to the clinic with depressive symptoms that have a significant family history of bipolar, it may be pertinent to inquire about symptoms of mania that the patient may not recognize as symptoms of a psychiatric disorder.

A third component of the psychiatric interview is obtaining a psychiatric history (Carlat, 2017). I find this piece of the psychiatric interview important because it gathers information about past treatments and the age of onset of symptoms (Carlat, 2017) Yale-Brown Obsessive-Compulsive Scale. It is important for a clinician to know which treatments were already tried and whether or not they were successful.

Psychometric Properties

The rating scale that I was assigned to explore and discuss is the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Originally developed for adults, this is a ten-item scale that establishes the severity of Obsessive-Compulsive Disorder (OCD) after a formal diagnosis is made (Stanford Medicine, 2020). The scale was developed in 1989, it showed psychometric properties in measuring the effects of medication and psychotherapy for the treatment of OCD (Castro-Rodrigues et al., 2018). However, the original scale showed a weakness in measuring severe cases and inconsistently measuring resistance to obsessions (Castro-Rodrigues et al., 2018).

The scale was revised in 2000, now known as the Y-BOCS-II (Castro-Rodrigues et al., 2018). Items in the scale were rephrased and the order of assessments were changed; this is now used as the gold standard to measure the severity of OCD symptom (Castro-Rodrigues et al., 2018) Yale-Brown Obsessive-Compulsive Scale.

Rating Scale Used in Practice

As stated above, the Y-BOCS is not used to make a case for the diagnosis of OCD, but rather establish the severity of symptoms. A clinician may implement this assessment and then share it with their patient in an attempt to assist the patient in recognizing the severity of their symptoms, and which symptoms may be part of their illness (Standford Medicine, 2020). In addition, a response to treatment may be measured through a decrease in scoring on the sale (Stanford Medicine, 2020).The revised scale, Y-BOCS II, has been found to have excellent psychometric properties in the measurement of the severity of OCD symptoms (Castro-Rodrigues et al., 2018) Yale-Brown Obsessive-Compulsive Scale.

Since its creation in 1989 for use in adult patients, the scale has been modified to assess children and adolescents (Lopez-Pina et al., 2015). In addition to assessing the severity of symptoms in OCD, the scale is useful in measuring the severity of symptoms where compulsions are a symptom of the disorder; for example, such as eating disorders, gambling, etc. (Lopez-Pina et al., 2015).

References

Carlot, D. (2017).
The psychiatric interview
(4
th
ed.). Wolters Kluwer.

Castro-Rodrigues, P., Camacho, M., Almeida, S., Marinho, M., Soares, S., Barahona-

Correa, J., & Oliveira-Maia, A. (2018). Criterion validity of the Yale-Brown Obsessive-Compulsive Scale second edition for the diagnosis of obsessive-compulsive disorder in adults.
Frontiers in Psychiatry, 9,
431. https://www.frontiers.org/articles/10.3389/fpsyt.2018.00431/full Yale-Brown Obsessive-Compulsive Scale

Lopez-Pina, J., Sanchez-Meca, J., Lopez-Lopez, J., Marin-Martinez, F., Nunez-Nunez,

R., Rosa-Alcazar, A., … & Ferrer-Requena, J. (2015). The Yale-Brown Obsessive-Compulsive Scale: a reliability generalization meta-analysis.
Assessment, 22
(5), 619.628. https://www.researchgate.net/profile/Ja-Lopez-Pina/publication/266380252_The_Yale-Brown_Obessive_Compulsive_Scale/links/550090d70cf2de950a6ea031/The-Yale-Brown-Obsessive-Compulsive-Scale.pdf

Stanford Medicine. (2020). Obsessive-compulsive and related disorders.

https://med.stanford.edu/ocd/about/diagnosis.html Yale-Brown Obsessive-Compulsive Scale

 

Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales

Assessment tools have two primary purposes: 1) to measure illness and diagnose clients, and 2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy. Yale-Brown Obsessive-Compulsive Scale

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

To Prepare:

Review this week’s Learning Resources and reflect on the insights they provide regarding psychiatric assessment and diagnosis.

Consider the elements of the psychiatric interview, history, and examination.

Consider the assessment tool assigned to you by the Course Instructor.

By Day 3 of Week 2

Post
 a brief explanation of three important components of the psychiatric interview and why you consider these elements important. Explain the psychometric properties of the rating scale you were assigned. Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.

Read
 a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond
 to at least 
two
 of your colleagues on 
2 different days
 by comparing your assessment tool to theirs.

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

 

Responses

Thank you for your very educational post.  I enjoyed reading yours and our colleagues’ posts this week because I am learning a lot in terms of various evidence-based rating scales.  I admit I am only familiar with a very few and those that we use in the hospital for our interviews and assessments with patients. Yale-Brown Obsessive-Compulsive Scale

Your post caught my attention because I have never heard of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).  This is one scale that we do not normally use in our hospital setting as clinicians.  Upon further research, I found out that The YBOCS was developed in the late 1980s by Drs Wayne Goodman and Dennis Charney to measure the severity of symptoms in OCD (Yale School of Medicine, n.d.).  As you mentioned, it has ten items rated based on a semistructured interview. The first five items concern obsessions: the amount of time that they consume, the degree to which they interfere with normal functioning, the distress that they cause, the patient’s attempts to resist them, and the patient’s ability to control them. The remaining five items ask parallel questions about compulsions (Sadock et al., 2015).  This scale is considered the gold standard to evaluate OCD.  According to Rector and Arnold (2016), the Y-BOCS was designed to measure and compare the efficacy of treatments, initial medical treatment, and then CBT in the field of OCD.  Sadock et al., (2015), added that the YBOCS has become the standard instrument for assessing OCD severity and is used in virtually every drug trial. It may also be used clinically to monitor treatment response.  This scale has been used in the first clinical trials demonstrating the efficacy of the medications that are now standard treatments for the disorder – the SSRIs and the neuroleptics. Yale-Brown Obsessive-Compulsive Scale

References

Rector, N., & Arnold, P. (2016, March). Yale-Brown Obsessive Compulsive Scale. Retrieved December 10, 2020, from https://www.sciencedirect.com/topics/medicine-and-dentistry/yale-brown-obsessive-compulsive-scale

Sadock, B. J., Ruiz, P., & Sadock, V. A. (2015). 
Kaplan et Sadocks synopsis of psychiatry: Behavioral sciences, clinical psychiatry
 (11th ed.). Philadelphia: Wolters Kluwer.

Yale School of Medicine. (n.d.). History of the Clinic. Retrieved December 10, 2020, from https://medicine.yale.edu/psychiatry/ocd/aboutus/history/ Yale-Brown Obsessive-Compulsive Scale

 

 

 

Thanks for your post!

When comparing the Hamilton Anxiety Rating Scale to the Yale-Brown Obsessive-Compulsive Scale, similarities become quickly apparent. Because Obsessive-Compulsive disorder is a specific type of anxiety disorder, it makes sense the two scales would address some of the same symptoms (Storch, et al., 2010). Like the HAM-A, the Y-BOCS is used to establish the severity of symptoms, but not as a tool for diagnosis. Both scales are subjective and require the provider to observe clinical presentation in addition to the scale results themselves, and then to interpret accordingly. Though the Y-BOCS is directed at a more specific subset of symptoms, they are very comparable in their purpose. Yale-Brown Obsessive-Compulsive Scale

References

Hamilton, M. (n.d.). Hamilton anxiety rating scale (HAM-A). 
Br J Med Psychol 1959
; 32:50–55. Retrieved from https://dcf.psychiatry.ufl.edu/files/2011/05/HAMILTON-ANXIETY.pdf

Storch, E. A., Rasmussen, S. A., Price, L. H., Larson, M. J., Murphy, T. K., & Goodman, W. K. (2010). Yale-Brown Obsessive-Compulsive Scale–Second Edition. 
Psychological Assessment,
22(2), 223–232. Yale-Brown Obsessive-Compulsive Scale

NURS – 6003 Week 1 Networking Opportunities

My Goals and University Vision and Mission

After being a nurse for 11 years, I feel the healthcare field is changing its dynamics and feel naturopathic medicine has become more excepted over recent years. Around five years ago, I developed an interest in naturopathic medicine and would like to pursue that after completion of my Nurse Practitioner degree.
 
My current professional goal is to eventually open a naturopathic office treating patients and also have a separate component for energy healing, massage, acupuncture, and other treatment modalities in the alternative medical field. “
Principles of Naturopathic Medicine
—that include such things as stimulating the healing power of the body and addressing the underlying causes of disease, rather than focusing on alleviating symptoms. NURS – 6003 Week 1 Networking Opportunities The practice of naturopathic medicine requires understanding illness within the context of a person’s whole life
 
(Education, 2020).
 
When searching a University to advance my degree, I did not yet know naturopathic and alternative medicine would be my focus. Therefore, my goal was to pursue a degree for Family Nurse Practitioner. Since I began at Walden University, I was able to slowly gain more detail and focus on what I believe to be my true interest. NURS – 6003 Week 1 Networking Opportunities

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I came to Walden University after finishing my BSN at Grand Canyon University. Once finished with my BSN, I found Grand Canyon’s NP program was not credentialed in Michigan and therefore had to find a college to transfer too. Several factors played a role in my choice at Walden University. Two of my biggest concerns were cost and flexibility. Like many, I compared the cost with other schools but that would not be the make it or break it in my decision. One very big concern was flexibility since I work two jobs. I found while completing my degree at Grand Canyon, that homework and assignments were consistently due throughout the entire program, on the same days. This type of consistency throughout the program, made it possible for me to work two jobs and create a work schedule that was consistent and able to be planned out ahead of time. I found that to be more beneficial than anything and was looking for an NP program with the same type of format. Walden had that same exact format, which was a huge two thumbs up for me. NURS – 6003 Week 1 Networking Opportunities After learning cost and its scheduling consistency, I began to research Walden’s mission, vision, and goals, for its University. I liked that Walden’s vision of knowledge being, “judged worthy to the degree that it can be applied by its graduates to the immediate solutions of critical societal challenges, thereby advancing the greater global good” (University, Vision, Mission, and Goals, 2019). I personally think of myself as a humanitarian and also make decisions based on the greater good of the people. By increasing my knowledge in this program, I feel I can be part of creating solutions for the greater good of society.
 
 Walden’s mission to create a diverse community within the professional healthcare system to allow healthcare professionals to advance their skills and knowledge in order to create a positive social change, allows everyone at all levels of healthcare to have an opportunity to make a difference in the community
 
(University, 2019). Attending a college that promotes diversity among its students, for me, is beneficial in promoting different perspectives within healthcare and among students. One of 
 
Walden’s goals are to “provide innovative, learner-centered educational programs that recognize and incorporate the knowledge, skills, and abilities”
 
(University, Vision, Mission, and Goals, 2019). My goal is to also do my best to develop these skills to better treat patients within my chosen field. NURS – 6003 Week 1 Networking Opportunities

 

 

University Outcomes

Walden University outcomes are in alignment with my outcomes to have the ability to “facilitate positive social change where they work, in their communities, and society”
 
(University, Vision, Mission, and Goals, 2019). My goal is to have the ability to create positive changes within my work environment and within my community and neighborhood. I relate these outcomes to having the ability to be an advocate of creating better outcomes within the healthcare system and having the knowledge to promote those outcomes to the community where I live and work. This also includes having the knowledge and expertise to know how to improve the healthcare field.
 

MSN Learning Outcomes

As most of us know, not only is high-quality healthcare an objective among our communities, but so is cost-effective healthcare. Everyone deserves both, and as stated in Walden’s learning outcomes, I considered this to be a primary goal in learning my role as an NP student. Good healthcare is well rounded and includes both of these criteria in order to benefit the patient. Learning how to “critique evidence-based literature”
 
(University, Master of Science in Nursing (MSN), 2019)
 
is also important for me to continue to educate myself in the future as the healthcare field changes with new technology and medical discoveries. NURS – 6003 Week 1 Networking Opportunities Walden also has a learning outcome to teach its students to develop the ability to correctly communicate not only to their patients, but to the community, other professionals within the healthcare field, and diverse populations
 
(University, Master of Science in Nursing (MSN), 2019). Communicating appropriately within this profession is beneficial in the advancement of my career.

Academic and professional individuals are vital to the success of completion of this program, but also important to helping you throughout your career. I am currently a member of the American Association of Nurse Practitioners which gives me access to professional individuals and vital information within my chosen field. I have also developed a relationship with two prior Walden students who have recently graduated the Nurse Practitioner program and have helped me connect with my current preceptor and two other preceptors in the future rotations. These prior students have been extremely valuable to me as resources for the program and as a support team for questions and answers regarding any first-hand information I may need regarding the program. By collaborating with these individuals, doors have opened for me to complete my degree and most likely obtain an NP position in the future.

 

References

Education, C. o. (2020).
 
Naturopathic Medicine
. Retrieved from Council on Naturopathic Medical Education: https://cnme.org/naturopathic-medicine-an-overview/

University, W. (2019).

University, W. (2019, October 4).
 
Master of Science in Nursing (MSN)
. Retrieved from Walden University Catalog: https://catalog.waldenu.edu

University, W. (2019, October 4).
 
Vision, Mission, and Goals
. Retrieved from Walden University Catalog: https://catalog.waldenu.edu

 

response

I was very impressed with your explanation of Naturopathic Medicine.  I am not to familiar with it, but I believe finding the etiology of the problem will be more beneficial for the patient instead of treating the symptoms.   It is also mentioned in your citations from Education, 2020 that it includes stimulating the healing power of the body and that is why I have chosen to obtain my degree as a Psychiatric Mental Health Nurse Practitioner (PHMNP). It was interesting when I did a search on the Web, I was able to find an article of similarity.  According to the Journal of alternative and complementary medicine (2016), the Mind-Body Complementary Health (CHAs) “are a diverse group of health care practices focused on the relationships among the mind, body, brain, and behavior that are not currently considered a part of the conventional medicine” (Burnett-Zeigler et al., 2016, para. 2). NURS – 6003 Week 1 Networking Opportunities

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     I was initially going to return to Chamberlain College of Nursing where I obtained my BSN, but knowing Walden utilized the same platform and provided a had specialization for Mental Health Nursing the decision became easier.  It was not until I spoke with the enrollment specialist and now reviewed in detail the Vision, Mission, and Goals set for by Walden that I have made the correct choice.  Walden’s mission to take an eager fresh new student again like myself and bring me into a community of professionals, so that I can promote a positive social change is what I will need and forever be grateful for (
Walden University
, 2020, para. 2).

References

Burnett-Zeigler, I., Schuette, S., Victorson, D., & Wisner, K. (2016). Mind–Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review. 
Journal of Alternative and Complementary Medicine
. Retrieved June 2, 2020, from 
https://doi.org/10.1089/acm.2015.0038

Vision, Mission, and Goals
. (2020). Walden University. Retrieved June 1, 2020, from 
https://catalog.waldenu.edu/content.php?catoid=172&navoid=59420

 

Discussion: Networking Opportunities

In this module, you begin laying the foundation for your academic and professional success. Your efforts begin with a vision that includes your own definition of success. Your vision may vary from those of your colleagues, but this does not mean you have to take these first steps alone. NURS – 6003 Week 1 Networking Opportunities

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

This Module’s Discussion asks you to consider how the Walden mission and vision as well as the College of Nursing’s mission and vision apply to your professional and academic goals. You will also begin to identify individuals and teams who can help you along the way as you begin designing the “blueprint”—your Academic Success and Professional Development Plan—that will guide you toward your own vision for academic and professional success.

To Prepare:

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

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

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

Also consider academic and professional individuals and teams with whom you may collaborate in support of your efforts as a student at the university and as a professional within your organization and career. NURS – 6003 Week 1 Networking Opportunities

By Day 3 of Week 1

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

By Day 6 of Week 1

Respond
 to at least 
two
 of your colleagues’ posts by suggesting additional individuals and/or teams with whom you wish to collaborate or by offering additional networking strategies.

 

I am currently attending Walden to receive my MSN and, ultimately, become a nurse practitioner (NP). I have been a nurse for a little over six years, primarily in the Oncology field. I hope to remain in the oncology field when I finish my degree.

Walden’s (n.d.) states their vision is to advance the greater good. The mission indicates there should be a transformation in students to scholar-practitioners (Walden, n.d.). A scholar-practitioner would use knowledge to drive commitment and ethical conduct (Miller, 2013). To become an NP, I feel I would be advancing the greater good as an NP can increase efficiency and effectiveness of care (Fowler, Landry, & Nunn, 2019). NPs also make care more accessible and improve patient satisfaction (Fowler, Landry, & Nunn, 2019) NURS – 6003 Week 1 Networking Opportunities. By transforming myself into an NP, I can utilize my knowledge to drive change in the world and ethically advance the greater good.

Nurses are taught from early on to follow one of the university outcomes, which is to practice ethical integrity (Walden, n.d.). By attending Walden and becoming an NP, I demonstrate my commitment to another university outcome: being a lifelong learner (Walden, n.d.). NURS – 6003 Week 1 Networking Opportunities

Another university outcome, specifically having a positive impact on my profession (Walden, n.d.), can be accomplished in part by professional networking. Professional networking can be achieved by being an active member of a professional nursing organization, such as the ANA (Schmidt, n.d.). Being a member of the Oncology Nursing Society fills not only this goal, but also the lifelong learning goal, as there are frequent networking and learning events sponsored by this organization. These events further our knowledge and understanding of providing the most up-to-date, evidence-based care to our patients. NURS – 6003 Week 1 Networking Opportunities

References

Fowler, L.H., Landry, J., and Nunn, M.F. (2019). Nurse Practitioners Improving Emergency Department Quality and Patient Outcomes. 
Critical Care Nursing Clinics, 31(2): 237-247. 
DOI: 10.1016/j.cnc.2019.02.010.

Miller, J. (2013). Theory to Practice or “Becoming a Scholar-Practitioner”. Retrieved from 
https://sites.psu.edu/joancsa/2013/02/10/theory-to-practice-or-becoming-a-scholar-practitioner/

Schmidt, K. (n.d.). 5 reasons nurses should engage in professional networking [Blog post]. Retrieved from 

5 Reasons Nurses Should Engage in Professional Networking

Walden University (n.d.). Walden University catalog. Retrieved from 
https://catalog.waldenu.edu
. NURS – 6003 Week 1 Networking Opportunities

Abnormal Involuntary Movement Scale (AIMS) – NRNP 6635 Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales

Assessment tools have two primary purposes: 1) to measure illness and diagnose clients, and 2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy. Abnormal Involuntary Movement Scale (AIMS) – NRNP 6635 Discussion

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To Prepare:

Review this week’s Learning Resources and reflect on the insights they provide regarding psychiatric assessment and diagnosis.

Consider the elements of the psychiatric interview, history, and examination.

Abnormal Involuntary Movement Scale (AIMS) – NRNP 6635 Discussion

Consider the assessment tool assigned to you by the Course Instructor.

By Day 3 of Week 2

Post
a brief explanation of three important components of the psychiatric interview and why you consider these elements important. Explain the psychometric properties of the rating scale you were assigned. Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.

Initial post, Abnormal Involuntary Movement Scale

The tool I was assigned to elaborate on was the Abnormal Involuntary Movement Scale. The AIMS tool is used to detect Tardive Dyskensia in patients receiving neuroleptic medications. “Tardive dyskinesia is a movement disorder characterized by irregular, stereotyped, and choreiform movements associated with the use of antipsychotic medication (Ricciardi, 2019).”

The AIMS tool measures the presence, severity, and changes in TD.  Medications associated with TD are normal given for schizophrenia and similar mental disorders these are known as antipsychotic drugs. Antidepressants can also cause TD, but studies show this is less prevalent in these types of medications. Since antipsychotic and antidepressants are used frequently in psychiatric care, it is important to pay attention and be aware of the signs and symptoms of TD. This is done by using the AIMS tool (Lepping, 2011). Abnormal Involuntary Movement Scale (AIMS) – NRNP 6635 Discussion

Not only is assessing patients with AIMS for TD important when they are medicated, but interview tools, are extremely vital for the patient treatment plan. One of the most important areas to investigate is the patient’s psychiatric history, including chief complaint, history of present illness, family history, and past history. Family history is a vital concept because of the common genetic factors found in mental disorders. “Scientists have long recognized that many psychiatric disorders tend to run in families, suggesting potential genetic roots. Such disorders include autism, attention deficit hyperactivity disorder (ADHD), bipolar disorder, major depression and schizophrenia. Symptoms can overlap and so distinguishing among these 5 major psychiatric syndromes can be difficult. Their shared symptoms suggest they may also share similarities at the biological level. In fact, recent studies have turned up limited evidence of shared genetic risk factors, such as for schizophrenia and bipolar disorder, autism and schizophrenia, and depression and bipolar disorder (Lancet, 2013).” Abnormal Involuntary Movement Scale (AIMS) – NRNP 6635 Discussion

Another valuable piece of the psychiatric interview is the role and activity of the interviewer. “In the structured approach, the interviewer must faithfully ask in a pre-determined sequence, a series of closed pre-defined questions, corresponding to the diagnostic criteria. To maintain the purity of the quasi-experimental framework, it is crucial to minimize variance in the interviewer’s performance and, especially, to quash any potential tendency to inference and interpretation or any tendency for the patient to veer from the initial question (Nordgaard, 2013.”

Suicidal intent is a question that should be addressed by any interviewer in any health care situation. “Because of the frequency of depressive disorders and their association with suicide, it always is necessary to address the possibility of suicidal intent in a first interview. Asking about suicide will not provoke the act. Such discussion may need to be extended until it is clear whether the patient may safely leave or needs hospital admission (Waldinger).” Abnormal Involuntary Movement Scale (AIMS) – NRNP 6635 Discussion

Ricciardi, L., Pringsheim, T., Barnes, T., Martino, D., Gardner, D., Remington, G., Addington, D., Morgante, F., Poole, N., Carson, A., & Edwards, M. (2019). Treatment Recommendations for Tardive Dyskinesia. 
Canadian journal of psychiatry. Revue canadienne de psychiatrie
, 
64
(6), 388–399. https://doi.org/10.1177/0706743719828968

Lepping. P.,
Antipsychotic medication and oxidative cell stress: a systematic review. J Clin Psychiatry. 2011 3; 72 3: 273- 285. doi: 
10.4088/JCP.09r05268yel
. pmid:20673558 Abnormal Involuntary Movement Scale (AIMS) – NRNP 6635 Discussion

CrossRef
PubMed
Google Scholar

Lancet.
 2013 Feb 27. pii: S0140-6736(12)62129-1. doi: 10.1016/S0140-6736(12)62129-1. [Epub ahead of print]. PMID: 23453885

Waldinger, R., Brown University. Retrieved from 
www.brown.edu/Courses/BI_278/Other/Clerkship

Nordgaard, J., Sass, L. A., & Parnas, J. (2013). The psychiatric interview: validity, structure, and subjectivity. 
European archives of psychiatry and clinical neuroscience
, 
263
(4), 353–364. https://doi.org/10.1007/s00406-012-0366-z

Read
 a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond
 to at least 
two
 of your colleagues on 
2 different days
 by comparing your assessment tool to theirs.

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
Submit! Abnormal Involuntary Movement Scale (AIMS) – NRNP 6635 Discussion

 

Abnormal Involuntary Movement Scale (AIMS) post

Antipsychotic medications are a central part of the treatment process for those with schizophrenia and other mental health conditions, including depression and bipolar disorder. As a result, the potential for an antipsychotic to contribute to the development of tardive dyskinesia continues to be a clinical concern (CPNA, 2020). Adverse events such as drug induced movement disorders play an important role in treatment considerations when quality of life and medication adherence must be considered (CPNA, 2020). Tardive dyskinesia (TD) has long been thought to be a generally irreversible consequence of the use of dopamine receptor blocking agents.

 

In general, psychiatric assessment tools serve as a tool to determine the severity of an illness and to more effectively use medications. Abnormal Involuntary Movement Scale (AIMS) can be utilized in practice to better assess patients for tardive dyskinesia and learn more about tardive dyskinesia. The AIMS is a 12-item clinician-rated scale to assess severity of dyskinesia (specifically, orofacial movements and extremity and truncal movements) in patients taking antipsychotic and neuroleptic medications. Tardive dyskinesia is considered a late form of extrapyramidal symptoms. Jiajun and colleagues (2019) consider the occurrence of EPS being associated with poor treatment outcome of schizophrenia. Analysis shows that antipsychotics with high D2 receptor antagonistic effect and illness duration are the risk factors of EPS for individuals who suffer from schizophrenia (Jiajun et al., 2019). As a PMHNP, offering quality care is being able to assess the effectiveness and tolerability of medication using movement disorder assessment tools to help identify both the presence and severity of movements. Once the severity of tardive dyskinesia is determined, providers can consider alternative medication regimen in order to slow the process, thus improving a patient’s quality of life.

 

Citrome, L. (2017). Clinical management of tardive dyskinesia: Five steps to success. 
Journal of

the Neurological Sciences
, 
383
, 199–204. 
https://doi-
            org.ezp.waldenulibrary.org/10.1016/j.jns.2017.11.019

 

College of Psychiatric & Neurologic Pharmacists. (2020). The AIMS Assessment and Tardive

Dyskinesia. Retrieved from 
https://cpnp.org/aims

 

Jiajun Weng, Yan Zhang, Huafang Li, Yifeng Shen, & Wenjuan Yu. (2019). Study on risk

factors of extrapyramidal symptoms induced by antipsychotics and its correlation with symptoms of schizophrenia. 
Shanghai Archives of Psychiatry
, 
32
(1), 14–21. https://doi-org.ezp.waldenulibrary.org/10.1136/gpsych-2018-100026 Abnormal Involuntary Movement Scale (AIMS) – NRNP 6635 Discussion

 

 

Responses

Thanks for your post!

When comparing the Hamilton Anxiety Rating Scale (HAM-A) to the Abnormal Involuntary Movement Scale (AIMS), the differences are most apparent. Though they are both designed to illustrate the severity of symptoms, and not necessarily to diagnose a problem, that is where the similarity ends. The HAM-A looks at symptoms of anxiety, which can be a generalized condition or a co-occurring issue that overlaps heavily with symptoms of other psychiatric conditions, such as major depression or obsessive-compulsive disorder (Hamilton, n.d.). In contrast, the AIMS scale is largely targeted at tardive dyskinesia, which is a psychiatric medication induced movement disorder. Because many dopamine blocking agents can result in involuntary movements, it is often the severity of these that determines whether the medication is continued (Montvilo, 2019). The AIMS score is compared to the benefits that client is experiencing from the medication to allow for an educated decision to be made. Abnormal Involuntary Movement Scale (AIMS) – NRNP 6635 Discussion

References

Hamilton, M. (n.d.). Hamilton anxiety rating scale (HAM-A). 
Br J Med Psychol 1959
; 32:50–55. Retrieved from https://dcf.psychiatry.ufl.edu/files/2011/05/HAMILTON-ANXIETY.pdf

Montvilo, R. K. P. D. (2019). Tardive dyskinesia. 
Salem Press Encyclopedia of Health.
 Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ers&AN=97176629&site=eds-live&scope=site

 

Abnormal Involuntary Movement Scale (AIMS)

Good afternoon Anthony and thank you for your insight into the Abnormal Involuntary Movement Scale (AIMS).  I work with our electronic medical record (EMR) for the documentation of all Behavioral Health within our system.  One assessment tool that we just updated was the AIMS assessment.  Have you ever used this assessment tool?  There are two parallel procedures, the examination procedure, which tells the patient what to do, and the scoring procedure, which tells the clinician how to rate what he or she observes (Sadock, Sadock, & Ruiz, 2015).  As you mentioned, there are 12 assessment items, Items are scored on a 0 (none) to 4 (severe) basis; the scale provides a total score (items 1 through 7) or item 8 can be used in isolation as an indication of overall severity of symptoms.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. Abnormal Involuntary Movement Scale (AIMS) – NRNP 6635 Discussion

Networking Opportunities NURS 6003

Networking Opportunities

     Currently, I have been working in the healthcare field for 20 years in various roles. It was in 2012 that I began my career as a Registered Nurse.  While working as a floor nurse, I wanted to advance my career, so I decided to obtain my Bachelor of Science in Nursing (BSN) on-line.  At the end of the program, I was still unclear about what I wanted to specialize in order to advance into the Master of Nursing Program.  After five years of learning about different areas to specialize in, I have chosen my passion for helping individuals in the field of Mental Health. Networking Opportunities NURS 6003.

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     Once I realized Mental Health is what I wanted to specialize in, I began discussing University options with my fellow co-workers.  As discussed in a Blog Post written by Schmidt, K. (2020), ” Professional networking can help nurses achieve the fundamental knowledge required to take the next step” (Professional networking is imperative to nursing career advancement section).  It was concluded that Walden University is well known and utilized frequently within my organization, which also includes a specialization in the area of Psychiatric Mental Health (PMH). To have the opportunity and ability to focus just on this specialization provided me with some confidence that success could be achieved. It was when I reviewed the University mission statement that this was the college for me.   The Walden University College of Nursing mission statement is described as  ” a diverse community of career professionals with the opportunity to transform themselves as scholar-practitioners so that they can effect positive social change” (
Walden University
, 2020, Mission section), which is exactly the guidance I will need to succeed.  It was also interesting to review how Walden defined positive social change.  Networking Opportunities NURS 6003. To be reassured that I will have a group of professional faculty members and an academic community promoting my individual growth, ideas, and producing actions within a social community provides me the confidence I have been seeking (
Walden University
, 2020, Social Change section). Networking Opportunities NURS 6003

     For me to achieve my goals as a successful Psychiatric Mental Health Nurse Practitioner, I reviewed the MSN Learning Outcomes.  Walden University not only promotes the delivery of the highest quality care, but it is also committed to the professional development of their students and to provide them with the tools that will be needed.  The understanding that I will have the ability to effectively communicate, critique evidence-based literature to support decision making, and continue to build on the improvement of patient center quality care is a reward in itself  (
Walden University
, n.d., MSN Learning Outcomes section).

References

Schmidt, K. (n.d.). 5 reasons nurses should engage in professional networking. 
BluePipes
. Retrieved June 1, 2020, from 

5 Reasons Nurses Should Engage in Professional Networking

Walden University
. (2020). Vision, Mission, and Goals. Retrieved June 1, 2020, from 
https://catalog.waldenu.edu/content.php?catoid=172&navoid=59420

Walden University
. (n.d.). MSN Learning Outcomes. Retrieved June 1, 2020, from 
https://catalog.waldenu.edu/preview_program.php?catoid=172&poid=67151&returnto=59823

 

response.

Nice to meet you Melissa. I am also on the path to being a Psychiatric Mental Health Nurse Practitioner and I agree with you on how the MSN Learning Outcomes align with helping your decision making skills using evidence-based literature. Especially knowing that evidenced- based behavior is how we deliver patient-centered and individualized care nowadays. Walden University’s mission  to “provide a diverse community of career professionals with the opportunity to transform themselves as scholar-practitioners so that they can affect positive social change”, will also go a long way in preparing you to acclimate with different members of a interdisciplinary team, but now as scholar-practitioner.

 

References

Walden University. (n.d.). MSN Learning Outcomes. Retrieved June 3, 2020, from 
https://catalog.waldenu.edu/preview_program.php?catoid=172&poid=67151&returnto=59823

Walden University. (2020). Vision, Mission, and Goals. Retrieved June 3, 2020, from 
https://catalog.waldenu.edu/content.php?catoid=172&navoid=59420

Discussion: Networking Opportunities

In this module, you begin laying the foundation for your academic and professional success. Your efforts begin with a vision that includes your own definition of success. Your vision may vary from those of your colleagues, but this does not mean you have to take these first steps alone. Networking Opportunities NURS 6003

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

This Module’s Discussion asks you to consider how the Walden mission and vision as well as the College of Nursing’s mission and vision apply to your professional and academic goals. You will also begin to identify individuals and teams who can help you along the way as you begin designing the “blueprint”—your Academic Success and Professional Development Plan—that will guide you toward your own vision for academic and professional success. Networking Opportunities NURS 6003.

To Prepare:

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

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

Consider how the information in these resources fit with your own goals and to your becoming a scholar-practitioner. Networking Opportunities NURS 6003

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

By Day 3 of Week 1

Post
a brief introduction of yourself to your colleagues. Include an explanation as to how Walden’s vision, mission, goals, and social change initiatives relate to your professional and academic goals and to your becoming a scholar-practitioner. Also include an explanation for how the Walden MSN Program Outcomes and perspectives relate to your professional and academic goals and to your becoming a scholar-practitioner. Networking Opportunities NURS 6003

By Day 6 of Week 1

Respond
 to at least 
two
 of your colleagues’ posts by suggesting additional individuals and/or teams with whom you wish to collaborate or by offering additional networking strategies.

ORDER A PLAGIARISM-FREE PAPER HERE

After receiving my nursing degree 2 years ago, I’ve worked on an ICU Stepdown unit. When I accepted this position, I completed a program called StaRN. This program eases the transition from school to “real-life” nursing through simulations and nursing skill reviews. The StaRN educators gave us the tools to feel more confident on our first day to our units. Studies have found that with positive facility-student relationships, improve student’s learning experiences to care, desire to care for others and self-actualization (Salehian, Heydari, Aghebati, & Moonaghi, 2017, p. 257). They inspired me to pursue a Nursing Educator career. Upon researching different jobs, I found that the majority of the positions require a master’s degree. I began researching various universities that offer a Master’s in Nursing Education, and after a coworker’s recommendation, I found Walden University. Networking Opportunities NURS 6003.

Walden University’s mission statement focuses on transforming ourselves into scholars that can improve society. I believe working in the healthcare field, we all have the drive to help and strengthen our communities. With positive social change being a focus for Walden, we can become role models and advocates for our society, which is essential as nurses. Networking Opportunities NURS 6003. Once I began reviewing Walden University’s goal statements, one, in particular, stood out to me: “To provide multi contextual educational opportunities for career learners” (“Vision, Mission, and Goals”, 2019). My career goal strongly influences my education, and having a flexible and unique way to fulfill that goal is crucial.

To effectively complete my goals of becoming a nurse educator, I must understand and achieve Walden University’s learning outcomes. “Evaluate health needs of diverse populations for necessary teaching/coaching functions based on specialist nursing knowledge to restore/promote health and prevent illness/injury” (“Master of Science in Nursing”, 2019). This learning outcome is crucial to succeeding in education. We, as nurses, must not only continue to educate and promote health in our patients but also ourselves. Networking Opportunities NURS 6003

Salehian, M., Heydari, A., Aghebati, N., & Karimi Moonaghi, H. (2017). Faculty-Student Caring Interaction in Nursing Education: An Integrative Review. 
Journal of caring sciences
, 
6
(3), 257–267. https://doi.org/10.15171/jcs.2017.025

University, W. (n.d.).
 
Master of Science in Nursing (MSN)
. Retrieved from Walden University Catalog: https://catalog.waldenu.edu

University, W. (n.d).
 
Vision, Mission, and Goals
. Retrieved from Walden University Catalog: https://catalog.waldenu.edu Networking Opportunities NURS 6003

The Psychiatric Evaluation and Evidence-Based Rating Scales

Hamilton Depression Rating Scale

According to Carlat (2017) three objectives of a psychiatric interview write-up include thoroughness, time efficiency, and readability. A psychiatric interview should take no longer than 10 to 15 minutes to write, utilize free text space to provide a narrative and be no longer than two pages to satisfy time efficiency and readability (Carlat, 2017). Important aspects of a psychiatric interview write-up include all components of a history and physical with additional sections about past psychiatric history, substance use, mental status examination, and DSM-V diagnoses.

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I was assigned the Hamilton Depression Rating Scale (HAM-D) created by Max Hamilton in 1960. Major depressive disorder is one the most diagnosed psychiatric conditions worldwide (Primo de Carvalho Alves, et al., 2017). The HAM-D is considered the gold standard in assessing depression severity and is comprised of 21 items with 17 scored questions including depressed mood, feelings of guilt, thoughts or suicide attempts, insomnia, among other categories (Rohan, et al., 2016) The Psychiatric Evaluation and Evidence-Based Rating Scales. The overall score is calculated based on each of the 17 scored categories. Fifty points is the highest possible score calculating to very severe depression. It is appropriate to use the HAM-D if any of the measured categories are assessed during the psychiatric interview, if the patient has a history of depression, or verbalize current feelings of depression. Use of the HAM-D assessment tool has been thoroughly studied and should be administered prior to treatment, during treatment, and after treatment to calculate any change in depression scoring (Rohan, et al., 2016). The psychiatric mental health nurse practitioner should complete this assessment in 10 to 15 minutes during the psychiatric interview (American Psychological Association, 2020). Results from the HAM-D can show an improvement in depression symptoms when compared to the assessment prior to treatment. The Psychiatric Evaluation and Evidence-Based Rating Scales

References

Carlat, D. (2017). 
The Psychiatric Interview
 (4th ed.). Wolters Kluwer.

Depression Assessment Instruments.
 (2020). American Psychological Association. https://www.apa.org/depression-guideline/assessment

Primo de Carvalho Alves, L., Pio de Almeida Fleck, M., Boni, A., & Sica da Rocha, N. (2017). The Major Depressive Disorder Hierarchy: Rasch Analysis of 6 items of the Hamilton Depression Scale Covering the Continuum of Depressive Syndrome. 
PLOS ONE, 12
(1), e0170000. https://doi.org/10.1371/journal.pone.0170000 The Psychiatric Evaluation and Evidence-Based Rating Scales

Rohan, K. J., Rough, J. N., Evans, M., Ho, S.-Y., Meyerhoff, J., Roberts, L. M., & Vacek, P. M. (2016). A protocol for the Hamilton Rating Scale for Depression: Item scoring rules, Rater training, and outcome accuracy with data on its application in a clinical trial. 
Journal of Affective Disorders, 200
, 111–118. https://doi.org/10.1016/j.jad.2016.01.051

 

Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales

Assessment tools have two primary purposes: 1) to measure illness and diagnose clients, and 2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy. The Psychiatric Evaluation and Evidence-Based Rating Scales

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

To Prepare:

Review this week’s Learning Resources and reflect on the insights they provide regarding psychiatric assessment and diagnosis.

Consider the elements of the psychiatric interview, history, and examination.

The Psychiatric Evaluation and Evidence-Based Rating Scales

Consider the assessment tool assigned to you by the Course Instructor.

By Day 3 of Week 2

Post
 a brief explanation of three important
components of the psychiatric interview
and why you consider these elements important. Explain the psychometric properties of the rating scale you were assigned. Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.

Read
 a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond
 to at least 
two
 of your colleagues on 
2 different days
 by comparing your assessment tool to theirs.

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

Thanks for sharing your post, I am familiar with the “The Hamilton Depression Rating Scale (HAM-D) “I know it is an assessment tool used to determine the severity of depression in a client before and even during treatment. It is better to use this assessment tool before initiating treatment for a depressed client in other to assess the severity of depression, and after treatment is started,providers will normally reassess with the same assessment tool,  in a month (4 weeks ) to see if the client’s depression symptoms are reduced or not. It is evidence based that the HAM-D has adequate internal reliability, but some of the items on the scale poorly contribute to the measurement of depression severity (Rohan, Rough, & Vacek, 2016).  Poor interrater and retest reliability has also been proven (Rohan et al., 2016).  The main criticism related to the scale is “construct validity, since it may represent a multidimensional measure due to its inclusion of symptoms beyond the core symptoms of depression” (Da Silva, Reche, Lima, Fleck, Capp, & Shansis, 2018).  It is important to keep in mind that “The HAM-D” only measures the severity of depression, and does not determine a depressive disorder (Olden, Rosenfeld, & Breitbart, 2009).

References

Da Silva, A., Reche, M., Lima, A., Fleck, M., Capp, E. & Shansis, F. (2018). Assessment of the Psychometric Properties of the 17-and6-item Hamilton Depression Rating Scales in Major Depressive Disorder, Bipolar Depression and Bipolar Depression with Mixed Features. Journal of Psychiatric Research. Retrieved from Walden Library database. The Psychiatric Evaluation and Evidence-Based Rating Scales

 

Rohan, K.J., Rough, J.N., & Vacek, P.M. (2016). A Protocol for the Hamilton Rating Scale for Depression: Item Scoring Rules, Rater Training, and Outcome Accuracy with Data on its Application in a Clinical Trial. Journal of Affective Disorders. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4894486/

Olden, M., Rosenfeld, B., & Breitbart, W. (2009). Measuring Depression at the End of Life: Is the Hamilton Depression Rating Scale a Valid Instrument? Department of Health and Human Services. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987780/pdf/nihms-563804.pdf The Psychiatric Evaluation and Evidence-Based Rating Scales

NURS – 6003 Discussion Posting Exemplars

Discussion Posting Exemplars

SAMPLE POST: Use this as a guide for writing and formatting posts

My Goals and University Vision and Mission

As a nurse for over 10 years and with the advances in technology applied to the

health care arena, I have become more interested in the role of a nurse within

informatics. My professional goal is to work full-time in the area of nursing informatics.

Unfortunately, I knew that obtain this position, I needed to advance my degree. I began

looking into various colleges and universities that can provide me with the education

needed to obtain an advanced degree with a focus in nursing informatics.

After several months of investigating, I located Walden University. At first, I was

drawn to Walden because it offered the flexibility that I needed. However, as I

investigated the university further, Walden’s mission and vision statement resonated

with me. I knew I had made the right choice. The College of Nursing vision and mission

statements described what I felt and thought yet could not put into words. According to

the Walden University College of Nursing (2011a), their vision is for graduates to

transform nursing to meet the needs of communities. Technology is transforming health

Discussion Posting

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Exemplars

NURS – 6003 Discussion Posting Exemplars

care and the degree I will obtain at Walden will help me to assist my organization with

this transformation.

Another reason I was drawn to Walden University was the high standards they

have for all students. The College of Nursing stated in their mission that their program is

“academically rigorous…contextually relevant…” (Walden University, 2011a, para. 4).

This statement matches my academic goal. I am not looking for just a piece of paper at

the end, I am looking to gain the necessary knowledge that I need to make an impact

within my organization.

Incorporation of Social Change

Walden University (2011b) defined positive social change as a “deliberate process

of creating and applying ideas, strategies, and actions to promote the worth, dignity, and

development of individuals, communities, organizations, institutions, cultures, and

societies” (para. 4). I have always had a feeling that I want my life to mean something

and to have an effect on those around me whether it is directly or indirectly. As a nurse,

the will to help others is a core foundation of why I got into nursing in the first place. I

plan to incorporate social change with the knowledge gained at Walden University by

“putting that knowledge into practice” (Walden University, 2010b, para. 3). I plan to

contribute to my field when I graduate by helping lead my coworkers and my

organization through the computerized changes and advancement of technology at

work. While helping others, I will be part of the clinical informatics team as the team

transitions the organization into new computerized programs. NURS – 6003 Discussion Posting Exemplars

© 2018 Laureate Education Inc. 3

References

Walden University. (2011a). About the school. Retrieved from

http://www.waldenu.edu/Colleges-and-Schools/College-of-HealthSciences/15863.htm

Walden University. (2011b). Vision, mission, and goals. Retrieved from

NURS – 6003 Discussion Posting Exemplars

Discussion: Factors That Influence the Development of Psychopathology

This week’s discussion aims to analyze historically and currently recognized biological, psychological, and sociocultural factors that inform the expression, course, and prevalence of psychopathology.  Historically, psychopathology’s perception is that of behaving outside the norm of what the present culture and society perceive as “normal.” Exactly who is responsible for deeming what is normal or not has perplexed this writer. Just as Marturano, A., (2020) wrote in his article “Italy and leadership: psychopathology or culture of a nation,” The history of an area, culture, war, persecution influences the prevalence of psychopathology.  The cultural beliefs of ancient times are still found in the leadership of the leaders in Italy. Discussion: Factors That Influence the Development of Psychopathology Aristotle was responsible for categorizing concepts and objects etc. It has always needed to have things organized into ideas with descriptions and lists of the intrinsic aspect of what is being classified.   The identification of psychopathology can be found during Biblical times when what would be called today psychopathology was considered being “possessed” by evil spirits. Discussion: Factors That Influence the Development of Psychopathology

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Experiences and education, research, studies have brought different theoretical constructs. As more information is gathered, more theories are discovered.  In the late 1970s, this writer can remember discussing the Nature vs. Nurture construct.  Today we would have to say both are responsible for the development or the expression of psychopathology as the interactions and experiences stimulate the individual’s biological and genetic expressions, which result in behaviors manifested.  However, it wasn’t until the Era of Enlightenment when the study and focus on psychiatric care came to be.  Until the 19
th
century, Schizophrenia, the worse of mental illness, was considered “another form of lunacy: (Kaplan,2008) Discussion: Factors That Influence the Development of Psychopathology.  During the era of Enlightenment, the attitude towards mental health began to change. Phillipe Pines, a psychiatrist during this era, believed in an illness model of symptoms and treatment. Thus, the mentally ill’s moral treatment was brought to light because it was the belief the cause of the mental illness was to be found in the patient’s environment Kaplan,2008). Pines believed in studying the brains of psychiatric patients hoping to find the root cause of mental illness. The rationalization of doing this resulted in the destruction of the once scientific German psychiatrist under the Nazi influence. They would gas their patients under a cloud of eugenics. Discussion: Factors That Influence the Development of Psychopathology

Masten and Kalstabakken (2018) Discuss the implications for developmental psychopathology (DP) as a multidisciplinary approach for research and therapy.  The idea is that one needs to understand the psychopathology in a developing person and know what the “normal” behaviors and expectations exist for a specific developing person at a given point in time. This developmental theory appears to have built upon Erickson’s theory of developmental psychology.  Individuals grow and learn from the interactions they have in society. “Individuals grow and change due to their interaction between natural ecosystem factors (e.g., air and water quality, and exposure to macrobiotic organisms) also play a critical role to development” (Masten, and Kulstabakken,2018).

Those who live in extreme poverty areas, lead-based tenements, gangs at each corner, and now the stress of virtual schooling and not being with their peers are greater at risk of having some form of mental health problem. Continuous pressure from the unknown increase an individual’s risk of psychopathology as well Discussion: Factors That Influence the Development of Psychopathology.  Those living in poverty with a lack of health care coverage, housing, and food security are at higher risk for mental health issues.

The root cause of psychopathology is related to social, cultural, genetic, and biological factors.  Not one element can be identified.

Reference

Kaplan, R. M. (2008). Being Bleuler:  the second century of Schizophrenia, The Royal Australian and New Zealand College of Psychiatrists. Doi:  10.1080/10398650802302176

Marturano, A., (2020), Italy and leadership: psychopathology or culture of a nation?, 
International Journal of Psychoanalysis and Education, 
12(1)

Masten, A.S., & Kalsstabakken, A. W., (2018), Developmental Perspectives on Psychopathology in Children and Adolescents, APA Handbook of Psychopathology:  Child and Adolescent Psychopathology, edited by Butcher, J. Nl, & Kendall, P. C. Discussion: Factors That Influence the Development of Psychopathology

 

response

There are so many great points in this post. I am worried about the mental health as well of the students having to be isolated and do virtual learning. “Social isolation leads to chronic loneliness and boredom, which if long enough can have detrimental effects on physical and mental well-being. The timelines of the growing pandemic being uncertain, the isolation is compounded by mass panic and anxiety (Duan, 2020).”  Not only has the pandemic caused illness and death across the country, it has wreaked havoc on the mental health of those who are isolated. The upcoming holidays are even more worrisome. With the social isolation that is now in place, our future as mental health providers is even more important that before. :Last year, about 374,000 people ended up in the nation’s emergency rooms with self-inflicted injuries, and 48,000 people died by suicide.” Discussion: Factors That Influence the Development of Psychopathology

Carley S, Hamilton M. Suicide at Christmas. Emergency Medicine Journal 2004;21:716-717

Duan, L., Zhu, G. (
2020
). 
Psychological interventions for people affected by the COVID-19 epidemic
. The Lancet Psychiatry, 7(4), 
300
–
302
.

 

Thank you for your post. I agree with your points in your post. Mental health has evolved over time and different ways of analyzing social and cultural views Discussion: Factors That Influence the Development of Psychopathology. Mental disorders impose a significant economic burden, not just on the individuals with the disorders but also on households, communities, employers, healthcare systems and government budgets (Jenkins, Baingana, Ahmad, McDaid & Atun, 2011). As you mentioned poverty can have an increased impact on mental health for those who are already at risk, although the effects of poor health on poverty are by no means unique to mental illness, their negative impacts are greater than for most acute and chronic illnesses (Jenkins et al., 2011).

Jenkins, R., Baingana, F., Ahmad, R., McDaid, D., & Atun, R. (2011). Social, economic, human rights and political challenges to global mental health. 
Mental health in family medicine
, 
8
(2), 87–96.

Discussion: Factors That Influence the Development of Psychopathology

 

In many realms of medicine, objective diagnoses can be made: A clavicula is broken.  An infection is present. TSH levels meet the diagnostic criteria for hypothyroidism. Psychiatry, on the other hand, deals with psychological phenomena and behaviors. Can these, too, be “defined objectively and by scientific criteria (Gergen, 1985), or are they social constructions?” (Sadock et al., 2015) Discussion: Factors That Influence the Development of Psychopathology.

Thanks to myriad advances during recent decades, we know that psychopathology is caused by many interacting factors. Theoretical and clinical contributions to the field have come from the neural sciences, genetics, psychology, and social-cultural sciences. How do these factors impact the expression, classification, diagnosis, and prevalence of psychopathology, and why might it be important for a nurse practitioner to take a multidimensional, integrative approach? Discussion: Factors That Influence the Development of Psychopathology

To Prepare:

Review this week’s Learning Resources, considering the many interacting factors that contribute to the development of psychopathology.

Consider how theoretical perspective on psychopathology impacts the work of the PMHNP.

By Day 3 of Week 1

Explain the biological (genetic and neuroscientific); psychological (behavioral and cognitive processes, emotional, developmental); and social, cultural, and interpersonal factors that influence the development of psychopathology.

Read
 a selection of your colleagues’ responses

By Day 6 of Week 1

Respond
 to at least 
two
 of your colleagues on 
2 different days
 by explaining the implications of why, as an advanced practice nurse, it is important to adopt a multidimensional, integrative model of psychopathology.

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

 

post

Mental, emotional, and behavioral (MEB) development is a product of complex neurobiological processes that interact with characteristics of the physical and social environment, beginning before conception and continuing beyond adolescence. Healthy development is shaped by experiences and circumstances that cross generations within families and affect entire neighborhoods and communities. Therefore, understanding of MEB development must be based on an integrated appreciation of connections that have been identified among.

Biological processes, including brain development and the expression of genes as individual characteristics; physical, social, behavioral, and intergenerational experiences that affect conception, gestation, and childbirth;  Although neurobiological mechanisms are a central focus of research on MEB outcomes, it is important to note that these mechanisms are the downstream consequence of complex cellular and molecular variation that emerges in response to the interplay between genes and environments. Genes and environments both operate to create variation, and the interplay between these variables is the foundation for the emergence of individual variation

Development accelerates in response to environmental threat. For example, girls who encounter several types of challenges experience the onset of puberty earlier than girls who do not. The challenges for which these connections have been established include an absent father, maternal depression, family conflict, and low ratio of income to needs, but these effects can be buffered by secure childhood attachment (Deardorff et al., 2011; Ellis and Garber, 2000; Sung et al., 2016) Discussion: Factors That Influence the Development of Psychopathology.

Neuroimaging studies suggest that the acceleration of development is also evident in brain systems, such as those that regulate fear and learning (Gee et al., 2013), and in the connectivity between cortical and subcortical brain structures that have implications for emotional regulation (Callaghan and Tottenham, 2016).

Genetic, environmental, neurobiological, and behavioral characteristics account for differences in the way’s individuals respond to influences such as stress or adversity. This phenomenon, known as differential susceptibility, provides a framework for thinking about ways to account for both healthy MEB development and the development of MEB disorders, a framework that focuses not on the relative vulnerability or resilience in distinct subtypes of individuals but on the degree of plasticity an individual exhibits. Cortical sensory processing capacity and the ability of the prefrontal cortex to filter emotional stimuli have been suggested as potential neural mechanisms accounting for differential susceptibility (Boyce, 2018).

A growing body of evidence is revealing the ways in which characteristics of the more distal social environment affect development. These factors include poverty and inequality, discrimination and racism, marketing of unhealthy products, and effects of involvement with the criminal justice system. These more distal influences on MEB development place distinct limits on society’s ability to foster healthy MEB development and prevent MEB health disorders at a population level.Discussion: Factors That Influence the Development of Psychopathology

Healthy early development (physical, social, emotional, and cognitive) strongly influences a wide range of later outcomes, including mental health, heart disease, literacy and numeracy, criminality, and economic participation across the life span. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic status; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion (Healthy People, 2015).

Furthermore, individual influences including sleep, nutrition, and physical activity; characteristics of the family and surrounding community, including safety, nurturing interactions, peer behavior, and social-emotional support in school; and characteristics of the broader society in which the individual, family, and community are situated, such as poverty and economic inequality, systemic racism and discrimination, law- and policy-driven factors, and the marketing of unhealthful products can also be a factors influencing the development of psychopathology.

References

Boyce WT. The orchid and the dandelion: Why some children struggle and how all can thrive. New York: Alfred A. Knopf; 2018 Discussion: Factors That Influence the Development of Psychopathology

Callaghan BL, Tottenham N. The stress acceleration hypothesis: Effects of early-life adversity on emotion circuits and behavior. Current Opinion in Behavioral Sciences. 2016; 7:76–81. 10.1016/j.cobeha.201511.018

Deardorff J, Ekwaru JP, Kushi LH, Ellis BJ, Greenspan LC, Mirabedi A, Landaverde EG, Hiatt RA. Father absence, body mass index, and pubertal timing in girls: Differential effects by family income and ethnicity. Journal of Adolescent Health. 2011;48(5):441–447.

Healthy People 2020. Disparities. 2015. https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities

 

responses

I enjoyed this post! Thank you for pointing out that mental health is not a choice! It a combination of so many things, and making the public aware of this is so important and vital to the future of mental health. “Depression is a disease, where neurotransmitters in the brain, such as norepinephrine, dopamine, and serotonin, are reduced, and there is something wrong in the mood control circuit of the brain (Yim, 2016).” Discussion: Factors That Influence the Development of Psychopathology

Your points if healthy early development is poignant in this post. In my initial post, I stated how the rural area that I live in has finally started mental health services in schools and I am hoping that this is the push needed to help my community has a brighter future in mental health as well as erasing the stigma associated with mental health. “The paradox is that young people aged between 12 and 25 years have had by far the worst levels of access to mental health care across the whole lifespan. Health services are poorly designed, grossly under-resourced and typically unfriendly to, and untrusted by, young people (McGorry, 2018).”

 

Yim J. Therapeutic Benefits of Laughter in Mental Health: A Theoretical Review. Tohoku J Exp Med. 2016 Jul;239(3):243-9. doi: 10.1620/tjem.239.243. PMID: 27439375.

 

McGorry PD, Mei C. Early intervention in youth mental health: progress and future directions

Evidence-Based Mental Health 2018;21:182-184 Discussion: Factors That Influence the Development of Psychopathology

 

 

   Thank you for your very informative post!  Brain development and the expression of genes begin from the time of gestation and continue to adulthood.  Many factors influence the biological processes that determine the growth of these structures.  These changes can result in psychiatric disorders such as depression disorders, anxiety disorders, and more severe disorders such as schizophrenia.  One such variable is stress. The stress response involves the release of the stress hormones epinephrine, norepinephrine, and adrenocorticotropic. These stress hormones are directly released into the maternal bloodstream and the fetal bloodstream.  The fetus will have an increased heart rate and blood pressure. (Sadock, Sadock, and Ruiz,2015, p 1083).  The developing brain circuits and medial prefrontal cortex (mPFC) have significant roles in the top-down regulation of the HPA (stress axis). The stress axis is particularly susceptible to environmental influences. Moreover, there does not need to be a direct experience with stress for the developing brain and genes to be affected. Being near someone who is stress can result in bystander stress (Lehmann, Weigel, Elkahloun, and Herkenham, 2017; Nelson, 2017).

     In today’s world, all are bombarded with stress. All of us are dealing with Covid-19. Many people have lost their dreams, having to close their business, lay off, or have their business burned to the ground.  Many have lost their jobs.  Even though people go through the everyday routine and are not guaranteed or who are “essential workers” and are employed, they put themselves in harm’s way; and stress is felt.  Our gene expressions are being changed.  Worry about finances, our future, or our loved ones’ future are all forms of stress. Stress has been associated with depression, anxiety, and psychosis (Holttum, 2014).    Today, children feel the stress of being confined and not being able to socialize with their friends. Those who are pregnant and undergoing the stress of this world are producing more children with depression, anxiety, ADHD, personality disorders, or psychotic disorders.  Psychotherapy has been found to change the structure of the gene expression and other brain structures.  Psychotherapy may be our saving grace in today’s world.  This writer believes that stress management skills and exercises should be taught in school, and perhaps telehealth sessions for children and adults.  How do you see this society being impacted by the stressors of today’s world? Discussion: Factors That Influence the Development of Psychopathology

References

Holttum, S.,(2014), when bad things happen our brains change, but psychotherapy and support can help the recovery of our brains and our lives, 
Mental Health and Social Inclusion
, 18(2), PP 52-58

Nelson, E. E., (2017), Learning through the ages:  How the brain adapts to the social world across development, 
Cognitive Development, 42(2017
), 84-94

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015), 
Sadock’s & Sadock’s synopsis of psychiatry,  
(11
th
ed.), Wolters Kluwer Discussion: Factors That Influence the Development of Psychopathology

NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success

Laureate Education (Producer). (2018). 
The Foundation of Success
 [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). 
The Walden Journey to a Masters in Nursing: The Journey Begins
 [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). 
The Walden Journey to a Masters in Nursing: Networking and Collaboration
[Video file]. Baltimore, MD: Author. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success

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Learning Objectives

Students will:

Analyze relationships among Walden’s vision, mission, goals, and social change initiatives to professional and academic goals

Analyze the relationship between MSN program outcomes and perspectives to professional and academic goals

Identify academic and professional collaborators for academic and professional success

Identify concepts for Walden student readiness

Identify individuals or teams to collaborate with for success in the MSN program and as a practicing nurse

Due By

Assignment

Week 1, Days 1–2

Read the Learning Resources.

Compose your initial Discussion post.

Begin to compose Part 1 of your Assignment.

Week 1, Day 3

Post your initial Discussion post.

Begin to check your knowledge with the Quiz.

Continue to work on of Part 1 of your Assignment.

Week 1, Day 4

Continue to check your knowledge with the Quiz.

Continue to work on Part 1 of your Assignment

Week 1, Day 5

Review peer Discussion posts.

Compose your peer Discussion responses.

Continue to check your knowledge with the Quiz.

Continue to compose your final draft of Part 1 of your Assignment.

Week 1, Day 6

Post two peer Discussion responses.

Continue to check your knowledge with the Quiz.

Continue to compose your final draft of Part 1 of your Assignment.

Week 1, Day 7

Wrap up Discussion.

Final day to complete Quiz.

Deadline to submit your final draft of Part 1 of your Assignment.

Photo Credit: David Baumber/Vetta/Getty Images

Learning Resources

Required Readings

Nurse.org. (n.d.). List of nursing organizations. Retrieved November 14, 2018, from https://nurse.org/orgs.shtml

Schmidt, K. (n.d.). 5 reasons nurses should engage in professional networking [Blog post]. Retrieved November 14, 2018, from https://blog.bluepipes.com/5-reasons-nurses-should-take-professional-networking-seriously/

Walden University. (n.d.). Connect to Walden. Retrieved November 14, 2018, from https://www.waldenu.edu/connect

Walden University. (n.d.). College of Nursing. Retrieved June 5, 2020, from https://www.waldenu.edu/about/colleges-schools/college-of-nursing

 

Review the College of Nursing’s vision and mission.

Walden University. (n.d.). Walden University catalog. Retrieved October 4, 2019, from https://catalog.waldenu.edu

 

Select College of Nursing, then Master of Science in Nursing (MSN). Review the MSN Learning Outcomes on this page.

Walden University. (n.d.). Walden University catalog. Retrieved October 4, 2019, from https://catalog.waldenu.edu

 

Select Introduction, then the link “Vision, Mission, and Goals” under the Introduction header. Review Walden’s vision, mission, and goals.

Walden University. (n.d.). Writing center. Retrieved November 14, 2018, from https://academicguides.waldenu.edu/writingcenter

Wofford, P. (2018). 10 networking tips for nurses who hate networking. Retrieved from https://nurse.org/articles/tips-for-nurse-networking/

Academic Success and Professional Development Plan Template (Word document)

Discussion Posting Exemplars (PDF)

Discussion: Networking Opportunities

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

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

This Module’s Discussion asks you to consider how the Walden mission and vision as well as the College of Nursing’s mission and vision apply to your professional and academic goals. You will also begin to identify individuals and teams who can help you along the way as you begin designing the “blueprint”—your Academic Success and Professional Development Plan—that will guide you toward your own vision for academic and professional success.

To Prepare:

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

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

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

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

By Day 3 of Week 1

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

By Day 6 of Week 1

Respond
 to at least 
two
of your colleagues’ posts by suggesting additional individuals and/or teams with whom you wish to collaborate or by offering additional networking strategies. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 1

To participate in this Discussion:

Week 1 Discussion

Quiz: Walden’s Student Readiness Orientation

You probably have a lot of questions (and perhaps some hesitation) about the journey you are undertaking. How do I navigate the online classroom? How can I have access to a library in this environment? The Student Readiness Orientation (SRO) minicourse available on your MyWalden page provides answers to such questions and helps ensure you understand how to navigate the online classroom and utilize the many resources available to you as a student at Walden. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success

The Readiness Check will help you determine your prepardness for navigating the online classroom.

The questions presented on the Quiz are derived from the readiness check presented in the SRO.

Click on the Week 1 Quiz link after you have read the directions carefully.

The readiness check includes 15 questions in various formats including true/false and multiple choice. If you score 12 or below, please retake the exam. You may retake the exam as many times as you would like in order to achieve your desired score. Your highest score will be recorded. To retake the Quiz, click on “Take Test Again” (this does not appear as a hyperlink but works as a hyperlink when you click on the area).

To view the questions you answered correctly and incorrectly, click on your score in the “My Grades” area.

To Prepare:

Review the Walden’s SRO found on your MyWalden page. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success

By Day 7

Complete the quiz.

Submission and Grading Information

Submit Your Quiz by Day 7 of Week 1

To submit your Quiz:

Week 1 Quiz

Assignment: Academic Success and Professional Development Plan

Part 1: Developing an Academic and Professional Network

When was the last time you read Meditation XVII of John Donne’s 
Devotions Upon Emergent Occasions
?

Unless you are a student of seventeeth-century poetry, you may not be all that familiar with this piece. However, you may be much more familiar with one of its well-known phrases: “No man is an island…”. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success

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

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

To Prepare:

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

Identify at least two academic and at least two professional individuals, colleagues, or teams that might help you succeed in your MSN program and as a practicing nurse.

Download the 
Academic Success and Professional Development Plan Template
. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success

The Assignment:

Academic and Professional Network

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

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

Explain why you selected these individuals and/or teams and how they will support your success in the MSN program and as a practicing nurse.

By Day 7 of Week 1

Submit
 Part 1 of your 
Academic Success and Professional Development Plan Template
.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success

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

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

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click 
Open
.

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

Click on the 
Submit
 button to complete your submission.

Grading Criteria

To access your rubric:

Week 1 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

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

Submit Your Assignment by Day 7 of Week 1

To submit your Assignment:

Week 1 Assignment NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success

African American Child Suffering From Depression marked

Treating Depression with Suicidality in Pediatrics Using Appropriate Medications: The Case of an 8 Year-Old African American Boy

The most authoritative and reliable diagnostic tool in psychiatry is the DSM-5 which is currently in its fifth edition. It is the
Diagnostic and Statistical Manual of Mental Disorders
. It classifies depression (major depressive disorder or MDD to be precise) under the broad diagnostic category of ‘Depressive Disorders’. The category also includes conditions such as dysthymia or persistent depressive disorder. Together with MDD, dysthymia presents with characteristic sadness, emptiness, and irritability (Sadock et al., 2015; APA, 2013). The case study is about an African American male child brought by his mother and who presents with sadness, thoughts about death, and a Children’s depression Rating Scale (CDRS) score of 30. Even without the symptoms, this CDRS score alone indicates that the boy is suffering from significant depression African American Child Suffering From Depression marked. From the history, it is clear that the boy avoids his peers in school and keeps to himself. He has complained of feeling sad, a sign that he may be experiencing anhedonia or indifference to happiness. The mental status examination or MSE also shows that the boy has suicidal thoughts (thoughts about death) as well as affect that is blunt. Considered in their totality, these symptoms align very well with the diagnosis of major depressive disorder (MDD) as outlined in the DSM-5 (APA, 2013). There are no other abnormalities found in the boy through laboratory investigations and physical examination. For this reason, the occurrence of the symptoms cannot be directly attributable to any physical illness or the effects of a substance or medication. DSM-5 criteria for diagnosing MDD include a lack of concentration, suicidal thoughts or thoughts about dying and death, prolonged sadness, a loss of interest in normal daily activities, feeling that one has no value, and psychomotor retardation (APA, 2013). This is a paper about the appropriate use of medications in treating this pediatric depression case. African American Child Suffering From Depression marked

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Decision Point One

At this decision point one; the decision taken is to give the 8 year-old boy with depression the selective serotonin reuptake inhibitor (SSRI) known as sertraline or Zoloft. This is an atypical antidepressant that happens to be effective against pediatric depression but that is only FDA-approved for use in treating the disorder in adults. What the FDA approval means is that there is still no safety and efficacy data from randomized controlled trials in children. However, clinicians still use such medications legally by reducing the dosages to fit the pediatric profile of their young patients. This is called off-label prescription (Allen et al., 2018; Vijay et al., 2018; Mir & Geer, 2017). In the case of Zoloft, there is enough anecdotal evidence that it is indeed effective in treating depression in children too when used off-label. The drug was started at an initial dose of 25 mg per day orally (Rosenthal & Burchum, 2018; Stahl, 2017). The child will then be monitored very closely for any signs of toxicity and adverse reactions that may occur. This is considering that information on these parameters is nonexistent for this medication in children. In other words, the information cannot be found in the package insert of medication literature that accompanies the medication (it is off-label in pediatrics).

The choice of sertraline is informed by several considerations. These are some of the reasons why a clinician may resort to off-label medications to treat pediatric conditions. Two of these stand out. The first one is when the child’s life is at risk and the physician or clinician thinks that they may benefit faster from the use of the off-label medication based on their personal experience and judgement. In this case, the African American boy has admitted to having thoughts about death and dying. This could be interpreted as suicidal ideation which places his life at risk. The second reason for using off-label medications in pediatric conditions is when there are not enough efficacious FDA-approved drugs to treat a pediatric condition. If the clinician feels that the child may then benefit from an off-label drug they have used before, they may then go ahead and use it in the spirit of beneficence as a bioethical principle (Haswell, 2019). Use of the off-label drug sertraline is therefore informed by the need to benefit the child far outweighing the risks.

The decision to choose sertraline (Zoloft) instead of the other two options (paroxetine or Paxil and bupropion or Wellbutrin) was informed by evidence-based practice (EBP). From the clinician’s experience and discussions with colleagues, sertraline has proved efficacious before when used off-label to treat pediatric major depressive disorder (Chon et al., 2017). The efficacy demonstrated by the off-label sertraline is such that remission of symptoms can be achieved within a matter of just four weeks. The hope when choosing sertraline or Zoloft was that remission of the boy’s symptoms would be achieved quickly. A confirmation of this would be made by patient testimony and repeat assessment using the CDRS (Shanahan et al., 1987). The child is expected to score lower than the initial 30 points that indicated major or significant depression.

A for the ethical considerations, the fact that the sertraline is off-label means that there is a real risk of unknown adverse effects affecting the child. However, the benefits to be gained by the child outweigh the risks and therefore it is beneficence that reigns. To mitigate the risk of harm to the patient, he will be monitored very closely and the sertraline stopped immediately there is any indication of an adverse outcome (nonmaleficence) (Haswell, 2019). These are the two bioethical principles that define the ethical perspective of this case.

Decision Point Two

On return for review and re-evaluation, the child and his mother reported that they had not experienced any improvement in the boy’s condition. In other words, the condition of depression and its symptoms remained intact even after starting the off-label sertraline (Zoloft). The boy had been taking the medication at a dose of 25 mg orally per day for the past four weeks as planned. But the absence of a change in the symptoms was not surprising at all. This lack of surprise is informed by knowledge about the pharmacodynamics of sertraline (Zoloft). Its therapeutic effect is known to start in earnest anywhere from two to four weeks (Stahl, 2017). Because of that, the boy was still well within the timeframe for the start of the therapeutic action of sertraline.

The decision taken at this decision point two was therefore to double the dose of the sertraline (Zoloft) to 50 mg orally every day for another four weeks. This decision is evidence-based as Stahl (2017) states that an increase in the dose of sertraline is indicated if the therapeutic effect does not kick in between four and six weeks. Also, increasing the dose would coincide with the beginning of the therapeutic effect and therefore maximise the benefit. The reasons for not choosing the other two options available were also evidence-based. An increase of the sertraline dose to 37.5 mg would have had minimal effect even after the therapeutic effect kicked in. Stopping sertraline and introducing fluoxetine or Prozac would have been premature and ill-informed. Even though Prozac is FDA-approved to treat MDD in children (Stahl, 2017); the off-label sertraline must first be given a chance to produce its full therapeutic effects before considering stoppage.

What was hoped would be achieved by doubling the dose of sertraline as done above was to produce a symptom reduction by about 50%, as indicated by the CDRS scores. In evidence-based practice, this is what is considered as a therapeutic response. Ethical considerations at this stage would be about autonomy. The mother and the child would be counselled and given psychoeducation so that they can remain adherent to the treatment and comply with the dosing. They will make this decision based not on coercion, but on the principle of concordance (Snowden et al., 2014). The decision by mother and child to continue with the same medication at an increased dose regardless of the apparent absence of improvement will therefore be informed (autonomy).

Decision Point Three

The child is returned after a total of eight weeks on sertraline (Zoloft), the last four of which were at an increased dose of 50 mg per day orally. As expected, the patient and his mother report a significant reduction of in his depressive symptoms. The CDRS assessment confirms this by showing that indeed the reduction in depressive symptoms is by half (50%). Indeed, the sertraline had now begun demonstrating its therapeutic effect after four weeks of use. Because the child was obviously responding well to the off-label sertraline, the decision made at this point was to raise its dose to 75 mg orally per day. This was expected to provide sustained symptom remission in a robust way. The other two options were rejected because there was a therapeutic response already demonstrated by the use of the off-label sertraline. The hope in increasing the sertraline dose was to increase the therapeutic response by at least another 25% to 30%. Ethically, beneficence and nonmaleficence were to be upheld as on the previous occasions.

Conclusion

This case of the 8 year-old African American male child with a diagnosis of major depression is a test of the pharmacotherapeutic acumen of the clinician. A thorough knowledge is required of the pharmacodynamics of each of the agents, as is knowledge about off-label use and FDA approval. Above all, the clinician needs to be abreast of the current evidence-based practice concerning pharmacologic treatment of childhood psychiatric conditions. Major depressive disorder is a diagnosis made in both adults and children. However, treatment by FDA-approved drugs in adults is straightforward. This is not the case in pediatrics. For this reason and based on anecdotal evidence and EBP, the choice of off-label sertraline was made. Knowledge of its pharmacodynamics enabled persistence even in the face of nonresponse within the first four weeks. The reduction in depressive symptoms by 50% was the turning point in treatment. It showed that the child was demonstrating a therapeutic response. This provoked a further increase to 75 mg orally every day, which was to sustain the effect and produce an even bigger response. In all, the decisions made were the best and the treatment was a success.

References

Allen, H.C., Garbe, M.C., Lees, J., Aziz, N., Chaaban, H., Miller, J.L., Johnson, P., & DeLeon, S. (2018). Off-label medication use in children, more common than we think: A systematic review of the literature.
The Journal

of the Oklahoma State Medical Association, 111
(8), 776–783.
https://europepmc.org/article/pmc/pmc6677268

American Psychiatric Association [APA] (2013).
Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5
th
ed
. Author. African American Child Suffering From Depression marked

Chon, M-W., Lee, J., Chung, S., Kim, Y., & Kim, H-W. (2017). Prescription pattern of antidepressants for children and adolescents in Korea based on nationwide data.
Journal of Korean Medical Science, 32
(10), 1694-1701.
https://doi.org/10.3346/jkms.2017.32.10.1694

Haswell, N. (2019). The four ethical principles and their application in aesthetic practice.
Journal of Aesthetic Nursing
, 8(4), 177-179.
https://doi.org/10.12968/joan.2019.8.4.177

Mir, A.N. & Geer, M.I. (2017). Off-label use of medicines in children.
International Journal of Pharmaceutical Sciences and Research
.

OFF-LABEL USE OF MEDICINES IN CHILDREN

Rosenthal, L.D., & Burchum, J.R. (2018).
Lehne’s pharmacotherapeutics for nurse practitioners and physician assistants
. Elsevier.

Sadock, B.J., Sadock, V.A., & Ruiz, P. (2015).
Synopsis of psychiatry: Behavioral sciences clinical psychiatry, 11
th
ed
. Wolters Kluwer.

Shanahan, K.M., Zolkowski-Wynne, J., Coury, D.L., Collins, E.W., & O’Shea, J.S. (1987). The Children’s Depression Rating Scale for normal and depressed outpatients.
Clinical Pediatrics, 26
(5), 245-247.
https://doi.org/10.1177/000992288702600506

Snowden, A., Martin, C., Mathers, B., & Donnell, A. (2014). Concordance: A concept analysis.
Journal of Advanced Nursing, 70
(1), 46-59.
https://doi.org/10.1111/jan.12147

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

Vijay, A., Becker, J.E., & Ross, J.S. (2018). Patterns and predictors of off-label prescription of psychiatric drugs.
PLoS ONE 13
(7): e0198363.
https://doi.org/10.1371/journal.pone.0198363

BACKGROUND INFORMATION

The client is an 8-year-old 
African
 
American
 male who arrives at the ER with his mother. He is exhibiting signs of 
depression
. African American Child Suffering From Depression marked

Client complained of feeling “sad”

Mother reports that teacher said 
child
 is withdrawn from peers in class

Mother notes decreased appetite and occasional periods of irritation

Client reached all developmental landmarks at appropriate ages

Physical exam unremarkable

Laboratory studies WNL

Child
 referred to psychiatry for evaluation

MENTAL STATUS EXAM

Alert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood is “sad”. Affect somewhat blunted, but 
child
smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does admit that he often thinks about himself being dead and what it would be like to be dead. African American Child Suffering From Depression marked

You administer the Children’s 
Depression
 Rating Scale, obtaining a score of 30 (indicating significant 
depression
)

RESOURCES

§ Poznanski, E., & Mokros, H. (1996). 
Child
 
Depression
 Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.

Decision Point One

Select what you should do:

Begin Zoloft 25 mg orally daily

Begin Paxil 10 mg orally daily

Begin Wellbutrin 75 mg orally BID

The Assignment: 5 pages

Examine Case Study: An 
African
 
American
 
Child
 
Suffering
 From 
Depression
. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. African American Child Suffering From Depression marked

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

Which decision did you select?

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. African American Child Suffering From Depression marked

Decision #2 (1 page)

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. African American Child Suffering From Depression marked

Conclusion (1 page)

Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

Rubric scores

Introduction to the case (1 page)

Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1–2 pages)

• Which decision did you select?

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). African American Child Suffering From Depression marked

• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples

Decision #2 (1–2 pages)

• Which decision did you select?

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1–2 pages)

• Which decision did you select?

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. African American Child Suffering From Depression marked

Conclusion (1 page)

• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.

RESPONSE

Agree with decision point one but I do not see the other two options addressed with primary literature to support not using either. Paxil has significant data that shows the highest rate of SI in this population. Wellbutrin has little evidence of use in peds and also, when studied, was looked at in MDD/ADHD.

Agree with decision point two and see an adequate discussion to support.

I would mention that a lack of ADE also supports escalating the dose here.

I do not agree with decision point three. It has only been 4 weeks since your last dose increase. Not a full 6-8 weeks and he has shown a full response (reduction of symptoms by 50% or greater). The most appropriate answer here would be to continue with the same dose. A dose increase here could lead to ADE.

APA formatting should be with a left justified top line with a one tab singular indentation for each line below per citation. African American Child Suffering From Depression marked