Post an explanation of how you anticipate enacting personal and professional commitment for advocacy to positively impact your patients, communities, and the profession. Be specific. Then, explain how your role as a DNP-prepared nurse contributes to advocacy for positive social change.

1. 

 My personal and professional commitment to advocacy includes both short and long-term goals within the nursing profession. From a professional standpoint, I am afforded the opportunity to offer input on ways to continuously improve the patient care experience and care delivery. Providing feedback offered directly from patients as well as discussing barriers I experience as a prescriber, including but not limited to coordination with other members of the care team or barriers within technology, will be at the forefront. Openly discussing setbacks provides the opportunity to brainstorm improvements, ultimately improving patient care outcomes.

            Personal commitments to the nursing profession and patient advocacy include the accountability to remaining current within my knowledge of medications and therapies available to treat the mental health population. The formal education provided within the Doctor of Nursing practice (DNP) program provides the structure and skills needed to employ within professional practice. These skills ensuring that the DNP is seeking out and utilizing quality, evidence-based measures to treat patients with interventions supported by adequate science and research (American Association of Colleges of Nursing, 2006). Networking with other mental health professionals both within the nursing field and in other capacities will also expand and enact my commitment to patient advocacy and social change. Learning from other professionals, hearing their perspectives on current events, and in exchange offering my perspective will offer a broad view of treatment approaches and current topics (Hann et al., 2020).

The Doctor of Nursing as a Social Change Agent

            As a DNP, I would like to employ my skills as a social change agent by engaging in educational opportunities within the mental health community, driven by research opportunities. Engaging in the research that guides evidence-based practices improves outcomes for the millions of patients impacted by care delivery and would exercise the practice-based research skills formed in DNP education (Iwama et al., 2023). Utilizing the terminal DNP degree to its utmost while continuing to engage in patient care would combine the aspects I found most rewarding of my MSN-PMHNP career and the completion of the DNP program. Advocating for improved treatment measures within the mental health community, as well as for increased access to appropriate care and diagnostic assessments, are all ways in which I would like to engage in DNP research opportunities. Providing education, facts, and data related to how patients are impacted by lack of access to specialized psychiatric care due to barriers such as telehealth restrictions and lack of full practice authority for nurse practitioners will continue to increase awareness of these topics and lobby for change. The DNP offers specialized insight into these topics as a professional working not only for but within the field, and holds significant weight when discussing these topics with both other professionals as well as non-professionals. 

References

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

Hann, K., Heather Pearson, Campbell, D., Sesay, D., & Eaton, J. (2020). Factors for success in mental health advocacy. Global Health Action, 8(0), 1–9. https://doi.org/10.3402/gha.v8.28791

Iwama, K., Travis, A., Nowlin, S., Souffront, K., Finlayson, C., Gorbenko, K., & Cohen, B. (2023). Barriers, facilitators, and opportunities for Doctor of Nursing Practice engagement in translational research. Nursing Outlook, 71(5). https://doi.org/10.1016/j.outlook.2023.102031In the nursing profession, advocating for our patients is something that is deeply ingrained in us.  One of the five key areas of the social determinants of health is access to healthcare (Centers for Disease Control and Prevention, 2021).  Unfortunately, approximately one in ten patients do not have health insurance (Berchick et al., 2018).  In the field of mental health, we often see patients who are too disorganized to navigate the health insurance system and experience lapses in insurance.  In Massachusetts, we are required to abide by the Expedited Psychiatric Inpatient Admissions (EPIA) Policy, which mandates that “no individual boarding in an ED waiting placement in a psychiatric hospital will wait more than 96 hours before Department of Mental Health has been notified, regardless of whether the individual is uninsured or has coverage not regulated by Division of Insurance” (Executive Office of Health and Human Services, 2023).  The pressure to decompress emergency rooms and move psychiatric patients out as quickly as possible means that we often receive patients who are uninsured.  In order to help our patients get the services they need, nurses and social workers assist our patients in taking the necessary steps to obtain health insurance.  This often means lengthy phone wait times on phone calls, but as advocates, we do what is necessary to ensure positive outcomes for our patients.   

                                                                     Advocacy in my Community

As an agent of positive change, I will advocate at the community level for residents who suffer from mental illness.  In spite of the “growing recognition of the burden associated with mental illnesses and the availability of cost-effective treatments, they are not yet afforded the same policy or program priority as comparably disabling physical conditions” (Stuart, 2017).  I aim to increase access to mental health services by expanding my organization’s service lines to include outpatient services for mental health and substance use disorders.  In order to gain buy-in from the community, I plan to attend town meetings to advocate for increased services as well as partnering with local Emergency Departments to educate them about the mental health services that my organization offers.  I plan to seek meetings with local politicians to advocate that resources be invested into increasing services for mental health and substance use disorder services. 

                                                                     Advocacy in my Profession

            According to a recent survey conducted by the American Psychiatric Nurses Association (APNA), “only 4% of licensed registered nurses (RNs) work in psychiatric-mental health, If that percentage is still consistent, then there are approximately 154,000 RNs working in psychiatric-mental health, which is not nearly enough to meet the demand” (APNA, 2018).  As a doctorally prepared nurse, it is critical that I take steps now to increase the number of nurses who specialize in mental health.  I aim to do this on the local level by partnering with local nursing schools to invite them into my organization for their psychiatric clinical rotations.  Additionally, I will attend local universities’ career fairs so that I can provide information to nursing students about the advantages of working in the field of mental health.

                                                                          Advocacy and Social Change

As a doctorally prepared nurse, I aim to help close the gaps in the inequities of access in the field of mental health.  To do so, I must first identify opportunities to advocate for my own patients by assisting them in obtaining health insurance so that they are able to have access to outpatient services.  At the community level, I aim to increase access to mental health services by expanding my organization’s service lines to include more outpatient services for psychiatry and substance use disorders.  With regard to the profession of nursing, specifically psychiatric nursing, it is imperative that I identify ways to increase interest for newly graduated RNs to join the field by promoting the field at local nursing schools.  By acting as an advocate on all three levels, I will be able to effect positive social change in the field of psychiatric nursing.

                                                                                   References

American Psychiatric Nurses Association. (2018). Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey. https://journals.sagepub.com/doi/abs/10.1177/1078390318777873?journalCode=japa

Berchick, E.R., Hood, E., & Barnett, J.C. (2018). Health Insurance Coverage in the United States: 2017. Retrieved from https://www.census.gov/content/dam/Census/library/publications/2018/demo/p60-264.pdfLinks to an external site. [PDF – 1.4 MB]

Centers for Disease Control and Prevention. (2021). Social determinants of health: Know what affects health. https://www.cdc.gov/socialdeterminants/index.htmLinks to an external site.

Executive Office of Health and Human Services. (2023). Expedited Psychiatric Inpatient Admissions (EPIA) Policy. https://www.mass.gov/info-details/expedited-psychiatric-inpatient-admissions-epia-policyLinks to an external site.

Stuart, H. (2017). Reducing the Stigma of Mental Illness. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5314742/

2. 

 My personal and professional commitment to advocacy includes both short and long-term goals within the nursing profession. From a professional standpoint, I am afforded the opportunity to offer input on ways to continuously improve the patient care experience and care delivery. Providing feedback offered directly from patients as well as discussing barriers I experience as a prescriber, including but not limited to coordination with other members of the care team or barriers within technology, will be at the forefront. Openly discussing setbacks provides the opportunity to brainstorm improvements, ultimately improving patient care outcomes.

            Personal commitments to the nursing profession and patient advocacy include the accountability to remaining current within my knowledge of medications and therapies available to treat the mental health population. The formal education provided within the Doctor of Nursing practice (DNP) program provides the structure and skills needed to employ within professional practice. These skills ensuring that the DNP is seeking out and utilizing quality, evidence-based measures to treat patients with interventions supported by adequate science and research (American Association of Colleges of Nursing, 2006). Networking with other mental health professionals both within the nursing field and in other capacities will also expand and enact my commitment to patient advocacy and social change. Learning from other professionals, hearing their perspectives on current events, and in exchange offering my perspective will offer a broad view of treatment approaches and current topics (Hann et al., 2020).

The Doctor of Nursing as a Social Change Agent

            As a DNP, I would like to employ my skills as a social change agent by engaging in educational opportunities within the mental health community, driven by research opportunities. Engaging in the research that guides evidence-based practices improves outcomes for the millions of patients impacted by care delivery and would exercise the practice-based research skills formed in DNP education (Iwama et al., 2023). Utilizing the terminal DNP degree to its utmost while continuing to engage in patient care would combine the aspects I found most rewarding of my MSN-PMHNP career and the completion of the DNP program. Advocating for improved treatment measures within the mental health community, as well as for increased access to appropriate care and diagnostic assessments, are all ways in which I would like to engage in DNP research opportunities. Providing education, facts, and data related to how patients are impacted by lack of access to specialized psychiatric care due to barriers such as telehealth restrictions and lack of full practice authority for nurse practitioners will continue to increase awareness of these topics and lobby for change. The DNP offers specialized insight into these topics as a professional working not only for but within the field, and holds significant weight when discussing these topics with both other professionals as well as non-professionals. 

References

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

Hann, K., Heather Pearson, Campbell, D., Sesay, D., & Eaton, J. (2020). Factors for success in mental health advocacy. Global Health Action, 8(0), 1–9. https://doi.org/10.3402/gha.v8.28791

Iwama, K., Travis, A., Nowlin, S., Souffront, K., Finlayson, C., Gorbenko, K., & Cohen, B. (2023). Barriers, facilitators, and opportunities for Doctor of Nursing Practice engagement in translational research. Nursing Outlook, 71(5). https://doi.org/10.1016/j.outlook.2023.102031

Read the following case study and answer the reflective questions.  Please provide evidence-based rationales for your answers.  APA, 7th ed. must be followed. 

 

 Due 10/13/23 @ 1600 EST

Respond by sharing ideas for how shortcomings discovered in their evaluations and/or their examples of incivility could have been managed more effectively. 

using APA, at least 2 scholarly references 

 

The results show that the organization encourages collaborative decision-making, where multiple stakeholders, including employees, have a say in important matters. This can lead to a more inclusive and democratic decision-making process. Members are actively involved in creating and shaping workplace policies. This involvement ensures that policies reflect the needs and preferences of those who work within the organization. The organization recognizes the importance of periodically reviewing its policies to remain relevant and practical. This proactive approach helps in identifying areas that may need improvement or adjustment. The organization is also open to revising policies as necessary. This flexibility allows for adaptation to changing circumstances or feedback from members.

Members of the organization share a vision and mission based on trust, respect, and collegiality. Communication at all levels of the organization is transparent, direct, and respectful. The organizational culture is assessed on an ongoing basis, and measures are taken to improve it based on the results of that assessment.

surprisingly “Most employees did not recommend the organization as a good or great place to work to their family and friends.” This suggests that despite some positive aspects mentioned in the assessment, many employees are dissatisfied to the point where they would not recommend the organization to others. This could indicate a significant issue with the workplace culture or conditions that may need urgent attention.

Another surprising thing is that “Individual and collective achievements are not celebrated and publicized equitably.” This lack of recognition and celebration of achievements can harm employee morale and motivation. It is surprising because recognizing and celebrating accomplishments is common in many organizations to boost employee engagement and satisfaction.

Before the assessment, I had an idea that “Communication at all levels of the organization is transparent, direct, and respectful.” the assessment confirms this aspect as it indicates that the organization values open and respectful communication and is seen as a positive sign, as effective communication is crucial for building trust and a healthy workplace culture (Dempsey & Assi, 2018).

It is evident from the findings that my workplace is civil because it values employees, fosters a positive and inclusive culture, invests in employee development, and prioritizes their well-being. Such an environment will likely attract and retain talented individuals and contribute to the organization’s long-term success.

The assessment also shows that my workplace is characterized by trust, respect, engagement, and a positive culture providing a healthy working environment. However, it is essential to continue monitoring and addressing any potential areas for improvement to sustain this healthy and civil work environment.

The concepts presented in the articles appear to be related to organizational culture and employee satisfaction. A healthy organizational culture that aligns with employees’ values and supports their well-being is more likely to result in higher employee satisfaction. When employees feel that they fit into the culture, are respected, and have opportunities for growth and development, their satisfaction increases. The assessment evaluates various aspects of an organization’s work environment, including trust, communication, employee engagement, leadership, and more (Cummings et al., 2018). These factors collectively contribute to the organizational culture and can significantly impact employee satisfaction and overall well-being.

In summary, the theory of organizational culture and employee satisfaction closely aligns with the assessment criteria in my workplace. A positive organizational culture, characterized by trust, communication, recognition, and employee well-being, will likely result in higher employee satisfaction, engagement, and morale (Cummings et al., 2018). Conversely, a negative culture can lead to dissatisfaction and a lack of employee recommendations. 

To apply the theory of organizational culture and employee satisfaction to improve organizational health and create stronger work teams, an organization can take several specific actions and initiatives:

Define and Communicate Clear Values and Mission by holding regular meetings or workshops to reinforce the organization’s mission and values. Ensure that all employees understand and can articulate these core principles.

Foster Trust and Open Communication by Implementing regular “town hall” meetings where leadership provides updates and encourages questions from all employees. Create anonymous feedback channels for employees to express concerns or suggestions.

Recognize and Celebrate Achievements through establishing an employee recognition program that acknowledges outstanding contributions and achievements. Celebrate milestones and successes as a team.

Employee engagement and morale through Conducting regular employee engagement surveys to gather feedback on job satisfaction and areas for improvement. Act on the survey results by implementing changes based on employee input.

The organization seems to prioritize a positive and inclusive culture where trust, respect, and collegiality are fundamental principles. This is a commendable approach that can contribute to a healthy work environment. Committing to transparent and respectful communication at all levels is crucial for maintaining trust and ensuring all employees feel heard and valued. Open and honest communication is key to a thriving organization. Recognizing employees as valuable partners rather than liabilities is essential as it fosters a sense of belonging and motivates employees to contribute to the organization (Atrizka et al., 2020). Encouraging shared governance, teamwork, and collaboration reflects a commitment to involving employees in decision-making processes, which can lead to better solutions and more significant employee investment in the organization’s success. Notably, most employees did not recommend the organization as a good or excellent place to work to their family and friends. This indicates a potential area for improvement and suggests that the organization should actively address any concerns or issues that employees may have.

In summary, the organization seems to have many positive elements for creating a healthy and supportive work environment. However, it should pay attention to the feedback provided by its employees to address any areas that need improvement and enhance overall employee satisfaction and advocacy.

                                                                                                              References

Atrizka, D., Lubis, H., Simanjuntak, C. W., & Pratama, I. (2020). Ensuring Better Affective Commitment and Organizational Citizenship Behavior through Talent Management and Psychological Contract Fulfillment: An Empirical Study of Indonesia Pharmaceutical Sector. Systematic Reviews in Pharmacy, 11(1).

Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P., & Chatterjee, G. E. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International journal of nursing studies, 85, 19-60.

Dempsey, C., & Assi, M. J. (2018). The impact of nurse engagement on quality, safety, and the experience of care: what nurse leaders should know. Nursing administration quarterly, 42(3), 278-283.

 Avsar, P., Budri, A., Patton, D.,  Walsh, S., & Moore, Z. (2022). Developing algorithm based on  activity and mobility for pressure ulcer risk among older adult  residents: Implications for evidence‐based practice. Worldviews on Evidence-Based Nursing, 19, 112–120. https://doi.org/10.1111/wvn.12545 

  Due today 09/28/23 2000 EST

Respond by making recommendations for how they might strengthen the leadership behaviors profiled in their StrengthsFinder assessment, or by commenting on lessons to be learned from the results that can be applied to personal leadership philosophies and behaviors.

2 scholarly references

The strength finder assessment I took is an eye opener to my strengths and weaknesses. It also showed me where to exert some effort and how to do it. The findings followed this order.

1. Achieving Person: Achiever means someone who is always looking to do better. This theme helps me understand what my drive is. I am always looking to get things done better and more manageable. 

2. Consistency: I care about balance. It is essential to treat everyone the same, no matter their situation, not wanting the scales to tip too far in favor of one person because that sends wrong signals to the team.  

 3. Gathering Information: I think critically and make out opinions of things and people. I might be trying to solve a problem, develop an idea, or understand how someone else feels. 

 4. Harmony/ Teamwork: I want people to have a common ground for achieving goals. There is little to gain from disagreement and chaos. When I know that the people around me have different ideas, finding common ground always breaks the ice and ensures we achieve common goals.

5. Relator/Relationship: The Relator theme makes me want to be with people I already know. Meeting new people might be challenging, but it is worth trying to achieve a common goal.

      The two central values that I would strengthen are optimism and creativity. There are times when I need more confidence concerning some situations. As for creativity, I do have various concepts that I can implement. Nurses are known for their emotional intelligence and critical thinking, which might affect their effectiveness. These attributes may affect clinical decision-making, reasoning, evidence-based practice, and practice-based knowledge in nursing. (Kaya et al. 2018) 

     The two strengths that I would make sturdier is self-confidence because, many times, self-doubt places a trick on me, especially when I am not sure about an issue. I will also work on building relationships because making new associates has advantages. 

       Two qualities must be improved upon: patience with my associates when handling issues. And delegating. Being a perfectionist makes me want to do everything myself to get the desired outcome. I need to harmonize these findings to achieve the best out of my strengths and weaknesses. 

                                                                                     Reference 

Kaya, H., Şenyuva, E., & Bodur, G. (2018). The relationship between critical thinking and emotional intelligence in nursing students: A longitudinal study. Nurse Education Today, 68(68), 26–32. https://doi.org/10.1016/j.nedt.2018.05.024

Rath, T. (2007). Strengthsfinder 2.0. Gallup Press.

Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer. (pp. 182–211)

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