Nursing

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Hello, Can you help me with my homework. 

Unit 2Weekly Clinical Communication and Documentation Requirements. 600w. 3 references. Due 11-11-22

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Clinical Decision-Making NU671

Unit 2Weekly Clinical Communication and Documentation Requirements. 600w. 3 references. Due 11-11-22

For this assignment the focus is a 50y/o male patient. construction worker. Came in for follow up after a 2024 ICD-10-CM Diagnosis Code M75. 102: Unspecified rotator cuff tear or rupture of left shoulder, not specified as traumatic. The injury occurred 1 month prior. The patient has not returned to work since his injury and is suffering from chronic pain, anxiety and depression related to his financial obligations at home. Patient is the head of his household; his wife does not work. He came in for a follow-up with his primary care provider. His blood pressure was also elevated due his stress. He was placed on fluoxetine (Prozac) 20 milligrams (mg) once a day in the morning and Carvedilol 6.25 milligrams (mg) 2 times a day. Over the counter Tylenol and ibuprofen recommended for pain. Patient education was provided regarding medication management and stress management.

1. Clinical Highlights.

· On your journey to become a psychiatric mental health nurse practitioner discuss a patient encounter that was particularly interesting and what you learned from it?

· Identify a personal learning need you discovered while assessing or managing a specific diagnosis. What steps will you take to improve your understanding or skills?

2. Looking Ahead

· What clinical goal would you like to tackle next week?

· What is your proposed clinical schedule (date/time/total hours) for next week?

Old assignment-paper
This is the assignment that was completed previous semester. I am retaking this class. The assignments are the same but I cannot submit the same work, the instructor runs all papers through the plagiarism checker. Please redo this assignment so I can resubmit it the content will be the same. Thanks

Unit 3 Weekly Clinical Preceptee Communication And Documentation

Name

Student’s Number

Course Title and Number

Professor’s Name

Institution

Date

Unit 3 Weekly Clinical Preceptee Communication And Documentation

Clinical Highlights

I had a patient interaction that was especially intriguing and taught me essential lessons throughout my training to become a psychiatric mental health nurse practitioner. A session was held with a young adult experiencing acute anxiety and depression. The patient's background of childhood trauma had a significant effect on how she felt mentally. It was challenging to develop a therapeutic connection with her when we first started our session because she looked reserved and guarded. I eventually won her trust through attentive listening and compassionate conversation. I discovered the extent of the patient's emotional suffering as she opened up and the survival skills she had developed. The experience showed me the value of being persistent and patient while establishing a connection with people who have undergone trauma. It reaffirmed how crucial it is to give people a secure, judgment-free area to express their emotions.

The incident also highlighted the challenges of treating coexisting mental health disorders. Her depression and anxiety were linked and exacerbated each other, which posed special difficulties in creating an all-encompassing treatment strategy. I saw the significance of providing mental health treatment using a holistic approach that considers all facets of a patient's life, particularly their social network, way of life, and coping mechanisms.

Personal Learning Need

I discovered a personal learning needs for treating individuals with personality disorders throughout my evaluations and management of various conditions. I found that there was room for development in the areas of understanding and treating borderline personality disorder (BPD). I felt the need to improve my knowledge and abilities since BPD is a complicated and sometimes misunderstood disorder. Acquiring evidence-based clinical knowledge is important in ensuring that people with BPD have better treatment (Iliakis et al., 2019). I have various actions I want to take to increase my knowledge about and management abilities for BPD. I will first do an in-depth study and analyze recent BPD literature to understand the underlying causes, symptoms, and evidence-based treatment options for BPD. This study will help me stay current on the most recent developments and suggestions for treating personality disorders.

I intend to seek mentoring or supervision from seasoned mental health practitioners knowledgeable about treating people with personality problems. Mentoring often provides mental health practitioners with insightful advice that will make them handle challenging situations easier (Zajac et al., 2021). I will look for chances for continuing education relevant to BPD and similar personality disorders. I will be able to communicate with professionals, gain knowledge from practical examples, and have conversations with others with similar learning interests by participating in these educational activities. Ultimately, I want to use my clinical rotations to put my newfound understanding of BPD and its treatment into practice. I may use evidence-based therapies and assess their efficacy while getting feedback from seasoned preceptors by actively interacting with BPD patients.

Looking Ahead

My clinical objective for the coming week is to improve my capacity for performing thorough mental health evaluations. A comprehensive assessment is crucial to psychological mental health practice since it is the basis for a precise diagnosis and efficient treatment planning (Maruish, 2019). The following is the proposed clinical schedule for next week.

Day

Activity

Monday

Shadow an experienced psychiatric mental health nurse practitioner during patient assessments in the morning. In the afternoon, review assessment tools and protocols.

Tuesday

Conduct mental health assessments under the supervision of a preceptor, focusing on gathering patient history, current symptoms, and potential risk factors.

Wednesday

Attend a workshop on the importance of cultural competence in mental health assessments, exploring techniques for conducting culturally sensitive interviews.

Thursday

Discuss assessment findings with preceptors, receive feedback, and participate in case discussions with fellow students to learn from their experiences.

Friday

Engage in self-directed study, reviewing assessment guidelines and practicing documentation skills to ensure accurate and thorough recording of patient information.

I intend to spend 30 hours on clinical work, education, and independent study during the week. I plan to considerably enhance my assessment abilities as a psychiatric mental health nurse practitioner by devoting time and effort to this clinical objective and offering better treatment to my future patients.

References

Iliakis, E. A., Sonley, A. K., Ilagan, G. S., & Choi-Kain, L. W. (2019). Treatment of borderline personality disorder: is supply adequate to meet public health needs?.
Psychiatric Services,
70(9), 772-781.

Maruish, M. E. (2019).
Essentials of treatment planning. John Wiley & Sons.

Zajac, S., Woods, A., Tannenbaum, S., Salas, E., & Holladay, C. L. (2021). Overcoming challenges to teamwork in healthcare: a team effectiveness framework and evidence-based guidance.
Frontiers in Communication,
6, 606445.

Nursing NUR425 Week 10 Assignment: International Disaster Risk Factors

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Step 1: Choose a disaster that occurred in a country (outside the United States) within the past 50 years

Step 2: Use the attached rubric to guide your research of the disaster.

When you have completed your assignment, submit a copy to your instructor. Submit the presentation and slide notes as one document. To do this, go to print the presentation and click next to the “Full Page Slides” to open the dropdown menu. Select “Notes Pages”. You should now see the presentation and the slide notes on one document. Under printer select “Print to PDF” and save the presentation in a safe place. Then submit your assignment. If you have problems submitting this way, it is ok to submit the presentation as a .ppt or .pptx file.

Cite any sources in APA format.

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Respond to what he wrote, be argumentative with the answers, and polite. References, and at least 2 paragraphs.

· Suggest a way to advocate for the profession.

· Share resources with those who are in your state.

Licensure and Certification in Georgia

            In Georgia, Advanced Practice Nurse Practitioners (APRNs) are governed and receive their practice authorization from the Georgia Board of Nursing. The Georgia Board of Nursing recognizes the use of the term “APRN” to cover a range of titles, which include Certified Nurse Midwives (CNM), Certified Nurse Practitioners (NP), Certified Registered Nurse Anesthetists (CRNA), Clinical Nurse Specialists/Psych-Mental Health (CNS-PMH) or Clinical Nurse Specialist (CNS). Also, in Georgia, an applicant must possess a valid registered nurse license before applying for an APRN license. According to Georgia Board of Nursing (2021), the applicant must meet the initial requirements for an APRN application, which include a completed Board application with required fee official transcript which verifies graduation with a master's or higher degree in nursing for the respective nurse practitioner specialty or a graduate level post-masters certificate in an advanced practice registered nurse practitioner specialty and evidence of advanced pharmacology within the curriculum or as a separate course, advanced physical assessment, and pathophysiology and certification of current national certification from the respective Board-recognized certifying organization. In addition, the applicant must show documentation that shows four years immediately preceding the date of current application that shows five hundred hours of practice as an APRN or graduation from a nursing education program or graduate level post-master certificate in an advanced practice registered nurse practitioner specialty or completion of Georgia Board-approved advanced practice registered nurse reentry/refresher program (Georgia Board of Nursing, 2021).

            In the state of Georgia, APRNs practice under a restricted regulatory structure. American Association of Nurse Practitioners (2022) noted that Georgia restricts patient access to nurse practitioner care and requires physician delegation/supervision for practice. Also, unlike other states, Georgia has two types of nurse protocol agreements. If the APRN is practicing under O.C.G.A. § 43-34-23, the APRN would evaluate the patient, formulate a diagnosis, determine the course of treatment, and they would call in the prescription to the pharmacy under their collaborating physician's name, just like a nurse or medical assistant would. This type of nurse protocol does not require approval from the medical board (American Association of Nurse Practitioners, 2022).  However, if the APRN practices under O.C.G.A. § 43-34-25, the APRN signs her prescriptions. This type of agreement must be submitted to the Board of Medical Examiners within 30 days of being signed (along with a fee of $150). APRNs must note that if they are to prescribe controlled substances, they must possess their own DEA number, and they are unable to prescribe Schedule II drugs in the state of Georgia. APRNs in Georgia are only allowed to prescribe Schedule III-V drugs. Regardless of which nurse protocol the APRN is practicing under, both protocols must include the following information: shall be in writing and signed by the advanced practice nurse and the delegating physician; shall be dated, available upon request, and specify parameters under which medical acts delegated by the physician may be performed; shall include provisions for periodic review of patient records by the delegating physician; shall be reviewed, revised or updated annually; shall include a provision for immediate consultation with the delegating physician or a physician designated in the absence of the delegating physician; hall contain written provisions regarding the procedure for dispensing dangerous drugs which comply with O.C.G.A. §§ 43-34-23(a)(3), (3.1), (4), and (5), if the dispensing of dangerous drugs is included as a delegated medical act in the nurse protocol agreement; and Shall contain written provisions regarding the procedure for ordering controlled substances which comply with paragraph (b)(1) of O.C.G.A. § 43-34-23, if the ordering of controlled substances is included as a delegated medical act in the nurse protocol agreement (Georgia Board of Nursing, 2021).

            Any medical provider that prescribes controlled substances must be registered with the federal Drug Enforcement Administration (DEA). This process can be done via the Drug Enforcement Administration's website. The online application consists of the following six components, personal information, email address validation, activity, state license (supervisory agreements, with specific authority for controlled substances), background information, application fee ($888) and confirmation (Drug Enforcement Administration, n.d.). This must be renewed every three years.

            The state of Georgia has a prescription drug monitoring program that is known as the Georgia Prescription Drug Monitoring Program (PDMP) is an online database that monitors and tracks the prescribing and dispensing of controlled substances in the state of Georgia (Georgia Department of Public Health, 2023). This information can be used to monitor a patient's-controlled substance history. All prescribers with an active Georgia professional license and active DEA number are required to register in the GA PDMP (Georgia Department of Public Health, 2023).

            According to Georgia Board of Nursing (2021), Georgia defines the scope of practice for a nurse practitioner as

“A nurse practitioner provides advanced practice nursing care and medical services specific to the nurse practitioner respective specialty to individuals, families and groups, emphasizing health promotion and disease prevention as well as the diagnosis and management of acute and chronic diseases. The nurse practitioner collaborates as necessary with a variety of individuals to diagnose and manage clients' health care problems (Georgia Board of Nursing, 2021).”

According to Hudspeth and Klein (2019), for safe practice and to optimize access to care, APRN's should have a clear and concise understanding of their board of nursing's standards of practice (SOP).

            When reviewing the licensure and certification for APRN for the state of Georgia I was surprised to learn about that Georgia has two different types of nurse-provider agreements. I also was surprised that the APRN must pay a fee to the medical board for the review of their supervision agreement. It seems that the medical board want to restrict the authority of APRNs in the state. Its very disheartening to be so restricted in Georgia, but I can move to a state like New York or New Mexico and have full authority. Overall, I feel that no matter the state, all APRNs should have the same authority. However, this is unlikely because medical boards and providers make money from the APRNs.  

 

                                                                 References

American Association of Nurse Practitioners. (2022, October). 
Georgia state policy fact sheet. Www.aanp.org. 

https://www.aanp.org/advocacy/state/state-practice-environment/state-policy-fact-sheets/georgia-state-policy-fact-sheetLinks to an external site.

Drug Enforcement Administration . (n.d.). 
Application for Registration Under Controlled Substances Act of 1970. Drug Enforcement Administration . 

https://apps.deadiversion.usdoj.gov/webforms2/spring/main?execution=e1s1Links to an external site.

Georgia Board of Nursing. (2021). 
Chapter 410-11:Regulation of Advanced Practice  Registered Nurses . Rules and Regulations of the State of Georgia. 

https://rules.sos.ga.gov/GAC/410-11Links to an external site.

Georgia Department of Public Health. (2023). 
Prescription drug monitoring program. Georgia Department of Public Health. 

https://dph.georgia.gov/pdmp#:~:text=The%20Georgia%20Prescription%20Drug%20Monitoring%20Program%20(PDMP)%20is%20an%20electronicLinks to an external site.

Hudspeth, R. S., & Klein, T. A. (2019). Understanding Nurse Practitioner Scope of Practice. 
Journal of the American Association of Nurse Practitioners, 
31(8), 468–473. 

https://doi.org/10.1097/jxx.0000000000000268Links to an external site.


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question

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Original work, no plagiarism, Cite, Reference 3-4 paragraphs.

Below is a list of research studies, including the targeted sample population to be included in the study.  Select 
ONE of these studies/populations and discuss how you might apply tools of the principles of human subjects research (autonomy, justice, beneficence). Review the 

slides
 and/or these resources (
University of Virginia
Links to an external site.
 ; 
University of Northern Iowa
Links to an external site.
) to identify specific considerations for your population and study. Consider a specific focus on issues around 1) risk and protections from risk for the specific population, 2) informed consent and how this will be acquired, and 3) additional concerns and protections based on the population or study.  I am not looking for expertise in the research topic but how well you address the human subjects principles for a specific population.

1) Efficacy study of an exercise enrichment program for nursing facilities in reducing fall-related injuries among elderly residents

2) Folic acid supplementation for pregnant women to improve neonatal health outcomes

3) Motivational interviewing and peer counseling to reduce recidivism after incarceration among inmates in federal prison

4) Mixed methods approach to nutritional characterization among parents of young children in low-income households

5) Behavioral interventions to improve asthma-related health outcomes among youth aged 5-12

Advocacy letter

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Preparation for writing the Advocacy Letter

1. Choose a topic that interests you.

2. If you are unsure what to advocate for or against, look at professional organizations for inspiration:

a.
APHA

b.
ANA

c.
Maryland Public Health Association

3. Look for advocacy groups that are working on the issue. We don't have to recreate the wheel.  See what strategies the advocacy groups are supporting. For example: Brady and Gifford non-profits focus on gun policy. 

4. Decide if you want to make change within an agency, at the local, state or federal level. Find the decision maker appropriate to that level. Click here to
find your elected official.

5. If you are writing to a legislator, look at that person’s website to see their position on the issue. Please do not ‘preach to the choir’—that is, if they already support the issue, it does no good to throw more facts at them.

6. If you are addressing a national issue, and your legislator aligns with your proposed action, consider looking at the committee that would hear a bill about your issue.

a. If there is a proposed bill that has not been active, you can ask the chair of the committee to bring it back up in committee.

b. Click here to
check for federal bills.

7. If you are addressing a state issue, the Maryland General Assembly meets January- April of each year.

a. You can see if state bill on your issue was unsuccessful in 2018, and ask your legislator to re-introduce it in 2019.

b. Click here to
check for state bills.

8. For evidence to support your proposed action, use the One Search through HS/HSL for the broadest results. If you are still having trouble finding articles, the premier journal for public health research is called The Nation's Health.

9. Reminders from the rubric:

a. Include your ‘Ask’ clearly and concisely in the first paragraph. In busy offices, staff may not read the entire letter.

b. In the same vein, keep the letter one page. References can be on a second page.

c. Include your credentials. All of you are BSN Candidates (and add whatever other credentials you have). This adds a professional weight to your voice.

10. As always, please let me know of any questions.
KGR

PHILOSOPHY OF NURSING PRACTICE

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Post an explanation of your philosophy of nursing practice that briefly describes your nursing experience and area(s) of expertise (pediatric psychiatric). Be sure to explain your beliefs that inform your philosophy of nursing practice and your goals for expanding your experience and practice as a DNP (e.g., embrace of diversity, global health issues, collaboration). Then, explain the DNP role as a social change agent and recommend at least one way you will advocate for positive social change as a Walden DNP. Be specific and provide examples, with all citations (at least 3 references) in APA 7 style.

informed consent

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Choose a patient-care situation in which the RN should intervene and advocate for the patient.  An example of such a situation might be when a patient has not been given complete informed consent.

  • Describe the clinical situation concisely and descriptively. It can be an actual situation or a hypothetical one.
  • Apply the Bioethical Decision Making Model to the specific clinical ethical situation that you choose. Address each section of the model. Conclude with a discussion of nursing advocacy in the clinical setting and the nurse’s role as a patient advocate.  

You must reference and cite 1-2 scholarly sources other than your text. Include a title page and a reference page to cite your text and adhere to APA formatting.