NR 603 WEEK 8: REFLECTION;Chamberlain College of Nursing
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NR 603
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Chamberlain College Of Nursing
NR 603 WEEK 8: REFLECTION;Chamberlain College of Nursing.Reflect back over the past eight weeks and describe how the achievement of the courseoutcomes in this course have prepared you to meet the MSN program outcome
#4, the MSNEssential IV, and the Nurse Practitioner Core Competencies...
nr 603 week 8 reflectionchamberlain college of nursing
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NR 603 Week 8 Reflection
Reflect back over the past eight weeks and describe how the achievement of the
courseoutcomes in this course have prepared you to meet the MSN program outcome
#4, the MSNEssential IV, and the Nurse Practitioner Core Competencies # 7.
Program Outcome #4: Integrate professional values through scholarship
and service in health care
In week number 3 we met the PO#4 by creating a treatment plan that would not
only address the acute medical needs of “Lorene” but also address the chronic
medical conditions that were present and additive risk factors to her
cardiovascular disease. Understanding the responsibility of the NP as a provider
to comprehend how each symptom/result/finding is relevant to and has effects on
whole health is gained through scholarship. Using clinical practice guidelines for
different conditions and combining recommendations in to a practical treatment
plan, individualized to a patient demonstrates service to patients and community.
In this specific case I addressed acute care for NSTEMI/ACS and provided for
appropriate follow up and treatment of co-morbid conditions and risk factors by
using JNC 8 Guidelines for HTN, ACC/AHA Guidelines for the Treatment
Cholesterol, American Diabetes Association Standards of Diabetes and USPSTF
recommendations.
PO#4 was also met in week 5 with the exploration of our APEA results. A
provider has the obligation to recognize his/her own strengths and weakness and
actively work to improve. In this exercise we identified weakness and designed a
practical learning tool for my own improvement and the benefit of our class
mates. I found that I was deficient in my ability to interpret Hep A & B screenings.
By building a specific case study I was able to build my own understanding of
subjective complaints, objective findings (including diagnostic testing) and
treatment for Hep A&B. These are 2 examples of how I have
MSN Essential IV: Translating and Integrating Scholarship into Practice
Recognize that the master’s-prepared nurse applies research outcomes
within the practice setting, resolves practice problems, works as a change
agent, and disseminates results.
MSN E IV revolves around the understanding and interpretation of research and
the application of that into practice. MSN E IV was met in week 1 by
demonstrating not only an understanding of each assigned disease process but
the similarities and differences in pathophysiology, presentation and treatments.
I was specifically able to apply my review of the current research (with in last 5
years) to my understanding of TBI vs post concussive syndrome. While there are
several overlaps in presentation, there is also a continuum that is possible from
post concussive syndrome into mild, moderate and sever TBI. Understanding this
, and sharing it with the class, mimics the dissemination of this research to a group
of practice colleagues which promotes positive change in patient care.
I was also able to meet MSN E IV with a clinical experience that I had. A primary
patient was seen in a behavioral specialist office for ADHD and had received a
prescription of clonidine 0.1 mg PO HS for sleep. When the medication history
was taken on this patient the primary provider was surprised that this was
ordered and disagreed with its use. Before stopping the medication, which had
been very effective, my provider and I both looked up articles on the use of this
medication for ADHD. While the exact mechanism is not known, it is thought that
the effect is on the prefrontal cortex. The provider shared her information with
her office nursing staff and with a NP that works with the group. The sharing of
this information applied research to practice, facilitated change in personal
practice and disseminated results.
Nurse Practitioner Core Competencies # 7 - Health Delivery System
Competencies
NPCC #7 was met with out VISE call. Number 1 of the NPCC #7 is “Applies
knowledge of organizational practices and complex systems to improve health
care delivery” (NONPF, 2017). The simulation of a specialist referral call
demonstrated the understanding of the interaction of complex systems and
provider practices to coordinate and facilitate health care delivery. In my VISE
call I presented a patient who had been assessed and treated within the scope
and to the limit of primary care practice and would require further specialty
evaluation. In an effective use the specialist’s time and with respect to his/her
knowledge, I presented the case concisely and listened for feedback and
recommendations for future practice. Both the patient and receiving specialist will
be confident in my care knowing that I have the knowledge base to work within
my scope, know when referral is needed and facilitate the next level of care.
NPCC #7, number 7 focuses on the collaboration in “planning for transitions
across the continuum of care” (NONPF, 2017). In week number 6, I focused on
the planning for future needs as part of my care plan. With my Opiate Use
Disorder patient, I planned for the needs beyond initial treatment. Once the initial
opiate use is addressed, this patient will require additional ongoing care in field
including PT, nutrition, psychology/psychiatry and possibly GI. As I continue to be
the care home for this patient it will be in part my responsibility to see that
transitions from my office to others and back are smoothly managed without gaps
for the patient. In this case a specific example is the initiation of physical therapy
for the acute shoulder injury and chronic leg pain. As the patient complete the
prescribed PT, it will be important to assess the patient’s level of function and
potential need for further PT. As the patient becomes stronger, it may be more
appropriate to move from restorative PT to an exercise specialist to work within
the patient’s capabilities for a weight loss program. Once finished with these
specialists, ongoing assessment of physical functioning will indicate the need for
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