NR 507 Reflection Assignment

I would like to start by saying this course has been very demanding yet, an enhancing course. The course needed prudent time management so as to complete assignments, readings, quizzes and exams. The advanced pathophysiology course has prepared me to function in an advanced practice role by offering a detailed understanding of the pathophysiological processes, allowing me to predict clinical symptoms, choose evaluative studies, begin appropriate treatments, and plan for possible complications (CCN, 2018). Insights into the underlying disease process will enable the nurse practitioner for incorporation of current and groundbreaking interventions. Relevant screening and diagnostic testing approaches will also be incorporated.

Program outcome

The MSN course program outcomes included delivering high standard, safe patient centered- care by forging a caring atmosphere and taking part in long lasting personal and professional development and advocating for positive health outcomes in virtue of evidenced-based synergetic advanced nursing practice (CCN, 2018). Course outcomes require exploring pathophysiology processes, investigating the approach in which homeostatic, adaptive and compensative physiologic processes may be sustained or altered through specific interventions, risk factors, and approaches of diagnosis and therapy of health problems in chosen populations and analogous research conclusions to management of patients with multifaceted pathophysiologic dysfunction (CCN, 2018). The course outcomes allow the advance practice nurse to utilize pathophysiology to support clinical decision making concerning diagnosis and therapy of acute and chronic presentations frequently managed by nurse practitioners (CCN, 2018).

MSN Essential

Essential IV: Interpreting and incorporating scholarship into practice (AACN, 2011). The master’s prepared nurse should apply research findings within the practice environment, solve issues, work as a change advocate and promulgates results (AACN, 2011). The case study assignments we did in this class allowed me to employ evidence, clinical discernment and interpreting methods to enhance related outcomes for patient groups (AACN, 2011). The advanced practice nurse must be able to articulate to a diversity of audiences, the evidence-base for practice determinations, in addition to the reliability of sources of evidence and the pertinence to the practice problem encountered (AACN, 2011).

Nurse Practitioner Competencies

Nurse practitioners have an extensive range of knowledge and expertise, which they bring into play in their appraisals and decision making to begin application of interventions to patients (Stanford, 2016). Their work is all evidence-based (Stanford, 2016). Competencies may be seen as a mixture of practical and academic knowledge that enhances performance or the capability to carry out a specific role (Stanford, 2016). The word advance practice is suggestive and oftentimes conferred in the context of a degree of practice with autonomy supported through skillful knowledge basis and clinical expertise through expanded and extended roles (Stanford, 2016). As advanced practice nurses we should utilize information in this course and use this information to evaluate patients, make diagnosis, order and translate diagnostic exams and conduct treatment plans in addition to prescribing medications as learnt from this course.

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References

American Association of Colleges of Nursing. (2011).The essentials of master’s education in nursing. Retrieved from. www.aacnnursing.org/Portals/42/Publications/MastersEssentials11.pdf (Links to an external site.)

Chamberlain College of Nursing. (2018). NR-507-62413. Program outcomes [Online lesson] Downers Grove, IL: DeVry Education Group.

Stanford, P. E. (2016). How can a competency framework for advanced practice support care? .British Journal Of Nursing, 25(20), 1117-1122.

I can truly say this class has challenged me over the past eight weeks to become a more effective nurse and a better student.

Program Outcome #1: Provide high quality, safe, patient-centered care grounded in holistic health principles. (holistic health & patient-centered care)

I have learned numerous ways to provide quality, patient centered care based in holistic health principles through the Grand Rounds sessions. These presentations consist of discussing medical problems and treatment methods that benefit the patient on a holistic level. In particular, the Grand Rounds session, “Hypothyroidism,” was extremely helpful in providing information for my week 6 PowerPoint presentation on hypothyroidism. The American Thyroid Association 2017 Pregnancy Guidelines compared to the 2011 Guidelines were noted in the presentation. The presentation made specific mention to the management of hypothyroidism during pregnancy and included recommendations regarding the interpretation of hypothyroidism tests during pregnancy, iodine nutrition, thyroid autoantibodies, complications during delivery, lactation concerns, and fetal and neonatal considerations to include thyrotoxicosis in pregnancy.

Through the weekly readings, I have augmented my understanding of evidence-based research and how it shapes and determines cost-effective and sustainable evidence-based outcomes that promote constructive behavioral changes in high-risk patient populations. The Week 4 reading lesson “Alterations in Renal Function” included information about disease causation. While I knew that urinary calculi (stones) are a common cause of functional urinary obstruction, I learned obstructions must be addressed quickly to prevent backflow of urine into the kidney before the condition results in permanent renal dysfunction. I can discuss with patients who have stones or are at risk for stones the best ways change their diet to balance their urine pH levels since the pH of the urine increases the likelihood of stone formation. I learned a good prevention or screening method is to teach patients the ideal pH levels for urine and what tests they can take to test the pH of their urine and saliva. Low pH increases one’s risk of developing uric acid stones and a high pH increases one’s risk of developing calcium phosphate stones. One of the goals of holistic care is to help patients understand the underlying cause (s) for their diseases and how this plays a role in how diseases are diagnosed and treated. In terms of providing evidence-based holistic care, I have learned that before I apply an intervention, I must decide if it should be directed at the person, agent, or environment. This leads to better patient outcomes and more effective nursing practices.

MSN Essential I: Background for Practice from Sciences and Humanities:

Throughout my graduate course studies, I have learned the importance of integrating scientific findings from various fields of nursing in my writings and in my practice. Healthcare research constantly generates large amounts of results regarding revised treatment methods for nurses and care management for patients. The lessons reiterate that if implemented in practice, scientific findings can help save lives and improve patients’ recovery times and quality of life. For example, the consideration of how culture affects one’s access to and acceptance of healthcare initiatives teaches me that nurses must carefully and thoughtfully analyze sociodemographic trends if they want to make an effective impact on culturally diverse patient populations. Reversing negative health outcomes for vulnerable populations begins with studying scientific findings appropriate to culturally diverse groups and taking the responsibility to acquire cultural competency skills. The weekly discussion posts helped to hone my skills in integrating and applying scientific medical findings. For example, when we learned about cystic fibrosis (CF) in Week 2, I learned the CDC estimates more than 10 million Americans are carriers of a faulty CF gene, but have no idea they are carriers (NCBI & NHLBI, 2018). Cystic fibrosis affects males and females from all racial and ethnic groups; however, the disease is most common among Caucasians, Latinos, and Pueblo and Zuni American Indians (NCBI & NHLBI, 2018). With this information, I can encourage my patients in their childbearing years who fall under the at-risk population category to get screened for the CF gene if they plan on having children.

Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

I have demonstrated my competency in analyzing, integrating, translating, and developing my understanding of scientific foundation competencies through the papers, weekly discussions, and presentations required in this class. One type of assignment in particular stands-out to me. The weekly faculty question required us to present evidence-based methods to the class and interpret the research question, methodology, results, and conclusions from what we had read and link it to another adverse health condition. This taught me the importance of critically analyzing the information in the article and translating the research. I understand now that the faculty question was meant to teach me the etiology of increased risk to develop another disease or condition when a patient is already being treated for a specific condition or disease is multifactorial and connected to traditional and patient specific symptoms. Furthermore, when gathering the data and information for my Week 6 speech and PowerPoint presentation, I was able to integrate what I had learned about culture and disease progression to determine the best way to approach women who suffer from post-partum about hypothyroidism.

In conclusion, I believe I still need to work on developing new approaches to nursing practice regarding specific diseases and serving various patient populations. To do this not only takes confidence but knowledge and understanding. I will feel more confident about doing this after I graduate and have practiced as an FNP for a few years.

References

National Center for Biotechnology Information (NCBI), & U.S. National Library of Medicine

(NLM). (2018). Cystic fibrosis (CF): Symptoms. Retrieved from PubMed Health website:

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022783/ (Links to an external site.) National Heart, Lung, and Blood Institute (NHLBI). (2018). Cystic Fibrosis. Retrieved from https://www.nhlbi.nih.gov/health-topics/cystic-fibrosis (Links to an external site.)

I have learned many things throughout this class and the classes before that I hope will continue to prepare me for the goal I am working to accomplish of the family nurse practitioner. Below I have discussed how this class, as well as classes before, has prepared me for this role and meeting the outcomes, essentials, and competencies in this program.

Program Outcome #1: Provide high quality, safe, patient-centered care grounded in holistic health principles. (holistic health & patient-centered care).

When in the role of the family nurse practitioner it is important to give the safest high-quality care that is patient centered. It is easy to forget that each patient is different and that while the diseases processes might carry certain components, the patient might present in a different manner due to differences in the genes and DNA of the individual person. Over this past 7 weeks I have learned many new things that has allowed me to meet certain components such as program outcome #1. The first example of criteria that I learned to help e achieve this outcome is the study of pathophysiology as it pertains to each body system. Each week we learned about a different body system and how each component of that system works in order to maintain normal function day to day. This will allow for me to understand how the systems should work for all patients that I see. Understanding this will allow for me to recognizes abnormalities and provide quick, safe, and high-quality care when a abnormality arises. The second example of criteria that I learned to assist me in meeting this outcome is gaining knowledge of alterations that arise for the adult and child in each body system. Many disease processes exist, and it is essential to understand the disease processes to provide the best quality if care. Each week we gained knowledge of the disease as well as how the cells perform and malfunction when these disease processes occur. Understanding the alterations will allow for high quality and safe care for all adult and pediatric patients that I might come into contact with as the family nurse practitioner.

MSN Essential I: Background for Practice from Sciences and Humanities:

Recognizes that the master’s prepared nurse integrates scientific findings from nursing, biopsychosocial fields, genetics, public health, quality improvement, and organizational sciences for the continual improvement of nursing care across diverse settings.

During this class we focused on the on the pathophysiology of the normal processes of each body system as well as the alterations that can arise in each of these body systems. While understanding the pathophysiology is important, it is also important to understand that healthcare is diverse and information from variety of places is essential to provide proper care. This information is how MSN essential 1 has been met in this course. One example of how this essential has been met is each week when case studies were presented. I had to research the information in the case in a variety of places that also included a variety of views from individuals. In healthcare it is essential to be flexible and search for the most up to date information in order to provide the best care possible. Another example of how this essential has been met is the information gained from the selected disease process by Dr. Arredondo. My assigned disease process was chronic renal disease and in order to find all of the needed information I done research and sorted through a variety of views to put together the presentation. I also focused a small portion on the team approach of managing this disease after being asked about this information by one of my class mates. I learned that team work is essential in treating the patient as a whole. New knowledge occurs daily and studies pertaining to better care is constantly being produced. As the family nurse practitioner, it is essential to stay up to date on the current standard of care in order to provide the safest, best care for the patients.

Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

Critically analyzes data and evidence for improving advanced nursing practice.

This competency was met every week while preparing the discussion case study answers as well as studying for the weekly quizzes. Having the ability to gain an understanding of the pathophysiology and disease processed from the most of to date data and evidence-based information has prepared me for the role of the family nurse practitioner and providing the most up to date safest care to patients.

Integrates knowledge from the humanities and sciences within the context of nursing science.

This competency was also met every week while performing the assigned readings, lesson, and research for the questions being asked. This class allowed me to gain an in-depth knowledge of each of body system and also the process of the diseases that we commonly see in the healthcare field. Understanding that while treating the disease process, we are also treating an individual person is important in providing the best care as well as establishing trust with the patients. Previous classes have taught of us the importance of patient centered care and that information was often used in this class when discussing the disease processes as it pertained to a specific individual such as in the discussion case studies.

Translates research and other forms of knowledge to improve practice processes and outcomes.

This competency was most met when researching all of information for the presentation of the assigned disease process. While the research was helpful in applying the factual information, using precious knowledge was also important in understanding the role of the nurse practitioner as well as the education that must be implemented in order for the patient to have the highest quality of life independently. It is essential for the nurse practitioner to stay up to date to provide the best care and education for the patients.

Develops new practice approaches based on the integration of research, theory, and practice knowledge.

This class as well as the classes before has prepared me for experiences that I will possibly encounter in the future. Using the knowledge in regard to pathophysiology as well as information such as nursing theory, statistics, and other up to date research, I feel that I have been prepared to continue my knowledge in areas such as pharmacology and anatomy in order to prepare for the upcoming role as the family nurse practitioner. I hope that with all this knowledge I can provide the best care possible to all patients I will encounter.

Program Outcome #1: Provide high quality, safe, patient-centered care grounded in holistic health principles. (holistic health & patient-centered care)

Throughout this course, the program outcome #1 was exemplified in all assignment and discussions. In week 2, we discussed cystic fibrosis and focused on the pathophysiology behind the disease. In addition to etiology and pathophysiology, the outcome was met by the research and discussion on teaching for the patient. As advanced practice nurses, it is imperative to incorporate holistic care in our everyday practices, including physical, spiritual, emotional, and cultural wellbeing. Our weekly discussion, all ended with teaching that would be provided to the patient and their caretakers. This provided the opportunity for high quality, safe care through education. In addition to expanding patient’s knowledge, this course assisted me in further understanding the background behind diseases and further dissecting each diagnosis. When providers understand the pathophysiology behind each disease, it assists in providing better care for our patients.

MSN Essential I: Background for Practice from Sciences and Humanities:

NR 507 met the goal of MSN Essential 1 by weekly assignments requiring research using scholarly articles that further emphasized the information that was being taught in the weekly lessons. Advanced practices nurses rely on research to stay abreast evidence-based practices. As medicine continually changes, it is imperative for nurse practitioners to utilize research to provide the best care for their patients. By nurse practitioners staying up to date through scientific research, they are able to also provide information that can be applied to not only their everyday practice, but also practices within their facility they are employed. Evidence based practice is the best practice. APN’s can focus on improving patient care by focusing on their community impact by using scientific exploration.

Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

Critically analyzes data and evidence for improving advanced nursing practice.
- Integrates knowledge from the humanities and sciences within the context of nursing science.
- Translates research and other forms of knowledge to improve practice processes and outcomes.
- Develops new practice approaches based on the integration of research, theory, and practice knowledge.

In the duration of this course, NR 507 provided the foundation for the Nurse Practitioner Core Competencies #1. The week 6 disease project focused on a specific disease. For my assignment, it was asthma. This outcome was met with this assignment by using scientific evidence and research to explore the dynamics of asthma from its etiology to the treatment options for the respiratory disease. In this assignment, I used statistical data to bring awareness to the severity of how many American’s affected by this diagnosis. The knowledge gained from this assignment improves my future practices, because the research that was done gave me a better understanding of the disease and how to diagnose and treat asthma.

NR 507 Reflection Assignment