Category: Nursing

Leading and Managing Change in Nursing: Utilizing Kotter’s Change Model

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Leading and managing change is an important part of successful project execution and implementation. The nurse leader and project manager should be intimately familiar with a particular change theory or model that serves as the framework for leading the change represented by a project.Spend time researching and investigating some evidence-based change models such as Kotter, Lewin, Lippitt, & Rogers (aka Diffusion of Innovations). Identify your “go-to” change leadership framework and discuss how you will use that framework to guide organizational change.Application: For change models with a series of steps or phases, identify which phase/step you are at now with your project and how the change model guides you in moving to the next phase/step.

Impact of Healthcare Models on Health Policy: A Focus on the Current U.S. Presidential Administration

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Explore how a healthcare model/framework impacts health policy. You will explain the current United States presidential administrations proposed changes to healthcare. This will help you understand the factors that affect healthcare finance.Healthcare changes rapidly. This assessment is designed to help you understand how healthcare is organized and financed. It is important that, as a nurse, you possess a solid understanding of healthcare finance and subsequent impacts on policy.You are working on a report that will be shared with everyone, including leaders of your department at work. Your report should include the following: Explain how the current presidential administration has organized the healthcare plan of this nation. Are social determinants evident in our existing healthcare policy? Based upon your research of the current healthcare framework, provide a summary of the proposed changes found under the current United States administration. Cite at least 3 peer-reviewed sources published within the last 5 years that support your assignment.

 

 

Reflective Essay on Significant Patient Encounters During AGACNP Clinical Rotation

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Instructions:
Choose Significant Patient Encounters: Reflect on significant patient encounters during your AGACNP clinical rotation. Focus on cases that left a lasting impression, presented challenges, or offered profound learning experiences.
Reflective Writing: Write a reflective essay detailing your experiences. Include: Patient cases or situations encountered. Personal emotions, thoughts, and reactions during those moments.Lessons learned, including medical insights, patient care, and the development of your skills and knowledge.Challenges faced and how they were addressed.Analysis and Future Applications: Analyze the impact of these experiences on your professional development. Discuss how these encounters have influenced your clinical decision-making, patient care approaches, and future goals as an AGACNP.Learning Points and Conclusion: Conclude your reflection with key takeaways and learning points. Summarize how these experiences will shape your future practice as an AGACNP.

 

 

 

Cause of the elevated blood pressure, edema, and rhonchi

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The home care nurse is seeing a 68-year-old Vietnamese woman for an initial visit. The patient was discharged from the hospital with a diagnosis of congestive heart failure (CHF). The home health nurse notices the patient’s blood pressure is elevated, and the patient has a productive cough. The patient speaks very little English. However, the patient’s daughter is present and able to interpret. The nurse completes a full health assessment, including a review of medications, and notes that the patient was prescribed a diuretic and a beta-blocker to regulate blood pressure. The daughter shares with the nurse that her mother does not like taking medications and chooses to take herbal remedies instead. Upon assessment, the patient’s vital signs are T 98.6 P 76 R 20 BP 160/80, 02 saturation 94%. The patient’s lungs are positive for scattered rhonchi in the upper bases, clear in the lower bases, rhonchi clears with cough. The patient’s heart rate is regular with no audible mummers, +2 edema bilateral in the lower extremities. The patient denies pain.

Question 1
Based on the information presented by the patient’s daughter, what is the most likely cause of the elevated blood pressure, edema, and rhonchi?

Answers may vary.

Question 2
What interventions should the nurse incorporate into the plan of care for this patient?

Question 3
What steps does the nurse need to take to become culturally competent?

Question 4
What interventions can the nurse include to provide care that reflects an acceptance of the patient’s health and illness beliefs and practices?

The Law and Our Legal System: An Analysis of Recent Developments

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The Homeless Patient Evaluation & Management Plan
The nurse practitioner (NP) is working at a health clinic in a homeless shelter during the early evening. A 48-year-old African American man approaches the practitioner and asks to have his blood pressure taken, saying that he has not had it checked “in a while”.
The man appears to be in some type of distress and experiencing pain. The man walks slowly, using a guarded manner, and he appears diaphoretic. His mucous membranes also appear pale. The patient’s blood pressure is 210/98. The patient reports that he has not been diagnosed with hypertension previously. The patient reveals that he has severe abdominal pain that is radiating to his back. The nurse finds a heart rate of 110, respirations 30 with shallow inspirations, and temperature 102.2°F. The patient’s skin is cool and clammy.
The patient reports a history of alcoholism, homelessness, and lack of access to health care. He says that the symptoms have been present and worsening over 3 days. The man says he thinks he might have pancreatitis again, which he had “a couple of years ago”. The NP recommends that the man should be seen at a hospital for his condition, but the patient says he does not have health insurance, so he does not want to go.
The NP proceeds with a physical examination, finding severe abdominal pain in the epigastric area, yellowed sclera, no abdominal distention, and hypoactive bowel sounds. The clinic is equipped with basic materials but no means to conduct lab or radiologic testing.

Discuss the following:
1. Considering the patient’s homelessness and lack of insurance, what action should the practitioner take?
2. When the patient asks why his condition cannot be managed outside of the hospital, how should the practitioner respond?
3. When the patient arrives at the hospital for further diagnostic work-up, what tests will likely be performed to evaluate the patient’s condition?
4. How will the severity of the pancreatitis be assessed when the patient is hospitalized?
5. How should the patient’s condition be managed when hospitalized?
6. What patient education should be included after the pancreatitis is resolved?

 

Ethical Issues in Human Research: The Tuskegee Syphilis Study

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Animal research is a necessary practice in the world of medical research, allowing scientists to develop life-saving interventions and to spot catastrophic problems before new techniques or products make their way to actual patients. However, this does not mean that we should deny that there are serious ethical issues involved.
Animal testing is not a pretty or pleasant process. It causes pain and suffering to animal subjects, and legitimate cases of abuse have been uncovered by animal rights groups. Consequently, the practice should be tightly regulated, and alternative methods should be employed whenever possible.
However, human research also is full of ethical issues. Let’s explore those.

However, human research also is full of ethical issues. Let’s explore those.
• Discuss a specific research study involving humans that had ethical issues (within past 30 years).
• What were the ethical issues involved? • What could have been done to conduct the research study differently to avoid these ethical issues?

 

 

Ethical Issues Facing John Male nurse working in a prison

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Scenario – John is a 32 year old male nurse working in a prison. He is married and has two children at home- one boy at 14 years of age and a girl that just turned ten years of age. A new prisoner to the institution has requested that John be a healthcare surrogate for him because he is 72 years of age and not in good health. John discovers that this prisoner is a pedophile and although no one at work is aware of this, John’s son was molested by the father of a friend of his sons while visiting their home. The son has gone through therapy and they continue to have problems with the son, John is hopeful that his son will improve his mental health.
John feels divided because on one hand he feels obligated to serve as an RN professional and on the other hand he feels very hateful of the pedophile lifestyle that seems to encompass the newly admitted prisoner.
Instructions:
1. Read the scenario above, and then answer the following questions:
a. What kinds of issues ethically is John dealing with?
b. How would you counsel John in his dilemma?
c. Finally, what would be a reasonable approach to this problem that John has professionally and personally?
d. Be sure to check the Ethics statements for the ANA and Nursing Code of Ethics for Nurses

 

EPISODIC VISIT: HEENT FOCUSED NOTE

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EPISODIC VISIT: HEENT FOCUSED NOTE
Focused Notes are a way to reflect on your practicum experiences and connect the experiences to the learning you gain from your weekly learning resources. Focused Notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.
For this Assignment, you will work with a patient with a HEENT condition that you examined during the last three weeks, and complete an Episodic/Focus Note Template Form where you will gather patient information and relevant diagnostic and treatment information and reflect on health promotion and disease prevention in light of patient factors such as age, ethnic group, past medical history (PMH), socioeconomic status, and cultural background. In this week’s Learning Resources, please refer to the Focused SOAP Note resources for guidance on writing Focused Notes.
Note: All Focused Notes must be signed, and each page must be initialed by your preceptor. When you submit your Focused Notes, you should include the complete Focused Note as a Word document and pdf/images of each page that is initialed and signed by your preceptor. You must submit your Focused Notes using Turnitin.
Note: Electronic signatures are not accepted. If both files are not received by the due date, faculty will deduct points per the Walden Late Policies.

RESOURCES
• Fowler, G. C. (2020). Pfenninger and Fowler’s procedures for primary care (4th ed.). Elsevier.
o Section 4: Eyes, Ears, Nose, and Throat
 Chapter 62, “Cerumen Impaction Removal” (pp. 388–392)
o Section 13: Urgent Care
 Chapter 200, “Corneal Abrasions and Removal of Corneal or Conjunctival Foreign Bodies” (pp. 1338–1344)
 Chapter 201, “Slit-Lamp Examination” (pp. 1345–1349)
 Chapter 202, “Auricular Hematoma Evacuation” (pp. 1350–1354)
 Chapter 204, “Removal of Foreign Bodies from the Ear and Nose” (pp. 1359–1364)
 Chapter 205, “Management of Epistaxis (pp. 1365–1371)
Practicum Resources
• HSoft Corporation. (2019). Meditrek: Home. https://edu.meditrek.com/Default.html
Note: Use this website to log into Meditrek to report your clinical hours and patient encounters.
• Walden University Field Experience. (2019a). Field experience: College of Nursing. https://academicguides.waldenu.edu/fieldexperience/son/home
• Walden University Field Experience. (2019b). Student practicum resources: NP student orientation.https://academicguides.waldenu.edu/StudentPracticum/NP_StudentOrientation
• Walden University. (2019). MSN nurse practitioner practicum manual.https://academicguides.waldenu.edu/fieldexperience/son/formsanddocuments
• Document: Episodic/Focus Note Template (Word document)

To prepare:
• Use the Episodic/Focus Note Template found in the Learning Resources for this week to complete this assignment.
• Select a patient that you examined during the last three weeks that suffered from any HEENT condition. With this patient in mind, address the following in a Focused Note:
Assignment:
• Subjective: What details did the patient provide regarding her personal and medical history?
• Objective: What observations did you make during the physical assessment?
• Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?
• Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.
• Reflection notes: What would you do differently in a similar patient evaluation?

Pamphlet: Ensuring Home Safety for Seniors

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Create a pamphlet to educate clients on one of the following current patient safety issues at home.
Topic:
Seek approval from your instructor if you have a question about a specific topic you would like to use not on the list.
Your pamphlet must include the following items:
Include five practical tips for preventive care. Each tip should be accompanied by a clear explanation of its importance and how it can be easily incorporated into their daily routine.
Include images that match each educational tip.
Include information that should be shared with family or caregivers and explain the importance.
Include two local resources in the community that might be available for this type of safety concern. List the address, phone number, and website. List one resource found online that addresses your safety issue.
Include three current (published less than 5 years ago to date) references in APA format on the pamphlet.

 

Importance of Regular Training for Nurse Educators on Web-Based Learning Management Systems

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Do you feel that weekly/monthly/yearly training session(s) should be in place for all nurse educators concerning the applicable web-based learning management system? In what manner? (Ex., online vs. on-grounds training sessions?) What would they look like?