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Background to advanced practice nursing
Challenges of advanced practice nurse
Challenges of advanced practice nurse
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OBJECTIVE: To obtain a position as an Adult Nurse Practitioner in which I can apply my education and experience.
EDUCATION:
January, 2018-Present Ursuline College Pepper Pike OH
Postmaster’s Certification in Family Medicine Nurse Practitioner expected May 2018
9/2011 - 5/2014 Ursuline College Pepper Pike OH
Master of Science in Nursing
9/1998 - 5/2003 Cleveland State University Cleveland OH
Bachelor of Science in Nursing
LICENSURE/CERTIFICATIONS:
Nursing License (including COA and CTP); 10/2019 Basic Life Support (BLS); 8/2019
DEA License; 11/2020
EXPERIENCE
12/2017-Present Cuyahoga Community College Cleveland, Ohio
Adjunct Faculty Member
Employ a range of suitable strategies to foster student learning
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Assessed the physical and psychosocial needs of the patients.
Initiated and directed interdisciplinary team conferences as required for the high-risk patients.
Treatment of common illnesses and provides high-quality care.
Evaluated the patient’s needs and implemented changes to the treatment plan as necessary.
3/2015-5/2015 Miodrag Zivic, LLC Euclid, Ohio
Nurse Practitioner, Adult Medicine
Managed adult patients with chronic conditions such as diabetes, hypertension, and hyperlipidemia. In collaboration with the physician, develops a treatment plan along with the patients and significant others.
Assess health status by obtaining relevant health and medical history.
Ability to collaborate with professional colleagues as necessary to provide quality care.
Ordered reviewed and interpreted laboratory data and other diagnostic studies to assess the patient's clinical problems and health care needs.
12/2014-2/2015 Optum Clinical Services Cleveland, Ohio
Nurse Practitioner, Adult Medicine.
Collaborates with nursing, medical and other healthcare team members regularly to ensure quality patient
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Administered parental and po medications, fluid therapy, and blood products.
Scheduled on-call for an emergency, acute care dialysis treatments.
2/2005-10/2010 Fresenius Medical Center Cleveland, Ohio
Staff/Charge Nurse
Delegated tasks, and monitoring all direct-patient staff, including LPNs and Dialysis Assistants, assessed care needs and developmental assignments.
Provided ongoing education to patients regarding their renal disease, vascular access and dialysis therapy, and other related health conditions.
Assessed patient's response to hemodialysis treatment therapy, making appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician.
Epogen and Iron doses titrated monthly based on lab values.
8/2003-2/2005 University Hospitals Case Medical Center Cleveland, Ohio
Registered Nurse
Evaluated the effectiveness of care through comparing patient response with observable outcomes.
Initiated discharge planning based on admission
The role of nurse practitioner in the Canadian healthcare system is relatively new compared to the traditional roles of doctors and registered nurses, and as with any new role, there are people who oppose the changes and others who appreciate them. Some members of the public and the healthcare system believe that the addition of the nurse practitioner (NP) role is an unnecessary change and liability to the system because it blurs the line between a doctor and a nurse; this is because nurse practitioners are registered nurses with additional training (usually a masters degree) that allows them to expand their scope of practice into some areas which can be treated by doctors. Other people feel that nurse practitioners can help provide additional primary care services, while bridging communication between nurses and doctors. There are always legitimate challenges to be overcome when changing a system as complicated as healthcare,
Additionally, the LPN cannot push medications into a peripheral intravenous line if the patient “weighs less than 80 lbs, is prenatal, pediatric, or antepartum”, although given that the situation is on a general med-surg floor it is unlikely these patients would be under Sarah’s care at this time. (Rules and Regulations of Practical Nurses. 2015) Sarah can delegate the postoperative patients who need dressing changes and ambulating them to the LPN, but Sarah should assess the wounds for complications initially and serve as resource to the LPN if she has questions about the wounds. Additionally, she could help the nursing assistant with answering calls and serve as a reference for the nursing assistant to ask questions or help with tasks if Sarah is not available. With regards to supervision, the LPN would need continuous supervision given that the working relationship is new. (Cherry and Jacob, 2014) Sarah should be available and willing to answer any questions or address any concerns the LPN
1. What is the difference between a. and a. Which K, S, and A pertain to the care you provided to the patient you have chosen? Why do you need to be a member? K- Describe the limits and boundaries of therapeutic patient-centered care. S- Assess levels of physical and emotional comfort.
All physicians, patients, nursing staff, and data collector were blinded to the patient group assignment. For all patients full clinical examination and laboratory investigations as regards renal and hepatic functions as well as cardiovascular status were done.
Ms. Bardsley functions as a hemodialysis liaison and leader in clinical practice with the following roles: charge nurse, preceptor, and mentor for her colleagues. She is the resource person for the Hct-Line monitoring tool. The tool is used to monitor patient’s fluid removal during treatment to avoid hypotensive episodes associated with decreased perfusion to the heart. She routinely monitors the patient outcomes which to date has resulted in 0 admissions. She recently updated the policy to make it more user friendly for the staff and to maintain staff competency.
The nurse needs to recognize the limitations of each staff member and learn what assignments are within the scope of their practice and what are tasks that need delegation. Delegation is defined as a complex process that requires clinical judgment and final accountability for patients’ care (Weydt, 2010). An assignment is defined as “giving someone else a task within his/her own practice and is base on job descriptions and policies” (NCSBN, 2005, p. 1). The Board of Registered Nursing (BRN) and the Board of Vocational nursing & Psychiatric Technicians (BVNPT) website, lists what duties the RN and the LVN can legally do and is within their scope of practice, this is called the ‘nurse practice act’. A nurse assistant personnel (NAP) or Unlicensed Assistive personnel (UAP) may perform different tasks depending on the state that they reside in, but most include tasks that are considered activities of daily living (ambulating, hygiene, grooming)(NCSBN, 2005). The LVN can perform tasks that the nursing assistant can do, as well as other tasks which include: medication administration (oral, subcutaneous, intramuscular), simple dressing changes, wound care, suctioning, catheter insertion, drawing blood from a patient, and starting an IV and intravenous fluids. IV and blood draws are dependent on the LVNs certification, competence, and
Observe, record, and report to physician patient's condition, treatment provided, and reactions to drugs and treatment
As a nurse, the author will ensure that as a leader, she delegates information by providing a holistic perspective of the patient’s needs and diagnoses. This will help the UAP to understand the importance and urgency of the tasks delegated. The nurse will also work to obtain a trusting, open, and honest relationship with the UAP. If the UAP believes the nurse has the UAP, the patient, and facilities best intentions at heart, the UAP will be more likely to carry out the delegated tasks without adjournment. The nurse will make sure to be mindful of why the UAP may have performed a task in an untimely, or incorrect fashion, and take responsibility for the mistake. The nurse will then consult with the UAP and adjust how communication takes place, to ensure that tasks get carried out correctly, in a way the nurse means for the UAP to carry them out. Overall, if the nurse and UAP can foster a trusting relationship that allows for open dialogue, and willingness to change the patient will receive the most optimal care, and in turn have the most positive
The effective collaboration between the members of the renal health care team resulted in successfully reducing John’s hypertension, hyperkalaemia and overloading in the short term.
I have known since I was a child that I wanted to be a physician. During my undergraduate years, I worked for an endocrinologist and volunteered as a diabetes educator at a clinic for the medically underserved. I learned a great deal about medicine with a specific focus on diabetes. I quickly came to notice a commonality among the patients seeking medical management of their chronic diseases. Patients did not present with an acute problem, but rather to have patches placed on their existing chronic conditions. In fact, many patients came in for routine care but had no interest in improving their health. I rarely felt satisfaction in the sense that a patient’s life changed during a single office visit. Unfortunately, I became frustrated with not seeing short-term results. One afternoon I had an eye-opening experience while accompanying the endocrinologist to the emergency department to see a patient in diabetic ketoacidosis. Captivated by the critical care management of this case, at last I saw immediate improvements occurring; thus, that day my interest in emergency medicin...
Discussion between the physician and the patient regarding treatment options and the risks and benefits of treatment.
To the majority of Americans, dialysis is a confusing process that they will hopefully never have endure, but for hundreds of thousands people, it is a daily fact of life. According to US News and World Report, “In the United States, almost 400,000 people undergo dialysis every year.” (Gordon, 2012, para. 4) Their lives revolve around receiving dialysis three days a week for three to four hours per treatment, usually at an outpatient clinic. While dialysis can prolong the end stage renal disease (ESRD) patients’ life, the three day a week trudge to this clinic can feel like and endless cycle of discomfort and inconvenience. Fortunately the ESRD patient has more than one option, namely, peritoneal dialysis.
My long-term goal is to obtain experience and proficiency as a Nurse educator to become a nursing educator instructor. As a Nursing educator instructor I will be able to build new educators in Graduate programs for th...
• Work with your health care provider to manage any long-term (chronic) health conditions you have, such as diabetes or kidney problems.
A detailed patient history including history of any recent trauma or systemic disease such as renal or cardiovascular problems should be taken. The diagnosis is usually reached by a high clinical suspicion through the history and physical examination.