Chamberlain College of Nursing NR 661 Hall_Portfolio-DreamMachine

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Table of Contents Mission and vision statement __________________________________________________________________3 Reflection postings _______________________________________________________________... ___________4 Résumé and job posting______________________________________________________________________14 Curriculum Vitae____________________________________________________________________________18 Salary expectations and justification____________________________________________________________21 Malpractice insurance Copy of a Malpractice plan and cost for FNP___________________________________21 Clinical log NR661___________________________________________________________________________22 Clinical Log Summary of Program_______________________________________________________________22 APEA learning modules CE____________________________________________________________________23 Board of nursing application APRN _____________________________________________________________24 Certification (AANP) application________________________________________________________________24 Drug Enforcement Administration application ____________________________________________________25 State prescribing and dispensing application______________________________________________________26 National Provider Identification (NPI) number application___________________________________________27 National competencies for family nurse practitioners_______________________________________________283 Mission To provide high-quality, compassionate, and individualized nursing care to all patients and their families. Committed to leading the way to promote health, provide hope and preserve dignity for each patient. Vision Focus on patients as individuals and care for them as such. Provide every patient an experience customized to their medical, emotional, social and spiritual needs. To grow professionally into successful practitioner working in dermatology or anesthetics. To develop cohesive relationships with collaborative health care teams while educating patients about their health and well-being and promote a positive difference in their lives. Share leadership skills by empowering all nursing staff to make decisions that affect the care we provide, the development of our profession and promotion of a respectful and nurturing environment for the future.4 Reflection Postings Advanced Pharmacology Reflecting over the eight weeks in this course, the achievements of the course outcomes in this course have prepared me to meet the MSN program outcome #3, MSN Essential IX, and NP Core Competencies # 5. The MSN Essential IX: Recognizing that nursing practice, at the master’s level, is a broadly defined as any form of nursing intervention that influences healthcare outcomes for individuals, populations, or systems. Master’s-level nursing graduates must have an advanced level of understanding of nursing and relevant sciences as well as the ability to integrate this knowledge into practice. Nursing practice interventions include both direct and indirect care components. Applying the science of pharmacology and integrating it into APN practice is what this course did. Throughout this course, treatment was based on using evidence-based therapies and researching up to date medications. This ensures patients get the best possible care. “Nurse practitioners have a professional responsibility to follow state and national guidelines and to be aware of best practices for safe opioid prescribing to protect patients, the public, and themselves if they become the subject of an investigation” (Hudspeth, 2016). Program outline #3: Use contemporary communication modalities effectively in advanced nursing roles. One of the most challenging aspects of prescribing medications is the possibility of dangerous interactions with those patients on multi-drug therapies. When it comes to prescriptive authority, sound critical thinking in decision making is crucial. Medications can and do alter people’s lives and the ability to prescribe them is an awesome responsibility. Part of the fear in having this responsibility lies in the fact that many times, as providers, we do not always know what medications a patient is already taking. Certainly, patients do their best in relaying their medical history and providing up-to-date lists of their current medications; however, we know that information is often forgotten or omitted from our conversations with them. This causes concern when prescribing new medications, as there may be harmful drug interactions that we are not able to avoid without all the pertinent information from the patient. It is our role an APN to communicate with all members of the patients care team to avoid any medication errors. This also must consider Nurse Practitioner Core Competencies #5 Technology and Information Literacy Competencies because as APN we must be able to integrate all the patients’ history and medications into a central file so that all members of the team are aware of the care plan (Allanetal, 2005). Of course, the future of my APN practice will be influenced by daily pharmacologic aspects. These influences are broad and will include: safety, cost, effectiveness, accessibility, and practical usage. As I progress in my clinical experiences and enter my own practice as an APN, I expect that these concerns and decisions will eventually become more and more familiar. However, pharmacology is an area of medicine that is constantly changing and evolving, so keeping up-to-date on new5 medications and indications will be critical and this class has shown me how to search and explore to keep up with the ever-changing medication arena. Reference Allanetal. (2005). The effect of nursing leadership on hospital nurses' professional practice behaviors. Journal of Nursing Administration, 366-374. Health Professions Educations: A Bridge to Quality. (2003, April 18). Retrieved from IOM: http://www.iom.nationalalacademies.org Hudspeth, R.S. (2016). Safe opioid prescribing for adults by nurse practitioners: Part 2. Implementing and managing treatment. The Journal for Nurse Practitioners, 12(4), 213-220. NR511- Differential Diagnosis In reviewing the clinical experience thus far, the knowledge and compassion for the whole person has been expanded. My current preceptor sees only adults over the age of 18, allowing me to focus on the complexities of multi-system diseases and how to manage chronic and acute illnesses. I have had the opportunity to see and treat acute illnesses of both woman and men off all stages of health. I have had the opportunity to touch base on a few procedures in the primary care setting including, steroid injections of the knee and removal of suspicious skin lesions. Because I am limited with the current preceptor to only seeing and treating adult patients, I do not get the exposure or experience in treating children or infants. I would also like to experience more procedures in the primary care setting, but I have not yet seen the opportunity in this practice setting. Within this practice there are two physicians, three physician assistants and one nurse practitioner. I have noticed that in the primary care setting, or maybe just this practice, many procedures are not done, referrals for specialists are made or patients have their procedures done elsewhere. The practicum plan for the next four courses include my current preceptor, and possibly adding an additional physician within the current practice to fulfill the requirement of seeing children and infants. The next two practicum courses following are with a family nurse practitioner, who ensures me that the practice sees infants and children as well as adults. I have also discussed the need for as many well-women checks as possible. The last practicum is in an urgent care setting, which will fulfill my acute sick visits for infants, children and adults as well as multiple procedures. I will get the practice with focused exams and urgent health care needs from the community.6 The overall progression within the course has grown personally and professionally. My background is in acute care setting, so the primary care setting is indeed an adjustment and a different pace that what I have been practicing. The ability to sit down and talk with patients about how their life is going and how their health is affecting their overall life is refreshing and a welcoming skill. The critical thinking throughout the clinical rotation has grown as in this setting the patient is treated person rather than treating their illnesses. In this primary care setting, they only utilize radiography and laboratory values as an enhancement but treat the patient’s symptoms instead. My goal is to be able to use my assessment skills and treat the patient conservatively if that is their wish. To achieve this goal by the end of the fourth practicum, I will continuously focus on taking a good history, review of symptoms and performing physicals to diagnosis possible differentials. Identifying and recognizing weaknesses as a student is always difficult because everything could be a new experience and a weakness. One weakness that I can easily identify is when patients ask to be placed on different medication than what they are already one. I have an idea of the classification of medication that the patient wants to be switched, but because I do not know all different manufactures of medications, I find myself researching medications, side effects and mechanism of action frequently. Doing the research has helped to expand my knowledge and broaden the range for possibilities of medication prescriptions. Another weakness in the primary care setting is managing time wisely to see all of the patients on the schedule without falling behind. In this first clinical rotation, we were to see at least one patient per hour, and that is an adequate pace for someone who has to look up their recent labs, history, medications, allergies, etc. But most primary care providers get 15- 30 minutes to see a patient, possibly a new patient to them. This time frame seems to me like it may be setting the provider up to miss an important detail, they may not have had the time to look over otherwise. To overcome this obstacle, I will slowly engage in seeing more patients as I become more comfortable navigating their EMR to place myself at a more realistic pace. The NONPF competency of Technology and Information Literacy integrates appropriate technologies for knowledge management to improve healthcare (Thomas, 2013). This clinical rotation fulfilled this competency by utilizing Allscripts as their EMR and electronic prescription writing to integrate the continuity of care across the healthcare team. This makes it convenient for the patient to have their prescriptions and lab requests sent electronically so they do not have to carry around a prescription or worry about losing the requests. This enhances the safety of the patient’s health record because it is able to track who is in the chart, at what time and for how long. The second NONPF competency that was met this clinical rotation is the independent practice competencies. In collaboration with the clinical preceptor I was ale to independently manage previously diagnosed and undiagnosed patients. Within this clinical rotation I was able to practice health promotion, disease prevention, health protection, disease management, anticipatory guidance, counseling and end of life/ palliative care.7 References Thomas,A. (2013). Population-Focused Nurse Practitioner Competencies. National Organization of Nurse Practitioner Faculties. Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/Competencies/Compilation PopFocusComps2013.pdf NR601-Matruing and Aged Adult Practicum [Show More]

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