Nursing

Write a formal paper (750-1,000 words) discussing the differences in competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level in nursing. For additional help finding research on this topic, refer to the library tutorial located at in the Student Success Center. Identify a patient care situation in which you describe how nursing care or approaches to decision-making may differ based upon the educational preparation of the nurse (BSN versus a diploma or ADN degree). Introduction

Nurses are prepared in two different educational backgrounds, the baccalaureate degree level of nursing and the associate-degree level of nursing. Though they are prepared in two different settings when completion of these programs both sit for NCLEX-RN exam. The NCLEX is the state board to license and RN for competency to work as a registered nurse. There are few differences in competencies between associate- degree nurses and baccalaureate degree level nurses including their level of commitment, leadership skills and their quality of patient care.

Education is an infinite process. Every day, new developments emerge and new deceases and remedies discovered. The overall outlook of healthcare professions has dramatically changed in the past few decades. Nursing plays a very critical and important part in efficient care and patient safety. Nurses work shoulder to shoulder with physicians in treatment planning and management. Legal and ethical responsibility of the care provided is also increasingly shared by the Nurses. Nursing profession thus calls for better qualified and well groomed nurses.

Even though associate degree programs prepare nurses for patient care in a hospital setting, that training is insufficient for a variety of nursing roles. Comparison Point one-Associate level nursing was established after World War 2 during a nursing shortage. This started at the community colleges; students would have to attend for 2 years to obtain your nursing degree. Community colleges were growing at a fast rate they were able to accept many more students than universities. Associate nurses were taught the skills of nursing to work as an RN.

One study showed that when reviewed by managers 86% of ADN nurses met or exceeded their expectation. (EEpg268) Point two Baccalaureate degree programs are help at the Universities, and students would attend these schools for four years to obtain their nursing degree. One study shows that nurses with their BSN are shown to be less task oriented, have critical thinking skills, are more professional in their role, and show more leadership skills. These nurses look at the patient as a whole and not just a list of things they need to accomplish during their day.

ADN program is designed to provide the skills and knowledge to become a compliant generalist nurse. In most cases, it is a 20 month program aimed to provide a reasonably good training for the licensure examination (NCLEX-RN) and then an immediate, decent staff position in hospitals and inpatient healthcare modern society human being, encompass extensively sophisticated requisites provoking advanced techniques of acquisition directly correlating to health care industry.

The health care is intensifying in complexity and observing beneficial amendments. The longevity and expectations have heightened thus nurses are obligate to become educated in higher echelon, the professional baccalaureate level, to comprehensively achieve composite necessities. The professional nurse who graduates with a baccalaureate is primed for broader role in numerous facet of health care in addition to global knowledge of functionality of medical system and diverse methods of application.

Enabling the application in daily patient care, the delegation of tasks, independent decision making, secure patient discharge, and numerous other aspects provoking an improvement in quality of care. Research has shown that lower mortality rates, fewer medication errors, and positive outcomes are all linked to nurses prepared at the baccalaureate and graduate degree levels. Education for nurses is life long process either at the bedside or school, nurses are continuously learning to meet the competencies of professional practice and growing demand of excellent care.

The difference between the nurse prepared at the associate degree level versus the baccalaureate degree level in nursing is the nurse with baccalaureate degree has the more prestigious degree and training in global aspect of health care Learning in complex systems is, itself, complex. Nonlinear systems confound attempts to develop and enforce simple models of cause and effect, and so traditional, hypothetical-deductive methods to explore cause and effect often fail.

We know that in the daily life of parenting, marital relationships, and team sports, where “continual learning and improvement” replaces “planned experiment” as an approach for gaining knowledge. Even where firm, cause-and-effect knowledge exists in science-based health care the knowledge, for example, that antibiotic A will almost always kill bacterium B the application of that knowledge runs straightaway into the messy world of complex systems.

That is, reliably getting the antibiotic safely into the body of a patient with that germ turns out to be a constant challenge as systems fail (the order got lost), unpredicted side effects occur (the patient is on an incompatible other drug), local circumstances become highly relevant (the drug is unfamiliar to the new doctor), and errors multiply (the bacteriological report was on the wrong patient). The fact is frustrating and inescapable: in health care, as in any complex enterprise, the simple, scientific facts lie fallow without continual Adaptation to local contexts.

The modern nurse who intends to improve the job effectively needs to be a master of the work So what is the difference and how will it affect the course of a career in nursing In today’s nursing world, more is expected from a nurse than following doctor’s orders and starting IVs. The nurse must be able to make critical decisions about a patient’s care, to question the doctor if orders seem inappropriate and to help the patient through, sometimes, difficult life-changing decisions.

These skills take an education that is broad based, one that includes critical thinking and exposure to many different people, thought processes, and culture and societal norms. Two year nursing programs do recognize these needs and address them as they can, requiring liberal arts classes to be taken before entering the program and teaching decision making skills along the way. At every level of nursing, the ability to connect with different people, recognize the pressures they face from their personal environment and find value in each is critical.

This is a lot to learn against a backdrop of proficiently performed procedures and giving the right medication. BSN programs offer more education aimed at developing these skills. These programs bolster knowledge about community and public health issues. There is also more attention paid to nursing management, that is, enhancing skills needed to help “direct reports” do their best work for the patient and the health care organization. Opportunity to refine patient assessment skills and examine more in depth the pathophysiology of diseases, also sets these rograms apart from their two-year program me Nurses who graduate with a BSN degree will find it easier to enter faculty teaching positions, higher level administrative roles in hospitals or other health care environments and State or Federal level government nursing jobs. And for some, these roles are more satisfying, allowing the individual to affect change at a more global level than one-on-one nursing. While it is true an experienced, talented nurse with an AS degree can move “up the ladder” into management and leadership roles, the Bachelor’s degree can make the climb a little less steep.

And, with all this said, there will always be a critical role for the nurse who works directly with the patient, teaching patients about their health care, assuring quality wound management in the hospital setting and observing patients for signs of a worsening condition. Nursing is a huge and welcoming field. It offers a satisfying career path for both AS and BSN trained nurses. Whatever path you have chosen in nursing, the essential wisdom is to continue enhancing your skills and education so that your community, your organization and your patients benefit from your broadened view of the world. Conclusion

I know personally from being an RN with my associate degree that I do think differently than other RNs. I find myself worrying a lot about the tasks that I need to finish before my shift ends and not looking at the reasons why I am doing things. I watch other RNs getting why they patient is experiencing these symptoms while I am just following orders and treating the patient. I have seen myself start critically thinking on what my patients need and asking the doctors for different things. References Conceptual foundations the bridge to professional nursing practice 5th edition 2011 American Association of college of nursing

Robert Rosseter april 2 2012The Future of Nursing: Leading Change, Advancing Health http://www. nap. edu/catalog/12956. html Aiken, L. H. , Cheung, R. B. & Olds, D. M. (2009, June 12). Education policy initiatives to address the nurse shortage in the United States. Health Affairs Web Exclusive. Accessed June 22, 2009 at http://content. healthaffairs. org/cgi/content/abstract/hlthaff. 28. 4. w646 American Association of Colleges of Nursing (2009). 2008-2009 Enrollment and graduations in Baccalaureate and graduate programs in nursing. Washington, DC: Author.

This article Is about caring for pediatric patients who are suicidal. I believe In coincided with what we have recently been learning about during our clinical experience. I was also Interested in this article because I had worked In pediatrics for six years prior to working in a rehab/nursing home setting. After reading this article, I learned ways to carefully screen the pediatric patient, how to do an assessment and how some families act and what measures of support they need during their families time of crisis.

This oracle gave a case study of a boy that was brought Into the emergency apartment with his mother and grandfather. When the nurse met him in the reception area he was sitting In a chair with his legs pulled up to his chest and his shoe laces were untied. He avoided eye contact during their meeting. The mother in the case study was visibly upset.

This boy was brought to the emergency department because this young boy was found in the kitchen holding a butcher knife to his neck, when his mother walked In and got the young boy to give her the knife, Prior to this day there were many changes in the young boys life, he recently started a new school and he was diagnosed with Espalier’s syndrome. This boy also had trouble making friends in his school and he was being bullied. Other children at school were threatening this boy. This story made me think of all the children that are In POEMS and how he seemed to have a lot of things In common with them. They were all in similar situations.

The nurse after obtaining this history from his mother and asking about any medications, vaccinations, allergies, possible exposures to communicable diseases also needed to obtain his vital signs and head to toe assessment The young boy let the nurse do his height and weight but as soon as the nurse put the stethoscope to he boys chest he felt his heart pounding and he thought It meant he was going to die. The boy had anxiety during the assessment so the nurse stopped the assessment and showed what she needed to do on his mother and after the boy relaxed a little bit, he allowed the nurse to finish the assessment on him.

The nurse got a one on one to stay with this patient because he was at risk for doing harm to himself. The nurse also had to obtain an EGG and urine drug screen. In our clinical setting, I have seen the urine drug screen used on every patient but not the EGG. According to this article, It Is Important to obtain a baseline EGG because many psychophysiology agents can affect the conduction system of the heart. After the boy was medically cleared, he was eligible to meet with the psychiatrist and social worker. He had to wait for the psychiatrist and he became agitated and started kicking the wall.

Security had to be called Into the room and the safety door was lowered. The nurse removed their name badge and their bandage scissors as they were both safety hazards. The nurse re-entered the room keeping their pathway to the door unobstructed. All dangerous items were removed from the room. The nurse used many different techniques to deescalate the situation and used the mother to get Information of things that have worked In the past. When the boy was ready to discharge, the nurse gave them education on a safety plan the called tort keeping knives out to the boys reach and tallow up tort outpatient care.

No medications were given to calm him down. The suicide rate in the entire world has increased over the past few decades with a greater number of boys attempting suicide then girls. In 2010, there was a study hat found 14% of children ages 11-20 reported having suicidal thoughts within the previous month. According to this article, Native American males have the highest suicide rate in the United States for children over 10, and non-Hipic black females have the lowest rate.

Some psychosocial risk factors include, the presence of an underlying psychiatric condition, a history of prior suicide attempts, a history of physical or sexual abuse, and a lack of mental health treatment. Poor coping skills have been identified as a predictive of a suicide attempt in both sexes. Environmental and social risk factors include owning a gun in the household, being homeless or living in a corrections facility or group home, poor parent-child communication, social isolation, bullying and difficulties at school.

Many emergency rooms are using the five level triage classification systems called Emergency Severity Index Triage Algorithm. This takes into account not only the acuity of the patient but also the number of resources that will be required during the evaluation. A level 1 patient would require immediate life-saving intervention. A level 2 patient would be considered in the “danger zone,” and needs emergent retirement. Level 3 patients need more the 1 resource, level 4 patients require 1 resource and level 5 patients require none.

At the Children’s Hospital Boston, the use a screening tool that consists of 4 questions, “Are you here because you tried to hurt yourself? ” “In the past week, have you been having thoughts about killing yourself? ” “Have you ever tried to hurt yourself in the past other than this time? ” “Has something very stressful happened to you in the past few weeks? ” If the patient answers yes to one or more of these questions they become characterized as SSI bevel 2, and the nurse would explain the policy on physical and chemical restraints which are only used as a last resort.

Some strategies that nurse’s use to promote successful interactions with the patient and their family members include active listening, close observation of behavior, attending to non-verbal body language, asking open-ended questions, conveying a non-judgmental attitude, clarifying information, and providing support. The patient’s safety is always the greatest concern as well as the staffs safety. Family education is very important when working with suicidal patients, because heir care is often managed at home.

It is important for them to follow up with outpatient care, outpatient psychiatric support, and a home safety plan. Also, the nurse needs to let the family know if when they will need to seek emergency care again. This article has helped me gain a better understanding of the psychiatric patient, no matter the age, even though it focused on pediatrics. All these techniques can be used when dealing with suicidal patients. Our role as nurse’s plays an important role in managing our patient’s care while they are in our care and promoting their health y educating our patients and their families.

This paper will also validate what I have learnt by providing examples of personal or professional experiences as it relates to essentials I and II. Lastly this paper will describe future learning needs necessary to achieve each essential. Annihilation of Learning The past 1 7 months at Nova Southeastern has molded me in understanding why a BBS degree was/is the standard for entry into the nursing practice.

An associate degree in nursing (DAN) and diploma nurses came about due to the massive shortage that the nursing profession was facing. According to Alton (201 1) “one rational for the push for BBS nurses is because recent studies have indicated that there is decreased morbidity, mortality, and failure-to-rescue rates in hospitals that employ larger percentages of baccalaureate prepared nurse” (p. 257). Essential I Essential I talked about the liberal education for baccalaureate generalist nursing practice.

According to the (American Association of College of Nursing CAN], (2008) “nursing graduates with a liberal education exercises clinical judgment, understanding the reasoning behind policies and standards, and respect responsibility for continued development of self and the discipline of nursing” (p. 1 1). Obtaining my BBS has shaped the way I View patient care especially in terms of the many theory developed by nursing theorist.

Evidence base practice has given me the insight into better and safer patient care while being able to teach others about what I’ve learnt. Essential II Essential II talks about the basic organizational and systems leadership for quality care and patient safety. Courses taken like leadership, budget and pathologically has equipped us to be better leaders, given us a greater understanding of disease processes, organizational skills needed to manage units, and lastly explore the many ways to improve quality of care and patient safety.

The CAN (2008) states that a “baccalaureate nursing graduates are distinguished by their abilities to identify, assess, and evaluate practice in care delivery models that are based in contemporary nursing science and are feasible within current culture, economic, organizational, and political prospective” (p. 13). Validation of Learning As patient acuity increases along with technological advances in healthcare, we as nurses need to be more educated in order to provide the best care possible to our patients. It is a disservice to our patients for nurses to be comfortable with a two year degree without thought of advancement.

Yes a nurse is a nurse, but being well rounded with the educational knowledge needed to better solve complex problems, provide better leadership qualities, and understand evidence base practice is all part of the critical liberal education a BBS degree provides. Essential Example One of the most influential class think was my budget class. The number en reason for this was due to the lack of knowledge about the topic. After completing the course it has help me to realize just how integral each and every one of us are to the budget process.

Understanding that healthcare is a business and every item that is used has a cost associated with it gives us the nurse a better awareness. Essential II Example Being able to differentiate between a good leader and a good manager, and learning what it takes to be both are some Of the things I have taken from my adhering class. Throughout my BBS journey Vive learned the reason why core measures were being done on my previous unit for each Congestive earth failure (CHEF) and Myocardial Infarction (MI) admission.

Evidence base practice has help me to bridge the gap between nurse patient ratios and medication errors which as a AND nurse could not be conceptualized. Future Learning Needs As navigate through my last 3 course to becoming a Bachelor prepared nurse, believe these courses will provide me with the skills needed to easily adapt to any future learning need that will arise. Being a nurse requires a commitment to lifelong learning. Most if not all of the potential learning outcomes outlined in essential I and II have been reach or is in the process of Ewing reached, from each class I have taken at Nova Southeastern.

Conclusion In the ever-changing world of healthcare, nurses need to be able to adapt and conform in order to keep up to the pace. According to Mugginess (2008) “research links BBS-educated Urns with improved patient outcomes” (p. 47). Research has shown that a BBS prepared nurse possess greater critical thinking skills thus better decision making which leads to a decrease risk of patient deaths and failure to rescue. Personally, having taken on the challenge to further my education has open many doors, along with awarding e greater insight to many processes involved in the ever changing healthcare arena.

Dress down Fridays, also known as Casual Fridays, is said to have originated in the 1950s. This practice was originally seen as an attempt by business leaders to improve the morale of staff and provide a more relaxed setting for many offices. The view then was to enable workers to wear more casual attire that was different from regular formal dress or uniform in order to create a relaxing atmosphere on Fridays and hopefully boost the staff’s spirits. Since then, dress down Fridays has gone global and the practice can be found in many countries across the world.

In fact, dress down Fridays has morphed into a culture that supports casual dress on all weekdays and this has been welcomed by the new dot. com firms. The subsequent dramatic bursting of the Dot. com bubble has seen many companies retreating from the previous stance of supporting casual dress. For companies such as StarBucks, the policy is to have a casual dress down day on Fridays in the form of a T-shirt in lieu of the regular attire, in this case, Starbucks Polo Shirt.

The Company may have made this decision to assist a generally younger staff to relax on Fridays and use this to build camaraderie and an atmosphere of relaxation and comfort. In many companies, this trend is acceptable and staff members look forward to this day. Many organizations have not reported a change in productivity or professionalism when staff dresses down on Fridays. Contrastingly, the Disney Corporation is noticeably different and consistent in its stance on dress down Fridays. The company’s philosophy is that staff should be dressed attractively, in the same manner all week: No dress down days.

I am in favor of the policy to have staff being dressed in the same manner all week without the inclusion of a casual day and there are several very important reasons for my decision. Appropriate dress for work connotes professionalism and in many instances, staff interacts directly with customers who will often make a decision about the company based on the attire of general staff. Casual dress is most inappropriate under some circumstances. For example, if a new client walks into an investment bank on Wall Street and sees everyone in faded jeans and slippers, he or she might pause to make a decision if the staff is indeed competent.

A Nurse or Doctor in casual jeans at a hospital will not be easily identified and so patients may complain that there is no one available to look after them when a medical practitioner may be feet away! Like the Disney rule, many clients prefer to deal with a clean, approachable and easily identifiable staff and a dress code that mandates staff to be similarly professionally dressed all week can help clients to form a favorable image of the organization.

For many businesses that do not adopt a dress down Friday policy, the aim is to provide a consistent image of having a cadre of competent professionals who will consistently deliver quality service. A harassed visitor to a Disney site can be comforted by the easily identified presence of staff who can attend to a concern. For those visitors, it helps to ease any anxieties about going in search of help and probably not be able to easily identify a Disney staff.

Staff are also not always consistent in following organizational guidelines in terms of what is acceptable casual dress on Fridays and in many instances, the company has to create definitive dress codes for casual days and then enforce the rules. Companies with dress down Fridays sometimes have staff reporting to work in dress that is too revealing, dresses too short, having inappropriate words written on T-shirts and in some cases staff report to work with flip-flops in a setting that clearly require other types of shoes.

In closing, there is an acceptable dress code for all types of organization and the decision to have a dress down Friday must be done after due consideration concerning the impact on staff moral, how the organization will be perceived by staff and clients, how will rules be enforced and whether the organization will mandate staff to use a particular type of clothing or let the staff decide what to wear. In my view, keeping dress consistent and professional reduces a plethora of headaches and potential problematic issues of what constitutes acceptable and professional attire.

References About. Com:Human Resources. ( 2009). Business Casual Dress Code: Manufacturing. Retrieved March 21, 2009 from http://humanresources. about. com/od/workrelationships/a/dress_code_man. htm NYU Arthur L. Carter Journalism Institute. (2005). The Secret Behind the Magic of Disney. Retrieved March 21, 2009 from http://journalism. nyu. edu/pubzone/livewire/archived/the_secret_behind_the_magic_of/ Sabath, Ann Marie. (2004). Beyond Business Casual. Bloomington, IN: iUniverse:

Unit 3 IP Leigh Ratliff There are reports of abuse in nursing homes every year. There are many types of abuse reported as well. Even though there are many reports there are also many cases that are not reported. Elderly being abused puts them in an even more vulnerable position that what they were in. They now have to fear for their lives from the people who should be taking care of them. With reported cases and non-reported cases the abuser is rarely punished which makes the situation much worse.

Elder abuse in nursing homes has grown at an alarming rate and not being reported and I firmly believe that the punishment should be increased for these abusers such as licenses being pulled and state stepping in more to investigate. There are many different types of abuse towards elders. Types of abuse are neglect, physical abuse, sexual abuse, and many more. There are more than an estimated 2. 1 million reports of abuse each year as found in the studies of American Psychological Association, 2011. Elderly abuse is often times overlooked especially when there is bruising of the skin.

The elderly are frail and the bruises are often mistaken for normal care on a frail individual which can happen. M. Lachs and K. Pillemer, also studied the same abuse issues and reported that many physicians were un-familiar with the mandatory reporting of abuse. In fact many physicians could not identify a case of elder abuse (1995-2006). Neglect is one of the most common reports of abuse in nursing homes. Neglect occurs when a caregiver fails to take care of a patient the way they should. In example, a caregiver does not change an elderly person every two hours.

Instead the elder is only changed every 4 hours. This can cause bed sores. Bed sores break down the skin and when urine and feces enter the wound the patient can become ill and even die. Another type of abuse is physical abuse. Physical abuse occurs when a care giver hits a patient. Physical abuse towards the elderly can have grave consequences as well. The elder are very fragile and when hit can easily cause broken bones and even death. It is very hard for the elderly to recover because they are so fragile. Many physicians do not recognize the signs of abuse.

The injuries are often mistaken for common issues with fragile elder patients. This means most cases of abuse are not reported and the abuser continues the acts. For cases that are reported the abuse usually is not punished in a meaningful way. Usually the abuser gets a slap on the wrist and in worst case scenario fired from the job just to go to another job and do the same thing. If the state would come in to the nursing homes more often or even a regular weekly basis to inspect. The state has a larger impact than expected and could put the situation under control.

The abusers should have their certifications and licenses revoked and should not be able to continue their work. Doing this would leave the patients with care givers who actually care and want to do the job correctly. There are many, many reports every year on abuse in nursing homes. The reports to not even come close to the actual number of cases since not all are reported. Abuse in nursing homes is a very serious matter and should be treated as such. The elderly deserve respect and great care. They have lived a long life and should not have to end it in tragedy.

Changing The Scope Of Practice For All Nurses October 21, 2012 Changing The Scope Of Practice For All Nurses The Institute of Medicine and the Robert Wood Johnson Foundation has proposed many changes take place in the field of education for nurses to assist in the Affordable Care Act to be a full success in transforming health care.

They have published the report “The Future of Nursing Leading Change Advancing Health” recommending that the scope of practice for all nurses which include the registered nurse, advance practice nurse, certified nurse anesthetist, and the certified nurse midwife to be able to practice at their education and skill level through continuing competencies. Now it is up to all nurses to decide if changing the scope of practice for nurses is a good or bad idea. This paper will show how changing the scope of practice will enable nurses to care for their patient more effectively.

Nurses are going to have to step up to the plate, and show the whole world how important nursing is to providing health care to all people. And for the Affordable Care Act to truly change the health care system to better help the people and communities of the United States, the scope of practice for nurses will need to change to better meet the needs of the public. Education The Institute of Medicine report encourages nurses who graduate with an associate degree to continue on with their education to at least the baccalaureate level. Nurses at the baccalaureate level are then encouraged to continue on to the masters or doctorate degree.

The different foundations and the federal government introducing funding opportunities and scholarships to students trying to find ways for schools and government to further nurse’s education to higher level to be more affordable (“The Future of Nursing” 2010. p. 177). It is important to stress the need to gain nurses with the knowledge to teach our future nurses. Nurses will also need to be involved in continuing education and continued competencies. Where nurses stay up to date with current practice and can demonstrate knowledge and skill in the practice (“The Future of Nursing” 2010. . 202). Also, equipping nurses with the skills and knowledge to take care of patients of today, who have more comorbidities than ever before. Equipping nurses with the knowledge and skill to not only preform the competency but understand the how and why it works, which will be a key factor in transforming health care. One proposal is that “Interprofessional education of physicians, nurses, and other health professionals, as well as new methods of improving and demonstrating competency throughout one’s career…” (“The Future of Nursing” 2010. p. 165).

This will allow better communication, collaboration, and respect between everyone involved in patient care. The Institute of Medicine also discusses different ways to make nurses continuing their education more affordable. Primary Care The way primary care nurses deliver care to patients will change if the report by the Institute of Medicine is adopted. Most of the changes will affect the advanced practice nurses, by allowing them to practice to their full potential of knowledge and skill level. They will be able to take care of patients without having to have a physician on the premises or overseeing their work at all times.

The Institute of Medicine gives an example where in Philadelphia there is a nurse managed health care center. This center is run by Nurses, Nurse Practitioners, and Social Workers. Other health care professionals help when needed like nutritionists, physicians, and others when needed. Places like this would be able to serve areas where there is little to no physicians available to meet the health care needs of the people who live there. Leadership By reading the report, “The Future of Nursing Leading Change Advancing Health”, it describes how important nurses are becoming stronger leaders for the future advancement of nursing.

With all the changes coming with the Affordable Care Act, this report recommends that nurses need to be playing a large contributing roll in the development of policies to maintain patient centered health care, making sure that health care is accessible to all, and is affordable. Stronger leadership skills can be developed through continued education. By nurses moving on to higher degree education, they are thus developing the leadership skills they will need to work more cohesively with others both in the health care field and out. Nurses need to be playing a role in all aspects of policy making.

From working in the hospitals and communities as advocates for patients which is defined as “The nurse is demonstrating the value of other-centeredness to advance the health of an individual” (Creasia & Friberg, 2011, p. 80). Nurses will need to sit on boards both in the hospitals and in the public sector, legislating to political officials, and even possibly holding a political office themselves. It is going to take all nurses to make a change from nursing students to advance practice nurses, educators, and nursing organizations leadership (“The Future of Nursing” 2010. p. 221-251). Goals for Practice

For the nursing scope of practice to change effectively, it will have to start in nursing school. Nursing students will need to start aiming toward a goal of higher education. Knowing they will need to be better prepared with the gained knowledge of continuing on to a baccalaureate, masters, or doctorate degree in nursing to be able to take care of the ever increasing health care needs. Nurses will need to maintain their knowledge and skill level for up to date practice through competency based learning throughout their career. They will need to be the future leaders in and out of the nursing profession.

Each nurse knowing that nursing consists of many different aspects, making sure to help in the advancement of all future nurses. Some nurses choose to go into the clinical field, community nursing, education, advanced practice, research, legislation, specialty associations, and many more to further nursing profession and health care. In conclusion, by changing the scope of practice for nurses, they will be able to deliver patient care that matches their knowledge and skill level. This will allow more health care professionals mainly nurses, to practice in areas that have lacked sufficient health care providers to meet the needs of the public.

The public will benefit from having nurse practitioners available in rural, suburban, and urban areas where physicians are scarce. Thus the public will have access to affordable, high quality health care to all who are in need.

References Creasia, J. , & Friberg, E. (2011). Conceptual Foundations the Bridge to Professional Nursing Practice. (5th ed. , p. 80). Retrieved from http://pageburstls. elsevier. com/books/978-0-323-06869-7 The Future of Nursing Leading Change, Advancing Health (2010). Retrieved October 13, 2012, from http://www. iom. edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health. aspx.

WHEN Is a focus on the primary medical management of women’s health throughout the phases of a man’s life. Many aspects of a woman’s life are variables that will affect her general health and wellness. For example, relationships, children, career, family, finances, environmental factors, spirituality, and other influences collectively impact a woman’s health and wellness. In my own nursing experience, I recall a difficult client care situation that perplexed me with serious ethical questions and allowed me to unfold a “bigger picture” of the woman’s life.

This woman contracted HIVE during her first sexual encounter at the age on nineteen. I had the privilege of knowing her when she was the age of thirty-three which for her was the end of her life due to the disease processes. I spent a good deal of time with her In clinical practice and came to a full understanding and appreciation of her life story but not at first. I created many barriers for myself and for her with respect to vast commodities and clinical needs beyond comparison to many other patients I had encountered.

The barriers were created because of my intolerance and objectivity I had created against the WAITED population. I learned later that she was the loving mother of a child that she could not physically see because she had lost her eyesight. She was alone. She was abandoned by the father of the child who was the carrier of the HIVE she had contracted. She was angry. She was scared. She was mistreated and abused by her family and the system. My moment of knowing myself finally came when I was able to see myself as being this person.

She could have been anybody life story. During this time I was able to re-evaluate my personal feelings and biases and this particular tuition brought to fruitful a nurse that was less Judgmental, more understanding, more tolerant, and most Importantly more knowing. This happened long before I knew there was Integrated Theory and Knowledge Development in Nursing. All the while, we nurses have been developing ways of knowing and like many of my fellow undergraduate nurses, I did not acknowledge the term “Knowing” in the sense of an art.

Former clinical experiences have influenced how I acquire knowledge in my latter clinical practice. I use an integrated approach to the collection and analysis of ATA from personal, ethical, and empirical perspectives. Personally, I am aware that I am human and can easily become consumed in opinions and prejudices. I understand that ownership of a prejudice in nursing creates barriers that will not allow the nurse patient relationship to flourish. The nurse’s failure in realizing the self as a potential barrier Is also the nurse’s failure In delivering the most therapeutic and holistic care possible.

I consider psychosocial, demographic, ethnic, cultural, and/ or religious factors that may bear weight on a therapeutic plan of care. I pay attention to facial expressions, educational level, language, and family members. Is religious practices that prevent certain treatments? Is the patient in pain? These are important questions that I ask or observe for gathering information and formulating a specific plan of care. What can I do as the primary nurse to be part of a therapeutic clinical plan of care? What can I say to add words of comfort in times of fear?

How can I be proactive in the community to raise a level of awareness concerning senseless acts of violence or the spread of disease and infection? Am I using the best possible aseptic techniques to facilitate the most optimal outcomes during wound care and other invasive procedures? A combination of clinical objectivity, personal knowing, and ethical/disciplinary knowing are utilized during clinical practice to ensure I deliver the best care I can to the patients that I serve. The Phenomenon of Interest that I would like to further examine is as follows: Investigating the quality of life and health in infertility.