Assignment Details

• What do you consider one of the most critical areas of distinction between NPs (nurse practitioners) and PAs (physician assistant) and why?
• refer to the comparison below when answering this question NP/PA. don't need to complete the worksheet below. Just answer the questions above. 

Initial answers to the discussion question must be substantive and in the range of 100-200 words.

Both the NP and PA professions began in 1965 as a response to a shortage of primary care providers and addressing healthcare access issues in underserved areas, respectively. There are about 248,000 NPs and 44 000 PAs. Notably, 15 of NPs are nonwhite graduates while one-fourth of PAs are nonwhite graduates. APRN use the Consensus Model while PAs use the Physician Assistant educational model. 

Degrees for NPs and PAs include master’s-level and post-master's programs and master's level and doctoral-level programs respectively. NPs are licensed as APRNs, while PAs must pass the PANCE exams by NCCPA to practice. NPs are certified by AANP, while PAs by NCCPA. NPs are restricted to engage in at least one element of NP practice while, all PAs must practice with a collaborating physician. 

The scope of practice for NPs include evaluating and diagnosing patients, order and interpreting diagnostic tests, initiating and managing treatments, and prescribe medications; while for PAs include taking medical histories, performing physical examinations, ordering and interpreting laboratory tests, diagnosing illnesses, develop and manage treatment plans for their patients, prescribe medications, and assist in surgery (NurseJournal.org, 2020). The salaries for NPs and PAs range from $92,410 to $123,470 and $50,200 to $125,610 respectively.

References

NurseJournal.org. (2020). Nurse Practitioner vs. Physician Assistant. Retrieved 31 March 2020, from https://nursejournal.org/nurse-practitioner/np-vs-physician-assistants/

Assignments Details

Write a 100- to 400-word discussion reflecting on the following issues: as nurse practitioner in walk in clinic in California 

• Identify any practice inquiries and how clinical outcomes are implemented in your clinical setting.
• Have you observed any opportunities for practice inquiry in your setting that do not currently exist?

In a clinical setting, practice inquiry will comprise of a small group method that is designed to engage a case based uncertainties in various clinical settings. Clinical uncertainty is often viewed as the puzzlement or confusion around the management, diagnostic, relationship, prognostic and ethical aspects from an individual patient situation. In California, due to lack of enough physicians, nurses will find themselves  in unfamiliar grounds; this means that nurses who have been practicing under physician supervision for a number of hours, can be allowed to work independently (Lazarus, 2017). As a nursing practitioner in a walk in clinic, I usually find myself meeting various medical situations that I will need to provide the client with the right advice or the treatment plan.  I am always required to conduct initial assessment which entails a physical examination and this is where the concept of practice enquiry comes in (Magyary, Whitney, & Brown, 2006). Most Nursing practitioners do not have the collegial opportunity to engage in various clinical in-eventualities that are in line with their work.  For example in emergency cases  in a walk in clinic, at times I am required to perform urgent emergency surgeries on a person that has injured himself while driving, or cut herself in the kitchen or when children are playing.  

In conclusion, working in a walk in a clinical setting, I have been able to learn a lot regarding various aspects of treatment and care that at times has forced me to write a medical examination report, prescribe medication or make diagnosis (Magyary, Whitney, & Brown, 2006).  The opportunities for practice inquiry in a walk in clinic are very vast as compared to an ordinary hospital where each department has defined roles and duties. 

References

Lazarus, D. (2017, October 10). Column: California doesn't have enough doctors, and this bad law isn't helping. Retrieved from https://www.latimes.com/business/lazarus/la-fi-lazarus-california-nurse-practitioners-20171010-story.html

Magyary, D., Whitney, J. D., & Brown, M. A. (2006). Advancing practice inquiry: Research foundations of the practice doctorate in nursing. Nursing Outlook, 54(3), 139-151. doi:10.1016/j.outlook.2006.03.004

Means of continuing education

Continuing nursing education is necessary to enable nurses to keep up to date with changes in the field, including the availability of new information and research that could strengthen their capacity to deal with patients. One of the easiest ways of doing this is through online platforms. The online platforms conduct their training through video conferencing, as well as course material sent to websites and individual nurses’ portals. These online portals are easily accessible, though they deny nurses the advantages of face-to-face learning. Some examples are the Global Leadership Summit and Dynamic Nurse training. Some colleges also offer classes for continued education, as do some hospitals. Northeastern University in Boston is a good example of such a facility, where nursing gain certification for additional education received in practical circumstances. 

Using an e-portfolio to illustrate the nursing practice

An e-portfolio has several advantages, not least because of the extent of its reach, and easy updatability. As a nursing practitioner, an e-portfolio will be utilized to show basic details, professional experience, and additional education and training. The e-portfolio will be configured in a manner that highlights professional experience and qualifications, as well as steps that are taken to improve expertise (Brandt, 2019). 

Discovering modalities and developing resources for nursing practice

In this process, the first step is a needs assessment to discover the needs for continued education, and what needs to be focused on. Next, existing programs are examined to see their relevance, especially concerning how they can be used to enrich the resources needed for nursing education. In developing the resources, online libraries play a critical role. Open access resources can also come in handy when looking for resources. Such resources include Nurse Educator, and Wolters Kluwer Health, among others (Keating et al, 2020). 

References

Brandt, C. (2019). Department of Nursing Master of Science in Nursing ePortfolio Policy. Enhancing Pedagogy, 26.

Keating, S., Berland, A., Capone, K., Chickering, M. (2020). Establishing Global Nursing Education Equity by Developing Open Access Resources. Nurse Educator, 45(2), 63-65.

Assignment Details

Read the following case scenario:

You have a 15-year-old teen mom who self-presented to your primary care clinic with her 18-month-old baby girl. You have seen the mom several times in your clinic for various health issues. This is the first time you are treating her baby. You ran into her in the hallway. She reports that she is worried about her baby because she is not drinking her formula. She was holding her smiling and somewhat energetic baby. You noted that the baby has rhinorrhea, but otherwise appears healthy. Before you can see her, your nurse manager (NM) reports to you that her mother had reported her as a runaway. Her mother is now on the way to the clinic. Your NM also informs you that he had called the police.

Post a substantive 250- to 400-word response to the following

• What would you do in this situation? Select a specific ethical principle or principles from this week’s readings, and explain how it applies to this case study to support your decision. Generalized and layperson’s terms of ethics will not be accepted.

Intervention for a Runaway Mother

Helping mothers to navigate motherhood may be challenging when they are young and traumatic. According to Bounds, Edinburgh, Fogg, and Saeywc (2019), intensive therapeutic care is very critical in helping mothers with running away episodes intervene in their condition more effectively. As a primary health care provider, I would organize an individual therapy session involving the client, a family member, and local authority to assess the patient and advise her accordingly. The first piece of advice would primarily focus on finding out the main cause of runaway. This would involve asking the patient where she is currently living, who is providing the meals, and the history of her run away episodes. Collecting extensive information concerning the runaway is vital as it assists in identifying the risk factors such as intra-familial abuse, sexual exploitation, and the teen mother’s safety while away from home (Bounds et al., 2019). In the current case, the mother complains that the baby has difficult in feeding. However, the objective assessment indicates that the child has rhinorrhea. As such, it is critical to advise the mother on how she can manage this condition as it may be the cause of feeding issues. I would start by teaching her on the importance of obtaining healthcare regularly rather than being resentful and running away. Some of these skills include how to effectively book for appointments, access information about health insurance and using public transportation to get assistant form health providers.  I would also discuss with the client’s parents or relatives about the risks involved with teen runaways. According to O’Brien, Moynihan, Saewyc and Edinburgh (2019) runaway victims should seek support from the local authorities, health and social network. 

Furthermore, there are significant measures that the mother should take to feed the baby appropriately. She should manage the presenting congestion symptoms to ensure that the child is more comfortable and easy to feed. She can use the suction bulb, a soft rubber instrument that can sip the mucus from the nose before feeding. Moreover, the mother can keep the child clear congestions by providing warm births.

Another important thing is to maintain a regular feeding program and check for wet diapers. This should go along way with removing all possible pollutants of allergens from the home’s air. Addressing the leading cause of runaway and helping the mother to feed and take care of her baby will help to stop future runaway episodes.

References

Bounds, D. T., Edinburgh, L. D., Fogg, L. F., & Saeywc, E. M. (2019). A nurse practitioner-led intervention for runaway adolescents who have been sexually assaulted or sexually exploited: effects on trauma symptoms, suicidality, and self-injury. Child abuse & neglect, 90, 99-107. doi.org/10.1016/j.chiabu.2019.01.023

O’Brien, J. R. G., Moynihan, M., Saewyc, E., & Edinburgh, L. D. (2019). Featured intervention for exploited and trafficked youth: the Minnesota Runaway Intervention Program. Child Abuse & Neglect, 104141. doi.org/10.1016/j.chiabu.2019.104141