May 30, | nursing, med, NURS, Paper
Virginia APRNs Prescriptive Authority discussing
1. The licensure of Advanced practitioner registered nurse (APRN) in the state of Virginia is regulated by the Board of Medicine and the Board of Nursing equally. Virginia’s nurse practice act (NPA) does require a collaborative agreement with a physician. The APRN and the physician collaborate as members of the patient’s care team (Virginia Law Library, 2020). The collaboration is a safety mechanism that ensures open communication and decision making in providing a safe and effective plan of care and treatment. As the APRN grows and develops clinical experience, which is defined by five years of full-time experience of 1800 hours per year totaling 9,000 hours, she/he may qualify for autonomous practice (Commonwealth of Virginia, 2020, p. 7).
2. The Commonwealth of Virginia requires APRNs to have a prescribing practice agreement with the collaborating physician who provides prescriptive authority. The APRN can only prescribe medications within the scope of the written or electronic practice agreement (Virginia Law Library, 2020). When prescribing medications, a prescribing agreement is necessary to ensure regulation that requires the practitioner to remain competent to ensure the required standard of care is being provided to the patient. Another way the Commonwealth of Virginia ensures patient safety is by limiting the number of collaboration a physician can have with an APRN at one time to 6 (Commonwealth of Virginia, 2020, p. 7).
3. The Commonwealth of Virginia grants authority for APRNs to prescribe Schedule II thorough Schedule VI controlled substances and devices as long as the collaborating physician has designated prescriptive authority to the APRN and the APRN has established a bonafide practitioner-patient relationship (Virginia Law Library, 2020). In prescribing schedule II through VI medications, the practitioner must perform an examination, initiate interventions and schedule follow up care to ensure that the medication is effective and that the patient is not experiencing side effects which may cause the patient not to complete the treatment.
4. Treatment of rashes does fall in the scope of practice of a CNP. As long as the CNP meets the criteria of being properly trained to perform a physical health assessment on the specific age group, can properly identify and diagnosis the rash, and has competency in the drugs to prescribe taking in consideration the patient’s medical history including comorbidities and current medications (Arcangelo, et al., 2017). then yes the CNP should treat rashes across the lifespan. In developing a treatment plan, the CNP should collaborate with a physician and only take the case as long as she/he has a thorough understanding of the rash and/or the secondary condition that could have caused the rash. Prior to prescribing a treatment plan, the CNP must be competent in prescribing a treatment plan to the specific age group and be able to provide a follow up appointment with the patient. If the CNP is relying on the collaborating physician to be the decision maker due to inexperience or or lack of knowledge with the age group or rash, then the CNP should not treat the patient and should refer the patient to a competent practitioner.
References
Arcangelo, V. P., Peterson, A. M., Wilbur, V. & Reinhold, J. A. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams I Wilkins.
Commonwealth of Virginia regulations governing the licensure of nurse practitioner. Retrieved from http://www.dhp.virginia.gov/media/dhpweb/docs/nursing/leg/Nursepractitioners.pdf
Virginia Law Library. (2020). The code of Virginia. Retrieved from https://law.lis.virginia.gov/vacode/54.1-2957.01/
Discussion 1
Locate your state’s nurse practice act (NPA) and associated regulations governing prescribing by advanced practice nurses (CNPs, CRNAs, CNMs, CNSs). Answer and discuss the following in this forum:
Does your NPA require the APRN to have a collaborative agreement with a physician? Discuss whether you think the NPA should or should not require the APRN to have a collaborative agreement, and explain why/why not.
Does your NPA require the APRN to have a prescribing agreement with a physician? Discuss whether you think the NPA should or should not require the APRN to have a prescribing agreement, and explain why/why not.
Does your NPA permit APRNs to prescribe all classes (schedules) of medications? Discuss whether you think the NPA should or should not permit APRNs to prescribe all classes of medications, and explain why/why not.
Describe collaborative approaches to treating rashes across the lifespan. Should the CNP treat without a collaborator or consultant? Support your statements based upon evidence.
Remember to respond to at least two of your peers. Please see the Course Syllabus for Discussion Participation Requirements and Grading Criteria.
The American Association on Nurse Practitioners (AANP) defines full practice authority as the “authorization of nurse practitioners to evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing” (AANP 2020). Twenty-two states and the District of Columbia currently have full practice authorization. Nurse Practitioners (NP) have consistent requirements nationwide regarding education, licensure, and certification. However, there is an inconsistency between states regarding the conditions which authorize NPs to practice.
The state of Virginia requires a collaborative agreement with a physician. In 2018, Virginia approved bill 793, allowing nurse practitioners with five years and nine thousand hours of physician supervision to advance to full practice autonomy. The autonomous nurse practitioner in Virginia will provide a plan to refer complicated and emergency patients to a physician or appropriate provider. I agree with allowing NP autonomy following a collaborative practice period with a supervising physician. However, five years is an excessive period. I support a national standard to guarantee the best healthcare.
Nurse practitioners in Virginia can prescribe Schedule II to VI medications. Virginia requires 1000 hours and 30 credit hours of pharmacology education for NP to qualify for prescriptive authority. Nurse Practitioners in Virginia have a prescribing agreement with a physician until the NP has met the requirements for independent practice. I agree that a term of monitored practice is reasonable; however, according to Buppert (2017), the supervision lacks evidence that care is enhanced. Therefore, I support nationwide standardization of NP requirements to certify the safest healthcare.
Rashes are common and can be difficult for nurse practitioners to diagnose. A thorough history and physical examination will aid in identifying these skin conditions. From diaper rash to acne to herpes zoster (shingles), rashes occur throughout the lifespan and can be complicated or straightforward to treat. The symptoms, size, and the affected area can help identify the need for collaborative care. Rashes not responding to conventional treatment would require consultation. The collaborative care model works to improve patient outcomes through an inter-professional team. Dieticians, Physiotherapists, or medical specialists are valuable adjuncts to the primary care team.
American Association of Nurse Practitioners (AANP) (2020, October 20). State Practice Environment. https://www.aanp.org/advocacy/state/state-practice-environment
Buppert, C. (2017). Thoughts About Drafting Bills to Give Nurse Practitioners Full Practice Authority. The Journal for Nurse Practitioners, 13(7), 497-498. http://dx.doi.org.americansentinel.idm.oclc.org/10.1016/j.nurpra.2017.05.015
Arcangelo, V. P. & Peterson, A. M. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams &Wilkins.
May 30, | nursing, med, NURS, Paper
NURS 6003 Week 1 Discussion: Networking Opportunities
Mission, Vision, and Personal Goals
From an early age, I knew I wanted to be in the medical field. I sought out classes, clubs, and activities that aligned with my goals. I really wanted to be a doctor; however, I realized that becoming a doctor required a lot more sacrifice and time than I was willing to give. Thus, I became a nurse because I have always been a people person who enjoys taking care of others. I have been a nurse for 15 years now, and I have truly found my calling. I ventured out of bedside nursing for a while and found that I really missed it. During my nursing career, I found that I was limited in my scope of practice and I could not impact health care as much I wanted to. Being witness to numerous gaps in the health care continuum led me to want a more active role in primary and preventive care. Hence, I decided to further my education and become a family nurse practitioner (FNP).
I started my journey to become an FNP about 10 years ago. I started the program at another university, but I did not get the support I needed to complete the program. I dropped out of the program and had second thoughts about becoming an FNP. I decided to go into diabetes education at another school and quickly figured out that I was missing out on my calling. This particular school did not offer an FNP program, so I had to drop out again. I was becoming disheartened because most schools would only take a small portion of my transfer credits. However, Walden University was my saving grace. I only had to repeat a couple of classes, and then I would be on my way to finishing my degree. I finished my first didactic class and practicum in 2014 and had to take a long hiatus due to various circumstances. Nevertheless, during my time at Walden, I found that their vision, mission, and goals closely aligned to my own beliefs and goals. Walden’s vision, mission, and goals center around a commitment to producing knowledgeable scholar-practitioners that promote positive social change, and that is exactly what I am striving to be and do (Walden University, n.d.-a).
Social Change
I have a passion for people and am working diligently to become an impactful, contributing member of society that assists people to become the best versions of themselves. Because of my desire to influence positive social change, I have started a nonprofit organization that focuses on women, children, and health prevention and promotion. I eventually want to pair my career as an FNP with my nonprofit in order to broaden my reach and become a change-maker that aids in decreasing morbidity and mortality, especially related to preventable diseases and illnesses. This correlates to Walden’s ideology about social change because Walden University (n.d.-a) aims to improve our society by providing education and resources to individuals to assist them in being agents of positive change in our society and their communities. Walden’s emphasis on social change is in-line with other educational institutions that have recognized the importance of social change in nursing and the positive impact the field can have in transforming health care by supporting efforts to promote equality, social justice, and other social issues that improve our society (Read et al., 2016).
MSN Program Outcomes and Perspectives
Walden University’s (n.d.-b) MSN program has seven learning outcomes. Two of the outcomes resonated with me and what I hope to accomplish as an FNP. One outcome focuses on advocating for individuals with the goal of closing the health care gap that is experienced by certain individuals and populations. The other outcome focuses on effective communication via various communication methods (Walden University, n.d.-b). I advocate for my patients now and plan to do so when I become an FNP. Also, I am working on being a better communicator. As a leader of a nonprofit and a future FNP, effective communication with others is key. Communication helps relationships to grow and be built and provides a platform to learn others’ points of view. Without effective communication, it would be difficult for an individual or organization to be successful (Kavithanjali, 2020).
This time around I am excited to finally finish my degree. I am in a different place in life and ready to take on what lies ahead with pursuing my education and furthering my career. Walden University’s vision, mission, goals, and learning outcomes align with my goals to become an FNP. Additionally, their perspective on social change also resonates with me. Through the resources available to me at Walden, I hope to grow my knowledge base, expand my network, and ultimately become a scholar-practitioner.
References
Kavithanjali, J. (2020). Art of Effective Communication for Professional Growth and Achievement. Language in India, 20(3), 99.
Read, C. Y., Pino Betancourt, D. M., & Morrison, C. (2016). Social change: A framework for inclusive leadership development in nursing education. Journal of Nursing Education, 55(3), 164-167. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.3928/01484834-20160216-08
Walden University. (n.d.-a). Vision, mission, and goals. Retrieved May 31, 2020, from https://catalog.waldenu.edu/content.php?catoid=172&navoid=59420
Walden University. (n.d.-b). MSN learning outcomes. Retrieved May 31, 2020, from https://catalog.waldenu.edu/preview_program.php?catoid=172&poid=67151&returnto=59823
Discussion: Networking Opportunities
In this module, you begin laying the foundation for your academic and professional success. Your efforts begin with a vision that includes your own definition of success. Your vision may vary from those of your colleagues, but this does not mean you have to take these first steps alone.
Walden University and the College of Nursing also have a vision and mission, which include helping you to make your own vision a reality. Members of your new academic community, such as faculty, support teams, and fellow students, can also be helpful. Current practitioners and other member of the professional community can also help you to clarify your vision.
This Module’s Discussion asks you to consider how the Walden mission and vision as well as the College of Nursing’s mission and vision apply to your professional and academic goals. You will also begin to identify individuals and teams who can help you along the way as you begin designing the “blueprint”—your Academic Success and Professional Development Plan—that will guide you toward your own vision for academic and professional success.
To Prepare:
Review the Walden and College of Nursing mission and vision statements, Walden’s goals and University Outcomes, and the MSN Program Learning Outcomes presented in this Module’s Learning Resources.
Reflect on your professional and academic goals as they relate to your program/specialization.
Consider how the information in these resources fit with your own goals and to your becoming a scholar-practitioner.
Also consider academic and professional individuals and teams with whom you may collaborate in support of your efforts as a student at the university and as a professional within your organization and career.
By Day 3 of Week 1
Post a brief introduction of yourself to your colleagues. Include an explanation as to how Walden’s vision, mission, goals, and social change initiatives relate to your professional and academic goals and to your becoming a scholar-practitioner. Also include an explanation for how the Walden MSN Program Outcomes and perspectives relate to your professional and academic goals and to your becoming a scholar-practitioner.
By Day 6 of Week 1
Respond to at least two of your colleagues’ posts by suggesting additional individuals and/or teams with whom you wish to collaborate or by offering additional networking strategies.
Discussion – Week 1
COLLAPSE
Networking Opportunities
A Registered Nurse was not on my list of things I wanted to be when I grew up. I became a Medical Assistant first because I needed a stable job that was not in a factory. I’m from a small town in Georgia and most people there work in carpet mills. I wanted something different. This change in profession sparked a fire in me. This was when I discovered my love for the medical field. College was a scary idea for me because I was a high school dropout and could not believe that I could do it. I was lucky to have family that believed in me more than I believed in myself. In 2011 I graduated with my Associates in nursing. This is when my adventure in nursing began.
My nursing career first started on a renal floor and from there I took notice that nursing had a broad field of needs. When I moved to Detroit, I had the desire to broaden my skills and that is when I stepped into the ER. This is where I found my home. The ER opened a true understanding of serving the community for me. Then with time, experience, and a growing need to be the best nurse I could be has led me to pursuing my masters.
When deciding on which school to pick I felt a bit overwhelmed. Undergraduate scared me and here I am jumping into the deep end of graduate school. Then I ran across Walden University. Walden’s vision hit home when I read “the degree that it can be applied by its graduates to the immediate solutions of critical societal challenges, thereby advancing the greater global good”, (Vision, Mission, and Goals, 2020, Vision section). This statement encouraged me to delve deeper in what Walden had to offer.
Walden University offered things that aligned with my goals and the flexibility I needed to be successful in my pursuit to becoming a better nurse. I kept debating on what program to pursue because I had several friends who were looking to be Family Nurse Practitioners. This just didn’t feel like a good fit for me. While looking at the list of programs one stuck out to me. The Adult Gerontology Acute Care Nurse Practitioner Program that had a RN track. This track along with outcomes that are practical and that can be applied within my professional development is what I was looking for. The MSN learning outcomes such as, “exhibit ongoing commitment to professional development and value of nursing theories/ethical principles (altruism, autonomy, human dignity, integrity, social justice) in accordance with ethically responsible, legally accountable, specialist nursing practice”, (Master of Science in Nursing, 2020, Outcomes section) is what helped me choose Walden University. It aligned everything I was looking for in a program.
The path that I am pursuing has brought me to connect with people who can help me achieve my goals. Unknowingly I had been networking my entire career. I am an inquisitive person that loves to meet people in different aspects of the health care field. This has led me to making connection that I can call on to help while in the program. The article 5 Reasons Nurses Should Engage in Professional Networking states, “every professional connection should be based on interactions that involve knowledge sharing and mutual professional development”, (5 Reasons Nurses Should Engage in Professional Networking, n.d., para. 5) and here I thought I was just making friends.
The advancement of my career is important to me and choosing the right college was imperative. The goals and outcomes are in coordination with my desires of becoming a better nurse that can inspire and affect change in my community. Walden University has developed an all-inclusive environment to help me succeed in my academic endeavors such as, writing center, library, online resources, and professional development resources.
In conclusion having a strong desire to better myself through education so that I can promote change in my community will become reality. I must stick to my path and utilize the resources at disposal and continue to professionally network to have the support I need.
References
5 Reasons Nurses Should Engage in Professional Networking. (n.d.). Retrieved June 3, 2020, from https://blog.bluepipes.com/5-reasons-nurses-should-take-professional-networking-seriously/
Master of Science in Nursing. (2020). Walden University. Retrieved June 3, 2020, from https://catalog.waldenu.edu/preview_program.php?catoid=172
Vision, Mission, and Goals. (2020). Walden University. Retrieved June 2, 2020, from https://catalog.waldenu.edu/content.php?catoid=172
NURS_6003_Module01_Week01_Discussion_Rubric
Grid View
List View
Excellent
Good
Fair
Poor
Main Posting
45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
35 (35%) – 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors.
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English.
15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Second Response
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English.
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Self-introduction, My goals and Walden University vision, mission and social change
My interest and enthusiasm for nursing first took root and flourished from a research topic I presented in high school. The topic explored the importance of nurses and how the world can be a better place with more nurses. Researching the topic exposed me to the need for nurses, and it was then that I began to realize a desire to engage in the nursing profession as a way of caring for and serving others. I followed up on this interest and obtained my registered nurse practice qualifications six years ago. I currently work as a Clinical Care Leader, a position that has had me use my MSN qualifications. However, I have developed an interest in psychiatric nursing and would wish to develop my professional and academic career towards this direction. I believe that as a psychiatric nurse, I could empathize with the self-loathing, frustration and embarrassment that typically accompanies mental illness. I consider it a privilege to take care of these patients who are emotionally, mentally and spiritually broken, and feel as though they have nowhere to go. Besides that, I feel that the work involved will rarely boring as the patients include complex and difficult personalities who most people cannot deal with. I shall integrate a social positive change to colleagues and community at large with the training taped from Walden University (Walden University, 2019). Although taking care of these patients will be heartbreaking, frustrating and exhausting, all at once, but also rewarding. In addition, I am looking forward to having a positive impact on my community and helping them get their lives back on track.
My dreams of practicing as a psychiatric nurse can only be achieved with the right education background. Towards this end, I intend to enroll for the MSN degree program offered at Walden’s University with a psychiatric-mental health nurse practitioner specialization. The institution’s mission and vision statements as well as goals indicate an intention to present graduates with the capacity to solve critical societal challenges and positively affect social change. These statements align with my intention to pursue a psychiatric nursing career (Walden University, 2020b). The MSN degree program is designed to allow to continue practicing as a nurse while attending school. Through joining the program, I expect to learn how to conducted assessment, diagnosis, provision of therapy, and medication prescription for persons with substance abuse problems, medical organic brain disorders, and psychiatric disorder. Also, I will acquire advanced skills and practicum training for treating families, groups, adults and children (Walden University, 2020a). In this respect, enrolling for the MSN degree program offered at Walden’s University offers me the opportunity to pursue my career objective of being a psychiatric nurse.
References
Walden University (2020a). Master of Science in Nursing (MSN) – Psychiatric-Mental Health Nurse Practitioner. Retrieved from https://www.waldenu.edu/online-masters-programs/msn-psychiatric-mental-health-nurse-practitioner
Walden University (2020b). Vision, Mission, and Goals. Retrieved from https://catalog.waldenu.edu/content.php?catoid=147&navoid=47257
Walden University (2019). College of Health sciences. Retrieved from https://catalog.waldenu.edu/preview_program.php?catoid=149&poid=57398&returnto=48220
