As soon as I read the requirements for this assignment, a nurse leader immediately came to my thought. In high school, I was introduced to a nurse at my local hospital and had the opportunity to interview to volunteer with her and her projects as Trauma Prevention Coordinator for Bergen County, New Jersey. This was a new opportunity for me to delve into the medical field and be exposed to different areas. She was the first nurse that I met that didn’t have a bedside role and she still had a crucial role in implementing safety and education to the community. I admire how Mel is a selfless leader that deeply cares about others and being involved in our path that we were creating for ourselves as high school students who were interested in the medical field. It was very apparent to me before completing hundreds of volunteer hours with Mel that she is a leader, she respects those around her and looks out for others and holds herself with high regard. During my time with Mel, looking back I had tunnel vision and only considered medical school for my future, however during my experience she exposed me to various medical professions and I greatly value that and that has helped me lead me to the path that I am currently on in a nursing program. She had a formal leadership position within the hospital system and represented Safe Kids New Jersey Bergen County through State Farm Insurance and received countless grants to provide helmet and safety information to kids across the state. I believe through her position she was able to also be an informal leader and help each of her volunteers become leaders themselves through building confidence and public speaking skills at volunteer events. Defining a difference between informal and formal leadership in my eyes is whether or not you have a title that defines your leadership position, but that doesn’t hinder anyone from holding leadership characteristics to be an informal leader. I am most looking forward to reconnecting with Mel and finding out how she has pursued other nursing leadership opportunities, the decision to leave bedside nursing and inquire about her MSN in Leadership program.
Author: rkryceski
Death with Dignity
- Discuss your preconceived thoughts and baseline knowledge of death with dignity. Include your initial thoughts, feelings, and viewpoints on the topic prior to completing the readings and watching the videos.
Death with dignity is a topic where I don’t know too much about the logistics of how it is done, however I am aware that it is only available in certain states and countries around the world. This is an option for someone with a terminal illness to be able to choose when they would like to end their life with the help of medical professionals before the disease process becomes unbearable or when they lose the ability to perform occupations throughout their day. I believe they need to go through a mental evaluation as part of the long process as well to see if they are doing this for a reason and to see if they have any underlying conditions that could hinder them from making a clear and sound choice. I value life, but I also see the value in allowing those that are terminal to have a say in their death and allow them to have it occur on their terms. I would feel uncomfortable right now with not having enough education on this topic (prior to readings and videos) to be a part of the process. I think that there is a possibility that I would support those that are interested in going through this process, but as of right now I am not interested in hospice or end of life care nursing.
How does death with dignity challenge your beliefs of the first ethical principle, nonmaleficence, or do no harm, which is directly tied to the nurse’s duty to protect the patient’s safety?
One detail that I am surprised to find in the Maine Death with Dignity Act was that the deciding person is a physician and doesn’t mention an NP being an example deciding person and able to prescribe the medications. I would hope in the future that this could change and have NP’s be an authoritative figure in this ethical matter. Death with dignity challenges my belief against nonmaleficence as it is an action that is ending someone’s life, however in the eyes of the patient it is not doing harm it is giving them the chance to end their life how they wish. As nurses we want to advocate and include patients in their own care plan and if we are in a state where there are laws that allow this process to take place then it is our duty to provide accurate and up-to-date information to them about this topic. We don’t need to voice our own opinion on the patient and tell them how we feel ethically, if we are employed by a practice where this is possible and could take place then we should just support them through it. Protecting their safety and promoting their health throughout treatment is what we can do through education and supporting all of their areas of wellness.
EBP 1
Course Description & Objectives
This course explores the philosophical and theoretical underpinnings that inform nursing knowledge relevant to the role of the baccalaureate-prepared nurse. Emphasis is placed on use of the best available evidence, clinical expertise, and patient preferences to improve healthcare quality.
At the completion of this course, the student will be able to:
- Apply knowledge from the art and science of nursing, the natural/behavioral sciences and humanities tonursing education, practice and research.
- Utilize theoretical frameworks as a basis for nursing and interprofessional practice, research, andeducation.
- Examine the assumptions and conceptual frameworks inherent in nursing’s core values that influencethe quality of health care for individuals and families.
- Demonstrate knowledge and skill in utilizing research evidence for nursing practice.
- Recognize the important leadership contributions that each nurse can make to implement EBP topromote quality and safety.
- Explore the use of theory and evidence based knowledge to guide a systematic approach to nursing care.
- Analyze and evaluate selected nursing theories for translation into practice, research and nursingeducation.
NSG 444
Course Description and Objectives
COURSE DESCRIPTION:
This course examines the intentional connection of concepts explored in nursing coursework and experiential activities. This active inquiry and engagement fosters the application of clinical judgement, interprofessional collaboration, and acquisition of leadership within professional practice.
COURSE OBJECTIVES:
Upon successful completion of this course, the student will be able to:
- Apply knowledge from the humanities, interprofessional education, andnatural/behavioral sciences in the provision of holistic nursing care.
- Apply principles of reflective practice, appreciative inquiry, and therapeuticcommunication across the spectrum of health in multiple settings/patient populations.
- Integrate the moral, ethical and legal elements inherent in the formation of professionalnursing values.
- Demonstrate the use of data and resources that impact health outcomes.
- Integrate principles of self-care that represent values inherent in the profession ofnursing.
- Apply concepts of nursing theory in the planning and evaluation of care for clients.
- Demonstrate evidence of clinical reasoning and clinical judgment in the plan of care forclients across the health spectrum and lifespan.
COVID-19 Contact Tracing
Reflect on what you learned from the John’s Hopkins University COVID-19 Contact Tracing Course. In a thoughtful, one- to two-paragraph post, describe ethical considerations around contact tracing, isolation, and quarantine. Describe some of the common barriers to contact tracing efforts as well as strategies to overcome them. How will you apply what you learned to your future nursing practice?
Completing the John’s Hopkins Contact Tracing course has allowed me to have a deeper understanding of new vocabulary and practices that are used in public health emergencies. To some the words of ‘isolation’ and ‘quarantine’ may mean the same, but this course has laid out the foundation to understand the concepts more. There can be many barriers when an individual is notified that they may be a close contact of an individual with an illness such as COVID-19. The different examples of contact tracer phone calls and zoom sessions showed a marked difference in how the individual felt after the call and if they felt like they were educated and supported in the phone call. Having more contact tracers in the community can allow for more people to keep safe and be notified in a timely fashion. When approaching each conversation with a potential contact or positive case, the top things I noted to remember are: tell them this is a private and confidential space, that you are there to support them and help them find resources and to have a calm and warm presence over the phone to make them feel valued. If an individual is receiving a phone call there is a high chance they are already under a great deal of stress so attempting to lessen the burden and help them in any way that you can is essential. I will apply these concepts of approaching patients in a caring manner and make each person feel valued during each interaction. I also now have a better understanding of the terms that are used and can help differentiate and provide up-to-date information for my patients.
EBP 1 Final Paper
Final EBP 1 Reflection
For my first experience completing an Evidence-Based nursing research project, I have learned a lot. As compared to previous research based classes I have been in, having a specific nursing lens on has allowed me to see how gaining knowledge on a specific area of research is very valuable to have and to educate my future patients on. It has been very helpful learning how to better navigate sites such as EBSCO and also learn about nursing research specific websites to utilize. I have enjoyed learning how nurses can play a key role in the research environment and help further investigate ways to improve current practices for the benefit of both the nurse and patient. To a potential employer, I would like them to know that I am still a beginner in the EBP research field, however, I am looking forward to further defining my skills and improving in EBP II next semester. I see how greatly practices can always be updated and followed in order to maintain safety and maximize health. I also enjoyed working in a team setting as I believe that our combined interest in the topic made it enjoyable to complete as well as we completed our project with no conflict and supported each other throughout. During this project, I learned that in my role as a team member I wanted to maximize my effort for the benefit of the group. I wanted to ensure that my work was completed to the best of my ability since it wasn’t just myself relying on a grade for the portion of the work that I completed. I also appreciated how timely we completed our assignments, often having them submitted at least a day prior to the due date.
Ethical Considerations for EBP
Prior to completing the ethics assignments, I wasn’t sure about much about the nurse’s role in ethics. I assume that nurses would want to be their patient’s best advocate in the entire process, so I’m curious if they would be more cautious with informed consent and weighing possible risks and benefits for them because of that. Since the nurse has arguably the most time at the bedside with the patient, they most likely would gather the most evidence if a project was implementing something in that setting. Prior to this class and watching videos from other chapters, I didn’t know that nurses were a part of the research role and could even come up with possible PICOT and ideas to better their facility and patient-care. I believe nurses will always keep their patient as their top priority and depending on the style of the study will need to be aware of maintaining confidentiality and respecting the research study and only providing what information the patient is allowed to know to them. Nurses could also answer any questions that the patients have throughout the process.
Completing these ethics assignments has broaden my view on how much of an impact nurse’s have to the ethical side of research. The most eye-opening was the movie Miss Evers’ Boys since that went into detail to the story of the Tuskegee experiment and the impact it had. The role of the nurse portrayed by the character Eunice rides the fine line between wanting to protect the nature of the study but yet provide accurate information on treatment to the patients some of whom are her friends. She was forced to withhold information from the patients about how this was still a worthwhile study to be a participant in even though Penicillin had already been found to be a valid treatment for Syphilis. This example shows how it may be difficult to treat certain patients, especially in this case when the morals of the study weren’t strong to begin with. Nurses should be aware of the history of ethics in order to self-reflect and analyze our own morals prior to possibly participating in a research study. With the many checkpoints now that research studies have to go through now there is a much slimmer chance for anything unethical like this to occur again. This course has introduced me to the basis of what nursing research is and what is possible to attain in my career. I will continue to gain knowledge in the next EBP course and get more confident in my research skills. I have enjoyed broadening my skills of using research engines through this course and learning how to make searches more specific.
Mental Health Simulation
Before this simulation day, I was somewhat nervous due to the fact that we had yet to have had experience in working with mental health patients in person due to our virtual simulation for this course. From my experience in undergrad with simulations with live actors, I knew very well that any plan made ahead of time with questions or a flow that you had envisioned was not going to go the way that you planned. This can be due to natural flow of conversation and the patient providing information at their own rate. One aspect that I was excited for was the fact that we were in groups as a part of an ACT team working with the mental health clients. This allowed us to bounce ideas off of each other and jump into the conversation when we had ideas and then let others voice their ideas. I wish that my group and I had more time to prepare together as a group for each of the clients rather than the short break in between patients.
Each patient brought unique challenges that I didn’t anticipate. Our first client was Carla who was experiencing a manic episode as part of her Bipolar disorder. This was particularly challenging for me because her outward energy was overwhelming for me and made me apprehensive to join in the conversation. When I did, she made comments to me about my appearance and how she liked my hair and others that made me uncomfortable and as a provider I wasn’t entirely sure on how to continue the conversation other than ignoring it. I wasn’t sure if I should acknowledge the comments or continue with asking questions. The second client of Paul made me feel more confident in the skills and tactics that I have learned through this course and felt as if I asked appropriate questions regarding his auditory hallucinations. The last client of Marnie and Borderline Personality Disorder was a unique case because she had a guard up very high and even made comments to us about how we were just asking questions off of a checklist. This was very apparent in our group as we had a very long awkward pause towards the end because we ran out of questions to ask her and personally, I avoided eye contact in that moment because I didn’t have anything to add to the conversation. This was a very good lesson to learn not to treat them like filling out a worksheet, they are a person with many dimensions, and we are there to get to know them in the moment and treat them like we would like to be treated as providers.
From this simulation, I learned that these interactions should be more of a fluid conversation rather than going down a checklist. This will come with time and practice and I think this was a great first practice. I learned that I need to have more experiences with mental health patients to gain more confidence in interacting with them because I am still apprehensive with knowing what the right things to say. I am grateful for this simulation day and for the great work of the standardized patient actors.
Appraisal and Synthesis Reflection
Completing the first draft of our synthesis paper and final assignments leading up to this has been a very smooth process working with Harrison. Both of us agreed that it wasn’t as time-consuming as we initially thought it would be to put together this draft. I can attribute this thought to the well-placed assignments that led up to this point, where I can see now all work together like puzzle pieces to give us the paper. When completing the evidence appraisal table, this allowed us to clearly lay out the major facts and pieces of information that we wanted to include in our synthesis. One thing that really stood out to me was that there was no clear answer in answering our PICOT question the way it was worded. This was based off of research that showed how infants that had a diet mostly of breast milk had lower fat mass only during a portion of the first year as compared to a diet mostly of cow’s milk formula having lower fat mass during the opposite time period in the twelve months. This makes me think that more research should done to have a mixture of diets and utilizing each during different months to have an overall low fat mass rather than the alternating lead in fat free mass. Also, another finding was that in one study that also included data about Soy Formula, that was the leader in fat-free mass as compared to the other two diets, this surprised me as I didn’t know this was an option for nutrition and more data should be completed among other alternatives. These findings will impact my future nursing practice as a hopeful labor and delivery nurse in supporting mother and parent’s decision for the diet of their child. I would advocate for breastfeeding for the beginning to aid in the mother-baby bond and then transition to using cow’s milk or soy formula. Yes, we both came to the same conclusions and I look forward to hearing his opinions on our findings.
