NURS 6341 Specialty in Clinical Nursing Essay Assignment Paper

NURS 6341 Specialty in Clinical Nursing Essay Assignment Paper Essay Help

NURS 6341 Specialty in Clinical Nursing Essay Assignment Paper

 NURS 6341 Entire Course Weekly Discussions And Assignments

NURS 6341 Discussion Response #2: Analyzing Patient Risk

Respond to the discussion #2 below using the following approach:

Offer and support an additional strategy a colleague might use to integrate the principle of stacking into his or her specialty of interest.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Ask a probing question, substantiated with additional background information, evidence, or research.
Discussion #2

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It has been more than 11 years that I have been working as a registered nurse, and yet, I can still remember exactly how I felt after the first time I got pulled to another unit.  I had been on my own about a month when I got pulled to the busiest med/surge unit in the hospital.  There is no schooling that prepares you for being pulled out of your element, and thrown into an environment where you feel clueless, helpless, intimidated, and scared.  I think I cried about 4 times that night, in between round-the-clock pain meds, Q 4 hours antibiotics, and numerous admissions.  I remember leaving the hospital the next morning, 2 hours late, and was faced with the aftermath of a blizzard.  As I left the building, up to my knees in snow, I headed to my car which I had parked on the street.  Physically getting to my car was no easy feat due to the snow.  Once I did get to the car and cleaned it off- I couldn’t get the car out of the spot and had to wait to be picked up.  Even though I could not wait to get home, and shut my mind off for a little while, none of what happened with the snow mattered.  In that time after leaving the hospital- nothing compared to the misery I had felt working that night.  It was a horrible, stressful, miserable experience that made me question my career choice over and over again.  I still remember to this day the overwhelming relief I felt as soon as I walked out of the hospital doors that morning.

The principle of stacking is the cognitive process, or mental to-do list that a nurse creates to promote good decision making and clinical judgments in order to provide and deliver safe, effective, and quality care to patients (Laureate Education, 2013). Effective ‘stacking’ and the ability to apply it to practice is a concept that is developed through clinical experience and actual provision of care (Ebright, 2010).  In my personal experience, the quality of care I delivered that night, as well as the safety of the patients could have been improved by stacking, or cognitively organizing and prioritizing what needed to get done.  As an advanced beginner, I mentally listed all of the tasks I had to do throughout my shift, constantly referencing my kardex as Dr. Ebright (2013) said I may.  Looking back, at the situation, a proficient or expert nurse would have been able to differentiate between what needed to get done, and what tasks were unnecessary- making the experience less stressful than it was.

A stacking strategy I feel may be helpful in managing the complexity of nursing practice in the ED would be routinization. Developing a routine while delivering care to patients can promote effective time management skills as the “repeated and integrated approach to routine situations” is successfully implemented (Kohtz, Gowda, & Guede, 2017, p. 18).  The advanced practice nurse in the ED setting could utilize routinization as a guide to deliver care in the fast-paced environment, while having the clinical experience and foundation of knowledge necessary to revise the routine if necessary.  Having clinical experience in the specialty field of ED nursing, as well as in the environment where care is being delivered is important in promoting positive patient outcomes.

References

Ebright, P. R. (2010). The complex work of RNs: Implications for healthy work environments. The Online Journal of Issues in Nursing, 15(1)

Laureate Education (Producer). (2013). Addressing complexity of nursing practice [Video file]. Retrieved from https://class.waldenu.edu.

Kohtz, C., Gowda, C., Guede, P. (2017). Cognitive stacking: Strategies for the busy RN. Nursing 2016, 47(1). Retrieved from: http://journals.lww.com/nursing/Citation/2017/01000/Cognitive_stacking_Strategies_for_the_busy_RN.7.aspx

Reminder:

1.    1 page only

2.    Put Citations in APA format and  at least 3 references… Articles must be 2011 to 2016.

Required Readings

Ebright, P. R. (2010). The complex work of RNs: Implications for healthy work environments. The Online Journal of Issues in Nursing, 15(1)

Retrieved from the Walden Library databases.

The author, an expert nurse, examines the meaning of “complexity” in nursing practice, how complexity impacts safety, quality, and retention, and considers recommendations and solutions for addressing complexity to reduce nursing stress and improve patient care.

Duffield, C., Diers, D., O’Brien-Pallas, L., Aisbett, C., Roche, M., King, M., & Aisbett, K. (2011). Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research, 24(4), 244–255.

Retrieved from the Walden Library databases.

This article details a study that links nurse staffing issues, increased workload, and unstable nursing unit environments with negative patient outcomes, including falls and medication errors, on medical/surgical units. As you read, compare the concept of nursing workload and nursing complexity and consider solutions in the Ebright article that might apply.

Required Media

Laureate Education (Producer). (2013). Addressing complexity of nursing practice [Video file]. Retrieved from https://class.waldenu.edu.

Note: The approximate length of this media piece is 8 minutes.

In this video segment, Dr. Pat Ebright and Dr. Mary Sitterding discuss complexities of nursing practice. Specifically, they highlight how the principle of stacking can help both novice and experienced nurses to make key workload decisions in the clinical environment.

Accessible player

Laureate Education (Producer). (2013). The role of the nurse educator [Video file]. Retrieved from https://class.waldenu.edu.

Note: The approximate length of this media piece is 9 minutes.

In this video segment, Dr. Pat Ebright and Dr. Mary Sitterding discuss the role of the nurse educator.

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NURS 6341 Week 4: Quality Indicators in the Specialty Areas

Recall Miriam, the graduate-level nurse from the Week 1 Discussion. After considering the clinical specialties available in her practicum setting, Miriam selected critical care as her specialty of interest. Given her strong passion for teaching new nurses, Miriam reasoned that critical care would deepen her own 3P knowledge. As Miriam entered her practicum, her priority was the same one that she intends to impress on her future students: to be fully versed on the quality indicators for nursing in her specialty area.

Like Miriam, your practicum experience in your specialty of interest will advance your knowledge as a nurse and nurse educator. To be prepared for clinical work in your specialty, the broad focus on Quality and Safety Education for Nurses (QSEN) from Week 3 now narrows to quality indicators in your specialty of interest. As you consider various quality indicators, you examine the difference between process indicators and patient outcome indicators, keep in mind that quality and safety in every aspect of nursing is always the goal.

Learning Objectives

Students will: Get NURS 6341 Specialty in Clinical Nursing Assignment Essay Help

• Analyze quality indicators specific to specialty areas of interest
• Evaluate the impact of specialty quality indicators on nursing knowledge and actions
• Evaluate the impact of physical assessment, pharmacology, and pathophysiology (3Ps) on quality indicators
• Evaluate a practicum experience in the context of quality*
• Analyze opportunities for integrating quality measures into health care educational settings*
• Construct a detailed practicum log**

* The Assignment related to this Learning Objective is introduced this week and submitted in Week 7.

** You continue working on the assignment related to this Learning Objective, first introduced in Week 1 and submitted in Week 7.

Discussion: Quality Indicators in Specialty Areas of Interest

As Miriam examined the quality indicators for nursing in critical care, she reflected on the reciprocal nature of quality indicators and 3P knowledge. For each indicator she assessed her own 3P knowledge and how it might impact the quality of her nursing practice. At the same time, she considered how quality indicators guide the knowledge she would apply in direct patient care. In the process, Miriam singled out particular quality indicators that she wanted to understand further or would want to emphasize with her future nursing students and/or staff.

For this Discussion, you examine quality indicators for your specialty of interest, sharing your conclusions and insights with colleagues.

To Prepare

• Research quality indicators that are specific to your specialty area of interest. For example, you might examine associations specific to your specialty such as the AACN, ASPAN, AORN, etc. You might also search the current literature for articles that inform your understanding of quality standards applicable to your specialty of interest.
• Based on your research, select one quality indicator to further investigate for this Discussion.
• Consider how this indicator impacts nursing knowledge and actions at the patient bedside, as well as how a nurse’s 3P knowledge impacts the indicator.

By Day 3

Post the quality indicator that you have selected. Explain how this indicator impacts your work as a nurse, as well as your actions at the bedside. Explain how the 3Ps might also impact the quality indicator. Support your response with current literature and APA references to the quality indicators.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

• Offer and support an additional quality indicator applicable to your colleague’s specialty of interest.
• Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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NURS 6341 Week 5: Introduction to the Specialty Focus

“Nurses in our study at the competent level were highly engaged nurses who sought daily to … continually improve their practice. It became clear to us that coaching from proficient to expert nurses would be highly beneficial to all nurses at the competent stage of clinical skill acquisition. It is at this point that they are ready to broaden their clinical imagination.”

—Benner, Tanner, & Chesla, 2009, p. 101

Think back to when you first learned that you would need to choose a clinical specialty for this practicum. What specialties of interest came to mind and why? How was your “clinical imagination” broadened by the opportunity to develop your expertise in a specialty area?

Although in previous weeks you have been addressing your specialty of interest in the context of universal nursing issues such as clinical judgment and quality and safety, this week you focus on how nurses within your specialty develop the particular expertise required for quality patient care. You investigate your specialty to expand your awareness of new advancements, best practices, and high-interest topics within this clinical arena.

Learning Objectives

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• Evaluate current topics as a means to facilitate clinical problem solving in specialties of interest
• Evaluate current topics for evidence of knowledge and application of physical assessment, pharmacology, and pathophysiology
• Evaluate the influence of current topics on nurses and nurse educators
• Analyze current research literature for applicability to specialty areas of interest*
• Evaluate a practicum experience in the context of quality**
• Analyze opportunities for integrating quality measures into the nursing classroom**
• Construct a detailed practicum log***

* The Assignment related to this Learning Objective is introduced this week and submitted in Week 6.

** You continue working on the Assignment related to this Learning Objective, first introduced in Week 4 and submitted in Week 7.

*** You continue working on the assignment related to this Learning Objective, first introduced in Week 1 and submitted in Week 7.

Discussion: Hot Topics in Specialty Areas of Interest

“‘A practice is not just a surface on which one can display instant virtuosity.’” 

—J. Dunne (Benner, Sutphen, Leonard, & Day, 2010, p. 177)

How do you gain expertise in any area of life? For example, if your personal passions outside of nursing include cooking or gardening, sports or music, how did you develop your knowledge or skill, and how do you maintain it? How does staying current on the latest trends and “hot topics” build your “virtuosity?”

As you focus on your specialty of interest, consider the importance of being “in the know” as a means of developing expertise. Whether examining technologies, medicines, processes, or techniques, it is imperative that nurse educators stay up-to-date with cutting-edge developments that are evolving to address clinical problems. In this Discussion, you explore a topic of significance and its implications for your specialty of interest.

To Prepare

• Investigate your practicum setting and/or current literature related to your specialty of interest to identify an advancement or development that is groundbreaking, controversial, and/or vital to nurses in this specialty of interest.
• Consider how this topic is impacting the health care field (i.e., clinical problems) and your work as a nurse. In addition, consider how this topic either builds upon or requires further knowledge of the 3Ps.
• Conduct research to locate two scholarly articles that support and expand your understanding of the topic.

By Day 3

Post a description of a “hot” topic in your specialty of interest. Explain the clinical problem that this topic helps to address as well as how it requires advanced knowledge and application of the 3Ps. Support your response with authentic observations from your practicum experience and by citing a minimum of two scholarly articles.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using the following approach:

• Explain how your colleague’s topic is impacting your current role as a nurse or future role as a nurse educator.

Assignment: Annotated Bibliography

Revisit Miriam, the graduate nurse whose specialty area is critical care. As Miriam’s practicum experience proceeds, she is increasingly interested in new technology and best practices in the care of acutely ill patients. Looking ahead to her work as a nurse educator, Miriam has begun researching scholarly articles on new developments in critical care. Her purpose is to both expand her own knowledge and create an annotated bibliography that she can share with her students.

In this Assignment, you gather information on advancements in your practicum specialty.

To Prepare

• Reflect on your specialty of interest and your practicum experience. What key topics, processes, best practices, advancements, and technologies have you seen or heard about?
• Search the Walden Library for articles on any or all of these dimensions. Keep in mind that your focus is on current developments and that articles you select should have been published within the last three years.

To Complete

• Create an annotated bibliography that consists of 10 scholarly, peer-reviewed articles.
• For each article:
  • Provide a brief summary (4–5 sentences).
  • Explain why this article is relevant (1–2 sentences).
  • Explain the application of the findings of the article to practice (1–2 sentences).

By Day 7 of Week 6

The Assignment, “Annotated Bibliography,” is due.

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NURS 6341 Week 6: Advancing Skills in Specialties of Interest

A common characteristic found in all great teachers is a love of their subject, an obvious satisfaction found in arousing this love in their students, and an ability to convince them that what they are being taught is deadly serious.

—J. Epstein

Think about what you see and what you note as you engage in clinical activities in your practicum setting. From your observations, how do the nurses who are regarded as “experts” provide quality care? In what ways do they bring both a telescopic and a wide-angle view of their patients and their specialty to their nursing practice?

This week you continue to advance your awareness in your specialty of interest by exploring how the physical, emotional, and social dimensions, also known as the “biopsychosocial science,” of illness and recovery are woven together in the application of highly skilled care. As a nurse with advanced knowledge, you reflect on how you negotiate these multiple dimensions and nuanced requirements, and as a nurse educator, how you will present or develop them in others.

Learning Objectives

Students will: Get NURS 6341 Specialty in Clinical Nursing Assignment Essay Help

• Analyze biopsychosocial strategies that improve patient care
• Analyze current research literature for applicability to specialty areas of interest
• Evaluate a practicum experience in the context of quality*
• Analyze opportunities for integrating quality measures into the nursing classroom*
• Construct a detailed practicum log**

* You continue working on the Assignment related to this Learning Objective, first introduced in Week 4 and submitted in Week 7.

** You continue working on the assignment related to this Learning Objective, first introduced in Week 1 and submitted in Week 7.

Discussion: Applying Biopsychosocial Science to Improve Patient Quality of Care

“We had a patient that was in the OR, and I’d gotten word that he had been … in the CCU beforehand, had a really poor heart….I was coming into work that evening and had received word that his family was sitting … in our waiting room. So I thought I’d go out and meet them.… They were like stressed to the max … [and] proceeded to tell me this whole story about what this poor man had gone through….[I]t was like they were just looking for this release valve and I gave it to them, and they seemed to appreciate that, and I think at that point we kind of clicked.”

—(Benner, Tanner, and Chesla, 2009, p. 142)

In this excerpt taken from your course text, the nurse describes her interactions with the patient’s family as a significant aspect of providing quality patient care. From her first interaction with both the family and the patient, she has an intuitive grasp of what is needed to calm the worries of the family as a system.

Consider examples such as these from your course text, practicum setting, and previous clinical experiences. Also reflect on your own experiences or observations of nurses engaged in patient care in which the larger impact on the family, or the community (the clinical staff or a broader group) was not as strongly considered or not acknowledged at all.

In this Discussion, you exchange views with your colleagues on the concept of quality patient care that is based on biopsychosocial knowledge.

To Prepare

• Review the article, “Biopsychosocial Model” and examples from the text reading that demonstrate its application. Reflect on your previous clinical experiences or those during your current practicum, and identify situations in which you used biopsychosocial knowledge when working with a patient.
• Reflect on your practicum experience through the lens of the biopsychosocial knowledge. How have you applied your advanced skill and knowledge when working with patients, families, or communities (clinical or others)? What specific biopsychosocial strategies have you used or could use to ensure or improve quality care in your practice?
• Conduct further research to locate evidence-based biopsychosocial strategies that improve quality care for patients, families, and communities.

By Day 3

Post an explanation of three biopsychosocial strategies* you use or may use to improve quality care for a patient, a family, and community. Explain how each strategy aids the individual/group by describing specific examples from your practicum and current literature.

* To meet the requirements of this Discussion, you must identify at least three strategies: one for the patient, one for the family, and one for the community.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one of the following approaches:

• Ask a probing question, substantiated with additional background information, evidence, or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Validate an idea with your own experience and additional research.

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NURS 6341 Week 7: Nursing Regulation

“Nursing regulation exists to protect the health, safety, and welfare of the public in their receipt of nursing services – and much more.”

—From National Council of State Boards of Nursing “Guiding Principles” (2007)

As nursing education, practice, and policy evolve, so must the laws and rules that govern the regulation of nursing.”

—From NCSBN Model Nursing Practice Act and Model Administrative Rules (2011, p. 1)

The quotes above spotlight the most publicized aspect of nursing regulation: the push for greater uniformity nationwide. Every practicing nurse must be familiar with the guiding purpose of nursing regulation and the specific language in the Nurse Practice Act that has jurisdiction over his/her work in a clinical setting. In particular, it is critical that nurse educators be well versed on nursing regulation and changes in nursing practice legislation. In addition, acquiring a clear understanding of the areas and levels of responsibility in the nursing hierarchy, particularly between advanced practice nurses (APN) and registered nurses (RN), is of high importance.

This week you focus on the broader topic of nursing regulation.

Learning Objectives

Students will:

• Analyze differences in skill sets between advance practice nurses and nurses with basic RN licensure in specific geographic locations
• Evaluate a practicum experience in the context of quality
• Analyze opportunities for integrating quality measures into the nursing classroom
• Construct a detailed practicum log

Discussion: Nurse Practice Acts

What licensure-required skills would you emphasize with aspiring RN students? What skill sets would you look for in an RN whose goal is to be a licensed APN? Recall the achievement of your most recent nursing degree or certificate. What are hallmark differences in your own skill sets as you acquire your master’s degree in nursing (MSN)?

In this Discussion, you consider differences in skill sets required of nurses at different levels of practice.

To Prepare

• Use this week’s Learning Resources, as well as your own research, to locate Nurse Practice Act(s) for your location (state, District of Columbia, or U.S. territory). If you live or work internationally, please select a U.S. location for the purposes of this Discussion.
• Examine the regulatory differences between nursing levels. For example, how do practice acts for advance practice nurses differ from nurses with basic RN licensure? Consider whether these differences can be seen in your practicum setting.
• Reflect on the responsibilities of RNs and APNs in your current practicum setting, as well as in previous clinical experiences, for differences in skill sets. Consider the role of nursing regulation in outlining the skills required of nurses at different levels of practice.

By Day 3

Post an analysis of the responsibilities of RNs and APNs as determined by a specific geographic location’s Nurse Practice Act. Through the lens of a nurse educator, note at least three differences in skill sets between advance practice nurses and nurses with basic RN licensure. Explain how these differences are exemplified in your practicum setting. Support your response with references to your geographic location’s Practice Act*.

* Provide APA citation for the practice act that you refer to in this Discussion.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one of the following approaches:

• Ask a probing question, substantiated with additional background information, evidence, or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Validate an idea with your own experience and additional research.

Assignment: Practicum Journal: Journal Entry 2

The second of your three narrative accounts of your practicum experience is due this week. Keep in mind that you will submit a total of three comprehensive journal entries by Week 11 of this course.

Journal Entry 2 (450–500 words)

• Describe a selected observed activity or situation (no more than half a page).
• Explain what you observed in the context of quality indicators in your specialty of interest.
• Explain at least one way you might integrate quality measures into an educational setting to advance the skills and knowledge of nursing students, staff, or patient populations. Support your response with specific observations from your practicum, quality indicators, and the current literature.
• Include APA-style citations and references.

By Day 7

The first entry for your Practicum Journal is due.

To complete

In your saved version of the NURS 6341 Practicum Time Log and Journal document (available in week one learning resources):

• Ensure that all the required information is included for Weeks 4-7, as indicated in the time log instructions including total hours, contact information, and objectives.
• Write a 450- to 500-word journal entry (identified as Journal Entry 1) in which you:
• Describe a selected observed activity or situation (no more than half a page).
• Explain what you observed in the context of quality indicators in your specialty of interest.
• Explain at least one way you might integrate quality measures into an educational setting to advance the skills and knowledge of nursing students, staff, or patient populations. Support your response with specific observations from your practicum, quality indicators, and the current literature.
• Include APA-style citations and references.

By Day 7

Your Practicum Journal document (including your first journal entry) is due. Remember that this is a continuous document that you will add to with each journal and log entry.

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NURS 6341 Week 8: Specialty Practice Standards

“The process of recognizing an area of practice as a nursing specialty allows the profession to formally identify subset areas of focused practice. A clear description of that specialty nursing practice assists the larger community of nurses, healthcare consumers, and others to gain familiarity and understanding of the nursing specialty…. As nurses focus their practice on new and different areas of healthcare, clear statements of the scope of specialty nursing practice and standards of specialty practice and professional performance help assure continued understanding and recognition of nursing’s diverse professional contributions.”

—American Nurses Association’s Recognition of a Nursing Specialty… Acknowledgement of Specialty Nursing Standards of Practice (2010, pp. 12 and 17)

Reflect on what you know about your specialty of interest and insights you have gained through your practicum experience. Is your specialty of interest well established or more recently developed? What are the levels of practice for nurses within the specialty? What standards of practice and professional performance guide and direct quality patient care within the specialty?

This week you reflect on your development as an advanced nurse educator as you share experiences from your practicum setting with your colleagues.

Learning Objectives

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• Evaluate the impact of practicum experiences on personal development as an advanced nurse educator
• Analyze specialties of interest for evidence of advance knowledge*
• Analyze professional standards as a means to develop advanced knowledge in a specialty of interest*
• Analyze the practicum experience for application of professional standards*
• Evaluate methods for integrating specialty practice standards into a teaching experience*
• Evaluate a practicum experience in the context of interprofessional collaboration**
• Analyze development of personal interprofessional collaboration competencies**
• Evaluate the impact of interprofessional collaboration on nurse educators**
• Construct a detailed practicum log***

* The Assignment related to this Learning Objective is introduced this week and due in Week 10.

** The Assignment related to this Learning Objective is introduced this week and submitted in Week 11.

*** You continue working on the assignment related to this Learning Objective, first introduced in Week 1 and submitted in Week 11.

Discussion: Sharing Experiences

“Learning to think like a nurse involves developing skill with narrative structures and narrative thinking….Reasoning across time involves the ability to construct a sensible story of immediate events, their sequence, and their consequences, in terms of illness trajectories and life concerns.”

—Benner, Sutphen, Leonard, and Day (2010, p. 225)

Every practicing nurse, regardless of years of experience, is always in the process of refining the ability to “think like a nurse.” Through your practicum, you are gaining clinical experience in your specialty of interest. Through your Practicum Journal, you are constructing narrative accounts that capture particular events indicative of the specialty area, with your reflections capturing the specific learning that advances your knowledge.

In this Discussion, you share examples from Journal Entry 2, which you submitted in Week 7, and exchange experiences, insights and perspectives with colleagues.

To Prepare

• Reflect on your second journal entry. How might the experiences outlined in your narrative contribute to your development as an advanced nurse educator?
• Select at least two highlights from your second journal entry to share with your colleagues. Consider what insights each of these convey about your specialty of interest and your practicum experience.

By Day 3

Post at least two highlights from your second journal entry. Explain how these contribute to your development as an advanced nurse educator. Support your posting with references to current literature.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

• Ask a probing question, substantiated with additional background information, evidence, or research.
• Validate an idea with your own experience and additional research.
• Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Assignment : Professional Standards in Specialty Areas of Interest

Recall Miriam, the master’s-level nurse who chose critical care for her practicum experience. The setting for her clinical experience is the Intensive Care Unit in the hospital that serves the rural area in which she lives. Within that setting, Miriam has observed and worked with patients with a variety of acute illnesses. She has begun to take a particular interest in oncology, motivated by an Advanced Oncology Certified Nurse (AOCN) at the hospital. Because the hospital is small and has only one ICU, Miriam has frequently observed the AOCN engaged in direct care of oncology patients and interaction with family members. Although Miriam’s goal is still to be a nurse educator, she is investigating oncology nursing as a future focus for her work, beginning with the professional standards for oncology nursing.

Consider in what ways your own practicum experience might be similar to Miriam’s. Have you begun to focus on a particular dimension of your specialty area of interest, or considered practitioners or patients within your practicum specialty as the audience that you would like to educate?

This Assignment furthers your investigation into your specialty of interest by further exploring professional standards that are evident in the day-to-day work within your practicum setting.

To Prepare: NURS 6341 Specialty in Clinical Nursing Assignment Essay

• Think about and observe the skills, knowledge, and actions of nurses in your practicum.
• Reflect on the Nurse Practice Acts (regulation and standardization) you explored in Week 7. In addition, consider the 3Ps and biopsychosocial sciences evident in your specialty of interest.
• Research the professional standards for your specialty of interest. You may choose your specialty of interest or an aspect of the specialty that has become your focus through the practicum.

Address the following in a 3- to 4-page paper

• Briefly explain how advanced knowledge is evident in your practicum setting. Support your response by citing specific references to practice standards and your practicum experience.
• Identify 2–3 professional standards that require knowledge of the 3Ps and biopsychosocial sciences. Support your answer with references to patient care in your specialty of interest.
• Explain how you are applying specialty practice standards in your specialty area of interest. Support your response with at least two specific examples.
• Explain how you might integrate professional standards into a teaching experience if you were educating nursing students, staff, or patients about a specific topic in this specialty of interest. Suggest at least one specific activity you might use.

By Day 7 of Week 10

Your Assignment, “Professional Standards in Specialty Areas of Interest,” is due.

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NURS 6341 Week 9: Complexity of Nursing Practice

“… [T]he RN must decide at a given moment between the following: stay with a patient who is alone, distraught, and anxious about a diagnosis; leave this patient to give a pain medication to a patient who called 15 minutes ago; check on the new graduate nurse who seems to be overwhelmed by her assignment; or prepare a room for a patient returning from the operating room…. [T]he patient who is distraught and anxious is threatening to refuse treatment and/or testing that is important for his plan of care; the patient who called for pain medication is scheduled for physical therapy and, if not medicated appropriately before the transporter comes, will not get full benefit of the session, and the nurse may be faulted in the weekly pain management audit; the new graduate is caring for patients who are stable but have the potential to ‘crash,’ and the RN wonders whether [she]…will be able to notice subtle signs of deterioration…; and the elderly patient whose surgery was risky and who has multiple co-morbidities…will need one-on-one monitoring for several hours.”

—From “The Complex Work of RNs: Implications for Healthy Work Environments” (Ebright, 2010)

Does it all sound familiar? Have you experienced or observed these complexities in clinical experiences or in the practicum setting? As a practicing nurse, what would you consider in prioritizing this set of tasks? As a nurse educator, how might you use this example with those you teach to examine the complexity of nursing practice and its impact on patient safety, staff retention, and ultimately, quality of care?

This week you explore the complexities that make nursing a highly demanding profession and consider how experienced nurses, such as the RN in this example, effectively manage the minute-by-minute organizing, prioritizing, and decision-making involved in maintaining patient safety and quality of care.

Learning Objectives

Students will: Get NURS 6341 Specialty in Clinical Nursing Assignment Essay Help

• Evaluate the principle of stacking as a means to improve quality of care and patient safety
• Analyze stacking strategies for managing complex nursing practices
• Analyze specialties of interest for evidence of advance knowledge*
• Analyze professional standards as a means to develop advanced knowledge in a specialty of interest*
• Analyze the practicum experience for application of professional standards*
• Evaluate methods for integrating specialty practice standards into a teaching experience*
• Evaluate practicum experiences in the context of interprofessional collaboration**
• Analyze personal development of interprofessional collaboration competencies**
• Evaluate the impact of interprofessional collaboration on nurse educators**
• Construct a detailed practicum log***

* You continue working on the Assignment related to this Learning Objective, first introduced in Week 8 and submitted in Week 10.

** You continue working on the Assignment related to this Learning Objective, first introduced in Week 8 and submitted in Week 11.

*** You continue working on the assignment related to this Learning Objective, first introduced in Week 1 and submitted in Week 11.

Discussion: Analyzing Patient Risk

“Through direct observation, interviews, and surveys, [researchers] Tucker and Spear identified a number of major categories of obstacles to nursing care, including physician orders, obtaining equipment and supplies, and staffing. These researchers reported that the average time nurses in this study spent at one task was 3.1 seconds and that nurses were interrupted mid-task eight times per shift.”

—From “The Complex Work of RNs: Implications for Healthy Work Environments” (Ebright, 2010)

What comes to mind as you consider the estimate of 3.1 seconds per task—and the multiple interruptions per shift? Even considering the likelihood of improvements in management of nursing tasks since the study year, how does this statistic speak to the inherent potential for mistakes and misjudgments?

It is recognized that nursing complexity and the stress that it generates can lead to medication errors, mislabeling of specimens, and procedural breakdowns. This week’s readings focus on strategies to address nursing complexity, including stacking, a strategy that nurses with advanced knowledge use to prioritize responsibilities and focus on quality of patient care.

To Prepare: NURS 6341 Specialty in Clinical Nursing Assignment Essay

• Review this week’s Learning Resources on nursing complexity and stacking.
• Review this week’s media, “Complexity of Nursing Practice.” Reflect on the insights and strategies shared by the Dr. Ebright and Dr. Sitterding.
• Locate current research articles that discuss complexity of nursing practice and stacking specific to your specialty of interest.
• Reflect on your practicum experience. Identify a situation in which the principle of stacking might have prevented an error, helped to decrease stress, or mitigated ambiguity/miscommunication for an individual nurse or group of nurses. If necessary, you may also select a situation from your past or current workplace or the current literature.
• Thinking broadly about your specialty area of interest, consider stacking as a means of addressing nursing complexity and improving quality care.

By Day 3

Post a brief description of the situation you selected. Explain how the principle of stacking might have improved the quality of care and/or safety of the patient(s). Then, explain a stacking strategy you might use to manage complexity of nursing practice in your specialty area of interest. Support your response by citing specific references to your practicum experience and current literature.

Note: With the exception of an example from a research article, maintain the privacy of those involved in your sample situation by changing the names of patient(s) and nurse(s).

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

• Offer and support an additional strategy a colleague might use to integrate the principle of stacking into his or her specialty of interest.
• Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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NURS 6341 Week 10: Interprofessional Collaboration

The strength of the team is each individual member. The strength of each member is the team.

—Phil Jackson, noted basketball coach

Team sports may be the ultimate authority on collaboration, as no game can be won without every member working together toward the mutual goal of success. However, this reflection by a professional basketball coach and former star player also speaks eloquently to the reciprocal nature of collaboration in the practice of health care.

The stakes in a clinical setting, of course, are far higher than those on any court, field, or diamond. A patient’s needs often go beyond one health care specialty, and health care “players” who work in concert collectively multiply their professional strengths. However, just as sports players must learn to function as a team, nurses and other health care professionals must develop the competencies for interprofessional collaboration.

Since Week 8, when you began your third Practicum Journal entry, you have been observing for evidence of interprofessional collaborative practice in your practicum setting. As you continue your focus this week, keep in mind the essential competencies for interprofessional collaboration, which were introduced in Week 8 and will be revisited this week.

Learning Objectives

Students will: Get NURS 6341 Specialty in Clinical Nursing Assignment Essay Help

• Analyze a practicum experience in the context of interprofessional collaboration
• Evaluate the impact of interprofessional collaboration on quality of care and patient safety
• Analyze specialties of interest for evidence of advance knowledge
• Analyze professional standards as a means to develop advanced knowledge in a specialty of interest
• Analyze the practicum experience for application of professional standards
• Evaluate methods for integrating specialty practice standards into a teaching experience
• Evaluate a practicum experience in the context of interprofessional collaboration *
• Analyze personal development of interprofessional collaboration competencies*
• Evaluate the impact of interprofessional collaboration on nurse educators*
• Construct a detailed practicum log**

* You continue working on the Assignment related to this Learning Objective, first introduced in Week 8 and submitted in Week 11.

** You continue working on the Assignment related to this Learning Objective, first introduced in Week 1 and submitted in Week 11.

Discussion: Sharing Practicum Experiences: Interprofessional Collaboration

[I]nterprofessional collaborative practice [is] key to the safe, high quality, accessible, patient-centered care desired by all.

—From “Core Competencies for Interprofessional Collaborative Practice: Report of an Expert Panel” (2011, p. i)

You may recall this quote from the introduction to your third journal entry assigned in Week 8. In light of your practicum experiences, how does this quote resonate with you? In this Discussion, you share your interprofessional collaborative experiences and exchange perspectives with colleagues.

To Prepare: NURS 6341 Specialty in Clinical Nursing Assignment Essay

• Reflect on the interprofessional collaboration that you have observed or in which you participated. For each situation, consider how collaboration among various professionals might have positively impacted the care given to the patient(s).
• Select one interprofessional collaborative situation as the focus for your Discussion posting. Consider the patient’s needs and how the situation benefitted from this collaboration.
• Review the four competencies for interprofessional collaboration. Reflect on the competency that is most relevant to your selected situation:
  • Values/ethics for interprofessional practice
  • Roles/responsibilities
  • Interprofessional communication
  • Teams and teamwork
• Consider insights you have gained through your practicum experience about interprofessional collaboration and the potential for improving patient safety and quality.

By Day 3

Post a description of the interprofessional collaborative practicum experience you selected and explain how this collaboration was beneficial to improving quality of care and patient safety. Then, explain one competency for Interprofessional collaboration that was particularly relevant to the situation.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

• Ask a probing question, substantiated with additional background information, evidence, or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Validate an idea with your own experience and additional research.

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NURS 6341 Week 11: The Cost of Health Care

… [F]or the first time, hospitals across the country will be paid for inpatient acute care services based on care quality, not just the quantity of the services they provide.

—From Fact Sheet on the Hospital Value-Based Purchasing Program (2011)

Throughout this course, the issue of patient safety and quality has repeatedly emerged. Increased emphasis on quality care through government-promoted efforts to control health care costs will likely have a direct impact on nursing practice. Performance on measures of clinical process of care and patient experiences are now sources of evaluation of hospitals and their staffs.

This week you consider the financial incentive to make significant improvements in patient quality of care.

Learning Objectives

Students will:

• Evaluate quality and safety measures that impact value-based purchasing
• Analyze nursing contributions towards the achievement of quality and safety measures
• Evaluate a practicum experience in the context of interprofessional collaboration
• Analyze personal development of interprofessional collaboration competencies
• Evaluate the impact of interprofessional collaboration on nurse educators
• Construct a detailed practicum log

Discussion: Managing Cost

Miriam, the advanced practice nurse preparing to be a nurse educator, is wrapping up her final clinical experience for her MSN program. In the last few weeks of her practicum in the Intensive Care Unit, Miriam has observed the influence of new clinical measures of care as the hospital transitions to the value-based purchasing program. Because many heart attack and acute pneumonia emergency cases are admitted to ICU, Miriam has attended both formal meetings and listened to informal discussions on how the measures relevant to these conditions in particular will impact critical care nurses and other staff, both in the Emergency Room and ICU. From her observations of the nursing staff, Miriam can see the significant role of nurses in meeting the measures for value-based care. Miriam is looking ahead to including understanding of value-based purchasing in her work as a nurse educator, helping future nurses recognize the win-win of managing costs and enhancing patient safety and quality of care.

As you consider Miriam’s experience in her practicum setting, reflect on your own experiences, noting how initiatives such as pay-for-performance and value-based purchasing are impacting your specialty of interest. In this Discussion, share your perspective on the role of advanced practice nurses in managing costs and enhancing quality care, based on evidence from your practicum experience and the Learning Resources.

To Prepare: NURS 6341 Specialty in Clinical Nursing Assignment Essay

• Review this week’s Learning Resources on the costs associated with health care. Specifically, examine the measures of value-based purchasing.
• Conduct research for additional resources on value-based purchasing applied to your specialty of interest to inform and support your Discussion posting.
• Reflect on your practicum experience. Which quality and safety measures might have the greatest impact on your practicum setting and/or specialty of interest? Why?
• Consider the actions and contributions of the nursing staff in your practicum setting. In what ways have you seen nurses—in particular, nurses with advanced knowledge—contribute to the measures outlined in the value-based purchasing program?
• Consider your perspective on the current role that nurses play in managing health care costs and promoting patient safety and quality of care, and how that role may grow or change through value-based purchasing and similar initiatives.

By Day 3

Post an explanation of how at least three quality and safety measures have a significant impact on value-based purchasing in your practicum setting. Then, explain how nurses with advanced knowledge are contributing toward the achievement of these measures. Justify your responses by citing examples specific to your practicum experience and current literature.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

• Ask a probing question, substantiated with additional background information, evidence, or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Validate an idea with your own experience and additional research.

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