Topic 1 DQ 1: Describe how the role of advanced registered nurse transformed over time

Sample Answer for Topic 1 DQ 1: Describe how the role of advanced registered nurse transformed over time Included After Question

Topic 1 DQ 1  Describe how the role of advanced registered nurse transformed over time

Describe how the role of advanced registered nurse transformed over time. Consider shifts in scope and expectations in the 20th and 21st centuries. In what ways will the advanced registered nurse role and responsibilities continue to evolve and emerge as the American health care system changes?

 

A Sample Answer For the Assignment: Topic 1 DQ 1: Describe how the role of advanced registered nurse transformed over time

Title: Topic 1 DQ 1: Describe how the role of advanced registered nurse transformed over time

If I were to rate myself as a nurse in general, I would give myself a proficient rating. I have specialized in emergency medicine and pediatrics throughout my nursing career, so I have been lucky enough to become comfortable with a wide variety of medical issues and patient populations. I have been a nursing supervisor at a pediatric clinic for about a year now, and this has expanded my nursing knowledge tremendously as well. My past work experience has helped me to gain more of a holistic understanding and to be able to more accurately predict what the assessment and treatment may be for many different medical conditions. I believe that my background in nursing knowledge has given me a great stepping stone to enter graduate school.

However, if I were to rate myself regarding this class, and graduate school in general, I would give myself the rating of advanced beginner. Up until reading from our assigned textbooks for this class, I did not fully understand the roles and vast background of advanced registered nurses. For instance, when I thought of advanced registered nurses, I only thought of certified nurse practitioners and certified registered nurse anesthetists. Finding out how much I did not know about the field of advanced registered nurses makes me very excited to gain a further understanding throughout this class.

 

I have had the opportunity to work a long side many great advanced registered nurses, and I have learned many of their roles. A handful of my close friends have gone through similar schooling, so I have been able to gain minimal knowledge from their experiences as well. With that being said, I still have so much knowledge to learn, and I am very eager to dig deeper into the specific roles.

 

Unfortunately, I was not able to open the second link on this discussion, so I may be missing some information with my reply to this discussion post.

In my 7 years of Nursing experience, I have worked in Medical-surgical nursing, Telemetry, and now the Intensive Care Unit. According to Patricia E. Benner’s Novice to Expert theory, I would rate myself as proficient. I remember when I started as a new graduate nurse, I learned how to draw insulin in the syringe, inserted a foley and nasogastric tube, and understood the basic tasks as a Registered Nurse. As foreign graduate, we did not have many resources to have hands-on experience and our understanding of how to do things as a nurse is very limited. I was very task-oriented and was not looking at the bigger picture. I had a mentor and an educator who helped me grow and learn simple tasks. When I started telemetry, I was very comfortable in basic nursing tasks and started looking at the bigger picture, learning why and how the patient acquired the disease. I realized that’s when everything I learned in school and hands-on experience come along. Then I started working in the Cardiac Intensive Care unit, and that’s when everything came together. I started sharpening my critical thinking skills and learning more in-depth specializing in cardiac diseases. As a travel nurse, I get to experience all types of Intensive Care Units from Medical-Surgical ICU to Trauma ICU. I have so many things to learn and will continue to learn as much as I can. I was able to take my telemetry and Critical Care certifications as well as my cardiac certifications to test myself and grasp a better understanding of how to take care of my patients.

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 With the evolvement of the nursing profession’s versatility and adaptive capacity, new career pathways for nurses have developed , attracting a larger and more broadly talented applicant and leading roles to expanded scopes of practice and responsibilities for nurses. Nurses have been an enabling force for change in health care along many dimensions (Aiken et al., 2009) .The changing landscape of the health care system and the changing profile of the population require that the system undergo a fundamental shift to provide patient-centered care; deliver more primary as opposed to specialty care; deliver more care in the community rather than the acute care setting; provide seamless care; enable all health professionals to practice to the full extent of their education, training, and competencies; and foster inter-professional collaboration. Achieving such a change will enable the health care system to provide higher-quality care, reduce errors, and increase safety. Providing care in this way and in these areas taps traditional strengths of the nursing profession.

References:

AMA (American Medical Association). 2009. The AMA scope of practice data series: Nurse practitioners. Chicago, IL: AMA.

Safriet, B. J. 2010. Federal options for maximizing the value of advanced practice nurses in providing quality, cost-effective health care . Paper commissioned by the Committee on the RWJF Initiative on the Future of Nursing, at the IOM

I read through the objectives of each topic in the syllabus and found that I am not familiar with a lot of the topics that will be discussed in this course. I am looking forward to learning more and becoming more familiar with them.

I have been a nurse for 26 years now and have taken on different roles but I think graduate school will be very challenging for me given that I have not been in school since 1996 and that the program is online. On top of that, I also need to juggle work, family, and school. Here is how I rated myself for each topic:

Topic 1: Emerging Roles for Advanced Registered Nursing Specialties – Beginner (I am aware of the roles but not familiar with them)

Topic 2: Scope of Practice – Competent (As a manager, I have to constantly be updated with any changes in the scope of practice since healthcare is heavily regulated)

Topic 3: Diversity and Global Practice of Care – Competent (We have frequent training on diversity in the workplace)

Topic 4: Theory-Based Nursing Practice I – Advanced Beginner (I know the basics, but I need to review them)

Topic 5: Theory-Based Nursing Practice II – Advanced Beginner (I know the basics, but I need to review them)

Topic 6: Role of Research and Research Process for Advanced Registered Nurses – Beginner (Research is a newer topic for me)

Topic 7: Evidence-Based Practice Initiatives – Advanced Beginner (This is one of the more popular reference topics in the workplace)

Topic 8: Role Development for Advanced Practice Nurses -Beginner (I only know the basic information but I am not familiar with the topic)

After reviewing the syllabus, I would rate myself between competent and proficient in relation to the concepts that will be discussed. In my 14 years as a nurse, I have been lucky to have many great experiences.

I started out my career on a medical surgical telemetry inpatient unit. I remember many telling me that this was the best way to start my career. As a novice nurse, it would give me the opportunity to use all of the skills I had just learned in nursing school and it did. I grew to an advanced beginner on that unit, and I then transitioned to a more specialized unit that included a step down area with otolaryngology and plastic surgery patients with fresh skin flaps. During this time, I feel I grew to a proficient nurse in my five years there.

The next step in my nursing career took me to an ambulatory area taking care of pediatric ear, nose and throat patients. I feel I took a step back in the level of nursing care to advanced beginner. I was familiar with ear, nose and throat patients from my experience in the step down area, but now I was taking care of pediatric patients with very different needs. They did not need a skin flap due to laryngeal cancer. They needed ear tubes or tonsillectomies. I focused more on family care and educating pre and post op needs. I again moved back up the level of nursing care with time and became proficient again.

I then became an assistant nurse manager in the Head and Neck Institute ambulatory area. In this role I was also able to work with all of the subspecialties of otolaryngology including the areas of ear, sinus, cancer, voice, speech, plastic surgery, and pediatrics. It is in this role that I met a great mentor. I feel this is where I started to learn about many of the topics we will be discussing in the syllabus. For example, scope of practice was a focus for my manager and me. We wanted the nursing team to work to the top of scope. This would help the providers in clinic and also improve nursing engagement. One example of increasing the top of scope for our nurses on the unit was to teach them how to pull drains post op. In our area, this was a new skill. We worked with the nursing education team to develop a competency check of list and training plan. Once the nurses were competent, the patients were able to schedule a nurse visit to have the drain pulled.

I learned more about diversity and global perspectives of care and promoting health and disease prevention in this role also. I was on a team that worked on a care path for laryngeal cancer patients.

I also started learning more about research in my new role and became certified in the Collaborative Institutional Training Initiative (CITI Program).  There is a specialized continuous improvement program where I work that I had the opportunity of participating in. During this time I worked with my manager to develop a way to decrease equipment repair costs. We worked with our innovation team and developed a prototype. Equipment repair costs were decreased significantly. We had the amazing opportunity to present our findings at the American Academy of Otolaryngology conference in Atlanta, Georgia.

A topic in the syllabus that I am not as familiar with is Topic 8: Role Development for Advanced Practice Nurses. I do not have experience with professional nursing organizations, but I am excited to learn about this topic as well as expand on the other topics we will be discussing in the class.

 

Topic 1 DQ 1: Describe how the role of advanced registered nurse transformed over time Grading Rubric

Performance Category	100% or highest level of performance 100% 16 points	Very good or high level of performance 88% 14 points	Acceptable level of performance 81% 13 points	Inadequate demonstration of expectations 68% 11 points	Deficient level of performance 56% 9 points	Failing level of performance 55% or less 0 points
Total Points Possible= 50	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic topics.	Presentation of information was exceptional and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was good, but was superficial in places and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was minimally demonstrated in all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in one of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in two of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in three or more of the following elements Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Application of Course Knowledge Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations	Presentation of information was exceptional and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was good, but was superficial in places and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was minimally demonstrated in the all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in one of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from and scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in two of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in three of the following elements Applies principles, knowledge and information and scholarly resources to the required topic. Applies facts, principles or concepts learned scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.
	10 Points	9 Points			6 Points	0 Points
Interactive Dialogue Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic.	Demonstrated all of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 3 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.			Demonstrated 2 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 1 or less of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.
	8 Points	7 Points	6 Points	5 Points	4 Points	0 Points
Grammar, Syntax, APA Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error.	The following was present: 0-3 errors in APA format AND Responses have 0-3 grammatical, spelling or punctuation errors AND Writing style is generally clear, focused on topic,and facilitates communication.	The following was present: 4-6 errors in APA format. AND/OR Responses have 4-5 grammatical, spelling or punctuation errors AND/OR Writing style is somewhat focused on topic.	The following was present: 7-9 errors in APA format. AND/OR Responses have 6-7 grammatical, spelling or punctuation errors AND/OR Writing style is slightly focused on topic making discussion difficult to understand.	The following was present: 10- 12 errors in APA format AND/OR Responses have 8-9 grammatical, spelling and punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand.	The following was present: 13 – 15 errors in APA format AND/OR Responses have 8-10 grammatical, spelling or punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand. AND/OR The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.	The following was present: 16 to greater errors in APA format. AND/OR Responses have more than 10 grammatical, spelling or punctuation errors. AND/OR Writing style does not facilitate communication
	0 Points Deducted					5 Points Lost
Participation Requirements	Demonstrated the following: Initial, peer, and faculty postings were made on 3 separate days					Failed to demonstrate the following: Initial, peer, and faculty postings were made on 3 separate days
	0 Points Lost					5 Points Lost
Due Date Requirements	Demonstrated all of the following: The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.					Demonstrates one or less of the following. The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.