discussion board

Note to writer: Please read student posts below, pick 2 out of the 4 posts and respond individually in 1 page each providing 2 peer reviewed articles for references for each post. Articles must be less than 5 years old. No cover pages required, thanks. Please use APA 7th edition referencing style.

 

Renay’s Post

 

Reflect on your past experiences in nursing and consider how the role change to NP may challenge your knowledge and skills.

     Reflecting on my previous experience with becoming a registered nurse I feel I know what aspects of role change that will most challenge my knowledge and skills. According to Stewart and DeNisco (2019) the most common issues may include “understanding the role of the NP, the expanded level of autonomy, leadership, clinical skills, and decision making” (p. 153). Knowing my personality and previous experience I feel I will be challenged by many of these issues. I tend to be quieter and like to observe individuals rather than speak up to give my opinion. I know as a nurse practitioner I will need to speak up and offer my opinion as to what I feel is the best treatment approach. I also like to collaborate with a treatment team and bounce ideas off one another. Depending on my clinical setting I know as a NP I will be challenged to become more autonomous regarding patient care.  When I began working on my current psychiatric unit, I struggled with becoming a leader and making decisions because I was a brand-new registered nurse. Compared to the rest of the treatment team I did not feel knowledgeable enough to be confident in my skills. I know when my role changes to NP I will struggle with this also due to feeling inept, however, just like my past experience as I have more patient interaction and experience I will feel more confident in my abilities to make decisions, delegate, resolve conflict, and act with integrity (Melnic Team, 2016, Four Areas for Leadership section).

Do you feel role change from an RN to NP will be a greater identity crisis than when you first became a licensed RN?

 

What strategies for using support in the clinical experiences are available?

     The clinical education is arguably one of the most exciting yet overwhelming experiences a NP student has. The American Association of Colleges of Nursing defines clinical practice experiences as “planned learning activities in nursing practice that allow students to understand, perform, and refine professional competencies at the appropriate program level” (2016, para. 1).  An NP student enters their first clinical experience as a novice with their previous nursing knowledge and information related to their new NP student role. “Overtime, the NP student’s thought processes mature, and their clinical reasoning expands to incorporate complex or vague information into their approach to patient care” (Pearson & Hensley, 2018, Clinical Learning section).

     Throughout a NP student’s educational experience there are a few people who they can lean on for support including themselves. These individuals would include NP faculty, the preceptor, and the student themself. A goal of the NP faculty is to be sure the NP student’s didactic knowledge is adequate. Some programs have clinical coordinators who can match students with the best suited clinical experience to meet their personality and needs. Another faculty member may include a clinical advisor. According to Stewart and DeNisco (2019) this individual “is the link for the student and preceptor” and may visit the student at the clinical site to be sure the student is progressing and gaining the knowledge they should (p. 151-152). These individuals can evaluate the students progress by direct observation either during a real patient discussion or using a simulation which may use actors as patients. During the visits, the faculty and student can have an open dialogue for any questions or concerns the student may be feeling (Stewart & DeNisco, 2019, p. 152).

     The next vital person in an NP students’ journey to becoming licensed is the preceptor during the clinical experience. “Preceptors must keep in mind that every NP student presents with theoretical understanding of subjects taught in didactic classes, their own unique history of clinical experiences, and an individual learning style” (Pearson & Hensley, 2018, Student-led methods section). The preceptor should be able to distinguish where a NP student is in their clinical education and assist and push them accordingly. Two of the most valuable things a preceptor can do for their student is to be an outstanding role model and demonstrate the use of evidence-based practice. A good preceptor should possess the knowledge of how to teach student through formal and informal methods. Most importantly the preceptor should have great communication skills, be empathetic, and consistent for the student to feel comfortable asking questions and voicing concerns (Stewart & DeNisco, 2019, p. 157).

     In addition to the NP faculty and preceptor the student also has immense responsibilities during the clinical experience. The student should always be professional and ask the appropriate questions to further their knowledge. The student should seek out learning opportunities and receive feedback graciously. Along with a licensed preceptor who enhances the students critical thinking abilities the student should utilize reflective journalism . This is a way the student can help facilitate role integration (Stewart & DeNisco, 2019, p. 156).

Who do you feel will be your biggest support through the clinical practice portion of this program and why?

References

American Association of Colleges of Nursing. (2016). CCNE Accreditation. https://www.aacnnursing.org/CCNE-Accreditation/Resources/FAQs/Clinical-Practice

Melnic Team. (2016). Think You Have What it Takes to Be a Great NP Leader? https://www.melnic.com/job-seekers/learning-center/well-being/leadership/np-leadership-skills/

Pearson, T., & Hensley, T. (2018). CEArticlePrint. Positive precepting: Identifying NP student learning levels and needshttps://www.nursingcenter.com/ce_articleprint?an=01741002-201902000-00009

Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.

 

Informational Form

Renay M. BSN, RN

 

 

Area of Concentration:

Aspiring psychiatric mental health nurse practitioner

 

Previous Work Experience:

Regarding my previous nursing experiences, I have held one job since obtaining my RN license. For the past four years I have worked as a charge nurse on a 10-bed inpatient adolescent psychiatric unit at Cincinnati Children’s Hospital & Medical Center. I have become comfortable with dealing with the care of adolescents who suffer from a variety of mental health illnesses. Some diagnosis that we deal with frequently are depression, borderline personality disorder, ADHD, disruptive mood dysregulation disorder, and psychosis. I am certified in TCI (Therapeutic Crisis Intervention) which means I have the knowledge on how to prevent and safely manage patients when they are escalating or in crisis. I feel I have grown to be calm in crisis situations, can correctly assess the situation, and perform the correct interventions needed in a timely manner. I have also worked in collaboration with the treatment team so each patient has a well-rounded team of individuals working to provide the best care possible so they can return to their daily routines as quick as possible.

 

Concerns Regarding Clinical:

I have a few concerns regarding my clinical experience. Due to the vast responsibility of a nurse practitioner I fear I will not be able to experience all the duties of a NP in a clinical setting due to time constraints which could lead to feeling ill prepared when I begin working autonomously. I also fear that I will not remember all the information taught didactically and I will become hard on myself for not being able to which will lead to anxiety and stress. I want to learn as much as possible without feeling too overwhelmed. Another concern I have is I will not be knowledgeable of all the uses, functions, and side effects of all the psychiatric drugs and will feel incompetent during my clinical experience. I tend to work best with individuals that have clear communication, makes expectations clear, and is approachable and not intimidating. I hope to enjoy my clinical experience at a facility that is open to students with many questions and be given the constructive feedback I need to be a successful NP. Although I do have some concerns regarding my clinical experience I am excited to start this part of my journey to becoming a psychiatric mental health nurse practitioner.

 

Rishi’s Post

 

Seminar Discussion Questions 1 & 2,

Question # 1- Reflecting on my past experiences in nursing and consider the changes to NP may challenge my knowledge and skills. One of the challenges that I will be facing as a new NP student is knowing how to make the right diagnosis with the right proper treatment. In my past nursing experiences working on the floor, I have worked with so many NP when I had to make a phone call to them for medical orders and treatment for my patients. Over time, I was familiar with what the NP would order for each and every disease process or prognosis. As an NP, my biggest fear is knowing how to make the right referral, consultations to another specialist, or transcribing a transfer order.     

Question # 2- That strategies for using support in the clinical experiences which are available to me are asking my preceptor for guidance and help. Asking another staff on board what is their input regarding this situation and looking at the policy and protocol for the procedure. “Providing students with early and extensive clinical experiences during their training is crucial.”  (Alhaqwi, 2015). According to Ali, his theory points out that every clinical student should put forth the time and effort to gain the experience they need as an NP.

References

Alhaqwi, A. L. (2015, March 01). Promoting excellence in teaching and learning in clinical education. Retrieved from Science Direct: https://www.sciencedirect.com/science/article/pii/S165836121500027X (Links to an external site.)

 

                                                                              One Page Requirement 

Rishi S

Northern Kentucky University

MSN- Psych Practitioner Program

Information Form for Nursing Preceptor

To Whom It May Concern,

            I want to introduce myself, I am Rishi Sharma, I been a nurse for the past four years and I am currently working on my MSN- Psych NP at Northern Kentucky University, located in Highland Heights, in Kentucky. I began my nursing career in 2013 at Galen College of Nursing, in Louisville, KY. I started off with my LPN, then went back for my RN and BSN Bridge Program at Galen. I been blessed though out my nursing career by working as a Float Nurse working almost all specialty units. The units I currently work on is; Float and Admission Nurse, Med Surge, Psychiatric, Long Term Rehab, ICU, Step Down, Orth-Surgery, Cardiac Step Down, Telemetry Unit, PCU and ER.

            Though my nursing career, I have been blessed to take care varieties of patients with many medical complication, not limited to; cardiac patients, Stepdown surgery patients, Patients who are intubated, and drips. I have worked with patient’s with 6-7 drips running at the same time and reason why I am writing this letter is to ask since I have worked in Psych settings before, I am hereby requesting to find a preceptor which I can work aside with for my clinical hours requirements. I am willing to share my information with you and I can be reached at …..

 

Thank you for taking your time to read this letter, I look forward hearing back from you soon.

 

 

Leandra,s post

1.    Reflect on your past experiences in nursing, and consider how the role change to NP may challenge your knowledge and skills.

          Stewart and DeNisco (2019) discuss how difficult and uncomfortable it can be for one to go from an experienced registered nurse (RN) to a novice nurse practitioner (NP). One may experience loss of confidence and professional identify (Barnes, 2015). I believe the role change to a NP will challenge how I assess and evaluate patient situations. For example, as an acute care RN, I am responsible for completing admission information and assessments on new patients. I then will report abnormal or concerning information to the doctor or NP. As the NP, however, I will need to use my medical knowledge to develop a care plan of action most appropriate for the patient. I will need to utilize additional knowledge learned to provide optimal care. This will involve critically thinking of how each potential intervention will impact the overall patient outcome. I will also be challenged by developing a different skill set. There are skills and training that are within the scope of practice of a NP that are not for a RN. For example, I will be able to order additional diagnostic tools that a RN would not be able to. I will need to understand and practice delegating certain tasks that I would normally complete as a RN, such as foley catheter placement or obtaining lab work. It will be challenging to transition my thinking from RN to NP, until I gain experience and build confidence in doing so (Stewart & DeNisco, 2019).

2.    What strategies for using support in the clinical experiences are available?

          There are many ways of obtaining support during the clinical experience. Prior to clinical placement, the facility takes steps to ensure the student will be successful (Stewart & DeNisco, 2019). These steps include clinical advisors and coordinators that can be used as resources. Obtaining their names and contact information (i.e. phone numbers, emails) would be important to ensure ability to utilize such resource. As the student, it would be beneficial to write down notes about each clinical experience. If a day was more challenging, exploring the events of that day with the preceptor or clinical instructor may provide insight into the given situation. The preceptor will be an ongoing resource during the clinical experience. One could establish time toward the end of each clinical day to debrief and discuss the day. Another going source of support will be the clinical instructor. The clinical instructor will not always be at the clinical site but will come to observe at different times (Stewart & DeNisco, 2019). Honest feedback and discussion during this time may provide additional support during the clinical experience. Farzi et al. (2018) describe how clinical experience helps guide the link between theory and practice. Utilizing my resources for support will aid in providing the most beneficial clinical experience possible.  

Do you have any fears when it comes to starting clinicals?

References

Barnes H. (2015). Exploring the factors that influence nurse practitioner role transition. The

           journal for nurse practitioners: JNP11(2), 178–183. https://doi.org/10.1016 (Links to an external site.)

          /j.nurpra.2014.11.004 (Links to an external site.)

 

Farzi, S., Shahriari, M., & Farzi, S. (2018). Exploring the challenges of clinical education in nursing

          and strategies to improve it: A qualitative study. Journal of education and health promotion7,

          115. https://doi.org/10.4103/jehp.jehp_169_17

 

Stewart, J. G., & DeNisco, S. M. (2019).  Role Development for the Nurse Practitioner, 2nd ed.

          Jones & Bartlett Learning.

 

One page letter to clinical faculty and preceptor:

 

Dear Clinical Faculty and Preceptor,

 

          I appreciate your willingness to precept a Psychiatric Mental Health Nurse Practitioner student from Northern Kentucky University. The guidance and knowledge displayed by you will provide me with essential components to aid in my transition from a Registered Nurse to an Advanced Practice Nurse. I value your time and expertise knowing this will only help in my growth as a future health care provider. I eagerly await our time together.

   

          I have worked as a registered nurse for two years. I currently work within a rural hospital on the acute care floor. I have work with medical-surgical, telemetry, intensive care, and pediatric patients. I have also worked in a long-term care facility as an agency nurse. This included working with rehab and dementia patients, with and without behaviors. My experience with patients ranges. I have worked with intubated patients on multiple intravenous medication drips, restraints, arterial/central lines, bladder thermometer etc. I have worked with patients recovering from a total joint replacements and other surgeries. I have also worked with patients experiencing acute illnesses and withdraw/detox, depression, anxiety, suicidal ideation, bipolar, schizophrenia, obsessive compulsive disorder, anorexia, attention deficit disorder, and post-traumatic stress disorder. I feel comfortable with all the different patient populations and situations I have worked in.     

 

          My biggest concern with beginning clinical is how to know what interventions or medications to start with for a patient. I believe there are so many options of where to begin treatment for someone. I fear not knowing where to begin. I am worried my treatment recommendations will not be effective and the patient will lose confidence in my medical knowledge. Another concern I have is not recognizing signs and symptoms due to not having a lot of psychiatric experience as a nurse. I have taken care of patients and family members with mental health diagnoses. However, I have not experienced an extreme of any mental health diagnoses. Those I have helped have been milder in severity.    

           

          I am excited to expand my knowledge and build upon my experience within the clinical setting. I know the textbook can only teach so much. I am eager to apply learned theories into the clinical setting. I am grateful to have your support and assistance during this time. If you have any advice or recommendations before beginning clinicals, please contact me by information provided below. Again, I want to thank you for the opportunity. I look forward to working with you.

 

Sincerely,

 

…. BSN, RN

PMHNP Concentration NKU

 

Jennifer,s Post

Reflect on your past experiences in nursing and consider how the role change to NP may challenge your knowledge and skills. 

Reflecting on my past experiences in nursing, I am rather proud of how much I have grown and how many fields I have been exposed too. In the last ten years, I went from my Associates Degree in Nursing (ADN), to my bachelor’s degree (BSN). When I first started, a Nurse Practitioner (NP) was never on my radar or in my bucket list of career goals. I started on a Neuro floor and then went to Labor and Delivery where a huge part of my passion will always be.  My husband went from a volunteer to a career fire fighter which lead me to home health for the flexibility. I did a short stent on a Cardiac floor before returning to Labor and Delivery.  My knowledge and skill set are the strongest in labor and delivery. Labor and Delivery may be my closet experience to mental health other than my own personal experiences.  Unfortunately, in Labor and Delivery we deal with fetal demise or the loss of an infant too often. However, I feel working in so many fields, I have gained a bit of insight from relating to patients from long term hospital admissions, to a few hours to bonding with them in their home. I have a broad scope of practice from the different fields. Reflecting on these past experiences, and considering my role change to NP, will certainly challenge my knowledge and skill set. As Stewart and DeNisco (2019), highlights the NP student has tremendous responsibilities with upcoming clinical experiences, and the RN to NP transition is often an uncomfortable one. As NP we are expected to correlate the medical knowledge we have acquired and apply it direct patient care. My ability to collaborate and often consultation and referrals will be taken to the next level.  

What strategies for using support in the clinical experiences are available?

Anyone who has been through a nursing program can attest to the stress of the program, with clinicals being no different. As students navigate through clinicals, peer support and personal mentoring have been noted as effective strategies to reduce stress and anxiety (George et al., 2020). With the support of senior nursing students in the role of mentors, beginning junior nursing students can be guided in patient care assignments within the clinical setting. This relationship fosters confidence as students communicate freely and ask questions without fear of reprisals from nursing instructors. Nursing students support each other in a student centered, non-threatening learning environment that minimizes the student’s anxieties when first entering unfamiliar clinical settings (George et al., 2020). The use of caring, competent clinical instructors, orientation to clinical sites, laboratory and simulation days, self-reflection, peer-support, and debriefing have also been beneficial strategies of support for clinical experiences (Roling et al., 2020).  

References 

George, T. P., DeCristofaro, C., & Murphy, P. F. (2020). Self-efficacy and concerns of nursing students regarding clinical experiences. Nurse Education Today90. https://doi-org.northernkentuckyuniversity.idm.oclc.org/10.1016/j.nedt.2020.104401 

Roling, G., Lutz, G., Edelhäuser, F., Hofmann, M., Valk-Draad, M. P., Wack, C., Haramati, A., Tauschel, D., & Scheffer, C. (2020). Empathy, well-being and stressful experiences in the clinical learning environment. Patient Education and Counselinghttps://doi.org/10.1016/j.pec.2020.04.025 (Links to an external site.)

Stewart, J. G., & DeNisco, S. M. (2019). Role Development for the Nurse Practitioner (2nd ed.). Burlington: Jones and Bartlett Learning. 

 

Information Form

Jennifer H

(859) ……..

Email:…..

PMHNP 

I have worked in various fields from Neuro, Home Health, Cardiac and primary Labor and Delivery. Labor and Delivery is my passion, where I interact with patients generally over a short time frame, but mainly in the most memorable times in their lives. My skill set and knowledge are strongest in this field. On the other end, Cardiac remains a great weakness. That is a specialty I have no strong desire to learn and therefore have never fully embraced or grasp the needed concepts. Neuro was of great interest and long-term care of patient allowed me to bond unlike any other specialty I have been in. My Neuro assessments remain strong and I still have great interest in that specialty. My greatest concern beginning clinical is first the unknown of many factors. The uncertainly of finding an amazing passionate preceptor. The unknown of where I will be and heading into the mental health field with no prior clinical experience, I feel I am possibly at a disadvantage.  

 

 

 

 

 

 

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discussion board

·         Module 3 Discussion

Note to Writer: Please read the 3 posts below, and comment on one in 1.5 but not more than 2 pages with references less than 5 years old. Use APA 7th edition format. No cover page needed. (agree, disagree, agree and disagree, and/or highlight points already discussed in the posts, thanks)

 

Kylee’s Post

Brusser and Joansy wanted to test the effectiveness of a new relaxation/biofeedback intervention on menopausal symptoms.  They invited women who presented themselves in an outpatient clinic with complaints of severe hot flashes to participate in the study of the experimental treatment.  These 50 women were asked to record, every day for 3 weeks before the intervention, the frequency and duration of their hot flashes.  The intervention involved five 1-hour sessions over a period of 1 week.  Then for 3 weeks after the treatment the women were asked to record their hot flashes again every day.   At the end of the study, Brusser and Joansy found that both the frequency and average duration of the hot flashes had been significantly reduced in this sample of 50 women.  They concluded that their intervention was an effective therapy in treating menopausal hot flashes.    

1. What is the independent variable in this study? 

          The independent variable â€“ or the intervention (Polit & Beck, 2020) – in the study is the five 1-hour sessions.  

2. What are the dependent variables in this study? 

          The dependent variables â€“ or the outcome (Polit & Beck, 2020) – in the study are the duration and frequency of the hot flashes the women experienced for the three weeks post the 1-hour sessions.  

3. Was there random assignment in this study? 

          There was no random assignment in this study as all 50 participants received the intervention. 

4. Is the design experimental, quasi-experimental, pre-experimental, or nonexperimental? 

          This design was quasi-experimental as it did not involve randomization but did include an intervention (Polit & Beck, 2020).  

5. What is the specific name of the design used in this study? 

          The specific name of the design is a time series design. Time series designs are used to show a before-after contrast. Time series designs institute an intervention and compare the outcomes from before the intervention to outcomes post-intervention a certain amount of time after (Polit & Beck, 2020). This design compares the hot flash frequency and duration of 50 women for three weeks prior to intervention to three weeks post intervention. Due to the time aspect and before-after comparison of this study, it allows for categorization of time series design. 

6. Is the study design within subjects or between subjects? 

          The study design is within subjects as it compares the women’s own hot flash experiences pre and post intervention. The focus is on the same participant at different times (Polit & Beck, 2020). It does not compare the women’s hot flashes to each other’s, only to their own prior experiences.  

7. Was there blinding in this study? 

          There was no blinding in this study as each participant received the intervention. There was no concealment of information as all participants understood they were receiving intervention, so blinding was not utilized (Polit & Beck, 2020). 

8. Provide at least one way in which this study could have been improved based on your chapter readings. 

          This experiment could have been improved with the utilization of blinding and multiple research groups. When blinding it utilized, it increases efficacy of the experiment. When participants are not aware if they are receiving the intervention, it minimizes the chance of “placebo effect” and does not impact the outcomes (Polit & Beck, 2020). The study could split the women into two groups of 25 women and give the five 1-hour sessions to only one group. The groups would be blinded to the intervention allowing for more accurate description of hot flashes and determination of efficacy of the intervention. This would allow for accurate comparison to determine if the intervention truly does help with hot flashes as one group would continue like normal and one would receive the intervention. 

 

Traina conducted a study to investigate the relationship between adults’ blood pressure and their suppression of anger.  Data were gathered from a sample of 347 healthy men and women aged 22 to 60 who were members of a gym in Washington DC.  Subjects completed two paper and pencil scales:  The Feeling of Anger Scale and the Expression of Anger Scale.  The scales used a 9-point rating scales.  Responses to each scale were summed to yield a total score for each variable.  The subjects’ BP was measured by nurses using zero calibrated aneroid sphygmomanometers.  Weight was measured with subjects wearing only gym shorts and a t-shirt on an upright scale to the nearest 10th of a pound.  Heights was measured without shoes, feet together.  All instruments were assessed at being below the eighth-grade level.  The results indicated for both men and women higher diastolic and systolic BP was associated with higher levels of suppressed anger even when various variables were statistically controlled. 

1. Which of the following types of data were collected in this study (self-report, observation, biophysiologic, records)? 

          This study collected biophysiologic measures or biomarkers. These biomarkers were objective and used in health research because of the availability of the equipment (Polit & Beck, 2020).  The biomarkers in this study were age, BP, weight, and height. The study also utilized self-report through the Feeling of Anger and Expression of Anger scales. These are self-reports as they allow for participants to share what they think and feel retrospectively (Polit & Beck, 2020). 

2. Were the data collection methods structured or unstructured? 

          The data collection methods were structured in this study. Structured data collection uses set questions and does not ask open-ended questions. This limits responses and allow for more comparable information gathering (Polit & Beck, 2020). The scales utilized in this study were 9-point rating scales, allowing for a limited response of numbers 1-9 without any open-ended response option. 

3. For which variables did Traina NOT derive numeric information? 

          While the 9-point scale used numeric ratings, these ratings symbolized levels of anger. This allowed for Traina to determine the level of suppressed anger each participant was feeling. This was not numeric data, but instead qualitative data that discussed the feelings of the participants (Polit & Beck, 2020). 

4. Which of the following specific methods were used (likert-type scale, semantic differential scale, event history calendar, rank-order questions, Q-sort)? 

          The specific method used is rating question. Rating questions ask a participant to choose how they feel about a certain statement or question. Their options are based on a scale that usually has two bipolar options at the lowest and highest options (i.e. strongly agree or strongly disagree). The scale typically uses an odd number so that there is a neutral midpoint (Polit & Beck, 2020). The anger scales used in this study are based on a 9-point rating scale. 

5. Which type of data collection was used: telephone interview, personal interview, web-based interview, or self-administered questionnaire? 

          A self-administered questionnaire was used in this study. Self-administered questionnaires eliminate interviewer bias which allows for more confidence in the study findings (Polit & Beck, 2020). The Feeling of Anger and Expression of Anger scales were completed at an individual level through paper and pencil. The researchers did not ask these questions and only had contact with participants when obtaining biophysiologic data, so no interview was completed.  

6. Was readability assessed?  At what level? 

          Readability was assessed in this study. Readability determines if the instruments used are culturally appropriate and fit the reading skill of the participants (Polit & Beck, 2020). Traina discussed in the study that all instruments were assessed and found to be below an eighth-grade level. 

7. Provide at least one way that data collection and measurement effort be improved in this study based on your readings. 

          The data collection could have been improved by utilizing a mixture of data collection sources. Conducting personal interviews with open-ended questions that elaborate on the specifics of the participants’ anger would eliminate any outliers for their level of anger. Another effort to improve this study would be using tools that are assessed at a lower level than seventh grade. The average American’s readability is a seventh to eighth-grade level (Marchand, 2017). This study’s tools are at an eighth-grade level which is the higher end of the average American. To ensure that all participants properly understand the tools, the study should aim to have a readability under that level.  

References

Marchland, L. (2017, March 22). What is readability and why should content editors 

          care about it? Center for Plain Language. https://centerforplainlanguage.org/what- (Links to an external site.) (Links to an external site.)

          is- (Links to an external site.) readability/#:~:text=The%20average%20American%20is%20considered,12%20to (Links to an external site.)

          %2014%20years%20old). (Links to an external site.)

Polit, D. F., & Beck, C. T. (2019). Nursing research: Generating and assessing evidence 

          for nursing practice (11th ed.). Lippincott, Williams & Wilkins. 

 

Ashley S

Discussion:

The focus of this assignment is for you to gain a better understanding how to analyze a quantitative research study.  This discussion board exercise introduces you to the various components of a critique and provides an opportunity for you to receive feedback prior to submitting your quantitative critique.

1.    Read this fictitious study and then answer the questions that follow:

Brusser and Joansy wanted to test the effectiveness of a new relaxation/biofeedback intervention on menopausal symptoms.  They invited women who presented themselves in an outpatient clinic with complaints of severe hot flashes to participate in the study of the experimental treatment.  These 50 women were asked to record, every day for 3 weeks before the intervention, the frequency and duration of their hot flashes.  The intervention involved five 1-hour sessions over a period of 1 week.  Then for 3 weeks after the treatment the women were asked to record their hot flashes again every day.   At the end of the study, Brusser and Joansy found that both the frequency and average duration of the hot flashes had been significantly reduced in this sample of 50 women.  They concluded that their intervention was an effective therapy in treating menopausal hot flashes.   

2.    What is the independent variable in this study?

The independent variable in this study is postmenopausal women with hot flashes.

3.    What are the dependent variables in this study?

The dependent variables are the frequency and duration of hot flashes.

4.    Was there random assignment in this study?

No. All 50 women were in an experimental group, there was no control group for random assignment.

5.    Is the design experimental, quasi-experimental, pre-experimental, or nonexperimental?

This design may be considered quasi-experimental because there was no random assignment to treatment (Polit & Beck, 2017). Some, but not all, quasi-experimental studies lack a control group; the hallmark of this design is an intervention without randomization (Polit & Beck, 2017). This study may also be considered pre-experimental. Pre-experimental research designs involve one group comparisons at two points in time; there are no control groups, just the treatment group, and they are evaluated with a pretest-posttest design method (Polit & Beck, 2017).

Experimental research requires random assignment and different treatment conditions (e.g. an intervention and placebo) (Polit & Beck, 2017).

Nonexperimental research does not introduce interventions (Polit & Beck, 2017).

6.    What is the specific name of the design used in this study?

This study used a one group pretest-posttest design.  

7.    Is the study design within subjects or between subjects?

This study design is within subjects.

8.    Was there blinding in this study?

No blinding is mentioned in the hypothetical research study.

9.    Provide at least one way in which this study could have been improved based on your chapter readings.

This study could have been improved several different ways. Researchers could have randomly assigned participants into an experimental group and a control group that does not have intervention; this would strengthen research validity (Polit & Beck, 2017). There is no mention of any blinding of research participants and researchers. There is also no mention of possible confounding variables that could be attributed to the reduction in hot flash frequency and duration.

 

 

o    Here is a brief summary of the data collection plan of a fictitious study.  Read the summary and then respond to the questions that follow.

Traina conducted a study to investigate the relationship between adults’ blood pressure and their suppression of anger.  Data were gathered from a sample of 347 healthy men and women aged 22 to 60 who were members of a gym in Washington DC.  Subjects completed two paper and pencil scales:  The Feeling of Anger Scale and the Expression of Anger Scale.  The scales used a 9 point rating scales.  Responses to each scale were summed to yield a total score for each variable.  The subjects’ BP was measured by nurses using zero calibrated aneroid sphygmomanometers.  Weight was measured with subjects wearing only gym shorts and a t-shirt on an upright scale to the nearest 10th of a pound.  Heights was measured without shoes, feet together.  All instruments were assessed at being below the eighth grade level.  The results indicated for both men and women higher diastolic and systolic BP was associated with higher levels of suppressed anger even when various variables were statistically controlled.

1.    Which of the following types of data were collected in this study (self-report, observation, biophysiologic, records)?

Self-report data collection involves direct verbal reporting from the study participant (Polit & Beck, 2017). Observation data collection is obtained by watching and recording participant behaviors or characteristics (Polit & Beck, 2017). Records data collection relies on hospital records, patient charts, etc. (Polit & Beck, 2017).

Biophysiologic measures, in vivo, are performed on living organisms and utilize many different variables, blood pressure being one such example (Polit & Beck, 2017). Many clinical studies rely on this method of data collection and it traditionally produces high quality data, and the data is objective (Polit & Beck, 2017).

2.    Were the data collection methods structured or unstructured?

Utilizing the 9-point stress scales is an example of a structured collection method (Polit & Beck, 2017).

3.    For which variables did Traina NOT derive numeric information?

 

4.    Which of the following specific methods were used (likert-type scale, semantic differential scale, event history calendar, rank-order questions, Q-sort)?

Lickert scales were used in this research study.

Semantic differential (SD) scales are a type of structured self-report that measure attitudes; they rank concepts (e.g. good/bad) (Polit & Beck, 2017).

Event history calendars are reflected by a data collection matrix that plots time on one axis and events or activities on the other (Polit & Beck, 2017).

Rank-order questions are a type of close ended question that request participants rank responses along a continuum (e.g. extremely unsatisfied to extremely satisfied)(Polit & Beck, 2017).

Q-sorts are another type of structured self-reports (Polit & Beck, 2017). Q-sorts deal with dimensions (e.g. most helpful/least helpful)) (Polit & Beck, 2017). Participants are giving comment cards and asked to sort them according to dimension (Polit & Beck, 2017).

5.    Which type of data collection was used: telephone interview, personal interview, web-based interview, or self-administered questionnaire?

This research study utilized self-administered questionnaires.

6.    Was readability assessed?  At what level?

Readability of materials was assessed and found to be below an eighth-grade level.

7.    Provide at least one way that data collection and measurement effort be improved in this study based on your readings.

Self-reports are subject to biases (Polit & Beck, 2017). Researchers can reduce potential for bias by pretesting rating scales prior to using them in the study (Polit & Beck, 2017). Preparation and training of observers (e.g. practice sessions) may also help reduce participant bias (Polit & Beck, 2017). Reducing the number of items on the Lickert scale may also be helpful to derive meaningful data (Dolnicar et al., 2011). 

 

 References

Dolnicar, S., Grun, B., Leisch, F. & Rossiter, J. (2011). Three good reasons not to use seven point Lickert items. [PDF document]. Retrieved from https://ro.uow.edu.au/commpapers/775/

Polit, D. & Beck, C. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Lippincott, Williams & Wilkins.

Kate’s post

1.Read this fictitious study and then answer the questions that follow:

Brusser and Joansy wanted to test the effectiveness of a new relaxation/biofeedback intervention on menopausal symptoms.  They invited women who presented themselves in an outpatient clinic with complaints of severe hot flashes to participate in the study of the experimental treatment.  These 50 women were asked to record, every day for 3 weeks before the intervention, the frequency and duration of their hot flashes.  The intervention involved five 1-hour sessions over a period of 1 week.  Then for 3 weeks after the treatment the women were asked to record their hot flashes again every day.   At the end of the study, Brusser and Joansy found that both the frequency and average duration of the hot flashes had been significantly reduced in this sample of 50 women.  They concluded that their intervention was an effective therapy in treating menopausal hot flashes.   

a.  What is the independent variable in this study?

The independent variable of this study is the relaxation/biofeedback treatment for menopausal symptoms. Polit and Beck (2017) define an independent variable as the variable that influences the dependent variable, and in research it is the treatment variable.

b.  What are the dependent variables in this study?

The dependent variable of this study is the menopausal symptoms, or hot flashes. The dependent variable is one that is hypothesized to be caused by the independent variable (Polit & Beck, 2017).

c.  Was there random assignment in this study?

There was no random assignment in this study. All of the women in the study were being treated in an outpatient clinic for hot flashes and all received the same treatment. Random assignment is when the participants of the study are assigned to treatment conditions at random (Polit & Beck, 2017).

d.  Is the design experimental, quasi-experimental, pre-experimental, or nonexperimental?

The design of this study is quasi-experimental. Quasi-experiment is a type of study design for an intervention study that study participants are not assigned to treatment conditions randomly (Polit & Beck, 2017).

e.  What is the specific name of the design used in this study?

 This particular study is a prepost comparison study, which is a quasi-experimental design with data that is collected before and after an intervention is introduced to the study participants and the findings are then compared (Handley et al., 2018).

f.  Is the study design within subjects or between subjects?

This study design is within subjects because it has a single group of participants that are compared under different points in time or different conditions (Polit & Beck, 2017). The participants in this study are compared before and after interventions to help with menopausal symptoms.

g.  Was there blinding in this study?

This was not a blinding study because the participants were not prevented from information about the study that may lead to bias (Polit & Beck, 2017). The participants in this study were aware of the interventions they were receiving for menopausal symptoms.

h.  Provide at least one way in which this study could have been improved based on your chapter readings.

This study could be improved if they had divided the participants into two separate groups and made one a control group and the other the experimental group. The control group would not receive the experimental intervention that the experimental group receives (Polit & Beck, 2017). This would help to make their research study finding more credible if they showed that the experimental group had significantly reduced frequency and duration of hot flashes compared to the control group. Making this change would make this study experimental in design because the researcher would control the independent variable by applying it to research participants randomly (Polit & Beck, 2017). An increased sample size would help to improve this study because it would be able to provide a better representation of menopausal women population (Polit & Beck, 2017). Another thing that could be done to improve the study would be to have blinding in the study so that there would not be potential for bias (Polit & Beck, 2017).

2.    Here is a brief summary of the data collection plan of a fictitious study.  Read the summary and then respond to the questions that follow.

Traina conducted a study to investigate the relationship between adults’ blood pressure and their suppression of anger.  Data were gathered from a sample of 347 healthy men and women aged 22 to 60 who were members of a gym in Washington DC.  Subjects completed two paper and pencil scales:  The Feeling of Anger Scale and the Expression of Anger Scale.  The scales used a 9 point rating scales.  Responses to each scale were summed to yield a total score for each variable.  The subjects’ BP was measured by nurses using zero calibrated aneroid sphygmomanometers.  Weight was measured with subjects wearing only gym shorts and a t-shirt on an upright scale to the nearest 10th of a pound.  Heights was measured without shoes, feet together.  All instruments were assessed at being below the eighth grade level.  The results indicated for both men and women higher diastolic and systolic BP was associated with higher levels of suppressed anger even when various variables were statistically controlled.

a.  Which of the following types of data were collected in this study (self-report, observation, biophysiologic, records)?

The types of data that were collected in this study were self-report and biophysiologic. Self-report is data collection that requires the participants of a study to provide a verbal report of information from them directly, it can be in the form of a questionnaire or interview (Polit & Beck, 2017). In the case of this study is was the collection of two scales that the participants filled out.  Biophysiologic data collection is data physical and physiological variable that are measured utilizing specialized equipment and technical equipment (Polit & Beck, 2017). Sphygmomanometers were used in this study to measure the subjects’ blood pressure, a standing scale to assess weight, and the subjects were measured to assess height.

b.  Were the data collection methods structured or unstructured?

Structured data collection is a data collection method that data is collected from study participants from either observations or self-reporting (Polit & Beck, 2017). Therefore, the data collection method In this study was structured. The participants filled out two scales: The Feeling of Anger Scale, and the Expression of Anger Scale.

c.  For which variables did Traina NOT derive numeric information?

The gender of the participants is a variable that does not derive numeric information for this study. nominal measurement does not have any quantitative significance and is the lowest level of measurement, examples of nominal measurement would be information like gender, hair color, marital status and occupation (Waltz et al., 2017).

d.  Which of the following specific methods were used (likert-type scale, semantic differential scale, event history calendar, rank-order questions, Q-sort)?

The specific method used for this study was the likert-type scale. Two scales with 9-point rating scales were completed by participants on feelings and expression of anger. This type of scale is traditionally used to measure attitudes that participants rate a set of items on a rating scale from their agreement or disagreement (Polit & Beck, 2017).

e. Which type of data collection was used: telephone interview, personal interview, web-based interview, or self-administered questionnaire?

The type of data collection that was utilized by this study was self-administered questionnaire. The participants completed two scales in pencil and paper format that were provided by the researchers.  

f.  Was readability assessed?  At what level?

Yes, readability was assessed with all instruments and they were below an eighth grade reading level. Readability is assessed to ensure that materials can be read by people with a wide variety of reading skills (Polit & Beck, 2017).

g.  Provide at least one way that data collection and measurement effort be improved in this study based on your readings.

One way that this study could be improved is with the use of an electronic or digital sphygmomanometer instead of the aneroid version so that there is less likelihood of misinterpretation from the person collecting the blood pressures. Training the data collectors not only on how to take appropriate blood pressures but also measuring height and weight appropriately and the same with each participant will help to ensure adequate information collected (Polit & Beck, 2017). Also, if they provided the nominal numbers for gender and compare it to the statistical data it may be possible to look at correlations between genders regarding anger and blood pressure along with age, height, and weight (Polit & Beck, 2017). This study like the previous one could improve with a larger sample size. It would decrease the potential for sampling error and be more representative of the population (Polit & Beck, 2017).

References

Handley, M. A., Lyles, C. L., McMulloch, C., & Cattamanchi, A. (2018). Selecting and improving quasi-experimental designs in effectiveness and implementation research. Annual Review of Public Health, 39, p. 5-25. https://doi.org/10.1146/annurev-publhealth-040617-014128 (Links to an external site.)

Polit, P. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice, (10th ed.). Philadelphia, PA: Wolters Kluwer

Waltz, C. F., Strickland, O. L., & Lenz, E. R. (2017). Measurement Theories and Frameworks. Measurement in nursing and health research, (5th ed.).New York, NY: Springer Publishing Company. https://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=1288050&site=eds-live (Links to an external site.).

 

 

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discussion board

Kylee’s post

1. Choose one of the conceptual models in your assigned reading in your Alligood text and answer the following questions:  a.  Name of the conceptual model; b.  Core concepts of the model; c.  Describe a nursing situation in which the model could be applied; and d.  Describe how you would apply your chosen model to the nursing situation to facilitate a process improvement. 

Conceptual Model and Core Concepts

          Neuman’s systems model is an example of a conceptual model. The core concepts of the model include â€œwholistic approach, open system, environment, client system, normal line of defence, health, stressors, degree of reaction, prevention as intervention, and reconstitution” (Alligood, 2018, p. 232). These core concepts work together to create Neuman’s ideal that nursing should focus on the whole person and should be focused on all aspects of that person’s life. Perception of the nurse also plays into the care that nurse gives the patient. Due to this, perceptions of both the nurse and the patient must be looked at and understood. Neuman also believed that wellness comes from the sum of the person’s needs being met, and that the environments (internal, external, and crated) can influence that wellness (Alligood, 2018). 

Nursing Situation for Neuman’s Model

          A nursing situation that would work well if following Neuman’s systems model is treating a patient with depression. For patients to improve with a mental health diagnosis, they must be treated holistically. The mental health condition will not improve if focusing solely on the physiological aspects of care – Neuman believed treatment should revolve around the patient as a whole (Alligood, 2018) and in this case would address physiological symptoms, environment causing the depression to worsen, mental health instability, and the patient’s perception of themself and their care. BaÅŸoÄŸul and BuldukoÄŸlu (2020) found that when utilizing the Neuman’s systems model for psychoeducation for those with depression, patients felt improved self-esteem (the perception aspect), decreased levels of depression (mental aspect), and encouragement to find other forms of treatment such as social support groups.  

Application for Process Improvement with Nursing 

          The Neuman system model can be utilized further within this situation to look at the perception of nurses to ensure quality nursing care for these patients. Mental health is attached to a stigma and nurses can feel uncomfortable treating those with severe symptoms. If the Neuman model was utilized to allow nurses to understand their own perceptions, it would help them overcome this stigma and provide the best treatment for these patients. The environment of the patient is also a large part of Neuman’s theory and could be utilized to help these patients. Helping the patient recognize a toxic environment that they are living in (external) or have developed within themself (created) that is hindering their care may allow them to leave that environment. Especially with regards to created environment, if a patient is stuck in a negative thought environment, it can hold them back from getting better as it utilizes denial and influences how the patient perceives their wellness (Alligood, 2018). Depression is widespread and can be predisposed to those with low self-esteem (BaÅŸoÄŸul & BuldukoÄŸlu, 2020), so if nurses are able to utilize Neuman’s system model and help these patients out of that recurrent thought process, they may be able to see their live and their self worth at a higher level, helping decrease the level of depression they are experiencing. 

2. Choose a borrowed theory from either your Polit and Beck text or the literature which could be applied to a nursing research article.  Answer the following items:  a.  Name the theory and the non-nursing discipline from which it comes; b.  Identify 3-4 of the core concepts of the theory; and c.  Explain why this theory might be a good fit from which to develop a nursing research study.  

Borrowed Theory and Concepts

          Bandura’s Social Cognitive Theory is a borrowed theory that is based in psychology and sociology (Polit & Beck, 2019). Bandura (1997) believed that self-efficacy forms people’s behaviors. This self-efficacy is created through mental events and thought processes that determine factors. The first factor, verbal persuasion, believes that if a significant person expresses realistic confidence in a person’s actions, that person will work harder to achieve goals and sustain changes even in times of self-doubt. The second factor, mastery experience, is regarded as the highest determination of self-efficacy – if a person has successful experiences, he is more likely to continue working toward achieving a goal and overcoming obstacles. However, if a person experiences failure, he is more likely to give up in difficult times as he will not believe he can overcome the hardships he is facing (Bandura, 1997). 

          A third factor, vicarious experience, relies more on the experiences of others as it shows a person that if others can achieve a goal, so can he. If a person sees someone similar achieving success, he will be more likely to work toward and complete that same goal as it seems attainable. The last factor, physiological or affective cues, work to signify an experience as positive or negative. If a person has negative cues, such as anxiety or pain, when working to achieve a goal, that person will be more likely to abandon the work as it creates negative experiences. However, if the person feels glee and excitement when working toward a goal, that will create a positive experience and make him work harder to achieve the result. Positive cues will lead to stronger self-efficacy (Bandura, 1997).  

Bandura’s Fit in Nursing

          This theory is a good fit for nursing research as it creates a basis for understanding patient behavior and what motivates them in terms of increasing self-efficacy. If a nurse can motivate a patient to stick to his plan of care by verbally persuading him that he can do it, the patient may be more likely to adhere to the medical advice. If a person is working in a group setting and sees the successes of those around him, he would also gain the self-efficacy needed to work harder to achieve his health goals. Knowing this, nurses could recommend treatment plans that encourage support groups or group PT/OT to help the patient improve. A nurse could also help to create experiences that would provide mastery of care of the illness the patient has such as educating through medication administration or inhaler usage until the patient has no more questions and can perform independently. These ideas created by Bandura can be used by nurses to change patient behaviors when it comes to their health condition and inspire high self-efficacy and self-care (Polit & Beck, 2019). 

3. Your assigned readings this week introduces you to the ways of knowing in nursing written by Barbara Carper.  This is a seminal work in nursing.    Answer the following items:   a.  List the 4 patterns of knowing according to Barbara Carper; b.  Provide an example from your practice for each of the 4 patterns; and c.  What are your thoughts about the pertinence of these patterns in nursing today?  

Carper’s Patterns       

         The four patterns of knowing by Barbara Carper are â€œ(1) empirics, the science of nursing; (2) esthetics, the art of nursing; (3) the component of a personal knowledge in nursing; and (4) ethics, the component of moral knowledge in nursing,” (Carper, p. 23, 1978).  

Pattern Examples and Pertinence Today

           Empirics plays into nursing by showing that continued knowledge and development of theory and law is critical in ensuring that nursing continues to be recognized as a science (Carper, 1978). Cincinnati Children’s Hospital utilizes this thought by creating an accessible place to develop theory and practice changes through scientific research. This writer completed a six-month development course that centered around nursing research and creating theory based on findings. After the research was completed, the findings were brought to directors and created practice change within the unit that helped better the nurses’ experiences on that unit. These practice changes help further nursing as a science by creating a standard to be followed that improved a process already created. It is pertinent that this pattern continues in nursing future as it presents new perspectives (Carper, 1978). Without these new perspectives, nursing practice and science would not advance and would create the best outcomes and experiences for patients or staff. 

          Esthetics is created on the ideal that nursing as an art is just as important as nursing as a science. The art of nursing consists of nurses’ ability to perceive the needs of the patient through subjectives and feelings instead of empirical knowledge and creatively treat those needs to best fit the patient (Carper, 1978). Working within pediatrics esthetics is critical in ensuring the best care for the patient. Pediatric patients are unable to express their discomfort through words like adult patients, so having the ability to perceive their feelings through their actions is extremely important. When it comes to treatment with pediatric patients, standard interventions do not work as they scare the patients since they do not understand what is going on – a nurse must have the ability to sense this and come up with creative ways to perform these interventions such as explain an IV flush as “giving the arm a drink.” These esthetic aspects of nursing are part of this writer’s everyday practice. Continuing to utilize esthetics in nursing is pertinent to ensure that patients are treated in a way that takes feelings and subjective experiences of the patient into context and treats the needs of the patient (Carper, 1978). Without this, patients, especially in pediatrics, would not achieve best outcomes as their needs would not be met in a way that helps them feel safe and addresses their feelings and subjective thoughts. 

          Personal knowledge in nursing is based in understanding interpersonal relationships and not seeing the patient as just an object â€“ it is important to create a relationship with the patient as a person rather than just a patient. The quality of these interactions and relationships can influence the patient’s coping and becoming well (Carper, 1978). This writer’s practice is rooted in creating these positive relationships with patients and families which allows for a trusting environment between the writer and the patient that produces openness between the care team and influences the outcome in a positive way. In one example, a chronic patient that had been doubted by all other care team members on the severity of her pain created a relationship with this writer and had an open conversation that gave her the confidence to express herself to the care team and create a change in plan of care allowing her to achieve adequate pain control leading to discharge later that week. This relationship led to the patient coping with her diagnosis and pain and becoming well at a quicker rate. It is pertinent to have adequate personal knowledge in nursing because it creates wholeness (Carper, 1978) without these interpersonal relationships, patients may not receive a more in-depth level of care that focuses on more than physiological symptoms.  

          Ethics in nursing revolves around the obligation of nurses to serve people while continuing to respect human life through that service. Nurses must attempt to stop suffering and promote health through actions that avoid being perceived as wrong (Carper, 1978). A large ethical dilemma in pediatric nursing falls within the NICU setting – parents sometimes make decisions about their child’s long-term plan of care such as traching or not withdrawing care on those with no brain activity without understanding the effects and how it will or will not improve the baby’s quality of life. This writer experiences this quite often when parents do not agree to a trach when their child will not be able to live without one – the ethical aspect of nursing requires that a nurse helps serve the parents by providing education to them regarding trachs and ensuring they understand all options completely prior to making a life-altering decision. Using ethics is important in ensuring that the most responsible actions are being taken in the treatment of the patient. Nurses are held accountable for ensuring that the patient and family have all knowledge prior to creating a decision so they can make the morally “right” choice (Carper, 1978). Without ethics, patients and families may not be provided with the resources needed to make informed, responsible decisions. 

4. There are multiple learning theories as you read in the Zhou & Brown chapter. Answer the following items:  a.  Choose and identify the name of one of the learning theories from the assigned reading of Zhou & Brown and b.  Develop a step-by-step program to decrease the frequency of medical mistakes in a healthcare practice setting.  Cite the principles or key concepts from your chosen learning theory that back each step of the program you develop.   

Learning Theory

          The Psychosocial Theory of Identity Development is a theory developed by Erikson. This theory believes that learning occurs in stages that build upon earlier stage completion; however completion of a later stage is not dependent on mastering an earlier stage. Each stage has two sides that compete to shape the future of the person, i.e. an infant will leave that stage of life with either trust or mistrust which can focus the outcome of the remainder of the stages (Zhou & Brown, 2015).  

Step by Step Program

          Step 1: Admit people who are determined to provide quality care and focused on the field of nursing to college programs; help them to find jobs within the healthcare field to gain experience prior to completing college program â€“ Erikson believes that those who are in the adolescence stage thrive on finding identity. If they can identify themselves as a nurse who will provide quality patient care and make decisions that will help them ensure that identity, they will be more focused on school and learning the correct practice skills creating a solid foundation for nursing practice. This will show them how they fit into society through their occupation (Zhou & Brown, 2015). 

          Step 2: Help nursing students find post-grad careers in a field of nursing they enjoy and want to work in; help the new grad nurse work through the transition years to nursing practice by supporting them through decisions and teaching them through mistakes – Erikson’s stage of adolescence encompasses young adults up to the age of 25. Identity formation takes a longer time because people are still learning the skills necessary to perform their adult tasks (Zhou & Brown, 2015). Since this is a time focused on learning, helping a nurse through the difficult transition to nursing practice and teaching them the assessment and intervention skills needed to be a high-quality nurse is crucial at this time. If nurses can be taught the correct way to perform any nursing intervention and supported through their development during this time, they will have less chance to make a mistake due to lack of knowledge or confidence. Their identity will be strong, and they will not doubt themselves when it comes to their practice as a nurse. 

          Step 3: Continue education and support for “senior” nurses; support promotion to charge roles or clinical advancement of bedside nurses; identify positive practice outcomes based on senior nursing practice – Erikson’s theory discusses that around 40 years old, a person needs to feel they are making a difference and contributing to the future (Zhou & Brown, 2015). If a more senior nurse stops feeling support or like they are making a difference in their role, they will be less inclined to follow policy and procedure or learn new practice changes which could lead to mistakes. Ensuring that a senior nurse feels like they are positively changing the outcome for future nurses or their patients ensures that they will put their best effort forward to continue doing such great work. When nurses work on bettering themselves and their work, they are more focused on doing the right thing and not making mistakes that could harm their reputation or lose the position they hold. 

References

Alligood, M. (2018). Nursing Theorists and their Work (9th ed.). Elsevier Inc.

Bandura, A. (1997). Self-Efficacy: The Exercise of Control. Macmillan.

BaÅŸoÄŸul, C., & BuldukoÄŸlu, K. (2020). Neuman Systems Model With Depressed  Patients:

          A Randomized Controlled Trial. Nursing Science Quarterly33(2), 148–158.  

          https://doi.org/10.1177/0894318419898172 (Links to an external site.)

Carper, B. A. (1978). Fundamental Patterns of Knowing in Nursing. Aspen Publishers.

Polit, D. F., & Beck, C. T. (2019). Nursing research: Generating and assessing evidence 

         for nursing practice (11th ed.). Lippincott, Williams & Wilkins. 

Zhou, M. and Brown, D. (2015). Educational Learning Theories: 2nd Edition.  Education

          Open Textbooks.  

 

·      Carrie’s Post

 

1.   I choose Dorothea Orem’s Self-Care Deficit Theory of Nursing.  The act of assisting others in the provision and management of self care to maintain or improve  human functioning at home.  The core concepts of this model are a combination of four theories:  self-care, dependent-care, self-care deficit, and nursing systems.  There are eight entities included; self-care (dependent-care), self-care agency (dependent-care agency), therapeutic self-care demand, self-care deficit, nursing agency, and nursing system (Alligood, 2018).   An example of using this theory in nursing practice would be a person living at home begins to show signs of a psychiatric illness.  He lives at home but is no longer taking care of his basic needs such as hygiene and eating.  Family takes him to the hospital and nurses begin working with him to get him to engage.  Use of different therapy sessions and teaching, doctors can get him on medication to help him maintain a normalcy so he can return home.  This often happens with new diagnosed psych  patients or those who go off their medications and are admitted to the hospital for a seventy-two hour hold.  

2.  A borrowed theory example would be Bandura’s Social Cognitive Theory.  This theory is borrowed from the psychology discipline.  The core concepts of this theory are self-observation, self-evaluation, self-reaction, and self-efficacy (Polit, 2020). These all have an effect of motivation and goal attainment.  Examples where the  use of this theory in nursing would be useful are with smoking cessation and weight loss.  

3.  The four patterns of knowing according to Barbara Carper are empirics, esthetics, the component of a personal knowledge, and ethics.  Empirics is the formal description, the science behind it.  We gain this through research.  Esthetics is the appreciation or the art.  Think of this as your “aha” moment.   Empathy is an example of this.  The personal knowledge is actualizing of the individual self.  How you as a nurse view yourself and the patient.  We gain this through observation.   Ethics is your moral code.  This is our sense of knowing right and wrong.  You have to have an understanding of different positions (Carper, 1978).   I feel these are still used in today’s nursing.  They have changed with the times but the core remains the same.

4.  The Experiential Learning Theory by Kolb explains why learners approach learning experiences in different ways but are still able to flourish (Zhou, 2017).  Some learners are just stronger learners than others and may pick up knowledge at a faster pace.   Kolp talks about one taking an internship to help build their knowledge and  skills.  In nursing a new nurse hired to a unit will work with a preceptor for an extended amount of time.  The preceptor will help the new hire learn nursing skills used on that unit from IV’s to equipment to charting for that specific unit.  Once the new nurse has a strong base they will be released to act and take on patients on their own. 

Alligood, M.R. (2018). Nursing theorist and their work (9th ed.). Elsevier Health Sciences.

Polit, D.F., & Beck, C.T. (2019). Nursing research: Generating and assessing evidence for nursing practice      (11th ed.). Lippincott, Williams, & Wilkins.

Zhou, M.Y. & Brown, D. (Eds). (2017). Educational learning theories.  Retrieved from https//: oer.galileo.usg.edu/education-textbooks.

 

 Kathie’ post

   1.) Choose one of the conceptual models in your assigned reading in your Alligood text and answer the following questions:  a.  Name of the conceptual model; Orem’s Self-Care Deficit Theory of Nursing. b.  Core concepts of the model; Self-Care, Dependent-Care, Self-Care Requisites, Universal Self-Care Requisites, Developmental Self-Care Requisites, Health Deviation Self-Care Requisites, Therapeutic Self-Care Demand, Dependent-Care Demand, Self-Care Agency, Self-Care Deficit, Dependent-Care Deficit, Nursing Agency, Nursing Design, Nursing Systems, Nursing Methods, and Basic Conditioning Factors (Martha Raile Alligood et al., 2017) . c.  Describe a nursing situation in which the model could be applied, this model can be applied to any nursing situation in any setting where a patient or client is unable to care for themselves. Or in a home setting where a loved one is being cared for by a caregiver. As an Intensive Care Unit (ICU) nurse I could use this theory for a patient receiving Targeted Temperature Management Post-Myocardial Infarction.  and d.  Describe how you would apply your chosen model to the nursing situation to facilitate a process improvement. I could use this theory to encourage early mobilization to decrease risk of pressure ulcers.

   2.) Choose a borrowed theory from either your Polit and Beck text or the literature which could be applied to a nursing research article.  Answer the following items:  a.  Name the theory and the non-nursing discipline from which it comes, The Transtheoretical (Stages of Change) Model. Is a biopsychosocial model. b.  Identify 3-4 of the core concepts of the theory, Precontemplation, Contemplation, Preparation, Action, and Maintenance and c.  Explain why this theory might be a good fit from which to develop a nursing research study. The Transtheoretical (Stages of Change) Model is a great fit for a research study because it can be incorporated into various conceptual frameworks such as Smoking Cessation, Drug Addiction and Recovery, Nutrition and Weight Loss Management Strategies.

   3.)  Your assigned readings this week introduces you to the ways of knowing in nursing written by Barbara Carper.  This is a seminal work in nursing.    Answer the following items:   a.  List the 4 patterns of knowing according to Barbara Carper: The four patterns of knowing according to Barbara Carper are: Empirics, Esthetics, The Components of a Personal Knowing in Nursing, & Ethics (Carper, 1978).   b.  Provide an example from your practice for each of the 4 patterns: Evidence-based practice is used every day in my unit to ensure best outcomes for our patients. One example is the use of bar-code scanning of the patients and medication to ensure that medication errors minimized. I make it a priority to connect with my patients so that I can understand who they are and what they need as individuals, so that the care I provide is not task oriented, but person oriented. The knowledge I have obtained is not instinctual knowledge but knowledge that has been obtained over years of studying not just at the academic level but also at the clinical level. I know what I know due to the experiences I have shared with my patients, my colleagues, and my collaborators. As with any profession we are governed by a code of ethics. It is within this code that we are bound to practice. It can be very difficult when our moral compass and the code of ethics are at odds with each other. As an ICU nurse I have seen this many time over. In end-of-life situations especially. I have said many times that just because we can extend life, does not mean that we should. Modern medicine is miraculous in many ways, however at what point do we say that enough is enough? Ethically, morally we as nurses have stated to do no harm, to do good on behalf of our patients. There are times when the “care” that we provide is in contradiction to those very things. and c.  What are your thoughts about the pertinence of these patterns in nursing today? Evidence-based practice is the standard for most of your larger teaching facilities. The esthetics of nursing seems to be fading from the bedside, especially in medical-surgical units and emergency departments due to a more task-oriented approach as well as the patient to nurse ratios. The component of personal knowledge may also be fading in those same units for the very reasons mentioned above. The ethical and moral aspects of nursing seem to be still as evident as ever in practice. Ethics committees still function and are just as active if not more so than ever before. I recently saw an article about a COVID-19 patient with disabilities in New York City who was taken off life support with out the consent of the family because the physicians felt that this man had no “quality of life”. This has caused quite a controversy as who are we as providers to say what a person’s “quality of life” is like without knowing that person. It is becoming national news.

  4.)   There are multiple learning theories as you read in the Zhou & Brown chapter. Answer the following items:  a.  Choose and identify the name of one of the learning theories from the assigned reading of Zhou & Brown I have chosen Classical Conditioning developed by Ivan Pavlov and b.  Develop a step-by-step program to decrease the frequency of medical mistakes in a healthcare practice setting.  Cite the principles or key concepts from your chosen learning theory that back each step of the program you develop. To decrease the incidence to medication errors nurses must have a barcode administration scanning percentage of at least 98% every month. To ensure that this is occurring every time they scan the patient’s armband, medication, and their badge in the appropriate sequence the computer will signal they have completed the task correctly. The signal is showing the nurse that this is the behavior we want to see. If they do not do this in the correct sequence the computer will show an error message and they will have to repeat the process until done correctly. Showing the nurse this is not the behavior we want to see. To ensure that there are no mistakes and the patient is not only the correct patient, but that they are receiving the correct medication at the correct time, via the appropriate route, the correct dosage, and the correct documentation is occurring. The nurse obviously wants to see that she is doing a good job, she does not want to injure her patients. She is going to continue to do the correct process (Carper, 1978).

References

Carper, B. A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science1(1), 13–24. https://doi.org/10.1097/00012272-197810000-00004 (Links to an external site.)

Martha Raile Alligood, Berbiglia, V. A., & Banfield, B. (2017). Self-Care Deficit Theory of Nursing. In Nursing theorists and their work (9th ed., pp. 198–212). Elsevier.

 

Note to writer

Please read the above student posts and respond to ONLY one.  Agree or disagree OR do both for the points highlighted and explained by student. Use APA 7th ed. and 1-2 sources NOT more than 5 years old, thank you. Post should not exceed 2 pages (preferably 1.5 pages).

 

 

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Discussion Board 2

Reply to your classmates. In your reply, compare and contrast the peer response to yours, introduce new questions, and/or present new information. Reply should be 200 to 400 words

Please see attached file below in which to respond to.

FYI.  No need for first page, this is a response to a discussion board

Thanks.

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