Case Study Of A Nurse Practitioner

The aim of this study is to provide a detailed account of the nursing care for a patient who is experiencing a breakdown in health. One aspect of their care will be discussed in relation to the nursing process. The model used to provide an individualised programme of care will be discussed and critically analysed.

1. The nurse is asked to implement a new, complex, and invasive procedure and is concerned that this may violate the state’s nurse practice act.

Hello, I am Angeline S. Bernard, licensed practical nurse, with Aetna’s utilization management department for long-term care. I am a 20 year veteran in the health care industry, primarily in the field of nursing, interested in pursuing a management role. With 15 years spent in the acute hospital environment, as a nurse, I have also practiced in other settings. School nursing, occupational nursing, quality management, and utilization management, are all additional areas of practice.

There are many professional practice issues that impact the role of the Family Nurse Practitioner (FNP). This occupation is continually changing and developing. There has been a recent increase in the demand for healthcare services. The growing shortage of primary healthcare providers has led to the need to utilize advanced practice nurses to fill in the gap in areas previously occupied by physicians. This has led to many issues impacting the profession including education, stress and burnout, and changing roles/scope of practice for the profession.

In today’s healthcare, challenging conditions are in a constant flux that calls for alternative solutions to provide the much necessary medical care to the aging population. Such is the case seen with the predicted lower numbers of newly graduated doctors going into primary care (Cassidy, 2012). The incorporation of Advanced Nurse Practitioners (ANP) into the primary care sector is an alternative that can assist fill this growing gap in primary care settings. Policies regulating the role of the ANPs occupation are in place to assure that the standards of care are maintained, and that safety practice are being executed in order to protect the public’s well being. Regulating agencies that control the role

It is very important for the Nurse Practitioner (NP) to know how the employer is billing for NP services. There are several different ways for the NP to get reimbursed for the services they render to their patients. The reimbursement method can get complicated, and the NP must be aware of the rules and regulations prior. For example, “Medicare will pay 85% of the physician rate for the services”(Bupper. C, 2011), when the NP renders service and bills by using their own NPI. However, if the NP is working with the physician, the NP can bill under the physician’s provider number, and acquire reimbursement at the full rate. This can get complicated because there are certain rules and regulations that would need to be followed. See below:

KR is a single 55 year old African American man providing primary care for his mother who’s health is abruptly declining due to dementia. Recently, KR has expressed the care of his mother requires excessive responsibility and the care has become burdensome. KR is susceptible to burnout if he is not able to cope with the caregiving requirements As a Family Nurse Practitioner (FNP), referrals for hospital and community based services, such as hospice or in-home care that are available to support KB and the care his mother should be prepared. Family caregivers frequently seek approval and support from health care professionals as they make decisions regarding the needs of their family member. It is imperative that family caregivers are aware of

The specialty area selected by this author among the Advanced Practice Registered Nurse (APRN) roles was that of the Family Nurse Practitioner (FNP). High among the list of reasons for choosing the FNP specialty track was the ability to care for patients who lack healthcare insurance, are of limited financial resources, or are stigmatized. The type of organization that would allow me to provide high-quality, patient-centered care in a manner consistent with my professional aspirations would be a Primary Care Organization (PCO). Being part of a PCO would allow me to implement clinical skills that are distinctive of the care provided by the FNP, such as to educate patients regarding management of chronic conditions as well as counseling on disease prevention and health promotion strategies. These skills would be provided in addition to the well-established responsibilities shared with other healthcare providers; such as performing examinations, making diagnoses, prescribing medications

As a new student, Mary must determine the direction of her nursing career. According to DeNisco and Barker (2013), there are four roles of an advanced nurse practitioner entail certified nurse midwife (CNM), clinical nurse specialist (CNS), certified registered nurse anesthetist (CRNA), and nurse practitioner (NP). Each role has different duties, responsibilities, and focus. The A CNM provides health care services for office visits, family planning, prenatal care, delivery, and postpartum care. CNSs are trained in a specific area of health care to include pediatrics, geriatrics,critical care, and the emergency department. CRNAs work in the operating room with the ability to care for surgical patients using pharmacological interventions. NPs diagnosis and treat, prescribe, and conduct exams. In order to decide which role is best for Mary, there is a need to examine the lists of pros and cons to delineate a method of comparison. This will help her make the right decision.

In my current role, I oversee one hundred forty to one hundred sixty patients. I have made it a practice to make a clinical coordination note any time I speak to patients, families, or if I need to return a message about a patient that I need to follow up. I plan to continue this practice as a Family Nurse Practitioner (FNP) therefore I would go to the patient’s medical record to see if I had made any notes on this patient’s chart. I would also review my other patient charts to make sure this has not happened before. If there was no documentation was noted in the patient's chart, I would take my concerns about Stephanie to the physician of the practice.

Respond to 11 questions to guide your description of the ethical challenge and prompt what you might say and do to make a values based decision. Follow the steps on the rubric to define the conflict, discuss what is at stake, define arguments you have to counter, and indicate responses that create a sound argument. The logistics of presenting your argument ask that you identify who, what time, allies, forum, communication style and support you will solicit when presenting your case.

The quality of care given by the advanced practice nurse (APN) is been assessed by the employers, patients, health care auditors, government quality improvement programs, peers, and researchers (Rhodes, Bechtle, & McNett. 2015). However, good quality is equated by different merits, for example; to an employer, good performance could be equated with high billings and Medicare may include a great performance in the Merit-Based Incentive payment system (MIPS) (Rhodes, Bechtle, & McNett. 2015. There could be some discrepancy with quality performance and cost measurement since the assessment of performance are not been evaluated equally, therefore setting a treatment code using a fee for service practice might be helpful (Rhodes,

Nurse practitioners evaluate, monitor, and diagnose patients. They are also able to prescribe pharmacologic and nonpharmacologic medications. They assess a patient by performing age-appropriate medical history and physical for illnesses (APRN, CCI Institute). Nurse Practitioners are able to assist in surgeries. They recommend different medical treatments. Facilitates patient's care: discharge, admits, and transfers. NP’s collaborate with other health care professionals and discuss orders in which need to be taken with their patients. A few employment characteristics would include:

Mary was seen today following a repeat chest x-ray, which reassuringly shows almost complete resolution of the effusion with just some mild pleural thickening seen in the right base, which is a reaction to the parapneumonic effusion.

assist in walking. In addition, there are now “smart” homes for frail elders. Smart homes are wired with sensors to detect motion and thus monitor safety of activities in the home, such as overuse of stoves and alert emergency services.” As the older team of nurses are ageing and becoming of retiring age, many are considering to retire thus others nurses of the new generation are entering into the workforce without the knowledge and experience that they could gain from the perspective of a seasoned nurse that has worked for many years nursing. A shortage of physician has been triggered due to the nurse shortage which would call for an increase in Nurse Practioners. The demand in healthcare would call for several specialists to increase in hospitals as well.