The Death Of A Nurse Practitioner

The Physician Assistant (PA) and Nurse Practitioner (NP) career fields were the medical fields’ response to the physician shortage that began in the 1960s, but the shortage still exists today. As the population continues to grow, the gap continues to grow as well. Medical schools were having a hard time producing as many doctors that were needed to fill in the gaps in a timely manner, leaving the medical field looking for ways they could have health care providers diagnose and treat patients, but educated in half the time of a doctor. The PA program was then born out of the military. Medical doctors watched as military doctors and medics came back, but they had no formal training except for on-the-job training. The NP program was derived from previous midwifery program. Currently, as the physician shortage is still impending more and more PAs and NPs are being hired to fill in the gaps. This is causing many questions to arise: Are they qualified?, What kind of education do they have?, and Should I feel safe?. Patients want to know that they are getting excellent care, and that their medical providers are qualified to diagnose and treat patients accurately.

I am a recent baccalaureate graduate of Charleston Southern University. I received my Bachelor of Science in Nursing in May of 2015. On June 20, 2015, I received my NCLEX-RN results and became a registered nurse in the state of South Carolina. After considering my options for a graduate program, I happily accepted my offer from Case Western Reserve University and moved to Cleveland to pursue my graduate studies. Over the course of my undergraduate career, theories were included in the curriculum but not in depth. It is for this reason that I am excited to partake in this course – to learn the foundational and applicable theories of the nursing profession.

Loretta Ford, is commonly known as the pioneer of the nurse practitioner role. The NP role was shaped by Ford, in collaboration with pediatrician Henry K. Silver in 1965, in response to the need for providers for well-child care, in community based settings (Zaccagnini & Waud White, 2017). Though many texts, Zaccagnini included, cite a physician shortage as the impetus for the creation of the role, Ford herself disputes the emphasis on this shortage, as one of several “myths” many of which continue to influence the NP movement (Towers, 2011). This creates a view of NPs as “physician extenders” or substitutes for physicians, and diminishes the role of the NP (Sullivan-Marx et al., 2007). The creation of the NP was in conjunction with nursing leadership, who were focused on creating graduate nurses for clinical specialization (Towers, 2011). The lack of providers simply created an opportunistic environment for nurses to reclaim the role that public health nurses had historically held, focusing on wellness, health promotion and disease prevention (Zaccagnini & Waud White, 2017). The first NPs were certified in the area of pediatrics, but soon began to develop focus on other populations, such as whole families, gerontology, women’s health, or psychiatry.

Jonathan is a 63-year-old man, born on August 23rd, 1956 and lives with his eldest son. He was married two times and has three children, two children from his first marriage and one from his second. He lives in northern Ontario but originally was from southern Ontario, he moved here shortly following his second divorce. He is of Italian decent and is a practicing Catholic. The patient’s weight is 95 kilograms; he is 178 centimeters tall and has a body mass index (BMI) of 28.3. Jonathan says he smokes around one pack of cigarettes a day, does not exercise enough and eats fast food a few times a week. The patient now has congestive heart failure as a consequence of his myocardial infarction (MI) or heart attack. He was transferred from another hospital in the beginning of November and was waiting for more tests to be completed before he could be discharged. Jonathan has some known comorbidities that can exacerbate his CHF, this includes smoking, obesity, and noncompliance with medications.

Healthcare workers in the United States work together to provide the best possible care for patients that come into their facility. Patients go through different waves of health care professionals before seeing an actual physician. Healthcare systems use a nurse practitioner, which is a registered nurse with more education and specialization, to help treat a patient in a timely manner. According to the American Academy of Nurse Practitioners, NPs have been providing care to patients for over 45 years. The year 2011 has seen 140,000 practicing nurse practitioners in the United States alone, with 9,000 more expected to enter the work force (American Academy of Nurse Practitioners a, 2010). With statistics demonstrating great expectations of

In order to practice as a Nurse Practitioner (NP) in Indiana you must hold a state registered nursing license complete a master 's program with certain course requirements. According to NursingLicensure.com (n.d.) there are two educational options leading to Advanced Practice Nurse (APN) recognition in Indiana: obtain a master 's degree or higher in nursing, or obtain a bachelor 's degree in nursing plus national certification. There is not a specific application to become a NP unless you are also pursuing prescriptive authority. Most laws in Indiana focus on regulating practice of nurse practitioners center around prescribing.

The role of nurse practitioner is valuable when discussing collaborative care. There are so many levels of care, so many health entities, and so many insurer criteria involved that it is instrumental to have a role that can work towards help bring all aspects together. In addition to diagnosing, treating, and managing care, the role of the nurse practitioner is to manage simple and episodic acute health issues along with chronic disease (Sangster-Gormley, Martin-Misener, & Burge, 2013). It is important to note that although this is a function of this role, nurse practitioners also practice from a holistic point of view which allows them to help manage patient conditions or wellness in a more complete fashion. This includes helping patients have access to care beyond primary and secondary care settings. This encourages nurse practitioners to work alongside other health care and allied health professions, and families to create an individualized plan for every patient (van

Fry, M. (2011). Literature review of the impact of nurse practitioners in critical care services. Nursing In Critical Care, 16(2), 58-66. http://dx.doi.org/10.1111/j.1478-5153.2010.00437.x

Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.

Role is a function played by an individual or particular group of individual in a particular situation. It includes connected obligations, behaviors, rights, beliefs, and norms as theorized by people in a social state. The role of a nurse practitioner (NP) started to manifest in the mid-1960s. This came as a response to the nationwide physicians’ shortage. The NPs were then classified under the advanced practice registered nurse (APRN) umbrella. The origin of the NP role in the United States came through the effort of Loretta Ford (RN) and Henry Silver a pediatrician who had insight for the nurses to be developed and be more effectively used to improve the health care. The demand for primary healthcare was increasing as physician were moving to areas of specialty because of the associated income, lifestyle incentives and status. The nurses were to fill the gap. To realize this, education was essential. The nurses where then equipped with skills of performing developmental tests, history taking, doing evaluative procedures, some laboratory procedures and physical examination and referral for medical care that traditionally had been a medicine domain (O’Brien, 2003).

The medical field of nursing is based on servitude in God’s mission and through the means of compassion. Our missional goals must align with God’s (Wright, 2012). Nursing consists of care and compassion for the disadvantaged, weak, sick, and injured. This is in addition to the pursuit of high standards in professionalism, articulated in the delivery of a valuable service that is based on unique knowledge and experience, performed ethically, and practiced autonomously. The major characteristic of compassion is from God and how it relates to this world of professionalism is seen through nursing. Any job that advances God’s work in the world is a Godly choice (Col. 1:16-20).

Growing up my family had little to no money. My parents, immigrants from El Salvador, worked two jobs each. Home was a small space with a conjoined kitchen and living room. When Mom and Dad first arrived to America, they never imagined a child of theirs would become a university student. Coming to America itself was in their wildest dreams. To them, an education of that level was unattainable. Now, I represent my family wherever I go. I am at TWU for my family and for my dreams. One day, I will be the Nurse Practitioner I always envisioned. But more importantly, I will give my parents and my grandmother everything they never had. Now that I am older I comprehend the magnitude of their sacrifices. When I hear the name Texas Woman’s University,

It was the winter of 2013; I could hear my heartbeat get louder and louder as I was anxiously waiting to hear back from the doctor. Not a second passed by that I was not praying for my dad’s life. Finally, a kindhearted nurse practitioner walked through the door to give us the latest update on my dad’s condition. Her optimistic words and positive attitude gave me every ounce of hope I needed to cling onto. My dad was fighting for his life in the operating room. This was his second open heart surgery caused by a rupture mitral valve. The urgency of the situation was intensified by the backflow of blood to his lungs. My family and I had no other choice but to consent to the risky operation that had a fifty percent survival possibility. Prior to the heart attack that left him in critical state, he had given up on doctor prescribed medication and instead turned to herbal therapy. He was consuming some unusual looking liquid contained in a large amber bottle that he had brought back from Pakistan. Upon asking he expressed his frustration in complying with his doctor prescribed heart regimen. At the time I tried my best to convince him of the danger of discontinuing his heart medication but all in vain. He had found ease in taking the liquid herbs and also felt much better without all the side effects. After the nightmare we lived through, he has promised to comply with his medication. However, he still constantly complains about the side effects he experiences and his

Jonathan is a 63 year old man, born on August 23rd, 1956 and lives with his eldest son. He was married two times and has three children, two children from his first marriage and one from his second. He lives in northern Ontario but originally was not born here, he moved here shortly following his second divorce. He is of Italian decent and is a practicing Catholic. The patients weight is 95 kilograms; he is 178 centimeters all and has a body mass index (BMI) of 28.3. Jonathan says he smokes around one pack of cigarettes a day, does not get a lot of exercise and eats fast food a few times a week. The patient now has congestive heart failure as a consequence of his MI. He was transferred from another hospital in the beginning of November and currently is waiting for more testing before he can be discharged from the hospital or moved to another facility. The patient has some known comorbidities that can exacerbate his CHF, this includes

There are two interesting stories I would like to mention before I start. The first one is called “Bisclavret” written by Marie de France. This is a story about a baron named Bisclavret who regularly turned into a werewolf, was betrayed by his wife, but finally regained all his status and honor back by showing loyalty to the king. The second story is a gothic literature named “The Old Nurse’s Story” written by Elizabeth Gaskell. This story is mainly about how the first person narrator Miss Hester and her little Rosamand strive to survive in the haunted mansion and how they get to know the secrets of the ghosts. In this writing I will compare the two different narration