You are called to the room and find Michael 2 hours old has been very irritable and spitting up large amounts of formula. He is very jittery. You do not know the maternal history before coming into the room so you advise the mother that you would like to return the baby to the nursery for an assessment and monitoring. In the medical record you focus on prenatal history. You witness the baby having some significant tremors.  

 It is determined that this baby is going through opioid withdrawal. Neonatal Abstinence Syndrome requires close observation and scoring. Methadone may be used. Neonatal Abstinence Syndrome Shows both the signs of withdrawal, scoring and the nursing care of a baby with Neonatal Abstinence Syndrome. 

 What is your feeling and knowledge regarding breastfeeding this baby? 150 words.

Choose a topic below related to the role of gender in history. You can choose particular women or divide the periods or tribes up to write this.

Answer ALLof the following questions in essay format. 2-3 pages. APA format. 12 Font Times New Roman only.

All work must be properly cited and unless otherwise noted; do not include pure opinion. 

 T/week 5/discussion

Topic 1

Generate a list of questions you will ask during the interview such as teaching strategies, theories, technology, and evaluation techniques.

Conduct the interview.

Your discussion post should include:

The setting.

How the interview was conducted.

The questions asked and the responses given.

Anything else you think to be important.

Setting: Hospital – Director’s Office

The interview was conducted as a one-on-one informal discussion in the Director’s office at the hospital during day shift. There were a few interruptions including a code blue however, we eventually got through it and it was very interesting and informative.

Interview Q&A

Q. Please share with me an example of how you helped coach or mentor someone. What improvements did you see in the person’s knowledge or skills?

A. Early in my nursing career, I worked on the Med-Surg unit and was orienting a new nurse to the unit. She had a patient that was very ill and had multi-organ failure. She was waiting for a hospice consultation when the patient coded. At that time, the patient was a DNR therefore she was not resuscitated. The nurse felt helpless and did not’t know what to do. She literally broke down in tears. I had a one-on-one conversation with her and explained the of end of life process and shared my first experience when I lost a patient. She later came back to me and thanked me for sharing with her as it was very helpful to process hers.

Q. Tell me how you organize, plan, and prioritize your work.

A. I begin each day with staffing which sets the stage for the rest of the team and the day. After staffing I meet with the day shift nurses, prior to them getting report to review and discuss any concerns or new implementations. I then meet with other directors and bed management to evaluate our bed availability and what needs to be done with any transfers or discharges. This information is communicated with the charge nurse and he or she will use this information to plan their day. Obviously, there are many obstacles that may arise or issues that may need to be resolved throughout the day which can’t be planned for. At the end of the day there is another staffing meeting to prepare for the next day. I guess you can say each day begins with and ends with staffing, the backbone to a successful unit and patient experience.

Q. Please share an experience in which you presented to a group. What was the situation and how did it go?

A. I have presented to groups on multiple occasions however, the one that comes to mind is my first. At the time, I was promoted to Clinical Coordinator. I had never been in a management position before and was extremely intimidated and anxious when I had to conduct my first staff meeting. I prepared several days in advance and even rehearsed how I would run the meeting. I did not’t sleep the night before and was worried I would fail my director. Everyone gathered in the break room and I handed out the agenda. At that time, I realized I had nothing to worry about and this was my team. I conducted the meeting flawlessly and took a deep breath when it was over and smiled. 

Q. Share an example of when you went above and beyond the “call of duty”.

A. Wow, that is a tough one. I don’t know that I can remember one in particular. I think it is something I do on a daily basis or whenever the situation arises. I believe that being a nurse you often do more than you are “asked” to do. That is what makes our field and profession different from others. We take care of people. It’s an amazing career.

Q. In your experience, what is the key to developing a good team? 

A. I believe the key to developing a good team starts with good communication. Which includes listening to staff complaints and concerns. If something isn’t working you can try to figure out a solution or how to resolve it. If you don’t know what is wrong, you can’t fix it. Treating others with respect is also key as it promotes professionalism and a positive attitude. All of which are important elements in a good team as well as many others.

TO REPLY WITH A COMMENT OF AT LEAST 5 SENTENCE EACH FOR POST 1 AND  POST 2 IT IS GOING TO BE 2 COMMENTS. EACH REPLY COMMENT WITH TWO CITATION AND TWO REFERENCE APA ABOVE 2013.

POST 1

 

Statistics show that “approximately 1 in 5 adults in the U.S., or 43.8 million people, experiences mental illness in a given year” (National, 2018a, p. 1).  The adolescent population, ages 13-18, accounts for “21.4% of mental health illness cases” (National, 2018, p. 1) which doesn’t include the “estimated 13% of children ages 8-15” (National, 2018a, p. 1) also suffering with mental illness in any given year.  In the U.S. of the “20.2 million adults living with substance abuse, 10.2 million of them have a co-occurring mental illness (National, 2018a, p. 1) and the price tag for treating mental health illnesses costs “America $193.2 billion in lost earnings per year” (National, 2018a, p. 1).  These statistics demonstrate a very big problem accompanied by very few solutions.  Advocating better care for our mental health patient population will also target the homeless and substance abuse populations as well.  Proper care can help give these people a second chance at life to live independently, secure employment, and to be productive citizens within their communities.

            There are several ways to help advocate better care for those suffering with mental illness including, “joining or starting a local support chapter, becoming a local advocate, volunteer, or becoming an ambassador” (Depression, 2018, p. 1).  Being involved can “make a real difference, not only in your own life, but in the lives of others” (Depression, 2018, p. 1).  A lot of patients that suffer with mental illness aren’t being heard or acknowledged for the treatment they desperately need, so it’s up to the general population to join and support this type of patient care and to show that mental health care is just as important as physical health care. 

            Advocating for those suffering with mental illness “improves the individuals’ understanding of their situation, enables their views to be heard, ensures that they have the opportunity to be partners in their care and increases their autonomy” (Varghese, 2015, p. 1).  Advocating also “promotes the rights of those who suffer discrimination because of their age, disability, sexuality, gender or culture, and it can ensure the quality of the care system” (Varghese, 2015, p. 1).

            The only way that change can occur is to make the issue aware, give it a face for people to see.  The stigma on mental illness needs to come to an end.  When a patient breaks their arm, they can go the hospital without judgement and get proper medical treatment and within a few weeks their arm will heal and be useful again.  However, when a patient suffers from a mental or psychotic break, they go to hospital and are judged from the beginning and then drugged until they act in a way that society will accept them.  A large population of mental health patients are diagnosed with illnesses they were born with or due to trauma they inherited them throughout life.  Instead of offering proper treatment and acceptance, healthcare providers are easily frustrated and judgmental because they either don’t care or don’t understand.

            Ways to help promote change and encourage education is by asking your local governor to make a proclamation, take action on advocacy issues, ask businesses and landmarks to light up green to raise awareness, address culture barriers, speak with teens, hand out ribbons and education, host an event, volunteer, implement a free community outreach program, become a program trainer, or help run a support group (National, 2018b, p. 1).  The end goal needs to be better and reliable care for our mental health patient population and to educate enough to end the stigma, so those suffering will no longer feel the need to hide and be scared of what others will think.

-Crystal Browne

Depression and Bipolar Support Alliance.  (2018).  Advocate for mental health.  Retrieved from:  https://secure2.convio.net/dabsa/site/SPageServer/PageServer?pagename=help_advocate_mental_health.

National Alliance on Mental Illness.  (2018a).  Mental health by the numbers.  Retrieved from:  https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers. 

National Alliance on Mental Illness.  (2018b).  Become a leader in the mental health movement.  Retrieved from:  https://www.nami.org/Get-Involved/What-Can-I-Do-/Become-a-Leader-in-the-Mental-Health-Movement.

Varghese, J.  (2015).  Advocacy in mental health:  offering a voice to the voiceless.  Indian Journal of Social Psychiatry.  Retrieved from:  http://www.indjsp.org/article.asp?issn=0971-9962;year=2015;volume=31;issue=1;spage=4;epage=8;aulast=Varghese.

POST 2

 

There are many views on mental health. Some cultures view mental health issues as a sign of familial conflict. Or as a sign to receive divine intervention or forgiveness. While other cultures have a more negative view such as demonic possession or a supernatural phenomenon (Choudhry et al., 2016). In America about one in four adults are diagnosed with some type mental health disorder (CDC, 2014). This can be from substance abuse, anxiety disorders or mood disorders. The commonality of mental health is an issue that will be faced in practice as well as the negative or unknown view of the public on mental health. This is were becoming an advocate and educator are important to make change for patients dealing with mental health issues.

Education and Mental Health

One of the foundational duties of being a nurse practitioner is to educate. This includes not only the patient, but the public. By educating the public on the facts of mental health is a start. Another beneficial strategy is educating the public on the signs and symptoms of mental health. For example, a mother may notice her once vibrant and social teenager is now distant and tearful. The mother may believe her child is “going through a phase”, when the teen is suffering from depression with suicidal ideation. Or when an individual has a stressful job and uses alcohol to help him “relax”.

Becoming a Social Change Agent for Mental Health

Education of the public can be done in many ways. Handing out pamphlets is a helpful approach, but this approach is limited. Venturing to different places, such as schools, offices and churches and speaking with individuals about mental health are ways to reach a wide variety of people. By having local mental health awareness sessions where people from all different walks of life come to learn about the facts of mental health is an initiative that allows people to ask question about mental health issues. This also allows for discriminatory or perceptions of mental health disorders to be addressed. Through education, the stigma associated with mental health can be changed.

.

References

Centers for Disease Control. (2012). Attitudes Towards Mental Illness. Retrieved from: https://www.cdc.gov/hrqol/Mental_Health_Reports/pdf/BRFSS_Full%20Report.pdf

Choudhry, F. R., Mani, V., Ming, L. C., & Khan, T. M. (2016). Beliefs and perception about mental health issues: a meta-synthesis. Neuropsychiatric disease and treatment, 12, 2807-2818. doi:10.2147/NDT.S111543

 

Reflect on the current roles of advanced practice nurses in healthcare as the care providers at the front line of disease management and health promotion in primary care and many other specialty settings. What do you think are some effective tactics for APN strategic positioning regarding pay equality? Should APNs position themselves as lower-cost providers who provide better care or push for comparable worth, same service and same pay?

Below is an article that provides great practical information that highlights how provider productivity is calculated in the clinical setting, which is important to know as future nurse practitioners.

Calculating Your Worth: Understanding Productivity and Value- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093517/

 all discussion posts must be minimum 250 words, references must be cited in APA format, and must include minimum of 2 scholarly resources published within the past 5-7 years.