 How Healthcare reform is impacting primary care https://www.ajmc.com/contributor/sophia–bernazzani/2016/03/how–healthcare–reform–is–impactingprimarycare 

•  Healthcare reform 101: What the health is going on in 2018? https://www.youtube.com/watch?v=cwTWhwWLzHQ  

•  Healthcare Transformation and Changing Roles for Nursing https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266427/pdf/ornur3612.pdf 

Frequently when the shortage of primary care providers is mentioned with regard to healthcare reform, insurance companies and other institutions forget to factor in the impact nurse practitioners can have on increasing access. How do you think we can improve this understanding of the nurse practitioner role?

Comment 1

The major difference between a Doctor of Nursing Practice (DNP) and a Doctor of Philosophy degree (PhD) is whether nurses translate research into practice to improve patient outcomes with a DNP or whether nurses want to advance the science of nursing, conducting research using a PhD (AACN, 2018). Most nurses who want to complete their DNP are oriented in the direction of improving outcomes, patient centered care and population health. Most nurses who want to complete their PhD are oriented in the direction of developing new nursing knowledge and scientific inquiry (AACN, 2018). Nurses who are committed to their practice will usually choose to purse a DNP when deciding on a doctoral program and nurses who want to commit their lives to research will most likely choose a PhD program of study. According to the American Association of Colleges of Nursing (2018), nurses who complete the DNP program or PhD program of study will be able to contribute to health care improvements through the development of practice and new knowledge from scholarly expertise in teaching and research.

Personally, if I had to choose between a DNP or a PhD in nursing I would go with a Doctor of Nursing Practice-Psychiatric Mental Health Nurse Practitioner (DNP-PMHNP), since that is where my passion and clinical expertise remains. After completing my BSN, I plan on becoming ANCC Psychiatric-Mental Health Nursing certified. There is so much more to discover when it comes to assessing, diagnosing, and treating patients who are seeking help with mental health disorders. I wish to acquire the advanced skills and abilities to integrate my knowledge, while making a positive contribution to the community and improving patient outcomes. I see myself as a leader in health care, taking initiatives to promote health, educating peers, patients and other health care providers.  I believe that a DNP would be in my best interest when it comes to my professional and personal goals as a professional nurse.

Comment 2

The Doctor of Nursing Practice (DNP) prepares BSN or MSN degreed nurses for the highest level of nursing leadership and practice within organizations with the ultimate goal of improving health care. The DNP will prepare nurses to become nurse leaders in interdisciplinary health care teams by providing the skills necessary to translate evidence gained through nursing research into their practice. The DNP program focuses on evidence-based practice and quality improvement and system leadership. They will have the skills to improve systems of care and measure outcomes of patient groups, populations and communities. (All Nursing Schools, n.d.)

The PhD in Nursing prepares nurse “scientist” to develop new knowledge for the science and practice of nursing.  They are prepared for an intellectual inquiry through scholarship and research. They pursue research interests; utilize external funding and creating well-designed methods to discover new knowledge related to nursing. PhD nurses will lead interdisciplinary research teams, design and conduct research studies and disseminate knowledge for nursing and related disciplines, particularly addressing trajectories of chronic illness and care systems. (All Nursing Schools, n.d.)

During my research of the DNP and PhD, I learned things about both degrees that I was not aware of. If I decided to continue my education to the doctoral level, I think I would go for the DNP. The DNP is more evidence based and hands on. I am more a hands on person and prefer to have the evidence there in front of me.

Comment 3

Difference between DNP AND PhD
 Based on Curriculum Content wise
The DNP is a practice doctorate that places greater emphasis on direct clinical practice. The curriculum focuses on organizational management, systems leadership, clinical-practice administration, quality improvement and program evaluation, in addition to other specialty areas, and less on statistics and research methodology.
 Ph.D. is more research-intensive and takes a scholarly approach to nursing. The curriculum for these degrees focuses on scientific inquiry and provides the evidence for nursing practice, as well as improving general nursing knowledge.
Based on Research Competencies
DNP-prepared nurses develop the skills necessary to implement the scientific findings conducted by nurse researchers with a Ph.D. or DNS (Doctor of Nursing Science). Graduates develop competencies in analytical methods, decision-making, enhanced knowledge and leadership skills to improve clinical practice and patient outcomes.
Ph.D. and DNS programs focus heavily on research methodology and scientific investigation. Graduates of these programs contribute to the improvement of healthcare by offering new information for practicing nurses.
Outcomes and Roles
 DNP programs have become the preferred preparation for advanced practice nurses, including nurse practitioners, clinical nurse specialists, nurse midwives or nurse anesthetists.  Meanwhile, graduates of DNS and Ph.D. programs pursue alternate paths within the field of nursing, commonly seeking roles as researchers, nurse scientists or scholars.
I would like to choose DNP if I decided to pursue my further study. We nurses frequently work alongside other health professionals with practice doctorates – physicians, pharmacists, physical therapists and more. The DNP provides nurses with a clinical option for nursing education that is more commensurate to the education of these disciplines.
According to the American Association of Colleges of Nursing, the DNP prepares nurses for the future tomorrow’s practice. If it is one’s interest in leading these changes, a DNP degree can help assume key executive positions as a nurse leader.

4-The functions of management include planning, organizing, staffing, directing, and controlling. Within each of these functions, decisions must be made to optimize the care provided while remaining fiscally responsible.

Leadership is a more challenging role to define. At times, leaders may not have formal authority, but they may have power through their ability to influence others. A leader’s emphasis is on interpersonal relationships; they may be known as mentors, coaches, advocates, or role model. (Lecture 1)

Management and leadership may coexist in one, though they may not at all. Some managers are leaders as well, and some are not. You may think they would go together, but we have all had experience with a manager that is NOT a leader. You know the one. The one who is the boss, and handles business, but not one that inspires, advocates or mentors staff.

One the other side of the coin, you may have had the pleasure of experiencing a manager that is a leader as well, someone who is part of the team and inspires, mentors, and coaches staff. The inspiration and the management. The boss who rally’s the troops and makes you WANT to be there and WANT to work for them. The two overlap in multiple areas.

As a nurse leader, I do believe I can expand my influence to create change by taking advantage of this overlap. I feel that I am inspiring and able to mentor and encourage and advocate for not only my patients, but my coworkers, company, and my profession. I would take advantage of the overlap by using my leadership abilities to continue to mentor, inspire, and encourage others in doing their best and being team players. A huge part of this is leading by example, which I strive for daily.

Resources

Lecture 1. (2018). NRS-451V. Theories and Concepts in Leadership and Management. Phoenix, AZ: Grand Canyon University.

5-management and leadership does overlapped to be a good manager you must have good leadership skills, managing is also means to lead making things happen,leader shares what he/she knows with others so that they can follow willingly. good leadership and  managment together can build a successful organization

6-Although often used interchangeably leadership and management are very different. “management and leadership do share many similar duties which consist of working with people and influencing others to achieve goals. Management skills are used to plan, build, and direct organizational systems to accomplish missions and goals, while leadership skills are used to focus on a potential change by establishing direction, aligning people, and motivating and inspiring.”(Algahtani, 2014). As a nurse leader you can expand your influence to create change and accomplish goals by overlapping your leadership and management skills. By using your leadership skills you can motivate other nurses to go above & beyond when caring for patients and encourage them to come up with solutions to our everyday problems. Leadership skills will also help you when developing your nurses to become future leaders or to meet their personal goals, doing so will in turn provide them with a sense of fulfillment. By using your management skills you can also ensure that your nurses have the adequate staffing and supplies needed to get perform their duties. A managers main function is “to provide services to the community in an efficient and sustainable manner”(Algahtani, 2014).

Algahtani, D. A. (2014). Are Leadership and Management Different? A Review. Journal of Management Policies and Practices,2(3). doi:10.15640/jmpp.v2n3a4

The “Pulse” Check.  Where are you in your journey and how are you doing?

DQ2 of Week 5 is an opportunity for you to self-assess and reflect on your journey. You can write about it or you can share a created video (you-tube) expressing your navigation through the Role course. Model from the scripts in this week, but be specific to your experience.

Evaluate how you have achieved course competencies and your plans to develop further in these areas. The course competencies for this course are as follows:

1. Explore the historical evolution of the advance practice nurse.
2. Differentiate the roles and scope of practice for nurses working in advanced clinical, education, administration, informatics, research, and health policy arenas.
3. Analyze attributes of the practice arena such as access and availability, degree of consumer choice, competition, and financing that impact advanced practice nurses and their ability to effectively collaborate with other health professionals.
4. Integrate evidence from research and theory into discussions of practice competencies, health promotion and disease prevention strategies, quality improvement, and safety standards.
5. Identify collaborative, organizational, communication, and leadership skills in working with other professionals in healthcare facilities and/or academic institutions.
6. Synthesize knowledge from values theory, ethics, and legal/regulatory statutes in the development of a personal philosophy for a career as an advanced practice nurse.