NURS6341 Discussion Response #4: Analyzing Patient Risk 2025

NURS6341 Discussion Response #4: Analyzing Patient Risk Respond to the discussion #4 below using the following approach: Offer and support an additional strategy a colleague might use to integrate the principle of stacking into his or her specialty of interest. Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence. Ask a probing question, substantiated with additional background information, evidence, or research. Discussion #4 As the acuity level of our patient’s health status increased, the complexity of our roles increases also. Attempting to manage multiple patients with complex health statuses requires the nurse to develop a care giving rubric that allows for this complex decision making process to occur seamlessly, with no harm coming to our patients. As novice nurses this task can seem daunting and overwhelming at times, but as we process through our career, the clinical decision making matrix becomes much easier to perform. One of those decision-making matrixes is stacking . Stacking is an RN cognitive process involving decision-making about workflow priorities (Shirey, Ebright, & McDaniel, 2013). Stacking as an important strategy used by experienced RNs for management of the complexity surrounding nursing care which involves complex reasoning and clinical decision making. My clinical setting for my example is the Operating Room (OR) of a large hospital. As OR nurses, it can be overwhelming even for a seasoned OR nurse to understand, and prioritize this complex, multifaceted environment. Being a high pressure environment, the OR can be a very fast-paced, stressful place. Surgeons’ tempers can run high, and that can trickle down to the staff, placing more emphasis on creating smooth running process, by the OR RN. Eskola et al. (2016) noted that the OR can be a stressful practice environment, where nurses might have either job stress or job satisfaction based on their competence. In my clinical example, the building was built in the early 1900’s with many, many additions over the years. In the Operating Rooms suites, their locations were scattered on 3 different wings of the hospital, and on 2 different floors. In addition, the Central Supply, which sterilized and stored the surgical instruments and disposable supplies, was located in the basement of the original building, requiring multiple elevators trips to gather supplies. Also, the elevators were not dedicated to the OR’s, but were general use elevators, which made timely delivery of supplies problematic. In this environment, the OR nurse needed to be very skilled in stacking, as regards to equipment and supply prioritization and optimization of use. In today’s hospital culture of, “just in time” supply delivery, many hospital items are not stocked in large quantities and so amassing of large quantities of possibly needed equipment and supplies was frowned upon. The prioritization skills of the novice nurse would have been taxed as even the more experienced nurses found the ability to have the correct supplies, in the correct quantities, in addition to planning for the unforeseen issues, daunting in the best of circumstances, and overwhelming in the worst of situations. Yildiz Findik, Ozbas, Cavdar, Yildizeli Topcu, & Onler (2015), remarked that the nursing students generally employed a helpless/self-accusatory approach among passive patterns as their clinical stress levels increased, and those who had never been to an operating room previously used a submissive approach among passive patterns. In this environment, emphasis must be placed on the prioritization decisions in preparing and stocking supplies, and in the relationship management with the physicians. For example, in cultivating a high relationship management technique with the operating the physicians, the OR nurse was better able to anticipate needs and have the correct items available, when they were needed. Patterson, Ebright, & Saleem (2011) said that in particular, being proactive on certain tasks was believed to reduce the overall amount of time spent on them. Being proactive in the OR environment requires a certain level of self confidence in the ability to communicate information quickly, concisely and accurately. References Eskola, S., Roos, M., McCormack, B., Slater, P., Hahtela, N., & Suominen, T. (2016). Workplace culture among operating room nurses. Journal of Nursing Management , 24 (6), 725-734. doi:10.1111/jonm.12376 Patterson, E. S., Ebright, P. R., & Saleem, J. J. (2011). Investigating stacking: How do registered nurses prioritize their activities in real-time? International Journal of Industrial Ergonomics , 41 (4), 389-393. doi:10.1016/j.ergon.2011.01.012 Shirey, m. r., Ebright, p. r., & McDaniel, a. m. (2013). Nurse manager cognitive decision-making amidst stress and work complexity. Journal of Nursing Management, 21(1), 17-30. doi:10.1111/j.1365-2834.2012.01380.x Yildiz Findik, U., Ozbas, A., Cavdar, I., Yildizeli Topcu, S., & Onler, E. (2015). Assessment of nursing students’ stress levels and coping strategies in operating room practice. Nurse Education in Practice , 15 (3), 192-195. doi:10.1016/j.nepr.2014.11.008 Reminder: 1. 1 page only 2. Put Citations in APA format and at least 3 references… Articles must be 2011 to 2016. Required Readings Ebright, P. R. (2010). The complex work of RNs: Implications for healthy work environments. The Online Journal of Issues in Nursing, 15 (1) Retrieved from the Walden Library databases. The author, an expert nurse, examines the meaning of “complexity” in nursing practice, how complexity impacts safety, quality, and retention, and considers recommendations and solutions for addressing complexity to reduce nursing stress and improve patient care. Duffield, C., Diers, D., O’Brien-Pallas, L., Aisbett, C., Roche, M., King, M., & Aisbett, K. (2011). Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research, 24 (4), 244–255. Retrieved from the Walden Library databases. This article details a study that links nurse staffing issues, increased workload, and unstable nursing unit environments with negative patient outcomes, including falls and medication errors, on medical/surgical units. As you read, compare the concept of nursing workload and nursing complexity and consider solutions in the Ebright article that might apply. Required Media Laureate Education (Producer). (2013). Addressing complexity of nursing practice [Video file]. Retrieved from https://class.waldenu.edu . Note: The approximate length of this media piece is 8 minutes. In this video segment, Dr. Pat Ebright and Dr. Mary Sitterding discuss complexities of nursing practice. Specifically, they highlight how the principle of stacking can help both novice and experienced nurses to make key workload decisions in the clinical environment. Accessible player Laureate Education (Producer). (2013). The role of the nurse educator [Video file]. Retrieved from https://class.waldenu.edu . Note: The approximate length of this media piece is 9 minutes. In this video segment, Dr. Pat Ebright and Dr. Mary Sitterding discuss the role of the nurse educator.

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Discussion Response #1 (NURS6351): Addressing Diversity to Promote Effective Learning Experiences 2025

Discussion Response #1 (NURS6351): Addressing Diversity to Promote Effective Learning Experiences Respond to the discussion #1 below using the three approaches: 1. Ask a probing question, substantiated with additional background information or research. 2. Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. 3. Validate an idea with your own experience and additional resources. Introduction There is much more diversity seen in education today. This creates a challenge for educators in the classroom (Bednarz, Schim, & Doorenbos, 2010). The typical demographic of the white female nursing student is quickly changing and as educators we need to accommodate this diversity in our classrooms (Adeniran & Smith-Glasgow, 2010). Today the non-traditional nursing student is known to be diverse. These diverse students are considered to be non-traditional students. These students consist of those under the age of 25, male, member of an ethnic or minority group, and those that speak English as a second language (Bednarz, Schim, & Doorenbos, 2010). In this discussion I will focus on the English as second language (ESL) student, and strategies to promote a positive learning environment. ESL Student I have spent a few years now in the field of nursing education. I encounter many students that have accents and English as their second language. I have noticed that many of these students struggle academically. At first I could not understand why they struggle when most of them speak very good English. It was a young lady who brought to my attention that she did not understand the meaning of many English words especially medical terms. Many ESL students have difficulties with medical language, nursing language, and American language (Bednarz, Schim, & Doorenbos, 2010). At that point I realized that I held a bias against these students. I felt they just did not have what it takes to succeed in this field. I was wrong and felt horrible for thinking this. This was an eye opening experience and a lesson learned. What she taught me was that these students are like everyone else, but they may require some additional help along the way. Strategies I am always willing to help any student who is struggling to succeed. This situation was one that helped me to better understand just how to help these ESL students. In order to promote a positive learning environment for these students I had to first be aware of my own values, beliefs, and biases. This awareness is necessary in creating an inclusive learning environment (Adeniran & Smith-Glasgow, 2010). A second strategy is to listen and learn. It is important to listen to what our students are saying and accommodate different learning styles by using a variety of teaching strategies (Bednarz, Schim, & Doorenbos, 2010). Once I listened I was better able to understand the student’s learning needs. Lastly, know what resources are available at your campus to accommodate ESL students (Bednarz, Schim, & Doorenbos, 2010). I refer my students to our learning assistance center. This is a free service for them and has proven to be very beneficial. Conclusion There are many strategies to help ESL students succeed in nursing education. I mentioned the ones that I have tried and work well for me. I learned a great deal from my experience and feel better prepared when working with this diverse group of students. References: Adeniran, Rita K, RN, DrNP(c), MSN,C.N.A.A., B.C., & Smith-Glasgow, M. (2010). Creating and promoting a positive learning environment among culturally diverse nurses and students. Creative Nursing, 16 (2), 53-8. Retrieved from http://search.proquest.com.ezp.waldenulibrary.org/docview/222732588?accountid=14872 Bednarz, H., Schim, S., & Doorenbos, A. (2010). Cultural diversity in nursing education: perils, pitfalls, and pearls. Journal of Nursing Education, 49 (5), 253-260. doi:10.3928/01484834-20100115-02 Reminders: 1. 1 page only 2. Put APA format citations 3. At least 3 references (APA format)… Articles must be 2011 to 2016. Required Readings Palmer, P. J. (2007). The courage to teach: Exploring the inner landscape of a teacher’s life . San Francisco, CA: Jossey-Bass. Chapter IV, “Knowing in Community: Joined by the Grace of Great Things” (pp. 91–116) This chapter focuses on the cultivation of community in education. Adeniran, R. K., & Smith-Glasgow, M. (2010). Creating and promoting a positive learning environment among culturally diverse nurses and students. Creative Nursing, 16 (2), 53–58. Retrieved from the Walden Library databases. This article describes strategies for addressing learning needs in culturally diverse nursing education settings. Bednarz, H., Schim, S., & Doorenbos, A. (2010). Cultural diversity in nursing education: Perils, pitfalls, and pearls. Journal of Nursing Education, 49 (5), 253–260. Retrieved from the Walden Library databases. The authors examine how increasing diversity creates a complex educational environment, which can lead to difficulties for students and teachers. They also explain the need for strategies to address these issues and promote effective educational experiences for a diverse student body. Davis, S., & Davis, D. (2010). Challenges and issues facing the future of nursing education: Implications for ethnic minority faculty and students. Journal of Cultural Diversity, 17 (4), 122–126. Retrieved from the Walden Library databases. The authors examine the recruitment and retention of faculty and students from ethnically underrepresented groups in nursing education programs. They focus specifically on the imperative to cultivate a technologically savvy workforce that can compete in the global economy. Duke, J., Connor, M., & McEldowney, R. (2009). Becoming a culturally competent health practitioner in the delivery of culturally safe care: A process oriented approach. Journal of Cultural Diversity, 16 (2), 40–49. Retrieved from the Walden Library databases. This article examines the development of cultural competence, referencing Benner’s novice-to-expert continuum, to promote health outcomes of marginalized cultural groups. Carr, S., & DeKemel-Ichikawa, K. (2012). Improving communication through accent modification: Growing the nursing workforce. Journal of Cultural Diversity, 19 (3), 79–84. Retrieved from the Walden Library databases. As the authors note, the presence of accents and dialects among nursing students can lead to communication barriers that can adversely impact student performance and patient safety. This article examines the effectiveness of a pilot program enacted to address this issue. Revell, S., & McCurry, M. (2010). Engaging millennial learners: Effectiveness of personal response system technology with nursing students in small and large classrooms. Journal of Nursing Education, 49 (5), 272–275. Retrieved from the Walden Library databases. The authors describe the use of technology to engage students, drawing from knowledge of learning preferences for different age groups. Oldenburg, N., & Hung, W. (2010). Problem solving strategies used by RN-to-BSN students in an online problem-based learning course. Journal of Nursing Education, 49 (4), 219–222. Retrieved from the Walden Library databases. This article examines problem-based learning within an online context to promote nursing students’ development of essential skills. Ierardi, J., Fitzgerald, D., & Holland, D. (2010). Exploring male students’ educational experiences in an associate degree nursing program. Journal of Nursing Education, 49 (4), 215–218. Retrieved from the Walden Library databases. The authors examine the effects of gender on nursing students’ experiences.

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NURS6341 Discussion Response #2: Nurse Practice Acts 2025

NURS6341 Discussion Response #2: Nurse Practice Acts Respond to the discussion #2 below using the following approach: 1. Ask a probing question, substantiated with additional background information, evidence, or research. 2. Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. 3. Validate an idea with your own experience and additional research. Analysis of RN and APRN All states have a nurse practice act that is governed by the individual state’s legislature (National Council of State Boards of Nursing, n.d.). Each state nurse practice act must contain a board of nursing, educational program standards, standards and scope of nursing practice, types of titles and licenses, requirements for licensure, and grounds for disciplinary action (National Council of State Boards of Nursing, n.d.). The purpose of state practice acts is to provide laws that regulate the nursing profession and to ensure patient safety (National Council of State Boards of Nursing, n.d.). In South Carolina, the roles of the advanced practiced registered nurse, APRN, and the registered nurse, RN, are outlined within the code of laws (South Carolina Legislature, n.d.). APRN’s are defined as certified nurse-midwives, clinical nurse specialists, certified registered nurse anesthetists, and nurse practitioners (South Carolina Legislature, n.d.). These individuals differ from RN’s in that they must have a minimum of a Master’s degree, can perform delegated medical acts, and can practice within approved protocols under physician support (South Carolina Legislature, n.d.). Also, each of the four types of APRN’s are defined individually in more detail within the code of law (South Carolina Legislature, n.d.). The roles of the RN and APRN overlap to an extent, because APRN’s can perform the duties of an RN in addition to the new ones that are defined by their specialty area of practice (South Carolina Legislature, n.d.). How These Differences are Seen in Practicum Specific skills that this nurse has observed the nurse practitioner, NP, use in the clinical setting include diagnosing patients, prescribing pharmacological interventions, and ordering laboratory tests (APRN Consensus Work Group, & National Council of State Boards of Nursing APRN Advisory Committee, 2008). All three of these skills are not permitted by the RN, and are considered advanced practice skills (APRN Consensus Work Group, & National Council of State Boards of Nursing APRN Advisory Committee, 2008). The NP is supported by two of the gastroenterologists at the office, and she does seek their input when a patient presents with a need outside of the usual protocols for care. She performs individual medical history reviews and physical assessments that allow her to create a patient diagnosis. Any laboratory tests such as blood work, cultures, and computerized tomography scans are ordered independently by the NP. After establishing a patient diagnosis and creating a treatment plan, the NP prescribes the appropriate pharmacologic treatment for the patient. References APRN Consensus Work Group, & National Council of State Boards of Nursing APRN Advisory Committee. (2008). Consensus model for APRN regulation: Licensure, accreditation, certification & education. Retrieved from http://www.aacn.nche.edu/education-resources/APRNReport.pdf National Council of State Boards of Nursing. (n.d.). Nurse Practice Act, Rules & Regulations. Retrieved from https://www.ncsbn.org/nurse-practice-act.htm South Carolina Legislature. (n.d.). South Carolina code of laws unannotated. Retrieved from http://www.scstatehouse.gov/code/t40c033.php Reminder: 1. 1 page only 2. Put Citations in APA format and at least 3 references… Articles must be 2011 to 2016. Required Readings American Association of Colleges of Nursing. (2011). Consensus model for APRN regulation. Retrieved from http://www.aacn.org/wd/certifications/docs/aprn-consensus-model-graphic.pdf APRN Consensus Work Group, & National Council of State Boards of Nursing APRN Advisory Committee. (2008). Consensus model for APRN regulation: Licensure, accreditation, certification & education. Retrieved from http://www.aacn.nche.edu/education-resources/APRNReport.pdf National Council of State Boards of Nursing. (n.d.). Nurse Practice Act, Rules & Regulations. Retrieved from https://www.ncsbn.org/nurse-practice-act.htm National Council of State Boards of Nursing. (2007). Guiding principles of nursing regulation. Retrieved from https://www.ncsbn.org/Guiding_Principles.pdf Required Media National Council of State Boards of Nursing (Producer). (2015). New nurses: Your license to practice [Video file]. Retrieved from https://www.ncsbn.org/8243.htm National Council of State Boards of Nursing (Producer). (2014, June 12 ). The nurse licensure compact explained [Video file]. Retrieved from https://www.ncsbn.org/364.htm Sent from my iPhone

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Discussion Response #1 (NURS6351): Addressing Diversity to Promote Effective Learning Experiences 2025

Discussion Response #1 (NURS6351): Addressing Diversity to Promote Effective Learning Experiences Respond to the discussion #1 below using the three approaches: 1. Ask a probing question, substantiated with additional background information or research. 2. Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. 3. Validate an idea with your own experience and additional resources. Introduction There is much more diversity seen in education today. This creates a challenge for educators in the classroom (Bednarz, Schim, & Doorenbos, 2010). The typical demographic of the white female nursing student is quickly changing and as educators we need to accommodate this diversity in our classrooms (Adeniran & Smith-Glasgow, 2010). Today the non-traditional nursing student is known to be diverse. These diverse students are considered to be non-traditional students. These students consist of those under the age of 25, male, member of an ethnic or minority group, and those that speak English as a second language (Bednarz, Schim, & Doorenbos, 2010). In this discussion I will focus on the English as second language (ESL) student, and strategies to promote a positive learning environment. ESL Student I have spent a few years now in the field of nursing education. I encounter many students that have accents and English as their second language. I have noticed that many of these students struggle academically. At first I could not understand why they struggle when most of them speak very good English. It was a young lady who brought to my attention that she did not understand the meaning of many English words especially medical terms. Many ESL students have difficulties with medical language, nursing language, and American language (Bednarz, Schim, & Doorenbos, 2010). At that point I realized that I held a bias against these students. I felt they just did not have what it takes to succeed in this field. I was wrong and felt horrible for thinking this. This was an eye opening experience and a lesson learned. What she taught me was that these students are like everyone else, but they may require some additional help along the way. Strategies I am always willing to help any student who is struggling to succeed. This situation was one that helped me to better understand just how to help these ESL students. In order to promote a positive learning environment for these students I had to first be aware of my own values, beliefs, and biases. This awareness is necessary in creating an inclusive learning environment (Adeniran & Smith-Glasgow, 2010). A second strategy is to listen and learn. It is important to listen to what our students are saying and accommodate different learning styles by using a variety of teaching strategies (Bednarz, Schim, & Doorenbos, 2010). Once I listened I was better able to understand the student’s learning needs. Lastly, know what resources are available at your campus to accommodate ESL students (Bednarz, Schim, & Doorenbos, 2010). I refer my students to our learning assistance center. This is a free service for them and has proven to be very beneficial. Conclusion There are many strategies to help ESL students succeed in nursing education. I mentioned the ones that I have tried and work well for me. I learned a great deal from my experience and feel better prepared when working with this diverse group of students. References: Adeniran, Rita K, RN, DrNP(c), MSN,C.N.A.A., B.C., & Smith-Glasgow, M. (2010). Creating and promoting a positive learning environment among culturally diverse nurses and students. Creative Nursing, 16 (2), 53-8. Retrieved from http://search.proquest.com.ezp.waldenulibrary.org/docview/222732588?accountid=14872 Bednarz, H., Schim, S., & Doorenbos, A. (2010). Cultural diversity in nursing education: perils, pitfalls, and pearls. Journal of Nursing Education, 49 (5), 253-260. doi:10.3928/01484834-20100115-02 Reminders: 1. 1 page only 2. Put APA format citations 3. At least 3 references (APA format)… Articles must be 2011 to 2016. Required Readings Palmer, P. J. (2007). The courage to teach: Exploring the inner landscape of a teacher’s life . San Francisco, CA: Jossey-Bass. Chapter IV, “Knowing in Community: Joined by the Grace of Great Things” (pp. 91–116) This chapter focuses on the cultivation of community in education. Adeniran, R. K., & Smith-Glasgow, M. (2010). Creating and promoting a positive learning environment among culturally diverse nurses and students. Creative Nursing, 16 (2), 53–58. Retrieved from the Walden Library databases. This article describes strategies for addressing learning needs in culturally diverse nursing education settings. Bednarz, H., Schim, S., & Doorenbos, A. (2010). Cultural diversity in nursing education: Perils, pitfalls, and pearls. Journal of Nursing Education, 49 (5), 253–260. Retrieved from the Walden Library databases. The authors examine how increasing diversity creates a complex educational environment, which can lead to difficulties for students and teachers. They also explain the need for strategies to address these issues and promote effective educational experiences for a diverse student body. Davis, S., & Davis, D. (2010). Challenges and issues facing the future of nursing education: Implications for ethnic minority faculty and students. Journal of Cultural Diversity, 17 (4), 122–126. Retrieved from the Walden Library databases. The authors examine the recruitment and retention of faculty and students from ethnically underrepresented groups in nursing education programs. They focus specifically on the imperative to cultivate a technologically savvy workforce that can compete in the global economy. Duke, J., Connor, M., & McEldowney, R. (2009). Becoming a culturally competent health practitioner in the delivery of culturally safe care: A process oriented approach. Journal of Cultural Diversity, 16 (2), 40–49. Retrieved from the Walden Library databases. This article examines the development of cultural competence, referencing Benner’s novice-to-expert continuum, to promote health outcomes of marginalized cultural groups. Carr, S., & DeKemel-Ichikawa, K. (2012). Improving communication through accent modification: Growing the nursing workforce. Journal of Cultural Diversity, 19 (3), 79–84. Retrieved from the Walden Library databases. As the authors note, the presence of accents and dialects among nursing students can lead to communication barriers that can adversely impact student performance and patient safety. This article examines the effectiveness of a pilot program enacted to address this issue. Revell, S., & McCurry, M. (2010). Engaging millennial learners: Effectiveness of personal response system technology with nursing students in small and large classrooms. Journal of Nursing Education, 49 (5), 272–275. Retrieved from the Walden Library databases. The authors describe the use of technology to engage students, drawing from knowledge of learning preferences for different age groups. Oldenburg, N., & Hung, W. (2010). Problem solving strategies used by RN-to-BSN students in an online problem-based learning course. Journal of Nursing Education, 49 (4), 219–222. Retrieved from the Walden Library databases. This article examines problem-based learning within an online context to promote nursing students’ development of essential skills. Ierardi, J., Fitzgerald, D., & Holland, D. (2010). Exploring male students’ educational experiences in an associate degree nursing program. Journal of Nursing Education, 49 (4), 215–218. Retrieved from the Walden Library databases. The authors examine the effects of gender on nursing students’ experiences.

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