I need it completed in 4 hours

There has been much recent discussion among nurse practitioners and other health professionals over the limitations in providing mental health care (diagnosis, therapy and medication) if you are not credentialed as a PMHNP. Please go to the Texas Board of Nursing and review implications for primary care NP’s who see patients experiencing mental health problems (many patients to be sure). This is available – https://www.bon.texas.gov/practice_bon_position_statements.asp

A.      

What are the needs for mental health services on a national and local level? How do believe your new role as a PMHNP may influence this? Do you feel the Board is too restrictive or appropriate in their position statement. Please post an initial posting with at least two references. If you are not located in Texas, you may apply this discussion topic to your state. After you have posted your initial posting by the third day of the module, respond substantively to at least two peers by the end of the module.

B. 

Do some research about the different rules for PMHNP practice in different states. What are the pros and cons of having Full, Limited, and Restricted practice? What is the situation in your state? Please post an initial posting with at least two current references. After you have posted your initial posting by the third day of the module, respond substantively to at least two peers by the end of the module.

RESOURCES

1. Freud’s psychosexual development | Individuals and Society | MCAT | Khan Academy
2. Erikson’s psychosocial development | Individuals and Society | MCAT | Khan Academy
3. Piaget’s stages of cognitive development | Processing the Environment | MCAT | Khan Academyrs

  

  

Policy and State Boards of Nursing

Within the far-reaching and multi-layered realm of policy and reform, government at the state level plays an essential role. Consider the federally enacted PPACA’s individual mandate which sought to increase the number of consumers who receive insurance coverage and, therefore, greater access to care. In a system that is already stretched beyond capacity and confronting a nursing shortage, how can the health care system meet this increased demand? Since state boards of nursing determine scope of practice, it is important to stay up to date and current with the policies and regulations that are created by the state board of nursing.

To prepare:

• Review      the Thomas, Benbow, and Ayars article and the Watson and Hillman article      focusing on how states regulate advanced nursing practice and how      legislative changes are impacting scope of practice.
• Visit      your state board of nursing website and/or contact the board to determine      how the state board controls advanced practice through regulations (google mbon.org for my state board      of nursing)
• Determine      if your state board has created any new policies or regulations that      address changes to scope of practice in response to legislative changes.

By tomorrow 04/25/2018 10am, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”

Post a cohesive response that addresses the following:

1) What are the most recent regulations promulgated through your state board of nursing for advanced practice?

2) How are the state regulations supported within your place of employment? (google mbon.org for my state board of nursing)

3) How do the states differ in terms of scope of practice? What impact does this have on professional nurses across the United States?

Required Readings

Chen, A. S., & Weir, M. (2009). The long shadow of the past: Risk pooling and the political development of health care reform in the States. Journal of Health Politics, Policy & Law, 34(5), 679–716. 

The authors provide an analysis of varying state health care policies, with a basic premise that health care risk is either “pooled”—shared, or “actuarial”—segmented by risk level. Most states have taken a segmented approach to health care, and therefore, have not solved health care issues such as rising costs and access to care. The authors maintain that federal action is needed to create a uniformed approach to health care.

Junghee, L. (2009). Cultural, social, and political influences on state-level indigent health care policy formation. Journal of Policy Practice, 8(2), 129–146.

This article provides details on a 50-state study of Medicaid spending. The authors concluded that political and economic factors can positively predict individual state Medicaid spending, and that actual need has a negative impact on spending. In conclusion, a uniform, federal structure may be the only method to ensure equal access to Medicaid.

Mills, A., Engelhard, C. L., & Tereskerz, P. M. (2010). Truth and consequences—Insurance-premium rate regulation and the ACA. New England Journal of Medicine 363(10), 899–901.

O’Connor, J. C., MacNeil, A., Chriqui, J. F., Tynan, M., Bates, H., & Eidson, S. K. (2008). Preemption of local smoke-free air ordinances: The implications of judicial opinions for meeting national health objectives. Journal of Law, Medicine & Ethics, 36(2), 403– 412.

Sommers, B. (2010). Enrolling eligible children in Medicaid and CHIP: A research update. Health Affairs, 29(7), 1350.

The enrollment and retention of eligible children in Medicaid and Children’s Health Insurance Program (CHIP) is a health care concern. The article concludes that some state processes have mitigated this issue but other requirements, such as providing citizenship documentation, may have a detrimental effect. Therefore, these concerns should be incorporated into the implementation on PPACA of 2010.

Thomas, M. B., Benbow, D. A., & Ayars, V. D. (2010). Continued competency and board regulation: One state expands options. Journal of Continuing Education in Nursing, 41(11), 524-528. 

The authors use the changes instituted by the state of Texas in regard to the licensing of nurses to illustrate the need to adapt state licensing requirements to the changing diversity and scopes of practice among nurses.

Watson, E., & Hillman, H. (2010). Advanced practice registered nursing: Licensure, education, scope of practice, and liability issues. Journal of Legal Nurse Consulting, 21(3), 25–29.

The expanded role of the advanced practice nurse has led to changes in licensure, education, certification, and scope of practice definitions. The author points out that this expanded role has led to increased liability and accountability concerns as well.

Yue, L., Harrington, C., Spector, W. D., & Mukamel, D. B. (2010). State regulatory enforcement and nursing home termination from the Medicare and Medicaid programs. Health Services Research, 45(6p1), 1796-1814. doi:10.1111/j.1475-6773.2010.01164.x

Those nursing homes receiving Medicare and Medicaid funding are subject to strict quality and safety regulations. This article examines the consequences of enforcing those federal quality standards.

  

Optional Resources

Wieck, K. L., Oehler, T., Green, A., & Jordan, C. (2004). Safe nurse staffing: A win-win collaboration model for influencing health policy. Nursing Education Perspectives, 31(3), 160-166.

People of French Canadian Heritage.

People of German Heritage.

Read chapter 14 and 29 of the class textbook and review the attached Power Point presentations.  Read content chapter 29 in Davis Plus Online Website.  Once done present a minimum of 600 words essay (excluding the first and reference page) explaining the evolution of health care beliefs of this these two heritage and explain if there is any similarity with the delivery of health care here in United States. Essay must have a minimum of three evidence based references excluding the class textbook and must be presented in an APA format, word document, Arial 12 font attached to the forum in the discussion tab of the blackboard title “Week 7 essay”.  

You must post at least two replies to any of your peers essay sustained with the proper references.  Essay will not be accepted via email.  

Read and review the attached Power Point presentations.  Once done answer the following question;

Describe the cultural health customs of the Egyptian and Filipino cultures and how they influence the delivery community health care.

As you can see I’m giving you one question to elaborate.  present your assignment in an APA format on an Arial 12 font word document.  A minimum of 3 evidence based practice references are required.  A minimum of 500 words are required.  

Applying Nursing Theory Discussion

Instructions:

1. Select one of the following scenarios related to a specific nursing. Think about what you would do in the scenario presented and post your ideas.
   
2. Post two discussion questions based on the readings along with your answers.
3. Read and then respond to at least two of your classmate’s postings.

Theorist	Scenario
Florence Nightengale	Using Nightengale’s concepts of ventilation, light, noise, and cleanliness, analyze the setting in which you are practicing nursing (working as an employee or student). Using Nightengale’s theory, evaluate the nursing interventions you have identified for an individual patient in your facility or practice. OR Your hospital patient is an 82 year-old woman. She does not have immediate family and has been living alone in her own home. Her hospitalization was unanticipated; it followed a visit to the emergency room for a burn on her lower leg. The patient has been hospitalized for 14 days. She pleads with you to allow her friend to bring her dog, a 16-year-old Scotty Terrier, to the hospital. She tells you that none of the other nurses have listened to her when she asked them about such a visit. Based on Nightingale’s model, and 13 cannon, what actions would you take for this patient?
Betty Neuman	Martina is a middle-aged Hispanic woman who brings her family to a local free clinic to obtain medical care. She works part time in a restaurant for minimum wage. She lives in a small apartment with her daughter and four preschool children; her daughter speaks only very broken English. Martina’s medical diagnoses are hypertension, arthritis, and depression. Use the Neuman System Model as a conceptual framework to respond to the following: Describe the family as a system. How does the dominant Anglo culture impact on  the family’s stability as a system? What stressors (actual and potential) threaten the family? What additional assessment data are needed related to Martina’s medical diagnoses? What additional assessment data are needed related to the family’s health status? How will cultural differences influence planning for prevention as intervention at primary, secondary, and tertiary levels? OR Using the Neuman System Model, organize a patient care conference in your workplace to deal with a patient situation that has been difficult to manage.  Involve caregivers from nursing and at least one other disicpline to discuss each of the following: What factors comprise the patient’s normal and flexible lines of defense and lines of resistance? What stressors are  causing the problems with this patitent? What is the patient’s reaction to the stressor? What is each discipline’s perspective on the problem or isssues that are involved? How is the situation influenced by the patient’s family system? By the patient’s environment? What would be the ideal coutocme in this situation from each discipline’s perspective?  From the patient’s perspective? What goals would be appropariate to neogotiate with the patient? What primary, secondary, and tertiary prevention-as-interventions would support attainment of these goals?
Imogene King	Think about and write your personal definitions of environment, health, nursing, and person. (Do these sound familiar to you?). Compare your definitions with King’s definitions. How are they similar? How are they different? Are they more alike than different? If they are more alike, develop a plan to use King’s framework and theory more extensively in your paper (and practice). OR Does the philosophy of one of the agencies in which you have practiced encourage the involvement of the patients in their care? If so, does mutual goal setting occur? If not, what changes would you suggest to promote more active involvement of the patients in their own care? Analyze an interaction  you have had with a patient. Were you able to achieve a transaction as King describes it? If so, think about what you did differently with this person? If not, think about the interaction and try to identify why the transaction was not achieved?
Hildegard Peplau	During the therapeutic relationship, patients may distort their perceptions of others. Therefore they may relate to the nurse not on  the basis of the nurse’s realistic attributes, but wholly or chiefly on the basis of interpersonal relationships existing in their environment. With  the patient and nurse roles you have described above, discuss how these distorted perceptions may affect the patient’s care and the nurse-patient relationship. OR Considering the nurse-patient relationship created in question #1 above, discuss the phases and the changing roles that would be considered when working with this patient. Consider experiences in which you would 0r/and would not be able to accomplish the appropriate goals for each phase of the nurse-patient relationship.
Madeleine Leininger	Discuss the usefulness of the Culture Care: Diversity and Universality Theory in the  21st Century to discover nursing knowledge and to provide culturally congruent care. Take into consideration the current trends of consumers of healthcare, cultural diversity factors, and changes in medical and nursing school curricula. Listed below are some examples of trends and changes you may want to consider in your discussion:  The importance of transcultural nursing knowledge in an increasingly diverse world An increase of lay support groups to provide information and sharing of experiences and support for patients and/or families experiencing chronic, terminal, or life-threatening illnesses or treatment modalities from diverse and similar (common) cultures. Use of cultural values, beliefs, health practices, and research knowledge in undergraduate, alternative medicine, herbs, vitamins, minerals, and other over-the-counter medications, which demand a transcultural knowledge base.