Clinical Nurse essay

This coursework establishes the goals and objectives of a clinical nursing specialist practicum. It demonstrates advanced knowledge and skill that a clinical nursing specialist should demonstrate in the care of patients with cardiovascular diagnoses. According to literature, cardiovascular diseases are so critical that no mistakes should be anticipated. As such, this cadre of clinical nurses should not just understand the patients’ medical condition, but also the effects of administering certain drugs to such patients. This is due to the fact that some drugs could aggravate cardiovascular complications, thereby worsening the patients’ medical condition.  In addition, the coursework focuses on the review of the current literature with particular emphasis on the treatment of Acute Coronary Syndrome (ACS). The literature advocates for a weekly plan that would enable nurses to monitor the progress of the cardiac complications and propose therapeutic intervention before the situation gets out of hand. Essentially, it would enable medical profession to develop in-service for cardiology nursing staff related to new treatments for ACS and present as a roving in-service that is acceptable to all stakeholders. In particular, my case would require a coordinated work with preceptor to identify high risk cardiac patients with a view to following them throughout practicum for regular consultation regarding nursing care. Ideally, this would allow me to appreciate the role of a clinical nurse in cardiovascular care from a first-hand perspective.

The conventional practice of clinical nursing has considerably grown over time. Even though fundamental top features of the discipline remain exactly the same, it would certainly be prudent that fresh clinical nurses attempt to be able to be familiar with system and the changes which have occurred in order to integrate these people into a workable system. The practicum program plan to integrate these scientific aspects that would allow me perfectly fit in to the current system of clinical nursing. For instance, I want to widely communicate with advance practice healthcare professionals so that I can learn from them certain growing conditions that are extremely relevant in order to the practice of clinical nursing. Besides, it might give the ample possibility to engage with people associated with different ages and decide the clinical advantages that will some sections of the community enjoy regarding cardiovascular problems. For instance, infants have got underdeveloped microvasculature that are unable to withstand high blood stress that is associated with hypertonie. Conversely, geriatrics has comparatively weakened vasculature due to nature of their conjoining tissues. This essentially predisposes them to severe consequences in the event they develop cardio complications.   However, the particular middle age is pretty resistant to the whole effects of these complications since they are less likely in order to suffer internal bleeding from hypertension (Hamric, Sprouse & Hanson, 2009).

Management Strategies of Acute Coronary Syndrome

Nursing specialists have a critical role in the management of Acute Coronary Syndrome. This is one of the cardiovascular complications that involve coronary arteries thereby leading to a blockade and eventually myocardial infarction.  For instance, the disease angina that develops due to exertion and resolves at rest could be very challenging to unsuspecting patients. In addition, the fact that it presents as chest pain gives it clearly similar presentations as most respiratory complications. In light of this, the nursing specialists who spend most of the time with clinical patients must be able to timely recognize and monitor the progress of these complications. According to the International Association of Cardiologists, Acute Coronary Syndrome is a typical coronaary thrombosis that has a strong correlation with drug abuse, especially cocaine. Notably, cocaine is not just a drug of abuse, but a therapeutic agent used in local anesthesia. This implies that medical practitioners dealing with cardiac patients who have to get minor surgeries must be keen on the types of anesthetic agents that they use. For instance, the use of cocaine and some of its derivatives would instead aggravate cardiac complications. In most cases, management of diseases also entails understanding the background information and the precipitating factors. For example, clinical nurses would provide better clinical care to cardiac patients if they properly understand the management of its precipitating factors, like anemia and increased heart rates (Adelman, 1992).

Although acute coronary syndromes are divided into several groups, unstable angina remains the most lethal. It is basically the type of chest pain that results from ischemia of the cardiac cells and often occurs over a prolonged period of time with little or no exertion. And due to the fact that unstable anginas are difficult to properly control on drugs alone, clinical management of patients is quite critical. For instance, the medical personnel would most likely be involved in monitoring the concentration cardiac enzymes as this is the safest method. As such, it becomes quite prudent that clinical nurses understand these principles so that they can provide the best patient care. According United States Cardiac Association, acute coronary syndromes should be given priority as they have lately become the major cause of mortality and morbidity in the global society. Essentially, the management of these complications would be one of my focal points, especially with regards to the administration of certain drugs, like aspirin as their administration would worsen the situation of cardiac complications (Morrison & Monagle, 2009).

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Clinical Nurse Specialist essay

This coursework establishes the goals and objectives of a clinical nursing specialist practicum. It develops a perfect understanding of the discipline, as well as the expertise required in the nursing practice. In particular, it focuses on the strategic management principles as relates to nursing care for asthma patients. In addition, it seeks to establish a systematic understanding of the expertise to be demonstrated in educating health care staffs, as well as in patients about the asthma related precautions. Further, the coursework focuses on how the acquired expertise in the nursing career can be used to improve the patient care and quality of life in general.

The programs involved in working as a clinical nursing specialist are quite intense and demanding. In light of this, a clearly thought out layout of the goals and objectives should be drawn early enough to ensure that nothing lags behind. Before embarking on the practicum, it has been necessary to collaborate with advanced practice nurses to establish the current trends in the nursing practice, as well as the emerging issues that may be necessary to understand. In particular, the populations that I will be dealing with often require specialized care that requires a thorough understanding. For instance, the adult populations have many issues to do with their reproductive life that require the special attention. In particular, women of adult age are either in childbearing stage or are getting into menopause. In both cases, they are being introduced into a new kind of life. As such, there are many things they may not understand about their personal life. In most instances, the clinical nursing specialist will be required to offer the appropriate advice. Although men of this age have limited health issues, the complications associated with the women equally affect them, as they are either fathers or husbands to women of this age (Hamric, Sprouse & Hanson, 2009).

Cardiology Nursing Staff essay

Undoubtedly, cardiac patients at the greatest risk are geriatrics approaching the age of 70 and experience cardiac pain even at rest. According to cardiologists, their electrocardiogram is quite characteristic in the sense that it has a segment of depression at the initial points. In handling these patients, clinical nurses are required to take utmost care because of the relative weakness of their organ systems with regards to drug interactions and drug metabolism. For instance, geriatrics could easily suffer drug toxicities as drug metabolic systems are not that competent to actively degrade the drug active agents in a predictable manner. As such, clinical nursing specialists must provide them with adequate and accurate in-service programs to triumph over their disease situations. On the other hand, cardiac patients who belong to the medium risk group often experience various complications that clinical nurses must properly take care of. These include the risk of ischemia after myocardial infarction, heart failure, diabetes mellitus or aspirin doze. According to current nursing modules, such patients are supposed to receive an appropriate doze of glycoprotein II b/ III a receptor inhibitors to help ease their complications, especially for conditions induced by aspirin does (Blevins & DeArmond, 1995).

The fundamental aspect of my objectives will be to rightly identify high risk patients and accord them the timely medical attention that is required of the medical profession. It would be appropriate and cost effective, for instance, to manage patients with no major risk factors even after exertion outside the hospital setting. Conversely, patients who exhibit these risk factors should not only be placed under clinical investigation, but should also be given the appropriate drugs that would effectively manage their complications. In this case, I would undoubtedly corporate with pharmaceutical professionals, especially clinical pharmacists, to administer the best kind of drugs and avoid drug interactions. Indeed, the practice of clinical nursing would take cognizance of the fact that the recent developments in the treatment and management of acute coronary syndromes have been mainly due to increased patient awareness of their patho-physiology. This would enable them identify the areas where patients need to be educated so that they can take charge of their health. For example, I would ensure that I initiate education with a view to enlightening the people about the rapture of atherosclerotic plagues that eventually causes intracoronary thrombosis. Besides, I will educate them on the risks of embolism, especially from a friable coronary thrombus that could eventually lead to tissue necrosis as blood supply will be inadequate (Morrison & Monagle 2009).

An Advanced Practice Nurse essay

An advanced practice nurse is described as a nurse with a large amount of clinical knowledge usually to a post-graduate level, with a high amount of skill and experience and wide scope in the practice of nursing. Hamric’s values should not be viewed as knowledge to be used in patient management by themselves, but rather they should be used as a channel or means of administering healthcare to patients. The advanced practice nurse should thus be able to utilize the vast amount of skill and experience and use it in patient management, while adhering to the core values with no problem. When used in this way, the patient is able to benefit from the advance practice nurse’s skill and knowledge in an environment that promotes his/her recovery. Integration of the core values into the advance nurse’s practice would provide the optimum conditions for patients’ recovery or management. The two are relatively different disciplines, and therefore their integration would not result in any friction. This would become easier with practice just as with any other discipline in healthcare (Australian Nursing and Midwifery Council, 2006).

A Career in Nursing essay

It is widely documented that the healthcare revolution that began in the late 1990s led to many changes especially those related to fiscal restraint and cost containment in the healthcare sector. Most importantly, the twentieth century is referred to as an era of downsizing and organizational restructuring; factors which caused a rapid increase in the number of nurses followed by an almost simultaneous nursing shortage. Besides the nursing shortage, the current healthcare trends including the technological revolution, globalization of health care, commodization of health care and environmental issues impact the healthcare sector and a nursing profession in different ways (Vallano, 2008). However, considering the current job outlook and prospects for registered nurses (RNs) across the United States, it is apparent that the nursing profession is excellent and demand for is expected to continue growing in all aspects.

To become a signed up nurse, one is likely to have either a diploma in a nursing program, a new Bachelor’ s degree inside Nursing (BSN), or a great Associate degree in Nursing (ADN). Moreover, individuals keeping degrees consist of programs might become nurses by task any of the available programs including a Master’ s degree in Nursing or a combined Bachelor’ s and Master’ s degree plan. On the other hand, all nurses working in any US territory have to be licensed following graduating by passing the National Council Licensure Examination (NCLEX-RN). Further, RNs can increase certification by becoming people of any professional association including ambulatory care, pediatrics, or gerontology. Despite the fat that certification will be voluntary, all RNs keeping among the four advanced nursing practice roles must become certified. In addition , RNs can advance from being staff nurses to positions in management, advanced practice, nursing education, or healthcare enterprise based on their encounter, performance, and continuous schooling (Bureau of Labor Data, 2012; Turnock, 2012).

According to the Bureau of Labor Statistics (2012), the median annual salary for RNs was estimated at $64,690 as of May 2010. This implies that the lowest 10% of RNs earned $44,190 or less and the top 10% of RNs made $95,130 or more in 2010. Moreover, the median annual wage for RNs working in the private sector was $66,650 in the same period. Most importantly, many employers in the United States offer RNs flexible work schedules, which entail working in both hospital and non-hospital settings. Many RNs work in general medical and surgical hospitals (both local and private), government agencies, educational facilities, physician offices, home healthcare service facilities, or nursing care facilities. Depending on the work environment, RNs have different work schedules. For instance, RNs who work in hospitals may have rotating shifts, which cover a 24-hour period. They may also work on public holidays and weekends; have night as well as part time shifts. Furthermore, most nurses are prone to back injuries because their work involves walking, standing, bending, and a lot of stretching (Bureau of Labor Statistics, 2012; Turnock, 2012).

Generally, to succeed as the registered nurse in the 21st century, one is expected to possess specific personal characteriistics. First and foremost, nurses must possess excellent critical-thinking skills because their work involves evaluation of the state of patients, which requires high levels of accuracy and proper judgment. Second, nurses must be compassionate and patient because their work is sometimes stressful. Most importantly, nurses must be emotionally stable in order to cope with various job stresses related to human sufferings and emergencies. Lastly, it is important for nurses to possess excellent communication and organizational skills because they interact with many patients with multiple needs and language constraints (Vallano, 2008).

On the other hand, the prospects for growth in the nursing profession are generally excellent considering that the current healthcare trends generate many opportunities and challenges, which drive the current changes in the healthcare sector. Furthermore, the future of nursing is bright because the employment rates are expected to increase up to 26% in 2010-2020 compared to other professions. Therefore, in order to retain qualified and high-performing nurses, employers may be forced to offer better salaries, bonuses, and attractive work-schedules. Moreover, nurses with a BSN or higher qualifications are expected to have better job prospects in the future (Bureau of Labor Statistics, 2012).

In conclusion, it is apparent that the nursing profession is growing rapidly if compared to other professions due to the current nursing shortage and other healthcare issues. As a result, building a nursing career will be an excellent decision for those individuals looking for a long-term and satisfying career.

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Death in a Nursing Home essay

Whether being admitted to a nursing home increases the risks of death is a difficult question. The current state of literature provides rich information on the risks and problems facing elderly nursing home residents. This paper is a review of literature intended to reconsider the risks of mortality in elderly nursing home residents. The following themes are included: inappropriate medication, falls, dementia, acquired infections, and unnatural deaths. Implications for the study of death risks in nursing home settings are provided.

Keywords: nursing home, death, elderly, nursing, risks, care.

Death in a Nursing Home

Introduction

The problem of deaths in nursing homes has long been a matter of public scrutiny. In 1992, the number of residents in U.S. nursing homes exceeded 1.5 million, and the percentage of the elderly residing in nursing homes was increasing with age (Corey, Weakley-Jones, Nichols & Theuer, 1992). In 1992, only two percent of the elderly aged 65-74 was expected to end their lives in a nursing home, compared to almost 22% older than 85 (Corey et al., 1992). Today, the number of nursing home residents has not changed: Centers for Disease Control and Prevention (2012) estimate that around 1.5 million older people currently live in nursing homes. Despite the recent advances in medical technology, the problem of deaths in nursing homes remains an object of serious concern. The goal of this review is to see whether nursing homes increase the risks of mortality in their elderly residents. The problem was selected mainly due to the lack of sufficient data and the growing pressure to contain medical costs at the federal level. The results of the proposed investigation may help nursing home professionals improve the quality and safety of care, while also balancing and even reducing its cost. This review reconsiders the problem of deaths in nursing homes from an empirical, mainly quantitative, perspective and is intended to create a solid basis for the implementation of future evidence-based care projects in nursing homes. The review is limited to deaths in nursing homes and does not include the problems of deaths in nursing home residents admitted to hospitals due to their health state.

Problem Statement

On March four, 2013, Monk News noted a death case in a facility for elderly individuals located in California. Based to Rafferty (2013), a great elderly female resident regarding Glenwood Gardens in Ca died as the nurse refused to provide timely health care assistance. The nurse rejected to perform a life-saving procedure on the game play that such steps were prohibited with the nursing home’s policy (Rafferty, 2013). The records of the conversation between the nurse plus the emmergency 911 operator indicate that this doctor openly refused to do CPR, thus violating a complete established of patients’ ethical privileges and damaging the image of nursing as a new profession was executed to promote patients’ beneficence and lives.

Almost simultaneously, Champaign Region released a report from the community’s Nursing Home table of directors. The record showed that, within the about three months preceding its syndication, the number of demise in the nursing experienced substantially increased. At least 62 deaths were registered inside the community nursing home in December-February, which has been much higher than the accepted average of 5. a few deaths per month (The News-Gazette, 2013).     The problem of deaths in nursing homes will be both obvious and underexplored. Reasons why nursing residence residents may face higher risks of death compared to home settings furthermore remain unclear. However, the problem has profound implications for the entire healthcare system, for the communities which have nursing jobs homes, and for the existing understanding of nursing since a caring profession. Upon the one hand, the growing incidence of fatalities in nursing homes is usually likely to lead to a considerable increase in law suits and litigation costs. “Lawsuits against nursing facilities are a comparatively new phenomenon” (Stevenson & Studdert, 2003, p. 219). Nursing homes need to be able to divert considerable resources to provide adequate legal protection and pay compensations. About the other hand, communities direct huge resources to support the long-term features of their nursing houses, plus the growing number associated with deaths is likely to taint their reputation as safe places to live and get quality care (The News-Gazette, 2013). Finally, looking at the problem holistically, the problem regarding deaths in nursing houses undermines the very idea of nursing as an occupation that brings satisfaction and serves the health and life needs of medical home residents. Apparently, much better knowledge of the problems going through nursing home residents is required to develop sufficient solutions and protect their safety and health.

Literature Review

Key Problems

It ought to be noted that loss of life as an outcome associated with nursing home care will be an essential indicator associated with care quality in the settings. Back in 1977, Linn, Gurel and Linn discovered the relationship between demise and care quality signals in nursing homes. In accordance with Linn et al. (1977), it is always desirable to have better info about patient outcomes. Offered the diversity of breastfeeding home residents, mortality in addition to death exemplify a feasible approach to measuring the top quality of care. It is not necessarily usually easy to predict patients’ recovery potentials or examine their progress. At typically the same time, death alone cannot be a possible measure of care quality in nursing homes, generally because, for many sufferers admitted to nursing homes, death is the most likely prognosis (Linn ainsi que al., 1977). Linn ou al. (1977) state that “one of the primary features of a nursing home is always to provide humane care for dying or significantly ill patients” (p. 338). Therefore, the incidence and risks of deaths inside nursing homes should be scored in terms of typically the expectations and prognoses, simply because well as in conditions of the quality plus appropriateness of care offered before death.

Most researchers who explored the problem of death inside nursing home residents made a decision to consider the risks regarding one or several well being complications that might be responsible with regard to those risks. Rubenstein, Josephson and Robbins (1994) reviewed the incidence and challenges of falls in assisted living facilities and their relation to the risks of death among nursing home residents. Rubenstein et al. (1994) wrote that three fourths of all deaths caused by falls occurred in people aged 65 years in addition to older. In healthcare organizations and assisted living facilities, the hazards of falls are abundantly documented: compared to typically the elderly living at residence, nursing home residents face the risks of drops that are three times higher (Rubenstein et ‘s., 1994). The mean incidence of falls in medical homes was estimated at 1. 5 per medical home bed (Rubenstein ou al., 1994). Once fallen, the elderly nursing home resident has much larger risks of fatality than a younger person with a similar trauma (Rubenstein et al., 1994). Medical homes have higher rates of hip fracture among their residents and higher fatality rates due to hip fracture than the similar indicators in community-based elderly residents (Rubenstein et ing., 1994). These results suggest that nursing homes boost the risks of death, several questions still remain unanswered. Rubenstein et al. (1994) are right, when saying the percentage of frail residents in nursing houses is much more than inside the rest of the community. Besides, only 1 in 5 fractures within elderly falls and cracks takes place in assisted living facilities (Rubenstein et al., 1994). These findings alone cannot support the thesis that this risks of death inside nursing homes are higher, although they confirm the require to study the issue inside detail.

Another problem explored in relation to deaths in nursing homes is that of dementia. Many residents are admitted to nursing homes due to their health state and require that their prognosis and the need for quality palliative care are evaluated (Mitchell et al., 2004). Still, most nursing homes and hospices report difficulties estimating the life prognosis in the enrollees, who have been diagnosed with dementia (Mitchell et al., 2004a). Even more disturbing are the emerging complaints that the quality of dementia care in nursing homes is below the accepted standards. This problem was thoroughly investigated by Mitchell, Kiely and Hamel (2004b).

The problem of death in patients with dementia is particularly acute, bearing in mind that almost 90% of them are institutionalized before death (Mitchell et al., 2004b). According to Mitchell et al. (2004b), older patients with dementia admitted to nursing homes often have to undergo burdensome and unnecessary nonpalliative procedures, even though their life expectancy is limited. In nursing homes, which are intended to serve the end-of-life needs of geriatric patients, dementia is often not recognized as a terminal condition (Mitchell et al., 2004b). Residents with advanced dementia living in nursing homes are more likely to have pressure ulcers, be treated with psychotic medications and be exposed to restraints than the residents with terminal cancer (Mitchell et al., 2004b). The provision of inappropriate nonpalliative medical measures to patients with dementia, including phlebotomy and feeding tubes, can potentially be related to higher risks of mortality in nursing homes: 25% of dementia patients in nursing homes were found to have died with a feeding tube compared to only 5% of residents with cancer (Mitchell et al., 2004b). Even then, the relationship between dementia care and death risks should be profoundly analyzed to exclude the influence of other potentially confounding factors, such as prognosis and the severity of the diagnosis.

The risks of death in nursing home are often considered through the prism of other diagnoses, including nursing-home acquired pneumonia (NHAP). This problem was thoroughly analyzed by Mylotte (2002) and Beck-Sague, Banerjee and Jarvis (1993). Beck-Sague et al. (1993) conducted the first population-based study to analyze the risks of infections in nursing homes and their relation to mortality. The results showed that bedbound residents of nursing homes faced higher risks of pneumonia (54.5 per 100 discharges)), whereas residents with indwelling catheters were also exposed to severe risks of urinary tract infections (Beck-Sague et al., 1993). NHAP also increased the risks of death in a nursing home (35% vs. 28%) (Beck-Sague et al., 1993).

Today, pneumonia is claimed to be the second most common cause of mortality in nursing homes, as well as the most common reason why nursing home residents are discharged to hospitals (Mylotte, 2002). Mylotte (2002) also writes that the nursing home residents who survive pneumonia experience significant morbidity. These results suggest that pneumonia is quite common in nursing home, but its causes and relation to the quality of nursing home care remain unclear. Beck-Sague et al. (1993) suggest that the risks of pneumonia-related mortality in nursing home residents may be associated with delays in evaluating the symptoms of the infection and providing timely treatment and support. The systems of infections controls in nursing homes are also imperfect: proven methods to reduce the risks of infections are rarely used (Beck-Sague et al., 1993). All these aspects imply that being in a nursing home is a more dangerous endeavor than spending the last days of life at home.

The analysis of unnatural deaths in nursing homes could add to the statistical findings presented above. Corey et al. (1992) claim that a significant amount of deaths in nursing homes is not investigated, because most residents suffered from serious medical illnesses. Corey et al. (1992) presented the analysis of nine accidental and homicidal deaths in nursing homes, their main causes including asphyxia, restraints devices, scald burns, airway obstruction, and hypothermia. Chest restraints were used improperly, leading to death. Failure to provide adequate life support was also responsible for one death. Poor enforcement of the existing legislation impedes the implementation of effective life support systems in nursing homes (Corey et al., 1992). Inappropriate medication prescriptions also increase the odds of being discharged to a hospital or dying the same month or next (Lau, Kasper, Potter, Lytes & Bennett, 2005). Statistically, 40% of nursing home residents face inappropriate drug choices, 13% experience drug-disease interactions, and 11% are compelled to take excess doses (Lau et al., 2005). At least 30% of all nursing home residents have to take inappropriately prescribed medications through their entire stay (Lau et al., 2005). Nursing homes that have regulatory difficulties are more likely to have registered unexpected or sudden deaths (Keay, Taler, Fredman & Levenson, 1997). Therefore, it is quality of care that matters and predetermines the likelihood of death in a nursing home.

Pros and Cons of the Issue

The pros and cons of the issue are obvious. On the one hand, the community has the right to know what is happening in nursing homes and how their professionals manage the quality of medical care provided by elderly residents. Compared to community-based elderly residents, those who are admitted to nursing homes experience higher risks of infections and mortality due to the absence of life support systems. In most cases, it is not residents’ incapacitating condition or frail state but the use of inappropriate medications, incorrect nursing decisions, or complete indifference towards nursing home residents that result in their death.

On the other hand, the relationship between nursing home admission and the risks of death is not straightforward. This relationship is moderated by a large number of confounding factors. The initial life prognosis plays one of the major roles (Linn et al., 1977). The frail state of most nursing home residents should not be ignored. Besides, that more residents die in nursing homes than in community settings does not tell much about the problem: according to Van Rensbergen, Nawrot, Hecke and Nemery (2006), the mere presence of a nursing home in the local community predicts higher percentage of the elderly, who die within the institution. The study of death risks in nursing homes may be costly and time-consuming, but it has profound implications for the quality of nursing home care. The problem must be investigated in detail because, regardless of the physical state in which elderly people are admitted to nursing homes, they have the right for adequate and humane nursing care before they die (Linn et al., 1977).

Conclusion

Whether being admitted to a nursing home increases the risks of death is an open question. The current state of literature raises many questions regarding the quality and professionalism of medical care provided to nursing home residents. Nursing homes are claimed to increase the risks of infections, inappropriate medication prescriptions, falls, and unnatural deaths. Apparently, it is not prognosis or residents’ frail state but the poor quality of care, unprofessionalism and noncompliance that result in so many deaths in nursing home settings. Still, a more detailed analysis of the factors, which moderate the relationship between nursing home admissions and death risks, should be performed.

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Graduate Nursing Education essay

The adult nurse practitioner program prepares students to undertake advanced nursing practice in providing primary care to “at risk” and chronically-ill adult patients and their families in a wide range of care settings including specialty clinics and urgent/emergency rooms. Furthermore, adult nurse practitioners (ANPs) must collaborate with other healthcare professionals to provide health management, promotion, and maintenance for adults. Therefore, those preparing for this profession must possess a wide range of personal qualities and attributes. First, ANPs must be fast learners and have the willingness to pursue extended education as necessary. Secondly, empathy and quick reasoning are important personality traits for ANPs.

Thirdly, ANPs must possess a chance to lead and handle other nursing staff found in a variety of nursing environments, implying that these people should also have excellent communication skills. Lastly, they must have the ability in order to remain calm and remain focused pressurized because regarding the urgent nature of the cases they handle. Above all, ANPs must be competent in health assessment in addition to diagnosis by employing different tools and techniques to be able to assess and synthesize clinical/assessment data. Moreover, these professionals need to demonstrate competence in well being promotion, healthcare management, prevention of illnesses/complications/injuries, and healing intervention by collaborating with other healthcare professionals, clients, and family members inside making informed clinical decsions.

In addition to the aforementioned qualities and attributes, ANPs must understand the true definition of cultural competence, ethical sensitivity, leadership, and life-long learning, and incorporate these important aspects of nursing into their practice. Here, cultural competence refers to the nurse’s ability to adapt to a variety of cultural beliefs and practices, particularly those influencing health outcomes, while disregarding stereotypes and cultural bias in their practice. Thus, I aspire to incorporate cultural competence into my practice by first understanding my own cultural views and those of my clients before applying this cultural information to improve the quality of care and health outcomes. On the other hand, ethical sensitivity refers to the ability to interpret different situations with empathy by considering the people involved, the possible actions to be undertaken, and the reactions or outcomes that should be expected. Accordingly, I intend to incorporate ethical sensitivity into my practice by considering the perspectives of my clients, reading emotions, preventing social bias, identifying the consequences of my actions, and providing care through connecting to my clients.

Further, nursing leadership entails the ability for a leader (preferably a “group leader”) to head, empower, motivate, inspire, and influence other people in order to achieve a common goal. Therefore, considering the nature of the adult nurse practitioner profession, I intend to employ aa variety of nursing leadership skills such as excellent communication and interpersonal skills and sincerity to head other healthcare professionals in efforts to provide quality care to adult patients. On the other hand, life-long learning refers to engaging in continuous professional learning over the period of a professional’s career to ensure that his/her skills remain up to date. Therefore, besides being a registered nurse (RN), I intend to remain engaged in life-long learning throughout my career in order to acquire current theory, clinical expertise, and research to inform my practice.

As a result, having considered the personal qualities, attributes, and competencies necessary for those aspiring to become adult nurse practitioners, it is important to outline the implications of graduate nursing education for my future career goals. Currently, I am a registered nurse (RN) working with mentally-disabled patients. In the near future, I aspire to become an adult nurse practitioner (ANP) working in the ICU. Besides, I would love to start my own urgent clinic to provide care to “at risk” and chronically-ill adult patients. Therefore, graduate education in an adult nurse practitioner program will enable me not only to realize my future career goals, but it will also give me the opportunity to serve my community by bringing urgent healthcare services closer to people. Most importantly, graduate education in nursing will ensure that my practice will be informed by current theory, research, and clinical expertise.

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