Katherine began her shift feeling well-rested after a two-week vacation. She found that none of her patients were familiar to her. One patient in particular, 45-year old Lynda, who had been admitted a week prior with an emergent tracheostomy and other health issues, seemed like she would require a lot of attention over the next 12 hours. By working with Lynda over several days, Katherine helped her gain independence by teaching her how to suction and feed herself through her PEG tube. Physicians were unsure of Lynda's discharge plans because her brother doubted she could care for herself, but Katherine was impressed with Lynda's confidence and progress.

1. Nursing Exemplar
Katherine Gallagher NU 310 Exemplar 2/21/2012 I arrived to work well rested and ready to start the day. I had just returned after a two week long
vacation. Because of the time off, I arrived to 7 East to find that the assortment of patients was not familiar at all. As I began getting reports on my
patients, one in particular I started to feel a little anxious and stressed. At first glance I could tell I would be busy for the next twelve hours. Lynda
was a 45 year old woman that was admitted almost a week ago after having an emergent tracheostomy placed. Lynda was newly diagnosed with
laryngeal cancer with already having several other diagnoses including: seizure disorders, mild mental retardation, behavioral issues, and was legally
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The look on Lynda's face was that of incredible confidence, I was truly impressed with her. By the end of our second twelve hour shift, Lynda had
learned how to suction herself. It was passed along in report to simply encourage her independence in suctioning herself. Day three, my mission was
to teach Lynda the proper care of her PEG tube, and to continue with the encouragement of her suctioning herself. After walking her though a bolus
feeding in the morning, she agreed to do the next one. Lunch time came around and sure enough, she was able to complete the bolus feeding with
minimum assistance. By the time came for the next feeding she was going to get the can of food to do it herself when I had walked in the room. She
laughed and told me I was right that the PEG tube was a lot easier than suctioning. At this point in Lynda's stay I knew that she would be going home
soon. Later that evening, while discussing Lynda's progress over the last few days with the physicians I asked them what the plan was and instructed
them that we needed to get nutrition, social work, and case management involved so that she could go home. The physicians stated that they would
place the consults that I requested but as for discharge they were unsure about when this would happen because Lynda's brother doesn't think she can
care for herself on her own. I was shocked to hear this, the brother who I had not
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2. Essay on Nursing Care Plan
Introduction: A nursing diagnosis identifies an actual or potential response of a patient to a health problem (Jones 2009). Nursing diagnoses are
important because they provide the foundation for the selection of nursing interventions (Walton 2008). This care plan is the concluding half to the
initial care plan that identified nursing diagnoses and goals with the aim of promoting the holistic wellbeing, mental health, and independence of a 68
year old Mr. Bertoli who has returned home from hospital after experiencing a stroke. Particular emphasis will be placed on proposed interventions to
achieve Mr. Bertoli's healthcare goals and the provision of rationales. This is important to justify the significance of the interventions and indicate
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However collaboration between a professional interpreter and a family member can be beneficial when dealing with the older person. This is because
family member can assist in the provision of physician–to–patient information after the conclusion of the encounter (Rosenberg, Seller & Leanza 2008).
Intervention 1b: The provision of written information in the patient's primary language containing the purpose and side effects of the patient's
medications (Aboul–Enein & Ahmed 2006). Rationale 1b: The provision of written medication information given to the patient helps significantly in
cases of medication non compliance (McGraw & Drennan 2004). This is because it aids in memory retention and presents patients with access to a
reliable source of concise medication information, particularly if the patient needs to be reminded of certain aspects (Gorgos 2006). These written
medication information sheets need to be provided in the patients primary, dominant language because it reduces the difficulty and limits barriers to
patient understanding (Gorgos 2006).This is important because this intervention aims to increase a patient's understanding of their medications, and
when a patient feels more competent with the use of their medications, reduced
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3. The nursing process Essay
The standards of practice describe a competent level of nursing care as exhibited by the critical thinking model known as the nursing process. This
practice includes the areas of assessment, diagnosis, outcome identification, planning, implementation, and evaluation. The nursing process includes
significant actions taken by registered nurses (RN) and forms the foundation of the nurse's decision–making ("American Nurses Association," 2010).
Assessment is the accurate collection of comprehensive data pertinent to the patient's health or the situation ("American Nurses Association," 2010).
Assessment is the first step in the nursing process and the most important. Assessment is the accurate collection of the patient's health date...show more
content...
It is during the second phase that the nurse must establish a nursing diagnosis. Only diagnosis approved and listed through The North American
Nursing Diagnosis Association (NANDA) may be used. Ineffective airway clearance, risk for impaired skin integrity, risk for infection and ineffective
coping are just a few examples of NANDA approved diagnosis. A nursing diagnosis is a clinical judgment about actual or potential individual, family, or
community experiences/responses to health problems/life processes. A nursing diagnosis provides the basis for selection of nursing interventions to
achieve outcomes for which the nurse has accountability (Defining the Knowledge," 2012). The third standard of practice is outcomes identification.
During this phase, the registered nurse identifies expected outcomes for a plan individualized to the patient or the situation ("American Nurses
Association," 2010). During this step outcomes must be derived from the nursing diagnosis and must be measurable, realistic and attainable by the
patient. The registered nurse involves the patient, family, heath care providers, and others in formulating expected outcomes when possible and
appropriate. The registered nurse must also consider associated risks, benefits, costs, current scientific evidence, expected trajectory of the condition,
and clinical expertise when formulating outcomes ("American Nurses Association," 2010). Example of an
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4. Advanced Practice Nursing Essay examples
My own perspective on Advanced Practice Nursing
ABSTRACT:
The need for continuing education in nursing has been accentuated in response to rapidly changing health care environment. Expanding knowledge by
pursuing higher education allows nurses to enlarge one's practice. Furthermore, higher education in nursing has been shown that a nurse's level of
education can become a critical factor to the patient–centered quality of care. This essay describes increased demand for higher education in nursing
and emphasizes the necessity of continuing education to provide optimum patient care in various setting.
Techniques and technologies in the medical field constantly evolve and change. With such a huge increase in information, there is...show more content...
As people's life expectancy increases, the nursing field needs to keep pace with the rapid changes. There's increased needs for nurses in many
different field as well such as nursing home, hospitals, ambulatory cares, palliative care, and hospices. Therefore, an expectation of a role as a nurse
has been rise. Nursing skills and knowledge cannot remain limited, but need to utilize in more various setting. In order to provide better care in
various nursing field, continuing education is essential. For example, as population and their lifespan increases there's also new diseases and new
treatment has been developed. A competence nurse must embrace old and new skills and thorough knowledge to achieve best quality of care and
optimum patient's overall outcome. The quality of patient care heavily depends on nurses' level of education. One research proves that nurses who
received higher level of education showed lower mortality rate, less medical errors, and higher patient satisfaction. This outcome is related to higher
education which prepared nurses to handle various circumstances with appropriate answers. Nurses are people who spend most of time with ill
individuals at the bed side. Nursing education will provide new demanding roles of nurses' requirement such as seeing the patient as a whole, providing
appropriate response to patient's condition, and integrating knowledge and skills accordingly.
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5. What Is Nursing? Essay
Nursing is universal in the sense that nurses can be found almost in all countries around the world (Henderson, 1978). They are in the hospitals, in
school clinics, in the community centres, residential homes and even play major roles in some of the popular soap operas in television. There are even
television shows that mainly revolve around nurses and which chronicles what they do at work – both the positive and the negative. It is one of the
most visible and easily identifiable occupations as compared for example to other occupations such as engineers, managers or even pharmacists,
medical technologists and other health related occupations. This is partly because of what nurses do and most especially how nurses look – with some
still...show more content...
The salient point in Henderson's definition is describing the duty of a nurse as one that cares or assists an individual whether sick or well in obtaining
a state of health in order to live an independent lifestyle (paraphrased). Henderson also described the independent and dependent role of nurses and the
importance of a collaborative work with the other members of the multi–disciplinary health care team especially the doctors (Henderson, 1966). The
Royal College of Nursing, on the other hand, described nursing as the utilization of clinical judgement in extending the care necessary for the
people to maintain and achieve an optimum state of life throughout their lifetime (RCN, 2003). Other significant definitions of nursing were those
given by the World Health Organization (WHO) and the American Nurses Association (ANA). The roles and functions of nurses have a very
fascinating history and have evolved since the 19th century. Landale (1895), in her letter to the editor of the Nursing Record and Hospital World
gave us a glimpse of what a nurse should be during that period. Referring to a nurse as a woman in uniform, it gave us an idea that nursing was a
female dominated vocation and not to be treated as an economical occupation for financial gain. Landale (1895) placed an emphasis on the
characteristic of being a servant and being devoted to service in order to be a nurse who was worthy of the uniform. The
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