Running head: ASSIGNMENT 4: ROLE AND SETTING 1 ASSIGNMENT 4: ROLE AND SETTING 5 Assignment 4: Role and Setting Ricardo Gonzalez Diaz November 22, 2016 NSG5000 S03 Role of the Advanced Practice Nurse Faculty Esposito I was admitted to South University to become Nurse Practitioner specialized in family practice. The role of Nurse Practitioner family practice is purely of clinical nature. It is mainly based on acquiring a sufficient or formal degree of knowledge and skills to do a task effectively, safely, and with competency. It is imperative for Nurse Practitioners to demonstrate that they are qualified with special attributes, skills, and knowledge to be able to deal with medical issues pertaining to disease and death, a situation traditionally carried out by physicians. Through the demonstration of these attributes, Nurse Practitioners elevate and separate them from the traditional nursing role, giving the opportunity to the physicians to corroborate their value in medicine, convincing them, the patients, and their families that Nurse Practitioners are trustworthy enough to carry out the patients’ clinical management at an advanced level. Rashotte, J. (2014). Walsh, A., Moore, A., Barber, A., & Opsteen, J. (2014). Educational role of nurse practitioners in a family practice centre: Perspectives of learners and nurses. Canadian Family Physician Médecin De Famille Canadien, 60(6), e316, e318. The authors of this article use a qualitative approach as a design to examine the role of nurse practitioners (NPs) as educators of family medicine residents in order to better understand the interprofessional dynamics in a clinical teaching setting in an urban area in southern Ontario, Canada. In order to develop this research, first year (8 of 9) and second year (9 of 10) family medicine residents were used as participants and utilized audiotaped and transcribed semistructured interviews. They were able to identify several points that served as the base for their study. These points included role clarification, professional identity formation, factors that enhance the educational role of NPs, and factors that limit the educational role of NPs. The function of NPs were recognized by the majority of the residents, but they were not sure about the NPs scope of practice. In fact, they responded differently to teaching by NPs. First year residents believed that nurse practitioner offer a better approach when teaching and they perceive a decreased sense of susceptibility when being taught by NPs. On the other hand, second year residents preferred being taught from physician teachers alleging that they needed to think like physicians. This created some discomfort among senior residents and did not appreciate the role of nurse practitioners in providing supervision of the day-to-day care of patients. It was evident the lack of an intentional orientation of the family medicine residents regarding the scope of practice of nurse practitioners ...

1. Running head: ASSIGNMENT 4: ROLE AND SETTING 1
ASSIGNMENT 4: ROLE AND SETTING 5
Assignment 4: Role and Setting
Ricardo Gonzalez Diaz
November 22, 2016
NSG5000 S03 Role of the Advanced Practice Nurse
Faculty Esposito
I was admitted to South University to become Nurse
Practitioner specialized in family practice. The role of Nurse
Practitioner family practice is purely of clinical nature. It is
mainly based on acquiring a sufficient or formal degree of
knowledge and skills to do a task effectively, safely, and with
competency. It is imperative for Nurse Practitioners to
demonstrate that they are qualified with special attributes,
skills, and knowledge to be able to deal with medical issues
pertaining to disease and death, a situation traditionally carried
out by physicians. Through the demonstration of these
attributes, Nurse Practitioners elevate and separate them from

2. the traditional nursing role, giving the opportunity to the
physicians to corroborate their value in medicine, convincing
them, the patients, and their families that Nurse Practitioners
are trustworthy enough to carry out the patients’ clinical
management at an advanced level. Rashotte, J. (2014).
Walsh, A., Moore, A., Barber, A., & Opsteen, J. (2014).
Educational role of nurse practitioners in a family practice
centre: Perspectives of learners and nurses. Canadian Family
Physician Médecin De Famille Canadien, 60(6), e316, e318.
The authors of this article use a qualitative approach as a design
to examine the role of nurse practitioners (NPs) as educators of
family medicine residents in order to better understand the
interprofessional dynamics in a clinical teaching setting in an
urban area in southern Ontario, Canada.
In order to develop this research, first year (8 of 9) and second
year (9 of 10) family medicine residents were used as
participants and utilized audiotaped and transcribed
semistructured interviews.
They were able to identify several points that served as the base
for their study. These points included role clarification,
professional identity formation, factors that enhance the
educational role of NPs, and factors that limit the educational
role of NPs. The function of NPs were recognized by the
majority of the residents, but they were not sure about the NPs
scope of practice. In fact, they responded differently to teaching
by NPs. First year residents believed that nurse practitioner
offer a better approach when teaching and they perceive a
decreased sense of susceptibility when being taught by NPs. On
the other hand, second year residents preferred being taught
from physician teachers alleging that they needed to think like
physicians. This created some discomfort among senior
residents and did not appreciate the role of nurse practitioners
in providing supervision of the day-to-day care of patients. It
was evident the lack of an intentional orientation of the family
medicine residents regarding the scope of practice of nurse
practitioners leading to difficulties in interprofessional

3. education.
Nurse practitioners viewed themselves as a safer and more
approachable source of help for residents and alleged that their
preparation as teachers was important and they believed they
were well trained for this role.
Clark, Shannon,B.A., PhD., Parker, Rhian, BSc, MSc,M.P.E.T.,
PhD., Prosser, Brenton, BA,GradDipEd, PhD., & Davey,
Rachel, BSc,M.MedSci, PhD. (2013). Aged care nurse
practitioners in Australia: Evidence for the development of their
role. Australian Health Review, 37(5), 594-601. Retrieved from
http://search.proquest.com.southuniversity.libproxy.edmc.edu/d
ocview/1556323312?accountid=87314
This article is about a study performed in Australia in which the
authors investigate the evidence of the benefits of NPs in
primary care and their role in aged care. In Australia the role of
NPs is taking relevance especially with the increase of the
ageing population and the need of policy report reviews related
to this specific population and advanced nursing roles.
It is obvious that the authors are trying to demonstrate that the
topics covered in the research made at a national level will
impact the understanding of the role of NPs in aged care in
Australia and make it extensive as an example to other countries
that are dealing with similar issues of an ageing population.
They used a three-stage exploratory strategy to identify peer-
reviewed and grey literature surrounding NPs, particularly in
aged care and focused their work on three aspects: contextualize
the current evaluation in relation to the historic development of
NPs and the conditions under which the role emerged; provide
an overview of the evidential basis for their efficacy; and
identify gaps in knowledge that the current evaluation
addresses.
Also, it is mentioned that the Australian government is making
efforts to implement legislative funding support of NP models
to equip the most productive way to assess the NP role in aged
care in Australia. Through this method this evaluation will help
provide evidence about the best models of care, their operating

4. environments, effectiveness and viability and sustainability,
which can inform future healthcare planning and policy.
Finally, the authors stated the need of more evidence on the
effectiveness, economic viability and sustainability of models
of care, including those utilizing nurse practitioners in
Australia.
Comola, G. M. (2014). A nurse practitioner's experience in a
post-graduate nurse practitioner urology fellowship. Urologic
Nursing, 34(3), 133-4, 138. Retrieved from
http://search.proquest.com.southuniversity.libproxy.edmc.edu/d
ocview/1544897527?accountid=87314
This article is a report on the experiences the author had on a
12-month post-graduate nurse practitioner fellowship program
conducted in the Division of Urologic Surgery at Washington
University School of Medicine and Barnes Jewish Hospital
academic centers in St. Louis, Missouri in 2012. Adult NP
students entering their final clinical rotation were offered the
opportunity for a two-week experience in the urology clinic at
the Washington University Division of Urology. After the
rotation, students interested in working in urology were
provided the opportunity to apply for a 12month urology
fellowship.
The author described the stages of the program, the settings,
and the different study techniques learned throughout the
fellowship. He shared his personal opinion about the program in
which it significantly helped him improve his knowledge and
necessary skills to diagnose and treat urologic conditions.
Furthermore, upon completion of this fellowship, he believed he
had achieved practical urology experience, improving his
resume and acquired the necessary skills to put into practice
what he learned and competently provide urologic patient care.
Reference
Clark, Shannon,B.A., PhD., Parker, Rhian, BSc, MSc,M.P.E.T.,
PhD., Prosser, Brenton, BA,GradDipEd, PhD., & Davey,
Rachel, BSc,M.MedSci, PhD. (2013). Aged care nurse

5. practitioners in Australia: Evidence for the development of their
role. Australian Health Review, 37(5), 594-601. Retrieved from
http://search.proquest.com.southuniversity.libproxy.edmc.edu/d
ocview/1556323312?accountid=87314
Rashotte, J. (2014). The Acute-care Nurse Practitioner: A
Transformational Journey. Edmonton [Alberta.]: AU Press.
Walsh, A., Moore, A., Barber, A., & Opsteen, J. (2014).
Educational role of nurse practitioners in a family practice
centre: Perspectives of learners and nurses. Canadian Family
Physician Médecin De Famille Canadien, 60(6), e316, e318.
Ochoa
Gloria Ochoa
English 1301
Roberto Santos
December 1, 2015
Obesity a Real Problem
Many people know that the United States has several issues that
American citizens need to be concerned about. They focus too
much in the outsider’s problems, and in the minor ones they
don’t give that much importance. United States have become
one of the first countries with obesity. People think that being
overweight is not a real problem, but they are wrong it’s a very
serious matter in the world, even though people don’t take it as
a global issue. Now-a-day’s citizens see more and more people
with overweight problems than ever. People can have family
members that are overweight and they don’t see it as a problem.
Therefore, people have to cut down on all the fast food
restaurants, start doing an exercise routine every day, and
investigate on how obesity can affect people’s health and their
self-esteem.

6. People have to cut down on all the fast food restaurants. The
short amount of time a person has is what makes them go to
these types of places. When people are driving on the road, in
almost every corner they will find a fast food restaurant from
the most famous McDonalds, Burger King, Taco Bell or any
other that will give them food instantly and at a low price.
There are approximately 200,000 of these types of restaurants in
the United States (“Franchisehelp”). Daily, one out of four
people eat some type of fast food, which means 46,000 million
people are fed from fast food restaurants every single day
(“vivavegie”).This states that the people from the United States
are becoming even unhealthy by eating this type of food every
day and also gaining weight without even noticed.
Approximately 46 million unhealthy meals are served every
single day. In fact, Americans have a problem they don’t really
see that it’s not healthy. For example, one of the most famous
restaurants a easy way to be there and also cheap is McDonald's
that has tried to put healthy things into the menu, to try to make
it look healthier, but in reality the condiments got to be worse.
Vegetables are frozen for day’s even weeks and have many
chemicals to help prevent their decomposition; this takes all the
nutrients away from the food. McDonalds say that they give the
choice to the customers to pick their salads or their hamburgers,
but customers in reality go there to eat their fries and their
hamburgers because in some weird way is addictive.
Furthermore, the prices are not the same between hamburgers
and salads; customers can buy a McDouble or McChicken by
one dollar if much a dollar with cent because of taxes; while
buying a salad can cost four to five dollars plus tax and still
there are not those much vegetables and these vegetables are
frozen. The new dollar menu from McDonalds consists of
different types of burgers, ice creams, or a small side salad;
even the name says it all; side salad meaning small; meant to
not get you completely full and have to buy a hamburger also or
any other thing that sells there. Fast food restaurants in general
have try to hide the truth, but it very obvious that Fast Foods

7. Restaurants are no good to anyone.
Customers would have to walk 7 hours straight to just burn off a
super-sized coke, fries and a Big Mac (‘Vivavegie”). This
means that instead of sleeping customers would have to use that
time to walk the calories out and no one would handle to do it;
but actually do people exercise? How many people do any kind
of exercise per day? In addition to the 49.6% of Americans who
reported that they exercised for at least 30 minutes three days
per week, 18.5% said they exercised one or two days per week,
and 31.3% reported they did not exercise on any day in the
given week (Wilbert). Doing some exercise is a very important
factor to the problem that the United States is facing; the lack
of exercise has created many overweight persons. People who
are too busy in their work, living life in a stressing way and not
having the time to think about how bad can be to not do any
type of exercise that in the end no one, but the person will be
affected. “I don’t have the time I will love to have, at morning I
leave my kids at school then I go to school, come back and
clean my house, pick up my children’s and give them something
to eat, take them to their practices, and when I got home my
husband is already there and wants dinner” Claudia Hernandez
said. Like her many people make and make excuses about how
difficult their life is and don’t even have time to think about
exercise. Exercise is not about doing weights or passing the
hours in the gym every day. Walking, running or riding a bike is
considering a type of exercise, but still people decide to drive
their cars to work, to the store, or everywhere they go, instead
of being active. While doing exercise people are actually saving
money from the gas they were going to spend and their brain is
more active. It goes take an effort for people to decide to be
active that is the only obstacle, there is no other excuse; now
let’s focus on how it affects kids. Helping kids lead healthy
lifestyles begins with parents who lead by example.The
percentage of overweight children in the United States is
growing at an alarming rate, with 1 out of 3 kids now
considered overweight. Many kids are spending less time

8. exercising and more time in front of the TV, computer, or
video-game console. In most of the schools there is a class
called physical education that is mandatory to take, but not all
the kids actually do exercise many just stand there and wait for
the class to be over or many don’t even change clothes at all.
Today's busy families have fewer free moments to prepare
nutritious, home-cooked meals. From fast food to electronics,
quick and easy is the reality for many people. Preventing kids
from becoming overweight means adapting the way the family
eats and exercises, and spend time together. Overweight
children are far more likely to become overweight adults than
are children who maintain normal weight through adolescence.
When kids grow up as adults it’s when the problem most
increases, because is not mandatory to do exercise; it’s up to the
person, and people create a lot of excuses about how difficult
can exercising can be and how there is not time to do it that
they are too busy doing other stuff.
In matter of fact, obesity creates many health problems that
might people not even be aware of, and can affect their self-
esteem. By 2030, more than half of Americans could be obese;
resulting in millions of new cases of diabetes, coronary heart
disease, and stroke says Dr. Maureen Braun. It varies a lot from
age, gender, and also by how active the person is, but at the end
if the case presents it affects everyone. The health problems
associated with obesity are numerous. Obesity is not just a
cosmetic problem; it's a health hazard. Someone who is 40%
overweight is twice as likely to die prematurely as is a normal-
weight person, imagine to die sooner than what is expected.
Obesity has been linked to several serious medical conditions,
including: Heart disease and stroke, High blood pressure,
Diabetes, Cancer, Gallbladder disease and gallstones,
Osteoarthritis, Gout, Breathing problems, such as sleep apnea
that means when a person stops breathing for a short episodes
during sleep and asthma; to mention just a few sickness
(“webmd”). Obesity kills. It takes years from people’s lives,
time that could be spent with the family. It not only the years it

9. takes away from the person, but also it makes the person depend
on someone else which can change life tremendously. Bernard
Werwie an overweight person in a documentary state: "I have
muscle and joint pain I was tired all the time because of all the
weight I carried. I relied on food for comfort everything
revolved around food I had nothing else; I have nothing with me
but the food." Like him many other people are suffering every
day because they can’t have a regular life, always having to
visit the doctor or in medication in order to fight obesity and be
able to continue living, and also having to paid all the bills
from the hospital that are not any cheaper at all. It’s important
to know that obesity not only creates health problems, but
emotional ones too. It’s widely known that overweight children
are more likely to be bullied by their classmates than anyone
and in most of the cases friends, teachers, classmates, and even
parents might not be aware off. The overweight child is alone
with anyone by their side giving the support their need or an
advice that could change their life. Being overweight at a young
age affects people’s future in different ways, might not get
accepted to be in sports because the over-weight person can’t
run fast also can’t be accepted by society because the person is
different, is not in shape as all the other persons; it is physical
not the same as the other person. Self-esteem makes an
important role on obesity. If people have a low self-esteem this
will cause depression because they will not be able to see
themselves in the mirror and be happy, they just be there not
trying to do anything by themselves. Also depression can cause
that an overweight person problems can lead patients to think in
a suicidal attempt because they are not happy with their lives or
they don’t resist all their suffering and the bullying they get.
The overweight person needs to have a power to resist all the
pressure that can come and also to be very strong minded in
order to do exercise or do a diet for a while.
America needs to solve the obesity problem because it’s
becoming a very important issue over the year. America has
changed from being a normal country to now almost every State

10. has overweight problems. The US has to change their ways to
become the healthy country they were, do more exercise and
less junk food. Obesity affects people’s lives in many ways
from creating depression and a low self-esteem that can cause
the people think of suicidal, but not only that having to life the
rest of their life’s in medication to try and help their organs
continue working and not have a heart attack. America needs to
stop and solve this problem because people don’t want to be the
number one in obesity. However; in order, to solve this problem
people would have to cut down on all the fast food restaurants,
start doing an exercise routine every day, and investigate on
how obesity can affect people’s health and their self-esteem.
Work Cited
Big as Life: Obesity in America Bill o’ Connor. Dir. Yves
Gerard Issembert.
2002. Documentary Film.
Braun, Maureen. Most Americans May Be Obese by 2030,
Report Warns”

11. Abcnews.go.com, Web. 02 December 2015.
“Fast Food Facts”
Vivavegie.org. Web. 01 December 2015.
"Fast Food Industry Analysis 2013 – Cost & Trends."
Franchiehelp.Franchiehelp.com. Web. 01 December 2015.
Wilbert, Caroline. “Are Americans Backing Off Exercise.
Exercise. Webmd.com. Web. 30 November 2015.