What new insights did you gain through this reflective practice opportunity? How will this apply to your practice as a nurse practitioner?

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Nursing knowledge is classified in a variety of ways, one of which is Carper’s Patterns of Knowing (Carper, 1978). Carper’s framework offers a lens through which the nurse can reflect upon insights acquired through empirical, ethical, personal, and aesthetic knowledge (Carper, 1978). Through intentional reflection using Carper’s Patterns of Knowing, nurses can process experiential learning and knowledge acquired through practice. The purpose of this assignment is to reflect upon a specific practice situation and better understand the professional knowledge and insights obtained through that experience.

Select an important nursing issue/topic that was inherent to the identified situation.

Briefly explain the situation

Identify the nursing issue inherent in the identified situation

As a method of refection, use Carper’s Patterns of Knowing to analyze the situation. In your discussion, address ONE of the following Patterns of Knowing:

What do you think was the underlying reason for the situation?

What were your thoughts and feeling in the situation?

What was one personal belief that impacted your actions?

What evidence in nursing literature supports the nursing importance of the identified issue?

What new insights did you gain through this reflective practice opportunity? How will this apply to your practice as a nurse practitioner? Be sure to use scholarly literature to support your position.

Identify three to four goals that can be used for strategic planning and organizational development. 

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Perform a SWOT analysis of your current place of employment (or a place of employment with which you are very familiar).

In a formal APA paper, describe the Strengths, Weaknesses, Opportunities, and Threats of the organization.

Identify three to four goals that can be used for strategic planning and organizational development.

Use the findings to define your organization’s competencies and competitive advantage. This assignment should be 3-5 pages in length with the exception of the title and reference pages.

How could these sources of competition impact your organization and how might your leadership team avert or respond to them?

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Strategy1.

What are 3 industry scenarios that could evolve over the next 36 months that threaten the organization?

What options does your organization have for preempting or responding to the potential scenarios?

Operations2.

What 3 big competitive opportunities would your organization be pursuing if it were more agile?

3. Obstacles

What 3 obstacles exist that prevent your organization from being strategically agile?

What is your organization doing to address these obstacles?

Marketing4.

Sources of competition What are 3 new possible sources of competition your organization may not have explored within the last 6 mo, but could potentially encounter?

5. Potential market disruptions

How could these sources of competition impact your organization and how might your leadership team avert or respond to them?

6. Market vigilance

What strategy could a competitor pursue over the next year that could cause a major market disruption?

7. Partnership potential

What strategy would your leadership team have in place to outsmart the major market disruption considered?

What vigilance strategies is your organization instituting to enhance its ability to quickly sense new market anomalies?

To what extent is your organization taking advantage of sophisticated predictive analytics that could anticipate shifting market and business trends?

Which of the organization’s customers represents the best leading indicator of future market opportunities?

What potential organizations could your institution partner with to drive changes in the marketplace?

Resources8. Recent destabilizers

Have you made major recent cuts particularly in human resources that could preclude your organization’s agility and growth potential?

9. Economic fluidity

How is your organization compensating for recent destabilizing cuts?

Has your organization been able to cut costs to maximize its agility through financial reserves?

Leadership10. Internal leadership

Who within the organization can be tapped as an emerging leader who could augment the formal leadership team to take advantage of market volatility?

Which portion of the organization needs to be fortified the most to maximize agility?

Discuss the objective (signs) and subjective (symptoms) data collated from the nursing assessment of the patient.

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Discuss the objective (signs) and subjective (symptoms) data collated from the nursing assessment of the patient.
• This account is to utilize a head to toe system analysis/framework.
• Normal and abnormal assessment data is to be outlined.
Then, using the template presented in appendix G, identify two (2) priority problems, along with their associated
NANDA nursing diagnosis statement, SMART goals, evidence-based intervention and rationale, and an evidence based outcome statement for each priority problem/NANDA diagnosis.
Diagnosis:

Identify one (1) actual and one (1) potential healthcare problem that the nurse is accountable and responsible to treat. The problems identified in this discussion are to directly link to the patient’s abnormal assessment findings outlined in the assessment data. Actual and/or potential healthcare problem MUST be written using NANDA taxonomy.

How could you incorporate listening for needs, purpose, or concern to create value in the conversation (including describing what that would look like)?

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The conversation could have been a long time ago or recently.

A. Explain what happened during the disagreement by answering the following questions:

• Describe the situation that led to the conversation.

• When did you realize that there was a disagreement during the conversation?

• Describe a bio-reaction(s) that was experienced during the disagreement.

• How did the conversation end?

B. Analyze the conversation by answering the following questions:

• Using the four levels of the conversation meter, what level were you listening at, and what level was the other person listening at?

• Give examples of two factors that describe how you and they were listening in at these levels in the conversation meter: feelings, behaviors, language, or tone.

• What were your points of alignment or disagreement?

C. Reflect on how the conversation encouraged you to listen differently by answering the following questions:

• How could you have listened differently moving up the conversation meter, and what effect would that have had on the disagreement?

• How could you incorporate listening for needs, purpose, or concern to create value in the conversation (including describing what that would look like)?

• What have you learned about accuracy and authenticity that could be used to improve the conversation?

D. Demonstrate professional communication in the content and presentation of your submission.

Elaborate on the skills you possess that will help you be successful in our nursing program and the nursing profession.

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• Maximum of one page typed double-spaced with one inch margins

• Top left of essay in single space will include the following: o Date (Month, Day, Year
Nursing is a rewarding and demanding career; some even describe it as a noble calling.

• Describe what factors led you to choose nursing as your career.

• Elaborate on the skills you possess that will help you be successful in our nursing program and the nursing profession.

This essay will help to provide evidence of your ability to communicate effectively through written words. Language, grammar and expression of id will be reviewed for clarity. Attention will be placed on formatting requirement as being indicative of the ability to follow directions.

What would you stress to your staff in a debriefing meeting to address this incident?

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Implicit Bias in Nursing

The son of a patient you have been taking care of for many years in your nurse practitioner clinic arrives with his mother. He is a 56-year-old white man from a rural community in upstate New York. Your nurse who is African American, is bringing patients back to be seen. Your patient’s son tells the front desk staff that he does not want “That black girl touching my mother.” As a nursing leader, how should you proceed?

As a leader you must address the needs of the patient, the family member and your staff. What would you stress to your staff in a debriefing meeting to address this incident?

What is the practicum site problem (practice problem for case-study option students) you have identified?

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Diabetes

The purpose of this session is to help you clearly define your practice question, and to ensure you have identified an appropriate evidence-based intervention to support the rigor of your project.

Answer the following questions using diabetes

My practicum will be on diabetics, either newly diagnosed or prediabetics. I will be doing the case study version so for those questions that do not need to be answered I put NOT APPLICABLE.

1. What is the practicum site problem (practice problem for case-study option students) you have identified?

2. How was this problem brought to your attention?

3. What is your goal for your DNP project; that is, what do you hope to accomplish?

4. How many participants do you anticipate being involved (or would be involved) in your project? (clearly identify if participants are patients, nursing staff, or others)

5. Has the practicum site provided you a letter of support on letterhead, stating that you can implement this project at the facility? (Not required for case-study option students) NOT APPLICABLE

6. Have you identified if there is an IRB process that needs to be done at the site? If, no, please make sure you get a letter from the site stating there is no IRB. If there is IRB needed from the site, please make sure to identify what is needed for the process so you may begin the necessary steps as soon as possible. (Not required for case-study option students) NOT APPLICABLE

7. In your search of the literature, what evidence-based intervention and tool (if necessary) have you identified for your project?

8. Has this tool been previously utilized with the same population of participants you plan to use?

9. Have you requested permission from the original author to use the tool?

10. Have you considered the implementation timeframe of eight – ten weeks, and do you feel you can successfully implement this project within the established timeframe?

11. What type of statistical analysis will you use to evaluate your project outcomes?

12. Have you identified a statistician to assist with your data analysis?

(Not required for case-study option students) NOT APPLICABLE

12. So, with this in mind, what is your practice question in the PICOT format? What are the elements of your PICOT question?

13. Population

14. Intervention

15. Comparison

16. Outcome

17.Time frame

How does the environment of care impact prioritizing care delivery? What is the effect on the patient outcomes?

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See the attached article to help you write this one-page essay and answer the following questions.

How does the environment of care impact prioritizing care delivery?

What is the effect on the patient outcomes?

When thinking about prioritizing care, what other influences beyond the scope of the article assigned can you see as being priority considerations?

 

What strategies should be considered to address this problem? The MORAL strategy is an example of dilemma.

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Addressing a Moral Dilemma

In some instances, this may be because they lack virtues – such as moral courage, wisdom, and integrity – which are required to speak up and bring about change. In other instances, however, when organizational cultures are defensive, unsupportive, and potentially punishing, the virtue of courage may not be adequate to change a situation.
Emily is your co-worker for 5 years at the facility you are working. You noticed several times the smell of alcohol on her breath. There are also rumors among staff that she comes to work under the influence of alcohol. No one has the courage to confront this problem in the past.
After arriving at work today, you noticed that Emily was covertly drinking from a dark-colored flask in her locker at the nurse’s lounge. What would you do?

Discussion Questions:
Share your thoughts on this dilemma.

Which ethical principles are involved? Justice, beneficence, non-maleficence, accountability, fidelity, autonomy, and veracity. Choose two to discuss.

What strategies should be considered to address this problem? The MORAL strategy is an example of dilemma