Week 1 discussion
Discussion Part I:
Scope of Practice, Credentialing, and Negotiation
Note: In this course, some Discussions will have two parts:
Part I will consist of a specific topic related to the
week’s content.
Part II will consist of a pharmacology review of
approximately 250 words. Please submit each posting separately but within the
same Discussion thread.
You will be assessed on your posting and responses to both
parts.
As medical care evolves, so does the role and scope of
practice of the advanced practice nurse in acute care settings. When providing
patient care, however, you, as an advanced practice nurse, must always ensure
that you are working within the scope of practice outlined by your state’s laws
and institution’s regulations. For this Discussion, you examine these laws and
regulations and consider how they might affect your future clinical practice,
consider the credentialing process for your area, and discuss negotiation
techniques you may use in a job search.
To prepare:
Locate a collaborative practice agreement. Based on this
agreement, consider the scope of practice of an advanced practice nurse in your
state.
Locate and select at least two hospitals where you would be
interested in working at once you obtain your licensure.
Locate the hospitals’ credentialing documents and
investigate the scope of practice at each hospital.
Note: All hospitals do not have the same scope of practice
even if they are located within the same city and state.
Consider how the laws and regulations of the state and
hospitals might affect your practice with medical and surgical patients in
acute care settings.
Think about how you would negotiate your first Advanced
Practice role. Consider issues such as salary range, Continueing Medical
Education (CME), license and DEA costs, insurance, hours, on call requirements,
etc.
Post on or before Day 3 an explanation of the scope of
practice of advanced practice nurses, as outlined in the collaborative practice
agreement. Then, identify the two hospitals of interest that you selected.
Based on the credentialing documents, explain the scope of practice for acute
care advanced practice nurses at each hospital. Explain how this might affect
your practice in terms of caring for medical and surgical patients in acute
care settings (i.e., medical treatments, procedures you can perform,
interpreting diagnostics, etc.). Finally, describe job negotiation
considerations.
Note: To support your Discussion post, you must include
references (with URL links) from the state and the hospitals you selected.
Read a selection of your colleagues’ responses.
Respond on or before Day 6 to at least two of your
colleagues on 2 different days who selected a different state or hospital from
yours. Share additional insights or alternative perspectives.
Discussion Part II: Pharmacology
Note: To access this week’s required library resources,
please click on the link to the Course Readings List, found in the Course
Materials section of your Syllabus.
To prepare:
Read the following articles to enhance your knowledge of
commonly prescribed medications:
Chalikonda, S. A. (2009). Alpha2-adrenergic agonists and
their role in the prevention of perioperative adverse cardiac events. AANA
Journal, 77(2), 103–108.
Retrieved from the Walden Library databases.
Frankenstein, L., Katus, H. A., Grundtvig, M., Hole, T., de
Blois, J., Schellberg, D., … Agewall, S. (2013). Association between
spironolactone added to beta-blockers and ACE inhibition and survival in heart
failure patients with reduced ejection fraction: A propensity score-matched
cohort study. European Journal of Clinical Pharmacology, 69(10), 1747–1755.
Retrieved from the Walden Library databases.
Hao, G., Wang, Z., Guo, R., Chen, Z., Wang, X., Zhang, L.,
& Li, W. (2014). Effects of ACEI/ARB in hypertensive patients with type 2
diabetes mellitus: A meta-analysis of randomized controlled studies. BMC
Cardiovascular Disorders, 14, 148.
Retrieved from the Walden Library databases.
Levy, P. D., Laribi, S., & Mebazaa, A. (2014).
Vasodilators in acute heart failure: Review of the latest studies. Current
Emergency and Hospital Medicine Reports, 2(2), 126–132.
Shi, C. (2013). Blood pressure lowering efficacy of alpha
blockers for primary hypertension. International Journal of Evidence-Based
Healthcare, 11(3), 204–205.
Retrieved from the Walden Library databases.
Tocci, G., Battistoni, A., Passerini, J., Musumeci, M. B.,
Francia, P., Ferrucci, A., & Volpe, M. (2015). Calcium channel blockers and
hypertension. Journal of Cardiovascular Pharmacology and Therapeutics, 20(2),
121–130.
Retrieved from the Walden Library databases.
Toppen, W., Sareh, S., Satou, N., Shemin, R., Hunter, C.,
Buch, E., & Benharash, P. (2014). Do preoperative ?-blockers improve
postoperative outcomes in patients undergoing cardiac surgery? Challenging
societal guidelines. American Surgeon, 80(10), 1018–1021.
Retrieved from the Walden Library databases.
Wang, A. (2012). Efficacy of class III antiarrhythmics and
magnesium combination therapy for atrial fibrillation. Pharmacy Practice,
10(2), 65–71.
Retrieved from the Walden Library databases.
All of the following groups of medications are commonly
prescribed in the acute care setting. Choose one of the topics below to
discuss. If it is a medication group, select a specific drug within that group.
(This is a good way to prepare for clinical practice, because you will get to
know the drugs you will prescribe for patients.). Focus your discussion on the
hospital or ICU setting and IV usage.
Alpha agonists
Alpha blockers
Beta blockers
Antiarrhythmics
Calcium channel
Vasodilators
ACE versus BBlocker with spironolactone in CHF
ACE versus ARB
Note: When sharing your initial post, select a topic that
has not yet been discussed. If all topics have been discussed, then you may select
that topic again, but select a different drug within the medication group.
For this Discussion, address 1 of the following options.
Post by Day 3:
Option 1: Post a description of a patient you have taken
care of (inpatient as an RN, or as an NP student) who has been prescribed the
medication you selected. Include the scenario, indication, dosing,
complications, and outcome. Then explain whether or not you would have ordered
the same drug and same dose.
Option 2: Conduct an evidence-based drug search on the drug
you selected and post an explanation of any possible issues. Are there any drug
interactions? Any black box warnings? To what type of patient would you
prescribe this medication?
Option 3: Post an explanation of the properties of the drug
you selected, including usages and dosing in the hospital or ICU. Describe a
patient to whom you would prescribe this medication.
