Category: Nursing

  • Educational preparation and role(s) of the clinical nurse leader (CNL)

    To respond to the following discussions on Educational preparation and role(s) of the clinical nurse leader (CNL)

    ORDER YOUR QUALITY PLAGIARISM-FREE PAPER NOW

    Identify the educational preparation and role(s) of the clinical nurse leader (CNL) designation. Give an example of how the CNL influences direct patient care whether in a hospital or out in the community.

    According to American Nurse Today, an American Nurses Association (ANA) journal, the Clinical Nurse Leader requires a minimum of a Masters’ of Science in Nursing (MSN) (Monaghan, 2011). They often compared to Clinical Nurse Educators and Clinical Nurse Specialists as the educational preparation is the same and some responsibilities overlap in the clinical setting.

    The role of the CNL is be part of the interdisplinary team as they integrate evidenced based practice at the point of care (Monaghan, 2011). The CNL role consist of six elements:

    Leadership and change

    Interdisciplinary relationships

    Knowledge transfer

    Outcomes management

    Clinician at the point of care

    Professional development (Monaghan, 2011).

    In the hospital setting an example of how the CNL influences care by being a facilitator of direct care. This means supporting floor nurses, being liaison for changes and setting positive examples for nurses (Monaghan, 2011).

    Reference:

    Monaghan, H., RN, MHSC. (2011). Clarifying the clinical Nurse Leader Role: Guardian of Care. American Nurse Today,6(4). Retrieved October 2, 2017, from www.americannursetoday.com.

  • Health Care

    Now that you know a little more about creative problem solving and the importance of health literacy, you will take the next step to approaching a problem by completing the initial phase of Creative Problem Solving: Problem Scoping. This process establishes clear requirements for creating a viable final solution. It often is initiated by the identification of a need or issue. This part of the problem-solving process focuses on the issue/need by gathering and analyzing information. In other words, you will clearly define what needs to be done prior to creating an effective solution.

    This SLP will help you practice your problem-scoping skills by completing a clear, focused Problem Scoping Document. This will provide a clear problem definition and target for solution development.

    Problem Scoping Assignment Instructions:

    As you complete the problem-scoping phase, your proposed document will include the following information:

    Develop      a problem statement.

    Determine      any potential constraints.

    Determine      the criteria.

    Identify      the stakeholders.

    Develop      a procedure for gathering data prior to decision making.

    Be sure to thoroughly complete and submit the 
    Problem Scoping Document Template
    .

    Select a public health issue from the CDC website that you reviewed for Module 3 at 
    http://www.cdc.gov/features/datastatistics.html 
    and incorporate the information found there into a Problem Scoping document by following these steps:

    Determine      what questions you would ask yourself:

    Scope       of the problem—Part of the Problem Statement.

    When       and where the problem occurs—Part of the Problem Statement.

    Impact—Part       of the Problem Statement.

    Identify       two criteria related to the problem statement that you created.

    Who       is directly involved with the problem? Stakeholders?

    Determine      how you would gather data important to educating the public on this issue.

  • Levy family – Assessing Clients With Addictive Disorders

    Levy family – Assessing Clients With Addictive Disorders

    To prepare:

    Review this week’s Learning Resources and consider the insights they provide.

    Review the 
    Levy Family
     video Episodes 1 through 5.

    The Levy family – Assessing Clients With Addictive Disorders  Assignment

    In a 2- to 3-page paper, address the following:

    After watching Episode 1, describe:

    What is Mr. Levy’s perception of the problem?

    What is Mrs. Levy’s perception of the problem?

    What can be some of the implications of the problem on the family as a whole?

    After watching Episode 2, describe:

    What did you think of Mr. Levy’s social worker’s ideas?

    What were your thoughts of her supervisor’s questions about her suggested therapies and his advice to Mr. Levy’s supervisor?

    After watching Episode 3, discuss the following:

    What were your thoughts about the way Mr. Levy’s therapist responded to what Mr. Levy had to say?

    What were your impressions of how the therapist worked with Mr. Levy? What did you think about the therapy session as a whole?

    Informed by your knowledge of pathophysiology, explain the physiology of deep breathing (a common technique that we use in helping clients to manage anxiety). Explain how changing breathing mechanics can alter blood chemistry.

    Describe the therapeutic approach his therapist selected. Would you use exposure therapy with Mr. Levy? Why or why not? What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)?

    In Episode 4, Mr. Levy tells a very difficult story about Kurt, his platoon officer.

    Discuss how you would have responded to this revelation.

    Describe how this information would inform your therapeutic approach. What would you say/do next?

    In Episode 5, Mr. Levy’s therapist is having issues with his story.

    Imagine that you were providing supervision to this therapist, how would you respond to her concerns?

    Support your approach with evidence-based literature.

     

    Transcript of video Levy Family:

    Episode 1

    Program Transcript

    [MUSIC PLAYING]

    FEMALE SPEAKER:
    You
    ‘re not dressed
    ?
    You
    ‘re
    going to be late for work.

    MALE SPEAKER:
    I
    ‘m
    not going to work.
    I
    ‘m
    sick.

    FEMALE SPEAKER: Of course
    you
    ‘re
    sick.
    You
    ‘re
    hungover.
    Idon’t
    want the

    boys
    to see
    you
    like this. Go back to bed.

    MALE SPEAKER: See
    me
    like what?
    I
    told
    you
    ,
    I’m
    sick.

    FEMALE SPEAKER: Well, what do
    you
    call it when someone is sick almost

    every morning, because they drink every night while they sit in the dark watching

    TV?

    MALE SPEAKER:
    You
    calling
    me
    a drunk?

    FEMALE SPEAKER: What do
    you
    call it?

    MALE SPEAKER: I call it, leave me the hell alone.

    FEMALE SPEAKER: Baby, you need to stop this. It’s tearing us up. The drinking,

    the anger– you’re depressed.

    MALE SPEAKER: You said, for better or worse.

    FEMALE SPEAKER: My vows don’t cover this. You were never like this before.

    You’ve changed. I want us back, the way we used to be.

    MALE SPEAKER: That way is dead. It died when I went to Iraq

     

     

    Levy Family: Episode 2

    Program Transcript

    FEMALE SPEAKER: I want to thank you for getting me this Levy case. I think it’s

    so interesting. Just can’t wait to meet with the client.

    MALE SPEAKER: What do you find interesting about it?

    FEMALE SPEAKER: Well, he’s just 31. Usually the vets I work with are older. If

    they have PTSD, it’s from traumas a long time ago. But Jake, this is all pretty

    new to him. He just left Iraq a year ago.

    You know, Iwas thinkinghe’d be perfect for one of those newer treatment

    options, art therapy, meditation, yoga, something like that.

    MALE SPEAKER: Why?

    FEMALE SPEAKER: Well, I’ve been dying to try one of them. I’ve read a lot of

    good things. Why? What are you thinking?

    MALE SPEAKER: I’m thinkingyou should really think about it some more. Think

    about your priorities. It’s a good idea to be open-minded about treatment options,

    but the needs of the client have to come first, not just some treatment that you or

    I might be interested in.

    FEMALE SPEAKER: I mean, Iwasn’t saying it like that. I always think of my

    clients first.

    MALE SPEAKER: OK. But you mentioned meditation, yoga, art therapy. Have

    youseen any research or data that measures how effective they are in

    treatment?

    FEMALE SPEAKER: No.

    MALE SPEAKER: Neither have I. There may be good research out there, and

    maybe one or two of the treatments that you mentioned might be really good

    ideas. I just want to point out that you should meet your client first, meet Jake

    before you make any decisions about how to address his issues. Make sense?

    FEMALE SPEAKER: Yeah.

    Levy Family: Episode 2

    Additional Content Attribution

    © 2016 Laureate Education, Inc.

     

    Levy Family: Episode 3

    Program Transcript

    JAKE LEVY: We’d be out on recon in our Humvees, and it would get so hot. We

    used to put our water bottles in wet socks and hang them right outside the

    window just so the water would cool off of a bit, and maybe then you could drink

    it.

    Man, it was cramped in there. You’dbe drenched, nowhere to breathe. It’s like

    riding around in an oven. And you’d have your helmet on you, 100 pounds of

    gear and ammo. I swear, sometimes I feel like it’s still on me, like it’s all still

    strapped on me.

    FEMALE SPEAKER: How many tours did you do in Iraq?

    JAKE LEVY: Three. After that last recon, I just– There were 26 of us. Five

    marines in the Humvee I was in. I remember I was wearing my night vision

    goggles. We passed through a village and everything was green, like I was in a

    dream or under water.

    And then there was a flash, bright light just blinded me. There was this explosion.

    Ican’t– Ican’t–

    FEMALE SPEAKER: It’s OK, Jake. Take it easy. I understand this is difficult.

    There’s something I;d like to try with you. It’s called exposure therapy, and it’s a

    treatment that’s used a lot with war veterans, especially those struggling with

    anxiety and PTSD.

    JAKE LEVY: Exposure therapy?

    FEMALE SPEAKER: Yes. It’s to help someone like yourself to confront your

    feelings and anxieties about a traumatic situation that you’ve experienced. It’s a–

    It’s meant to help you get more control of your thoughts, to make sense of what’s

    happened, and to not be so afraid of your memories.

    JAKE LEVY: Put that in a bottle and I’ll buy 10 cases of it.

    FEMALE SPEAKER: Well, one part of it is learning to control your breathing. And

    whenyou practice that, you can learn to manage your anxiety, to get more

    control of it, not let it control you, to protect yourself. Do you want to try it?

    JAKE LEVY: Right now?

    FEMALE SPEAKER: Sure.

    JAKE LEVY: Why not?

     

    Levy Family: Episode 3

    FEMALE SPEAKER: OK. Well, I know this sounds crazy, but a lot of people don’t

    breathe properly. And it really comes from bad habits. When they inhale and

    exhale, all the effort is here in their chest and shoulders. And the problem with

    that is you get a really short, shallow breath. And that really increases the stress

    and anxiety in your body.

    Instead, a more natural breath should always involve your diaphragm, right here

    in your abdomen. When you breath in, your belly should expand. And when you

    breath out, your belly should fall. OKJAKE LEVY: OK.

    FEMALE SPEAKER: So, let’s practice. Close your eyes. Now, I want you put one

    hand on your abdomen and the other across your chest. Good. Good. Now, I just

    want you to take a few breaths, just like normal. What are you feeling?

    JAKE LEVY: I feel my chest moving up and down. But my belly, nothing.

    FEMALE SPEAKER: OK. So that’s what I was just talking about. That’s OK. Let’s

    try this. I want you take a breath. And this time, I only want you to allow your

    abdomen to expend when you breathe in and to fall when you breathe out.

    OK, let’s try it. Breathe in. Breathe out. Breathe in. Breathe out.

    You feeling better? More relaxed?

    JAKE LEVY: Yes.

    FEMALE SPEAKER: And the more you practice it the easier it will become. So

    when you find that stress and anxiety coming on, just do your breathing. You can

    keep yourself from getting swept by all those bad thoughts. OK?

    JAKE LEVY: Yes. Thank you.

    FEMALE SPEAKER: So, do you want to try to go back to what you were telling

    me about before?

    JAKE LEVY: I can try. It was night. We were out on recon. It was my third tour in

    Iraq

     

     

    © 2016 Laureate Education, Inc. 1

    Levy Family: Episode 5

    Program Transcript

    FEMALE SPEAKER: It was such an intense story. I just kept seeing things the

    way he did, you know. The weird green of his night-vision goggles, his sergeant

    screaming for Jake to kill him. I just keep seeing it all in my head.

    [MUSIC PLAYING]

    MALE SPEAKER: Why, do you think?

    FEMALE SPEAKER: Why what?

    MALE SPEAKER: Why do you think you keep thinking about this story, this

    particular case?

    FEMALE SPEAKER: I don’t know, maybe because it’s so vivid.You know, I went

    home last night, turned on the TV to try to get my mind off it. And a commercial

    for the Marines came on, and there was all over again– the explosion, the

    screams, the man dying. Such a nightmare to live with, and he’s got a baby on

    they way.

    MALE SPEAKER: Could that be it, the baby?

    FEMALE SPEAKER: Maybe. That’s interesting you say that. I mean, the other

    vets I work with are older, and they have grown kids. But Jake is different.

    I just keep picturing him with a newborn. And I guess it scares me. I wonder if

    he’ll be able to deal with it.

    Levy Family: Episode 5

    Additional Content Attribution

    MUSIC:

    Music by Clean Cuts

    Substance Abuse Addiction. In Their Own Words

    Program Transcript

    NICOLE: My name is Nicole. And May 30, I will have five years in recovery.

    RICKY: My name is Ricky. I’ve been in recovery for 10 years.

    GRETCHEN: My name is Gretchen. And I’ve been in recovery for about three

    years.

    JASON: Myname’s Jason, and I’ve been in recovery for five months.

    ODESSA: My name is Odessa, and I have been in recovery for six years.

    SHANE: My name is Shane, and I have 11 years clean.

    FEMALE SPEAKER: Six addicts, six remarkable stories of addiction, treatment,

    and recovery in their own words.

    GRETCHEN: My addictions are prescription pain pills and alcohol. I’m a survivor

    of childhood sexual trauma, so that’s– and my parents are addicts. And my

    parents always used around me. Their friends always used around me.

    I grew up thinking that was normal. I grew up thinking chaos was normal and

    negative type behaviors. My mother had breast cancer, and mymother has other

    health issues. And she’s addicted to her pain pills.

    I would try and reach out to her for help, and she would just say, you know, go

    get me a bottle or go getme a beer or go get this. And she would take those pain

    pills with that alcohol. When you sit there and you watch your mother do that and

    not help you and not support you and not listen to you, and the whole time I was

    there I was telling her I needed to get help.

    I needed help. I needed counseling. I needed treatment. I needed something.

    In the worst stage of my addiction, I just kind of went off the deep end with it all. I

    just realized that Icouldn’t handle it anymore and Ididn’t know how to fix it. SoI

    just self-medicated and drank, and drank, and drank, and took pills and drank.

    And some things happened that just caused me to realize that I was going to die

    if I didn’t reach for help.

    JASON: I snuck into a Casino with a fake ID at 14 and won $1,000 playing

    Blackjack, and then it was like my whole life went this way. It was like college,

    that all canwait, because there’s no way I can make this much money. So it was

    just off to the races from then.

    © 2016 Laureate Education, Inc. 1

     

    In Their Own Words

    I can remember one time I cashed out my 401k, took out like $30,000, went

    straight to the casino. Doubled that and didn’t leave. And then lost $40,000.

    I think I got the same feeling losing or winning. It was as long asI was gambling.

    It didn’t matter. It’s the same. It’s the rush.

    I would go to the casino. And, of course, they’d give me a room for a week or two

    weeks, whatever I wanted. I would stay there literally. I just wouldn’t go to work.

    And of course, no employer’s going to put up with that.

    I pretty much just lost everything. And I knew it was time to do something.

    RICKY: My daddy, when I finished high school, he passed away. So that just,

    that left me, the oldest son, on the farm. So I had to drop everything. There was a

    lot of pressure. There was a lot of disappointment, and the only way I could cover

    that up was by drinking.

    NICOLE: My addiction began when I was a child. I was ADHD, always bouncing

    off the walls. And that’s when I first got my first experience with pills.

    And I remember that chemical feeling of feeling relaxed, and I liked it. And

    throughout my adolescence I experimented with marijuana, pills, alcohol,

    whatever.

    I had a schedule where I would drink at noon, and then I would drink at 2:00. You

    know I had this whole schedule of– it was really silly. It’s funny how you have this

    whole mindset and you can trick yourself. And you’re thinking in addiction is

    absolutely crazy.

    My addiction got really bad. I was in an abusive marriage. I had a heart attack

    during that time. And anyway, it was just really, really bad. And basically, I just

    wanted to numb the bad feelings.

    ODESSA: Addiction started for me at an early age, probably around eight-yearsold,

    nine-years-old. My grandparents made homemade wine, and I would like

    taste it. So that’s where I think it actually started for me.

    It started with alcohol, marijuana, and cocaine, and then later crack cocaine. For

    most of my 20s and 30s, I was an active addict. I could stop for many years and

    then start back. But every time I would start back, the addiction would get worse

    and worse.

    Once I got to a point in my life where things were falling totally apart. Foreclosure

    on homes, repo of vehicles, family dynamic totally destroyed, living on the

    streets, prostituting, doing whatever I had to do to get drugs. That’s when I

    realized I needed help.

    © 2016 Laureate Education, Inc. 2

     

     

    In Their Own Words

    SHANE: I found my drug of choice right out of high school, which was

    methamphetamine. When I found my drug of choice, nothing else really mattered

    to me. It was just the getting and using and finding ways and means to get more.

    Through that period of life I got married a coupletimes, but one thing was clear, I

    stayed married to methamphetamine. Ididn’t have the ability to get away from it.

    It became a normal part of life for me.

    And I called myself being a functioning addict, because Ihad the ability to go to

    work. Ihad the ability to be an energetic father, and all these lies I kept telling

    myself, because I was able to function in everyday society. That addiction cost

    me two marriages. It almost cost me my family. And it pretty much destroyed my

    relationship with my kids.

    First treatment center I went to they brought a guy by me in a straight jacket, and

    I left out after about three hours, because I knew that if I talked to somebody that

    they were going to know I was crazy. Because I knew the things that were

    happening in my head were not supposed to be in my head. SoI ran. Told them I

    needed to get a bag out of the car, and I was gone.

    I guess some of the first events that happened to me that allowed me to begin to

    open my eyes was, first of all, was a suicide attempt. I had a pistol in the truck,

    and Icouldn’t pull the trigger. I had it to the roof my mouth, and I had that blink of

    something’s wrong and I need help. I can’t do this on my own. And I want to die. I

    just couldn’t do it.

    Second glimmer was I had hit– I had gotten arrested. And I can remember laying

    there in that jail cell, and looking up at that ceiling, being on suicide watch in a

    paper suit, not really thinking the substance was a problem, but thinking that

    something was a problem.

    I am not meant to be in this cell. Something’s wrong, and I need to get some

    help. That time, they released me straight out of jail into treatment. All those

    things came flooding back up, and I just wanted to live right back in that denial

    again and blame it on everybody else but myself. But that was the start.

    The steps that helped me the most from my addictions counselor’s standpoint is

    the ability to sit down and talk to me like a human being. I guess I had a definition

    of myself when I got to treatment the last time from being in jail and being called

    a convict that I was just trash and that I’d never amount to anything.

    And thenyou hear all the rumors of when somebody’s an addict, they’re always

    an addict. And there’s no help for people like us. That addictions counselor

    actually treated me like a human being, and he asked me a point blank question.

    What do I want to do with my life?

    © 2016 Laureate Education, Inc. 3

     

    In Their Own Words

    And hereI was a 28-year-old man that didn’t have a clue what he wanted to do

    with his life. That was the starting point that hey, this guy wants me to do

    something. So maybe I should start thinking about my dreams again.

    Everybody had dreams as a child. But I had lost mine somewhere. I had gotten

    into this monotonous life of getting high, going to work, that didn’t work anymore.

    What was I going to do with my life?

    He built me up. He gave me confidence to walk into a 12-step meeting, to walk

    into a public place and actually talk.

    ODESSA: I had to relapse several times to understand that Icouldn’t do this by

    myself. Icouldn’t beat this thing. The first step, I had to admit that I was an

    addict. For years, Ididn’t want to accept that, because I had been so productive

    for so long.

    And the second thing was for me to be able to surrender to something. It’s hard

    to surrender to something that youdon’t know anything about. So to be able to

    trust someone in recovery was like foreign land to me.

    RICKY: If Idon’t do anything about this, I’m going to die. And I had to come out of

    this denial stage and realize that. I began to come open-minded to suggestions,

    because Iwasn’t living. I was trying to survive. Iwasn’t living.

    JASON: The first 30 days, 35 days or so, it was like extensive group therapy

    every morning of the week, where you get in groups with a bunch of people,

    maybe 10, 15 people with my addiction. We talk about it, talk about what we’re

    going through, and what not, what’s on our mind, just whatever, and just be open.

    And then you have these classes that you deal with about the addiction. And

    then, of course, the meetings at night, 12-step meetings. After the 35 days,

    another 60 days of the same thing, but a little bit more freedom, not so intense,

    but staying around people in recovery and not just going back out there to where

    I came from.

    I’ve been in treatment four times. And I’ve always gone back. Gotten out and

    gone back to where I came from. It does help to kind of relocate and then be

    around people that are trying to do what you’re doing for sure.

    Because every time I would go back to that old environment– of course, I’m with

    my old friends. They don’t have that problem, but they’re going to do it. And then

    here you are getting dragged back into it.

    NICOLE: This lady who had been my cousin’s sponsor, her name popped into

    my head. And so I called her and I said, Idon’t know what’s going on with me. I

    said,I tried to quit drinking.

    © 2016 Laureate Education, Inc. 4

     

     

     

    In Their Own Words

    But I feel like if Idon’t get a drink, I’m going to die. And I know that that means

    something is wrong. And she was like, well, I’m going to chair a meeting tonight,

    a narcotics anonymous meeting. Why don’t you come?

    And I was like, well, Idon’t need a meeting. I’ve never done cocaine or shot

    needles in my arms. I don’t need a meeting. And so I got through the afternoon

    by the grace of my higher power somehow. And I was throwing up. I was so sick.

    And I was like, no, I’m not going. Yes, I’m going to go. No, I’m not going to go.

    And finally, I went. And I’ll never forget that day.

    And I walked in, and it was full of people. And I’m so scared. And when they did

    the readings at the meeting, I was like, it just got chills. And I knew I was home.

    GRETCHEN: I would not suggest to anybody to do it the way I did. I would

    suggest someone maybe in my position to get medical detox, which I didn’t do. It

    could have killed me. But I detoxed at home.

    I was very violently ill. And I just kept telling myself, God doesn’t want me to

    forget what this feels like. He doesn’t want me to forget this time.

    And the people at my church and the people in my meetings, they helped me.

    They helped me through it. They helped me to understand that I was going to be

    all right and that even though it didn’t seem like that there was going to be a

    better day, there was.

    And I just reached out to every resource I could find to get information on why I

    might be doing the things I was doing or feeling the way I was feeling and what to

    do about it. And I’m still doing that, and I’m not going to stop. Nothing stopped me

    when I was in my addition, and now, nothing’s going to stop me in my recovery.

    JASON: The best program out there for me is the 12-step program. I meet a lot

    of people that are coming into the program, and they think once they go to

    church and get saved, and all this kind of stuff, they’ll be fine. Which if it works for

    them, good. But for me it didn’t, because I wasn’t around those people with the

    same problems that I had. So the 12-step program has definitely been the most

    beneficial to me.

    SHANE: I think the most successful treatment that helped me would be cognitive

    behavior. It allowed me to see that the problem wasn’t the problem. It was the

    thought about the problem. I would think it, and then all of sudden, it became a

    problem, because it would be rethought, and rethought, and rethought before it

    becomes this monstrous mountain I can’t get through.

    SoI was beginning to see that if I just dealt with my problems as they came

    along, they didn’t become these monsters. They were just life. And then of

    © 2016 Laureate Education, Inc. 5

     

     

    In Their Own Words

    course, the motivational interviewing, the being able to sit down right where I am,

    and meetme there, and then walk from me there was just amazing to me.

    Of course, the 12-steps played a monstrous role. And I continue working the 12

    steps today. It is part of the maintenance program that I utilize day in and day

    out. Those three things are probably the most powerful things that happened in

    my life and some of the things that I’m the biggest proponent of today.

    RICKY: Connecting with God, spirituality. When that clicked in, it was on. All of it

    began to make sense, all of it. I made that connection. And Idon’t think I would

    have made that connection without the 12 steps. Iwouldn’t be sitting here to be

    honest with you. It saved my life. Literally, it did. I made that connection with

    God.

    ODESSA: 12 steps was the most helpful for me. It gave me an outlet. And not

    only with people that are just like me, but people that were totally opposite.

    People that you could say that youwouldn’t think would be there were there, the

    support. They understood.

    NICOLE: 12 step was really the only I’ve– I mean it worked. We started a

    women’s only group, which has been great, a coupleyears ago. And that’smy

    home group. And so I go to a couple a week. I’m always working on step work,

    and I will be the rest of my life.

    GRETCHEN: I just kind of winged it myself. But that’s dangerous. I realize that

    now. I mean I knew I was sick when I was withdrawing. I knew, but I didn’t know

    what physically could have happened to me really. I’m here now.

    RICKY: The most successful thing that I learned that guarded me against relapse

    was seeing the people coming to treatment and realizing that it’s still out there,

    bigger than ever, badder than ever. And allI had to do is take that one slip and

    that’s it.

    JASON: The most successful things I’ve learned to guard myself against relapse

    would be like triggers. Certain kinds of music is a trigger for me, as weird as it

    sounds. Or definitely talking about it, entertaining glory stories of, man, one time I

    went, and I won this amount of money.

    Entertaining that thought, and then my blood is flowing, and that becomes my

    obsession in my head. So just realizing the fact that I’ll never be able to gamble

    again, not keeping that reservation in the back of my mind that, well, maybe one

    day if I’ll be able to manage it.

    ODESSA: Cravings still come, thoughts of using. Just driving past a place that

    you’re familiar with. To be able to pick up the telephone and call someone and

    © 2016 Laureate Education, Inc. 6

     

    In Their Own Words

    tell them about the things that you’re thinking. That was a hard, hard thing for me

    to do.

    And to ask for help from others, it is was just almost unheard of. But that was the

    main thing that helped me to start my road to recovery.

    SHANE: Some of the things that I learned in treatment that allowed me to begin

    to see what some barriers would be or what would be some walls that I could put

    up to stop me from relapsing, of course, was the ability to talk to people. When I

    was able to share those sick thoughts, then they dissipated. They would leave

    me.

    I can remember the very first time I did that with an individual, the first person I

    called, my sponsor. And I reached out and I said, here’s the craziness that I’m

    thinking, that I could go out and use just one time, that I could be successful with

    it this time, or just use on the weekends.

    And he said, man, do you know how crazy that sounds. And it hit me. He did. He

    knew how crazy that sounds because he had thought the same thing. That

    connection was the beginning of being able to trust people again. And that there

    were people just like me.

    NICOLE: To make a cake you have to have all the ingredients. And if you leave

    out one of those ingredients, the cake’s not going to turn out. So to prevent

    relapse, you have to have all the ingredients, which is have a sponsor go to

    meetings and learn the steps with your sponsor.

    GRETCHEN: I’ve watched other people die. I’ve watched other people relapse.

    And I came to a place inside of my addiction, where I could have really died. I

    knew I was going to. I knew I was. if I didn’t stop it.

    And now I’m seeing it happen to other people, and everybody thinks it’s not going

    to happened to me. Yes, it happens. It can happen to you. And it scares me. I’m

    scared.

    But my last relapse, just all the events that took place, really reality hit. And I

    became very afraid, and my fear of it seems to keep me, it seems to drive me

    towards recovery, more and more every day.

    SHANE: I still go to 12-step meetings. I still have a sponsor. I still talk to my

    sponsor if not every day, but every other day, because those sick thoughts will

    come back. And that beast is waiting on me.

    JASON: Man, how am I going to enjoy football or sports without betting on them.

    I even told myself for a little while that maybe I’ll do it again one day, but just not

    © 2016 Laureate Education, Inc. 7

     

     

     

    In Their Own Words

    today. I’m going to, just today, I’m not going to think about gambling. I’m not

    going to gamble. I’m not going– I’m just going to be.

    GRETCHEN: It’s kind of like you’re in a boat with a pale, and you’re throwing the

    water out of the boat, and youdon’t want to give your pale to anybody, because

    you know you’ll sink. But at the same time, you know you are trying to help others

    as well.

    Ihave to remember that I’m still in recovery, and I have to take care of me first.

    Or I’ll be a disaster, and Iwon’t be able to take care of anybody else.

    RICKY: What I do now, I’m an alcohol and drug counselor. It feel good to know

    you’re helping others in the same predicament that you were once in. And I’m

    going to continue doing that, because I know what it’slike.

    SHANE: One of the counselors had a mirror in his office, and he said, go look in

    that mirror. And I walked into that mirror. And he said, now, look straight in the

    eyes of the person that’s looking at you in that mirror and say, if that’s not the

    problem, there is no solution, because Ican’t change anything else but that.

    And that scared me. It scared me, because I was the one destroying everybody

    around me, including myself. It’s like I was OK with dying. I was afraid of living.

    And boy, it impacted so much in my life. It’s one of the things that still draws me

    to recovery today.

    And I want tear up thinking about it right now, because it’s one of the powerful

    things that keeps me going. And that addictions counselor doesn’t know how

    much he’s helped me.

    NICOLE: An addiction counselor helped me and pushed me to go back to school

    and back to college. And I graduated with honors, and I would have never even

    tried it if it weren’t for him. And we got married. And he’s my husband today.

    ODESSA: For so many years, I only believed in me and what I was incapable of

    doing. But no man is an island. And I’ve learned that. And reaching out to others

    and working in a 12-step program and being held accountable has made my life

    successful. Matter of fact, all the years that I thought I was productive, Iwasn’t at

    peace. Today, I’m at peace.

    © 2016 Laureate Education, Inc. 8

     

     

     

    Week 6: Psychotherapy for Addictive Disorders

    “A long-standing debate has roiled over whether addicts have a choice over their behaviors. The disease creates distortions in thinking, feelings, and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause.”

    –Dr. Raju Hajela, former president of the Canadian Society of Addiction Medicine

    A common misconception is that addiction is a choice, and addicts are often labeled as individuals who lack morals, willpower, or responsibility. However, addiction is a clinical disorder that must be treated with the support of a health care professional. Although many people who are exposed to potentially addictive substances and behaviors continue life unaltered by their experiences, some people are fueled by these experiences and spiral out of control. In your role as the psychiatric mental health nurse practitioner, you must be prepared to not only work with these individuals who struggle with addiction, but also help them and their families overcome the social stigmas associated with addictive behavior.

    This week, as you explore psychotherapy for addiction, you assess clients presenting with addictive disorders. You also examine therapies for treating these clients and consider potential outcomes. Finally, you develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

    Photo Credit: Laureate Education

    Learning Resources

    Required Readings

    Wheeler, K. (Ed.). (2014).
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    (2nd ed.). New York, NY: Springer Publishing Company.

    Chapter 7, “Motivational Interviewing” (pp. 299–312)

    Chapter 16, “Psychotherapeutic Approaches for Addictions and Related Disorders” (pp. 565–596)

    American Psychiatric Association. (2013).
    Diagnostic and statistical manual of mental disorders
    (5th ed.). Washington, DC: Author.

     

    Note:
    You will access this text from the Walden Library databases.

    Albrecht, U., Kirschner, N. E., & Grusser, S. M. (2007). Diagnostic instruments for behavioral addiction: An overview. German Medical Science Psycho-Social-Medicine, 4, 1–11. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736529/

    Fisher, M. A. (2016). The ethical ABCs of conditional confidentiality. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 13–25). Washington, DC: American Psychological Association. doi:10.1037/14860-002

    Walden University. (2016). ASC success strategies: Studying for and taking a test. Retrieved from http://academicguides.waldenu.edu/ASCsuccess/ASCtesting

     

    Required Media

    Laureate Education (Producer). (2013c).
    Levy family: Episodes 1
    [Video file]. Baltimore, MD: Author.

     

    Note:
    The approximate length of this media piece is 2 minutes.Laureate Education (Producer). (2013c).
    Levy family: Episodes 2
    [Video file]. Baltimore, MD: Author.

     

    Note:
    The approximate length of this media piece is 2 minutes.

    Laureate Education (Producer). (2013c).
    Levy family: Episodes 3
    [Video file]. Baltimore, MD: Author.

     

    Note:
    The approximate length of this media piece is 6 minutes.

     

    Laureate Education (Producer). (2013c).
    Levy family: Episodes 4
    [Video file]. Baltimore, MD: Author.

     

    Note:
    The approximate length of this media piece is 5 minutes.

    Laureate Education (Producer). (2013c).
    Levy family: Episodes 5
    [Video file]. Baltimore, MD: Author.

     

    Note:
    The approximate length of this media piece is 2 minutes.

     

    Laureate Education (Producer). (2012c).
    In their own words
    [Video file]. Baltimore, MD: Author.

     

    Note:
    The approximate length of this media piece is 23 minutes.

     

    Dronen, S. O. (2012). New research about Facebook addiction. Retrieved from http://www.uib.no/en/news/36380/new-research-about-facebook-addiction

    Substance Abuse and Mental Health Services Administration. (2005). Substance abuse treatment for adults in the criminal justice system. Treatment Improvement Protocol (TIP) Series 44. Rockville, MD: Author. Retrieved from http://store.samhsa.gov/shin/content//SMA13-4056/SMA13-4056.pdf

    Substance Abuse and Mental Health Services Administration. (2007). Problem gambling toolkit. Retrieved from http://store.samhsa.gov/product/Problem-Gambling-Toolkit/PGKIT-07

    Substance Abuse and Mental Health Services Administration. (2013). Substance abuse treatment for persons with co-occurring disorders: A treatment improvement protocol. Treatment Improvement Protocol (TIP) Series 42. Rockville, MD: Author. Retrieved from http://store.samhsa.gov/shin/content//SMA13-3992/SMA13-3992.pdf

  • Health of people and the country

    Health of people and the country

    We are constantly looking for information on the health of people and the country. According to one site, health statistics provide key indicators that help us know about the conditions of life in a country (Importance, n.d.). The author goes on to say these statistics help us understand the impact of health on people and work for their betterment. As we monitor the health of a population, we enhance our understanding of strategies to promote its health (Importance, n.d.).

    Discuss whether or not you feel health planners, government officials, and healthcare organizations are using social issues/pressures or health statistics to determine strategies? Which is more reliable?

    Reference:

    Importance. (n.d.). Retrieved from 
    http://www.nlm.nih.gov/nichsr/usestats/importance.html

    Uses. (n.d.). Retrieved from 
    http://www.nlm.nih.gov/nichsr/usestats/uses.html

  • Patient with undifferentiated schizophrenia about medications

    Patient with undifferentiated schizophrenia about medications

    How would your plan for teaching a patient with undifferentiated schizophrenia about medications differ from the plan for a patient with depression? What issues would you consider when teaching a patient with paranoid schizophrenia about his or her medication? Provide your responses in a 450-word APA format summary. Include list of all references used to support your answer.

  • PROBABILITY THEORY AND HEALTH STATISTICS

    Probability Theory and Health Statistics

    Your specific assignment for this week is to select one type of quantitative health datum to collect from your own life. Some examples of data to collect could be:

    How many minutes do you spend exercising each day?

    What is your total daily caloric intake in calories?

    What is your resting heart rate in beats per minute?

    How many ounces of water do you drink each day?

    What is your estimated total caloric expenditure from exercise each day?

    What is your estimated daily intake of saturated fat in grams?

    What is your daily systolic/diastolic blood pressure?

    Your Task:

    Choose one variable that varies measurably from day to day. Be sure to specify the units of measurement, and state how it will be gathered.

    Then collect at least 5 days worth of data on that one variable. For example, if your variable is how many minutes you spend exercising each day, simply record the number of minutes that you spend exercising each day during the sampling period. Be sure to save this data for use in remaining SLP assignments. The more data points that you gather during the session, the better.

    Describe the data you have collected and its importance in relations to individual/population’s health.

    Submit your Probability Theory and Health Statistics paper by the end of this module.

  • Health Statistics Case

    Health Statistics Case

    Respond by classifying each of the following variables as either: nominal, ordinal, interval, or ratio. Provide a brief explanation where indicated.

    A researcher studying lifespan categorizes individuals into single, married, divorced, or widowed. What type of variable measurement is this?

    A cognitive scientist places her subjects into categories based on how anxious they tell her that they are feeling: “not anxious,” “mildly anxious,” “moderately anxious,” and “severely anxious,” and she uses the numbers 0, 1, 2 and 3 to label categories where lower numbers indicate less anxiety. What type of variable measurement is this? Are the categories mutually exclusive?

    A Physician diagnoses the presence or absence of disease (i.e., yes or no). What type of variable measurement is this?

    A person weighing 200 lbs. is considered to be twice as heavy as a person weighing 100 lbs. In this case, what type of measurement is body weight?

    A nurse takes measurements of body temperature on patients and reports them in units of degrees Farenheit as part of a study. What type of variable measurement is this?

    Patients rate their experience in the emergency room on a five point scale from poor to excellent (1 = very poor, 2 = not very good, 3 = neither good nor bad, 4 = quite good, and 5 = excellent). What type of variable measurement is this? Is the difference between a 1 and a 2 necessarily the same as the difference between a 3 and a 4? Explain briefly.

    Part II: Statistics (1/2 page)

    Given what you’ve learned in this Health Statistics Case module about the meaning of “statistics,” choose one of the examples from Part I (1-6), and raise a relevant question of your own that could be answered by a statistician. Then without answering your own question, explain how a pattern could be studied or a useful prediction made based on data that are to be collected.

    Part III: Quantitative vs. Qualitative Data (approximately 1–1½ pages)

    A health scientist wishes to measure how well participants diagnosed with Post Traumatic Stress Disorder are coping. Explain how a variable such as coping could be measured quantitatively or qualitatively.

  • Arthritis

    MP is a sixty-five-year-old male who has recently retired. He is coming in today for a complaint about pain in his back, knees, and hips. He reports that he has been experiencing this pain for the past six months, and he has been able to control the symptoms with OTC Advil. He describes the pain as stiffness and occasional shooting and aching pains radiating all over. He denies any swelling of his joints. However, the OTC medications are not working well, and he is here to see whether there are any other options he might try. On physical exam, he has tenderness on palpation on the right and left hips and both knees are positive for crepitus. All blood work is within normal limits. Answer the following questions in a 2 pages Word document:

    • What additional information would ask him? Does MP need any additional testing?

    • What possible issues could contribute to his symptoms? (arthritis) What would your treatment plan be? For medications, include dosages and schedules

    • He asks about injections to both knees to increase his comfort. How would you respond to that?

    • Include highlights of patient teaching and/or lifestyle alterations. Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication

  • Nursing Engagement

    Rationale:

    Nursing engagement is linked to critical safety, quality, and patient experience outcomes.Nurses and the medical profession must understand the intricacies of engagement to improve patient care and move the practice to higher levels of professional interaction.

    Proposed Topic:

    The proposed
    qualitative
    research topic examines and analyzes
    emergency room nurseburnout and retention
    . Burnout is a problem in most professions.  This is especially true with the rigors of nursing.Career aspirations and dreams represent the motivation to enter the profession. These are present at the beginning of a career and present an anticipatory set of ideal working conditions.  The actual experiences of day-to-day working conditions, workload, expectations, treatment, management, and environment represent a reality which determines the level of possible burnout or satisfaction for the nurses. The relationship of anticipated aspirations and dreams versus experience can lead to exhaustion and burnout as described by Aiken, Clarke, Sloan, Sochalski, and Silber (2002).The study will
    sample 25 emergency room nurses with one to five years of experience
    , who will be administered a
    survey
    to collect data. The survey will have respondents
    answer Likert Scale items
    indicating the level of satisfaction with various aspects of their current position, along with their career dreams and aspirations at the beginning of their career. The survey will also ask respondents to respond to a series of items which will indicate levels of burnout and likelihood to be retained within the profession. In addition to the survey, ten separate nurses will be
    interviewed
    to better assess their engagement and opinions on the practice

    Independent Variable-
    Career dreams/aspirations and job satisfaction elements

    Dependent Variables-
    Level of burnout/engagement, and the likely retention of emergency room nurses.

    Research Question:

    What are the key differences between emergency room nurse career dreams/aspirations and their actual experience in the practice?

    What are the key factors leading to emergency room nurse burnout and possible exit from the nursing practice?

  • Nursing Care Plans for Pregnancy Essay

    Nursing Care Plans for Pregnancy Essay Discussion: Care Plans for Pregnancy. After confirming and dating a pregnancy, you must collaborate with patients to develop a personalized care plan. These pregnancy care plans are integral to prenatal care as they help to ensure the mother and child’s well-being throughout the entire pregnancy. Pregnancy can be a wonderful, yet difficult time for women as a woman’s body goes through many physical, mental, and emotional changes that might be challenging or even overwhelming for some. Whether or not these women share their concerns, as the advanced practice nurse, you must routinely watch for signs and symptoms of any developing physical or mental health issues. By collaborating with patients and discussing concerns, you can modify care plans and often address potential issues before they become a significant health problem. For this Discussion, consider pregnancy care plans for the women in the following case studies:Case Study 1:On 1-15-13, you are seeing a 25-year-old Caucasian female in the clinic because she believes she’s pregnant. Her LMP was 12-1-12. Her home pregnancy test was positive, and she has been having nausea and breast tenderness.

    Nursing Care Plans for Pregnancy Essay

    To prepare:

    Review Chapter 30 of the Schuiling and Likis text and Chapter 2 of the Tharpe et al. text.

    Review and select one of the two provided case studies. Analyze the patient information.

    Consider how to date the pregnancy and estimate the date of delivery for the patient in the case study you selected.

    Based on the dating of the pregnancy, reflect on the appropriate clinical guidelines for procedures and screenings. Think about the implications of any missed procedures or screenings.

    Determine a plan of care for the patient. Identify procedures, screenings, diagnostic testing, pharmacologic and nonpharmacologic treatments (if appropriate), management strategies, and patient education.

    Post the estimated date of delivery for the patient (EDD), in the case study. Include an explanation of how you dated a pregnancy and which of the patient’s factors led to your estimated date of delivery.

    Then, based on the dating of the patient’s pregnancy, explain the appropriate clinical guidelines for procedures and screenings.

    Explain implications of any missed procedures and/or screenings.

    Finally, explain a plan of care for the patient, including procedures, screenings, diagnostic testing, pharmacologic and nonpharmacologic treatments, management strategies, and patient education.

    Here are some recommended references for Nursing Care Plans for Pregnancy Essay:

    1.Schuiling, K. D., & Likis, F. E. (2017). 
    Women’s gynecologic health
     (3rd ed.). Burlington, MA: Jones and Bartlett Publishers.

    2.Tharpe, N. L., Farley, C., & Jordan, R. G. (2017). 
    Clinical practice guidelines for midwifery & women’s health
     (5th ed.). Burlington, MA: Jones & Bartlett Publishers.

    3. 
    Centers for Disease Control and Prevention. (2012b). 
    Women’s health
    . Retrieved from http://www.cdc.gov/women/

    National Institutes of Health. (2012). 
    Office of Research on Women’s Health
     (ORWH). Retrieved from http://orwh.od.nih.gov/

    U.S. Department of Health and Human Services. (2012a). 
    Womenshealth.gov
    . Retrieved from http://www.womenshealth.gov/