Essay on "Clinical Framework for Advanced Practice Nurse"

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By highlighting the use of master's-equipped nurses to oversee care from the hospital to within the home, this model has been able to reduce re-hospitalizations for elderly patients with multiple chronic conditions. Research shows that using the Transitional Care Model aids patients attain better long-term health results and evade repeat hospitalizations, all at a cheap cost. Experts agree the program does need more nurses in order to develop some innovations.

Person/Client/Client System

The research explains that each client system is unique, a composite of characteristics and factors within a given range of responses that are contained within a basic structure. Experts also make the point that many known, unknown, and universal stressors exist. Each of these stressors differs in its potential for troubling a client's usual constancy level or normal LOD (Line of Defense).

When it comes to the clients, the particular inter-relationships of client variables at any point in time can affect the degree to which a client is protected by the flexible LOD against possible reaction to stressors (Villanueva, 2008). With that said, research shows that each client / client system has evolved into a typical range of replies to the environment that is referred to as a normal LOD. The normal LOD at times, is able to be used as some form of a standard from which to evaluate health deviation.

It is also interesting to note that when the flexible LOD is no longer adept of protecting the client / client system against an environmental stressor, the stressor then starts to do things such as breaking through the normal LOD. The client whether in a st

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ate of illness or wellness, is a lively compound of the inter-relations of the variables. Also, it is important to understand that wellness is on a range of obtainable energy in order to support the system in a perfect state of system stability (Villanueva, 2008). Along with understanding the system stability, implicit within each client system are internal resistance factors recognized as LOR, which basically function to realign and stabilize the client to the typical wellness state.

When comes to the client, primary prevention connects to G.K. that is applied in client intervention and assessment, in identification and decrease of likely or actual risk factors. Secondary prevention narrates to symptomatology succeeding a reaction to stressor, suitable ranking of intervention significances and treatment to decrease their noxious properties. When it comes to the Tertiary prevention, it relates to adjustive processes which are taking place as reconstitution starts and upkeep factors move the back in circular manner toward primary prevention (Villegas, 2012). Another interesting thing is that the client as a system is in dynamic, constant energy interchange with the environment.

Environment

The environment is considered to be a vital arena that is relevant to the system and also its function. Research shows that the environment is something that may be looked at as all factors that are affected and are simply affected by the system. However, the internal environment is something that exists within the client system. It is interesting to note that every one of the forces and interactive influences that are solely inside the boundaries of the client system are what make up this environment. An environment that is recognized as being created (intrapersonal, interpersonal, and extra personal) is something that is put together from the exchange of energy from the external and internal environments and is watched through the changing scene of the five system variables (Swain, 2009). The patient may or may not be conscious of the five variables that influence the response to the stressors and how the resistance and lines of defense alter to bring the body back into constancy. The health care provider's role is to assist the patient in making sure that they are recognizing the negative and positive created environment and help with movement toward a wellness range. Since the patient is an open system, there is continuous collaboration with the complete environment. As mentioned earlier, the environment can be an internal and external.

Also as mentioned, stressors are the forces that are created by the environment. Most of the time, these stressors are tensions that are able to produce certain alterations in the normal flow of the environment. The research also shows that these stressors can be:

1. Intrapersonal -- takes place within the self and includes of man as a psycho-spiritual being

2. Interpersonal -- happens among one or more individual and comprise of man as a social being

3. Extra personal - take place outside the individual and may consist of environmental factors

Health

Health is defined as the condition or degree of system stability and is looked at as a continuum from wellness to illness (Castner, 2011). The research shows that when system needs are met, optimal wellness is what exists. When needs are not content, illness occurs. When the energy needed in order to support life is not obtainable, death then takes place.

The main focus of nursing is to define the suitable action in situations that are stress-related or in relation to likely responses of the client or client system to the stressors. Nursing interventions are what are intended at assisting the system to adjust or adapt and to restore, retain, or support some grade of stability among and between the client system variables and also the environmental stressors with a focus on being capable of conserving energy.

When it comes to health as being equated with wellness, health/wellness is described as "the condition in which all subparts and parts (variables) are in agreement with the entire of the client (Villegas, 2012)." The client system is what moves in the direction of illness and death when more energy is needed than is obtainable. The client system moved in the direction of wellness when more energy is accessible than is desirable. This nursing-based model includes a traditional medical model joint with a nursing-based model which challenges to make a contemporary day provider accessible to serve the present population in this changing health care environment (Villanueva, 2008). This will raise the Advanced Family Nurse Practitioner's posture in practice and promoting optimistic health outcomes.

Nursing/APN (Factors Effecting APN's Practice and Implementation of the APN

Nursing Process)

A created environment (intrapersonal, interpersonal, and extra personal) is developed

From the exchange of energy from the internal and external environments and is viewed through

The kaleidoscope of the five system variables. The client may or may not be aware of the five variables that influence response to stressors and how the lines of defense and resistance adjust to bring the body back into stability. The health care providers role helps the client recognize the positive or negative created environment and assist with movement toward a wellness continuum. Since the client is an open system, there is constant interaction with the entire environment (Castner, 2011).

One of the factors that effects APN are the ethics. Ethics is an essential component of graduate education in nursing. Research shows that the education of nurse practitioners for advanced practice will need to be build upon students' previous academic and clinical experiences associated to ethics. On the other hand, a review of the literature discovered that no studies have been published unfolding the starting point ethics-related knowledge of graduate students who are beginning their coursework for advanced practice as nurse practitioners (Castner, 2011). An emergent body of nursing knowledge mirrors rich influences of nurse theorists, nurse ethicists, nurse clinicians, and nurse educators. The significance of ethics in nursing is further validated by academic and professional standards, as well as the American Nurses Association Code of Ethics for Nurses with Interpretive Statements, which starts ethics as "an integral part of the foundation of nursing"

The process for evaluating and implementing APN roles is as dynamic and complex as the roles themselves. The PEPPA framework is formed by the fundamental principles and standards steady with APN, namely, an emphasis on addressing patient health needs through the delivery of synchronized care and collaborative associations among health care suppliers and systems. Engaging environmental shareholders as participants in the process provides prospect to recognize the need and shared objectives for an evidently defined Advanced Practice Nurse role. The process endorses increased understanding of Advanced Practice Nurse roles and optimal use of the broad range of Advanced Practice Nurse knowledge, skills, and knowledge in all role domains and scope of practice. The steps for planning and implementation are designed to create environments to support Advanced Practice Nurse role development and long-term addition within health care systems. The goal-directed and outcome-based procedure likewise provides the basis for potential ongoing evaluation and improvement of both the part and distribution of health care services.

Interrelationships of Client System, Environment, Health, and Nursing/APN

People are considered to be the vibrant of systems looked at as being bendable are universal in nature. The main point of everything is to be able to have some kind of effect on every part with an expectant end… READ MORE

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Quoted Instructions for "Clinical Framework for Advanced Practice Nurse" Assignment:

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Each Nurse Practitioner Student (NPS) will develop his/her own narrative description of the Advanced Practice Nurse (APN - FNP-Fmily Nurse Practitioner) Clinical Practice Framework to guide the student*****s clinical interactions with clients. The narrative description will address all components of the APN Clinical Practice Framework Schematic developed by Cook (2004). The Clinical Practice Framework of the Advanced Practice Nurse (Cook, 2004) should be identified as Appendix A when you address it in the introduction of the paper. A narrative description of the clinical practice framework will be developed and organized by the NP student in the following manner:

A. The major components in the narrative of the practice framework that will be presented, described and explained include: Introduction Person/Client/Client System

Environment Health Nursing - APN Interrelationship of Client System, environment, health, & nsg (APN)

B. Introduction should include: Definition and description of conceptual frameworks in general and then specifically related to clinical practice frameworks; the purpose and the use of a specific clinical practice framework in Advanced Practice Nursing includes a definition of Advanced Practice Nursing; state the purpose of this paper: to provide a narrative description of the application of the Clinical Practice Framework for the Advanced Practice Nurse (Cook, 2004) to my clinical practice as an (state your specific type of NP practice); identify that the primary theoretical source for the Framework is

provided by the Neuman Systems Model (Neuman , 2002 ***** cite chapter author), and that the Framework is organized and described according to the four concepts of the nursing metaparadigm: Person/Client System, Environment, Health, and Nursing and the interrelationship of these four concepts to accomplish the goal of nursing. Provide a transition paragraph to the body of the paper and describe how the paper is organized and the content of the paper is presented.

C. The next major section of the paper is a description of the Framework that includes the nursing metaparadigm concepts. Provide an introduction to the section related to the content and organization. Then , as subsections, define and describe each of the major components above according to Neuman (2002) as the primary source. DO NOT use secondary sources ***** Use Neuman! The nursing component will include other concepts from other theoretical sources in addition to Neuman. NOTE: do not say, According to Neuman (2002) ***** just describe the concept and cite Neuman in parentheses using correct APA format. Esp. include:

1. Client System Define & describe all system elements according to Neuman - FLD, NLD, LOR, Basic Structure, the 5 system variables (in detail); Can also include description of the perinatal client; description of client system as family, including Neuman*****s OR other family theorists.

2. Environment In detail according to Neuman, including the internal, external, and created environments, relating and describing type of environment to types of stressors, and the relationship of the 5 system variables to the intra-, inter- & extra-personal stressors.

3. Health In detail according to Neuman, including concept of health continuum from optimal wellness to illness/death; include

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definitions of concepts of entropy & negentropy. Also include a description of health outcomes described by Dunphy & Windland-Brown (1998) in the Circle of Caring.

4. Nursing/APN Definition of APN in general, Nurse Practitioner, and your NP type specifically; identify the goal of nursing according to Neuman; define and describe the Nursing Process of the APN developed by Cook (2003).

You can insert the next 2 paragraphs verbatim into the paper under the description of the Nursing concept. The paragraphs below would come after the general definitions of APN, NP, and your specific type of NP. These paragraphs come directly from The Nursing Process of the Advanced Practice Nurse document.

The Nursing Process of the Advanced Practice Nurse (APN) (Cook, 2003) provides the mechanism of interaction between the APN, the client, environment, and health (see Appendix B). The Nursing Process of the APN is a care management process that guides the APN-Client interaction toward achievement of optimal client health outcomes via primary, secondary, and/or tertiary interventions in the client*****s internal and external environment (see Appendix B). It is through the implementation of this care management process that the APN operationalizes the Clinical Practice Framework of the Advanced Practice Nurse (Cook, 2004) (see Appendix A). The Nursing Process of the APN represents an adaptation of the Nursing Process of the Master Clinician, originally developed by Moxley and Allen (1982), and the adaptation and synthesis of selected concepts from the Neuman Systems Model (Neuman, 1995) and the Circle of Caring (Dunphy & Winland-Brown, 1998), as they relate to the steps of the Nursing Process and the role and scope of practice of the APN (Cook, 2003).

All phases of the Nursing Process of the APN (Cook, 2003) are enacted within the context of a caring environment created by the APN. Within this caring environment, the APN demonstrates the characteristics of patience, advocacy, commitment, knowing, courage, authentic presence (Dunphy & Windland-Brown, 1998), empathy, and compassion (Cook, 2003). A complete description of The Nursing Process of the APN is provided in Appendix B.

Cook Reference Citations:

Cook, S.E. (2003). Nursing process of the advanced practice nurse. Unpublished manuscript, Northwestern State University of Louisiana at Shreveport.

Cook, S.E. (2004). Clinical practice framework for the advanced practice nurse.

D. Also, identify & describe the factors that influence the APN*****s practice and implementation of the APN Nursing Process: Scope and Standards for specific NP practice and education (Appendix C in your paper); Level of attainment of APN role competencies (ID according to Hamric et al. text book); Personal & professional philosophy & ethics; Extent or level of personal & professional knowledge; NP*****s critical thinking abilities; NP Practice environment (NAT. ,state; local)( include all factors identified on the schematic) (Do not need to go into a lot of detail here, except for scope & standards).

E. Then you need to summarize the interrelationship of the above 4 concepts - describe how they are linked to and influenced by one another, and for what purpose;

F. The narrative must be consistent with and reflect the schematic of the framework furnished to you -

G. Provide a complete reference list for the paper.

H. Use appropriate APA (6th ed.) citation format in the narrative and reference list. This is a formal paper and should reflect graduate level work. Use appropriate APA and MSN Guidelines for Formal Term Paper format. Include appropriate headings for the different sections (and within the sections) of this paper. *****

*****

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