NURS 6512 Primary care is a critical aspect of patient care

Primary care is a critical aspect of patient care, as a nurse practitioner requires education in providing primary care beginning with a proven foundation in patient communication. The proficiency of conversing while building a trusted patient-to-provider relationship is a time-honored skill. Prudent patient care delivery develops from open communication; which depends on developing an honest, trust-driven conversation (Phillps, et al., 2017).

There are so many sources that entail the life of Florence Nightingale. This version makes me envision Florence as a very inspiring accolade. Florence Nightingale refused to be married when she was 17 years old as she chose to answer her calling despite her parents being against enrolling as a nursing student at the Lutheran Hospital in Germany. Nightingale faced a cholera outbreak in an unsanitary environment when she returned from school to London and worked at Middlesex hospital. She worked hard to improve the environment’s sanitation, significantly decreasing the number of deaths. All the hard work eventually affected Nightingale’s health. The Crimean War happened between the British and Russian Empires, and many soldiers were admitted into military hospitals. There were not enough female nurses stationed at Crimea hospitals. England then was angry due to the neglect of the soldiers who had fallen ill and injured and lacked medical care due to insufficient caregivers leading to dreadful unsanitary, and inhumane conditions. Nightingale then was called to her calling despite barely recovering from her illness. She assembled a team of nurses and sailed them to Crimea. Nightingale and her nurses warned of the conditions they were about to face but were still unprepared for what they witnessed upon their arrival.

Collecting a patient’s personal information is the first prerequisite in assessing and observing a client. The nurses should be knowledgeable on the components of a patient’s health history. The communication and interview styles for building a patient’s health history would differ with each patient after evaluating the type of patient (Nichol JR et al., 2020). Different techniques would be utilized with children, adults, individuals living with disabilities, language barriers, and education. Inpatient C, regular interviews could be conducted because the patient is young and most likely educated. Besides, a pregnant woman may understand various aspects of her health, especially if she attended clinic check-ups. The social determinant would help structure the patient’s health history because asking in-depth questions would help understand the person’s health status (Nichol JR et al., 2020). In part patient C, I would focus on knowing her socio-economic status because she resides in a reservation that reduces the chances of proper health care access. The patient may have significant exposure to health risks that may endanger the unborn child’s life, hence the need to ask direct but mostly open-ended and analytical questions.

Since patient C is a pregnant woman, the appropriate risk assessment is a risk screening that evaluates both medical and non-medical issues that may contribute to poor health for her and the unborn baby. The exercise would establish the mother’s diet, psychological problems, or living conditions. In order to protect the lives of indigenous women and children as she is, it is essential to document the problem and identify contributing factors. This is difficult for many reasons, maternal mortality among indigenous women is not consistently reported (Vos et al., 2015). According to patient C, the potential health-related risk is vagina yeast infection common among pregnant women. The living conditions in the reservation may lead to disease, infections, mostly if wet clothes are used. The below questions are targeted at the patient to assist the clinician in understanding the needs of the patient.

As a clinician my risk assessment is checking her and her unborn baby, running lots of blood work making sure the female and the baby are doing all right. scheduling her next appointment for vaccination and to see the OBGYN. Scheduling ultrasound for the baby.

I enjoyed reading your post. It is important that providers know and understand different modes of communication, when, and how to use them with their various patients. In addition to communication, they should also know how health beliefs may vary from one culture to another, also how diet and nutritional practices may be different (Ball, et., 2019). Anticoagulants or blood thinners are a serious and important class of medication that prevent or reduce the risk of a blood clot. Patients should be educated on why they are on this medication, its use, and when and how to take the medication. They should be aware of labs and how often the lab should be monitoring and foods they needed to avoid while on this medication. As you mentioned in your discussion that the culture of the patient, therefore has an impact on his health because it dictates his willingness to adhere to the treatment (Collado, 2019). Some cultures or countries believe that they do not need medications for some illnesses because of not being aware of illness, resources, or how to treat them. Providers should educate, provide resources and allow patients to demonstrate what they learned or skills in order to make sure that they understand what was discussed.

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Collado, Z. C. (2019). Challenges in public health facilities and services: evidence from a geographically isolated and disadvantaged area in the Philippines. Journal of Global Health Reports, 3.

What are the symptoms you are experiencing?
When did you begin to experience these particular signs?
What makes these signs worsen whenever you experience them?
Have you tried any form of treatment?
Are the symptoms incapacitating your daily activities

References

Nichol JR, Sundjaja JH, Nelson G.(2020). Medical History. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534249/

Phillps, A., Frank, A., Loftin, C., Shephard, A.(2017). A detailed review of systems: an educational feature, Journal of Nurse Practitioners,13(10), 681-686.

Vos, A. A., Van Veen, M. J., Birnie, E., Denktaş, S., Steegers, E. A., & Bonsel, G. J. (2015). An instrument for broadened risk assessment in antenatal health care including non-medical issues. International journal of integrated care, 15. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359383/

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Discussion: Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

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To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
How would your communication and interview techniques for building a health history differ with each patient?
How might you target your questions for building a health history based on the patient’s social determinants of health?
What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

By Day 3 of Week 1

Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:

Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
Suggest additional health-related risks that might be considered.
Validate an idea with your own experience and additional research.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

To Participate in this Discussion:

Week 1 Discussion

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What’s Coming Up in Module 2?

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In Module 2, you explore the impact of functional assessments, diversity, and sensitivity in conducting health assessments. You also

examine various assessment tools and diagnostic tests used to gather information about patients’ conditions and examine their validity, reliability, and impact in conducting health assessments.

Next week, you will specifically examine functional assessments as they relate to diversity and sensitivity

Registration for Shadow Health

Throughout this course, you will participate in digital clinical experiences using the online simulation tool Shadow Health. The Shadow Health digital clinical experience provides a dynamic, immersive experience designed to improve nursing skills and clinical reasoning through the examination of digital standardized patients. Using Shadow Health you will participate in health histories, focused exams, and a comprehensive assessment.

There will be four Shadow Health assessment components that you will need to complete in Module’s 2 and 3:

Health History Assessment (Week 3 & 4)
Focused Exam: Cough (Week 5) for a pediatric patient presenting with cough
Focused Exam: Chest Pain (Week 7) for an adult patient presenting with chest pain
Comprehensive (Head-to-Toe) Physical Assessment (Week 9)

Before you can participate in these simulations, you will need to register for a Shadow Health account. To do this:

Go to the Walden Bookstore and purchase access to Shadow Health and the required texts.
Once Shadow Health has been purchased, an access code will be emailed to you from the bookstore.
Review this video explaining how to register in Shadow Health: https://vimeo.com/275921826/c12d50ee6e
Use the Shadow Health link located in the navigation menu on the left in the Blackboard course.
Follow the prompts to register in Shadow Health. You will need the access code provided from the bookstore to register. Once registered, Shadow Health should always be accessed via the link in Blackboard.
Use only Google Chrome when accessing Shadow Health and make sure all other programs are turned off on your computer. Other browsers do not work well and will not allow the Shadow Health speech to text function to work.
Once registered, complete the Shadow Health Orientation in the Shadow Health website/program and review the videos designed to assist with navigating and completing assignments.
Read the Shadow Health Nursing Documentation Tutorial located in the Week 1 Learning Resources.

Note: As nurses you typically use the word assessment to mean completing the physical exam. However, in the SOAP Note format, assessment means diagnosis so start getting in the habit of calling the physical exam exactly that.

Week 2 Case Studies

In Week 2, your Instructor will assign you a case study related to your Discussion by Day 1 of the week. Please make sure to review the “Course Announcements” area of the course to verify your assigned case study. Please plan ahead to ensure you have time to review your case study and your Learning Resources so that you can complete your Discussions and Assignments on time.

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Practicum – Upcoming Deadline

In the Nurse Practitioner programs of study (FNP, AGACNP, AGPCNP, and PMHNP) you are required to take several practicum courses. If you plan on taking a practicum course within the next two terms, you will need to submit your application via Meditrek .

For information on the practicum application process and deadlines, please visit the Field Experience: College of Nursing: Application Process – Graduate web page.

Please take the time to review the Appropriate Preceptors and Field Sites for your courses.

Please take the time to review the practicum manuals, FAQs, Webinars and any required forms on the Field Experience: College of Nursing: Student Resources and Manuals web page.

Next Module

To go to the next module:

Module 2

Rubric Detail

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Content

Name: NURS_6512_Week_1_Discussion_Rubric

	Excellent	Good	Fair	Poor
Main Posting	Points Range: 45 (45%) – 50 (50%) “Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	Points Range: 40 (40%) – 44 (44%) “Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	Points Range: 35 (35%) – 39 (39%) “Responds to some of the Discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.	Points Range: 0 (0%) – 34 (34%) “Does not respond to the Discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness	Points Range: 10 (10%) – 10 (10%) Posts main post by Day 3.	Points Range: 0 (0%) – 0 (0%) N/A	Points Range: 0 (0%) – 0 (0%) N/A	Points Range: 0 (0%) – 0 (0%) Does not post main post by Day 3.
First Response	Points Range: 17 (17%) – 18 (18%) “Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	Points Range: 15 (15%) – 16 (16%) “Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 13 (13%) – 14 (14%) “Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	Points Range: 0 (0%) – 12 (12%) “Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response	Points Range: 16 (16%) – 17 (17%) “Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	Points Range: 14 (14%) – 15 (15%) “Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 12 (12%) – 13 (13%) “Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	Points Range: 0 (0%) – 11 (11%) “Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation	Points Range: 5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.	Points Range: 0 (0%) – 0 (0%) N/A	Points Range: 0 (0%) – 0 (0%) N/A	Points Range: 0 (0%) – 0 (0%) Does not meet requirements for participation by posting on three different days.
Total Points: 100

Excellent

Good

Fair

Poor

Main Posting

Points Range: 45 (45%) – 50 (50%)

“Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Points Range: 40 (40%) – 44 (44%)

“Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Points Range: 35 (35%) – 39 (39%)

“Responds to some of the Discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.

Points Range: 0 (0%) – 34 (34%)

“Does not respond to the Discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness

Points Range: 10 (10%) – 10 (10%)

Posts main post by Day 3.

Points Range: 0 (0%) – 0 (0%)

N/A

Points Range: 0 (0%) – 0 (0%)

N/A

Points Range: 0 (0%) – 0 (0%)

Does not post main post by Day 3.

First Response

Points Range: 17 (17%) – 18 (18%)

“Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.

Points Range: 15 (15%) – 16 (16%)

“Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.

Points Range: 13 (13%) – 14 (14%)

“Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Points Range: 0 (0%) – 12 (12%)

“Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.

Second Response

Points Range: 16 (16%) – 17 (17%)

Points Range: 14 (14%) – 15 (15%)

Points Range: 12 (12%) – 13 (13%)

Points Range: 0 (0%) – 11 (11%)

Participation

Points Range: 5 (5%) – 5 (5%)

Meets requirements for participation by posting on three different days.

Points Range: 0 (0%) – 0 (0%)

N/A

Points Range: 0 (0%) – 0 (0%)

N/A

Points Range: 0 (0%) – 0 (0%)

Does not meet requirements for participation by posting on three different days.

Total Points: 100