In order to complete this week’s assignment please perform the following tasks: 

1. Step 1: Choose a mental disorder or problem that you want to study further.Perhaps you are interested in the problem of depression, anxiety (such as test anxiety or social anxiety), substance abuse, or another issue. 
2. Step 2: Explore the treatment options for the disorder you have chosen. You might find the information you need at Types of Psychological Treatment http://www.guidetopsychology.com/txtypes.htm   What is Cognitive-Behavioral Therapy? http://www.nacbt.org/whatiscbt.htm, National Alliance for Mental Illness (NAMI)http://www.nami.org/ (do a search for the illness or type of treatment you are looking for) 
3. Step 3: Write a 1-page summary on treatment methods for your chosen disorder. 

• Describe the treatment used and what would occur during treatment. Are there other treatment approaches that might also work? What are they?  Is the treatment approach supported by research? Describe, if you can, the results of the research done on this treatment approach. Compare and contrast the therapy approach with at least one other therapy approach for this problem. 

This assignment must be submitted in “doc” or “ docx.” format. Additionally, it must be typed, double spaced, Times New Roman font (size 12), one inch margins on all sides. Type the question followed by your answer to the question. A title page is to be included. The title page is to contain the title of the assignment, your name, the instructor’s name, the course title, and the date. All assignments must be submitted in “Blackboard by by clicking on the Assignment link under the appropriate weekly unit and clicking on Browse to attach your work as a .doc or .docx. 

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

One of the main issues noted at the Ben Archer Health Clinic in Las Cruces in addressing evidence based practice is meetings only happen once a month (Chaires, 2017). That is the only time they are able to get everyone together at one time and dissiminate important information.  While it sounds like the best opportunity for addressing a solution, there is so much information that needs to be given, it tends to be overwhelming.  “The top three barriers to adopting evidence based practice were lack of time, inability to understand statistical terms, and inadequate understanding of the jargon used in research articles” (Majid et. al., 2011). Enough time is needed to give the information, and to process it.  The first step to resolving this would be set a time specifically to address one issue and solution at a time.  It cannot be a time when other information is being given.  Whether they add an inservice once a month, or do it every other month during their monthly meetings, a time needs to be set aside just for this one thing.  Every other month would be a good way to start.  Have one month where information is given out, and the next for an evidence based practice inservice.  It would be helpful to give everyone information prior to the meeting (an email, or flyer, with the general overview).  This will allow everyone to be familiar with the information prior to the meeting so that not too much new information is thrown at them at once.  

References:

Chaires, K. (2017). [Personal interview].

Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y., Chang, Y., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: nurses perceptions, knowledge, and barriers. Journal of the Medical Library Association : JMLA, 99(3), 229-236. doi:10.3163/1536-5050.99.3.010

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

The organization I chose to do my practicum at is a health clinic that services an assortment of patients.  They pride themselves on caring for patients regardless of payment, and their mission statement states: “Our mission is to significantly improve the health status of its population through the prevention of illness, the promotion of health education, the provision of quality primary care, access to the under-served and a strong commitment to chronic disease” (BAHC, n.d.).  There are 11 clinics across New Mexico.  The majority of the population seen at the Las Cruces clinic are Hispanics.  One of the most common diagnoses seen is GERD and heartburn. While GERD is common in Hispanics, there is not a lot of evidence that says spicy foods itself causes it (a staple in Mexican diets). “While there’s some evidence these foods can trigger heartburn, experts say how you eat is more important than what you eat when it comes to controlling painful flare-ups” (Heid, 2015). This is a health education issue that I feel needs to be addressed.  Too often, it’s the type of food that gets blamed (spicy to be exact), rather than the when, how, and why.    This needs to be address as it has a few implications for nursing.  One, many patients self-medicate.  They take over-the-counter Zantac or Pepcid or other antacids instead of being treated by a provider and educated, so when they do get seen, they have worse issues than the original problems.  Another implication is this leads to worse issues and further studies being done.  Endoscopies, colonoscopies and such, as well as studies for H. Pylori.  This adds to patients being admitted, which adds to the patient load that is already stressed on the inpatient floors.  References:  BAHC. (n.d.). About Us . Retrieved from https://bahcnm.org/site/about.php#mission Heid, M. (2015, October 30). It’s Not Food Causing Your Heartburn-Here Are The 5 Real Culprits. Retrieved from https://www.prevention.com/food/5-real-causes-heartburn

 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 150-200 WORDS

Principalism is a concept made up of four ethical principles that outline the basics of bioethics. These principles include respect for autonomy, nonmaleficence, beneficence, and justice. Respect for autonomy can be described as respect for the decisions made by autonomous persons. Nonmaleficience means doing no harm to others. Beneficence describes the principles of preventing harm, providing benefits, and doing what is in the best interest of others. Justice describes fair distribution of benefits, risks, and costs (Beauchamp and DeGrazia, 2004).

I would personally rank the four principles as follows:

1. Nonmaleficence
2. Beneficence
3. Autonomy
4. Justice

I think as a society, we should “first do no harm” and take care of each other as fellow human beings. Secondly, I would rank beneficence, as this principle gives us all an opportunity to do no harm plus to do good for others. Autonomy gives us the freedom to choose what we wish to do and what good we choose to participate in. Justice ensures all humans are fairly represented and that everyone is a recipient of the beneficence of others. I think the Christian narrative would rank the principles in the order of nonmaleficence, beneficence, justice, and autonomy last. To live as Christ lived would be to put the needs of others before our own.

According to our lecture, principalism in the United States, particularly regarding bioethics, has been critiqued for raising autonomy to the most important principle on the list (Lecture 3, 2015). I can see where this concern is coming from, as American culture tends to get selfish and people forget to balance their needs with the needs of others. I can think of a personal example from working in the hospital that was most disturbing to me. We had a 23 year old woman on our unit with chronic GI issues that was well known to the entire hospital for being a drug seeker who tried to manipulate providers and exercised control by refusing aspects of her care – gait belts, lab draws, vital signs, you name it. Her refusal of an initial colonoscopy led to multiple infections throughout her hospital stay. I was frustrated one night because she refused to let me change the dressing on her infected IJ line, and my sentiment echoed that of all the nurses and doctors at the hospital: “what is she doing here if she will not let us help her get better?” I spoke with my nurse manager about this, and while she acknowledged my concerns, we could not force her to do anything she refused – we could only document it. This patient later overdosed on heroin that her boyfriend brought to the hospital for her and remained in the ICU for months. So yes, according to the principle of autonomy, this patient had a right to make all the decisions that caused her condition to worsen. I think American culture could use a little modification on the importance of autonomy. Although this woman was competent, her drug addiction heavily influenced her mental capacity. I struggle with the fact that “we could only document her refusal,” when she really should have had access to mental health services and addiction counseling. The hospital system could have done better to prevent harm and offer her the services she needed.

Beauchamp, T. L., and DeGrazia, D. (2004). “Principles and principalism” in Philosophy and medicine vol. 78. Handbook of bioethics: Taking stock of the field from a philosophical perspective. Dordrecht: Kluwer Academic Publishers.

Lecture 3. (2015). PHI-413V: Biomedical Ethics in the Christian Narrative. Phoenix, AZ: Grand Canyon University.

I NEED A POSITIVE COMMENT BASEDIN THIS ARGUMENT..BETWEEN 100-120 WORDS

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.

Clinical nurse leader (CNL) was proposed American Association of Colleges of Nursing, an effort to improve patient safety and quality of care (Graduate Nursing Edu.org). CNL is a generalist clinician who have education at master’s degree level or higher (Graduate Nursing Edu.org), upon graduation must sit for Clinical Nurse Leader Certification Examination by the Commission on Nurse Certification (University of Pittsburgh). A CNL has an advanced knowledge, not just in one area or discipline, but on general medicine, which is helpful for coordinating the care provided by the interdisciplinary teams.  

CNL has roles different from other advanced practice clinicians, they are responsible for designing patient care, implementing, and evaluating the care provided to the patients, making sure that the patients receive the right care, while coordinating, delegating, and supervising the care provided by other health care teams clinically.

CNL can influence patient care by the use evidence-based practice and the latest innovated technology to improve patients’ care, they work with physicians, pharmacists, nurse practitioners and other health care teams to provide the most effective medical care (Graduate Nursing Edu.org). It is important to know that CNL serve as mentors to nursing staff, oversee the environment to ensure it is safe for the patients.

CNL can act like a patient’s advocate; they serve as a middle person between the patients and they physicians or healthcare providers. For example, a patient in the community who is not sure what and where to go for help, a CNL would use his/her expertise to inform or teach the patients and family members, the disease condition, and its management, and refer them to the appropriate places for best care.

                                                                                  References

Graduate Nursing Edu.org. (2017) Retrieved on October 2nd. From https://www.graduatenursingedu.org/clinical-nurse-leader/

University of Pittsburgh (2017) Clinical Nurse Leader (CNL). Retrieved October 2nd from http://www.nursing.pitt.edu/degree-programs/master-science-nursing-msn/msn-program-majors/clinical-nurse-leader-cnl-onsite