This paper builds up from the previous one already done. I will copy and paste the previous one A Psych APN Interview
APN
interview of a Psych NP
Introduction
During the 1960s, the Advanced Practice Nurse (APN) role
was initiated because of an inadequate number of primary physicians in many
care settings. This is a
statement / conclusion that needs a citation. When this was accomplished,
the step aimed at the fulfilment of the basic care health requirements of the
unreached, rural, or vulnerable groups (Allen Watts et al., 2021). Since then,
the number of advanced practice nurses has been increasing for the purpose of
addressing the care demands of underserved or less privileged communities (Ford
et al., 2018). To explain
the role of psychiatric care, advanced practice nursing or APN is used to
ensure provision of care to people experiencing mental breakdown and requiring
community-based care. This sentence doesn’t quite make sense.
Through the reflections of the answers derived
from the interview questions, this paper reflects on the issues and challenges
encountered in the APN role, workplace, and business ethic, historical and
profession expectation and the cost factor in the care of psychiatric patients.
Interview
The interview with Psychiatric
Mental Health Nurse Practitioner (PMHNP) involved questions on ethics, health
policy, interdisciplinary collaboration, expectations as a professional,
leadership, and theoretical understanding of EBP contributing to care delivery.
This means that through evidence-based practice, a nurse can develop his/her
perceptions and interventions in line with present evidence that could help in
developing the most effective patient care form (Brodsky et al., 2018). The
PMHNP interviewed is an APN in a low-income based community clinic in New York
City that deals with all kinds of pharmacologic and non-pharmacologic forms of
psychiatry interventions. She is also certified both as the Family Nurse
Practitioner (FNP).
1. What are the
challenges that newly appointed Nurse Practitioners encounter?
As this was my first PMHNP
position, the initial three months presented some of the most strenuous
moments. It took three days of orientation before a complex task of attending
to a patient who is charged with a criminal offense was assigned to me. This doctor
who was training me went on vacation, and soon I started to discover that
nurses and other employees thought I was the stand-in for her. In the blink of
an eye, I was treating her patients along with my own.
2. Which type of
research do you apply most often to your practice, and on what theoretical
framework is your nursing practice based upon?
I tend to explore anything to
remain current with the latest EBP research. That is why I am very careful each
time I am making a diagnosis and even when I am making prescriptions that go
directly to the patient. Furthermore, during the implementation of any
non-pharmacological treatment for a patient, I do this carefully to employ the
most suitable and effective intervention tools. As much as one may want to
consider other factors in a patient, medication errors are dangerous if not
well handled in terms of prescription.
3. What has been done
by advanced practice nurses in the past?
The first thing I understood upon
joining here is that my role is cover for the doctor whenever he is off or when
the hospital has a shortage of the providers. With the increase in the number
of APRNs conducting psychiatric business at the clinic, care has been
transformed over the years, as virtually all the nurse practitioners are keen
on psychiatric care. It is inspiring to sometimes see what some of the other
fresh PMHNPs are doing and looking forward to achieving more change.
4. Now let me ask
you: What is your professional identity?
The following are the key
responsibilities of the position: I prescribe medications, I assess clients, I
also give them therapy sessions and sometimes recommend a specialist to see
them. A general overview of patients accompanied by their progress or regression.
I work mostly with psychiatry and sometimes I have to follow ups to see if the
patients are reacting well to their therapy. I am also there in my FNP call
when called upon.
5. Do others consider
you as a leader in your workplace?
I would say so since the clinics
Department of Psychiatry promoted me to an Assistant Director besides being a
nurse practitioner. The program to be established was to look for a way to use
screening tools for patients with caregivers, medication, and housing
insecurity in the community. Thus, the community dwelling in the given area can
be given care especially for the patients with complications and who are
otherwise likely not to access care due to the long distance.
6. The following are
health policies that the clinic has put in place to make sure it delivers
quality health care services.
Of all the mentioned policies,
HIPPA is the most well-known. Patients’ privacy and confidentiality are
essential aspects that need to be always maintained for patient safety. The
HIPAA health policies are strictly followed in the clinic where such patients
are admitted because they often worsen and need attention from more than one
person or care from more than one nurse.
7. Have you ever been
in practice when you doubted an ethical or unethical decision?
Yes, I did. I believe that at some
point in your practice you will be starting as a new nurse practitioner, in
which case you are likely to find yourself questioning some of the decisions
you have made. I especially recall a certain patient that I referred to as a
non-compassionate patient since he was always rude to the other staff members
and even myself. It also raised my uncertainty on whether I was right in
choosing the right and ethical thing to do. One can only agree with the fact
that experience plays a crucial role in facing ethical issues. The more that
you dug in and became acclimated to your job the less that you are going to
guess your decisions.
8. After this, were
you able to get an approval for tuition reimbursement for further education?
I did get some amount of tuition
reimbursement from my clinic, but it barely compensated 20 percent of total
tuition. It meant that I had to box my ears to repay the loans after getting an
increase in pay, although it was a few years.
9. What challenges or
achievements have you encountered regarding interprofessional collaboration?
During my working with other
stakeholders in my position, I have encountered some difficulties. In some
cases, doctors can make patients feel inferior, not in terms of work or
position, as one surely is not for the other. Therefore, whenever you work in a
team, at times your decisions are questioned and “double-checked.” Sometimes,
psychiatric patients may become aggressive toward me, and I couldn’t help but
wonder whether they would do the same to a Medical Doctor (MD). This area
remains largely understudied in terms of raising awareness of the general
population about our mandate.
10. In turn, the
following question arises: How did you overcome these obstacles?
So, I kept on doing my job as
effectively as possible because I realized that I needed to work hard in order
to gain the trust of my superiors. Well, guess what I did? That was what I did.
You’re never going to escape that persistent argument about how you “shouldn’t
be doing what you’re doing since you’re not a doctor. Though, I have endeavored
to employ best practices in patient- centered care and thus when treating the
psychiatric issues of my clients at the clinic they receive the best results.
In conclusion it is your work ethic and outcomes that will provide evidence of
how good you are at being a provider. Also, I have consolation in realizing
that there are occasions when I use Psychiatrists questions and probably, they
are forced to do some search like me. It is important to keep in mind that no
provider can have it all in terms of knowledge especially in psychiatry or
mental health.
The interview has produced the
following findings: The involvement of a community-based clinic in the care of
psychiatric patients that require pharma or nonpharma entrenched care. The
PMHNP that was interviewed became the leader of a clinic that positively
transforms the lives of many by contributing more resources to the
underprivileged around the globe. She also helped change some professionals’
beliefs about self and other nurse practitioners in the provider role regarding
being efficient and working within protocols that reflect evidence-based
practice preferred by multidisciplinary teams in the delivery of care (Rankin
et al., 2018). These responsibilities included delivering excellent individual
care, annual health checks, and mental health risk assessments; all of which
the nurse practitioner was tasked to do. She offer’s population-based
leadership and patient education at her location.
Conclusion
In conclusion, the present paper
discussed an interview with a psychiatric nurse practitioner and analyzed the
role of the APN comparing it to theory and current evidence-based practices.
The focus of APN as described by the nurse practitioner is aligned with the EBP
and theory. She snaps
?? herself as a
leader, a workhorse, reconstructing healthcare one hater at a time, and
influencing healthcare by making patient care decisions so good that they
cannot be argued against. Nurses encounter patients at every stage in the human
lifespan. The examination in the training of APNs enables them to practice
independently, order relevant tests and equipment, and prescribe medications in
numerous healthcare institutions. The mission statement of her organization is “to deliver
comprehensive, accessible, and affordable primary healthcare services in areas
that were previously underserved due to racism and poverty to patients of any
financial capacity” as stated by IFH, 2022. When I have ended this interview, I
can say that she is doing it.
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