NUR 504 Module 6 Discussion

NUR 504 Module 6 Discussion

You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your responses must be substantive and not just agreeing with someone’s work. You need to add by explaining more, refuting a point or correcting a point. A minimum of 150 words and one reference with in-text citation, one reference for each response. 

Discussion 1 George

Introduction

Nursing practice requires specialized knowledge and skills attained through education and training in accredited institutions. The boards of nursing in each state have their requirements for certification and scope of practice. This essay discusses the scope of practice in the state of California and compares it with that of Florida.

Scope of Practice for The Advanced Practice Nurse (APN) in The State of California

The scope of practice for the advanced practice nurse in California is among the strictest laws in the United States. According to Montague (2020), the regulations require nurse practitioners (NPs) to have a written agreement with the supervising physician and make treatment decisions collaboratively with the physician. Notably, one of the Board of Registered Nursing (BRN) requirements is that NPs should practice under a physician’s oversight and comply with the standardized procedures established via teamwork with various healthcare disciplines such as administrators, surgeons, physicians, and nurse practitioners.

The standardized procedures provide NPs with the ability to do tasks that would otherwise fall under the practice of medicine. Additionally, NPs require accreditation from the BRN for prescribing or ordering medications or devices used in the standardized procedures in California (Montague, 2020). Generally, these supervisory agreements render physicians legally responsible for NP’s practice, and they determine the suitable level of supervision.

The state recently introduced some law changes under AB 890, effective from January 2023, which permits independent NPs’ practice after a transitional supervision period (Montague, 2020). Two categories of NPs created by this law function independently. However, if an NP does not want independent practice or does not meet the qualifications under this law for the two categories, they continue to practice their current agreements. The two categories are under sections 2837.103 and 2837.104 with special schooling, preparation, accreditation, governing requirements (Montague, 2020). This law expands the scope of practice of NPs such that they can practice independently without standardized procedures in any setting. The law allows them to open their own practice.

Comparison to Florida state practice laws for APNs

California compares to Florida in terms of supervision laws in that both states require physicians to supervise NPs. In Florida, a physician supervises NPs in at least four settings, excluding their primary practice setting (Toney-Butler & Martin, 2018). The physician does not have to physically avail themselves at the health setting for consultation but must be available via phone. Additionally, the state requires that patients receive notifications about the availability of physicians at a clinic. The stricter rule applies to speciality clinics where physicians can only oversee nurse practitioners in one health setting in addition to their primary practice settings, and they have to be at most 75 miles apart (Toney-Butler & Martin, 2018).

Also, both states require the nurse to meet certain competency standards to become fully certified to perform tasks within their scope of practice as per the state. Bushy (2019) establishes that registered nurses must demonstrate high competence and accountability in all aspects of practice, including suitable recognition, referrals, consultations, and appropriate interventions when complications arise.

In contrast with California, Florida NP prescribing laws do not allow them to prescribe controlled drugs despite a physician’s supervision. To prevent some practices from circumventing this law, the state created laws that bar NPs from using pre-signed physicians’ prescription forms and their DEA numbers on prescriptions (Toney-Butler & Martin, 2018).

References

Bushy, A. (2019). Laws and Rules Governing Nursing Practice in Florida. Retrieved from https://www.nursece.com/courses/129-laws-and-rules-governing-nursing-practice-in-florida

Montague A. (2020). Expanding scope of practice for nurse practitioners in California: AB 890 compromises to permit independent practice. California legislative beat. Retrieved from https://sourceonhealthcare.org/expanding-scope-of-practice-for-nurse-practitioners-in-california-ab-890-compromises-to-permit-independent-practice/

Discussion 2 Mentor

Scope of Nursing Practice in Texas

Scope of nursing practices are the activities performed by nurses in the healthcare setting when delivering patient care. Professional nursing is applying a certain level of skills, judgment and the appropriate performance based on the understanding and the use of the principles of social, physical, and biological science acquired by a nurse after completing a nursing course (Grimes et al., 2018). The legal scope of practice for professional registered nurses in Texas is defined by Nursing Practice Act (NPA) (Grimes et al., 2018). Experienced nurses in Texas have the duty of observing, assessing, evaluating, rehabilitating, caring for, and educating ill patients and those experiencing changes in their normal health processes (Grimes et al., 2018). Nurses are also responsible for upholding health living in the hospital and the prevention of diseases.

In addition, nurses administer medicines to the patient according to the physician’s prescription. They oversee and educate other nurses; they are also responsible for administering and evaluating nursing practices, policies, and procedures (Grimes et al., 2018). It is the responsibility of practice nurses in Texas to receive, sign, and distribute samples of prescription drugs to patients (Grimes et al., 2018). Therefore, the responsibility of the registered nurse in Texas is to provide safe nursing care to patients.

Scope of Practice in Florida

In Florida, nurses are responsible for providing specialized and advanced nursing practice. Through professional nursing practice, nurses perform advanced-level nursing acts recommended by the board (Unruh et al., 2018). Nurses might perform certain actions such as medical and nursing diagnosis, nursing treatment, and prescription following an established protocol. Florida has legislation enabling nurses to practice independently in delivering primary care practices (Unruh et al., 2018). The same is applicable in Texas for ARPNs to treat and diagnose illnesses and offer advice to patients concerning their health, control chronic conditions, and engage in continuous education to remain ahead of other developments in the field.

The scope of nursing practice in the two states is also similar in that they license nurses to operate in the healthcare sector. In Texas, the enhanced nurse licensure compact (eNLC) model allows nurses to physically, electronically, and telephonically practice in the home state and other eNLC states (Unruh et al., 2018). Nurses in Florida are also given licenses to offer patients healthcare services (Unruh et al., 2018). Therefore, the two states are licensure compact states because their nursing licensure compact is a multi-state agreement that enables nurses to practice in different states without applying for a new license.

Nursing license requirements in Florida differ from those in Texas. For instance, there are various options for primary licensure, which vary according to the professional designation of an individual (Unruh et al., 2018). Florida’s board of nursing handles the initial licensure and renewals for all classes for nursing staff. Even though there are some variations, in all cases, applicants ought to graduate from an accredited institution, complete fingerprinting for a criminal background check, pass a specific examination and pay for the examination and licensing fees (Unruh et al., 2018). On the other hand, Texas issues licenses to graduates of approved nursing education programs seeking licensure by exam.

References

Grimes, D. E., Thomas, E. J., Padhye, N. S., Ottosen, M. J., & Grimes, R. M. (2018). Do state restrictions on advanced practice registered nurses impact patient outcomes for hypertension and diabetes control?. The Journal for Nurse Practitioners, 14(8), 620-625. https://doi.org/10.1016/j.nurpra.2018.06.005

Discussion 1 Lindsay

1. Explain the significance of family and kinship for the Perez family

Familism is the value of family considerations over individual or community needs, and is a strong value in the Hispanic community (Kemp, 2001). The Perez family lives within close proximity to one another and has a strong reliance on family in day-to-day life, as well as in sickness. Both Mr. and Mrs. Perez rely on their nurse daughter to guide them and advise on their health care and will be present during her father’s pacemaker implant surgery. A family-centered model of medical and health decision-making is more valued than patient autonomy (Kemp, 2001). Mr. Perez is also the main provider for the family. The Perez family places a strong emphasis on family as the major source of one’s protection against hardships in life. Close-knit family relations provide the Perez family with a network of security and support, especially in times of need. The significance of family in Mexican Americans is the most important aspect of life and is believed that what God united cannot be separated by man (Evason, 2018).

2. Describe the importance of religion and God for the Perez family

Religion and God are very influential and important to the Perez family. The Perez family has numerous spiritual items and symbols in their household and attends mass every Sunday morning. The Perez family believes their health is in the hands of God and prays for the health of the family frequently with handmade bequests. Mr. Perez often visits a curandero for medicinal folk remedies. Curanderos are traditional native healers that use folk remedies such as herbs and ointments to cure physical ailments and to offer relief from bad luck (Evason, 2018). In Mexico, they often combine both religious and supernatural elements or levels.

3. Identify two stereotypes about Mexican Americans that were dispelled in this case with the Perez family

One stereotype that was dispelled in this case with the Perez family is traditional gender roles. Typically, in the Hispanic culture men are obligated to be the family provider and protector (Nance et al., 2018). Men are expected to be strong, brave, courageous, and good family providers. Mexican American males are stereotyped to have characteristics of being a good spiritual and emotional provider for the family (Nance et al., 2018). Although, Mrs. Perez is the provider of spiritual, physical, and emotional care for the family.

Another stereotype that was dispelled in this case with the Perez family is immigration status. Historically, many Americans hold negative feelings toward immigrants especially as political campaigns and voter initiatives indicate, in the case of Mexican immigrants (Vargas & dePyssler, n.d.). Media misrepresentations of Mexican immigrants play a substantial role in shaping public attitudes and opinions. Except for Mr. Perez all other family members were born in the U.S. The entire Perez family can speak both Spanish and English fluently.

4. What is the role of Mrs. Perez in this family?

Mrs. Perez is the main provider of spiritual, physical, and emotional care for the family. Spiritual care is a type of health care that supports the spirit or soul of a person to help deal with health challenges that your loved one may be facing. Spirituality is a powerful and important source of strength in families. When a family faces a difficult situation, including a health problem, their religious beliefs and practice help them fight feelings of helplessness, restore meaning and order to life situations, and promote regaining a sense of control (Nemours Foundation, 2001). Emotional support is demonstrating care and compassion for others. Being the family’s emotional care provider means helping other family members cope with their emotions and experiences and showing them that they are not alone.

References

Evason, N. (2018). Mexican culture.  The Cultural Atlas. https://culturalatlas.sbs.com.au/mexican-culture

Kemp, C. (2001). Culture and the end of life. Hispanic cultures (focus on Mexican Americans).  Journal of Hospice & Palliative Nursing, 3(1), 29-33.

Discussion 2 (Geanny)

The significance of family and kinship for the Perez family

Family is always essential since they provide both financial and emotional assistance. They exhort the patient to maintain optimism and the belief that, despite their illness, they will recover. They supply whatever equipment the hospital needs to care for the patient. Additionally, the family tends to the sick members’ physical needs, such as washing and feeding them. Family comes first, and loyalty is exercised regardless of the circumstances. There is a strong sense of tradition, honor, and loyalty in Mexican family culture. According to Mexican culture, “unity is strength,” and family is of utmost importance. Among Mexicans, family is the most important aspect of life. As a result, family relationships are typically very close. An individual’s family has a significant impact on them, providing a sense of identity, community, and support. Mexicans and Mexican descendents are generally expected to be loyal and committed to their family by putting the interests of the family above their own. In times of need, Mexicans rely on their close family relationships for support and security.

The importance of religion and God for the Perez family

The Perez family places a high value on religion and God. According to Christian doctrine, God is a healer who provides for people’s necessities. The family prays for recovery and the success of the surgery since Christians believe that God answers prayers if they are believed. Since Perez family are descended  from Mexico,  Mexican Americans place a high value on religion. In order to ensure the best possible familial and professional care, family members took spiritual and secular actions as well as influenced God’s good will for them.

Two stereotypes about Mexican Americans that were dispelled in this case with the Perez family

Social classes have a different household structure in Mexico. Rural and urban households are dominated by nuclear families, but multigenerational living is still prevalent. It is common for children to stay with their parents until they get married or get a job that requires them to move/leave. Mexican Americans enjoy living close to one another, and the Perez family is located in a community where Mexican Americans are the majority. The photos at Mr. Perez’s home and the manner they pray are evidence that Mexican Americans are religious and strongly maintain Christianity.

The role of Mrs. Perez in this family

Mexican culture is largely patriarchal, with men having more authority than women. Regions, socioeconomic classes, as well as rural and urban areas have different gender roles and dynamics. Mrs. Perez provides the family with emotional, spiritual, and physical care. This implies that she offers the family members emotional support as well as spiritual nutrition in the form of teachings, bible verses, and prayers. She also takes care of the family members’ bodily needs. For instance, she will take care of Mr. Perez if he is unable to look after himself, especially following a surgery.

Reference

Mexican and Mexican Americans’ beliefs about god in relation to disability. (n.d.). https://www.researchgate.net/publication/289141787_Mexican_and_Mexican_Americans’_beliefs_abou

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