Here is my paper and also my teacher comment ans I will also send a techer example so you can look and make it look like hers.
Teacher comment Youre almost there. Just write succinct goals and objectives rather than going into the narrative. Just simply state the goal and the corresponding objectives underneath.Also come up wit better objectives as example I will send you
Here is my paper. it does not need to be APA Just three pages Goal 1: Understanding My Role as a Clinical Nurse Specialist
1.1 One of my primary objective to my first goal as a CNS who practices in clinical settings is to fully understand the various roles required to successfully treat my patients and understand the full extent of care required. In order to accomplish this I intend to widely interact with my advance practice nurse so that I can learn from her certain emerging issues that are extremely relevant to the practice of clinical nursing treating and solving their various problems beginning the minute patient enter the clinic and seek care.
1.2 An additional role and responsibility is consultation. I must be able to consult effectively for my patients and determine appropriate care and service even if it lies outside my expertise and qualifications. I must be able to identify and direct my patients to the appropriate specialist and confer with them as necessary. I must take advice from my preceptor in these activities and employ a collaborative approach in the decision making process.
1.3 I must also serve in an advisor role for patients. For example I must go beyond being an advocate for a patient with heart disease and also become an advisor to communicate with them the appropriate actions that must be taken to reduce their symptoms and prevent further damage.
1.4 In combination with my other responsibilities I must also consider my role as teacher for patients and their families. In this role I would serve as teacher to provide them with enough medical and practical information to enable them to comprehend what was required to reduce the chances of heart disease and also prevent stroke and heart failure. An example would be providing them dietary instruction proper exercises and potential rehabilitation options for cardiac patients.
1.5 Develop advanced knowledge and critical thinking For instance I intend to widely
Interact with advance practice nurses so that I can learn from her certain emerging
Issues that is extremely relevant to the practice of clinical nursing. Besides it would
Give the ample opportunity to engage with people of different ages and determine the
Clinical advantages that some sections of the society enjoy with regards to
Cardiovascular problems. For instance infants have underdeveloped microvasculature
that cannot Withstand high blood pressure that is associated with hypertension.
Conversely geriatrics Has relatively weakened vasculature due to nature of their
connective tissues. This Essentially predisposes them to severe consequences in case they
develop cardiovascular Complications. However the middle age is quite resistant to the
full effects of these complications as they are less likely to suffer internal bleeding from
hypertension (Hamric Sprouse & Hanson 2009).
Goal 2: Identify High Risk Cardiac Patients
2.1 The fundamental aspect of my objectives will be to rightly identify high risk patients
And accord them the timely medical attention that is required of the medical profession. It would
be appropriate and cost effective for instance to manage patients with no major risk factors even
after exertion outside the hospital setting.
2.2 Patients who exhibit these risk factors should not only be placed under clinical
Investigation but should also be given the appropriate drugs that would effectively manage their
complications. In this case I would undoubtedly corporate with pharmaceutical professionals
especially clinical pharmacists to administer the best kind of drugs and avoid drug interactions.
2.3 The practice of my clinical nursing would take cognizance of the fact that the recent
developments in the treatment and management of acute coronary syndromes.
2.4 Increased patient awareness of their patho-physiology. This would enable them identify the
areas where patients need to be educated so that they can take charge of their health. For
example I would ensure that I initiate education with a view to enlightening the people about
the rapture of atherosclerotic plagues that eventually causes intracoronary thrombosis. Besides I
will educate them on the risks of embolism especially from a friable coronary thrombus that
could eventually lead to tissue necrosis as blood supply will be inadequate (Morrison &
Monagle 200).
Goal 3: Management Strategies of Cardiac Patients
3.1 The main goal of managing the cardiac patient is to treat and educate the patient. My first objective is to educate patients about their disease and the cause of cardiovascular disease and effectively communicate this at their level of comprehension and understanding. I must consider their background and education to be successful. A common topic would be providing an explanation to patients regarding how fatty food can accumulate on the walls of the arteries to their heart. For example provide better clinical care to cardiac patients if they properly understand the management of its precipitating factors.
3.2 Part of a patients education would obviously include an explanation of how important oxygen delivery is and how the narrowing of their arteries can delay delivery of oxygen to their heart. Additional information would include the importance of knowing how the heart works in order for them to be able to relate to the information and to stress the importance of them knowing this information.
3.3 Educating patients on the strategies of managing their cardiac disease.
3.4 Included in the education provided in managing their cardiac disease is information that
provides them with the ability to identify the signs symptoms and prevention i.e shortness of
breath chest pain etc
3.5 Essentially the management of these complications would be one of my focal points
especially with regards to the administration of certain drugs like aspirin as their administration
would worsen the situation of cardiac complications (Morrison & Monagle 2009).
Goal 4: Develop advanced knowledge and clinical expertise in the care of the patient with Acute Coronary Syndrome (ACS)
4.1 With advise of my preceptor to understand my critical role in the management of Acute Coronary Syndrome. It is critical to know how to treat patients with ACS. For example As a clinical nurse will be able to provide better clinical care to cardiac patients if they properly understand the management of its precipitating factors like anemia and increased heart rates (Adelman 1992).
4.2 I must apply intensive management techniques during their office visit hospitalization and monitoring to effectively reduce the factors .
4.3 It is equally important to ensure the proper use of drugs closely monitor blood pressure and utilize a cardiac monitor for patients while in hospital and to monitor any side effects of drugs. A determination must be made prior to their return home for the appropriate prescription. Consideration must be given to the fact that they will no longer be closely monitored as they would otherwise be if they were in a hospital setting.
4.4 Educate patient to monitor their BP at home and have a log for next visit also instruct them if the number of their BP is below or above certain number contact their primary caregiver. Other hand a good instruction.
4.5 The lab work must be closely monitored for any side effects of drug therapy and follow up before patients are sent home.
4.6 In light of this as clinical specialists which we spend most of the time with clinical patients must be able to timely recognize and monitor the progress of these complications. According to the International Association of Cardiologists Acute Coronary Syndrome is a typical coronary thrombosis that has a strong correlation with drug abuse especially cocaine.
Goal 5: Consult Closely with Cardiologist and Utilize Research
5.1 Consultation with a cardiologist should be done for the purpose of cardiac rehabilitation.
5.2 I will continually maintain close contact with the Heart Association of America to ensure that my practice is aligned with their recommendations and guidelines of practice.
5.3 I will also seek to establish a relationship with local research institutions in the areas concerning cardiac patients.
Goal 6: To be involved with In-Service for Cardiology Nursing Staff
6.1: In future I will ask my preceptor how I will able to attend In-service regarding cardiac patient for clinical nurse specialist.
6.2 In service will increase my knowledge such as; cardiac patients at the greatest risk are geriatrics approaching the age of 70 and experience cardiac pain even at rest. According to cardiologists their electrocardiogram is quite characteristic in the sense that it has a segment of depression at the initial points. In handling these patients as clinical nurse are required to take utmost care because of the relative weakness of their organ systems regards to drug interactions and drug metabolism
6.3 As a clinical nurse specialist it is important for me to be more informed on drug interaction
For instance geriatrics could easily suffer drug toxicities as drug metabolic systems is not that
competent to actively degrade the drug active agents in a predictable manner
These include the risk of ischemia after myocardial infarction heart failure diabetes mellitus or
aspirin doze.
According to current nursing modules such patients are supposed to receive an appropriate doze
of glycoprotein II b/ III a receptor inhibitors to help ease their complications especially for
conditions induced by aspirin does (Blevins & DeArmond 1995).
Goal 1: Develop advanced knowledge and expertise of the Clinical Nurse Specialists as an Acute Care Nurse Practitioner.
1.1 Collaborate with the APN in order to glean knowledge and comprehension of the CNSs role in the care of the Emergency Room patient (adults only at this time.)
1.2 Practice professional and knowledgeable behavior in the ER while developing the role of the CNS and comprehend the responsibility and ownership of the CNSs role.
1.3 Consult with the CNS on the needs of the ER patient in a small rural community and develop skills and knowledge of frequent procedures/tests performed in the ER.
1.4 Prepare and sit for certification as a Critical Care Clinical Nurse Specialists (CCNS) through the American Association of Critical Care Nurses.
1.5 Prepare and sit for certification as an Advanced Practice Nurse Certificate through the Tennessee State Board of Nursing in compliance with Rule 1000-04-03 (Tenn. Comp. R. & Regs. Tit. 11. CH 1000-4-03).
1.6 Prepare and appeal for a Certificate of Fitness to the Tennessee State Board of Nursing Rule No. 1000-04-04 to prescribe and issue legend drugs (Tenn. Comp. R. & Regs. Tit. 11. CH 1000-4-03).
Goal 2: Develop advanced knowledge and clinical expertise in the care of the ER patient (These are noncritical patients. The ER physician sees critical and the APN sees noncritical or fast track patient (meaning quick in and out patient in the ER).
2.1 Observe the direct clinical practice through assessment evaluationand treatment modalities of the ER patient.
2.2 Review synthesize and analyze treatment tests and procedures related to the non urgent care of ER patient.
2.3 Analyze the local trends related to a small community ER and implement procedures treatments and medications appropriately to fit those trends.
2.4 Attend annual conference presented by the Acute Care Nurse Specialist/Practitioner to stay current with medical trends and procedures to assist in care of the ER patient
Goal 3: Demonstrate advanced expertise and knowledge of the ER patient through gleaning information from the ER physician radiologist further studies in line with EBP and collaborating with ER staff.
3.1 Collaborate with the ER physician and other ER staff team members on the diagnosis pathogenesis and current treatment options for ER patient.
3.2 Support and mentor nursing staff on the proper techniques of sterile technique procedures such as suturing dressings and intravenous lines on noncritical procedures in prevention of nosocomial infections related to hospitalized ER patients.
4. Develop advanced knowledge and expertise in the direct patient care techniques related to the Emergency Room and the unique functions of the CNSs role as an NP.
4.1 Develop and maintain therapeutic relationships with patients utilizing the American Association of Critical Care Nurses Synergy model.
4.2 Implement communication skills and rapport with patients to communicate and implement a quick plan of treatment of the ER patient related to acute medicine
4.3 Teach and communicate to the ER patient regarding disease prevention and care to educate the ER patient on disease process/prevention in the short time the patient is in the ER
4.4 Review medications prescribed by the APN for appropriateness to the ER patient in an acute care setting of noncritical patients in accordance to Tennessees guidelines and in reference to the following paragraphs and the Tennessee State Board of Reagents (Tennessee Nurse Practitioner Certification nd).
Below is teacher exampleGoal 1: Develop advanced knowledge and expertise of the Clinical Nurse Specialists as an Acute Care Nurse Practitioner.
1.1 Collaborate with the APN in order to glean knowledge and comprehension of the CNSs role in the care of the Emergency Room patient (adults only at this time.)
1.2 Practice professional and knowledgeable behavior in the ER while developing the role of the CNS and comprehend the responsibility and ownership of the CNSs role.
1.3 Consult with the CNS on the needs of the ER patient in a small rural community and develop skills and knowledge of frequent procedures/tests performed in the ER.
1.4 Prepare and sit for certification as a Critical Care Clinical Nurse Specialists (CCNS) through the American Association of Critical Care Nurses.
1.5 Prepare and sit for certification as an Advanced Practice Nurse Certificate through the Tennessee State Board of Nursing in compliance with Rule 1000-04-03 (Tenn. Comp. R. & Regs. Tit. 11. CH 1000-4-03).
1.6 Prepare and appeal for a Certificate of Fitness to the Tennessee State Board of Nursing Rule No. 1000-04-04 to prescribe and issue legend drugs (Tenn. Comp. R. & Regs. Tit. 11. CH 1000-4-03).
Goal 2: Develop advanced knowledge and clinical expertise in the care of the ER patient (These are noncritical patients. The ER physician sees critical and the APN sees noncritical or fast track patient (meaning quick in and out patient in the ER).
2.1 Observe the direct clinical practice through assessment evaluationand treatment modalities of the ER patient.
2.2 Review synthesize and analyze treatment tests and procedures related to the non urgent care of ER patient.
2.3 Analyze the local trends related to a small community ER and implement procedures treatments and medications appropriately to fit those trends.
2.4 Attend annual conference presented by the Acute Care Nurse Specialist/Practitioner to stay current with medical trends and procedures to assist in care of the ER patient
Goal 3: Demonstrate advanced expertise and knowledge of the ER patient through gleaning information from the ER physician radiologist further studies in line with EBP and collaborating with ER staff.
3.1 Collaborate with the ER physician and other ER staff team members on the diagnosis pathogenesis and current treatment options for ER patient.
3.2 Support and mentor nursing staff on the proper techniques of sterile technique procedures such as suturing dressings and intravenous lines on noncritical procedures in prevention of nosocomial infections related to hospitalized ER patients.
4. Develop advanced knowledge and expertise in the direct patient care techniques related to the Emergency Room and the unique functions of the CNSs role as an NP.
4.1 Develop and maintain therapeutic relationships with patients utilizing the American Association of Critical Care Nurses Synergy model.
4.2 Implement communication skills and rapport with patients to communicate and implement a quick plan of treatment of the ER patient related to acute medicine
4.3 Teach and communicate to the ER patient regarding disease prevention and care to educate the ER patient on disease process/prevention in the short time the patient is in the ER
4.4 Review medications prescribed by the APN for appropriateness to the ER patient in an acute care setting of noncritical patients in accordance to Tennessees guidelines and in reference to the following paragraphs and the Tennessee State Board of Reagents (Tennessee Nurse Practitioner Certification nd).
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