NUR 658 Topic 1 DQ 1 5

Topic 1 DQ 1 5.0

As a new graduate I would carefully look over the contact, to make certain the expectations were within the competencies of an Acute Care Nurse Practitioner (. Additionally, I would assure that I have current copies of my license, and Drug Enforcement Administration number as needed per job qualifications. Then using the article written by Buppert (2014) as a guide to create a list of questions to assure that the situation with the job is mutually beneficial. Unfortunately, as I have previously experienced, there are different environments that can cause more stress the necessary. Because of this I approach every job offer with pause, and do careful research ensuring that not only is the job going to benefit myself, but my family. Additionally, you want to ensure that the environment is a good place for a new graduate nurse practitioner to grow into a competent care provider.

California Board of Registered Nursing [CBRN] (2016) Advanced Practice Certificate, retrieved on 5/12/16 from http://www.rn.ca.gov/applicants/ad-pract.shtml

Buppert, C. (2014). 20 Questions to Ask a Prospective Employer. Journal For Nurse Practitioners, 10(1), 62-63 2p. doi:10.1016/j.nurpra.2013.10.011

Wayne and John,

The sad thing is, despite the fact that California is supposed to be such a forward thinking state in many ways it’s not.  In 2015 the California Association for Nurse Practitioners tried again with the help of Senator Hernandez, to get passed bill SB 323 for nurse practitioners to have autonomy in California (Aguilera, 2015).  Unfortunately the California Medical Association came out equally strong to assure that it was defeated, with a vote of 9 to 4 (Aguilera, 2015).  For some reasons these physicians fear Nurse practitioners having more power, why are we such a threat?   Maybe they worry that we will give more competent care then they will?  It’s confusing, because we are meant to work as a team to help things be better for patients.

Aguilera, E (2015) Nurse Practitioner autonomy bill fails in state assembly, retrieved from http://www.scpr.org/news/2015/06/30/52800/nurse-practitioner-autonomy-bill-fails-in-state-as/

Prescription drug deaths

As nurse practitioners we are focused on the individual patient, and not just making money. I think sometimes doctors forget to ask, what other medications do other doctors have you on and that nurses take the extra step and time to listen in order to get the entire picture of the patient’s needs. But let’s face it if a patient is drug seeking they will just find another doctor or nurse practitioner that is not so thorough. The article written by Lev et al (2016) discussed the factors for who is at risk for prescribing doses of medication to drug seeking patients, and it did not find ER doctors to be the issue but Pain doctors. I know from experience, having worked with a pain doctor, that they just want to move patients in and out at a quick rate. I often wonder if the rush to make money, and the rush for pain control because let’s face it we cannot judge someone else’s pain. From the study done by Lev et al (2016), one has to wonder why these prescriptions were not caught and why patterns were not quickly recognized.

There should be a better system in place for doctors and nurse practitioners to enter patient data to ensure that medications are not over prescribed. This is something that nurse practitioners, doctors and pharmacists could collaborate on creating a functional system.

Lev, R., Lee, O., Petro, S., Lucas, J., Castillo, E. M., Vilke, G. M., & Coyne, C. J. (2016). Original Contribution: Who is prescribing controlled medications to patients who die of prescription drug abuse?. American Journal Of Emergency Medicine, 3430-35. doi:10.1016/j.ajem.2015.09.003

DQ 2

Topic 1 DQ 2 5.0 As part of your commitment to 
provide quality care to individuals experiencing pain, you are obligated to understand the rationale for special licensure procedures in order to obtain a Drug Enforcement Administration (DEA) number. Discuss the measures you must take on the state and national levels regarding these procedures prior to implementation of this privilege.

It’s kind of sad, because when I decided to move to the State of California I was excited because I thought it was so forward thinking. Only to sadly discover that nurse practitioners are still required to work under a physician. According to the California board of registered nurses (2016), “BRN issues a furnishing number” it is through this number that a nurse practitioner “May obtain a Drug Enforcement Administration number” (CBRN, 2016, p. 2). According to the state of California they require advanced pharmacology course includes has “three semester units or five quarter units” (CBRN, 2013, p 4). I would have to take the knowledge obtained from my advanced pharmacology course to prove why I am giving a certain treatment (CBRN, 2013). Be able to define drugs, and how they absorb and analyze a patient’s history and physical necessity of a treatment (CBRN, 2013).

California Board of Registered Nursing [CBRN] (2016) Advanced Practice Certificate, retrieved on 5/12/16 from http://www.rn.ca.gov/applicants/ad-pract.shtml

California Board of Registered Nursing [CBRN] (2013) Instructions for applying for a nurse practitioner furnishing number, retrieved 5/12/16 from http://www.rn.ca.gov/pdfs/applicants/npf-app.pdf