Narrative Analysis: MSN-FNP Program

RUNNING HEAD: Narrative Analysis: MSN-FNP Program 2

Narrative Analysis: MSN-FNP Program 2

Narrative Analysis: MSN-FNP Program

Amber Cajina

Chamberlain University

NR667: FNP Capstone Practicum & Intensive

Dr. Rinehart

Oct 2022

Intro: MSN/FNP Program – Narrative Analysis

The purpose of this narrative analysis is to demonstrate the achievement of outcomes outlined in the MSN-FNP program. Chamberlain University's Master of Science in Nursing, Family Nurse Practitioner program. In order to prove how meticulously the program provided a guided and well-planned academic framework that achieved the goal of success and accomplishment that is required as an FNP. This analysis consists of an evaluation to demonstrate how the FNP program outcome correlates with the assignments selected for the eportfolio and how the courses also create a link to the chamberlain academic framework. The review will establish professional growth and development as a graduate student in the cognitive, psychomotor, and affective domains as it relates to this program. The duty of this analysis is also to connect personal advancements achieved through the program to the American Association of Colleges of Nursing (AACN) MSN Essentials for Graduate Education and the National Organization of Nurse Practitioner Faculties (NONPF) Competencies. Lastly, I will reflect on how my own cultural competencies have been transformed in the completion of the MSN/FNP program.

MSN-FNP Program Outcomes

There are five program outcomes in the Chamberlain College of Nursing Family Nurse Practitioner program and they include: “1. Provide high quality, safe patient centered care grounded in holistic health principles, 2. Create a caring environment for achieving quality health outcomes, 3. Engage in lifelong personal and professional growth through reflective practice and appreciation of cultural diversity, 4. Integrate professional values through scholarship and service in health care, and 5.Advocates for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice” (Chamberlain University, 2022).

Reflective Narrative – Courses and Artifacts

NR 503: Population Health, Epidemiology, & Statistical Principles

NR503- Population Hlth, Epidemiology & Stat Princ

Course outcomes:

1.Define key terms in epidemiology, community health, and population-based research.

NR503: #1 Healthy People 2020 Impact Paper- Oral Health Research (Oral Health in school-aged children) School Aged Children)

NR503: #2 Wk5 Infectious Disease Research Paper (Community-Acquired Pneumonia)

NR503: #3 Wk3 Discussion – Epidemiological Methods and Measurements (Trial of Prazosin for Post-Traumatic Stress Disorder in Military Veterans)

Artifact #1: Healthy people 2020 impact paper. The purpose of this assignment was to provide the framework for the study of infectious and chronic health issues/diseases, which provides a rich source of data for the analysis of trends in disease and health (NR 503 Syllabus, n.d). This assignment correlates with program outcome #2 which allows the student to obtain population health information from surveillance, observation, community, and control trial-based research.

Artifact #2: Infectious disease paper. The purpose of this assignment was to provide the student an opportunity to explore a communicable disease, to apply the epidemiological triad, and to discern the demographic and at-risk background data for a specific infectious disease agent (NR 503 Syllabus, n.d). This correlate with program outcome #5 by advocating for positive health outcomes through compassionate, evidence based, collaborative advanced nursing practice.

Artifact #3: Chronic health problem paper. The purpose of this paper was to identify a common chronic health issue and provide a detailed background and significance of the disease. The topic I chose was alcohol addiction and I provided current surveillance and reporting, epidemiological analysis, screening and guidelines, and a thorough treatment plan. This assignment correlated with program outcome #5 by displaying compassionate care through evidence-based research for positive health outcomes.

NR 507: Advanced Pathophysiology

NR507- Advanced Pathophysiology

Course Outcomes:

1. Analyze pathophysiologic mechanisms associated with selected disease states across the lifespan.

2. Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions across the lifespan. (PO 1)

NR507: #1 Disease Process presentation- Influenza

NR507: #2 WK 8 Discussion course reflection

NR507: #3 WK 6 Discussion – cholinergic urticaria

Artifact #1: Disease process presentation assignment. the purpose of this assignment was to begin the exploration of the disease process. The topic I chose for this assignment was polycystic ovarian syndrome and I introduce the disease with a brief definition and description with risk factors and the connection to the etiology (NR 507 Syllabus, n.d). This assignment correlates with program outcome #1 by analyzing pathophysiologic mechanisms associated with selected disease states across the lifespan.

Artifact #2: Reflection discussion over weeks one through eight. The purpose of this assignment was to reflect over the past eight weeks and describe how the achievements of the course outcomes in this course have prepared the graduate nurse to meet the MSN program outcome, MSN essentials, and NONPF Core competencies (NR 507 Syllabus, n.d). This assignment correlates with program outcome #1 which relates to research findings in the management of patients with complex pathophysiologic dysfunction.

Artifact #3: PCOS PowerPoint part 2. The purpose of this assignment was to build on the presentation developed in Week 2 by submitting a PowerPoint presentation that contains thorough speaker notes, detailed information on the chosen topic, and the entire disease process presentation. This assignment correlates with program outcome #1 by integrating advanced pathophysiological concepts in the diagnosis and treatment of health problems in selected populations.

NR 565: Advanced Pharmacology Fundamentals

NR565- Adv Pharmacology Fundamentals

Course Outcomes:

1. Make appropriate evidence-based therapeutic treatment decisions for individual patients utilizing drugs from the major drug classes

2. Apply knowledge of pharmacokinetics, pharmacodynamics and pharmacogenomics in prescribing patient treatment

3. Distinguish internal and external environment factors affecting drug action, reaction, efficacy, and interaction

4. Identify client indicators of therapeutic, ineffective, adverse responses and side effects to drug therapy

NR565: #1 Florida State Specific Guidelines for Prescribing Substances

NR565: #2 Grand Rounds Presentation – Migranes

NR565: #3 Wk 7 Discussion- Gastrointestinal Case study

Artifact #1: The autonomic nervous system study discussion. The purpose of this assignment was to provide a problem-based learning methodology designed to help students develop the reasoning process used in clinical practice through problem solving actual patient problems This assignment correlates with program outcome #2 by assisting to make appropriate evidence based therapeutic treatment decisions for individual patients utilizing drugs from the major drug classes.

Artifact #2: State specific guidelines when prescribing controlled substances for the nurse practitioner. The purpose of this paper was to provide the student an opportunity to explore themost recent guidelines and recommendations in the student state of practice for pain management therapies and education. This assignment connects with program outcome #1 and 2 by identifying client indicators of therapeutic, ineffective, adverse responses and side effects to drug therapy.

Artifact #3: Reflection of the past eight weeks discussion. The reasoning for this assignment was for the student to be able to reflect on personal and professional growth toward achieving competence as a family nurse practitioner. This assignment correlates with program outcome #4 by integrating professional values through scholarship and service in healthcare.

NR 566: Advanced Pharmacology for Primary Care Family

NR566- Adv Pharmacology for Care of the Family

Course Outcomes:

1. Select appropriate medications according to patient presentation and unique patient factors.

2. Analyze factors pertinent to making the most effective drug selection for a client with a specific diagnosis in the primary care setting.

3. Analyze client indicators of therapeutic, ineffective, adverse responses and side effects to drug therapy.

4. Write appropriate prescriptions according to evidence-based practice guidelines.

5. Identify legal and ethical issues related to the pharmacological management of the patient and family.

6. Analyze whether pharmacologic therapy is appropriate for individual patients.

NR566: #1 Vaccine Assignment

NR566: #2 Wk 3 discussion – Hypertension Guidelines

NR566: #3 GrandRounds Presentation – CVA/Stoke

Artifact #1: Hypertension guidelines discussion. The reasoning for this assignment was to provide students with the opportunity to compare two common but different hypertension clinical practice guidelines. The two clinical practice guidelines discussed was the JNC8 and ACC/AHA guidelines for hypertension. this assignment allowed for program outcome #5 by writing appropriate prescriptions according to evidence-based practice guidelines.

Artifact #2: Respiratory guidelines discussion. The purpose of this paper was to discuss how to address the several types of respiratory issues encountered in the primary care setting. Includedin this paper was information regarding how to select appropriate medications, analyze factors pertinent to making the most effective drug selection, and analyze client indicators of therapeutic and adverse responses to drug therapy. This assignment correlated with program outcome #5 bye learning how to write appropriate prescriptions according to evidence-based practice guidelines.

Artifact #3: Week five immunization paper. The purpose of this assignment was to familiarize the student with the most recent guidelines and recommendations for vaccine preventable illnesses in the United States. I chose the topic of the pneumococcal vaccine and how it can prevent bacterial pneumonia. This assignment correlated with program outcome #5 by teachingthe student to analyze whether pharmacological therapy like vaccines is appropriate for individual patients.

NR 509: Advanced Physical Assessment

NR509- Advanced Physical Assessment

Course Outcomes:

1. Complete focused health history and examination for various patient populations.

2. Document findings of the history and physical examination in a logical and organized sequence.

NR509: #1 Alternative Assignment – Lymphatic System

NR509: #2 Alternative Assignment – Nervous System

NR509: #3 Wk5 Soap Note – Abdominal Pain

Artifact #1: Introduction of the soap note. The purpose of this assignment was to gather subjective and objective data by completing a focused, detailed health history and physical examination for each physical assessment assignment. In this assignment I created a personalized soap note for a patient in the clinical setting and submitted for review to my professor. This correlates with program outcome #1 and 2 by completing a focused health history an examination for various patient populations.

Artifact #2: Week three soap note template. The purpose of this assignment was to provide the opportunity to conduct a focused exam on the shadow health patient who presented with recent episodes of chest pain in a non-emergency setting. After seeing the patient in the shadow health setting, the student was to create a soap note and compile a list of differential diagnoses. This correlates with program outcome #1 and 2 by in the graduate student how to document findings of the history and physical examination in a logical and organized sequence.

Artifact #3: Week four soap note discussion. The purpose of this assignment was to complete a shadow health physical assessment on a female patient named Tina Jones who was two days prior in a low-speed car accident. The physical assessment of this patient allowed me to increase my own understanding of advanced practice physical assessment skills and techniques and to conduct focused and comprehensive histories and physical assessments for various patient situations. This correlates with program outcome #1 and 2 by teaching the student how to differentiate normal from abnormal physical examination findings and how to document these findings in a subjective and objective format.

NR 511: Differential Diagnosis & Primary Care Practicum

NR511- Differential Diagnosis & Prim Care Practicum

Course Outcomes:

1. Develop comprehensive differential diagnoses through analysis of histories, physical findings, and diagnostic studies

2. Make appropriate use of diagnostic tools with consideration of costs, risks, and benefits to individuals 

3. Analyze clinical practice guidelines for application in practice

4. Formulate an evidence-based management plan for acute and common health problems based on needs of the patient and family

5. Perform and accurately document an appropriate system-focused and comprehensive history and physical exam

6. Demonstrate novice level proficiency in prioritizing patient needs

NR511: #1 SNAPPS Oral Presentation – Gastroesophageal Disease

NR511: #2 Clinical Practice Guidelines Presentation Presentation – Allergic Rhinitis

NR511: #3 Wk 3 Clinical Case Study Differential Diagnosis Discussion – Allergic Rhinitis

Artifact #1: Allergic rhinitis PowerPoint. The purpose of this assignment was to create a problem-based learning methodology designed to help students develop the reasoning process used in clinical practice. In this assignment I created a treatment plan for allergic rhinitis based on the most current clinical practice guidelines. This assignment correlates with program outcome #5 by formulating an evidence-based management plan for acute and common health problems based on the needs of the patient and family.

Artifact #2: History and physical discussion. The purpose of this assignment was to teach the student how to summarize the history and physical findings briefly and concisely as if you were presenting it to another health care team member using the pertinent facts from the patient. This assignment connects with program outcome #5 by developing comprehensive differential diagnosis through analysis of histories, physical findings, and diagnostic studies.

Artifact #3: Week 2 SNAPPS assignment. The purpose of this assignment is to create a learner centered approach to case presentation in the clinical setting. The SNAPPS model allows the student to take an active role in their educational encounter by discussing the patient encounterbeyond the facts. In this assignment I was able to summarize patient findings into an organized oral presentation. This assignment correlated with program outcome #5 by making appropriate use of diagnostic tools (SNAPPS) with consideration to costs, risks, and benefits to individuals.

NR 601: Primary Care of the Maturing & Aged Family Practicum

NR601- Primary Care of Maturing & Aged Fam Practicum

Course Outcomes:

1. Employ appropriate health promotion guidelines and disease prevention strategies in the management of mature and aging individuals and families.Integrate theory and evidence-based practice in the care of mature and aging individuals and their families.

2. Assess and manage risk factors for common conditions prevalent in mature and aging individuals and families.

3. Conduct pharmacologic assessment addressing polypharmacy, drug interactions and other adverse events in the care of mature and aging individuals and their families.

4. Apply appropriate evidence-based screening tools in the functional assessments of mature and aging individuals and their families.

NR601: #1 Wk2 Case Study – COPD

NR601: #2 Wk1 Discussion – Comprehensive Geriatric Assessment

NR601: #3 Wk5 Case Study – Diabetes mellitus

Artifact #1: Psychiatric disorders in primary care. The purpose of this assignment was to provide the student an opportunity for application of depression and anxiety screening tools for a selected case patient. This assignment correlates with program outcome #1 by employing appropriate health promotion guidelines and disease prevention strategies in the management of mature and aging individuals and families (NR 601 Syllabus, n.d).

Artifact #2: Week 2 COPD case study part one. The purpose of this assignment was to demonstrate competence in the evaluation and management of common respiratory problems by distinguishing between obstructive and restrictive lung diseases (NR 601 Syllabus, n.d). This assignment correlates with program outcome #5 by formulating appropriate diagnosis and evidence-based management plans for mature and aging individuals and families.

Artifact #3: Endocrine case study. The purpose of this assignment was for the student to analyze provided subjective an object if information to diagnose and develop a management plan for a selected case study patient and apply national diabetes guidelines to create an appropriate treatment plan (NR 601 Syllabus, n.d). This assignment correlate with program outcome #4 by integrating theory and evidence-based practice in the care of mature and aging individuals and their families.

NR 602: Primary Care of the Childbearing & Childrearing Family Practicum

NR602 Care of Child/Family Practicum

Course Outcomes:

1. Integrate current evidence based clinical practice guidelines in the care of childbearing and childrearing families ( ).

2. Appropriately apply anticipatory guidance and health promotion in the care of childbearing and childrearing families ( ).

3. Assess growth and developmental milestones in the care of childbearing and childrearing families ( ).

4. Construct an evidence based reproductive health management plan ( ).

NR602: #1 Immunizations: Pediatric Vaccine Case Studies

NR602: #2 Clinical Pearl Pediatric Case

NR602: #3 Marginalized Women and Childbearing Families

Artifact #1: The discussion of marginalized women. The purpose of this assignment was to provide the student with an opportunity to explore the concept of marginalization and how it impacts the health care of women in childbearing families. This assignment reminded me to provide the most compassionate care to all my patients because you never know what someone

is going through. This assignment correlate with program outcome #5 by identifying and addressing health care needs of the marginalized childbearing and child rearing families.

Artifact #2: Week three immunization case study. The purpose of this assignment was to familiarize the student with the most recent guidelines and recommendations for vaccine preventable illnesses in the United States. This assignment correlates with program outcome #5 by integrating current evidence based clinical practice guidelines in the care of childbearing and child rearing families.

Artifact #3: Week four Pediatric Clinical Pearl discussion. The purpose of this assignment is to guide students in identifying behaviors and interactions that commonly occur during the health history portion of a well child exam. This assignment correlates with program outcome #5 by appropriately applying anticipatory guidance and health promotion in the care of childbearing and child rearing families.

NR 603: Advanced Clinical Diagnosis & Practice Across the Lifespan Practicum

NR603- Adv Clin Diag & Practice Across Lifespan Practicum

Course Outcomes:

1. Interpret subjective and objective data to develop appropriate diagnoses and evidence based management plans for patients and families with complex or multiple diagnoses across the lifespan.

2. Develop management plans based on current scientific evidence and national guidelines.

NR603: #1 Wk 6 Mental Health Case Study – Bulimia Case Study

NR603: #2 Wk 3 Cardiovascular Case Study – exercise induced stable angina

NR603: #3 Wk 2 Pulmonary Case Study – Asthma

Artifact #1: Cardiovascular and hematological conditions in primary care case study. The purpose of this assignment was for the students to be able to improve their ability to formulate diagnosis based on clinical presentation of patients and their ability to understand and apply national guidelines for that diagnosis. This assignment correlates with program outcome #5 by teaching how to interpret subjective and object if data to develop appropriate diagnosis and evidence-based management plans for patients and families with complex or multiple diagnosis across the lifespan.

Artifact #2: Mental health clinical presentation part one. The purpose of this assignment was for the student to have the opportunity to integrate knowledge and skills learned throughout all core courses in the FNP track and previous clinical courses in to develop management plans based on current scientific evidence and national guidelines. This assignment correlate with program outcome #5 by incorporating cultural preferences, values, health beliefs, and behaviorsinto the care of patients and families with complex or multiple diagnoses across the lifespan.

Artifact #3: Mental health final treatment plan/analysis Part 2. The purpose of this assignment as to compile a final treatment plan that included the primary diagnosis, diagnostic testing recommended by national guidelines. This assignment correlates with program outcome #5 by involving the patient and family in the formulation of management plans that align with their goals and perspectives of health and wellness.

Unplagiarize the highlighted yellow parts in this entire section and rewrite and reorganize based on the artifacts listed for each selection. This was just an example of what I needed. If it matches my artificate that are highlighted in blue that you can use it but please rewrite it and unplagiarized. I already complete NR667 section below.

NR 667: FNP Capstone Practicum & Intensive

This course I feel has well-prepared me to take the board certification exam. The Apea exams have filled in learning gaps and the construction of the eportfolio has motivated me to initiate my search for positions The capstone practicum and intensive have fulfilled all the MSN/FNP program outcomes through safe quality primary care clinical practice, exam-based competencies tests and collaboration to improve quality care.

Artifact #1: Narrative Analysis. This assignment was an extensive review of the submitted assignments and personal growth and development through courses and clinical experiences. The narrative analysis demonstrates how selected course artifacts reflect MSN/FNP program outcomes. This assignment is parallel to program outcome #5 this course accomplishment summary outlines the development of positive health outcomes through evidence-based assignments. The appraisal of my personal growth as a master-prepared nurse practitioner through the collaboration of competencies, essential, program outcomes, and personal gains is also in conjunction with PO #5.

Artifact #2: NP transition from student to practice discussion. The purpose of this assignment was to reflect on the transition from being a student nurse practitioner to preparing to go into practice as a practicing NP. This assignment correlates with program outcome #3 by the reflection of transition to practice the NP can perceive the obstacles and goals that are individualized to established personal and professional traits earned through academics and experiences.

Artifact #3: Certification review plan. This assignment’s purpose was to develop a dedicated study plan in order to improve success in the certification exam. The assignment builds the basic NP competencies and essential knowledge needed for safe deliverence of primary care. The certification review plan program outcome #1, #2, and #5 the work of building knowledge equals to safe quality care that is holistic,evidence-based and has quality outcomes.

Evaluation of Professional Growth and Development as a Graduate Student

The three domains of learning are categorized as cognitive, psychomotor, and affective. These categories are the basic objectives to learning and involve recognizing and remembering facts, comprehending facts, and using them in application, analyzing the new knowledge while building a structure or pattern from diverse elements to form a whole, and evaluating oneself by making judgments about information in presenting defending opinions. In this program, I felt Like the education I had received was all being put together once I started clinicals. I was remembering facts and skills that I did not think had sunk in. the clinical setting and collaborating with patients. Once I started really working with each patient and learning about their needs and requests, the patient end-provider relationship formed, and I genuinely wanted the best for each patient. Bloom and his team did not add to the psychomotor domain however, other educators have created their own psychomotor taxonomies. In clinical, I am learning to produce differentials along with treatment plans and present them to my preceptor who guides me in the correct direction. . Unplagiarize and add 3 more sentences and 1 citation.

AACNS MSN Essentials

The American Association of Colleges of Nursing developed nine Essentials of master’s Education as a guide for the graduate nurse to work in various health care settings (AACN, 2021). The nine essentials are; “1. background for practice from science and humanities, 2. organizational and systems leadership, 3. quality improvement and safety, 4. translating and integrating scholarship into practice, 5. informatics and healthcare technologies, 6. health policy and advocacy, 7. interprofessional collaboration for improving patient and population outcomes, 8. clinical prevention and population health for improving health, and 9. masters level nursing practice” (AACN, 2011).

NONPF Core Competencies

The National Organization for Nurse Practitioner Faculties (NONPF) developed core competencies that reflect the goals for each nurse practitioner program. The NONPF competencies include “1. Scientific Foundations, 2. Leadership, 3. Quality, 4. Practice inquiry, 5. Technology and information literacy, 6. Policy, 7. Health delivery system, 8. Ethics, 9. Independent practice” (Nurse Practitioner Core Competencies, 2017).

Summative Evaluation in Correlation to AACN Essentials and NONPF Competencies

Throughout this program, I have grown into a more confident nurse and patient care provider. I have been a nurse for about 10 years, but have never felt the level of confidence that I have now gained through completion of the MSN//FNP program. I feel I have mastered the AACN’s essentials. Through the utilization of EBP, critical thinking, and master-level analysis I have been able to make the best clinical decisions that correlated to safer and quality patient care. Through great organizational and systems leadership, staff satisfaction would be high all while caring for our patients in a more compassionate way. These competencies explain the steps involved to become confident and educated nurse practitioners. In my own growth and development, I began this career with a scientific foundation by attending graduate school, becoming a leader and charge nurse on a busy cardiac unit, giving ethical and quality care to each patient, and being a disseminator of patient education. Unplagiarize, add 5 more sentences and Include 1 citation. This paragraph shoukd like the following “The student provides summative evaluation of their own professional growth and development as a graduate student as it pertains to the National Organization of Nurse Practitioner Faculties (NONPF) Competencies;and AACN’s MSN Essentials for Graduate"

Reflection of Cultural Competence Transformation

There are many factors outside the traditional healthcare setting when it comes to health. These social determinants often cause many of our patients to have negative health outcomes, often at no fault of their own. Over the last 9 months, I am happy to say the clinic I have done my clinical hours in have been eye-opening and have evolved my own cultural competence as well as my emotional intelligence. I was able to meet many Afghanistan refugees and their families as well as learn more about their culture and ways of thinking. It is extremely important nowadays to fully embrace ea

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