Health Medical
Ashford University Personal Philosophy of Advanced Practice Nursing Paper

ashford university

Question Description

Need help with my Health & Medical question - I’m studying for my class.

A professional Portfolio is a collection of documents that provides evidence of your education, skill sets, accomplishments, goals, competencies, professional background, your dedication to life-long learning, and anything else that validates your commitment to your profession. A professional Portfolio is a tool to help you prepare and plan your career as well as assist you in role acquisition. Once you complete your Portfolio, much of what you need for the next phase of your career will already be collected! Additionally, this Portfolio assignment will promote a process of self-reflection and self-awareness which are necessary components to acquiring a new professional identity. Once completed, you will be able to identify your strengths and accomplishments which will help you develop confidence as you transition from the role of a registered nurse to that of an advanced practice nurse.

Directions

Below is a list of documents/artifacts that you will need to include in your portfolio. For this unit you need to complete and submit items 1–4. Please scan these and save as a PDF document. At the end of Unit 8 your ePortfolio should be one PDF document. The following format should be used:

  1. Title Page (APA format)
  2. Table of contents
  3. Personal Philosophy: Write a brief page on your philosophy of advanced practice nursing in primary care.
  4. NP Role definition: Write a brief paper that includes your definition and characterization of the NP role in the current U.S. healthcare environment.
  5. Resume: Develop a resume that is no more than three pages and includes contact information, at least three professional goals, all undergraduate degrees and certifications, all previous formal education, recent continuing education or training, employment history, and accomplishments such as awards or publications.
  6. NP job description: Describe your ideal NP position with details of duties and responsibilities (look at NP job descriptions on the Web for structure), work environment, patient population, interdisciplinary team members, salary requirements with expected benefits, scope of practice (i.e. independence vs. collaboration), and hours.
  7. Cover Letter: Write a cover letter for the above position you just described. Make sure your cover letter includes a career goal, a paragraph that explains why you are a perfect fit for this job and how your background, training, and education qualifies you for this job.
  8. Recommendations: Obtain three letters of recommendation and include these with your resume.
  9. Documents: Provide (copies) of the following professional documents: nursing license, certifications, malpractice insurance, academic transcripts, a completed application for the nurse practitioner certification examination (ANCC or AANP), recent professional activities such as committee work, volunteer work, published works. Evidence of professional association memberships.
  10. National Certification: Describe step by step what you will need to do to become nationally certified as an NP (ANCC or AANP). Include a list of the requirements needed for you to apply for national certification as a Family Nurse practitioner or Adult Nurse Practitioner. What is the minimum score on the certification exam to pass? How will you prepare for the exam? (Be specific on what you plan to do such as attend a national review course.)
  11. Scholarly work: Include an exemplar of a scholarly paper (3 to 5 pages in APA format) on the relevance of evidence based practice in primary care (you may use a previously submitted Assignment).
  12. Clinical Judgment: Include an exemplar of a case study that demonstrates your critical thinking skills, diagnostic skills, utilization of evidenced based practice, and clinical judgment, pharmacological management, follow up plan, and how you would promote preventive care for this patient (you may use a previous Assignment).

Plan for Lifelong learning: Describe a plan for how you will meet continuing professional development, practice hours, and continuing education as required by your State Board of Nursing and your credentialing organization. Specifically, do you plan on using online CEUs, publishing, attending national seminars and conferences?

Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool's honor code & terms of service.

Final Answer

Hello, am organizing the paper.
Attached.

Running head: PROFESSIONAL PORTFOLIO

Professional Portfolio
Student’s Name
Institutional Affiliations

1

PROFESSIONAL PORTFOLIO

2

Table of Contents
Personal Philosophy of Advanced Practice Nursing ...................................................................... 3
NP Role Definition ......................................................................................................................... 6
Registered Nurse Resume ............................................................................................................... 8
NP Job Description ....................................................................................................................... 11
Cover Letter .................................................................................................................................. 13
Recommendation Letter 1 ............................................................................................................. 16
Recommendation Letter 2 ............................................................................................................. 18
Recommendation Letter 3 ............................................................................................................. 20
Steps to Become an AANP ........................................................................................................... 22
Scholarly Work ............................................................................................................................. 24
Clinical Judgement........................................................................................................................ 26
Plan for Lifelong Learning............................................................................................................ 30
References ..................................................................................................................................... 31

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Personal Philosophy of Advanced Practice Nursing
Advanced Practice Registered Nurses (APRN) perform numerous roles in clinical
settings, including conducting physical examinations, diagnosing patients, ordering lab tests,
inferring results, and assessing the progress of patients and their response to treatment. APRN
also interact with the public, frequently acting as link between a physician and the patient’s
families. The advanced training implies that APRNs have increased levels of knowledge, and
therefore, demonstrate expertise in areas such as assessment and diagnosis, planning, enactment,
and evaluation of healthcare plans.
My philosophy of advanced practice nurse is an extension of Florence Nightingale’s
pioneering efforts of turning nursing into a profession that incorporates education and
responsibilities into the job. Though the practice is guided by empirical evidence and scientific
theory, it also derives numerous concepts from abstract knowledge such as models and theories
of caring and empathy. In effect, I don’t perceive patients a physical illness, but in the context of
a whole person, i.e., body, mind, and spirit. I understand that caring for patients implies
acknowledging the individuality of each person while delivering compassionate care, educating
patients and their families, and striving to create a healthcare setting that is therapeutic and
accords respect to all human beings. This philosophy coincides with the Code of Ethics as
prescribed by the American Nurses Association, wherein patients should be treated as
individuals. I believe that patients should be partners in their care plan, and therefore, any wishes
must be respected. As a subscriber of the cognitive model of learning, I believe that active
learning occurs when knowledge is shared or presented to patients in a way that they can easily
apply it.

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As an APRN guided by a holistic approach in nursing, I focus on delivering care that
meets the needs of a patient as a whole. This approach of wholeness, peace, and healing by
values the mental, physical, and emotional needs of a patient. The philosophy is also guided by
the metaphysical underpinning of comfort in care. Influenced by Katherine Kolcaba’s theory of
comfort, I assess the comfort needs of a patient, develop and implement appropriate nursing care
plans that empower patients to transition seamlessly from admission to discharge. The
philosophical footings also enable me to advance opportunities and services that meet health
needs through the concepts of nursing metaparadigm: person, environment, health, and nursing. I
consider a patient as an individual, family, or community that needs primary, tertiary, and
preventing care. I regard health as the optimal functioning of people and communities as
facilitated by the provision of comfort needs. Lastly, the environment is any variable in a
healthcare setting or of a patient that I can manipulate to improve the comfort needs of a patient.
The philosophical concepts of the theory allow me to identify the needs of patients and
families that have been met and modify intervening variables (factors that I cannot change, such
as diagnosis and poverty). Using these concepts, I develop a comfort care plan to enhance
comfort over an assessment of baseline comfort. After improving the comfort needs of patients
or their families, I engage them consciously to develop health-seeking behaviors that are agreed
upon treatment goals. When patients and their families do better, institutional integrity increases,
and this can be considered as a measure of patient satisfaction (Ferrandiz & Martín-Baena,
2015).
In conclusion, my philosophy of nursing is to offer care in a setting that promotes respect,
compassion, and integrity. In the future, I look forward to more responsibilities that will afford
me a more significant role in the improvement of skills. This role will allow educating patients

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and the community on measures to improve health and prevent transmission. I seek to embrace
this challenge and commit to keep the community free of illness.

5

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NP Role Definition

In the United States, NPs are the primary group of advanced-practice nurses that deliver
primary care, placed at the first point of patient contact in numerous healthcare setups. They
work in both collaborative and independent practices organizations, leading in roles such as
management and medical in primary care system. The contemporary American healthcare
system is afflicted by a convergence of issues that affect the primary care model. The increase in
elderly and chronically ill populations has compounded concerns about the workforce's adequacy
in meeting quality. Gaps in quality, complemented by the shortage of nurses, have threatened the
delivery of services. Nonetheless, America is benefitting from the increase in the number of
nurse practitioners since the per capita supply is estimated to increase yearly by an average of
9% (Naylor & Kurtzman, 2010).
As an NP with a Bachelor of Science in Nursing, my role includes disease diagnosis,
treating conditions, and delivering evidence-based education to patients. I assess patients by
examining medical history, conducting physical examinations, maintain detailed records, and
developing individualized care plans. I also collaborate with other healthcare practitioners to
ensure the continuation of education and keep updated on the methodological and technological
developments in the healthcare field. Despite making essential contributions to the valued
primary care, significant obstacles prevent me from practicing to my full abilities. Various state
laws are significant barriers that limit the NP scope practice since some laws restrict us from
delivering comprehensive primary care services as regulated by licensure and educational
preparation. The state to state disparities in practice scope has resulted in NPs migrating from
highly limiting to lesser restrictive states (Naylor & Kurtzman, 2010).

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Another barrier is professional tension. The healthcare system has resisted the expansion
of the NP's practice of scope, and as a result, NPs lack the independence to operate
autonomously. Some states require NPs to practice alongside physicians, instead of collaborating
as members of the healthcare team. Besides the extensive medical expertise, NPs have a unique
scope of practice, holistic patient advocacy focus, and expertise in areas such as pain
management and patient education. Additionally, nursing is a distinct scientific field where
nursing scholars train nurses in degree programs that last 2-4 years in colleges and universities.
Despite these obstacles, the unique scope of nursing ha began gaining recognition from
various state agencies. Numerous state nurse practice acts define the practice in broad and
independent terms that do not rely on doctors and other practitioners. For instance, the
Massachusetts law describes nursing as a service to help people and groups attain optimal health
(Naylor & Kurtzman, 2010). NPs in the state can administer procedures, make clinical decisions
based on theories, enact care strategies, evaluate responses to care and management, coordinate
care deliveries, and collaborate with members of the healthcare team. As the Institute of
Medicine suggests, fostering teamwork eliminates tension and creates effective interdisciplinary
care team models.

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Registered Nurse Resume
John Doe

3300 W Camelback d Phoenix, AZ 85017
818-330-6310
johndoe@np.com
Professional Statement
Dedicated RN with more than 15 years of experience providing care to broad variety of patient
populations, assessing patient health conditions, implementing nursing care plans, and
maintaining medical records. As I advance my career, I seek to leverage established nursing
skills in your organization. Licensed to practice in Maryland and Florida.
Core Qualifications


Highly experienced nursing professional with more than 10 years’ experience in the
ward.



Outstanding computer skills.



Proficient in using modern technology to deliver care.



Skilled in creating and implementing care plans.



Knowledge of primary functions in healthcare settings such as infection control,
administration of medications, and care plans.

Experience
Holy Cross Hospital, Silver Spring, Maryland 2003-2015


Provided critical care to diverse patient populations



Maintained a hygienic, sterile, and safe environment.



Managed patients’ medical records and evaluated their progress.

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Regularly interacted with the patients and their families to meet their mental, social and
physical needs.



Supervised licensed NPs.



Attended educational workshops, thus increasing practical and professional knowledge.



Interacted and coordinated with the interdisciplinary teams, thereby upholding pleasant
relationships.

Florida Hospital East, Orlando, Florida 2015-present


Meaningfully enhanced the facility’s public image by guaranteeing outstanding patient
satisfaction.



Involved in performance improvement activities in core measures and enhancing clinical
outcome in nurse-sensitive indicators



Performed clinical assessments, screening evaluations, vital signs, ECGs, blood sampling
as scheduled & per protocol.



Reviewed patient's medical history, health status, and medications.



Mentored nursing interns by offering support, leadership, and assistance as required



Periodically performed the role of Charge Nurse where I delegated duties, allocated
nurses, and ensured compliance with rules, procedures, and regulations.

Professional Goals


Achieve core features that define an experienced and successful nurse.



Dedicate myself to all-time learning.



A nurse educator to impart knowledge and skills to nursing students.



Deliver ongoing community services to patients and communities in need of healthcare
services.

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Skills


Capability maintain calmness during emergency situations.



Flexible to the ever-changing environment of the healthcare sector.



Crucial skills- team player, compassionate, tolerance, and kindness.



Outstanding interpersonal and communication skills.

Education


Bachelor of Science in Nursing, BSN



NP student 2017- Present

Licensure & Certification


RN License

Achievements and Recognition


Attained “Management Recognition Award” for excellent nursing skills.



Certificate of Excellence



Star of the quarter award

10

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NP Job Description

My ideal NP position is a holistic NP, characterized by duties and responsibilities that
include disease diagnosis, patient assessment by examining medical histories, performance of
diagnostic tests, administer medicines and treatment, maintaining patient records, and train
patients and families on ways to manage and illnesses and disease prevention (Raftery, 2016).
This position will enable me to work in a conventional medicine primary care practice in an
outpatient clinic. The patient population will be adult-gerontology, where I can apply both
traditional and complementary healing practices. An essential modality that I will specialize in is
mind-body medicine that includes hypnotherapy, art therapy, and meditation.
This position will enable me to work with an interdisciplinary team made of case
managers, physicians from different fields, pharmacists, and respiratory technicians. This
interdisciplinary approach will involve members of the team working collaboratively with
common goals and sharing resources and responsibilities. The significance of the approach is
that it will benefit the growing number of older people needing healthcare in the U.S. This
population requires numerous different diagnoses. Therefore, the approach will deal with
complex comorbidities and psychological issues. The approach is effective in improving patient
outcomes, level of satisfaction, and healthcare processes. It also prevents duplication of
assessment, resulting in more inclusive and holistic records of care. This position will allow me
to earn a median pay of $107,030. I will also be entitled to a range of benefits that include health
insurance, vacation pay, onsite childcare, tuition reimbursement, and professional liability
coverage.
My ideal scope of practice is collaboration that involves combining nurses to work as a
team to develop patient care. The approach leverages the diversity of experience, skills, and

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education levels. Nurses work collaboratively and share responsibilities. Benefits associated with
the model include increased nurse satisfaction and morale as the entire staff feel supported. For
instance, when an experienced nurse is paired with a novice nurse, the former will assist the
latter through sharing essential skills and observation. Staff communication also improves,
thereby improving quality and patient safety since timely communication reduces the occurrence
of adverse events. Lastly, the ideal shift is an 8-hour shift as compared to a 12-hour shift or
longer shifts. Longer shifts are detrimental to the nurse as they are associated with burnouts and
reduced job satisfaction. They also affect patient outcomes since a person is likely to make
medical errors due to exhaustion.

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Cover Letter

John Doe
3300 W Camelback d Phoenix,
AZ 85017
818-330-6310
March 30, 2020
Jane Doe
Director of Human Resource
AON Healthcare Group
125 Main Street
3466 NY
Dear Miss Doe:
I am delighted to express my interest in a holistic NP position available at AON Healthcare
Group. As a Registered Nurse, I am licensed to practice in Maryland and Florida and with more
than 10 years of experience. I have been impressed by the AON Healthcare Group' reputation as
a top emergency care center in the city, and I believe that my professional experience would add
value to your team of nurse practitioners.
In my role as an NP, I have proved to be an efficient and reliable holistic nurse practitioner. In
the course of caring for various patient populations, I have become proficient in diagnosing
diseases and formulating and implementing care plans. At my previous place of work, I have
also had a chance to:


Meaningfully enhanced the facility’s public image by guaranteeing outstanding patient
satisfaction.

PROFESSIONAL PORTFOLIO


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Performed improvement activities in core measures and enhance clinical outcomes in
nurse-sensitive indicators.



Performed clinical assessments, screening evaluations, vital signs, ECGs, blood sampling
as scheduled & per protocol.



Reviewed the patient's medical history, health status, and medications.



Mentored nursing interns by offering support, leadership, and assistance as required



Periodically performed the role of Charge Nurse where I delegated duties, allocated
nurses, and ensured compliance with rules, procedures, and regulations.

Additionally, I have strong interpersonal and interaction skills, possess the capability to maintain
calmness during emergency situations, and flexible to the ever-changing healthcare sector.
Having attained a Bachelor of Science in Nursing, BSN at the university level, I possess the
proficiency and skills to provide holistic care since my philosophy is guided by pioneers such as
Florence Nightingale and Katherine Kolcaba.
I strive to achieve core features that define a knowledgeable and positive nurse to facilitate the
best effective long-term care plans that will help patients transition to community care as they
get discharged. I also commit myself to lifelong learning since nursing is an ever-evolving
profession. Lastly, I intend to deliver ongoing community services to patients and communities
in need of healthcare services since I believe that solving healthcare problems at the community
level is the best preventive strategy.
Attached is my resume and list of references. Please feel free to contact me to discuss the
position in detail. Thanks in advance.

Sincerely

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John Doe.

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Recommendation Letter 1

Michael Tasman
1244 Forest Glen Road
Silver Spring

Holy Cross Hospital
1500 Forest Glen Rd,
Silver Spring, MD 20910, United States
+1 301-754-7000

To Whom It May Concern:
It is my pleasure to recommend John Doe for the position of a nurse practitioner at your
organization. I have worked with Doe for 12 years as his nurse manager at Holy Cross Hospital,
where he exhibited excellent nursing skills in primary care. I am confident that Mr. Doe's
personal qualities, professional experience will make him a dedicated and skilled nurse at your
organization.
Doe joined Holy Cross Hospital after graduating from nursing school, and for the period he has
been with us, he has gained extensive knowledge of medical procedures. Physicians and
surgeons have enjoyed working with him due to his professionalism and efficiency. He has also
worked with diverse patient populations, where he often forged therapeutic relationships with
them. Doe has a strong work ethic, responsibility, sense of duty, emotional flexibility, and
stamina. He is flexible when it comes to working late due to changing shifts or an emergency.

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Doe has my highest recommendation for NP position in any hospital because he is the most
reliable NP I have had the privilege of supervising. I do not doubt that he will make a quality
addition to your interdisciplinary team. Please feel free to reach for if you have any questions
regarding his candidacy or past performance.
Sincerely
Michael Tasman
Nurse Manager
Holy Cross Hospital

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Recommendation Letter 2

Jamie Pennyworth
8383 N Davis Hwy,
Pensacola

West Florida Hospital
8383 N Davis Hwy,
Pensacola, FL 32514, United States
+1 850-494-3212

To Whom It May Concern:
John Doe worked for five years in the pediatric ward at West Florida Hospital, where I was the
supervisor. In the entire time in the ward, he was a dependable nurse who was committed to
provide patients with comfort care.
Doe was an asset in this hospital. He was always committed to tasks and willing to offer
assistance in any department of the hospital. He displayed vital skills such as tolerance, team
player, kindness, and compassion in his roles and duties. Doe was also interested in learning and
often led other nurses in CEUs.
Doe has my highest recommendation for the position of an RN in your hospital. I have no doubt
that he will be an asset to your team. Please feel free to contact me if you need more information
regarding his performance.

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Sincerely,
Jamie Pennyworth
Head Nurse, Pediatric Department
West Florida Hospital

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Recommendation Letter 3

Joe Baldwin
2041 Georgia Ave NW,
Washington

Howard University Hospital
2041 Georgia Ave NW,
Washington, DC 20060, United States
+1 202-865-6100

To Whom It Might Concern:
I am writing to recommend John Doe for the position of a registered nurse in your healthcare
organization. I have known Mr. Doe for four years in my capacity as a nurse manager at Howard
University Hospital. He worked with our pediatric department as an RN from May 2015 to
December 2019.
Mr. Doe has plentiful strengths to offer. For example, he is a professional, accountable, wellorganized, committed, and understanding. For the time Mr. Doe has worked at Howard
University Hospital, he has distinguished himself as an exceptional nurse who is ready to go
ahead of what is expected of him, and as a result, he formed many connections with our patients
and their families. With a superb attendance record, Mr. Doe has always maintained a strong
professional relationship with other members of the healthcare team.

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To summarize, I highly recommended Mr. Doe for an RN position in your hospital. Based on
performance at Howard University Hospital, I guarantee that Mr. Doe would be a quality
addition to your team of nurses.
I wish him all the best in future endeavors, and in case of additional information, feel free to
contact me.

Sincerely,
Joe Baldwin
Nurse Manager
Howard University Hospital

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Steps to Become an AANP

As I complete my Nurse Practitioner program and plan to join the workforce, I need to
achieve a national certification from an accredited certifying body. The selected certifying body
is AANP, where I will apply for national certification as a Family Nurse Practitioner (FNP). FNP
certification examination is a competency-based examination that tests clinical knowledge in
individuals/family across the life span. The program has 150 questions, and the score of the
candidate is based on 135 questions. The remaining 15 are pretest questions that are utilized in
examination to get statistical data for establishing the proficiency of a candidate before vetting.
The first step to become a nationally certified FNP is to create an online profile account
at the AANP website. During the period of certification, I will notify AANPCB of any changes
in contact formation. The application process should be completed within 30 days once started.
As an applicant, I will be notified by email once a week of any additional information is
required. These applications are reviewed to establish the qualifications to take the examination
and for completeness to undergo professional review by qualified NPs. For a candidate to take
the examination, he or she must meet the required qualifications and eligibility. First, one must
meet given education that prepares graduate students in national proficiencies of family/across
lifespans. The second requirement is that one must complete the APRN core courses as well as
complete all educational and clinical NP program coursework, which entail all facultysupervised clinical clock hours as specified in the NP program. Thirdly, a current U.S. or
Canadian RN licensure is needed, and lastly, a person’s educational preparedness must be
consistent with the conforming national certification process. It should also be noted that the
examination cannot be completed twice in a calendar year.

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I will prepare for this examination by utilizing review books and completing the
Fitzgerald course review online. Fitzgerald Faculty has courses that meet the needs of practicing
NPs in three formats: live, online, or recorded. Additionally, the Fitzgerald Bookstore will
provide resources that will help me prep review for all examinations. Therefore, I will enroll in a
Fitzgerald online course to prepare myself for the exams.

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Scholarly Work

Hypertension
Hypertension (also known as high blood pressure) is a medical condition whereby the
blood pressure in the arteries is constantly elevated eventually resulting in health complications,
e.g., heart attack. World Health Organization (WHO) describes hypertension as a "silent killer"
(Blood Pressure: From Bench to Bed, 2018). This is because most hypertensive persons are
unaware of the problem because in most cases it usually has no symptoms or any warning signs.
For this reason, it is therefore important that blood pressure is regularly measured to detect any
development of hypertension. Uncontrolled high blood pressure can cause grave damage to the
heart. Excess blood pressure causes the arteries to harden, therefore reducing the rate of flow of
both blood and oxygen to the heart (Blood Pressure: From Bench to Bed, 2018). The
combination of increased blood pressure and reduced rate of blood flow can cause angina (chest
pain), heart attack (occurs when the blood supply to the heart is cut and the cells of the heart
muscles die due to lack of oxygen), heart failure (occurs when the heart fails to pump sufficient
blood and oxygen to other vital organs), and an irregular heartbeat which may cause sudden
death. High blood pressure can also burst/block the arteries that supply blood and oxygen to the
brain, causing a stroke.
The prevalence of high blood pressure is higher in adults than in children. Chances of
becoming hypertensive increase as we age. According to the WHOs 2016 report on the
prevalence of high blood pressure, women are more likely to become hypertensive after age 65.
For men, the common hypertensive risk age is below 65. As aforementioned, high blood pressure
is detectable. A healthy lifestyle is the best defense action against high blood pressure. Eating
balanced diets, doing physical fitness exercises, avoiding consumption of excess alcohol,

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avoiding smoking, managing stress, eating less salt, and monitoring blood pressure at home are
some of the hypertension management practices (Blood Pressure: From Bench to Bed, 2018).
However, there is various medication to treat hypertension. The medications have different
modes of action. If one drug does not lower the blood pressure, another might do it. Sometimes,
however, a combination of two or more drugs may be required to treat hypertension.
Hypertension medications include the diuretics, Beta-blockers, Alpha-Beta blockers,
Angiotensin-converting enzyme (ACE) inhibitors, Angiotensin II receptor blockers (ARBs), and
vasodilators.
Diuretics (also called water pills), assist the kidneys to get rid of excess water and sodium
(salt). These drugs lower the volume of blood passing through the blood vessels which in turn
reduces the blood pressure (Editore, 2014). Beta-blockers assist the heart to beat with less speed
and force and therefore reduce the blood pressure (Editore, 2014). As for Alpha-beta-blockers,
they have a dual effect. These drugs lower the constriction of blood vessels as alpha-1 blockers
drugs do, and slow down the rate and force of the heartbeat as beta-blockers do (Editore, 2014).
ACE inhibitors assist the body produce less angiotensin II, a hormone responsible for the
narrowing of the blood vessels. ACE inhibitors help to reduce blood pressure by causing blood
vessels to expand. Angiotensin II receptor blockers (ARBs) inhibit the action of angiotensin II
hormone, therefore, causing blood pressure to reduce (Editore, 2014). Finally, vasodilators help
in relaxing the muscles in arterioles. Consequently, the blood vessels become wide allowing free
flow of blood. Blood pressure significantly reduces as a result (Editore, 2014).
In conclusion, generally, the treatment for high blood pressure includes both ongoing care
and individual treatments. It is important to have regular blood pressure checkups to allow the
doctor to monitor the progress of the treatment and execute any necessary adjustments to the

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treatment plan (Blood Pressure: From Bench to Bed, 2018). Additionally, doctor’s visits give the
patient a chance to make inquiries about both the condition and the treatment. Resistant
hypertension or secondary hypertension requires additional treatment plans. Resistant
hypertension occurs when the blood pressure remains high despite trying at least three different
types of blood pressure medication. Secondary hypertension occurs when high blood pressure is
directly caused by either another ailment or drug (Blood Pressure: From Bench to Bed, 2018)

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Clinical Judgement

An Evidence-Based Management Plan for The Frail Elderly Patients
Patient Description
The patient is a 72-year-old Hispanic male diagnosed with nosocomial pneumonia,
hypertension, and hepatitis C. The patient’s allergies include penicillin, sulfa, and iodine.
Medication for Nosocomial Pneumonia


Chloramphenicol 1g every 6 hours for 7 days



gentamicin 5 mg/kg daily in divided doses



Ceftriaxone 1g every 12 - 24 hours for 7 days.

Medication for Chronic obstructive pulmonary disorder


Carbinoxamine 4mg taken orally once a day



Triprolidine 1.25 mg taken daily once a day

Medication for Hepatitis C:


Daclatasvir 60mg taken orally once a day



Sofosbuvir 400mg taken orally once a day



Velpatasvir 100mg taken orally once a day



Glecaprevir 40mg taken orally once a day

Age-Related Changes Pharmacokinetics and Pharmacodynamics
Advancing age results in significant changes in body composition. Progressive reduction
occurs in lean body mass and total water body, causing an increase in body fat (Mangoni &
Jackson, 2003). Age-related pharmacokinetics changes that are present in this patient's clinical
situations include congestive heart failure, ACE inhibitors, and diuretics. Studies exploring
potential age-related differences in cardiac functions in patients with heart failure display an

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increase in systematic vascular and decrease in heart rate in elderly patients (Mangoni &
Jackson, 2003). These effects are related to increased concentrations of plasma noradrenaline and
serum creatinine.
Some drugs in the category of ACE inhibitors are active compounds (lisinopril), but they
are pro-drugs that undergo activation in the liver. In patients with hepatic congestion or severe
heart failure, this biotransformation might be impaired (Mangoni & Jackson, 2003). ACE
inhibitors are excreted from the body via the kidney through glomerular filtration and tubular
secretion. In patients with renal impairments, the plasma concentration increases, and thus, the
dose a patient receives must be adjusted accordingly.
In pharmacodynamics, significant age-related changes include an increase in acute and
chronic antihypertensive effects with calcium channel blockers, a decrease in peak diuretic
responses with a drug such as Furosemide, and no significant change with heparin drug. Other
age-related changes include anticoagulant effect, chronotropic effect, analgesic effects, and
cognitive functions (Mangoni & Jackson, 2003).
The American Geriatrics Society Beer’s Criteria
The AGS Beer Criteria is a tool that reduces the elderly's drug-related problems since the
elderly population experience the highest occurrence of adverse drug events, yet many of these
events are preventable (American Geriatrics Society 2015 updated Beers Criteria, n.d.). Based on
the AGS Beer criteria, drugs that should be discontinued in this patient’s treatment regime are
carbinoxamine and triprolidine. Carbinoxamine is an anticholinergic that should be avoided since
its use leads to dry mouth, constipation, and toxicity. On the other hand, triprolidine causes
severe allergic reactions. Other drugs listed can be continued. In place of carbinoxamine,
Loratadine may be used, and an alternative to triprolidine is pseudoephedrine.

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Challenges Faced by Nurse Practitioners (NP)
As a nurse practitioner, two challenges regarding the regulation of complementary and
alternative medications in the care of the frail elderly are toxicity and adulterants (Broom &
Adams, 2007). Many consumers of complementary and alternative medications assume that
these drug products are safe because they are regarded as natural. However, these medications
can cause toxicity through drug interactions or by delaying the traditional care that is proven
effective. Determining the safety of these medications has been hindered by a lack of
scientifically collected data on adverse reactions since the evaluation of the safety and efficacy of
these drugs has been significantly anecdotal (Broom & Adams, 2007). There is also the risk of
adulteration or contamination of dietary supplements with toxic substances such as carcinogens
in some imported products.
Specific Strategy to Assess Reconciliation
Complementary and alternative medications lack reliable scientific data concerning their
safety and efficacy. As an NP, a particular strategy that I will consider is the use of reputable
informational sources and efficacy to determine the safety and efficacy of these products. The
first source that I will use is the U.S. Food and Drug Administration. This is a significant source
that provides information about the regulation of CAM and other drug products (Broom &
Adams, 2007). The U.S. Pharmacopoeia is another source that I will consider because it is a
public standard-setting authority for over-the-counter, prescription, and other health care
products that are produced and used in the U.S. The source also describes quality standards of
CAM and other dietary products (Broom & Adams, 2007).

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30
Plan for Lifelong Learning

The nursing field is broad, ever-expanding, and dynamic. As a result, nurses have an
opportunity to advance the profession, increases knowledge, and improve patient care. Florence
Nightingale, a pioneer in nursing, also indicated that people should never consider themselves as
finished nurses, they must be learning all their lives (Kroning, 2016). My plan for lifelong
learning is to join a professional nursing organization in the second year of my practice. I seek to
join the American Association for the History of Nursing (AAHN) and learn strategies that I can
implement to resolve some of the social issues such as inadequate access to healthcare among the
minority populations.
I also plan to attend national seminars, workshops, and conferences to interact and learn
from experts in the nursing field. Attending workshops will make me eligible for continuing
education units (CEUs). Also, I anticipate that free CEUs will be offered in my place of work
throughout the year. Since I am licensed in Florida, I will require 20-30 contact hours every time
to renew my license. During my free time, I will make use of some of the free online CUE
courses such as Keep It Clean, Medication Reconciliation, Substance Abuse and Women,
Medication Nonadherence, and Transformational Leadership (Hamstra, 2020). Lastly, I
anticipate to research in various fields to increase my knowledge in the delivery of care.
Conducting research will provide me a chance to partner with experts and contribute to nursing
journals.

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31
References

American Geriatrics Society 2015 updated Beers Criteria for potentially inappropriate
medication use in older adults Clinical Practice Guidelines. Retrieved 4 February 2020,
from https://www.guidelinecentral.com/summaries/american-geriatrics-society-2015updated-beers-criteria-for-potentially-inappropriate-medication-use-in-olderadults/#section-date
BoD – Books on Demand, 2018. (2018). Blood Pressure: From Bench to Bed.
Broom, A., & Adams, J. (2007). Current issues and future directions in complementary and
alternative medicine (CAM) research. Complementary Therapies in Medicine, 15(3),
217-220. doi: 10.1016/j.ctim.2006.08.001
Certification Qualifications - AANPCB. Retrieved 31 March 2020, from
https://www.aanpcert.org/certs/qualifications
Editore, S. (2014). Drug treatment for hypertension. SICS Editore, 2014.
Ferrandiz, E., & Martín-Baena, D. (2015). Translation and Validation of a Spanish version of the
Kolcaba's General Comfort Questionnaire in Hospital Nurses. International Journal of
Nursing, 2(1). doi: 10.15640/ijn. v2n1a12
Hamstra, B. (2020). Top 15 Free Online Continuing Education Units for Nurses. Retrieved 31
March 2020, from https://nurse.org/articles/top-online-free-continuing-education-nurses/
Kroning, M. (2016). Lifelong Learning in Nursing. Journal of Christian Nursing, 33(1), 60. doi:
10.1097/cnj.0000000000000235
Mangoni, A., & Jackson, S. (2003). Age-related changes in pharmacokinetics and
pharmacodynamics: basic principles and practical applications. British Journal of
Clinical Pharmacology, 57(1), 6-14. doi: 10.1046/j.1365-2125.2003. 02007.x

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32

Naylor, M., & Kurtzman, E. (2010). The Role of Nurse Practitioners in Reinventing Primary
Care. Health Affairs, 29(5), 893-899. doi: 10.1377/hlthaff.2010.0440
Raftery, C. (2016). The Role of Nurse Practitioners in Interdisciplinary Education. The Journal
for Nurse Practitioners, 12(7), 495. doi: 10.1016/j.nurpra.2016.05.016

Attached.

Running head: PROFESSIONAL PORTFOLIO

Professional Portfolio
Student’s Name
Institutional Affiliations

1

PROFESSIONAL PORTFOLIO

2

Table of Contents
Personal Philosophy of Advanced Practice Nursing ...................................................................... 3
NP Role Definition ......................................................................................................................... 6
Registered Nurse Resume ............................................................................................................... 8
NP Job Description ....................................................................................................................... 11
Cover Letter .................................................................................................................................. 13
Recommendation Letter 1 ............................................................................................................. 16
Recommendation Letter 2 ............................................................................................................. 18
Recommendation Letter 3 ............................................................................................................. 20
Steps to Become an AANP ........................................................................................................... 22
Scholarly Work ............................................................................................................................. 24
Clinical Judgement........................................................................................................................ 26
Plan for Lifelong Learning............................................................................................................ 30
References ..................................................................................................................................... 31

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3

Personal Philosophy of Advanced Practice Nursing
Advanced Practice Registered Nurses (APRN) perform numerous roles in clinical
settings, including conducting physical examinations, diagnosing patients, ordering lab tests,
inferring results, and assessing the progress of patients and their response to treatment. APRN
also interact with the public, frequently acting as link between a physician and the patient’s
families. The advanced training implies that APRNs have increased levels of knowledge, and
therefore, demonstrate expertise in areas such as assessment and diagnosis, planning, enactment,
and evaluation of healthcare plans.
My philosophy of advanced practice nurse is an extension of Florence Nightingale’s
pioneering efforts of turning nursing into a profession that incorporates education and
responsibilities into the job. Though the practice is guided by empirical evidence and scientific
theory, it also derives numerous concepts from abstract knowledge such as models and theories
of caring and empathy. In effect, I don’t perceive patients a physical illness, but in the context of
a whole person, i.e., body, mind, and spirit. I understand that caring for patients implies
acknowledging the individuality of each person while delivering compassionate care, educating
patients and their families, and striving to create a healthcare setting that is therapeutic and
accords respect to all human beings. This philosophy coincides with the Code of Ethics as
prescribed by the American Nurses Association, wherein patients should be treated as
individuals. I believe that patients should be partners in their care plan, and therefore, any wishes
must be respected. As a subscriber of the cognitive model of learning, I believe that active
learning occurs when knowledge is shared or presented to patients in a way that they can easily
apply it.

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4

As an APRN guided by a holistic approach in nursing, I focus on delivering care that
meets the needs of a patient as a whole. This approach of wholeness, peace, and healing by
values the mental, physical, and emotional needs of a patient. The philosophy is also guided by
the metaphysical underpinning of comfort in care. Influenced by Katherine Kolcaba’s theory of
comfort, I assess the comfort needs of a patient, develop and implement appropriate nursing care
plans that empower patients to transition seamlessly from admission to discharge. The
philosophical footings also enable me to advance opportunities and services that meet health
needs through the concepts of nursing metaparadigm: person, environment, health, and nursing. I
consider a patient as an individual, family, or community that needs primary, tertiary, and
preventing care. I regard health as the optimal functioning of people and communities as
facilitated by the provision of comfort needs. Lastly, the environment is any variable in a
healthcare setting or of a patient that I can manipulate to improve the comfort needs of a patient.
The philosophical concepts of the theory allow me to identify the needs of patients and
families that have been met and modify intervening variables (factors that I cannot change, such
as diagnosis and poverty). Using these concepts, I develop a comfort care plan to enhance
comfort over an assessment of baseline comfort. After improving the comfort needs of patients
or their families, I engage them consciously to develop health-seeking behaviors that are agreed
upon treatment goals. When patients and their families do better, institutional integrity increases,
and this can be considered as a measure of patient satisfaction (Ferrandiz & Martín-Baena,
2015).
In conclusion, my philosophy of nursing is to offer care in a setting that promotes respect,
compassion, and integrity. In the future, I look forward to more responsibilities that will afford
me a more significant role in the improvement of skills. This role will allow educating patients

PROFESSIONAL PORTFOLIO
and the community on measures to improve health and prevent transmission. I seek to embrace
this challenge and commit to keep the community free of illness.

5

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6
NP Role Definition

In the United States, NPs are the primary group of advanced-practice nurses that deliver
primary care, placed at the first point of patient contact in numerous healthcare setups. They
work in both collaborative and independent practices organizations, leading in roles such as
management and medical in primary care system. The contemporary American healthcare
system is afflicted by a convergence of issues that affect the primary care model. The increase in
elderly and chronically ill populations has compounded concerns about the workforce's adequacy
in meeting quality. Gaps in quality, complemented by the shortage of nurses, have threatened the
delivery of services. Nonetheless, America is benefitting from the increase in the number of
nurse practitioners since the per capita supply is estimated to increase yearly by an average of
9% (Naylor & Kurtzman, 2010).
As an NP with a Bachelor of Science in Nursing, my role includes disease diagnosis,
treating conditions, and delivering evidence-based education to patients. I assess patients by
examining medical history, conducting physical examinations, maintain detailed records, and
developing individualized care plans. I also collaborate with other healthcare practitioners to
ensure the continuation of education and keep updated on the methodological and technological
developments in the healthcare field. Despite making essential contributions to the valued
primary care, significant obstacles prevent me from practicing to my full abilities. Various state
laws are significant barriers that limit the NP scope practice since some laws restrict us from
delivering comprehensive primary care services as regulated by licensure and educational
preparation. The state to state disparities in practice scope has resulted in NPs migrating from
highly limiting to lesser restrictive states (Naylor & Kurtzman, 2010).

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7

Another barrier is professional tension. The healthcare system has resisted the expansion
of the NP's practice of scope, and as a result, NPs lack the independence to operate
autonomously. Some states require NPs to practice alongside physicians, instead of collaborating
as members of the healthcare team. Besides the extensive medical expertise, NPs have a unique
scope of practice, holistic patient advocacy focus, and expertise in areas such as pain
management and patient education. Additionally, nursing is a distinct scientific field where
nursing scholars train nurses in degree programs that last 2-4 years in colleges and universities.
Despite these obstacles, the unique scope of nursing ha began gaining recognition from
various state agencies. Numerous state nurse practice acts define the practice in broad and
independent terms that do not rely on doctors and other practitioners. For instance, the
Massachusetts law describes nursing as a service to help people and groups attain optimal health
(Naylor & Kurtzman, 2010). NPs in the state can administer procedures, make clinical decisions
based on theories, enact care strategies, evaluate responses to care and management, coordinate
care deliveries, and collaborate with members of the healthcare team. As the Institute of
Medicine suggests, fostering teamwork eliminates tension and creates effective interdisciplinary
care team models.

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8
Registered Nurse Resume
John Doe

3300 W Camelback d Phoenix, AZ 85017
818-330-6310
johndoe@np.com
Professional Statement
Dedicated RN with more than 15 years of experience providing care to broad variety of patient
populations, assessing patient health conditions, implementing nursing care plans, and
maintaining medical records. As I advance my career, I seek to leverage established nursing
skills in your organization. Licensed to practice in Maryland and Florida.
Core Qualifications


Highly experienced nursing professional with more than 10 years’ experience in the
ward.



Outstanding computer skills.



Proficient in using modern technology to deliver care.



Skilled in creating and implementing care plans.



Knowledge of primary functions in healthcare settings such as infection control,
administration of medications, and care plans.

Experience
Holy Cross Hospital, Silver Spring, Maryland 2003-2015


Provided critical care to diverse patient populations



Maintained a hygienic, sterile, and safe environment.



Managed patients’ medical records and evaluated their progress.

PROFESSIONAL PORTFOLIO


9

Regularly interacted with the patients and their families to meet their mental, social and
physical needs.



Supervised licensed NPs.



Attended educational workshops, thus increasing practical and professional knowledge.



Interacted and coordinated with the interdisciplinary teams, thereby upholding pleasant
relationships.

Florida Hospital East, Orlando, Florida 2015-present


Meaningfully enhanced the facility’s public image by guaranteeing outstanding patient
satisfaction.



Involved in performance improvement activities in core measures and enhancing clinical
outcome in nurse-sensitive indicators



Performed clinical assessments, screening evaluations, vital signs, ECGs, blood sampling
as scheduled & per protocol.



Reviewed patient's medical history, health status, and medications.



Mentored nursing interns by offering support, leadership, and assistance as required



Periodically performed the role of Charge Nurse where I delegated duties, allocated
nurses, and ensured compliance with rules, procedures, and regulations.

Professional Goals


Achieve core features that define an experienced and successful nurse.



Dedicate myself to all-time learning.



A nurse educator to impart knowledge and skills to nursing students.



Deliver ongoing community services to patients and communities in need of healthcare
services.

PROFESSIONAL PORTFOLIO
Skills


Capability maintain calmness during emergency situations.



Flexible to the ever-changing environment of the healthcare sector.



Crucial ski...

ProfessorEmily (10661)
Purdue University

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