Assignment: Professional Portfolio 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. The following format should be used: Title Page (APA format) Table of contents Personal Philosophy: Write a brief page on your philosophy of advanced practice nursing in primary care. NP Role definition: Write a brief paper that includes your definition and characterization of the NP role in the current U.S. healthcare environment. 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. 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. 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. Recommendations: Obtain three letters of recommendation and include these with your resume. 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. 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.) 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). 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?

What are windshield and walking assessments? Using the Community Tool Box reading, "Section 21. Windshield and Walking Surveys," located in the topic resources, summarize the guidelines for windshield and walking assessments. List two unique factors that impact population health positively and negatively in the neighborhood in which you are completing your practicum.  (Adults)  WHAT ARE WINDSHIELD AND WALKING SURVEYS? WHY WOULD YOU CONDUCT WINDSHIELD AND WALKING SURVEYS? WHEN SHOULD YOU CONDUCT WINDSHIELD AND WALKING SURVEYS? WHO SHOULD CONDUCT WINDSHIELD AND WALKING SURVEYS? HOW DO YOU CONDUCT WINDSHIELD AND WALKING SURVEYS?  One way to get a sense of a community is to drive or walk around it, observing and taking note of its characteristics. These windshield and walking surveys can be an important part of a community assessment. In this section, we’ll describe them in more detail, and discuss how to conduct one successfully. WHAT ARE WINDSHIELD AND WALKING SURVEYS? Windshield surveys are systematic observations made from a moving vehicle. Walking surveys are systematic observations made on foot. Either or both can help you better understand either the community in general or a specific condition or aspect of it. Windshield surveys are particularly useful when the area you want to observe is large, and the aspects you’re interested in can be seen from the road. A walking survey might be a better choice when you’re seeking to understand things that are harder to see from a moving vehicle. Windshield and walking surveys can be used to assess general community needs – to estimate the poverty level, for example – or to examine more specific facets of the community’s physical, social, or economic character. Some possibilities: The age, nature, and condition of the community’s available housing Infrastructure needs – roads, bridges, streetlights, etc. The presence or absence of functioning businesses and industrial facilities The location, condition, and use of public spaces The amount of activity on the streets at various times of the day, week, or year The noise level in various parts of the community The amount and movement of traffic at various times of day The location and condition of public buildings – the city or town hall, courthouse, etc. WHY WOULD YOU CONDUCT WINDSHIELD AND WALKING SURVEYS? Windshield or walking surveys can be structured to provide an objective view of the community. They can be adapted to community-based participatory research, inviting community participation. They can be the easiest and quickest way to get an overview of the entire community. They allow clear comparisons among different parts of the community, and can help to determine where to focus your efforts. They can be very useful in understanding specific aspects of a community. If your concern is with the community’s relationship to the environment, the nature of street life, traffic, or with any other particular element of community life or functioning, a windshield or walking survey that concentrates on that element can provide you with an overview and help you decide where to go next for more information. They give you a “feel” for the community. WHEN SHOULD YOU CONDUCT WINDSHIELD AND WALKING SURVEYS? Often in the Community Tool Box, the answer to the “When…?” question is that there are times when performing an action is politically, socially, or logistically more appropriate than others. Here, that’s not the case: windshield or walking surveys can be conducted whenever they’re needed. However, if you want to understand how people use the community, you’ll need to conduct your survey at a time – perhaps a number of different times – when they’re likely to be engaged in activity you can see. To get the best picture of the community, you may have to do a number of surveys at different times of the day, week, and/or year. WHO SHOULD CONDUCT WINDSHIELD AND WALKING SURVEYS? The answer to this question depends on a number of factors. How large is the area to be surveyed? How many times will surveys be conducted? Is this a participatory research project? Will you be conducting surveys in teams or as individuals? A small neighborhood or rural village might be adequately surveyed in one day by a single person, whereas a large city might require several days with several teams of observers. If you’re engaged in participatory research, you might organize observers in teams, each of which has representatives of different ages, cultures, ethnicities, income levels, community sectors (business, government, health and community services), etc. One important issue is safety. If there is hostility between races or ethnic groups, it may not be safe for some people to survey particular neighborhoods. Even if there is no real danger, but only a perception of danger, the resulting anxiety can affect the accuracy and completeness of a survey. Another difficulty with conducting a windshield or walking survey as a participatory research project is that community members might already have set ideas about many of the questions that need to be asked. On the other hand, a windshield or walking survey can also serve to open community members’ eyes to the realities of their environment. HOW DO YOU CONDUCT WINDSHIELD AND WALKING SURVEYS? Windshield and walking surveys are similar in many ways, but there are some important differences. Here, we’ll give some guidelines that relate to both, and then look at each in turn. GENERAL GUIDELINES FOR BOTH WINDSHIELD AND WALKING SURVEYS Determine who will conduct the survey The reason this guideline is first is that you’re likely to get the best results if those who will be conducting the survey are involved in its planning. Their observations will be sharper if they understand what they’re looking for, which is most likely if they help to develop the survey. The ideal, whether you’re driving or walking, is to use a team or teams if you have the resources to do so. The variety of perspectives will enrich the survey, and each team member can focus on a particular task – observation, recording, etc. – making for a more efficient survey. Decide on the questions you want your survey to answer The questions you choose will determine the scope and structure of your survey. If your basic survey question is something like “What is the nature of the community?” then there will be a number of secondary questions to ask that will help you answer that first one. If your focus is much narrower, you may need only one question, such as, “Do most streets in the community have sidewalks?” or perhaps one question with more than one part: “How, by whom, and how much are public playgrounds used?” Decide on the areas you’ll include in your survey If your work is in a large city – New York, Tokyo, Cairo, etc. – you’re probably only concerned with a small section, or with a particular segment of the population. But you might want to survey other parts of the city as well, to get a sense of the city as a whole and fit that neighborhood or population in its context. Your choices will help shape your understanding of the community, so you should make them thoughtfully.What areas will best reflect the aspects of the community you want to know about? Which locations best relate to the work you want to do? Decide when you’ll conduct your survey Consider how the time of day, week day versus weekend, and the season will affect your survey. You may want to repeat your survey more than once in order to capture the differences between community conditions or activities at different times. Train the people who are going to conduct the survey Training here is fairly simple, but there are some important points to be covered: Get well acquainted with your questions, the purpose of the survey, and what you’re looking for. Make and use a checklist to ensure that you address all of your questions, and observe all the areas you want to. Try to be unobtrusive. Not only do people act differently when they know they’re being observed, but they may also become suspicious or hostile. Carry identification. Take notes as you go along. You may also want to shoot photos or videos with a camera or cell phone, in order to both remember and illustrate what you’ve seen. If you wait to take notes until after the survey is done, you may not remember everything clearly, or you may ignore important details. If you’re working in teams, assign roles. A team should have at least one observer and at least one recorder. Discuss your findings as you go. Pay attention to safety. Be aware of the neighborhood and situation you’re in, especially if you’re walking. If you feel threatened, leave. What to examine in a general community assessment survey Housing. What is the age and condition of housing in the neighborhoods you’re surveying? Are houses and apartment buildings kept up, or are they run-down and in need of repair? Are yards neat or overgrown? Other buildings. Are the buildings mostly or fully occupied? Do public and commercial buildings seem accessible to people with disabilities – ramped, street level entries, etc.? Public spaces. Are there public spaces where people can gather? Are they well kept up? Do they have seating areas, trees and plants, attractive design, cafes or food vendors, or other features meant to encourage people to use the space? Who uses these spaces? Is there diversity? Parks. Are parks used by a variety of people?? Are they well kept up? Are there sports facilities – basketball courts, soccer pitches, baseball fields, cricket pitches, etc.? Are they used at night? Culture and entertainment. Are there museums, libraries, theaters, restaurants, clubs, sports stadiums, historic sites, etc.? Are they accessible to all parts of the community (centrally located, reachable by public transportation)? Do they reflect the cultures of community members? Streetscape. The streetscape is the environment created by streets and the sidewalks, buildings, trees, etc. that line them. Are there trees and/or plants? Are there sidewalks? Are building facades and storefronts attractive and welcoming? Are the streets and sidewalks relatively clean? Are there trash cans? Is there outdoor seating? Street use. Are there people on the streets at most times of day? In the evening? How late? Do they interact with one another? Are streets and sidewalks well lit at night? Commercial activity. What kinds of businesses are there? Are there boarded-up or vacant storefronts? Is there a mix of large and small businesses? Are there grocery stores and supermarkets, pharmacies, and other stores that provide necessities in all parts of the community? Signs. What languages are business signs in? Are traffic signs informative? Are there signs directing people to various parts of the community (downtown, museums, highways, etc.)? Industry. What kinds of industry exist in the community? Does it seem to be causing pollution? Land use. How much open space is there? How are residential, commercial, and industrial areas distributed? Do major roads or railroad tracks divide neighborhoods, or are they on the edges of the community? Infrastructure. What is the condition of roads, bridges, sidewalks, etc.? Are there differences in these conditions from one area of the community to another? Do all parts of the community seem to be equally served by electricity, water, phone, fiber optic, wastewater treatment, waste disposal, and other infrastructure services? Public transportation. Is there a functioning public transportation system? Is it well used? By whom? Does it allow relatively easy access to all parts of the community? How easy is it to navigate and use? How much does it cost? Are its vehicles energy-efficient? Traffic. How heavy is traffic in the community? Is it mostly commercial and industrial – vans, trucks, etc. – or mostly private cars? Is there ever gridlock? Is there much bicycle traffic? Are there bike lanes? Are there bike racks in many places? Environmental quality. How much usable green space is there, and is it scattered throughout the community? Is there smog or haze? Does the air smell of smoke, garbage, car exhaust, chemicals, industrial waste, etc.? Does the water in streams, ponds, lakes, etc. seem reasonably clear? Race/ethnicity. Who lives in the community? Are there identifiable racial and ethnic groups? Do particular groups seem to live in particular areas? Faith communities. What kinds of religious institutions are there? Do the institutions of one particular religion or sect dominate? Are there separate houses of worship for people of different ethnicities or races, even if they share the same faith? Health services. How many hospitals and clinics are there in the community? Where are they located? How big are they? How easy are they to get to? Community and public services. Are there identifiable community service providers and organizations in the community – mental health centers, food banks, homeless shelters, welfare offices, etc.? Are they concentrated in a particular area? Are they easy to reach by public transportation? Community safety. Where are police and fire stations located? Are they in good repair? Is the community well-lit at night? Public schools. Are schools in different neighborhoods in noticeably different states of repair? Are schools well maintained? Or in some developing countries, are there schools in the community at all? Higher education. Are there two- and four-year colleges and/or universities in the community? Where are they located? Do they seem open to the community, or do they seem self-contained and isolated? Political activity. Are there signs or other indications of political activity? Is it clear that political activity is allowed and/or encouraged? Are there protests or demonstrations? Community organizations. What evidence is there of organizations in the community? Are there service clubs – Lions, Elks, Masons, etc.? Are there other organizations – centered around community issues, the environment, sports or leisure pursuits, socialization, etc.? Media. Are there local media outlets – radio and TV stations, newspapers, Internet sites devoted to local issues? Are they independent, or are they sponsored or run by government or corporations? Where are their facilities? Differences among neighborhoods or areas of the community. What are the differences among different parts of the community? Are schools, stores, public and other buildings, streets, etc. in different areas in different condition? Do some areas seem neglected, while others are clearly maintained? The “feel” of the community. What is your overall impression of the community? GUIDELINES FOR A WINDSHIELD SURVEY Use a map. Google Maps or similar services are an excellent resource If you can, try to use a team of at least two. That way, one person can concentrate on driving while the other navigates and records observations. It’s difficult to observe closely and drive safely at the same time. Drive at a moderate speed, and avoid unexpected actions Drive both on major and minor streets, particularly in residential neighborhoods. You’ll want to get a sense of different parts of neighborhoods and different streets. Pull over at regular intervals to make and compare notes Try to be inconspicuous GUIDELINES FOR A WALKING SURVEY Study a map beforehand, or do a drive-through so you’ll know where you’re going Try to work in teams. Teams should probably not be larger than two or three, unless you’re splitting up. Two or three people walking together is a normal group, but five or six is a crowd, and stands out. If you want to experience the community, take part in everyday activities. Take public transportation, eat in a local restaurant, buy something in a drugstore or supermarket or discount store. This will give you a chance to listen to people’s conversations and to get a sense of how they interact. Go inside public buildings and cultural institutions Sit down in a quiet place to take notes IN SUMMARY Sometimes, the best survey can be a combination of walking and driving. You might survey the whole city or area in a vehicle, then use a walking survey to look closely at the area you’re most interested in. Or you might send out walking and driving teams to survey different aspects of a community or neighborhood. You’ll see different things and more detail on foot; you’ll cover more ground and get a broader perspective from a vehicle. But even once your survey is finished, your job isn’t done yet. You have to analyze what you’ve seen and decide how to use it. Some general questions you might want to consider: What are the community’s outstanding assets? What seem to be the community’s biggest challenges? What is the most striking thing about the community? What is the most unexpected? Are you struck by the aesthetic quality of the community, either positively or negatively – i.e., is it particularly beautiful or particularly ugly? Whether you’re starting an all-encompassing campaign to eliminate poverty in your community, or simply looking for good places to paint murals to stimulate community pride, a windshield or walking survey can be a good way to begin your effort. It will give you a view of the community that you can use to help you decide how to take your next steps effectively in order to address real needs and improve the quality of community life.

Clinical Experience Week 5 REMEMBER THIS IS FOR AN ADULT PATIENT AT A CLINIC SETTING  Describe your clinical experience for this week. Did you face any challenges, any success? If so, what were they? Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales. Mention the health promotion intervention for this patient. What did you learn from this week's clinical experience that can beneficial for you as an advanced practice nurse? Support your plan of care with the current peer-reviewed research guideline.