What are your responsibilities as an assistant nurse manager

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Discussion
Isaac has worked as a staff nurse on the telemetry floor for over 15 years. He holds seniority in the unit. His patient care is satisfactory; however, his interpersonal behaviors are becoming an increasing issue for his coworkers. He throws papers around the unit, gives short answers to questions, and seems generally miserable. He tells the staff that they are lazy and stupid. He is constantly questioning their decisions. You have come from another local hospital in the role of the assistant nurse manager. Based on your observations, you have met with Isaac informally and discussed his behaviors, but they have not changed. Now three new nurses have already come to you saying that this unit is a great match for them, except for one problem. Although they have not identified Isaac by name, they have told you that one of the nurses is extremely abusive verbally, and they have been calling in sick on the days they are scheduled to work with this person.

1. What are your responsibilities as an assistant nurse manager in regard to Isaac’s behavior problem?

2. What is the next step in dealing with Isaac’s behaviors?

3. How will you, as the manager, have Isaac develop more effective people skills?

This is your first position as a nurse manager. The holidays are rapidly approaching, and the hospital policy states that each unit will negotiate holiday coverage individually. You are already getting requests via e-mail and on Post-it notes for holiday time. Several staff members have come to you stating that they “never” seem to get their requests for holidays. Discussion among the staff members is creating dissension and conflict.

1. Discuss the potential impact of this problem on you and the unit staff.

2. Describe a minimum of one positive consequence and one negative consequence of this conflict.

3. Select a model of conflict resolution and explain how you, as a nurse manager, might resolve this conflict.

Poor Patient Outcome  Relying solely on the classic features of a disease may be misleading

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Assignment
Poor Patient Outcome  Relying solely on the classic features of a disease may be misleading. That’s because the clinical presentation of a disease often varies: the symptoms and signs of many conditions are non-specific initially and may require hours, days, or even months to develop.  Generating a differential diagnosis; that is, developing a list of the possible conditions that might produce a patient’s symptoms and signs — is an important part of clinical reasoning. It enables appropriate testing to rule out possibilities and confirm a final diagnosis.     This case portrays a poor patient outcome after a misdiagnosis.  Case scenario  A previously healthy 35-year-old lawyer presents to a primary care office with a chief complaint of chest pain and a non-productive cough. The pain started suddenly 2 hours prior to coming to the office while the patient was sitting at his desk. The patient describes the pain as sharp in nature, constantly present but made worse with inspiration and movement, and with radiation to the base of the neck. His blood pressure in the right arm and other vital signs are normal.  On physical examination the only findings of note are chest wall tenderness and a faint cardiac murmur. The ECG in the office is normal. The patient is observed for an hour in the office and assessed. He is diagnosed with viral pleurisy and sent home on non-steroidal analgesics.  The following day the patient collapses at home and cannot be resuscitated by the paramedic service. An autopsy reveals a Type 1 aortic dissection with pericardial tamponade.  Written Assignment:  Developing a list of possible conditions that might produce a patient’s symptoms and signs is an important part of clinical reasoning. 1.As an NP in primary care what would you have done differently? 2.Discuss the importance of creating a list of differentials for this patient. How could it have changed this outcome?  If a serious diagnosis comes to mind based on a patient’s symptoms: •Ask yourself; Have you considered the likelihood of it and whether it needs to be ruled out by testing or referral? •Because many serious disorders are challenging to diagnose, have you considered ruling out the worst case scenario? •Ask yourself: Do you have sufficient understanding of the clinical presentation to offer an opinion on the diagnosis? •What other diagnosis could it be? How might the treatment to date have altered the patient outcome? •What other diagnostic and laboratory or imaging was needed in order to make a complete differential list?  What support tools would you consider using in helping to create a differential diagnosis list? •Are you familiar with the current clinical practice guidelines for the investigation of a suspected condition such as chest pain?     To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.  Assignment Requirements:  Before finalizing your work, you should: •be sure to read the Assignment description carefully (as displayed above); • consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and • Utilize spelling and grammar check to minimize errors.  Your writing Assignment should: •follow the conventions of Standard English (correct grammar, punctuation, etc.); • be well ordered, logical, and unified, as well as original and insightful; • display superior content, organization, style, and mechanics; and • use APA 6th Edition format as outlined in the APA Progression Ladder.  How to Submit:

Is it within the scope for an FNP to diagnose and treat uncomplicated mental health conditions like depression, anxiety, and ADHD?

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Scope-Of-Practice (SoP) Laws That Govern The Practice Of Nurse Practitioners (NPs)
Much of the ongoing debate over scope-of-practice (SoP) laws that govern the practice of nurse practitioners (NPs) across the country focuses on the cost of and access to health care and on whether these laws legitimately promote patient safety or are simply anticompetitive restrictions on NPs’ ability to compete with physicians. After completing the following CE activity at Medscape https://www.medscape.org/viewarticle/506277_1 ( sign for the free account), please answer the following questions:
Should an NP who is educationally prepared as an acute care NP work in an adult primary care setting?
Is it within the scope for an FNP to diagnose and treat uncomplicated mental health conditions like depression, anxiety, and ADHD?
Are there any restrictions for the FNP to treat patients with mood disorders and to prescribe them antipsychotics or SSRIs ?
Use APA Style and appropriated references.

Presigning blank prescription forms

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CS/SB 614 authorizes  an ARNP to prescribe, dispense, administer, or order any drug, which would include controlled substances.

ARNP disciplinary sanctions are added to the bill in s. 456.072, F.S., (Section 5) to mirror a physician’s sanctions for prescribing or dispensing a controlled substance other in the course of professional practice or failing to meet practice standards. Additional acts for which discipline may be taken against an ARNP relating to practicing with controlled substances that are added to the Nurse Practice Act (Section 10) include:
 Presigning blank prescription forms.
 Prescribing a Schedule II for office use.
 Prescribing, dispensing, or administering an amphetamine or sympathomimetic amine drug, except for specified conditions.
 Prescribing, dispensing, or administering certain hormones for muscle-building or athletic performance.
 Promoting or advertising a pharmacy on a prescription form unless the form also states that the prescription may be filled at the pharmacy of your choice.
 Prescribing, dispensing, or administering drugs, including controlled substances, other than in the course of his or her professional practice.
 Prescribing, dispensing, or administering a controlled substance to himself or herself.
 Prescribing, dispensing, or administering laetrile.
 Dispensing a controlled substance listed in Schedule II or Schedule III in violation of the requirements for dispensing practitioners in the Pharmacy Practice Act.
 Promoting or advertising controlled substances.
After reading the following news article http://c-hit.org/2015/04/06/high-prescribing-nurse-surrenders-drug-licenses/
Identify what issues may arise with prescriptive authority of controlled substances and how you may avoid these situations? use APA style and appropriate references.