Task 1 A. Self-care is not only important for nurses to implement, but it is also important for nurses to ensure patients self-care needs are being met. Dorothea Orem developed the nursing theory of self-care. Orem developed this theory to focus on helping patients return to their maximum level of functioning, which restores their sense of well being (Cherry & Jacob, 2019). Daily, nurses apply the theory of self-care to implement excellent nursing care. They do this by supporting, educating, and promoting a healthy environment for their patients. Being a cardiac ICU nurse, this theory applies to my professional practice in that all patients require self-care needs during their stay in the ICU. B. There have been several historical nursing figures that influence nurses to this day. Sister Callista Roy is one historical figure from 1974. According to Cherry and Jacob (2019), Roy developed that adaption model, which involves the patient having to adapt to different conditions with the use of environmental stimuli to aid in healing. With modifying stimuli, the patient is assisted in improving their health, dignity, and independence. This can help the patient adapt to stressors and aids in faster healing. This influences my professional nursing practice today because applying this theory and implementing a supportive healing environment for my patients leads to better outcomes for them. Another important theorist is Imogene King. In 1971, King devolved the goal attainment theory. This theory encompasses the importance of developing patient centered goals that both the patient and nurse work together towards (Cherry & Jacob, 2019). Including patients in their care and goal making is important in that it aids in the healing process and promotes patient independence. As a nurse, we must ensure that goals are attainable for the patients. This theory influences my professional nursing practice because making goals with patients to help with their recovery is in important step in the nursing process. As a nurse I aim to restore my patient’s health and using the goal attainment theory to help implement this action improves patient outcomes. C. The American Nurses Association (ANA) represents the nations nursing population as a professional nursing organization (Cherry & Jacob, 2019). The ANA has high standards of nursing practice. The ANA members work with regulating, legislating, and political activities to support and protect nurses. According to Cherry and Jacob (2019) the ANA has passed the Medicare and Medicaid bill, along with improving patients’ rights, safe workplace environments, and access to health care. Another organization is the State Board of Nursing, which is a state specific regulator and licensing association (GraduatenursingEDU, 2020). The State Board of Nursing makes the guidelines for safe nursing practices and the scope of practices for nursing, along with issuing licenses. Each state has members that make up the National Council of State Boards of Nursing. This organization administers the States’ licensure examination to become a registered nurse; the NCLEX-RN exam. The American Nurses Association and the State Board of Nursing both influence my professional nursing practice. The ANA works as an advocate for all nurses by promoting a safe work environment. The State Board of Nursing to my specific state defines my roles as nurse and makes specific scopes of practice for my career. The state of Maine has specific requirements for license renewal. According to maine.gov (2017) the first time you are issued a nursing license it will be active for at least one year, and no more than two years. The renewal date will be on your first upcoming birthdate and every two years thereafter on or before your birthday without a grace period. Failure to maintain licensing requirements results in a lapsed license and the inability to practice until resolved with the Boards office. Once lapsed, there are several steps to reinstate a license. The lapsed nurse must complete an application, pay an $85.00 fee, a written explanation, and a criminal background check if not currently employed (maine.gov, 2017). There are states that have established an agreement with each other that allow registered nurses to practice in another state without acquiring another license (Cherry & Jacob, 2019). The specific states are part of the Nurse Licensure compact (NCL). States that are apart of the NCL are referred to as compact states. Non-compact states are the states that are not included into the NCL. If a nurse is a resident of a non-compact state, that nurse is only allowed to practice in that state, and that state only. However, that nurse may apply for a license by endorsement in a compact state (NCSBN.org, 2020). The nurse will then only be eligible to work in that state applied for and the current state they reside in. They may have as many single-state licenses as they please, upon eligibility for a resident of a non-compact state (NCSBN.org, 2020). D. The Food and Drug Administration has the responsibility to protect the health of the public. They do this by ensuring drugs, medical equipment, food, and many other products are safe for people (fda.gov, 2018). The FDA.gov (2018) explains its responsibility for changing certain products to make them more affordable, safer, and effective for the public. The Center for Medicare and Medicaid Services helps support patients by improving the quality, accessibility, and affordability of health care by putting patients first (cms.gov, 2019). The Medicare program is a health insurance program that consists of several parts that help people over the age of 65 and or with certain disabilities (cms.gov, 2019). Medicare assists with hospital expenses, outpatient expenses, and medication coverage. According to Medicaid.gov (2020), Medicaid provides health coverage for low-income adults, pregnant women, children, elderly, and people with disabilities. It is a program that is funded by the states and federal government. The Food and Drug Administration and Center for Medicare and Medicaid Services have influenced my professional nursing practice because the two have helped make health care more affordable for patients. Medicare and Medicaid may affect some patients’ treatment plans. For example, they may or may not cover certain procedures or therapies. As a nurse, it is my duty to be a patient advocate and promote patient safety. If I have patient request to use an alternative therapy, it is my role to advocate for this patient. Supporting the patient with their decision sustains the patients’ autonomy. I will continue to educate the patient in their decision. It is also my role to promote safety for the patient when they request to use an alternative therapy. By promoting safety, I need to ensure that the alterative therapy is safe and does not impose any risks to the patient. Patients have the right to make their own decisions, with that being said the nurse has the responsibility to advocate, educate, and promote safety for the decisions. E. The purpose of the State of Maine Nurse Practice act is to protect the public health and welfare in the nursing practice (legislature.maine.gov, 2020) The Statute states that an individual must submit evidence in the State of Maine that they are qualified to practice and hold a nursing license. This has made an impact on my nursing practice in the fact that I had to prove to the State of Maine that I am qualified to practice as a registered nurse. To do so I had to take a state exam called the NCLEX-RN exam. The Maine State Board of Nursing has a specific scope of practice for registered nurses. Maine.gov (2017) discusses that the scope of practice for a registered nurse includes the nursing process (assess, diagnose, plan, implement, and evaluate), teaching, managing care, patient safety, collaborating with the health care team, and delegating care to other whom are qualified. The Nurse Practice Act permits registered nurses to delegate tasks to licensed practical nurses (LPN) and certified nursing assistants (CNA) only (maine.gov, 2019). The registered nurse must also consider the Skills Checklist for CNA’s and cannot delegate a task that is not listed. Also, the RN must also determine the degree of supervision needed for the nursing assistant performing the delegated task. F. A registered nurse plays several different roles in their professional practice. These roles may include being a scientist, a detective, and even a manager of the healing environment. Registered nurses play the role as scientist in that they are continuously researching. It is important to use current evidence-based practice when implementing care. Working with patients directly at the bedside the registered nurse also acts a detective. This is done by continuously assessing the patient. For example, assessing a patient’s pain before and after the administration of pain medication will help determine the effectiveness of that intervention. That is just one of many examples on how a nurse acts as a detective. Lastly, a nurse is the manager if the healing environment for the patient in several different ways. One way is that it’s important to keep a calm and peaceful environment for the patient to help with rest and comfort. Another way is keeping the environment safe for the patient. Applying these three roles to my nursing practice will promote the patient in healing and help me succeed as a registered nurse. G. Provision number three states: The nurse promotes, advocates for, and protects the rights, health, and safety of the patient (Ovid, 2015). This provision influences my professional nursing career because it is my duty to protect my patients, whether it’s their rights, safety, or health. It is also my ethical duty to advocate for all patients. For example, if I notice that another nurse is harming their patient by purposely withholding a medication, it is my duty to report that patient to the charge nurse or nurse manager. Reporting the nurse will help protect the safety and health of the patient. Provision number four states: The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care (Ovid, 2015). As nurse this provision influences my professional career because I am responsible and accountable for the decisions I make. Going along with the nurse purposely withholding that medication, I am held accountable for reporting that to the charge nurse. Making that decision will promote the health for that patient and possible other patients in the future. H. Leadership is defined as the act of guiding or influencing people to achieve desired outcomes and occurs any time a person attempts to influence an individual or group (Hersey & Blanchard, 1988). It’s essential for nurses to have and gain several leadership qualities in their career to represent excellence in nursing. Some of these qualities include communication, respect, mentor, and critical thinker. These qualities are important for nurse to represent leadership at the bedside as well as within a nursing team or interdisciplinary team. Communication is key in the field of nursing. Effectively communicating with patients at the bedside may help reduce their anxiety of having to be in the hospital and put their mind at ease. Also, it is important that patients understand their illness and treatment plan. Likewise, it is just as important to communicate with the interdisciplinary team. This includes relaying to the providers and changes in the patient’s health status. Not only is it important to communicate with providers, it is also vital to correspond with the nurse’s aides and other healthcare staff to ensure the patient receives the best care possible. At the bedside it is important to show patients and their family’s respect. Showing respect helps develop trust from the patient and their family and promotes a healthy healing environment. Working with a nursing team in a respected environment enables others to pass that feeling of caring and respect into their patients and other colleagues (Cherry & Jacob 2019). As a leader, nurses have the responsibility to act as a mentor to new nurses, this helps them develop their own leadership skills (Cherry & Jacob, 2019). It’s also influential to even mentor patients. For example, many patient’s do not have a lot of knowledge regarding their illness whether its new to them or old. A good nurse mentor teaches and shares their knowledge with their patient to help them manage their illness independently at home. Finally, being a critical thinker is vital to represent leadership. At the bedside nurses are continuously critically thinking, whether its assessing patients, analyzing, planning, implementing, evaluating. These are all steps of the nursing process. The nursing process has proved to be effective in managing complex decisions that are required in the nursing practice (Cherry & Jacob, 2019). Working with the nursing team and interdisciplinary team, the nurse is constantly involved in critical thinking while working on the unit. The nurse must prioritize their care along and even collaborate with other health care personal to help solve problems. As a registered nurse your work environment impacts leadership, decision making, and professional development. An effective nurse leader inspires other on the health care team to make patient-centered care an important aspect of all care activities (Cherry & Jacob, 2019). Doing so helps improve patient outcomes and promotes a healthy healing environment. Work environment impacts decision making in several different ways. For example, a calm, organized, and respected environment help nurses and others make decisions more effectively than a stressful, disorganized, hostile environment. Lastly, a work environment impacts professional development by encouraging nurses to further their knowledge. This can be done by helping their employees with tuition and supplying them with a work area in which they can concentrate in learning. Many hospitals also provide education classes involving their specialty area.