NR 601 CC WK 7 Advance Directives Assignment

NR 601 CC WK 7 Advance Directives Assignment

NR 601 CC WK 7 Advance Directives Assignment

Family nurse practitioners often care for older adults as they experience changes in functional health. Assessments may reveal that clients are unsafe in their current environment or that they may require additional assistance to remain at home. Carefully read the questions below and address each in your initial post.

1. Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
   1. Discuss the laws in your state related to the nurse practitioner’s (NP) role and responsibility in creating and signing advanced directives (ADs). Indicate if the NP can independently complete AD documents or a physician is required to sign or cosign the documents.
   2. Consider clients you’ve encountered in practicum (or in your practice as a registered nurse). Identify at least ONE client who may have benefited from a referral to hospice or palliative care. Indicate why this client would have benefited from these services. Describe how as an NP you might approach the conversation with the client.
   3. Discuss at least TWO recommendations you have for improving palliative and hospice care access to vulnerable and underserved populations in your community.

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 Advanced Directives in Virginia Sample Solution

The nurse practitioner (NP) scope of practice in Virginia is restricted practice, meaning NPs do not have full autonomy and must operate under the career-long supervision, delegation, or team management of a physician (Virginia Code, 2023). However, in Virginia, nurse practitioners have the authority to participate in the creation and signing of advanced directives. Advanced directives in Virginia encompass documents such as living wills, durable powers of attorney for health care, and do-not-resuscitate (DNR) orders. NPs are allowed to independently complete and sign these documents without the need for a physician’s co-signature (Virginia Code, 2023). This reflects the recognition of NPs as primary care providers with the capacity to make critical decisions regarding patients’ healthcare preferences, especially in end-of-life situations.

Identification of a Client Benefiting from Hospice or Palliative Care

   In my practicum experience, I encountered a client who was an elderly individual with advanced-stage cancer and multiple comorbidities. The client’s physical condition was deteriorating, and curative treatments were no longer viable. In this case, referral to hospice was highly beneficial. The transition to hospice provided better symptom management and emotional support for the patient and her family and improved the overall quality of life during the remaining time.

   As an NP, approaching this conversation involved empathy and active listening. I started by gauging the patient’s understanding of their current health status and prognosis. I  then introduced the concept of hospice or palliative care as a supportive measure focused on enhancing comfort and addressing their specific needs. It was crucial to emphasize that these services aim to provide comprehensive care tailored to their preferences and ensure the patient’s dignity is maintained throughout the process.

Recommendations for Improving Access to Palliative and Hospice Care

1. Community Education Programs

      Developing and implementing community-based education programs to raise awareness about palliative and hospice care is an important role for the nurse practitioner. Many underserved populations are not fully informed about the benefits of these services. Targeting community centers, places of worship, and local events can help disseminate information and dispel misconceptions about end-of-life care (Abel et al., 2021).

1. Collaboration with Community Health Workers

     As an NP, I recommend establishing partnerships with community health workers who have close ties to underserved populations. Community health workers can serve as liaisons, helping bridge the gap between healthcare providers and communities. They can assist in identifying individuals who may benefit from palliative and hospice care, offering culturally sensitive information, and facilitating the necessary connections (Abel et al., 2021). This aim is to enhance accessibility, awareness, and cultural competence in palliative and hospice care within the community, particularly for vulnerable and underserved populations in Virginia.

References

Abel, J., Kelleher, A., Mills, J., & Patel, M. (2021). Access to palliative care reimagined. Future Healthcare Journal, 8(3), e699–e702. https://doi.org/10.7861/fhj.2021-0040

Virginia code. (2023). Code of Virginia code – article 8. Health Care Decisions Act. Virginia.gov. https://law.lis.virginia.gov/vacodefull/title54.1/chapter29/article8/

Wiesen, K. (2023). Nurse practitioner scope of practice by state – 2023. Nursingprocess.org. https://www.nursingprocess.org/nurse-practitioner-scope-of-practice-by-state.html