Week 7 Discussion: Collaboration Cafe Discuss the laws in your state (ARIZONA) related to the nurse practitioner s (NP) role and responsibility in creating and signing ADs

Week 7 Discussion: Collaboration Cafe Discuss the laws in your state (ARIZONA) related to the nurse practitioner s (NP) role and responsibility in creating and signing ADs

Week 7 Discussion: Collaboration Cafe Discuss the laws in your state (ARIZONA) related to the nurse practitioner s (NP) role and responsibility in creating and signing ADs

Week 7 Discussion post instruction

Purpose

The purpose of this Collaboration Café is to provide an opportunity to reflect on and identify barriers to discussing advanced directives (AD) with clients.

Initial Post

1. Discuss the laws in your state (ARIZONA) related to the nurse practitioner’s (NP) role and responsibility in creating and signing ADs(Advanced directives). Indicate if the NP can independently complete AD documents or a physician is required to sign or cosign the documents.
   

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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.

*Please use peer reviewed evidenced- based practice journal from the United States within 5 years

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Discussion Post

In nursing practice, advance directives refer to the legal documents that enable nurse practitioners to make decisions concerning end-of-life care. These nurse practitioners manage to assist the patients in formulating effective strategies on how to engage their families and friends. According to Starr et al. (2019), advance directives exist in three categories: health care proxy, power of attorney, and living will. The health care proxy is a legal document where individuals designate specific people in healthcare decisions when they become incapable of making others acknowledge their wishes. Power of attorney is where individuals draft a legal document that gives the attorneys power to make decisions when the individual becomes medically incapacitated. However, an individual specifies the medical treatment types they desire for the living will. Therefore, the discussion post will evaluate Arizona’s laws on nurse practitioner roles and responsibilities in signing and creating advanced directives. The discussion post will also evaluate

Arizona’s nurse practitioners’ scope of practice allows nurses to engage in full practice, thus allowing them to practice autonomously. In Arizona, the nurse practitioner can examine, diagnose and treat the patients without collaborating or being supervised directly by the physicians. Also, these nurses are allowed by state laws and regulations to prescribe medications, including class II-V scheduled drugs. Concerning the advanced directives, Arizona’s nurse practitioners are allowed to sign death certificates and order physical therapy, including signing placard forms for disabled people (Peterson & Morris, 2019). Arizona’s nurse practitioners’ other role concerns their eligibility to sign the Physician Orders for Life-Sustaining Treatment (POLST) forms. However, despite these nurse practitioners having the advantage of practicing without supervision, Arizona States law indicates that they need to refer patients that may be out of their experience and knowledge to other healthcare providers or physicians or collaborate to identify the best way to intervene on their conditions.

Cancer is one of the killer chronic illnesses globally where; in the United States; the country recorded approximately 1.9 million cancer cases while the death toll rose to 609,360 deaths in 2021 (Siegel et al., 2021). During the practicum, our healthcare organization had been intervening for different patients with different cancer stages. However, this particular cervical cancer patient was deteriorating daily, thus requiring the healthcare organization’s nurse managers to brainstorm the best way to intervene in her condition. After consultation, the healthcare providers agreed to transfer the patient to palliative care. Palliative care is essential for patients with life-threatening illnesses since they receive more advanced healthcare interventions, including their families (Starr et al., 2019). The patient would benefit from the transfer because most cancer patients in palliative care tend to receive standardized treatment that improves their moods and quality of life as they continue managing their health conditions. Therefore, the best way that nurse practitioners may approach the patient includes integrating effective patient education to the patients and their families to enable them to understand why the transfer matters and instill confidence in them that the patient’s condition will improve when handled by palliative care nurse staffs.

The underserved and vulnerable patient population’s access to healthcare has been one of the issues globally and in the United States. The main reason is that they lack health insurance, have limited healthcare resources, and have poor means of accessing this healthcare due to the remoteness of their residence (Starr et al., 2019). Hence, the main recommendation to improve hospice and palliative care is to create awareness of government insurance programs like Medicaid and Medicare to relieve the financial constraints they may incur when seeking palliative and hospice care when uninsured. Also, there will be a need to establish telehealth that will help incorporate evidence-based research and interventions to improve cancer screening and diagnosis techniques, thus preventing cancer from advancing to untreatable stages. Telehealth will also be effective since healthcare providers can collaborate to enhance patient-centered healthcare services. In conclusion, the Arizona nurses being permitted by the state laws and regulations to perform full practice is essential when performing advanced directives. It is also evident that nurse practitioners have a great role in ensuring that patients in the end-of-life phase receive better healthcare services that improve their quality of life.

References

Peterson, K. S., & Morris, B. C. (2019). Creating synergy between academia and practice: the Arizona State University and Mayo Clinic Arizona model. Journal of Professional Nursing, 35(4), 305-313. https://doi.org/10.1016/j.profnurs.2019.01.003

Starr, L. T., Ulrich, C. M., Corey, K. L., & Meghani, S. H. (2019). Associations among end-of-life discussions, healthcare utilization, and costs in persons with advanced cancer: a systematic review. American Journal of Hospice and Palliative Medicine®, 36(10), 913-926. https://doi.org/10.1177/1049909119848148

Siegel, R. L., Miller, K. D., Fuchs, H. E., & Jemal, A. (2021). Cancer statistics, 2021. Ca Cancer J Clin, 71(1), 7-33. https://web.archive.org/web/20220526195035id_/https://acsjournals.onlinelibrary.wiley.com/doi/pdfdirect/10.3322/caac.21708