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MSNCB Medical-Surgical Nursing Certification

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Our affiliated professional association- the Academy of Medical-Surgical Nurses- offers the Medical-Surgical Nursing Certification Review Course. It is a 2-day course designed for nurses preparing to take the Certified Medical-Surgical Registered Nurse (CMSRN�) Certification Exam.

In order to meet the varied needs of nurses and facilities- AMSN offers the course in a number of live and independent study formats- including bringing it to your facility or accessing it through the AMSN Online Library.

An alternative to nurses preparing for the CMSRN test is the Focused CE Series- a collaboration between AMSN and nurse.com. The Focused CE Series is a blended learning model that combines weekly online CE course readings- weekly live webinar presentations- and an online forum for information exchange and networking with peers.

1. Helping Role
– Maintain an environment in which patient confidentiality is assured.
– Assess patient’s level of comfort/pain.
– Act as an advocate to help patient meet needs/goals.
– Acknowledge- respect- and support emotional state of patient and/or family as they experience and/or express their emotions.
– Assist patients to achieve optimal level of comfort- using an interdisciplinary approach.
– Modify plan of care to achieve patient’s optimal level of comfort- i.e.- pharmacological interventions- heat- cold- massage- positioning- touch- etc.
– Provide a therapeutic environment- considering privacy- noise- light- visitors’/providers’ interaction with patients.
– Provide culturally competent patient care- including education.
– Support family involvement in accordance with patient’s wishes regarding caregiving and decision making.
– Assess for potential for self-harm.
– Identify need of patient/family for support systems/resources and make appropriate referrals.
– Work on behalf of patient/family to help resolve ethical and clinical concerns.
– Coordinate care across multiple settings.
– Identify- acknowledge- support- and facilitate patient/family decisions regarding end-of-life care.
– Identify signs of domestic or intimate partner violence.
– Assess and provide for spiritual needs of patients and families.
– Identify ethical issues in clinical practice and facilitate a resolution with patient- family- and staff.

2. Teaching/Coaching Function
– Assess the patient’s and family’s readiness and ability to learn.
– Identify barriers to learning.
– Prepare/educate patient for transition in care- e.g.- discharge to home or other facility.
– Provide information and rationales related to diagnosis- procedures- self-care- prognosis- wellness- and modifiable risk factors.
– Utilize opportunities for spontaneous education.
– Encourage patient’s and family’s participation in establishing educational goals.
– Develop and implement an individualized teaching plan for patient and/or family.
– Evaluate and modify teaching plan based on achievement of pre-established and ongoing learning needs.
– Assist staff in identifying educational needs of patients and their families.
– Assist staff in selecting/developing educational materials appropriate for intended learner(s).
– Teach patient and family about available community resources.

3. Diagnostic and Patient Monitoring
– Conduct and document a comprehensive baseline assessment.
– Anticipate patient’s response to treatment and monitor for potential problems.
– Reassess patient based on established standards of care at appropriate intervals.
– Interpret results of laboratory and diagnostic studies and take appropriate action.
– Use invasive and non-invasive methods to collect data.
– Analyze all patient data in formulating a plan of care.
– Participate in medication reconciliation at transitions of care.
– Anticipate the patient’s response and needs related to physiological- psychosocial sexual- spiritual- and cultural aspects of his/her illness.
– Prioritize identified problems and modify the plan of care to achieve the best possible outcomes.
– Develop an individualized plan of care congruent with patient goals.
– Identify purpose and appropriateness of diagnostic studies.

4. Administering and Monitoring Nursing Interventions
– Administer medications accurately and safely.
– Identify subtle changes in patient’s assessment to prevent deterioration of patient status.
– Assess patient’s level of consciousness.
– Monitor patients for therapeutic responses- reactions- untoward effects- toxicity- and incompatibilities of administered medications.
– Implement measures to ensure adequate oxygenation and gas exchange.
– Monitor and implement measures to prevent alterations in skin integrity.
– Initiate- maintain- and monitor intravenous therapy.
– Identify- document- and report deviations from expected findings.
– Monitor for signs and symptoms of complications of disease processes.
– Implement measures to address threats to patient safety- e.g.- falls- seizures.
– Maintain patent airway.
– Maintain integrity and prevent infection of invasive drainage systems- e.g.- catheters- percutaneous drains.
– Implement measures to maintain adequate hydration and electrolyte balance.
– Provide care to patients on continuous cardiac monitoring.
– Use adaptive/assistive devices for mobility- immobility- positioning- and comfort.
– Interpret cardiac rhythm strips.
– Monitor for complications of musculoskeletal trauma and surgical procedures.
– Perform a neurovascular assessment- e.g.- extremities- flaps- grafts.
– Provide optimum nutrition during hospitalization- allowing for cultural and individual preferences.
– Identify and implement transmission-based precautions based on patient’s history and symptoms.
– Monitor effectiveness of nutritional interventions.
– Develop and implement a wound management strategy.
– Care for patient receiving IV patient-controlled analgesia
– Perform central line dressing change.
– Administer heparin drip
– Apply and/or monitor devices used to immobilize affected area- e.g.- cast- splint- collar- etc.
– Care for patient receiving epidural analgesia
– Provide care for patients who have chest drainage systems.

5. Effective Management of Rapidly Changing Situations
– Recognize signs that a patients condition is deteriorating and take appropriate action.
– Obtain appropriate orders to address a change in the patients condition-
– Determine priorities in rapidly changing situations.
– Use existing guidelines/protocols/policies to respond to changing patient situations- e.g.- hypoglycemia- wound dehiscence.
– Use existing guidelines/protocols/policies to respond to urgent and emergent situations- e.g.- acute chest pain- stroke.
– Initiate basic life support.

6. Monitoring/Ensuring Quality Health Care Practices
– Communicate effectively to the healthcare team.
– Question/clarify orders as appropriate.
– Incorporate evidence-based practice into the patient’s plan of care.
– Coordinate and/or participate in interdisciplinary activities to ensure consistent patient outcomes- e.g.- core measures.
– Report system failures- e.g.- chain of command- equipment- safety- medication administration- computer systems.
– Assist nursing staff in incorporating evidence-based practice and quality improvement into practice.
– Participate in quality improvement activities.
– Identify clinical problems for further investigation.

7. Organizational and Work-Role Competencies
– Practice in accordance with the rules and regulations of the state board of nursing in state(s) of licensure.
– Adhere to the Scope and Standards of Medical-Surgical Nursing Practice.
– Utilize electronic/computer resources to optimize patient care.
– Set priorities based on assignment- unit- and institutional needs.
– Act as a professional role model.
– Participate as an active member of the interdisciplinary healthcare team.
– Delegate patient care assignments based on competency levels and scope of practice of healthcare team members.
– Act as a resource for other nurses on the unit.
– Provide collaborative- interdisciplinary- coordinated care.
– Incorporate strategies that support effective team dynamics in a caring and nurturing environment.
– Evaluate own practice based on established standards of care.
– Evaluate nursing care based on outcome criteria.
– Recognize unsafe work practices (nurse/patient ratio- ergonomics- standard precautions- etc.) and intervene appropriately.
– Identify- develop- and implement strategies to reduce readmissions.
– Use the chain of command appropriately.
– Serve as consultant to nursing staff and other disciplines.
– Coordinate and/or participate in interdisciplinary activities to ensure consistent patient outcomes- e.g.- core measures.
– Identify- develop- and implement strategies to decrease length of stay while improving patient/family/staff satisfaction and patient care.
– Provide expert support to unit educators- preceptors- and nurse managers.
– Follow institutional policies and procedures in response to an internal or external crisis or event.
– Serve as preceptor/mentor for students and staff.
– Assist with data collection (e.g.- patient outcomes- nurse-sensitive indicators).


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Medical Medical-Surgical Dumps

Hope for Healthcare- Returning Civility and Cooperation to health Care | MSNCB test Braindumps and PDF Questions

useful resource issues

in accordance with a survey of forty three,329 registered nurses working in adult acute care hospitals, forty one% talked about they were disenchanted with their existing job. The survey results, published in fitness Affairs on can also 7, 2001, also indicate that one third of all nurses beneath the age of 30 plan to leave their jobs inside the next yr. The present ordinary age for a registered nurse is forty seven years. With retirement looming for many nurses in the next 15 years and intensely few nurses to replacement them, the ambiance of care in lots of facilities has develop into a sea of desperation.

Many nursing contraptions are understaffed. Most managers are overextended, trying to manipulate numerous contraptions with responsibility for greater than one hundred body of workers participants. The excessive regulatory environment locations huge burdens on each unit for practising, safety and competency necessities. The continuous lessen in compensation for capabilities has cause minimal assist team of workers and even fewer elements for schooling and skill construction. as a result of the 24 hour/ 7 day every week care requirements, there is rarely a time when all the staff can come together in a single room for a meeting or dialogue of issues affecting the birth of care. communique becomes fragmented and rumors and fantasy exchange facts. The curative environment turns into primed as a battleground and the entire aspects for battle ripen into horizontal violence between clinicians.

Physicians, social workers, therapists and assist personnel are below elevated pressure to provide more features with fewer components. Collaborative relationships are strained as competitors raises for beds on the acceptable degrees of care. Emergency departments in city areas are automatically compelled to divert patients due to an absence of crucial care beds or applicable group of workers. Transition through the fitness care equipment is advanced by poor tips technology and complicated admission/transfer and discharge processes. Flexibility and cooperative spirit among the fitness care group members is strained by using a consistent stretching of the elements of time, house, and individuals.

On excellent of the interior strife affecting affected person care, exterior pressures from involved families and sufferers provides gasoline to the hearth. generally, families consider the deserve to remain on the affected person’s bedside to make certain that a person is there to support or to look ahead to one of the all too general error so commonly mentioned in the media. The steady and speedy turnover of patients allows little time for dialog, schooling, and validation. regardless of the focal point on error discount and prevention, it turns into increasingly more tricky to manipulate the limitations inside the equipment. sufferers and households enter the hospital simplest after navigating the HMO and insurance approval process and are confronted with restricted hospital stays and fears of finding sufficient components to assist them after their discharge domestic. households are met by using nursing body of workers who’ve restricted time and a limited capability to deal with the complexity of competing needs. Physicians often have too little time to spend assessing and treating sufferers and the scientific relationship suffers. both the clinicians and the families are confronted with cases that make them feel compromised and an absence of trust drives aside the two strongest advocates a affected person has.

Competing pursuits

in addition to useful resource constraints, difficulties arise across the conflicting pursuits and wishes of the a number of stakeholders within the fitness care device. Stakeholders consist of physicians who’ve restricted time and lengthening pressure to stick to monetary profiles, sufferers with advanced care wants together with social help and fiscal tips, households who need emotional aid and information from a posh and sometimes chaotic firm, and directors who’re concerned that financially the health facility might also not make it through a further year without earnings. each and every stakeholder competes to have their wants met in a constant supply and get that casts a shadow over the medical decisions taking area in the foreground.

Values Disputes

in all probability the most intricate of all are the values-based conflicts. Disagreements over the suitable volume of take care of a terminally sick person abound. The selections of withdrawing existence aid, resuscitating aggressively, honoring an advanced directive, deciding upon the needs of the family unit, or opting for the wishes of a affected person who can no longer express his or her wishes are complicated. The battle in values between an administrator who has the responsibility for preserving the health facility practicable and clinicians who have the accountability for maintaining the affected person potential can drive many useful resource negotiations. distinct cultural wants region extra demands on the device for translation functions and flexible policies to allow integration of varying cultural beliefs. problematic choices are made through a posh series of negotiations taking place every hour of day by day.

practicing needs

brought on true of the resource, hobby, and values-based conflicts, exists a well-expert, tremendously skilled clinical personnel with little or no practising in battle management and communique suggestions. The capabilities of negotiation and conciliation are realized on the job. within the better of cases, high-quality position models will exist to assist book folks that are looking for a template for how to hear and are seeking agreement. in the worst of situations, competitive, power-primarily based authoritarians and battle avoiders abound developing instances which cause escalation of disputes and needless stress.

Hope

it’s time for hope to come to healthcare. Hope that consequences from imagining what’s possible. As fitness care providers, they have the ability to hear and to be mindful the pastimes and needs of their patients, their families and every other. they now have the means to reveal empathy and to deal with each different with civility and admire. they now have the option to shift their standpoint from one which specializes in the inability of elements to one that considers what they accomplish together to be the authentic miracle. They don’t seem to be obligated to satisfy each want that society dumps at their doorstep, however they do owe it to ourselves to feel proud about the wants they will meet and the compassion that they exhibit to folks that want us most.

there’s hope for making feel of the complexity and chaos surrounding health care. It takes an intentional move toward appreciation of competing needs and an contract to work together to obtain respectable consequences. It takes looking for out tips on how to design policies that do not create conflict and developing techniques that permit for dialogue between people rather than litigation between disputants. they can present their knowledge of empathy and advocacy to every other. they are able to inject humor and creativity into their work. They can also be current in the second and discover the pleasure that comes from being part of a group working to solve a frequently described difficulty.

all and sundry have the potential to generate hope via collaboration and mutuality. they now have the artistic ability to remedy the useful resource riddles and to ascertain a gadget that optimizes care and not just remedy. they now have handle over their choices to communicate naturally, to get to the bottom of conflicts early and to express regret gracefully. they will repair hope by valuing the intangibles that are at the core of healing. As Vaclev Havel stated, “We have to try harder to have in mind in place of to explain.” It is thru their realizing that their fitness care gadget will shine once more.

Ms. Gerardi is a mediator and fitness care dispute resolution advisor and Chair of the application on Healthcare Collaboration and battle decision at the Werner Institute for Negotiation and Dispute decision at Creighton college.

Ms. Gerardi is a certified essential care nurse with greater than 15 years of clinical and administrative journey in tutorial health care agencies. Her healthcare heritage comprises affected person protection program design, administration of surgical and clinical intensive care units, administration of VIP medical/surgical features and of ambulatory fitness capabilities. Her mediation adventure comprises advanced multi-celebration disputes, organizational mediation, civic speak facilitation and community mediation. She has educated greater than 5,000 certified in conflict administration, creativity, negotiation and communique capabilities.

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