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The Institute of Medicine (IOM) developed a report on "The Future of Nursing" which urged nurses to take their roles in making changes in health care (Heinen et al., 2019). Master-level degree APRNs are expected to demonstrate leadership competencies and collaborate with other healthcare professionals, such as nurses and physicians, to deliver patient focused care. Leadership and collaboration are expressed throughout the medical field with each health care profession to provide quality care. I had a 31 y/o male patient was came to the ER complaining of stomach pain, nausea and vomiting. His medical diagnosis was DKA with a blood sugar of 450. He was admitted to the PCU, as my patient. The Endocrinology NP came to speak to the patient and discussed his situation with the Endocrinologist over the phone. After, she discussed with me the plan to begin an insulin drip and NS at 250 mL/hr. The plan was to achieve a blood sugar level below 200 and a normal anion gap in 24 hours. The NP explained to me the importance of titrating the insulin drip according to the blood sugar levels which should be checked every hour. After she asked me if there is anything I need. I explained to the NP that this patient is newly diagnosed with diabetes and a diabetes educator or dietary consult order would be helpful to educate him. She agreed. I also requested for a social worker to discuss the American Diabetes Association Patient Assistance Program with him, as he did not have medical insurance and would most likely need insulin after being discharged. Lastly, I spoke with my nursing assistant and discussed the importance of checking blood sugar levels every hour for our patient and reporting the level to me on the hour.
The leadership and collaboration from all healthcare professionals involved in this patient's care made a difference in his care. The NP clearly stated the goal for this patient and the path to follow in order to receive desired results. I also included some resources that would help our patient understand diabetes. I also demonstrated leadership by explaining to the nursing assistant why there is a need to check the blood sugar levels every hour. The overall communication and motivation of the entire team delivered the most effective result. The patient's condition successful improved and he was discharged from the hospital. An important point that I would like to mention, is that nurses in general, APRN or RN, are concerned with the entire well-being of our patients. This includes the patient's stay at the hospital and after discharge. We are concerned about after hospital care and if our patient's have the ability of complying with their mediations. We want to ensure the patient understands their diagnosis throughout the treatment process and after. We are caring and curing healthcare providers which differentiates us from physician assistants and physicians.
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