The Nurse Practitioner's Role

Decisional incapacity is the inability to make decisions for oneself caused by mental or physical impairment. With technologic advances in health care and the growing proportion of elderly in American society, the problem of decisional incapacity occurs more frequently. In the past, medical decision making was based on the principle of beneficence, and the judgment of others was used to determine medical interventions. The current trend is to base decisions as much as possible on the principle of patient autonomy. Advance directives allow for the greater use of this principle.
The primary care nurse practitioner (NP) can take an active role in promoting patient autonomy by helping the adult patient plan for decisional incapacity. By including the value history as a routine part of the health history, the NP can help patients identify their beliefs, values, and attitudes about health care. This documented value history can then be used to provide evidence of a patient's wishes should he or she become decisionally incapacitated.     

The Magical Role of a Nurse Retentionist

This article describes the innovative nurse retentionist role that a large academic medical health system in the southeastern United States implemented to improve nurse retention. The program leveraged 5 key strategies to drive results. Example outcomes during the first 2 years include a 27% increase in clinical ladder participation, a 43% clinical ladder advancement, and an 187% increase in ambulatory nurse recognition. Internal promotions increased 31%. Participation in nursing career development increased 294%. Extern program increased 420%, and 77 nurse residents were retained that initially considered resignation. Nurse turnover dropped to 11.8% with the retention of 254 nurses.     

The Nurse Practitioners'' Role in Smoking Cessation

Most people who smoke want to quit. Smoking is a combination of nicotine addiction, psychologic dependency, and habit. Nurse practitioners are in a unique position to influence clients to stop smoking. The authors discuss individual and group therapy programs and the role of the nurse practitioner. Nurse practitioners are encouraged to start smoking cessation programs in their communities.     

An Emerging Role: The Nurse Content Curator

A new phenomenon, the inverted or “flipped” classroom, assumes that students are no longer acquiring knowledge exclusively through textbooks or lectures. Instead, they are seeking out the vast amount of free information available to them online (the very essence of open source) to supplement learning gleaned in textbooks and lectures. With so much open‐source content available to nursing faculty, it benefits the faculty to use readily available, technologically advanced content. The nurse content curator supports nursing faculty in its use of such content. Even more importantly, the highly paid, time‐strapped faculty is not spending an inordinate amount of effort surfing for and evaluating content. The nurse content curator does that work, while the faculty uses its time more effectively to help students vet the truth, make meaning of the content, and learn to problem‐solve.

Brooks     

The Integral Role of Nurse Practitioners in Community Paramedicine

An academic medical center and emergency medical services system collaborated to implement a community paramedicine program. The objectives of the program are to reduce 30-day unplanned hospital readmissions, emergency department, and 9-1-1 system use, and overall health care cost. Multidisciplinary team members collaborate to identify social determinants of health for a vulnerable population, largely ill defined by health care administrators and clinicians. The focus for nurse practitioners is to assist patients to engage in health behaviors that improve and sustain health habits to prevent disease and decrease mortality and morbidity. The economic drive is to improve value and patient care.