Course & Practicum Reflections

Youngstown State University

Family Nurse Practitioner

Tiffany Ward

January 2021-August 2022

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Index
Spring 2021
Page 4 …………………………………………….…NURS 6900 Healthcare Issues and Trends

Page 6 …………………………………………………NURS 6902 Advanced Pathophysiology

Page 8 ………………………………………NURS 6918 Advanced Diagnostics & Technologies

Page 10 ………………………………………………NURS 6904 Advanced Health Assessment

Summer 2021

Page 12 ……………………………………………………NURS 7003 Advanced Practice Role

Page 14 …………………………………………………….NURS 6903 Advanced Pharmacology

Page 16 ………………………………………………….NURS 7046 Family Nurse Practitioner 2

Page 18 …………………………….NURS 6901 Theoretical Foundations in Science & Research

Fall 2021

Page 20 ………………………………………………….NURS 7047 Family Nurse Practitioner 3

Page 22 ……………………………………………………….NURS 6917 Differential Diagnoses

Page 24 ………………………………………………….NURS 7045 Family Nurse Practitioner 1

Spring 2022

Page 26 ……………………………………NURS 7048 Family Nurse Practitioner 1 Practicum

Page 28 ……………………………………NURS 7050 Family Nurse Practitioner 3 Practicum

Summer 2022

Page 30 …………………………………… NURS 7049 Family Nurse Practitioner 2 Practicum

Page 32 …………………………………… NURS 7051 Family Nurse Practitioner 4 Practicum

Page 34 ………………………………………………………………….… NURS 7005 Capstone

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Spring 2021: Healthcare Issues and Trends

Healthcare Issues and Trends was one of the first classes I took starting the MSN pro-

gram at Youngstown State University. This class focused on issues we see in the workplace and

gave excellent examples and ways to change the issues currently in the nursing field. During this

class, we had weekly discussion talking about different issues within nursing and we were able to

offer our own solutions to the problems and discuss them upon our peers. Our professor encour-

age us to share our own thoughts and issues we noticed in our own workplace. Being a nurse for

over two years, I have already seen many issues that can be and need to be fixed. This course

brought forth more issues that I did not know about and provided us with education and taught us

how to deal with these issues. This course opened my eyes to the multiple issues in healthcare

and allowed us to form our own solutions. This course allowed us to see what our future profes-

sion holds and issues we may encounter.

In this class, we had to choose one topic regarding an issue in the nursing workplace and

write a paper about it and offer solutions. I chose to write about nursing shortage. I first began by

offering the history of nursing and when the “shortage” began and what the nursing shortage cur-

rently looks like today. Currently, the nursing shortage is the worse I have ever seen and hospi-

tals and long term care facility are hurting. I offered multiple solutions to the problem, such as

hospital based nursing schools, the increase use of LPNs in the hospital setting, and improving

the mental health state of healthcare workers. This is an ongoing problem and we as nurses must

stand up for our profession and create the change.

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Spring 2021: Advanced Pathophysiology

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Advanced pathophysiology was another class I took during my first semester as a graduate stu-

dent at YSU. I was very eager for this class to begin, so I can build from the knowledge I cur-

rently have. During this course, we covered every aspect of the human body in a short seven

week course. This class was very fast paced, but I feel like I learned a lot from this course. This

course allowed me to look at the cellular level of the human body and work outwards. It is im-

portant for nurses to understand the pathophysiology of the body in order to treat patients effec-

tively. It is important to understand what medications or treatment therapy our patient needs

based on the pathophysiology in their body. I learned a lot of valuable information from this

class and I believe I will constantly look back at my notes and in the book for review and clarifi-

cation during this program. This course is the foundation of my graduate nursing career.

In this course, we did weekly lectures, reading, tests and case studies. In our case studies,

we were given a scenario with a patient with minimum information. We were asked questions

about the patient, such as what the diagnosis would be and how we as advanced practice nurses

would treat those patients. These allowed us to expand our knowledge as well as learn from oth-

ers when they shared their treatment plans.

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Spring 2021: Advanced Diagnostics and Technologies

During this course, we were able to look at different labs and diagnostic testing results.

As a nurse, I typically read the report written by a radiologist and do not see the films. During

this class we reviewed different scans such as CAT scans, MRIs and chest x-rays. It was very in-

teresting to look at these scans, but I still find it difficult to fully understand what I am looking at

in this films. I think this technique is something that comes to us as advanced practice nurses

with time. We also learned about EKGs and echos, which is something I am very familiar with. I

currently work on a post cardiac catheterization unit and see these tests daily. We also reviewed

different lab work in this class. I have a basic understanding on what labs need to be ordered and

what normal levels should be. This class was a great review for lab results.

During this class, we had weekly discussion, reading, tests and case studies. We were

given a scenario with either lab results already or had to make the decision of what test we want

to order. It was nice to be able to use my current knowledge and new learned knowledge to de-

velop a plan of care for my patient.

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Spring 2021: Advanced Health Assessment

During this course, we added more skills to our head to toe assessment. I have

been a nurse for over two years now and know the head to toe assessment basics. We took the

skills that we already know and added some skills as well as enhanced our current head to toe as-

sessment. Each week, we focused on a specific group of systems and learned how to assess a pa-

tient using our advanced skills. We learned what was abnormal and normal for our patients. The

skills we performed were explained in great detail as to why we perform certain assessments. In

my current career, I do a more focused assessment along with a focus history and physical. Dur-

ing this course, we learned the aspects of an extensive history and physical, rather than a focused

assessment. At the end of this course, we had to perform an advanced full head to toe on a pa-

tient as well as obtain a history. This class taught me the important questions to ask in order to

get a full look into what is happening with our patients.

This class taught us the foundation of our assessments as an advanced practice nurse. I

have my basic skills, but I am now able to perform advanced skills such as EENT exam and ab-

dominal assessment. This one of my favorite classes so far because it was more hands on and set

us up for our future assessments on real patients.

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Summer 2021: Advanced Practice Role

During this class, we explored the concepts, theories, and research about the role of an

advanced practice nurse. We look into the development of the advanced practice nurse role and

their place in the healthcare setting. We went into detail about the scope of practice regarding an

APRN and how it differs from state to state, facility to facility. We learned about the hesitation

from the healthcare community regarding advanced practice nurses and difficulties we may en-

counter in our careers. This course also explained the different routes you can take with a MSN

such as NPs, midwives, nurse anesthetists (DNP) and case management. We also looked into the

DNP program and if the future and current nurse practitioners will have to obtain their DNP in

order to practice.

During this course, we began our preparation for our future role as advanced practice

nurses by writing a resume, cover letter, thank you note and a standard of care agreement be-

tween ourselves and a physician. We also created a portfolio on Weebly, that clearly lays out ev-

erything a potential employer will need to know about us. This is very helpful for me in the fu-

ture for interviews. It is nice to have this set up now and get feedback so I can make the appro-

priate changes.
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Summer 2021: Advanced Pharmacology

I am currently in the middle of advanced pharmacology and this is one class I was look-

ing forward to the most. I was quite nervous for this course because as advanced practice nurses,

we are the ones prescribing so it is important to understand the mechanism of action, side effects,

therapeutics effects and contraindications of medications. I think that having a strong pharmacol-

ogy course in my undergraduate program and working as a registered nurse for over two years

really helped me throughout this course. This course is very helpful in expanding my knowledge

of medications and also is a great review course on the medications I do not typically see in my

work environment.

In this class, we have weekly discussions, tests, reading and case studies. In our case

studies, we were given a patient scenario and told to come up with a diagnosis and medication

treatment plan. From work experience, I know what the doctors I work with typically prescribe

to this patients, but this class helped me put the puzzle pieces together and completely under-

stand why these medications are ordered for specific patients. These case studies helped me

place my knowledge into real life scenarios and gave me a glimpse of my future as a prescribing

advanced practice nurse.

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Summer 2021: NURS 7046 Family Nurse Practitioner 2

Family Nurse Practitioner 2 was the first didactic course I took in the program that re-

view the systems of the body and broke down each disease process and treatment plans. This

course was a great refresher for me since I have not thought of some the disease processes since

undergrad nursing school. It was nice to review them again and expand my knowledge and learn

how to treat each one individually. This course focused on both adult and pediatric disorders that

included HEENT, respiratory, cardiovascular, neurological, psychosocial, and endocrine. I found

this course to be particularly difficult because the content we reviewed includes very extensive

disorders that coexist with each other. However, I was able to review the topics I already knew

well and revisit topics I do not know so well such as neurological disorders.

This class taught me how to treat specific diseases and disorders based on the systems I

explained above. I feel confident in identifying a problem and know what the correct treatment

should be. I feel confident in clinical situations, I will be able to address with my preceptor a

problem a patient has and how to treat. At the end of this course, we were able to create a patient

scenario and develop a treatment plan for that patient. I did my presentation on obesity and I be-

lieve it helped me develop non-pharmacologic ways to help my patients.

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Summer 2021: NURS 6901 Theoretical Foundations in Science & Research

I was quite nervous for the course, because I struggled to read research and implement

into my care. It is important for nurses to use evidence based practice when providing care to

your patients. Excellent care improves patient outcomes and quality improvement. In this class,

we were to develop a PICOT questions related to nursing care. I did mine on follow up care after

a CABG surgery. I worked on a floor that recovered patients after a CABG surgery and we were

trained in the follow up process, however not after discharge.

Researching different studies about how nursing care in hospital and out of the hospital

improve patient care were astonishing. Most nurses do not realize the impact we have on our pa-

tients. We go to work and get into our routine of how we take care of each patient. After review-

ing these studies, I think it is important for nurses to slow down and create a plan with each pa-

tient individually and assess how we can make their care better while they are in the hospital and

after discharge. Doing this project, it showed me how much influence nursing truly has on our

patients and their families.

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Fall 2021: NURS 7047 Family Nurse Practitioner 3

Family Nurse Practitioner 3 was the second course class I took that reviewed systems in-

dividually and how to treat each disease process. In this particular class we reviewed gastroin-

testinal, musculoskeletal, genitourinary, hematology, infectious diseases, and integumentary dis-

orders. This class was a little difficult for me because I worked as a cardiac nurse for 3 years and

rarely had patients that has musculoskeletal, infectious diseases or integumentary problems. In

this course, we learned how to do a full musculoskeletal exam to determine what type of injury a

patient has, which was quite difficult to remember each motion. However, I was able to review

topic I learned about previously and get a refresher course.

In this class, we were taught how to proper examine a patient and develop a treatment

plan that was appropriate. Working in the primary care, we will see most of these disorders and

treat before referring them to a specialist. It is important to understand each disease process and

how to properly treat each one.

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Fall 2021: NURS 6917 Differential Diagnoses

I was particularly excited for this course, because as nurses we are not allowed to diag-

nose a patient. Throughout this course, we were learning how to properly diagnose a patten from

an APRN point of view and it made me feel like I am getting somewhere in my program and can

use my knowledge I have gained to develop an appropriate plan for a patient. At the end of this

course, we developed a powerpoint presentation using a diagnosis and were able to develop a

plan for the patient.

I did my presentation on palpitations, which as a cardiac nurse I was very familiar with.

Even though as a RN, we know what the diagnosis should or could be, under our scope of prac-

tice we are legally not allowed to diagnose a patient. I found this class to be one of my favorite

because I was able to bring all that I had learned in the program together in one project. It is im-

portant to look at the patient as a whole to develop the correct diagnose and plan to effectively

treat them.
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Fall 2021: NURS 7045 Family Nurse Practitioner 1

Family Nurse Practitioner 1 was my third and final core course to take before moving

onto clinical hours. In this course, we reviewed women’s health, pediatric development, men’s

health and sexually transmitted diseases. I was particularly nervous for this course because as a

RN, I never worked with these populations before. These are very specialized areas of nursing

and I have not reviewed since nursing school. However, I was taking my women’s health and pe-

diatric clinical rotation after this class, so it was a great review right before clinical. This course

reviewed the basic topic in each speciality and taught how to treat each problem effectively.

This class set me up to effectively treat patients in each area. However, I still struggle

with these specialities, I believe once I am in clinical it will all come together for me. I am a

hands on learner and when I can physically see or deal with in person, I can remember a lot eas-

ier.
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Spring 2022: NURS 7048 Family Nurse Practitioner 1 Practicum

My first NP practicum was with Lauren Zuga at NOMS OBGYN, in which I completed

80 hours. I was very nervous because I have never worked in women’s health before and did not

know what to expect. Lauren made me feel very comfortable in the clinical site and is extremely

knowledgeable in women’s health. She taught me how to perform a PAP smear and pelvic exam,

birth control management, IUD removal, and OB monitoring. By the end of the clinical experi-

ence, I was able to independently perform a PAP smear and pelvic exam and discuss different

birth control methods. I did not think I would like women’s health, but she made my clinical ex-

perience so enjoyable that I fell in love with women’s health and can for see myself working in

that speciality.

In the same semester, I completed 100 hours with Dr. Adekunle. Again, I was very ner-

vous for this clinical because I have never worked with the pediatric population before. Pediatric

nursing is not just treating small adults, there is a vast difference between them. Dr. Adekunle is

very educated and explained everything to me whenever I had a question. By the end of the clini-

cal experience, I was able to perform a head to toe assessment, do a H&P and develop a plan that

was presented to my preceptor. I feel confident in assessing pediatric patients and developing a

plan that is suitable for them.

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Spring 2022: NURS 7050 Family Practitioner 3 Practicum

I completed 200 hours of primary care with Doug Sposetta. I was very excited for this

clinical, because in primary care you see everything and are able to treat the patient as a whole.

This clinical allowed me to use what I know and what I learned to properly diagnose and create

an appropriate plan for each patient. By the end of this clinical, I was able to independently as-

sess the patient, obtain a H&P and develop a treatment plan for each patient. Doug is very

knowledgeable and answered any questions I had. He also helped me greatly when it came to

medical billing, which is something that I struggle with.

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Summer 2022: NURS 7049 Family Practitioner 2 Practicum

I completed 180 hours with Lauren Zuga NP at NOMS OBGYN. I have done a clinical

with her before and was very excited to return the world of women’s health. As mentioned be-

fore, I see myself working in this speciality, so I wanted to do another with her. During this clini-

cal, I was able to perform a H&P independently as well as performed clinical skills such as PAP

smears, pelvic exams, OB visits. I also feel like I was able to solidify my clinical skills and use

my knowledge to create a plan of care for patients independently. Lauren made me feel very

comfortable at the clinical site which made my learning experience so beneficial.

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Summer 2022: NURS 7051 Family Practitioner 4 Practicum

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During this practicum, I completed my final 60 hours of clinical in express care with Sab-

rina Kifer NP at Southwoods. I was particularly excited for this clinical because you see a variety

of patients daily and it is a different pace than a regular doctor office. During my time here, I was

able to see diseases that I have never seen or heard of. Sabrina allowed me to use my knowledge

to create a plan of care for these patients. I also was able to perform clinical skills such as EENT

exam, burn treatments, pain management, infection control and more. One thing different about

express care is that you do not focus mainly on their prior medical history, rather you focus on

the problem at hand. Express care is more of a focused assessment, whereas in primary care you

look at the whole picture. Sabrina made me feel very welcomed and helped me tremendously in

creating the right plan of care for patients with different disease processes.
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Summer 2022: NURS 7005 Capstone

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During this course, we dug more into research and implementing into our nursing care we

provide for our patients. It is important to use evidence based practice when providing and creat-

ing a plan of care for patients. Excellent care improves patient outcomes and quality improve-

ment. In a previous class, we created a PICOT question and in this class we expanded more on

our project and developed a plan on how to implement our study. Digging more into this topic, I

realized how important nursing care is for our patients. As an APRN, patients trust you fully with

their life and expect you to create a plan of care that is safe and effective for them. Using re-

search and evidence based practice, we are able to do that for our patients.