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Exam Name : 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 teaching

correct medical doctors 2021: Scramble to contend with COVID-19 might Reshape scientific training | MSNCB braindumps and Real test Questions

dr kimberly baker genaw - medical educationDr. Kimberly Baker-Genaw, inside medicine

Dr. Kimberly Baker-Genaw, the director of scientific training at Henry Ford medical institution in Detroit, remembers the moment in early March 2020 when Gov. Gretchen Whitmer briefly closed all surgical clinics and shut down all non-obligatory hospital approaches in Michigan. “All their medical training actions ceased that day as they shifted to COVID care,” says Baker-Genaw, who oversees some seven-hundred medical residents (most of their mid-to-late 20s) in 83 distinct courses on the downtown health facility. “It was all arms on deck.”

For instructing hospitals across the country, specially these in city areas, the beginning of the pandemic in March 2020 changed into also the starting of an intense period of innovation. lots of the solutions and methods scientific educators adopted — improved virtual gaining knowledge of, collaboration, and health supplies — they believe are bound to have an effect on scientific practising in the future.

For the clinical school at Henry Ford, the greatest preliminary problem of the pandemic become the way to take care of the onslaught of COVID-19 sufferers in metro Detroit while also continuing to instruct residents with all clinics and surgical approaches shut down. 

fortunately, the Accreditation Council for Graduate medical training — the nonprofit company that units necessities for U.S. graduate scientific education for residents — approved Henry Ford’s request for Pandemic Emergency popularity and waived all curriculum requirements for 30 days. Baker-Genaw changed into then in a position to right now pull roughly 200 surgery and anesthesia residents into the intensive care unit and emergency rooms to help doctors — lots of whom would always be doing elective methods — care for COVID-19 patients. “every mattress was filled. They had over 500 COVID patients,” she remembers of that first wave.

understanding a second wave would ultimately turn up, Baker-Genaw put a structure in place. “Our residents had loads of educational considerations, so they created a really organized plan for the next wave,” she recollects, explaining that they checked out every resident’s stage of coaching to see who may well be of help with COVID patients sooner or later, while additionally making bound all residents would proceed to be carefully supervised by means of scientific faculty. Residents with little ICU and ER experience, equivalent to ENT and dermatology residents, could help with COVID nasal swabbing, as most had executed all the way through the primary wave. “We proceed to tug up their plan and update it, as they are doing now, expecting yet a further wave of the unvaccinated,” she said in August. 

Dr. Eric Scher, Internal Medicine - medical educationDr. Eric Scher, inner medicine

Dr. Eric Scher, the chair of medication, who runs the inner drugs Residency software at Henry Ford, thinks the medical field may also see a shift in career choices because of the pandemic. “students might gravitate into different residencies, and residents might choose distinctive fellowships counting on the influence this has had on their own and skilled lives,” he says.

The pandemic also compelled a brand new type of instructing for the likes of Dr. Bob Rabbani, who runs Henry Ford’s cardiology fellowship software. while a physician might constantly train residents a physique of skills already in existence, residents as a substitute witnessed attendees trying to study, battle, and deal with a brand-new ailment. 

Dr. Geneva Tatem, director of the Pulmonary and critical Care drugs Fellowship, supervised teams of up to 6 residents and two fellows in the ICU from the beginning of the pandemic, when little become nonetheless typical concerning the ailment. “We doubled the beds they continually have in the ICU to about a hundred and fifty within per week and a half,” she says. “each person had COVID, but no longer all and sundry become providing the same way or having the same medical path or outcomes, and they didn't know a way to manage the disorder.”

Tatem recollects affected by “suggestions overload” from the facilities for ailment handle and Prevention and from other hospitals providing most suitable practices. “There changed into no time to severely consider,” she says. “We had been getting to know about COVID at the same time as the residents. They were simply working and participating collectively however recognizing there is a means to get a hold of decent answers and be answer-oriented in spite of the fact that you don’t be aware of if it’s the correct reply.”

provides Tatem, “Collaboration via science and schooling throughout healthcare techniques and educational scientific centers has had monstrous positive exchange in clinical training that i'm hoping continues sooner or later.”

Dr. Bob Rabbani, Cardiology

clinical school at Henry Ford additionally increased the clinic’s intellectual fitness supplies to aid assist their youngest suppliers. Behavioral fitness consultants offered assess-ins, referrals, help agencies, and even an inner website (referred to as the COVID Diaries) the place every person could share experiences.

“We worry about their intellectual health as a good deal as their physical fitness,” Scher says. “suppose about what you’re supposed to be doing in your mid-20s: going out, striking out with chums, relationship. None of them might do any of that within the major of their youth. as an alternative, they’d come here every day to take care of unwell sufferers and then go home to be on my own.”

Worse yet, that cycle isn't ending. “We hear ‘hero to zero’ from the frontline personnel who are discouraged by the continuing pandemic regardless of vaccines, increased knowledge of the ailment, and ineffective/unused personal and public prevention concepts,” Baker-Genaw says, noting how community help for medical certified has diminished.

She has, besides the fact that children, been impressed via how residents have coped. “Many adopted or discovered own wellbeing and resilience thoughts. i suspect this focal point will likely convey accelerated attention/attention to work-life steadiness to future physicians and multiplied substances for personal and emotional fitness for suppliers.”

in the late spring of 2020, as quickly because it changed into possible, Baker-Genaw resumed the residents’ regular curriculum. “We spent a lot of time and components pivoting into digital telehealth and didactic digital experiences,” she says, including, “I think that there can be persevered pressures to increase digital researching in each undergraduate and graduate scientific training with new educational concepts to deliver the required skills and advantage to transition to and from virtual to in-grownup patient care.”

Dr. Geneva Tatem, important Care drugs

All three docs are quick to point out that situational studying — in-grownup care that takes area at the bedside — need to proceed to be a priority. “That knowledge can not be replicated in a digital environment,” Tatem says. “It influences how residents and fellows continue to boost the behaviors that reveal care, kindness, and emotional reference to sufferers. Cultivating interpersonal and conversation advantage together with clinical knowledge is elementary for spectacular affected person care and vital for the increase and construction of today’s trainees into dedicated, compassionate physicians of the future.”

In June, Scher attended the in-adult commencement of 36 interior medical residents. In his commencement speech, he told them he couldn't be “prouder of how they responded to the most fulfilling crisis of their lifetime.” He also knew his job was done.

“I at all times tell them originally that residency is about more than simply discovering a collection of abilities and fund of competencies,” he says. “It is ready forming knowledgeable identity. not just appearing like a physician but feeling like a doctor. If there's a silver lining to this pandemic, I believe it truly reaffirmed why they went into this profession.”

each and every of the physicians featured during this story made their 2021 good medical doctors listing. See who else made the record here, and find more reports from the October 2021 challenge of Hour Detroit magazine in our digital version. 

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