Narrative Analysis
The following narrative analysis indicates how all of the artifacts submitted and the course in
which they were produced meet each MSN program outcome. The analysis evaluates the
preparation of an MSN-prepared Family Nurse Practitioner (FNP) according to the Chamberlain
University’s program for practice. I have included my growth and development through different
artifacts that showcase my competence in the program as a graduate FNP nurse. Additionally, the
narrative analysis is essential to my evaluation, reflection, and synthesis of the processes of
beginning my career after graduation. Moreover, through professional self-assessment, I will use
the narrative analysis of the artifacts to evaluate my psychomotor, affective, and cognitive
development over the program duration. Therefore, I will highlight how I accomplished and
achieved the anticipated core competencies by evaluating different artifacts from my coursework
and reflecting on the positive impacts of my learning experience on my readiness as an entry-
level family nurse practitioner.
NR 500NP Foundational Concepts & Applications
This course was an instrumental introduction to my learning experience as a Master’s-prepared
family nurse at Chamberlain University. The NR 500 was an introduction to the foundational
concepts and skills essential for the master’s-prepared FNP. Additionally, it introduced me to the
role of scholarly communication and professional nursing knowledge in practice. The NR 500
was essential to achieving program outcomes 1, 2, 3, 4, and 5.
Some of the milestone developments in the course include roles in advanced nursing practice
assignment (Week 2), area of the interest PowerPoint presentation (Week 6), and the incivility
and healthful environments discussion (Week 7). The week 2 assignment required the students to
go over the requirements in transforming from being a bachelor’s to Paris to functioning as an
3
advanced practice master’s prepared to explore the possible roles and competencies associated
with the role. The presentation in week 6 required the learners to identify and discuss one area of
in interested relating to their specialty task and recommend possible solutions. Therefore, I
selected smoking cessation and recommended increased nursing training on smoking cessation
interventions and increased availability of resources to support cessation programs. Considering
the health implications associated with cigarette smoking, including the increased risk of heart
disease, cancer, stroke, lung disease, chronic obstructive pulmonary disease, diabetes, and other
lung diseases, this assignment was a great health promotion tool.
Therefore, the assignment assisted me in achieving MSN Essentials I, II, V, and VII and course
program outcomes 1, 2, 3, 4, and 5. Moreover, I managed to meet the NONPF core competencies
1, 2, 4, 7, and 9 through the course assignments and discussions. The incivility and healthful
environments discussion was a collaborative discussion engaging faculty and students to
organize, integrate, apply, and critically appraise knowledge about advanced nursing practice
using scholarly information. The discussion was aimed at achieving course outcomes 1, 2, 3, and
- The discussion was instrumental in applying person-centered care concepts to nursing practice
situations.
NR 501NP Theoretical Basis for Advanced Nursing Practice
The NR 501NP course required the students to examine several nursing theories and others from
relevant fields and critique the components of these theories. Additionally, the course aimed to
enable the learners to explore the value and contributions of theories to nursing, advanced
nursing, and evidence-based practice. This course was essential to my development and
acquiring critical inquiry skills. I also learned how to apply several nursing theories to general
nursing practice and evidence-based care in different fields. I highlighted and applied the
4
systems theory to nursing practice during this course. The systems theory attempts to explain the
relationship between an individual and stress and the interaction between organisms in their
environments. The theory posits that the human being has five essential variables, including the
psychological, sociocultural, psychosocial, spiritual, and developmental variables. It also
discusses the defence mechanisms, including the outer and inner layers of protection. The theory
applies to nursing practice and evidence-based care because it asserts that nursing seeks to ensure
the client is stable by reducing stressors. I also related the application of the theory to future
nursing in care for patients with psychological and mental disorders.
The assignments and discussion in this course were instrumental to achieving program outcomes
1, 2, 4, and 5. In the first week, we discussed nursing theory and its importance to the nursing
profession. During the introductory discussion, we focused on its importance to nurse
practitioners and how theory informs their practice. In my discussion, I explained how nursing
theory could lead to change by asking questions such as how does the change affect me?
Therefore, the theory will be essential to adapt to different changes in the nursing practice. The
discussion was instrumental in fulfilling program outcomes 1, 2, and 4, MSN Essentials, I, II,
and IV, and NONPF core competencies 1 and 9. In Week 6 discussion, I used a literary analysis
of a paper that concluded that nurse leaders in hospitals and other healthcare systems are calling
for the renewal to deal with critical socio-economic-political issues in today’s contemporary
praxis environment. The discussion helped me fulfil program outcomes 1,3 and 4, MSN
Essentials I, II, and VIII, and NONPF core competencies 1, 3, 5, and 7.
NR 503NP Population Health, Epidemiology, & Statistical Principles
The NR 503NP course introduces the learners to advanced practice competencies utilized by
advanced practice nurses, including the use of epidemiological and statistical principles to serve
5
as a basis for assessing, developing, and implementing evidence-based interventions for
populations. Additionally, the course focuses on utilizing epidemiology to identify, predict, and
intervene for risk factors impacting different populations. In the Week 2 discussion post to
discuss the epidemiological methods, the learners were required to achieve the course outcome 4
of discriminating among various screening tools applicable in the provision of advanced care as
an advanced practice nurse. Therefore, I chose to discuss the HIV rapid testing, which is the
most commonly used screening tool in outpatient and inpatient settings. I recommended that the
rapid testing kits be incorporated into care for patients suspected to have been infected with the
virus. My recommendation was consistent with various research studies due to the advantages,
including low costs, easily accessible, and did not necessarily require risk-reduction counseling.
Week 2 assignment required that the students identify appropriate outcome measures and study
designs applicable to epidemiological sub-fields, including chronic disease, infectious disease,
reproductive health, environmental exposure, and genetics, and identify sources of
epidemiological data. In Week 5, I selected Hepatitis B from the provided infectious diseases
list. I identified, defined, and synthesized the determinants of health, epidemiological triad, and
nurse practitioner role in disease management according to the Healthy People 2020 initiative.
Nurse practitioners play a significant role in diagnosing and managing HBV through physical
examinations, interpreting diagnoses, conducting patient education and counseling, and
prescribing medications according to practice guidelines. Additionally, they work closely with
patients and their families in reinforcing behavior change. Learning about chronic health,
infectious diseases, and the Healthy People 2020 initiative was instrumental to fulfilling program
outcomes 1, 2, 3, 5, and 6; NONPF core competencies 1, 2, 3, 7, and 9; and MSN Essentials I, II,
IV, and VIII.
6
NR 505NP Advanced Research Methods: Evidence-Based Practice
The NR 505NP course provided the learners with the integration of evidence-based practice with research
to foster holistic and scholarship, person-centered care in diverse healthcare settings. The course presents
the students with content related to research methodologies, problem identification, critique findings or
literature, and application to evidence-based practices. Additionally, they are required to provide an
opportunity to practice learning and principles through the development of an evidence-based project
focusing on quality improvement. The assignments highlighted in this course in the artifacts section
include evidence-based practice, quality improvement and research methodologies (Week 1), quantitative
research article appraisal (Week 5), and research article critique (Week 6).
Week 1 aimed at enhancing the students’ understanding of an evidence-based practice compared to
quality improvement and research methodologies, including quantitative and qualitative methods. The
qualitative research critique was essential to developing my critique skills in research as a master’s-
prepared family nurse practitioner. I selected an article discussing the factors that enable good end-of-life
care for people with dementia to achieve Program Outcomes 1 and 5, MSN Essentials I, III, IV, and VII,
and NONPF core competencies 1, 2, 7, and 9. The Week 6 research article critique aimed at providing the
learners an opportunity to practice reading and critiquing research articles for application to evidence-
based practice. Therefore, the students were required to write three separate critiques and complete the
John Hopkins Research Appraisal tool for qualitative, non-research, or quantitative evidence. I
successfully completed this assignment when developing my PICOT question, which was essential to
meeting program outcomes 1 and 2; NONPF core competencies 1, 2, 5, 7, and 9; and MSN essentials I,
III, IV, and VII.
NR 506NP Healthcare Policy
The NR 506NP course tasked the students to explore healthcare policy and its impacts on nursing
practice, consumers, and systems from the institutional to the global sphere. Using their roles as
advocates, the students were required to propose healthcare policies reflecting person-centered care and
population health needs. Therefore, I used to research and other online materials to analyze the impacts of
7
healthcare policies within ethical, social, and legal contexts. The course was instrumental in achieving
program outcomes 1, 3, and 4. The highlighted assignments and discussions include nursing support
smoking cessation, Quality Healthcare: Measuring NP Performance, Kaltura Health Policy Analysis, and
the discussion on the Scope of Practice and Patient’s Healthcare Accessibility.
The discussion was aimed at identifying the scope of practice in my state, including the level of
independence of practice, prescribing authority, any limitations to practice, the process of obtaining
licensure, certification, and the education requirements for licensure. My discussion was based in
Alabama State. The assignment was instrumental in learning about different aspects of practice in my
state, including collaborative agreements with physicians for prescribing authority, limitations of practice,
and authorities involved in practice within the state. The assignment helped me achieve program
outcomes 1, 3, and 6; NONPF core competencies 5 and 6; and MSN Essentials I, II, and IV.
Week 4 assignment to develop a healthcare policy analysis presentation was essential in the development
of policies. The assignment was instrumental in understanding the roles of different stakeholders in the
policy development process. Additionally, it helped me improve my research into the backgrounds of
different phenomena and use this knowledge to formulate state and national person-centered
recommendations. The assignment was essential to meeting program outcomes 1, 3, and 4; MSN
essentials I, III, IV, VII, and IX; and NOPF core competencies 1, 3, 4, 7, and 9. Finally, the Quality
Healthcare: Measuring NP Performance assignment in Week 3 focused on familiarizing the learner with
measurement tools of nursing practice. The assignment helped me meet program outcomes 1, 3, and 4;
MSN essentials I, III, IV, VII, and IX; and NOPF core competencies 1, 3, 4, 7, and 9.
NR 507NP Advanced Pathophysiology
The NR 507NP focused on providing the learners with advanced content in pathophysiology and human
psychologic responses across the lifespan. The students were required to explore, analyze, apply, and
evaluate the normal and abnormal human responses to selected pathophysiologic mechanisms and
conditions during the course. Therefore, I highlighted a series of assignments, including Disease Process
Presentation Assignment Part 1 (Week 2), Disease Process Presentation Assignment Part 2 (Week 5), and
8
Disease Process Presentation Part 3 (Week 7). The assignments were essential to achieving program
outcome 1.
In the presentations, I discussed Parkinson’s disease, a CNS disorder affecting movement, including
tremors among older populations, especially after reaching age 60 and above. Most patients with
Parkinson’s disease live between 10 and 20 years after diagnosis. This assignment taught me about
several risk factors, including patient’s age, gender, heredity factors, and exposure to toxins. Additionally,
I learned about the progression of the disease from stage 1 to 5, which is the most advanced and
debilitating state. The assignments helped me accomplish program outcome 1; MSN essentials I, III, IV,
VII, and IX; and NOPF core competencies 1, 3, 4, and 8.
NR 509NP Advanced Physical Assessment (C/CR/RM) – JUL19
The course develops the knowledge of health assessment principles specific to the advanced practice
nurse’s role. The learners were required to develop assessment techniques related to physical exams and
history assessments of different patients across the lifespan, including mental and psychiatric health and
related supportive assessments. In addition to the hours of lab practice of physical assessment skills, the
course also assisted me in evaluating different assessment tools and techniques as they are applicable to
different patient settings.
The assignments selected from the artifacts in this course include health history assessments and
completing the provided soap notes. I completed assessments of two different patients in the soap notes.
The first patient complained of coughing a lot. According to the assessment, the patient was diagnosed
with acute nasopharyngitis as the primary diagnosis, allergic rhinitis, and viral rhinosinusitis as the
secondary diagnosis. I learned the treatment plan, referral, and education for the client. In the other soap
note, the client reported chest pains and was tested according to her subjective history and objective
observations. Consequently, the differential diagnosis included congestive heart failure (primary
diagnosis), chest pain, and coronary artery stenosis (secondary diagnosis). Week 1 assignment was
instrumental to understanding different sections of the patient assessment, from collecting biodata, the
chief complaint, collecting histories, review of systems, health history questions, and normal and
9
abnormal findings of health history special populations. The assignments collectively helped me fulfill
program outcomes 1 and 2; MSN Essentials I, III, IV, VI, and IX; and NONPF core competencies 1, 3, 4,
and 8.
NR 511NP Differential Diagnosis and Primary Care Practicum
NR 511NP aimed at providing the students with the required knowledge to formulate a differential
diagnosis for patients within the primary care settings. It also introduced the learners to critical diagnostic
skills to cultivate evidence-based behaviors while emphasizing processing client information in a
progressive, logical way and formulating differential diagnoses for clients across the lifespan. The
selected assignment for this artifact section includes the SNAPPS written assignment, Week 6 clinical
case study part two, and reflection. The clinical case study was a follow-up to the first part. It tasked the
learners to identify their primary diagnosis, including its ICD-10 code, provided a treatment plan,
medication, patient education, additional testing, and referral, and provided an active problem list for the
patient based on the information available on the case. I worked on hyperthyroidism (ICD-10 E03.9) in
the first part of the assignment and prescribed levothyroxine 12.5 to 25 mg orally once daily as the first-
line treatment for the client. The assignment helped me achieve program outcomes 1, 2, and 4 and MSN
Essentials II, III, and IV.
The SNAPPS written assignment presented a learner-centered approach to case presentation in the
clinical setting to assist the learner in taking an active role in their educational encounter through an in-
depth analysis of the patient’s treatment plans. Using the screening, narrowing the differential diagnosis,
analyzing the differential diagnosis, probing the preceptor through questioning, planning for the patient’s
medical issues, and selecting a case-related issue for self-directed learning was essential to improving my
diagnostic skills. Completing this assignment helped me achieve program outcomes 1, 2, and 4, NONPF
core competencies 1, 3, 6, and 7, and MSN Essentials I, IV, VII, and IX. Finally, the reflection was
instrumental in identifying gaps in practice experience, progression in clinical practice, areas of weakness,
and the NONPF competencies.
NR 565NP Advanced Pharmacology Fundamentals
10
The NR 565NP course enabled the students to focus on mastering pharmacokinetics, pharmacogenomics,
and pharmacodynamics alongside the fundamental pharmacology and therapeutics used in the treatment
of selected health conditions that advanced nurse practitioners encounter in the primary care setting. The
course emphasized the decision-making process used to effectively and safely prescribe and monitor
pharmacotherapeutics when treating patients with chronic and acute diseases. The course helped me
achieve program outcomes 1, 2, 4, and 5. The artifacts selected in this course include State specific
guidelines and recommendations for prescribing controlled substances, pharmacokinetics (Week 1), and
the course reflection.
The week one assignment allowed the learners to discuss the impact of human genetic variations on
pharmacodynamics and pharmacokinetics of drugs and the implications in clinical settings. The
assignment helped me understand various prescription concepts, especially drug and human body
interactions. The second assignment is about the guidelines and recommendations in Alabama state
prescription requirements governed under the Alabama Legislative Act 2013-223, and the Prescription
Drug Monitoring Program (PDMP) authorized under the Code of Alabama, 1975, § 20-2-210. Finally, the
Week 8 reflection focused on how the course has been instrumental in achieving different course
outcomes and MSN Essentials. The course has improved my passion for advocacy for positive patient
outcomes through compassionate, collaborative, evidence-based, and advanced nursing practice. I have
also demonstrated that I have learned how to apply research on improving patient-specific, client- and
provider-centered care outcomes.
NR 566NP Advanced Pharmacology for Care of the Family
The course aimed at building the student’s expanded knowledge of pharmacology and its principles
across the lifespan of their patients. The learners were expected to apply foundational principles from
previous courses. Additionally, specific client issues were addressed, including the effects of ethnicity,
culture, age, gender, pregnancy, and funding on pharmacologic management. Moreover, ethical and legal
considerations were discussed as they related to pharmacotherapeutic approaches in care and treatment.
after completing the previous course (NR 565) on advanced pharmacology, the current course was
11
necessary to improve my knowledge and skills in applying the previously learned concepts of
pharmacodynamics, pharmacokinetics, and pharmacogenomics. Completing the course helped me
accomplish program outcomes 1, 3, and 5; MSN essentials I, III, IV, VII, and IX; and NOPF core
competencies 1, 3, 4, and 8.
The immunization assignment is the human papillomavirus (HPV) vaccine Gardasil, which is an
inactivated, non-infectious recombinant vaccine. I discussed contraindications, precautions, adverse drug
reactions, the minimum age to receive the vaccine, the routinely recommended vaccine schedule, and
special situations. I also discussed the rotavirus vaccine (RotaTeq (CDC, 2018a) along with the same
subtopics. The second assignment was aimed at providing the students with the opportunity to compare
and contrast the ACC/AHA and JNC8 guidelines for hypertension. The assignment helped me establish
the ACC/AHA and JNC 8 treatment goals, accomplish MSN Essentials I, VI, and VIII, and program
outcomes 3, 4, and 5. Week 5 and 8.
NR 599NP Nursing Informatics for Advanced Practice
The NR 599NP course provided the learners with introductory and fundamental knowledge about
informatics with an emphasis on developing and understanding nursing informatics concepts. The
selected assignments for the course in the artifacts sections include EHRs Benefits and Drawbacks (Week
3), Clinical Decision Support Systems (Week 5), and Post TANIC Self-Assessment and Reflection Post
(Week 7) discussions. The Week 3 assignment required the students to use the ideas and beliefs
underpinning the use of electronic health records. Working on the benefits and drawbacks, pros and cons
of the clinical decision support system, and responding to other classmates’ discussion posts helped me
achieve program outcomes 1, 3, and 5, MSN essentials I, III, IV, VII, and IX; and NOPF core
competencies 1, 3, 4, 7, and 9.
On the other hand, the post-TANIC self-assessment followed the self-assessment using the TIGER-based
Assessment of Nursing Informatics Competencies (TANIC) tool. The TIGER (Technology Informatics
Guiding Education Reform Initiative) helped me identify the minimum informatics competencies for
students and nurses graduating from the program. Therefore, completing the TANIC self-assessment
12
helped me understand the competencies in nursing informatics essential in planning strategies to enhance
knowledge and skills. After completing the self-assessment, I felt strongly about the information I
provided in the first assessment. I will continue to perform this by completing critical reviews of HIT and
the benefits, including; safety, cost-effectiveness, and improved patient outcomes as a result of EHRs. I
believe that as a result, I will develop personally as well as professionally. As previously stated, this can
be achieved using several different methods.
NR 601NP Primary Care of the Maturing and Aged Family
The course is based on prior knowledge and accomplishments in other courses about health assessment
principles specific to the role of the family nurse practitioner. It focuses on the common health care
needed and the problems of middle-aged and older adults and their families. During this course, the
learners explored, analyzed, applied, and evaluated various chronic health conditions frequently
encountered in the primary care settings for older adults. The clinical practicum experience in a precepted
primary care setting in this course will help the learners to manage referrals and client follow-up. The
selected artifacts include Psychiatric Disorders and Screening (Week 3), Post-Menopausal and Sexuality
Issues in the Maturing and Older Adult (Week 6), and Discussion Board – Polypharmacy (Week 1). The
course helped me achieve program outcomes 1, 3, 4, and 5; MSN essentials I, III, IV, VII, and IX; and
NOPF core competencies 1, 3, 4, 7, and 9.
The polypharmacy discussion aimed at discussing a deeper understanding of polypharmacy by
summarizing different definitions, discussing risk factors, and explaining the action steps for
polypharmacy prevention. In the week 3 discussion, we applied depression and anxiety screening tools to
a selected case-patient, and I used the PHQ-9 -Depression and GAD-7 -Anxiety assessment tools. In week
post-menopausal and sexuality issues in the maturing and older adult discussion, we discussed sexuality
issues in the maturing and older adults and their relationship to post-menopause. After viewing the
NAMS video, I encountered a challenging situation I had not considered when interviewing older women.
I also encountered the genitourinary syndrome of menopause (GSM) related to menopause. Therefore, my
interviewing skills have significantly improved when assessing older populations.
13
NR 602NP Primary Care of the Childbearing & Childrearing Family Practicum
The NR 602NP course is a continuation of the knowledge of health assessment principles required for the
role of a family nurse practitioner. The course focuses on the healthcare needs of women and families
throughout the childbearing and reproductive years. During the course, learners improved their skills
related to disease prevention, health promotion, management of health problems typical in different
communities, and diagnosis of different conditions across the lifespan of these women. The care strategies
discussed in the course include protocol development, patient education, client follow-up, and referral
processes through a clinical practicum experience in a precepted primary care setting.
The course outcomes for this class included integrating current evidence-based clinical practice guidelines
in the care, assessing growth and development milestones, applying appropriate anticipatory guidance and
health promotion in caring for childbearing families, and identifying and addressing the healthcare needs
of marginalized childbearing families, and constructing evidence-based reproductive health management
plans. The artifacts selected for this course include Immunization Case Study Assignment (Week 3),
Pediatric Clinical Pearl Case Study Assignment (Week 4), and Marginalized Women and Childbearing
Families (Week 8). The week 3 assignment required the learners to familiarize themselves with current
guidelines and recommendations for vaccine-preventable diseases in the United States. The Week 4
assignment guided the learners in identifying behaviors and interactions commonly occurring during the
health history part of a well-child exam. Finally, Week 8 assignment allowed the learners to explore the
concept of marginalization and its impacts on healthcare for the population under consideration. Through
the assignments and discussion, I accomplished program outcomes 1, 3, 4, and 5; NONPF core
competencies 1, 2, 5, 7, and 9; and MSN essentials I, III, IV, and VII.
NR 603 Advanced Clinical Diagnosis and Practice across the Lifespan
The NR 603NP course is the second last course I took in the Master’s program. The course continually
expanded the practical and theoretical knowledge, and diagnostic principles learned in previous courses.
The current course generally focused on the healthcare needs of all populations across their lifespan. The
learners were tasked with developing their skills related to disease prevention, health promotion,
14
diagnosis, and disease management in chronic and acute conditions, such as behavioral health. The care
strategies addressed in this course include protocol development, patient education, patient referral, and
follow-up in the community setting through the practicum experience. The course was essential to
meeting program outcomes 1, 2, 4, and 5; NONPF core competencies 1, 2, 5, 7, and 9; and MSN
essentials I, III, IV, and VII.
The artifacts selected for this assignment include Compare and Contrast Assignment (Week 1), Case
Discussion Pulmonary (Week 2), and Case Discussion: Cardiovascular (Week 3). The assignments and
discussions helped develop my understanding of different concepts applicable to the family nurse
practitioner role. In week 1, I improved my knowledge and understanding of disease processes in
neurology and integrated the knowledge and skills in primary care settings. The course also helped me
evaluate my research skills in analyzing literature. In Week 2 case study part 1, I developed a differential
diagnosis, including a primary diagnosis (severe persistent asthma) and secondary diagnosis (occupational
exposure to allergens) and their ICD-10 codes. I addressed the patient’s treatment plan and the education
involved in the patient’s request for an antibiotic through patient education.
NR 667 FNP Capstone Practicum & Intensive
The NR667NP course is the last course I handled in the Master’s program. The course required
the learners to synthesize all the clinical management skills and knowledge while analyzing,
applying, and evaluating diverse aspects of patient assessment and healthcare interventions. The
topics discussed in the course include case studies, clinical management skills, practice critiques,
and chart reviews. At the end of the class, the learners were expected to be ready and prepared to
enter into clinical practice and provide primary care to different patient populations across their
lifespan after passing the national certification and other state-specific requirements for the
family nurse practitioner. The course was essential to achieving all the program outcomes, MSN
Essentials, and NONPF core competencies.
15
The artifacts selected from this course include the certification plan, grand rounds, and Week 1
discussion. The discussion helped me analyze, synthesize, and evaluate different factors
influencing contemporary advanced practice nursing and the transmission period occurring
within the first year of clinical practice. I developed my goals according to my strengths and
weaknesses in the certification review plan to prepare for different exams. Finally, the grand
rounds presentation assignment helped me improve my knowledge about depression and
developed an algorithm for care, treatment, expected patient outcomes, and follow-up care.
