Tonya Coates

Welcome

Hello. Welcome to my portfolio. Please allow me to introduce myself. My name is Tonya Coates. I am a Family Nurse Practitioner board certified with AANPCB, and licensed in Utah as an APRN with a current controlled substance license. I have over 12 years of nursing experience as a registered nurse in the clinical environments of both hospital and home. My experience includes women and children’s services, adult care, surgical services, home health and hospice, nursing education, and nurse management. I received my Bachelor of Science in Nursing from Weber State University in 2016 and earned my Master of Science in Nursing-Family Nurse Practitioner from Weber State University in April 2020. I am currently employed by Intermountain Healthcare, Home Health and Hospice as a Nurse Educator and a field nurse. Thank you for taking the time to learn more about me.

Welcome: About

About

Tonya Coates MSN, APRN, NP-C

Family Nurse Practitioner

Phone:

435-691-1746

email:

lyntonya63@gmail.com

Address:

729 N. Claymill Cutoff Rd.

P.O. Box 233

Aurora, Utah 84620

Philosophy

Nurse Practitioner

Philosophy of Care

Partnership

The nurse practitioner is a partner in health. As the professional in the partnership, it is the practitioner’s responsibility to guide treatment, but the patient is in charge of where the guide will take them. The practitioner must incorporate the patient’s desires, concerns, situation, and plans when setting the course. In short, the goal of the partnership is the best possible health for the patient. This cannot be fulfilled to its best potential if the patient is not vested in achieving the goal. Ralph Waldo Emerson said, “The only person you are destined to become is the person you decide to be.” As a Nurse Practitioner, it is my duty to help my patients determine who they want to become as far as health is concerned and help guide them to that goal. We must both look at multiple factors, not just the numbers from the diagnostic tools, to decide where we want to take the patient. Realistic goals must be set that the patient is completely sold on.

Education

A good nurse practitioner must take continuing education and training seriously. Medicine is constantly changing; requiring the NP to be prepared with either the knowledge of current practices, or the ability to find and develop that knowledge when they face a rare situation.
The nurse practitioner is a fully trained primary care provider prepared to meet the patient’s health needs. Because the nurse practitioner role evolved from the nurse, I see my role as being more patient-centered than disease-centered. The NP works with the patient, their family, and other providers to achieve the best health outcomes for all their patients. We must be the primary care providers who look at the patient’s whole picture and can bring those barriers and assets to bear on the health plan. We will collaborate with specialists with focused experience when a patient has needs beyond our training. We must be skilled and knowledgeable so that best practices can be implemented appropriately for each individual and their circumstances.

Shared Decision Making and Autonomy

All parties in the medical field place significant value in life, happiness and dignity. However, I feel the best NP will also respect the individual’s autonomy. When we look at a patient as the person who must decide for themselves what they can do about their health, I truly believe we stand a greater chance at affecting positive change in health. The NP must determine barriers to health, encourage the patient to see better health as something attainable, understand patient’s limits in what they are willing to do, and set goals for better health that the patient can achieve. No matter how important it is for a patient to give up a bad habit, or start a new one, if they don’t see change as realistic they are less likely to try. I can instruct them to change as much as I want, but the behavior will not change until they see it is possible. When I seek to understand why they do not see it as realistic, then help them set short term goals that make my long-term goal attainable, the patient may celebrate small victories that encourage the greater win. It all comes back to me being a partner with my patients rather than their boss and ultimately respecting the patient’s autonomy.

Curriculum Vitae

Career Objectives

My career objective as a Nurse Practitioner is to continue to be involved in direct patient care by providing advanced clinical care to adults and children throughout the lifespan. I am excited to use my 12 years of nursing experience combined with my Nurse Practitioner degree to expand my professional development as a primary care provider who assesses my patient holistically, evaluates data from their tests, then works with them to develop meaningful care plans that my patients can commit to.

Short term Goals

Secure a position as a primary care provider among colleagues who are committed to effective and meaningful care.
Find and designate a mentor who can support and advise my development in my new career.
Build confidence and become independent in practice.

Five-Year Trajectory

Obtain experience in a specialty area, such as hospice and/or palliative care, cardiology, oncology, etc.
Further my professional development by acquiring an advance practice certification.
Maintain clinical practice as an advanced care clinical practitioner for adults and children with focused experience.

Long-Term Goals

Maintain licensure as a Family Nurse Practitioner.
Maintain professional certification.
Serve as a mentor for a new family nurse practitioner.
Continue to grow and develop as a primary care provider by increasing my learning experiences through educational opportunities.

NP Competencies

Nurse Practitioner Competencies

Scientific Foundations

The nurse practitioner does the following to ensure care is founded on scientific and evidence-based practices:

Critically analyzes data and evidence for improving advanced nursing practice.
Integrates knowledge from the humanities and sciences within the context of nursing science.
Translates research and other forms of knowledge to improve practice processes and outcomes.
Develops new practice approaches based on the integration of research, theory, and practice knowledge.

(The National Organization of Nurse Practitioner Faculties, 2017).

My Master’s Project involved several hours of research discovering the benefits of making an early referral to palliative care and the possible reasons why providers are hesitant to make referrals. Once the benefits were realized, I developed a plan that could be used to introduce a palliative care program to rural providers that explains the benefits while addressing concerns they may have in making such referrals.

Practice Inquiry

Practice inquiry uses clinical practice to generate knowledge that improves patient outcomes. It applies clinical investigative skills to improve health. It leads one to evaluate and disseminate evidence to diverse audiences with multiple modalities and analyze clinical guidelines to be applied individually in practice. (The National Organization of Nurse Practitioner Faculties, 2017).

Every interaction with a patient provides an opportunity to learn. With each encounter, I have found I add to my knowledge base. This is where experience contributes to knowledge. I look forward to expanding my nursing experience as a Nurse Practitioner and building the knowledge base that allows me to provide safe, effective, and quality care to my patients.

Health Delivery Systems

The nurse practitioner applies knowledge of organizational practices and complex systems to affect change and minimize risk to patients and providers at both the individual and system level by using broad-based skills of negotiating, consensus-building, and partnering. He/she collaborates in planning for transitions across the continuum of care by addressing the needs of culturally diverse populations and evaluating the impact of health care delivery on patients, providers, stakeholders, and the immediate environment within the organizational structure by assessing and utilizing resources available to improve the delivery of care

(The National Organization of Nurse Practitioner Faculties, 2017).

Competence in multiple healthcare delivery systems is integral to the success of the nurse practitioner. I look forward to working and collaborating with multiple providers in different specialties to provide individualized care to each of my patients that integrate their goals into the plan of care. By collaborating with multiple providers as well as with the patient and their caregiver, we can assure a plan of care that is patient-centered and has a greater chance of successful outcomes.

Leadership

Nurse practitioners demonstrate leadership by using clear written and oral skills combined with reflective and critical thinking to initiate and guide change for improved access to high quality, cost-effective health care. We assume complex roles to cultivate collaboration with multiple stakeholders and professional organizations to advocate for the incorporation of innovative ideas and principles of change to advance nursing practice and health outcomes for populations (The National Organization of Nurse Practitioner Faculties, 2017).

As a member of the educational team for home health and hospice, my years of experience in home care have provided me the opportunity to train, mentor and guide new employees as they take on new roles and develop and hone their skills to benefit patients. I use effective communication skills to develop critical thinking skills in caregivers to bring about effective and high-quality care of patients in their homes.

Technology and Information Literacy

The NP uses electronic resources and datasets to enhance patient safety by identifying current evidence-based care, capture data from different care variables, communicate with other professionals and patients, support differentials, review medical records, evaluate practice and improve quality, cost and efficiency of care. (The National Organization of Nurse Practitioner Faculties, 2017).

We are truly living in a technological age. Though there are many responsibilities we must attend to in keeping patient information safe, the use of technology will allow the Nurse Practitioner unprecedented access to information, data, other providers, and patients. Additionally, it provides direct access of patients to their provider and their records. The nurse practitioner who takes advantage of what technology has to offer is poised to provide the most current, informed care possible.

Ethics

The nurse practitioner integrates ethical principles into decision making and evaluates the ethical consequences of his/her decisions. The NP applies ethically sound solutions to complex issues related to individuals, populations, and systems of care. The NP relies on multiple sources for facilitating ethical decision making including

theories of ethical decision making
ethics committees
genetic counseling
clinical research
legal statutes
cultural sensitivity
scope of practice

(The National Organization of Nurse Practitioner Faculties, 2017).

Ethical dilemmas are often confronted by healthcare professionals. As a provider, I am committed to evaluating each difficult circumstance that presents itself to me using the ethical principles and the tools listed above to help my patients, and myself negotiate difficult medical decision-making issues.

Quality

The Nurse Practitioner uses the best available evidence to continuously improve the quality of clinical practice. The NP evaluates the relationships among access, cost, quality, and safety and their influence on health care; how organizational structure, care processes, financing, marketing, and policy decisions impact the quality of health care; then the NP applies skills in peer review to promote a culture of excellence and anticipates variations in practice and is proactive in implementing interventions to ensure quality.

The National Organization of Nurse Practitioner Faculties, 2017).

My research for my master's project revealed that early intervention with palliative care resulted in improved quality of life, better communication with caregivers, more shared decision making, longer life expectancy, and lower overall healthcare costs. This led me to design a presentation to providers that would encourage them to make earlier referrals to palliative care for their patients who are suffering from chronic illness with heavy symptom burden.

Policy

Nurse practitioners demonstrate an understanding of the interdependence of policy and practice. To that end, they analyze the ethical, legal and social factors that influence policy; then advocate for and contribute to the development of policies that promote access, equality, and quality at a reasonable cost.

(The National Organization of Nurse Practitioner Faculties, 2017).

With a Bachelor's degree majoring in political science, I have a passion for policy, how it is developed, made and the effect it has on the citizenry. Healthcare policy is, therefore, a particular passion for me. I look forward to opportunities to become active in the political arena in the promotion of quality, cost-effective, evidence-based healthcare that is accessible across all cultural, geographic, social, and economic groups.

Independent Practice

The Nurse Practioner functions as an independent practitioner and must demonstrate the highest level of accountability for professional practice. The NP uses the full spectrum of health care from health promotion to end-of-life care to address the needs of all types of patients. The NP employs advanced health assessment, screening, and diagnostic skills to differentiate between normal, variations of normal and abnormal findings, then manage the healthcare needs of his/her patients (The National Organization of Nurse Practitioner Faculties, 2017).

My training as a registered nurse has given me multiple opportunities to assess patients, review their history, anticipate problems and monitor for them, and carry out treatments as ordered by providers. In my new role as a nurse practitioner, I look forward to continuing to apply my nursing skills but now at an advanced level whereby evaluation and treatment of health issues will become my responsibility. It is an exciting time.

Reference

The National Organization of Nurse Practitioner Faculties (NONPF). (2017). Nurse practitioner core competencies content: A delineation of suggested content specific to the NP core competencies. Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/competencies/2017_NPCoreComps_with_Curric.pdf

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