Mikki Meadows-Oliver

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This chapter explores the case of Five-year-old Lamont, who is presented to the primary care office with his father, Allen, with a complaint of a toothache. Allen gave Lamont an over-the-counter pain reliever to help with the pain. The pain reliever helped, and Lamont went back to sleep. However, when Lamont awakened this morning, he was again complaining of a toothache, and Allen decided to bring him in for a visit. The chapter provides essential guidance and information for understanding how to diagnose and manage this case. This includes differential diagnosis and a series of critical thinking questions ideal for the family nurse practitioner.

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There is a clear and growing need to be able record and track the contributions of individual registered nurses (RNs) to patient care and patient care outcomes in the US and also understand the state of the nursing workforce. The National Academies of Sciences, Engineering, and Medicine report, The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity (2021), identified the need to track nurses’ collective and individual contributions to patient care outcomes. This capability depends upon the adoption of a unique nurse identifier and its implementation within electronic health records. Additionally, there is a need to understand the nature and characteristics of the overall nursing workforce including supply and demand, turnover, attrition, credentialing, and geographic areas of practice. This need for data to support workforce studies and planning is dependent upon comprehensive databases describing the nursing workforce, with unique nurse identification to support linkage across data sources. There are two existing national nurse identifiers– the National Provider Identifier and the National Council of State Boards of Nursing Identifier. This article provides an overview of these two national nurse identifiers; reviews three databases that are not nurse specific to understand lessons learned in the development of those databases; and discusses the ethical, legal, social, diversity, equity, and inclusion implications of a unique nurse identifier.

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Discussion of culture is complex and, within a mental health context, may prove to be complicated and controversial. This chapter defines culture, acculturation, and marginalization, explores cultural factors that advanced practice registered nurses (APRNs) must understand. It addresses the complex needs of immigrant, refugee, displaced, and culturally vulnerable youth living in challenging in country environments or who are crossing numerous global geographic boundaries. Cultural factors have an impact on the mental/behavioral health of immigrant and refugee children and the children of immigrant parents. The chapter also includes practice, education, and research implications along with recommendations for APRNs working with immigrant, refugee, displaced, and culturally vulnerable populations, and concludes with a case exemplar to illustrate key considerations.

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Pediatric bipolar, now more commonly referred to as disruptive mood dysregulation disorder (DMDD), is estimated to impact between 0.8% and 4.3% of youth. This chapter describes the symptoms, etiology, and management of mood dysregulation in children and adolescents with a focus on depression, DMDD, persistent depressive disorder, and persistent mood disorder. Additionally, the NIMH researched severe mood dysregulation disorder descriptors are presented. Associated risk factors, screening and assessment tools for use in primary care, evidence-based management strategies, roles for the advanced practice registered nurse (APRN), consequences of untreated mood dysregulation disorders, and implications for conducting and using nursing research in practice with this population are also presented. The chapter differentiates between the roles and responsibilities of primary care practitioners and child and adolescent psychiatric-mental health APRNs in managing the range of mood dysregulation disorders in children and adolescents.

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Among the many lessons that have been reinforced by the SARS-COVID-19 pandemic is the failure of our current fee-for-service health care system to either adequately respond to patient needs or offer financial sustainability. This has enhanced bipartisan interest in moving forward with value-based payment reforms. Nurses have a rich history of innovative care models that speak to their potential centrality in delivery system reforms. However, deficits in terms of educational preparation, and in some cases resistance, to considering cost alongside quality, has hindered the profession’s contribution to the conversation about value-based payments and their implications for system change. Addressing this deficit will allow nurses to more fully engage in redesigning health care to better serve the physical, emotional, and economic well-being of this nation. It also has the potential to unleash nurses from the tethers of a fee-for-service system where they have been relegated to a labor cost and firmly locate nurses in a value-generating role. Nurse administrators and educators bear the responsibility for preparing nurses for this next chapter of nursing