Reflect on your decision to pursue a specialty within the MSN or PMC program, including your professional and academic goals as they relate to your program/specialization/certification.
Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member.
Your post should be at least 1000 words, formatted and cited in current APA style with support from at least 2 academic sources.
Rubric
Main Posting
50to >44.0 ptsExcellentAnswers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. … Supported by at least three current, credible sources. … Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
This criterion is linked to a Learning OutcomeHistory of present illness (HPI) and Admitting Diagnosis
8 ptsProficientExplains 1) HPI and 2) admitting psychopathology in detail with clear and accurate and in-depth understanding. 3) The DSM 5 clearly and accurately supports the identified diagnosis and presenting signs/symptoms. 4) Evidence-based rationales clearly and accurately support the HPI.6 ptsAcceptableExplains 1) HPI and 2) admitting psychopathology in some detail with adequate understanding of chief complaint. 3) The DSM 5 adequately supports the identified diagnosis and presenting signs/symptoms. 4) Evidence-based rationales adequately support the HPI.
4 ptsNeeds ImprovementExplains 1) HPI and 2) admitting psychopathology in limited detail with limited understanding of chief complaint. 3) The DSM 5 mostly supports the identified diagnosis and presenting signs/symptoms. 4) Evidence-based rationales vaguely support the HPI or are not present.0 ptsUnsatisfactoryFails to explain 1) HPI or 2) admitting psychopathology with poor understanding of chief complaint. 3) The DSM 5 does not support the identified diagnosis and presenting signs/symptoms, or the diagnosis is incorrect. 4) Evidence-based rationales do not support the HPI or are not present.
8 pts
This criterion is linked to a Learning OutcomePathophysiology of past medical/social histories
4 ptsProficientIncludes 1) all past medical and social history detailed with 2) full explanation of pathophysiology for each diagnosis. 3) Thoroughly describes potential complications for each diagnosis. 4) Clearly and accurately relates pathology to the identified diagnostic criterion based on the clients history and presenting symptoms.3 ptsAcceptableIncludes 1) most past medical and social history detailed with 2) partial explanation of pathophysiology for each diagnosis. 3) Adequately describes potential complications for each diagnosis. 4) Adequately relates pathology to the identified diagnostic criterion based on the clients history and presenting symptoms.
2 ptsNeeds ImprovementIncludes 1) some past medical and social history detailed with 2) minimal explanation of pathophysiology for each diagnosis. 3) Vaguely describes potential complications for each diagnosis. 4) Vaguely relates pathology to the identified diagnostic criterion based on the clients history and presenting symptoms.0 ptsUnsatisfactoryNo 1) past medical or social history or given without 2) explanation or pathophysiology. 3) Does not describe potential complications for each diagnosis. 4) Does not relate pathology to the identified diagnostic criterion based on the clients history and presenting symptoms.
4 pts
This criterion is linked to a Learning OutcomeSocial Determinants of Health
4 ptsProficientClearly and accurately 1) describes socioeconomic and psychosocial background in detail 2) with evidence-based citations to support social determinants of health. 3) Identifies at least 3 or more psychosocial concerns with interventions/ recommendations.3 ptsAcceptableAdequately 1) describes socioeconomic and psychosocial background in detail 2) with evidence-based citations to support social determinants of health. 3) Identifies at least 2 psychosocial concerns with interventions/ recommendations.
2 ptsNeeds ImprovementVaguely 1) describes socioeconomic and psychosocial background in detail 2) with limited to no evidence-based citations to support social determinants of health. 3) Identifies at least 1 psychosocial concern with interventions/ recommendations.0 ptsUnsatisfactoryFails to 1) describe socioeconomic and psychosocial background 2) with limited to no evidence- based citations or social determinants of health. 3) Identifies no psychosocial concerns or interventions/ recommendations.
4 pts
This criterion is linked to a Learning OutcomeEriksons Developmental Stages
4 ptsProficient1) Identifies and 2) defines correct stage 3) with examples of meeting/not meeting tasks 4) supported by evidenced based citations.3 ptsAcceptable1) Identifies and 2) defines correct stage 3) with vague examples of meeting/not meeting tasks 4) supported by evidenced citations.
2 ptsNeeds Improvement1) Identifies correct stage 2) without adequate definition and 3) without examples of meeting or not meeting tasks. 4) No citations.0 ptsUnsatisfactory1) Identifies incorrect stage 2) without definition or 3) without examples of meeting/not meeting tasks 4) without citations.
4 pts
This criterion is linked to a Learning OutcomeSubstance Abuse, CAGE Questionnaire, and Movement Assessment
4 ptsProficientClearly and accurately 1) identifies all abused substances. 2) Completes patient interview for CAGE questionnaire. 3) Accurately codes involuntary movements based off client assessment.3 ptsAcceptableAdequately 1) identifies most abused substances. 2) Mostly completes patient interview for CAGE questionnaire. 3) Adequately codes involuntary movements based off client assessment.
2 ptsNeeds Improvement1) Identifies some abused substances. 2) Somewhat completes patient interview for CAGE questionnaire. 3) Adequately codes involuntary movements based off client assessment.0 ptsUnsatisfactoryFails to 1) identify abused substances. Does not 2) complete patient interview for CAGE questionnaire. Incorrectly 3) codes involuntary movements based off client assessment.
4 pts
This criterion is linked to a Learning OutcomeTeaching Assessment & Client Education
4 ptsProficientClearly and accurately 1) identifies areas of instructional needs, 2) learning preference, and 3) learning barriers. 4) Provides clear and concise client education related to their condition that will aid in health promotion, health maintenance and self-care activities. 5) Client education is supported by evidence-based practice.3 ptsAcceptableAdequately 1) identifies areas of instructional needs, 2) learning preference and 3) learning barriers. 4) Provides adequate client education related to their condition that aids in health promotion, health maintenance and self-care activities. 5) Client education is supported by evidence-based practice.
2 ptsNeeds ImprovementVaguely 1) identifies areas of instructional needs, 2) learning preference and 3) learning barriers. 4) Provides minimal and vague client education that will aid in health promotion, health maintenance and self-care activities. 5) Client education is supported by evidence-based practice.0 ptsUnsatisfactoryFails to 1) identify areas of instructional needs, 2) learning preference and 3) learning barriers. 4) Does not provide client education that will aid in health promotion, health maintenance and self-care activities. 5) Client education is not supported by evidence-based practice.
4 pts
This criterion is linked to a Learning OutcomeRisk Assessment
4 ptsProficientClearly and accurately 1) identifies all risk factors related to the clients history and presenting symptoms.3 ptsAcceptableAdequately 1) identifies all risk factors related to the clients history and presenting symptoms.
2 ptsNeeds ImprovementVaguely 1) identifies all risk factors related to the clients history and presenting symptoms.0 ptsUnsatisfactoryFails to 1) identify all risk factors related to the clients history and presenting symptoms.
4 pts
This criterion is linked to a Learning OutcomeDischarge Planning
4 ptsProficientClearly and accurately 1) identifies admission and current pertinent laboratory tests with applicable indications, 2) addresses abnormal values, and 3) recognizes trends related to a clients disease process 4) with evidence-based rationales.3 ptsAcceptableAdequately 1) identifies pertinent laboratory tests with applicable indications, 2) addresses abnormal values, and 3) recognizes trends related to a clients disease process 4) with evidence- based rationales.
2 ptsNeeds ImprovementVaguely 1) identifies pertinent laboratory tests with applicable indications, 2) addresses abnormal values, and 3) recognizes trends related to a clients disease process 4) with limited to evidence-based rationales.0 ptsUnsatisfactoryFails to 1) identify pertinent laboratory tests with applicable indications, 2) address abnormal values, or 3) recognize trends related to a clients disease process 5) with limited to no evidence-based rationales.
4 pts
This criterion is linked to a Learning OutcomeLabs
4 ptsProficientClearly and accurately 1) identifies admission and current pertinent laboratory tests with applicable indications, 2) addresses abnormal values, and 3) recognizes trends related to a clients disease process 4) with evidence-based rationales.3 ptsAcceptableAdequately 1) identifies pertinent laboratory tests with applicable indications, 2) addresses abnormal values, and 3) recognizes trends related to a clients disease process 4) with evidence- based rationales.
2 ptsNeeds ImprovementVaguely 1) identifies pertinent laboratory tests with applicable indications, 2) addresses abnormal values, and 3) recognizes trends related to a clients disease process 4) with limited to evidence-based rationales.0 ptsUnsatisfactoryFails to 1) identify pertinent laboratory tests with applicable indications, 2) address abnormal values, or 3) recognize trends related to a clients disease process 5) with limited to no evidence-based rationales.
4 pts
This criterion is linked to a Learning OutcomeDiagnostics/procedures
4 ptsProficientClearly and accurately 1) describes the clients diagnostic criteria and indications 2) with evidence- based rationales that clearly support the chief complaint and presenting signs/symptoms.3 ptsAcceptableAdequately 1) describes the clients diagnostic criteria and indications 2) with evidence-based rationales that adequately support the chief complaint and presenting signs/symptoms.
2 ptsNeeds ImprovementVaguely 1) describes the clients diagnostic criteria and indications 2) with limited to no rationales which vaguely support the identified chief complaint and presenting signs/symptoms.0 ptsUnsatisfactoryFails to 1) describe the clients diagnostic criteria and indications 2) with limited to no rationales and does not support the identified chief complaint and presenting signs/symptoms.
4 pts
This criterion is linked to a Learning OutcomeMedications
8 ptsProficientClearly and accurately 1) identifies all components of the medication list, including name, class, route, dose, frequency, mechanism of action, applicable indication(s), side and adverse effects, interactions, and nursing considerations relevant to the clients current health condition, 2) with evidence-based citations.6 ptsAcceptableAdequately 1) identifies some components of the medication list, including name, class, route, dose, frequency, mechanism of action, applicable indication(s), side and adverse effects, interactions, and nursing considerations relevant to the client, 2) with evidence-based citations.
4 ptsNeeds ImprovementVaguely 1) identifies few components of the medication list, including name, class, route, dose, frequency, mechanism of action, applicable indication(s), side and adverse effects, interactions, and nursing considerations relevant to the client, 2) with limited to no evidence-based citations.0 ptsUnsatisfactoryFails to 1) identify all components of the medication list, including name, class, route, dose, frequency, mechanism of action, applicable indication(s), side and adverse effects, interactions, and nursing considerations relevant to the client, 2) with limited to no evidence-based citations.
8 pts
This criterion is linked to a Learning OutcomeAssessment & Review of Systems
14 ptsProficient1) Documents thorough assessment that includes all components of the mental status examination as performed by the student. 2) Utilizes an organized format and appropriate terms to describe both normal and abnormal assessment findings.10 ptsAcceptable1) Documents thorough assessment that includes 75% of the relevant components of the mental status examination as performed by the student. 2) Utilizes an organized format and appropriate terms to describe both normal and abnormal assessment findings.
6 ptsNeeds Improvement1) Documents thorough assessment that includes 50-75% of the relevant components of the mental status examination as performed by the student. 2) Format may be moderately disorganized with mostly appropriate terms to describe both normal and abnormal assessment findings.2 ptsUnsatisfactory1) Documents thorough assessment that includes less than 50% of the relevant components of the mental status examination as performed by the student. 2) Format is mostly disorganized and may be lacking appropriate terms to describe both normal and abnormal assessment findings.
14 pts
This criterion is linked to a Learning OutcomeRecognition of cues (Assessment)
4 ptsProficient1) Identifies all imperative cues taken from the environment, patient assessment/observation, medical record, other resources, time pressures, task complexity, and cultural considerations. Minimum of 15 cues required.3 ptsAcceptable1) Identifies most imperative assessment cues. Some cues are relevant. cues taken from the environment, patient assessment/observation, medical record, other resources, time pressures, task complexity, and cultural considerations. Less than 15 cues.
2 ptsNeeds Improvement1) Identifies some assessment cues. Few cues are relevant. cues taken from the environment, patient assessment/observation, medical record, other resources, time pressures, task complexity, and cultural considerations. Less than 10 cues.0 ptsUnsatisfactory1) Fails to identify imperative assessment cues. Cues are not relevant. Less than 5 cues.
4 pts
This criterion is linked to a Learning OutcomeAnalysis of cues (Analysis)
6 ptsProficient1) Establishes 4 priorities of care based on the client’s health problems (i.e., environmental factors, risk assessment, urgency, signs/symptoms, diagnostic tests, lab values). 2) The clinical decision is clear, accurate, and presents correlation from the recognized cues. 3) Identifies the framework used to identify priority order (ABCs, Maslow, safety, acute v chronic, unstable v stable, urgent v non-urgent).4 ptsAcceptable1) Links and clusters recognized cues to the client’s clinical presentation. Adequately 2) establishes prioritized client needs based off the patients clinical presentation. Clearly and accurately clusters cues to establish probable patient needs, concerns, or problems.
2 ptsNeeds ImprovementDoes not 1) link and cluster recognized cues to the client’s clinical presentation. Vaguely 2) establishes prioritized client needs based off the patients clinical presentation. Clearly and accurately clusters cues to establish probable patient needs, concerns, or problems.0 ptsUnsatisfactoryFails to 1) analyze cues or does not support the prioritized client needs and plan of care. 2) Fails to link and cluster cues to a patients clinical presentation in establishing probable patient needs, concerns, or problems.
6 pts
This criterion is linked to a Learning OutcomePrioritization of hypotheses (Analyze)
4 ptsProficient1) Establishes 4 priorities of care based on the client’s health problems (i.e., environmental factors, risk assessment, urgency, signs/symptoms, diagnostic tests, lab values). 2) The clinical decision is clear, accurate, and presents correlation from the recognized cues. 3) Identifies the framework used to identify priority order (ABCs, Maslow, safety, acute v chronic, unstable v stable, urgent v non-urgent).3 ptsAcceptable1) Establishes 3 priorities of care based on the client’s health problems (i.e., environmental factors, risk assessment, urgency, signs/symptoms, diagnostic tests, lab values). 2) The clinical decision is mostly clear, accurate, and presents correlation from the recognized cues. 3) Identifies the framework used to identify priority order (ABCs, Maslow, safety, acute v chronic, unstable v stable, urgent v non-urgent).
2 ptsNeeds Improvement1) Establishes 2 or less priorities of care based on the client’s health problems (i.e., environmental factors, risk assessment, urgency, signs/symptoms, diagnostic tests, lab values). 2) The clinical decision is vague or incorrect, and presents little correlation from the recognized cues. 3) Identifies the framework used to identify priority order (ABCs, Maslow, safety, acute v chronic, unstable v stable, urgent v non-urgent).0 ptsUnsatisfactory1) Fails to establish priorities of care based on the client’s health problems (i.e., environmental factors, risk assessment, urgency, signs/symptoms, diagnostic tests, lab values). 2) Fails to identify clinical decisions with no correlation from the recognized cues. 3) Does not identify the framework used to identify priority order (ABCs, Maslow, safety, acute v chronic, unstable v stable, urgent v non-urgent).
4 pts
This criterion is linked to a Learning OutcomeGeneration of solutions (Planning)
8 ptsProficientClearly and accurately 1) establishes one expected outcome to address each hypothesis that can be achieved with nursing assistance to ensure a clients needs are met. Outcomes are specific, measurable, realistically attainable, and appropriately timed. 2) Identifies 4 solutions for each outcome supported by evidence-based practice. Clearly and accurately identifies at least 16 solutions that are independent nursing interventions supported by scientific rationale and evidence-based practice.6 ptsAcceptableAdequately and accurately 1) establishes one expected outcome to address each hypothesis that can be achieved with nursing assistance to ensure a clients needs are met. Outcomes are mostly specific, measurable, realistically attainable, and appropriately timed. 2) Identifies 3 solutions for each outcome supported by evidence-based practice. Clearly and accurately identifies at least 12 solutions that are independent nursing interventions supported by scientific rationale and evidence-based practice.
4 ptsNeeds ImprovementVaguely and accurately 1) establishes one expected outcome to address each hypothesis that can be achieved with nursing assistance to ensure a clients needs are met. Outcomes are somewhat specific, measurable, realistically attainable, and appropriately timed. 2) Identifies 2 solutions for each outcome supported by evidence-based practice. Clearly and accurately identifies at least 8 solutions that are independent nursing interventions supported by scientific rationale and evidence-based practice.0 ptsUnsatisfactoryFails to 1) establish one expected outcome to address each hypothesis that can be achieved with nursing assistance to ensure a clients needs are met. Outcomes are not specific, measurable, realistically attainable, and appropriately timed. 2) Identifies no solutions for each outcome supported by evidence-based practice. Clearly and accurately identifies at least 4 solutions that are independent nursing interventions supported by scientific rationale and evidence-based practice.
8 pts
This criterion is linked to a Learning OutcomeTake actions (Implementation)
4 ptsProficient1) Implements appropriate interventions in priority order based on nursing knowledge, priorities of care, and planned outcomes to promote, maintain, or restore a client’s health. 2) Nursing actions are always aimed at the expected outcomes and directed at the stated health deviation based on the nursing assessment and Eriksons stages of development.3 ptsAcceptable1) Implements adequate interventions in priority order based on nursing knowledge, priorities of care, and planned outcomes to promote, maintain, or restore a client’s health. 2) Nursing actions are aimed at the expected outcomes and directed at the stated health deviation based on the nursing assessment and Eriksons stages of development.
2 ptsNeeds Improvement1) Implements vague interventions that are not prioritized based on nursing knowledge, priorities of care, and planned outcomes to promote, maintain, or restore a client’s health. 2) Nursing actions are vaguely aimed at the expected outcomes and are directed at the stated health deviation based on the nursing assessment and Eriksons stages of development.0 ptsUnsatisfactoryDoes not 1) implement appropriate interventions in priority order based on nursing knowledge, priorities of care, and planned outcomes to promote, maintain, or restore a client’s health. 2) Nursing actions do not address expected outcomes and are not directed at the stated health deviation based on the nursing assessment and Eriksons stages of development.
4 pts
This criterion is linked to a Learning OutcomeEvaluate
4 ptsProficientClearly and accurately 1) identifies criteria for evaluation, effectiveness of interventions, and measurement of goal completion. 2) Evaluation is clearly and accurately linked to the generated solutions and overall plan of care. 3) Modifies, revises, and recommends alternative solutions with evidence-based citations as applicable.3 ptsAcceptableAdequately 1) identifies criteria for evaluation, effectiveness of interventions, and measurement of goal completion. 2) Evaluation is adequately linked to the generated solutions and overall plan of care. 3) Modifies, revises, and recommends alternative solutions with evidence-based citations as applicable.
2 ptsNeeds ImprovementVaguely 1) identifies criteria for evaluation, effectiveness of interventions, and measurement of goal completion. 2) Evaluation is vaguely linked with generated solutions and overall plan of care. 3) May or may not modify, revise, or recommend alternative solutions with limited to no evidence-based citations as applicable.0 ptsUnsatisfactoryFails to 1) identify criteria for evaluation, effectiveness of interventions, and measurement of goal completion. 2) Evaluation is not linked with generated solutions and overall plan of care. 3) Does not modify, revise, or recommend alternative solutions with limited to no evidence- based citations as applicable.
4 pts
This criterion is linked to a Learning OutcomeGeneral Organization
4 ptsProficient1) Clear and accurate APA format. 2) Concisely appropriate citations and references. 3) No spelling or grammar errors.3 ptsAcceptable1) Adequate APA format. 2) Adequate appropriate citations and references. 3) Few spelling or grammar errors.
2 ptsNeeds Improvement1) Inadequate APA format. 2) Inappropriate citations and references. 3) Some spelling or grammar errors.0 ptsUnsatisfactory1) Fails to utilize APA format. 2) No appropriate citations and references. 3) Many spelling or grammar errors.
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Responses to Other Students: Respond to at least 1 of your fellow classmates with at least a 200-word reply about their Primary Task Response regarding items you found to be compelling and enlightening. To help you with your discussion, please consider the following questions:
What did you learn from your classmate’s posting?
What additional questions do you have after reading the posting?
What clarification do you need regarding the posting?
What differences or similarities do you see between your posting and other classmates’ postings?
For assistance with your assignment, please use your textbook and all course resources.
post to read and respond
tumor Markers – Uses, Limitations, and the Screening Debate
Tumor markers have become a valuable part of modern cancer care and primary care practice. These substances – most often proteins – are produced either by cancer cells or by the body reacting to cancer’s presence, and they can be detected through blood, urine, or tissue samples. Their clinical value depends heavily on how and when they are used. Primary Uses of Tumor Markers One of the strongest applications of tumor markers is tracking how well a patient is responding to treatment. For instance, clinicians caring for colorectal cancer patients may follow CEA levels, while CA-125 is commonly trended in ovarian cancer patients to gauge whether therapy is working. A single value means little on its own – what matters most is how the number moves over time in response to intervention. Tumor markers also serve a meaningful role in catching cancer recurrence before it becomes clinically apparent. An upward trend in PSA following prostate surgery, for example, can alert providers to returning disease before imaging picks it up, giving patients a critical window for earlier action. Beyond recurrence monitoring, certain markers help determine eligibility for targeted therapies, essentially acting as a guide for precision treatment decisions. Understanding a tumor’s molecular profile through these markers can directly shape which drugs are chosen for a given patient. The Screening Debate: Should Tumor Markers Be Used for the General Population? This is where the discussion becomes more complex, and where my clinical background shapes my perspective strongly. As an oncology nurse, I do not believe tumor markers should be routinely checked across all patients. These markers are cancer-type specific – a marker relevant to one malignancy carries little diagnostic meaning when applied broadly to someone without a targeted clinical concern. Using them indiscriminately introduces confusion rather than insight. There is also an important human dimension that the data alone does not fully capture. In my experience working directly with oncology patients, few things generate anxiety faster than an abnormal lab result – even one that ultimately proves benign. Patients already living under the weight of a cancer diagnosis, or fearing one, can be significantly distressed by elevated marker values that turn out to have a completely harmless explanation. Creating that fear without strong clinical justification is something I believe providers should actively work to avoid. The science reinforces this concern. Research has consistently shown that tumor markers lack the sensitivity and specificity needed to function reliably as population-wide screening tools. Many non-cancerous conditions can cause marker elevations – benign prostate conditions can raise PSA, and smoking or gastrointestinal inflammation can elevate CEA -meaning false positives are a genuine and frequent problem. When a marker intended to detect cancer also rises in perfectly healthy or benign situations, its screening value is fundamentally compromised. Even PSA, which was once broadly recommended for prostate cancer screening, has faced significant criticism because it cannot reliably separate aggressive disease from slow-growing tumors that would never harm the patient, contributing to overdiagnosis and unnecessary treatment. There is another practical consequence of widespread tumor marker screening that deserves serious consideration: the downstream burden on the oncology system. If primary care providers begin routinely ordering tumor markers on the general population and elevated results come back (even falsely elevated ones) those patients will need referrals to oncology for further evaluation. This creates a bottleneck effect within an already strained specialty. Oncologists would find themselves spending significant time evaluating relatively healthy individuals with benign marker elevations, while patients who genuinely need oncology care face longer wait times to be seen. Delayed access to care for true cancer patients carries real clinical consequences, and any screening strategy that worsens that access problem must be weighed carefully against its potential benefits. Tumor markers do hold promise for targeted high-risk populations when paired with imaging, physical examination, and biopsy – but that is a very different use case from broad population screening. Emerging multi-cancer detection tests may eventually shift this conversation, but those tools are still under investigation and have not yet received regulatory approval. In conclusion, tumor markers are most powerful and most appropriate when used with clinical intention – for monitoring known disease, detecting recurrence, and guiding treatment decisions. Applying them broadly to the general population risks false positives, patient anxiety, overdiagnosis, and a bottleneck in oncology access that ultimately harms the patients who need that care most. Both the evidence and frontline clinical experience point toward targeted, purposeful use rather than routine screening.
National Cancer Institute. (2021, May 11). Tumor markers.
Tumor Markers – Uses, Limitations, and the Screening Debate
Tumor markers have become a valuable part of modern cancer care and primary care practice. These substances – most often proteins – are produced either by cancer cells or by the body reacting to cancer’s presence, and they can be detected through blood, urine, or tissue samples. Their clinical value depends heavily on how and when they are used.
Primary Uses of Tumor Markers
One of the strongest applications of tumor markers is tracking how well a patient is responding to treatment. For instance, clinicians caring for colorectal cancer patients may follow CEA levels, while CA-125 is commonly trended in ovarian cancer patients to gauge whether therapy is working. A single value means little on its own – what matters most is how the number moves over time in response to intervention.
Tumor markers also serve a meaningful role in catching cancer recurrence before it becomes clinically apparent. An upward trend in PSA following prostate surgery, for example, can alert providers to returning disease before imaging picks it up, giving patients a critical window for earlier action. Beyond recurrence monitoring, certain markers help determine eligibility for targeted therapies, essentially acting as a guide for precision treatment decisions. Understanding a tumor’s molecular profile through these markers can directly shape which drugs are chosen for a given patient.
The Screening Debate: Should Tumor Markers Be Used for the General Population?
This is where the discussion becomes more complex, and where my clinical background shapes my perspective strongly. As an oncology nurse, I do not believe tumor markers should be routinely checked across all patients. These markers are cancer-type specific – a marker relevant to one malignancy carries little diagnostic meaning when applied broadly to someone without a targeted clinical concern. Using them indiscriminately introduces confusion rather than insight.
There is also an important human dimension that the data alone does not fully capture. In my experience working directly with oncology patients, few things generate anxiety faster than an abnormal lab result – even one that ultimately proves benign. Patients already living under the weight of a cancer diagnosis, or fearing one, can be significantly distressed by elevated marker values that turn out to have a completely harmless explanation. Creating that fear without strong clinical justification is something I believe providers should actively work to avoid.
The science reinforces this concern. Research has consistently shown that tumor markers lack the sensitivity and specificity needed to function reliably as population-wide screening tools. Many non-cancerous conditions can cause marker elevations – benign prostate conditions can raise PSA, and smoking or gastrointestinal inflammation can elevate CEA -meaning false positives are a genuine and frequent problem. When a marker intended to detect cancer also rises in perfectly healthy or benign situations, its screening value is fundamentally compromised. Even PSA, which was once broadly recommended for prostate cancer screening, has faced significant criticism because it cannot reliably separate aggressive disease from slow-growing tumors that would never harm the patient, contributing to overdiagnosis and unnecessary treatment.
There is another practical consequence of widespread tumor marker screening that deserves serious consideration: the downstream burden on the oncology system. If primary care providers begin routinely ordering tumor markers on the general population and elevated results come back (even falsely elevated ones) those patients will need referrals to oncology for further evaluation. This creates a bottleneck effect within an already strained specialty. Oncologists would find themselves spending significant time evaluating relatively healthy individuals with benign marker elevations, while patients who genuinely need oncology care face longer wait times to be seen. Delayed access to care for true cancer patients carries real clinical consequences, and any screening strategy that worsens that access problem must be weighed carefully against its potential benefits.
Tumor markers do hold promise for targeted high-risk populations when paired with imaging, physical examination, and biopsy – but that is a very different use case from broad population screening. Emerging multi-cancer detection tests may eventually shift this conversation, but those tools are still under investigation and have not yet received regulatory approval.
In conclusion, tumor markers are most powerful and most appropriate when used with clinical intention – for monitoring known disease, detecting recurrence, and guiding treatment decisions. Applying them broadly to the general population risks false positives, patient anxiety, overdiagnosis, and a bottleneck in oncology access that ultimately harms the patients who need that care most. Both the evidence and frontline clinical experience point toward targeted, purposeful use rather than routine screening.
References
National Cancer Institute. (2021, May 11). Tumor markers.
This is a Collaborative Learning Community (CLC) assignment.
The purpose of this assignment is to collaborate with your group from Topic 2 to create a PowerPoint presentation that summarizes and analyzes a recent, instructor-approved nursing research article on a diabetes intervention or treatment tool for elderly or pediatric populations, using the PICO(T) framework to highlight key findings, discuss integration into nursing practice, and address the psychological, cultural, and spiritual needs relevant to patient care. The article must be published within the last 5 years and relevant to nursing practice.
Develop a 12-15-slide PowerPoint presentation (excluding the title and references slides) that highlights the study’s findings and discusses how nurses can apply these findings as an intervention. Be sure to include speaker notes for each slide, as well as separate slides for the title page and references.
Include the following:
Describe, using the PICO(T) question template, the specific population and intervention or treatment tool used in the article.
Summarize the PICO(T) outcome evaluated by your selected article. The research presented must include pathophysiological findings that are current, thorough, and relevant to nursing practice.
Provide a description of how the treatment tool or intervention can be integrated into nursing practice. Provide evidence to support your discussion. Reflect how the treatment tool or intervention will affect nursing practice and the disease process.
Explain why psychological, cultural, and spiritual aspects are important to consider for the patient population which your article reviews. Describe how support can be offered in these respective areas as part of a plan of care for the patient. Provide examples.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.
Remember to include creativity to engage your audience (e.g., cited images, bright colors, etc..).
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
American Association of Colleges of Nursing Core Competencies for Professional Nursing Education
This assignment aligns to AACN Core Competency 2.5.
Evaluate the concepts of cellular biology and altered cellular and tissue biology for their implications to disease management (EOPSLO# 1).
Distinguish knowledge of normal physiology and pathologic alterations across the lifespan that are expressed as diseases of organs and systems (EOPSLO# 1, 9).
Analyze current research findings with evidence-based guidelines for the management of selected diseases (EOPSLO# 4, 9).
Instructions: Please choose one disease or condition being learned in the course. Once the disease or condition is chosen, you are to write a three-to-five-page paper in APA format 7th edition with the following sections and level 2 headings:
Literature Review
-conduct A thorough literature review to explore the molecular pathophysiology of the chosen disease.
-Identify and analyze peer reviewed articles, research studies, and/or scholarly sources to define molecular mechanisms, genetic factors, environmental triggers, and/or immunological pathways associated with the condition.
Pathogenesis
-provide a detailed analysis of the molecular mechanisms underlying the pathogenesis and progression of the chosen disease. This may include genetic predisposition, dysregulation of immune responses, cellular signaling pathways, and tissue-specific effects.
Clinical Correlation
–correlate the identified molecular pathways with the clinical manifestations and symptoms of the chosen disease.
-Discuss how an understanding of the molecular pathophysiology can inform clinical assessment, diagnosis, and treatment decisions.
Conclusion
-Recap points discussed in paper
-Importance of understanding pathophysiology as an advanced practice nurse.
References
-Please include at least 3 references on its own page, within the last 5 years with included in-text citations.
Responses to Other Students: Respond to at least 1 of your fellow classmates with at least a 300 word reply about their Primary Task Response regarding items you found to be compelling and enlightening. To help you with your discussion, please consider the following points:
What new information did you learn from your classmate’s posting?
Do you need additional information or clarification?
What differences and/or similarities are there between your posting and other classmates’ postings?
What questions do you have about other classmates postings?
All sources should be cited using APA format. Grammar, spelling, punctuation, and format should be correct and professional.
read and respond
Healthcare financing has significantly shaped my practice as a bedside postpartum nurse at Kaiser Permanente over the past several years. The shift from fee for service reimbursement to value based care has changed how care is delivered, measured, and prioritized on the unit.
One of the most noticeable changes is the strong focus on measurable outcomes. Reimbursement is now closely tied to patient outcomes rather than the volume of services provided. In postpartum care, this includes shorter lengths of stay when appropriate, reduced hospital acquired infections, lower maternal complication rates such as hemorrhage, fewer readmissions for both mothers and newborns, and improved exclusive breastfeeding rates prior to discharge.
These metrics have directly influenced daily nursing practice. Discharge teaching, for example, has become more structured and time sensitive. Nurses are expected to ensure patients understand warning signs, newborn care, medications, and follow up instructions within a shorter hospitalization window. At the same time, there is increased responsibility to prevent readmissions through thorough assessment and education. Pittman et al. (2021) explain that value based payment models link nursing care more directly to both clinical outcomes and cost, making nursing impact more visible within healthcare systems.
Breastfeeding rates are another major quality metric that influences postpartum care. Hospitals are expected to support exclusive breastfeeding prior to discharge, which has increased the presence of lactation support services, early skin to skin practices, and more consistent breastfeeding education from nursing staff. While these efforts have improved breastfeeding initiation rates, they can also create challenges when patients experience difficulties or choose alternative feeding methods. Green et al. (2023) emphasize that quality improvement initiatives must be balanced with individualized care to avoid unintended stress or disparities.
Staffing and workload are also affected by healthcare financing. In many settings, including postpartum units, cost containment efforts result in leaner staffing models while expectations for quality metrics remain high. Nurses are often responsible for managing multiple couplets while still providing education, emotional support, documentation, and coordination of care. Research has shown that inadequate staffing is associated with poorer outcomes, including higher readmission rates and reduced patient satisfaction (Saldanha et al., 2023).
Overall, I do believe these changes have improved patient care in several meaningful ways. The emphasis on measurable outcomes such as reduced infections, improved breastfeeding support, and fewer readmissions has increased accountability and encouraged evidence based practice. Yakusheva et al. (2022) note that value based care models can strengthen nursings role by highlighting the connection between nursing practice and patient outcomes.
At the same time, there are clear challenges. The focus on metrics can sometimes shift attention toward documentation and efficiency rather than patient interaction and individualized support. Postpartum care requires time for education, reassurance, and emotional support, which can be difficult to fully provide in a fast paced environment with staffing constraints. While healthcare financing has driven important improvements in quality and safety, ongoing adjustments are needed to ensure expectations align with the realities of bedside nursing.
In conclusion, healthcare financing has had a significant impact on postpartum nursing practice. The shift toward value based care has improved focus on outcomes such as shorter stays, reduced complications, increased breastfeeding rates, and fewer readmissions. However, balancing these metrics with adequate staffing and individualized patient care remains an ongoing challenge in practice.
References
Pittman, P., Rambur, B., Birch, S., Chan, G., Cooke, C., Cummins, M., Leners, C., Low, L., Meadows-Oliver, M., Shattell, M., Taylor, C., & Trautman, D. (2021). Value based payment: What does it mean for nurses? Nursing Administration Quarterly, 45(3), 179186.
Yakusheva, O., Rambur, B., OReilly Jacob, M., & Buerhaus, P. I. (2022). Value based payment promotes better patient care and can empower nurses. Nursing Outlook, 70(2), 215218.
Green, J. (2023). Quality improvement initiatives in maternal health and their impact on patient outcomes. Journal of Perinatal Nursing, 37(2), 112119.
Saldanha, I. J., et al. (2023). Health insurance coverage and postpartum outcomes in the United States: A systematic review. JAMA Network Open, 6(6), e2316536.
Responses to Other Students: Respond to at least 1 of your fellow classmates with at least a 350-word reply about their Primary Task Response regarding items you found to be compelling and enlightening. To help you with your discussion, please consider the following points:
What new information did you learn from your classmate’s posting?
Do you need additional information or clarification?
What differences and/or similarities are there between your posting and other classmates’ postings?
What questions do you have about other classmates postings?
All sources should be cited using APA format. Grammar, spelling, punctuation, and format should be correct and professional.
read post and respond
Over the course of my nursing career, Ive seen firsthand how changes in healthcare financing influence daily practice. Early on, care was largely guided by a feeforservice approach, where the focus was on completing tasks and moving patients efficiently through the system. Over time, that focus has shifted. Today, reimbursement is much closely tied to patient outcomes, quality indicators, and patient satisfaction. In my current role as a clinical educator, I see the impact of these changes not only at the bedside, but also in how nurses are educated, evaluated, and supported.
One of the most noticeable shifts has been the growing emphasis on quality measures that affect reimbursement. Metrics such as readmission rates, length of stay, patient experience scores, and compliance with care bundles are closely tracked. These expectations influence how nurses prioritize their work each shift. From an education perspective, this has changed how we teach nurses. There is less focus on simply completing tasks and more emphasis on understanding how nursing decisions affect patient outcomes over time. Accurate documentation, effective patient education, and strong coordination of care have become essential parts of practice because they directly connect quality outcomes with funding.
Another change related to healthcare financing is the increased focus on teamwork and coordination across disciplines. Valuebased care models encourage collaboration, which has strengthened the nurses role as a communicator and advocate for patients. Yakusheva and colleagues (2022) noted that valuebased payment systems aim to improve outcomes and lower costs (Yakusheva et al., 2022) while also creating opportunities for nurses to demonstrate the value of their work. In practice, this has meant that nurses are more frequently involved in quality improvement initiatives, discharge planning, and efforts to reduce complications and readmissions.
From my experience, these financial changes have resulted in some positive improvements in patient care. There is greater attention to evidencebased practice, patient education, and safety initiatives. I have observed more structured education for staff and more consistent processes for discharge teaching and followup care. Research supports these observations. A systematic review by Le?o et al. (2023) found that valuebased payment models are often associated with improved clinical outcomes and fewer preventable hospitalizations. This aligns with what I see in practice when nurses are given clear expectations, appropriate education, and ongoing support.
At the same time, these changes have also introduced challenges. Increased documentation requirements, performance tracking, and accountability measures can add strain to already demanding workloads. Nurses may feel caught between meeting metricdriven expectations and addressing the individual needs of patients, especially when staffing or resources are limited. Le?o et al. (2023) also reported that while patient outcomes may improve under valuebased models, many providers experience frustration when they feel excluded from how these payment systems are designed. If unaddressed, this can contribute to disengagement and burnout.
Overall, I believe changes in healthcare financing can improve patient care when they are implemented thoughtfully. From my perspective as a clinical educator, it is important to help nurses understand how financial models connect to everyday practice while continuing to emphasize compassionate, patientcentered care. When nurses are supported through education, adequate staffing, and leadership involvement, valuebased care has the potential to benefit both patients and the nursing workforce.
References
Yakusheva, O., Rambur, B., OReilly-Jacob, M., & Buerhaus, P. I. (2022). Value-based payment promotes better patient care, incentivizes health care delivery organizations to improve outcomes and lower costs, and can empower nurses. Nursing Outlook, 70(2), 215218.
Le?o, D. L. L., Cremers, H. P., van Veghel, D., Pavlova, M., & Groot, W. (2023). The impact of value-based payment models for networks of care and transmural care: A systematic literature review. Applied Health Economics and Health Policy, 21(3), 441466.