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a. These are the instructions that the person responded to below-
b. Discuss the laws in your state related to the nurse practitioner’s (NP) role and

responsibility in creating and signing advanced directives (ADs). Indicate if the NP
can independently complete AD documents or a physician is required to sign or
cosign the documents.

c. Consider clients you’ve encountered in practicum (or in your practice as a
registered nurse). Identify at least ONE client who may have benefited from a
referral to hospice or palliative care. Indicate why this client would have benefited
from these services. Describe how as an NP you might approach the conversation
with the client.

d. Discuss at least TWO recommendations you have for improving palliative and
hospice care access to vulnerable and underserved populations in your
community. 

Read this. This is what you are to respond to- I currently reside in Georgia. In
Georgia, a nurse practitioner must work under a physician supervision. NPs and
their physician supervisors must work together under “nurse protocol”. (Georgia
GOV, 2024). A nurse protocol is a written document in which the supervising
physician gives the NP authority to perform medical care, and immediate
consultation. Advance directives, which is also part of provider orders for life-
sustaining treatment (POLST) are set of portable medical records that allow
someone ill to communicate their end-of-life care wishes for providers and medical
facilities (NCSL, n.d). In the state of Georgia, NPS are not explicitly authorized to
sign POLST forms. (NCSL, n.d). The AD document does require physician to sign.
I work as a critical care PACU nurse. One client that would benefit to hospice or
palliative care was a 72-year-old female who had stage 4 lung cancer. In stage 4 lung
cancer, the median survival time is four months (Lung Cancer Center, 2024). I would
recommend hospice care. Hospice is comfort care without curative intent. In my
client’s case, her stage 4 lung cancer could not be cured. She was in constant pain
and just wanted to leave the hospital. Hospice care typically care for patients that
have less then 6 months to live. Palliative care would be beneficial for individual with
serious illness that does not have life expectancy or prognosis. Patients are still
receiving treatments and focuses on pain and symptom management. I would
approach my client with brochures of diZerent hospice facilities and provide
information about hospice care. I would make sure I answer all their questions. I
know some people will not like the idea of hospice care but presenting this
information will also give them options that they never though oZ or existed. As a
nurse practitioner, it is important to present all information to the patient because
you are there to help them in the best way possible.
One recommendation I have to improve palliative and hospice care access to
vulnerable and underserved populations in my community is by hanging flyers and
having brochure’s in local grocery stores and laundry mats. These are places that

many people go and will stay for hours. Having information available to them in
common area will help spread the word across the neighborhood. Another
recommendation I have is attending health fairs and other local neighborhood
events and spreading the information by handing out brochures. Many people
attend these events hoping to see and learn something new. They will understand
the diZerence between palliative and hospice care and know that they have options
and access to care.

Instructions- Engage by oZering new insights, applications, perspectives,
information, or implications for practice. Communicate using respectful, collegial
language and terminology appropriate to advanced nursing practice. Communicate
with minimal errors in English grammar, spelling, syntax, and punctuation. 2 APA
references using a scholarly article within 5 years. Please write on an advance
college level.

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