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Richard Frejomil II, NP-C, AGPCNP, MSN, RN
Richard Frejomil II is a nationally certified nurse practitioner with the AANP. He holds Masters degree in nursing science from St Joseph's College where he enrolled in the Nursing Masters in Sciences-Adult-Gerontology Primary Care Nurse Practitioner Concentration. He received his Bachelors in Nursing Science degree from Chamberlain University and his undergraduate degree in Applied Sciences from Suffolk County Community College. His Clinical background began at Long Island Community Hospital, the former Brookhaven Memorial Hospital Medical Center. He began his RN career there on the telemetry/stepdown unit care for patients who suffer from various cardiovascular and pulmonary conditions. He has also cared for patients in various other units within the hospital including the surgical unit, medical intensive care unit, stroke unit, and the emergency department. Richard has been employed as an RN at LICH for the past five years and continues to practice in the telemetry unit. Currently Richard is searching to begin his new career as a nurse practitioner. Richard is eager to bring his education, clinical experience, love for learning, and desire to care for others to his future Nurse Practitioner career.
Table of Contents
Five Graduate Program Learning Outcomes
Synthesize theoretical and empirical knowledge from nursing, humanities and the sciences to provide rationale for practice as a master’s prepared nurse
Integrate leadership concepts, knowledge and skills to provide safe, high quality care for diverse populations within complex organizational systems.
Advocate for relationships that support individual and population health outcomes through interprofessional collaboration.
Exemplify a life characterized by integrity, intellectual and spiritual values, social responsibility and service.
Actualize way of being through multiple ways of knowing to support a culture of excellence in master’s level nursing practice.
“Human behavior flows from three main sources: desire, emotion, and knowledge”
Plato
Learning Outcome 1
Synthesize theoretical and empirical knowledge from nursing, humanities and the sciences to provide rationale for practice as a master’s prepared nurse
Nursing theories are essential in guiding the nursing profession. The birth of nursing theory began with Florence Nightingale. Her theory explored the inter-relationship with external influences and patient outcomes. This basic, holistic theory spawned the creation of numerous other theories over the course of more than 100 years. The emergence of these theories has guided the practice of a multitude generations of nurses and future nurses to come.
During my first semester at St. Joseph's College Nurse Practitioner Program I completed my first theory assignment. Nursing theory had not really impacted my practice until I attended the St. Joseph's theory course. After countless hours of researching various theories and theorist, I came across a theory that really spoke to me. The theorist is named Meredith Troutman-Jordan. Her theory coined "the theory of successful aging" focuses on healthy aging by promoting mental health, physical activity and social well-being. I found that my personal outlook on life was very closely related to Dr. Troutman's theory. In my theory assignment I have explored "the theory of successful aging" and its positive impact on not only my clinical environment but in health care as a whole. Through the use of evidenced based practice I have incorporated "the theory of successful aging into my practice and will continue to do so for years to come.
The theory of successful aging has continually helped me to improve my practice and the healthcare outcomes of my patients. Patient-centered care is an important part of my practice and I have found that incorporating The Theory of Successful Aging into my day to day practice has aided in actively involving my patients in their care. Increasing mental stimulation by having meaningful conversations regarding a patient’s healthcare, as well as improving their health literacy, has helped alleviate barriers to healthcare such as lack of social and familial support, previous bad experiences in the health system, and lack of understanding or knowledge. I routinely promote the mental, physical, and social well-being of all my patients by utilizing resources such as physical therapy, psychological services, and emotional support groups.
Learning Outcome 2
Integrate leadership concepts, knowledge and skills to provide safe, high quality care for diverse populations within complex organizational systems.
Advanced practicing nurses embody from leadership skills. They stand up for what they believe is right regardless of what others think. Nurse practitioners have an obligation to the patients, their co-workers, and the community they serve to advocate for what is right. Throughout these year in the NP program I have been exposed to various leadership style and roles. I was also given the opportunity to take on a leadership position and raise attention to a public safety concern.
One specific example that exhibits leadership was a letter I wrote to Senator John E. Brooks. In the letter I was petitioning for the Amendment to the Social Host Law. The original Social Host Law stated that the host of a social event would be held legally liable if a person under the age of 21 is intoxicated and injures, causes personal and/or property damage or death. The amendment would include additional drugs and illegal substances that would impair and individual’s ability. I know that this is a very controversial law that I am petitioning for however, I feel it is one that must be addressed. Countless lives are affected each by underaged drivers whom are cognitively altered by alcohol, marijuana, etc. Many believe it is safer to allow their child to “party” at their homes but with no regard to what happens afterwards. My goal is no to punish people for allowing this to happen but rather to bring more attention to a situation that has resulted in numerous injuries and deaths. My goal is to make our communities safer for our friends and our families.
In addition to demonstrating leadership skills in the community by petitioning for an amendment to the social host law, I Integrate strong leadership skills during my practice to ensure high quality care for my patients. An effective leader possesses strong communication skills and conflict resolution skills, both of which I use routinely during practice.
Learning Outcome 3
Advocate for relationships that support individual and population health outcomes through interprofessional collaboration.
A community health issue that continues to plague our homes and health care facilities is falls. Falls can occur at any time, in any place. Falls are one of the leading cause of hospitalizations in the united states. Falls has led to numerous hospitalizations, injuries and deaths. The medical cost for falls each year is in the billions. Through the Capstone Project at St Joseph’s College, I am able to serve a community and future registered nurses to help improve their knowledge and understanding of falls.
My research on the topic of falls has been an evolving process that I began two years ago. The end result is my Capstone which is a cumulation of two years of research. My Capstone Project is designed as a multifaceted approach to understanding falls. I have researched the statistics of falls, identifying falls, rates, what age groups are most at risk, annual medical cost, annual death rates, etc. understanding and visualizing these statistics aid in supported the urgency of the topic at hand. I further elaborate of the various fall risks and contributors to falls. After addressing the contributing factors to falls I provide interventions to help prevent them. Near the completion of this project I felt the best way to serve my community in preventing falls would be to education the undergraduate registered nursing class at St Joseph’s College. As the Dalai Lama once said, “Just as ripples spread out when a single pebble is dropped into water, the actions of individuals can have far-reaching effects”. My goal is to educate these future nurses in fall prevention in hopes that they can not only prevent falls in their communities and work places but, further spread the knowledge I have bestowed upon them to their friends, family, coworkers, and most importantly, their patients.
Interprofessional collaboration is an important foundation in healthcare. When all members of the healthcare team are actively involved in the patients care, it leads to improved healthcare outcomes. With regard to falls specifically, it is important that multiple disciplines are involved to help prevent falls and fall related injuries. I incorporate disciplines such as physical therapy and social work in the plan of care for patients who are at risk for falls as they can coordinate care both within and outside of the hospital/inpatient setting to help prevent falls. In my experience when all members of the care team are on the same page and have the same goals, the patients have more of a positive outcome.
Learning Outcome 4
Exemplify a life characterized by integrity, intellectual and spiritual values, social responsibility and service.
I value the relationships I have with my peers and place great emphasis on creating honest relationships that are open to productive and effective communication. Values I carry with me across all relationships in my life and my work are dependability and trustworthiness.
I believe that as a nurse I have a social responsibility and should be using my knowledge and skills to service my community and educate my peers. My grandmother suffered from PTSD after being involved in two traumatic motor vehicle accidents. She struggled to sleep after her accidents, and had frequent vivid nightmares. In addition to PTSD she suffered from chronic back pain as a result from multiple herniated discs. After years of physical therapy, an array of muscle relaxers and pain medications, and psychotherapy, she still could not find relief from pain or insomnia. Only after she was prescribed medical marijuana did she find relief and see improvement in her daily life. I educate my patients to research all avenues of pain/symptom relief as I am a strong advocate for alternative medication. My interest in alternative medication led me to further research the implications of medical marijuana and I was able to create a PowerPoint presentation to present to my peers. Although cannabis is not an FDA approved product and there is a social stigma regarding its usage, I believe there is more education needed regarding the conditions it can treat.
Learning Outcome 5
Actualize way of being through multiple ways of knowing to support a culture of excellence in master’s level nursing practice.
In order to provide our patients with the best care possible, the Nurse Practitioner must search deep inside themselves and understand why they are doing what they are doing. Through the St. Joseph’s College multiple ways of knowing reflective case study assignment I fashioned a reflective analysis of a recent clinical situation in which I had the opportunity to aid a patient on their diabetes management.
Reflecting upon my actions, I was able to define the patterns of nursing knowledge that I had utilized during my clinical environment. In addition, I also explored the various internal and external factors that influenced my decision making and actions. Via personal, empirical, ethical, and aesthetic ways of knowing I felt I was and will be able to effectively care for my patients in a manner that is consistent with my new and upcoming role, a Nurse Practitioner.
