PATHOPHYSIOLOGY NR507 WK8 TD1

Week 8: Genomes, Genetic Alterations, and Reproductive Disorders - Reflection Loading... Discussion This week's graded topics relate to the following Course Outcome (CO). 8 Reflect on personal and professional growth t ...

Week 8: Genomes, Genetic Alterations, and Reproductive Disorders - Reflection Loading... Discussion This week's graded topics relate to the following Course Outcome (CO). 8 Reflect on personal and professional growth toward achieving competence as a family nurse practitioner. (PO 5, 10) Reflection (graded) Reflect back over the past eight weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #, MSN Essential VIII, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies Program Outcome #4: Evaluate the design, implementation, and outcomes of strategies developed to meet healthcare needs (MSN Essentials III, IV, VIII). MSN Essential VIII: Clinical Prevention and Population Health for Improving Health •Recognizes that the master’s-prepared nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregates/identified populations.Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies 1. Critically analyzes data and evidence for improving advanced nursing practice. 2. Integrates knowledge from the humanities and sciences within the context of nursing science. 3. Translates research and other forms of knowledge to improve practice processes and outcomes. 4. Develops new practice approaches based on the integration of research, theory, and practice knowledge. Responses Liberty Neoh Reflection 6/19/2016 2:20:44 AM Dr. Brown and Class, First, I would like to thank you Dr. Brown for teaching this class and for all your feedbacks. The last 3 weeks has been very difficult for me due to my mother’s passing. I truly appreciate your understanding and support during those times. I also want to thank my classmates for their postings and responses. You are all awesome. Reflect back over the past eight weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #, MSN Essential VIII, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies Program Outcome #4: Evaluate the design, implementation, and outcomes of strategies developed to meet healthcare needs MSN Essentials III Quality and Safety The case studies taught us how to isolate relevant information in order to gain a more comprehensive diagnosis and differentials. Additionally, the requirements of up to date scientific articles expanded our understanding. It was often a huge challenge for me and sometimes takes me hours to find credible resources and up-to- date articles but I also understand that advances in healthcare technology and research are constantly evolving. I feel that the wealth of knowledge that we acquired during this class taught me how to provide more effective, evidence-based diagnosis and treatments. MSN Essentials IVThis element of master prepared nursing ties in to the aforementioned essential. Each differential diagnosis and treatments are based on the most recent studies. Discussing the pathological process in the cellular level and sometimes in molecular level has provided me a better understanding of the disease process. As such, this serves to reinforce the core concept of this essential. MSN Essentials VIII Our future roles as Primary Care- FNP will focus on prevention and treating illnesses. Conducting case studies and research allows one to examine details thoroughly. This careful analysis leads to a comprehensive knowledge base, and thus allows healthcare providers to educate patients. Each patient encounter serves as a learning opportunity, and the experience of this class has prepared me such that I may seize them and provide better care for my patients. Thank you. . Alice Jeffries reply to Liberty Neoh RE: Reflection Liberty, I am so sorry to hear about your mother's passing. We have also had some very difficulty times. Having the class and classmates has been very helpful for me, and I hope it was for you, also. It was nice to get to know someone also from Hawaii! I hope to see you in future classes and if you come to Oahu, maybe we can see one of Aimee's shows together. Aloha nui loa, Ali Liberty Neoh reply to Alice Jeffries RE: Reflection 6/21/2016 6:16:50 AM Thanks Ali. Will you pls send me a friend request on FB. I do not know your FB name. Thanks Lorna Durfee reply to Liberty Neoh RE: Reflection Liberty: I am sorry for your loss. My father passed during my undergraduate nursing education. I wish you the best going forward. Lorna Matthew Dove reply to Lorna Durfee RE: Reflection 6/21/2016 10:53:08 AM 6/21/2016 8:01:33 AM 6/20/2016 11:26:11 PMDeepest condolences. Your determination and grit to continue in the program despite adversity demonstrates your strength and perseverance. Undoubtedly, these qualities are the result of your mom's influence and you honor and carry her legacy through your work and dedication to your family and patients. All the best and my sympathies. Liberty Neoh reply to Matthew Dove RE: Reflection Thank you Matthew Liberty Neoh reply to Lorna Durfee RE: Reflection Thank you Lorna Lanre Abawonse Reflection 6/19/2016 9:05:20 AM To be a nurse practitioner, it is important to be well rounded in knowledge of the problems facing the sick population. The broad nature of science requires dedicated effort and collaboration of knowledge from different interdisciplinary teams. Over the course of 8 weeks in this class, I have done a lot of research, critical thinking and using evidence based works to analyze and provide information to every case study. I must admit that it has not been easy. I have learned from everyone’s input on several case studies that were presented. In all of these case studies, new ideas were being formed from what I thought it ought to be, to what possibilities it could have been, and what it actually is. The idea of having one to three differentials diagnosis help to add to existing knowledge and gaining some new information about evidence based practice (EBP) in solving numerous case studies. Understanding pathophysiology is a very valuable knowledge that helps in understanding the basis of the scientific evidence foundation of theoretical models and the knowledge of evidence-based interventions within the problem area, followed by the ability to make an informed choice of the best intervention plan. Meeting the MSN essential eight through proper education and developing that education into evidence based study helps provide the patient with better safe care. Chan (2013) stated that education preparation is an important strategy to overcome knowledge barriers. It was added that 6/21/2016 1:50:14 PM 6/21/2016 1:51:01 PMto maximize the contributions of EBP and promote safety and quality of care, continuing efforts are required to integrate EBP in everyday nursing practice. The complex work of integrating evidence in practice is now more feasible with the advancement of information technology, such as automation of data collection and analysis, and online or real-time sharing. Every student in this class has used their scientific knowledge throughout these eight weeks to perform extensive research, have studied their content and used the best evidence available to integrate and collaborate to disseminate the information gathered. Reference Chan, S. (2013). Taking evidence-based nursing practice to the next level. International Journal Of Nursing Practice, 191-2 2p. doi:10.1111/ijn.12208 Instructor Brown reply to Lanre Abawonse RE: Reflection 6/22/2016 7:02:00 AM Lanre, Please include the following in your reflection: describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #, MSN Essential VIII, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies Lanre Abawonse reply to Instructor Brown RE: Reflection 6/22/2016 8:54:05 PM The achievement of this course will allow me to put my knowledge into practice of helping people who are in great need. This course has helped me to understand the foundation of each disease process, and by so doing, I have been able to understand how different diseases affect different populations and cultures. With this in mind, this course will go a long way in helping design sound scientific care to each patient I care for in the future. Thescientific background of this course is very important in making critical decisions and diagnosis concerning patient health. With the knowledge in this course, I can map out the populations that have heath disparities using scientific data and can uses critical analyses to find vulnerable populations in my area of practice. The knowledge in this course will also enable me to provide needed education to the patients I see in the future. The patients deserve to know the truth about their health. Understanding this course has given me abundant material to explain information to my patients in more meaningful ways so that correct decisions can be made between the patient and their families. Brittany Heller reflection 6/19/2016 3:04:32 PM This course has been an incredible learning experience. As a nurse practitioner knowing the pathophysiology of disease processes is important to know how to take care of my patient population. The weekly discussion threads have been an immense learning process. I enjoyed being presented with case studies and having to discuss the different differentials. Writing the different processes has expanded my knowledge base. Knowing the process of the disease helped understand how and why patients are treated. Evaluating, implementing, and developing strategies for outcomes to improve the patient's healthcare needs has been met through writing the case studies that were presented. Instructor Brown reply to Brittany Heller RE: reflection 6/20/2016 9:20:52 AM Brittany, Please include the following information: describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #, MSN Essential VIII, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies Lorna Durfee Reflection Reflection (graded) 6/19/2016 3:08:25 PMReflect back over the past eight weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #, MSN Essential VIII, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies Doctor Brown and Class: Thank you for sharing your knowledge and personal experiences. As we progress forward, I wish you all the best in your future endeavors. Program Outcome #4: Evaluate the design, implementation, and outcomes of strategies developed to meet healthcare needs (MSN Essentials III, IV, VIII). Outcome #4. This outcome was met and achieved and has prepared me for what designs can be used to provide care and how the implementation of the strategy is important regarding the population we serve when it comes to providing quality, safe, and effective care utilizing cost control measures. Course Outcomes: (Syllabus) that I gained: 1. Analyzed the pathophysiology of the disease. 2. Gained an understanding of epidemiology, etiology, and pathogenesis of the disease. Interpretation of laboratory values, their importance, and the manifestations of the disease. 3. We learned therapeutic interventions and developed an understanding of the compensatory mechanisms involved in the disease process. 4. We discovered the risk factors associated with the disease. 5. We evaluated the outcomes of alterations of the physiologic processes of disease. 6. We evaluated risk factors of disease states. 7. We developed the understanding of age and the physiologic changes through the lifespan. 8. We developed an understanding of our personal and professional growth and competence as we enter the nurse practitioner practice (Chamberlain, 2016). MSN Essential VIII: Clinical Prevention and Population Health for Improving Health •Recognizes that the masters prepared nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregates/identified populations. This class was instrumental in providing an understanding what clinical prevention is and what population health encompasses. Each week we were called upon toformulate diagnoses that were client-centered. Also, the cultural aspects of care were emphasized. Our plan and delivery included evidence-based information and guidelines to follow to provide the safest, quality, effective and evidence-based care. Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies 1. Critically analyzes data and evidence for improving advanced nursing practice. In this class, we were expected to analyze data critically and find current evidence to support our diagnoses. Using current and up-to-date information is the core of our practice. When we are required to be in the field and utilize this skill, we have had experience in finding the proper websites and use of resource information that help us decipher and transfer the knowledge to provide our patients the best we can in medical care. 2. Integrates knowledge from the humanities and sciences within the context of nursing science. As with all of our classes knowledge from humanities and sciences are the foundation of our knowledge. We use these two vital classes as the base of our practice. As information changes, we continue to stay up-to-date with all the new technical, medical and educational information so we can provide safe, quality care. 3. Translates research and other forms of knowledge to improve practice processes and outcomes. In Nursing 507, we were required to understand the latest research and apply it to our differentials. We had to be able to use that information to determine our subjective assessment, the objective assessment, and the physical assessment. We use this to develop our plan of care. 4. Develops new practice approaches based on the integration of research, theory, and practice knowledge. With the infinite resources that are available through Chamberlain, we can find the latest approaches to effective and compassionate care to the use of theory and the practice knowledge that can steer our diagnosis and plan. I will use my foundation in nursing as well as my Master's degree education to problem solve, provide interventions and evaluate the outcomes. I will also build on my health assessment, pathophysiology, and pharmacology skills to provide care to diverse populations (American Association of Colleges of Nursing, 2011). The MSN program outcomes align with the American Association of Colleges and the Essentials of Master’s Education in Nursing. The ability to practice top quality and safe practice aligned with concepts and knowledge from other specific disciplines is outcome #1 (Chamberlain College of Nursing, 2016). In summary, the course has prepared me for the next phase in my FNP track. I am looking forward to utilizing my knowledge in advanced pharmacology and advanced physical assessment. References American Association of Colleges of Nursing. (2011). Essentials of Master's Education in Nursing [PDF]. Retrieved from http://www.aacn.nche.edu/education- resources/MastersEssentials11.pdfChamberlain College of Nursing. (2016). Graduate Program Outcomes. Retrieved from http://www.chamberlain.edu/docs/default-source/academics- admissions/catalog.pdf?sfvrsn=224 Chamberlain College of Nursing. (2016). Syllabus. Retrieved from http://chamberlain.edu/docs/default-source/academics-admissions/catalog.pdf 6/22/2016 8:53:27 PM Lanre Abawonse reply to Lorna Durfee RE: Reflection The essentials you listed and summarized were done very well. The MSN essentials have provided us the opportunity to grow in knowledge and critical thinking. Through this program and the MSN essential outcome, I have come to realize the importance of critical thinking and the use of scientific evidence in making correct decisions about patients’ lives. As nurses we interpret data before calling a doctor for a final decision. With the knowledge provided in the MSN essentials, we are now able to incorporate and look into data in a scientific way, which encompasses best research evidence. Not all research outcomes or conclusions will be practical or of benefit to individual patients, but the ability to interpret this data and the application of the findings matter to every MSN trained nurse practitioner. When all knowledge and research is put together, a new practice is formed or added to the existing one. These practices help us to provide safe care for the patients and their families. Joleen Jimenez week 8 reflection 6/19/2016 6:23:23 PM Dr. Brown and class, The past eight weeks have flown by, but in that time I have learned a great deal regarding the pathophysiology of disease processes, specific clinical manifestations, epidemiology, and treatment strategies in regards to specific disease processes. When caring for patients as a practitioner, it is essential that we understand what is happening at a cellular level and why during a disease process. Byunderstanding the specific details of a disease process, practitioners can treat the patient effectively and appropriately. This course has guided my thinking, improved my knowledge base, and directed my research in order to discover the best, most up to date approaches to treating disease. I also had the ability to continue practicing my research techniques to find the most current and accurate research articles. I will have the capability of incorporating all that I learned throughout this course with future courses in order to provide research based patient-centered holistic care. Joleen Jimenez Instructor Brown reply to Joleen Jimenez RE: week 8 reflection 6/20/2016 9:21:28 AM Joleen, Please include the following information: describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #, MSN Essential VIII, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies Joleen Jimenez reply to Instructor Brown RE: week 8 reflection 6/22/2016 4:02:13 PM Dr. Brown, This course has adapted my thinking in regards to care and diagnosis of a patient. With completion of this course, as an advanced practice nurse, I will have a better understanding of how to care for each patient as an individual. Taking into consideration the patient’s family history, prior medical history, signs and symptoms, and disease process along with research based practice will result in best practice patient- centered care. This course has also incorporated the epidemiology of disease to allow for insight on what patient populations are more prone to a particular disease. In all forms of healthcare, it remains essential to remain up to date on patient care strategies, new treatment techniques, and first line medications. Therefore, learning and practicing to locate peer-reviewed research along with having the ability to translate this information into patient care is an important skill for all advanced practice nurses to possess. This course allowed me to practice and gain these skills along with gaining essential knowledge. Joleen Rechel DelAntar Reflection 6/19/2016 8:41:15 PM Hello Professor and Class, ReflectionThe last eight weeks have been both challenging and rewarding. The course was about the study of advanced anatomical, functional, and biochemical alterations in correlation with disease processes and their clinical manifestations. The course was very detailed down to the molecular levels and utilized case studies were to develop the information learned to evaluate and analyze how the cascade of events unfold and how body systems are affected. By understanding the normal processes of the body, we are able to understand the disease process more, why the symptoms are as they present themselves and the rationale for the treatment used. It involved the understanding of lab values, signs and symptoms presented, and how cells respond to various stimuli in various stages in life, which became challenging. It also brings greater understanding on how the body systems are connected to each other that although one system the symptoms may manifest in a different system. By developing medical diagnosis weekly on case studies, it provides understanding about the things that should be looked at clinically while taking into account their age, culture, family dynamics and socio-economic status in providing an appropriate care plan as a clinician. In developing these diagnoses, it provides the opportunity to research more on the illness and treatment of these disease. There is always constant research ongoing on disease causation and new treatment practices that patients may benefit a lot from these new ideas. Our healthcare environment is evolving rapidly and the demand for FNP nurse leaders increase as people seek access to primary care. The understanding of pathophysiology in conjunction with research promotes personal and professional growth, which is an important tool in becoming clinical nurse leaders providing primary care who promote, maintain and restore health not just to individuals but also to their families and communities across the life span. Instructor Brown reply to Rechel DelAntar RE: Reflection Rechel, Please include the following information: describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #, MSN Essential VIII, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies Rechel DelAntar reply to Instructor Brown RE: Reflection 6/20/2016 8:52:40 PM Hello Professor and Class, The MSN Scientific Core competency requires critical data and evidence analysis to improve Nursing practice; integration of knowledge from humanities and science; translating research and other knowledge to improve practice and development of new practice approaches based on integration of research, theory and practice (The National Organization of Nurse Practitioner Faculties, 2011). The course was designed with the intent so that each week, students are able to comprehend and demonstrate the different systems of the body first discussing the normal body processes before discussing the diseases involved in the current system being studied. By understanding advanced anatomy and physiology, an understanding is gained in how a particular disease affects normal function of 6/20/2016 9:22:09 AMthese organs and systems. A systematic approach to problem solving provides a good foundation as clinicians to be able to identify accurate differential diagnosis. From this, it prompts us as clinicians to search for the best treatment modalities for the patient, which essential to independent clinical practice as Nurse practitioners. The search for advanced treatments leads us to research to improve health practices, formulate with new ones as well as develop new health policies that may benefit the community. As NPs proficiency in this course enables us to apply this information and practice inquiry to improve health outcomes, policy and healthcare delivery. Reference: The National organization of Nurse practitioner Faculties. (2011). Nurse Practitioner Course Competencies. Retrieved from http://c.ymcdn.com/sites/ www.nonpf.org/resource/resmgr/competencies/npcorecompetenciesfinal2012.pdf. Sarah Boulware Reflection 6/20/2016 4:09:13 PM Dr. Brown and Class, This class has been very educational and helpful in preparing me to become a Family Nurse Practitioner (FNP). Program Outcome #4 was met after completing this eight-week course. The outcome is aimed at evaluating the design, implementation, and outcomes of strategies developed to meet healthcare needs. This outcome was met by evaluating the three case studies that were completed each week. The case studies presented a scenario and I was required to create a differential diagnosis and further explore the primary diagnosis by discussing the testing, treatment, or epidemiology of that diagnosis. The scenarios were ones that were likely to be seen during practice and forming differential diagnosis prepared me to complete this task in the future as a FNP. Through readings and lessons I learned of ways to meet healthcare needs. This includes diseases that affect specifically children. There were one or two chapters each week that focused on a different body system and how it is presented in the pediatric population. MSN Essential VIII is based on clinical prevention and population health to improve health. A master’s-prepared nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in planning, delivering, and managing care for patients. This essential was met through completion of this course. I was given a range of patients with different ages, rages, in the case studies each week. Some of the case studies required me to form an appropriate treatment plan for the patient, which needed to be patient-centered and culturally appropriate. I also had to use evidence-based research to complete the case studies. This not only furthered my skills in evidence based research, but also allowed me to practice incorporating evidenced based practice into care. The Nurse Practitioner (NP) Core Competency #1 includes critically analyzing data and evidence for improving advanced nursing practice. It also includes integrating knowledge, translating research, and developing new practice approaches. The quizzes each week helped to meet this competency. They required the materialfrom the readings to be analyzed and translated each week to complete them. They covered a lot of material and were a great way to evaluate knowledge of the material. After reading the chapters each week and doing research for the case studies I was able to develop new approaches to how I would look at symptoms and treat patients. Keough, Stevenson, Martinovich, Young, and Tanabe (2011) found NPs have been proven to provide high-quality, cost-effect care and are a huge part of today’s healthcare system. This is an important time in the history of NP education. NPs are responsible for interpreting laboratory results, ordering diagnostic tests, mentoring NPs, and writing orders. It is important these competencies are gained through educational programs. I feel this course has helped prepare me to one day be proficient in these areas by the completion of case studies, quizzes, and instructor feedback and discussion. I learned how to form differential diagnosis based on a patient scenario including history, symptoms, and lab values. I learned how to create a primary diagnosis and include tests and treatments for that diagnosis using evidence- based research. I also gained advanced in-depth knowledge of diseases that I will likely see in practice. This knowledge will help me fulfill my role as a FNP and meet the outcomes discussed. Thank you for a great eight weeks, Sarah Boulware References Keough, V., Stevenson, A., Martinovich, Z., Young, R. & Tanabe, P. (2011). Nurse Practitioner certification and practice settings: implications for education and practice. Journal of Nursing Scholarship, 43(2), 195-202. doi: 10.1111/j.1547- 5069.2011.01395.x Matthew Dove Reflection 6/21/2016 10:46:06 AM From allergic rhinitis to advanced stages of dementia, we've covered so much ground in this course. At times, elevating our evidenced based practice feels like attempting to take a drink from an open and active free flowing fire hydrant. When you read the MSN Essential VIII, that the FNP, “applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregates/identified populations,” the pressure and rate of that statement often feels consumptive and daunting. During this class, perhaps the most useful information gleaned was that we can’t know everything. As I have evolved in pathophysiology, it has often been asked of mentoring NPs, MDs, and DOs how they can keep track and process all this information. While there are sound suggestions like knowing guiding principles in patho, and subscribing to ameliorating processes like relevant medical journals, the most colorful comment was, “You know why it sometimes takes so long for the doctor to see you after announcing your chief complaint in the office or after we have done our assessment of you? We are in our office looking it up!!” While I would like to be a professional that doesn’t have to look it up, the sentiment is resonant that we should lean into evidence based resources, colleagues, and trusted materials to augment our clinical judgement. This course has been exceptionally powerful in developing critical thinking skills throughdiscourse and developing differential diagnosis. Despite feeling like I had a handle on the chief complaint with some of the presented case studies, it has been imperative to not be locked into one way of thinking, so much so that you could miss what is really going on. I’m grateful for extrinsically developing these skills through the differential process to integrate NP core competency #1 to have scientific foundation of knowledge, translate research, and motivate new approaches. Thank you to Dr. Brown and everyone in this class for providing insights and thought provoking inquiries! Ultimately, I reflect that I entered this field with a healthy sense of curiosity always asking why and this—I believe—sustain me in school and medicine. Admittedly, there is a healthy fear as we soon begin rotations because I know that I don’t know everything. The achievement of completing program outcome #4 and this course implicates a thorough academic foundation and strategy in preparation for these next steps moving into the next phase of this program. Rechel DelAntar reply to Matthew Dove RE: Reflection 6/21/2016 7:08:55 PM Hello Matthew, I agree with you, we really have covered so much ground is such little time. I felt like a "pinata" being bombarded with so much useful information. Through all this it, it has opened up new understanding about disease processes, being objective when looking at a patient and looking at the bigger picture when diagnosing and treating. It has encouraged the importance of research not just for new treatment modalities but also in understanding the "why's' and "how's" of the disease in order to find other options that may be explored. This course has has truly been one of the foundations in preparing us to becoming productive clinician's with the role of promoting health, preventing disease and striving for educational and professional growth. Alice Jeffries reply to Matthew Dove RE: Reflection Matthew, I appreciate your post so much!! Instead of feeling confident after finishing this course, I feel overwhelmed and doubtful about my ability to be an NP. There is so much information flowing from the class, and my cup is just 10 ml. Is fast as I scoop up the information, other information is passing me by and I'm getting further behind. I have been told my physicians many times that they can't know everything and that's why there are specialists, referrals, and collaboration. Thank you for the reminder! Enjoy your next year of classes and rotations. I hope to see you in future classes! Maybe in the days you have before the next class starts, you can learn to skateboard!! Ali Matthew Dove reply to Alice Jeffries RE: Reflection 6/22/2016 5:11:39 PM 6/22/2016 2:09:56 PMThat's a great idea--I could be the skateboarding FNP! Certainly a positive when completing this program is we will know how to optimize our time. As an extra bonus to the education, I have been given the gift of finely tuned prioritizing and leveraging of time management skills. Thank you for reading my posts, It's been a great class, and all