PRACTICE SUMMARY PAPER
NURS 403 – Transition to Baccalaureate Nursing Practice
(please see paper linked below)
Purpose:
The purpose of this paper is to guide you through a process of self-reflection and self-evaluation to discover the scope of your personal and professional development while enrolled in the RN to BSN nursing program at Old Dominion University.
Student Approach to Assignment:
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I approached this assignment by self-reflecting on my personal and professional growth while enrolled in the RN to BSN concurrent program of nursing. This assignment reflects my values and interests by addressing the principles of my current nursing practice. Through this written assignment, I discovered that I have grown professionally and academically. Self-reflection is the most effective tool in evaluating one’s self, personal growth and educational accomplishments. For this assignment, I also compiled all pertinent assignments completed in the RN to BSN program in efforts to organize and address all core standards (critical thinking, nursing practice, communication, teaching, research, leadership, professionalism and culture).
Reason for Inclusion of this Assignment in the Portfolio. This piece of academic work should be included in my portfolio because it displays my growth and development as a student and registered nurse. This assignment represents my work ethic, current nursing practice and highlights major educational achievements. Throughout my academic journey towards my baccalaureate-degree in nursing, I have accomplished all eight core standards of the program; this paper defines how each objective was successfully fulfilled.
Critical Thinking
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o Uses nursing and other appropriate theories and models to guide professional practice
Throughout the RN to BSN program, I have written several assignments and practiced in ways that are sculpted by critical thinking. Throughout the program, I have researched several nursing philosophies, compiled the information and evaluated what I felt was most important; one of those nursing philosophies was that of Florence Nightingale. In my professional practice, I apply Nightingale’s basic principles to guide my nursing care. For example, I conduct thorough head-to-toe assessments, ensure the patient’s environment is clean/hygienic so it is conducive for proper healing and implement standard precautions daily to prevent the transmission of infectious diseases. If there are abnormalities in my physical assessments, I immediately review vitals, current lab values/medications and any other sources that could cause the unwanted symptoms. While doing this review, I am thinking critically in an attempt to determine what factors are causing or contributing to the patient’s decline of health status.
o Uses decision-making skills in making clinical or professional judgments
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I was on the med-surg floor and had a patient who was just admitted due to a CVA. The patient had right-sided weakness and difficulty swallowing (earlier that morning, she was taking a sip of water and got strangled badly). I was notified that speech therapy would be making a round on our floor to assess her condition. I knew that in similar situations there was usually an NPO order until cleared by speech therapy. However, the breakfast tray was delivered and she was about to start eating (with her right sided weakness and decreased ability to speak); I immediately spoke to my nurse about the situation. As of 0700 there was no dietary orders. I knew that her attempting to eat was risky because she couldn’t swallow and this would therefore increase her chances of strangulation. Before the patient began eating, I checked the computer once more at 0736 and saw that a strict NPO diet was just ordered one-minute prior, at 0735.
Nursing Practice
o Performs therapeutic interventions that incorporate principles of quality management and proper safety techniques
Patient safety is my top priority and I strive daily to ensure I am upholding safe practices. For example, if I see that an antibiotic is due to run as a secondary intravenous (IV) line, I always refer to my facility’s IV drug compatibility resource guide (LexiComp). This guide will inform the user if two drugs are compatible and therefore safe to run together as primary and secondary lines. Though some nurses choose to relay this information during shift change and report, I double-check the compatibility as needed.
o Implements nursing care practices as appropriate to provide holistic health care to diverse populations across the lifespan
One responsibility as a nurse is to assure a patient is cared for in a culturally congruent manner. For example, there was one female patient admitted whom was Muslim. Her husband demanded that her nurse be of the same sex, a female. This cultural preference was addressed weekly in the unit and patient assignments were rearranged accordingly for this family. I took the additional patient for one of my own. I was sure to converse with the patient and her husband and asked his for his opinion/ input for all medical discussions, as this it is important in Muslim culture for the male to have input on the wife’s decisions.
Communication
o Uses therapeutic communication within the nurse-patient relationship
When conducting my assessment on one of my patients, I am sure to ask how s/he is feeling, being mindful to focus solely that patient. I offer myself by standing by their bedside and offering my hand for comfort if need be. Most importantly, I offer silence and allow the patient confess any worries s/he may have.
o Adapts communication methods to patients with special needs
In ICU, there are several elderly patients admitted, these patients often are equipped with our facility’s “pocket-talker.” This device amplifies sound and is transmitted through wearable headphones; this device is light-weight and is easily stored in the patient’s pocket for hassle-free mobility.
o Expresses oneself and communicates effectively with diverse groups using a variety of media
One discussion board that displays this effective communication comes from the course NURS 490W, the introduction discussion board. With this assignment, each member of the online class was instructed to post a short narrative about themselves (hobbies, academic goals, leadership experience, etc.). The second part of the discussion board required that each participant respond to five classmates. This facilitated communication and helped to welcome each student.
Teaching
o Provides teaching to patients and/or professionals about health care procedures and technologies in preparation for and following nursing or medical interventions
Through this assignment, I was able to research a clinical practice problem and develop an instructional session for a group of nursing students. The content was centered around the current healthcare issue and the purpose behind the teaching session was to provide nurses with the necessary information to properly administer medication. The goal of the teaching session was to have nurses independently administer medication using all six rights. For example, I lectured on each of the six rights of medication administration (right patient, right drug, right time, right route, right dose, right documentation) and then guided the students to the simulation lab to practice medication administration on the mannequins. Today, I utilize those same six rights when giving medications to my patients.
Research
o Differentiates between descriptive nursing literature and published reports of nursing research
While enrolled in the NURS 363 course, I was an active participator of a research group who constructed a complete research design paper on the effects of advanced parental education on Sudden Infant Death Syndrome (SIDS) and its correlation to the number of SIDS deaths. In short, we conducted thorough research on our topic and compiled all pertinent nursing research to compose a well-written research design paper.
Leadership
o Assumes a leadership role within one’s scope of practice as a designer, manager, and coordinator of health care to meet the needs of populations
I assumed the role of community leader (course NURS 490W) in efforts to coordinate a clothing drive for my surrounding county. The leadership style I implemented the most was the democratic approach. During the organization of the clothing drive, I ensured that input from all church members was addressed and discussed. For example, during one of our weekly meetings we were discussing the best method of alerting the community of the clothing drive; I suggested making an online group and sending notifications in that manner but many other members thought it would be best to create handouts/flyers and disseminate accordingly. I also was responsible for disseminating hand-outs in my community, alerting the public of the date, time and location of clothing drive.
Professionalism
o Demonstrates accountability for one’s own professional practice as well as limits to one’s own scope of practice
Each work shift, I am sure to check IV lines, drug compatibility, use gloves and protective gear as needed and if I make a mistake, I immediately admit it and seek the proper actions to correct it. For example, one day I had four critical patients and one was due an antibiotic (Rocephin), I go to the medication room where pharmacy had left all antibiotics on a table and proceeded to pick out the antibiotic needed. During my scan of medications into the computer, I realized I had the correct antibiotic but it was labeled for a different patient. I immediately, stop what I am doing, return the unopened antibiotic to the medication room, grab the correct one and double check all medication rights. At the time, I was precepting and immediately informed her of my mistake and discussed ways to reduce its occurrence. I am also aware that I cannot legally implement nursing interventions without a doctor’s medical order.
Culture
o Articulates an understanding of how human behavior is affected by culture, race, religion, gender, lifestyle, and age
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As a nurse, I understand that culture and religion affect an individual’s lifestyle and therefore the medical choices that are made. For example, during one of my work shifts, I had a patient whom was a Jehovah’s witness. When practicing this religion, they are against receiving outside blood, such as blood transfusions. I discussed with my patient the possibility of needing a transfusion and he promptly denied. Respecting his religious beliefs, I complied with his wishes.
o Demonstrates sensitivity to personal and cultural definitions of health, and how these beliefs influence an individual’s reactions to the illness experience and end of life
NURS 457 allowed me to “demonstrate sensitivity to personal and cultural definitions of health, and how these beliefs influence an individual’s reactions to the illness experience and end of life” by conducting research on Native American Indians and their view on the end of life process. Native Americans believe that sickness is caused by disruption of spiritual, emotional and physical elements. Trust is something valued and death is not viewed as “bad.” Post-mortem care should be allowed for family members of the deceased patient. This culture does not believe in autopsies, as it disrupts the body and soul.
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