Political Advocacy 

PRACTICE SUMMARY PAPER

NURS 403 – Transition to BSN practice

Purpose of Assignment

            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>BSN nursing program at Old Dominion University.

Student Approach to Assignment

This assignment helped me to reflect on my personal and professional development during the RN-BSN program. It was a great feeling to reflect on my accomplishments. It took me a few weeks to reflect and produce this paper.       

Reason for Inclusion of this Assignment in the Portfolio

This project demonstrates the achievement of the core competencies through the attainment of specific elements within them. This paper will be a showcase of my accomplishments during the RN-BSN program.  

Critical Thinking

•  Uses nursing and other appropriate theories and models to guide professional practice

I used the Roy Adaptation Model to guide my professional practice. If there is any concern, my first step is to find out the focal stimuli and contextual stimuli. For instance, I work with many patients with status post hip surgeries. During the admission, I gather data pertaining to the Roy adaptation modes. This is done through a comprehensive health assessment. I identify focal stimuli and contextual stimuli pertaining to physiologic mode. Status post hip-surgery serves as the focal stimuli, whereas history of falling serves as the contextual stimuli.

• Evaluates nursing care outcomes through the acquisition of data and the questioning of inconsistencies

I was able to evaluate nursing care outcomes through the acquisition of data and the questioning of inconsistencies. I.e., at my work, we used to have bed alarms and chair alarms as fall preventive measures. When our nursing team evaluated the nursing care outcomes for bed alarms and chair alarms, it was evident that bed alarms and chair alarms did not provide enough support to prevent falls. Our nursing team decided to discontinue bed and chair alarms since they did not prevent falls.

• Revises actions and goals based on evidence rather than conjecture

Our nursing team at work revises actions and goals based on evidence rather than conjecture. As a nursing team, we had to revise actions and goals of fall prevention based on evidence. Having a bed/chair alarm free facility was not an easy change in the beginning, but the evidence-based literature and evaluation of nursing care outcomes assisted our nursing team to make the decision of having a bed/chair alarm free facility.

Nursing Practice 

•  Applies appropriate knowledge of major health problems to guide nursing practice

I apply appropriate knowledge of major health problems to guide nursing practice. Since I work in a long-term care skilled nursing facility, I take care of patients who have major health problems such as diabetes, hypertension, Parkinson’s, Alzheimer’s, and CVA. For instance, when I take care of a patient with diabetes, I make sure the diabetic patients follow the diabetic diet, check blood sugar levels, assess diabetic patients’ feet for any sores, and monitor for signs and symptoms of hyper or hypo glycemia.

• Performs therapeutic interventions that incorporate principles of quality management and proper safety techniques

I perform therapeutic interventions that incorporate principles of quality management and proper safety techniques. I learned to implement nursing interventions for groups of people. I learned it from community health nursing class (NURS 492). I had to do an assignment on a community health project. When I brainstormed, I realized that I am already promoting community health at the skilled nursing facility through managing chronic health conditions among the patient population. Moreover, I perform therapeutic intervention, which includes that when rehabilitation patients walk in the hallway, I ensure that they are wearing non-skid socks, and that they wear gait belts. I also make sure to provide supervision. This practice supports maintaining proper safety techniques during ambulation.

• Demonstrates an awareness of complementary modalities and their usefulness in promoting health

I demonstrate an awareness of complementary modalities and their usefulness in promoting health. I.e., in the NURS 363 class, I worked on a research proposal on, “Will the Use of a Relaxation Technique, Such as Music Therapy, Decrease the Usage of Opioids During the Management of Patients Age 40-45, Post Knee Athroplasty?” Through the assignment, I learned the complementary modalities and their usefulness in promoting health. I was able to demonstrate my knowledge at work by incorporating music therapy and aroma therapy for the patients who are in pain. There are times I have encouraged them to meditate, and I noticed a difference. Residents reported low pain levels. 

Communication

• Uses therapeutic communication within the nurse-patient relationship

I use therapeutic communication within the nurse-patient relationship. In order to promote therapeutic communication, I incorporate my communication skills such active listening, seeking clarification, observing non-verbal language, and reflecting. I adapt communication methods to patients with special needs. At my job, I work with patients with dementia. When I communicate with them, I talk about one thing at a time so that it will be easier for them to follow. Also, I listen to them without interrupting. I refined these skills during the RN-BSN program.

• Demonstrates skills in using technology, informatics, and communication devices that support safe nursing practice

I demonstrate skills in using technology, informatics, and communication devices that support safe nursing practice. For instance, I get to demonstrate skills in using technology at work by the use of Matrix clinical charting for documentations, utilizing email to communicate with fellow nursing staff and other interdisciplinary staff members, and using the fax machine for communication with homecare department and the pharmacy. 

Teaching

• Provides teaching to patients and/or professionals about health care procedures and technologies in preparation for and following nursing or medical interventions

 I provide teaching to patients and/or professionals about health care procedures and technologies in preparation for and following nursing interventions. For instance, there are times I work as a preceptor for the new nurses who join our nursing team. My teaching includes nursing interventions and nursing technologies -- i.e., teaching how to use the bladder scanner. I also teach nursing assistants, residents and residents’ families. For instance, I did a teaching project for my nurse educator class (NURS 402). The teaching project was focused on nursing assistants and fellow nurses.

Research

• Differentiates between descriptive nursing literature and published reports of nursing research

Although I had basic knowledge about research skills, this program helped me to refine the knowledge I already had. I took Nursing Research class (NURS 363) last spring. In this class, I learned the differences between quantitative versus qualitative data collection. Before the class I had an idea about data collection. Moreover, I learned to differentiate between descriptive nursing literature and published reports of nursing research. For instance, I learned to distinguish primary data and secondary data. 

• Applies research-based knowledge from the arts, humanities and sciences to complement nursing practice

In the Nursing Research class, I engaged to produce a research proposal on “Will the Use of a Relaxation Technique, Such as Music Therapy, Decrease the Usage of Opioids During the Management of Patients Age 40-45, Post Knee Athroplasty?”. This was as application of research-based knowledge from the arts (Music) to complement nursing practice. I learned about effects of music therapy, aroma therapy, and medication for pain management. I apply research-based knowledge at my work, especially for patients who need pain management. 

Leadership

•  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 assume a leadership role within one's scope of practice as a designer, manager, and coordinator of health care to meet the needs of populations. For instance, my current role as a charge nurse assisted me to become a leader/designer at my work. I was able to design and implement my teaching project on pressure injury prevention. It is a very common health concern at the facility.

• Articulates the values of the profession and the role of the nurse as member of the interdisciplinary health care team

I articulate the values of the profession and the role of the nurse as member of the interdisciplinary health care team. I.e., During the care plan meetings, I report the patient’s current status and improvements. It helps me to articulate the values of the profession and role of the nurse as member of the interdisciplinary health care team.

• Delegates and supervises the nursing care given by others while retaining accountability for the quality of care provided

I delegate and supervise the nursing care given by others while retaining accountability for the quality of care provided. Working as charge nurse enables me to delegate and supervise the nursing care given by nursing assistants. For instance, I ensure that they provide ADL care, monitor intake and output, and monitor the weights of the patients

Professionalism

• Understands the effect of legal and regulatory processes on nursing practice and health care delivery

I understand the effect of legal and regulatory processes on nursing practice and health care delivery.  For instance, at work it is mandatory to take the class on abuse every year. It teaches types of abuse and legal and regulatory process on nursing practice and health care delivery. Also, I learn any new state regulations every year due to annual state inspections.

• Demonstrates accountability for one’s own professional practice as well as limits to one’s own scope of practice.

I demonstrate accountability for my own professional practice. For instance, I supervise the nursing care given by others while retaining accountability for the quality of care provided. Working as charge nurse enables me to delegate and supervise the nursing care given by nursing assistants. Also, I work as a preceptor for the new nurses who join our nursing team.

• Advocates for professional standards of practice using organizational and political processes.

I have advocated for professional standards of practice using organizational and political processes. For instance, to prevent CAUTIs, it is the standard of care for the nursing assistant to provide catheter care to patients q shift. If  a nursing assistant violates this standard, I advocate by addressing the issue. 

Culture

• Maintains an awareness of global environmental factors that may influence the delivery of health care services

In Community Health Class (NURS492) I learned about global environmental factors that may affect delivery of health care services. For instance, climate change and exposure to hazardous substances in the air, water, soil and food can contribute to health concerns. At my work, we ensure that we dispose hazardous waste according to facility protocol. Moreover, our facility does not use bleach for cleaning purposes since it is against the Occupational Safety and Health Administration (OSHA).

Theraputic Nursing Interventions Paper

THERAPEUTIC NURSING INTERVENTIONS PAPER

NURS 403 – Transition to BSN practice

Purpose of Assignment

The purpose of this paper is to define a clinical problem, review the literature for appropriate research supported nursing interventions, critique current practice and provide a plan for changing or adapting clinical practice.

Student Approach to Assignment  

This assignment opened my awareness to a significant clinical problem at my work: medication errors. I discussed the current situation and came up with nursing interventions that can help the clinical issue. 

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Reason for Inclusion of this Assignment in the Portfolio 

This assignment is a proof addressing a clinical issue at my work. It has nursing interventions and a plan for adapting clinical practice. Also, I have elaborated my personal experience with the clinical issue as well.

Critical Thinking

•  Uses decision-making skills in making clinical or professional judgments

In this assignment, I have listed how I used decision-making skills on a clinical situation and how I made the best clinical judgment. For instance, I was faced with an embarrassing and potential medication error moment when medication cabinets were not locked during the state inspection. This event happened in 2017 when the state was inspecting our facility. Both state and federal inspector were following me during medication administration. I was the nurse who is in charge of the 7-11 shift in my unit. Each resident has a medicine cabinet located in each room. When I went to a resident’s room for medication administration, I found that the medicine cabinet was not locked. My first reaction was to stop the medication pass and assess other rooms in the unit in order to ensure that other medication cabinets were locked. My critical thinking skill was very effective. I was able to find a few other cabinets that were not locked. I locked each unlocked cabinet prior to the medication administration.  

• Engages in creative problem solving

This assignment made me engage in creative problem solving. For instance, labeling medications, increasing reporting, learning from medication incidents, getting rid of expired and discontinued medication on a regular basis, and minimizing error prone abbreviations are some of the solutions for the clinical issue. 

Nursing Practice 

• Performs therapeutic interventions that incorporate principles of quality management and proper safety techniques

Through this assignment, I was able to perform therapeutic interventions that incorporate principles of quality management and safety techniques. For instance, the facility should have a scheduled day to go over each medication cabinet and get rid of the medications that are expired and discontinued. These medications can lead to potential medication errors as well. Implementing a schedule can promote better patient outcomes and avoid potential medication errors.

Teaching

• Provides teaching to patients and/or professionals about health care procedures and technologies in preparation for and following nursing or medical interventions

In order to implement the plan of change, first step was to provide teaching to professionals about the importance of uninterrupted medication administration.

Research

• Shares research findings with colleagues

This project is aimed towards the nursing staff at my work. My plan is to share the research findings with colleagues. For instance, it is my plan that my colleagues will adapt a “no interruption” zone so that it will reduce medication errors.

Leadership

•  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 a leadership role within one’s scope of practice as a coordinator of health care to meet the needs of populations. This project required coordinating skills. It requires coordinating with the nursing staff, non-nursing staff, and nursing administration. I had to request their coordination to make this project successful because coworkers interrupt amid medication administration and the nursing administration expect the nurses to answer the nurses’ phone at all times.

Professionalism

• Understands the effect of legal and regulatory processes on nursing practice and health care delivery

I understand the effect of legal and regulatory processes on medication administration. For instance, the usual protocol for the medication errors encompasses filing a medication error incident report. This incident report has few requirements. First, the nurse who finds the medication error must file the incident report and explain the incident descriptively. Then, she has to notify the primary care provider, and the resident’s Power of Attorney (POA). Finally, the nursing administration will do any further investigation.