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Professional Development Plan

Adrianne Tozer

Ferris State University

Abstract

This paper discusses the standards of professional performance set forth by the American Nurses Association (ANA). I have created a professional development plan which afforded me the opportunity to reflect on my strengths and weakness as it relates to each standard. Based on these professional standards, I have developed both five and ten year goals along with an evaluation of those goals.

Professional Development Plan

The field of nursing is growing and developing at a rapid rate, but at the core remains constant standards of professional performance, all of which have been developed by the ANA. Upholding and evaluating these standards is the duty of each and every nurse. This paper closely examines the strengths and weaknesses of my current nursing practice through the use of examples, references and comparisons. Lastly, I have created both short and long term career goals which include time frames.

Standards of Professional Performance

Standard 7: Ethics

So often the nursing profession is without clearly defined rules, solutions or answers. At times like this, all nurses, including myself, are guided by the code of ethics. According to the ANA, the nurse, “Delivers care in a manner that preserves and protects healthcare consumer autonomy, dignity, rights, values, and beliefs” (ANA, 2010, p. 47). No matter what patient presents before me, they are provided with the best care I can provide, every time, without exception. This often requires that I put my own beliefs and thoughts aside, focusing solely on what is best for the patient. The ANA (2010) also states the nurse has an added responsibility in assisting patients and their families, “in self determination and informed decision-making” (p. 47). I am accountable for providing unbiased and correct information. This allows the patient and family to make an informed decision based on their beliefs, wishes and values. More importantly, is my willingness to show respect no matter if I agree or disagree with the choices made.

I find myself becoming increasingly opinionated as the years go by, which does not always make it easy to agree or respect the choices of others. However, this is where maturity and professionalism come to play. If the situation were reversed, I would expect the nurse to show respect and consideration for my decisions. There are as many ethical dilemmas’ as there are people but one issue that I find disturbing is spending valuable resources on someone who has no quality of life. For example, I recently had a 92 year old male patient that had a stroke which caused complete paralysis to the left side of his body. This same patient was completely dependant for all of his care. He was unable to ambulate had mild dementia, a tube feeding, incontinence and an array of other maladies. I do not recall his diagnosis but he was on telemetry and a full code. Of course, the type of care I provided remained that of high standards and compassion. However, I wondered why this patient and his family have been allowed to burden our already broken medical system. I realize my opinion is harsh and would never go without criticism but these are the types of ethical challenges I find difficult to deal with.

Standard 8: Education

According to the ANA, a registered nurse, “Demonstrates a commitment to lifelong learning through self-reflection and inquiry to address learning and personal growth needs” (ANA, 2010, p. 48). The field of nursing is constantly changing and in order to remain a competent I must commit myself to higher education and continuous self-improvement. I have seen a great deal of emphasis placed on education over the last few years. Nurses are being asked to take on more responsibilities and tasks than ever before. “Nursing is a dynamic profession and lifelong learning is essential for nurses to stay current with the increased complexity of the healthcare needs of today and into the future” (Ellis, n.d., para, 5). I see increasing my knowledge base through education, as the best way to offer my patients top notch care, however, education does not stop there. In order to enhance and strengthen the profession we need to share learning experiences and ideas with our peers (ANA, 2010).

The bare essentials of my education start by keeping up to date with the Michigan Board of Nursing Continuing Education Requirements. I have also returned to school to obtain my bachelors of science in nursing (BSN). I am certified in basic life support (BLS) and as of last month, I received my certification as a first aid/cardiopulmonary resuscitation and automatic external defibrillator (AED) instructor, through the American Red Cross. Lastly, I took a semester long course at my local community college in telemetry monitoring. It is my responsibility to keep accurate and up to date records on all my education requirements and competencies.

I find myself discussing issues, facts or projects that I am working on for my BSN, with my coworkers, which always sparks a debate. It opens up communication and stimulates our critical thinking skills. I am also a new hire preceptor where I have the responsibility of educating new nurses on our policies, procedures and work flow. This allows me the opportunity to share information and skills with other nurses, in hopes of adding to their knowledge base. At the same time, I rely on our more experienced and seasoned nurses to guide me in developing my own practice.

Standard 9: Evidence-Based Practice and Research

The ANA states the registered nurse, “Utilizes current evidence-based nursing knowledge, including research findings, to guide practice” (ANA, 2010, p. 51). Nearly all of my patient care and nursing duties are centered on evidence-based research. Looking back on my sixteen years of practice, it is amazing to think of all the improvements and changes that have made through research. Evidence-based practice and research has not only been beneficial to the profession but to the lives of our patients. This includes everything from washing my hands with an antibacterial soap to encouraging my patients to cough and deep breath after surgery.

As I move forward in my education, it is my hope to contribute to the advancement of nursing through research. At this point in time I have not had the opportunity but would surely enjoy doing so in the future.

Standard 10: Quality of Practice

The ANA (2010) states the registered nurse participates in quality improvement by, “Developing, implementing, and/or evaluating policies, procedures, and guidelines to improve the quality of practice” (p. 52). Thanks to the watchful eye of nurses we have safer patient care, along with constant improvements in the quality of care we can offer. This is probably the standard that I consistently show strength in. Being involved in direct patient care offers me a chance to address a variety of issues that could improve patient outcomes. For example, on the medical/surgical floor at my facility, we frequently admit confused patients. We used to assess and wait to see if they required a bed alarm. It was not until the patient started climbing out of bed or actually fell to the floor that we would set up a bed alarm. This was unsafe so we brainstormed for ideas to enhance safety. Now, our policy states to immediately apply a bed alarm, red socks and a yellow wristband indicating a fall risk, on all confused patients upon admission. We have improved our quality of practice by enhancing patient safety.

Another area that applies to quality of practice is, “Collecting data to monitor quality and effectiveness of nursing practice” (ANA, 2010, p. 52). Many of the nurses during down time make discharge phone calls to patients that were recently discharged from our floor. We ask questions such as; “Did you make a follow up appointment with your doctor?” “Are you taking all of your prescribed medications?” “Is there anything that could have made your stay better?” We review the information as a group with our nurse manager and discuss any areas of concern. The amount of noise on midnight shift was an ongoing complaint, so we now offer ear plugs and even white noise sound machines. Often it is little improvements that make the largest impact.

Standard 11: Communication

The registered nurse, “Maintains communication with other providers to minimize risks associated with transfers and transition in care delivery” (ANA, 2010, p. 54). Communication is vital to maintain high quality patient care and safety, yet we often fall short. Poor communication during patient handoffs can lead to medication errors, gaps in patient care, wrong-site surgery and even deaths (Friesen, White, & Byers, 2008). Effective communication takes time and effort. When calling report to another nurse it is important to be unhurried and have all the patient information at hand (labs, medications, allergies, diagnosis). I make sure there is ample time to answer any questions and look up further information if needed. It is also imperative to be approachable and maintain a professional attitude. If a nurse is receiving report on a patient and the reporting nurse is in a hurry or rude, this can causes a breakdown in communication. One way to avoid situations like this is to speak calmly and answer all questions willingly. After I am finished with the report, I always say, “If you have any questions just call me at 227-3377.” By making this statement I am setting the tone to maintain open communication.

It is also important that I assess my own communication skills with patients, families and colleagues (ANA, 2010). One area that I need to improve upon, is remembering to change my language in order to fit the situation. I find myself using medical terminology and jargon when speaking to the patient, which is not an effective approach, especially if I am teaching. They look at me with bewildered eyes then I remember to speak in layman’s terms.

Standard 12: Leadership

Nursing needs strong leaders to guide us into the feature. A good leader consists of mentoring other nurses while showing dignity, trust and respect (ANA, 2010). I am committed to consistently demonstrating these qualities not only in my profession but throughout other areas in my life. I am a preceptor for new hires and at times a charge nurse. This not only allows me to share my knowledge but demonstrate professional behaviors through example. I have been a nurse for nine years on the medical/surgical floor so other nurses look to me for direction. However, this can be difficult when busy because I feel pulled in many directions and can lose my patience. I have to remind myself that over the years many nurses have sacrificed their time and sanity to help me grow.

The nurse should be able to model proficient and expert practice to their patients (ANA, 2010). Patients want to know that their nurse will step up to the plate and get things done. They want someone who is strong, willing to advocate and work hard. If a patient is rapidly declining, I never show my fear. Showing anxiety and incapability fosters a lack of trust between the nurse and patient.

Standard 13: Collaboration

According to the ANA (2010) the registered nurse, “Partners with others to effect change and produce positive outcomes through the sharing of knowledge of the healthcare consumer and/or situation” (p. 57). I am constantly collaborating with physicians, social workers, respiratory therapists, dieticians and physical therapists. We share observations, concerns and our expertise on how to better care for the patient. For example, if I am caring for a newly diagnosed diabetic it is important that he receive information on proper nutrition. I understand the expertise and knowledge the dietician can lend to this patient so I request her assistance. Possibly this patient can not afford his diabetic supplies so I contact the social worker because she is better suited to meet these needs.

I definitely see an area of weakness, not necessarily with myself, but with the health care team as a whole. My facility does not hold patient care conferences. I feel it would be beneficial to sit down as a group and discuss the patient and his or her care. This way we are all on the same page and can share our individual perspective to format a complete plan of care.

Standard 14: Professional Evaluation

“The registered nurse evaluates her or his own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules, and regulations” (ANA, 2010, p. 59). One way in which I gain feedback on my nursing practice is through yearly evaluations with my nurse manager. This evaluation is a tool that is used to identify my strengths and weaknesses as a nurse. My manager and I discuss ways to build upon my skill, knowledge and overall competencies. Most nurses do not enjoy getting work evaluations, however, I look forward to it because I really respect and admire my nurse manager. I hold her in high esteem and really take her recommendations to heart.

In keeping with this standard, the ANA (2010) recommends that the registered nurse, “Engages in self-evaluation of practice on a regular basis, identifying areas of strength as well as areas in which professional growth would be beneficial” (p. 59). I am constantly comparing my nursing practice to those who have years of experience and knowledge. I take special note of their attitudes, skills and communication techniques. Then I can incorporate their expertise into my own practice.

The best evaluations come from my patients. At the end of my shift, a patient may thank me for providing good care. Being able to drive home and reflect on how I made a difference in someone’s life is the most powerful evaluation tool of all!

I find my weakness lies in receiving feedback from someone who I do not respect. Even if he or she is right, instead of taking their advice into consideration, I take offense to it. I need to remember that everyone has good and bad points. Just because I do not particularly like a person does not mean I should disregard their point of view or suggestions.

Standard 15: Resource Utilization

“The registered nurse utilizes appropriate resources to plan and provide nursing services that are safe, effective, and financially responsible” (ANA, 2010, p. 60). My facility has a website that includes access to their full medical library, educational materials for patients and a wealth of other resources such as information on the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). I am constantly looking up health care information not only for my patients but for school.

According to the ANA (2010), the registered nurse, “Advocates for resources, including technology, that enhance nursing practice” (p. 60). My nurse manager makes scheduled rounds on her nurses and one of the questions she asks without fail is, “Do you have all the tools you need to perform your job?” More often than not, whatever the nurses feel they need, she gets! We needed new blood pressure machines, thermometers, bed alarms, IV poles (that did not make so much noise rolling on the floor) and white boards, all of which we now have. Our manager sees this as a way to enhance both patient and nurse satisfaction.

The ANA (2010) recommends the nurse assist both the patient and their families in cost reduction, risks and benefits, as it relates to decisions about their treatment and care. This is a weak area for me, as I have little knowledge about the cost of medications or treatments. If a patient or family inquires about a cost I usually suggest they ask their doctor. Or if cost is a concern, due to a lack of health insurance, I will order a social work consult. Instead of taking the time to educate myself or perform a little research, I just pass it off to someone else.

Standard 16: Environmental Health

All nurses are expected to provide care that is environmentally safe. The ANA (2010) states a registered nurse, “Assesses the practice environment for factors such as sound, odor, noise, and light that threaten health” (p. 61). This is something I automatically do without even thinking about it. If trash is overflowing, then I empty it. If someone is incontinent, than I change their brief. Assessing our surroundings to promote a fresh, clean and safe environment is a necessity. Visitors do not want to walk into a patient’s room and smell foul odors or see a left over lunch tray. Nurses may be desensitized to many sites and odors but must remember that most people are not, and will take offense to it. Keeping a clean unit is important for staff morale, too. All health care workers want to be proud of the environment they work in.

Another environmental health standard is, “Utilizes scientific evidence to determine if a product or treatment is an environmental threat” (ANA, 2010, p. 61). I definitely have a weakness in this area. I make the assumption if a product is on the floor or a treatment is being utilized, than it is safe. Of course this is not necessarily true and I should take the time to review the policy or read instructions before choosing to use something new.

Goals

Five Year Goals

I have always had professional goals but it was not until returning back to school that I started to spend more time focusing on them. I am currently back in school for my BSN and my completion date will be May, 2014. I decided to return to school for a variety of reasons. First, I feel having a BSN will provide job security along with increasing my wages. Secondly, it will expand my qualifications as a nurse allowing for more job opportunities. Lastly, I love nursing and could not imagine doing anything else. Furthering my education will allow me to realize my dreams and become the nurse I always wanted to be. Besides completing my BSN, another five year goal of mine is to become certified in advanced cardiovascular life support (ACLS). Lastly, I want to become a member of the ANA.

Ten Year Goals

My ultimate goal is to teach nursing so I will earn a Master of Science Degree in Nursing (MSN) at Ferris State University with a focus on education. So, why did I choose Ferris? Everything from scheduling to technical support has been smooth. The curriculum is relevant to what nursing is today and where it is heading in the future. My thought process has really expanded and I have begun to consider nursing in ways I never thought of before. This is helping me to overcome some weak areas, as addressed earlier. The flexibility of taking online classes is perfect for a busy, single mother like me. Staying with Ferris will allow me to transition easily from the BSN program to the MSN program as I will already be familiar with MyFSU and other processes. Lastly, Ferris was ranked number one by U.S. News and World Report for best online graduate nursing program (Owens, n.d.).

My decision to become a nurse educator did not come overnight. Over the past couple of years I have been involved with training new nurses on the floor, along with instructing staff on our new electronic medical charting system. Since I enjoyed the entire process of teaching others, I decided to take it a step further and earn my instructors certificate. This enables me to teach first aid, CPR and AED classes. I also researched the need for nursing instructors and found that according to the American Association of Colleges of Nursing (AACN) there is a shortage of faculty in schools of nursing throughout the country (2005). The AACN further states the shortage has grown critical because a large number of current faculty educators are at or near retirement. The problem is further aggravated by the fact there is a decrease in the level of younger replacements. This will certainly help my prospects practicing in this field.

Evaluation

I am well on my way to earning my BSN. I only have one more year after this semester. In a previous class I developed a detailed plan on how to successfully complete the program in a timely manner. My tuition is completely paid for by my employer, which takes a huge burden off of me. I will become certified in ACLS at my local community college and apply for ANA membership through the internet by summers end.

Since my employer is paying for my BSN I had to agree to work an additional two years after graduating. This poses no problem since I can simply work on my masters while finishing out my contract. I have been reviewing information about the Ferris MSN program but have found myself confused as to the exact number of credits that will be needed. My off campus advisor is Dionne Serges and I plan on speaking to her before this semester is over. She has been extremely helpful to me in the past and is a wealth of information. This ten year goal seems so far away; then I remember working as a licensed practical nurse (LPN) and thinking how long becoming a registered nurse (RN) would take. Now here I am working on my BSN!

Conclusion

After spending sixteen years in the nursing profession, I am well aware of the constant changes and growth nursing has seen. Understanding the daily obstacles nurses face, has forced me to grow, mature and adapt. In order to meet my dreams I must work hard and stay dedicated. I feel my standards are high but there is definite room for improvement. Staying committed to my goals will allow me to enrich my nursing practice, overcome any weaknesses and realize my dream of teaching future nursing students.

References

American Association of Colleges of Nurses. (2005). Faculty shortages in baccalaureate and graduate nursing programs: scope of the problems and strategies for expanding the supply. Retrieved from Ferris State University Web site: http:/​/​fsulearn.ferris.edu/​webapps/​portal/​frameset

American Nurses Association [ANA]. (2010). Nursing: scope and standards of practice (2nd ed.). Retrieved from hppt:/​/​​ebooks/​download/​nursingScopeStandards.pdf

Ellis, S. (n.d.). Nursing articles to BSN or not to BSN-that is the nurse's question. Retrieved from Web site: http:/​/​​articles/​se060326-bsn-nurse.htm

Friesen, M. A., White, S. A., & Byers, J. F. (2008). Handoffs: implications for nurses. In RJ. Hughes (Ed.), Patient safety and quality: an evidence-based handbook for nurses (Vol. 2, pp. 285-332). Retrieved from http:/​/​ncbi,nlm.nih,gov/​books/​NBK2649?

Owens, S. (n.d.). Master of science in nursing. Retrieved from Ferris State University Web site: http:/​/​ferris.edu/​HTMLS/​colleges/​alliedhe/​Nursing/​MSN-program/​HOME-Nursing

CHECKLIST FOR SUBMITTING PAPERS

|CHECK | |

|DATE, TIME, & |PROOFREAD FOR: APA ISSUES |

|INITIAL | |

| |1. Page Numbers: Did you number your pages using the automatic functions of your Word program? [p. 230 and example on p. |

|Yes |40)] |

|Yes |2. Running head: Does the Running head: have a small “h”? Is it on every page? Is it less than 50 spaces total? Is the title|

| |of the Running head in all caps? Is it 1/2” from the top of your title page? (Should be a few words from the title of your |

| |paper). [p. 229 and example on p. 40] |

|Yes |3. Abstract: Make sure your abstract begins on a new page. Is there a label of Abstract and it is centered at the top of the|

| |page? Is it a single paragraph? Is the paragraph flush with the margin without an indentation? Is your abstract a summary|

| |of your entire paper? Remember it is not an introduction to your paper. Someone should be able to read the abstract and know|

| |what to find in your paper. [p. 25 and example on p. 41] |

|Yes |4. Introduction: Did you repeat the title of your paper on your first page of content? Do not use ‘Introduction’ as a |

| |heading following the title. The first paragraph clearly implies the introduction and no heading is needed. [p. 27 and |

| |example on p. 42] |

|Yes |5. Margins: Did you leave 1” on all sides? [p. 229] |

|Yes |6. Double-spacing: Did you double-space throughout? No triple or extra spaces between sections or paragraphs except in |

| |special circumstances. This includes the reference page. [p. 229 and example on p. 40-59] |

|Yes |7. Line Length and Alignment: Did you use the flush-left style, and leave the right margin uneven, or ragged? [p. 229] |

|Yes |8. Paragraphs and Indentation: Did you indent the first line of every paragraph? See P. 229 for exceptions. |

|Yes |9. Spacing After Punctuation Marks: Did you space once at the end of separate parts of a reference and initials in a |

| |person’s name? Do not space after periods in abbreviations. Space twice after punctuation marks at the end of a sentence. |

| |[p. 87-88] |

|Yes |10. Typeface: Did you use Times Roman 12-point font? [p. 228] |

| |11. Abbreviation: Did you explain each abbreviation the first time you used it? [p. 106-111] |

|Yes |12. Plagiarism: Cite all sources! If you say something that is not your original idea, it must be cited. You may be citing |

| |many times…this is what you are supposed to be doing! [p. 170] |

|Yes |13. Direct Quote: A direct quote is exact words taken from another. An example with citation would look like this: |

| |“The variables that impact the etiology and the human response to various disease states will be explored” (Bell-Scriber, |

| |2007, p. 1). |

| |Please note where the quotation marks are placed, where the final period is placed, no first name of author, and inclusion |

| |of page number, etc. Do all direct quotes look like this? [p. 170-172] |

|Yes |14. Quotes Over 40 Words: Did you make block quotes out of any direct quotes that are 40 words or longer? [p. 170-172] |

|Yes |15. Paraphrase: A paraphrase citation would look like this: |

| |Patients respond to illnesses in various ways depending on a number of factors that will be explored (Bell-Scriber, 2007). |

| |It may also look like this: Bell-Scriber (2007) found that…… |

| |[p. 171 and multiple examples in text on p. 40-59] |

| |For multiple references within the same paragraph see page 174. |

|Yes |16. Headings: Did you check your headings for proper levels? [p. 62-63]. |

|Yes |17. General Guidelines for References: |

| |A. Did you start the References on a new page? [p. 37] |

| |B. Did you cut and paste references on your reference page? If so, check to make sure they are in correct APA format. Often |

| |they are not and must be adapted. Make sure all fonts are the same. |

| |C. Is your reference list double spaced with hanging indents? [p. 37] |

| | |

| |PROOFREAD FOR GRAMMAR, SPELLING, PUNCTUATION, & STRUCTURE |

|Yes |18. Did you follow the assignment rubric? Did you make headings that address each major section? (Required to point out |

| |where you addressed each section.) |

|Yes |19. Watch for run-on or long, cumbersome sentences. Read it out loud without pausing unless punctuation is present. If you |

| |become breathless or it doesn’t make sense, you need to rephrase or break the sentence into 2 or more smaller sentences. Did|

| |you do this? |

|Yes |20. Wordiness: check for the words “that”, and “the”. If not necessary, did you omit? |

|Yes |21. Conversational tone: Don’t write as if you are talking to someone in a casual way. For example, “Well so I couldn’t |

| |believe nurses did such things!” or “I was in total shock over that.” Did you stay in a formal/professional tone? |

|Yes |22. Avoid contractions. i.e. don’t, can’t, won’t, etc. Did you spell these out? |

|Yes |23. Did you check to make sure there are no hyphens and broken words in the right margin? |

|Yes |24. Do not use “etc.” or "i.e." in formal writing unless in parenthesis. Did you check for improper use of etc. & i.e.? |

|Yes |25. Stay in subject agreement. When referring to 1 nurse, don’t refer to the nurse as “they” or “them”. Also, in referring |

| |to a human, don’t refer to the person as “that”, but rather “who”. For example: The nurse that gave the injection….” Should |

| |be “The nurse who gave the injection…” Did you check for subject agreement? |

|Yes |26. Don’t refer to “us”, “we”, “our”, within the paper…this is not about you and me. Be clear in identifying. For example |

| |don’t say “Our profession uses empirical data to support ….” . Instead say “The nursing profession uses empirical data….. |

|Yes |27. Did you check your sentences to make sure you did not end them with a preposition? For example, “I witnessed activities |

| |that I was not happy with.” Instead, “I witnessed activities with which I was not happy.” |

|Yes |28. Did you run a Spellcheck? Did you proofread in addition to running the Spellcheck? |

|Yes |29. Did you have other people read your paper? Did they find any areas confusing? |

|Yes |30. Did you include a summary or conclusion heading and section to wrap up your paper? |

|Yes |31. Does your paper have sentence fragments? Do you have complete sentences? |

|Yes |32. Did you check apostrophes for correct possessive use. Don’t use apostrophes unless it is showing possession and then be|

| |sure it is in the correct location. The exception is with the word it. It’s = it is. Its is possessive. |

Signing below indicates you have proofread your paper for the errors in the checklist:

Adrianne Tozer 4/7/2013

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