Practice Summary Paper



Practice Summary Paper

Kevin M. Ryan

Old Dominion University

Practice Summary Paper

The goal of this paper is to demonstrate the personal and professional development I experienced while enrolled in Old Dominion University’s RN to BSN program. The activities and objectives achieved throughout the program have enabled me to demonstrate the attainment of the eight core competencies of the nursing professional. These core competencies include critical thinking, nursing practice, communication, teaching, research, leadership, professionalism, and culture. Examples of how these competencies were achieved and demonstrated will be reviewed.

In December of 2012, I graduated with an associate’s degree in nursing. I then sat for the state boards in Arizona, and received my nursing license two months later. While completing my preceptorship at the Mayo Clinic in Phoenix Arizona, I learned that Mayo limits entry level hires to a BSN (bachelor’s degree in nursing). It was at this time that I became 100% sure I would continue my education and acquire a bachelor’s degree in nursing.

Once enrolled in the BSN program at Old Dominion University, I became aware of a BSN to MSN bridge program. The program allows for candidates to take graduate level courses that would serve a dual purpose of retiring both undergraduate and graduate level requirements at the same time. This idea was attractive because it was both a financial and time saving opportunity. I tested and applied for the program, and was thankfully accepted.

When I started the program, my goal was to become a more well-rounded nurse, with the understanding that a bachelor’s degree opened more career doors. Completing a master's degree would also make possible the opportunity to become a nurse educator later in my career. The RN to BSN to MSN track has at times been daunting. Through the encouragement of family, friends, and peers, I have continued to make progress towards accomplishing this goal.

Some of my goals have changed since I enrolled in the BSN program at Old Dominion University. At one time, I was laser-focused on working for the Mayo Clinic. Now, I have come to enjoy my current position as a hospice nurse. I do expect to continue to provide hospice nursing care for at least one or two more years. I will then explore other opportunities outside of hospice care which may or may not include working for the Mayo Clinic.

Critical Thinking

While working on both my Associates degree and my bachelor’s degree, many opportunities to demonstrate and enhance my critical thinking skills were presented. Critical thinking skills are important in both the clinical and the administrative nursing environments. I had opportunities to watch instructors, peers, and patients demonstrate their critical thinking skills. It is enjoyable to watch someone with a different perspective creatively solve a problem or take an action that improves the patient’s condition.

I recall a personal example of critical thinking when I was once charged with the care for a patient with a fresh chest tube placement. Suction needed to be done on my shift, and I had never performed suction before. After reading the instructions, I performed the step-by-step procedure. Once the vacuum pack container was attached, only a few milliliters of drainage ware produced. My preceptor nurse looked everything over, and had the patient cough a few times, and still there was no more drainage. She checked for a kink in the tube and for any leaks in the container or around the tube. No reason was found for the unexpected small amount of drainage. I was unsure we had drained off everything, having seen in the chart that over 500 milliliters had been drained off at the end of the prior shift.

I then suggested we disconnect and reconnect the vacuum container, which did produce more drainage. The process of disconnecting and reconnecting was done a number of times. It reminded the author of milking a goat as a child. Small blood or tissue clots seemed to clog up the tubing which would be dislodged when the vacuumed container was disconnected and reconnected. A total of almost 300 milliliters was drained off, and the patient felt much better. He said it helped him breathe easier and he thanked me and the other nurse for our help.

Nursing Practice

The ability to apply what has been learned throughout our education, our clinical experiences, and our knowledge of disease processes helps us to become better practicing nurses. One example of how I have mastered this skill is through the use of applying a healthy diet teaching project I completed. I developed it into a presentation and training class, which I was able to present at a local manufacturing company in Phoenix, Arizona. I was able to transfer the knowledge to the employees in both English and Spanish with the help of an interpreter. Handouts for children were also provided in both languages so that the employees could get their kids involved in eating healthier diets. They were educated in how to reduce sodium intake, make healthier food choices for ethnically specific food items, and how the wrong choices made today affected their bodies in the future.

Communication

It makes sense that to be effective interacting with others it is important to be an effective communicator. Communication is a process that some believe is mainly focused on our ability to speak well, or transmit information well. When looked at more closely it becomes clear that hearing or receiving information, understanding that information, and removing barriers other may have to receiving your information are as much if not more important in effective communication. I have been able to demonstrate this skill on a number of occasions.

One specific demonstration of effective communication came during my capstone/preceptor ship at the Mayo Clinic in Phoenix Arizona. Near the end of my overnight shift in the oncology department, a declining patient was visited by his wife, daughter, and son. Like the patient, both the daughter and son were attorneys. They began to question the plan of care as it related to medications and the amount of time and attention the staff was providing. The patient was non-communicative, the mother was tired and emotionally spent, and it became apparent that the lack of control over the situation was creating a stressful situation for everyone.

With the support of my preceptor I was able to separate the adult children from the patient and the mother so that they could express their concerns and ideas in a quiet room where they could receive my uninterrupted attention. After letting them both vent, ask any questions they had, and make suggestions on how their father’s plan of care could be more effective, they thanked me and the entire staff for all we were doing for their parents. Difficult conversations can be much more positively and effectively handled in an area away from the patient's bedside and the nursing station. Repeating back the adult children's concerns enabled me to explain the plan of care, while also listening to, and incorporating their ideas into the plan. Small changes like tapering medication dosages, reporting lab results as they arrive, and assigning a nursing assistant helped resolve all of the family’s concerns. Taking the adult children to a private setting to allow them to vent away from the patient and the mother saved all parties, and other patients, a significant amount of stress.

Teaching

I think of the nurse’s role as teacher in the sense of helping patients and family members understand disease processes, nursing interventions, and medications. The curriculum at Old Dominion University has taught me to look at teaching from the perspective of a teacher in a classroom setting, as well. The preparation, the skills needed, and ability to creatively adapt to unforeseen human and technical challenges were skills that surfaced during my teaching project.

As previously mentioned, I developed and delivered a training class on healthy eating habits for a group of employees at a manufacturing facility in Phoenix, Arizona. I mentioned the documents and handouts produced for the class, as well as the fact that a bilingual assistant helped translate some of the learning material into English. What I did not mention was the fact that the overhead projector that was the central point of my presentation would not work the day of the training class. I found myself flustered and perspiring while trying to think on my feet. In the end, the handouts and a dry erase board were the main tools used to transfer the knowledge. In a strange way this may have led to more one-on-one interaction with the employees in the class. Handling the situation with humor and creative thinking demonstrated my ability to teach others even when technology had failed me.

Research

I have a love-hate relationship with research. When I am very interested in a topic I thoroughly enjoy reading research generated from a variety of sources. I became effective at using scholarly databases to research peer reviewed articles during my studies at both Yavapai College and Old Dominion University. Finding the information was only the first step in doing quality research. Other steps include evaluating the source of the research, reviewing the research methods used, and understanding how limited or applicable the research is for the population the researcher is serving.

Leadership

From an early age I often found myself taking a leadership role in social, sScholastic, and sporting environments. Later in life, leadership roles within my family, social settings, and employment positions were opportunities that I readily accepted. It wasn't until my experiences in nursing school that I learned that sometimes a good leader must recognize the leadership skills in others and accept a position as a supportive team member. This became apparent in more than one situation during my undergraduate studies at Old Dominion University.

While working on many group projects I found myself planning, organizing, and managing the work for my group. On at least two occasions I met with resistance and potential confrontations with peers that were also used to leading group study projects. On one assignment, after assuming a leadership role I found that my contributions, feedback, and even suggestions were often edited out and disregarded to the detriment of the group project. I learned that it is best to ask my peer groups if anyone wanted to volunteer as the group leader. This enabled me to take a more supportive role when another leader accepted the responsibilities associated with managing a project. This strategy has been effective with a number of subsequent group projects. Good leadership skills should include one's ability to recognize and enable other leaders when appropriate.

Professionalism

The Merriam Webster online definition of professionalism is “the skill, and good judgment, and polite behavior that is expected from a person who is trained to do a job well.” I find that my education in nursing has taught me to be more professional in my personal and professional life. I can remember an instructor stating that the person you were rude to or unfriendly in traffic this morning could be the patient you see later in the day. That idea has stayed with me and elevated my level of professionalism in those and other aspects of my life. I have demonstrated professionalism in my work and interactions with my peers, my professors, and the administrative staff at Old Dominion University.

In my Career Pathways Assessment paper, I provide examples of the professionalism I have demonstrated in my personal and professional life. In my personal life I have acted as a professional in my volunteer work with organizations like Habitat for Humanity, the New Day Center, St. Vincent De Paul in the greater Phoenix area, and Fit Kids of Northern Arizona. Arriving on time being prepared to work, and being excited to work with others are all examples of professionalism in leadership in my personal life.

Culture

The Cultural Exploration project enabled me to take a closer look at the number of cultural, religious, socio economic, and other diverse groups in the United States. I was able to demonstrate my understanding of the demographics, cultural makeup, and cultural beliefs related to healthcare, common disease processes and other aspects of the groups. As demonstrated, my knowledge of various beliefs related to physical contact, eye contact and space customs, as well as genetic dispositions and beliefs about immunizations.

Summary

I would like to begin by acknowledging the people who have been so helpful in these last four years of study. The knowledge, the skills, and the paradigm shift that has occurred in me had a lot to do with the guidance of my professors, my administrative advisors, and my peers throughout this many-years journey.

I have learned to be more creative and have sharpened my communication and critical thinking skills in the environments I live and work in. I have elevated my level of professionalism and my ability to interact and teach others. I am able to research clinical situations and think critically as I evaluate the research’s significance as it relates to each specific situation.

I feel confident in my ability to practice nursing in an effective way while respecting cultural, religious, political, and other diverse groups; I find common threads to develop trusting relationships based on mutual respect. When I am asked to lead, I can do so with confidence, while retaining the ability to follow a leader and support him or her to the best of my ability.

I chose nursing as a career for many reasons. The most important one was to provide people with meaningful, thoughtful, appropriate care while developing new relationships with my patients, my peers, and the administrative and support staffs. In combination, it helps us become the best nurses we can be.

Conclusion

This project has been an eye-opener. As I plugged, and sometimes chugged, through the coursework I have completed, I can trace the evolution of my world view as it was growing and changing. Now reviewing the body of work completed in this journey from RN to BSN my view of the world, the education I received, and the mindful planning of my professors and administrators at Old Dominion University has evolved once again. Reviewing the writings, the many discussion boards, and the overall curriculum has been very rewarding. My goal is to greet the world in a positive and professional way using the tools have acquired throughout this educational journey. I will keep in mind the many amazing professors, their teachings, and their encouragement as I represent Old Dominion University. It is an institution of which I am proud to be an alumnus.

Honor Code:

I, Kevin M. Ryan, pledge to support the Honor System of Old Dominion University. I will refrain from any form of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a member of the academic community it is my responsibility to turn in all suspected violations of the Honor Code. I will report to a hearing if summoned.

Kevin Michael Ryan

Kevin Michael Ryan

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