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Professional Progress SummaryOld Dominion UniversityLeigha WilsonProfessional Progress SummaryAs a soon to be new graduate nurse, I have the opportunity to look back upon my journey through three years of nursing school. Over these last three years, I believe I have learned a lot about what it means to be a nurse and have been given the tools to start my nursing career. During my time in this program, the “Great Eights” have been a standard of which to uphold each week during clinical. These eight characteristics include critical thinking, nursing practice, communication, teaching, research, leadership, professionalism, and culture. Thus, throughout my time in the nursing program, I have grown in each of these eight characteristics. Critical ThinkingIn the area of critical thinking, the nursing student must demonstrate this to facilitate nursing practice through inquiry, problem solving, and synthesis. Being able to use critical thinking in the clinical setting is important throughout the three years and will be used everyday in a nursing career. Throughout these three years, my ability to use critical thinking has grown and I have been able to apply it to specific patients.Sophomore yearDuring clinicals in sophomore year, I was placed on a unit where the patients were not in critical condition and were very independent. One aspect of critical thinking that became important during this rotation was being able to associate a nursing theory to these particular patients. For several of my patients that I was assigned to during this rotation, I was able to apply Sister Callista Roy’s Adaptation model in order to describe how these independent patients were learning how to care for themselves while in the hospital and in the transition back home. Junior yearWith more nursing classes, critical thinking in junior year became more in depth than the previous year. We now had more nursing knowledge and were able to think more critically about the medical diagnosis that out patients had. During my telemetry rotation, I was assigned to a patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) and was concerned about his fluid restriction after looking at the patient’s lab values. Because of not having studied this diagnosis in class yet, I looked up the disease and treatments and was able to get the answers to my own questions and have a better understanding of the care he was receiving. Senior yearAfter going through critical care classes and clinicals, I believe I have a better understanding of how everything is connected; such as, how each primary and secondary diagnosis is related to one another. During my last week of this clinical, I was assigned to a patient that presented with a non-ST elevated myocardial infarction. After reviewing this patient’s chart, I could see that she had a positive fluid balance of several liters and was not able to void. Also, the patient’s blood pressure was borderline low and the nurse that I was working with gave the patient Lasix to eliminate the extra fluid. Because of the patient’s already low blood pressure, I was able to use critical thinking to anticipate an even further drop in blood pressure, which I monitored closely. Nursing PracticeTo demonstrate competency in nursing practice, the nursing student must perform therapeutic nursing and interdisciplinary interventions to deliver nursing care in the cognitive, affective, and psychomotor domains. Over the course of three years, skills involved in nursing practice ranged from taking vitals to inserting IVs. Thus, I believe I have learned a lot of nursing skills over the last three years. Sophomore yearDuring sophomore year, focus for nursing practice was placed on taking vital signs and performing AM care. On a typical day in clinical, activities performed included vital signs, head to toe physical assessment, oral care, making an unoccupied bed, and helping the patient with a bed bath. One week, I was given instructions by the patient’s physician to get the patient’s blood pressure at different intervals throughout the morning while receiving a change in her treatment plan. I was able to obtain the vital signs at the instructed times and report the information back to the nurse I was working with.Junior yearDuring junior year, the same skills were focused on and new ones were added. Activities such as blood glucose checks and foley care were added to daily routines. Also new this year, we were given the opportunity to give medications. My first time giving medications to a patient was in the fall semester and I was nervous at first. After getting the patient’s information the night before and creating a medication sheet, I was able to pull the medications from the pyxis with assistance from my instructor and identify the patient’s dose and reason for receiving the medication. Senior yearDuring senior year, especially in critical care clinical, more focus was put on performing activities other than AM care. In my week in the emergency department, I was able to insert several IVs, do discharge teaching, and participate in a STEMI alert by completing a blood draw and giving medications. Also during this year in my pediatrics rotation, I got to give medications through a g-tube for the first time. In role transition, I was able to give IV push medications for the first time during a clinical. By getting this experience in clinicals, I believe I will be better prepared for them after graduation and look forward to gaining even more experience with them. CommunicationTo demonstrate competency in communication, the nursing student must justify verbal, non-verbal, and written communication techniques appropriate for clients and professionals. Throughout the last three years with various writing assignments, including the portfolio, and clinical logs, I believe I have been able to produce a clear, accurate, and relevant writing using correct grammar, spelling, and punctuation. Communication during various clinicals included patients, peers, nurses, and other members of the interdisciplinary team. Sophomore yearLooking back on my first week of clinical as a sophomore, I was very nervous communicating with my patient and the nurse I was working with. Throughout the weeks during this rotation, I became more comfortable talking with patients, but was still nervous when it came to giving handoff report to the nurse I was working with at the end of the clinical day. During this clinical, we were given the opportunity to become more comfortable talking with patients by obtaining a detailed health and social history from a patient. Junior yearIn the first week of clinical for my telemetry rotation in junior year, I was assigned to a patient that spoke only Spanish. Because I do not speak Spanish, I was concerned how I was going to be able to communicate with this patient throughout the day. To help, the nurse that I was working with was able to speak some Spanish and help in the translation. Communicating with the staff during this clinical was easier because some of the nurses were very good at teaching and were willing to answer any questions we had. Senior yearDuring my pediatrics rotation senior year, it was apparent how important communication was for both patients and family members. In my first week of clinical, I was assigned to the pediatric telemetry unit, where I would later do my role transition, and was able to help a patient’s grandmother make sense of several medications that her granddaughter was taking. By taking the time to talk to the patient’s grandmother, she felt more comfortable with the care that her granddaughter was receiving. Also on this unit, communicating with the staff was easy because they were very helpful and were willing to answer questions. TeachingTo demonstrate competency in teaching, the nursing student must utilize teaching strategies to maximize client health and enhance professional development. During the last three years, I have been given many opportunities to develop teaching plans for possible learning sessions, teach patients about medications, and present topics for instruction to other nursing students. By using many different resources including nursing research, textbooks, hospital policies, and other online sources, I believe I have been able to use information technologies and other appropriate methods to enhance my own knowledge base. Sophomore yearFor most of the first clinicals of sophomore year, most of the teaching that I was a part of was through observation of the nurse I was working with instructing patient and evaluating its success. During my last week of clinical of sophomore year, I was able to teach my assigned patient about the importance of the use of the incentive spirometer. In addition to its importance, I was also able to show him how to use it and observe him using it the prescribed ten times. Junior yearIn my junior year, I was given two opportunities to provide teaching to other nursing students in my group and create a teaching plan for a patient. For the first assignment, I was able to give a presentation to my clinical group on Patient Controlled Analgesia (PCA) pumps. I was able to identify their use, common medications, and incorporated technology by including a video. For the second assignment, with several other group members, we were able to create a teaching plan for a patient newly diagnosed with diabetes and have the clinical group demonstrate how to perform an insulin injection on an orange. Senior yearIn my senior year, I was able to create a teaching presentation with other group members on restraint use in the intensive care unit. After reviewing hospital policy at Riverside, we were able to identify common use, procedure for obtaining an order for restraints, and how long they can be in place. After obtaining this information, we were able to create a presentation, including videos and demonstrations, to instruct other classmates on proper restraint use in the ICU.ResearchTo demonstrate competency in research, the nursing student must incorporate primary research findings as a basis for therapeutic nursing interventions. Throughout nursing school, research has been a large part of learning. Research is behind interventions that are commonly used in clinicals, evidence based practice, and in creating new ways to treat medical issues. By looking into research from not only nursing sources, but other disciplines, we can learn more effective ways to treat patients and restore them to their previous state of health. Sophomore yearIn my sophomore year, focus was on being able to identify nursing research and apply it to an assigned patient in a clinical log. During this rotation, the research portion of the clinical log regarded any issue that we encountered during the clinical day that we believed would benefit from research. This was important as a new nursing student because although we were unfamiliar at how to find current nursing research, we could identify situations seen in a clinical setting that would be interesting for research.Junior yearIn my junior year in research class, I was able to create an evidence based practice project that focused on smoking cessation along with other classmates. Also during this class, my group was able to create a research topic and design an experiment that we believed would benefit from research. My group decided on creating a qualitative study about breast cancer social support. Also, we were able to anticipate results should the study actually be done. Senior yearIn my senior year in leadership class, I was able to pick a topic that is currently relevant to nurse managers and find research to show support for my issue. The topic I chose was the incorporation of a nurse residency program into more hospitals in order to prepare new graduate nurses for a smoother transition into the world of healthcare. After choosing this topic, I was able to find eleven sources of supportive research that ranged from direct nursing research, testimonials, and information about several nurse residency programs in the area. LeadershipTo demonstrate competency in leadership, the nursing student must show self-direction, professional accountability, and advocacy adhering to legal and ethical nursing practice as a novice nurse. As a student nurse, it can be difficult to show leadership in clinical settings, but with time, I believed I have improved and become self-directed and assertive. Also as a student nurse, I believe that clinicals are great places to be a patient advocate due to becoming familiar with the patient’s health history and current medical issues. Sophomore yearDuring the first clinical of sophomore year, we were given a partner for the clinical day. Due to having two people, we were able to split some AM care activities in order to better plan the clinical day and work together on others. In this situation, I believe I was able to delegate and supervise the nursing care given by others while retaining the accountability for the quality of care given to the patient. Also during this day, I believe I was able to show professionalism during a conversation between the patient and her physician in reference to clarification of medications. Junior yearIn the later weeks of both clinicals of my junior year, I was given the opportunity to care for two patients. During these clinical days, I was able to show leadership by planning my day according to the needs of both patients, including providing AM care, obtaining vital signs, and giving medications. Also, I was able to help classmates during this time. With my first experience having two patients, I believe I was able to assume a leadership role within my scope of practice as a designer, manager, and coordinator of health care to meet the special needs of vulnerable populations in a variety of practice settings. Senior yearIn my senior year during my role transition on a pediatric telemetry unit, I was given the opportunity to have more responsibility and independence under the supervision of my preceptor. With the help of my preceptor, I was able to make a plan for my twelve-hour shifts including assessment and medication times and take responsibility for making sure each activity was performed and documented. I enjoyed having this increased responsibility and independence while having a preceptor available if I needed help. ProfessionalismTo demonstrate competency in professionalism, the nursing student must show advocacy, accountability, and adherence to standards of practice and legal and ethical principles. Throughout clinical experiences of many specialties, we have been given the opportunity to show professionalism in order to represent both Old Dominion University’s nursing program and ourselves positively. By having standards for professionalism, we will graduate and begin our careers with knowledge and experience of how to be professional in the healthcare environment. Sophomore yearDuring my sophomore year in clinical, I was able how professionalism in order to be an advocate for the patient that I was assigned to. The patient I was assigned to had recently transferred from a chair back to her bed and was in a great deal of pain, but stated that she did not want a pill. When I relayed this information to the nurse that I was working with, she was not familiar with all of the patient’s medications. I was able to tell the nurse that the patient had IV morphine for use as needed. After determining that this patient would receive the IV morphine, the nurse wanted to administer the medication to the patient, which I told her that I was not able to do. With this incident, I believe I showed an understanding of the effect of legal and regulatory processes on nursing practice and health care delivery, as well as limits to one’s own scope of practice. Junior yearDuring my junior year in clinical, I was assigned to care for a patient that had recently had a hip replacement. While obtaining vital signs, she stated to me that she was in pain and requested medication, which I passed along to the nurse I was working with. During my assessment, I noticed that the area around her incision site was red, warm, and tender. Also, I noticed that the patient had developed a fever. I believe that I was an advocate for this patient by being able to relay my findings to the nurse. Senior yearDuring my senior year in role transition, I was able to use professionalism when relaying important information to the resident assigned to one of the patients I was helping to care for. On one of my first night shifts on the pediatric telemetry unit, a six-month old girl was admitted for bronchiolitis and required supplemental oxygen. Over the course of the night, my preceptor and I attempted to wean the patient off oxygen according to the physician’s orders, but were unsuccessful due to the patient’s oxygen needs. I was able to relay this information to the resident assigned to this patient and her treatment plan was adjusted. With this situation, I believe I was able to demonstrate accountability for my own professional practice. CultureTo demonstrate competence in culture, the nursing student must show cultural awareness and sensitivity. Throughout many clinical experiences over the last three years, I have been given the opportunity to interact and learn about many different cultures in order to provide culturally competent care. Whether it is a patient from another country, or a patient with a different lifestyle, culture comes in many forms and can influence healthcare interventions. Sophomore yearDuring sophomore year, cultural differences in clinical mainly focused on the patients being of an older age with limited mobility. This affected their care because interventions had to be tailored to their specific needs and abilities. In this clinical rotation, I was assigned to several patients with this cultural difference and was able plan my care to accommodate these differences. Junior yearDuring the first clinical of my junior year, I was assigned to a patient that only spoke Spanish. Because I did not speak Spanish, this cultural difference caused concern for communication and his level of understanding of what was going on. This barrier was overcome by the nurse that I was working with being able to speak Spanish and translate for the patient to decrease anxiety. Senior yearDuring my role transition, I helped care for several patients and families that only spoke Spanish. Because of my not knowing Spanish, I was concerned about being able to communicate with the patient and family as well as their understanding of what was going on. This culture difference was overcome with the use of translation phones, which were able to help the families stay informed of their child’s care in a language that they understood. ConclusionThroughout my three years in nursing school, I believe I have learned a lot and improved in the areas of critical thinking, nursing practice, communication, teaching, research, leadership, professionalism, and culture. Knowledge and experience with these eight important factors will be important as I prepare to begin my nursing career. Thus, as my wonderful time in nursing school comes to an end, I believe I will have gained the tools necessary to be begin being the best nurse that I can be for the patients I will help care for. Honor Code“I 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 violators of the Honor Code. I will report to a hearing if summoned.”Name: ____________Leigha Wilson__________________________________ (Print Name)Signature: _____________Leigha Wilson______________________________ ................
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