Ashley Snider's Nursing Portfolio



Self-Assessment of Professional PracticeAshley SniderFerris State UniversityAbstractThe American Nurses Association wrote the Nursing Scope and Standards of Practice (2010) and The Code of Ethics for Nursing (2001). The Nursing Scope and Standards of Practice (2010) describes the expected level of care by the nurse as a professional and the best possible patient outcomes. The Code of Ethics for Nursing (2001) is the principles and standards of commitment to the patients when entering the nursing profession. I’m going to present an evaluation of my practice as a nursing student and how I met the criteria of the nursing standards of practice and ethic principles. For the standards of practice and ethic principles I did not achieve as a student, I’m going to offer a plan and present my goals how I will meet these expected standards as a professional nurse. Self-Assessment of Professional PracticeThe American Nurses Association Nursing Scope and Standards of Practice (2010), outlines expectations for the professional role of the registered nurse, that today significantly shapes nursing care delivery. The first six are the standards of practice for nursing and the last ten are standards for professional performance of nursing. The American Nurses Association Code of Ethics for Nursing (2001) outlines the ethical obligations, standards, and nursing’s understanding of the commitment to society. This paper will describe how my experiences in clinical helped my achievement towards professionalism in nursing. Nursing Scope and Standards of PracticeStandards of PracticeAssessment. “The registered nurse collects comprehensive data to the healthcare consumer’s health and/or the situation” (American Nurses Association [ANA], 2010, p.32). I have met this standard of practice because it is the first thing I do when meeting my patients. Collecting assessment data is an ongoing process throughout your shift. Getting holistic data collection involves the patient, family and any other healthcare professionals (ANA, 2010). Before starting my shift I check my patients kardex and chart to get a baseline of what is going on before getting bedside report. As I get bedside report I make sure to ask any questions I have about my patients and if there is anything I have to be concerned about. When assessing patients I use visualization, auscultation, touch/feel, smell, and palpation. After my assessment is complete I make sure to document my finding accurately and in a timely manner. An example from one my the assessments I preformed at clinical was discovering right sided swelling on a patients neck that was reddened and warm to touch. After notifying the nurse of the situation, the patient was sent for an ultra sound and the results showed a right-sided thrombosis in their neck. Diagnosis. “The registered nurse analyzes the assessment data to determine the diagnoses or the issues” (ANA, 2010, p.34). I have met this standard by using the assessment data I collected and compare it to other assessment data that has been charted to see if the patient’s condition has improved or has gotten worse. Being able to compare and contrast clinical findings with the normal and abnormal variations really helps formulate diagnosis for the patient (ANA, 2010). For example, when I was assisting a patient to the bedside commode they had some urgency and their urine had a strong, foul odor. After the patient was done I assessed the urine and it was hazy yellow and had a strong, foul odor. I notified the nurse and she talked to the doctor to put in an order to get a urine specimen collection. When the results came back, the patient was positive for a urinary tract infection with a high white blood cell count. A diagnosis for this could be acute pain r/t inflammation and infection of the urethra. Outcomes Identification. “The registered nurse identifies expected outcomes for a plan individualized to the healthcare consumer or the situation” (ANA, 2010, p.35). I have met this standard by talking with the patient to get them involved with their care by coming up with reasonable expected outcomes to be met in a timely manner. When identifying expected outcomes for patients you must take the patient in to consideration as well as their culture, values and ethical beliefs (ANA, 2010). When taking the patients culture, values, and ethical beliefs in to consideration, it allows me to identify interventions and an estimated time for patients to meet expected outcomes. Modifications to expected outcomes according to changes in the status of the healthcare consumer or evaluation of the situation (ANA, 2010). Modifying patients expected outcomes is expected if there is a change that occurs in the patient’s status. An example of an outcome identification I did at clinical was for a patient that was a day post-op from a spinal fusion. The expected outcome for this patient was to ambulate in the hallway three times a day and sit up in a chair for thirty minutes, three times a day within one day post-op. Planning. “The registered nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes” (ANA, 2010, p.36). I have met this standard by developing and initiating individualized care plans with collaboration from the patient and other healthcare providers. For example, the care plan I developed included, the nursing diagnosis of acute pain related to surgical procedure and appropriate interventions to allow for recovery and proper healing. By initiating a care plan for a patient and documenting that plan in their chart, other nurses and healthcare professional can become aware of the interventions implemented and aware of the timeline for goals to be met. Care plans are always subject to change based on, the ongoing assessment of the healthcare consumer’s response and other outcome indicators (ANA, 2010). Implementation. “The registered nurse implements the identified plan” (ANA, 2010, p.38). I feel that I have only met part of this standard, which include, health teaching, health promotion, and coordinating care for the patient. When coordinating care for the patient, I implemented the plan of care and documented when I implemented the plan. When implementing the plan of care, “the registered nurse will partner with the patient, family, significant others, and caregivers as appropriate to implement the plan in a safe, realistic, and timely manner” (ANA, 2010, p.38). Having everyone involved in the patient’s plan of care is important because they need to know the expected outcomes and what timeframe is involved. For example, the patient I worked with that had a spinal fusion and was confused as to why they needed to wear their back brace when getting out of bed. I included teaching the patient about the importance of wearing a back brace after a spinal fusion in the plan of care. I explained to this patient that the back brace after a spinal fusion is used to limit motion to the spine, which helps the bone fusion grow in place. The parts of the implementation standard that I have not met are consultation, prescriptive authority and treatment. Both of these elements in this standard require a specialty nurse or advanced practice nurse. Consultation “synthesizes clinical data, theoretical frameworks, and evidence when providing consultation” (ANA, 2010, p.43). Prescriptive authority and treatment “prescribes specific pharmacological agents or treatments according to clinical indicators, the healthcare consumer’s status and needs, and the results of diagnostic and laboratory tests” (ANA, 2010, p.44). I have not been able to be apart of these elements of this standard because I’m not an advanced practice or specialty nurse. I plan to become more knowledgeable of these elements when I start working as a licensed registered nurse. I also plan to further my education in the nursing field to specialize in anesthesia as I get a year or so of work experience. Evaluation. “The registered nurse evaluates progress toward attainment of outcomes” (ANA, 2010, p.45). Evaluation of planned strategies is an ongoing process following care plan expectations and the indicated timeline. The nurse uses ongoing assessment data to revise the diagnosis, outcomes, the plan and the implementation as needed with the patient and other healthcare professionals involved (ANA, 2010). “Participants in assessing and assuring the responsible and appropriate use of interventions in order to minimize unwarranted or unwanted treatment and healthcare consumer suffering”(ANA, 2010, p.45). Results of the evaluation will be documented. I have met this standard of evaluation when discharging my patients. Before getting discharge documents ready, I evaluate if the plan of care I initiated and interventions were effective for the patient in their recovery process. In the care plan I stated the patient would walk in the hallway three times a day as well as sit in a chair three times a day for thirty minutes one day post-op. Upon reevaluation of this patient, they were up walking in the hallway sometimes more then three times a day and sitting in a chair for breakfast, lunch, and dinner. Standards of Professional PerformanceEthics. “The registered nurse practices ethically” (ANA, 2010, p.47). I have met this standard of ethics as a student nurse. A nurse practicing ethical care is someone that delivers care in a manner that preserves and protects the patient’s autonomy, dignity, rights, values, and beliefs (ANA, 2010). Confidentiality should be upheld within legal and regulatory parameters (ANA, 2010). Patients and their families should be seen as core members of the healthcare team when making decisions about the patient’s care. Action should be taken regarding illegal, unethical, or inappropriate situations may endanger the best interests of the patient or situation (ANA, 2010). A nurse should advocate for their patient’s when other healthcare professionals implement practices that could jeopardize the best interests of the patient or situation (ANA, 2010). In clinical I believe that quality of care, confidentiality, and autonomy is very important. I ensure my patients values and beliefs are respected when working with them. To avoid any legal situations I make sure to know whom the legal decision maker is, before getting consent forums signed and initiating care plans. I believe being a strong patient advocate is important. Even though I’m a student nurse, I feel I should voice my concerns when the patient’s values and beliefs aren’t being attended to. Education. “The registered nurse attains knowledge and competence that reflects current nursing practice” (ANA, 2010, p.49). I have met this standard as a nursing student and will continue to build nursing knowledge, as I become a registered nurse. Nurses have a commitment to lifelong learning through self-reflection and inquiry to address learning needs (ANA, 2010). An excellent nurse reflects their current practice to maintain knowledge, skills, abilities, and clinical judgment or role performance (ANA, 2010). When entering the nursing field, nurses must obtain twenty-five hours of continuing education in order to keep our license current and up to date. It’s our responsibility to seek formal or independent learning experiences to develop and maintain clinical skills, professional skills, and nursing knowledge (ANA, 2010). As I go further in the nursing program, I’m always learning new skills and information that I bring to the clinical setting to use in clinical practice. At clinical our group went to an educational conference about the new caps they have for central and PICC lines. These caps are called Curos Disinfecting Port Protector. The caps contain alcohol in them so you don’t have to use an alcohol swab to wipe them off every time. They are very convenient after you take one off you put another on after your done pushing medication, or checking the patency of the line. “Cours caps disinfect the port in three minutes and if they are not removed, the port stays clean and protected for seven days” (Ivera Medical Corporation, 2014). As a nursing student I’m always seeking new experiences and acquiring new knowledge to better myself, as I become a registered nurse. Evidence-Based Practice and Research. “The registered nurse integrates evidence and research findings into practice” (ANA, 2010, p.51). I have met this standard as a nursing student and will continue to use evidence-based practice and research when becoming a registered nurse. As a student we are taught in school to utilize evidence-based nursing knowledge and research findings to guide practice (ANA, 2010). Being able to share personal or third party research findings with colleagues and peers is important because staying up to date with evidence-based practice and research can improve over all quality of care for patients (ANA, 2010). In clinical I was able to use the Curos Disinfecting Port Protector caps on a patient with a central line. Throughout the day the evidence and research about these caps really proved themselves. Using the Curos caps cut down on using alcohol swabs and if we didn’t have to access the central line it was always protected with the Curos cap on which protects the patient from infection. As I become a registered nurse, I will always be researching new evidence-based practice skills that I can contribute to everyday nursing practice. Quality of Practice. “The registered nurse contributes to quality nursing practice” (ANA, 2010, p.52). I have met this standard as a nursing student because the quality of care for my patients and doing effective, safe work is of upmost importance to me. Nurses must demonstrate quality work by documenting the nursing process in a responsible, accountable, and ethical manner (ANA, 2010). Being able to collect data to monitor the quality and effectiveness of nursing practice is important to ensure quality of care (ANA, 2010). As a nurse, you have to be able to analyze data to identify opportunities to improve nursing practice and implement activities to enhance the quality of nursing practice (ANA, 2010). I’m always analyzing factors related to quality, safety, and the effectiveness of my practice as a student nurse (ANA, 2010). Making sure your patient is given the best quality of care in a safe and effective manner is important in the patient’s overall outcome. An example of quality of practice I demonstrated in clinical was dealing with a high fall risk patient. I explained to the patient the importance of the bed alarm being on at all times and to push the call light if they needed anything. I also explained how the bed picks up movement and the alarm will go off if trying to get out of bed without assistance. I told the patient that what I was doing is for their safety to ensure ethical and quality care. As I am responsible for their safety, I made sure a fall risk bracelet was on, the bed alarm was on, and there was a sign outside on the door to inform other healthcare professionals that this patient is a high fall risk. I also made sure to do hourly checks and document that I did a visual check or if anything has changed. Communication. “The registered nurse communicated effectively in a variety of formats in all areas of practice” (ANA, 2010, p. 54). I have met this standard as a nursing student because having excellent communication is important when it comes to quality of care for patients. Having good communication skills as a nurse is important to be able to convey information to patient’s, families, and the interprofessional team, in communication formats that promote accuracy (ANA, 2010). As nurses we must be advocates for our patient’s, by questioning the care process and decisions of other healthcare professionals if they do not appear to be in the best interest of our patient (ANA, 2010). It’s also important to maintain communication with other providers to minimize risks associated with transfers and transition in care delivery (ANA, 2010). An example of how I used communication during clinical would be, getting report at the beginning of my shift and talking with my nurse throughout the day. Before I get report in the morning I look up my patient’s information that is most important. One time when getting report I noticed the nurse told me the wrong spot of where the IV was and the wrong times pain medication is due. I told her what I saw on the patients chart in the morning, so we pulled the chart up together and she thanked me for catching her mistake. Communication is one of the most important skills to have as a nurse; it leads to better quality and safer care for patients. Leadership. “The registered nurse demonstrates leadership in the professional practice setting and the profession” (ANA, 2010, p.55). I have met this standard of leadership as a nursing student. You can be a leader without having the title of a “nurse leader”. The nurse in this position oversees the nursing care given by other nurses while retaining accountability for the quality of care given to the patient (ANA, 2010). Nurses in leadership positions must abide by the vision, associated goals, and the plan to implement and measure progress of an individual patient within the context of the healthcare organization (ANA, 2010). As a leader you must communicate effectively with the patient and colleagues also, treat colleagues with respect, have trust in them, and show dignity (ANA, 2010). I plan to take on a nursing leadership role when I become a registered nurse. To become a nursing leader I will advance my knowledge and skills so I can oversee other nurses with confidence to ensure they are giving quality and safe care to patient’s. As a nursing student I show leadership by helping my peers in need, working hard in clinical by giving the best care to my patients, and always willing to be the first one to volunteer for a procedure. Collaboration. “The registered nurse collaborates with the healthcare consumer, family, and others in the conduct of nursing practice” (ANA, 2010, p.57). This standard allows communication with the patient, the family and healthcare providers regarding healthcare, the patient’s care and the nurse’s role in the provision of care (ANA, 2010). Nurses collaborate with other nurses and healthcare providers to make effective changes and produce positive outcomes for patients by sharing knowledge and techniques with one another (ANA, 2010). Being able to collaborate with colleagues, patients and families about decisions related to the care and delivery of services will provide better quality of care. An example of collaboration at clinical was, having a stroke patient with left sided paralysis. This patient had full function of the right side but needed some assistance eating. I collaborated with the nurse about different ways we could set up the try and table to give the patient better access and feel more independent. We sat the patient up in bed to a fifty-degree angle to prevent choking and aspiration. I put the tray closer to the right side and cut the food in manageable pieces. Then, I placed the fork in the patient’s right hand and guided the patient’s hand to the plate. This patient gained more independence and self-confidence due to the nurse and I collaborating about different ways to make eating easier for the patient. Professional Practice 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). As a nurse, engaging in self-evaluation of practice on a regular basis, identifying areas of strength, and areas of professional growth is not only beneficial to your self but to patients as well (ANA, 2010). Being able to interact with peers and colleagues to enhance your own professional nursing practice or role performance can enhance over all patient care and outcomes (ANA, 2010). In my clinical practice my nursing instructor, peers, and other nurses evaluate my performance by giving me constructive feedback. For example, on my last day of clinical on the neuroscience and spinal floor we had evaluations. My clinical instructor said to me “you are there as nurse already you just need to pass the NCLEX but, when you have three to four patients you want take everything on yourself, its ok to ask for help from your peers”. With that feedback from my instructor, it opened my eyes as to; yes it’s ok to ask for help when I need it because I can’t always to everything on my own. I feel as though I haven’t fully met this standard because having a true professional practice evaluation you must be a registered nurse, not a student. As a student, I feel we are just glorified techs and don’t really get the full experience of being a registered nurse. My goal as I become a registered nurse is to know the facilities, regulations and rules for practice guidelines and standards. As I start working in the nursing field, I feel it will be easier to engage in self-evaluation of my practice on a regular basis and identify my strengths and weaknesses for professional growth to benefit me as a nurse (ANA, 2010). 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). When considering resource allocation, the nurse identifies healthcare consumer care needs, potential for harm, complexity of the task and the desired outcome (ANA, 2010). As a nurse, assessment is always ongoing and changing when it comes to care. Nurses must assess individual healthcare consumer needs and the resources available to achieve the desired outcomes (ANA, 2010). When deciding the best services for the patient based on safety, effectiveness and affordability, it’s best to assist the patient and the family to identify the best services available to address the patient’s needs (ANA, 2010). I feel I have not met this standard yet because it involves more knowledge and experience that a registered nurse gains from working in the field. Working as a registered nurse for a while increases your knowledge about the right services and resources for patients that are safe, effective, and affordable. I believe that I will extend my knowledge of resource utilization when I become a registered nurse and will be able to collaborate with my colleagues about the best services and resources for patients. Environmental Health. “The registered nurse practice in an environmentally safe and healthy manner”(ANA, 2010, p.61). The nurse has knowledge of environmental health concepts and promotes a practice environment that reduces environmental health risks for workers and patients (ANA, 2010). Nurses will also communicate environmental health risks and exposure reduction strategies to patients, families, colleagues, and communities (ANA, 2010). Another important part of environmental health is assessing the practice environment for factors such as sounds, odor, noise, and light that can threaten patient’s health (ANA, 2010). I have met this standard of environmental health as a nursing student. An example of when I practiced this standard in clinical was, when I had a patient in contact isolation for MRSA. When going in and out of this patients room I make sure to wash my hands, put a gown on, and gloves to ensure I don’t come in contact without protection. As I’m in the patient’s room I explain the reasoning as to why I’m wearing a gown and gloves when I come in the room. I explain how it’s for my safety and other patient’s safety to prevent the spread of a virus or infection. After leaving the patients room, I would make sure to take my gown and gloves off in the patients room so it wont come in contact with other patients. I make sure to wash my hands when leaving the patients room because it’s very important to wash in and out. Code of Ethics for NursingEthical Standard OneThe first ethical standard states, “the nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by considerations of social and economic status, personal attributes, or nature of health problems” (American Nurses Association [ANA], 2001, p.3). In order to give holistic care to patients, the nurse must establish relationships and deliver nursing services with respect to the patient’s beliefs and values without prejudice (ANA, 2001). I have met this ethical standard in various ways. I give the best quality and holistic care to my patient’s regardless of their age, race, religious background, ethnicity, sexual orientation, or socioeconomic status. I also treat my patient’s with upmost respect, dignity, and giving them their right to be actively involved in their care. Compassion, respect, and caring come natural for me. These qualities I have make it easy for me to be the best nurse and advocate I can for my patient’s.Ethical Standard TwoThe second ethical standard states, “the nurse’s primary commitment is to the patient, whether an individual, family, group, or community” (ANA, 2001, p.5). Nurses strive to provide patients with opportunities to participate in planning care, which assures the patient finds the plan acceptable, and support the implementations of the plan (ANA, 2001). Collaboration is important; it involves the nurse, healthcare team, and the patient when it comes to decision making about patient care issues (ANA, 2001). Nurses must recognize and maintain professional boundaries that establish appropriate limits with patients and colleagues (ANA, 2001). I have met this ethical standard of commitment as a nursing student because I strive for excellence every time I step foot in the door. I chose nursing as a long-term commitment not just as a paycheck. When I first started nursing I knew it was for me, I’m committed to this profession and committed to being the best nurse possible. I showed commitment to my patient who had to get plasmapheresis and didn’t want to sit alone. As a student we have the opportunity to see these types of things while at clinical. I had already established a professional and caring relationship with this patient so they felt comforted with me siting with them through it. Being able to sit and talk with this patient throughout the procedure showed that I was committed to the patients well being and over all quality of care. Ethical Standard ThreeThe third ethical standard states, “the nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient” (ANA, 2001, p.6). The nurse must safeguard the patient’s right to privacy along with maintaining confidentiality of all patient information (ANA, 2001). As the advocate for the patient, the nurse must be alert to and take appropriate action regarding and instances of incompetent, unethical, illegal, or impaired practice by any member of the healthcare team that puts the patient’s health in jeopardy (ANA, 2001). I have met this ethical standard as a nursing student by advocating for my patient’s rights, health, and safety when it comes to patient care. During clinical, I had a patient that wouldn’t get out of bed or move around when they were more capable of doing so. The doctor put in orders for lovenox, and pneumatic compression devices. Going to the patients’ room to put on the pneumatic compression devices the patient refused to wear them. I explained to the patient the purpose of them and how they prevent blood clots when not getting up to move around. After educating the patient on the purpose of them, the patient still refused. I acknowledged it’s the patient’s right to refuse, so I documented it as patient educated, refused to wear pneumatic compression devices. Ethical Standard FourThe fourth ethical standard states, “the nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient care” (ANA, 2001, p.8). I have met this ethical standard as a nursing student by providing optimum patient care, delegating appropriate task to the nursing assistance, and taking accountability and responsibility of my practice as a nursing student. Nurses practice direct care activities, acts of delegation, and other responsibilities such as educating patients, research and administration (ANA, 2001). Nurses are also accountable for their judgments made and actions taken in the course of nursing practice, irrespective of health care organizations’ policies (ANA, 2001). The nurse is accountable for the quality of nursing care given to patients, and for delegating assignments of nursing responsibilities to other nurses and nursing care activities to other healthcare workers (ANA, 2001). At clinical, us nursing students have many responsibilities. I’m caring for multiple patients, passing medications, getting patients pain medication, performing technical skills, educating, and documenting. I know that I won’t be able to do everything on my own so I delegate tasks to the nursing assistance. The mornings at clinical are the most hectic compared to the afternoon. There are many times at clinical when I complete morning assessments on my patient’s, then pass medications, get vitals, bladder scan and straight catheterize, assist patients to the bathroom and document everything. When I’m this busy, I delegate taking vitals on all my patients and blood sugars that need it. That way I have time to pass medications, bladder scan and straight catheterize patients that need it, and stay on top of documenting. I then follow up with the nurse assistance to check patient’s vitals and blood sugar reading so I can give insulin to the patient’s that need it. Ethical Standard FiveThe fifth ethical standard states, “the nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue person and professional growth” (ANA, 2001, p.9). I have met this ethical standard as a nursing student by having responsibility to preserve my integrity and safety, and to maintain competence and personal growth in the nursing profession. Nursing is a very compassionate, caring, self-less profession that has a lot of stressors involved. However, as nurses we need to be aware of our limits and remember to take care of ourselves. In clinical, I had a rather heavy patient that was unsteady on their feet and was being transferred to x-ray via stretcher. This patient was rather anxious to get up, knowing this would be a three-person job and I could potentially hurt myself if I attempted it alone, I called for help by using the patients call light. I am leaps and bounds from day one of the nursing program to where I’m at now. I have showed great personal growth in the nursing profession. As I grow as a student nurse into a professional nurse, I get more and more complements from patients and nurses I work with. Charge nurses at multiple clinical sites told me, the nurses working on the unit, request that I work with them because I take care of patient’s like they take care of their patient’s. I also was inducted in to Sigma Theta Tau International, which is a very prestigious honor. It shows my personal growth in the nursing profession by how dedicated and determined I am as a student nurse to become the best nurse possible. Ethical Standard SixThe sixth ethical standard states, “the nurse participates in establishing, maintaining, and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession though individual and collective action” (ANA, 2001, p.11). Nurses have an ethical obligation to environments of practice, such as observable features like working conditions, and written policies and procedures that set expectations for nurses to follow (ANA, 2001). Nurses take responsibility for the healthcare environment; contributing to a moral environment that encourages respectful interactions with colleagues, support of peers, and being about to identify any issues that need to be addressed (ANA, 2001). I have met this ethical standard as a nursing student by maintaining and improving the healthcare environment for patient safety and colleagues as well. I meet this ethical standard by maintaining a sterile environment when doing a procedure, following isolation precautions, and washing in and out of patient’s rooms. At clinical, when I had an isolation patient, I made sure to follow the isolation precautions listed on the door. I first washed my hands, then put a gown and gloves on so I was protected from any skin-to-skin contact with the patient. After I was done in the patients’ room, I placed my gown in the soiled utility cart, threw my gloves away, and washed my hands when leaving the patients’ room. Being able to work together as a team with my peers, providing safe and quality patient care by maintaining the organizations standards and values improves the over all healthcare environment. Ethical Standard SevenThe seventh ethical standard states, “the nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development” (ANA, 2001, p.12). I have not met this ethical standard as a nursing student. This standard involves advancement of the nursing profession contributing to practice, education, administration and knowledge development (ANA, 2001). In this ethical standard, nurses can advance the profession by serving in leadership or mentorship roles, or on committees within their place of employment (ANA, 2001). Nurses should also engage in scholarly inquiry to identify, evaluate, refine, and expand their knowledge that forms the foundation of their discipline and nursing practice (ANA, 2001). I feel as though, not being in nursing that long restricts me from meeting these advanced goals. My goal is to become an advance practice nurse by obtaining my doctorate in anesthesia and being able to educate other nurses. As I grow as a nurse and build on my nursing knowledge, I will be able contribute my ideas to practice and educate others along the way. Ethical Standard EightThe eighth ethical standard states, “the nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs” (ANA, 2001, p.12). The nurse has a responsibility to be aware of not only health needs of individuals but also broader health concerns such as lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources (ANA, 2001). Nurses have responsibilities to the public by supporting and participating in community organizations. The nurse can assist to educate the public, identify conditions and circumstance that contribute to illness, promote healthy lifestyles, and participate in institutional and legislative efforts to promote health and meet national health objectives (ANA. 2001). I have met this ethical standard as a nursing student by collaborating with other health professionals and the public in promoting community, national, and international efforts to meet health needs (ANA, 2001). As an example, my service-learning project consists of taking patient’s blood pressures in a rural community care center that only accepts Medicaid and Medicare. In effort to promote healthy blood pressure ranges, I made up cards of what a healthy blood pressure is and what you can do to maintain that. I gave a card to everyone I did a blood pressure on and they were appreciative of those cards because majority of the people I saw were unaware of what a healthy blood pressure is. Ethical Standard NineThe ninth ethical standard states, “the profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintain the integrity of the profession and its practice, and for shaping social policy” (ANA, 2001, p13). A professional association is responsible for expressing the values and ethics of the nursing profession and encouraging the professional organization and its members to function according to those values and ethics (ANA, 2001). The values and ethics of the organization influence the power structure of the association in guiding, correcting, and directing activities (ANA, 2001). As a student nurse I have met this ethical standard by being inducted in to Sigma Theta Tau International Nursing Honors Society. Being in this organization is an honor and demonstrates my excellence in the nursing profession thus far. “The mission of the Honor Society of Nursing, Sigma Theta Tau International is?advancing world health and celebrating nursing excellence in scholarship, leadership, and service” (Sigma Theta Tau International, 2014). Being a part of this organization gives me the opportunity when I become a registered nurse, to express the values and ethics of the nursing profession and encourage members of my organization to express those values and ethics as well. Once I become a registered nurse, I plan to join other organizations that will expand my nursing knowledge and meet my needs as a nurse. Professional Development PlanAs graduation and becoming professional nurse is getting closer, I believe the nursing program here at Ferris State University has prepared to me to attain and maintain competency in these nursing standards and ethics. When I graduate from the nursing program in August 2014, I plan to stay current on all evidence-based research and new procedures by joining the American Nurses Association and going to educational classes to build on my nursing knowledge. To maintain competency in the nursing standards and ethics is important for safe, effective, quality patient care. Staying current on the nursing standards and ethics will also help in dealing with legal and ethical issues in the organization so I will know what foot I have to stand on if it ever happens. Also, I want to go further in my education and become a nurse anesthetist by October 2018, so being able to stay current on these standards and ethics is important because being a nurse anesthetist is a lot of responsibility having legal and ethical issues involved. Action & Evaluation PlanThe first and most important thing as of right now is graduating from Ferris State University with my RN, BSN in August 2014. In order for that to happen, I plan to keep working hard in school, at clinical, and staying organized to achieve that ultimate goal. In order to know I met the goal of graduation is being able to sign up for the NCLEX licensure exam in September 2014. Next, while I’m waiting for my results to come back, I will be applying to full-time nursing jobs on any floor, hoping to land a job in the emergency room or on the intensive care unit. Knowing if I met this goal, I will receive a notification via email or mail, that I passed my boards and I will accept a job accordingly as I get phone calls for interviews. If I met the goal of getting an interview, I will get a phone call from the hospital I applied to, accepting the interview. Waiting for a phone call back if I got the job is nerve wrecking. When I get a phone call from the hospital for a job there as full-time nurse by October 2014, I will continue to work towards my goal of starting to apply for nurse anesthetist schools because it is a yearlong process in hopes of getting accepted to one by December 2015. Knowing if I got accepted to a nurse anesthetist school, I will get a phone call for an interview by October 2015. I will attend the interview and get another phone call in two weeks for acceptance to a nurse anesthetist school. I have until December 2015 to accept the offer; if I get accepted to more then one then I will have to make a decision of what school best fits me. ConclusionThe way nursing is shaped today is based off of the nursing standards and ethics. In order to guide our personal nursing practice, ongoing self-evaluation these nursing standards and ethics will help us to become effective and safe in our practice. As a nursing student I have applied all these standards and ethics when at clinical. A few of the standards are mainly for an advance practice nurse but we as students can learn from them in the way they preform those standards. I applied these standards and ethics to my nursing practice as a student and came up with a professional developmental plan. My professional developmental plan included an action and evaluation plan as well, which outlined my professional goals that are specific and measurable. Staying current and up to date with these nursing standards and ethics will improve my nursing practice when I become a registered nurse and help me grow as a the best nurse I can be. ReferencesAmerican Nurses Association [ANA]. (2001). Code of ethics for nurses with interpretive statements. Retrieved from EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics.pdfAmerican Nurses Association [ANA]. (2010). Nursing: Scope and standards of practice. (2nd ed.). Silver Spring, MDIvera Medical Corporation. (2014). Curos disinfecting port protectors: products & services. Retrieved from Theta Tau International Honor Society of Nursing. (2014). STTI organizational fact sheet. Retrieved from ................
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