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Practice Summary Introduction PaperNursing 403-Career Pathway- Expand HorizonsPractice Summary PaperPurpose of AssignmentThe purpose of this paper is to guide you through a process of self-reflection and self-evaluation to discover the scope of your personal and professional development while enrolled in the RN-BSN nursing program at Old Dominion University. Approach to AssignmentIn order to self reflect and self evaluate my progress through ODU’s RN-BSN program, I looked back through past assignments that would fulfill the rubric requirements for this particular paper. What was unique about this assignment was the fact that I could call upon my experience at the bedside to give examples as to my personal and professional development and how it has evolved.Reason for InclusionThis paper was integrated into this portfolio as a testimony to my personal and professional development. Critical ThinkingUses nursing and other appropriate theories and models to guide professional practice In Nurs490W, Nursing Leadership we learned about change theory Discussed behavior such as tardiness and taught the unfreezing-change-refreezing model developed by Kurt Lewin. While this is helpful in making change with staff, it is also helpful in using this model with patients to get them to change a behavior or to make a healthy habit. Uses decision-making skills in making clinical or professional judgments In making quiz questions up for an assignment in Nurs490W, I called heavily upon my nursing experience where clinical and professional judgment were key in the outcome of staff and patients. Such examples included, creative staffing to staff a unit along with mentoring and instructing staff on therapeutic nurse patient relations.Evaluates nursing care outcomes through the acquisition of data and the questioning of inconsistencies In completing this assignment in Nurs490W we had to not only develop a well thought scenario question, but we had to give our rationale as to why this was the correct answer. This evaluation was key to assessing the outcome.Revises actions and goals based on evidence rather than conjecture Throughout the course of Nurs490W, we were taught to revise our actions and goals in leadership based on evidence rather than conjecture. Engages in creative problem solving When the original quizzes established by the publisher were unreasonable, our instructors creatively came up with a plan for the students to write their own quizzes. This gave the students a taste of writing test questions, as they too had to be creative in writing the questions. Nursing PracticeApplies appropriate knowledge of major health problems to guide nursing practice I have been a nurse for 20 years now at the bedside and have encountered patients with major health problems. On my unit, we attempt to keep our patients (hematology/oncology) as long as we can support their needs before considering moving them to an ICU setting. At times, I am the bedside nurse, the charge nurse and the preceptor.Performs direct and indirect therapeutic interventions that incorporate principles of quality management and proper safety techniques based upon assessment findings I am a member of the shared governance committee on my unit. The inpatient and outpatient clinic meet to discuss interventions to bridge the two units in order to have better communicate and outcomes with our patients. We collaborated and developed a teaching tool in order to ensure that both areas where teaching our patients the same information. This closed the gap in inconsistency of teaching between novice and expert nurses along with the clinic and in patient nurses.This group also collaborated on techniques to hang chemotherapy to ensure we were all preparing and administering the chemotherapy the same for continuity and safety.Implements traditional nursing care practices as appropriate to provideholistic health care to diverse populations across the lifespan Working in the hematology/oncology field, I have found using complimentary medicine in conjunction with traditional medicine to be helpful in the well being of the patient as well as it is essential throughout a patient’s life span. From infants to adults, touch, aromatherapy, music, guided imagery and massage are helpful to the patient. It is also helpful for the caregiver to learn these techniques to help their loved ones along with self-soothing. Often times the caregiver is forgotten, but being cognizant of their journey as well is helpful for the nurse to keep in mind as they help the family through this journey. This journey through school has helped me to be more aware to the different cultures point of view at diagnosis, time of treatment and if necessary, at end of life. Demonstrates an awareness of complementary modalities and their usefulness in promoting health In addition to my above entry, complementary modalities are helpful in promoting health through play as well. We use play therapy at our hospital. In being mindful of Erik Erikson, Freud and Piaget’s stages of development, we can take better care of these children without traumatizing them. Establishes and/or utilizes outcome measures to evaluate the effectiveness of care Annually we receive an evaluation to gauge the effectiveness of our care. I have received positive comments in all of my evaluations, which include feedback from my patients, families along with my peers and management team. This is a time I use to set up educational and professional goals for myself to achieve over the following year.With the tool the shared governance committee created for teaching, we are currently conducting surveys with the staff to measure the effectiveness and ease of use (of the tool) with staff. This survey comes six months after staff has been taught how to utilize this tool. Our assessment to measure the effectiveness of this tool with the families is through the teach back method. Our patient’s parents are often times eager to show us what they know by reciting our teaching back to us upon municationUses therapeutic communication within the nurse-patient relationship Communication is key in developing a nurse-patient relationship, whether it is verbal or nonverbal, our words and actions carry meaning. This proves to be a challenge when our patients are non-English speaking or hard of hearing (HOH). Verbal and non-verbal communication comes into play with body posture and touch. Going above and beyond their expectations to find a way to communicate with one another is validating their importance in this nurse-patient relationship.Adapts communication methods to patients with special needs At my hospital we have a list of medical interpreter that are within the hospital during the day when we have a HOH patient or non-English speaking patient. During off hours (evening, nights, weekends and holidays) we use a Cyracom phone or an iPad to link us with an interpreter to communicate with our patients under these special circumstances. Expresses oneself and communicates effectively with diverse groups and disciplines using a variety of media in a variety of contexts In my many roles at the hospital, I work with a diverse group of people. My communication skills must be clear and concise in order to be successful in these roles. I communicate with others at work through face-to-face communication, text paging, and email. At the bedside my patients vary from infant to adult and this greatly affects the method of communication used to explain or teach a patient about a procedure or discharge instructions. Parents also now come in a variety of ages as well, which proves challenging at times when attempting to teach them home care of their child. The teach back method has been invaluable in these types of situations as it confirms whether the parents understand what has been taught, or if they need further instruction prior to discharge. Within this program, I have been involved in multiple group projects with students that range in nursing experience from novice to expert. We were successful in our endeavors through communicating via email, text and discussion board.Produces clear, accurate, and relevant writing using correct grammar, spelling and punctuation In this assignment, I used correct grammar and spelling. I lost one point for punctuation; otherwise, my paper was clear, accurate and relevant.Accesses and utilizes data and information from a wide range of sources to enhance patient and professional communication My hospital has seen an increase in a variety of non-English speaking families. This can prove to be challenging without resources. My employer has formatted a list of medical interrupter and purchased and iPad to facilitate communicate with these patients.Teaching Provides teaching to patients and/or professionals about health care procedures and technologies in preparation for and following nursing or medical interventions Under this topic, I can reiterate, that the teach back method tool that has been instrumental in not only teaching but also in measuring the effectiveness of the instruction. Whether I am teaching a new diagnosis family, a young patient or a teen-ager, this tool works, as the learner is able to teach me what they have learned.Provides relevant and sensitive health education information and counseling to patients, and families, in a variety of situations and settings I developed a teaching plan in Nurs402, for the parents of my children’s softball team on healthy snack and meal options while we are traveling to tournaments. I identified this need while observing the unhealthy snack options the children where receiving in this group setting.Uses information technologies and other appropriate methods to communicate health promotion, risk reduction, and disease prevention across the life span In Nurs492, as a group we developed a plan to reach out to middle school children in an effort to decrease their risk of cardiovascular (CV) disease, by teaching them in during PE/Health about the benefits of a healthy diet and exercise. Our group chose this area due to its high rate of CV disease and large African American population. Uses information technologies and other appropriate methods to enhance one’s own knowledge base Throughout the program at ODU, I have utilized their online library to gather research, data and articles to support and guide my teaching plan and teaching assignments.ResearchDifferentiates between descriptive nursing literature and published reports of nursing research In completing our research paper in Nurs363, our group had to utilize published nursing research reports and studies to justify our findings that breast-feeding mothers were more successful when a lactation consultant was involved in her care.Evaluates research that focuses on the efficacy and effectiveness of nursing interventions Within the group paper completed in Nurs363, we discussed the role of evidence-based practice (EBP) in the success of a breastfeeding mother. In the hospital setting, EBP is steering the care of patients. This term has been used throughout my formal education at ODU as it encourages students and nurses to continue to research data along being able to differentiate between a reliable research or study before applying it to practice.Shares research findings with colleagues Working in the pediatric hematology/oncology world, research is constantly changing our practice for the better. My hospital works closely with the Children’s Oncology Group so that we can access to the most current studies and treatment options for our patients. Nurses join this group so that they also have access to the treatment plans in order to ensure compliance with orders and studies along with the most up to date research information. We share significant changes or new findings with one another during staff meetings and during bedside report.LeadershipInitiates community partnerships to establish health promotion goals and implements strategies to meet those goals In my practice we call upon community resources for our patients. Two resources that I mention in this paper were Head Start and Edmarc. Head Start helps underprivileged youth from birth to five years old with nutrition, social skills and other services. This group helps younger children become ready for school as well. Edmarc is a childhood hospice service that we utilize when our patients are diagnosed with cancer for additional support throughout their treatment. They are also instrumental in our patients care when a palliative approach deems necessary.Articulates the values of the profession and the role of the nurse as member of the interdisciplinary health care team As a senior nurse on the unit, I am a resource to both nurses and new residents. I meet with the residents prior to multidisciplinary rounds to ensure that they have the most up to date assessment along with my concerns as we go in to discuss this patient as a group before the entire team.Delegates and supervises the nursing care given by others while retaining the accountability for the quality of care given to the patientWhen I am scheduled in the role of the charge nurse, I am accountable to my staff, as well as to all of the patients. I round on all of the nurses first to ensure that their assignments are acceptable and their patients are well. Then I round with the patients and their families to ensure that their needs are being met. This is also a perfect time to address concerns by the patient or family before it festers and becomes a problem that affects the patient’s hospital stay. Delegation is utilized not only for nursing assistants, but when I am in the role of charge nurse, I delegate to fellow nurses when admissions are coming to our unit. ProfessionalismDifferentiates between general, institutional, and specialty-specific standards of practice to guide nursing care Being mindful of professional boundaries as well as therapeutic nurse patient relationship in regards to the pediatric oncology patient is essential in surviving in the role of the nurse. There are policies written by institutes to ensure that lines are not crossed. Facebook is off limits for staff and patients. There are activities where staff and patients come together out the hospital setting, though. St Baldrick’s is a fundraiser that staff and patients attend together to raise money for childhood cancer. Other group activities consist of Relay for Life, and Survivor day. I am mindful not to cross boundaries in exchanging of personal information, not adding patients or families as a Facebook friend or meeting patients outside of these controlled activities. I also take the time to teach these guidelines to our newer staff that may not realize they are crossing boundaries that could cost them their job. Understands 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 Within my scope of practice, I can notify a MD of my assessment of seeing frank blood in stool, but I cannot order a test to confirm my suspicion without a MD’s order. The ANA lists a nurse’s Scope and Standards of Practice one must adhere to as well. Veering from this list leaves one open for serious repercussions. Demonstrates accountability for one’s own professional practice. In Nurs401, I presented a slide show of my image of the professional nurse. I addressed a nurses attire, presentation, behavior/attitude, maintaining professional boundaries, along with prevention of bullying fellow nursesAdvocates for professional standards of practice using organizational and political processes. I am certified within my field, as a Certified Pediatric Hematology/Oncology Nurse (CPHON). Since passing this exam and going back to school, I have encouraged my peers to elevate themselves as well and join me as I expand my knowledge in this ever-changing practice. Within the Shared Governance committees at the hospital, we also are encouraging others to go back to school to earn a higher degree, as well as become certified in their field. We are working towards a clinical ladder to recognize those that value their education and profession as a whole. We are working towards becoming a Magnet hospital.CultureArticulates an understanding of how human behavior is affected by culture, race, religion, gender, lifestyle, and age At the beginning of this semester in this class, I successfully completed the United States Department of Health and Human Services online educational program that was geared towards being a culturally competent nurse. I felt this program was so powerful, that I shared it with my liaison, Marta Cox from the department of Cultural/Language Services, to share with the hospital. Demonstrates sensitivity to personal and cultural definitions of health, and how these beliefs influence an individual’s reactions to the illness experience and end of life In Nurs458, Genetics, I addressed the importance of individualizing genetic information based on the patient/family’s culture, religion, knowledge level, literacy, and preferred language. I recommended using the 4 C tool developed by Stuart Slavin MD, Geri-Ann Galanti PhD and Alice Kuo MD when working with another culture to discuss teaching or end of life care. Integrates knowledge of cultural diversity in performing nursing interventions Through using the tool listed above, a nurse is able to extract the information necessary to effectively care for the culture diverse patient. Just because a patient is of a certain culture, does not mean that they practice or believe all that their ancestors or relatives do at this stage in their life. I have encountered generations of a culture in one room before and found a broad spectrum of tradition and belief system. The patient was the least engaged with their culture while the grandparents where the most stringent follower of their belief system. Nursing has the unique challenge to be mindful of the differences and to not offend, but help the family as a unit. ................
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