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Running head: PROFESSIONAL DEVELOPMENT PLAN

Professional Development Plan Cheryl Veres Ferris State University

PROFESSIONAL DEVELOPMENT PLAN Abstract Throughout this professional development plan I revisit the standards of professional nursing

practice as outlined and defined by the American Nurses Association (ANA), and refer often to our text book for this semester, Professional Nursing: Concepts and Challenges (Chitty & Black, 2011). Using the standards and competencies in the ANA reference, I will compare it to my standards of practice while acknowledging my strengths and weaknesses. After evaluating my practice standards, I address my five and ten year goals that I have set for my professional practice. This paper also includes a plan for evaluation of goal attainment and my conclusion.

PROFESSIONAL DEVELOPMENT PLAN Professional Development Plan To be a nurse is to protect, promote optimal wellness, to prevent injury and illness,

alleviate suffering by way of diagnosing and treating the human response, and to advocate care of the individual, family, community and population. There is a responsibility of the professional nurse to continuously demonstrate and maintain competence. It is a rightful expectation of the public (ANA, 2010). Utilizing the Standards of Professional Nursing Performance has assisted in addressing my current standards of practice, and the development of a professional plan within the content of this paper. Standards of Professional Performance Standard 7: Ethics Ethics are a standard of nursing that encompasses the primary responsibility of respect for humans as a function of human dignity (Chitty & Black, 2011, p. 108). Registered nurses are expected to preserve and protect the rights, values, beliefs, dignity, and autonomy of the healthcare consumer regardless of economic or social status, nature of the clients health problems, or their personal attributes (ANA, 2010). I tend to use a combination of principles when faced with ethical dilemmas and value having my own set of standards that extend beyond the code of ethics that have been developed by members of the nursing profession. This is important when establishing responsibility and accountability in the delivery of quality care. There was a patient that I was assigned to that was admitted for complications from hepatitis and cirrhosis. This patient was a frequently admitted patient and was on the list for a donor liver. While he denied any current alcohol or drug usage, each time he was admitted he would show clear signs of detoxification and withdrawal. He was also non-compliant during his admission and had developed a negative attitude toward the nursing staff during care. It was

PROFESSIONAL DEVELOPMENT PLAN challenging to provide unbiased care because of the cumulative issues that surrounded this scenario. In this context, this situation proved to be an ethical dilemma. When I was providing

care for this individual, it was important to maintain a therapeutic relationship and to remain an advocate for impartial healthcare. Though it was trying to put aside my personal set of values, it was crucial to remember that professional ethics outweigh personal ethics in a professional setting (Chitty & Black, 2011, p. 116). This was frustrating and ethically challenging. Caring for his immediate health care needs, providing education by informing him of the risks, benefits, and outcomes of his health care regimen (ANA, 2010, p. 137), and assisting this patient in self-determination in a non-judgmental manner was the ethical conclusion that I used to deliver care. Standard 8: Education Nursing is a profession with a distinct body of knowledge. The registered nurse is educationally prepared in the art and science of nursing with the objective of helping others attain, maintain, and restore health (ANA, 2010). An important aspect of this standard is continuing education; Lifelong learning through continuing education is considered essential for all professionals, particularly in practice-based disciplines such as nursing (Chitty & Black, 2011, p. 168). Current nursing practice will be reflected through the procurement of competence and knowledge. Some competencies of the education standard include participation in ongoing educational activities, self- reflection and inquiry, seeking experiences to maintain skills, knowledge, abilities, and judgment, sharing educational findings, and maintaining professional records that can substantiate the evidence of learning and competence attainment (ANA, 2010).

PROFESSIONAL DEVELOPMENT PLAN I have completed the Michigan requirements for a Registered Nurse (RN) Associate

Degree. Just prior to passing the state board examination and receiving my RN license, I had the impetus to begin the continuation of my education in pursuance of a bachelor of science in nursing (BSN). In the RN to BSN program, we often utilize self-reflection and inquiry for a means of self-evaluation and share educational findings through various discussion boards and group projects. Volunteering in the community free clinic and the local elementary school is a way for me to seek outside experiences to enhance my continuing education as well as ongoing educational activities. I also keep my basic life support (BLS) credentials valid, and maintain a poignant records, learning experiences, competencies accomplished, licenses, and credentials profile in a professional portfolio.. Standard 9: Evidence-Based Practice and Research Nursings unique body of knowledge has changed and expanded over time. Nursing is no longer based on trial and error but increasingly relies on theory development and research as a basis for practice (Chitty & Black, 2011, p. 66). Research provides support for certain practices and discouragement of others. It not only improves patient care, but has an effect on the health care system as well. While the student nurse can participate in research as a consumer, the BSN nurse can identify problems, collect data, and read, interpret, and evaluate research for relevance to nursing (Chitty & Black, 2011). While I do participate in research during my enrollment in the BSN program, I do not participate much outside of this. Because I am a currently a student and engage in research, I do take notice as a consumer in my experiences and the experiences of patients that I have worked with. When I have seen discrepancies, I research information making sure that it is from a

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scholarly source, in order to identify what is the current practice on that particular issue. I do use current evidence based research to guide my practice both as a student and when nursing, and incorporate research as a learning basis. I have identified problems, collected data, and made interpretations and evaluations. Though I am not in a position to incorporate changes, I do share research findings with my peers. This is a weakness in my practice, and I plan to join a formal program or committee, use research findings to help develop procedures, policies, and standards of practice in regards to patient care according to the competencies of this standard (ANA, 2010). Standard 10: Quality of Practice As a registered nurse we are to contribute to the quality of nursing practice. As a professional, there is an ethical responsibility to preserve and improve the practices of the health care environment to be beneficial to the delivery of quality health care. Because a strong link exists between the professional work environment and the registered nurses ability to provide quality health care and achieve optimal outcomes (ANA, 2010, p. 5), it is important to incorporate various competencies in order to support this endeavor. Documenting the how the nursing process was applied in an ethical manner demonstrates quality. This is something that I do every time that I am caring for a patient. Creativity is incorporated into my patient care, as all people have a different way of learning and may also require innovation in order to meet the unique needs of each patient. I have participated in the daily meetings where the heads of staff and physicians meet to evaluate the clinical care of the admitted patients. When providing care, I have been able to identify everyday work routine problems and discuss them with the charge nurse as well as analyze factors that relate to the safety, quality, and efficacy of care. Another way I participate in quality of practice is by being

PROFESSIONAL DEVELOPMENT PLAN mindful of unnecessary duplication which will help to minimize costs. These are some of my stronger points while the developing, and implementing of quality care issues are weak points. Standard 11: Communication Interpersonal skills are immensely vital because of the interaction with a variety of

people in many different areas of practice (Chitty & Black, 2011). Therefore, registered nurses are to communicate effectively in a variety of formats in all areas of practice (ANA, 2010, p.54). Effective communication is required in order to have efficacy in collaboration, and todays health care workforce is multi-generational and multi-culturally diverse. Addressing communication skills is crucial because failure to communicate effectively either in documentation, with a patient, with a physician or other team member, or in delivery of care, is one of the six major categories of negligence in malpractice lawsuits (Chitty & Black, 2011). I do feel that communication is one of my strong points because I have seen the difference it can make in the nurse patient relationship. I am able to assess which communication format is preferred by the person I am interacting with. This makes a big difference because there is uniqueness to each individual, and this can avoid any breakdown in communication. I assess my communication skills, particularly when I notice a contradiction in the feedback. This is a way that I avoid inaccuracies in my message, or how I perceive information that I have received. Though I do not hesitate to share concerns of an error in practice, it is important to me to use the appropriate means of communication when having discussions with other professionals about my own perspective. My weakness in this area is that I am still intimidated when communicating with physicians. I realize this is something I need to work on as it will help with transitions in the delivery of care. Another area is that I am uneasy

PROFESSIONAL DEVELOPMENT PLAN with conflict resolution. It is not that I do not pursue the resolution of issues, as much as I still need to build confidence in addressing these uncomfortable situations. Standard 12: Leadership The indication of a leader is one who has the ability to identify problems, set a goal for resolution, and know how to merge with others in order to reach that goal (Chitty & Black,

2011). The registered nurse demonstrates leadership in the professional practice setting and the profession (ANA, 2010, p.55). To me, leadership is someone who has initiative and confidence. I think some people are naturally born with these traits, while others have to work a little harder at it. A strong leader can inspire and empower others, and give encouragement as well as guidance and support. Some of the competencies of leadership that I incorporate into practice are treating colleagues with respect and dignity. I am currently continuing my education and I do have a commitment to lifelong learning and have a strong desire to educate myself and others. I feel I have strong communication skills with the healthcare consumer and colleagues, but need to develop more confidence in the area of conflict resolution communication. I have had difficulty when attempting to direct the certified nursing assistants (CNAs). There seems to be a culture where the assistants are on their own agenda and there could even be a seniority component with the length of employment, as in a territorial issue. I am beginning to understand that this is a prime scenario where guidance and support should be implemented, and appropriate communication is crucial. I am not participating in a professional organization at this time, and that is a weakness I have in regards to the leadership standard. I also hope to someday be a mentor to other

PROFESSIONAL DEVELOPMENT PLAN colleagues for the advancement of nursing practice, the profession, and quality health care (ANA, 2010, p.55).

Standard 13: Collaboration As nurses are becoming more educated, they are also entering into collaborative relationships with physicians and other health professionals as equals. This is due to the increase of knowledge and self-confidence that results from the acquisition of more education, which ultimately results in the best possible outcomes for patients and reinforces the profession (Chitty & Black, 2011). I feel it is important to always collaborate with the patient which allows them to play a central role in their health care plan. Family members should also be included to create continuity of care. Nurses must be relentless in pursuing and fostering a sense of team and partnership across all disciplines (ANA, 2010, p. 5). In consideration of the competencies of this standard, I make it a priority to practice amid my peers and colleagues in a way that will promote teamwork. I have informally collaborated with respiratory therapy and physical therapy, the diabetic counselor, and dietician. This was applied when creating a care plan that relates to the patients services and health care. I believe it is essential to communicate the plan of care during its evolution to allow for any modifications to be made. Weaknesses I have in the area of collaborations would revolve around the lack of experience. I have never partnered with another discipline formally or assisted an interdisciplinary process. Standard 14: Professional Practice Evaluation Nurses should constantly assess and re-evaluate their personal practice. Critiquing oneself is important in order to make adjustments and modifications in practice. I feel is

PROFESSIONAL DEVELOPMENT PLAN important if we are committed to lifelong learning, and I hope to always advance ahead to

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improve my professional practice. I believe that if I am not moving forward, then I have become stagnant, and stagnancy is a sign of complacency. The registered nurse evaluates her or his own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules, and regulations (ANA, 2010, p. 59). One of my strengths is being able to deliver care to my patients in an age-appropriate manner. Because my clinical training is fairly fresh, I can recall all of the nuances of working with distinctly different age groups and settings. Unfortunately, one of my weaknesses in this area is the lack of working with much diversity in cultural groups in order to provide experience with ethnically sensitive situations. I do understand and appreciate the value in cultural competence however, and hope to gain more experience in this area of nursing. I do engage in self-evaluation often, in fact sometimes I can be too excessive where it loses its effectiveness and it can become negative. Because I want to be a person of encouragement to myself (Chitty and Black, 2011, p. 250), this is something I need to work on as I do not want to be a negative impact on my own confidence While I have participated in open group evaluations, it has been awkward. I find that I can accept criticism better than I can provide it to others. When I find a contradiction in my practice, I dig deep to find the rationale for why I have practiced in that way. I always take some measure of action to achieve the goal of change from any evaluation whether from myself, peers, or colleagues. Standard 15: Resource Utilization Nurses perform an important position in influencing health care costs as they have the most direct and frequent contact with patients. Helping to reduce unnecessary spending does not mean there has to be reduction in the quality of care as well (Chitty & Black, 2011). The

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registered nurse considers factors related to safety, effectiveness, cost, and impact on practice in the planning and delivery of nursing services, and utilizes appropriate resources to be financially responsible (Chitty & Black, 2010, p. 140). While I do advocate for the patient financially by assessing their needs and what resources are available, I have not actually assisted the patient and family with personal cost factoring. I have questioned the possibility for alternative medications and if it was an option, and have helped patients and families by supplying information on alternative resources. I volunteer at the local free clinic and patients can be directed there for routine checkups, diagnostic and treatments services, laboratory tests, x-rays, and referrals for specialists, dentists, and ophthalmologists. This clinic also supplies free or low cost medications through the Medication Access Program. The clinic is funded through fundraisers, community clubs and organizations, private donations, churches, and grants (AuSable Free Clinic, Inc., 2009). Standard 16: Environmental Health According to the ANA (2010), registered nurses practice in an environmentally safe and healthy manner (p. 61). To me, this means being aware of positive environmental health concepts and promoting those concepts. The environment can have a profound impact on the welfare of all individuals by interfering or promoting homeostasis (Chitty & Black, 2011). When I think about assessing the practice environment in regards to the patient, I always think about assessing what may affect the senses. Some scents can be strong, so even strong smelling shampoo may be offensive and induce a headache or vomiting. I always ask the patient prior to turning the light on or at the very least, let them know when it is necessary. Not all sound stimuli can be eliminated, but attempts to reduce it should be taken if it is having a negative effect. It is also important to follow the hand washing rules and to always use sanitizer.

PROFESSIONAL DEVELOPMENT PLAN After all, this has been identified as the number one way to prevent the spread of illness and infection (CDC, 2012). In addressing the competencies of this standard, other environmental health strategies that I observe are the everyday environmental safety factors. For example,

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confirming allergies, following bio-hazard protocol, checking that items from an isolation room stay in an isolation room, making sure my stethoscope is wiped down between use, following proper body mechanics, and educating the patients and their families about environmental health concepts are everyday factors. I have not done any scientific research in regards to treatments or products that threaten the environment. That fact that I am not more socially involved is a weakness. Goals Five Year Goals I have determined the professional development goals that I hope to attain within five years. At this time, I am currently enrolled in the RN to BSN program. I have made a commitment to finish this degree in order to expand the breadth and depth of my professional practice. I feel that completing this degree combined with advancing my clinical experience will provide more definition within my professional position as a registered nurse. I would like to obtain specialty certification within five years, and some admission requirements include a baccalaureate degree. I hope to advance in the clinical ladder to a minimum level of clinical nurse level III in five years from the date of this submission. This may also depend on the completion of specialty certification. I have not joined a professional organization at this time, and hope to within one year or less from now.

PROFESSIONAL DEVELOPMENT PLAN Ten Year Goals

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Goals that I would like to accomplish in ten years are slightly ambiguous. Because of my special needs child, I may have to re-evaluate in five years to see if the goals I have today need to be modified. This will depend on what kind of education and care he will need at that time. I hope to be fully advanced in the clinical ladder. At this time I do not wish to further my formal education to a MSN, however I would like to obtain at least two areas of specialty certification by this time, and participate in at least two professional organizations. Evaluation In consideration of my five year goals, the first goal I have is to complete my BSN degree. I already have a plan in place for completion of this goal. I am currently, and plan to continue to follow, the suggested course sequence for optimal program success. This includes taking four to seven credit hours per semester. The next semester in this sequence is the summer semester of 2012, for which I am already enrolled. I will thoroughly examine what specialty areas interest me after I have had at least two years of clinical experience. As I am a new nurse, I want to gain experience in several areas before I make this decision. I will assess the terms and expectations of which professional organization prior to joining. I do not want this endeavor to lack depth, and I want to make sure that I am in a position to make the appropriate contributions toward the goal of the mission. When considering my ten year goals, I hope to be well established in my profession as a nurse. As I do not wish to further my education, I do plan to re-evaluate this after five years. Because I will be well established, I should be able to pursue with confidence a second area of specialty certification. I plan to stay in northern Michigan as my support system, including my family, reside in this area.

PROFESSIONAL DEVELOPMENT PLAN Conclusion In conclusion, after reviewing my practice standards with the standards set forth in the

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ANA (2010), I have discovered the strengths and weaknesses in my professional practice. While I do realize that gaining experience will most certainly contribute to the strengthening of my weaknesses, I also realize that I need to make a conscience effort to seek out a path that will lead to full competency. As I am beginning this journey into the nursing profession, I hope to be able to contribute to the recognition of nursing as a profession and not just an occupation.

PROFESSIONAL DEVELOPMENT PLAN References American Nurses Association [ANA]. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: Author AuSable Free Clinic, Inc. (2009). Information pamphlets. Chitty, K.K., & Black, B.P. (2011). Professional nursing: Concepts and challenges (6th ed.). Maryland Heights, MO: Saunders. CDC. (2012). Wash your hands. Retrieved from http://www.cdc.gov/features/handwashing/ RN to BSN Completion Program-Course Schedule [Schedule Options] (2012). Ferris State University. Retrieved from

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http://myfsu.ferris.edu/cp/render.UserLayoutRootNode.uP?uP_tparam=utf&utf=http%3A %2F%2Fwww.ferris.edu%2Fhtmls%2Fcolleges%2Falliedhe%2Fhomepage.htm

PROFESSIONAL DEVELOPMENT PLAN Appendix Five Year Goals Obtain BSN Clinical Advancement Ladder Join professional organization Specialty certification Ten Year Goals Complete Clinical Ladder Involved at least two organizations Completed two specialty certifications Expected Completion Fall, 2013 April, 2015 September, 2012 April, 2017 Expected Completion April, 2020 April, 2020 April, 2020 Completed

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Completed

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CHECKLIST FOR SUBMITTING PAPERS CHECK DATE, TIME, & INITIAL

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PROOFREAD FOR: APA ISSUES 1. Page Numbers: Did you number your pages using the automatic functions of your Word program? [p. 230 and example on p. 40)] 2. Running head: Does the Running head: have a small h? Is it on every page? Is it less than 50 spaces total? Is the title of the Running head in all caps? Is it 1/2 from the top of your title page? (Should be a few words from the title of your paper). [p. 229 and example on p. 40] 3. Abstract: Make sure your abstract begins on a new page. Is there a label of Abstract and it is centered at the top of the page? Is it a single paragraph? Is the paragraph flush with the margin without an indentation? Is your abstract a summary of your entire paper? Remember it is not an introduction to your paper. Someone should be able to read the abstract and know what to find in your paper. [p. 25 and example on p. 41] 4. Introduction: Did you repeat the title of your paper on your first page of content? Do not use Introduction as a heading following the title. The first paragraph clearly implies the introduction and no heading is needed. [p. 27 and example on p. 42] 5. Margins: Did you leave 1 on all sides? [p. 229] 6. Double-spacing: Did you double-space throughout? No triple or extra spaces between sections or paragraphs except in special circumstances. This includes the reference page. [p. 229 and example on p. 40-59] 7. Line Length and Alignment: Did you use the flush-left style, and leave the right margin uneven, or ragged? [p. 229] 8. Paragraphs and Indentation: Did you indent the first line of every paragraph? See P. 229 for exceptions. 9. Spacing After Punctuation Marks: Did you space once at the end of separate parts of a reference and initials in a persons name? Do not space after periods in abbreviations. Space twice after punctuation marks at the end of a sentence. [p. 87-88] 10. Typeface: Did you use Times Roman 12-point font? [p. 228] 11. Abbreviation: Did you explain each abbreviation the first time you used it? [p. 106111] 12. Plagiarism: Cite all sources! If you say something that is not your original idea, it must be cited. You may be citing many timesthis is what you are supposed to be doing! [p. 170] 13. Direct Quote: A direct quote is exact words taken from another. An example with citation would look like this: The variables that impact the etiology and the human response to various disease states will be explored (Bell-Scriber, 2007, p. 1). Please note where the quotation marks are placed, where the final period is placed, no first name of author, and inclusion of page number, etc. Do all direct quotes look like this? [p. 170-172] 14. Quotes Over 40 Words: Did you make block quotes out of any direct quotes that are 40 words or longer? [p. 170-172] 15. Paraphrase: A paraphrase citation would look like this: Patients respond to illnesses in various ways depending on a number of factors that will be explored (Bell-Scriber, 2007). It may also look like this: Bell-Scriber (2007) found that

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[p. 171 and multiple examples in text on p. 40-59] For multiple references within the same paragraph see page 174. 16. Headings: Did you check your headings for proper levels? [p. 62-63]. 17. General Guidelines for References: A. Did you start the References on a new page? [p. 37] B. Did you cut and paste references on your reference page? If so, check to make sure they are in correct APA format. Often they are not and must be adapted. Make sure all fonts are the same. C. Is your reference list double spaced with hanging indents? [p. 37]

PROOFREAD FOR GRAMMAR, SPELLING, PUNCTUATION, & STRUCTURE 18. Did you follow the assignment rubric? Did you make headings that address each major section? (Required to point out where you addressed each section.) 19. Watch for run-on or long, cumbersome sentences. Read it out loud without pausing yes unless punctuation is present. If you become breathless or it doesnt make sense, you need to rephrase or break the sentence into 2 or more smaller sentences. Did you do this? 20. Wordiness: check for the words that, and the. If not necessary, did you omit? yes 21. Conversational tone: Dont write as if you are talking to someone in a casual way. For yes example, Well so I couldnt believe nurses did such things! or I was in total shock over that. Did you stay in a formal/professional tone? 22. Avoid contractions. i.e. dont, cant, wont, etc. Did you spell these out? yes 23. Did you check to make sure there are no hyphens and broken words in the right margin? yes 24. Do not use etc. or "i.e." in formal writing unless in parenthesis. Did you check for yes improper use of etc. & i.e.? 25. Stay in subject agreement. When referring to 1 nurse, dont refer to the nurse as they yes or them. Also, in referring to a human, dont refer to the person as that, but rather who. For example: The nurse that gave the injection. Should be The nurse who gave the injection Did you check for subject agreement? 26. Dont refer to us, we, our, within the paperthis is not about you and me. Be yes clear in identifying. For example dont say Our profession uses empirical data to support . . Instead say The nursing profession uses empirical data.. 27. Did you check your sentences to make sure you did not end them with a preposition? yes For example, I witnessed activities that I was not happy with. Instead, I witnessed activities with which I was not happy. 28. Did you run a Spellcheck? Did you proofread in addition to running the Spellcheck? yes 29. Did you have other people read your paper? Did they find any areas confusing? no 30. Did you include a summary or conclusion heading and section to wrap up your paper? yes 31. Does your paper have sentence fragments? Do you have complete sentences? yes 32. Did you check apostrophes for correct possessive use. Dont use apostrophes unless it is yes showing possession and then be sure it is in the correct location. The exception is with the word it. Its = it is. Its is possessive. Signing below indicates you have proofread your paper for the errors in the checklist:

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NAME:____C.V._____________________________________ DATE: April 29,2012