Running head: Evaluating My Own Practice

Evaluating My Own Practice Julie Walker NURS 324

Running head: Evaluating My Own Practice Abstract This paper discusses my personal evaluation of the quality of nursing care that I practice on a daily basis. Included are matters of how I continue my education, how I assist others, the ANA Code of Ethics impact on my practice, and how I work with other staff members at my facility or in the community. Additionally, I reflect on ways I may continue to improve my practice to make certain that I am providing a high standard of care.

Running head: Evaluating My Own Practice Evaluating My Own Practice Governing bodies and healthcare organizations require a standard of care. As I nurse, I must take care to provide care at least at this standard. I make certain that I provide quality care by evaluating myself regularly. This evaluation includes how I interact with patients and other members of the interdisciplinary team, how my practice matches up to the ANA Code of Ethics, if research has an impact on my daily work, and if my practices contribute to a healthy environment. Quality Care I make certain that I am delivering quality care by three different ways: using my hospitals policies, forming relationships with my residents, and seeking assistance from experienced coworkers. I familiarize myself with the General Nursing Policies and Procedures provided my employer and refer to this manual when faced with tasks I may not have recently performed. Forming relationships with my residents reminds me that I am caring for someones mother or father, and this motivates me to provide the same quality of care I would want for my friends and family. Finally, I seek assistance from my coworkers who may have more strength in a given area than I do. For example, I have little experience starting IVs and rather than practice on an ill elderly person, I bring an extra kit and an experienced nurse into the room with me in case I am not successful. Continuing Education My education is continued by regularly scheduled training programs provided by my employer, reading and testing through an online continuing education program, and by participating in classes toward my BSN. Spectrum Health requires clinical employees to attend Skills Days twice each year. In advance of the training, my supervisor will have designated

Running head: Evaluating My Own Practice which stations will be of benefit to me. Additionally Spectrum Health provides a link to an

online continuing education program where I can read articles relevant to general nursing or any specialty and take a quiz thereafter. This program provides continuing education credit for license renewal. Taking classes toward my BSN involves reading the most recent publications and available research. How to Evaluate When evaluating my own practice, I ask myself if I would want to be my own nurse or that of a loved one. Unfortunately there are times that corners must be cut in order to provide timely care. There are ways in which to do so that do not compromise care. By asking myself if my practice would be acceptable for my family member or myself, I determine how to proceed. Additionally, my understanding of the principle behind a given rule allows me to judge its appropriateness for the circumstances. Helping Others I provide help to others in my profession by staying in contact with my classmates from nursing school, offering to train and orient nurses new to our unit, and sharing tips with my coworkers that have been given to me by seasoned nurses or those I may have discovered on my own. I remain in contact with my classmates from school and notify them of job openings that I know will be of interest to them. I use my experience in the business side of things in my previous career to help them draft a resume and cover letter; I have even given tips on how to dress for the interview. Since our unit is mainly long term care, we have a fairly high turnover rate. Even in a work environment where we do not experience the phenomenon of eating our young, still I remember how uncomfortable it is to be a new employee, so I am eager to orient the new nurses and get them acclimated to our unit for a more comfortable transition. With

Running head: Evaluating My Own Practice regard to new tasks, I ask the person I am teaching if they would prefer to practice or if they would like to watch the first time through. Finally, I enjoy sharing tips with my coworkers on various tasks such as inserting a urinary catheter into a female patient or keeping a feeding tube free of clogs. Working as an Interdisciplinary Team

A large portion of the care provided on my unit is rehabilitation after repair of a fracture. Many of these residents have therapy twice daily, once with an occupational therapist and once with a physical therapist. Each morning I consult the therapy schedule for the day in order to plan pain medication in advance of therapy. This is with the goal of better therapy tolerance for the resident. Additionally, I strive to schedule medications and treatments at times that will not conflict with therapy or respiratory treatments. I have developed a good relationship with the therapists, the respiratory team, pharmacy, and our physicians. When I express concerns or have a question, we are able to have a good working discussion of the issue; I truly feel that I am on a team. Code of Ethics Reviewing the Code of Ethics has caused me to recognize that I need to take a more active part in health promotion for the community and in the improvement of the profession as a whole (Chitty & Black 453). Currently, I feel I practice in an ethical manner by providing the same standard of care regardless of my patients background, holding myself and support staff accountable for a high standard of care, and by having my commitment be to the patient rather than the medical staff or family members. One example of this is that recently I had a resident who, at every opportunity, reminded me how much money he donated to our hospital and with whom he is acquainted in the hierarchy of the community. Around the third or fourth visit to his

Running head: Evaluating My Own Practice room, I once again patiently listened to his resume. When he was finished I asked him why he was telling me this. He said Oh, I dont know. I then told him that I appreciate everything he

shared with me, but that he could be confident that my goal was to be his best nurse regardless of who he knows or how much money he has. He laughed and said I like you, youre a keeper. I truly meant what I said and give the same high standard of care to all of my residents, and I require that my support staff do the same. Research The extent of research I have conducted for my current position rests with medication administration. Generally, I have done this in order to schedule times for medications to be passed or to determine if a different form or brand may be best suited for a resident. Beyond this, my daily practice is not based on my own research but rather that set forth by the state of Michigan. Every step we take in long term care is regulated by the state, and as we are also attached to a hospital, anything not covered by the state is governed by JCAHO. Referrals and Cost-Effectiveness Most often I refer residents to Social Services when a need arises that I am unable to satisfy. I am unable to answer questions regarding the specifics of Medicare coverage or what home health agency might best suit the patients circumstances. However, the social worker on our unit is a wealth of information, and I regularly seek her out for answers or ask her to speak with a family about their financial concerns. I attempt to be cost effective in my care by investigating a dressing before gathering supplies. Additionally, anything that I do not use that has been brought to the residents room gets placed in a drawer within their room in case it can be used for the next treatment, rather than

Running head: Evaluating My Own Practice throwing it away. Additionally, I strive to complete my assignments within my shift in order to avoid costing our unit extra payroll caused by my staying over. Healthy Work Environment I firmly believe that I am a team player. I subscribe to the belief that no one person on the unit should have a bad day while everyone else goes about his or her own business. I prefer

that we all have a less than perfect work-day and solve the units problems together. At our staff meetings I remind support staff that while we all have a patient assignment, the unit as a whole is everyones assignment. I routinely offer to assist the other nurse with his or her patients and am rewarded with offers of assistance when I am in need. I also help the support staff with toileting, repositioning, and feeding the residents as I am able. Additionally, we recently implemented a new computer program for our unit, and I volunteered to be a super-user. This involved more training, but provided an opportunity for me to be the go-to person when questions arise with the program. As I stated in one of our class discussions, I am fixer and relish opportunities where I can have a positive impact on another persons day. I am fortunate to work with four of my classmates from nursing school, and we have been told that our camaraderie has been infectious on our unit.

Running head: Evaluating My Own Practice References Chitty, K. K. & Black, B. P. (2011). Professional Nursing Concepts & Challenges (6th ed.). Maryland Heights, MO: Saunders Elsevier.