Running head: NURSING STANDARDS OF PRACTICE 1

Self-Assessment of Nursing Standards of Practice

Kelli J. Koop
Ferris State University





















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Self-Assessment of Nursing Standards of Practice
Nurses are expected to uphold certain standards and provisions in the healthcare
field. As a result, the nurse provides safe, quality, and evidence-based care to each
patient. The American Nurses Association (ANA) provides two sources to guide the
nurses thoughts and actions: Nursing Scope and Standards of Practice (2010), which
outlines the expectations and competencies of the nursing profession and Nursing Code
of Ethics (2001), which provides the ethical framework for the registered nurse. Together
they provide a solid foundation to develop and refine current nursing practices. The
following provides an evaluation of my current nursing practices according to the ANA
standards and provisions of nursing.
Nursing Scope and Standards of Practice
Standards of Practice
According to the ANA (2010), the Standards of Practice describes what a
competent nurse demonstrates through the nursing process. The nursing process is made
of six components: assessment, diagnosis, outcome identification, planning,
implementation, and evaluation. Together these steps form the strategies used to make
decisions for the patients plan of care.
Standard 1: Assessment. According to the ANA (2010), this standard involves a
comprehensive collection of data pertaining to the patients current health and plan of
care. The assessment includes, but not limits, the following collection of data: physical,
functional, psychosocial, emotional, cognitive, sexual, cultural, age-related,
environmental, spiritual, and economic. This is done while honoring the uniqueness of
the individual (ANA, 2010, p. 32). The thorough assessment allows the nurse to obtain a
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holistic data collection and get a full picture of their current health status (American
Nurses Association, 2010).
This standard has been met at the clinical setting. From the beginning,
assessments have been performed for each patient. Though the quality of my assessment
may have started off poorly, it has developed and improved through each performance.
Every assigned patient has a thorough assessment completed at the beginning of the shift,
providing a baseline for the patients current health status. The assessment progresses
until the patient has been examined from head-to-toe. The patients mental and emotional
status is also evaluated. Focused assessments are then performed throughout the shift to
track the patients progress or decline in health. Assessment skills will continue to grow
as more experience is gained in the nursing profession.
Standard 2: Diagnosis. Standard two involves the analysis of the obtained data
during the assessment to diagnosis the patients current health issues (ANA, 2010). The
diagnosis could be a validation of a current diagnosis or previous health condition. It
could also be a nursing diagnosis that is identifying actual or potential health risks. The
diagnosis follows a standard classification system and tools.
This standard has been met after every assessment to verify the medical diagnosis
made by the physician. Also, nursing diagnoses were made during the physical and
verbal assessments. Most of the time, a lack of knowledge was an issue for the patient.
During one particular assessment, the patient had a painful spot in her leg and it was
swollen. A nursing diagnosis of risk for ineffective peripheral tissue perfusion was made
for the patient and the physician was contacted immediately. During the diagnosis, the
nurse identifies actual and potential risks to the patients health and safety (ANA, 2010).
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This patient was at risk for severe or permanent damage to her leg; if blood flow had
stopped, the tissue could become necrotic. Therefore, accurate and thorough assessments
will develop a pertinent and quality diagnosis, which will aid in the care and recovery of
the patient.
Standard 3: Outcome Identification. According to the ANA (2010), this
standard identifies the expected outcomes for each persons individualized situation. The
nurse helps develop the desired outcomes with the patient, family, and other healthcare
providers (ANA, 2010). The outcome should produce goals that follow the SMART
acronym, which stands for specific, measurable, achievable, relevant, and time-based
(Taylor, LeMone, Lillis, & Lynn, 2011). This helps individualize the outcome of each
patient because a specific goal may be achievable for one individual but not for another.
Standard three has been met during clinical and while completing a clinical
integration assignment. A portion of the assignment required the identification of
outcomes for two nursing diagnosis of an assigned patient. When a diagnosis is made, the
desired outcome seems obvious. For example, when a patient has ineffective tissue
perfusion, the desired outcome is maintaining adequate tissue perfusion. However, the
patients outcome not only identifies the goal, but also identifies the evidence needed to
achieve the goal. Therefore, the patient will maintain adequate tissue perfusion as
evidence by palpable peripheral pulses, warm and dry skin, adequate urine output, and
absence of respiratory distress (Ladwig & Ackley, 2011). The focused assessments
performed throughout the day will concentrate on the goals to see if and when they are
achieved. With experience, outcome identification will become easier to detect; however,
they will always be individualized for each patient.
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Standard 4: Planning. According to the ANA (2010), planning not only
produces strategies to attain the goal, but also alternatives to help tailor the plan to each
individual. The plan can promote and restore the health of an individual or it can prevent
illness and injury. It could also support those who are dying and alleviate their pain and
suffering. The healthcare team collaborates with the patient, family, and others to
establish priorities and interventions that will be appropriate for each particular
individual.
This standard has been met during the clinical experience. When a patient was
experiencing pain from a surgical incision, an icepack was added to the plan of care to
help alleviate his or her pain. Therefore, additions were made to the plan of care for this
patient. I have not participated in an admission of a patient when a plan of care would
need to be established. However, the care plan will always be evolving, having additions
and eliminations to the plan as the patients health changes. The patients health may
improve and they no longer need a certain medication or medical device. On the other
hand, the patients health may decline and they may require new medications or assistive
devices to accomplish activities of daily living. Therefore, the nurse is continuously
revising the plan of care of each patient. Accurate assessments are pertinent to identify
changes in the patients health, which may require a change in the patients plan of care.
Standard 5: Implementation. According to the ANA (2010), the
implementation of the plan involves four components: coordination of care, health
teaching and health promotion, consultation, and prescriptive authority and treatment.
The ANA (2010) states that the nurse must coordinate the delivery of care according to
everyone involved in the patients care; this includes, but is not limited to the patient,
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family, physician, physical therapy, speech therapy, and occupational therapy. The nurse
will not only be providing the patients care, but also providing education that will help
promote their health and keep them safe in their environments. The nurse will not rely on
their own knowledge for the complete care of the patient, but will consult others to
improve nursing care and create a positive and effective change in the patients health.
Finally, the advanced practice nurse will use prescriptive authority, procedures,
referrals, treatments, and therapies in accordance with state and federal laws and
regulations (ANA, 2010, p. 10)
Only a portion of standard five has been met during clinical time. During the care
of each patient, coordination was achieved with other members of the care team, which
provided organized and efficient delivery of care. When assessments and treatments were
being performed, physical therapy or occupational therapy would adjust their schedule or
visa versa. Each member of the patients healthcare team is just as important as the other;
there is not or should not be any hierarchy in the team because without one member, the
patients quality of care declines. Teaching health promotion techniques was also
achieved during the clinical experience. Many times educational sheets were given about
their current health condition so they could better understand what was occurring in their
bodies and why certain treatments were being performed. Also, patients were continually
educated on their medications during each administration. The patient was educated on
health promotion strategies when given the incentive spirometer; they were taught how to
properly use it, how and why it helps their health, and how often it should be used. On
the other hand, the consultation and prescriptive authority and treatment categories were
not met because a graduate-level prepared specialty or an advanced practice education
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had not been attained. Therefore, I do not have the authority to make a consultation to
other healthcare team members or prescribe any type of treatment. The responsibilities
that are assumed of the nursing student are implemented in a safe, efficient, and timely
manner.
Standard 6: Evaluation: According to the ANA (2010), this standard evaluates
the progress made toward achieving the outcomes. The evaluation process is ongoing
throughout the patients entire care because their health status is continually changing. It
should be conducted in a systematic and criterion-based method to be efficient and
effective (ANA, 2010). The evaluation is not only done by the nurse, but also involves all
members of the patients healthcare team; combining all aspects of their care allows for a
more holistic evaluation.
This standard has been met during each clinical day. The patients treatments are
evaluated during the focused assessments throughout the day and also during rounds with
the physician and other healthcare team members. Some units have implemented a new
standard of rounding on each patient with the healthcare members involved in their care.
This allows the nurse, physician, and others to assess the patients progress together,
creating a holistic evaluation. During the focused assessments, the patients response to
the treatment is monitored and tracked. This allows for early detection of any adverse
reactions that may occur. For example, a patient receiving blood transfusions was
continually monitored and evaluated on a routine basis so that allergic reactions could be
detected early to minimize harm to the patient. Patients should be continually evaluated
so adjustments can be made to their plan of care and implemented in a timely manner,
which will improve the patients health more quickly and efficiently.
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Standards of Professional Performance
According to the ANA (2010), the standards of professional performance describe
the behaviors a competent nurse should exhibit; for example, actions related to ethics,
education, evidence-based practice, research, communication, and others. Each nurse
must be accountable for his or her own professional actions, whether they were right or
wrong. It is easier to take credit for performing correctly; however, taking responsibility
for ones mistakes shows good character.
Standard 7: Ethics. According to the ANA (2010), standard seven requires
nurses to perform patient care in an ethical manner. Not only is it good practice to
perform nursing skills correctly, in addition, an excellent nurse will implement ethical
behaviors as well. To practice ethically, the nurse should deliver care in a manner that
preserves and protects healthcare consumers autonomy, dignity, rights, values, and
beliefs (ANA, 2010, p. 47). The nurse recognizes the patient and the family as the center
of the healthcare team, meaning not only is the patients health problem treated, but also
their emotional, spiritual, and mental needs.
This standard has been met in clinical in a variety of ways. Treating others in an
ethical manner has always been a priority. The education provided in nursing school has
allowed my ethics to develop and mature, which then can be integrated into my
professional performances. For example, simple practices that demonstrated ethical
considerations to the patient were closing the door or curtain to provide privacy, allowing
them to perform their own hygiene practices to uphold their dignity. Consulting patients
for decisions in their treatments to preserve their autonomy also demonstrates ethical
practices. More complex situations involved discovering their religious or cultural beliefs
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and practices so they could be considered when developing their plan of care. For
example, a Hispanic patient was assigned and an interview was performed upon
admission, focusing on his cultural beliefs to make sure it did not interfere with the
recommended plan of care. Also, autonomy is practiced regularly when medications or
treatments are administered or procedures are performed. The patient has a right to refuse
any medication or treatment and a written consent must always be obtained from the
patient before any procedure can be performed. Though some behavioral manners seem
simple and obvious, ethical practices may become complex issues that are very difficult
to handle.
Standard 8: Education. According to the ANA (2010), the education standard
requires the nurse to attain relevant knowledge and competence that supports current
nursing practices. A nurse should be committed to his or her career and seek out current
education to maintain his or her skills, abilities, and judgments. The nursing profession is
continuously evolving and improving, which means newly obtained education will be
required to update nurses practices.
This standard is currently being met four days of the week, during clinical and
during class. Nurses who have been in the profession for decades still say they learn
something new every day. Because healthcare is comprised of so much information,
education continues throughout the entire career of nurses. In addition to the education
obtained in the classroom, the clinical setting presents students with further education to
help develop and improve their nursing skills and abilities. For example, basic nursing
practices were introduced to my class in skills lab. The skills were then practiced, refined,
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and improved in the clinical setting. Education will be continuous throughout the nursing
profession due to the amount of information presented with every new patient.
Standard 9: Evidence-Based Practices and Research. The ANA (2010)
describes standard nine as integrating and utilizing evidence-based practices (EBP) into
the patients care. Nurses must continue evolving, as new evidence-based skills are being
discovered and implemented into policies. The healthcare facility, as well as the nurse,
has the responsibility of discovering new EBP to improve patient care.
This standard has been met in the classroom and during post-conference of
clinical. For students, the most current EBP is taught in the classroom. There are times
when the students practices are more current than what is practiced at the clinical setting.
For example, when a patient required an intramuscular (IM) injection, the nurse requested
that the injection be inserted into the dorsogluteal area. This action was respectively
refused and the nurse was informed of the current nursing education on IM injection
sights; the dorsogluteal sight is no longer EBP. The patients injection was instead placed
into the ventrogluteal area. Unfortunately, there is a noticeable lag in the entry of new
education into the clinical settings. Research can narrow this gap; EBP is implemented
into practice after they are first discovered through research. For example, new research
studies are telling nurses that intravenous (IV) catheters can be changed as clinically
needed, rather than on a routine schedule. Though this practice has not been implemented
into practice, nurses can present this research to the healthcare facility to be reviewed.
Standard 10: Quality of Practice. According to the ANA (2010), standard ten
involves the nurses contribution to the quality of the nursing profession. Responsibility
and accountability is taken for every action in an ethical manner, whether good or bad.
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Nursing is a complex profession, involving detailed and time-consuming responsibilities.
Quality of practice can easily decline if neglected.
This standard has been met through documentation, procedures, policies, and
general nursing care. Striving for effective and efficient patient care is always a priority.
Nursing skills are being practiced in the clinical setting so improvements can be made to
provide quality care to the patients. Before entering the clinical setting, nursing
assessments were practiced in the classroom. This allowed for more efficient and
effective assessments in the healthcare facility, which provided better quality of care to
the patient. A tool that helps provide quality care is the nursing process. It requires a
thorough routine of assessment, diagnosing, planning, implementing, and evaluating,
which is continuously repeated throughout the clinical time. Accountability for each
action motivates toward improvement and excellence in our profession.
Standard 11: Communication. According to the ANA (2010), the nurse should
be able to communicate with a variety of individuals effectively, including physicians,
family members, physical therapists, etc. The nurse may be addressing concerns or
observations of the patient, questioning decisions that do not appear to be in the interest
of the patient, or advocating for their patient by making recommendations. Maintaining
open communication between all healthcare providers is pertinent to achieving effective
and efficient care.
Standard eleven has been met throughout each day at clinical. Changes in the
patients health statuses were reported promptly to the nurse. When the patients
temperature began to consistently rise from 37.2 to 37.6 to 37.9 degree Celsius
throughout the morning, the nurse was informed of the change. The patients temperature
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was closely monitored there after for any serious complications. The standard was also
met when communication was established with the physical therapist (PT). The PT was
updated on the patients current accomplishments of the morning and whether or not the
patient was pre-medicated for pain prior to therapy. Though there was little
communication with the physicians, it is hopeful that the professional relationship
between nurses and physicians will become open and effective.
Standard 12: Leadership. ANA (2010) states that standard 12 requires the nurse
to demonstrate leadership skills in the professional healthcare settings. The nurse should
oversee the care given to the patient, effectively communicate with all members of the
healthcare team, and mentor to other nurses. The nurse is committed to life-long learning
and advancement in the nursing profession.
Currently, this standard has not been met. Though there is a passion to obtain a
leadership role, my lack of experience, knowledge, and growth in the nursing profession
prevents me from meeting this standard. Nursing practices are accomplished under the
supervision of a preceptor and the primary nurse of each patient. Therefore, nursing tasks
are delegated to me. Becoming an effective and reliable follower will create a foundation
for a leadership role in the nursing profession.
Standard 13: Collaboration. According to the ANA (2010), the collaboration
standard includes other members of healthcare team, the patient, and the patients family
in the nursing practices. The nurse should encourage communication between colleagues
and the patient to promote cooperation, respect, and trust. The goal is to effectively
change and produce a positive outcome for the patient.
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This standard has been met through a variety of ways. At the beginning of the
shift, the nurses gather together to collaborate and discuss all the patients on the unit. For
example, we discuss which ones are do not resuscitate (DNR), have indwelling urinary
catheters, need sitters, are busy patients, or are on telemetry. This allows for a better
understanding of the units current situation. Also, this standard was met when the nurse
collaborated with the patient. During the morning assessment, the patient will usually
discuss their goals and desires for the day; for example, walking or eating. This allows
me to initiate communication between the patient, nurse, physician, and PT, reporting any
pertinent information that needs to be discussed or implemented to resolve conflicts.
Standard 14: Professional Practice Evaluation. The ANA (2010) states that
standard 14 requires nurses to evaluate their own practices, comparing it to the
professional standards and guidelines of practice. This is done to identify development
and improvement in the nurses abilities to provide appropriate and ethical care. The
constructive criticism is taken seriously and is used to improve their abilities.
This standard has been met. After every clinical week, the students are required to
complete a weekly evaluation on their nursing capabilities, explaining how they were
effective in their actions. For example, explaining how they advocated for the patient or
performed safe medication administration would be included in the evaluation.
Afterwards, the instructor evaluated the students nursing abilities, allowing for
constructive feedback. For example, the instructor pointed out my good nursing instincts
and capabilities, however I needed to slow down when performing medication
administrating and other nursing procedures. Also, upon completion of this paper, I will
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have performed a thorough and extensive evaluation of my nursing capabilities in relation
to The Nursing Scope and Standards of Practice and The Code of Ethics.
Standard 15: Utilization. According to the ANA (2010), standard 15 utilizes
appropriate nursing resources to provide safe, quality, and effective nursing care.
Modifications are made to nursing practices when appropriate resources are integrated
into the healthcare system. Overall, resources are used to benefit patient care by
informing nurses of new evidence-based practices.
This standard has been met during clinical, as well as in the classroom. When
there is a lack of knowledge about a patients condition or plan of care, educational
resources are used to expand our knowledge. This allows for better understanding of the
patients current status or needs, which will enable us to provide quality and effective
care. In the classroom, resources are used continuously to complete projects and gain
knowledge. For example, when the mental health condition dementia was assigned for
simulation lab, educational resources were utilized so it could be properly presented
during class.
Standard 16: Environmental Health. Standard 16 requires the nurse to practice
in an environmentally safe and healthy manner (ANA, 2010). According to the ANA
(2010), health risks should be minimized through tactical environmental health strategies.
This can be done through assessment of the environment and communication of current
risk-reduction strategies.
This standard has been met. When practicing in the healthcare environment,
information is given as to the current exposure and risk-reduction strategies. For example,
when there is droplet precaution for a patient, gowns, masks, and gloves are used to
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minimize risks for exposure. In Interventional Radiology, a lead vest is worn in the
procedure room to reduce the risk of radiation exposure. When handling blood or other
body secretions, gloves are always worn. Therefore, starting an IV requires gloves to
protect the nurse from exposure to the patients blood. Also, nurses communicate to
patients and family members of their health risks and the strategies used to reduce those
risks. When a patient had Clostridium difficile (C. diff), the patient and family were
informed to wash hands with anti-microbial soap upon entering and exiting the room,
rather than using hand sanitizer. Hand sanitizer is ineffective in killing C. diff. This would
reduce the exposure risk to the family and other visitors.
Code of Ethics
There are a variety of ways to address ethics. The American Nurses Association
(2001) provides The Code of Ethics with nine provisions that address ethics in the nursing
profession. The purpose is to state the obligations and duties of each nurse, provide a
non-negotiable standard, and express a commitment society (American Nurses
Association, 2001).
Provision 1
According to the ANA (2001), provision one requires care be given in a
compassionate and respectful manner. The patients dignity, worth, and uniqueness must
be considered to provide individualized care. The provision addresses the nurses
professional relationship with patients, as well as with other members of the healthcare
team.
This provision has been met. Since the very beginning of the nursing program,
each person encountered has been treated with respect, compassion, dignity, and
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uniqueness, including, but not limited to instructors, physicians, PTs, other nursing
students, nursing assistants, receptionists, and patients. For example, when caring for
patients, each one is given individualized and compassionate care to meet their specific
needs. A patient withdrawing from drugs or alcohol is provided a quiet, dim-lit, and low
stimulated room. Judgment of the patients actions is not a nurses concern, but rather the
treatment of their physiological, mental, and emotional needs. This also requires
provision of care that is self-determined by the patient, allowing their autonomy to be
preserved (ANA 2001).
Provision 2
As stated by the ANA (2001), provision two requires the nurse to be committed to
the patients care. The commitment not only involves the patients interests, conflicting
issues, and collaboration, but also professional boundaries. Since the nurse becomes
immersed into the patients personal life, provision two can become quite difficult.
This provision has been met in the clinical setting. When providing care, each
patients interests and choices were respected and integrated into the plan of care. For
example, when a patient had been gradually weaning off Ativan, she requested not to be
given anymore Ativan. Though small doses of the medication could have helped ease her
symptoms of withdrawal, her choice was respected. The Ativan order was changed to an
as needed (PRN) medication. On the other hand, conflicting situations can arise when
the patient or family disagrees with the physicians orders or if the physician and
consulting physician disagree. Since the nurse is usually carrying out the physicians
orders, the conflict can easily be transferred to the nurse. Furthermore, when providing
care to the patient or collaborating with other healthcare providers, a professional
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boundary is always maintained. There has never been inappropriate conversing or
touching amongst other healthcare workers or patients. It is important for me to establish
and maintain professional boundaries so my career is not hindered undesired situations.
Provision 3
According to the ANA (2001), provision three protects the patients rights, safety,
and health. The patients rights include issues pertaining to privacy and confidentiality.
Safety issues include intervening during questionable practices on behalf of the patient.
Also, advocating for care they may need or want protects their health.
This provision has been met through a variety of methods at the clinical setting.
For example, a patients confidentiality is protected through Health Insurance Portability
and Accountability Act (HIPPA). If HIPPA were violated, the nurses license would be
revoked; in my case, I would be expelled from the nursing program. Therefore, patient
information has never been communicated to others or revealed on social media; the
patient has only been discussed with appropriate members of the healthcare team. The
patients health and safety are protected through evidence-based practice regulations.
Procedures are done according to hospital policy or evidence-based practice, not by
personal preferences. For example, though it may be easier for insulin to be given by one
nurse, hospital policy requires a second nurse to ensure the safety of the patient by
checking the dosage. If a practice is questioned in regards to the patients safety, it should
be done so respectively and efficiently; I would never perform a questionable practice
without confirmation.
Provision 4
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As stated by the ANA (2001), provision four requires the nurse to be responsible
and accountable for his or her own practices. Furthermore, appropriate delegation is
needed to improve patient care. When delegating care, the nurse is still responsible for
the overall care of the patient.
This provision has not been met. Though there is a responsibility for my own
nursing practices, the primary care of the patient is not within my control. Also,
delegation of patient care is not within my scope of practice yet; instead, patient care is
delegated to me. A registered, licensed nurse should make the necessary decisions about
patient care; their acquired knowledge equips them to make educational judgments.
Provision 5
According to the ANA (2001), this provision extends beyond respecting ones own
morals to respecting the morals of others. The same duties that we owe to others we owe
to ourselves (ANA, 2001, p. 10). Also, the nurse should maintain competency and
continue professional and personal growth.
This provision has been met. Throughout the nursing program, my integrity or
morals have never been sacrificed. Though I have a duty to my professional career, I also
have a duty to myself to maintain my personal morals. In addition, others morals and
integrity have not been compromised due to my actions or requests. There has never been
a request to lie or cover-up information in my behalf. Furthermore, I always strive to
advance my professional and personal growth. When there are opportunities to perform
nursing practices or be involved in other procedures, they are gratefully taken and
appreciated. For example, during a trauma code, there was a request to perform a round
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of compressions for cardiopulmonary resuscitation (CPR); anxiously, I accepted. After
completing the nursing program, the plan is to become certified as a scrub nurse.
Provision 6
The ANA (2001) states that provision six involves the nurses participation in the
moral and ethical environment. Nurses should be encouraging respectful interactions
between patients, nurses, and other healthcare workers. The nurse can directly influence
the environment or support current ethical and moral environmental practices.
This provision has been met. While in the clinical setting, communication and
interactions are performed in a respectful and moral manner. As insignificant as please
and thank you sound, they are continuously used throughout the day to inspire
cooperation and teamwork. Help is given to anyone in need, no matter the task. If
someone needs help with wiping his or her buttock or other bathroom details, it will be
done without hesitation. Also, if tasks are inappropriately done, non-judgmental
corrections are made. For example, after charting a Braden skin assessment incorrectly,
the nurse respectfully and pleasantly corrected me and encouraged my learning.
Similarly, when a nursing assistant forgot to chart a patients urine output, a respectful
and pleasant reminder was given without any criticism.
Provision 7
According to the ANA (2001), provision seven requires the nurse to participate in
the advancement of the nursing profession. This is done through developing, maintaining,
and implementing current professional standards into the healthcare settings. The nurse
could also promote the nursing profession by expanding their body of knowledge in
regards to nursing.
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This provision was met by being educated in my scope and standards of practices.
While in the clinical setting, practices are only performed if they are in my scope of
practice. For example, as a student, being the second nurse to check for a patients insulin
dosage is not within my scope of practice. On the other hand, giving the insulin injection
to the patient is within my scope of practice. Standard seven is also met through the
advancement of the nursing profession through gaining knowledge. Twice a week, my
nursing knowledge is substantially expanding by participating in class activities, listening
to lectures, and completing assignments. After graduation, my knowledge will continue
to grow as experience is gained and my career advances.
Provision 8
According to the ANA (2001), provision eight involves the nurse promoting
community, national, and international health. Nurses should be knowledgeable about the
communitys health strengths and weaknesses. They should collaborate with other
healthcare workers to create strategies that meet the health needs of the community.
This provision was met in Antigua, Guatemala. Voluntarily, help was given to the
people of Antigua. The people in need were taught health promotion strategies and given
supplies, all free of charge. For example, a free clinic was opened so examinations could
be performed; if possible, the individual was treated. Toothbrushes, toothpaste, and
vitamins were given to each individual who came in. The community of Antigua has
many weaknesses that may hinder their health. Though our efforts seemed minuscule, a
huge impact was made on the few individuals that were helped. I am hopeful that
gradually, the strength of the community will grow and improve the lives within it.
Provision 9
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The ANA (2001) states that provision nine involves the communication and
affirmation of nursing values. Nurses should promote awareness of the professions
ethics and values to the community, other members of the healthcare system, and to all
nurses. Individually and collectively, nurses have the responsibility to shape and reshape
their profession within our healthcare system.
This provision was not met during clinical or classes. Currently, I am not a
member of a nursing association and have not been in a position to teach others about
nursing values and ethics. However, when in clinical and in class, I support the values
and ethics of the nursing profession. As a student, I am still learning the ins and outs of
the nursing profession, absorbing as much information as possible. Once licensed, I will
have the responsibility to help uphold and develop the nursing profession. Until then,
learning and developing nursing abilities is my responsibility.
Goals
The goal is to maintain knowledge and the implementation of The Nursing Scope
and Standards of Practice and The Code of Ethics in Nursing throughout my nursing
career. More specifically, my goal is to continue my education and receive my scrub
nurse certification within five to ten years of graduating nursing school. Also, I would
like to join a nursing association, such as the Michigan Nurses Association, within two to
three years of graduation. This goal will help me attain provision nine. In addition to
being hired after nursing school, I would like to achieve a leadership role, such as a
charge nurse or nurse manager, after five years of employment. Acquiring a leadership
role will enable me to create change and improvement in my profession and help achieve
many of the standards and provisions that have not been met.
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Action Plan
To achieve my goals, I plan to evaluate my abilities according to the nursing
standards and code of ethics annually. While in the clinical setting, I will perform nursing
care according to the standards of practice, without taking short cuts or eliminating any
type of care. Every step of the nursing process will be accomplished and repeated as
needed. My personal ethics and values overlap my professional ethics and values, causing
them to be continuously evaluated throughout my career. After graduation, I will research
nursing associations to discover where my abilities would best be utilized, possible by
joining an association related to my professional field. To further my education, I plan to
begin taking online classes one year after graduation; gradually, attaining enough credits
to receive my scrub nurse certification. Acquiring more knowledge will also improve my
overall ability as a nurse. Once I have matured and refined my knowledge and abilities, I
will apply for a leadership role in the nursing field. I will work hard to prove myself by
becoming a natural leader on the floor.
Evaluation Plan
To measure my progress towards these goals, I will evaluate whether the
standards and provisions are consistently met each year; my efforts will be focused on
where my abilities are lacking. To evaluate my leadership abilities, I plan to interview
fellow employees on whether I would be an effective and valued nurse manager. The
interview will reveal my strengths and weaknesses as a nurse, allowing me to make
changes and improvements. Utilization of my abilities will be measured by my
participation in the nursing association; to make an effective change in the nursing
profession, I should become an active member in activities and events. Finally, after
NURSING STANDARDS OF PRACTICE 23
approximately five to ten years, I will hopefully be applying for or have already obtained
a scrub nurse position; this will signify my continued education.
Conclusion
Therefore, the ANA has established standards and ethical guidelines to direct all
nurse practices. Adhering to these guidelines is pertinent in becoming a competent,
effective, and successful nurse. The ANA has provided nurses with the tools to become
great nurses. If a nurse is not committed to the profession, his or her actions could fall
short of these standards and provisions. Therefore, it is pertinent to properly obtain and
maintain these guidelines to excel in the nursing profession.














NURSING STANDARDS OF PRACTICE 24
References
American Nurses Association (2001). Code of ethics for nurses. Retrieved from
http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthic
sforNurses/Code-of-Ethics.aspx
American Nurses Association (2010). Nursing: Scope and standards of practice (2
nd
ed.).
Silver Spring, MD: Nursesbooks.org.
Ladwig , G., & Ackley , B. (2011). Mosbys guide to nursing diagnosis (Third ed.).
Maryland Heights: Mosby, Inc.
Taylor, C., LeMone, P., Lillis, C., & Lynn, P. (2011). Fundamentals of Nursing: The Art
and Science of Nursing Care. Wyoming: Lippincott Williams & Wilkins.