Self-Assessment of Nursing Scope and Standards of Practice Jordan Y. Mullauer Ferris State University
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2 Self-Assessment of Nursing Scope and Standards of Practice The American Nurses Associations, Nursing: Scope and Standards of Practice (2010) and The Code of Ethics for Nurses (2001) provide guidelines for exceptional nurses to ensure both quality and safety of patient care. Upon completion of the baccalaureate program and throughout the professional nursing career, it is expected that the nurse meet all of these standards. With only seven months of nursing school remaining, these standards will be evaluated to determine my readiness for nursing practice. Following review of all 16 practice standards and nine ethical standards and identifying both strengths and weaknesses, a plan will be developed to help maintain or achieve goals to meet these standards. Standards of Practice The American Nurses Association developed a set of 16 standards that define and thoroughly describes the who, what, where, when, why, and how of nursing practice (American Nurses Association [ANA], 2010, p. 2). All registered nurses are expected to follow these standards and each of the competencies listed with them in order to provide the highest quality of patient care. Using these standards, a registered nurse can be confident that he or she will be a competent, professional nurse that will make a positive impact in his or her area of practice. Each standard will be described and an analysis of whether or not this standard has been achieved will follow. Standard 1. Assessment A vital part of the nursing process begins with the initial assessment of the patient. The first of the American Nurses Association standards defines that assessment involves collecting comprehensive data that pertains to the patients health or condition. SELF-ASSESSMENT
3 (ANA, 2010, p. 32) The registered nurse (RN) gathers the most important information in a timely and efficient manner. Through my experiences in the nursing program both in the classroom and in the clinical setting, I have adequately met this standard. Using the knowledge gained during the first semester of nursing school, basic assessment skills were developed. As the semesters progressed and more patients were encountered, I learned to adapt and perfect assessment skills to proficiently complete a full assessment that adequately reflected the patients condition. Every clinical day begins with assessment, and I feel confident entering a patients room to perform an assessment with the knowledge of what normal and abnormal assessments look like. Standard 2. Diagnosis After the initial assessment, the RN uses the information gathered to come up with appropriate diagnoses related to the patients condition. (ANA, 2010, p. 34) These diagnoses can be used to recognize hazards in the patients life and current situation. Standardized methods are used to identify these diagnoses, such as the North American Nursing Diagnosis Association (NANDA). Nurses select appropriate diagnoses from the list developed by NANDA based on the defining characteristics and related factors. (North American Nursing Diagnosis Association [NANDA], 2014) These diagnoses improve communication with other members of the patients health care team. Part of the requirements for the clinical aspect of nursing school involved extensive paperwork. A section of this paperwork asked for several diagnoses that relate to the patients condition. Through this paperwork I feel that I was able to meet the diagnosis standard of nursing. I learned to use the assessment data and correlate the SELF-ASSESSMENT
4 information gathered to identify a diagnosis. An example of this would be a patient I had with pancreatic cancer. I was able to identify a risk for infection as a nursing diagnosis for this patient because the cancer was attacking their immune system. Standard 3. Outcome Identification Once the diagnosis or diagnoses are made, the RN must be able to identify a suitable outcome for the patient based on their condition and situation. (ANA, 2010, p. 35) The nurse will include other members of the health care team to identify this outcome to make sure they are realistic and achievable for the patient. After a re-evaluation, the RN must also be able to adapt the patients outcomes to better fit his or her abilities in a specific time frame. Finally, documenting these outcomes ensures continuity of care. I have met this standard in nursing school because I feel confident in selecting outcomes for my patients. While on an orthopedics medical surgical floor, I was able to identify an outcome for a patient to ambulate to the end of the hallway by the end of the shift. This was appropriate for them because they had recently had a hip replacement and their ultimate goal was to go home. By identifying this outcome, I was able to give the patient something to work towards that was appropriate and achievable. Upon completion of this outcome, timely documentation was done so that a new outcome could be developed. Standard 4. Planning The fourth standard of nursing practice describes planning as a way of developing an individualized plan to achieve the outcome identified. (ANA, 2010, p. 36) This plan usually involves all members of the patients health care team and family members. The RN adapts this plan to correctly fit the patients cognitive skills, beliefs, lifestyle, SELF-ASSESSMENT
5 environment, and available resources. The RN integrates evidence-based practice to create a plan that prevents further illness and injury while promoting optimal health. Financial and cultural considerations must also be taken into consideration by the RN when developing this plan. Although I have made large strides in this standard, I do not feel that I have met it completely. I do a pretty good job planning out my day and the steps that will help a patient reach their goal, but I would like to work on the collaboration part of planning. I have never made a phone call to a physician, and my plan to meet this goal is to be more assertive and ask if I can make a phone call in the next few months of nursing school. I would also like to communicate more with the nursing technicians and aids. Often I get caught up in communicating with the nurse assigned to the patient and forget to tell the nurse what I have or have not done. By improving my collaboration skills, I believe this will help me better plan out a patients day and ensure that they are progressing towards their goal. Standard 5. Implementation The fifth standard of nursing practice of implementation has several characteristics. While implementing a plan, the RN must also coordinate care with other health care team members and incorporate education and health promotion. (ANA, 2010, p. 38-41) Using a holistic approach the nurse makes sure that every member of the patients team is on board and updated and that each task is completed within a timely manner. Organization is a crucial part of implementation that the nurse utilizes to ensure that the patients plan runs smoothly. The nurse also uses education to keep the patient SELF-ASSESSMENT
6 informed of their plan and encourage them to lead healthy lifestyles to promote healing in their own process. Similar to the standard above, I have partially met this standard at this point in nursing school. Education is something that I feel very comfortable with, and I actually enjoying teaching patients about their disease process and what they can do to improve their situation. Collaboration, however, is where I feel I need to improve. I would like to interact more with physicians and other members of the patients health care team to ensure continuity of care. To achieve this standard, I plan to find out when a physician is scheduled to visit a patient and make sure I am present to ask any questions I may have and make sure they are aware of the patients current status and goals. Standard 6. Evaluation The sixth standard of nursing practice states that, The registered nurse evaluates progress toward attainment of outcomes (ANA, 2010, p. 45). This part of the nursing process involves other members of the health care team as well as the patient. If the patient believes that they have or have not met an outcome, the nurse collaborates with them to evaluate the situation and come up with a new plan. The nurse must continuously evaluate the patient and document this information accordingly. I feel confident that I have met this standard through my experiences in the clinical setting. Throughout the day I make sure to ask the patient how they are feeling and if they think they have improved. I read over previous nursing progress notes and lab values and vital signs to see if there is improvement. At the end of my shift I also perform a focused assessment on my patient and evaluate whether their condition has SELF-ASSESSMENT
7 improved compared to the patients morning assessment. If there are any changes in the patients progress I make sure to document them immediately. Standard 7. Ethics Nurses encounter different cultures every day and practice in many different settings, and therefore must practice ethically. (ANA, 2010, p. 47) The nurse should respect the patients dignity and autonomy at all times and protect their privacy. Patients should be able to make their own decisions and it is the nurses responsibility to make sure the make informed decisions by providing the answers they are looking for. The RN should also maintain a therapeutic and professional relationship with the patient while giving care and report any illegal or unethical activity. I do believe that I meet the ethics standard of practice completely because I try to think before I say or do anything. I strive to be professional with all patient interactions, and warn a patient that their behavior is inappropriate if they should say or do anything that makes me feel uncomfortable. Privacy is very important to me, so I make sure to only talk about patients in post conference where it is acceptable. If a patient is feeling uncomfortable or embarrassed, I try to protect their dignity by making them feel at ease. I find educational materials to give to patients so that they can be completely informed about their situation and make good choices when it comes to their care. Standard 8. Education The eighth standard of nursing practice states that nurses should be knowledgeable and proficient. (ANA, 2010, p. 49) Even after completion of all necessary nursing classes, the nurse should participate in ongoing education. The health of the population and the diseases at hand are constantly changing, so it is important for nurses SELF-ASSESSMENT
8 to keep themselves informed about new treatments and technological advances. The nurse should also seek out opportunities in the clinical setting where he or she can learn more or gain new experiences. At this point in nursing school, I have met this standard of practice, but I know there is more I can do in the future. Several times I have had patients in clinical with conditions that I was unfamiliar with so I would take time out of my day to research that condition. By educating myself on the patients unfamiliar condition, it not only made me more aware of my patients situation, but increased my knowledge as well. I dedicate several hours a day to studying and homework outside of nursing classes, and plan to continue my education further by getting a masters degree after graduation from Ferris. I fully believe that I have learned the most in nursing school through clinical experience. Standard 9. Evidence-Based Practice and Research The ninth standard of nursing practice states that, the registered nurse integrates evidence and research findings into practice (ANA, 2010, p. 51). This research can be used to justify a change in practice that will provide better outcomes for the patient and staff. The nurse keeps up to date with current evidence and research and shares this information with his or her colleagues to make a change in practice. Evidence-based research is also used by the nurse to guide his or her every day nursing interventions. I have definitely met this standard of nursing practice both through classroom and clinical experience. Through the research class last semester, I learned how to search for evidence and determine if a resource is credible and considered nursing research. I also learned how to collaborate this data and use the evidence-based research in practice. For example, through several different research articles I learned that temporal artery SELF-ASSESSMENT
9 thermometers are much more accurate and less invasive than other methods of thermometry, so I try to use this method in the clinical setting whenever possible. Standard 10. Quality of Practice This standard, simply put declares that the nurse provides quality care. (ANA, 2010, p. 52) In order to provide this quality care, the nurse documents all care given, integrates best evidenced-based practice, and helps develop new policies and procedures. Quality patient care also involves being cost effective and utilizing all resources carefully to cut costs for the facility and for the patient. Identifying problems is another factor to quality care; nurses must always be aware of their surroundings and double-check everything for problems or errors. At this point in nursing school, I do provide quality care for patients and thus have met this standard, but I also believe that this is an on going process that I will continue to improve upon throughout my career as a nurse. In the clinical setting, I always try to document any interventions as soon as possible and make sure to change the time if I do not get to document until later in the day. I am aware and very careful with any resources that I use throughout the day in order to cut costs for the patient and the hospital. In the future, I plan to be aware of not only my own actions, but my co-workers as well so that I can identify problems and make plans to fix these problems. As a student nurse, I am not able to have input on a hospitals policies and procedures, but when I am an RN I hope to be involved in the process for improving patient care. Standard 11. Communication Communication is very important for a nurse because he or she is constantly collaborating with everyone around them. The RN must assess his or her own SELF-ASSESSMENT
10 communication skills and make sure they are using the format that a healthcare provider prefers. (ANA, 2010, p. 54) The nurse must also learn to communicate information to the patient and other members of the health care team in a format that promotes both accuracy and timeliness. Another part of communication is being able to speak up when the nurse has a question or does not understand an order. These communication skills help keep ideas and information flowing between people to ultimately make the patients healing process as smooth as possible. This is one standard that I feel I really need to work on. I am a generally shy person, but I usually find it easy to communicate with patients whether it is about their health condition or just every day small talk. What I would like to really improve on is the communication with the assigned nurse, the nurses aid, and eventually the physician or resident. Sometimes I find myself holding back questions that I think might be considered a stupid question although I may be confused. For the next few months of nursing school I will be more confident when asking questions. I also hope to communicate better with the aid such as asking what time they like to take vital signs or just making sure they know I am available for any help needed. I have never made a phone call to a physician, so this is an opportunity I would really like to seek out and accomplish before I complete nursing school. Standard 12. Leadership To meet the standard of leadership, the registered nurse, oversees the nursing care given by others while retaining accountability for the quality of care given to the healthcare consumer (ANA, 2010, p. 55). Leadership also involves a commitment to lifelong learning and treating co-workers with respect. The nurse also mentors his or her SELF-ASSESSMENT
11 colleagues and participates in organizations to improve policies and procedures. A good leader also learns to communicate effectively with the patient and co-workers and seeks out ways to advance nursing care. I have partially met this standard of nursing practice, but still have a long way to go. During nursing school I have been a part of the Ferris Student Nurses Association, which has helped me to be a leader. I am able to let my peers know what goes on during the meetings and speak for them during a meeting. In the future as a nurse leader I plan to participate in committees to further improve nursing practice. I would also love to work at a teaching hospital where I can have the opportunity to mentor an orienting nurse or student nurse. I plan to further my nursing education with a masters degree, as I am very interested in lifelong learning. Although I am not very assertive, I plan to be a leader by setting a good example for others and helping my colleagues do the same. Standard 13. Collaboration In order to provide the best care possible, it is crucial that the nurse collaborate with all members of the health care team including the patient, the patients family, physician, and nursing aid among others. (ANA, 2010, p. 57) This collaboration involves communication and action by the nurse and everyone else involved in the patients care. The nurse engages in teamwork and helps resolve conflicts within the group. Another part of collaboration states that the nurse follows all codes and standards to ensure that the group works well together and has an optimal environment to work in. Collaboration is one of the standards of nursing standards that I have partially met, but still need to work on through out my nursing career. When I plan my clinical day I try to coordinate what I am going to do around when physical therapy (PT) or SELF-ASSESSMENT
12 occupational therapy (OT) visit, and when they are in the room working with the patient I make sure to collaborate with the therapist and let them know how the patient has been doing. If there are family members present during my clinical day, I also make sure to include them in the patients care and teaching process so that they know how to take care of them after discharge. I try to follow all codes and standards to make sure that there are no bumps in the road, and this helps keep the day running smoothly. I need to work on my collaboration with the nursing aids and physicians as I have mentioned previously, and this is something I hope to improve on during the next few months of nursing school. Standard 14. Professional Practice Evaluation The 14 th standard of nursing practice states that, the registered nurse evaluates his or her own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules, and regulations (ANA, 2010, p. 59). The nurse continually evaluates him or herself to make sure they are following all practice standards and providing quality care. Providing developmentally, ethically, and culturally sensitive care is all part of quality nursing care the nurse must constantly assess. The RN obtains feedback from others occasionally in order to identify strengths and weaknesses that he or she does not recognize. Once evaluation is complete, the nurse uses this information to set goals and make plans to achieve these goals. Finally, the nurse also provides feedback for other colleagues to help them improve their quality of care as well. Currently I do meet this standard, and I will make sure to continually evaluate my practice skills throughout my nursing career. In nursing school, evaluations are done almost every week in clinical where questions are asked about what goals one might have SELF-ASSESSMENT
13 and how they plan to achieve those goals. I find this paperwork very helpful in guiding my next clinical day. This paper is also evidence that I am constantly evaluating myself as I go through each of the standards of nursing practice and analyze whether or not I have met each one and make a plan as to how I will achieve them. In the future I will be sure to ask my colleagues for feedback as well as give out feedback so that together we can improve our clinical practice skills. Standard 15. Resource Utilization The registered nurse uses resources properly in order to be cost effective and safe. (ANA, 2010, p. 60) Each patient should be assessed individually to determine what their available resources and needs are so they can be provided with the information necessary to access helpful resources. The RN must also know when, how, and what tasks to delegate to other health care team members such as the nurses aid. The nurse also works with the patient and the patients family to locate any services needed such as home care. Resource utilization also involves assisting the patient and family on how to treat a condition based on finances and resources available. I have met this standard at this point in nursing school. During my rotation in public health I became well aware of different resources available to families in need such as Women Infant Children (WIC), and even got to talk to families using these services. When I have a heavy patient load, I know what tasks I can delegate to the nurses aid such as taking vital signs and performing the patients daily bath. I have also been present during discharge when the nurse helps set up a time for a patient to receive home care after they are home. When using resources such as every day items like SELF-ASSESSMENT
14 thermometers and manometers, I make sure to be careful as to not damage the equipment and waste money. Standard 16. Environmental Health The final standard of practice states that, the registered nurse practices in an environmentally safe and healthy manner (ANA, 2010, p. 61). The nurse makes sure that he or she is reducing environmental health risks for him or herself as well as the patient and other colleagues. Being aware of all environmental health concepts, such as how to dispose of bodily fluids also keeps the nurse safe. The nurse continuously assesses the environment for any disturbances including sounds, odors, and light that may threaten the health of others. If there are any health hazards present in an environment, the RN reports these issues promptly. I have definitely met this standard of nursing practice through my experiences in the clinical setting. After I give an injection of any sort I make sure to dispose of used needles in the proper container and report to the charge nurse if a rooms sharps container is full so that it can be emptied properly. Whenever I am cleaning up a mess in a patients room, I make sure to dispose of the soiled linens in the proper bag and take them to the soiled utility room afterwards. I pay attention to all wet floor signs and warn my patient of any hazards in their room. During a clinical day the fire alarm went off and I knew that protocol was to close the patients door, so I did so without alarming my patient beforehand. If I identify any hazardous objects or sounds, I make sure to report them immediately. Code of Ethics SELF-ASSESSMENT
15 Along with the standards of nursing practice, there are nine provisions for the code of ethics that every good nurse should follow. Each of these provisions outline, the primary goals, values, and obligations of the profession (American Nurses Association [ANA], 2001, p. 2). These provisions spell out the duty and commitments that every nurse makes when they become a registered nurse. Ethics help nurses decide what decision to make and how they should behave in everyday situations. Nurses should use the code of ethics to guide their practice, as they are non-negotiable. Provision 1. The first provision for the code of ethics states that the nurse, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of the health problem (ANA, 2001, p. 3). No matter what the patients values or beliefs, the nurse respects all of his or her patients individually. In providing excellent care, the nurse must also respect the patients religious beliefs and lifestyle and base their care around their preferences. Autonomy is of utmost importance when it comes to the patients care as well; the nurse allows the patient to make his or her own decision and respects their choice. Respect not only applies to the nurses patients, but to their colleagues as well. So far in my career as a nursing student I have met this provision, but this may be something I will have to work on in the future. In all the clinical rotations I have had thus far, I have had a few culturally different patients that I showed respect for. Last semester I had a patient that was a Jehovah s Witness that requested no blood transfusions and I made sure to respect her decision and not try to convince her otherwise. Even in SELF-ASSESSMENT
16 everyday clinical settings I make sure to respect my patients autonomy and accept their decisions. In the future, I may come in contact with someone who has beliefs or a cultural background vastly different from mine that I may not agree with. When this situation arises, I will be sure to show respect for their values and not let it be shown whether or not I agree. Provision 2. The second provision for the code of ethics simply states that the nurses primary responsibility is to the patient. (ANA, 2001, p. 5) If a conflict arises with the patients family or community, the nurse seeks to solve this problem, but if it does not resolve, the nurses obligation still lies with the patient. Collaboration is a crucial part to centering care around the patient as well. Nurses should make sure that all necessary members of a health care team are involved in the patients treatment and that all questions by the patient are asked and answered by the appropriate member. The nurse must also establish professional relationships with his or her colleagues and the patient by keeping a respectable distance but still maintaining authenticity. This is definitely a provision I have met through my clinical experiences in nursing school. I am very aware that my primary responsibility is to the patient. I have had experiences where the patients family member does not agree with their choice, but still made sure to respect the patients decision. I also remain professional at all times while still showing care and compassion for the patient. I have been involved in the collaboration process of a patients treatment plan when I was present during a consult with team members such as the physician, pharmacist, and physical therapist. Provision 3. SELF-ASSESSMENT
17 For the third provision of the code of ethics, the nurse must advocate for the health, safety, and rights of the patient. (ANA, 2001, p. 6) Privacy is something that every patient values, and in the hospital setting it can be difficult to maintain. The nurse should protect the privacy of his or her patients physically during procedures, and also by protecting the confidentiality of their information. Occasionally, patients are asked to participate in research, and it is part of the nurses responsibility to make sure they are fully aware of the research being conducted and permission has been given by the patient to participate in the research. The nurse must also be aware of the patients surroundings and others that take of him or her. If there is any unethical, illegal, or incompetent care given to the patient, it is the nurses responsibility to report it as an advocate for the patient. I am a very good advocate for my patients, and this is something that will always be important to me. I always make sure to maintain privacy in the patients room during a procedure by closing the door or drawing the patient, and when I am viewing a patients chart I make sure that no one else is around that could potentially read the information. I have not had any experience with a patient being involved in research, but if I do in the future, I will make sure the patient is fully aware of the research being conducted and gives complete consent. I have not encountered any unethical, illegal, or incompetent care, but I am confident that I would report any of this activity in the future if it were to arise. Provision 4. Provision four of the code of ethics states that the nurse is fully responsible for the patients care and they should determine the appropriate tasks to delegate to others. SELF-ASSESSMENT
18 (ANA, 2001, p. 8) The nurse shows accountability for all nursing care and ensures that even delegated tasks conform to the nursing standards of practice. Nurses are also responsible for evaluating their own competence and identify with the needs of their patient exceed their own capabilities and seek help. When care is delegated to other nursing staff or nursing aids, the nurse is accountable for their actions and for making sure they are competent enough for the task. Although I have not had a lot of experience with delegation, this is a provision I have met through education in the classroom and experience in the clinical setting. I know what tasks can and cannot be delegated to nursing aids, but in the clinical setting I am usually responsible for these tasks as part of primary care and do not do a lot of delegation. However, I have had experience in delegating tasks to my peers when I am busy with one patient and another patient needs assistance. Occasionally, I come across a task or procedure that I have not performed yet or do not feel comfortable with, and I always ask for assistance whether it is from the nursing instructor or the nurse assigned to my patient. I know in my future career as a nurse there will be times where I will have multiple patients and will delegate a lot of tasks to other nursing staff or nursing aid, and I will be sure to know what tasks can be delegated. I will also make sure that the staff I am delegating is competent. Provision 5. The fifth provision states that, the nurse owes the same duties to self as others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth (ANA, 2001, p. 9). In doing so, the nurse maintains self-respect and preserves their character as well. The nurse commits him or SELF-ASSESSMENT
19 herself to life-long learning to advance knowledge and skills. In order to maintain a wholeness of character, the nurse integrates both professional and personal aspects of his or her life to become a unique individual and still respects his or her own morals. To preserve integrity, the nurse may have to compromise to remain consistent with their personal and professional values, as long as it does not jeopardize the well-being of the nurse or others. Currently, I meet this provision of the code of ethics, but I am sure it is something I will continually work on to maintain throughout my nursing career. I respect my own morals and values and if I were to have a patient that made treatment choices that went against my values, I would find a way to change my assignment without offending the patient. I have already committed myself to life-long learning as I plan to attend grad school after I finish my bachelors degree. I am always aware of myself and preserve my integrity and character as much as possible during practice to show respect for myself as well as for my patients. Provision 6. The sixth provision talks about the environment the nurse works in and states that the nurse continually maintains and improves the environment. (ANA, 2001, p. 11) It is the responsibility of the nurse to create an environment where virtues and excellence can thrive and allow the nurse to fulfill his or her obligations. The nurse observes working conditions daily and follows all policies and procedures. Nurses contribute to a good moral environment that their patients and colleagues can thrive in. No nurse should work in a place that violates patient rights or requires the nurse to compromise standards of nursing practice. SELF-ASSESSMENT
20 I have met this provision of the code of ethics through my experiences in clinical rotations. I try to contribute to a good working environment by staying positive and asking what I can do when I see other staff members that are frustrated. I assess the working conditions around me and would report anything that I believe may be unsafe to my colleagues or patients. I take pride in hospitals that strive to achieve good working conditions, and would never allow myself to work in a hospital with less than optimal conditions that would cause me to compromise on standards of nursing practice. Provision 7. Provision seven of the code of ethics for nurses states that, the nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development (ANA, 2001, p. 12). Nurses can advance their practice through leadership roles, being a member of a committee, and improving nursing policies. It is the responsibility of the nurse to identify his or her scope of practice and follow the guidelines in the standards of practice. Professional nurses should study scholarly resources and apply this knowledge to advance nursing practice and improve patient outcomes. In nursing school I have absolutely met this standard of advancing my practice. I am a member of the Ferris Student Nurses Association (FSNA) and actively participate in events and listen to speakers talk about the nursing career. Being a part of this organization has helped me be more aware as a nurse and will continue to help me advance my practice in the future. I plan to be a part of a committee in any future jobs I have as a nurse not only to show initiative but to help improve the nursing environment and patient outcomes. I have studied several scholarly resources in nursing school and SELF-ASSESSMENT
21 have used this information in the clinical setting. Even after school I will be sure to continue to study evidence-based practice and stay up to date to help advance my skills. Provision 8. The eighth provision states that the nurse collaborates with the patient, community, and other health professionals to meet health needs of not only an individual, but a community or population as a whole. (ANA, 2001, p. 12) The nurse must focus on the well-being of the population that she lives and works in and be aware of the health services available to the public as well as the health concerns such as pollution or hunger. Nurses have a responsibility to be aware of these conditions and report them to the public. Through public organizations and groups, the nurse can educate people on how to avoid hazardous situations and make informed decisions as well as promote healthy lifestyles. I have partially met this provision, and will completely meet it through my future practice as a registered nurse. Through FSNA I participated in a blood pressure screening where I took blood pressure readings for people and educated them on what to do to improve their heart health. I believe this helped out the community by helping people become aware of the risks that can increase their blood pressure and also how to achieve a healthier lifestyle. Living a healthy life is very important to me, so I plan to be a part of an organization in the future where I can help the public become of aware of health concerns that can affect them and what they can do to help the situation. Provision 9. Provision nine talks about the nursing profession as a whole and states that it is responsible for expressing nursing values and maintaining the integrity of the practice. SELF-ASSESSMENT
22 (ANA, 2001, p. 13) The nursing profession lets the public know its values that it believes will contribute to social change and enhance health. Guidelines are developed by the profession to clarify the nurses duties and obligations to society. Among many others, the code of ethics and standards of nursing practice are examples of these. The profession also encourages its members to follow these guidelines, thus one of its duties is to make all members aware of the values and ethics. The professional association must also speak for nurses as a whole and contribute to social reform through health care policies and legislature. This provision is not one that I can meet on my own, but after I become a registered nurse, I will officially be a part of the professional nursing association and responsible for knowing all standards and ethics and following them. I will keep up to date on current events in the nursing profession and aware of any changes in health care policies. I will also be sure to support the profession and stand behind the standards of practice to guide my practice skills. Conclusion Throughout the paper, goals and plans were addressed for the individual standards or ethics that I have not met yet, but a broad goal as also been established for all the standards and ethics as a whole. This goal follows the acronym SMART, which stands for specific, measureable, attainable, realistic, and timely. (Top Achievement, 2011) The goal states that I will meet all standards of practice and provisions to the code of ethics before graduation in December of 2014. My plan to meet this goal is to be as proactive as possible. I will make a list of all the standards and provisions that I have not met yet and carry it with me while I am in the clinical setting. At the end of each week I plan to SELF-ASSESSMENT
23 re-evaluate this list and determine if I have met them or not. I will also ask my clinical instructors to get involved and evaluate whether they think I have met my goal. By the end of the nursing program I plan to have achieved all of my goals so I will be one step closer to being prepared to enter the nursing career as a registered nurse.
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24 References American Nurses Association (2001). Code of ethics for nurses. Silver Spring, MD: American Nurses Association. American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: American Nurses Association. North American Nursing Diagnosis Association. (2014). About us. Retrieved from http://www.nanda.org/about-nanda-international.html Top Achievement. (2011). Creating s.m.a.r.t. goals. Retrieved from http://topachievement.com/smart.html