Running head: SELF-ASSESSMENT

Self-Assessment
Jack Arnold
Ferris State University

Self-Assessment of Nursing Standards of Practice

Nursing is a profession that is always changing and updating its processes. Nurses come
from different backgrounds, races, and life experiences which is why the American Nurses
Association (ANA) found it necessary to devise a standardized set of guidelines for nurses to
follow. This paper will describe the last ten standards and my practice as a nurse with regard to
these concepts and a professional plan to improve areas where the standard is yet met. Examples
from my own clinical practice will be used to demonstrate my development and growth as a
professional nurse. It is important for each nurse to meet and uphold the standards of practice
and by analyzing my own practice; I will be able to expose areas where improvement is required
to meet this goal.
ANA Nursing Standards of Practice

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The ANA (2012), developed 16 standards of practice dealing with situations and
circumstances nurses deal with on a daily basis. The first six standards describe the nursing
process and the last ten discuss quality of nursing care. These standards were put in place to
assist nurses in guiding their professional practice.
Ethics
Ethics are interwoven into all the nursing standards of practice. How a professional nurse
chooses to practice their profession is dictated throughout their life experiences with family,
friends and strangers (American Nurses Association [ANA], 2012). These experiences are what
guide their interpretation of the ethical standards. Most of the ethical issues that will be
encountered as nurses will involve clients and their families, but ethical situations arise among
co-workers and other health care professionals. Nurses must first and foremost advocate for the
patient even when personal choices and beliefs conflict with client choices. Such choices may
include advance life directives, refusal of medical treatment for personal or religious beliefs, and
lifestyle choices (ANA, 2012). When facing ethical situations, more than one possible choice
may present itself to deal with the matter at hand. Ethics are not only what is displayed in the
face of others, but the actions one takes in private as well.

My patients are ultimately my

responsibility and I treat them as such. It is my ethical duty to protect them from harm, ensure
confidentiality, and provide care for them to the best of my ability. As a nursing student, I find it
difficult to voice my concerns against medical professionals above myself when my knowledge
seems inferior to theirs.
An example of my achievement in this area involves recent care of a bedridden COPD
elderly patient who had previously refused use of pneumatic compression devices on their legs.
Simply allowing them to refuse based on perceived discomfort of the devices was not an ethical

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choice to me. I asked if she knew why we recommended using compression devices. She did
not, so I felt morally obligated to educate her on the potential for deep vein thrombosis with her
limited mobility and explain the possible harmful effects from developing one. Her refusal based
on an informed decision was morally and ethically acceptable to me, but after educating her, she
allowed me to place them on her legs with the agreement that if they hurt I would remove them.
She left them on the rest of my time on the unit and her daughter informed me she left them on
all night when I arrived the next day. My goal is to ensure my clients make educated choices
about their care and to provide this education myself or to enlist the help of other health
professionals if the material is outside my scope of practice.
Education
The registered nurse (RN) must demonstrate a broad array of knowledge from theorybased evidence to evidence-based practice techniques (ANA, 2012). This knowledge is attained
through collegiate education and continued with practicing experiences. Education is one
standard I believe cannot ever fully be achieved. Since nursing encompasses so many areas of
the health care profession and standards and practice is ever changing, education is a continual
process throughout a nurses career. I have partially met the standard of education by my
progression through Ferris State University bachelorette of nursing program and being on the
cusp of completion. My advancement of education also continues through my clinical
experiences. I thrive to learn and continually ask questions of my preceptor RNs to gain
knowledge and insight into rationale for practice decisions, organizational strategies, and disease
processes or medications I am not familiar with. If satisfactory explanation is not given, I
research the area myself. My goal for education is continuation of the learning process by
returning to school within two years after graduation pursing a nurse practitioner degree.

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Evidence-Based Practice and Research

Research and evidence are keys that form the practice of all RNs. Evidence-based
practice is founded on continual research which determines what type or form of care is best for
our patients. It allows RNs to provide the highest quality of care based on proven data gathered
through extensive research (ANA, 2012). What may be best practice today may not prove to be
best practice in a year. This is why RNs must continue to educate themselves to keep up with the
ever changing profession. RNs also need to be involved in the research itself. By doing so, best
practice standards research can be focused from a nurses perspective and address areas that we
identify as needing improvement. I have met this standard by being educated with evidencebased research and incorporating this into my practice. This is evident through my actions of
patient positioning. I follow best practice by re-positioning my patients, who are determined to
be at risk for pressure ulcers, every two hours as per evidence-based research. I use approved
Prevalon boots to prevent heel sores, pillows to relieve bottom and back pressure, and friction
reduction devices during repositioning and transfers to prevent skin tears on compromised
patients. My goal is continued education on best practice methods to ensure the highest quality
and safest care for my patients. I will strive to maintain this goal throughout my nursing career.
Quality of Practice
Quality of practice in nursing care can refer to many areas and aspects. The use of
evidence-based practice is one example of quality in nursing care (ANA, 2012). Evidence based
practice ensures knowledgeable safe care for all patients. Patient centered care is another
example of quality of practice. Patient centered care allows the uniqueness and qualities of each
patient to be considered in their care plan (ANA, 2012). I am continually aware of and focused
on the quality of my practice. By delivering quality in my care, I am able to ensure that my

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patients needs are met in a timely manner, my patients are safe, and they are kept informed of all
procedures, medications, and plan of care. An example of my quality of practice is explanation
of all medications, ensuring patient understanding and answering any questions before they are
administered. Another display of quality in practice is making sure to always wash my hands
both upon entering and leaving the room. By guaranteeing proper hand hygiene, it safeguards
patients from the spread of infection especially amongst those who are immune compromised.
My goal is to continue patient knowledge about their medications and maintain proper hand
hygiene at all times. By continuing these measures, I will ensure my patients remain safe and
receive quality personal care.
Communication
Establishing an open line of communication between nurses and their patients is one of
the most important elements of the nurse client relationship. Effective communication certifies a
satisfactory, compliant, and safe outcome (ANA, 2012). Communication between nurse and
client is not the only crucial link the nurse needs to make. RNs must establish open lines of
communication both verbal and written with the entire health care team, from the physician and
pharmacist to the nursing aid and the clients family. By the entire team working together and
communicating results with one another, the client is guaranteed a better outcome with higher
satisfaction. I have met the communication standard through complete and accurate
documentation of my patients status in their chart. This information ensures that any changes in
status can be detected and communicated with the appropriate member of the health care team. I
also communicate verbally with direct caregivers of the team also. I discuss daily tasks which
need to be accomplished for each patient with the nursing assistant and inform my fellow nurse
team member of my patients status and needs at check-point in case I am unavailable. My goal

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is to continue to communicate any changes in my patients status with other health care team
members and maintain hourly updates and status checks in the clients chart.
Leadership
Leadership is an essential part of the registered nurses responsibility (ANA, 2012).
Leadership includes such characteristics as being a good communicator, able to delegate
appropriate tasks, addressing patient relation concerns, and respect for all members of the care
team. The RN displays these qualities on a daily basis when they work with nurse aides, doctors,
other nurses and members of the health care team. I have displayed leadership in my practice by
communicating and delegating tasks to the nursing aide assigned to my group of patients; by
doing this, we work together to collaborate a plan for each patients care and to perform timely
tasks which need to be completed throughout the day. I feel leadership has many different styles.
My approach is leading by example. I would not delegate a task or ask a fellow RN or nursing
technician to do something that I would not do or have not done myself already. My goal is to
continue to work with other team members to facilitate the best approach for each of my patients
care needs after morning report and at check point each shift.
Collaboration
As a registered nurse, collaboration means cooperating and working together with other
members of the health care system to facilitate the best possible outcome for each patient (ANA,
2012). Collaboration not only means working with other health care professionals, but working
with patients and their families as well to ensure all needs are met. Collaborating requires
respect for each persons opinion and choices, communication of ideas and available options, and
trust between each member of the team to have the patients best interests in mind. I have been
successful in meeting this goal. I had a patient who recently had surgery on a leg and was unable

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to ambulate very well. I collaborated with physical therapy and together we assisted the trial of a
cane and walker with the patient. Upon trial of both devices, we (the physical therapist, patient,
and I) determined that the walker was the best choice for the patient to use for ambulation both at
the hospital and at home until the patient was strong enough for the use of a cane. I then
collaborated with the physician about the patients need for the walker which he then in turn
wrote an order for one so the patients insurance would cover the cost. My goal is to work with
each patient twice per shift to identify any new care needs they feel are not being met.
Professional Practice Evaluation
The registered nurse frequently monitors their adherence to professional practice
standards and guidelines and assumes accountability for upholding these criteria (ANA, 2012).
By performing these self-evaluations nurses can compare their work performance with the set
professional standards of practice to determine where additional education and training is
needed. It is the RNs responsibility to ensure to perform these evaluations of their work in order
to maintain accurate and current knowledge of requirements for professional practice (ANA,
2012, p. 188). I have not met this standard within the intent it was written. As a student nurse, I
am typically under supervision to ensure no harm comes to any patients. While I would never
intentionally harm a patient, there is much I do not know yet. Therefore, I am under direct
supervision during all medication administrations and procedures. Due to the fact that I am still
learning, it is nice to have professional guidance from a nurse or the instructor to verify my
adherence to professional practice guidelines. In order for me to perform these self-evaluations,
I feel I must be working as a registered nurse under my own licensure. At this time I should be
able to frequently evaluate my performance when compared to professional standards of
practice. My goal is to perform daily performance evaluations of my work once I am an RN. I

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feel through continual self-checks, I can progress my professional growth to be the best possible
nurse for my patients. Another goal is to become involved with process improvement
committees and strive toward becoming a preceptor for new nurses. Through these channels I
will be able to further improve my practice guidelines knowledge.
Resource Utilization
The registered nurse must remain cost conscious using the appropriate resources while
maintaining a safe and effective atmosphere (ANA, 2012). The resource utilization standard
focuses on the RN being financially responsible with the services provided. To me this means
being observant of goods and services used to treat the patient without compromising the safety
or effectiveness of the patients care. I have not yet met this goal. I believe when I am a
practicing on my own and have full control of my patients care, I will be better equipped at
understanding the full scope of all my patients needs and using the necessary resources to meet
those needs. My goal is to stay abreast of each of my patients health care needs and to make
sure ordered test and procedures serve a required purpose and to use a questioning attitude when
I feel costs can be saved on unneeded items.
Environmental Health
The RN considers the environment in which the patient lives to potentially have an
impact on that patients health both physically and mentally (ANA, 2012). The environment is a
factor which often gets overlooked but is a major influence on many disease process
exacerbations. Low stimulation, relaxing, and warm and soothing is the type of healing
atmosphere that patients need to facilitate wellness. This is the type of hospital environment in
which the nurse needs to strive to maintain for the clients benefit. When it comes to the home
environment, the nurse needs to educate the client and their family to continue the healing

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process once they leave the hospital. I have met the standard of environmental health. I strive to
maintain a healing environment for all my patients. This is evident with a recent patient I had.
There were numerous family members in the room visiting and I could see that my patient was
not in a state for such commotion. I respectfully asked the family to gather in the unit family
lounge for a while to allow the patient to rest peacefully. I educated them on the need for rest for
their family member to help facilitate the healing process. The family agreed and retired to the
lounge. After the family had left, the patient thanked me and said they did not have the heart to
ask them to leave. My goal is to continue to strive for a healing environment for all my patients
and to always advocate for their wellness first.
Conclusion
While I have met many of the ANA nursing standards, there are still several that require
my attention. I feel that as I advance in my professional practice, I will fully comply with all the
standards. I have outlined a plan for those standards which I have yet to meet and established
goals on how I plan to continue to meet all the standards which I have covered in this paper. It is
important that I maintain competency in each standard throughout my career and look forward to
advancing my knowledge continually. As I grow as a professional, I plan to become involved in
my departments process improvement initiatives and shared leadership committee. With the
assistance of these tools, I will be able to share my ideas within the department and work with
my fellow employees to enhance the quality of our patient care. One last goal I have is to
become a mentor/preceptor to new graduate nurses and aid them in the proper ways and steps to
interpret the ANA nursing standards to ensure they become the best and most ethical nurses
possible.

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10
References

American Nurses Association. (2012). The Essential Guide to Nursing Practice. Silver Spring,
MD: Author.