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Professional Progress Introduction

Nursing 489
Purpose of Assignment
The purpose of this assignment is to reflect on the development and understanding of
nursing principals learned in the sophomore year of school and to explore the differences in how
they are applied through the senior year as a result of implication in student nursing practice.
Student Approach to Assignment
This assignment provided specific examples of the core values of nursing as described by
the ODU School of Nursing and how they have been used to provide quality patient care
throughout the three years at ODU.
Reason for Inclusion of this Assignment in the Portfolio
This assignment gives an opportunity to view what the corps values are and how they are
utilized to provide care through the curriculum. Furthermore, they demonstrate effectiveness, and
are a tool to be utilized in the future of my career.
Critical Thinking
Engages in Creative Problem Solving
Example: In one case where I was assigned a patient with cerebral palsy, I developed
a word chart as well as an alphabetical board in order to better communicate with the
patient as she could not speak coherently. This allowed me to not only better meet the
needs of the patient, but to evaluate the results of the interventions and teaching as
well. Later in the same day it was discovered that the hospital had access to electronic
boards to even better aid in this patients communication with staff members and her
family.
Revises actions and goals based on evidence rather than conjecture
Example: While in the intensive care unit I encountered a patient who was very non
cooperative with staff and their interventions. Whenever he would come out of
sedation he became agitated and repeatedly tried to pull his vent tube out. This
increased his vitals and he could not meet the criteria for extubation. However, when
his sister was in the room he was always calm and would write notes to her. It was
suggested that, based on the evidence of behavior with his sister present, he be put on
a weaning trial while his sister was visiting. The next weaning trial was successful
and the patient stated that he was grateful that I got his sister to explain what was
going on and reassure him that we were trying to help him.
Nursing Practice
Performs therapeutic interventions that incorporate principles of quality management and
proper safety techniques based upon assessment findings
Example: During the MedSurg rotation one of my patients was urinating cloudy urine
with sediments in his Foley bag. Upon further assessment that morning I found him to
be febrile and notified his primary nurse. It was determined that he had a urinary tract
infection and was put on antibiotics by his doctor.

Implements traditional nursing care practices as appropriate to provide holistic health


care to diverse populations across the lifespan
Example: in rehabilitation my patient wanted to go home, but was saddened about the
new living conditions in which he would return to. In order to involve him in his care
and motivate him to a better recovery, we had to help him with the financial burdens,
push him to be more independent on his care and decision making, and educate him
on the importance of managing his comorbidities. Only after he became more
involved in managing these did he start to improve to the point where a discharge
conference was held on his behalf.
Communication
Adapts communication methods to patients with special needs
Example: a particular patient I provided care for could not effectively communicate
verbally, I had to communicate by means of a letter boards that was created. With the
new ability to communicate with staff the patient was able to ask for simple items like
food or water and request assistance for the bathroom. Another benefit to this letter
board was the ability to ask questions to her in determination of effective education.
Accesses and utilizes data and information from a wide range of sources to enhance
patient and professional communication
Example: A rehab patient was in great need of resources to help ease the stress of
managing his new lifestyle. We had to dig and find some veterans programs that
would help him financially in order to deal with his anxiety and fear. After we showed
him these programs he began to communicate more on the needs he had and concerns
for changes. After addressing and talking about issues that were to be faced he was
involved in his discharge meeting and obtained reassurance through multiple aid
programs like the VA, Medicare, Medicaid, and private insurance, which were
explained to him via the discharge manager, occupational therapists, and myself.
Teaching
Provides relevant and sensitive health education information and counseling to patients,
and families, in a variety of situations and settings
Example: A young man around the age of 20 years old was admitted a few days prior
to me being assigned to him and was awaiting discharge. Upon the initial assessment
I had located a hernia and explained why the presentation was different depending on
the anatomical position of the patient and referred him to his primary care doctor to
have it evaluated.

Example: Completing my role transition in the emergency department gave me the


opportunity to treat and discharge numerous people with many different ailments.
Each patient needed different discharge instructions that were relevant to his or her
own diagnosis. Education included medication administration, knowing when to
return to the doctor for worsening conditions, explanation of tests and procedures,
therapeutic communication to reduce stress and anxiety, and much more.

Uses information technologies and other appropriate methods to communicate health


promotion, risk reduction, and disease prevention across the life span
Example: A presentation of the new My Plate food nutrition tool was given to a class
of school aged children. The project was completed in groups of three, and we
discussed the importance of eating healthy foods in accordance to the new My Plate
tool. To measure the effectiveness of the teaching, we had the students hand in props
that were described as healthy or unhealthy, fruit, vegetable, milk, meat, or grains. We
finalized our evaluation by having each child construct their own My Plate tool to
hang in their kitchen. The information used in the presentation was gathered from
online research and literature reviews and included an interactive video as well.
Evaluates the efficacy of health promotion and education modalities for use in a variety
of settings with diverse populations
Example: community health assessment on drug court aggregates showed a strong
prevalence of hypertension and prompted weekly assessments, referral, and teaching
to. The results of this lead to 25% of the group involving themselves in Community
Health day and 15% utilizing eastern Virginia Medical School HOPES clinic.
Research
Applies research-based knowledge from the arts, humanities and sciences to complement
nursing practice
Example: A case study was completed on a patient that offered a care plan for
someone who was diagnosed with diverticulitis. The patient had many hobbies and
eating habits that she was unsure of including popcorn, nuts, and certain seeded fruits.
Although the common practice was to discontinue these foods for patients with
diverticulitis, research has shown a significant amount of evidence to support the fact
that there is no significant difference in eating foods like popcorn, nuts, and seeded
fruits with diverticulitis. This evidence based practice allowed for higher patient
satisfaction with her diet due to the healthy snacking habits she had always had.
Leadership
Assumes a leadership role within ones scope of practice as a designer, manager, and
coordinator of health care to meet the special needs of vulnerable populations in a variety
of practice settings
Example: I was able to complete a focuses assessment based on the chief complaint
and make recommendations to the doctors based on the findings. This allowed a good
evaluation of interventions and expected outcomes
Initiates community partnerships to establish health promotion goals and implements
strategies to meet those goals
Example: Community Health forded the chance to develop a relationship with people
within the community and help them to focus on their individual health. Based on the
commonality of most of the aggregates health problems, mainly being hypertension,
my group would check blood pressures, teach on nutrition, preventative health, and
exercise, and refer to free clinics

Delegates and supervises the nursing care given by others while retaining the
accountability for the quality of care given to the patient
Example: In the emergency room I became very busy and had to delegate some tasks
such as IV boluses and blood draws to the corps staff. This enabled me to complete
new assessments of incoming patients and document in their charts.
Professionalism
Differentiates between general, institutional, and specialty-specific standards of practice
to guide nursing care
Example: General protocols are the same no matter where you work. Hand washing,
personal protective equipment, and two patient identifiers foe example are general
protocols that are required in all healthcare settings. During our rotation through the
mother baby unit however, specialty specific protocols were followed. These
standards are different from other practices in that they are specific to a certain
specialty. In the mother baby unit nurse to patient ratios are determined such as 1:1
coverage for initiating epidurals, 1:2 Pitocin induction or augmentation of labor, or
1:1 for newborns requiring multisystem support. Lastly there are institutional
guidelines that are specific to a certain facility. Hospitals have different codes that are
called overhead that signify a variety of alarms to the employees and gives guidance
on what to do for each. For example, at Sentara Norfolk a code rainbow is a child
abduction, but at Walter Reed National Military Medical Center, a code pink is an
abduction.
Understands the effect of legal and regulatory processes on nursing practice and health
care delivery, as well as limits to ones own scope of practice
Example: Understanding the limits to practices that are legally allowed by licensed
nurses allow me the comfort to perform quality interventions without fear of reprisal.
By utilizing NANDA approved diagnosiss, evidence based practice, and reviewing
hospital standards of operation manual, I have also been more comfortable with the
level of responsibility that I am given.
Demonstrates accountability for ones own professional practice.
Example: Patients sometimes have risky interventions, such as certain medications
that need constant monitoring, procedures like lumbar punctures that require lying
flat, or blood transfusions. Understanding the seriousness of these interventions and
the responsibility that comes with them requires that I have full comprehension on
them. In most of these cases, due to the lack of experience as a student, I have worked
with a licensed nurse.
Culture
Demonstrates sensitivity to personal and cultural definitions of health, and how these
beliefs influence an individuals reactions to the illness experience and end of life
Example: During the palliative care course we discussed the differences in cultures
on topics like meaning of health and how that meaning can influence the choice to
receive care. The knowledge gained from this class helped me to understand a patient

that I had in my mental health clinical. He was of Native American decent and said I
feel fine, Im not sick and I just want to go back to my house He said he did not need
help based on the fact that he physically felt normal. When I explained to him that his
mind was sick he did not gather that in turn he was sick as well. This understanding to
his view of health lead me to ask him what activities gave him problems at home by
causing frustration, anger, and anxiety. He responded with saying that his family did
not want to be around him because he was had attempted suicide numerous times and
they were done with me. He was not routine with his treatment due to his lack of
understanding of depression being a mental illness, and needed interventions that
explained why he felt the way he did and how the medicine could help if he was to
consistently take it.
Integrates knowledge of cultural diversity in performing nursing interventions
Example: Culturally sensitive care centers on the personal opinion, values, or beliefs
of individuals as well as larger groups who share the same practices. Fundamentals of
nursing has given multiple examples of different cultures that require personalized
approaches to health care such as Asian cultures who tend to avoid eye contact or
physical touch with providers or Native Americans who may not wish to see the body
of a loved one due to spiritual beliefs. Although each patient may be different these
broad examples help us to focus the care for individuals rather than one acceptable
approach and aid in the therapeutic response to each patient.
Considers the impact of research outcomes and, the effects of health and social policies,
on persons from diverse backgrounds
Example: Community health nursing has challenged me to look at the environmental
factors such as amount of grocery stores in the neighborhood compared to small
convenience stores, Average level of education, average salary, and availability of
public transportation to evaluate the difficulty within the aggregates at Norfolk Drug
Court in obtaining and maintaining health. Drug court programs originally started out
in European countries like Australia and do not evaluate the improvement of physical
aspects of health such as hypertension, common among drug abusers globally. The
same environmental issues that affect the health of the aggregates tent to exist in other
parts of the country as well as England, Australia, and Germany.