Running Head: EVALUATING YOUR OWN PRACTICE

Evaluating Your Own Practice

Amber Dykstra
NURS 324

EVALUATING YOUR OWN PRACTICE

When I was young I had the thought of becoming a nurse in my mind. I thought that line
of work was interesting. After high school I attended North Central Michigan College and after 5
years, received my Associate Degree in Nursing. I have been a nurse for three years and every
day I go to work I look at my practice and contemplate how I can improve. I am a true believer
that it does not matter how long someone has been a nurse, there is always room for
improvement. Nursing is a field that continues to grow. New techniques and technologies
encourage nurses to expand their knowledge and improve the quality of care they are giving.
There are many ways to ensure that I am giving the best care possible. One way is by
following facility policies. I have recently moved to a new facility and am eager to learn these
new policies and procedures. It is important to understand that policies and procedures change.
When a new policy or protocol is put into effect I compare it with the previous policy. I become
inquisitive on the improvement and how it affects my patients care. This expands my thinking
into my daily practice and I try to have high standards.
To give quality care I believe it is important to continue my education. To many people
this means going back to school to obtain a higher degree. It also means fulfilling the continuing
education credits required to renew my nursing license. While I am currently fulfilling both
objectives to continue my education, I also continue learning at work. As a nurse with three
years experience I have learned some tricks of the trade, but I believe there is much more in the
nursing field that I do not know. At work I continuously ask questions regarding a rationale. This
helps me analyze the situation and possibly devise a plan that will help me exceed next time the
situation arises.

EVALUATING YOUR OWN PRACTICE

Another way I am continuing my education and expanding my experience is working on

the chemotherapy inpatient unit. I do not have experience with cancer patients and I will be able
to identify new techniques to comfort, encourage and overall care for patients. Although I am
currently here, I am still young and plan on continuing my education by floating to other units. I
am a firm believer that the more experience you have, the wiser you become.
While continuing my education I still evaluate how I can improve my daily practice. One
way I evaluate myself is to get a coworkers prospective. I ask my coworkers and managers how
they think I am doing. When asked this I expect honest answers. I do this because if I continue to
make the same mistake and do not recognize it, I cannot improve. My coworkers critique me and
give me suggestions on how to improve. This is important to me and it builds trust within each
other.
To evaluate my daily practice I also sit down in a quite spot and meditate on how I feel I
am doing. As someone once said you are your own worst enemy. This quote applies to me as I
meditate on the actions I have taken in difficult situations. I reflect and ask myself how I can
improve.
One way I can evaluate my own practice is by asking myself how much I helped others
during the week. There have been multiple times where I am at the work station charting and I
look up to see a fellow nurse moving very quickly down the hallway. I stop my charting and say
to the nurse, It looks like you are busy running around. I have time to help you if you would
like. A look of relief fills her eyes and a smile creeps across her face and she accepts. I know I
have had the same look on my face on a busy day.
Other times I run into situations where there isnt time to ask if my coworker needs
assistance. One example is when I was walking down the hall and saw a patient who was a one

EVALUATING YOUR OWN PRACTICE

person assist attempting to stand up on their own. I assisted the patient with what they needed
and let the nurse know I found them standing without help.
Teamwork is an important aspect of making patient care quality better. I will carry my
sense of teamwork into my new facility. One of my favorite experiences in nursing was when
there was a crisis and every nurse was there to help. In my experience during an emergency, I let
the charge nurse know how I am helping or waited for them to ask. I believe working through a
crisis develops trust and builds the relationship.
Nurses are not the only part of the patients care. I have worked with other disciplines. An
example is dietary. I did not get along with the dietary manager. I felt that he was undermining
my every move although he did not understand my reasoning. I took him aside privately and
explained calmly how I felt. Little did I know he felt the same way about me. We talked to each
other calmly and worked out our differences. In the end we were able to work together and create
a better work atmosphere and overall give our residents better care.
After we worked out our differences he would give me suggestions and I would ask for
opinions. We worked together well after our discussion. Many times I had PEG tube feedings
and had to consult him on the formula. The dietary manager was more knowledgeable than I
thought and I learned a lot from him. One case was a younger resident who was receiving 5 cans
of Fibersource daily. After administrating this amount for a week I observed her residual to be
increasing in the morning. I told the dietary manager that I felt she was getting too much. He
took my opinion into consideration, calculated the formula for how much she should be
receiving and agreed. The mother was notified and thankful that we changed the patients amount
of feeding to the correct dose.

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To enhance my work practice I review the Code of Ethics it reminds me that by

promoting and implementing the codes, I am giving my patients and their families the best care
possible. All of the codes are important but there is one that I hold close to my heart, provision
three The nurse promotes, advocates for, and strives to protect the health, safety and rights of
the patient.
This code is particularly important to me because I had a relative that CPR was
performed on and that was not her wish. I carried this over to my daily practice of advocating for
my patients wishes. A day I practiced this I had a patient who was declining fast. Her advanced
directives were clear; when her heart stopped she did not want any interventions. This was an
issue because her advanced directives had not been signed by two doctors, therefore not in effect.
I knew her wish and her guardian gave orders not to send her to the emergency department for
treatment. I contacted our administrator who instructed to do chest compressions if her heart
stopped. I did not feel ethically right performing CPR. I knew the only way to get two doctors
signature was to send her to the emergency department. I told her care provider that she was full
code and he instructed to send her. There, she was deemed incompetent and her advance
directive went into effect. She passed on a few days later, peacefully at her home with family by
her side. Just the way she wanted. I felt that I had to be an advocate for this patient. She was not
able to verbally instruct her wishes and I was able to fulfill her wish of dying peacefully.
I also practice provision 7, the nurse participates in the advancement of the profession
through contributions to practice, education, administration, and knowledge development. If I
am working and a learning opportunity arises I ask the physician or the other nurse if I can watch
the procedure or ask questions. I believe the more knowledge a nurse has, the better care a
patient will receive.

EVALUATING YOUR OWN PRACTICE

To become more knowledgeable it is vital to do research. In my professional career I

have not done official research. The research that I read consists of professional journals and
publications. Although this is not official research, I learn new techniques and apply them to my
daily practice. Some techniques are less efficient than mine and some are more efficient. By
performing trial and error I am able to develop a practice that is better for my patients.
An area of my practice I can develop my skills in is referring my patients to other
resources. I rely on the social workers to refer my patients to the appropriate help they need after
discharge. A way to develop this skill is by becoming more familiar with my surrounding area.
By doing this I will be able to refer my patients to activities and meetings that will benefit their
health after they are discharged from my services.
In my three years of practice I have had good days and bad. While being interviewed for
a job I was once asked how do you know you were meant to be a nurse? My answer was that it
didnt matter if I had a good day at work or a bad, I never come home hating my job. I try to
create a positive environment for my coworkers and I. Our patients are affected by our attitudes.
Although I try to create a positive atmosphere I still have my bad days. An improvement I can
make is not letting my emotions show. If I become upset I need to remember to smile.
After three years of being a nurse I have learned many ways to make my daily practice
better. I continue my education and expand my knowledge. I attempt to work well with others
and collaborate to give the most efficient care possible. I try to create a positive work
environment. I am also young in my career. I only have three years of practice and there is more
to learn. I believe that I will continue to learn new things as my career moves forward. There is
always room to grow.