Professional Documents
Culture Documents
Abstract
This self-assessment will analyze the American Nurses Association standards of practice and
their meanings within personal nursing practice. An introspective look into the strengths and
weaknesses will assist in developing goals with a clear plan of action and an evaluation process
that will be the topic of discussion in this self-assessment for improvement.
stand-by assist or in need of a walker or any other assistive devices. In this manner, I am
delivering safe and quality care for the patient.
Standard 3Outcomes Identification
Outcome identification refers to the formulation of specific, measureable, achievable,
realistic, and time-framed (SMART) outcomes (ANA, 2012, p. 63). Formulating goals for the
patient involves collaboration with the health care team. A patient admitted with a medical
diagnosis of chronic obstructive pulmonary disease exacerbation that is currently using five liters
of oxygen yet only uses two liters at home, may have a goal of reducing oxygen consumption to
two liters prior to discharge. Another goal would be to increase ambulation by 200 feet at end of
shift with decreased shortness of breath and increased oxygen saturation. Educating the patient
and setting clearly defined goals empowers the patient to be an active participant in their care.
Standard 4Planning
Every stage of the patient care experience requires a plan of action. A plan for the day is
initiated at bedside report while involving the patient in decision making, information sharing,
and goal setting. Plans are individualized based on patient needs: rehabilitation may be needed or
home care might be warranted. Careful planning that involves specialties such as pulmonology,
cardiology, physical therapy or case management will provide comprehensive care. It is a very
important part of my job to initiate and follow the plan of care to optimize health outcomes.
Standard 5Implementation
Implementation requires nurses to combine thinking and doing, as well as feeling,
sensing, and valuing (ANA, 2012, p. 88). I care for very ill patients on my unit. Some are
motivated to return to health and others are not. I feel very confident in my skills to determine
what barriers exist that might impede implementation of the plan. I am not afraid to sit and talk
with the patient about their feelings or worries or involve family in order to have successful
outcomes. Possessing the skills to connect with the patient is critical to the implementation
process of care.
Standard 6Evaluation
Evaluation is the process of determining progress toward attainment of expected
outcomes, including effectiveness of care (ANA, 2012, p. 105). This also encompasses the
process of revising goals where appropriate. For instance: if breathing treatments for chronic
obstructive pulmonary disease are exacerbating another issue such as tachycardia, it is my job to
notify the health care provider. Treatments and nursing interventions are consistently evaluated
for the promotion of patient safety and well-being.
Standard 7Ethics
Ethics is an integral part of the foundation of nursing (ANA, 2012, p. 114).As I reflect
upon my education thus far, it is clear that ethics must play an important role in our daily
activities as a nurse. We are looked upon by our patients and the public as one with the
knowledge and skills to facilitate health and well-being. We learn in our early formal education
to properly assess, diagnose, identify, plan and implement nursing actions. Patients rely on us to
be thorough in our assessments in order to relay accurate information to other members of the
healthcare team. I feel as one embarks on the nursing career, one agrees to adhere to the ethical
standard of nursing. Doing what is in the best interest of the patient and public is attributable to
the code of ethics. This includes being a leader and advocate of patient safety through use of
evidence based research and quality control.
Standard 8Education
Education is requisite for acquisition of the knowledge, skills, and abilities needed to
maintain current, safe, and effective clinical practice (ANA, 2012, p. 123). When I graduated
with my associates degree of nursing, I knew that I wanted to further my education with a
bachelors in nursing. At first, I enrolled with the mind-set that it would be a requirement in
many healthcare settings. I am nearly finished with the bachelors program and the insight I have
gained is empowering. I feel better prepared and more comfortable in my critical thinking skills.
Furthering my education was by far the best decision I made. Understanding the importance of
staying current in the latest research is essential to providing quality patient care. There is room
for educational improvement: Progressive Care Critical Nurse (PCNN) certification that I have
discussed with my unit manager and plan to take advantage of for professional enhancement.
Standard 9Evidence-Based Practice and Research
Evidence-based practice uses explicit methods to critically appraise and rate both the
level (strength) and quality of evidence to answer a practice issue or question (ANA, 2012, p.
133). Evidence-based practice leads to best patient practices. Policy and procedure at McLaren is
based on evidence-based practice. Research is integral to the advancement of the nursing
profession to stay competent and current in quality improvement. We began initiating bedside
report at our facility. Evidence-based practice shows that patient safety is one of the greatest
benefits of bedside report, along with employee teamwork, ownership and accountability (Baker,
2010). Further, bedside report increases patients involvement in their plan of care; they feel
more comfortable asking questions; and feel more informed of their care which reduces anxiety
and facilitates compliance (Baker, 2010). While I have not personally conducted any research at
my facility, I hope to eventually become a part of the quality team that develops policies based
on evidence-based research.
common goals (ANA, 2012, p. 163). This is an area that I still at times struggle with, however,
since starting the bachelors program and gaining more experience as a nurse, I have gained
more confidence. I feel that I am ready to take on the challenge of charge nursing and have
talked with the floor manager about this goal. I enjoy being a preceptor to new graduates by
encouraging and motivating them.
Standard 13Collaboration
The registered nurse is expected to be proficient in collaborating with health care
professionals and to be an effective part of an inter-professional health care team that provides
high-quality and safe patient care to individuals and populations (ANA, 2012, p. 175). This is an
area of strength for me. I used to be uncertain about when to notify a doctor or sometimes I
would be afraid to call for fear of seeming incompetent. I toughened up real fast. I also realized
that it was not about me: it was about the patient and being a patient advocate. Patient outcomes
have a better chance for success when the health care team communicates and collaborates
together.
Standard 14Professional Practice Evaluation
The professional registered nurse has a responsibility to engage in evaluation activities
to maintain and enhance her or his professional performance as part of accountability to the
healthcare consumer and to the profession (ANA, 2012, p. 187). I maintain professional
performance by following policy and procedure at my facility, seeking evaluation from my
peers, upholding the ANAs standards of practices, and furthering my education. I spend a lot of
time re-evaluating myself and my actions throughout the shift. I seek support and feedback from
my co-workers. I find that I have learned a great deal about myself as a professional through the
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I respect and appreciate the dedication of peers in the nursing field to promote power and
knowledge for the betterment of health care related outcomes, patient advocacy, and self-worth. I
am motivated and empowered to strengthen and improve upon the areas of education, evidencebased practice, research and leadership during my career as a professional nurse.The following is
an outline of goals and plan for improvement.
Education
I currently need seven credits at Ferris State University to complete my bachelors of
science in nursing (BSN). I am thrilled that the end is near with graduation in December 2014. I
have strongly considered obtaining my masters as a family nurse practitioner (FNP). It is
predicted that by 2015, the U.S. will be facing a shortage of about 63,000 doctors, according to
the Association of American Medical Colleges (Lopatto, 2012).This will increase the need for
advanced practice registered nurses. Sadly, Ferris does not offer a masters in FNP. I have looked
into Chamberlain School of Nursing online and Saginaw Valley State University as options to
complete this goal. I will take the spring semester off to research more options and by summer
2015, I will have decided on a school of study. I also plan on completing the PCCN certification
by summer 2015 and will take advantage of the hospital reimbursement, the $500 bonus for
completion as well as the enrichment the certification provides.
Evidence-Based Practice and Research
This is an area that I would like to take more of an active part in. My goal is to become a
part of the quality management team that develops and supports hospital policies and procedures
with supporting evidence-based research. Once my BSN is complete, I will contact Sue Meister,
RN, who is part of the quality team at McLaren-Lapeer Region by January 2015. I hope to be
able to participate in research studies and be of assistance in the search for best practices. In
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doing so, I am demonstrating a contribution that supports Standard 9 of the American Nurses
Association scope of practice. It further demonstrates intention to grow professionally.
Leadership
I have already taken the necessary steps toward the goal of developing my leadership
skills. I spoke with Brian Groff, RN, Nurse Manager of the progressive care and intensive care
units at McLaren-Lapeer Region. We mutually decided that on the next work schedule, he will
allow time for me to orientate with one of our charge nurses. I expect that by August 2014, I will
have initiated this training and hopefully be a part of the rotation of charge nurses on the unit. I
also plan to discuss adding additional days of training new hires and graduates with Stephanie
Wilson, RN, Nurse Educator at McLaren-Lapeer Region by January 2015. Demonstrating an
active interest in developing leadership skills supports Standard 12-- leadership. Although I have
only been practicing for two years, I feel more confident and comfortable with my skills and
ready to accept the challenge.
Evaluation
I will successfully complete my BSN by December 2014. I feel very strongly about
obtaining FNP licensure and am motivated by a thirst for knowledge and a challenge to succeed.
I will use the break in August 2014 between Ferris summer and fall semesters to research and
evaluate my progress in leadership as well as research more options for furthering my nursing
education. In December 2014, I plan to evaluate my progress with a role in quality assessment as
well as involvement as a preceptor. January 2015 will bring about a much needed break from
studies: my husband and I have planned a vacation to Punta Cana. I value the importance of
taking a break to refresh and revitalize the soulonce I return, I will continue the search for the
education that will best suit my needs and forge ahead with enrollment in a masters program.
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Conclusion
The world of nursing continues to provide opportunities for advancement and calls upon
its own to be leaders in the profession. Growth and advancement occurs when we are empowered
to remain active through research, education and awareness. This self-assessment has allowed
me to critically examine areas of strength and weakness and develop a plan that will enhance my
contributions in the profession of nursing.
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References
American Nurses Association [ANA] (2012).The essential guide to nursing practice: Applying
ANAs scope and standards in practice and education. Silver Spring, MD: Author.
Baker, S. J. (2010). Bedside shift report improves patient safety and nurse accountability.
Journal of Emergency Nursing,36, 355-358. doi: 10.1016/j.jen.2010.03.009
Institute of Medicine (IOM). (2001). Crossing the quality chasm:A new health system for the 21st
century.Washington, DC: National Academies Press.
Lopatto, E. (2012, March 22). Nurse practitioners, handmaidens no more. Bloomberg
Businessweek. Retrieved from http://www.businessweek.com/articles/2012-03-22/nursepractitioners-handmaidens-no-more
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