Running head: NURSING SCOPES AND STANDARDS

Nursing Scopes and Standards Self-Reflection

Adam Bennett
Ferris State University

Nursing Scopes and Standards Self-Reflection

The purpose of writing this essay is to evaluate how I met the standards of practice set in
place by the American Nurses Association. In doing this evaluation, I am able to understand
each standard better and it allows me to see what standards I am meeting. This will show me
what standards I need to improve in and allows me to set goals and an action plan related to these
standards.
Nursing Standards of Practice Self- Reflection
Nurses are held to the some of the highest standards in the professional world. The American
Nursing Association (ANA) has a set of 16 standards that nurses are held to and are expected to
uphold. These standards ensure that a patient receives the highest and safest care that can be
received. If high patient care is attained, it would lower length of patient stay, increase patient
satisfaction, and limit barriers between nurses and patients. This essay looks at nursing standards
seven through 16 and assesses how a student nurse has met these standards.
Standard 7: Ethics

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Standard seven is ethics. Ethics is defined as moral principles that govern a persons or
groups behavior. It is very important that all nurses deliver care in this manner. This means that
a nurse preserves and protects the patients autonomy, dignity, rights values, and beliefs (White
& OSullivan. 2012). This also implies that the nurse maintains a working relationship with all
coworkers and shows them respect. Finally, this means that the nurses follow all of the
guidelines set by HIPAA. In order to be a nurse that abides by this standard, there is some
knowledge, skills, and attitudes a nurse must have. A nurse first must know what the patient
wants. There are some instances where a nurse may disagree with a patient refusing a treatment
or becoming a DNR. However, the nurse must respect the patients decision because of the
patients right to autonomy. The nurse must also know the HIPAA laws because a breach in
these laws breaks confidentiality. A nurse also must have effective communication skills in order
to be ethical. This is because the nurse needs to be able to explain things to the patients so they
understand. If the patient does not understand the information, they cannot make an informed
decision and this reflects on the nurse. Finally, the nurse needs to have a non-biased attitude.
This is so the patient can respect the autonomy of the patient and not let their feelings affect the
patients care.
There are many times in the clinical setting where I have come across an ethical problem.
One event is when a 25-year-old patient wanted to become a DNR. The patient was recently
admitted to the hospital and was septic. He asked the nurses to become a DNR. However, his
parents did not want the patient to become a DNR. They believed that his medical condition was
affecting his judgment and that he would not make this decision properly. However, the nursing
staff had to respect the patients autonomy and placed him on DNR. The reason why this is an
ethical dilemma is because some of the nursing staff believed that the patient should not be a

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DNR. The staff had to recognize the patients right to autonomy, values, and beliefs by letting
him become a DNR.
Standard 8: Education
Standard 8 is education. Education is when a nurse attains knowledge and competence
that reflects current nursing practice. This means that the nurse participates in ongoing
educational activities, demonstrates a commitment to lifelong learning, identifies learning needs,
and shares educational findings with coworkers (White & OSullivan. 2012). Some skills a
nurse would need for education include; study skills, a good work ethic, and the ability to
acknowledge where deficits are. These skills will enhance a nurses ability to learn and would
make sure the patient is receiving the best practice. There are many attitudes associated with
education. This includes; curiosity, self-discipline, and being able to understand concepts rather
than memorize them. All of these traits are very important to have as a nurse who values
education. For example, if a nurse did not understand the process of a certain disease, they may
be ineffective in treating that particular disease or no would not recognize if the symptoms were
getting worse.
Nursing school is a great example of how I value my education. In my clinical
experience, I choose what I want to get out of it. There are certain times where I have had the
option to start an IV or insert a catheter. This has given me the opportunity to use some of the
skills and knowledge that I have learned in the classroom and apply them in the clinical setting.
In addition, while in the clinical setting I have seen many of the diseases discussed in class and
have been able to help in the process of healing for the patient. This has allowed me to visualize
some of the information that I have learned in my med-surge and pathophysiology classes. In the
future, I plan on getting a masters degree and continuing my education. I have also been able to
educate patients. This has included; diabetic teaching, teaching how to use an inhaler, and how

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to give shots at home. This has helped me with my communication skills, which is important in
education.
Standard 9: Evidence-Based Practice
Standard 9 is evidence- based practice. Evidence based practice in nursing is used to
provide the best form of care for their patient(White & OSullivan. 2012). It is important for all
nurses to use evidence-based practice in nursing in order to make sure that the patient receives
the safest and most effective form of care. In order to achieve this standard, a nurse would have
to have good research skills, a positive learning attitude, and know the benefits of the resources
around. This would ensure that the patient receives the best care and the patient would be safe.
In nursing school, I met this standard by writing a paper about evidence-based practice.
In this paper, I looked at if the use of bed alarms system and if they were the best practice for
decreasing falls. The research showed that bed alarms do not decrease the amount of falls a
patient has. The best way for a hospital unit to eliminate falls is by having a sitter in all fall risk
rooms. However, this is not practical or cost effective. This paper allowed me to do research on
a specific topic that involved evidence-based practice therefore, reinforcing the skills that I have
already learned. In addition, in my technical skills lab, I was taught evidence-based practice in
all procedures and skills that I would be expected to perform as a nurse. With this teaching, I am
now able to execute these skills with the knowledge that it is the safest way for my patient.
Standard 10: Quality of Practice
Standard 10 is quality of practice. Quality of practice includes the nurse being able to
demonstrate quality by documenting the nursing process in a responsible, accountable, and
ethical manner (White & OSullivan. 2012). In order to be successful in this standard, a nurse
would need to be knowledgeable in the nursing process, the policies of their facility, and a
background in pathophysiology and pharmacology. Quality of care is based off the nursing
process. The nursing process is a way to ensure that a patient is receiving the best care in an
organized manner. If this process is used along with the policies of a nurses facility, their

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quality of practice is high. There are many attitudes associated with quality of care. These
include a desire to provide good care for patients, the nurse must be resourceful, and responsible.
These attitudes are pertinent in the nursing process. The nurse must have the desire to provide
good care and use best practice in order to ensure that a patient receives the best quality of care.
It is also important that a nurse is resourceful. If a nurse has a question about a patients
condition, the nurse cannot be afraid to ask for help. A nurse has to be willing to collaborate
with other health professionals include physicians, dieticians, and case managers if questions
arise regarding patients. Some skills associate with quality of care includes leadership, good
communication, and being open to working with other fields in the health profession.
I have met quality of care in my nursing career in many ways. I chart in a timely manner
while in clinical. When passing insulin, I make sure that the dosage is correct with another
nurse. In my assessment, I report any abnormal findings to both my clinical instructor and
precepting nurse immediately. I also clarify doctors orders as needed. Finally, I monitor vital
signs before giving medications to make sure it is safe to give the medications. These activities
have helped me meet the standard of quality of care by holding me accountable for patient care.
In addition, they have maintained a high level of expectation for practice.
Standard 11: Communication
Standard 11 is communication. Communication is defined as a registered nurse
communicates effectively in a variety of formats in all areas of practice (White & OSullivan.
2012). Communication is one of the most important standards. This standard focuses on
relaying information to the patient, health professionals, and caregivers. The knowledge needed
for communication include knowing verbal and nonverbal cues, understanding, and the ability to
interpret. An example of looking at verbal and nonverbal cues is when palpating a patients
stomach when they say they are not in pain and they flinch and verbalize pain. It is important to
be able to understand and interpret communication effectively because if a nurse is unable to,

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errors are made in patient care. Skills needed for effective communication include using the
right tone, eye contact, and knowing your audience. All of these are important in communication
because if a nurse speaks with the wrong tone or if a patient does not understand the nurse,
barriers can form and decrease patient satisfaction and care. The attitudes a nurse needs to be an
effective communicator include nun- judgmental attitudes, reactions have to be appropriate to the
situation, and maintain professionalism. If a nurse does not use these, they can be a barrier to
patient care.
I have met this standard in the clinical setting. During clinical I start my day by getting
report. This is when another nurse uses effective communication to inform me about patient
status. This also gives me the opportunity to ask questions and clarify any discrepancies. Also I
communicate with other health care providers such as physical therapy, occupational therapy,
and physicians with concerns about patients. Also, I answer questions that my patient has and if
I do not know the question, I ask my clinical instructor or the precepting nurse. The examples
above show how I have communicated effectively in the clinical setting. I advocate for the
patient and answer any questions appropriately.
Standard 12: Leadership
Standard 12 is leadership. Leadership is defined as a nurse overseeing the care given by
others while retaining accountability for the quality care given to the healthcare consumer (White
& OSullivan. 2012). The knowledge a nurse needs to be an effective leader includes group
dynamics, strengths and weaknesses of yourself and other caregivers, and religious and cultural
awareness. This knowledge gives a leader a better look into the group they are overseeing and
facilitates communication among staff and patients. The attitudes a nurse needs in order to be an
effective leader honesty, integrity, they have to be a good listener, decisive. These attitudes
illustrate ones ability to adapt to a situation in order to facilitate the optimum level of patient
care. The skills needed in order to be an effective leader include willingness to take charge,

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staying calm in stressful situations, and delegating jobs or assignments with respect. These skills
show that a nurse is in charge but is approachable.
I have shown leadership in many ways in nursing and in other aspects of my life. I have
been in a charge nurse role on the floor. This gave me the opportunity to go to a leadership
seminar and to attend a meeting with other charge nurses around a hospital. This also gave me
the opportunity to delegate tasks to my peers. In addition, I am captain of the football team. As
a captain, I am seen as a leader and as an example for other members of the team. If a teammate
has a question or a concern, they can come to me and I will direct them on what to do. Both of
the examples above are seen as leadership roles. They give me an opportunity to enhance my
leadership skills and help me gain confidence as a leader.
Standard 13: Collaboration
Collaboration is when a nurse works together with other health care providers, family,
and others to ensure that a patient is receiving the best quality of care (White & OSullivan.
2012). Collaboration includes promoting conflict management and engagement, engaging in
teamwork and the team-building process, and participating in building consensus. Knowledge
needed in order to be an effective nurse in this standard includes knowing the personalities of the
people a nurse is working with, knowledge of team-building strategies, and conflict resolution.
When all of these are combined, a nurse would be successful in collaborating. The attitudes
needed in order to be successful in collaboration include being non-judgmental, hardworking,
and a good listener. These are component every member of a group would need to be successful.
If one member of a group does not have these attitudes, barriers can form and it would be harder
to accomplish the goal. Skills needed in order to be successful collaborators include team player,
resourcefulness, and organizational skills.
In nursing school, I took part in an interdisciplinary project between the nursing program
and the pharmacy program. In this project, I worked with four pharmacy students, collaborating

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on the care of patient in Big Rapids. I had to have effective communication with this group in
order to provide the best quality of care for our patient. In the clinical setting, there are many
opportunities for student nurses to work with other facets of healthcare providers. For example, I
have had the opportunity to work with physical therapy, occupational therapy, dieticians, and
physicians. Therefore, I have met this standard of nursing in the clinical setting by working with
other professionals in the heal field. This has given me the confidence to work with doctors and
not be afraid of them. This has given me insight into their field and made me realize how
important collaboration is. Collaboration is a very important standard; it creates a trusting
working atmosphere that leads to better patient care and satisfaction.
Standard 14: Professional Practice Evaluation
Standard 14 is professional practice evaluation. Professional practice evaluation is a
nurse evaluates her or his own nursing practice in relation to professional practice standards and
guidelines, relevant statutes, rules, and regulations (White & OSullivan. 2012). The knowledge
associate with this standard includes professional policies, guidelines of the facility, and
knowledge of peer reviews. The attitudes associated with professional practice evaluations are
the ability to take constructive criticism, the want to improve, and determination. The skills
associated with this include self-assessment skills, being able to critique others, and being able to
interact with colleagues on a professional level. These skills make it easier for nurses to evaluate
themselves and their peers.
In the clinical setting, student nurses fill out weekly evaluation forms. In these forms, the
student nurse evaluates what he or she did well that week and what they could have worked. As
a student nurse, I have filled out many of these. I give myself a weekly score in categories based
on my performance that week. Along with doing the self-evaluation, I would also do an
evaluation with my instructor. The instructor would rate me in the same categories that I rated
myself. We would then discuss a plan of action if I were lacking in a certain spot. This meets

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that standard of professional practice evaluation. I was doing two different forms of evaluation
every week and then was able to make a plan of action to improve my nursing skills, attitudes,
and competence.
Standard 15: Resource Utilization
Standard 15 is resource utilization. This standard is the registered nurse utilizes
appropriate resources to plan and provide nursing services that are safe, effective, and financially
responsible (White & OSullivan. 2012). This standard is very important in patient care. A
nurse would need to know who to go to in order to receive the right help or information, where
information is located in the computer, if further education is needed for the nurse to receive in a
certain subject. All of the previous knowledge is important to know because it is a direct
correlation to patient care. The attitude for resource utilization includes not being afraid to ask
for help, honesty, and being humble. These attitudes are necessary when accessing a resource.
Skills include being able to identify the patients needs, modifying practice when necessary to
promote care needs, and advocating for patients.
In the clinical setting, I have had many opportunities to use resource utilization. If I have
a question about a patient that was under my care in clinicals, I would go to my clinical
instructor. He or she would then give me a plan of action or oversee me doing a procedure. If
my clinical instructor was not available I would then go to the precepting nurse. Another way I
use resource utilization in the clinical setting is by looking up patient education in the chart.
Spectrum Health has a specific tab in their computer in which a person can print off patient
education on many different diseases and disorders. I would use this resource when doing any
type of patient education, including discharge teaching. The reason this leads me to believe that
I have met this goal is because I am using all of the tools and resources around me to ensure that
the best quality of care is given to all patients. This shortens healing time and increases patient
satisfaction.

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Standard 165: Environmental Health

Standard 16 is environmental health. Environmental health is when the registered nurse
practices in an environmentally safe and healthy manner (White & OSullivan. 2012). This
would include using only the necessary supplies when performing a procedure, discarding
supplies in an appropriate manner, and being ready for any weather disaster. The knowledge
needed in order to meet the standard of environmental health includes knowing where certain
things need to be thrown out, environmental laws, and hospital policies on environmental health.
Some attitudes associated with environmental health include open minded, wanting to better the
environment, and cost effective. Skills associated with environmental health are good
communication, utilizes scientific evidence to determine if the product is hazardous, advocating
for the proper disposal of certain products.
In the clinical setting, there have been many times I have been an advocate for
environmental health. First, I ensure that I only use the necessary products for any patient
procedure, treatment, or medication administration. This means that there will not be any excess
amount of supplies used that would damage the environment. I also ensure that if there is any
medication that needs to be wasted or disposed of, I make sure to put it into the correct container
to ensure that it is safe for both the environment and for the patient. This meets the standard of
environmental health because it shows ways in which I have cared for the environment. I am
thinking about how I will not waste supplies and properly dispose of medication.
Professional Development Plan
After addressing the 10 American Nurses Associations standards in this essay, I have
created a professional development plan that includes goals, and action plan, and an evaluation
plan that will be used to help ensure that I give the safest and best quality of care for patients
based off of the standards above.
Goals

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The first goal is to continue my nursing education by getting a masters degree within
five years of graduating nursing school. Eventually, I would like to become a nurse anesthetist
but this requires a masters degree. My father is a nurse anesthetist and I have had the
opportunity to shadow him. There is a lot of pressure that is associated with this field of nursing
and the standards such as evidence-based practice, ethics, and collaboration are very important
for this goal. It is very important for a nurse to advocate for the patient and make sure that the
patient receives the best evidence based practice while under anesthesia. It is also important for
the nurse to work with other healthcare providers such as surgeons and physicians as an
anesthetist.
My second goal is to work in a critical care unit or in an emergency room within one year
after graduating nursing school. This will aid me in reaching my first goal because in order to go
to anesthesia school, a nurse must work in a critical care unit for at least six months. This will
help me strengthen my critical thinking skills while also making me more confident as a nurse.
Working on in one of these units will also continue my education and help enhance teamwork
skills.
My final goal is be a specialist on the unit I am working on. In Spectrum Health, a nurse
can attain many specialties. One specialty is a skin champion. A skin champion performs skin
checks on patients and determines if they are at risk for developing a bedsore. I would like to
become a skin champion because I have seen many different types of skin ulcers that have
debilitated patients.
Action Plan
In order to reach my first goal of becoming a nurse anesthetist, I will need to first work in
a critical care unit for six months. If I am not hired directly into a critical care unit or emergency
room after graduating nursing school, I will find a job on a progressive care unit and wait for job

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opening on one of the critical care units. I will apply for the job on the critical care unit and after
working for the six months, I will apply to anesthesia school.
My goal of working on a critical care unit or emergency room will be accomplished by
being hired into one of the units after graduation or by waiting for a job opening. If I have to
wait for a job opening, I will first look for the first job opening in one of those units. Also, I
would introduce myself to the care manager and other staff on the floor in order to build a
professional relationship and rapport with them.
In order to achieve my third goal, I will need to continue my education on pressure
ulcers. I will take classes on skin ulcers and talk to other wound champions to see what needs to
be done in order to become a wound champion. I will then pass the required test.
Evaluation Plan
The evaluation plan for my first goal entails first working on a critical care unit. Once
that is achieved, I will then begin the application process for anesthesia school. Once accepted, I
will study and prepare to become a nurse anesthetist. I will do monthly evaluations of myself
while working on the unit and during nursing school to see if I am retaining the knowledge that I
learned through these experiences.
The first way I will evaluate my second goal is to see if it is possible to work on a critical
care unit right after graduation. If this is not possible, I will need to determine which type of unit
would guide me in getting the desired skills needed to work in a critical care unit. I will then fill
out a weekly checklist to see if I am improving on the desired skills. The ultimate evaluation
includes if I am able to work on a critical care unit or not in the time allotted.
Evaluating my final goal will be done by performing weekly evaluations to see if I have
the desired skills and training of a skin champion. I will go through the proper training and pass
the evaluations needed in order to become a skin champion. This evaluation will be complete
when I have become a skin champion. However, it is still important to continue my education on
pressure sores and the best way to treat them.
Conclusion

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This essay examined the ANA Nursing Scope and Standards of Practice standards seven
through 16. The essay gave insight on how a nurse would be able to successful embody all of
the standards through the knowledge, attitude, and skills needed to be successful in each
standard. The student nurse also talked about how he was able to meet every standard. Finally,
the student determined what his goals were in relation to the standards and how he planned to
meet those goals. The standards a nurse has to follow are initiated in order to ensure the highest
quality of care for the patients and to ensure that a patient stays safe at all times.
References
White, K. M., & OSullivan, A. (Eds.). (2012). The essential guide to nursing practice: applying
ANA's scope and standards to practice and education. Silver Spring, MD:
Nursesbooks.org.