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Practice Summary Introduction Paper

Nursing 403-Career Pathway- Expand Horizons

Practice Summary Paper
Purpose of Assignment
The purpose of this paper is to guide you through a process of self-reflection and
self-evaluation to discover the scope of your personal and professional development
while enrolled in the RN-BSN nursing program at Old Dominion University.
Approach to Assignment
In order to self reflect and self evaluate my progress through ODUs RN-BSN
program, I looked back through past assignments that would fulfill the rubric
requirements for this particular paper. What was unique about this assignment was the
fact that I could call upon my experience at the bedside to give examples as to my
personal and professional development and how it has evolved.
Reason for Inclusion
This paper was integrated into this portfolio as a testimony to my personal and
professional development.
Critical Thinking
o Uses nursing and other appropriate theories and models to guide
professional practice

In Nurs490W, Nursing Leadership we learned about change theory

Discussed behavior such as tardiness and taught the unfreezingchange-refreezing model developed by Kurt Lewin. While this is
helpful in making change with staff, it is also helpful in using this
model with patients to get them to change a behavior or to make a
healthy habit.

o Uses decision-making skills in making clinical or professional judgments

In making quiz questions up for an assignment in Nurs490W, I

called heavily upon my nursing experience where clinical and
professional judgment were key in the outcome of staff and
patients. Such examples included, creative staffing to staff a unit
along with mentoring and instructing staff on therapeutic nurse
patient relations.

o Evaluates nursing care outcomes through the acquisition of data and the
questioning of inconsistencies

In completing this assignment in Nurs490W we had to not only

develop a well thought scenario question, but we had to give our
rationale as to why this was the correct answer. This evaluation
was key to assessing the outcome.

o Revises actions and goals based on evidence rather than conjecture

Throughout the course of Nurs490W, we were taught to revise our

actions and goals in leadership based on evidence rather than

o Engages in creative problem solving

When the original quizzes established by the publisher were

unreasonable, our instructors creatively came up with a plan for the
students to write their own quizzes. This gave the students a taste
of writing test questions, as they too had to be creative in writing
the questions.

Nursing Practice
o Applies appropriate knowledge of major health problems to guide nursing

I have been a nurse for 20 years now at the bedside and have
encountered patients with major health problems. On my unit, we
attempt to keep our patients (hematology/oncology) as long as we
can support their needs before considering moving them to an ICU
setting. At times, I am the bedside nurse, the charge nurse and the

o Performs direct and indirect therapeutic interventions that incorporate

principles of quality management and proper safety techniques based upon
assessment findings

I am a member of the shared governance committee on my unit.

The inpatient and outpatient clinic meet to discuss interventions to
bridge the two units in order to have better communicate and
outcomes with our patients. We collaborated and developed a
teaching tool in order to ensure that both areas where teaching our
patients the same information. This closed the gap in inconsistency
of teaching between novice and expert nurses along with the clinic
and in patient nurses.

This group also collaborated on techniques to hang

chemotherapy to ensure we were all preparing and

administering the chemotherapy the same for continuity

and safety.
o Implements traditional nursing care practices as appropriate to provide
holistic health care to diverse populations across the lifespan

Working in the hematology/oncology field, I have found using

complimentary medicine in conjunction with traditional medicine
to be helpful in the well being of the patient as well as it is
essential throughout a patients life span. From infants to adults,
touch, aromatherapy, music, guided imagery and massage are
helpful to the patient. It is also helpful for the caregiver to learn
these techniques to help their loved ones along with self-soothing.
Often times the caregiver is forgotten, but being cognizant of their
journey as well is helpful for the nurse to keep in mind as they help
the family through this journey. This journey through school has
helped me to be more aware to the different cultures point of view
at diagnosis, time of treatment and if necessary, at end of life.

o Demonstrates an awareness of complementary modalities and their

usefulness in promoting health

In addition to my above entry, complementary modalities are

helpful in promoting health through play as well. We use play
therapy at our hospital. In being mindful of Erik Erikson, Freud
and Piagets stages of development, we can take better care of
these children without traumatizing them.

o Establishes and/or utilizes outcome measures to evaluate the effectiveness

of care

Annually we receive an evaluation to gauge the effectiveness of

our care. I have received positive comments in all of my
evaluations, which include feedback from my patients, families
along with my peers and management team. This is a time I use to
set up educational and professional goals for myself to achieve
over the following year.

With the tool the shared governance committee created for

teaching, we are currently conducting surveys with the staff
to measure the effectiveness and ease of use (of the tool)
with staff. This survey comes six months after staff has
been taught how to utilize this tool. Our assessment to
measure the effectiveness of this tool with the families is

through the teach back method. Our patients parents are

often times eager to show us what they know by reciting
our teaching back to us upon discharge.
o Uses therapeutic communication within the nurse-patient relationship

Communication is key in developing a nurse-patient relationship,

whether it is verbal or nonverbal, our words and actions carry
meaning. This proves to be a challenge when our patients are nonEnglish speaking or hard of hearing (HOH). Verbal and non-verbal
communication comes into play with body posture and touch.
Going above and beyond their expectations to find a way to
communicate with one another is validating their importance in
this nurse-patient relationship.

o Adapts communication methods to patients with special needs

At my hospital we have a list of medical interpreter that are within

the hospital during the day when we have a HOH patient or nonEnglish speaking patient. During off hours (evening, nights,
weekends and holidays) we use a Cyracom phone or an iPad to
link us with an interpreter to communicate with our patients under
these special circumstances.

o Expresses oneself and communicates effectively with diverse groups and

disciplines using a variety of media in a variety of contexts

In my many roles at the hospital, I work with a diverse group of

people. My communication skills must be clear and concise in
order to be successful in these roles. I communicate with others at
work through face-to-face communication, text paging, and email.
At the bedside my patients vary from infant to adult and this
greatly affects the method of communication used to explain or
teach a patient about a procedure or discharge instructions. Parents
also now come in a variety of ages as well, which proves
challenging at times when attempting to teach them home care of
their child. The teach back method has been invaluable in these
types of situations as it confirms whether the parents understand
what has been taught, or if they need further instruction prior to

Within this program, I have been involved in multiple group

projects with students that range in nursing experience from novice
to expert. We were successful in our endeavors through

communicating via email, text and discussion board.

o Produces clear, accurate, and relevant writing using correct grammar,
spelling and punctuation

In this assignment, I used correct grammar and spelling. I lost one

point for punctuation; otherwise, my paper was clear, accurate and

o Accesses and utilizes data and information from a wide range of sources to
enhance patient and professional communication

My hospital has seen an increase in a variety of non-English

speaking families. This can prove to be challenging without
resources. My employer has formatted a list of medical interrupter
and purchased and iPad to facilitate communicate with these

o Provides teaching to patients and/or professionals about health care
procedures and technologies in preparation for and following nursing or
medical interventions

Under this topic, I can reiterate, that the teach back method tool
that has been instrumental in not only teaching but also in
measuring the effectiveness of the instruction. Whether I am
teaching a new diagnosis family, a young patient or a teen-ager,
this tool works, as the learner is able to teach me what they have

o Provides relevant and sensitive health education information and

counseling to patients, and families, in a variety of situations and settings

I developed a teaching plan in Nurs402, for the parents of my

childrens softball team on healthy snack and meal options while
we are traveling to tournaments. I identified this need while
observing the unhealthy snack options the children where receiving
in this group setting.

o Uses information technologies and other appropriate methods to

communicate health promotion, risk reduction, and disease prevention
across the life span

In Nurs492, as a group we developed a plan to reach out to middle

school children in an effort to decrease their risk of cardiovascular

(CV) disease, by teaching them in during PE/Health about the

benefits of a healthy diet and exercise. Our group chose this area
due to its high rate of CV disease and large African American
o Uses information technologies and other appropriate methods to enhance
ones own knowledge base

Throughout the program at ODU, I have utilized their online

library to gather research, data and articles to support and guide my
teaching plan and teaching assignments.

o Differentiates between descriptive nursing literature and published reports
of nursing research

In completing our research paper in Nurs363, our group had to

utilize published nursing research reports and studies to justify our
findings that breast-feeding mothers were more successful when a
lactation consultant was involved in her care.

o Evaluates research that focuses on the efficacy and effectiveness of

nursing interventions

Within the group paper completed in Nurs363, we discussed the

role of evidence-based practice (EBP) in the success of a
breastfeeding mother. In the hospital setting, EBP is steering the
care of patients. This term has been used throughout my formal
education at ODU as it encourages students and nurses to continue
to research data along being able to differentiate between a reliable
research or study before applying it to practice.

o Shares research findings with colleagues

Working in the pediatric hematology/oncology world, research is

constantly changing our practice for the better. My hospital works
closely with the Childrens Oncology Group so that we can access
to the most current studies and treatment options for our patients.
Nurses join this group so that they also have access to the
treatment plans in order to ensure compliance with orders and
studies along with the most up to date research information. We
share significant changes or new findings with one another during
staff meetings and during bedside report.

o Initiates community partnerships to establish health promotion goals and
implements strategies to meet those goals

In my practice we call upon community resources for our patients.

Two resources that I mention in this paper were Head Start and
Edmarc. Head Start helps underprivileged youth from birth to five
years old with nutrition, social skills and other services. This
group helps younger children become ready for school as well.
Edmarc is a childhood hospice service that we utilize when our
patients are diagnosed with cancer for additional support
throughout their treatment. They are also instrumental in our
patients care when a palliative approach deems necessary.

o Articulates the values of the profession and the role of the nurse as
member of the interdisciplinary health care team

As a senior nurse on the unit, I am a resource to both nurses and

new residents. I meet with the residents prior to multidisciplinary
rounds to ensure that they have the most up to date assessment
along with my concerns as we go in to discuss this patient as a
group before the entire team.

o Delegates and supervises the nursing care given by others while retaining
the accountability for the quality of care given to the patient

When I am scheduled in the role of the charge nurse, I am

accountable to my staff, as well as to all of the patients. I round on
all of the nurses first to ensure that their assignments are
acceptable and their patients are well. Then I round with the
patients and their families to ensure that their needs are being met.
This is also a perfect time to address concerns by the patient or
family before it festers and becomes a problem that affects the
patients hospital stay. Delegation is utilized not only for nursing
assistants, but when I am in the role of charge nurse, I delegate to
fellow nurses when admissions are coming to our unit.

o Differentiates between general, institutional, and specialty-specific
standards of practice to guide nursing care

Being mindful of professional boundaries as well as therapeutic

nurse patient relationship in regards to the pediatric oncology
patient is essential in surviving in the role of the nurse. There are

policies written by institutes to ensure that lines are not crossed.

Facebook is off limits for staff and patients. There are activities
where staff and patients come together out the hospital setting,
though. St Baldricks is a fundraiser that staff and patients attend
together to raise money for childhood cancer. Other group
activities consist of Relay for Life, and Survivor day. I am mindful
not to cross boundaries in exchanging of personal information, not
adding patients or families as a Facebook friend or meeting
patients outside of these controlled activities. I also take the time
to teach these guidelines to our newer staff that may not realize
they are crossing boundaries that could cost them their job.
o Understands the effect of legal and regulatory processes on nursing
practice and health care delivery, as well as limits to ones own scope of

Within my scope of practice, I can notify a MD of my assessment

of seeing frank blood in stool, but I cannot order a test to confirm
my suspicion without a MDs order. The ANA lists a nurses Scope
and Standards of Practice one must adhere to as well. Veering from
this list leaves one open for serious repercussions.

o Demonstrates accountability for ones own professional practice.

In Nurs401, I presented a slide show of my image of the

professional nurse. I addressed a nurses attire, presentation,
behavior/attitude, maintaining professional boundaries, along with
prevention of bullying fellow nurses

o Advocates for professional standards of practice using organizational and

political processes.

I am certified within my field, as a Certified Pediatric

Hematology/Oncology Nurse (CPHON). Since passing this exam
and going back to school, I have encouraged my peers to elevate
themselves as well and join me as I expand my knowledge in this
ever-changing practice. Within the Shared Governance
committees at the hospital, we also are encouraging others to go
back to school to earn a higher degree, as well as become certified
in their field. We are working towards a clinical ladder to recognize
those that value their education and profession as a whole. We are
working towards becoming a Magnet hospital.

o Articulates an understanding of how human behavior is affected by

culture, race, religion, gender, lifestyle, and age

At the beginning of this semester in this class, I successfully

completed the United States Department of Health and Human
Services online educational program that was geared towards being
a culturally competent nurse. I felt this program was so powerful,
that I shared it with my liaison, Marta Cox from the department of
Cultural/Language Services, to share with the hospital.

o 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

In Nurs458, Genetics, I addressed the importance of

individualizing genetic information based on the patient/familys
culture, religion, knowledge level, literacy, and preferred language.
I recommended using the 4 C tool developed by Stuart Slavin MD,
Geri-Ann Galanti PhD and Alice Kuo MD when working with
another culture to discuss teaching or end of life care.

o Integrates knowledge of cultural diversity in performing nursing


Through using the tool listed above, a nurse is able to extract the
information necessary to effectively care for the culture diverse
patient. Just because a patient is of a certain culture, does not mean
that they practice or believe all that their ancestors or relatives do
at this stage in their life. I have encountered generations of a
culture in one room before and found a broad spectrum of tradition
and belief system. The patient was the least engaged with their
culture while the grandparents where the most stringent follower of
their belief system. Nursing has the unique challenge to be mindful
of the differences and to not offend, but help the family as a unit.