Running head: SELF-ASSESSMENT 1

Self-Assessment: Scope and Standards of Practice

Sydonie Stock
Ferris State University
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 2

Abstract
The American Nurses Association has laid out a list of sixteen scope and standards by which all
professional nurses must abide (American Nurses Association, 2010, p. 1) and nine provisions
for an ethical nurse (American Nurses Association, 2001, pp. 1-2). By reviewing the scope and
standards of practice, and the ethical provisions, and comparing these to my own practice as a
Nursing Student, I have found areas of patient care that I am competent in, and areas where I
need improvement. I will, throughout my nursing career, strive to meet all the scope and
standards of practice and ethical provisions by goals and action plans developed here.
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 3

Self-Assessment: Scope and Standards of Practice
Every profession must have scope and standards of practice to tell those professionals
what they should be doing and what competency level they should meet. The American Nurses
Association, or ANA, developed the scope and standards of practice for professional nurses
(American Nurses Association, 2010, p. 1). The Code of Ethics for Nurses was developed by the
ANA to have set ethical obligations and duties that every nurse must follow, to state the
professions nonnegotiable ethical standard, and to express nursings own understanding of its
commitment to society (American Nurses Association, 2001, pp. 2-3).
Every nurse should analyze her or his own practice periodically to ensure she or he is
meeting these standards and ethical provisions set forth by the ANA. If the nurse finds an area
that needs improvement, she or he should then set a goal and form an action plan in order to meet
the scope, standard, or provision.
Scope and Standards of Practice
Standard of Practice
Assessment. The first standard, assessment, is considered by the ANA to be: The
registered nurse collects comprehensive data pertinent to the healthcare consumers health and/or
the situation (American Nurses Association, 2010, p. 32). In order to be considered competent,
the nurse must include a holistic approach to the assessment process.
In analyzing this standard, I feel I have met the competency requirements. Each day I
attend clinical, I get change of shift report from the night nurse. Using this information and the
information on the patients chart, I determine what is the priority assessment data. I then
conduct my physical assessment while conversing with the patient and assessing his or her
psychosocial, emotional, cognitive, and sometimes spiritual status. Throughout the shift, I am
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 4

constantly checking in on my patients, and I am able to determine if there has been shift from the
morning assessment. I document my assessment finding appropriately and timely, and I keep all
my patient information confidential.
My plan to continue meeting this standard in the future consists of repeated exposure to
differing situations which I have to analyze and respond to in assessing my patients. I will
continue to learn more about the human body, illness, and psychosocial influences of illness and
relationships in order to better care for my patients.
Diagnosis. The second standard, diagnosis, is the registered nurse analyzes the
assessment data to determine the diagnoses or issues (American Nurses Association, 2010).
The competencies for this standard help the nurse find the most appropriate diagnosis for each
patient.
In my practice as a student nurse, I have not yet completely mastered this standard.
While analyzing the assessment data, I do note areas where the patient is at risk or could be at
risk, but I am not yet in the habit of forming a standard Nursing Diagnosis for my patients. In
class, I have completed many diagnoses, but I have yet to document one in a patients chart in
the clinical setting.
Once I become a Registered Nurse and have experience conducting an inpatient
admission assessment, I will be better suited to meet this standard. I will have to work hard to
make myself think of specific diagnoses for my patients now, so when the time comes to
document a diagnosis, I will be used to thinking of them.
Outcomes Identification. The third standard is called outcomes identification. In this
standard, the registered nurse identifies expected outcomes for a plan individualized to the
healthcare consumer or the situation (American Nurses Association, 2010). Under this standard
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 5

the nurse includes the patient, the patients family, and other health care providers in
formulating expected outcomes for the patients health (p. 35).
Again, I have not fully met the obligations of this standard. In the clinical setting, I assist
my patients in meeting their daily goals set forth by the Registered Nurses, but I have not formed
these goals myself. I have formulated several goals as homework assignments, but have never
used this with an actual patient.
In order to meet this standard in my practice I will have to work with other care providers
in making appropriate goals for my patients (American Nurses Association, 2010). I will have to
understand the Nursing Diagnoses from which the objectives are formed, and know how best to
advise the patient to reach his or her health goals (p. 35).
Planning. In the fourth standard, planning, the registered nurse develops a plan that
prescribes strategies and alternatives to attain expected outcomes (American Nurses
Association, 2010). The nurse in this case must understand that each patient is different and take
into account their individuality. The plans should have a specific timeline for the patient to
follow (p. 36), such as walk 25 feet three times a day for three weeks.
The planning aspect comes as a challenge to me. Once I am in the workforce, I will gain
more experience and will learn how to create appropriate plans for each patient. I have not made
any plans for my patients within the clinical setting, but have formulated several during
homework assignments.
As a registered nurse, I will collaborate with my patient, their family, and other health
care providers to form an individualized plan (American Nurses Association, 2010, p. 36). I will
also have to revisit the plan periodically to make adjustments as the patients situation changes
(p. 36). Using the ambulating example, I might update the distance to 50 feet after the three days.
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 6

Implementation. Within the fifth standard of implementation, there are, what can be
considered, sub-standards. Implementation simply states that the registered nurse implements
the identified plan (American Nurses Association, 2010, p. 38).
In my practice, I have met the standard of implementation. Though I do not formulate it,
I assist the patient in following through with the plan. I consider my patients preferences, and
encourage them to do as much as they can without hurting themselves. The patients safety is
always a priority (American Nurses Association, 2010, p. 39).
When I become a registered nurse and have an average of five or six patients on my case
load, it will be more difficult for me to work with the patient during the implementation of the
plan. I will need to work on my time management skills and also delegate some tasks to
appropriate assistive personnel.
Coordination of care. Within implementation, there is coordination of care. This sub-
standard states that the registered nurse coordinates care delivery (American Nurses
Association, 2010). This means the nurse works with the patient in order to deliver the best,
most appropriate care for that individual (p. 40).
I am able to meet this standard by acknowledging the patients loss of control that
happens when one is in the hospital. I try to give some of that control back by encouraging my
patients to perform their own activities of daily living, or ADLs, if they are able. I let them, as
much as possible, decide when they would like to wash up or go for a walk.
As a registered nurse, I will continue to recognize the importance patient independence is
in recovering from illness or injury, and will continue to encourage my patients to do as much of
their own care as possible. I will make sure each patient is treated in a dignified manner and will
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 7

help them find alternative care options that best suits each person (American Nurses Association,
2010, p. 40).
Health teaching and health promotion. In the second sub-standard, health teaching and
health promotion, the registered nurse employs strategies to promote health and a safe
environment (American Nurses Association, 2010, p. 41).
I do not consider myself competent in health teaching and health promotion. Unless a
patient is newly diagnosed with a condition, such as Congestive Heart Failure, or lacks
knowledge about a lifestyle choice, such as smoking, I have a difficult time finding teaching
opportunities. I find that by the time I reach the patient, other health care providers have
explained everything. This may also stem from my own lack of knowledge and lack of
confidence in the knowledge I do have.
As a registered nurse, I will have to teach my patients about many aspects of their health.
Depending on what unit I work in, I will be teaching about new medication, a new diagnosis,
lifestyle changes after surgery, or simply the benefits of taking a walk every day. When teaching
my patients, I will have to assess whether or not they are receptive or willing to learn, and I will
have to modify my education to fit each individuals needs (American Nurses Association, 2010,
p. 41).
Evaluation. Evaluation is the sixth standard. In this standard, the registered nurse
evaluates progress toward attainment of outcomes (American Nurses Association, 2010, p. 45).
This means the nurse does not only implement the plans made, but also examines how well the
patient is progressing in the plan toward the desired goal.
I evaluate my patients progress when I assist them getting washed in the morning, or
taking a walk, or feeding themselves their own meals. Depending on the patient and his or her
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 8

situation, I have seen patients improve rapidly, slowly, and some even regress in their attempts to
reach their goals.
Evaluation is an important task for the nurse to perform. If the nurse fails to evaluate the
patients progress, he or she may be experiencing complications that will go undiagnosed and
untreated. On the other hand, the patient may be progressing quickly and could be discharged
early. I will continue to meet this standard in my practice as a registered nurse by observing my
patients during the implementation phase and critically analyzing their progress toward their
goals. I will also discuss their progress with my patients, and their families when appropriate, to
determine if the patient feels he or she is improving. I may have to change the patients nursing
diagnosis, outcomes, and plans as his or her situation changes (American Nurses Association,
2010, p. 45).
Standards of Professional Performance
Ethics. In the seventh standard, ethics, the registered nurse practices ethically
(American Nurses Association, 2010, p. 47). The Nursing Code of Ethics will be discussed in
detail shortly.
I believe I practice ethically. I maintain confidentiality, in accordance with ethical
obligations as well as the Health Information Portability and Protection Act, or HIPPA. My
patients safety is an important aspect of my care, and I include my patients in making healthcare
decisions.
As a registered nurse, I will have more opportunities to practice ethically. I will continue
to maintain confidentiality. Safety will always be a concern with my patients, and I will be in a
better position, as the patients main nurse, to include him or her in decisions made about his or
her care. I will encourage my patients to make informed decisions, and to not just follow along
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 9

with what the physician requests. I will be able to advocate more effectively for my patients if I
notice the need for quality improvement (American Nurses Association, 2010, p. 47).
Education. The education standard, number eight, states that the registered nurse
attains knowledge and competence that reflects current nursing practice (American Nurses
Association, 2010, p. 49). Once a nurse graduates from college and passes the National Council
Licensure Examination, or NCLEX, the nurse is not done learning.
As a nursing student, I am constantly learning and gaining competence, therefore I am
meeting this standard. In class I am learning the theory and facts that go into being a nurse,
while in clinical I am able to put that knowledge to use and seek out more opportunities to
experience new problems.
After I pass the NCLEX and become a registered nurse, I will enhance my knowledge by
attending Continuing Education classes held in the hospital or by the nursing organizations of
which I will be a member. I also intend on attaining a higher degree, either a Masters in Nursing
or a PhD. I would like to participate in research studies and would then disseminate the research
findings to other nurses and health care professionals.
Evidence-Based Practice and Research. The ninth standard is called evidence-based
practice and research. In this standard the registered nurse integrates evidence and research
findings into practice (American Nurses Association, 2010, p. 51). This means the nurse must
stay up-to-date on relevant nursing research and utilize this research in his or her practice, when
appropriate.
As a student nurse, I am being taught evidence-based practice, and so that is what I use in
the clinical setting. In my various classes, I am required to research different aspects of the
nursing profession and share what I have learned with the class.
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 10

My future nursing career will be driven by evidence-based research in many aspects. On
one hand, hospital policies and procedures should be updated to follow the latest research. This
will enable the nurses to provide the best care possible. If I find research that shows a new and
better way of completing some task, it will be my responsibility to approach the appropriate
people to make hospital changes. On the other hand, I am interested in a career in research. I
will be expected to disseminate my research findings with all others in my profession so that all
nurses may learn what I have found (American Nurses Association, 2010, p. 51).
Quality of Practice. The tenth standard, quality of practice, states that the registered
nurse contributes to quality nursing practice (American Nurses Association, 2010, p. 52). This
does not only include the quality of care given to individual patients, but also the quality of the
unit and the hospital as a whole (pp. 52-53).
There are many aspects that go into this standard and I believe I only meet some of them.
For example, I document my care given in a responsible, accountable, and ethical manner,
however I am not involved with implementing processes to remove or weaken barriers within
organizational systems (American Nurses Association, 2010, pp. 52-53). In the clinical setting,
I unconsciously analyze healthcare situations for quality risks and safety risks to the patient.
As a professional nurse, I will be more involved with what the ANA (2010) calls the
organizational system (p. 52) and will be better able to identify areas that need more focus to
increase the quality of practice, not only for myself but for the whole hospital. I will be able to
influence policy to improve quality.
Communication. In the eleventh standard, communication, the registered nurse
communicates effectively in a variety of formats in all areas of practice (American Nurses
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 11

Association, 2010, p. 54). This communication includes that with the patient and with other
health care providers.
I have met this standard because I am able to converse with my patients, and I am able to
coordinate care with the other nurses and nurse aids on the floor. I ask for help when I need it,
and offer help to the others working around me. However, I know communication is a weakness
in myself and I need continual practice to improve.
I will continue to improve my communication skills as a registered nurse. This
improvement will also have a positive influence on my self-confidence, and I will feel more able
to question an action or an order that seems inappropriate for a given patient and communicate
my concern with the physician (American Nurses Association, 2010, p. 54). As my
communication skills grow, I will be more open to participating with interprofessional team[s],
giving feedback and offering my opinions during conferences (p. 54).
Leadership. Leadership is the twelfth standard. This standard states that the registered
nurse demonstrates leadership in the professional practice setting and the profession (American
Nurses Association, 2010, p. 55).
I have met only portions of this standard as a nursing student. I treat others with respect,
trust, and dignity and I communicate with the patient and other health care professionals,
however I do not mentor colleagues nor do I try to influence healthcare policy (American
Nurses Association, 2010, p. 55). I am a member of a professional organization, Sigma Theta
Tau International (STTI), though I do not consider my induction to equal participation in the
nurses honor society.
Once I become a registered nurse, I will be able to participate in the organization and by
doing so, I will continue to learn about new evidence-based research which I can then bring back
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 12

to my coworkers. After I gain experience, I may be assigned to mentor a new nurse. It will be
my responsibility to ensure he or she knows how to provide quality health care and is
dedicated to the nursing profession (American Nurses Association, 2010, p. 55). As a nurse
researcher, I will [seek] ways to advance nursing autonomy and accountability (p. 55) through
my studies.
Collaboration. The thirteenth standard, collaboration, states that the registered nurse
collaborates with the healthcare consumer, family, and others in the conduct of nursing practice
(American Nurses Association, 2010, p. 57). This standard ties in closely with the standard of
communication.
I meet this standard in school and at clinical. In school, I collaborate with my classmates
on group projects and to ensure the whole class knows what to do for each assignment. A
clinical, I work closely with my patients, with their assigned nurses, with my instructor, with my
classmates, and with the nurse aids on the floor. Working together, we give the patients better
care than if I was on my own.
After becoming a registered nurse, I will continue to collaborate with my patients and my
coworkers. I will communicate effectively with my patients physicians to ensure the proper
orders are in place. I will work with my patients and their families to ensure all their care needs
are met. Collaborating effectively will enhance our departments sense of unity (American
Nurses Association, 2010, p. 57).
Professional Practice Evaluation. The fourteenth standard is called professional
practice evaluation. This standard states that the registered nurse evaluates her or his own
nursing practice in relation to professional practice standards and guidelines, relevant statutes,
rules, and regulations (American Nurses Association, 2010, p. 59).
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 13

I believe I have met this standard of nursing practice. I attempt to give age appropriate
and culturally competent care to all of my patients. After every clinical day, I review the
positives and negatives of my care, evaluating my practice and making note of where I need
improvement. In school, I assist my classmates by reviewing their papers and offering advice on
how to improve the assignments before submitting.
I will continue to meet this standard as a registered nurse by providing appropriate,
individualized care for each of my patients. I will continually review my practice and make
adjustments where needed to meet the scope and standards of nursing care, both in an informal
manner as I do after clinical, and in a more formal manner at least once a year. I will welcome
the advice of other professionals on how I can improve my care, and work toward being the best
registered nurse possible. Conversely, I will offer my coworkers feedback on their nursing
practice in order to aid them in bettering their care (American Nurses Association, 2010, p. 59).
Resource Utilization. The fifteenth standard created by ANA is resource utilization. In
this standard, the registered nurse utilizes appropriate resources to plan and provide nursing
services that are safe, effective, and financially responsible (American Nurses Association,
2010, p. 60).
I have met this standard in my clinical practice by ensuring my patients deemed fall-
risks always wear a gait belt with assistance when ambulating. I utilize the nurse aids by
requesting they complete tasks appropriate for their level of training, such as ambulating with
patients and obtaining blood glucose levels.
As a registered nurse, I will have the opportunity to discuss differing care options with
my patients and their families, factoring costs, risks, and benefits into their choice (American
Nurses Association, 2010, p. 60). I will work with my patients, their families, and varying
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 14

healthcare services in order to arrange appropriate care during hospitalization and after
discharge. After working on a unit for some time, I will have the experience to know what
resources improve nursing care and I will be able to advocate for their use (p. 60).
Environmental Health. Finally, the sixteenth standard, environmental health, states that
the registered nurse practices in an environmentally safe and healthy manner (American
Nurses Association, 2010, p. 61). Of course, safety is a top priority for a nurses patients, but it
should also be a priority for the nurse as well.
I am able to meet part of this standard as a nursing student. I communicate
environmental health risks and exposure reduction strategies (American Nurses Association,
2010, p. 61) when I utilize the isolation cart outside a patients room. I ensure there is a sign
on the door telling other staff, family, and visitors of the need for personal protection equipment
when entering the patients room. When assisting the patient with a bed bath or changing bed
linens, I raise the bed height to a safe working height to prevent back injury. After I finish my
task, I lower the bed again to ensure patient safety.
I will be in a better position to meet all aspects of this standard once I am a registered
nurse. I will be able to advocate for appropriate products to ensure the healthcare staff remain
safe and healthy while providing the best care. I will be better able to assess the workplace for
staff health and safety issues. I may also be able to join health promoting committees in the
community (American Nurses Association, 2010, p. 61).
Code of Ethics for Nurses
Nursing has been known for its concern for the welfare of the sick, injured, and
vulnerable and for social justice but nurses also have a role in the prevention of illness, the
alleviation of suffering, and the protection, promotion, and restoration of health (American
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 15

Nurses Association, 2001, p. 2). It was the Code of Ethics that first used patient to name those
who receive nursing care (p. 3). The term patient covers those who utilize nursing care to
recover health and those who wish to maintain their health (p. 3).
Provision 1
The first ethical provision includes the respect for human dignity, relationships to
patients, the nature of health problems, the right to self-determination, and relationships
with colleagues and others (American Nurses Association, 2001, pp. 3-5).
I follow this provision by treating all of my patients with respect of the inherent worth,
dignity, and human rights of every individual (p. 3). This respect is evident in the relationships
I form with each patient and his or her family. I do not to judge the patient because of the illness
or injury that brought him or her to the hospital. If it was avoidable, such as uncontrolled
diabetes, or if it was an accident that brought the patient to me, he or she needs and deserves my
care and attention. Part of respecting the individual is acknowledging the patient has the right to
choose his or her own care, the patient is autonomous. I try not to force my patients to do
anything against their will, even if I know it would benefit the patient. My respect is not
reserved only for my patients, either. I hold all of my coworkers, other nurses, nurse aids and
technicians, nutrition services, environmental services, and other department employees, in the
highest regard. I recognize that without the assistance of everyone in the hospital, I would not be
able to care for my patients the way they need (American Nurses Association, 2001, pp. 3-5).
I will continue to follow this ethical provision of respect once I become a registered
nurse. I know my patients have the right to choose and refuse care, and I will respect them in
their choices. I will do my best to form professional relationships with my patients and
coworkers in order to best serve my patients.
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 16

Provision 2
The second provision states that the nurses primary commitment is to the patient,
whether an individual, family, group, or community (American Nurses Association, 2001, p. 5).
This means the patient is the nurses priority. The nurse must be able to identify and work
through conflicts of interest. The nurse also has to, not only cooperate with others, but put forth
the effort needed to reach a common goal. The nurse needs to recognize and maintain the
professional boundaries of his or her relationship with patients (pp. 5-6).
In my practice as a student nurse, I have met this ethical provision. I am committed to
my patients health. I work with my patients and other healthcare providers in order to regain
and maintain their health, even if I dont always agree with my patients decisions. My
relationship with my patients and their families is founded on professionalism, trust, and caring.
As a registered nurse, I will continue to view my patients needs as a top priority. I will
continue to work on identifying potential conflicts of interest, whether the conflicts are with my
own beliefs and values or between my loyalty to the hospital and to the patient. I will gain
experience working with others and encouraging my patients to work hard to recover or keep
their health. My professional and caring manner will encourage a strong working relationship
with my patients and other healthcare providers (American Nurses Association, 2001, pp. 5-6).
Provision 3
In the third ethical provision the nurse promotes, advocates for, and strives to protect the
health, safety, and rights of the patient (American Nurses Association, 2001, p. 6). This
includes privacy, confidentiality, protection of participants in research, standards and
review mechanisms, acting on questionable practice, and addressing impaired practice (pp.
6-8).
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 17

I maintain privacy and confidentiality of all my patients. Even in post-conference, I do
not use names, calling him or her my patient in room, I give out as little information as
possible. In my practice as a nursing student, I have not had the opportunity to work with
anyone participating in a research study. The requirement of standards and review
mechanisms means that only those who are qualified with the necessary knowledge, skill,
practice experiences, commitment, and integrity have access to patients (American Nurses
Association, 2001, p. 7). Through nursing school, I am gaining the knowledge, skill, and
experience; I feel I have shown my commitment and integrity to be a nurse through my studies
and my time in the clinical setting. I am able to recognize patient care that is incompetent,
unethical, illegal, or impaired, luckily, I have not yet encountered this in the clinical setting.
Unfortunately, it is highly likely I will find this poor care at some point during my career,
and it will be my responsibility to advocate for the patient and see that the lack of professional
care is corrected. I will maintain my qualifications as a nurse by continuing my education, even
after graduation. As a registered nurse, and especially if I continue my educational path to
become a researcher, I will have the chance to work with study participants, and I will have to
ensure the participants are treated ethically and are protected from harm.
Provision 4
The fourth provision states that the nurse is responsible and accountable for individual
nursing practice and determines the appropriate delegation of tasks consistent with the nurses
obligation to provide optimum patient care (American Nurses Association, 2001, p. 8). Under
this provision, the nurse accepts accountability and responsibility of the care provided to his or
her patients. The nurse is accountable for nursing judgment and action and is responsible for
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 18

nursing judgment and action (pp. 8-9). The delegation of nursing activities also falls under
the nurse, since he or she is accountable for the quality of care (p. 9).
Even though I am still a student, I take responsibility for my patients, for my decisions,
and for my actions. I hold myself accountable for everything that happens while I am caring for
my assigned patients. If I am unable to complete a task and I delegate that task to a nurse aid or
one of my classmates, I double check that the task was completed properly because I know it is
ultimately my responsibility to ensure the task is done (American Nurses Association, 2001, pp.
8-9).
In the eyes of my patients, I will hold even more accountability and responsibility as a
registered nurse than I do now as a student. I will work hard to ensure quality care is given by
myself and by those to whom I delegate tasks.
Provision 5
The fifth ethical provision is about the nurses health. It states that the nurse owes the
same duties to self as to others, including the responsibility to preserve integrity and safety, to
maintain competence, and to continue personal and professional growth (American Nurses
Association, 2001, p. 9). Aspects of this provision include moral self-respect, professional
growth and maintenance of competence, wholeness of character, and preservation of
integrity (pp. 9-10).
According to the ANA, having moral respect leads to feelings of moral worth and
dignity in the person (American Nurses Association, 2001, p. 9). Though I may not have self-
confidence, I do have self-respect. As a student nurse I am constantly increasing my
professional competence. By wholeness of character, the ANA means that my personal and
professional selves are combined (p. 10). I do not believe I have met this requirement yet. I do
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 19

believe I am able to preserve my integrity as a student nurse. I understand that there will be
more challenges that test my dedication to the Code of Ethics as a registered nurse.
I will take have to take the time to think through my choices to ensure I make ethical
decisions when my integrity is threatened. Gaining experience in the hospital, I will be able to
more fully develop my professional identity, thus contributing to my wholeness of character
(American Nurses Association, 2001, p. 10). Maintaining my competence as a nurse will take
the form of the continuing education that all nurses must obtain, and by welcoming new
experiences where I may learn different techniques or treatment methods for my patients.
Provision 6
Under the sixth provision, the nurse participates in establishing, maintaining, and
improving health care environments and conditions of employment conducive to the provision of
quality health care and consistent with the values of the profession through individual and
collective action (American Nurses Association, 2001). This provision includes the influence
of the environment on moral virtues and values, the influence of the environment on ethical
obligations, and the responsibility for the health care environment (p. 11).
The ANA uses the term excellences to describe habits of character that predispose a
person to do a particular job or task well (American Nurses Association, 2001). The
excellences needed for a nurse are compassion, patience, and skill (p. 11). I have the
characteristics of compassion and patience, and through school, I am improving my skill as a
nurse. As a student, I am not on any committees or boards dedicated to improving the work
environment, but I do what I can in the clinical setting; organizing the nurses work station or
clearing the clutter out of a patients room after passing meds. In the clinical setting as well as in
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 20

my classes, I contribute to a moral environment by respecting my peers, instructors, and
coworkers.
Once I am a registered nurse, I will be expected to join a committee or board and will be
able to provide my suggestions on how to maintain a healthy work environment. I will continue
to gain skills and improve my excellences with the goal of promoting human dignity, well-
being, respect, health, independence, among other values (American Nurses Association, 2001,
p. 11). I will continue to respect my coworkers, peers, and patients, and work to earn their
respect in return.
Provision 7
The seventh provision is about the profession of nursing. In this provision, the nurse
participates in the advancement of the profession through contributions to practice, education,
administration, and knowledge development (American Nurses Association, 2001). Actions
under this ethical provision include advancing the profession through active involvement in
nursing and in health care policy, advancing the profession by developing, maintaining, and
implementing professional standards in clinical, administrative, and educational practice, and
advancing the profession through knowledge development, dissemination, and application to
practice (p. 12).
Since I am currently a student, I do not feel I am able to advance the profession of
nursing. While I am a member of STTI, I am not able to contribute to the meetings. As
previously discussed, I am able to demonstrate some of the standards set in place for nurses in
the clinical setting. However, I will be better suited to advance the nursing profession utilizing
these standards after I become a registered nurse. As a student, I am not able to add to the
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 21

knowledge base of the nursing profession, instead I am learning already established evidence-
based practice.
Once I am a registered nurse, I will be able to actively participate in any and all
professional organizations I join. I will also advance the nursing profession by my actions in the
community. As a registered nurse, I will follow my plans, stated previously, to meet the
standards of practice. After I obtain a higher degree and become a nurse researcher, I will be
able to help develop new standards, not only in the clinical setting, but in all aspects of the
profession. I will have to publish papers describing the research results, give presentations to
other nurses, and follow many other forms of disseminating information (American Nurses
Association, 2001, p. 12).
Provision 8
The eighth ethical provision pertains to public health. In this provision, the nurse
collaborates with other health professionals and the public in promoting community, national,
and international efforts to meet health needs (American Nurses Association, 2001). The nurse
must be aware not only of specific health needs of individual patients but also of broader health
concerns (p. 12). Nurses should also maintain knowledge about the health status of the
community and existing threats to health and safety (p. 13).
I have not been following this provision. I do not watch the news to find out what is
happening in my community or around the world. I have only a vague understanding of
international conflicts.
As a registered nurse, it will be expected that I know what is happening in the world
around me. I will have to make it a daily routine to sit and watch a news program every day, or
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 22

listen to the news on the radio. If I do not know what is happening in my community, I will not
know how best to promote and protect the health of my community members.
Provision 9
Finally, the ninth ethical provision formed by the ANA (2001) states that the profession
of nursing, as represented by associations and their members, is responsible for articulating
nursing values, for maintaining the integrity of the profession and its practice, and for shaping
social policy (p. 13). Under this provision, professional organizations must communicate and
affirm the values of the profession of its members (p. 13). The professions accountability to
society must be continuously developed to be communicated clearly to the public (p. 13).
Another duty of professional organizations is to promote awareness of and adherence to the
Code of Ethics and should critique the activities and ends of the professional association itself
(p. 13). Lastly, a professional organization should speak for nurses collectively in shaping and
reshaping health care within our nation (p. 13).
As previously discussed, I am a member of the professional nursing honor society, STTI.
As a student I do not have much influence on the organization; however the organization itself
does meet the ninth ethical provision requirements. The organizations mission is advancing
world health and celebrating nursing excellence in scholarship, leadership, and service (Sigma
Theta Tau, 2014).
I plan to continue my membership in STTI as a registered nurse. Working as a nurse
researcher, I will have the opportunity to present my findings at the meetings, thus aiding the
organization with promoting health around the world. I may also join an organization pertaining
to the specialty I am in. Before joining any organization, I will ensure it meets these
requirements put forth by the ANA.
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 23

Conclusion
Through the analysis of my current performance as a nursing student revealed that I do
not currently meet all the standards of nursing practice or all the ethical provisions, I will be able
to correct my practice as a registered nurse. As discussed in the fourteenth standard of
professional development, my plan for continued evaluation includes a daily review of my
performance, and a yearly, in-depth, review of the scope and standards of practice and code of
ethics. This assessment will assist me in identifying aspects of my patient care and professional
development that need improvement.
SELF-ASSESSMENT: SCOPE AND STANDARDS OF PRACTICE 24

References
American Nurses Association. (2001). Code of ethics for nurses. Silver Spring, MD:
Nursebooks.org.
American Nurses Association. (2010). Nursing: Scope and standards of practice (2
nd
ed.).
Washington, DC: Nursebooks.org.
Sigma Theta Tau International Honor Society of Nursing. (2014). STTI organizational fact sheet.
http://www.nursingsociety.org/aboutus/mission/Pages/factsheet.aspx.