Running head: Reflective paper

Reflective Paper
Jenna Spotts
Cedar Crest College

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Abstract

The purpose of this paper is to take an in-depth look at each clinical objective and to reflect back
on each clinical experience. Each objective was to be met at clinical experiences along with
personal objectives for each clinical experience. The purpose leadership clinical experiences was
to be able to learn and grow as a leader throughout school and as a future nurse. Each objective is
described in ways to be met and each objective is described in how they were met throughout the
clinical experiences. There is a personal reflection to help with showing how I was able to meet
each objective as well as my own personal objectives and my thoughts on the entire clinical
experience.
Keywords: Leadership, nursing, management, ethics

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Reflective Paper

Leadership is something that is taught and learned. I was assigned to complete 84 clinical
hours for leadership. The clinical hours were community service, service leadership, political,
nursing supervisor, management, peer, patient logistics, continuing education, research, ethics,
and independent hours. Each of these experiences had a major impact on me personally and
educationally. I learned something new at each experience which is so important to me.
Throughout this paper is each clinical objective and how it was met. For each clinical experience
I had two personal objectives and I was thankful to meet each of those objectives as well. It is
important to me to always be able to learn and this class helped to show how much I have
learned from previous courses and how important it is to keep learning in order to grow.

Objective One
As a student nurse, I started my first nursing course terrified. I had to learn how to take
care of another human, something I knew I always wanted to do since I was a young girl.
Dreaming and doing it are two very different concepts. This course is where I would learn how
to take care of the basic needs of another human, learn assessment skills, and how to organize
care. As each semester goes on I learn new skills to add onto the previous skills that have been
taught to me. Leadership is an important aspect in a nurse because we have to lead in many
ways. We lead by example, by teaching, by learning, and most importantly by caring.
Diversity is an important aspect in life, everyone has the right to be different, it is
important to be able to look at someone and be okay with who they are. No matter what,
everyone is similar on the inside of their bodies, they are similar in that they need help with their
ADLs, to cope with an illness, or a death in their family. Throughout this leadership course I

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chose different areas that would allow me to do some teaching. I was able to teach visitors at the
Rodale Aquatic Center about the importance of keeping your blood pressure in check, why it is
important to get the flu vaccine, and to have a low sodium diet. I was able to help junior level
students on how to organize their care, how to pick out priority nursing diagnoses, and how to
manage report in the morning. Being in the unknown is a very stressful situation and being able
to be a teacher for those in their unknown was a very beneficial feeling.
Objective Two
Ethics is a considerable factor in nursing. According to the American Nurses Association
the code of ethics affects all aspects of a nurses life, the code of ethics establishes the ethical
standards of not only nurses but companies who represent health care and patients (ANA, 2015).
The code of ethics is a guide to help nurses with decision-making and helps with analyzing
ethical situations (ANA, 2015). While working through leadership I had to work through using
the code of ethics while completing my community service. I was placed at Daybreak, a facility
for people with addiction to drugs, mental health, and HIV. There was a member that was talking
about something that happened, and ethically I needed to decide what I was going to say to them.
It was a tough situation and decision, but the member and I were able to work through the
problem at hand. I had to say what was important to give the member options, but I also had to
understand that I did the best I could with the situation, even if the member didnt want to hear
the options listed.
According to Marquis and Huston (2015) a leader is one who is out in front of the crowd,
taking risks, achieve goals shared by the crowd, and inspire action. A manager is one who leads
and directs parts or all of an organization through manipulation and deployment of resources
(Marquis & Huston, 2015). To help with management skills I was able to follow a nurse

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supervisor of perioperative services. I was able to learn how to effectively communicate with
other staff members about concerns. I followed a nurse manager that was extremely down to
earth, she walked through her units multiple times to make sure everyone was okay, she stopped
to ask how their shift was going, thanked them for coming in early or staying later, went to
meetings, and was able to be extremely modest towards staff as well as myself.. She was a leader
I would follow for management style.
Objective Three
I look at each clinical as a job interview. In order to be even considered for employment,
one must be professional, early to any appointment, courteous, willing to work with others, and
be respective. It would be difficult to work with anyone who couldnt be this way, especially inn
a team oriented environment. Nursing isnt about being on your own all the time, delegation
happens, we will always need help. I was always able to arrive early to any clinical experience I
made, I was in the proper uniform; whether clinical uniform or professional business attire. In
order to effectively communicate I was always able to email or call whoever I needed to talk to
about my clinical experiences. For all of my experiences I sent out a thank you email for those
who took time out of their busy day and schedule to show and teach me new skills. It is super
important to be able to learn new skills, but it is also important to remember those who took the
time to teach new skills.
Objective Four
According to Wilson, Paterson, and Kornman (2013) leadership development increases
job satisfaction, increase in team work, increased culture in the workplace, and an increase in
patient outcomes. Before starting leadership I almost felt as though I would be a bother towards
those who were there to teach me, on the contrary it was exactly the opposite of how I felt. The

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nurse supervisor I followed was able to show me how she works with another hospital and the
other floors individually to make the best possible outcome for the most amount of people. Being
a supervisor is a difficult task, and she was able to show me how to effectively manage time and
critically think between seven floors and make sure there was enough staff. She stated that it
doesnt always work out the way it needs to work out, but it is important to remember to keep
moving forward and to work with what is given to you.
Objective Five
Being an advocate for a patient and other nurses is a quality that cannot be removed from
a nurses core. There isnt a way to care for people but then not to help them in any way a person
can. Recently at a peer leadership I heard about a patient who had a Foley that was then removed
because of pain, however this patient was retaining large amounts of urine, the patient was then
being straight catheterized instead. I asked the student if there was a schedule for bladder scans
and asked about why the patient should have the Foley instead of the numerous straight
catheterizations. It is important to communicate with a patient the importance of keeping the
Foley inserted into the bladder and performing interventions for the patient for pain rather than
intermittent straight catheterization, simply for the reduction of infection. It is a difficult decision
to inform a patient about the importance of one treatment versus another treatment even when
the patient is refusing the treatment. I feel that it would be morally and ethically wrong to ignore
informing a patient about different treatment options and the risks and benefits of each treatment,
this goes along side informing the patient why the treatment is necessary.
Objective Six
In order to learn new skills and come up with new ideas to practice, one needs to be
willing to learn. This was the belief I thought of each time I arrived to clinical, I not only learn

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from books and classroom, but I learn from other people such as, managers, supervisors, peers,
and patients. I take what I learn from each experience and I think of how things can go different
or if they should stay the same. Healthcare is always changing and even though I learned
amazing things through all of my clinical experiences it is important that to be able to handle
change one must be able to change as well. I love to learn but I am open to change. Prior to each
clinical experience I had personal objectives that I wanted to meet, and I was able to do that for
each experience. I was also able to be open to learning more than the objectives set for me and
by me. To me learning is an important aspect, it keeps your brain from becoming stagnant. In
order to be involved in change and new ideas being implemented into practice, we as nurses need
to be open to change.
Objective Seven
In order to be involved in policy making it is important to remember that one needs to be
involved. During my clinical experience in Harrisburg, I learned all about policy and how to be
involved. It is important to join the committees that are there for change and policy, unit councils
on the hospital floor, township, county, and state government. Another major area to help with
being involved in the political aspect of nursing is to join the Pennsylvania State Nurses
Association (PSNA) as well as the American Nurses Association (ANA). The PSNA were able to
send out two members to Harrisburg to speak with my nursing class. I didnt know that so little
nurses were involved in the PSNA, we can have a major impact on nursing with such a loud
voice, we can have a loud voice for politics, the unfortunate part is we dont have this voice. I
learned that change is inevitable, but what isnt inevitable is having a voice to show concern for a
change that is or is not being made in nursing. Healthcare will always change with or without the
strong voices of nurses backing up the change, the important part is to be involved in the change.

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Objective Eight

The code of ethics is a non-negotiable code that nurses are taught to live by to guide them
through the difficult decision making process of an ethical decision (ANA, 2015). An ethical
decision can be something minor such as a disagreement between two coworkers to something
major such as whether to chemically restrain a patient without consent. The code of ethics is an
important aspect in a nurses life because without it there wouldnt be a set standard on how to
complete the decision making process for an ethical decision (ANA, 2015).
According to Marquis and Huston (2015) authority is a power to act, this power is given
to someone and they are to direct others. There are many authority positions in a hospital, for
instance a manager is given the ability to hire, discipline, and fire workers in their unit. Authority
is necessary in a work place, without it there would be chaos and confusion. There is also a
confusion between workers in an authority position versus workers with status, status shows
skill, education, level of responsibility, salary, and specialization; a worker with a high status
level doesnt have the authority to do the same actions as a manager on a unit. A worker with a
high status level would be a charge nurse for the shift, this is the person that most go to looking
for help and to ask questions prior to asking the nurse manager of the unit (Marquis & Huston,
2015).
Personal Exploration
The clinical objectives that I had made prior to each experience were accurate.
Sometimes it seemed difficult to come up with objectives if I wasnt sure what to expect from the
experience. The best part about making your own objectives is that you are determined to learn
those and more. Throughout each experience I not only had personal objectives for the paper but
I kept making objectives in my head to meet, and I was able to learn from each experience to

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help with learning more at the next experience. I always expected to learn about the job and job
qualifications for certain positions but the fact of the matter is that in any job there are so many
ways to explain a position but you wont know or understand until you experience the job. The
nurse manager job is a very complex position, the manager goes throughout the units and attends
meetings, is an advocate for his or her employees, works on payroll, communicates problems
through the chain of command and more. It is difficult to explain the position to someone
without being able to be in their shoes for a day.
During clinical orientation I remember Dr. Robb stating that it is of upmost importance to
have an agenda to be able to manage our time effectively throughout the clinical course. To
manage my work and school schedule I needed to have an agenda and I would also put all of the
appointments on my phone. I consistently would check my email for reminders for any clinical
experience I signed up for. Keeping an agenda has also been beneficial for my time management
skills of meeting the objectives set for the course and the personal ones I set for myself. I feel as
though managing work, school, and clinical hours that having an agenda and a calendar on my
phone has helped me to manage my time effectively and I dont feel as though I would change
anything for another semester. I also was able to make a checklist to help me manage what is the
most important task to complete and in between each task I would study, this procedure would
allow me to complete everything on time and still have some time for myself.
I feel as though leadership is standing in front of those and taking charge. Leadership is
something that is taught and learned. You can learn how to be a leader and the definition of a
leader, although actually being able to advocate for those around you is something that a person
is born with. I feel as though all of my experiences are up to date with the definition of
leadership, but not every person I followed was a leader. There are those who are willing to

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advocate for family, friends, themselves, employees, and patients; there were some who were not
willing to be a leader. I feel that through nursing it is important to be an advocate for those
around you, it's in our nature to care, and its difficult to care but not advocate for them.
Each clinical experience was more than I had hoped for. I was able to see how far I have
come as a nursing student through peer leadership in being able to teach and guide nursing
students through their clinical day and through the questions and stress of videotaping. Through
patient logistics I was able to see how patients are moved around on the floor, I have seen it
through working in a hospital but it was eye-opening to be able to see it from the other side and
how patients are moved throughout the floor of the hospital. I was able to walk through the floor
with the nurse supervisor and see how nurses and aids are moved around throughout the hospital
to make sure there is enough staff for patient satisfaction. It is unfortunate when some nurses and
aids have more patients then their care model design, but patients need to be taken care of. Being
able to see how the hospital works from both sides of the spectrum is beneficial to every person
involved, it is stressful for both parties, but highly beneficial to each side.
When asked in the beginning of the semester which of us students were leaders very few
of us raised our hands when all of us should. Being in nursing school sometimes makes it
difficult that you are being a leader and that you are changing someones life, when in fact we are
doing exactly that. This is why in the beginning nursing courses we are taught to build a
therapeutic relationship with patients and to keep building from each semester. By the end of the
semester I finally started to feel as though I am a leader, this class truly helped me to see that I
am. I am able to provide patient care, answer the patients questions, and most importantly I am
able to advocate for those patients even when I feel as though I shouldnt because I am only a
nursing student. It can be difficult to be on the floor and go up to a nurse and tell them that I

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think the patient should receive a different treatment compared to the one that they are receiving
or to tell a nurse that a patient is in a lot of pain and that the intervention should be completed for
them. This class has really enforced my advocacy skills, Ive always had them but I learned how
to better manage my anxiety when advocating for the patient to the nurse. This goes alone with
behaviors that needed to be changed about myself as a future nurse. I always have had anxiety
talking to the nurse about patient care, it shouldnt be that way because both of us are there to
take care of the patient so why should I be scared to communicate with the nurse, even the
doctors. I have been able to communicate more effectively with the nurses and doctors in my
other clinical experience because of this class. This class has truly brought out a leader in me that
I was a little scared that I would never find.
My view has changed of nursing leadership because when I started this course I didnt
think a lot would change about who I am as a nursing student, when in fact I was able to selfreflect on who I have become as a person and as a nursing student. This class has given me the
ability to set aside the constant stress and be able to see how far I have come and to be proud of
myself for this. I was completing my last peer leadership clinical in Nur 321 and it was the
classes last 321 clinical and it was amazing to sit there and listen to the students and the clinical
instructor talk about how she has watched them grow throughout the semester, and they were
able to see it themselves and what they have ended the semester with versus what they started
with. It was an explorative experience to remember back when I was sitting in their same shoes
and how far I have come. I will be forever grateful to have that experience to always look back
on.

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Conclusion

Over the course of the semester we were assigned to complete 84 clinical hours with the
option to complete more but no less. I remember being nervous to juggle work and two clinicals
at the same time. I remember thinking that I dont understand how full-time nursing students do
it. Thankfully I was able to manage completing all of my clinical hours for both experiences, this
class has not only taught me about being a leader, but also how to be an effective leader, to have
a voice, and very beneficial time management skills that I will take with me throughout the rest
of my life. Ethical situations will always arise throughout life either in a persons career or in
their private life. It is important to think back to learning about the code of ethics and its
importance in a nurses life. The code of ethics is a learned code but also a guide to how an
ethical situation should be handled, without it there would be chaos. Leadership is learned and
taught, it is important to have the want and need to be a leader; especially in nursing; but it is
highly beneficial to be taught leadership skills. These skills are going to be used throughout life,
leadership skills are necessary to be successful. Each clinical objective is presented to the
nursing class in the beginning of the semester, it is important to remember them throughout each
experience in order to be able to reflect back on each clinical. It is also important to write clinical
objectives for yourself. Having the objectives gives me the chance to be able to look back at each
experience to see how I have grown, what I have learned, and most importantly who I will
become because of these learning experiences.

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References

Code of Ethics for Nurses (2001). Code of ethics for nurses with interpretive statements. Pages
1-76. Retrieved from:
http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNur
ses
Marquis, B., & Huston, C. (2015). Leadership Roles and Management Functions in Nursing.
Philadelphia: Wolters Kluwer.
Wilson, V., Paterson, S., & Kornman, K. (2013). Leadership development: An essential
ingredient in supporting nursing unit managers. Journal of Healthcare Leadership, Pages
53-62.