RunningHead:PRACTICESUMMARY

PracticeSummaryPaper

ErinKeim

OldDominionUniversity
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PracticeSummaryPaper

IgraduatedfromJ.SargentReynoldsCommunityCollegewithmyAssociatesDegreein

NursinginAugust2014.Idecided,beforeIevengraduated,thatIwouldpursuemyBachelors

Degree(BSN)soonafterbecominganurse.IpassedtheNCLEXandbecameanursein

September2014.IgavemyselfthesemesteroffsoIcouldfocusonmynewcareerand

orientation.IbeganworkingtowardsmyBSNinJanuaryof2015,stillenrolledatJSRCCtaking

myprerequisites.In2016,IbeganmyjourneyatOldDominionUniversity.Iknewthat,by

obtainingmyBSN,itwouldopensomanymoreopportunitiesformeasanurse.Iwantedto

haveoptionstoadvanceineducationaswellaswithmyjob.IdonotthinkIquiterealizedhow

muchmorewritingIwoulddo,butknewIwouldlearnaboutthedifferentaspectsofnursing.At

thebeginningofmyjourney,Iwantedtoworkonmyresearchandwritingskills.Ihave

improvedinboth.Ihavelearnedtorelyonresearchthatisevidencebased.Icannowsaythat,

byobtainingthisdegree,ithastaughtmehowtoresearchnewmaterial,becomeastrongleader,

bemoreinvolvedinmycommunity,andhasmademeintoabetterroundednursewhocanmake

abiggerimpactonmypatients.

Analysis

CriticalThinking

Criticalthinkingisusedthroughinquiry,problemsolvingandsynthesis.Itrequiresmore

thanjustwhatIlearnedinnursingschool.Itrequiresapplyingresearch,knowledgeand

experiencetoeachpatientandsituation.Criticalthinkingskillscanbeacquiredthroughin
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serviceteachingsessions,committees,staffmeetings,evidencebasedresearch,protocolsand

policies,andexperienceslearnedinpersonandthroughcoworkers.

I believe my critical thinking skills could best relate to the bullets, Revises actions and

goals based on evidence rather than conjecture, and, Uses decision-making skills in making

clinical or professional judgments. With the first bullet, I have realized the importance of

basing my practice on evidence, rather than on tradition or the way other nurses were taught. My

paper on Therapeutic Nursing Interventions breaks this down even further. For instance,

working in the recovery room, we give many medications, especially narcotics. The type of

narcotics used has changed over time. Some of the more experienced nurses recall using

Demerol more often for pain; now we use medications like Fentanyl, Dilaudid, and Morphine.

As research has grown, people are realizing the benefits for patients by using multi-modal

medications and non-pharmacological interventions. Evidence has shown that using other

medications, such as Tylenol, Toradol, and Gabapentin pre-operatively and intraoperatively can

help decrease the amount of narcotics used post-operatively.

With the second bullet and using decision-making skills, I face this every day in my job.

Prioritizing is a huge deal. When I work my stepdown-telemetry job, there are people that I must

see before anyone else and I must prioritize who I see first. If I have someone that is having an

acute issue like respiratory distress, abnormal cardiac rhythms, chest pain, and such, I am not

going to go see the patient who wants crackers and a soda first.

NursingPractice
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NursingPracticeisbestdescribedasusingavarietyofnursinginterventions,including

thosethataredependent,independentandinterdependenttotakecareofeachpatientasawhole.

Nursingpracticedoesnotjusttreatthephysical,butthecognitive,affectiveandpsychomotor

domains.

Many of my classes and experiences as a nurse have centered in this area of nursing

practice. Based on the bullet point, performs direct and indirect therapeutic interventions that

incorporate principles of quality management and proper safety techniques based upon

assessment findings, I have used evidenced-based practice to guide my interventions such as

pain management (as discussed in my Therapeutic Nursing Interventions paper) and the use of

different types of medications and interventions, the care of a patient recovering from anesthesia

and surgery, and, through my palliative care class, how to help patients and their families through

difficult times. In my palliative care class, I learned how beneficial palliative care can be and the

many resources that are available to my patients and their families. No longer is the word

palliative a condemning word- it provides help and resources and a sense of comfort for the

families involved. Everyone deals with terminal illnesses and death differently. In my Palliative

Care Class, we did a PowerPoint on a selected culture group. I chose to research how Indians

deal with end of life issues. I chose that group of people, because, at my other job, I have many

patients who are Indian. It was an eye-opener to the different views they have regarding

illnesses, treatment, death and the funeral.

Communication
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Communicationincludesverbal,nonverbalandwrittentechniquestailoredtoeach

patient,theirfamiliesandthestaff. Thebullet,Usestherapeuticcommunicationwithinthe

nursepatientrelationshipappliestomanyinstanceswithinmyschoolworkandjob.

The first class that comes to mind when I think therapeutic communication is my

psychiatric nursing class. Before I became a nurse, I thought this really only applied to those

who cried or those with psychiatric issues. Working in the recovery room has shown that

therapeutic communication applies to anyone and everyone. I use it daily to console children

who wake up scared, to those who experienced a spontaneous abortion and miscarried, to those

who are newly diagnosed with cancer and underwent their first surgery, and to their families who

are in the waiting room, scared for their loved ones.

Teaching

Teaching is a big part of nursing and involves so many different strategies. Teaching is

vital when taking care of a patient. The nurse should always be teaching their patients, their

families and other staff. Nursing is a profession of constant learning and teaching. Daily, I use

the bullet, Provides teaching to patients and/or professionals about health care procedures and

technologies in preparation for and following nursing or medical interventions.

In my Nurse as Educator class, we had to choose a problem we see at work that needed a

teaching session. I choose to educate my co-workers on how to properly fill the SBAR form out

as a means of report to the next nurse, either within the PACU or on the unit. The teaching

session included the use of PowerPoint, poster, demonstration, discussion, and return

demonstration. After the session was complete, nurses were evaluated on their competency of

completing the SBAR form. As a result of the teaching session, it was discovered how much
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time, culture, age, and experience play into the receptiveness of the learner. Some of the more

experienced nurses would say that they did things a certain way for years and years and seemed

to be the hardest to comply. I taught nurses from Haiti, Africa, and the Philippines and did not

come across any problems with communication or compliance.

Research

Researchshouldbethebasisofmostofournursinginterventions.Foreachintervention,

weshouldbethinkingaboutevidencebasedpracticeratherthanwhathadbeenpreviouslybeen

done. Thebullet,Evaluatesresearchthatfocusesontheefficacyandeffectivenessofnursing

interventionsappliestowhatourgoalinresearchshouldbetobeanefficientandeffective

nurse.

In my Nursing Research class, we had to work as a group to address a problem using our

research skills. My group wrote a paper on proper hand hygiene including proper technique,

supplies used, and promoting it at work. We researched which material was effective against

certain bacteria such as C.Diff and the wash/rub times. This paper took something as simple as

hand washing and gave it substance and purpose. Not only was I washing my hands at work

because they were dirty and it was a habit, but I was more conscious of why I was washing them

and how long I needed to wash them. I also paid attention to what bacteria I may have had on

my hands and how to effectively kill the germs.

Leadership
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Leadershipincludesselfdirection,professionalaccountability,andadvocacy,whichare

surroundedbylegalandethicalstructures.Itisimportanttolearnthebasicsofnursingaswell

asthenursesscopeandhospitalpoliciesinordertobecomeaneffectiveleader.

My assistant director, Valorie, has shown me how an effective leader grows and works.

She defines the bullet, articulates the values of the profession and the role of the nurse as

member of the interdisciplinary health care team. She strives to empower each nurse and to

give us a voice in any decision made. In my Nurse Leader Interview Paper, I described Valories

leadership qualities and styles. She loves to encourage nurses and pushes us to do more. I have

learned, through the leadership class, what style I would strive to achieve and how I can be an

effective leader.

Professionalism

Professionalismincludesadvocacy,accountabilityandadherencetostandardsofpractice

andlegalandethicalprinciples.

Itisimportantfornursestoknowtheirorganizationspolicyandwheretofindthem.

WiththehospitalthatIworkat,wehavePolicyStat,whichisfoundonthehospitalintranet.

Here,IcanfindthepolicyonanysubjectIwant,suchasbloodproductsadministration.I

believe,withprofessionalism,comesstandardsandconsistency.Thebullet,differentiates

betweengeneral,institutional,andspecialtyspecificstandardsofpracticetoguidenursingcare

appliestogeneralstandardsofpractice(general),hospitalpolicy(institutional),andPACU

specificstandardsofpractice.Forinstance,whenIgiveapainmedication,Imustfirstassessthe

pain.Imustaskthepatientwhereithurts,howlongithasbeenhurting,whattypeofpainitis,
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andpainscaleofseverity.AfterIadministertheappropriatemedication,Imustreassessthepain

tomakesurethereisimprovement,ortryothermedicationsorinterventions.Thisexample

reflectsgeneralstandards.Forhospitalpolicy,ImustdocumentinMeditechtheassessmentand

reassessment.ForPACU,Icangivemultipledoseswithinashortamountoftime,whilealso

tryingothertypesofmedications.Theycouldnotdothatonthefloor.

Culture

Nurses should always be sensitive to each patients culture. In order to help each patient,

we should understand their culture and how to best communicate with them. Not only does a

persons culture play into their treatment, but also their family situations, financial backgrounds,

religion, gender, lifestyle, age, and experiences in life.

When I took the Palliative Care class, I gained a better understanding of how different

cultures view death and grieving and was able to apply the bullet, demonstrates sensitivity to

persona and cultural definitions of health, and how these beliefs influence an individuals

reactions to the illness experience and end of life. Not everyone views death like Americans.

Some cultures, like the Indian culture, view death as a stage of life and many of them believe that

they should die on the ground. There are certain rituals performed before death and after death

that nurses should be aware of and be sensitive to.

Some people come from different religions that practice a certain way. For instance, I

have had Muslim men as patients and knew, that at certain times of the day, they would be

praying, with their small rug and would chant fairly loudly. I quietly closed the doors to give

them privacy and to also create calmness for my other patients that it might be disturbing to.

AppraisalandSummary
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WhenIfirststartedmyBSNjourney,Iwasalittleapprehensive,thinkingthatIalready

learnedthemajorcomponentsofnursingwithmyassociatesdegree.But,asIprogressed

throughouttheprogram,Irealizedhowmuchthisprogramhasaddedtomycurrentpractice.I

amgladthatIbecameanursefirstbeforereceivingmybachelorsdegree.Ihavetakenreal

nursingpracticeandappliedittomystudies,aswellasmystudiesbeingappliedtomynursing

practice.Someofthehugebenefitsofthisprogram,forme,havebeenthevalueofnursing

research,improvementsofmywritingskills,palliativecarenursing,nurseeducation,leadership

skills,andhowtobecomeamoreprofessionalnurse.

Nursingtheoryhasinfluencedmyoverallphilosophyandpracticeofnursingthrough

applyingresearchandfactsthathavebeentestedandfoundaccuratetomyeverydaypractice.I

lookatpolicies,researchstudies,evidencebasedpracticeandexperiencegainedasmyguiding

factors.ThroughstudyingFlorenceNightingaleandothertheorists,Ihavelearnedtotreatthe

wholepatientandnotjustthephysical.

IhaveseenmuchprogressasanursesincemyenrollmentintheBSNprogram.Ihave

appliedmyresearchonpainmanagementandmultimodalapproachestomyeverydaypractice.

Patientoutcomeshaveimprovedaswellaspatientandfamilysatisfaction.Theseoutcomeshave

taughtmethevalueofresearchandhowitbenefitseveryone.

MygoalshavenotchangedmuchbetweenbeginningmyBSNjourneyuntilnow.Iwas

entertainingtheideaofcontinuingontomyMastersdegreeandbecomingaNursePractioner,

orbecomingaCertifiedRegisteredNurseAnesthetist(CRNA),buthavenownarroweditdown

tobecomingaCRNAaftertakingasmallbreakinbetween.Iwouldliketocontinuemyinitial

goalofbecomingabetterwriterandresearcheraswell.
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Conclusion

Inconclusion,myexperienceatOldDominionUniversityhasbeenapositiveone.I

havegainedvaluableknowledgeonresearch,criticalthinking,nursingpractice,educationand

leadershipthatIknowwillaffectmycareerasanurseforever.Ihopetocontinuegrowingand

learningasanurseandtobewellroundedsothatImayhelpmypatients,theirfamiliesandmy

coworkers.

"I pledge to support the honor system of Old Dominion University. I will refrain from any form

of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a

member if the academic community, it is my responsibility to turn in all suspected violators of

the honor system. I will report to Honor Council hearings if summoned." Erin Keim
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Appendix

Practice Summary Paper

NURS 403- Transition to BSN Practice

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.

The assignment is designed to help you prepare for your Portfolio. The Practice

Summary Paper is designed to demonstrate the attainment of the 8 core competencies in general.

The Portfolio demonstrates the achievement of the Core Competencies through the attainment of

specific elements [the bullets] within the Core Competencies.

Approach to Assignment
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This paper helped me to realize my development as a nurse and as a student working

throughout this BSN program. Though there were not any references included, there were many

clinical experiences and college papers included showing detail in my attainment of each of the

eight core competencies.

Reason for Inclusion

I included this paper in my Portfolio because it summarizes all the hard work I put into

going to school for my BSN. It showcases my growth as a nurse and in writing. One of my

educational goals was to become a better writer. Although my writing still needs work, it has

improved since my first class. I have learned how to research better and to become more

professional in my papers.

Critical Thinking

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

Revises actions and goals based on evidence rather than conjecture.

Nursing Practice

Performs direct and indirect therapeutic interventions that incorporate principles of

quality management and proper safety techniques based upon assessment findings.

Communication

Uses therapeutic communication within the nurse-patient relationship.

Teaching

Provides teaching to patient and/or professionals about health care procedures and
technologies in preparation for and following nursing or medical interventions.
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Research

Evaluates research that focuses on the efficacy and effectiveness of nursing

interventions.

Leadership

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

Professionalism

Differentiates between general, institutional, and specialty-specific standards of

practice to guide nursing care.

Culture

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.

Practice Summary Paper Grading Rubric

Criteria Comments Points

Introduction
Why did you enroll in the RN>BSN program?
What did you hope to accomplish by obtaining this
degree?
Did your goals change during the program? (4)
Critical Thinking
How did the activities chosen demonstrate
attainment of behavior?
Correlate an example to one or more defining
characteristics. Provide specific examples from
coursework or your nursing practice demonstrating
attainment of behavior.(9)
Nursing Practice
How did the activities chosen demonstrate
attainment of behavior?
Correlate an example to one or more defining
characteristics. Provide specific examples from
coursework or your nursing practice demonstrating
attainment of behavior.(9)
Communication
How did the activities chosen demonstrate
attainment of behavior?
Correlate an example to one or more defining
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characteristics. Provide specific examples from

coursework or your nursing practice demonstrating
attainment of behavior.(9)
Teaching
How did the activities chosen demonstrate
attainment of behavior?
Correlate an example to one or more defining
characteristics. Provide specific examples from
coursework or your nursing practice demonstrating
attainment of behavior.(9)
Research
How did the activities chosen demonstrate
attainment of behavior?
Correlate an example to one or more defining
characteristics. Provide specific examples from
coursework or your nursing practice demonstrating
attainment of behavior.(9)
Leadership
How did the activities chosen demonstrate
attainment of behavior
Correlate an example to one or more defining
characteristics. Provide specific examples from
coursework or your nursing practice demonstrating
attainment of behavior.(9)
Professionalism
How did the activities chosen demonstrate
attainment of behavior?
Correlate an example to one or more defining
characteristics. Provide specific examples from
coursework or your nursing practice demonstrating
attainment of behavior.(9)
Culture
How did the activities chosen demonstrate
attainment of behavior?
Correlate an example to one or more defining
characteristics. Provide specific examples from
coursework or your nursing practice demonstrating
attainment of behavior.(9)
Summary
Discuss and reflect on your learning, skill
attainment and growth as a nurse with the
coursework of the program. Three (3) part
summary as discussed in Paper Guidelines.
How has knowledge of nursing theory influenced
your overall philosophy and practice of nursing?
How has your practice changed as a result of your
enrollment in BSN program? Intro page attached
as appendix (4)
Grammar/syntax (10)

APA formatting (10)

Total
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