1 Running Head: Self-Assessment of Standards

Self-Assessment of Nursing Standards of Practice Kym Otremba Ferris State University

2 Running Head: Self-Assessment of Standards Abstract This professional development plan will describe and analyze my professional behaviors using the current American Nurses Association (ANA) standards of practice. It will explain my roles as an emergency room nurse. I will explain my five year and ten year goals.

3 Running Head: Self-Assessment of Standards Professional Development Plan Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. I have wanted to take on the role of a nurse for as long as I can remember. In the following pages of my professional development plan, you will find my current practices according to the ANA standards. I will also include my five and ten year goals. Standard 7: Ethics A registered Nurse should practice ethically. The ANA standard of ethics ensures that nurses deliver safe, autonomous care while respecting the patients dignity, rights, values and beliefs. The ethics standard recognizes the centrality of the healthcare consumer and family as the core members of the healthcare team, upholds confidentially, informed decision making, maintains therapeutic and professional healthcare consumer-nurse relationships, speaks appropriately and advocates for equitable healthcare consumer care.(ANA, 2010, p.47) I take into account these ethics on a daily basis in my current practice. I am an emergency room (ER) nurse and therefore I work with multiple patients and families on a daily basis. I treat everyone with the same amount of respect and dignity they deserve. There are days in the ER that can be very challenging. I have multiple patients that abuse the emergency room for narcotic pain medication. As a nurse working full time in the department, I see these patients weekly for the same thing over and over again. Our doctors are contracted from a different area, so they dont always recognize the patients. It is my duty to inform the doctor of the recurrent ER visits; however they have the final say as far as treatment and prescriptions. I personally try to respect these patients and treat them each time as if it is

4 Running Head: Self-Assessment of Standards their first. This becomes difficult after being lied to over and over again, or seeing their names in the local paper for running a drug house. Ethically I feel it is important to educate these patients on the use of the emergency room while still respecting them and maintaining their dignity. Its important to keep in mind that just because I dont agree with their behavior, I still need to treat them. Standard 8: Education Continuing education is a standard for all nurses. This will keep us up to date in our nursing care. The registered nurse attains knowledge and competence that reflects current nursing practice.(ANA, 2010, p. 49) Each facility has ongoing education that must be completed to remain competent in your current practice as well as state regulated education. In my practice, I have monthly readings with tests that must be completed. Yearly competencies including airway management, IVs, medication calculation, intraosseous insertion, monitors, chest tubes, and pacemaker setup must be demonstrated. I am also advanced cardiac life support (ACLS), basic life support (BLS) and pediatric advanced life support (PALS) certified. I am currently working towards my masters of science in nursing (MSN) hoping to become a nurse practitioner (NP). I am mandated to maintain an education file at work. Working in an ER I learn something new every day. I am privileged to work with an exceptional group of doctors and seasoned nurses that love to educate. I have been an RN in the ER for six years so I take every opportunity to teach others. It can be very rewarding to teach someone about a disease process or new diagnosis. I feel that if the nurse is knowledgeable the patients are more comfortable in stressful situations. Standard 9: Evidence-Based Practice and Research The registered nurse integrates evidence and research findings into practice.(ANA, 2010, p. 51)

5 Running Head: Self-Assessment of Standards Every day I use evidence to base my practice on. We order lab work, x-ray, cat scans, and other studies to base our treatment. It is evidence to prove a diagnosis. The medicine and treatment I give after all the tests are complete is based on research that someone has done. I was part of a research group in our facility to determine if it is ethical for nurses to insert intraosseous (IO) devices. An IO device is another way to gain vascular access when peripheral IVs are not an option. Months of research ended with our emergency room nurses being able to insert the IOs. I am proud to have been part of this project and I am responsible for the yearly education on the IO. I have to complete yearly competencies to remain competent with the devices. Being involved in this research and actually seeing an outcome that will benefit our patients, makes me want to be involved in more research. I have not had any opportunity to do research since the IO, but I hope to do more in the future. Standard 10: Quality of Practice According to the ANA, the registered nurse contributes to quality nursing practice.(ANA, 2010, p. 52) On a daily basis in my practice I have to use creativity to treat my patients. I have to individualize my patient care based on the situation to enhance the patient outcome. I see a wide array of patients and each of them is individual and deals with emergency situations differently. For example, parents bring their children in for small non emergent things however to them it is an emergency. I have to come up with ways to keep the parents informed and calm in the situation. I do this by talking calmly to the parent and child and explain everything I do to the child. Formulating recommendations to improve nursing practice and outcomes (ANA, 2010, p. 52) is necessary in contributing to quality care. We as nurses should take any experience and evaluate it and if it doesnt work, give suggestions that will improve the situation. In my practice

6 Running Head: Self-Assessment of Standards I have found that not all kids like to step on the scale to be weighed. I know this is a very important part of medication administration so to ease their anxiety I have the parent weighed and then re-weighed holding the child. This not only alleviates stress from the child it shows the parents that I am personalizing patient care for the comfort of the patients. As a graduate nurse one day I hope to be more involved in the design and implementation of policy to improve patient care. Standard 11: Communication The registered nurse communicates effectively in a variety of formats in all areas of practice.(ANA 2010, p. 54) I take great pride in the way I communicate with my patients. As stated previously, I work in the emergency room and each patient is different with a different situation. I have to be able to communicate in many different ways on a daily basis depending on the patient I am treating. I have the advantage of working close with the physicians, so we are in constant communication regarding patient care and outcomes. I learned a valuable lesson while my grandpa was being treated at a hospital. He was sent home with a catheter. He had never had a catheter before and the nurse came in and attached a leg bag and said empty it twice a day and keep track of the urine in the bag. My grandpa had no idea what she was talking about and looked to me for guidance (thankfully I was a nurse). I learned that day that I have to not only be a good communicator with my patients, but a great communicator. From that day on, I learned to talk to my patients in a manner that they can understand and also learned to listen to the questions and concerns they have. Standard 12: Leadership I think as nurses we are leaders. We take on roles that are uncomfortable and live through our career. I treat colleagues with respect and dignity. I try to influence my patients,

7 Running Head: Self-Assessment of Standards family and friends. The registered nurse demonstrates leadership in the professional practice setting and the profession.(ANA, 2010, p.55) My patients look to me for answers and guidance. They need to be assured I am confident in my treatment. In my practice, I delegate tasks as needed and take on tasks delegated to me. I am a mentor to student nurses when they are assigned to our department. I provide support and education to other nurses when they are not confident in a task. I have a hard time delegating to my coworkers; some of them have been nurses 20 years longer than I have. I find it intimidating to take the lead in a crises situation and have the other nurses looking at me for direction. I have taken on this task many times and I seem to be getting more confident with every experience. For example, if I am assigned a code blue patient it is my duty to assign who is doing medications, CPR, charting and all other tasks that encircle a code blue patient. Even though I am the lead nurse in that situation, my department is very good at teamwork and we do what is best for patient outcomes. Standard 13: Collaboration According to this standard, Nurses partner with others to effect change and produce positive outcomes through the sharing of knowledge of the healthcare consumer and/or situation. (ANA, 2010 p. 57) I feel that collaboration is the single most important of my current practice. I have the support of nurses and doctors in the emergency room and we work collaboratively to treat our patients. Not one person can do all the tasks at hand so we work as a team to meet outcomes. We are a close group and always rely on each other for help. I dont think anyone in our department is afraid to ask for help when needed. It also important in the emergency room to involve the patients in the care they are provided. Standard 14: Professional Practice Evaluation

8 Running Head: Self-Assessment of Standards I am most critical of my nursing performance. Actually, my boss is pretty critical also! According to standard 14, registered nurses evaluate her own nursing practice in relation to professional practice standards and guidelines (ANA, 2010 p. 59) I think it is important to look at how one performs as a nurse and evaluate each situation differently. I take pride in being a nurse, I love my job and I think that reflects on my professional practice. I am always interested in learning and looking for ways to improve my practice. In our department we have yearly evaluations, peer review and patient satisfaction surveys. Unfortunately, I find that my weakness is reflecting on my performance mainly when something goes wrong. I do look at cases and try to determine what could have been better, but I find myself doing it more when a patients experience was poor, or they have a bad outcome. I also have a hard time with peer review. I dont want my peers to know that I give them a poor evaluation because it may affect our working relationship. I continue to work on these negative aspects of my practice. Standard 15: Resource Utilization The ANA standards (2010) state the registered nurse utilizes appropriate resources to plan and provide nursing services that are safe, effective, and financially responsible. (p. 60) I work in a rural hospital. I tend to use other departments for resources. I call the pharmacy when I have a medication question, the case manager when I need help getting a patient to a nursing home, the financial lady when people cant afford to get the prescriptions they need, and my coworkers when I need help doing a new procedure or something I am not comfortable with. Standard 16: Environmental Health Practicing in an environmentally safe and healthy manner (ANA, 2010, p. 61) keeps nurses and patients safe. We use standard precautions to protect ourselves and our patients. Our

9 Running Head: Self-Assessment of Standards equipment is checked daily to make sure it is safe for use. By doing all of these things I continue to provide a safe environment for me and my patients. I can evaluate our environment by walking into a patients room. I look at the patient, listen to the equipment, and sadly smell is very important. (ANA, 2010) In the emergency room there is so much going on I sometimes tune out smells, patient alarms, and people around me talking. This can be a weakness, because patients may need my immediate attention and it may take me a few extra minutes to respond. I am working on paying better attention to the environment around me. Goals Five Year Goals The most important five year goal I want to achieve is getting my Master of Science Degree in Nursing (MSN) with a focus as a Nurse Practioner (NP). I am currently obtaining that goal by attending Ferris State University (FSU) RN to MSN online program. A NP focus is not offered through FSU, so I plan on transferring to Michigan State University to finish. I also want to become more involved in my organizations planning committee. Ten Year Goals In the next ten years I want to be efficiently practicing as a NP. I want to be part of an ER physician group and continue to work in my ER. The physician group that is employed in our organization hires nurse practitioners to work alongside physicians to provide emergency care. I want to become part of an Advanced Nurse professional organization so I have organizational support and to further enhance my career. Evaluation

10 Running Head: Self-Assessment of Standards Both my five and ten year goals are obtainable. I am well into my program at FSU and hope to be completed with all the credits needed to transfer to MSU by December 2013. I have a great professional relationship with the physician group I want to work with; therefore I do not see any problems getting a job through that group. I have a full time job, I teach two aerobics classes a week, and I am a single mom of a beautiful six year old daughter. I do find it challenging to stay diligent in my studies, but I have the drive to accomplish my MSN in nursing. Conclusion Throughout this paper I have taken standards from the ANA and related them to my current practice. I have reiterated the importance of ANA standards and how they affect me. I feel if I follow this professional development plan and work to obtain my goals, I will be an efficient, productive Nurse Practioner.

References

11 Running Head: Self-Assessment of Standards American Nurses Association (ANA) (2010). Nursing: Scope and Standards of Practice (2nd Ed.). Silver Spring, Maryland: Author .

12 Running Head: Self-Assessment of Standards Appendix A Five year Goals Complete MSN Expected Completion December, 2014

Transfer to MSU to get my NP December, 2014 Ten Year Goals Working with ER group as NP Join Advanced Practice Professional Organization Expected Completion December 2016 December 2018