Running head: FINAL REFLECTIONS

Final Reflections
Andrea Hunter
University of Arizona

Running head: FINAL REFLECTIONS

2
Final Reflections
Overview

Nursing today is expanding into amazing and deeper waters of responsibility and power
in healthcare and beyond. Working as a medical surgical nurse 10 years ago, where an associates
degree was sufficient, now more commonly requires a four-year degree. That is what spurred my
want to further my education. I felt I was becoming part of the crowd, and I wanted to maintain
my marketability for future jobs. Another goal was to expand my nursing knowledge. Having
some years of experience under my belt made me feel now was an excellent time to apply them
to this new endeavor. Another ambition that kept me going throughout the program was my want
to become a more empowered nurse. I wanted this program to help me become re-validated that
this amazing profession is truly limitless in possibility and opportunity. It did that and more, and
I am a new person because of it.
I have had read some amazing, informative, powerful things over the last 15 months.
There were three references I feel have formed not only my thinking regarding clinical systems
leadership, but also affirmed and fostered my current leadership style. Turkels 2014 article titled
Leading from the heart: Caring, love, peace, and values guiding leadership truly allowed me to
embrace my leadership style. It reminded me to lead from a place of love and compassion, with
open communication and mutual respect and a focus towards self-care at the core. The book
Quality and Performance Improvement in Helathcare: A Tool for Programmed Learning (Elliot
& Shaw, 2012) and the Institute for Healthcare Improvement (IHI) website both reminded me
that many errors occurring in healthcare today come from incorrect processes and lack of
communication rather than staff negligence.

Running head: FINAL REFLECTIONS

Some highlights of my educational journey include my statistics class. Because of my

nursing experience I was able to apply concepts to real life situations and truly understand what I
was learning. The book was so excellent I even wrote the author telling her as such. Another
highlight was the holistic nursing class. It allowed me to remember why I wanted to become a
nurse, the importance of self-care, and the ability to create a healing environment with simply
intention, without any process or policy change or a dollar spent. I came out of that class a new
person, and as a result later on in my career I would like to earn my PhD in holistic nursing.
Program Outcomes
All of the classes in this program helped me in my ability to design and patient centered
care in a variety of areas. This came naturally through course design with the focus on topics in
which we were not experts, such as me taking on COPD for my immersion project, to working
with health promotion and prevention of childhood injury, or working to develop an entire
clinical research office. As a result, I have applied my education in working with our unit Shared
Leadership Council to develop practice improvement projects and improve patient care, and I am
a better and more effective leader in this endeavor.
The group work done throughout this program allowed me extensive time to work with
others unfamiliar to me in a variety of practice situations and areas of expertise. Working with
the group to develop a disaster plan and root cause analysis in simulated real-time allowed us
excellent practice to develop skills to adapt and work well with a focus on high quality and the
end result. This scenario truly was beneficial to me when I was a member of our
interprofessional team developing a disaster prevention plan to treat patients with Ebola. I was an
active member of the team, and took team decisions to staff to prepare and inform them,
allowing them to perform their jobs with more confidence.

Running head: FINAL REFLECTIONS

The holistic nursing course truly helped develop my ability to apply healing through a
bio-psycho-social perspective. I have applied this concept extensively in my nursing practice.
Through peaceful, caring, and loving intention I work to provide patient care. Not only does this
not cost any money, it is so easy to do with a simple change of perspective and can be taught to
anyone. I was also reminded the importance of self care; which without it would render my own
abilities to then care for others less effective. Understanding the entirety of a patients story helps
them heal even faster, and helps me as a nurse find the best way to lead them down that path.
Healthcare technology is growing at a rapid pace in healthcare today, and its
incorporation into patient care to develop and improve evidence-based practice is essential.
Perhaps most important is the improvement of communication on all levels-but especially with
healthcare provider to patient. Electronic health records, telemedicine practices such as home
monitoring, wireless vital sign communication, video patient consultations, personal health
records, and electronic wireless education and communication all improve patient care through
the ease and transparency of information and education. In the development of a program to care
for patients with COPD, my group was able to utilize extensively the electronic and personal
health records for communication and education purposes. For risk reduction and health
promotion, we utilized population-specific, targeted technology-based care that incorporated a
computer kiosk survey that delivers tailored patient education based on personal needs. This has
helped me in the promotion of technology use in practice areas, especially for patient education.
For instance, I now work frequently with interdepartmental healthcare professionals and nurses
to develop and produce educational patient videos. We have made videos on post-surgical
education and processes, nutrition, and transplant medication and home care enhancement to
name a few, and deliver this education via tablets and offering DVD copies.

Running head: FINAL REFLECTIONS

Care coordination throughout the care continuum and transitions is essential for safe,
quality patient care and positive outcomes. Communication is key in this endeavor. The
development of effective communication techniques utilizing technology, care coordinators, and
a diligence in their effective use is essential. Nurses play a huge role in the collaboration and
communication on the patients behalf. We see the patient throughout the care continuum and
develop trusting and caring relationships. This gives us the unique ability to coordinate care
effectively and with an understanding of the entire care process from a holistic perspective. The
leadership immersion course has allowed me extensive practice in care coordination of the
COPD patient population, working to develop an entire care coordination plan for their proper
education and to maximize positive outcomes in this high-risk population. I apply concepts of
care coordination every day on my floor, working with patients with chronic disease and new
diagnoses and developing collaborative plans, education, and service referrals for them for the
safe and effective transition to discharge. I have a deeper understanding of the care coordination
process and the whole system perspective needed to be an effective patient and family advocate.
It is essential to remember the role of evidence-based practice in healthcare. When
properly applied, care improves and outcomes follow suit. The challenge is promoting change
towards evidence based practice improvement in a timely fashion, which can be painfully slow.
Nurses have the responsibility to promote practice improvement and evaluate and question the
status quo of their current practice. Working to design, coordinate and evaluate systems allows
nurses to improve practice with patient-centered care at the core. As a result of this program, I
have gained a deeper understanding of the necessity for change, the process in which it needs to
occur and how to positively influence staff to accept and embrace it in their practice. Through
my work in guiding my units Shared Leadership Council I utilize evidence-based knowledge

Running head: FINAL REFLECTIONS

combined with practice improvement processes and plan-do-study-act cycles to promote change.
Our monthly meetings evaluate our current systems and take into account process improvement
opportunities, and in analyzing tests for change implement positive changes into practice.
Conclusion
This journey reminded me time and time again some things are worth waiting for, and what is
gained from knowledge and empowerment is worth the time and effort. I can now call myself
among the small (but growing!) number of advanced degree nurses, which certainly makes me
more marketable. My nursing knowledge has expanded exponentially as well. I appreciate
having experience to apply to concepts learned, and I feel I have a well-rounded, deep
understanding of concepts related to nursing and nursing leadership. This, in turn, causes me to
feel truly empowered by my abilities and influence as a nurse and a nurse leader. I feel so excited
about the future of nursing and in the roles I can play and the change for which I can be catalyst.
Strengths I have developed as a result of this program include a more clear
communication style. Online communication and group work necessitates this, however it can
easily be applied to real-life situations in the collaboration of care and communication in a fastpaced hospital environment. I am more confident in my skills as a leader and in my leadership
style, accepting my weakness as what makes me who I am and my strengths as what I can
uniquely offer to the team. I have a strong holistic leadership perspective allowing me to develop
caring relationships based on mutual respect and trust. My personal vision for my future is to be
a motivating, caring and inspirational leader that empowers nurses to be more than they are,
embrace change, and question the status quo. I want others to follow me not because they have
to, but because they recognize my drive, compassion and passion for what nurses can be, and
what we can give to patients and the community to improve the lives of others.

Running head: FINAL REFLECTIONS

References
Turkel, M. C. (2014). Leading from the heart: Caring, love, peace, and values guiding
leadership. Nursing Science Quarterly, 27(2), p. 172-177. doi
10.1177/0894318414522663
Elliot, C., Shaw, P.L. (2012). Quality and Performance Improvement in Healthcare: A Tool for
Programmed Learning. Chicago, IL: American Health Information Management
Association.
Institute for Healthcare Improvement (2014). Retrieved from
http://www.ihi.org/education/ihiopenschool/Pages/default.aspx