Running Head: SELF-ASSESSMENT

Self-assessment Of Competency
Cameron Verkaik
Ferris State University

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Abstract
This paper discusses the American Nurses Association Scopes and Standards of Practice. Each
standard is evaluate based on my own personal view point. I then analyze where I believe I am
at in my nursing career in regards to being competent in that specific standard. This paper also
analyzes the code of ethics as written by the ANA. This is analyzed in a step wise fashion. I
determine where I am at in regards to each provision. At the end I analyze where I feel I need
most improvement and how I can achieve competency in these standards.

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Self-assessment of Competency
The ANA has laid out a set of sixteen scopes and standards of practice. They are based
on the nursing standards of assessment, diagnosis, outcome identification, implementation,
evaluation, and planner (American Nurses Association, 2010). These standards drive the nursing
profession and given nurses a guideline to follow. When coupled with the Code of Ethics for
Nurses you have a well-developed road map for what a nurse should strive for. If followed, they
allow for nurses to develop skills which best serve the patient population. They are able to adjust
and critically think on their feet. These are two tools every nurse must be aware and should use
on a daily basis. Nurses should use these to evaluate themselves and determine where they need
to grow. In this paper I will discuss each standard and each code of ethics as described by the
ANA. I will then evaluate myself on each one to determine where I need work.
Standards of Practice
Assessment
The first standard of practice is assessment which states the registered nurse collects
comprehensive data pertinent to the healthcare consumers health or situation (ANA, 2010, p.
32). In order to demonstrate competency of this standard a nurse must be able to collect data
through methods such as they physical assessment. They must be able to use this data to care for
the patient while keeping the patients preferences in mind (ANA, 2010). The nurse must also be
able to accurately document this data (ANA, 2010.) This needs to be done in a timely manner
while prioritizing the data collected in order to better anticipate the patients needs as well as
those of the healthcare provider (ANA, 2010).

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I have met this standard during my clinical experiences while assessing patients and
documenting my findings in Cerner. Cerner allows me to be look at data collected by me and by
others caring for the patient. I am able to determine the clients current status by reviewing and
analyzing their blood work as well as reviewing the findings from any procedures or exams done
on the patient. I can compare this data from when the patients was admitted up to current time.
This allows me to better anticipate clients needs. It also allows me to better inform the
healthcare provider about the patients current condition. I have used Cerner to document
patients assessment findings. I have found important changes in lung sounds that were not
similar to those previously documented. I was able to notify the healthcare provider who was
then able to order treatment needed to decrease the patients discomfort and improve their
respiratory function quickly.
Diagnosis
This standard states, The registered nurse analyzes the assessment data to determine the
diagnoses of the issues (ANA, 2010, p.34). Competency in this standard requires that the nurse
must be able to analyze data and determine any issues that may be present (ANA, 2010). They
must be able to document these finds in a specific way that allows for quick and appropriate
treatments to be put into place. Issues may involve the patient, family, or other healthcare
providers (ANA, 2010). The nurse must also be able to relay this data to the primary physician
as well as family and the patient clearly and concise.
AS stated above, I have fulfilled this requirement in my daily duties as a nursing student.
I have performed many assessments on patients who have suffered from a wide variety of
illnesses. From the data I have collected during the initial assessment I was able to focus on the
systems which were of most importance. Have this data allowed me to anticipate any need the

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patient may have as well as the family. Through documentation in Cerner I was able to relate the
current illness to past medical history. I would analyze the labs to determine if the illness was
improving or getting worse. From here I developed a care plan for the patient which included
nursing diagnosis. This allowed me to generate goals as well as interventions needed for patient
to reach these goals.
Outcomes Identification
Standard three states, The registered nurse identifies expected outcomes for a plan
individualized to the healthcare consumer or the situation (ANA, 2010, p. 35). In order for a
nurse to meet this goal, they must be able to define expected outcomes and incorporate these into
the care of the patient. These must be culturally sensitive and meet the goal set related to the
expected outcome (ANA, 2010). Outcomes must be measurable modifiable according to the
situation (ANA, 2010). This must all be done with cost, risks, benefits and the consumer in mind
(ANA, 2010).
I have not had much experience with this standard. I do not feel that I have mastered it as
of yet in that I have not been able to follow a patient for a long enough period of time to fully
follow through with a plan of care and see it to the end. I have put in place many plans of care
for the day I have been with a patient such as walking three times a day or make sure to
reposition a patient every two hours due to risk of skin breakdown. This information is then
document in the patients chart and walks are written on the board. This gives the patient a visual
goal that they see every day. I have found that in writing the walks on the board has prompted
them to ask to go for a walk more often so they can fulfill the requirements.
Planning

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The fourth standard states, The registered nurse develops a plan that prescribes
strategies and alternatives to attain expected outcomes (ANA, 2010, p. 36). To fulfil this
standard, the nurse must be able to developed plans of care which are patient centered and
focused. The patient should be included in the development of the plan. It needs to include the
specified diagnoses and take into account the patients cultural background, values, and beliefs
(ANA, 2010). Like all plans of care, it needs to be measurable, attainable, specified by time, and
changeable. It must be based on evidence of best practice as well.
I have fulfilled this requirement through the development of a plan of care for a patient
who had just had a total knee replacement. It took into account their living situation as well as
who would be there to assist them. It included a specific number of times to do the exercises
prescribed as well as level of measurement for improvement which included an increase in the
angle of extension and flexion of the knee joint over a period of two weeks.
Implementation

Evaluation
This standard specifies that the nurse evaluates progress toward attainment of outcomes
(ANA, 2010, p.45). To demonstrate competency in this standard the nurse must do an ongoing
assessment of the patient and their progress towards the goal identified. They are able to revise
the plan if needed and implement the revised version. This includes assessing and ensuring that
the treatment being used is effective and warranted (ANA, 2010).
I have had a lot of experience with this standard of care during my clinical. I have had
the opportunity to care for many patients with pneumonia over the last few months. In doing so,
I have assessed the patients lung sounds multiple times throughout the shift to determine if any

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progress is being made or if the infection is getting worse. I have also analyzed labs values to
determine the degrees and severity of the infection. I have made sure the treatment regimen
being used (antibiotics) is correct through evaluation of sputum cultures and antibiotic resistance
tests.
Ethics
This standard of practice states that The registered nurse practices ethically (ANA,
2010, p. 47). In order to achieve competency in this standard the nurse must follow the
guidelines listed in the Code of Ethics for Nurses with Interpretive Statements. They need to
protect the dignity, rights, and beliefs of the patient. They must also stand up for the patients
rights and advocate for them when an ethical dilemma arises (ANA, 2010).
I have met this standard in both my clinical experience as well as my role working as a
nurse technician. I believe keep a patients modesty and dignity intact is crucial for them to have
a good few of us as health care providers. I feel that all too often we just go into a patients room
and forget that they are people and need to be treated as such. An example would be helping a
patient with washing up. Regardless of age, if they are female I will always offer to another
female to assist them if they would like. I make sure they know that it is not a problem to do this
so that they feel they have a choice. This allows them to keep their modesty as well as have
autonomy in some of their decisions while under our care. It is a little thing but I have seen it
make a world of difference.
Education
This standard states The registered nurse attains knowledge and competence that reflects
current nursing practice (ANA, 2010, p.49). To fulfill this standard, the nurse must continue to

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be involved in education. This may take place via online learning tools or in services that come
to the floor.
This standard will be an ongoing fulfillment for competence throughout my nursing
career. As a nurse tech, I have been involved with annual competency test which are used to
make sure we are up to date on any changes that may have occurred. I have also been involved
in many in services for new devices and technology that has come to our floor.
Evidence-Based Practice and Research
Standard nine states The registered nurse integrates evidence and research findings into
practice (ANA, 2010, p. 51). To meet this requirement, the nurse must utilize current evidence
based practices in their care of the patients to help direct their care in the most effective way for
the patient. They will also seek to find evidence to help support any possible changes in policy
or procedures they wish to bring forward.
I have met this competency throughout my nursing program in the many paper I have
researched and written. All of these have used evidence based practice to guide my research and
to give me accurate and detailed findings. I was then able to share this information with my
peers.
Quality of Practice
This standard states The registered nurse contributes to quality nursing practice (ANA,
2010, p. 52). This includes demonstrating quality documentation, participating in quality
improvement, and using data to determine the quality of the nursing practice (ANA, 2010). From
here they can then analyze the quality and safety issues present and implement ways to improve
these issues (ANA, 2010).

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I have met some of the requirements of this standard such as safety, but I do not feel that I
am yet competent in it. I do not believe I will be until I am a nurse working on my own. At this
time I will be able to analyze how I care for patients. I can then better address the concerns
surrounding my care and make changes to improve it so that my patients can get the best care.
Communication
To meet this requirement The registered nurse communicates effectively in a variety of
formats in all areas of practice (ANA, 2010, p.54). This includes assessing their own
communication techniques and making sure they are appropriate for the setting such as talking to
physician or a family member. This is going to require to different styles to get the information
relayed in a manner that is clear and understandable (ANA, 2010).
I have fulfilled this requirement and will continue to work on it to maintain my
competency. I have learned many different types of therapeutic communication which allows me
to better interact with the patient. It allows me to build rapport with them. Also, when I have
discharged patients I make sure to review their depart before going to their room. This has
allowed me to take areas in it that are very medically vocabulary concentrated and break it down
into a new phrase that is better understood by the family.
Leadership
The twelfth standard states The registered nurse demonstrates leadership in the
professional practice setting and the profession (ANA, 2010, p.55). This includes showing a
commitment to continued education, treating other colleagues with respect, and developing
communication techniques to manage conflict and resolve it (ANA, 2010).
Leadership is a standard which I am still working on. I will not have fully met this
requirement until I have more experience. I dont feel that I can be a good and strong leader at

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this stage in my career. There are aspects which I will continue to work on such as treating
colleagues as I wish to be treated. I will also work towards finding ways which may contribute to
better healthcare standards for my patients and bring these ideas to management and help
implement them.
Collaboration
This standard state The registered nurse collaborates with healthcare consumer, family,
and others in the conduct of nursing practice (ANA, 2010, p.57). This is working as a team for
the greater good of the patient and their family. This allows for better communication and
development of care plans that are patient centered and focused on a positive outcome. The
nurse must also engage in team-building exercise and group discussions (ANA, 2010).
I have and continue to meet this standard. I do this by focusing on the patients wants
and needs when developing my care plans. I then communicate this the other nurses caring for
the patient. This allows for them to continue to work towards the initial goal and produces better
continuity of care from nurse to nurse. I will also become more involved in share leadership
meetings as a nurse. This will allow me to share my input with others regarding policies that I
feel could better serve the patient if changed.
Professional Practice Evaluation
Obtaining competence in this standard requires that The registered nurse evaluates her
or his own nursing practice in relation to professional practice standards and guidelines, relevant
statutes, rules, and regulations (ANA, 2010, p. 59). This involves practicing care that is based
in ethics and practicing self-evaluation of ones own skills and techniques. It also includes using
peer review as feedback and taking action to make necessary changes that agree with evidence
based practice (ANA, 2010).

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This is another standard that requires continued effort on my part to maintain

competency. I currently participate in peer review annually as a nurse tech. It has allowed me
take others input in how I provide care to make changes which helps to better serve the patient
and family members I care for. I really value the input of others and continue to encourage them
to challenge me to be better in my practice.
Resource Utilization
This standard states The registered nurse utilizes appropriate resources to plan and
provide nursing services that are safe, effective, and financially responsible (ANA, 2010, p. 60).
This requires the nurse to delegate task appropriates to certain staff members. It also
incorporates assisting the patient and family in obtaining necessary resources and services while
factoring in cost, risk, and benefits in regards to treatment plan and discharge (ANA, 2010).
I have not become competent in this standard yet. I have done some planning with the
social workers in setting up home care for patients. I have done some delegating to other student
nurses when I needed some extra help.
Environmental Health
This standard states The registered nurse practices in an environmentally safe and
healthy manner (ANA, 2010, p. 61). To obtain competence in this standard a nurse must gain
knowledge of the environmental concepts, promote environmental practice that reduces health
risks, and communicate these risk to the patient, family, colleagues, and community (ANA,
2010).
This is a standard that is going to take time and experience to become competent in. It is
going to require that I understand and know all policies. I do practice same environment to
reduce health risks by washing in and washing out of every room. I follow isolation guidelines

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and make sure to wear gloves when handling bodily fluids. I also make sure to dispose of any
biohazards appropriately as well as putting all sharps into the sharps container.
Code of Ethics
Provision One
This provisions states The nurse practices with compassion and respect for the inherent
dignity, worth, and unique attributes of every person (ANA, 2015, p.1). Every person
regardless of status deserves the same level of care with the same amount of compassion and
respect.
I feel that I have met this provision. When I enter a patiences room I leave all biases at
the door. Regardless of what I may think before entering the room I treat all patience the same.
This is especially hard with VIP patients as they feel they are entitled to more one on one care.
AS a tech I have encountered this many times and have caught myself giving them more
attention than the alcoholic in the other room.
Provision Two
This provision dictates that the nurses primary focus is to the patient or group whom
they are providing care (ANA, 2015). Each population is unique and a nurse must be able to
adapt and provide specific care related to that groups specific needs.
I am working towards meeting this ethical standard in my clinical practice. This is
something that I will learn as I continue to grow as a nurse. Being able to quickly adapt to
changing conditions is not something you can teach. Learning the preferences of each type of
population is also something I will learn. I do provide my patients with the best care I can and
treat each one as equal. Their concerns are my priority. Recently I took care of a patient who
was in tears because he was unsure of what was happening to him. I sat down with him and

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explained his situation. I then contacted the cardiology group to see if they would talk to him
some more and try to ease his anxiety. The next day he thanked me for my efforts and said he
was feeling much better about everything.
Provision Three
This provision states The nurse promotes, advocates for, and protects the rights, health,
and safety of the patient (ANA, 2015, p. 9). Much like the second provision, this involves
making your patient the priority.
I have met this standard in my clinical setting as I helped a patient understand the
importance of moving while in the hospital. When they were getting ready to discharge they
expressed concern that they were not ready. They didnt believe they could care for themselves
at home. I told them they have the right to appeal their discharge or we could talk to social work
and get rehab set up for them and in home nursing. They liked this idea and they were
discharged the next day with in home care.
Provision Four
The nurse has authority, accountability, and responsibility for nursing practice; makes
decisions; and takes action consistent with the obligation to promote health and to provide
optimal care (ANA, 2015, p. 15).
As a student, this provision is difficult for me to accomplish. I am not able to delegate
nursing tasks at this point. I do not have authority. I am accountable for the actions I take
however as well as the decisions I make. These actions are reviewed by my instructor prior to
performing them to make sure I am doing something that is going to enhance the patients health
and not diminish it.
Provision Five

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This provision says that the nurse must promote personal health and safety in order to
preserve their own integrity and to continue personal and professional growth (ANA, 2015).
I have performed this topic many times in my clinical experience. An example would be
using proper body mechanics to boost a patient or to get them up to the chair. I had one patient
who was taking three people to get him out of bed. I was not comfortable with this and
suggested the use of the sit-to-stand lift. This require only two people and put no stain on our
backs or the patients skin.
Provision Six
This standard states that the nurse must maintain a work environment that is conducive to
safe and quality care through maintaining an ethical work environment (ANA, 2015).
I have obtained competence in this provision in my time a nursing student. Maintaining
patient confidentiality is a major concern of mine. I make sure that if I am talking about a patient
to my instructor that I only use pronouns and not their name. I dont use their room number
either. I also make sure that I am not in a public setting were other patients and family members
can hear.
Provision Seven
The nurse, in all roles and settings, advances the profession through research and
scholarly inquiry, professional standards development, and the generation of both nursing and
health policy (ANA, 2015, p. 27).
I have performed this to some degree during my classes as a nursing student. This has
been done primarily through writing papers on evidence based practice. During my future
nursing career I will learning more and being more involved with promoting changes in nursing
and health policies.

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Provision Eight
This provision states The nurse collaborates with other health professionals and the
public to protect human rights, promote health diplomacy, and reduce health disparities (ANA,
2015, p. 31).
As a nursing student, I have obtained some skill in this provision but not totally. I
communicate daily with the other staff on the floor as well as physicians.

I will need to join

organizations which are involved in community total competency. I hope to volunteer a City on
a Hill ministries in Zeeland once I have obtained my license. This will allow me to promote
health to the community.
Provision Nine
This provision dictates that the nurse maintain integrity of the nursing profession through
integration of social justice and health policy (ANA, 2015).
I do not feel that I have obtained competency in this area. This is something that will
come in time once I have achieved a confident level as a staff nurse. I will then be more willing
and able to join an organization or community to better promote and integrate health policy.
Professional Development Plan
The American Nursing Association has developed the tools to help nurses evaluate their
practice periodically. I know where I am at now and will reevaluate myself once I am in
practice. Being able to follow the standards and ethics laid out for me by the ANA will allow me
to become a better nurse and better patient advocate.
Areas for improvement
There are many areas in my nursing practice which need improvement. I believe this will
always be the case. Anyone who think they do not need improvement need to reevaluate

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themselves. One part I need improvement in is communication. I have a hard time at this stage
in my career communicating with physicians and other staff as I dont feel confident enough with
my decision making. This is something I need to work on and accept that at times I will be
wrong. These times will only be learning experiences. As I work more I will become more
confident in myself and believe in myself more.
Another area I need improvement on is utilizing resources. I will complete this standard
through learning what tools I have available to me and using them. I will ask for more education
from the instructors as well as my manager once I am working. This is a standard I believe I will
always be working on. I feel it is one that can always be improved no matter how skilled a nurse
I become. With the cost of health care rising so much each year being able to assist the patient in
obtaining the cheapest healthcare possible is important to me.
I also need to learn to have authority for my nursing practice as well as leadership. This
is going to require me to become competent in my nursing duties and be confident in my
abilities. In order for me to fell competent I will need to ask for feedback from fellow nurses and
instructors. This will allow me to work on things I need improvement in and be master the skills
I am doing well. Doing this will allow me to have authority in my nursing practice. I will be
confident in the care I am providing. It will also hold me accountable for my actions.
Evaluation Plan
When I graduate I will be setting up goals for me with my manager. I will base most of
these off how I can become competent in the ANA standards of practice as well as their code of
ethics. I will evaluate myself periodically and with my manger every couple months. This will
allow me to see how I am growing and improving as a nurse. It will show where I need

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improvement and then we can discuss what I need to do in order to accomplish my goals. When
one goal is achieved we will set another goal. Always raising the bar up another step.
Conclusion
The standards in practice and the code of ethics discussed in this paper are important and
valuable to any nurse. They must be reviewed periodically be each nurse in order to make sure
they are providing the best care for their patient. These are important tools we can use to guide
our practice.

Reference
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements.
Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/
CodeofEthicsforNurses/Code-of-Ethics.aspx.

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American Nurses Association. (2010). Nursing: Scope and standards of practice (2nded.). Silver
Spring, MD: Nursingbooks.org.