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Running head: REFLECTION 1

Reflection Paper
Morgan Howe
Ferris State University


The purpose of this paper is to examine my current nursing practice. It will reflect on the
knowledge, skills and attitude I need to perform as an associates prepared nurse. This paper will
allow me to see the differences in my current practice and the bachelors prepared role as a
registered nurse (Ferris State University, 2013).


Reflection Paper
The purpose of this paper is to examine my nursing practice. It is important to reflect on
my current practice to see how it will change with my transition into a bachelors prepared nurse
from an associates prepared nurse. Ferris State University (2013) states identification of your
current scope of practice allows you to differentiate this from future practice as you transition
into the BSN role.
Margaret J. Wheatley (2002) said, Without reflection, we go blindly on our way,
creating more unintended consequences, and failing to achieve anything useful. In this paper I
will reflect on where I am in my professional career to gain insights into where I am going with
my future practice.
Current Practice
I currently work in private duty pediatric home care. I have been in this sector for four
years. I have had the privilege of working with children of varying disabilities and disorders. No
two patients have been alike. I have gained experience with ventilators, tracheal suctioning,
enteral feedings and non-pharmacologic comfort measures. In the following sections I will detail
the knowledge, skills and attitude needed in my current position.
In order to be a registered nurse I had to complete a degree program at an accredited
school and pass the state licensure. To keep my nursing license in good standing I am required to
obtain 25 hours of continued education every two years with one of the 25 hours in pain
management. I had to have first aid and CPR certification; which is also renewed every two

These were only the minim requirements I had to have. To be able to work with most of
the patients I have worked with over the last four years, I had to have extra training provided by
my company. I attended a ventilator training course where I was familiarized with a couple
different models of ventilators and how to use them.
Annually, I must have a competency check done to ensure that I am still providing care
correctly. During this competency my skills are checked by one of my supervisors either in the
office or in the home. In the next section I will discuss the skills needed to perform my job.
A nursing skill is a task that can only be completed by someone who is a Registered
Nurse (RN) or Licensed Practical Nurse (LPN) who has been deemed competent to complete this
task, (, 2013). My skills are verified every year to ensure patient safety. I
am required to perform tracheostomy care and suctioning, enteral tube feeding and changing as
well as urinary catheterization of both male and female patients.
I must have excellent assessment and monitoring skills. Assessment is the foundation on
which all health promotion, risk reduction for disease, prevention of illness and injury, care
management, and organizational decision making is built (American Nurses Association, 2013).
I need to be able to assess my patients needs and perform interventions within the scope of my
current practice as well as following the policies and procedures of my company.
I must be able to work independently and be confident in my training. I work alone in the
home with only the patient and the parents for reference. I must be able to think critically to
intervene when changes with my patient occur.
Good communication skills are a necessity in home care. I am the liaison for my
company. They must be made aware of any changes that occur with my patient while they are

under my care. Not only do I need to have good communication skills with my supervisors I
must have good communication skills with my patient and their family.
My rapport with my patient and their family is almost more important than my rapport
with my supervisors. In home care, it is the family that decides if I work on a case or not. This
requires more than good communication skills. This requires a good attitude as well. In the next
section I will address the attitude needed for my current position.
In private duty pediatric home care I have been to many patients homes. It is important
that the patient as well as the family feel comfortable around me. I need to have a professional
attitude. I need to not only present myself professionally, but I need to act in a professional
It is important to have a caring attitude, but I still have to maintain professional
boundaries. It can be very easy in private duty home care to become over involved and
professional boundaries can become blurred. I had a case that I allowed myself to become too
involved with the patient. The family repeatedly said they loved having me take care of their
child after the child died I was given a new case.
After I was given a new case I tried harder to not become too involved. It can be difficult.
There were some parents that seemed to like the care I provided while others felt I was cold and
stand-off-ish. I must maintain the delicate balance of caring and friendly while at the same
time remaining professional and distant.
This paper has examined who I am as a nurse. There are times in my current practice that
I do not feel like much more than a glorified baby sitter. This paper has helped me to see that I

am much more than that. I use my knowledge and skills obtained in nursing school without
giving it a second thought. I provide a greatly needed service to my patient and their family.
I continually build on the knowledge I gained in nursing school. I perform regular
competencies to assure my skills are up to date and I maintain a caring and professional attitude
with my patient, their family and my employer. Black (2013) says a profession is different from
an occupation in at least two major wayspreparation and commitment. Nursing school
prepared me and my commitment to my patients health and wellness are what make me a
professional nurse.


American Nurses Association. (2013). The essential guide to nursing practice. Silver Springs,
Black, B.P. (2013) Professional nursing: Concepts and challenges.7
ed. St. Louis, MI. Elsevier
Ferris State University. (2013). NURS 324: Transition into professional nursing [course
syllabus]. Retrieved from Ferris State University MyFSU course page
Wheatley, M.J. (2002). Its an interconnected world. Retrieved from (2013). Nursing skills: Clinical nursing skills learned in nursing school.
Retrieved from