Running head: LEARNING PLAN

NURS 1020 Learning Plan

Nicole Warren
0492022
Trent University

LEARNING PLAN

Name: Nicole Warren

Course Number: NURS 1020H-W11

Course Name: NURS 1020

Area of Practice: Long Term Care

Competency Category
Professional Responsibility
Knowledge-Based Practice
Ethical Practice
Service to the Public
Self-Regulation
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Goal One:
I want to understand the progression of Alzheimers disease in a patient by my
fifth week in the LTC clinical setting.
Goal Two:
I want to understand the impact of Parkinsons disease on an individual in
regards to their mental cognition, and want to understand this disease by my sixth
week in the LTC clinical setting.
Goal Three:
I want to review the literature regarding how to best communicate with a
nonverbal, but cognitively sound patient by my seventh week in the LTC clinical
setting.

Activities, Necessary Resources and Timeframe to achieve my goal?

o Goal One: I completed my second week in a LTC placement on February
2, 2015. Within five more weeks I want to have completed an adequate
literature review, and regarded my textbook about Alzheimers disease.
One article I would like to thoroughly review is by Braak and Braak
(1991). My assigned resident has been diagnosed to be in the early stages
of the disease, and for the purpose of the therapeutic relationship I am
establishing with her, I want to better understand the progression of the
disease. This knowledge will help me understand how to address the

LEARNING PLAN

resident regarding questions I ask her about her past, and what questions to
avoid the resident from becoming agitated when asked information she
cannot recall.
o Goal Two: I want to better understand the onset of Parkinsons disease
and particularly its effects on an individuals cognition, if any. I do not
know much about the disease and will again need to complete a literature
review, including the article by Zimmerman et al. (2014), and use my
textbooks as a reference, to better understand the disease, within the next
six weeks. There was an individual that has Parkinsons disease and is
usually nonverbal. However, when a PSW said that he was still mentally
sound I was completely caught off guard. I realized the gap in my
knowledge regarding this condition, and quickly want to fill it with
knowledge while in the LTC setting by the sixth week of placement.
o Goal Three: I have been in situations already with dependent people who
are nonverbal but are cognitively sound. However, with my limited current
knowledge I find it hard to communicate with them, and to understand
information they are conveying to me. I would like to review the literature,
including the article by CarisVerhallen, Kerkstra, and Bensing (1999),
regarding how to communicate with individuals so you can understand
one another, without using language by my seventh week of placement. I
feel like this would be so advantageous in the LTC setting if I could
improve my non-verbal communication (body language, facial
expressions, touch) and listening skills in anyway. This could reduce
tension between the resident and myself and improve their quality of care
being received.

LEARNING PLAN

Evaluation
o Goal One: I will know I have achieved my goal when I can on the spot
explain Alzheimers disease to various audiences with simple through
complex explanations of the disease as appropriate, without error or
hesitation. The achievement of this goal will also be identifiable when I
can communicate with my resident using appropriate questions that will
not over task her memory, and understanding how to frame questions so
she doesnt feel like she has been put on the spot with having to produce
an answer from recall.
o Goal Two: I know I will have achieved my goal when I can reiterate
information regarding the disease without hesitation to individuals, and
provide simple through complex descriptions of the disease as appropriate.
I feel if I better understand the disease, then I will be more efficient in
helping residents that have the disease, and will feel more competent in
communicating with them and providing them with appropriate care.
o Goal Three: This goal has a deadline to set a time frame for when I want
to have at least started my literature search by, however this will be
something that I will be working on for the rest of my career. If the
literature review can provide me with some sort of guidance in nonverbal
communication, it will help fill a gap in my knowledge and allow me to
better my skills. I will then feel more comfortable with addressing
nonverbal patients and assessing them for their reaction, needs and
possibly wants.

LEARNING PLAN

Name: Nicole Warren

Course Number: NURS 1020H-W11

Course Name: NURS 1020

Area of Practice: Long Term Care

Competency Category
Competency Category
Professional Responsibility
Knowledge-Based Practice
Ethical Practice
Service to the Public
Self-Regulation

Goal One:
I want to ensure that my ability to bathe an individual is sufficient to provide
appropriate care, and be able to do this comfortably and without supervision if
need be by my sixth week in the LTC clinical setting.
Goal Two:
I want to review the literature on how to best provide an elderly adult with
support if I should suspect any other person is abusing them, by seventh week in
the LTC clinical setting.
Goal Three:
I want to better understand how to provide appropriate care and hygiene to a
difficult patient, and review the literature for basic standards of how much care to
provide despite resistance from the patient by my eighth week of placement.
Activities, Necessary Resources and Timeframe to achieve my goal?
o Goal One: If I am required to attend to a resident alone, I want to feel
confident in my skills to provide that resident with safe and ethical care
that will meet their needs. I want to know that I am performing the bathing
correctly, and ensure that all concerns regarding hygiene are being met
and surpassed. I want to be able to do this quickly but efficiently to limit
the length of time the resident is exposed and vulnerable to room

LEARNING PLAN

temperature, which they often find very cool. I would like to be able to do
this by my sixth week of placement. I will refer back to the article by
Grant, Giddings, and Beale (2005) to review an individuals vulnerability
when it comes to bathing.
o Goal Two: I know elder abuse is an issue that is gaining attention lately,
however, if a situation were to arise I know I would feel as vulnerable as
the elderly resident if I witnessed anything. Each scenario will be
different, but reviewing various case studies would provide excellent
resources into course of action that other individuals took. I want to be
able to jump to action, appropriately, if a situation ever arose that needed
an intervention and/or was required to be brought to somebodys attention.
I would like to discuss with Sarah by my seventh week in placement the
appropriate response to anything witnessed, regarding how I would
intervene and how you proceed after. I will bring this up at the next
conference meeting to address this issue, and formulate a plan with Sarah
and my peers as to how we should all proceed. As well, I would like to
take the time to look over the book by Wallace and Bonnie (2003)
regarding elder abuse to see interventions they would suggest
implementing for different scenarios.
o Goal Three: This is a hard goal to put an exact deadline on, however I
think it is important cause Ive already faced this dilemma in placement.
The time frame regarding this goal is in reference to by what point in time
When providing care to a resistant patient, who may be cognitively
impaired, I want to better understand how to provide basic care to that
patient, while protecting myself but ensuring the patients basic hygiene
requirements have been met. I want to know what the general consensus

LEARNING PLAN

regarding standards of care are for patients and want to review case studies
for how people handled different situations of patients with different
inflictions that were difficult. This will require reevaluation of the posted
videos, reading the assigned readings for the bathing lab and further
literature review. I want to complete reading the article by Fonagy (1998)
and bring up any pertinent information during our group conference on the
eighth week of placement. As well, Id like to discuss with peers their
criteria for what makes a difficult patient. I also want to know about
situations they have been in, how they have perceived that situation and all
the variables that affected the situation (patient mental state, health state,
emotional state), and my peers course of action at that time. With this
knowledge I would then have a better idea of how to handle a similar
situation when it arises again.
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Evaluation
o Goal One: I know I will have completed this goal once I can look at a
staff member of St. Josephs and confidently agree to attend to the resident
without further assistance, unless its regarding lifts or transfers
o Goal Two: This goal will be completed once I perform research that looks
into what I should verbalize if I witness elder abuse, how to protect the
resident from further harm, who to go to for further help, and what I need
to do to protect myself, as well as act ethically. Once I have reviewed
enough cases that I have a sense of how different situations were handled,
then Ill be able to rest easier and know that I have completed my goal as I
feel like I will be able to more competently address the situation.

LEARNING PLAN

o Goal Three: I want to have completed a literature review of articles

regarding this. However, with life experience I will be adding individual
cases I encounter to my repertoire that I will be able to later utilize as
situations arise. However, I need to create a basis of knowledge so that
when faced with this situation I have a starting point for how to handle to
issue.

LEARNING PLAN

My Learning Plan Addresses:

Self Reflection
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I have identified gaps in my knowledge and have carefully structured goals that
will help close these gaps and that are relatable to my current nursing placement
in LTC.

Course Learning Objectives (1,3,4,5)

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I have ensured that the goals are based off both the course work and the nursing
placement, in order to use the knowledge obtained through these goals to prepare
myself for my current placement in long term care and better prepare myself for
the lab testing at the end of semester.

Consideration to previous evaluation

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I reflected on my previously composed reflections to help identify areas that I

found I was lacking in, or wasnt responding to appropriately. I then built goals
around these areas to improve my knowledge and to relieve me of the stress that
comes with uncomfortable situations, or situations I did not feel comfortable with.

Cumulative and Appropriate for educational level

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I am giving myself time to complete each goal and have staggered the timeframes
by which they are due. However, I have made them all do before the end of my
clinical, so that I can apply the achievements I make by completing these goals to
the last of my clinical placements. All the goals are reasonable and achievable for
myself, and require research and access to resources that are provided through
Trent University. The goals are relatable to both the placement and the winter
semester.

LEARNING PLAN

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References
Braak, H., & Braak, E. (1991). Neuropathological stageing of Alzheimer-related changes.
Acta Neuropathologica, 82(4), 239-259.
CarisVerhallen, W. M., Kerkstra, A., & Bensing, J. M. (1999). Nonverbal behaviour in
nurseelderly patient communication. Journal of Advanced Nursing, 29(4), 808-818.
College of Nurses of Ontario. (2014). Developing SMART learning goals. Retrieved
from: http://www.cno.org/Global/docs/qa/DevelopingSMARTGoals.pdf.
Grant, B. M., Giddings, L. S., & Beale, J. E. (2005). Vulnerable bodies: competing
discourses of intimate bodily care. The Journal of Nursing Education, 44(11), 498-504.
Fonagy, P. (1998). An attachment theory approach to treatment of the difficult patient.
Bulletin of the Menninger Clinic 62(2): 147-169.
Wallace, R. B., & Bonnie, R. J. (Eds.). (2003). Elder Mistreatment: Abuse, Neglect, and
Exploitation in an Aging America. Retrieved from
http://www.ncbi.nlm.nih.gov/books/NBK98788/.
Zimmermann, R., Gschwandtner, U., Benz, N., Hatz, F., Schindler, C., Taub, E., & Fuhr,
P. (2014). Cognitive training in Parkinson disease Cognition-specific vs nonspecific
computer training. Neurology, 82(14), 1219-1226.