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Running head: PROFESSIONAL PROGRESS SUMMARY

Professional Progress Summary


Beza Fissaha
Old Dominion University

PROFESSIONAL PROGRESS SUMMARY

Professional Progress Summary


My clinical experience at Old Dominion Universitys School of Nursing has allowed me to
grasp and uphold the essential principals to the nursing profession. Through clinical rotations, I
was able to acquire the core competencies established by the program; these competencies
included critical thinking, nursing practice, communication, teaching, research, leadership,
professionalism, and culture. Obtaining the Great Eight competencies through out my nursing
years has developed me into a professional nurse and strengthened my nursing skills.
The purpose of this assignment is to show my achievements of the Great Eight
competencies through out my years in nursing school
Critical Thinking
Sophomore Year
My sophomore year provided various clinical experiences that required the use of critical
thinking. My first clinical day consisted of care for a 65-year-old male diagnosed with Chronic
obstructive pulmonary disease (COPD) exacerbations. I acquired the use of critical thinking by
implementing essential nursing principals to the care of my first patient in a clinical setting. I was
able to establish a nursing diagnosis of impaired gas exchange; I identified this diagnosis by
navigating through the patients medical history prior to my clinical day. Evidence of impaired
gas exchange was evident in this patient as he displayed dyspnea, abnormal breathing, and changes
in arterial blood gas values. Although I was nervous for my first clinical experience, I was able to
use my nursing care plan book to guide me in establishing an effective care plan that would guide
my interventions. While I cared for this patient, I made sure that I incorporated knowledge that I
learned from lectures regarding COPD; for example, I auscultated breath sounds, assessed
respirations, thought ways to conserve energy, encouraged pursed lip breathing and expectoration

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of sputum, and continuously assessed oxygen saturation. I was also able to incorporate the work of
theorists such as Florence nightingale by altering the environment of the patient; elevating the head
of bed can promote improvement in gas exchange and clearance of secretions. I was able to
provide effective nursing interventions by appropriately assessing the patient and adequately
treating his health responses.
Junior Year
Clinical experiences gained through my junior year rotations included competencies
learned from medical-surgical and labor and delivery. Additionally, my rotation at the psychiatric
clinical also contributed to my understanding of the Great Eight competencies. I was able to
expand on my critical thinking skills my establishing an understanding for certain disease
processes and their manifestations. For example, I cared for a pregnant woman with type I
diabetes that had experienced loss of consciousness after a hypoglycemic episode. I consistently
monitored her glucose levels and assisted the nurse in titrating her continuous insulin based on the
glucose readings. Although, I had to care for multiple patients I was able organize my care and
recognize that the diabetic patients insulin took priority over my second patient requesting
assistance in giving the newborn a bath.
I also used critical thinking in caring for a patient in the postpartum unit. While conducting
a head to toe assessment, I recognized that her fundus was not centered or at the umbilicus; I
recalled from lecture that this could be due to a full bladder, so I encouraged the client to urinate. I
was then able to assess her again and recognize that her uterus would not firm up upon massaging
it. I knew that this was a potential sign for bleeding so I notified the nurse of my findings.
Anticipating clinical outcomes can prevent undesired medical events that can dramatically change
the patients condition. Analyzing the clinical situation and applying critical thinking to guide my

PROFESSIONAL PROGRESS SUMMARY

care strengthened my nursing skills and allowed me to provide holistic care to my patient.
Furthermore, accommodating new clinical situations into my plan of care was necessary because
clinical events often transpired from the time my care plan was finished the prior day, to the time
my clinical experience began in the morning. I used critical thinking to identify new problems that
require interventions; this required continuous assessments and identifying new priorities that at
times completely redirected my plan of care.
Senior Year
My clinical rotations experienced during my senior year provided me critical thinking
opportunities that reflected a higher-level mastery of nursing, although not an expert quiet yet, it
demonstrates my continuous growth through out the program. Clinical knowledge acquired from
critical care, pediatrics, community health, and role transition contributed to preparing me in
transitioning into the professional role of a nurse. Critical thinking was demonstrated in role
transition during the care of a patient with a lumbar drain. While assessing the patient, the nurse
and I noticed that her inter cranial pressure (ICP) was reading at a negative seven. The nurse began
to look for any mechanical errors and was assessing the drain to identify what the problem was.
Recalling my knowledge about ICP and connecting my knowledge to the clinical situation, I
recognized that the patient displayed signs of decreased ICP and suggested that the reading was
perhaps accurate and not a mechanical error. The nurse and I further assessed the patient and
discovered that her lumbar drain was leaking; we were then able to page the anesthesiologist to
notify him of the problem.
Nursing Practice
Sophomore Year

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Providing nursing practice at a novice / beginning level was challenging but also
educational; I continuously learned from clinical situations that fostered my growth as a nurse.
Implementing basic fundamental nursing practices such as obtaining vital signs, changing linens,
giving baths, conducting assessments, and establishing therapeutic relationships are the core
foundations that established the principals to my nursing care today. Knowledge gained from
lectures allowed me to provide adequate care that centered on foundations of fundamental nursing.
For example, during the care for a patient with hypertension, I made sure that I walked the patient
so that she would get out of bed, provided teaching on diet, exercise, and the importance of
medication adherence. I also assessed the patients knowledge by asking him questions after the
teaching was implemented.
Junior Year
During my junior year, I was able to deliver my care across various cultures and
populations by clinical experiences acquired during medical surgical, child-bearing family (OB),
and mental health nursing. Establishing a care plan allowed me to provide care based on the
patients disease response; upon continuous assessment of the patient, I ensured that I altered or
reprioritized interventions. Additionally, I also made sure that I evaluated the success of
interventions implemented and identified the reasons for those that were not successful. For
example, during the care of 85-year-old African American male with congestive heart failure, I
made sure to assess the heart and lung sounds, monitor blood pressure, monitor oxygen saturation,
monitor intake and output, maintain patient on a low sodium diet, administered medications, and
elevate the head of bed. I was able to continue these interventions, as they were successful in
improving the patients condition. Appropriate use of the nursing process has allowed me to better
organize and manage my care effectively.

PROFESSIONAL PROGRESS SUMMARY

Senior Year
Senior year was when I truly comprehended the impact that the nursing process has on the
profession of nursing. Through research, use of evidence based practice, and growth in my nursing
education; I was able to complete my studies understanding that the nursing process is a critical
component to care in any population. It is the principal that essentially guides the different
competencies in nursing. It is pivotal that the nursing process is individualized and delivered to
every patient.
During the care of a 49 year-old patient with a cerebrovascular accident, I made sure that I
provided adequate nursing care by effectively utilizing the nursing process. I assessed the patient
and identified the nursing diagnosis of ineffective cerebral tissue perfusion related to interruption
of blood flow. I then planned my care and identified the desired outcome related to the patients
disease process; conducting research to identify evidence based practice is critical during planning.
Lastly, I implemented interventions such as assessing for decreased ICP, monitoring neurological
status, evaluating pupils, and assessing for nuchal rigidity and seizure activity. Upon continuous
assessment, I recognized that the patient was restless and complained of a painful migraine. The
application of abstract thinking acquired through the years of my nursing education has
strengthened my ability to incorporate various clinical data to better comprehend the bigger
picture. Therefore, I was able to associate these findings with increased ICP; I identified the nurse
who then called the physician for further assessments. Through out my senior year, I was able to
witness the significance of using the nursing process and appreciate its role in improving patient
outcomes.
Communication

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Sophomore Year
Communication was taught through out the beginning stages of my nursing education. In
fundamental nursing, I learned the importance of both verbal and non-verbal communication. In
nursing theories I learned the impact of building rapport through learning the works of different
theorists such as Paplaus therapeutic communication theory. At this level of my education, I was
able to provide the basic components to communication as it pertains to nurse-patient relationship.
For example, I always made sure that I introduced myself as a nursing student upon shift report.
Additionally, I made sure that I assessed non verbal signs of pain in patients who were
neurologically impaired. I also communicated significant clinical findings to the nurse; vital signs,
temperature, and assessment data is essential to managing effective care, therefore, communicating
any changes from the patients baseline can further prevent undesired outcomes.
Junior Year
Through out my junior year, I was able to expand and grow in my communication skills. I
was able to advance my knowledge and gear my focus towards the physical and emotional well
being of my patients. I provided therapeutic interventions by using communication techniques such
as using silence, accepting, using broad openings, encouraging description of perceptions,
reflecting and exploring. Therapeutic communication between patients and nurses is essential for
the successful outcome of nursing care. When I cared for a 16-year-old with depression, I made
sure to provide individualized care that geared focus towards restoring balance of emotions and
improving functioning. I would gently initiate conversations that would explore his thoughts and
feelings; through this process, I was able to provide therapeutic communication by validating the
patients feelings and praising the patient when he opened up. This allowed me to gain a better

PROFESSIONAL PROGRESS SUMMARY

understanding on his thoughts, thus allowing me to refocus my plan of care and identify any
additional interventions needed.
Senior Year
My senior year allowed me to master my communication skills and transition my care to
the professional nurse. I was able to provide compassionate nursing care by incorporating evidence
based practice into my care; For example, during the care of a 45 year-old deaf patient, I was able
to implement adequate nursing care by ensuring that a sign language interpreter was present
during any patient interaction. I was also able to apply knowledge I acquired from research;
although the patient was deaf, I faced and looked at during any interactions and made sure that the
interpreter was only facilitating the conversation. This is important as it makes the patient feel
involved in their care despite their disability.
During my pediatric clinical rotations at Childrens Hospital of The Kings Daughters, I
had to alter my communication skills towards the pediatric client. This was difficult to adapt to as
it consisted of a variety of age groups that each required individualized techniques. During the care
of a 4-year-old patient in the PICU, I had to alter my care to the preschool client; I was able to
recognize that four year olds speak clearly and use more complex sentences, are able to run, hop,
throw, and are at the initiative vs. guilt stage in Eriksons stages of development. This is important
because I was able to provide the child with play situations that allow them to initiate decisions.
Since this period also consists of the child interacting with other children, I made sure that I took
my patient to the play room so that he can interact and play with other children his age.
Teaching
Sophomore Year

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Educating patients was a pivotal component to providing holistic care. During my


sophomore year, I was able to understand the importance of teaching patients health promotion and
health management as it pertains to their disease process. While caring for a 56-year-old Hispanic
female with diabetes and hypertension, I was able to implement education sessions on diet and
lifestyle modifications. After gathering data from the patients medical record, I recognized that
the patient has been a smoker for forty years and was morbidly obese. I was able to promote
healthy practices such as exercising and promote a more balanced nutrition. Additionally, I
educated the patient on limiting salts, recognizing the signs and symptoms of hypoglycemia,
importance of monitoring glucose levels, and identifying signs of a stroke. These teachings were
implemented based on the patients teaching needs and readiness to learn. After teachings were
implemented, I was able to assess the effectiveness of the session by evaluating their knowledge. If
they lacked understanding, I ensured that I taught the material again using another method.
Additionally, I made sure to observe any instances that the patient mentioned implementing
healthy changes in their life. My sophomore year was able to provide the essential components to
implementing an effective education session. I was able to assess readiness to learn and provide
individualized health promotion.
Junior Year
During my junior year, I was able to advance in my teaching delivery as I learned how to
stimulate the patients interest, consider the patients strength and limitation, and including family
members in the teaching process. Additionally I was able to provide health promotion to each
patient through individualized assessments of their health and learning needs. I was able to
effectively provide education by requesting return demonstration, educating during interactions,
and using positive reinforcement when the patients adequately understood a more challenging

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concept. During my rotation at labor and delivery, I cared for a 16-year-old pregnant mother. I
assessed her learning needs by building a therapeutic communication relationship. I was able to
recognize that she did not have family support or have adequate knowledge about the daily tasks
required for a newborn. I was able to recognize that her anxiety level high and did not reflect the
readiness to learn. I was able to decrease her anxiety by informing her on what she should expect
in the next hours. Once her anxiety decreased I was able to gradually introduce health promotion
and education. I provided teachings on breast-feeding and breathing exercises. I also provided
health promotion by discussing sex contraception; this was approached by the client as she opened
up about being scared and regretting her actions. Additionally, I was also able to work in a
collaborative team as the social worker and lactation consultant too, provided care to ease her
fears. My junior year allowed me to gain experience in recognizing a clients readiness to learn
and approaching education and health promotion in a way that is individualized and tailored to the
patient.
Senior Year
My senior year allowed me to see the results teaching can have on the patients health
outcome. During my role transition rotation at the vascular intensive care unit at Sentara Norfolk
Hospital, I consistently provided education to patients and families and incorporated evidence
based research into my teaching sessions. When I cared for a 62-year-old patient with a thoracic
abdominal aortic aneurism, she had a lumbar drain that was initiated based on ICP readings. Her
husband was very involved in her care and had questions about what was being drained and the
purpose of draining CSF fluid. I was able to inform him about the therapeutic range of ICP and the
necessary need to drain if readings are above therapeutic numbers. Additionally, I was also able to

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provide the husband with research articles that provided information on the basic concepts of
lumbar drain and its relation to ICP.
During my clinical at CHKD, I provided teachings to a nine-year-old patient newly
diagnosed with diabetes. I was able to talk to alter my care to his developmental level; I began to
talk to him about school and his favorite foods to get a better insight into his eating habits. Upon
exploring the childs day-to-day activities, I discovered that the patient had very poor eating habits
and consumed fast food on a daily basis. I was able to provide education to the parents and
emphasize the importance of a healthy diet. I made sure that I assessed the parents knowledge by
engaging them in the teaching sessions and asking questions that evaluate their knowledge.
Research
Sophomore Year
Research is a pivotal part of nursing practice and was instilled in my studies during my
sophomore year. Nursing courses such as fundamentals and nursing theories consisted of
assignments that required research; I was able to gain an in-depth understanding of evidence based
nursing through scholarly journals that explored disease processes and nursing practice. I also used
evidence based nursing to deliver patient care; during the care of a 60-year-old patient with heart
failure, I used research conducted by Lorraine and colleagues titled Compliance Behaviors of
Elderly Patients With Advanced Heart Failure. This article was able to provide ways that nursing
can encourage and promote medication compliance; this was relevant because the patient I cared
for did not adhere to his medication regimen and lacked interest in his care.
I was enrolled in nursing research during my sophomore year; upon completing this class, I
was able to explore the future trends and historical foundations of nursing research and evidence
based practice, distinguish the steps scientific inquiry by appraisal of research evidence, and

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incorporate evidence based inquiry into my professional nursing practice. Sophomore year allowed
me to learn the importance of incorporating research findings into my nursing practice.
Junior Year
Junior year was able to teach me the influence that research has on nursing for current and
future nursing practice. Through clinical experiences I was able to recognize that clinical research
was essential to improving patient care, therefore, I ensured that I was knowledgeable on evidence
based practice and implemented them throughout my care. During my community health clinical
rotation, I cared for the Drug Court aggregate of Norfolk. After implementing multiple educational
sessions on topics that our aggregate needed additional teachings on, we discovered that the
aggregates posttest assessment scores were below the pre-test scores. This indicated that our
teaching lessons were not effective; therefore we explored nursing research to improve our care.
My group and I explored literature that provided ways to effectively promote teaching, this
included exercise breaks, incentives, encouraging interactions, providing multiple ways of teaching
delivery. After we implemented the findings from the literature, our aggregates post test scores
demonstrated that findings from the research article was effective. More importantly, our
aggregate demonstrated adequate understanding of the material we provided teaching sessions on;
this include coping mechanisms, healthy relationships, and phases of addiction. Throughout my
junior year, I was to use nursing research to encompass a more holistic approach into my care.
Senior Year
The senior year curriculum exposed me to many evidence based practice nursing and
allowed me to experience the significance of nursing research in the nursing profession. My
clinical experiences I gained from working in the vascular intensive care unit, included using
nursing research to incorporate into my patients care. During my time at the unit, I was able to

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explore various literatures that pertained to my patients disease process. During the care of a
patient with a lumbar drain, I used knowledge acquired from a research article to provide
evidenced based practice care. While caring for a patient with decreased ICP, I recalled reading
literature about positioning the bed in tredelenburg to help increase ICP. After suggesting this to
the nurse, I evaluated the effectiveness by monitoring the patients ICP. The intervention
implemented was successful and improved the patients ICP. My senior year allowed me to
advance in delivering evidence-based research by recognizing that for evidence based practice to
be successful, nurses and other health care professionals must adapt it. Through pediatrics,
community health, critical care, and role transition, I was able to incorporate evidence-based
research to patient care while evaluating processes and outcomes.
Leadership
Sophomore Year
My sophomore year provided me the tools I needed to demonstrate leadership skills in the
clinical setting. I was able to apply my scope of practice to patients and advocate for their care.
During the care of a 35-year-old African American patient with sickle cell disease, I was able to
advocate for the patient when he complained of pain. The nurse was not available, so I was able to
notify the nurse manager, who took appropriate measures to treat the patients pain. My
sophomore year provided clinical experiences that reflected the importance of advocating for each
patient, additionally, I was able to recognize the impact that an active health care leader can have
on clinical settings.
Junior Year
My junior year provided me clinical experiences that enhanced my leadership skills in
developing nursing practice, optimizing patient outcomes and improving quality of care.

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During my clinical rotations at Mary Immaculate hospital, I cared for a 84-year-old patient who
had multiple health problems including diabetes, hypertension, cirrhosis, CHF, and depression.
When I first introduced myself to the patient, I noticed that she was not given adequate hygiene
care and that the linens were heavily soiled. There was a shortage in care partners and the nurses
had to attend to other patients before providing her bath. I took it upon myself to change the linens,
provide a bath, and assist in dressing her. After these were implemented, the patient improved in
mood and physical condition. Through out my clinical experiences, I noticed that sometimes, this
area of nursing is abandoned; but these too, are responses of the human body that must be taken
care for. My junior year clinical provided me with opportunities to display my leadership qualities,
I hope that I continue to fulfill the characteristics that qualify one to be an effective nursing leader
through out my nursing profession.
Senior Year
Clinical experiences gained throughout my junior year provided me opportunities to
implement leadership qualities into my daily practice. I made sure that I assisted with all patients
regardless if they were or not my assignment and assisted others with patients care when needed.
While completing my role transition at vascular intensive care unit at Sentara Hospital, I was able
to improve my delegation skills. When my patient assignments consisted of a heavy load, I often
asked the care partners to assist with things that pertain to their scope of practice. For example,
while caring for a patient with a lumbar drain, I requested assistance in recording blood sugar
reading from my other patient since her ICP was at a seven. In this situation, I was able to
prioritize which patient needed by attention first. Although the patient was due for a glucose check,
I recognized that decreased ICP required immediate attention.
Professionalism

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Sophomore Year
My sophomore year provided me knowledge on how to conduct myself as a professional
nurse. I was able to understand the significance of holding professional values as it too, promotes
effective patient care. I made sure that I conducted myself professionally in both lectures and
clinical; I made sure that I arrived on time to each lecture, presented myself professionally to
clinical instructors, and made sure that I abided by the traditional practices of nursing.
Junior Year
Junior year allowed me to expand the foundations of my nursing practice by expanding the
depth and meaning of professionalism. Professionalism is required in all aspects of nursing such as
evidence-based practice and research. I was able to implement these practices while considering
the significance of credentials of authors, date of publication, and significance to the patients care.
This allowed me to provide efficient and safe nursing care to my patients.
Senior Year
During my senior years role transition clinical, I was able to grow in my professionalism
as my roles of a nursing student increased. I provided patient education to each patient and tried to
provide care rich in compassion. Additionally, I made sure that I presented myself professionally
by demonstrating the willingness to help others and promoting optimal health to every patient. My
senior year has allowed me to recognize the impact of using professionalism as a guiding tenet.
This has significantly enhanced the clinical outcomes of my patients.
Culture
Sophomore Year

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Culture is a big component of nursing care. My sophomore year provided me with the
principals and foundations of providing culturally sensitive nursing care. I cared for patients from
diverse backgrounds, beliefs, values, and principals. In considering these variables, I recognized
the importance of evaluating my own values and beliefs. Reflecting on my values allowed me to
recognize and respect others , although I may sometimes not agree, it is critical that I learn to
separate my beliefs to hole heartedly care for anothers.
Junior Year
Through clinical rotations experienced during my junior year, I was able to develop
stronger patient interactions and develop therapeutic relationships thus making my patients
comfortable to express and practice their cultural beliefs. During the care of a 48-year-old patient, I
was able to assist a nurse in questioning a blood order because he was Jehovahs Witness. I
recognize the impact that culture has on nursing practice and have learned to include the beliefs
and values of my patients to my nursing care.
Senior Year
My understanding of culture as it relates to patient care was enhanced trough out my
clinical rotation at VICU. During a code, I cared for a Filipino family that was grieving the sudden
death of their mother. I was able to provide culturally sensitive care by providing empathy and
support. I also promoted their cultural practices by giving them space to pray. Through out the care
of patients from various cultures and backgrounds, I was able to recognize the correlation of health
care and culture and its effect on one without the other.

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Conclusion
The clinical experiences obtained from Old Dominion Universitys School of Nursing has
allowed me to grow as a student and prosper as a professional nurse. Through out my years in the
nursing program, I was able to flourish as a student and a nurse as I challenged myself to excel in
my studies and acquire quality education from an accredited institution. I plan to apply the
knowledge I have gained through lectures, clinical rotations, research, and words of wisdom from
my memorable professors. I am beyond blessed and humbled to acquire a degree in a field that
correlates my passion of medicine and helping others. The process of obtaining a BSN degree
reflected the significance of research and evidence based practice, therefore, I plan on providing
nursing practice that will promote optimal clinical outcomes. I am nervous and anxious to
transition my role of a student to a nurse but I also am excited and determined to make an impact
in the field of nursing.