Running head: GRADUATE PROGRAM COMPETENCY: REFLECTION PAPER 1

Graduate Program Competency: Reflection Paper

Sherrill Butler-Williamson

Delaware Technical Community College

Capstone

NUR: 460

November 30, 2018

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Graduate Program Competency: Reflection Paper

Introduction

My journey through Delaware Technical Community College RN-BSN program has been

professional and personally life changing. As with any formal education program, there are

program requirements that must be completed to obtain a degree of completion. Delaware

Technical Community College requires that each nurse complete nine Graduate Program

Competencies (PGC) to obtain a Bachelor of Science in Nursing Degree. In this paper I will

demonstrate how I have meet Delaware Technical Community College Bachelor of Science in

Nursing Degree requirements.

Graduate Program Competency 1: General Education

The didactic portion of any BSN program prepares the students with the

fundamentals to integrate general educational skill, and aptitudes to advance nursing education

and growth in professional practice to obtain optimal patient outcomes. The extensive

coursework in Liberal Arts, and Science gives the student the ability to assess social-economical

and psychosocial patient behaviors while being culturally competent. While walking down my

BSN pathway, I enrolled in a class called Spanish for Healthcare Providers. This general

education course has propelled my clinical practice in the Spanish-speaking community. For

example, I recently had the honor of assisting a Spanish-speaking patient during surgical

procedure. This patient arrived in the United States one week prior to his admission to the

hospital. He was admitted for acute abdominal pain. He was diagnosed with an erupted

appendix. We rushed him to the operating room. I am not fluent in Spanish, but I was able to

do a full clinical assessment without the assistance of an interpreter. He was an older

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gentleman and respect is important to his culture. I address him formally throughout our

conversation. He thanked me several times. I have learned through this educational experience

how important it is to treat the whole patient, not just the acute issue. Pathophysiology has

broadened my understanding of the disease process, and allows me to assess acute change in a

patient’s health status efficiently.

Graduate Program Competency 2: Leadership

Leadership skill are essential for any nurse. There are different types of leadership styles

and theories. During my leadership course for my BSN, I received education that assisted me

with formulating my Nursing Leadership Philosophy. My Nursing Leadership Philosophy is I

believe in displaying the characteristics that I would like other to possess. I believe in being

honest. I believe in effective communication. I believe in encouraging and inspiring others to

become all that they desire. I believe that every team member has a voice. I believe in

collaboration. I believe in helping others to reach their fullest potential and I believe in

following a mission with a vision. Most of all, I believe in transformative leadership. A

transformational leader can incorporate these four components; idealized influence,

inspirational motivation, intellectual stimulation and individualized consideration of others

(Deschamps, Rinfret, Lagace, & Prive, 2016). Learning to become a transformational leader has

guided my professional nursing practice by allowing me to demonstrate leadership skills to

promote patient safety and deliver quality healthcare. I have completed this competency

through education and professional practice. As a charge nurse, it is my responsibility make

sure that staff has the skills and the resources needed to ensure safe patient care. I have

learned to listen to the needs of staff and allow them to assist in the decision-making process. I
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believe that the people who are performing the daily task have the best insight on the needs

and issue promote patient safety in the operating room. For example; the hospital where I work

decided to use disposable sheets on the operating room surgical beds, these sheets are plastic

and they slide when the operating room table is rotated into different positions. There is a

potential fall risk. Staff brought this issue to my attention one evening while I was working, I

addressed the issue immediately with management with the understanding that the purpose of

the disposable sheets were to decrease the possibility of surgical-site infections. The disposable

sheets are now only used when there is no risk for patient injury. Also, through my practicum

experience, I had the opportunity to be mentored by an extraordinary nurse leader. She is a

transformative leader. I was educated through her interaction with staff. She gave constructive

criticism, while receiving and accepting constructive criticism from staff. She encourages staff

while offering a helping hand. She never gives staff a specific assignment, she discusses the

assignments with the team and ask who is want each assignment. I watched staff mentally

assess their weakness and strengths and volunteer for the assignments that would strengthen

their weakness while using their strengths. This is my goal as a leader.

Graduate Program Competency 3: Evidence-Base Practice

Evidence-based practice in nursing facilitates optimal patient care. It promotes the

opportunity for nursing care to be more personalized, while maximizing the effects of clinical

judgment. It is more effective (Youngblunt & Brooten, 2001). Evidence-based nursing practice

and Nursing Research are complementary (Youngblunt & Brooten, 2001). I have taken the

knowledge that I have acquired from my Nursing Research course and have gained an appetite

for inquiry, analysis and information literacy to support evidence-based professional nursing
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practice by becoming a novice nursing researcher. I have learned importance of evidence-based

nursing practice and research and I have applied the knowledge to my clinical practice as a

nurse. I am currently working on two nursing research projects. One with the technological

advancements in the operating room and the other is a data analysis project for a nursing

mentor program that I have been given the privilege to oversee. I have learned at a recent

research conference that I attend during my Capstone course that research always begins with

a question.

Graduate Program Competency 4: Technology

The profession of nursing is advancing daily, just as technological advancements in

healthcare has grown by leap and bounds. It is the foundation of the future of healthcare.

Patients believe that the advancements in healthcare will produce safer, improved and cost-

efficient healthcare services (Powell-Cooper, Nelson, & Patterson, 2008). In my Nursing

Informatics course I learned that the technology advancements in healthcare goes beyond the

Electronic Medical Record. Graduate Program Competency pertaining to the integration of

information management and technology to improve patient outcomes, is part of my daily

nursing practice. I have accomplished this through education and research with the goal of

implementation. The goal is to use the technological advancements regarding the surgical

count process. Currently, at my place of employment we manually count to prevent retained

surgical item. I have researched and presented the evidence to hospital administrators

indicating that a manually count is not the most efficient and safest way to prevent retained

surgical items. Evidence-base practice now recommends the use of an automated counting

system that uses a Radiofrequency Identification Device (RFID) for counting all surgical sponges,
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sharp, and instruments. The effectiveness of RFID technology far exceeds that of radiography

and manual counts due to the unique identifiers that each item is given (Steelman &

Alasgheirin, 2012).

Graduate Program Competency # 5 Advocacy (Healthcare Policy)

I have gained a wealth of knowledge about the importance of nurses using their voice to

advocate for patients and the nursing profession through healthcare policy on the local, state,

national and global levels. Before being educated through my Nursing Policy Course, I was not

aware of the impact that a group of nurses with a common concern can have on our elected

officials. According to the American Nurses Association (ANA), nurses are the frontline defense

and we as nurses offer an expert perspective on every aspect of healthcare. The efforts to

improve healthcare and the system that delivery healthcare to patients must be directed to the

policy makers and the agencies that makes decision that affect both patients and caregivers

("American Nurses Association," 2018). Recently, I had the opportunity to advocate for the

needs of our community to help combat the opioid crisis due to the lack of resources in Dover

Delaware in front Senator Thomas R. Carpers and other local officials. I also attended a local

debate where all the individuals that are running for state offices were in attendance. I presented

the same information to that entire group, asking them how they can assist with this issue. Both

opportunities were priceless and life -changing for me. I am developing the skills and the

courage to assist with change. I am currently on the Board of Directors for the Del-Mar Chapter

for the Association of Perioperative Registered Nurses (AORN) and I will be voting national for

the first time on a health policy in 2019. Nurses at all levels regardless of titles or positions must

remember that it is our duty to advocate for our patients to promote a safer and more efficient

quality of life not just for the present, but for the future ("Speak to be Heard," 2017).
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Graduate Program Competency 6: Advocacy (Patient-Center Care)

According to ANA, there needs to be a transition in the education of nursing practices

that prepares graduates for the interactions with a wide and diverse population of professional

and nonprofessional healthcare delivers. Interprofessional communication and collaboration is

essential for safe and evidence-based healthcare (Moss, Seifeit, & O’Sullivan, 2016). Direct

patient-centered care through advocacy, interprofessional communication, collaboration, and

delegation are competency goals that I accomplished through my practicum experience in my

Community Nursing, and Nursing Capstone courses. During Community Nursing, I had the

opportunity to follow an emergency room nurse. The emergency room (ED) evaluates a diverse

patient population. During one of my practicum experiences, a patient entered the ED in

cardiac arrest. Paramedic were doing chest compression. It was all hand on deck. The patient

expired after eight rounds of CPR and multiple doses of epinephrine. I had the opportunity to

present the devasting news to his wife that spoke very little English and had no family or friends

locally. Remembering that at times the entire family can become the patient. I know that she

could not be left along. I called her daughter, and her close friends and it would take three

hours before they could meet her at the hospital. She did not want the body moved until her

daughter was able to say goodbye to her dad. The ED policy only allows for a body to stay in a

room for an hour. I explained the situation to my practicum instructor and she gave me the

permission to do what could to assist the patient’s wife. I first called Pastoral Services and

Guest Relations to assist with comforting measures. I then called the House Supervisor to

obtain permission to keep the body in the room until her daughter arrived. The House

Supervisor called the Hospital Administrators, the request was granted. During my Nursing
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Capstone Practicum, I had the opportunity to visit Slaughter Neck Community Center. This is an

underserved community with minimum local health resources. I assessed a patient that was

experiencing weakness and tremors. He was in the beginning stage of Parkinson disease. I

collaborated with the local hospital and developed a plan of care. With the assistance of my

practicum instructor, the patient was accepted into The Greater Balance Program. This program

was is designed to give patients the necessary tools to regain their balance and strength.

Graduate Program Competency 7: Health Promotion and Disease Prevention

The skill obtained to integrate health promotion and disease prevention practices to

positively impact the delivery of healthcare to a diverse population was evaluated during my

practicum experience in my Nursing Capstone Course. I went to Greater Faith Mission. This is a

male homeless shelter that has a community center that is open to anyone that is homeless.

During my first visit we did a Clinical Needs Assessment on the facility and the patients. The

goal was to establish the needs of the community. We also collaborated with the counselors

and the director of the program. After the data was evaluated, we returned for the initial

implementation for the offsite clinic. According to the data, there was a need for health

education and disease prevention. We came prepared to educate patients and to complete a

healthcare assessment on each patient. We collaborate with local physicians to facilitate

optimum health of this underserve community.

Graduate Competency 8: Ethic

Practicing professional nursing within an ethical framework was implanted and rooted in

my everyday professional nursing practice during my Associate Degree Nursing Program at

Delaware Technical Community College and readdressed in my Nursing Capstone didactic

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coursework and practicum experience. During my didactic experience I completed a case study

on ethic. The purpose of the case study was to ensure that I had a clear and concise

understanding of the ANA Nursing Code of Ethic. According to ANA the Code of Ethics for

Nurses with Interpretive Statements creates and ethical standard for all professional nurses by

presenting a framework for nurses to use while ethically analyzing decisions ("Code of Ethic,"

2018). I had the opportunity to attend an Ethics Committee meeting during my practicum

experience. I saw first had how the Nursing Code of Ethics was used to make life changing

decisions regarding patients and their families. I was able to give input on the decision-making

process. Being included in that process has forever impacted my process for making patient-

centered decisions in healthcare. The ANA’s Code of Ethics will guide all my patient care

decisions.

Graduate Program Competency 9: Life-Long Learning

According to the Institute of Medicine (IOM), life-long learning positively impacts

professional, personal and social growth in nurses. It directly enhances patients’ experiences

and outcomes during health-related occurrences (Qalehsari, Khaghanizadeh, & Ebadi, 2017). I

have demonstrated life-long learning that empowers personal and professional growth by

completing my BSN Graduate Program Competencies. My life-long learning is both formal and

informal. I will continue my formal education in January 2019 with the goal of achieving a

Doctoral Nursing Practice Degree with a concentration in Psychiatric and Mental Health Nurse

Practitioner (DNP-PMHNP). My informal education consists of life situations and staying current

in my profession by achieving my operating room certification; CNOR, being an active member

of the American Nurses Association, completing necessary continual educational requirements,

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and staying up to date with evidence-based practices. As a nurse, I want to have the ability and

the knowledge to work at the full compacity of my licensure by understanding an utilizing my

scope of practice to it fullest. Healthcare is forever advancing, and I am learning something

new in the healthcare arena daily.

Conclusion

In Conclusion, my journey to achieving my Bachelor of Science in Nursing at Delaware

Technical Community College has forever change my life professionally and personally. My

professional nursing practice has advanced through the didactic and practicum experiences that

were presented throughout the RN-BSN program. I can conceptualize nursing care beyond the

bedside. Nursing is global with a diverse patient population. I have learned that patient-

centered care through evidence-based practices is limitless without boundaries and as a nurse I

can affect change in the deliverance of healthcare through advocacy, policy, education, and

technology. Achieving my BSN is an accomplishment, but I have learned my greatest lessons

from my failures. This educational experience has awakened all my senses, I have obtained a

new form of boldness through humility.

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References

Code of ethics for nurses with interpretive statements. (2018). The American Nurses

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Health policy. (2018). Retrieved from https://www.nursingworld.org/practice-policy/health-

policy/

Moss, E., Seifeit, P. C., & O’Sullivan, A. (2016). Registered nurses as interprofessional

collaborative partners: Creating value-based outcomes. The Online Journal of Issues in

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http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJ

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Interprofessional-Collaborative-Partners.html

Powell-Cooper, G., Nelson, A. L., & Patterson, E. S. (2008). Patient care technology and safet. In

Patient safety and quality: An evidence-based practice handbook for nurses (Ch. 50).

Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2651/

Qalehsari, M., Khaghanizadeh, M., & Ebadi, A. (2017). Lifelong learning strategies in nursing: A

systematic review. Us National Library of Medicine: National Insitutes of Health.

https://doi.org/10.19082/5541

Speak to be heard: Effective nurse advocacy. (2017). Retrieved from

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Youngblunt, J., & Brooten, D. (2001). Evidence-based nursing practice; Why is it important.

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