Running head: SELF ASSESSMENT 1

Self Assessment of Nursing Standards of Practice

Mollie J. Morrissey
Ferris State University









SELF ASSESSMENT 2

Self Assessment of Nursing Standard of Practice
The American Nurses Associations (ANA) Nursing: Scope and Standards of Practice
and The Code of Ethics for Nursing are different standards that familiarize nurses with the
exceptional practice needed to maintain safe and quality care to each individual patient. Every
nurse that is practicing in the field or in nursing school should be knowledgeable with each
standard and able to maintain these standards throughout the nursing career. When a nurse is able
to assess themselves and evaluate how they meet each standard about what they are capable of
doing for themselves, the patient, families, and health care providers it shows that nurses are
giving the care the patient needs to become healthy. This paper explains how as a nursing
student, I have been able to meet each standard to the best of my ability and those that havent
been met; I will be able to maintain and achieve competency as my journey of nursing beings.












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Nursing Scope and Standards of Practice
Standards of Practice
Assessment. As a student nurse this is a goal that I have met. The registered nurse
(RN) collects data which plays an important role to the patients health and situation (ANA,
2010, p.39). This involves healthcare consumer, family, and other healthcare providers as appropriate,
in holistic data collection. (ANA, 2010, p. 40).
Throughout nursing school, a majority of assessments that have been done in the clinical
setting were head to toe assessments, which included direct contact with the patient. When
assessing patients at Pine Rest for mental health, a psychosocial assessment was taken. Having
direct contact with the patient wasnt necessary for this assessment, but asking questions and
assessing their mental stages were. The atmosphere at Pine Rest has been different than what I
have experienced in the past, but I am able to listen and advocate for my patient by collecting
data from their past and figuring out ways that I can understand their condition and help them
reach the goal of leaving Pine Rest, safely.
Diagnosis. I have met the goal of diagnosing in the clinical setting and in the class room
setting. The registered nurse analyzes the assessment data to determine the diagnoses or the
issues (ANA, 2010, p. 40). Which includes documenting diagnoses or issues in a manner that
facilitates the determination of the expected outcomes and plan (ANA, 2014, p. 41).
A specific example diagnosis was in the classroom setting during lab. I played a role as
the primary nurse in the asthma lab. The patient was in the ER and had ineffective breathing and
coughing. I had to role play what the nurse was expected to do as well as think of a plan and
diagnosis for the patient. I was able to diagnose the patient with ineffective breathing pattern and
administer correct medications and educate on the importance of the breathing techniques.
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Outcomes Identification. The registered nurse identifies expected outcomes for a plan
individualized to the healthcare consumer or the situation (ANA, 2010, p. 41). This is a goal
that I have met multiple times in the clinical setting. I have been able to help patients achieve
goals and meet them in a timely, specific, measurable, attainable, and realistic manner.
A patient that enjoyed spending his time in the hospital due to being neglected at home
was trying everything he could to elongate his stay. He made it seem that he couldnt and didnt
want to walk to help build his strength. I made sure that the two days I had him as a patient I
wrote down the walking schedule on his white board with the times I would come in and walk
him and how far he walked. We made a deal that he would get a snack or a meal after each time
he walked. The goal was at least three times when I was there and to go around the floor at least
once. He was able to meet these goals and enjoyed having an incentive. He helped me develop
the plan which motived him and he was able to feel proud of himself after. This is something I
do with most of my patients now because it is a way that I can set up goals and outcomes for
each individual patient.
Planning. This goal of planning has been met by me as a student nurse. The RN
develops strategies that provide the patient to achieve the expected outcomes (ANA,
2010). This includes strategies in the plan that addresses each of the identified diagnoses or
issues. These strategies may include but are not limited to strategies for: Promotion and
restoration of health; Prevention of illness, injury, and disease; the alleviation of suffering;
and Supportive care for those who are dying. (ANA, 2010, p. 43).
A specific example of how this was met is in the clinical setting is when I am giving
report to my nurse. At the end of each clinical day I sign off with my nurse and give her
report on how the patient was throughout the day and what the plan should be while she takes
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the patient back over. The nurses aide also receives a plan from me so that the patient is
getting the best quality of care and is on the right plan to get out of the hospital as quickly as
they can.
Implementation. I have been able to meet this standard as a student nurse. The RN
initiates and implements the plan for the patient efficiently (ANA, 2010). Not only through the
care with the patient, but also using the technology given by Spectrum to take care of the patient.
A specific example of partnering with the person, family, significant others, and
caregivers as appropriate to implement the plan in a safe, realistic, and timely manner (ANA,
2010, p. 45) was when I was working in community health at the health department. A younger
girl had come in and was worried about getting pregnant and wanted to be started on some type
of birth control. The RN and I thought of different ways that we could help prevent this from
happening, giving her different options such as the birth control pill, the Depo-Provera shot, and
Intrauterine device placement. A plan was made so pregnancy could be prevented.
I also Utilize technology to measure, record, and retrieve healthcare consumer data,
implement the nursing process, and enhance nursing practice (ANA, 2010, p. 45) through
Cerner, on Spectrum Healths network. I go through the patients charting before I start my day
and write down all the necessary lab values, medications and the plan for the day with the
patient. I am able to use this information to implement the type of care I will be giving this
patient while I am taking care of them.
Evaluation. This is a standard that I have met through my clinical experience. The
registered nurse evaluates progress toward attainment of outcomes. (ANA, 2010, p. 52) I make
sure this is done with the patient, family and health care providers.
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A specific example of using evaluation through my experience was in the classroom. We
had an activity during our Obestric (OB) class that we had to evaluate someone that we knew
that was pregnant. During this evaluation we had to ask them a set of questions, do an
assessment and come up with goals and outcomes for them. I evaluated my best friends sister,
who is very unhealthy. We came up with an eating plan to keep her healthy during her last
months of pregnancy by making a chart for her eating habits. An exercise plan of just walking
twenty minutes down the street was attained as well. She was able to achieve this goal and feel
proud of herself.
Standards of Professional Performance
Ethics. This is a goal that I have met as a student nurse. The RN practices in an ethical
manor and provides care that protects patients values and beliefs (ANA, 2010). As a student
nurse it is important to make sure that we keep this in the back of our minds at all times.
A specific example of attaining this goal would be in the clinical setting. I was in
Interventional Radiology and the nurse that I was shadowing was religious and asked each
patient before she took them in if we could say a quick prayer with them. When a patient
responded with no I was able to respect that patients decision and did not judge their values or
beliefs.
Education. This is a goal that I havent completely met. The RN attains knowledge
and competence that reflects current nursing practice (ANA, 2010, p. 56). I will continue to
finish up nursing school by December and will have fully met this goal.
Two more semesters are left for me to fully reach this goal. I plan to further my education
in my future in nursing even after I graduate. Nursing profession is always changing and learning
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is done every day in the clinical setting. I plan to work for a company who can help pay for my
masters degree so that I am able to work my way up in my career.
Evidence-Based Practice and Research. This is a goal that has been met as a student
nurse. The RN uses evidence and research findings to help guide correct practice decisions
(ANA, 2010). As a student nurse I utilize current evidence-based nursing knowledge, including
research findings, to guide practice (ANA, 2010, p.58).
Throughout this last year and a half, in the classroom, we have been assigned different evidence-
based practice papers for certain topics. A research topic is given and we are responsible to get the correct
articles that are evidence based to write the paper on. The class has been taught the correct way to find
these articles and ways to critique them so that we are getting the evidence-based information.
Quality of Practice. I believe that I have met this goal throughout as a nursing student.
The registered nurse contributes to quality nursing practice. (ANA, 2010, pg. 59) By achieving
this goal, I am making sure that I am able to give the best quality care and making sure that the
supplies being used are not being wasted.
One specific example of this is in the clinical setting. Before I start my shift at clinical, I
make sure to be well prepared. One way that is done, is I fill my pockets with alcohol pads.
There have been too many situations that arose where I needed an alcohol pad and had to stop
what I was doing to find one in the patients room. The first couple weeks of doing this I ended
up with pockets full at home. I realized how much was being wasted, so I brought them all back
and made sure that before I left each shift, I emptied my pockets with any supplies so I was not
wasting any supplies. By doing this I was able to save Spectrum Health money.
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Communication. This is met every day at clinical. The RN communicates effectively
in a variety of formats in all areas of practice (ANA, 2010, p. 61). This not only pertains to the
health care team, but also to the patient and the family members.
One specific example of how this has been demonstrated is by educating the patient. The
last two semesters I have been responsible for educating the patient and the family, if they are
present. I print off information in Krames, which an insight program provided by Spectrum
Health, pertinent to their diagnosis and communicate the information to the patient and the
family. After giving the patient the information I chart in Cerner under the education tab that the
patient had or had not understood.
Leadership. This has not been fully met. The registered nurse demonstrates leadership
in the professional practice setting and the profession. (ANA, 2010, p. 62) This is something
that once I graduate; it will be a continuous role that I take.
A specific example of how this has partially been met would be the NURS 440 class that
I am currently enrolled in. This class is teaching me how to be a leader in the nursing role, so in
the future I can have the qualities and strengths of a great leader (charge nurse or manager). I feel
like during the clinical setting leadership has been taken by me multiple times. More specifically
would be when the nurse passes medications with me. I know the five rights, explain to the
patient what each is for and then administer them without the help of the nurse.
Collaboration. I have met this with a couple of examples. The registered nurse
collaborates with healthcare consumer, family and others in the conduct of nursing practice.
(ANA, 2010, p. 64) Communication is essential, but when you are collaborating with the patient
and healthcare team, it puts the patient at ease seeing this first hand.
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One specific example of how collaboration is used as a student nurse would be when I
was at Blodgett. My patient was going into surgery at 1300 and as I was passing my morning
medications with the nurse, the doctor had stopped in to see the patient. One of the medications
that the doctor ordered, that had been pulled from the pixus, I noticed had been given 4 hours
prior and she couldnt receive it again, it was something that the doctor had not noticed. The
doctor, nurse and I were able to work together and make a decision on what else to give her, then
change it in Cerner so that she wasnt getting double the medication. Without this collaboration
between the health care team, the patient could have had complications to worsen her condition.
Professional Practice Evaluation. As a student nurse, I have met this goal in every
semester that I have had clinical. 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. 66). This is a goal that I will be achieving for the rest of my nursing
career.
Each week in clinical the clinical group is to fill out a weekly evaluation with what was
learned, achieved and goals for the next week and hand them into the instructor. In this middle of
each semester our clinical instructor gives our group a summative or a midterm evaluation so we
know are strengths and weakness and where we stand within the clinical setting. The last
evaluation given is a formative evaluation from the instructor, which is a more in depth and
specific evaluation of how we did the entire semester. I am able to take the feedback from the
instructor, move on to the next clinical site and learn from my strong and weak points.
Resource Utilization. I am able to achieve this as student nurse in the clinical setting.
The RN utilizes appropriate resources to plan and provide nursing services that are safe,
effective, and financially responsible (ANA, 2010, p. 67). It is important to provide patients
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with the best care nurses can and by using resources that are financially fit for the patient, this
can be successful.
When I am give the patient educational materials at the end of my shift with them, I print
off information from Krames. One of my patients was going in for hip surgery and she was
confused on the operation that was being done. When I went to print out the information there
was a stack of information that would have been too overwhelming for my patient, so I wrote
down in my own words a shorter length of what was going to be happening to her. I saved paper
this way and helped utilize the hospitals cost. Making sure she had the correct information on
how to help herself post operatively, hopefully it will decrease the chances of her coming back
into the hospital.
Environmental Health. This is a standard that I have met. The registered nurse
practices in an environmentally safe and healthy manner. (ANA, 2010, p. 69). The need for
keeping a healthy environment for our patients is important.
A specific example where I have met this goal would be when I went into a room where
there was a patient that was on isolation contact due to Methicillin-resistant Staphylococcus
aureus (MRSA). I have specifically never had my own patient on isolation, but when a call light
is flashing I answer those. Before I headed into the room, I noticed the isolation cart was out, I
put my gown, gloves and mask on and went in and helped rotate the patient. By using the
isolation precautions I was able to keep the environment safe and healthy.
Code of Ethics for Nurses
Ethical Standard One.
The first ethical standard reads as follows: The nurse, in all professional relationships,
practices with compassion and respect for the inherent dignity, worth, and uniqueness of every
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individual, unrestricted by considerations of social or economic status, personal attributes, or the
nature of health problems (American Nurses Association [ANA], 2001, para. 1). As soon as I
walk into the clinical setting and meet my patients my main goal is to make sure that they are
being treated with the best quality of care and are safe in the environment they are in. No matter
what the situation is. Specifically a patient that I had come in contact with who was HIV
positive, that was something I hadnt been exposed to in the past, I made sure to keep that out of
the care that I was giving the patient and treated them as I would with any other person.
Ethical Standard Two.
The second ethical standard reads as follows: The nurses primary commitment is to the
patient, whether an individual, family, group, or community (ANA, 2001, para. 2). A specific
example of how I have achieved this standard was when I was doing my home health visits. I
was strictly there for the care of the male client, cleaning out his wound with the RN, but the
wife had a break down. She had just found out that she had cancer and the husband was getting
frustrated with her because she wasnt being strong in front of us. I made sure the comfort the
wife the best I could, but to keep in mind that I was there for her husband and had to focus on his
wound.
Ethical Standard Three.
The third ethical standard states, The nurse promotes, advocates for, and strives to
protect the health, safety, and rights of the patient (ANA, 2001, para. 3). A specific example of
how I achieved this standard was this semester in clinical. It was another students patient, but I
went in and helped her take care of the patients needs. The patient was not aware of what was
going on around him and was being neglected from the staff. We had noticed that a spot in his
inner thigh had become inflamed, reddened and warm. We marked off where it was and noticed
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within an hour that it had grown 4 inches around his thigh. We immediately told the RN, who
seemed to blow it off, so once the doctor came in to make rounds, we mentioned it to her and
something was done right away. We were able to advocate the patient and stop from an infection
from occurring.
Ethical Standard Four.
The fourth ethical standard reads as follows: The nurse is responsible and accountable
for individual nursing practice and determines the appropriate delegation of tasks consistent with
the nurses obligation to provide optimum patient care (ANA, 2001, para. 4). This is a standard
that I have met. When role playing in lab specifically being in the primary nurse role, it was my
responsibility to delegate what the secondary nurse was to do so that we could take care of the
patient safely and in a timely manner. I was able to pull and administer medications on my own
while the secondary nurse took a set of vitals and assessed the patient. We got our duties done
more quickly while providing optimum care.
Ethical Standard Five.
The fifth ethical standard reads as follows: The nurse owes the same duties to self as to
others, including the responsibility to preserve integrity and safety, to maintain competence, and
to continue personal and professional growth (ANA, 2001, para. 5). I have met this standard
specifically in the clinical setting. When I am having a bad day, something happened outside of
school with my family or had a bad night where I couldnt get enough sleep, I make sure that as
soon as I show up to clinical I put all of that aside and give my 100 perfect focus to my patient
and to their needs. I am sure the let the instructor know before I start my day, so if I need a 10
15 minute break that I am taking them so that I dont get too over whelmed.
Ethical Standard Six.
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The sixth ethical standard reads as follows: The nurse participates in establishing,
maintaining, and improving health care environments and conditions of employment conducive
to the provision of quality health care and consistent with the values of the profession through
individual and collective action (ANA, 2001, para. 6). This standard is met multiple times
throughout the day in the clinical setting. I have done evidence-based practice research on the
importance of washing in and out of each patients room. Just by doing this simple action, nurses
patients, family members and doctors decrease the chances of passing around infections to each
other. More specifically, when I am inserting a catheter, I make sure that I am using sterile
technique because on each floor I have been in the staff pushes the importance of patients not
getting a urinary tract infection. I make sure to educate the patient on the importance of infection
and make sure they understand.
Ethical Standard Seven.
The seventh ethical standard reads as follows: The nurse participates in the advancement
of the profession through contributions to practice, education, administration, and knowledge
development (ANA, 2001, para. 7). I have been able to meet this standard partially. Each
semester I learn more nursing skills, medications, safety, education and diagnoses with each
patient I get. This has helped developed my knowledge to further my degree. I plan to keep
working towards more goals in the nursing profession specifically working on my masters in
nursing, so this standard will keep growing as I grow as a nurse.
Ethical Standard Eight.
The eighth ethical standard reads as follows: The nurse collaborates with other health
professionals and the public in promoting community, national, and international efforts to meet
health needs (ANA, 2001, para. 8). I have met this standard during my service learning project.
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I worked with a retired surgeon from St. Marys hospital and two nurses at the Lacks Medical
Center by assessing employers who meet the requirements of employment at Lacks Enterprises. I
helped with drug, hearing and eye tests as well as obtaining the clients weight, height, blood
pressure and heart rate. I was able to collaborate with the doctors and nurses if any of the clients
didnt fit the criteria needed for the job description in this community.
Ethical Standard Nine.
The ninth ethical standard reads as follows: The profession of nursing, as represented by
associations and their members, is responsible for articulating nursing values, for maintaining the
integrity of the profession in its practice, and for shaping social policy (ANA, 2001, para. 9).
This is a standard that I havent met, but I plan to meet in the future. I havent got much exposure
from this due to only being a student nurse, but I plan to maintain this standard as soon as I
graduate and get a full time job and understand the different policies and procedures for different
companies.
Professional Development Plan
Goals
Throughout nursing school I have been exposed to different aspects of health care I didnt
know were possible. There are so many different directions that I can take after obtaining my
degree. In order to maintain competency and work towards being the nurse that I want to be
would be to make goals for myself after I graduate. I have come up with three different goals that
are measurable and able to achieve in my nursing career. The first goal would to be to finish
nursing school and get my Bachelors degree from Ferris State University. The second goal
would be to go back to school after I graduate and continue my education, hopefully my masters
and can become a nurse practitioner. Some of the standards that werent met yet were because I
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need to be able to further my education. Another goal that I have that I want to achieve as soon
as I get out of school is to become a part of an organization, specifically Up on the Roof at St.
Marys hospital in Grand Rapids. My great uncle Dick Lacks Jr. died from cancer and our family
donated money to make the Lacks Cancer Center of St. Marys. This is something that I have
wanted to become a part of and with the knowledge I have attained from school, I will be able to
bring new nursing knowledge to the team.
Action Plan
For my first goal of graduating from the Ferris State University BSN program, I have
committed to lifelong learning. Nursing is a profession where the learning never stops. It took
me a couple years and a lot of applying to even get into the program at Ferris State. My goal is to
finish in December, take the HESI a couple of times with classmates, study a few months for the
NCLEX and then pass it on my first try and get a job at St. Marys. I have enjoyed working at
Pine Rest, but I think staying on a medical surgical floor for a year or two will help me obtain a
lot of skills needed to become the best nurse I can become.
The second goal that I have for myself is to be able to attend school again. I am interested
in taking Ferris States online masters program a couple years after I graduate from the BSN
program. Getting a couple years under my belt will help educate and ready me for the next level
of my career. I would like to become a charge nurse then hopefully a case manager some day. I
would like to take that leadership standard and be able to teach other nurses all the knowledge
that I have to offer.
My third goal is to become a part of an organization. I already know the organization that
I want to become a part of. My cousins and brothers are on the board and they arent even in the
medical field. If I become part of this team at St. Marys I will be able to use my knowledge that
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I had learned from school and pertain it to situations with patients and helping to raise money to
help cure cancer. I want to be able to choose from other organizations also. If I decide that I want
to become a nurse practitioner I would like to become part of the American Academy of Nurse
Practitioners.
Evaluation Plan
The way that I will evaluate my first goal is to make an organized chart that keeps my
skills, medications, NCLEX style questions and any other information that I know I will need to
prepare myself for the upcoming tests that I will be taking in the next year. While I am preparing
for the NCLEX, I can pull out this information and use it to help familiarize myself with skills
that I need to keep up to help my pass this exam.
The way that I will evaluate my second goal is to make sure that once I have a couple
years of medical surgical unit under me that I find it most important to take leadership and show
my staff that I want to and deserve to further my education. Many work places are offering
money to nurses who want to further their education. I will do this as soon as I feel that I am
comfortable in the setting that I am in. (See Appendix A)
The third goal that I have I plan to evaluate right when I graduate from school. I have
already looked into different options of things that I could do, but I havent had the time to
commit to the organization completely. I know that by doing this I will help patients and the
team members on the committee. I want to be able to show my family the hard work that I have
achieved and that I can make a different with all of them. (See Appendix B)
Conclusion
The standards and ethics of nursing are important to every nurse in the profession. After
assessing myself in each one of these standards, I can see how important it is to make sure that
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nurses are reviewing and understanding each of them individually. I now realize all that I have
done in the past year in a half and how much of a difference I have made to patients in a safe
environment, by helping the hospitals and other care providers. This is something that I will be
reviewing multiple times in my career and will make sure that I am sharing this information with
all of my coworkers.



















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References
American Nurses Association. (2001). Code of ethics for nurses. Silver Spring, MD.
American Nurses Association. (2010). Nursing Scope and Standards of Practice. Silver Spring,
MD.





























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Appendix A

1. Graduate from FSU 3. Work on a Med Surg floor for a couple years 5. Obtain a masters
2. Pass NCLEX 4. Take the position of charge nurse at St. Marys 6. Work as a case manager





















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Appendix B
1.After I graduate call St.
Marys Lacks Cancer Center
and get information on how to
become part of the
organization
2.Go to meeting with the
committee
3.Attend Events at the Lacks
Cancer Center
4. Shadow a doctor for a
couple weeks throughout the
hospital
5. Help come up with
fundraising idea to raise
money for the organization
6. Stay on the committee for as
long as I am in the nursing
career