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Running head: SELF ASSESSMENT 1

Self-Assessment of the American Nurses Association Scope and Standards


Rebecca Cavanagh
Ferris State University

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Self-Assessment of the American Nurses Association Scope and Standards
The American Nurses Association (American Nurses Association [ANA], 2010) has
developed the Scope and Standards for Professional Nursing. These standards define the
responsibilities of nurses. The registered nurse (RN) is expected to perform these standards
competently. The Code of Ethics was also developed by the ANA to create for goals, values and
obligations of the profession (ANA, 2001). As a soon to be RN graduate, a self- assessment of
the Standards and Code of Ethics is necessary to see if the student is prepared for the nursing
profession. After careful examination, a professional development plan will be created to help
meet standards not currently met and maintain those that are.
Standards of Practice
Assessment
Assessment is the collection of data pertinent to the patients health and situation. It is
comprehensive and holistic to the individual (ANA, 2010). This includes assessment of emotions
as well as the physical being. The registered nurse also prioritizes which patients need to be
assessed first (ANA, 2010). I have met this standard through my clinical experiences and
knowledge in the classroom.
In the first semester of nursing, students are taught and evaluated on how to perform a
head-to-toe assessment. Building off the foundation in the classroom a head-to-toe assessment is
completed at clinical for every patient in the morning. A focused assessment is performed in the
afternoon specific to the patients situation. Through assessments I have identified some
abnormal findings including pitting edema, crackles in the lung sounds, skin breakdown, altered
mental status in patients. Through experience and taking on multiple patients I am also able to
prioritize which patients need to be seen first. A patient in respiratory distress and oxygen
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saturation levels in the 70 percentile needs to be seen before a patient with influenza like
symptoms.
Diagnosis
Analysis of the assessment data is used to create a diagnosis that is unique to the patient
(ANA, 2010). The diagnosis is based on assessment data and uses standardized classification
systems. The diagnosis may be an ongoing problem for the patient or may be an issue for which
they are at risk (ANA, 2010). I have met this standard through the critical thinking summaries
completed for clinical and many case studies for classes.
After completing an assessment of data, including a head-totoe assessment, laboratory
values, vital signs, and speaking with the patient about concerns, a diagnosis is formed. The
diagnosis is made using Mosbys Guide to Nursing Diagnosis (Ackley & Ladwig, 2011). The
diagnosis should be most pertinent to the patient, and should meet criteria to the patient. An
example is risk for falls related to weakened lower extremities and left knee dislocation.
Outcomes Identification
In this standard The registered nurse identifies outcomes for a plan individualized to the
healthcare consumer or situation (ANA, 2010, p.35). The patient and their families should be
involved in their plan of care and the outcomes, goals, and time to complete those goals. I have
met this standard.
In critical thinking summaries completed as part of clinical paperwork one outcome is
identified per diagnosis that is unique to each patient. Outcomes are designed around the
patients physical, emotional, and motivational level so that they can be successful. One example
is a patient who was at risk for infection due to impaired skin integrity related to an open
abdominal wound. The outcome for this patient would be to remain free from infection. Based on
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their motivational and educational level a discussion can occur on how to achieve this outcome
and then a plan can be made.
Planning
This standard involves creating an individualized plan to achieve expected outcomes
(ANA, 2010). This is the next step in the nursing process. When developing a plan it is important
to come up with alternatives so patients have options to complete the outcomes. Include the
patient and their families in the plan because it keeps them invested in their health and strive to
meet goals.
This standard has also been met through critical thinking summaries for clinical. In the
critical thinking summaries three interventions are planned for each diagnosis and outcome for
each patient. Also in clinical development of daily goals is done in the morning with the patient.
The goals are written on the patients board as a reminder to both the patient and the nurse of
what should be accomplished that day. One goal of a post-surgical patient was to go for three
walks during the day. This was a good goal because walking helps to prevent blood clots,
improves skin integrity, and helps strengthen muscles to keep the patient independent.
Implementation
In this standard the registered nurse implements the identified plan for patients (ANA,
2010, p.38). To be competent in implementation, the nurse must coordinate with the patient and
caregivers of the patient to carry out the plan in a safe manner. The RN should also be caring
towards the health care consumer, use evidenced based interventions, and apply available
healthcare technologies to optimize outcomes (ANA, 2010).
I have met this standard. For example, I implemented a plan for a patient with stress
hyperglycemia due to acute pancreatitis. The patient was on an insulin drip to control blood
sugars. Endo Tool was used to track the blood sugars, control the rate of insulin, and schedule
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intervals of blood sugar checks. Implementation of this plan was founded on evidenced based
interventions, used health care technologies, and included the patient in education about diabetes
and pancreatitis.
Evaluation
The goal of a care plan is to achieve the outcomes set together by the patient and the
nurse. Evaluation is the appraisal of progress made toward accomplishment of the outcomes
(ANA, 2010). The registered nurse should work in partnership with the patient to evaluate the
progress toward outcomes. Also ongoing assessments and documentation of the results of the
evaluation should be done (ANA, 2010). I have met this standard through assessment and
evaluation of pain control.
An outcome for many post-operative patients is pain control. This can be evaluated by
follow up assessment after pain medication administration, identifying which medications work
best for the patient and creating a schedule that works to keep pain under control. Also,
educating the patient on alternatives to pain medication can help to keep them comfortable is
helpful. After assessment of the efficacy of pain medication and education of alternatives,
adjustments in the plan can be made as they start to heal.
Ethics
This standard ensures the nurses perform their practice in an ethical manner (ANA,
2010). Nurses act ethically by protecting patients confidentiality, maintaining therapeutic
relationships, and respecting values and beliefs of the patient. I have met this standard.
Evaluation of meeting the criteria for Ethics will be addressed in the Code of Ethics section of
this paper.


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Education
The medical field is constantly changing. The nurse must gain knowledge and skills that
reflects current nursing practice (ANA, 2010). To gain this knowledge the nurse may participate
in ongoing educational activities, have a commitment to lifelong learning, and identify learning
needs. I have met this standard.
Through the education in the nursing program I am constantly involved in scholarly
activities that further the knowledge of the nursing practice. These activities use the most current
resources available to teach evidenced based practices. By choosing nursing as a profession I am
committed to lifelong learning. There will always be new research, continuing education, and
seminars to attend in the nursing profession to further education. Through the tools and
experience I have gained so far, I am equipped to learn. Through this self-assessment of the
ANAs Standards and Ethics I am also evaluating my learning needs.
Evidenced Based Practice and Research
In this standard, the nurse integrates evidence from research findings into practice
(ANA, 2010, p.51). Using current evidence promotes safety and optimal care for patients. I have
met this standard. I can competently search for and find credible research through the nursing
research class. I have also been taught the most up to date evidence in performing skill. I have
then been able to incorporate the findings into the clinical area. For instance it is now evidenced
based practice to not inflate the balloon of an indwelling catheter before inserting it. I have had
to share this information with other RNs at clinical facilities who were still inflating the balloon
before inserting. Not only have incorporated evidenced based practice into my skills but
educated other nurses.
Quality of Practice
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Nurses should participate in efforts to improve the quality of nursing practice (ANA,
2010). This includes documenting the nursing process and activities of quality improvement.
Aspects of quality improvement include monitoring, collecting, data, implementing and
evaluating outcomes. I have not fully met this standard.
I am able to document the nursing process as evident as meeting the first six standards. I
have also monitored for quality of practice when shadowing the charge nurse. I assessed the
completion and accuracy of the white boards in patients room and the satisfaction of the
patients care during their stay. At this point in time I have not been involved in identifying a
problem in the clinical area or the steps involved to identify a solution. I plan on fully meeting
this standard through the goals in the Professional Development Plan section of this paper.
Communication
Communication is an important aspect of nursing. The ANA (2010) states the nurse
should communicate effectively throughout all areas of healthcare. Some competencies
associated with communication include assessing the preferences of communication, seeking
continuous improvement, conveying information accurately, and disclosing observations to the
appropriate level. I have met this standard.
My communications skills have improved greatly since beginning the nursing program.
In the clinical area communication between the nurses and nurse technicians is constant so to
ensure no gaps in care. I also look for feedback with my communication. Giving report to my
instructor is an area which, I have greatly improved. I also assessed and addressed the preference
of a patient who spoke Spanish by getting an interpreter for the purpose of completing an intake
form.
Leadership
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The nurse is a leader in the healthcare field as well as a leader in the practice setting
(ANA, 2010). A leader communicates effectively, oversees care of the patient, demonstrates a
commitment to lifelong learning, treats colleagues with respect, and follows through on care
plans. I have met this standard. A leader treats colleagues with respect, is a team player, and
communicates effectively. In the clinical setting I act in a professional manner, treating everyone
I interact with respect and dignity. I am an effective communicator when delegating tasks and
giving report. I oversee the care provided to my assigned patients given by myself, nursing
technicians and nurse. I make sure between the three of us that care be completed for the patient.
That the patient reaches the goals for the day and that they are treated in a caring and respectful
manner. This involves constant communication and a clear vision of the plan established in the
morning.
Collaboration
In this standard The registered nurse collaborates with healthcare consumer, family, and
others in the conduct of nursing practice (ANA, 2010, p. 57). Collaboration includes engaging
in teamwork, communicates effectively to those involved in the patients care, and cooperates in
creating a plan for patients. I have met this standard.
In the clinical setting I am constantly collaborating with fellow students, instructors,
nurses, and nurse technicians. Participating in team huddles to discuss the plan for the day and
who will do what with the patient. I also attend team spirit meetings with the whole floor. I work
as a team player by answering other patients call lights, and asking if anyone needs help when I
am caught up.
Professional Practice Evaluation
This standard requires nurses to evaluate their practice (ANA, 2010). This includes
recognizing strengths and areas for growth. Evaluation also includes obtaining informal
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feedback, participating in peer review, and taking action to complete goals. I have met this
standard.
I have evaluated areas of strength and areas of growth through the assessment of this
paper. In the clinical area I received informal feedback both from instructors as well as nurses I
am working with. Every semester my performance is evaluated according to certain criteria. I
take the informal feedback and the evaluations seriously to know what to work on the most. In
the professional development plan in this paper goals are set along with an action and evaluation
plan to attain those goals.
Resource Utilization
This standard states The registered nurse utilizes appropriate resources to plan and
provide nursing services that are safe, effective, and financially responsible (ANA, 2010, p.60).
Criteria of this standard include assess the needs of individual patients, delegates care
appropriately, and assisting patients in getting services for specific needs. I have met this
standard.
Delegation of tasks to nursing technicians is done daily at clinical. A plan of the day is
divided among the staff during team huddles. I also participated in meetings with the charge
nurse to discuss the amount of staff needed on the floor for the afternoon shift based on the
patient load for the floor. I have also contacted case management about supplies needed after
discharge for a patient and their caregivers.
Environmental Health
The environment is an important aspect of nursing. This standard states The registered
nurse must practices in an environmentally safe and healthy manner (ANA, 2010, 61). This
includes creating a healing environment, using strategies to promote healthy communities, and
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reducing health risks for workers and patients. I have met this standard through my rotation in
public health and in the acute care settings.
The public health rotation promoted healthy communities by vaccinating and providing
education through Women Infants and Children (WIC), and family planning. In the clinical
setting I remove risks by making sure the rooms are cleaned and tidy to reduce risks for falls. I
also make sure to project a happy and calm attitude to reduce stress.
Nursing Code of Ethics
Provision 1
The first provision of the Code of Ethics states that nurses treat people with respect,
dignity, and compassion regardless of socioeconomic status or health problem (American Nurses
Association [ANA], 2001). This includes patients, family members, and other members of the
health profession. I meet this provision.
I chose to pursue nursing because of the passion I have for people. Patients, students, and
health professionals are treated with respect. I understand that each individual is unique and
comes with different life experiences. Every patient, student, and health profession is an
opportunity to learn from. They way people act, life choices, and attitudes all come from life
experiences.
Provision 2
Provision 2 of the code of ethics states the nurses number one priority is to the patient
(ANA, 2001). The patient can be an individual, family, or a whole community depending on the
setting. I have met this ethical provision.
Asking a patient if they need anything else before I leave the room is one way to make
sure needs are met. This includes making sure family members are taken care of as well. Not
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only taking care of physical needs but emotional needs as well. Listening and providing
therapeutic communication are important in the healing process.
Provision 3
The nurse protects the privacy of the patient and promotes health and safety (ANA,
2001). This includes confidentiality of patient information. I have met this provision. All
documents with patient names are placed in the shred box and do not leave the facility. Patients
are only discussed in post conference after clinical and no names are used. To promote health and
safety, education is provided, environment is kept form potential risks and beds are locked and in
the lowest position. If the patient is a fall risk making sure the bed alarms on every time I leave
the room protects patient safety.
Provision 4
In provision 4 the nurse takes responsibility for their own actions (ANA, 2001). The
nurse must remain accountable for the care they are providing and the care the delegate to others.
I have met this ethical provision. At the clinical I am responsible for the care I provide to the
patients assigned. I chart accurately and timely the care that provided. I delegate baths and vitals
to nursing assistants when necessary.
Provision 5
The nurse strives for personal and professional growth to maintain integrity, competence,
and safety (ANA, 2001). Throughout every experience in nursing school I have grown both
personally and professionally. My confidence in taking care of patients and my nursing skills
have grown tremendously. Reflecting back on situations and critically thinking has maintained
my integrity. Through this assessment of the ANAs Standards and Code of ethics I have realized
which areas I need to improve and areas of strengths. An action plan for future goals will help to
maintain of this ethical provision and can be found in the professional development plan section.
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Provision 6
The nurse promotes a work environment that fosters the values and virtues of the
profession. This includes ethical considerations that nurses are treated fairly. I have met this
standard. Being aware of the attitude I project is an important aspect of creating a good working
environment. In the clinical area I have a calm and happy attitude. Being a team player is also
important aspect of creating a healthy work environment. I help to keep the environment safe by
arriving on time, answering call lights, and keeping them clean and free form risks.
Provision 7
Provision 7 states The nurse participates in the advancement of the profession through
contributions to practice, education, administration, and knowledge development (American
Nurses Association, 2001, p.12). I am partially meeting this provision of the Code of Ethics. I am
not currently involved in an organization that further advances the profession of nursing. I am
involved in ongoing scholarly activities through assignments, research projects, and the annual
Nursing Scholarship day by Ferris State University. I am gaining knowledge specific to the body
of nursing every day.
Provision 8
In this provision nurses collaborate with other health professions to promote health and
wellness in the community as well as nationally and internationally. I have met this provision on
the community level through my rotation in public health. Collaboration with social services,
health educators, and primary care providers was done to promote health in the community. The
primary goal of public health was prevention and health promotion. Helping people get the
resources they need to be successful in maintaining health. Where there was a lack of access it
meant bringing the can to the people through flu clinics. I have not met this provision on the
national or international level.
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Provision 9
Provision nine is, The profession of nursing, as represented by associations and their
members, is responsible for articulating nursing values, for maintaining the integrity of the
profession and its practice, and for shaping social policy (American Nurses Association, 2001,
p.13). Nurses have an obligation to society to outline their duties and keep the profession well
respected by upholding the ANA Standards and Code of Ethics. I have partially met this
provision by completing this assessment of the Standards and Code of ethics. I met all but one of
the standards and partially meet three of the Code of Ethics. By meeting these I am helping to
uphold the nursing profession. I have not yet had the opportunity to shape social policy or be a
part of a nursing association. To ensure that I meet and maintain the ANA standards and the code
of ethics a professional development plan will be developed.
Professional Development Plan
A professional development plan will be used to maintain the standards and ethical
provisions that I have already met and to attain the ones I have not. Through this self-assessment
I have met every standard except standard seven, Quality of practice. All of the Code of Ethics
provisions have been met except for provision seven and nine. The following goals will help
meet those specifically mentioned and maintain all others.
Goals
My first goal is to join the (ANA) after graduation. This goal will help me meet all three
standards not yet met. By becoming a part of the ANA it allows me to advance the profession of
nursing, help effect change in social policy, and provide resources to address clinical problems.
My second goal is to enter into a leadership position after two years of practicing. This goal will
help to maintain of the standards that I currently meet. I have personal qualities that would make
a good leader and I found I enjoyed the role of charge nurse in the clinical experience. My third
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goal is to look at these standards and provisions every six months and reassess how I am meeting
them. This way I can constantly improve my quality of care I am providing with more
experience.
Action Plan
The first step toward my goal of joining the ANA would be to become licensed RN. After
graduation I plan on taking a NCLEX review class and then studying to pass my boards. My
plan is to take my boards in February and find a job by May 2015. I can then apply to become a
member of the ANA. My second goal is to have a leadership position after two years of
experience. Two years gives me time to practice and develop my skills as nurse before leading
others. After the two years I would apply to be a charge nurse. Please see appendix A for
suggested time line of goals.
Evaluation Plan
To evaluate my plan I will use the time line I created (Appendix A) as a guide to
completing the goals I have set. I will do monthly checks on my time line to evaluate the
progress I am making toward my goals and adjust dates as needed to fulfill the goals.
Conclusion
Through this self-assessment of the ANA standards of nursing and the Code of Ethics I
realize how prepared I am to be a registered nurse. The education received in class is the
foundation to build on in the clinical setting. A reflection on these standards is necessary to
access the care provided to patients and the quality of the nurse.




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References
Ackley, B., & Ladwig, G. (2011). Mosb'ys guide to nursing diagnosis. (3rd ed.). Maryland
Heights: Elsevier.
American Nurses Association (2001). Code of ethics for nurses with interpretive statements.
Silver Spring, MD: American Nurses Association.
American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver
Spring, MD: American Nurses Association.

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Appendix A
Time Line for Accomplishing goals
Reassessment of Standards 12- 10-14
Graduation 12-13-14
Hurst NCLEX Review 1-15-15
Pass NCLEX 2-15-15
Have First Nursing Job 5-10-15
Become an ANA member 6-1-15
Reassessment of Standards 6-10-15
Reassessment of Standards 12-10-15
Reassessment of Standards 6-10-16
Reassessment of Standards 12-10-16
Apply for Leadership Position 5-10- 17
Reassessment of Standards 6-10-17
Have a leadership Position (Charge Nurse) 6-10-17
Reassessment of Standards 12-10-17