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Introduction

Throughout the course of the BSN program, we were taught through various forms of
educational opportunities via course content and through a variety of clinical locales in attempt
to better understand both the patients and their environments. In addition, we have learned about
nursing informatics and the technologies surrounding healthcare, the political side of healthcare
with a focus on the Affordable Care Act and its impacts on the populous, healthcare and
healthcare needs within the community, along with nursing research and leadership. I have
outlined below how I have met each objective during my time in the RN-BSN program.
Outcome 1: Plan and implement safe, effective, ethical, evidence-based practice activities in
primary, secondary and tertiary settings promoting health as well as preventing or
reducing mortality, morbidity, and health disparities from physical and mental health
problems in individuals, families, communities and populations.
The planning and implementation of safe, effective, ethical practice has always played an
important part in my nursing abilities. Until completing the BSN focus of nursing care, I did not
completely understand the importance of evidenced based care, nor did I know how to properly
perform a level of research that could promote better care and a better care environment. Using
information taught, I feel as if I am more competent to perform more thorough and in-depth
patient assessments in order to obtain a broader picture of the variables that may have
contributed to a patients illness or disparity. Having incorporated this learned knowledge in my
professional practice, I am able to confidently provide and educate patients about information
that may prevent, promote or sustain optimal health, beyond what the physician prescribed
regimen may be. I am also confident in my abilities to encourage patients to be proactive in their
care and make use of reliable online resources to learn about actual or potential disease
processes.
Outcome 2: Demonstrate and evaluate effective communication with patients, peers,
colleagues, families, communities and interdisciplinary teams.
Effective communication skills are not just limited to the interactions of the nurse and
patient, but collectively between the nurses, providers, interdisciplinary team members, patients,
and members of the community. Healthcare members and patients alike should expect and
deserve clear information and instructions and should be given opportunities to clarify any vague
or imprecise information. Ineffective communication between health care team members gives
room for care to be missed or unsafe practices to occur. Being able to effectively communicate
with patients, families and/or care providers promotes the continuance of care and the knowledge
needed to do so. We must also be able and willing to communicate our needs with each other and
be able to support each other as we provide the most safe and optimal care possible.
Outcome 3: Integrate, evaluate and interpret analytical, contextual and holistic thinking
through problem solving, diagnostic reasoning and clinical decision-making.
As nurses, caring for patients in a variety of settings, we are accustomed to getting large
influxes of subjective and objective patient information that we must be able to effectively sift

through in order to provide the most appropriate care. Many times we dont have all the
information we need to make an informed decision about why or what is occurring with our
patients. Sometimes we have to take a step back and look at the bigger patient picture. For
example, if a patient is repeatedly seen by the provider for an acute asthmatic reaction and the
patient has followed previously prescribed treatments, we have to look at what are some of the
possible underlying causes or influencing factors that are triggering the asthmatic reactions. This
means that we as nurses have to be willing to ask patients about their home life, living
environments, and if the patient is engaging in any particular activities when the reaction occurs.
If none are identified, then a case worker may be called upon to perform an in home inspection
to determine if there are any environmental factors that may be causing the reactions. Nurses and
providers must not be content with only the information the patient decides to provide, but must
be willing to look at all of the angles and engage patients for further information. We must have
the ability to look at and deduce decisions from known and factual information about disease
process along with problem solving and diagnostic reasoning abilities.
Outcome 4: Build collegial and collaborative caring relationships with culturally diverse
individuals, families, communities and populations.
As mentioned afore, the BSN program has allowed me to experience many opportunities
as a student in a variety of patient care and community settings that I would not have ordinarily
participated in. Much to my surprise, I thoroughly enjoyed my time working beside the school
nurse in an elementary school setting. I felt a plethora of emotions during my time there, from
apprehension to joyfulness. I learned how to effectively approach and communicate with this
population and learned how to treat a variety of ailments with minimal resources. My largest
concerns with that experience were how many students failed their vision screenings and more
importantly, how many students were food insecure and needed food assistance through the
Backpack Buddy program. That part of my experience was very disheartening and I used that
information as a foundation for my community assessment project, which involved bringing
community gardens into the schools and teaching the children about learning to care for and
grow a sustainable garden.
Outcome 5: Design and implement educational experiences for individuals, families,
communities and populations with an emphasis on primary prevention and health
promotion.
This outcome was met when I performed an in-home family interview and assessment
with a blended family of two parents, biological children, and foster children. The homes
physical environment, interior and exterior, were assessed as well as interviews completed with
each family member individually and as a family unit to identify safety, stress, health and risk
factors. After a series of three interviews, I reviewed and discussed my findings with the family
and assisted them in identifying areas that needed improvement, such as their lack of physical
activity, diet, and areas within the home that if left unaddressed, could cause harm or injury to
any of the family members. From there, the family came up with ideas that would improve their
safety, exercise, and dietary habits in order to promote primary health prevention and health
promotion.

Outcome 6: Analyze and manage resources for patient care, program planning and
impacting the environment of nursing practice.
I took on the opportunity to review, analyze, and provided suggested revision
recommendations to the blood administration policy and guidelines (excluding pediatrics), along
with creating a quick reference blood administration guide for qualified staff members in the
emergency department at Habersham Medical Center. I chose this as a project after witnessing
various staff members question and infused blood products with misguidance and without the
appropriate knowledge for doing so. So many various reactions can occur when blood products
are administered appropriately and can greatly compromise a patients safety. I analyzed the
policy line by line, checking for inaccuracies or processes that did not meet the national
standards set by AABB. I learned a valuable lesson and that I cannot assume a certain person is
qualified or allowed to complete a certain task, just because I saw them do it. From that I learned
the significance of knowing what each person is allowed to do per the facilities protocols and
determined scope of practice. In the process, certain warming equipment was identified as unsafe
and unfit for usage for warming blood products due to the inability to monitor fluids for specific
temperatures. Throughout the process, I frequently communicated with our ED nurse educator,
blood bank/lab staff, ED physicians, and staff nurses and paramedics about their knowledge of
blood product transfusions. My finished project is an outlined, step by step, easy to read,
reference guide for qualified emergency staff members to utilize when blood product
transfusions are needed.
Outcome 7: Embody the personal and professional attributes of a leader and influence the
development of leadership in others.
Though I am not yet a manager or a charge nurse, I still consider myself a leader. I make
it a point to learn as much as I can about everything and I thoroughly enjoy passing that
information onto others. I try to involve myself in much of the learning activities at work and
take on roles that challenge me as a person as a nurse. I enjoy learning and sign up for continuing
education classes for the knowledge, the experience, and to meet new people. I keep my patients
in mind anytime I perform a task, because I am there for them, to help the patient and their
families through difficult times. That is why I am a nurse. I aim to encourage others around me
to learn and to step outside of their comfort zone and take the opportunity to teach someone else.
I encourage patience with my peers during dealings with patients and families and try to remind
them that our patients may not be like us on a scholarly level, but they continue to deserve the
same respect we show each other. As I complete my work, I volunteer my assistance to others
and always try to be available. In addition, I am always looking for ways to improve the way we
provide care to our patients, along with making positive suggestions to improve how we
document our actions.
Outcome 8: Access, appraise, and synthesize current scholarly resources to support
evidence based practice.
Working in conjunction with two of my peers, we developed an evidenced based practice
project utilizing a literary analysis process that addressed the question: Does implementing
bedside shift reports lead to greater patient satisfaction with care when compared to traditional

shift change reports at the nurses station? Research articles, reports, and pilot studies were
reviewed by all three group members. What we ascertained was that patient satisfaction did
increase when change of shift reports were performed at bedside because patients felt like they
were more involved in their own care. In addition, beside shift reporting allowed the nurse and
patient to meet at the start of the shift and allowed for any patient information to be clarified, an
opportunity for the plan of care to be reviewed, and increases nursing productivity. Further areas
of research that were identified included: bedside shift reporting on pediatric units, optimal ways
to wake up a patient/family, and post-implementation effectiveness.

Implications for Practice


The knowledge I have obtained through the course of the last two years in the RN-BSN
have proven to be invaluable. I can see in myself the changes in the way I practice, even in the
smallest instances. I have been trying to find ways to improve the way our department operates
and try to stay up-to-date on new findings and research by reading evidenced bases practice
articles. Getting the opportunity to precept both staff and students gives me great pleasure to
teach others what I know and encourage them to do and to ask questions. Having learned about
the financial priorities and budgeting for necessary resources, I make sure to only take what I
need and remind others to do the same. I care about my patients and make sure that before they
go home, they understand what their diagnoses are, what it means, what treatment regimen the
doctor has prescribed, what to do when they get home, and provide opportunities for questions
and clarification. Due to my clinical experience with the children at the elementary school, I now
feel much more confident communicating with them on their level and do so more effectively. I
feel the opportunities I have experienced during this program have made me a better wellrounded nurse who is capable of preventing, promoting, maintaining, and improving patient
health and the care we provide.
There have been many changes in the way healthcare is obtained and accessed and continues to
change at a rapid pace, affecting every aspect of patient care. Technologies are changing with the
times and more people are facing issues obtaining adequate health care. I is my goal to use the
knowledge I have obtained from this program to improve the care we provide by staying up to
date with cutting edge research and even participating in the research process. In attempts to help
change the future of nursing, it is my goal is to obtain a role in nursing informatics to improve
and promote patient centered care efficiently utilizing current and future technological resources
available to the nursing profession