The program of study that is necessary to obtain a bachelor’s degree in nursing has a

tremendous impact on every person who sets out to become a registered nurse. It is truly

humbling to be entrusted with the care of our patients. It is a program filled with many new

experiences and opportunities, many of which place the student into circumstances in which they

must grow as a person. Completing a nursing program is not an easy experience, intellectually,

emotionally, or personally. The difficulty of obtaining the bachelor’s degree in nursing creates a

point of relation that is shared among nurses. This time forces us to learn and grow in new areas

as well as expand our worldviews. In this paper I will demonstrate continued attainment of the

eight behaviors that are embodied within the graduating registered nurse. These qualities are

necessary to perform educated, compassionate, and culturally competent care.

Critical Thinking

Junior Year

During my second semester in the program, I participated in clinicals at Sentara Norfolk

General Hospital and cared for a patient that was admitted for exacerbation of her chronic

obstructive pulmonary disease. I observed the patient have difficulty swallowing liquids from her

breakfast tray, so I suggested she set it aside for a moment. I notified the nurse and checked the

patient’s chart and found that she was recently downgraded to nectar-thick liquids. I returned to

the patient’s room and assessed her lung sounds before replacing all non-thickened liquids.

Senior Year

Fall 2019, I took a rehabilitation nursing course with clinical learning at Sentara Norfolk

General Hospital. During this time, I cared for an elderly gentleman who had been admitted for

rehabilitation following a stroke. He experienced pain that was not adequately decreased by
acetaminophen. He did not want to request as needed narcotic pain medication, so he asked for a

warm pack. I relayed this information to the nurse who stated that none were available. I created

a makeshift warm pack using supplies available on the unit. A washcloth saturated with warm

water and placed within a plastic baggie provided the relief that the patient required.

Nursing Practice

Junior Year

While caring for the gentleman mentioned above, I initiated a game of Scrabble that I noticed

in his room. I assisted the patient from his bed to his chair and set up the game on the bedside

table. Scrabble allowed the patient to practice fine and gross motor movement. The boardgame

also challenged the patient mentally as he arranged letters into words and considered the layout

of point modifiers on the board. Finally, the game distracted him from the pain for which he

requested the warm pack.

Senior Year

During my Adult Health II clinical rotation, I was tasked with assisting a nurse in changing

dressings on a leg with multiple small wounds. Utilizing proper wound care technique, I ensured

that I changed gloves after cleaning each wound and before applying clean dressings. It is

important to change gloves and sanitize your hands throughout the process such that wounds are

not cross-contaminated.

Communication

Junior Year
 The second semester of the nursing program placed me in clinicals at the psychiatric

treatment facility within Bon Secours Maryview Medical Center. During these clinical

experiences, I had many opportunities to practice therapeutic communication. Following a group

therapy session, I spoke with one of the patients who had participated. While discussing the

group session, I used open ended questions to elicit thought and reflection. As with all patients, I

made eye contact when we were speaking with one another. To ensure my understanding of his

words, I occasionally restated his words. These techniques convey that the nurse is listening and

provides the patient with the opportunity to clarify his words when necessary.

Senior Year

During my role transition shifts, needed drugs were unavailable in both medication rooms on

multiple occasions. I utilized intranet communication systems to request the medications from

the pharmacy. On one occasion, time-sensitive medications had not arrived from the pharmacy

and I was forced to call and make the request. They informed me that the medication would be

sent to the unit immediately after the conversation ended. Throughout my time in role transition,

I intentionally spoke to and learned from many members of the healthcare team. From

respiratory therapists to transport workers, all had something that I could learn.

I had the opportunity to participate in a hospital intraprofessional education session at Norfolk

General Hospital during my senior year. Every position of the healthcare team was represented

within this session. The session focused on medical errors and featured speakers who had lost

loved ones as a result of preventable medical errors. The session provided techniques for

ensuring patient safety. They focused on reading back phone medication orders, having multiple

nurses verify the doses of sensitive medications, and communication among all members of the

healthcare team.
 Teaching

Junior Year

During my first clinical rotation, my patient was using his incentive spirometer. I noticed that

the patient failed to hold his breath after inhaling through the device. This is an important part of

the exercise because it promotes lung expansion. I reeducated the patient with the proper

technique and assessed his next attempts. The patient verbalized understanding and demonstrated

proper procedure without prompting. Almost every patient I cared for required education in the

use of the incentive spirometer.

Senior Year

My Community Health group held a health fair for members of the Up Center. It is a program

that mentors youth in their communities. As part of this health fair, I provided hand washing

education to a group that contained children, teenagers, middle aged adults, and older adults. I

“contaminated” their hands with an ultraviolet light-reactive gel and allowed everyone to

practice proper handwashing. Afterwards I assessed their hands with the light and found areas

that were not washed thoroughly. The group was surprised by the “bacteria” that remained after

washing and reported that they would wash their hands more thoroughly in the future.

During my pediatrics course, I had the opportunity to volunteer at Park Place Child Life

Center. The volunteer group focused on diet, breastfeeding, and handwashing. We created

“germs” with craft supplies before providing handwashing education, designed plates based on

the recommended amounts of daily nutrients, and taught about the benefits associated with

breastfeeding.

Research
Junior Year

During the geriatric nursing course, I assisted in the creation of a tool to assist older adults in

obtaining suggested amounts of daily nutrients. I performed research and found that older adults

often consume too little fats, calcium, fiber, and vitamins D and B12. I then researched foods that

are rich in these nutrients and created a visual aid that older adults can easily reference.

Senior Year

As part of our community health project, we needed to identify an area of need in our

assigned community. I performed research on our population and found that the rate of

childhood excess weight in our area significantly exceeded averages elsewhere in the state.

Sharing this information with my group allowed us to focus our research and formulate a health

fair that addressed topics directly relevant to the needs of our population. After the health fair,

the participants reported that they had new information and health behaviors that they planned to

implement.

Leadership

Junior Year

During my rehabilitation clinical rotation, our clinical instructor tasked us with identifying a

patient issue for which we could enact a nursing intervention. Two of my classmates stopped me

in the hall and asked if I could help them think of a nursing intervention for their patients. After

they described their patient and patient circumstances, I suggested interventions that they

attempted with success as reported during post-conference. The first was assigned to a patient

with a recent amputation. His therapy was progressing well, but he was continuing to have

breakthrough pain. I suggested that she attempt therapeutic communication techniques to engage
the patient and distract him from his pain. The other classmate reported that their patient was

withdrawn and not very communicative. I suggested that she give the patient some quiet time if

she conveyed that she did not want company. The classmate reported that after giving the patient

some time alone, the patient expressed appreciation and became interested in communicating.

Senior Year

During my role transition shifts, I had the opportunity to provide care to patients in a role that

is more comparable to that of a registered nurse than a student. While providing care for my

patients, a patient rang their call bell and needed assistance toileting. I was occupied, so I asked a

nurse care partner to answer the call. I completed the current task then checked on the patient

who had rung. When I arrived, the nurse care partner had not yet had the opportunity to assist the

patient, so I helped them onto their bedside commode. Members of the healthcare team are often

busy juggling the needs of many patients and the care partner was in the middle of his own task

when I made the request.

I had an opportunity to volunteer at a health fair for veterans at Fort Monroe. I assisted

veterans in locating relevant services that were being provided in a large gymnasium. The

veterans were able to get their vital signs checked, receive hearing tests, receive information for

arranging appointments, sign up for visual-assisted telephone systems, receive eye exams, and

receive diabetes screenings. I met the veterans in the lobby and assisted them with any

registration paperwork before discussing their needs and directing them to the relevant stations.

Professionalism

Junior Year
 While participating in psychiatric clinicals, a patient requested a pen because he was

dissatisfied with the pencils that were available. I immediately remembered that psychiatric

patients were not permitted to have pens. Instead, I suggested the patient select a more

satisfactory pencil from the available stock. This simple act embodied multiple nursing standards

of practice. I assessed the situation, determined an effective solution, and offered it to the patient.

The patient was disappointed, but appreciated the suggestion.

Senior Year

During my senior year ethics course, my group identified legislation that would ban

conversion therapy in Virginia. Conversion therapy is not substantiated by scientific studies and

may present the potential for the development of depression and other problems. We prepared a

document outlining the legislation and support for our stance then submitted it to Jay Leftwich, a

member of the Virginia House of Delegates.

I had more opportunities to complete skills during role transition than I had for all other

clinical experiences. I was able to insert a nasogastric tube, draw blood, administer medications,

perform assessments, perform research, and become more acquainted with the feel of a

practicing registered nurse. As students, we were not permitted to perform intravenous pushes of

medications. After preparing medications for my patient, my preceptor accompanied me to the

patient’s room for administration. I administered all the medication except for the medication

that required a push. My preceptor forgot that I was not allowed to push medications and asked

why it had been omitted. Instead of administering the medication, I reminded my preceptor that I
was not permitted. She thanked me for the reminder and did not forget for the remainder of our

shifts.

Culture

Junior Year

Culture is an extremely important part of patient’s lives. Living in Hampton Roads, we care

for patients from a great number of cultural backgrounds. During my Adult Health I clinical

rotation, I cared for a female patient from India. The patient was very close with her family; her

daughter remained in the room for the entirety of my clinical shift. Knowing that a female

caregiver may be preferred, I asked the patient if there were any cultural preferences that may

impact care. They reported that they would prefer a female to provide any necessary bathing or

incontinence care. I assisted with transfers, administered medication, and collected vitals. Asking

patients if they have any preferences allows the nurse to ensure that they are providing culturally

competent care.

Senior Year

For the required elective, I enrolled in Global Health. During this course I thoroughly

analyzed the United Kingdom and how its culture impacts the health of its inhabitants. The entire

class shared all their findings through virtual webpages designed for each student’s selected

country. The last discussion board post required us to compare the countries to our own. This

course provided glimpses into many countries, their health care systems, their health statistics,

and their cultures. The impact of culture must always be considered when caring for a diverse

population.

Conclusion
 There were many interesting learning opportunities during my time at Old Dominion

University. Unfortunately, there were fewer than I expected. Entering the program with five

years of experience as a licensed practical nurse was very beneficial. I had heard that a

bachelor’s education in nursing was significantly more difficult than that of becoming a licensed

practical nurse through a diploma program, but that was not my experience. Even though I faced

enormous personal difficulties throughout my time in the program, my grades rose throughout

the program. In my practical nursing education, all information that was taught was directly

relevant to my future role as a nurse. During my registered nursing education, I was extremely

surprised at the amount of time some lecturers spent telling stories that did not directly teach or

convey information regarding the topics at hand. I also found it interesting that skills lab was

under-utilized. It would have been nice to have more hands-on experience with skills prior to

partaking in clinicals. I spoke with classmates who had different experiences, but I had very few

opportunities to practice skills during my time in clinicals. I consistently made myself available

to nursing staff and my assigned nurse regularly told her coworkers that there were students who

would like to perform any available skills. I understand that availability of tasks is not always

high, but I was very surprised and disappointed at the lack of experiences. Were it not for my

previous experience as a licensed practical nurse, I would not feel as confident entering into a

nursing position following graduation. Thankfully, I feel entirely prepared, excited, and ready to

begin my nursing practice as soon as I pass the licensing examination.

My greatest strengths as a nurse involve my critical thinking ability, my empathy, and my

passion to provide uncompromisingly excellent care to every patient I care for, whether they are

in my assignment or the assignments of my peers. If it is a patient or a family member, I will do

absolutely everything within my power to meet any need or request within reason. During my
time working in nursing homes, I witnessed many nurses who had obviously lost their passion

for patient care. Their lack of fire only served to stoke my own. Every nurse has areas of strength

and weakness. My own weaknesses typically involve recalling specific processes of diseases and

their impact on body systems. With this awareness, I always consult peers or resources when I

am unsure. My time at Old Dominion University significantly increased my level of

understanding of relation among body systems and disease processes, but I still have much left to

learn. Every clinical experience, I spent time in patient charts reading about the details of their

health. Most patients had numerous ailments and reading about the interrelated illnesses had a

tremendous impact on my understanding of disease processes. I look forward to continuing my

education and pursuing a certification in wound care. I would also like to pursue my master’s

degree to become a geriatric nurse practitioner. My time working in nursing homes showed me

that the elderly population is in desperate need of health care workers who are genuinely

passionate about the aged.