1

PGC Reflection Paper

Lexi Leskovac

Delaware Technical Community College

NUR 460 Nursing Capstone

Dr. Wagamon

December 5, 2021
 2

During my first semester of the Bachelor of Science in Nursing (BSN) program, I was

introducing myself as a new graduate nurse. I would discuss my struggles as a new graduate who

just started their career in the intensive care unit (ICU) during a pandemic. Since progressing

through this program, I have been able to gain a more professional and purposeful perspective on

my career. Studying the principles and policies of nursing has contributed to my confidence and

professionalism in the work field. The knowledge I gained from my BSN courses allowed me to

step away from the task-oriented mindset that my new-graduate self was stuck in. A mindset that

I described in my nursing philosophy paper for NUR 300. The BSN courses have encouraged me

to research information and dive deeper when I do not understand something, to thoroughly read

policies, join committees, and even step into leadership roles. Throughout my courses, I have

chosen topics that relate to critical care and that I am passionate about for all my final projects.

Some of my research projects have attracted the attention of management and leadership and

shed light on areas that could be improved within my unit. This was encouraging to see how my

hard work and voice was taken into consideration to improve patient care. I am grateful that the

BSN program has allowed me to explore healthcare issues and propose solutions in this manner.

Upon completion of my SWOT analysis, I gained a better understanding of my strengths,

weaknesses, opportunities, and threats. Outlining these traits helped me appreciate my current

strengths and strive to reach my goals. My strengths included program graduate competencies

(PGCs) such as, advocacy for patients and the nursing professions, patient-centered care, and

integration of health promotion and disease prevention into care delivery. BSN courses such as,

NUR 400 Nursing Leadership, NUR 320 Health Assessment, and NUR 330 Population and

Community Health helped me develop these strengths. In NUR 400, I discovered that I was a

transformational leader. In my NUR 320, I assessed my boyfriend’s health needs and outlined a
 3

plan of care that was specific to his health and wellness needs. My practicum experience in NUR

330 gave me the opportunity to assess the stroke population in Sussex County. I was able to

identify the specific needs of this population through development of SMART goals. The

research put into these courses and projects have allowed me to meet the PGC of collaborating,

advocating, and promoting patient-centered care for my patients in the ICU, as well as the

community that I served in.

In my SWOT analysis, I also identified my opportunities. The PGCs that I met and

viewed as opportunistic were integration of education, knowledge, and skill into practice,

demonstration of leadership skills to promote patient safety and high-quality care, and

demonstration of lifelong learning. There is always opportunity to learn and grow in the nursing

profession. I always knew that I wanted to work at a level one trauma center. I viewed the

obtainment of my BSN as an opportunity to achieve that goal. Upon starting my nursing journey,

I thought I knew that I wanted to be a nurse anesthetist. The option is still on the table; however,

the BSN program has opened my eyes to the number of career opportunities in nursing that I did

not know existed. The first course that really gave me that insight was NUR 410 Nursing

Informatics. I am grateful to be in a field that has so many options, and I am grateful to be

earning my BSN which will open more doors in my career

Truthfully, all the BSN courses helped me achieve my goals because without them I

would not have completed the program. However, there were a few that especially enlightened

me. Through identifying my nursing philosophy, NUR 300 RN to BSN transition helped me

realize that as a new graduate nurse, I was experiencing the same fears, insecurities, and

frustration that every other new graduate faces. This reassured me that I was not alone, and that

my feelings were validated. In my nursing philosophy, I included that Dr. Benner’s theory
 4

provides reassurance that overtime, through clinical experience, continuing education, and

teamwork, my clinical competence as a new graduate nurse will progress to the next level of

proficiency (Nursing Theory, 2020). 15 months later, I can certainly say that my clinical

competence has not only progressed, but I have become less hard on myself. I have learned

things I didn’t know that I would, I have stepped into leadership roles that I didn’t think I would,

and I have developed confidence. Through this development, I have become more driven to seek

more learning opportunities. ENG 122 Technical Writing and Communications allowed me to

conduct a thorough research project on my topic of choice. I chose to do my project on early

mobility programs in the ICU. Conducting surveys and interviews, gathering data, and

transcribing a thorough research paper on a topic that was in the realm of critical care developed

my confidence and deepened my love for acute care. I also earned the respect and attention of

many practitioners and leaders in my unit. Gaining their acknowledgement and even their

consideration to adjust the ways of our care based on my research was so fulfilling and proved

that I am capable of even more.

During my shadowing experience for NUR 460 Nursing Capstone, I chose to shadow a

nurse from my hospital’s Emergency Nursing Intervention Team (ENIT). ENIT nurses are

utilized by every floor in the hospital as a resource; they are seen as leaders, because they offer

their support and their evidence-based knowledge towards the best course of care. ENIT nurses

are consulted for every patient on the CIWA and sepsis protocol. They help ensure that nurses

are following the protocols appropriately by reviewing charts and rounding on the floors. We

also collaborated with the interprofessional team by communicating with hospitalists regarding

patient care and orders that ENIT felt would benefit the patient. This demonstrates how they

integrate information management technology with protocols and auditing, advocate for patients,
 5

and integrate general knowledge to improve patient care. ENIT nurses are comprised of

registered nurses with emergency department and intensive care backgrounds. They must have at

least two years of experience with acute care. This demonstrates their commitment to lifelong

learning. I was so fortunate to learn from such a skillful and knowledgeable nurse during my

practicum experience.

For my NUR 330 Population and Community Health practicum, I shadowed Bobbi

Hensey, the stroke coordinator at Beebe Medical Center (BMC), who had recently become the

neurological coordinator as well. My practicum focused on the stroke population at BMC and

within Sussex County. Shadowing Bobbi was insightful towards how much a population health

nurse truly does. A great deal of time is spent researching, planning, organizing, educating, and

evaluating to promote improved patient outcomes. While shadowing Bobbi, we audited charts,

created individualized stroke packets for patients, educated nurses about tPA administration,

revised stroke policies, arranged “swag bags” for a stroke 5K, and created case studies for

educational purposes. This allowed me to meet PGCs such as, demonstration of leadership skill,

support of evidence-based practice, integration of health promotion and disease prevention, and

demonstration of lifelong learning. Shadowing Bobbi proved to me the impact that nurses can

make within our community. I am grateful to have played a role in improving the health of our

local stroke population.

In NUR 310 Global Health, my final paper addressed how the lack of infrastructure

affects global health with an emphasis on Lima, Peru. Utilizing the Health Impact Pyramid, I was

able to identify public health interventions that could improve their lack of infrastructure. In

NUR 320 Health Assessment, I assessed my boyfriend’s health needs as a kidney transplant

recipient and devised an individualistic plan of care for him. For ENG 122, I surveyed my ICU
 6

and identified an issue with our physical therapy department. My research paper defended

research findings that supports early mobility for critically ill patients to improve patient

outcomes. In turn, my project was recognized by leadership, and I was asked to be on a

committee for pressure injuries. In NUR 420 Nursing Policy, I created a policy action plan in

support of a national paid leave program. The benefits of paid parental leave are well established,

yet the United States (U.S.) is the only industrialized nation that does not have a national paid

parental leave program mandated (Delaware.gov, n.d.; Romig & Bryant, 2021). All of these

research projects have allowed me to research, explore, and develop personal opinions regarding

the individual needs of patients and communities. Having a comprehension of these scholarly

resources has contributed to my role as a patient advocate by allowing me to be aware of what

resources and options are available. Completing these projects have also helped me realize the

influential role that nurses play in public health and health policy.

After completing my ENG 122 final, I was informed that my ICU previously had an early

mobility committee. Unfortunately, due to lack of resources, the committee fell apart and was

unable to proceed. My final project sparked a conversation and made the unit aware that this was

still an issue. Upon completion of my NUR 320 final on mandating paid parental leave, I saw the

topic make headlines by President Joe Biden. Seeing topics that I have researched myself be

recognized by leadership in the workplace and at large by our nation’s President is very

validating. It confirms that the research we conduct as nurses is purposeful and impactful. These

experiences have encouraged me to continue to address current issues in the future, and to

collaborate with my colleagues.

SOC 213 Ethical Issues in Health Care required me to analyze the nine provisions of the

Nursing Code of Ethics and apply principles of bioethics to these provisions. Upon completion
 7

of my final, I gained a better understanding of my profession’s code of ethics. A key element of

my paper was that the principles of justice and beneficence went hand-in-hand with one another.

Justice conceptualizes fairness. In today’s healthcare system, better care is seen to be offered to

the rich than the poor, the urban dweller over the rural, and the elderly over the children (Edge &

Groves, 2018). Nurses should treat all individuals fairly, regardless of their age, race, religion,

culture, income, etc. By treating all patients equally and fairly, nurses are also preventing harm

from prejudice and discrimination. Because treating everyone fairly promotes good and prevents

harm, justice also implicates the principle of beneficence (Edge & Groves, 2018). Other courses

such as NUR 310, NUR 330, and NUR 460 have helped me recognize underprivileged

communities that face disproportionate adversities. Understanding these differences has helped

me meet the PGC of practicing professional nursing within an ethical framework.

Having a nursing philosophy is great to look back on and see how you have grown and

developed as an individual. My nursing theory discusses how competent level nurses consist of

preceptors or charge nurses that help novice and advanced beginner nurses ensure that important

patient needs do not go unattended (Benner 1982). Competent level nurses help novice nurses

critically think since they need assistance in setting priorities because they operate on a task-

based mindset (Benner, 1982). When I wrote about that in my philosophy, I never thought that at

this stage, I would be considered a competence nurse. I have trained for charge, and I have

precepted new graduate nurses, new full-time nurses, and travelers. Just as my philosophy states,

skills are developed overtime through education and experience. These courses have contributed

to my educational development. One of the best things I took away from having a philosophy

was the realization that every other nurse felt exactly what I felt when they first started their jobs.
 8

As a BSN nurse, I have recognized the impact that nurses can make with their recognition

of healthcare problems and their voice. In NUR 420 Nursing Policy, I was asked to outline the

steps a bill takes to become a law. Additionally, I learned the role that registered nurses play in

enacting laws. Creating a policy action plan for mandatory paid parental leave helped me meet

the PGC of advocating for patients and the nursing profession with regard to healthcare policy at

the local, state, national, and global level. In NUR 420, I also identified what it meant to

advocate for the nursing profession. This helped me realize that as nurses, it is important to let

our voices be heard. Some of my classmates spoke in our discussion boards about their

experiences with writing testimonials for healthcare bills to become law. NUR 420 has motivated

me to play an active role in healthcare policy as I continue in the nursing profession.

Completing my BSN has allowed me to meet the PGC of demonstrating lifelong learning

that empowers personal and professional growth. I always wanted to work at a level one trauma

center, and I knew I needed my BSN to achieve that goal. I am proud to say that last week I

accepted a position in a Trauma ICU at a level one trauma center in Northern Virginia. Putting

my plan into action and reaching my goals has been incredibly rewarding. My short-term goals

from here include obtaining my CCRN or TNCC within the next year. I see these goals as ways

to develop my nursing skills and become more confident in my practice. As for my long-term

goals, I am considering CRNA school. However, after gaining exposure to the many pathways of

nursing from courses like NUR 410, I am more open to the idea of staying at the bedside while I

figure out my next path. Regardless of where nursing takes me, I know with certainty that there

will be more education involved. If it is anything like this BSN program, I know I will walk

away a better nurse for it.

 9

References

Benner, P. (1982). From novice to expert. The American Journal of Nursing, 82(3), 402-407.

https://doi:10.2307/3462928

Delaware.gov. (n.d.). Paid parental leave. https://governor.delaware.gov/paid-parental-leave/

Edge, R. S., & Groves, J. R. (2018). Ethics of health care: A guide for clinical practice (4th ed.).

Cengage Learning.

Nursing Theory. (2020). From novice to expert.

https://www.nursing-theory.org/theories-and-models/from-novice-to-expert.php

Romig, K. & Bryant, K. (2021). A national paid leave program would help workers, families.

Center on Budget and Policy Priorities. https://www.cbpp.org/research/economy/a-

national-paid-leave-program-would-help-workers-families