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Program Graduate Competency Reflection

Abigail Angell

Delaware Technical Community College

NUR 460-201 Nursing Capstone

Dr. Wagamon

November 27, 2022

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Program Graduate Competency Reflection

“Professionalism in nursing means providing top-quality care to patients, while also

upholding the values of accountability, respect, and integrity”(USAHS, 2020). While obtaining

my degree I have learned alot about nursing professionalism, leadership, policy, research and

public health. Each class I took I was able to learn more about how to properly and

professionally care for my patients as well as how to become a leader in my field. Through what

I have learned I feel like I have been able to apply this to my professional career. I have learned

the importance of being willing to research, take initiative within my job, and how to

professionally interact with my patients and co-workers.

Each class taught me something new in relation to nursing, this allowed me to become a

better nurse and provide better patient care. For example, through my nursing research class I

worked on my research skills. I found that I enjoyed researching and finding ways to possibly

improve or gain more education on different aspects of nursing or providing patient care. For my

nursing research paper I focused on the effects of stress and ways to relieve that stress. Doing

this research allowed me to not only find ways to better manage my stress but I was also able to

help my co-workers and even my patients. For my population and community health class I had

just moved to Arizona and I focused on what my community population seemed to need most,

which was more mental health support. Through this class I was able to create a plan that can be

carried out to hopefully provide more support to those within the community who struggle with

mental health. From each class I can explain how it has helped me grow as a nurse and because I

have grown as a nurse this will lead and has led to me providing better care to my patients.

Throughout this paper I aim to show how I have improved and became a more professional well

rounded nurse through the classes I took and how this has positively impacted my career.
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Practicum Experiences

First I wanted to explain the experiences I had in the last two classes I took, which were

nursing 330 population and community health and nursing 460 nursing capstone. During these

two classes I was required to complete 45 hours of hands-on learning experiences and

observation. During the nursing 330 class I chose to participate in the virtual practicum

experience because I had just moved to Arizona and I hadn’t had time to find a preceptor. For the

virtual practicum the focus was on covid-19 and I had to pick a population to focus on and I

chose children and schools. This population has been greatly affected because they were all

forced to participate in a home schooling environment. During the time of the pandemic the

majority of schools were not prepared to transfer their in person learning experience into an

online learning experience. This had a huge impact on how and what the students did learn

during the school year. As I researched the impact covid-19 had on the schools and students I

created a powerpoint explaining my findings and also ways to combat covid-19 and hopefully

prevent it from continuing to spread throughout schools. It was interesting looking up

information about this new virus and seeing how it all started and how it progressed. I would

definitely be willing to do this in the future for other viruses, just so I can learn more about what

viruses are prevalent in the community and how to handle them. I was sad that I wasn’t able to

follow a preceptor around and have more hands-on and personal experiences, but I did enjoy

completing this virtual practicum project.

When it came time for me to take the nursing 460 class, I started a few months early so I

would have time to find a preceptor and so the college would also have time to get an agreement

in place. Even though I started my search early, many of the preceptors I found fell through but I

was finally able to find a preceptor at the community college here in Thatcher, Arizona who was
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willing to have me follow her as she taught students. She was a newer teacher and she was

teaching the licensed nursing assistant, or LNA classes and skills labs. I started my precepting

hours the second week of school and spent every Friday there, as well as a couple hours during

the week completing all 45 hours. It was difficult juggling completing all the hours and still

working a full time job that was Monday - Thursday. But, I enjoyed helping out and observing

her teaching and interacting with the students. I mostly helped with skills labs because that is

what they had every Friday. I would go and observe my preceptor but also help teach and guide

the students in their skills as well. Then I would take a couple hours off work during the week so

I was still able to get the classroom experience. During the classroom time, I again observed the

preceptor and then I actually would help teach the class. I gained a lot of experience during this

practicum and was grateful I had this opportunity. It helped me realize that I might want to

become a nursing instructor later on in my career after I gain more experience as a nurse. While

in this nursing 460 class, I also looked at what I thought were my strengths and weaknesses and

set goals based on them and my program graduate competencies, or PGC, doing this analysis and

making sure every week that I was growing and thinking of ways to improve my weaknesses I

realized how much I had grown and learned about nursing and myself over the past couple years

while completing this degree.

SWOT Analysis

Strengths

Through my SWOT analysis the first thing I looked at were my strengths, things that I

did well. I was able to think about and draw from my 3 years as a certified nursing assistant, or

CNA as well as my year and a half as a nurse. I have also been able to practice and grow in some

skills because of what I have learned in the classes I had taken for my bachelors degree both
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general and nursing related. The first strength I identified was good time management, which I

was able to perfect during my 4 years of hospital experience as well as taking multiple classes at

once. The second strength is general patient care knowledge and again this came from

experience working in the hospital, as well as through my nursing courses and practicums. The

third strength was willing to learn or find answers to my questions. I know that I still have a lot

to learn as a nurse and I am always willing to listen to what others have to teach me and I am

willing to do research on my own to find the answers as well. The fourth strength I feel that I

have had but have strengthened since starting to work as a CNA is good teamwork abilities. I

have always strived to help those around me and make sure that not only were the patients taken

care of but also my co-workers. The final strength that I have strengthened since becoming a

nurse is advocating for my patients. As a CNA I would just need to tell the nurse if there was

anything wrong or off with the patient and then if the nurse hadn’t seen the patient yet I would

just reiterate what I had seen with the patient. But, as a nurse I have had to take the information

the CNA provided and other information like labs or test results and do things to help correct a

situation where the patient isn’t at the health level they should be. As I have worked to build my

confidence as a nurse and work on developing these strengths through my experiences and

through what I have learned while obtaining this degree it has been great to see my development,

even the development made throughout this semester alone. Now, there are some things in the

beginning of the semester that I felt were weaknesses that needed to be developed.

Weaknesses

These weaknesses are things that I felt at the beginning of the semester that needed to be

developed, so that they would not take away from patient care. From these weaknesses I learned

more about myself and I used these weaknesses to later guide my goals for this semester in
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relation to the program graduate competencies, or PGC’s, that will be discussed later. The first

weakness that I wanted to work on was delegation, this is a weakness that I struggled with

because I didn’t want to burden my co-workers with a job that I already knew how to do. I didn’t

want to burden them and ask for their assistance because I knew they were busy as well. This is

something I struggled with the most when becoming a nurse because I knew how busy CNA’s

can be. An example of this was when I had to ask my CNA to help a patient to the bathroom, or

something along those lines because I knew I needed to give another patient their medications.

The second weakness I identified was developing leader-ship skills and not being as soft-spoken.

Again my transition from being a CNA and always being able to discuss things with my nurse, to

becoming a nurse was difficult and having to learn to be a leader was difficult. The final

weakness was that since I am a newer nurse I am still learning about certain disease processes

and techniques involved in patient care. I wanted to find ways to strengthen myself, so that when

I came across something I didn’t understand I would know how to research and ask questions so

that I would understand and feel confident in finding the answer on my own. As I have

completed this semester and reflected on these weaknesses and the goals I created, I have

realized that I actually had the tools to overcome some of these weaknesses already, I just needed

this final course to help me recognize that. This recognition will be shown throughout the rest of

this paper.

Smart Goals

After completing my SWOT analysis I was asked to then create five goals that I wanted

to work on and hopefully achieve this semester based on the weaknesses in my SWOT analysis

and the 9 program graduate competencies. The five goals that I decided on were PGC 2 which is

improving leadership skills, PGC 3 continuing my education and being willing to research, PGC
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6 learning to collaborate and delegate, PGC 7 health promotion and disease prevention, and PGC

8 practicing professional nursing and providing ethical care.

The first smart goal involves PGC 2, leadership skills, since this was one of my

weaknesses I knew I needed to improve upon this skill to not only better my patients but also

myself. The goal I set for myself was being willing to step up and taken on leadership positions,

which I realized as I continued through the semester I was already doing because as a public

health nurse I am incharge of a couple different programs where I have to stay on top of

obtaining and coordinating patient care and information between the patients and doctors that we

have. But I was also able to develop this skill further while completing my practicum hours this

semester, in the nursing 460 course. I was able to assist and sometimes teach the students myself.

I taught in the classroom a couple times and I was also able to teach some of the skills. While in

my nursing 400 course I was able to learn and develop my leadership style, prior to completing

my practicum hours. This course allowed me to look at who I am and what kind of leader I

wanted to be which was important in gaining the confidence I needed to continue to develop my

leadership skills.

The second smart goal was related to PGC 3, which is continuing my education and being

willing to research new processes to improve patient care. I knew this was something I needed to

improve upon because healthcare is always changing and expanding. I wanted to make sure I had

the skills necessary to provide the best care necessary to my patients. I achieved this goal

through many different aspects in my career as well as through my course work and practicum

work. I developed my research skills within the nursing 340 course, which focused on us

learning how to research and the different steps that go into conducting research. This skill was

further developed over the summer while in my nursing 330 class, which contained a practicum
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that needed to be completed but because I had just moved from Delaware to Arizona I chose the

online practicum option which involved me researching a population group that was affected by

covid-19. To obtain this information I really needed to research and search through articles and

learn how to determine which articles were credible. Another way I have developed this skill is

within my job, one of the programs I am in charge of is the management of latent and active

Tuberculosis(TB) clients. For many years the regimen for managing and treating latent TB

involved 9 months of daily Isoniazid(INH) and vitamin B6 therapy. INH is very hard on the

body and because the treatment is so long many patients are unwilling to complete the treatment.

Recently, there have been studies that suggested the use of Rifampin for 4 months. I looked into

the benefits, risks, and the effectiveness of each treatment plan and I was able to come to the

decision and present that to my supervisor to change the treatment to Rifampin. Since I knew

how to research and I knew that this could greatly increase the chances that the patients would

complete their treatment, I was able to effectively present this information to my supervisor who

was able to get it approved. Because of all these experiences I feel that I have effectively turned

this weakness into a strength that has allowed me to help my patients in a meaningful way.

The third smart goal involved PGC 6 learning to collaborate and delegate. This

competency as I stated before was something that has taken me a while to learn and as I have

thought about all the courses I have taken while in the bachelor's degree program I realized that I

learned a little about collaborating and delegation even before I became a nurse. One of the first

courses I took for my bachelors degree was Nursing 111, cultural competency and health. Since

this was an optional course and being an RN wasn’t required I took this class my second

semester in college and my first semester in the associate's degree program for nursing. For this

course we would have to prepare to go abroad and provide healthcare to patients in a foreign
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country who did not have access to healthcare because of where they lived or their financial

situation. My class went to the Dominican Republic for a week and prior to going we had to

coordinate and find supplies to bring. We had to learn how to assess patients and work together

to accomplish what was required. When we got there and went to the first site we saw many

people and had to speak to these patients through a translator in order to fully understand their

needs. Once we completed our assessments we were able to provide them with kits that

continued hygiene products or medications depending on what they were seen for. We also had a

doctor with us that we could ask to assist with and assess a patient if we felt they needed a higher

level of care. I took this course about a year before I completed my associates degree and looking

back I realized it taught me alot about collaboration. I also learned this while working as a nurse,

even if at times I tried to do everything myself, I am not always able to do so and because of this

I have been forced to ask for help. While in these situations I have realized that most people are

willing to help because they have been busy themselves and have needed that assistance, so I

now recognize that it is okay to delegate.

My fourth smart goal involved PGC 7 health promotion and disease prevention. This goal

I felt went along with PGC 3 because I am wanting to continue to research and look up better

ways to improve the health of my patients. This is seen in the way that I was able to change the

treatment plan for my latent TB patients. But, I also learned about the bases of disease in my

biology 130 class on disease pathophysiology. Within this class we learned about the different

bacteria and how they grow and mutate and the different ways to treat them. It was an interesting

class and helped me to understand the different things that can be done to prevent disease from

spreading or worsening. In my nursing 320 health assessment class, I was able to conduct
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research and an assessment and come up with a plan for a patient that was complete with goals

and resources they could use to improve their health and well being.

My fifth smart goal was PCG 8 which is practicing professional nursing and providing

ethical care. This goal was learned throughout each course because the focus is to improve the

kind of patient care we provide. This means that we act professionally and provide the best care

possible within our scope of practice. But, the main courses that focused on this were nursing

310: global health, sociology 213: ethical issues in healthcare, nursing 330: population and

community health, and nursing 420: nursing policy. Each of these courses worked to either

expand our view of healthcare and provide inclusive healthcare or they focused on improving

how we provide care to our patients.

As I worked to accomplish these goals and improve upon these weaknesses I was able to

recognize that for the most part I had already had these skills, I just needed the ability to see how

each of these PGC’s were met within the classes that I took throughout this bachelors program.

There are also other program graduate competencies that I felt I had already accomplished prior

to this course.

Program Graduate Competencies (PGC)

Above I discussed how I met and achieved the PGC’s 2, 3, 6, 7, and 8. I still need to

discuss the accomplishment of achieving PGC 1,4,5, and 9 because they are required to be met

and achieved at the completion of this degree. I think the PGC’s are important and have really

allowed me to reflect upon the experiences I had in each course and how it related to each

competency. The first competency discusses education and the need to continue to gain

knowledge in nursing as well as in general education. I feel that I met this competency as I have

continued to go to school for my bachelors and complete it because not only have I learned more
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about what being a nurse means, I have also learned and have become a well-rounded nurse

since I have also had to take some general education classes like technical writing, statistics,

general psychology, and world history. I have further achieved this competency as I complete

education courses for work and attend seminars to better understand the different treatment

options open to my patients.

The forth PGC deals with the integration of technology to help improve patient outcomes.

While in the hospital there was always something new to learn about and apply to nursing care

and I was always willing to do that but in my current position there is not much use of

technology. There are still paper charts and handwritten notes; the only technology in use is

when we input vaccines given into the Arizona database on the computer. Through the nursing

informatics course I learned about some of the new technology that may soon become available

in hospitals and/ or that is given directly to all patients to use outside of the hospital. After taking

that class I feel I will still continue to try and keep up with all the possible new technology that

may soon be introduced. When looking at the fifth PGC, I feel I did and continue to strive to

advocate for my patients when needed, but I have not looked at the need for possible policy

changes. When I took the nursing policy class over the summer it was interesting to learn about

the different policies and also create my own. Through this class I learned how important it was

to have and create new policies for patients and their safety.

PGC eight and nine go together in the sense that as we continue our education and

continue to be willing to learn new things we will continue to provide the best care possible to

our patients so that no harm comes to them while they are in our care. Both these competencies I

felt were learned throughout all the courses required for this degree. My main focus is to

continue to research and learn so that I can continue to provide safe, professional, and ethical
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care to my patients. After reviewing each of these competencies I feel I have grown and learned

a lot while obtaining my bachelor’s degree. I have had experiences in each course as well as in

my practicum experiences that have allowed me to become a better nurse. As I look back to the

first nursing course that I took for my bachelors degree nursing 300: RN to BSN transition, I

have learned so much, but I was also able to stick to the beliefs I developed in that course as

well.

In that course we were to come up with our own personal nursing philosophy that has

guided us through our nursing career. Within that paper I stated that “My personal nursing

philosophy has been influenced by many different things in my life like life experiences, family,

and my personal beliefs. Because of these experiences while caring for people in my career, I

have tried to understand and remember I am caring for people that, at the moment, may not be at

their best. I feel it is my job to not only care for them physically, but also mentally as well. Since

I understand and feel this way my nursing philosophy follows the idea that as a nurse I need to

practice and provide care in a respectful, kind, and caring manner”(Angell, 2021). Since I created

this personal philosophy I have not left this idea or have felt the need to change it. I think as I

strive to improve myself through learning and making sure I provide care in a respectful, kind,

and caring manner my patients and co-workers will recognize this and appreciate it. Even when I

have a bad day, I recognize that everyone has bad days and if I can make their day a little easier

with the care I provide then I feel that I have done my job as a nurse who is caring for those who

are not currently at their best.

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References

University of St. Augustine for Health Sciences. (2020, June). The importance of

professionalism in nursing. https://www.usa.edu/blog/professionalism-in-nursing/

Angell, A. (2021, July 25). My nursing philosophy.

https://docs.google.com/document/d/1bdWKTTxkBNS00l4RCKjAdll0Y2LiXshtNB8mm

L9Wgl0/edit?usp=sharing