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Program Graduate Competency Reflection Paper

Teryn Green

Delaware Technical and Community College

NUR 460: Nursing Capstone

Dr. Wagamon

November 27, 2022

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Program Graduate Competency Reflection Paper

From the very start of my journey into the RN to BSN program at Delaware Technical

and Community College, I was introduced to the program graduate competencies (PGCs). It was

my understanding that these were the nine goals I was striving to meet that would dictate my

progress throughout my general education and nursing-focused courses. Despite the long and at

times stressful journey of working full-time while finishing a degree has been, I can truthfully

say that I am a more competent nurse today because of it all.

The first PGC speaks to the graduate nurse's ability to integrate knowledge and skills

gained from general education courses into their current practice. This PGC is one I struggled

with the most as I found it very hard at first to try and connect courses like statistics and world

history directly to my work as an intensive care unit (ICU) nurse. I later found that statistics were

all around me, every time I went to work, I found myself dealing with predicting various

outcomes based on patient demographics, current health, responses to medications, and much

more. For me, statistics changed how I analyze material as a nurse. Instead of trying to figure out

which avenue to go down, it helped me widen my capacity for thought to instead look at each

problem through a lens of various possibilities that each could result in the benefit of the patient.

My world history course was much easier to draw connections to within my nursing practice as

educating myself on the histories of numerous countries and cultures around the world allowed

me to better serve patients of any background that were under my care.

The second PGC encompasses the nurse’s ability to demonstrate leadership within their

care. When I first entered this program, I had around six months of nursing experience to my

name, today I have close to two and half years of ICU practice. Many of my struggles with this

PGC are related to my inexperience I remember several times working in the hospital calling
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doctors only for them to disregard me or not listen to my opinions on how we should guide the

patient's care. I remember watching nurses more senior to myself with outstanding rapport with

physicians and the mutual respect established and wanted so badly to reach that level of

expertise. Throughout this program, my nursing leadership course helped me understand how to

overcome this obstacle the best. I found that it was truly my lack of confidence that held me

back. I took the chances within my practicum experiences to practice being more headstrong in

my conversations and decisions. At first this proved difficult as entering a new place meant I

would be starting from scratch with each of my peers and would have to work to develop my

credibility amongst this new team. Like my transition to travel nursing where I would enter a

hospital knowing no one, I knew that the way to show my leadership abilities was to prove that

my primary focus was on the patient or client and their safety. When individuals see you are

dedicated to the well-being of your patient they gain a deep respect for you, which allows for

confidence within each discussion or collaboration at hand. As the confidence came it naturally

pushed me into roles where I served in leadership positions such as a preceptor, head of codes,

and charge nurse.

Applying analytical skills in addition to having a high information literacy to support

one's nursing practice relates to the third PGC of the graduate nurse program. Inquiring was

never something I struggled with throughout my educational and professional journey. I have

always been the type of person who needed to understand why something was done rather than

blindly following orders, which has always resulted in a safer and more optimized level of care

for the patients. My global health course stood out regarding this PCG as it allowed me to

understand just how different the needs of each patient are and how demographic can play a huge

role. I began to understand that not only is the disease or disorder we are treating the object of
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study but also the patient. The global health course forced me to dive deeper into not only

specific health issues facing a foreign country but also the people within it and the cultural

practices they follow. By becoming more informed on the medical practices followed along with

the people being treated it can provide a very deep level of understanding on how to better care

for them.

Under the fourth PGC is where the importance of technology and information

management plays in. I found my most recent practicum experience shadowing the school nurse

within a local district to be the most beneficial in meeting this PGC. Unlike in the hospital where

there is one technological information system that collects all patient data within one chart,

schools are a bit more behind on this organizational practice. I found that the school nurse would

have to not only establish a digital file for each student to hold their medical information but also

keep up with a physical copy of this chart and contact the student's primary care providers and

legal guardians by phone to gain any information missed. Although this process is not the most

efficient and can be quite time-consuming it allowed me to see how information can be

integrated from multiple sources to ensure each student can be appropriately cared for during

their time within the school. In one of my other courses, nursing informatics I discovered that

electronic health records reduce medical errors by up to 60% (Hoover, 2017). Comparing this

information to how records were managed within the school facilities I was able to better

understand just how true that stat was as the scattered information can easily result in errors.

The fifth PGC was one that I felt I had met before the start of my RN to BSN journey but

found I was able to develop much deeper once I began completing courses. PGC five relates to

patient advocacy at all levels. The course I found that helped me to better understand how to

meet this PGC fully was my nursing policy class. This class forced me to dive beyond bedside
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nursing and look deeper into the policies that guide my practice at the local, state, and federal

levels. Advocating for patient needs is great, but the real change that makes a difference for all

patients is focused on changing the policies in place that may stifle care. I demonstrated this

advocacy through my paper regarding the health benefits of cannabis for numerous populations

and how the current variations in policies at the state and federal levels are preventing further

research into these avenues (Kiel, 2019). Looking into a topic that has been under public scrutiny

for so long helped me to challenge my way of thinking. My nursing philosophy has always been

centered around advocating for my patients' needs and ensuring their care is personalized to

provide the best outcomes for them. The nursing policy course helped me to develop one more

way in which I can ensure that I am advocating for my patients while fully understanding the

guiding factors of my practice.

PCG number six was one of the main areas in my SWOT analysis that I felt I needed to

develop further. This competency addresses the ability of the nurse to advocate for their patients

through interprofessional collaboration. Since the very beginning of both my educational and

professional journey, this has been an area in that I have grown in. Within every course, I have

been allowed to work alongside fellow graduate nurses in group projects like the ones completed

within this course. This has not only grown my ability to effectively communicate with my peers

when it comes to ease of sharing my thoughts or ideas, but it has also shown me how to work

around obstacles that arose due to the virtual structure. The ability to address information

effectively is vital within my role as a night shift nurse as physicians are not usually present on

the unit, therefore virtual communication is a staple. Being able to grow my ability to share all

pertinent information and ideas without being face to face with the individuals I'm speaking to

has been invaluable to my success working on the ICU night shift team. I have been able to see a
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complete change in not only how vocal I am within collaborative settings but also how well I can

address patient needs to ensure they are receiving the best level of care.

The seventh PGC relates to health promotional practices and disease prevention within

diverse populations. My population & community health course in addition to my global health

course were the primary classes that I felt addressed serving diverse populations specifically.

Throughout my research into population and community health, I was required to look into the

needs of the youth which is a much different population than I usually work within a medical-

surgical ICU which primarily sees patients 18 and older. While in my global health course I

focused on the needs of the people within Sierra Leone, primarily the female population, which

provided a great deal in understanding a diverse and underserved population’s needs. Both of

these courses challenged me to change my way of thinking about what interventions would truly

benefit these groups and provide them with ways in which they could promote their well-being

outside of a hospital setting. Even within this most recent practicum experience, I was given the

chance to formulate a morning announcement to help educate on hygienic practices to reduce the

spread of infection for a school that works with students with intellectual and physical

disabilities.

PGC number eight speaks to ethics within the nursing practice. Within this class, my

nursing capstone, we completed a case study that looked specifically into the ethics of end-of-life

decisions and the familial involvement that often complicates things. This was one of my

favorite assignments yet because I was able to draw from my own clinical experience. Often, I

have struggled with similar situations such as the one provided in the case study, the quality of

life for the patient would be abysmal, but the family refuses to make a necessary decision due to

their emotional turmoil regarding the situation. Being able to review the nursing code of ethics
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and the ethical principles that exist have helped me a great deal in navigating how to

appropriately handle these highly sensitive situations and individuals. I look back today on some

recent interactions I have had with families and patients in critical situations and the thanks they

have given me, proud to know that in such a time of agony for many, they can call upon me as

not only a sound mind but also someone they can trust to ensure the safe care of their loved one.

Lastly, PGC number nine states the graduate nurse should demonstrate lifelong learning

that supports their professional growth and proficiency. For this PGC every class from the start

of my journey into nursing school up until I retire one day hopefully 30-40 years down the line

reflect the achievement of this competency. Within the nursing practice, there is never a time

when one stops learning. Outside of courses such as the RN to BSN program, competencies

remain present to ensure each nurse is maintaining best practices within their facility. Each of

these classes has helped me grow into a strong nurse and has challenged my thinking in ways

that I did not realize I needed to be tested. Even the courses such as my general education classes

which I deeply felt had no true purpose in a nursing degree I ended up understanding how they

play a pivotal role in what I am doing today.

In conclusion, this has been one of the most rewarding experiences in my life. Being able

to finish this last assignment with the knowledge that this means I have finally proved myself to

all the amazing professors and fellow peers I have met along the way is an incredible feeling. I

know that moving forward in my career I will look back on this program with the skills I have

gained and have nothing but thanks to giving for every individual who has had a hand in helping

me get here. Throughout this journey, I have faced many challenges but have learned that with

dedication, perseverance, and a few caring hearts such as Dr. Wagamon and her team new levels
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can be reached. I hope to one day have as strong of an impact on future nurses as these amazing

women have had on me.

References
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Hoover, R. (2017). Benefits of using an electronic health record. Nursing 2020 Critical Care,

12(1), 9-10. http://doi.org/10.1097/01.CCN.0000508631.93151.8d

Kiel, C. (2019, November 24). Why doctors know almost nothing about the health effects of

marijuana. AAMC; AAMC. http://www.aamc.org/news-insights/why-doctors-know-

almost-nothing-about-health-effects-marijuana