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RN to BSN Program Graduate Competencies Reflection

Amanda Scott

Delaware Technical Community College

Nursing Capstone

Dr. Karen Wagamon

March 11, 2023

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RN to BSN Program Graduate Competencies Reflection

I have always struggled when I get asked about my career pathway. I did not have that

dream of being a nurse ever since I was a little girl. I did not really have an “ah ha” moment

later in life when something profound caused me to go running to a nursing degree. For me, I

have always loved learning new things. The human body has always amazed me. To think

about how God designed each and every part of us, to know how our body repairs and restores

itself, is astounding to me. To know that God has given man the knowledge to actually create

the modern medicine and technology to be able to help with sustaining life is so awesome.

People also fascinate me. I’m always curious about the lives of those around me. How

did they get from point A in their life to point B? What has happened in their lives to make

them the way they are? Are they genetically predisposed to this or that behavior or

characteristic? Have they had struggles or has it always been easy for them? I love the history

of all our ancestors, where they came from, where they went, and what they had to go through

to get there. I just love people, and I would like to think that I am outgoing. I try to make

people smile, even strangers I pass in the store, especially if they look like their day has

turned sour. Combining all of those things is what led me towards nursing.

Program Graduate Competencies, Coursework, and Practicum Experience

General Education Courses

I knew when I began my path to becoming a nurse, I would want to at least continue

my education on to my bachelor’s degree. I looked forward to learning more in depth about

different parts of nursing that we only very briefly touched on in the ADN program. As I
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progressed through the BSN program, I kept in mind the Program Graduate Competencies

(PGC), as I feel that these are all instrumental to nursing. The nursing courses that we took

focused on one or more of the PGC’s, and these courses led to my own personal and

professional growth as a nurse (PGC #1/#9). Some of the general education classes also lined

up with the PGC’s.

I really enjoyed the Sociology 213 course, Ethical Issues in Healthcare, and I feel that

it was very relevant to the BSN program and to nursing in general (PGC #1, #6, #8).

Discussing the ANA Nursing Code of Ethics in depth was such a good experience. Nurses

constantly face ethical dilemmas. By having the Nursing Code of Ethics, nurses can better

navigate these dilemmas. The nursing profession must maintain their professional Code of

Ethics. The provisions provided can help nurses by helping them to make ethical decisions,

which in turn reduce stress and improve patient outcomes. The Nursing Code of Ethics is an

amazing guide to how nurses should practice professionally, and it is also a guide for us when

facing difficult situations.

The Biology 130 course, Disease Process and Pathophysiology, was an excellent course.

I learned a lot in the ADN program, and I learned even more once I got to bedside. There are so

many layers to the human body, and each system can directly or indirectly affect something else.

As nurses, we must put pieces of the puzzle together to see the bigger picture. The information in

this course, however, helped me so much, especially in the ICU (PGC #1, #7, #9).

Nursing Courses

I have always known professionalism and professional behavior is important within a

workplace, but nursing is a career that is viewed highly and trusted. I have learned much
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throughout this program, and a lot of that has surrounded professionalism and professional

behavior. As I have progressed through my nursing career and through this program, I really feel

that my perception of nursing and my beliefs were reinforced throughout. I have seen this impact

with advocating for my patients, having cultural sensitivity, having effective communication

with the interdisciplinary health care team, in precepting, and in leadership when trying to be an

example to nurses. All of that also goes into how the program has impacted the care that I

provide to my patients, such as being sensitive to my patients’ needs and being sure they are

cared for in a manner that makes them feel seen and heard. Advocating for the needs of patients

with professional behavior is also important, regardless of whether those on the healthcare team

are also interacting professionally. All these things were met throughout each of the courses that

we completed.

To write this paper, I decided to go back through my other completed course work. In the RN

to BSN Transition course, we worked through conflict resolution and personality types. We

discussed communication and nursing theories. We also formed our personal nursing philosophy

and wellness plan. I wrote my final paper for this course on compassion fatigue. It is something

that I am very passionate about. Taking time for personal wellness is just as important as patient

care, as how we are personally doing will reflect in our patient care. All of this helped me to

meet PGC’s #1, #6, and #9.

“Global health implies a global perspective on public health problems. It suggests issues that

people face in common, such as the impact of potential risks of climate change on health. The

topics also relate in important ways to problems that require cooperative action” (Skolnik, 2016,

p. 7). This course taught me that improving global and public health benefits everyone,

worldwide, and that I must provide a holistic approach to creating a better world. There are many
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factors affecting global health, such as environmental, cultural, social, and behavioral risk

factors. I knew global health was important, but I really learned so much in this course. I learned

how important it is to identify determinants of health and ways to address them, not just at a

local level, but worldwide. There must be a willingness to accept responsibility and make

changes in hopes of allowing all people to live happy, healthy lives for as much and as long as

possible. This course really incorporated a lot of the PGC’s, as leadership, ethics, informatics,

collaboration, and health promotion and disease prevention are all factors. I think that PGC’s #2,

#3, #4, #5, #6, #7, #8 were all touched on in this course.

In Population and Community Health, we discussed the role of the nurse within the

community and identifying healthcare needs, health determinants, and health promotion

within the community. I chose to discuss the elderly population. I learned that the health

determinants of the elderly can include so many things and are often multifaceted, and these

determinants can substantially impact the quality of life of the elderly. As a nurse, I believe that

it is important for me to always advocate for all of my patients. I have learned that I can do this

in many ways, and although I was already practicing advocating for my patients, I feel that I

learned a lot more about integrating health promotion and disease prevention into my practice.

PGC’s #3, #5, #6, #7, and #8 were met with this class.

Throughout the Health Assessment course, advocacy was weaved in, and it reiterated that

a thorough, holistic assessment will always provide the most beneficial impact on a patient’s

plan of care. Nursing encompasses the whole patient, their physical, spiritual, social,

psychological, and cultural parts, their environment, and their wellness or illness, not just their

immediate health concerns. This is key to how the patient responds to the care that they are

receiving. A holistic assessment will allow us to meet each patient’s specific needs in a
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respectful way (Wallace, 2013). No patient will ever present the same, whether it be physically,

mentally, emotionally, etc. This will never change. It is important that we always remember that.

“An explicit definition of holistic care will improve clinical performance and encourage nurses

to provide this type of care, which will, in turn, improve the quality of nursing” (Madineh,

Valizadeh, Zamanzadeh, Keogh, 2017). We must treat the whole patient, not just their diseases.

This course covered PGC’s #3, #6, #7, and #8.

Throughout the Nursing Research course, I learned that research is a valuable part of nursing

and can directly affect patient care. It allows for comprehensive, evidence-based clinical

practice. Without it, we wouldn’t be able to practice safely and effectively. Nurses, especially

those at bedside, see and experience first-hand what is happening with and being done to their

patients. This enables them to see where changes could be made to better patient care. As the

medical field continues to advance, it becomes more and more important to change with it for the

better. Nursing researchers are able to take these gaps in care and discover new or better ways to

provide care that will be valuable. Research has a remarkable impact, not only on the present

nursing practice, but on the future of nursing practice.

In the ICU, we are always looking at ways to decrease the use of Foley catheters to

decrease catheter-associated urinary tract infections. Typically, patients in the ICU and

sedated and intubated. They are fully dependent on the nursing staff for their care. They need

to be turned every two hours and are incontinent of urine and stool. Being incontinent of both

can lead to skin breakdown. By using a Foley catheter, we are at least able to control urine.

However, on the opposite end of this, their incontinence of stool can lead to UTI’s with the

use of the catheters. The patient needs to meet certain criteria, such as having severe

respiratory issues, meaning they cannot be turned often to be cleaned of urine, if they are
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being prone, or unless we need to collect strict output. They have established a flowsheet to

use to determine whether we should use a Foley catheter or a less invasive method, such as a

Purewick. Evidence-based research has had an impact on what we are doing.

Nursing Leadership in healthcare, specifically among nurses, can be a special type of

leadership, as nurses are focused on caring for patients and are on the frontlines of managing

and maintaining patient care. Provision 2 of the Nursing Code of Ethics states the nurse’s

primary commitment is to the patient, whether an individual, family group, community or

population, which includes primacy of the patient’s interests, conflict of interest for nurses,

collaboration, and professional boundaries (ANA, 2015). Provision 3 states that the nurse

promotes, advocates for, and protects the rights, health, and safety of the patient, which includes

protection of the rights of privacy and confidentiality, protection of human participants in

research, performance standards and review of mechanisms, professional responsibility in

promoting a culture of safety, protection of a patient health and safety by acting on questionable

practice, patient protection, and impaired practice (ANA, 2015). Nurses as leaders can drive

patient outcomes and should take this responsibility seriously. “Improvement of health services

is dependent upon the way patient centered care is understood,” and “leadership that promotes

the values of patient centered care-respect, dignity, compassion, caring-will lead this

transformation” (Kitson, 2001, p. ii79). Investing in nurse leadership cannot only lead the way

for better patient care, but it can pave the way for the betterment of nursing. “Nursing is a

holistic profession; similarly, nursing leadership should also be holistic, dynamic, inclusive,

flexible, and adaptable” (Jackson, Clements, Averill, & Zimbro, 2001, p. 153). This course

helped me to remember that being a nurse leader is challenging and comes with many

responsibilities, but leading can be rewarding and worthwhile. It also helped me to see that I
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want to gain more confidence in this area and become a better nurse leader. I started to fill in for

preceptors when needed, and even volunteered to be a permanent preceptor. I relate PGC’s #2,

#5, #6, #8, and #9.

Nursing Informatics was something that, while I was familiar with it, I did not think

much about. It taught me a lot about its importance. From the system that I use for charting to the

IV pumps, to the monitors and alarms. Nursing informatics is a huge area, and it is important to

incorporate evidenced-base practice into the technology. It was increasingly important during the

height of the COVID pandemic, as it allowed providers to have the information that they needed

to continue to deliver quality healthcare. This course met PGC’s #3, #4, #6, and #7.

In Nursing Policy, we discussed the importance of nurses being involved with developing

healthcare policies, legislative process, and how nurses can be involved in different levels of

government at local, state, national, and global levels. According to JCAHO, an organization

should also be sure they are implementing other evidence-based practices to their policies to

ensure best patient outcomes (2021, page 5). While I am not very familiar with this area of

nursing, and while I do not believe that I would enter into this area of nursing, I did learn quite a

bit from this class, and I am very glad that it was a requirement. PGC’s #2, #3, #5, #6, 7, and #8.

I did not attend practicum for the Population and Community Health Class, but I was

able to for Nursing Capstone. I was able to experience many of the PGC’s during this

practicum. I was able to discuss evidence-based practice, advocacy, information management

technology, and collaboration all from a leadership standpoint during a medication error issue

and a patient fall (PGC #2, #3, #4, #6). We discussed practicing professional nursing within

an ethical framework while intervening in an employee discussing private information about

other employees (PGC #8). We met with other leaders to discuss issues with the program they
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use for charting and medication administration (PGC #4, #6). I was truly blessed to be able to

witness great leadership during my final practicum (PGC #2). My preceptor emulated all the

qualities of an amazing nurse and a great leader.

SWOT Goals Analysis

I have enjoyed learning about the field of nursing more deeply throughout this program. I do

feel that many of my strengths and weaknesses have more to do with clinical, hands-on, bedside

nursing at this point, but I do have some things that I feel the program has helped me to be

stronger at bedside. Developing a lifelong learning for personal and professional growth has been

important to me. I have used research and learning, particularly evidence-based, to strengthen my

knowledge of illness and disease to be able to better care for and support my patients. This is

critical to my role as an ICU nurse and has helped me to achieve this as a strength. The

pathophysiology class that we were required to take also helped me to achieve my strength of

being more thorough and became an opportunity for improvement. I’d always tried to be as

thorough as possible, but that course specifically helped me to better “connect the dots” for my

patients. I have a passion for wanting new grads to not just be successful as new nurses that give

high-quality patient care and promote patient safety, but to also be sure their mental health stays

healthy, as nursing is a high-stress career. I consider this a strength, as one day I hope to be a

professional mentor.

Lifelong Learning

Even though I struggle with how to answer when people ask me what my career goals

are and even though I do not currently have an ultimate career goal, I can still focus on

smaller steps, like continuing to gain enough knowledge and experience to become a

preceptor, a charge nurse, and/or a hospital nursing supervisor. Learning never ends. I may
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not always be seeking an educational degree, but I know will forever be learning (PGC #1 and

#9).

There will always be new opportunities to learn more. It could be learning more in my

particular specialty, or I may branch out into other areas and learn new types of nursing.

Healthcare is always changing and evolving. I will never be done learning when it comes to

healthcare. There will always be new and better ways of doing something we already do.

Healthcare is so big and broad that we will never be able to know it all, even if it is just one

area. Learning in our career may end once we have retired from it all, but our individual

learning will last until we draw our last breath.

We are learning in our daily lives. We are growing and evolving as individuals. We

learn from our experiences, and we gain more knowledge. We can go through tests and trials

and learn from them. We can use that experience and maneuver through life a little easier. We

can most definitely help to guide others when we have already been through something

ourselves. Even then, it won’t be an end-all. There will still be something more we gain and

learn from similar experiences. We never stop learning about ourselves and the ways in which

we stretch and grow. How strong we can be, especially when we have no other choice. We are

even learning to do new things that will become hobbies that we enjoy, like sewing, knitting,

playing an instrument, ballroom dancing. Lifelong learning is how we grow not only as

individuals, but as a society.

We learn acceptance. We learn caring and compassion and empathy. We learn how to

communicate with strangers, with acquaintances, with friends, with enemies. Something very

important to learn in life is agreeing to disagree, finding a balance or a middle ground when
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one can be had and knowing when to walk away when it can’t. Lifelong learning encompasses

everything, every area of our lives, not just brick and mortar education.

The BSN program has been a positive experience. I have learned a lot, and I will carry

what I have learned into the future. No matter what career pathway I choose to take within the

nursing profession, I will be able to incorporate what we were taught.

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References

ANA. (2019). Code of ethics for nurses with interpretive statements.

https://www.nursingworld.org/coe-view-only

Jackson, J., Clements, P., Averill, J., & Zimbro, K. (June 2009). Patterns of knowing: Proposing

a theory for nursing leadership. Nursing Economics, 27(3), 149-159. http://web.a.

ebscohost.com.libproxy.dtcc.edu/ehost/pdfviewer/pdfviewer?vid=15&sid=a311351e-

9942-42d3-b950-77ca1095b788%40sessionmgr4008

Kitson, A. (December 2001). Nursing leadership: Bringing caring back to the future. Qual

Health Care, 10(Suppl 2), ii79-ii84. doi: 10.1136/qhc.0100079

Madineh, J., Valizadeh, L., Zamanzadeh, V., & Keogh, B. (2017, January). A concept analysis of

holistic care by hybrid model. Indian Journal of Palliative Care, 23(1), 71-80. http://dx.

doi.org.libproxy.dtcc.edu/10.4103/0973-1075.197960

Skolnik, R. (2016a). Global health 101. Burlington, MA: Jones & Bartlett Learning.

The Joint Commission. (2021, January 1). National patient safety goals.

https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-

safety-goals/2021/npsg_chapter_ncc_ jan2021.pdf

Wallace, S. (2013, January). The importance of holistic assessment: A nursing student

perspective. Nuritinga, 12, 24-30. https://www.researchgate.net/ publication/275893594