Running head: PAPER B

Paper B
Erin Ludwick
Ferris State University
Transition Into Professional Nursing
NURS 324

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Paper B

Nursing school has a number of objectives for the nursing student. While each of those
objectives is important, the one that overshadows everything else is critical thinking. Nurses
must always look into their scope of practice with a critical mind. Identification of your current
scope of practice allows you to differentiate this from future practice as you transition into the
BSN role (Gustman, 2014, p. 7).
Professional Identity
The characteristics of a profession vary depending on who you talk to. The general
consensus is that a profession is an occupational group with a set of attitudes or behaviors, or
both (Black, 2014, p. 52). While there are many scholars who have attempted to define a
profession in their own words, there are many characteristics that most seem to agree on. In the
1990s, the Task Force on Professionalism spent many years studying these characteristics and
combined many of the scholars characteristics into one common list. Among the characteristics
listed are: prolonged specialized training; ideology based on original meaning; a theory of
societal benefits derived from the ideology; service orientation; and authority granted by society
in the form of a licensure/certification to name a few. Although not all scholars agree, there are
three characteristics that consistently show up on every list: service, specialized knowledge, and
autonomy/ethics (Black, 2014).
There is a large difference between a profession and an occupation. According to Black,
characteristics of an occupation include (but are not limited to): on-the-job training that varies in
length; decision making is largely guided by trial and error; and values & ethics are not
prominent features of preparation (Black, 2014, p. 55). These characteristics vary greatly from
the characteristics of a profession. Generally speaking, someone will study hard and be wholly

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committed to a profession while an occupation may change. Nursing takes intense preparation
that includes study of a common theory, commitment to bettering themselves and others, and
emphasizing core competencies that calls for increased teamwork across disciplines and teambased care (Black, 2014, p. 54).
The status of nursing as a profession is important because it mirrors the value society
places on the work of nurses and the significance of this work to the good of the people. Many
nurses hear the calling of nursing because of altruism, their desire to help others. Professional
nursing practice involves dedicated skill set essential to the execution of a professional role. The
two main concepts that are in the forefront of professional nursing are accountability and
autonomy. Accountability is the state of being responsible and answerable for ones own
behavior. Autonomy in nursing is the freedom and the authority to act independently. It
implies control over ones practice, and it applies to both decisions and actions ("Standards,"
2010, para. 5).
Scope of Practice
According to the American Nurses Association (ANA), the definition of nursing is the
protection, promotion, and optimization of health and abilities; prevention of illness and injury;
alleviation of suffering through the diagnosis and treatment of human response; and advocacy in
the care of individuals, families, communities, and populations (American Nurses Association
[ANA], 2012, p. 5). The nursing scope of practice builds on this definition to include the
essentials of life, everything from the who down to the how. In order to illustrate a complete
picture of nursing, all of those essentials must be adequately answered. The scope of practice
embodies the values, beliefs, and ethics that are all part of an integral characteristic of a
profession. This is one reason of many why nursing is considered an elite profession.

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Planning
There are currently 16 standards of nursing that encompass what nursing is and what is
necessary for adequate nursing. Those 16 include assessment, diagnosis, outcome identification,
planning, implementation, evaluation, ethics, education, evidence-based practice & research,
quality of practice, communication, leadership, collaboration, professional practice evaluation,
resource utilization, and environmental health (ANA, 2012). Each standard is equally as
important as the next, and each must be executed precisely in order to be effective. The two
standards I feel are incredibly important are planning and implementation.
Planning is the standard where the nurse develops a blueprint that proposes a different
approach and alternatives to achieve expected outcomes. To develop this blueprint, one must
integrate the assessment & diagnosis along with a scientific basis in order to achieve the outcome
that was previously identified. Factors in the planning standard relate to nursing as well as
patients, resources, evidence-based practice, and even the environment.
Planning affects nurses at every level. During nursing school, nursing students are
required to complete case studies and care plans for their patients. These are written plans that
the nurse will follow in order to achieve an optimum outcome. In administrative nursing, the
manager must develop a plan after a discrepancy has been noticed in order to correct the issue
and prevent it from happening again. Research is considered the highest level of comprehensive
planning. Research develops plans on what to look for, how to research the topic, and how to
present the information.
Implementation
Implementation is another important standard that relates directly to planning.
Implementation is when the plan is acted upon in order to achieve the outcomes. The nurse

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coordinates the delivery of care while promoting the health and safety of the patient.
Implementation may include direct & indirect care, delegation, and it will combine critical
thinking with actions. There are four sub-standards for the implementation standard:
coordination of care, health teaching & promotion, consultation, and prescriptive authority and
treatment (ANA, 2012).
Implementation can be shown during practice in a number of ways. While educating new
nurses, nursing professors must be able to maintain a safe and healthy work environment for
their students. They have a plan in place to teach the students but they must be able to adapt to
put safety concerns first. It can also be related to Administration by constantly adopting delivery
models and changing policies & procedures in order to put nursing and patient safety first (ANA,
2012).
Transition
Every standard of practice can be somehow related to the knowledge, skills, and attitudes
(KSA) of BSN-level nurses. KSAs are necessary to improve the quality and safety of healthcare
systems (Quality and Safety Education for Nurses [QSEN], 2014). The model of professional
nursing can be broken down into different sections, each pertaining to the KSAs as well (Black,
2014). For instance, knowledge and skills relate to policies and procedures, standards of care,
and the professional scope of practice. Attitude goes along with the self-determination aspect of
the model.
Although each standard can somehow be related to each factor, discussion will relate
only one standard to knowledge, skills, and attitude. Knowledge can be related to Evaluation.
Skills can be related to Implementation. Attitudes can be related to Quality of Practice.
Knowledge

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Evaluation is a professional performance standard that relates to knowledge. Evaluation

is when the nurse is reviewing the progress the patient is making towards their outcomes. In
order to evaluate, the nurse must have adequate knowledge of the outcomes and the processes to
obtain the objectives. This knowledge includes asking the right questions, finding the appropriate
information to answer those questions, and making a decision based on the answers.
Evaluation is a standard that can relate to the Quality and Safety Education for Nurses
Evidence Based Practice competency (QSEN, 2014). The competency requires the nurse to be
able to demonstrate current knowledge in the scientific method, research vs. clinical opinion
pieces, and distinguish between valid and invalid results. Being able to research information and
understand the results is pivotal for patient care. This allows the nurse to be able to evaluate the
patient accurately and with clear information on whether the patients goals need to be changed
or if theyre on the right track.
RN knowledge includes an in-depth review of the six elements of the nursing process:
assessment, diagnosis, identified outcomes, planning, implementation, and evaluation. The
remaining standards in practice are examined thoroughly as a BSN. The BSN will have more
knowledge in research and management abilities as well.
Skills
Assessment is a standard that directly relates to nursing skill. Being able to utilize all
skills during an assessment is crucial when youre trying to figure out what is going on with your
patient. Assessment includes physical, psychosocial, and emotional aspects of the patient.
Physical assessment includes a detailed review of all body systems. Psychosocial assessment
includes medical history, the patients environment, and health habits (such as smoking, overeating, or not being able to afford medications). Emotional assessment includes reviewing the

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patients emotional state and asking yourself questions such as is this patient receptive to
information? Utilizing all of those skills are critical in painting an accurate overview of the
patient, to determine what needs to be worked on.
RN skills and BSN skills are very much alike with little differences. Those differences,
however, include an advanced critical thinking ability for the BSN-level nurse. Critical thinking
is important during an assessment in order to obtain accurate information regarding the patient.
Being able to look at things critically gives the patient the best possible chances for a positive
outcome, as it covers all bases.
Attitude
Attitude directly relates to the standard Quality of Practice. Quality of practice is when
the nurse gives patient centered, quality care to the patients. The nurses attitude greatly affects
the quality of care given. If the nurse has a poor attitude, the patient care may suffer. If the nurse
doesnt have a caring, confident, positive attitude, the patient will not be receptive to care,
therefore no education will be done either.
Quality of practice is everyones responsibility in healthcare. However, since the nurses
role includes being a liaison between all practicum (physicians, respiratory therapists, case
managers, etc.), the nurse has taken on the responsibility of ensuring quality from all aspects of
healthcare. Being able to handle this type of responsibility is stressful, but keeping a positive
attitude is essential to build a trusting relationship between the team and the patient.
Significance and Conclusion
BSN prepared nurses can improve quality and safety in a health system because they
have had more exposure to critical thinking. They are well-rounded in the sense that they have
had more exposure to different nursing scenarios such as management, community health

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nursing, research, and humanities. The additional course work boosts the students professional
development, prepares a newer nurse for a larger scope of practice, and provides the nurse with
a better understanding of the cultural, political, economic, and social issues that affect patients
and influence healthcare delivery (Rosseter, 2014, p. 1). Although all nurses take the same
NCLEX exam in order to become registered, BSN graduates enter the workforce with a broader
spectrum of knowledge. Many BSN educated nurses are able to handle more intricate levels of
treatment and education. They are also responsible for creating, coordinating and implementing
comprehensive treatment plans for the length of a patient's stay at the hospital ("BSN," 2012)
The nursing workforce is the largest workforce in the healthcare industry ("Future of
Nursing," 2010). Because of this, nurses are leading the way in healthcare. We are the center of
the healthcare team, often considered the middle man. We join together physicians, physician
assistants, respiratory therapists, case managers, social workers, and families with the patients.
Although we try to fly under the radar, nurses are usually front and center, relaying information,
educating patients and families, and managing care.
The nursing scope of practice is to be used as a guideline. The more mature the nurse is,
the greater the meaning of the scope of practice. Every nurse follows the scope of practice, but
nurses who are experienced are able to find notable significance in them and can think more
critically during each patient care scenario. BSN graduates have more experience with critical
thinking skills, and that allows them to see beyond the first layer of the Scope of Practice.

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References

American Nurses Association. (2012). Nursings social policy statement. In K. M. White, & A.
OSullivan (Eds.), The essential guide to nursing practice (pp. 1-10). Silver Spring, MD:
Nursesbooks.org.
Bachelor of science in nursing. (2012). Retrieved from http://www.nursing-schooldegrees.com/Nursing-Articles-Interviews/bsn-degree.html
Black, B. P. (2014). Professional nursing concepts and challenges (7th ed.). St. Louis, Missouri:
Elsevier.
Gustman, S. (2014). Paper A. In NURS 324: transition into professional nursing syllabus (pp. 78). Big Rapids, Michigan: Ferris State University.
Nursing standards. (2010). Retrieved from
http://www.currentnursing.com/nursing_management/nursing_standards.html
Quality and Safety Education for Nurses. (2014). Pre-licensure KSAs. Retrieved from
http://qsen.org/competencies/pre-licensure-ksas/
Rosseter, R. J. (2014). The impact of education on nursing practice. Retrieved from
http://www.aacn.nche.edu/media-relations/EdImpact.pdf
The future of nursing: leading change, advancing health. (2010). Retrieved from
http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-AdvancingHealth.aspx