Running head: PRACTICE SUMMARY

Practice Summary Paper

Taylor W. Neuburg

Old Dominion University

PRACTICE SUMMARY 1

Practice Summary Paper

I enrolled in Old Dominion University’s (ODU) RN to BSN program to continue my

education and progress in the process of becoming a nurse practitioner. Through my enrollment

in the BSN program, I hoped to expand my knowledge as a nurse and refine previously learned

nursing skills. My experience, papers, projects, and assignments completed during the BSN

program have provided me with the opportunity for personal growth and professional

development. ODU’s BSN program is constructed on eight core competencies. The core

competencies are critical thinking, nursing practice, communication, teaching, research,

leadership, professionalism, and culture. The purpose of this paper is to demonstrate my

attainment of the eight core competencies through examples from course assignments and

clinical experiences.

Critical Thinking

Critical thinking is key in the profession of nursing. Basic skills and nursing knowledge

are learned in nursing programs. Critical thinking is the application of basic knowledge to

question inconsistences and keep patients safe. During one of my clinical rotations in an

intensive care unit (ICU), I was assigned to take care of a patient admitted for sepsis. The patient

was critically ill and required several vasoactive medications to maintain an adequate blood

pressure.

During report, the off going nurse reported that the patient was alert and had required

several high doses of insulin coverage due to elevated blood sugars. On assessment, the patient

was minimally responsive. I immediately assessed the patient’s vital signs, previous lab values,

vital sign trends, and referenced the patient’s history. All the patient’s lab values and vital signs

were within normal range expect the patient’s blood glucose was extremely elevated in the
PRACTICE SUMMARY 2

majority of the previous labs. I remembered that the off going nurse said she had drawn the labs

from the patient’s central line. The patient had a vasoactive medication diluted with 5% dextrose

solution infusing through one of the central line ports. I questioned if the glucose labs were

falsely elevated due to the previous nurse having drawn the labs from the line while the 5%

dextrose solution was infusing. I used a glucometer to perform two finger stick blood glucose

tests and then did another test using blood from the patient’s line with all the infusions paused

and flushed. The patient’s blood sugar was in the 40s. With the guidance of my preceptor, I

administered a glucose solution per protocol and within minutes the patient was alert and able to

follow commands.

This patient scenario is an example of how I was able to use critical thinking to make

clinical judgements and question inconsistences. If I had taken care of this patient at the

beginning of my nursing program, I might not have questioned the patient’s lab values and

connected them to the patient’s clinical presentation. After experience with drawing labs from

central lines and refined knowledge of vasoactive medications through progression in the BSN

program, I was able to apply my knowledge and think critically to help save a patient.

Nursing Practice

Nursing practice involves the use of nursing interventions to aid in healing and recovery.

During my preceptorship in an intensive care unit (ICU), I was assigned to work with a patient

that was on a mechanical ventilator. Due to the unique circumstances of the patient’s condition

and social background, I had to utilize cognitive, affective, and psychomotor domains to develop

and deliver therapeutic nursing care for my patient.

My patient had a history of autism and was admitted to the ICU after an accident caused

trauma to the patient’s cervical spine and consequential quadriplegia. I implemented the patient
PRACTICE SUMMARY 3

appropriate aspects of the ventilator acquired pneumonia bundle and aspiration precaution

guidelines during care. I communicated with the patient using a picture board. One of the

highlights of my nursing relationship with the patient was the incorporation of music therapy and

humor. During routine care I would play music and dance to one of the patient’s favorite artists.

The patient would smile and start laughing.

I was able to use nursing knowledge of how to manage care for ventilated patients,

incorporate appropriate safety techniques, implement nursing interventions, and include

complementary modalities in the nursing care delivered to my patient as a result of the skills

learned in the ODU BSN program. My nursing practice was developed based on the individual

needs of the patient. If I had taken care of this patient at the beginning of nursing school, my care

would not have been as therapeutic and effective for the patient due to limited knowledge of

ventilator management and critical care experience. My experience and knowledge learned

through the program enabled me to keep my patient safe and positively influence outcomes.

Communication

Effective communication is vital in the profession of nursing. Verbal, non-verbal, and

written communication are used to communicate with clients and professionals. During my

preceptorship in an ICU, I was required to present my patient during interdisciplinary (ID)

rounds. A rounding flowsheet was used to outline patient systems and best practice guidelines. I

incorporated assessment findings, current interventions, best practice standards, lab values, and

chart review to complete the sheet and present my findings to the interdisciplinary team. I

presented my patient to the ID team and was able to make recommendations based on

assessment findings, data, and gaps in the flowsheet. I would not have been as confident and

clear in my communication if I had presented my patients at the beginning of the nursing

PRACTICE SUMMARY 4

program. Experience of how to use the rounding tool and implementation of practice bundles

were key in my ability to effectively communicate during rounds.

Teaching

Nurses incorporate teaching strategies to enhance patient outcomes and aid in

professional development. In NURS 492, Community Health Nursing, I was required to perform

a community needs assessment, identify an aggregate, identify a need, and develop an

intervention to address the need based on assessment findings and personal involvement with the

identified aggregate. The teaching intervention I developed for the members of a local diabetes

education program is an example of using teaching strategies to enhance client health and

outcomes.

The members of the program were older adults with diabetes from low socioeconomic

and educational backgrounds. I implemented a teaching intervention based on the theory of

social support to improve attendance and educational outcomes. I used a pre-test, educational

pamphlets, videos, slideshow presentation, and demonstrations to communicate information to

participants. I provided teaching on diabetes education, insulin administration, and how to

accurately check blood sugar. Outcomes were measured through attendance, a score of 90% or

greater on post-test, and demonstration of how to check blood sugar and administer insulin. The

intervention was effective due to members that attended all the meetings being able to meet the

outcome measures. I incorporated knowledge and leadership skills gained through my

involvement in the BSN program to teach a group of individuals in my community ways to

improve diabetes management.

PRACTICE SUMMARY 5

Research

Research is a vital part of nursing. Nurses need to know how to use appropriate resources

to find research and use findings to guide practice. In NURS 363, Nursing Research, I was

required to complete an evidence-based practice (EBP) assignment. I conducted research on best

practice recommendations for patient bathing methods and used my findings as a basis for

therapeutic nursing interventions. I used the ODU library and online resources to find

appropriate primary peer reviewed articles relevant to my topic. I evaluated the efficacy and

effectiveness of the bathing method in each to draw a conclusion from my research. I organized

my findings into a poster and gave an oral presentation to my peers. This was one of my first

assignments in the BSN program. My ability to conduct research has improved throughout the

program. The assignment reinforced the importance of using valid research to guide nursing

interventions, identify gaps in practice, and improve patient safety.

Leadership

The program identifies a leader through demonstration of self-direction, professional

accountability, and patient advocacy while upholding both legal and ethical standards. I am a

preceptor on my unit. I acclimate new nurses to the unit and teach them how to independently

manage ICU patients. I am responsible for my actions as a nurse and also responsible for

delegating and overseeing the care provided by the nurse I am training.

Working with student nurses is a very influential position. The student’s experience

ultimately influences their opinion of the hospital and the profession of nursing. The

relationships developed with community nursing programs have the potential to influence

staffing and community relationships. It is vital to lead by example and positively empower

students during the preceptorship experience. I have recruited several nurses to work on my unit
PRACTICE SUMMARY 6

through the student preceptorship process. The leadership skills and experiences gained through

the BSN program have enabled me to get to a point where I am able to share the knowledge I

have learned with others. It is truly an honor to be recognized as a leader by my manager and be

trusted to train new employees and students.

Professionalism

The ODU program associates the characteristics of advocacy, accountability, and

following legal and ethical standards of practice with being a professional nurse. Professionalism

is key when managing patient care. In the ICU, I was responsible for taking care of a patient with

end stage cancer. While I was performing routine patient care, I overheard the patient tell his

wife he wanted to have care withdrawn and just be comfortable. The wife expressed that she did

not want the patient to pass because she would not receive his social security check. Shortly

after, the patient was intubated and not able to communicate.

Due to the wife being the legal decision maker and having possible ulterior motives, I felt

obligated to communicate the conversation I overheard to my manager. In efforts to advocate for

my patient, I initiated an ethical consult. I utilized the knowledge learned from the BSN program,

hospital policy, the nursing scope of practice, legal guidelines, and proper chain of command to

advocate for my patient in a professional manner to reach an ethically sound solution.

Culture

Culture awareness and sensitivity are essential to provide competent and effective care to

diverse patient populations. During my labor and delivery rotation, I worked with a Muslim

couple. During the initial interaction, the husband explained that they were Islamic and that his

wife spoke minimal English. I researched Muslim culture using the hospital database to reinforce

knowledge of culturally competent nursing interventions. I kindly and clearly explained that for
PRACTICE SUMMARY 7

patient safety and per hospital policy, I would have to use the hospital translator phone to

communicate procedures with the wife. The husband was speaking for the wife and the wife did

not make eye contact. I recognized that Muslim culture influenced communication and made it a

priority to highlight that the phone would supplement communication and only be used to

explain medical procedures and to obtain consent. I asked the couple if there were any

preferences they had in care that I could address to respect their culture and enhance their

experience. The husband explained their preference to using only female staff and allowing the

wife to keep on her hijab during the delivery process. I communicated with the healthcare team

and ensured that the couples’ requests were carried out. I provided culturally competent care to

my patient during the delivery process through utilization of research and knowledge learned

through the BSN program.

Summary

It is hard to believe that in a few short weeks I will be graduating from ODU’s BSN

program. I originally enrolled in the program as a stepping stone to work towards being a nurse

practitioner. The skills and knowledge I learned through my assignments, papers, projects, and

volunteering have far surpassed my initial expectations of the program. The BSN program built

on the previously learned foundations of nursing through incorporation of leadership, teaching,

culture, community health, theory, ethics, law, and research. My enrollment in the program has

made me a more well-rounded nurse and enhanced my ability to keep my patients safe.

Nursing theory is the foundation of nursing practice. When I first started the nursing

program, I utilized basic knowledge and innate drive to help others to aid in skill development.

Learning about nursing theory in the BSN program has enhanced my practice and personal

philosophy through providing purpose behind my actions and beliefs. Kristen Swanson’s Theory
PRACTICE SUMMARY 8

of Caring Nursing theory serves as a guide for my personal philosophy of nursing and practice.

The theory incorporates aspects of other influential theories and focuses on patient

empowerment. Learning and incorporation of her theory has aided in skill refinement and

providing theory driven care for my patients.

ODU’s BSN program has made me a better nurse and professional. During the final year

of the program, I worked as a nurse full time. It was challenging to balance work and school.

When assignments had teaching, leadership, or quality improvement requirements, I tried to use

my hospital as the clinical site when appropriate. Application and incorporation of assignments

in my practice has enhanced my career and provided me with opportunities to get more involved.

Since my enrollment in the program, I have received several promotions and taken on new

leadership roles. The assignments, clinical experience, knowledge, and skills learned through

ODU’s BSN program have made me a better nurse and professional.

Conclusion

With graduation approaching, it is important to reflect on my progression through the

program and attainment of the outcome measures identified by ODU. The Core Competencies of

critical thinking, nursing practice, communication, teaching, research, leadership,

professionalism, and culture were met through examples in clinical practice and course

assignments. At the beginning of the program, I was a novice nurse with minimal clinical

experience. The clinical experience, assignments, leadership opportunities, and papers I

completed during the program have influenced my personal and professional development. I am

now in a position where I am able to train other nurses and positively influence their personal

and professional development. I am thankful for my experiences and plan to take what I have

learned to continue to my education and provide the best possible care to my patients.
PRACTICE SUMMARY 9

Appendix

Practice Summary Paper

NURS 403 – Transition to BSN Practice

Purpose of Assignment
The purpose of this assignment is to guide the student through a process of self-reflection
and self-evaluation to discover the scope of personal and professional development while
enrolled in the RN to BSN program at Old Dominion University.

Student Approach to Assignment

I approached this assignment through a process of self-reflection and self-evaluation.
This paper demonstrates achievement of the eight core competencies through examples of
clinical experience and course assignments. This paper reflects application of my knowledge
learned in the program. I learned how much I have accomplished during my time in the program
and how it has positively influenced my personal and professional development.

Reason for Inclusion of this Assignment in the Portfolio

This paper is included in my portfolio because it depicts how I met the outcome measures
of the BSN program. The assignment represents me as a nurse because it exemplifies specific
examples experienced in practice. This paper is a demonstration of growth and summarizes my
progression from the beginning of the program to the end of the program.

• Critical Thinking
o Uses decision-making skills to in making clinical or professional judgements
- Example: see pages 1 & 2, paragraphs 2 & 3 (Critical Thinking)
- Example: see page 3, paragraph 1 (Communication)

o Evaluates nursing care outcomes through the acquisition of data and the questioning of
inconsistencies
- Example: see page 3, paragraph 1 (Communication)
- Example: see pages 1 & 2, paragraph 2 (Critical Thinking)

o Revises actions and goals based on evidence rather than conjecture

- Example: see pages 1 & 2, paragraphs 2 & 3 (Critical Thinking)
- Example: see page 3 & 4, paragraph 1 (Communication)

o Engages in creative problem solving

- Example: see pages 2 & 3, paragraphs 2 & 3 (Nursing Practice)
PRACTICE SUMMARY 10

• Nursing Practice
o Applies knowledge of major health problems to guide nursing practice
- Example: see pages 2 & 3, paragraphs 2 & 3 (Nursing Practice)
- Example: see page 3, paragraph 1 (Communication)
- Example: see page 4, paragraphs 1 & 2 (Teaching)

o Performs direct and indirect therapeutic interventions that incorporate principles of

quality management and safety based upon assessment findings
- Example: see pages 2 & 3, paragraphs 2 & 3 (Nursing Practice)
- Example: see page 3, paragraph 1 (Communication)
- Example: see pages 6 & 7, paragraph 1 (Culture)
- Example: see pages 1 & 2, paragraph 2 (Critical Thinking)

o Implements traditional nursing care practices as appropriate to provide holistic health

care to diverse populations across the lifespan
- Example: see pages 2 & 3, paragraphs 2 & 3 (Nursing Practice)
- Example: see pages 6 & 7, paragraph 1 (Culture)
- Example: see page 4, paragraphs 1 & 2 (Teaching)
- Example: see page 6, paragraph 1 (Professionalism)

o Demonstrates an awareness of complementary modalities and their usefulness in

promoting health
- Example: see pages 2 & 3, paragraphs 2 & 3 (Nursing Practice)

o Establishes and or utilizes outcome measures to evaluate effectiveness of care

- Example: see page 4, paragraphs 1 & 2 (Teaching)

• Communication
o Expresses oneself and communicates effectively with diverse groups and disciplines
using a variety of media in a variety of contexts
- Example: see page 3, paragraph 1 (Communication)
- Example: see page 5, paragraph 1 (Research)
- Example: see pages 6 & 7, paragraph 1 (Culture)

o Adapts communication methods to patients with special needs

- Example: see pages 2 & 3, paragraph 2 (Nursing Practice)

o Accesses and utilizes data and information from a wide range of sources to enhance
patient and professional communication
- Example: see page 3, paragraph 1 (Communication)
PRACTICE SUMMARY 11

o Utilizes therapeutic communication within the nurse-patient relationship

- Example: see page 3, paragraph 2 (Nursing Practice)
- Example: see pages 6 & 7, paragraph 1 (Culture)

• Teaching
o Provides relevant and sensitive health education information and counseling to patients
and families, in a variety of situations and settings
- Example: see pages 6 & 7, paragraph 1 (Culture)
- Example: see page 4, paragraphs 1 & 2 (Teaching)

o Uses information technologies and other appropriate methods to communicate health

promotion, risk reduction, and disease prevention across the lifespan
- Example: see page 4, paragraphs 1 & 2 (Teaching)

o Evaluates the efficacy of health promotion and education modalities for use in a variety
of settings with diverse populations
- Example: see page 4, paragraphs 1 & 2 (Teaching)

• Research
o Applies research-based knowledge from nursing as a basis for culturally sensitive
practice
- Example: see pages 6 & 7, paragraph 1 (Culture)

o Applies research-based knowledge from the arts, humanities, and sciences to

complement nursing practice
- Example: see page 5, paragraph 1 (Research)
- Example: see pages 6 & 7, paragraph 1 (Culture)

o Evaluates research that focuses on the efficacy and effectiveness of nursing

interventions
- Example: see page 5, paragraph 1 (Research)

o Shares research findings with colleagues

- Example: see page 5, paragraph 1 (Research)

• Leadership
o Assumes a leadership role within one’s scope of practice as a designer, manager, and
coordinator of health care to meet the special needs of vulnerable populations in a
variety of practice settings
- Example: see pages 5 & 6, paragraphs 1 & 2 (Leadership)
PRACTICE SUMMARY 12

- Example: see page 4, paragraphs 1 & 2 (Teaching)

- Example: see page 6, paragraphs 1 & 2 (Professionalism)
- Example: see page 3, paragraph 1 (Communication)

o Articulates the values of the profession and the role of the nurse as a member of the
interdisciplinary health care team
- Example: see page 3, paragraph 1 (Communication)

o Delegates and supervises the nursing care given by others while retaining the
accountability for the quality of care given to the patient
- Example: see pages 5 & 6, paragraphs 1 & 2 (Leadership)

• Professionalism
o Advocates for professional standards of practice using organizational and political
processes
- Example: see page 6, paragraphs 1 & 2 (Professionalism)

o Demonstrates accountability for one’s own professional practice

- Example: see page 6, paragraphs 1 & 2 (Professionalism)
- Example: see pages 5 & 6, paragraphs 1 & 2 (Leadership)

• Culture
o Articulates an understanding of how human behavior is affected by culture, race
religion, gender, lifestyle, and age
- Example: see pages 6 & 7, paragraph 1 (Culture)

o Integrates knowledge of cultural diversity in performing nursing interventions

- Example: see pages 6 & 7, paragraph 1 (Culture)
PRACTICE SUMMARY 13

Honor Code

“I pledge to support the Honor System of Old Dominion University. I will refrain from
any form
of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a
member of the academic community it is my responsibility to turn in all suspected violations of
the Honor Code. I will report to a hearing if summoned.”

Electronically signed, Taylor Neuburg