BSN Professional Portfolio

Welcome to my professional portfolio created for my Senior Capstone at Dixie State University. Please use the  above links to find and reference material I have created and researched throughout my time at Dixie State University. The experiences and material have helped to shape my learning and nursing practice so that I am prepared to provide exceptional care to my patients, their families and the community in which I serve.

Thank you for taking the time to read my work and consider my progression throughout this course of study and into my professional career.

Outcome1

Apply leadership concepts, skills, and decision making in order to provide oversight and accountability for the delivery of safe, quality care in a variety of healthcare settings.  

I have had the opportunity to be in a leadership position for most of my nursing career. I have always enjoyed teaching, mentoring and helping my fellow nurses. I enjoy knowing what is going on with patients and being involved in every aspect of their care whether it is the actual nursing part of their care or helping them manage their emotions or putting out fires; I enjoy it all.

Since being in the BSN program I have learned a lot and have been able to apply those things while practicing nursing and help my coworkers to excel in their nursing care as well. I learned a lot while in the health assessment class. I think the first time through my nursing courses I was so worried about passing the NCLEX that I didn’t really absorb everything I should have. This time around with less pressure I have been able to absorb and apply my learning right away into my practice. I know that my patients have benefited from what I learned in that class.

Another area that I have been able to apply into my daily routine is the concepts I learned in Transcultural Nursing. I take care of people from different cultures on a daily basis and I learned many things in that class that not only benefited me as a leader (as I was able to help my coworkers) but also benefited me as a person.

These are just two examples, but throughout the course I have caught myself saying “Oh! That’s how I should do it!” and then changing my practice.

I am including a link to the Fadiman paper I wrote after reading the book The Spirit Catches You and You Fall Down written by Anne Fadiman.

Fadiman Response Paper

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Outcome 2

Integrate reliable evidence from multiple perspectives to inform practice and make reasonable clinical judgments.  

Integrating reliable evidence from multiple perspectives and using that to guide practice and make reasonable judgments can sometimes be difficult. I have found that in my practice, before I go to see a patient I will read the transcribed history on the computer, the history submitted by the patient, and progress notes. This allows me to not only go into the patient room with a better understanding of why they are here, but what everyone did while working with them.

If I come across a particular illness, medication, or procedure that I am not familiar with I will research it so I can be familiar with it. I have not always done this and found myself guessing or making assumptions about patient care. Once I learned to prioritize my time so that I could use different people’s perspectives and research in my practice, I found my patients were happier, I was more confident and my peers started to look to me for advice and help.

While I cannot pinpoint one specific course that has helped me with this particular situation, I can say that nursing research, and leadership helped me to hone my research skills and become a better leader/teacher for my peers and also for my patients.

Clinical judgment isn’t something that everyone has, but I do believe that it can be learned and that it can be honed if you work at it. By making time to research, read histories, review progress notes from the dietitians/physical therapists/ and other members of the interdisciplinary team, and talk to the patient about their concerns, clinical judgments will be more accurate and patients will be better cared for.

Outcome 3

Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice in a variety of healthcare settings.

The first thing that came to mind when reading the post for this week was the new scanning process for medications. Scanning medications isn’t new, but the process has changed and now all units within the hospital where I work are required to scan where this wasn’t the case until just this month.
Scanning patient medications and the patient identification band on the unit I used to work on was always best practice, however, it wasn’t always done in real time and often, medications were “overrode” for nurse convenience and speed when giving medications. Now, nurses are required to scan the patient band and the medication in real time.

If the medication is a “high alert” medication (some vasoactives, insulin, heparin/lovenox, pediatric medications, PCA and PCEA) another nurse is required to witness and scan their badge into the system for proof that they witnessed the correct medication being given to the correct patient in the correct dose.

This change was not happily accepted as it took time to find another nurse to go into the room with you and made medication administration slower. The process has improved patient safety and decreased medication errors.

The new unit I work on has just started the scanning process. Although some nurses are upset, most have embraced the change because of the benefits. Real time charting, patient safety, and it really is easier than having to go in and document everything by hand.

Outcome 4

Demonstrate basic knowledge of healthcare policy, finance, and regulatory environments including local, state, national, and global health care trends.

This has been a difficult discussion for me to respond to. I am currently in Nursing Policy and Ethics and I find each post and discussion takes me many hours to be able to get my thoughts out in a manner that conveys how I feel and what I know. This is an area where I think constant learning and growth happens (and has to) because it is always changing. Healthcare policy, finance, and regulatory environments are the subject of many topics on all levels of government right now due to Obama Care and other health care options that are being put forth.

Right now there is only one paper that I plan to put into my portfolio. This may change based on the rest of the semester, but for the Public Health Nursing Ethics assignment I not only researched information but I interviewed nurses and physicians on their opinions and experiences regarding the changes in health care and the “us” vs. “them” mentality of the health care community. I learned a lot and am proud of the work I put into the assignment.

Even though I am not as familiar with this subject as I should be, I think that I am in a good position right now because I am currently in the class and there is so much going on in the community it gives me the opportunity to not only take part if I want to, but to understand better the consequences and benefits of proposed changes.

Public Health Nursing and Ethics

Outcome 5

Communicate, collaborate, and negotiate as a member and leader within interdisciplinary health care teams to improve patient health outcomes. 

Trying to remember a time when I had the opportunity to communicate, collaborate, and negotiate as a member and leader of the interdisciplinary team reminded me of the Research class when we researched a topic and reviewed the literature about that certain topic. I chose to research c-diff. At that time there were many cases of C-diff not only among the patients on the post surgical unit where I worked, but two staff members had also gotten C-diff.

I researched this topic for many, many hours and came up with some pretty interesting information. I worked with my manager and spoke with some of the physicians about the research I was doing in hopes they could share some of their expertise with me. After the paper was complete I gave a copy to one of the surgeons to see what he thought about it and I was surprised that he said there was information in my paper that he didn’t know and he would take that into consideration if he had another case of c-diff with his patients. I presented my paper to my clinical educator in hopes it would facilitate change within my unit. Because I was a charge nurse, I talked with the staff during our shift huddles about the information I discovered and encouraged them to follow the small changes outlined. 

Before I quit working on that unit we started to wear full PPE (we were probably supposed to anyway, but no one did) including shoe covers and everyone was better at watching the labs of suspected patients and getting the C. diff test sent sooner. Now that I don’t work there I’m not sure if things are still in place of if they have gone a different route. I plan to include this paper in my portfolio.



Clostridium Difficile Literature Review

Outcome 6

Manage the direct and indirect care of individuals, families, groups, communities, and populations to promote, maintain, and restore health.

During the Community Nursing class I was able to participate in several different health fairs and flu shot clinics. These health fairs consisted of testing glucose, cholesterol, blood pressure and body fat percentages. School district employees, state employees, private businesses in the community all enlisted our services to screen and educate their employees and anyone under the insurance or in the household of the employee. This made it so that I was able to interact with and educate not only individuals but also their families and the community that they worked in  to promote, maintain and restore health.

During my interactions I saw that many people didn’t understand what caused high blood sugar or high cholesterol. They didn’t understand how cholesterol was used in the body or what the consequences were if it were untreated. Many people I saw were obese or nearly obese, had high cholesterol and high blood pressure. Providing education about diet and exercise was not only fun, but it was also rewarding to see them respond and actually seek out change.

In response to the unhealthy lifestyles I encountered I did my Community Health Assessment and plan of action obesity within my community. I put together a plan of action and power point with suggestions for education and health promotion within the community based on the interactions I had with the clients at the health fairs. I enjoyed answering questions, and educating families and the community about lifestyle changes that were easy and maintainable. I plan to include this assessment and power point in my portfolio.

Please access the power point from the link found on the side bar and the Community Health Assessment from the link at the top of the page.