1 Running head: PROFESSIONAL DEVELOPMENT PLAN

Professional Development Plan Renee Ivers Ferris State University

PROFESSIONAL DEVELOPMENT PLAN Abstract

Using the American Nurses Associations standards for professional nursing practice guidelines I am able to measure my current nursing practice. These standards have been reviewed and explained using examples from my daily patient care. I have developed both five and ten year professional goals to assist me on my journey of becoming the best nurse possible.

PROFESSIONAL DEVELOPMENT PLAN Professional Development Plan Florence Nightingale worked hard to define nursing as a profession. Throughout the years, nursing has come to be one of the most trusted professions. Nurses have earned this title by holding themselves to standards of practice put forth by the American Nurses Association (ANA). Personally, I use these standards to evaluate my nursing practice and set the bar for the patient care I deliver. In this paper, I have explained those standards and how they influence me

as a nurse. I will include my strengths, weaknesses and how I plan on working to improve both. I have great plans for my professional life using these standards to help guide me through. Standards of Professional Nursing Performance Standard 7: Ethics The ANA has given us a standard of ethics. Using these standards, I know I can deliver the best patient care by protecting their autonomy, dignity, rights, values, and beliefs. This code is designed to ensure nurses avoid unethical behavior, maintain a professional relationship and act as an advocate for the patient and their family in healthcare decisions among other ethical guidelines (ANA, 2010, p. 47). I work on a unit where you truly need to reflect on and understand your own values. Without doing this first you are more likely to have difficulty caring for patients whose situations you do not agree with. Most of my patients are being kept alive on a ventilator; many can no longer recognize or communicate with their family and friends. It can be difficult to care for a patient daily if you are of the opinion that the family should let their loved one go. By recognizing your own values you are more able to accept those of others. Autonomy assures that the patient has the right to make their own decisions. For instance, I have a patient that is a Jehovahs Witness. His hemoglobin is chronically low. Our common

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practice is to transfuse blood cells. However, the patients personal beliefs do not allow it. By not going against the patients beliefs, even when it may have a negative impact on their health we are respecting his autonomy. Just because the patient is in the hospital does not mean they no longer have values and beliefs. They need to be honored just as I would want mine own personal beliefs honored if roles were reversed. I am able to maintain my patients dignity by providing privacy when necessary, allowing time to digest information and by treating them holistically. Betty Neumans nursing philosophy is health is a condition in which all parts and subparts are in harmony with the whole of the client. Using this philosophy along with the standards of ethics I am able to care for my patients physiological, psychological, developmental, sociocultural, and spiritual needs. A weakness I have recognized is that I stand up for the patient when the family is not putting the patient first. I am ignoring that truly I am taking care of the family as well and perhaps I need to take more of a holistical approach to better recognize what I can do to help them. Standard 8: Education A nurse takes on the title of life-long learner just as they accept the title of Registered Nurse (RN). Healthcare is ever changing due to evidence-based research, technology, pharmaceutical breakthroughs and so much more. As changes are occurring the nurse needs to stay up to date on his/her education to give the best patient care. The ANA has developed a standard of education to remind us of this. This standard is to ensure that the nurse acquires knowledge and skills they need. Also, that they share that knowledge and then continue to seek more formal and independent learning experiences (ANA, 2010, p.49).

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Currently, I am in school to obtain my bachelors of science in nursing (BSN). Annually I obtain continuing education units (CEUs) for my degree. These are obtained by attending conferences, classes or doing approved lessons. While, I say I am doing these things for CEUs the truth is that I do enjoy them. I appreciate learning things that I can use in my daily practice; the new skills, practices and information keep me excited about nursing. I participate in webinars through ANA gaining knowledge about leadership and delegation or other relevant topics. I often seek out new experiences in order to learn something new. One of the requirements on my floor is that RNs must maintain a BLS certification with the option of ACLS. I am a preceptor for new RNs on our floor and try to teach them everything I know; many times they teach me something as well. The first thing I teach new RNs is not to be afraid to ask questions. I have never been shy about asking questions and I feel that has truly led me to be a strong RN in a short period of time. A strong nurse knows who and where the available resources are. A weakness of mine is procrastination. While I enjoy learning and education I do tend to procrastinate. This is a fault because it causes undue stress. If I could instead plan ahead and set up a time schedule to attend extra classes or work on specific projects this skill would benefit me and those I care for. Standard 9: Evidence-Based Practice and Research The standard for evidence-based practice states the registered nurse integrates evidence and research findings into practice (ANA, 2010, p. 51). This standard ensures the ability to incorporate evidence to guide practice and initiate changes. It also helps facilitate the sharing of new knowledge with others (ANA, 2010, p. 51). I recently made some changes on my floor. The implementation of changes was easier to accomplish with the help of evidence-based practice. My floor has a high number of indwelling Foley catheters. There had recently been an increasing

PROFESSIONAL DEVELOPMENT PLAN number of catheter associated urinary tract infections. After research, communication and education we have decreased those numbers. Simply put, the staff was educated on proper catheter care and the proper placement of Foley catheter stat-locks with positive outcomes. Without previous research and documentation done by others educating staff and changing procedures would have been much more difficult. My lack of desire to perform or work in research is a weakness. While I understand the importance of research, I find the studying of statistics and data boring. I would rather be a subject in a study and let someone else count me. Standard 10: Quality of Practice The ANA created a standard of quality of practice to ensure that nurses are documenting the nursing process and that they are creative and participating in the improvement of nursing

care. (ANA, 2010, p. 52) As a member of Metros Professional Nursing Council and the head of the Unit Based Council I am greatly involved with improving the practice around me. I am in direct contact with both management and staff on the floor listening for concerns regarding care and ways we can work together to make improvements. Since taking on this role I have gone through the whole process from diagnosis to treatment and evaluation of a problem on our floor. One example would be the high numbers of med errors on the floor that I work. These med errors were meds that were being left in a med drawer at the end of the night, this indicated that the med was not given as charted. The initial step was realizing that this was an ongoing problem. The next step was to figure out who this problem targeted. Then it was time to brainstorm possible causes. The last step was coming up with possible ways to correct the problem. After choosing the path that was best we educated the staff on the upcoming changes and started those changes on the floor. For the first few months we monitored the number of med

PROFESSIONAL DEVELOPMENT PLAN errors and listened for feedback regarding our new process. Our errors had decreased and the staff was adjusting to the changes. We officially made those changes in the quality of practice. My weakness is that I actually take on too much responsibility. We have a lack of willingness to participate in committees on my floor. So, I end up taking on the task to insure they are getting done. Standard 11: Communication Communication is so important in nursing that the ANA created a standard for it. This standard states, The registered nurse communicates effectively in a variety of formats in all areas of practice (ANA, 2001, p. 54). With the help of this standard I am able to convey

information to not only the patient but also families, care team and other coworkers. On my floor communication is actually not as simple as just talking. Most of our patients are unable to speak due to the tracheostomy. Our patients mouth words, gesture, spell words using a spell board, write, or some even do sign language. It is important to assess how the patient communicates and understands. I find myself relying on nonverbal communication more on this floor than any position I have held before. Chitty and Black confirm Nonverbal communication is particularly important to patients using mechanical ventilation or whose ability to speak is otherwise impaired (2011). Beyond communication with the patient it is beneficial to keep in mind that the family is undergoing stress and wants to be involved in the treatment of their loved one. One mistake made by healthcare workers is to view the family as simply being in the way. These standards remind us to do otherwise. Open communication with other team members on the floor makes for good teamwork. A breakdown in communication is a sure way to deliver poor patient care.

PROFESSIONAL DEVELOPMENT PLAN The ability to seek improvement in communication has benefited me in my nursing practice. In orientation it was difficult learning the many patients and their modes of communication. I listened to feedback from my preceptor, peers and the patients themselves. I once was told by a patient, I am not deaf. Apparently I was yelling when talking with the patient. Unintentionally, of course, but a mistake I no longer make. One weakness I have is being aware of my own nonverbal communication when I feel rushed with the patient. The patient has to know that they are important and if I am inching toward the door or looking at my watch. The patient recognizes this. Standard 12: Leadership

The RN must be a leader not only as someone the patient can look to, but also for the care team. This ANA standard states that the RN oversees the nursing care given by others, communicates effectively, participates in efforts to influence healthcare policy (ANA, 2010, p.55). The RN must demonstrate leadership in all tasks. The RN retains accountability for the quality of care given even when a task has been delegated. This is important on my floor. For my assigned group of patients I have one Licensed Practical Nurse (LPN) and one Nurse Aide (NA) working with me. The LPN passes medications and the Nurse Aide obtains vitals and performs baths. While I am not the one performing these tasks I am still responsible for the results of them. The LPN and NA look to me for guidance and expect me to be a leader. As I see problems on the floor I seek to fix them. I see this as a weakness. I try to be a leader in the way that instead of complaining about an issue I simply find a way to fix it instead of managing. This probably sounds like a good thing but as you can see I get quite a list of things going and some things need to be managed not just fixed.

PROFESSIONAL DEVELOPMENT PLAN Standard 13: Collaboration The standard of collaboration as written by the ANA states the registered nurse collaborates with healthcare consumer, family, and others in the conduct of nursing practice

(ANA, 2010, p. 57). The care team for my patients is quite large. The care team consists of RN, LPN, NA, nurse practitioner, doctor, dietary, social work, pharmacy, occupational and physical therapy, respiratory therapy, pastoral care, and many other specialties depending on the patients needs. The day to day care for the patient is directed by all of these people. Collaboration between those working in all of the different disciplines produces positive outcomes. Once a month we have a team meeting where the team gathers and discusses the patient as a whole. This standard ensures the ability to cooperate, partner, and communicate with the team to effect change. My weakness in this area is working night shift. The majority of the team works on day shift. As it is important to communicate to the rest of the team most of the communication is done through email and it can be difficult to always get the point across. Standard 14: Professional Practice Evaluation The standard of professional practice evaluation is in effort to ensure the RN selfevaluates his/her practice regularly with the ability to identify and take action to improve any areas of weakness. This standard lists not only self-evaluation, but peer review, and feedback from patients and coworkers as forms of professional practice evaluation. I am constantly reflecting on the care I give to identify any areas I can improve. I have learned how to prioritize after days that did not go as planned. During a code where the patient was not stabilized, I was able to identify the recorder as where the trouble was. I find myself reflecting and self-evaluating more often after something goes wrong. This is logical since these are the times when I need to

PROFESSIONAL DEVELOPMENT PLAN improve on something. I am able to take criticism and constructive feedback, using it to my benefit. I do not take it personally. Perhaps my weakness is that I do not self-evaluate enough after positive outcomes. If I did this more frequently I would recognize what went right as well as what could be improved. Standard 15: Resource Utilization The ANA standards state, The registered nurse utilizes appropriate resources to plan and provide nursing services that are safe, effective, and financially responsible (ANA, 2010,

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p. 60). I am able to use these standards when I delegate tasks, or when I look for materials for my floor. I understand that the resources I use affect the whole floor and budget of the hospital. A weakness I have in this area is that most of my patients are there long term combined with the fact that I work night shift, means that I do not have much experience in discharge education. I do not have the opportunity to explain cost effective ways to care for their loved one and the social worker usually discusses insurance and treatment options. Standard 16: Environmental Health The last standard identified by the ANA in the standards of professional nursing practice is environmental health. According to the ANA the RN practices in an environmentally safe and healthy manner (ANA, 2010, p. 61). My floor is known to be filled with germs and patients in isolation status. Personal protective equipment is worn in every patient room. It is stressed to visitors to abide by these guides to prevent the spread of infection. Metro has adopted the wash in, wash out initiative; this is also in efforts to prevent the spread of infection. Each person to enter a patient room must wash before entering and before exiting the room. In addition to this you must wash and re-glove between tasks with the patient. You definitely do not want to do

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peri-care and trach care with the same gloves on. In addition to cleanliness it is also important to identify sounds, odors and lights that can be lessened to make the patients stay better. My biggest weakness is my own health. I dont always put myself first while working. Bathroom breaks and raising the bed to a safe level often go to the wayside in efforts to be efficient with my time with my patients. Goals Five Year Goals I have begun working to attain my five year professional goal. I am in the program to obtain my BSN. I returned to school after realizing that most hospitals are adopting the ANA initiative to have RNs with a BSN degree. Obtaining my BSN will put me at an advantage in the hiring field. I enjoy working in the hospital setting doing bedside care. In five years I hope to have obtained a day shift position in an ICU setting. After obtaining my BSN in December 2014 I will get my ACLS. I will continue using the ANA standards to grow as a professional nurse. By 2017 I will apply to the Family Nurse Practitioner program at Georgetown University. This is a 26 month, part-time, Masters of Science Degree in Nursing, delivered online. Ten Year Goals In the next ten years, I will complete that Master of Science Degree in Nursing (MSN). I will use that degree to continue working at the bedside caring for patients. I will always be learning. I am a member of the ANA and I will continue this. I believe in ten years I will be ready to be more involved with either the Nurses Association in Michigan or the ANA. I am eager to continue my education and professional adventure. Evaluation

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I believe in myself and recognize that the goals I have laid out for myself are obtainable. I work full time and have a family, but I do not view those as barriers. I use my coworkers and family as support and I use my job as a means to further my education. The one of the barriers to reaching my goals is myself. I could become complacent and comfortable with my life and choose not to push myself to do all I can. I will continue to evaluate my goals in attempt to continue to push myself. Conclusion Using the ANA standards of professional nursing practice I can become a better nurse. I can be worthy of being part of one of the most trusted professions. I have only been a nurse three years. However, using these standards as a guide for my practice I feel that I am a veteran nurse. I know my place in this profession is at the bedside I will not be choosing the life of a manager or educator. I am choosing the life of a Nurse Practitioner where I can continue to diagnose and treat human response and advocate for the care of individuals, families, communities and populations.

PROFESSIONAL DEVELOPMENT PLAN References American Nurses Association [ANA] (2010). Nursing: Scope and Standards of Practice (2nd Ed.). Silver Spring, Maryland: Author

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Chitty, K. K. and Black, B. P. (2011). Professional nursing: Concepts and challenges (6th ed.). Maryland Heights, MO: Saunders Georgetown University. Family Nurse Practitioner Part-Time Program Curriculum. Retrieved from http://online.nursing.georgetown.edu. Retrieved on August 6, 2013. Malinski, V. (2003). Research issues. Nursing research and nursing conceptual models: Betty Neuman's Systems Model. Nursing Science Quarterly, 16(3), 201.

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PROOFREAD FOR: APA ISSUES

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1. Page Numbers: Did you number your pages using the automatic functions of your Word program? [p. 230 and example on p. 40)] 2. Running head: Does the Running head: have a small h? Is it on every page? Is it less than 50 spaces total? Is the title of the Running head in all caps? Is it 1/2 from the top of your title page? (Should be a few words from the title of your paper). [p. 229 and example on p. 40] 3. Abstract: Make sure your abstract begins on a new page. Is there a label of Abstract and it is centered at the top of the page? Is it a single paragraph? Is the paragraph flush with the margin without an indentation? Is your abstract a summary of your entire paper? Remember it is not an introduction to your paper. Someone should be able to read the abstract aond know what to find in your paper. [p. 25 and example on p. 41] 4. Introduction: Did you repeat the title of your paper on your first page of content? Do not use Introduction as a heading following the title. The first paragraph clearly implies the introduction and no heading is needed. [p. 27 and example on p. 42] 5. Margins: Did you leave 1 on all sides? [p. 229] 6. Double-spacing: Did you double-space throughout? No triple or extra spaces between sections or paragraphs except in special circumstances. This includes the reference page. [p. 229 and example on p. 40-59] 7. Line Length and Alignment: Did you use the flush-left style, and leave the right margin uneven, or ragged? [p. 229] 8. Paragraphs and Indentation: Did you indent the first line of every paragraph? See P. 229 for exceptions. 9. Spacing After Punctuation Marks: Did you space once at the end of separate parts of a reference and initials in a persons name? Do not space after periods in abbreviations. Space twice after punctuation marks at the end of a sentence. [p. 87-88] 10. Typeface: Did you use Times Roman 12-point font? [p. 228] 11. Abbreviation: Did you explain each abbreviation the first time you used it? [p. 106111] 12. Plagiarism: Cite all sources! If you say something that is not your original idea, it must be cited. You may be citing many timesthis is what you are supposed to be doing! [p. 170] 13. Direct Quote: A direct quote is exact words taken from another. An example with citation would look like this: The variables that impact the etiology and the human response to various disease states will be explored (Bell-Scriber, 2007, p. 1). Please note where the quotation marks are placed, where the final period is placed, no first name of author, and inclusion of page number, etc. Do all direct quotes look like this? [p. 170-172] 14. Quotes Over 40 Words: Did you make block quotes out of any direct quotes that are 40 words or longer? [p. 170-172] 15. Paraphrase: A paraphrase citation would look like this: Patients respond to illnesses in various ways depending on a number of factors that will be explored (Bell-Scriber, 2007).

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It may also look like this: Bell-Scriber (2007) found that [p. 171 and multiple examples in text on p. 40-59] For multiple references within the same paragraph see page 174. 16. Headings: Did you check your headings for proper levels? [p. 62-63]. 17. General Guidelines for References: A. Did you start the References on a new page? [p. 37] B. Did you cut and paste references on your reference page? If so, check to make sure they are in correct APA format. Often they are not and must be adapted. Make sure all fonts are the same. C. Is your reference list double spaced with hanging indents? [p. 37]

PROOFREAD FOR GRAMMAR, SPELLING, PUNCTUATION, & STRUCTURE 18. Did you follow the assignment rubric? Did you make headings that address each major section? (Required to point out where you addressed each section.) 19. Watch for run-on or long, cumbersome sentences. Read it out loud without pausing yes unless punctuation is present. If you become breathless or it doesnt make sense, you need to rephrase or break the sentence into 2 or more smaller sentences. Did you do this? 20. Wordiness: check for the words that, and the. If not necessary, did you omit? yes 21. Conversational tone: Dont write as if you are talking to someone in a casual way. For yes example, Well so I couldnt believe nurses did such things! or I was in total shock over that. Did you stay in a formal/professional tone? 22. Avoid contractions. i.e. dont, cant, wont, etc. Did you spell these out? yes 23. Did you check to make sure there are no hyphens and broken words in the right margin? yes 24. Do not use etc. or "i.e." in formal writing unless in parenthesis. Did you check for yes improper use of etc. & i.e.? 25. Stay in subject agreement. When referring to 1 nurse, dont refer to the nurse as they yes or them. Also, in referring to a human, dont refer to the person as that, but rather who. For example: The nurse that gave the injection. Should be The nurse who gave the injection Did you check for subject agreement? 26. Dont refer to us, we, our, within the paperthis is not about you and me. Be yes clear in identifying. For example dont say Our profession uses empirical data to support . . Instead say The nursing profession uses empirical data.. 27. Did you check your sentences to make sure you did not end them with a preposition? yes For example, I witnessed activities that I was not happy with. Instead, I witnessed activities with which I was not happy. 28. Did you run a Spellcheck? Did you proofread in addition to running the Spellcheck? yes 29. Did you have other people read your paper? Did they find any areas confusing? yes 30. Did you include a summary or conclusion heading and section to wrap up your paper? yes 31. Does your paper have sentence fragments? Do you have complete sentences? yes 32. Did you check apostrophes for correct possessive use. Dont use apostrophes unless it is yes showing possession and then be sure it is in the correct location. The exception is with the word it. Its = it is. Its is possessive. Signing below indicates you have proofread your paper for the errors in the checklist:

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______NAME_____Renee Ivers____________DATE:_August 6, 2013__