competencies updated winter 2017 | Nursing | Competence (Human Resources)

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Fall 2016 A competent nurse practice within utilizes and contributes to the broader health-care system. I am gaining more confidence with every experience to contribute to a broader health care system. I now identify with every patients condition and try to propose or hold a dialogue about ways to improve or prevent what may have lead to their hospitalization. For example, discussing safety measures with a hemithorax patient that could have prevented a devastating fall by checking equipme
  Fall 2016A competent nurse practice within utilizes and contributes to the broader health-care system. I am gaining more confdence with every experience to contribute to a broader health care system. I now identiy with every patients condition and try to propose or hold a dialogue about ways to improve or prevent what may have lead to their hospitalization. For example, discussing saety measures with a hemithorax patient that could have prevented a devastating all by checking equipment beore using it. I have begun inquiring about resources that can be used or patient and also understanding how community resources work together. ! !# when assigned to the $ental %ealth &are 'nit I was able to provide inormation additionally on the (eterans )*airs organization that was a potential resource or a patient on the +oor. )lso, during my time in the 'nit I was able to add my perspective to the collaborative meeting amongst health care providers. A competent nurse bases personal and professional actions on a set of shared core nursing values . n ! !# I spent a shit in the -ehavioral %ealth 'nit and witnessed a lot o proessionalism but also borderline ethical dilemmas that are most likely encountered regularly. he patient requested a lesser dosage o /yprexa. he nurses did not acknowledge the patients thoughts or take into consideration their opinion. I was able toask the doctor when they were available i there was a possibility to doso. he patient expressed gratitude and stronger rapport because I asked. 0nowing and having the experience to enact boundaries with patient1s including administration o medications and even ood choices are a constant predicament. he team on this unit was in constant collaboration and I elt like I could contribute to the conversation on care or the patients. A competent nurse uses reection! self-analysis and self-care to develop insight.  his quarter I ound mysel not nervous but excited to hear rom my clinical instructor on how I can improve. 2!3!# I had the opportunity to work on the Intensive &are 'nit. he patient was on a ventilator and needed more advanced care. his setting made me apprehensive and I was able to identiy the need or another nurse to oversee my care o the patient. )s the shit proceeded I elt more comortable administering medications through the 45 ube. I also perormed inadequately in one o the frst 6ab $edication 7asses in 6abthe frst week o ctober and realized there was signifcant learning  and improvement to be made. I was able to use the eedback to establish a more consistent, sae, and organized manner o passing medications. A competent nurse engages in intentional learning 11 1# 16 In 6abor and 8elivery I worked with a patient that had already delivered. )lthough I learned signifcantly I sought out opportunities to have exposure to a birth and also other patients in di*erent stages o labor. I was able to witness a birth ater I sought permission rom a amily and also saw the delivery o a placenta. he 7rovider then was able to point out the parts o the placenta and what she was observing or. In the mental %ealth unit I reerred to the di*erent manuals and inquired about the mental status o my patient and others that were admitted. his gave me a more rounded view o what was happening on a cognitive level with the patient. A competent nurse demonstrates leadership in nursing and healthcare. I tend to think this is a competency that takes a signifcant amount o time when reerring to the degree o confdence. I have ound mysel less in the shadows with the care o a chest tube patient, a mechanically ventilated patient, or one with e*ective schizophrenia. 2!9!# on the 7ost :urgical 'nit I took the reigns o blood administration and also worked in a stronger collaborative capacity with the nurse. I do believe one example o calmness I displayed was attempting an I( site on an agitated patient that was not staying still. Iwas able to saely fnd an I( site and have a +ash, but was unable to thread the needle tip. Instead o removing it in a panicked manner I did slowly with a steady hand. In the classroom capacity I acted as president o the nursing club and organized several meetings throughout the quarter. I participated and coordinated on a local level with 7urses or ;urses, Fred $eyer or a git wrapping undraiser, and volunteering with a local church or a community meal. A competent nurse collaborates as part of a health care team In the 4mergency 8epartment on ! <!# I assisted the team starting +uids and I( as the other nurse perormed an assessment and readied a patient or surgery. I also perormed a lab simulation as part o a team and I believe we both re+ected a strong sense o a collaborative health care team. =e were able to compliment each other in the interventions we completed in a timely ashion. I also intervened and provided my perspective in particular situations but in a respectul and tactul way. his was also something I have done in  the hospital. I consistently ask other sta* members to assist whether in the mental health unit with an uncooperative patient or resource with gathering supplies. A competent nurse practices relationship-centered care. I was able to branch out this quarter balancing patient centered care and also developing a relationship with the patient. n 2! <!# on the 7ost :urgical &are 'nit, ne patient in particular was experiencing an immense amount o pain and had di>culty fnding restwith the constant care team in the room. I was able to establish a commonality with the patient o the 5rateul 8ead -and. he patient seemed more relaxed and it was an alternative way to divert attention rom the pain. he patient told me about shows they had been to and about their amily. he patient re+ected on this and no boundaries were crossed. I also, on many occasions ound mysel being a listeningear to the patient and or the amily repeating inormation back so they were aware o my attentiveness towards their concerns. A competent nurse communicates e$ectively. I always acknowledge the amily or support people in the room making note o their concerns and discussing di*erent things with them. ! !# I did advocate or a patient in the mental health unit that wanted their dosage altered o a medication. )lthough the request was not acquiesced the patient realized that someone was advocated or. I was in constant coordination with the nurse in the intensive care unit confrming my actions were correct and communicating uncertainties. A competent nurse ma%es sound clinical &udgments I am learning to pay closer attention to labs and orders or the patient. I have been realizing patterns and deviations in inormation especially in regards to a patient I had in both the Intensive &are 'nit!$edical &are 'nit. I picked up on the e*ectiveness o the medications and i pain was being managed correctly. n 2!9!# thepatient had ordered xydodone!)7)7?!9 ? @A% or pain. he patient was wincing and expressing being painul but not verbalizing it. I decided that it was appropriate to administer every our hours. I am also learning to prioritize patients especially when dealing with more than one. 0nowing when and who is the priority in care. For example Ihad a more critical hemithorax patient and a less critical knee replacement recovery patient. I spent more time checking on the condition o the hemithorax because their labs were so altered and  they were receiving blood. he other patient was ar more stable and hourly rounding was only necessary. A competent nurse, in making practice decisions, locates, evaluates and uses the bestavailable evidence, coupled with a deep understanding of client experience and preferences In the Mental Health Unit 11/21/16 I was able to identify a manual in order to research and understand a patients condition better. I also have written several  pathophysiology papers and feel confident in identifying credible sources that are peer reviewed. I have utilied all websites that are government based including !enter for isease !ontrol and #ational !enter for $iotechnology and the #ational %ibrary of Medicine in order to support pathophysiology findings. &lso' rug (uides and utiliing more than one when finding information and proper administration and I) push  parameters are always critical with any medication. I am confident in utiliing the schoollibrary database and also proper Internet searches . 'pring 2016A competent nurse practice within utilizes and contributes to the broader health-care system. I am beginning to gain comprehension o the health care system and the many acets o it. %owever, it remains an intricate puzzle that will take more time and experience to know. I value the importance o preventative care and policies that are in place to have best practice. Ihave been in ethical situations where I have deemed a medication contraindicative or a person and have had it eliminated rom the patient1s orders. I constantly include the patient1s dignity and rights into the care. I have been able to translate in :panish and pass on the necessary resources or ollow up postpartum care. A competent nurse engages in intentional learning  his quarter has been a testament to my ability to be +exible andopen to new learning opportunities. I have had the chance to do clinicals on the -ehavioral %ealth 'nit, 6abor and 8elivery, and Bespiratory. 4ach experience has reminded me the vast amount o skills and specialties needed or each one o these units. I have learned multiple skills and new technologies or me. I have spent time learning about telemetry and 4051s. I have educated on the importance o )&, telemetry, etal heart monitoring, bladder
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