Professional Mission Statement
The choice of a career is often guided by personal desires and motivations in life. I believe that the baccalaureate nurse preparation process will help me to achieve my lifetime goal. My mission for this lifetime goal is to become a nurse leader focused on utilizing evidence-based practice to improve patient safety and care quality. I intend to use the knowledge and skills gained through a combination of academic and practice training to accomplish this mission. The career goals that would help me to achieve the mentioned include becoming a registered nurse one year, at most, after graduation; to rise to a clinical practice nurse position, possibly in a specialty area such as obstetrics; to build my performance track record in the assigned department overtime, and be promoted to a nurse leader position in clinical practice. I also desire to focus most of my time on building proficiency in obstetrics nursing practice, and I believe that this mission statement can help me to progress towards that path as it will keep me focused on the long-term goal.
Providing a testimony of professional competency can be a challenging task, especially in the absence of a reference. However, I believe that the testimonials provided in the form of school completion certificates and the professional reports provide sufficient representation of me as a learner and as a nursing professional. The school completion certificates confirm my proficiency in the educational aspects while the professional reports from different references represent my growth and activity in professional practice. As a learner, the school completion certificates provide evidence that I have undergone specific trainings in relation to the outlined course content and have thus achieved the desired program outcomes in nursing practice. Additionally, the reference questionnaire, recommendation letter, and the professional references prove my capabilities in professional practice. The assignments I have completed represent my professionalism because they indicate that I have learned through both practice and academic experience to follow through evidence-based procedures in achieving effective nursing outcomes.
Besides representing me as both a learner and a professional, the portfolio items also present my strengths in various areas. I am a flexible individual who is ready to learn. I have worked in diverse environments and had experiences with diverse cultural groups. These experiences have proven that I am a flexible learner, always ready to foster an understanding of the evidence-based practice and capable of implementing the standard procedures in place. Furthermore, I am tough and good at managing workload. Various testimonials show that I have put myself on task in practice while at the same time undertaking my studies. For instance, the assignments attached as part of my portfolio provide evidence of my progress in academics, with specific focus on the assignments I have worked independently at in order to achieve educational qualification. The nursing conceptual model represent my growth in practice concepts and hence my professional capability. The IHI course catalogue and the professional resume both show how I have grown as a professional both through various educational undertakings and practice variations.
I have also mentioned that implementing evidence-based practice has been a challenge due to the educational demands. However, the recommendations, references, and school certificates point to effectiveness in workload management both at an educational level and at a professional level as I did not break at any given point. I believe these strengths will be essential in nursing practice as the profession is demanding and requires strong organization and workload management skills (Furukawa et al., 2017). Indeed, I believe I will be able to deliver as expected and even exceed expectations in nursing practice.
During my program, the biggest challenge I faced was the workload. The program requires the combination of practical clinical work with the academic work, the achievement of which can be difficult. The practice work is time-consuming and demanding. Similarly, the academic aspect of the training can be daunting. As a nursing student, I have been quite aware that both the clinical and the educational elements of the training are important, as reported by Jamshidi et al. (2016). The clinical training enables nursing students to perform the roles that they know through educational training. To address the challenge of workload management, I had to initiate a process of self management and organization, through which I outlined my key goals on a daily basis. I listed the three most important targets for each day outside clinical practice and set aside time to accomplish them. The rest of the time was spent in practice. In this way, I built the discipline to manage my time effectively and to gain the most out of it.
The educational training has built me in various ways, including enabling me to accomplish the nine program outcomes associated with the BSN in my school. The first outcome is to be able to communicate effectively orally, through writing and in both interpersonal and electronic forms. I believe that through the constant communication demands in this coursework, which have taken diverse forms, including electronic and interpersonal communication and oral and written communication, the coursework has steered me towards the first program outcome. The second outcome is the use of clinical reasoning for quality and safe healthcare service delivery to patients, and it has been motivated by the coursework as it requires evidence of clinical and theoretical practice hence fosters the combination of practice and theory in performing nursing roles. Other expected outcomes include assumption of accountability in the provision of safe and efficient healthcare, in which the coursework has enabled me to understand how as a nurse, I would be liable for all professional decisions, including after delegation; providing passionate and patient-centered care; applying leadership and interpersonal skills in engaging others; inter-professional collaboration; incorporating genomics and genetics knowledge in patient care; and the use of information technology for communication, error mitigation, and provision of patient care. To foster the understanding of how to provide patient-centered and passionate care, the coursework came with the theoretical frameworks that are commonly used in nursing practice, which portray nursing as a care profession that requires passion and empathy. An understanding of the role of the nurse in creating a healing environment has enabled me to develop the proficiency for passionate and patient-centered care.
Leadership and interpersonal skills and inter-professional collaboration have been promoted through the coursework based on its exposure to a culturally diverse work environment. Through that exposure, I have developed the capacity not only communicate effectively in written and oral forms, interpersonal and electronic forms but also to deliver high-quality patient care based on evidence-based practices and professional guidelines. In all the aspects of the coursework, there has been continuous communication, which has enabled me to develop my skills in using information technology for communication; this is also one of the outcomes of the program. While working with diverse patient populations in practice, I have had to combine the knowledge obtained in patient-centered care to build competency in incorporating genomics and genetics knowledge in patient care. In the outlined ways, I have been able to accomplish the program outcomes.
While working on the coursework, I have had the experience of working as a scientist, a detective, and a manager of the healing environment in different ways. As a scientist, I have conducted research. I have presented my research findings in the classroom and in the work environment. As a detective, I have pursued the use of the evidence-based practice, which is the principle behind using clinical imagination and science to make judgments regarding the best courses of action and the potential consequences of subtle changes in everyday patterns and procedures for clinical action (Parrish, 2018). From the report provided regarding my experiences in an actual clinical set-up, I narrated that evidence-based practice can result in the deviation of nurses from conventional procedures; on account of sufficient evidence to show that the alternative procedures can work just as effectively or even better. As a manager of the healing environment, the nurse spends a lot of time with the patients and is responsible for making them consider the environment therapeutic. I have worked with interprofessional teams, some of whom are outside the healthcare profession. I have consistently applied Florence Nightingale’s environmental theory, which Medeiros, Enders, and Lira (2015) have explored, to inform the management of the healthcare environment and evaluate the capability of the environment to promote healing. I have also overseen the provision of resources and support towards healthcare improvement, aspects that contribute to the healing environment.
Given the experiences I have had through educational and clinical practice, I can confidently say that my professionalism has grown significantly. Contrary to my perception at the beginning of the program, I have come to learn that nursing is an interdisciplinary profession that extends beyond caring for patients. Nurses create an environment for healing and have to coordinate continuously with various professionals in the industry. My interest in studies that foster interprofessional collaboration has also grown. Additionally, I have learned the importance of evidence-based practice and how it contributes to improving clinical outcomes and understood the nature of the nursing profession as a leadership and support role in healthcare. Through all these lessons, I have come to understand that nursing requires one to be both a leader and a servant in equal measure.
Part B: Quality and Safety
One of the aspects of concepts that have evolved through my program is that of quality and safety. My perspective about healthcare quality and patient safety at the beginning of the program was somewhat abstract. I considered quality as merely the delivery of the full range of healthcare service from observation through diagnosis and eventually administration of medication. On the other hand, I considered patients’ safety merely as ensuring that the patient comes out in a better condition than that in which they came into the healthcare facility. The program has shaped my definition of the concepts of quality and patient safety to include service that satisfies the entire range of quality and safety indicators outlined in the millennium development goals. I have moved from the superficial definition of patient safety and care quality by understanding the implications of my role as a nurse on care effectiveness. The Institute of Healthcare Improvement (IHI) certificate has helped me to understand my role as a nurse towards ensuring patient safety and care quality and in motivating me to push myself towards providing better quality healthcare willingly. The IHI certificate is also one of the artifacts that signify my growth in the understanding of quality care and patient safety, as the IHI training focuses on continuous nursing improvement by highlighting the role of the nurse in care quality and patient safety and also emphasizing professional development through coaching. In this way, undertaking the IHI training purposed to improve my understanding of the services that can satisfy the range of quality and safety indicators in the MDGs, and subsequently shaped my perception of care quality and patient safety.
Part C: Evidence-Based Practice
Prior to pursuing this program, my definition of evidence-based practice was constrained to the use of evidence from research to inform clinical decisions. Nevertheless, the program has taught me what the definition of evidence-based practice is, and that it entails forming strong deductive and inductive arguments based on research, clinical expertise, and experience, to guide clinical decision making (Parrish, 2018). My journey of transitioning this understanding has been informed by several factors, including my experience in clinical practice, as evidenced by various portfolio artifacts, including previous assignments and certificates. Furthermore, my professional roles as a nurse practitioner and the values associated with nursing practice such as altruism, integrity, and autonomy, have enabled me to define evidence-based practice within the context of my professional role. My definition as at now incorporates these roles and values into the general description of evidence-based practice, which relates to deductive and inductive arguments utilization in guiding clinical decision making.
Applied nursing practice differs from evidence-based practice, but the two have some similarities. Compared to applied nursing research, in which peer-reviewed original research findings are used directly in clinical decision making (Tingen, Burnett, & Zhu, 2009), evidence-based practice incorporates both theoretical and practical evidence in practice. The two aspects of nursing education and practice take into consideration the relevancy and believability of the data, concepts that are tied to data reliability and validity. In each case, the data is founded on previous evidence, confirmed either through peer review or through consistently positive outcomes in practice. However, applied nursing research relies more on the actual research data, while evidence-based practice focuses on actual practical quality improvement attained through actual nursing activities. Additionally, both consider secondary research, which entails reliance on evidence from past published research, crucial for effective practical decision making. Evidence-based practice takes up the secondary research and strengthens it using primary research conducted using actual patient data and actual practitioner and patient experiences as evidence for particular practice effectiveness. My experience as a student nurse and in practice has enabled me to differentiate the two effectively and to understand the need for both aspects of nursing innovation and quality improvement. Furthermore, the previous assignments shared as artifacts in this portfolio purpose to confirm the extent to which I have learnt about evidence-based practice. In particular, the clinical practice reports can be used to establish my effectiveness at translating the evidence-based coursework outcomes into practice. The clinical practice reports give a description of particular activities in which I have been involved in and the decision making practices that guided the practice. Through these decision making practices, it is possible to highlight particular circumstances in which evidence-based practice was implemented.
Part D: Applied Leadership
A nurse is also a potential healthcare leader. The fact that nurses spend a lot of time with patients compared to other healthcare providers is an indication of the importance of their role in healthcare service delivery. Prior to this program my understanding of leadership was that someone had to be assigned a position defined specifically as a nurse leader in order for them to lead. However, I have had to redefine my understanding of what applied leadership is based on my experience in practical nursing as well as in education. By understanding the professional responsibilities, roles, values, and accountability expected of a nurse, I have developed the perception that applied leadership in nursing simply means being able to lead others in care as part of one’s conventional work scope without being necessarily assigned the position of a nurse leader. Through using the educational and clinical evidence gained through this course for the benefit of improving healthcare, I have extensively used applied leadership skills to bring change. Furthermore, through the leadership roles, as described by my artifacts, I have had to initiate and foster interprofessional collaboration in the workplace as that has become the foundation of nursing leadership success. I have instructed others, supervised others, consulted other practitioners where need be, and carried out the instructions of other professionals if need be. The report on community work practice fully describes the scope of roles I engaged in and how these roles included interprofessional collaboration. The professional resume also shows the scope of practical involvement I have had following my training. These artifacts prove my proficiency not only in tackling the general nurse practice roles but also in leading the non-nurse professionals in the workplace, thereby reinforcing my definition of leadership within the conventional work scope of the nurse.
Part E: Community and Population Health
As a student nurse, I have learned the importance of community health on direct patient health. I have come to understand that community and population health has to be at the core of any health worker’s scope of duty due to its implication on care quality and patient safety. In this way, I have redefined the concept of community and population health based on the nurses’ roles by emphasizing the implications of care quality and patient safety on community and population health. The roles of the nurse and the values in nursing practice are also used to redefine the extent of professional involvement in community health initiatives.
Community health nursing tasks enabled me to understand the health risk issues that affect communities and how they can be addressed and thus enabled me to successfully diagnose community problems. Therefore, as part of my portfolio, the community health nursing tasks helped me to settle the concern that had driven me to select the type of community health nursing task in which I was involved, which was the concern that healing effectiveness can only be sustained if the community health is good and there are preventable illnesses or infections. I thus my focus shifted to preventive nursing after the program, and the American Museum of Natural History (AMNH) certificate proves my competence in community health nursing. The AMNH certificate provides evidence of training in the application of genetics and genomics in providing patient-centered care in a nursing environment. By understanding the application of genetics and genomics in nursing care and through combination with the roles of the nurse in community health, it will be possible for me to effectively identify at risk populations and to refer them for better care in case of specific health conditions.
Furthermore, my understanding of the nursing role is that the nurse is supposed to bridge the gap between research and clinical practice. Nurses can intervene in the community and population health issues commonly faced in conventional societies by enhancing the capacity of the populations to attain genetics/genomic information. The AMNH certificate confirms my capability as a nurse to foster an understanding of genetic influences on community health. I will use the competency gained to obtained detailed family histories when working with communities, and to help patients identify conditions to which they are vulnerable by virtue of their family histories and subsequently to make informed health decisions. In this way, various community health issues can be diagnosed and even addressed before they become significant causes of productivity loss.
Furukawa, P.O., Cunha, I.C.K.O., Pedreira, M.L.G., & Marck, P.B. (2017). Characteristics of nursing professionals and the practice of ecologically sustainable actions in the medication processes. Revista Latino-Americana de Enfermagem, 25. Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC5492652/#__ffn_sectitle
Jamshidi, N., Molazem, Z., Sharif, F., Torabizadeh, C., & Kalyani, M.N. (2016). The challenges of nursing students in the clinical learning environment: A qualitative study. The scientific World Journal. Retrieved from www.hindawi.com/journals/tswj/2016/1846178/
Medeiros, A.B., Enders, B.C., & Lira, A.L.B.C. (2015). The Florence Nightingale’s environmental theory: A critical analysis. Escola Anna Nery, 19(3). Retrieved from www.scielo.br/scielo.php?script=sci_arttext&pid=S1414-81452015000300518&lng=en&nrm=iso&tlng=en
Parrish, D.E. (2018). Evidence-based practice: A common definition matters. Journal of Social Work Education, 54(3), 407-411. Retrieved from www.tandfonline.com/doi/full/10.1080/10437797.2018.1498691
Tingen, M.S., Burnett, A.H., & Zhu, H. (2009). The importance of nursing research. The Journal of Nursing Education, 48(3), 167-170. Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC3677814/
Appendix A: Prior Assignment
Task 3: Portfolio Shell Creation
Quality and Safety
Patient safety is inseparable from quality healthcare because quality healthcare is correlated to better health outcomes for patients. Through hours of learning and training, I was able to identify some of the greatest threats to quality healthcare and by extension, patients’ safety. They include lack of availability or poor quality of medicines, inadequate or unhygienic infrastructure, and poor compliance to evidence-based clinical interventions and practices. They also include a lack of competent or motivated staff, and poor documentation and use of information (World Health Organization, 2019). During my training, I worked with healthcare facilities with limited resources and a shortage of competent manpower. I noted that sub-standard quality healthcare increased the risk of hospital-acquired infections such as ventilator-associated pneumonia, bloodstream infections, surgical site infections, and urinary tract infections. This experience was important as it sensitized me to the importance of quality healthcare in ensuring patient safety.
My training as a baccalaureate-prepared nurse has enabled me to recognize that nurses play a central role in the provision of quality and safe healthcare to patientsbecause compared to other healthcare professionals; nurses spend more time interacting with patients. Besides, I have learned that ensuring the quality of care and a healthcare safety culture is a concerted effort that requires the input of nurses and nurse leaders. Hospitals need to develop a culture that promotes quality healthcare and patient safety. In my practice in the future, I intend to promote the provision of quality, evidence-based healthcare in order to improve health outcomes and avoid undesirable situations such as hospital-acquired infections.
Evidence-based practice is defined as an approach to clinical practice that integrates the best evidence from reliable studies, clinical expertise, and also a patient’s values and preferences when making decisions about a patient’s healthcare (Youngblut & Brooten, 2001). This approach to healthcare is essential as it provides useful insights into evidence-based methods in nearly all facets of healthcare delivery, including direct patient care, infection control, supply management, workflow issues among others. Evidence-based practice is integral as it has the potential to improve the quality of care and health outcomes.
My training to become a baccalaureate-prepared nurse has enabled me to appreciate the importance of evidence-based practice. For instance, the evidence-based practice can cause healthcare professionals to alter or even abandon long-standing practices if evidence suggests that they may be defective or if a new methodology proves to be more effective and efficient. Unfortunately, during my practice, I noted that there are many existing obstacles to evidence-based practice. For instance, many professionals assert that while the evidence-based practice is important, because of a heavy workload, they are not able to be updated on new evidence. Moreover, many professionals lack the necessary skills in the area of literature researching and understanding evidence, which is a hindrance to evidence-based practice.
Fortunately, through effective leadership and management, hospitals can encourage the evidence-based practice by providing nurses with the training and teaching necessary for grasping concepts and applying them in practical situations. Evidence-based practice is a valuable endeavor that hospitals ought to invest in order to exploit new knowledge developments and to keep up with the latest technological advancements.
Leadership in nursing can be defined as the ability to motivate followers towards a specific goal(Al-Dossary, 2017). In healthcare, the goal is often to improve health outcomes for patients. One of the most important characteristics of a leader is the ability to communicate professionally and effectively with a team. Additionally, the ability to harmonize and coordinate the efforts of persons with different expertise is also crucial for a leader to possess, especially in the healthcare field (Reeves & Lewin, 2004). As part of my course work, I worked with an interdisciplinary team, which played a great role in enhancing my leadership skills. This learning experience enabled me to learn the value and importance of interprofessional collaboration in the delivery of quality care.
As a professional nurse graduate, I intend to utilize the knowledge and experience that I have gathered during this course to provide quality healthcare and improve health outcomes. I also intend to consolidate the experience I gathered during my clinical rotation with the insight gained during the BSN program in order to be a competent professional. I will do my best to ensure that each patient receives the best quality healthcare available and if entrusted with a position of leadership, I intend to be a servant leader guided by ethics and professionalism.
Community and Population Health
The Community and Population Health course that was offered in my BSN program at Western Governors University was by far the most insightful and educative onebecause the programput me in a position to interact with members of various communities. Working with different communities was a great learning experience as the opportunity exposed me to unique health problems in which nurses are expected to develop interventions to improve health outcomes. This often involved the identification of causative factors of health disorders in the communities as well as preventative measures.
Some of the health issues I found to be most prevalent in the communities I worked in included lifestyle diseases such as obesity and other related health disorders. These conditions were a reflection of a national health risk as one in seven youths in America is said to be obese(State of Childhood Obesity, 2019). I was able to research on this particular issue extensively through analyzing publicly available resources and interviewing community members in order to gain a complete scope of the extent of the issues. I noted that communities that had the highest health risk of obesity were predominantly members of poor minority communitiesbecause economic hardship made it difficult to afford healthier food options, causing an over-reliance on fast foods to meet nutritional requirements. By working with different partners, we developed meal plans for healthier food options based on recommendations from choosemyplate.gov(USDA, 2019). After school programs were also recommended in the communities where obesity was more predominant as a way of enhancing exercise.
The course was insightful as it taught me the importance of research and evidence-based practice in tackling health issues in the community, which is important as there are various neglected health issues facing many communities across the country, such as depression, cardiovascular disorders, and sexually transmitted infections. This course equipped students with the necessary skill set to become problem-solvers in our respective communities and to make Americans healthier than ever. I intend to utilize the knowledge gained in this course to help improve lifestyles and, by extension, health outcomes.
Appendix B: Conceptual Framework