Practice Summary Paper

Nurs 403 – Transition to Baccalaureate Nursing Practice

Purpose of Assignment
The purpose of this assignment is to guide you through a process of
self-reflection and self-evaluation to discover the scope of your personal and
professional development while enrolled in the RN to BSN nursing program at
Old Dominion University. This assignment is designed to help you prepare for
your Portfolio. The Practice Summary Paper is designed to demonstrate the
attainment of the 8 core competencies in general. The portfolio
demonstrates the achievement of the Core Competencies through the
attainment of specific elements (the bullets) within the Core Competencies.
Student Approach to Assignment
The first step I took to complete this assignment was to view the
grading rubric for it. Doing so enabled me to become familiar with the critical
components to the paper so that I address each one of them within the
paper. I then went through my portfolio assignment to determine which
bullet points I was unable to discuss within the portfolio and made sure to
discuss them within the progress summary paper. By completing the
assignment, it became evident to me that the BSN program had a profound
impact on my practice as a RN. I had the opportunity to reflect on completed
assignments throughout the program and brought key concepts back into
thought and therefore, back into use. The assignment reflects my desire to
learn, to grow, and provide complete and holistic care to my patients which
is evidenced by the examples provided within the paper. I approached the
assignment in the manner that I did so that I was certain that every
component on the grading rubric was included in the paper and that key
elements were not overlooked.
Reason for Inclusion of this Assignment in the Portfolio
I included this assignment in the portfolio because it shows that I have
successfully obtained the competency bullet points outlined in the “Great
Eight” Old Dominion University BSN portfolio assignment. The paper shows
the growth that I have since I entered the program not only as a person, but
as a care provider as well. This assignment also highlights some of my
strengths such as attention to detail, my ability to follow directions, and the
ability to provide thorough self-analysis on previous works.

• Critical Thinking
 o Engages in creative problem solving.
In the progress summary paper, I discussed a situation where I
had to think creatively to solve a problem with nasogastric suctioning
on an overdose patient. The suction failed, and despite efforts by my
co-workers, it would not start working again. In lieu of removing it and
starting again, I envisioned the way the tube could possibly be resting
inside the stomach due to the curvature of the tube itself. I figured that
it was curved toward the wall of the stomach and was getting plugged
by the tissue. I gently twisted the tube resulting in the curvature
moving away from the stomach lining and the suction was restored.
Creative problem solving was honed through an assignment that I
completed during my Nurs 490W course where we had to identify a
safety concern within our workplace and think of ways to improve upon
it. We utilized brainstorming, diagramming, and thorough research to
decide which safety measure from The Joint Commission’s 2019 safety
goals to address and apply to our work environment. We then applied
our improvements and re-evaluated the process. These same steps
were used in the case with the suctioning issue and proved to be
successful.
• Nursing Practice
o Demonstrates an awareness of complementary modalities and their
usefulness in promoting health.
The concept of complementary and alternative medicine (CAM) was taught
during my Nurs 403, Transition to Baccalaureate Nursing Practice class using a power
point lecture and online readings. It outlined that there is more than one way to provide
comfort to your patients besides using pharmaceuticals. An example of where I used
CAM is in the progress summary paper when the use of therapeutic
massage was discussed. I talked about an elderly patient that suffered
from severe leg cramps and was not receiving relief with medications. I
utilized moist heat followed by several minutes of deep tissue massage
to alleviate her discomfort. As a result, the patient was able to rest
more comfortably while she waited for the medication to take effect.
• Communication
o Adapts communication methods to patients with special needs.
Leininger’s Transcultural Theory covered in Nurs 306 discusses
the concept of culturally congruent care. This states that the care that
is provided should appropriately fit the cultural values, beliefs, and
lifestyle of the patient to enhance their health and well-being. This
bullet was highlighted during the discussion about a patient I cared for
 that was Spanish speaking only. In the progress summary paper, I
mentioned the tools I utilized to help communicate with this patient
due to the language barrier so that I could ensure that his needs were
met and that his care was tailored to fit his cultural values and that it is
complete and accurate. I mentioned that I used my limited Spanish
vocabulary coupled with the hospital language interpreter line to
handle his special needs of not being an English language speaker.
• Teaching
o Evaluates the efficacy of health promotion and education modalities.
In the progress summary paper, I discussed a situation where I
encountered a patient that could not read during a teach back session
during his discharge process. As I was going over his discharge papers,
I asked him to point out where the dosages and scheduling was for the
new medications he was prescribed. The pt stood there with a blank
stare on his face. I then I realized he could not adequately read the
papers. I utilized the repeat back method of teaching to ensure that he
fully understood the instructions prior to leaving. I would read the
instructions to the patient and he would repeat them back to me. This
occurred several of times until we both felt comfortable with his
understanding. This skill was enhanced during my Nurs 402, Nurse as
Educator course. In that class I learned the ASSURE model which
proved to be beneficial during this patient encounter. I was able to
analyze the learner and state my objective to him, I selected the
appropriate learning material (discharge instructions), I used the
papers to help solidify the teaching instructions, I required him to
participate by showing my on the instructions his medication regimen,
and evaluated the learning and adjusted the teaching when I found out
he could not read.
• Research
o Applies research-based knowledge from the arts, humanities, and
sciences to complement nursing practice.
My Nurs 363, Principle of Practice: Research as Foundation for Practice class is
where I acquired the ability to effectively use research and evidenced based practice
findings to drive my interventions chosen for my patients. This was accomplished by
learning Lewin’s Change Theory. This skill was demonstrated in a project that was
completed during my associate of nursing program that dealt with
premature infants and the use of a pacifier induced lullaby to help
soothe them. The project discussed poor feeding schedules along with
inadequate rest and slow healing due to the environment with the
 neonatal intensive care unit. The pacifier involved had sensors in it
that were preprogramed to a set sucking pressure that the baby had to
achieve in order to trigger the lullaby/music to play. It would only play
for a short period and turn off which would cause the baby to have to
suck harder to trigger the music to play again. This in turn resulted in
the improved feeding and a more relaxed baby.
• Leadership
o Delegates and supervises the nursing care given by others while
retaining accountability for the quality of care provided.
I learned the different styles of leadership during my Nurs 490W
course and was able to determine based on what I read, the type of
leader that I most closely resemble. In this example it was more of a
Laissez-Faire approach, giving authority to my teammates to accomplish the
assigned task as they felt appropriate. This was highlighted when I
discussed the utilization of co-workers to establish an IV and draw
blood samples from my patients. I don’t directly supervise them while
they perform the task, however, I must verify that the task is
completed and that the IV is patent prior to the administration of
medications through it. If an error occurred, it is ultimately my
responsibility to correct it because I am accountable for my patient.
• Professionalism
o Understands the effect of legal and regulatory processes on nursing
practice and health care delivery.
Legal and regulatory processes were the topic of discussion in
my Nurs 412 class. It was in that class that I became more familiar with
the concepts of negligence and nonmaleficence. These terms came
into play in a situation where I witnessed a medication error. The
provider did not want to report the error, however, it resulted in the
overdose of a medication that has a sedative effect on the patient. The
provider was negligent because he didn’t follow appropriate guidelines
for medication administration and violated the code of nonmaleficence
by causing harm to the pt, although minor in this example. Hiding the
error could have resulted in an adverse outcome for the patient, not to
mention that it is legally and ethically wrong to not report it. Since it
was reported, the pt was able to be more closely monitored to ensure
that they maintained adequate ventilatory effort.
• Culture
 o Articulates an understanding of how human behavior is affected by
culture, race, age, gender, lifestyle, and age.
This was demonstrated during the discussion about the project
that was completed in my Nurs 401 class. The assignment involved the
exploration of a culture other than my own. I researched the Ethiopian
culture. I talked about the importance of eye contact for them and how
they perceive an individual gets sick. For example, they believe that an
individual gets sick as a result of God and how much they sin. They
also believe that mental illness is the result of evil spirits.