Practice Summary Paper

NURS 403 – Transition to BSN Practice

Purpose of Assignment

The purpose of this paper 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>BSN nursing program at Old Dominion University.

Student Approach to Assignment

I approached this assignment by reviewing the 8 core competencies taught within the BSN
program. I reflected on how I have met each competency and examples to showcase. I looked
back on why I decided to pursue a degree in nursing and where this pursuit has taken me. While
at first I was unsure if I had adequately completed each competency, I learned that through my
years in the BSN program, I can recall multiple examples of how I have displayed each
competency.

Reason for Inclusion of this Assignment in the Portfolio 

         This assignment is a great look into how I have personally grown throughout the BSN
program. It showcases my completion of each competency and how my practice has changed and
strengthened.  This assignment represents my path from student nurse to experienced RN.

• Critical Thinking

o Engages in creative problem solving

When assessing my patient with the resolving GI bleed, I tried to figure out why she was
not any of her meals. I had to get creative in finding a way for her to get the foods she
liked and would eat. I looked into whether or not her family could bring in food for her
that was culturally appropriate. Fortunately, the family agreed and so did her doctor.

• Nursing Practice 

o Applies appropriate knowledge of major health problems to guide nursing practice

I used the example of caring for a patient with diabetes type 2. I need to understand how
the disease works and affects the body in order to provide appropriate care. I also carried
out timely blood sugar checks and administered corrective insulin when needed to keep
his blood glucose levels in a therapeutic range.

• Communication 

o Adapts communication methods to patients with special needs

 While in a clinical rotation at St. Mary’s home for children, I used many alternative ways
of communication with the non-verbal patients. I was able to utilize communication
boards, light up signals, and non-verbal cues such as head nodding or pointing. 

• Communication

o Expresses oneself and communicates effectively with diverse groups using a variety of media

During my RN program, I was part of a group teaching assignment where we were tasked
with educating a group of patients and their family members about the subject of heart
health. I utilized a verbal teaching lecture, educational handouts, and a presentation board
to educate a diverse group of patients. 

• Communication 

o Demonstrates skills in using technology, informatics, and communication devices that support
safe nursing practice

I have utilized many communication devices and technology in my workplace. One of the
most common is hearing aids or amplifiers for patients who are hard of hearing. Another
newer technology is the MARTI. This device links the patient and staff member to a face-
to-face video call with an experienced medical translator. All of these devices ensure that
each patient can clearly understand their plan of care as well as enable them to ask
questions and communicate with staff. 

• Communication

o Accesses and utilizes data and information from a wide range of sources to enhance patient
and professional communication.

In the professional setting, I regularly utilize email and communication boards to receive
and share information with nursing staff. The paging system is used to communicate with
providers. For patients and family members, I utilize white boards in the room for basic
information updates, contact information and daily goals. 

• Teaching

o Provides relevant and sensitive health education information and counseling to patients and
families.

During my group teaching assignment on heart health, I provided education on heart

health statistics, common heart health issues and risk factors. I was able to provide follow
up information to the patients and family members present in the form of a question and
answer forum after the presentation. 

• Research
o Applies research-based knowledge from arts, humanities, and sciences to complement nursing
practice.

 When collecting information and statistics for my community health assessment

powerpoint, I referenced many types of sources. I found numbers of COVID 19 cases,
deaths, completed tests, and trends on local and national government websites. The CDC
website also had many useful facts, trends, and guidelines for dealing with the COVID 19
pandemic. This research helped me to gain a better understanding of the local vs. national
COVID 19 status and testing efforts already in place. 

• Leadership

o Assumes a leadership role within one’s scope of practice as a designer, manager, and
coordinator of health care to meet the needs of populations.

While carrying out my community health service hours, I used my role as a nurse to help
organize and manage COVID 19 testing events. Many of these events took place in long-
term care facilities and the goal was to test every resident and staff member. I assisted in
managing small groups of other volunteers as they conducted testing, as well as
performing COVID 19 tests myself. 

• Leadership

o Organizes, manages, and evaluates the development of strategies to promote healthy

communities

I took on a leadership role in my heart health teaching group assignment. I assisted in

delegating topics of education to each group member. I also collected information from
each member on their topic to make up educational pamphlets to hand out to each patient
detailing the information they heard during our presentation. We used a variety of media
during our presentation to cater to different learning methods (visual, auditory, tactile
ect.) I evaluated the success of our education based on a question and answer time at the
end of the presentation. 

• Leadership

o Delegates and supervises the nursing care given by others while retaining accountability for
the quality of care provided

During clinical practice, as an RN I am ultimately responsible for the care of my patients.

Any tasks I delegate to another staff member (RN, NCP, charge nurse ect.) I still have an
obligation to ensure the task was completed and completed correctly and in a timely
manner. I use the example of delegating the task of obtaining vital signs to a NCP
(nursing care partner.) Whenever I delegate this I always check to make sure they were
completed, then I assess the values. I am responsible for performing any necessary
interventions based on the results. 
• Professionalism 

o Understands the effect of legal and regulatory processes on nursing practice and health care
delivery

While in clinical practice, I came across the issue of an order for blood to be administered
to a patient who did not have a consent form signed. Legally, if I were to have
administered the blood without this consent, there could have been legal ramifications.
Especially if the patient was to have an adverse reaction. However, as I had been taught, I
first checked the chart for a signed consent form prior to administration. Having not
found one, I went over the form with the patient and witnessed his signature. 

• Professionalism 

o Demonstrates accountability for one’s own professional practice as well as limits to one’s own
scope of practice

On my nursing unit, there is a hypotension protocol for post operative orthopedic patients
that is routinely ordered. It has parameters for administering an IV fluid bolus if the
patient's blood pressure falls within certain limits. It is within my scope of practice to use
my clinical judgement and follow the protocol if necessary. However, it would fall
outside my scope to use this protocol if had not been ordered on a patient or if the patient
did not meet the specific parameters for administration. 

• Professionalism 

o Advocates for professional standards of practice using organizational and political processes.

In an assignment for NURS 412, Ethics and Law, I along with a partner, wrote out a one
page policy brief regarding a current health bill. The bill dealt with prohibiting
conversion therapy as a treatment for changing a young patient’s sexual identity. The one
page brief introduced the bill, provided background information regarding conversion
therapy, showcased current research and provided a recommendation. I along with my
partner, used our position as student nurses to recommended the bill be passed. 

• Culture 

o Demonstrates sensitivity to personal and cultural definitions of health, and how these beliefs
influence an individuals reactions to the illness experience and end of life.

While in clinical practice I was caring for an elderly Asian-American post-op patient. He
was reluctant to rate his pain accurately. Despite his body language and vital signs
suggesting he was in severe pain, he continued to deny until his family members were out
of the room. I also cared for a terminally ill cancer patient as a nursing student. She stated
that she was a practicing catholic and that her faith had impacted her outlook on her
diagnosis. 
• Culture
o Integrates knowledge of cultural diversity in performing nursing interventions
When caring for my Asian American post-op patient, I was sensitive to the fact that he
might have been hesitant to show pain while his family members were in the room. In my
experience, some men of Asian cultures can be very stoic and do not like to admit pain as it may
portray weakness to their family. I made a point to come back when the family was gone so as to
better assess his pain at the time.

• Culture 

o Maintains awareness of global environmental factors that may influence delivery of health
care services.

The most recent global environmental factor faced by myself as well as all health care
workers is the COVID 19 pandemic. It has affected not only local health care, but health
care around the world. Different states and countries have had to place new guidelines
specifically in hospitals to help slow the spread and treat those affected. In my workplace,
all staff are required to wear masks and are screened for fever when entering, visitors are
restricted, and staffing has been altered to fully staff the new COVID units. When
speaking with some patients, they have expressed increased anxiety about being in the
hospital as it puts them at a greater risk for contracting the virus.