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Michelle Mcknight

Delaware Technical Community College

Nursing 460

Dr. Jeanmarie Maloney

November 30, 2021

Introduction

I can’t believe I am embarking on completing a mission I started over thirty years ago,

longer than most of my classmates have been living, but here I am writing my last paper for my

Bachelor’s Degree. It has been a long journey and one that I am so proud of. Because of my lack

of technical skills I probably found it more challenging than most, which gives me more

satisfaction! Through this program I have grown academically as well as professionally in my

nursing profession.

PCG 1

The first graduate competency focuses on integrating general knowledge, skills, and

aptitudes to advance nursing education and growth in your professional practice. Nursing

competency includes core abilities that are required for fulfilling one’s role as a nurse. Therefore,

it is important to clearly define nursing competency to establish a foundation for nursing

education curriculum ( Yam, 2018). When I think about the first goal It takes me back to when I

first started the Bachelor’s program, and I questioned why we had to take World History II. I

thought to myself what does this have to do with nursing. After taking the course I was working

on the ACE unit which is age sixty- five and up. I had a patient that fought in World War II with

the United States and I was able to converse with him because of what I learned in my class.

Another class I questioned was statistics. I wondered when I would ever use it.Then one day I

was working on a particular unit and the tech recorded that my patient’s blood pressure was

totally out of the norm, it was at that moment my statistics language was needed I realized this

was an outlier and probably was incorrect. Each class we took in this program has prepared us

for the next level. I think back on how strategic our program coordinators were in picking units
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for us to do our clinical rotations, it coincided with what we were learning in the classroom. The

skills I learned through this program gave me the confidence I needed once I became a nurse.

PCG 2

The goal of this PCG is to demonstrate leadership skills to promote patient safety and the

delivery of high quality healthcare. The leadership role is very important when it comes to the

safety of our patients, we are responsible for their well being while they are in our care, and

many of them are too sick to advocate for themselves, so we must do it for them. The leadership

style I identify with is Transformational Leadership ,This leader inspires his or her followers

with a vision and then encourages and empowers them to achieve it. Recently I have had the

opportunity to precept new nurses starting in the float pool. My method is to use constant

motivation and reassurance. I encourage them to let me know when they don’t understand

something and I will do my best to explain it or get the answer for them. I want them to know

that this is a team effort and as nurses we work together for the best outcome of our patients.We

had an assignment week two of Nursing 460 called the SWOT analysis, we had to write about

our strengths, weaknesses, opportunities, and threats. My main strength was and still is being a

team player. My biggest weakness was delegating tasks, taking the assignment as a preceptor

has strengthened me in that area. I'm more comfortable with delegating than I was before. My

employer has given me the opportunity to advance my career by paying for me to get my

bachelor’s degree, and now that I am near the finish line I have the opportunity to apply for

positions that require a bachelor’s degree. My biggest threat at the time was my lack of

technological skills and although I am not where I want to be, I have learned a lot during this

course and I will continue to improve in that area. During my Nursing 460 Practicum I had the

opportunity to interview three Nurse Managers. Angela uses an Authoritarian Leadership style,
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which is very strict and can lead to rebellion, it reduces group synergy and leads to an increase in

employee turnover rates. The second Manager I interviewed was Liz , she stated that “she likes

to use a Democratic style leadership”. She said she likes to get the input of her staff when

working on ideas to improve the unit. Kristin was the last manager I interviewed and like me, she

likes the Transformational Leadership style, she stated that she believes this style works best for

her unit, she said it lets her employees know that she values their ideas as well as their opinions.

All hospitals are overseen by a board of directors, whose responsibilities include but are not

limited to formulating the organizational mission and key goals , ensuring financial viability,

monitoring and evaluating the performance of high-level hospital executives, making sure the

organization meets the needs of the community it serves and ensuring the quality and safety of

care provided by the organization. However, hospital boards have traditionally had little direct

engagement in evaluating and improving quality and safety ( PSNet, 2019).

PCG 3

This PCG applies skills of inquiry, analysis, and information literacy to support evidence-

based professional nursing practice. The Institute of Medicine directed healthcare providers to

use EBP as a means to improve patient safety, efficiency and effectiveness of healthcare

services. The importance of developing information literacy is an essential component in the

application of EBP ( NIH.GOV, 2020). Throughout this program we have focused on how

important EBP is,we did a group assignment on nurse to patient ratios, and we proved how

important it is to have a safe ratio, it cuts down on pressure ulcers, because we are able to turn

and reposition our patients properly, it also cuts down on the number of in- patient falls reported.

Last but not least it increases patient satisfaction.

PCG 4
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This PCG integrates information management technology to improve patient outcomes.

Patient safety is a subset of healthcare and is defined as the avoidance, prevention, and

amelioration of adverse outcomes or injuries stemming from the processes of healthcare

( NIH.GOV, 2020). One of the greatest inventions for nurses is the medication barcodes. Bar

code medication administration systems that integrate electronic medication administration

records with bar code technology. These systems are intended to prevent medication error by

ensuring that the right patient receives the right medication at the right time. Our Nursing

Informatics class required us to come up with a topic we would like to improve on. The topic I

chose was Catheter Associated Urinary Tract Infections. Because a large percent of our

population come in with Urinary Tract Infections, I felt that we needed to find a way to cut down

on the number of cases. I came up with a plan to track how long the foleys have been inserted

and when they need to be changed. The current policy we have in place for tracking indwelling

catheters has been somewhat ineffective. The procedure is we place a catheter in a patient, we

document the placement , and we receive a notification every shift to access it, and to perform

foley care. Sometimes our elderly patients are hospitalized for well over a month and there is no

team to track the time the catheter has been in place without being changed, which increases the

risk for UTIs! I suggested we have a plan in place to fire a task to remind us to change the foleys.

PCG 5

The fifth PCG is to advocate for patients and the nursing profession with regards to

healthcare policy at the local, state, national, and global level. Nurses enter the profession

because they have the desire to help others. The core value of helping to prevent or manage

suffering is a significant part of this. This can be achieved at the physical , emotional or

psychological level, and is one of the most important aspects of patient care ( Alvernia, 2021).
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As a nurse advocating for your patients is one of the most rewarding feelings there is, when you

go to bat for someone who can not defend or speak for themselves is what we are sworn to do. I

know I have mentioned this before, but one of my most proudest moments came as a new nurse

when I advocated for a patient that had gastric by-pass, and was experiencing some

complications afterwards, and the doctor was preparing to send her home and I advocated for her

and finally he ordered further testing for her which revealed a bleed in her abdomen, she was

taken immediately in to surgery to repair a leaky bowel. If I had not advocated for her, she may

not have survived.

PCG 6

The sixth PCG involves direct patient-centered care through advocacy, interprofessional

communication, collaboration, and delegation. Patient care is, and should remain, the priority of

the APRN. Within this realm several roles emerge, including patient advocate, educator to the

patient and family, case manager ( Direct Care, 2011). Where I work we are mandated to do a

bedside shift report, this involves two nurses going to the bedside of the patient and passing all

the information we have about the patient to the oncoming nurse, during this time the patient is

also getting an update on his or her plan of care. This allows time for the patients to voice any

questions or concerns about their care. We usually have rounds on the floor every morning, the

round involves the entire interdisciplinary team ; doctor, nurse, pharmacist, and case

management. We discuss each patient's needs and concerns, as well as what their discharge plan

is.

PCG 7

The seventh PCG Integrates health promotion and disease prevention practices to

positively impact the delivery of healthcare to diverse populations.As a discipline, preventive

medicine has traditionally been described to encompass primary, secondary, and tertiary

prevention. The fields of preventive medicine and public health share the objectives of

promoting general health, preventing diseases, and applying epidemiologic techniques to these

goals ( Prev Med, 2015). Since the beginning of Nursing School we have focused on preventing

the spread of germs and the main way to do that is by proper hand washing, as healthcare

workers we cannot express enough how important this practice is! Since the Covid Pandemic I

believe more people are cautious of hand hygiene than ever before, more people are using hand

sanitizers when they are unable to use soap and water. A year after I started working at the

hospital, we adopted a new practice of using Curo Caps on all central lines as well as the tubing

on the IV machines to prevent Central Line Associated Infections. Statistics show our Central

Line Infections have decreased tremendously!

PCG 8

This PCG involves practicing professional nursing within an ethical framework. The

onset of nursing ethics can be traced back to the late 19 century. At that time, it was thought that

ethics involved virtues such as physician loyalty, high moral character, and obedience. Since that

early time, the nursing profession has evolved, and nurses are now part of the healthcare team

and are patient advocates (Gov/books, 2021). As a nurse I promise to always treat my patients

with dignity and respect ,and to never harm them. I treat all my patients the same no matter what

their Socioeconomic background is. Where I work many of my patients are from the inner city

and lack education. I meet them where they are and I explain everything to them in terms that

they understand. My job is not to judge them, it is to treat them with respect and do no harm.

PCG 9
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The final PCG is demonstrating lifelong learning that empowers personal and

professional growth. Trying new things and stretching ourselves helps us grow mentally and

emotionally, as do the mistakes that will inevitably come with this . We must treat mistakes as

opportunities , and never as crimes ( Insight/Agency, 2020). When I finished the Associates

Program at Del Tech I knew that I wanted to further my education. I never thought in a million

years that I would consider becoming a Family Nurse Practitioner. My plan is to enroll at

Wilmington University in the Fall to pursue that dream, and lately I have even considered going

for my Doctorate in nursing. I realize now that age is just a number and it’s never too late to

learn. I am fifty two years old and I make it my business to encourage other people in my age

group to pursue their dreams, and let them know that I did it and they can too.

Conclusion

Throughout my time in this program I have learned tons of education that will carry me

into the next chapter of my career. I feel that I have completed all nine of the PCG’s and I am

proud to have had a top notch education and I am proud to be a Delaware Technical Community

College graduate!
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References

Yonago Acta Med. 2018 Mar. Nursing Competency: Definition, Structure and Development

Journal of Medical Sciences, doi:10.33160/yam.2018.03.001

Tanner, A. & Pierce, S. (2004). Readiness for evidence-based practice: information literacy

needs of nurses in the United States. Stud Health Technol Inform. 2004;107(Pt 2):936-

40.

Yasser, A. & Frank Federico. (2017). The impact of health information technology on patient

safety. Saudi Med J. 2017 Dec; 38 (12): 1173-1180. Doi: 10.15537/smj.2017. 12. 20631.

Leadership Role in Improving Safety. (2019, September 7).

https://psnet.ahrq.gov/primer/leadership-role-improving-safety

Critical Care: The Role of Nurses as Patient Advocates ( 2016, January 29).

https://online.alvernia.edu.

Ather, A., & Katz, D. (2015). Disease Prevention and Health Promotion. Am J Prev Med. 2015

Nov; 49(503): S230-S240 doi:10.1016/j.amepre.2015.07.019.

Haddad, L., & Geiger, R. (2021). Nursing Ethical Considerations.

https://www.ncbi.nlm.nih.gov/books/NBK526054/

Crockett, L. ( 2019, October 29). 6 ways to Build Lifelong Learning Skills In Your

Learners.https://blog.futurefocusedlearning.net/6-lifelong-learning-skills.