Competency Statement Analysis

The CRNA has deeper understanding of disease processes, pharmacological treatment and technological interventions when caring for patients. Advance practice comes with a high level of responsibility; furthermore, increased autonomy is why I aspire to advance my nursing practice. I want to be the nurse that eases my patient’s way through what may be the most stressful time in their life. During my anesthesia shadowing experience I witnessed the complexity and compassionate care that the CRNA provided safely and efficiently. Most importantly I observed clear communication that was vital to all involved in the care of the patient’s unique needs. My shadowing experience fueled my drive to continue to pursuing CRNA School and extend my knowledge at the

In the beginning of my practicum for this competency, I honestly had no thoughts of how I would achieve this. I haven’t explored any ideas of how I was able to perform critical thinking and communicate to the elderly population. Overall, I was pretty frightened of how I was going to compete this at my placement. I believe that without knowing how I was going to start doing this competency terrified me because I didn’t want to end up doing something wrong. In my reflection during September 1st to September 3rd I recall a time when Carney said something like “If you don’t make mistakes, you aren’t learning. Mistakes are okay, they don’t define you.” This helped me try new approaches when it came to this competency.

Delirium continues to be a major concern in the adult intensive care setting, as many as 60-80 percent of patients on mechanical ventilation and 20-50 percent of patients without mechanical ventilation are affected by delirium through their course of treatment (Brummel & Girard, 2013). Delirium is a serious concern for intensive care units (ICU) given the detrimental consequences it can lead to. It is associated with actions that can compromise the safety of the patient, such as self extubation and an increased rate in the use of patient restraints, it can lead to longer hospital stays along with an increase in mortality rates (Brummel & Girard, 2013). Further, another factor to consider is the possible residual long-term cognitive impairment it often leads to (Rivosecchi, Kane-Gill, Svec, Campbell, & Smithburger, 2016). Based on the prevalence of delirium in adult critical care patients, it is evident that new interventions must be explored in order to reduce its incidence. In current studies, one of the proposed interventions to alleviate this issue is through the implementation of cycled lighting, in an effort to improve patients’ sleep patterns, which in turn reduce the incidence of delirium (Chong, Tan, Tay, Wong, & Ancoli-Israel, 2013). (Mireya)

The inability to sleep is a source of anxiety and stress for patients in the intensive care unit (ICU); this inability can lead to cardiorespiratory disturbances, immune system dysfunction, impaired wound healing, hormonal and metabolic imbalances, cognitive changes, and delirium. Through the use of quiet times and nursing actions that encourage sleep, or, sleep hygiene bundles, nurses can assist in improving sleep quality in the ICU. These bundles include noise and light reduction, scheduling routine procedures outside of reserved sleep times, the use of earplugs and eye masks, and the grouping of nursing care activities to minimize sleep interruptions. The aim of this proposal, therefore, will be to implement a nurse-driven, sleep hygiene protocol, in order to improve patient care by promoting quality sleep in ICU patients. Barriers to implementation include staff resistance to the concept, concerns regarding patient care during sleep times and difficulties in coordinating care with other units. Studies used to gather information for this proposal were published between the years of 2011 and 2016 and were found in several databases: Academic Search Complete, Medline, and OVID Journals.

Delirium continues to be a major concern in the adult intensive care setting, as many as 60-80 percent of patients on mechanical ventilation and 20-50 percent of patients without mechanical ventilation are affected by delirium through their course of treatment (Brummel & Girard, 2013). Delirium is a serious concern for intensive care units (ICU) given the detrimental consequences it can lead to. It is associated with actions that can compromise the safety of the patient, such as self-extubation and an increased rate of the use of patient restraints, it can lead to longer hospital stays along with an increase in mortality rates (Brummel & Girard, 2013). Further, another factor to consider is the possible residual long-term cognitive impairment it often leads to (Rivosecchi, Kane-Gill, Svec, Campbell, & Smithburger, 2016). Based on the prevalence of delirium in adult critical care patients, it is evident that new interventions must be explored in order to reduce its incidence. In current studies, one of the proposed interventions to alleviate this issue is through the implementation of cycled lighting, in an effort to improve patients’ sleep patterns, which in turn reduce the incidence of delirium (Chong, Tan, Tay, Wong, & Ancoli-Israel, 2013).

QP provided the purpose of this session which was to complete “Contract for Change” from Lesson 7 in SFP.

By building this partnership, Cindy works collaboratively with the MCAT Prep Team and myself to meet shared objectives. I have worked with Cindy Allen on a number of publications, such as the Practice Exam 2, Biochemistry Textbook Roadmap, and am currently working with her on the 5th edition of the Official Guide.

Based on these results, it is our recommendation to implement the use of cycled lighting in the ICU at YRMC, to decrease the occurrence of ICU delirium. We recommend a unit staff training on purpose of the implementation of light regulation and its benefits. Use of lighting should be utilized between the hours of 0600-2100 each day, with light restrictions and decreased sleep disruptions during the hours of 2100-0600 to improve sleep cycles (Patel et al., 2014). During the daylight hours patients should have at least two hours of bright lighting that can come from various sources such as “windows, room lights, or bright light exposure devices”(Ono et al., 2013) to help promote healing and rest. Chong et al., (2013), and Ono et al., (2013)

Competency-based interview questions are used to assess your ability to carry out a particular job efficiently. The purpose of competency-style interview questions is to evaluate your skills for the position being offered. Different jobs require different skills - retail positions often require skills in communication and teamwork, whereas someone applying for a job in a legal field will need strong research abilities.

I am a consumer product marketing expert with expertise in growing businesses within categories that are highly competitive. My core competency is the ability to build integrated online marketing strategies, which can take a sometimes technical product, and leverage all digital communications (owned, earned and paid), to fully attract, engage and convert the audience.

In an effort to meet the needs and challenges triggered by the 21st century demand in healthcare, there have been constant calls across the nursing spectrum and beyond to standardize the entry level position into nursing practice. These calls stem from the fact that several research studies have concluded that hospitals with greater number of baccalaureate prepared nurses as an entry- level position have observed considerable benefits as a result. These benefits are associated with the practical differences in competencies exhibited by baccalaureate prepared nurses and experienced by the hospitals (magnet hospitals) that hire greater number of

In higher education there are many different positions requiring many different competencies, when these competencies of individuals are practiced and built on, the education system, and students win. It is up to the educational institute to make sure employees are developing more competencies, and building on the ones they have. This is very important in higher education today because of the pressure of high expectations, and being scrutinized at every turn makes professional development important. Student affairs is a very important part of higher education with students at risk making it imperative to continue to build on competencies.

I developed an interest in Nurse Anesthesia as a student nurse in my clinical rotation in the OR. While observing, I met an anesthesiology resident who took me under his wing and showed me what he did. He was extremely pleasant and friendly. He was also calm and collected during tense situations. Above all, he enjoyed what he did. After this initial exposure to Anesthesia Caregivers, I researched and discovered that there was a pathway for registered nurses (RN) to be Anesthesia Caregivers called Certified Registered Nurse Anesthetist (CRNA). CRNA as an advanced practice nurse specialty excited me, as it gives the opportunity to provide nursing care by focusing on patient needs with greater independence and substantial clinical judgement. It affords RNs to make rapid clinical decisions,

As of 2000, 96% of Hmong households reported Hmong (L1) as the primary spoken language at home with English (L2) not being introduced to a child until later in their development (Reeves & Bennett, 2004). Upon entering school, Hmong children progress into sequential bilingual speakers where L2 is introduced after L1 is already well established. Bilingualism is frequently stated as the use of two or more languages by an individual (ASHA, 2004). Two of the most common types of bilingualism include simultaneous bilingualism (acquisition of both languages occur early on from birth) and sequential bilingualism (exposure to the second language occurs after the first language is already established, usually after 3 years of age).

There seem to be a variety of different definitions, but competencies can be thought of as a composite of worker-oriented characteristics which can be linked to knowledge, skills, abilities, and other characteristics (KSAOs), and may be connected to higher performance (Scotty & Reynolds, 2010). Another definition of competencies is a combination of KSAOs and behaviors used to make assessments of overall performance (National Institutes of Health [NIH], 2017). KSAOs can be considered discrete data (Scott & Reynolds, 2010), in that they are narrowly defined and either individuals have a particular characteristic or they do not. For example, knowledge is information an individual either possesses or does not at the time of an assessment; although knowledge can be gained at a later time, it