Learning Outcomes in a Nursing Environment

This is the fifth article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare

The Principles of Nursing Practice were introduced by the Royal college of Nursing (RCN) with the input from the Department of Health, the Nursing Midwifery Council, service users and user organisations. They indicate to the public what they should expect from nursing practice, no matter if they are a colleague, service user, or the relatives or carers of the service users. The Principles explain what makes up the safe and effective nursing care, and encounter the aspects of behaviour, attitude and approach that underlie good quality care. They are important to health professionals, in delivering safe care because they indicate how to follow the principles, to be able to assist you in reflecting on your practice and development as a

The first pattern of knowing in nursing presented is the Empirics: the science of nursing. Carper (1978) described this empirical knowing as factual evidence and proven medical research or documentation used for patient treatment. This empirical knowledge is vastly related explanations and predictions from facts and things that have been proven. This author believes that most of this scientific evidence or knowledge stems from books and clinical experiences gained in healthcare facilities under the leadership of trained educators or licensed medical providers. This author believes this because as a nursing student, she will learn nursing techniques such as inserting foley catheters, and doing injections first by observing the nursing

As the demand for nursing education grows and with the rapidly advancing roles of nursing, educators need to stay up-to-date. “Theory-based practice provides nurses with a perspective” (Parker, 2006, p.28). With the comprehension and use of educational theories, nursing educators can support student knowledge and development into practice. These theories are outlines of cohesive concepts and principals that describe, explain, or predict how people learn. Every one learns differently and as an educator you need to be familiarized with and open to the use of one or more combinations of theories to successfully teach adult learners in this ever changing health care system. This paper will highlight the use of Constructivist Learning Theory and its application to nursing practice.

The key learning points and insights learned is that in nursing, learning never ends. As the health care system continues to change, it is the nurse’s obligation to do the same. By reflecting on previous clinical feedback I realized that entering my first year of practice, I will be a novice nurse that will have a lot of personal and professional development to gain. The CNO style-learning plan will aid me in my first year of practice on a medicine floor.

This assignment will reflect on and critically analyse my personal and professional development in the domain of care management over the last three years. It will additionally outline how I plan to continue to develop in this domain once I have qualified as a registered nurse. My development so far will be analysed from the perspective of the skills, knowledge and values required of a registered nurse. Through this reflection I hope to confirm that my practice meets the standards for entry onto the nursing register as outlined by the nursing and midwifery council ((NMC) 2008).

I’ve learned to integrate the essentials of baccalaureate education into my current practice by setting professional goals for myself and learning that I’m in a proficient level of nursing in my current practice as well as what it will take to reach expert level. I also learned how the use of evidence base practice is necessary for this changing healthcare environment and how nursing leadership can help through advocating for policy changes or new policies. The continuous changes in the healthcare environment have also created special populations who require a particular level of care. Also learned how important critical thinking is when it comes to developing a focused plan of care based on evidence along with the necessity of advocacy in

In Australia, the scope of practice has been further refined by AHPRA through competencies, codes, and standards. Although there are some common areas of practice in nursing and midwifery, midwives and midwifery students must be aware of the more extensive definition specialized for the midwifery practice. Within the scope, midwives provide care in the continuum model whilst establishing partnership with woman and family, provide health counseling, conduct birth, implement care for newborn, and practice within professional boundaries of the partnership regulated by AHPRA. Also, midwives must be able to identify the condition, in which the involvement of collaboration with other health professionals is required, and be familiar with the national guidelines for consultation and referral. As a midwifery student, it is my responsibility to always work within my current scope of practice, which is what I have been taught, skilled, and authorized to perform. As a midwifery student, the scope of practice is limited to that of a student regardless my nursing registration with AHPRA. Before the commencement of my clinical placement, I must read, understand and remember the code, competency standards, and professional boundaries for midwives. And ensure my practice always adhere to those guidelines during my clinical

Advance practice nursing has been applied to variety of roles like Acute Care Nurse Practitioner (ACNP), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Nurse- Midwife (CNM) and Certified Registered Nurse Anaesthetists (CRNA). Even though clinical expertise is the core ingredient for APN practice, these nurses are expected to demonstrate competencies like use of holistic perspective, initiation relationship with patients, use of expert critical thinking and use of diverse health and illness management (AACN, 2006). Additionally they need to express core competencies like consultation, collaboration, leadership, research and expert coaching (NACNS, 2004). Experienced staff nurses may exhibit these competencies whereas the APN make it visible in their practices and they are believed to be basic components of every APN (Hamric B, 2009 p 84). Furthermore a brief consideration of Benner’s model is required to understand the acquisition of expertise in nursing. Benner defines expertise as a mixture of theoretical and practical knowledge and every APN begins as a novice and ends up with some expertise.

Using Nursing and Midwifery Board of Australia Competency standard thirteen (National Midwifery Board of Australia, 2006), this essay will provide a thorough discussion and critical analysis of the reflective process, known as Gibbs reflective cycle (Bulman & Shutz, 2008) and how this reflective process in conjunction with competency standard thirteen, will be utilised to enable the author to fulfil their professional and personal goals in becoming a midwife. Personal limitations and strengths of the author as a first year Bachelor of nursing science-Bachelor of midwifery student, will be identified and linked to goals the author has formulated in order to achieve personal and professional development within practice. This will also include strategies that the author is going to incorporate into their practice in order to address development of these goals, inclusive of a time frame for the achievement of these goals. Lastly, this essay will also include how the author will evaluate achievement of these goals.

Within this assignment I will utilise the Nursing and Midwifery Council Standards of Proficiency (NMC 2004a) for entry to the register to critically reflect upon my portfolio of evidence in order to demonstrate that I am fit to practice. In doing this I will discuss the terms ‘proficiency’ and ‘reflection’. I will identify the model of reflection I am going to use within this assignment and will give a rationale for this choice. For each domain I will provide a critically analysed reflection, using evidence taken from my portfolio. For each domain I will demonstrate what learning has taken place, identifying a learning outcome and action plan from each reflection.

The health care field is ever changing, the article The Future of Nursing: Leading Change, Advancing Health (2010), explains all the changes that need to happen in the health care system (Institute of Medicine, 2010). The recommendations that the Institute of Medicine has for the health care field are ones that are important for the workers as well as the patients. This report applies to my career because being in the master’s program I am furthering my education, which is one of the messages that this article has to the readers (Institute of Medicine, 2010, p. 4). Message one is also relevant to my career because it talks about nurse residency program and I have been in a program for a little over a year (Institute of Medicine, 2010, p. 5). As a nurse doing continuing education is a way of following new trends and developments in information.

It is one’s duty as a nurse to always keep up with current trends. This is accomplished by partaking in a multidirectional approach to furthering education. Through academic, evidence based practice, clinical practice, and others; I will forever seek opportunities to expand my knowledge base to provide my patients with the best, well-rounded care I am capable of. Only through this will I continue to grow as a nurse and ensure that I am preserving my beliefs of core nursing characteristics.

Australian Nursing and Midwifery Council 2005, National Competency Standards for the Registered Nurse, Australian Nursing and Midwifery Council, Victoria, viewed 4 November 2011,

Expectations are defined as something that you believe will happen to you. Before nursing school, I had several expectations. Some of these expectations have shown to be very true while adapting to this new lifestyle. Other expectations have fallen to the waist side and soon were forgotten. At the time, they seemed to be very real. I expected to study, study, and study some more. I wanted the program to be challenging and prepare me to be a nurse. I expected to struggle financially because of having to reduce my days off work. I thought this would give me extra study time and I would make all As on every assignment. I hoped to form study groups to ensure that I would excel in making those grades. But, my most important expectation of myself was to stay organized and ahead on all assignments. I expected this to get me through nursing school.