My Tie at Emory Nursing School

My second clinical day took place on September 24th, 2015 at Saint Barnabas Hospital in Livingston, New Jersey. My preceptor Maria Brilhante, MSN, RN, allowed me to observe the morning huddle that took place with all the nurse managers that are in the hospital. The purpose of this huddle was to keep the director of nursing informed about the census on each unit. I found this processed to be very uniformed and professional because the DON was engaged. The day went on with me attending meetings on how managers could implement plans to contain cost for the hospital. Maria did her daily rounds on her patients and her nursing staff. She has a folder that contains papers on how each nurse is progressing from the time they get off orientation. Her motto to the nurses is, “You are good at what you do, so when I coach don’t take offense. I am only trying to get you to be great”. This boost their confidence which I thought to be important.

For the majority of nurses working within the field of modern medicine, one of the most difficult tasks associated with the job must be maintaining the tenuous balance between the pull of professional ambition and honoring the responsibility owed to their current role. Nursing remains one of the most stratified occupations in terms of recognized qualification, and a wide disparity exists between the positions of Licensed Practical Nurse (LPN) and Registered Nurse (RN) in terms of both experience and education. While standards vary from state to state, individual LPNs may be required to complete many of the same duties as their RN counterparts, including the administration of intravenous fluids, the withdrawal of blood for testing, and other crucial aspects of inpatient care. Despite the similar set of skills possessed by LPNs and RNs, the latter position commands a greater level of prestige and a significantly higher salary within the nursing field, and because of this many qualified LPN's aspire to attain the rank of RN in order to better their personal and professional lives. As a working LPN beginning the transition to future RN career, I have encountered many difficulties and obstacles which I feel will only strengthen my resolve and crystallize my ambitions. During the extensive reading required to gain the knowledge needed to work as an RN, a statement made by the authors of LPN to RN Transitions: Achieving Success In Your New Role resonated deeply with me, and I

I currently work as a wound ostomy specialist for the hospi-tal. I desire to continue to grow as a nurse and professional. I am now ready to advance my career again and become an Acute Care Nurse Practitioner. In each position I’ve held, I have taken away a skill-set that has helped to mold me into the professional I am today. I have identified that there is a great need, in the Acute Care setting, for Acute Care Nurse Practitioners that can provide comprehensive and holistic care to the critically ill. According to Nursing and Health Sciences, hospital-based nurse practitioners influence team function, as well as facilitate advanced patient care, provide leadership and education as well as implement unit specific re-search. With my knowledge of the intensive care setting as well as my knowledge of pressure ul-cers, pressure ulcer prevention, wound management and advanced wound healing I feel that I would be a great asset to the profession as well as the hospital-based team. Once graduated, I plan to work in the Acute Care Setting, most likely in a specialty such as General

It is no secret that communication is key when providing direct patient care in a skilled nursing facility. However, there is a noticeable lapse in the communication between the care team when providing care to the individual or groups of individuals. Two main parts of any care team are the registered nurse and the certified nursing assistant, as these are the two people whom have the most direct and impactful roles with residents in a skilled facility. The Registered Nurse and the Certified Nursing Assistant play similar roles in providing patient care, but have different roles in its entirety. The role of the Registered Nurse (RN) is defined as having the competency and skill to provide direct and indirect health care to individuals, their families, and communities around them. Services are also provided designed to give out medications, to promote comfort or healing, promote healing, and to also provide the dignity of their patients and patient’s families (American College of Rheumatology, 2015).

As an acute care nurse practitioner I hope to utilize my experience as an Intensive Care Unit nurse along with clinical knowledge and skills acquired through a graduate level program to provide the highest quality patient care. In my current role, I place high value on patient-family centered care and advocacy as well as commitment to lifelong learning. I have built my nursing career upon these values. I am excited to begin the journey of becoming an acute care nurse practitioner and to further my education and expand my scope of practice in the field of critical care, for which I have already developed a passion.

Over the course of this preceptorship, I have written a few different journals with the nursing process as my topic, the reason for this is because the nursing process is everywhere and has become a part of my day to day life, not just during my different clinicals over these past couple of years, it has spilled over into work, school work assignments, and home life, as well as. I now find myself assessing everything that needs to accomplish throughout my day and developing a plan of action, setting priorities to works towards their completion. Another topic that I feel is very important for a nurse is professionalism and important in developing a trust with the patients in your care, as well as, to earn the respect of your fellow nurses and other members of the hospital staff. Over these past couple years and I have seen that many of the patients and their families look to their

In today’s healthcare system, nursing is a challenging field as a result of rapid technological advances and changes in healthcare policies. As a dedicated nursing professional, with a great passion for learning, I strive to stay on top of these changes. I am determined to increase my knowledge to be an instrumental part of providing quality healthcare. The demands of nursing are high; however the rewards are even higher. Nursing requires both a supreme understanding of the science of health, and a caring bedside manner befitting only those who seek a position of such a personal involvement in the well-being of a patient. Academically, I will put forth all of

Transitioning from nursing school to working in a hospital setting can be a challenging time for a new graduate. Due to the nursing shortage, new graduate nurses are being hired with little to no experience. This is overwhelming for new nurses, especially when they are not getting adequate support or training from the hospital. The amount of stress, pressure, and lack of training is leading to a high turnover rate for new graduate nurses. With patient acuity on the rise, new graduate nurses that are filling these vacancies in the hospitals, need to be competent nurses to provide proper and safe care to the patients.

On November 1st, 2016 I had the opportunity to conduct an interview with Katherine M. Sawyer RN, BSN of Owosso, Michigan. Katherine, a female nurse who has worked in the nursing field for thirty-six years began her nursing career at Ingham Medical where she was a full-time staff-nurse for three years; then worked as a per-diem staff-nurse for eleven years. After working at Ingham for a total of fourteen years, Katherine obtained a position at Memorial Healthcare in Owosso where she worked as a nurse educator for fifteen years. Shortly after this she became a Basic Life Saving (BLS) instructor as her main role as a nurse educator was to provide nursing orientation and this additional role fit in perfectly. After some time she became involved in Quality Improvement for four years, and she has now switched back to the nurse educator role where she once again has the role of nursing orientation for Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Patient Care Techs (PCTs). The number of staff she teaches and orientates each month varies between one and ten individuals. She also teaches BLS and First Aid at Baker College of Owosso. Her contact information is as follows: Phone number (989) 413-1974 and e-mail address kmsawyer521@gmail.com. The purpose of this paper is to inform the reader of Sawyer’s role in the nursing profession as a nurse leader. Individuals will learn of Sawyer’s many different roles, responsibilities, and the organizational structure of Memorial

North Cypress Medical Center continues to strive to be one of the most respected hospital organizations in Texas. The organization philosophy of nursing practice involves being the leader in superior, affordable, patient care. The nurse utilizes this principal by making sure to perform skills the right way the first time such as foley catheter insertions and IV infusions. The nurse knows the patient is charged for all equipment, and having to discard equipment because of unsterile techniques causes increased inconvenience for the patient. Also, North Cypress Medical Center creates a comfortable environment from admission to discharge. One of the most important roles the nurse play is to make sure all patient needs are meet. The beliefs of nursing

Relationships among workers in the ICU of Changeable Medical Center are at best, strained. In the past six months, the unit has expanded from 8 to 12 beds, changed to a different electronic health record vendor, and changed unit managers. Ten of thirty registered nurses have resigned or left, two of the remaining twenty are out on sick leave, and absenteeism is at a record high. As the new unit manager, you are looking for ways to improve morale and deal constructively with the many problematic relationship issues.

Over the past seven years as a clinical nurse on the McKeen Pavilion (the medical-surgical amenities unit at New York Presbyterian/Columbia Medical Center), I have committed to excelling in a clinical bedside capacity, as well as a member of the NYP community. This combination has allowed me to be a true advocate for my patients, their families, and my colleagues. The unit has afforded me a tremendous amount of hands on nursing experience, as

Going back to when I was a novice nurse, I was nervous, scared, afraid of making medication error, charting errors or fail to recognized patients worsening symptoms. These fears, made me vigilant, focused and kept me on my toes at all times. No matter which part of nursing I ended up as I grew up the from medical surgical nursing to stepdown unit nursing to intensive care nursing, I felt those fears in every step of my growth and they helped me be a better nurse for my pateints. Today, I am in the advanced practitioner program to become a nurse practitioner who is responsible for: interviewing, assessing, diagnosing, counseling and treating patients. To provide safe and quality healthcare, I am expected to have good critical thinking and decision making abilities (Maten-Speksnijder, Grypdonck, Pool, & Streumer, 2012). while I can recognize clinically deteriorating patients and recommend treatments, I am now responsible for providing treatments. I am now recognizing that facts about being not only responsible for the patient, but also to provide safe care that keeps the patient out of the hospital and out of the ICU. Knowing these facts, I am yet again, faced with the fears of my limited clinical practice knowledge as a practitioner. The amount of information that I have received and learned during this clinical rotation was both exciting and overwhelming at the same time, because I realized as a novice student nurse practitioner (NP), the limited depth of

As a competent registered nurse, my career goal is to become a healthcare quality improvement leader, a position that would enhance my commitment in promoting patient safety. I not only believe in enhancing the capacity of other care providers, but also in improving the quality of the healing environment for the benefit of both patients and their care providers. This means not only promoting collaboration with the multidisciplinary teams, but also building the necessary healing partnerships with our patients. To enhance the quality of the healing environment, I aspire to continue analyzing researches for evidence based practices and advocating for their actualization. I will continue focusing my time and energy in encouraging other nurses to improve their skills through formal education, so they can empower themselves as advocates of quality improvement for the benefit of their patients and coworkers.

In the surgery department, I work as a circulator, scrub nurse, and a charge nurse. Using these different approaches, ideals, and standards of care are often needed and applied to my assessments. Being compassionate, respectful and honest to patients is a required principle our hospital expects in caring for each