In this article, the authors discuss a study used to identify complications, such as infiltration and phlebitis that can be associated with peripherally inserted vascular (PIV) therapy; due in part to a complacent health care system that can ultimately lead to detrimental outcomes. The study was directed towards medical-surgical nursing staff who agreed to a pretest, a competency-based education program, and a post-test as part of the study. A specific area being evaluated by the study is that nurses refine their clinical expertise by going through phases; and that these phases have specific components to assess their clinical experience, according to Patricia Benner’s, Novice-to-Expert Model. There are 5 levels to Benner’s model; novice, advanced
Ms Debra Shannon, BSN, perioperative RN is assigned to the OR consisting of 6 main rooms and 1 cysto room and provides support to the interventional radiology, during this rating period. She serves as Service Lead to Cardio, Vascular and Thoracic Services. She provided valuable input for this proficiency. This proficiency report demonstrates examples of how Ms. Shannon uses her perioperative nursing expertise to provide patient centered nursing care in exceeding the Qualification Standards in the four areas for a Nurse II.
In 1999, expert surgical nurse authors at the Association of periOperative Registered Nurses (AORN) developed a comprehensive curriculum to assist in the education and transition of nurses entering perioperative clinical specialty for the first time (Beyea, 2002). In 2007, Periop 101: A Core Curriculum (AORN, n.d.) was created which moved the instructor-based program into an online format of modules designed to assist with mastering core perioperative competencies. The program provides instruction with videos, assigned readings, and quizzes at the end of each module. The learning focuses on patient safety and the program is best utilized when combined with preceptorships and skills labs.
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
The success of NPs depends on practicing evidence-based care with competency in assessment, diagnosing, managing patients, and maintaining a caring practice. The nursing component of the NP role continues to be challenged from within nursing, as well as by large national physician organizations. NPs are extensions of nursing practice who are guided by nursing theory. The transformation from nurse to the advanced practice role of NP involves development of advanced knowledge and skills for listening, knowing, being with patients, connecting patients to their communities, promoting health,
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
Bachelor’s prepared nurses are better equipped to make clinical decision more effectively and efficiently. Nurses have to make clinical decisions all the time to improve a client’s health and to maintain wellness. For example, it is the nurse who usually takes immediate action when a client's clinical condition deteriorates, who decides if a client is experiencing complications that warrant notification of the physician. A nurse must be able to think critically, solve problems and find the best solution for client's need to assist clients in maintaining or improving their health. For instance, if an elderly patient status post hip replacement, bed-bound complains of pain in the affected leg and swelling, an ADN prepared nurse might carry out the order for pain management and will elevate the leg to subside swelling. On the other hand, a baccalaureate prepared nurse will critically think about the potential complication status post hip replacement surgery and will take the clinical manifestation of swelling of the leg might be secondary to DVT and will notify the Medical Provider immediately in order to prevent complication. “Research has shown that lower mortality rates, fewer medication errors, and positive outcomes are all linked to nurses prepared at the baccalaureate and graduate degree levels” Rosseter (2012)
The basic nursing function is only the beginning. The need to monitor complex pumps, deal with advanced electronic charting, a challenging health care environment and face an increasing number of colleagues with bachelor degrees, all point to the need for BSN. Studies also found that nurses prepared at the baccalaureate level have stronger communication and problem solving skills (JOHNSON, 1988) and a higher proficiency in their ability to make nursing diagnoses and evaluate nursing interventions. (Giger & Davidhizar, 1990) Hospitals are increasingly looking to improve outcomes for their patients whether for a routine checkup or surgical stay. BSN’s because of the increased training are able to provide the best outcome
A newly graduated registered nurse is well prepared to pass NCLEX for licensure; however, being prepared for the acute care setting in a hospital is a completely different issue. Nursing schools develop the foundation of nursing knowledge, creates critical thinking skills, and touches on nursing tasks. All of these are great tools to possess, but they do not prepare the new graduate nurse for safe, acute patient care. At Boulder Community Health (BCH) on the orthopedic neurology unit, new graduate nurses are given five weeks of orientation. Expecting a newly licensed nurse to learn all of a hospitals policies and procedures concerning patient care and how to incorporate the policies into their practice after five weeks is highly risky and leads to unsafe patient care. On the orthopedic neurology unit at BCH the new nurse trains with several nurses during the five week orientation period. This does not allow for the nurse to learn a consistent system to follow or incorporate into their personal practice as each nurse has their own system. This can become frustrating for the novice nurse. This paper will propose a change in the orientation program at BCH. A one year new graduate nurse residency (NGNR) and mentorship program will be presented to the management administration at BCH. The proposal will serve to prove that a residency program will actually save the hospital money by retaining quality nursing staff through
Patricia Benner is known as one of the most recognized theorist of our time. Patricia born in 1955 in Hampton, Virginia spent most of her childhood in California. It was there that she received her professional education. This paper will focus on her Novice to Expert theory using the Model of Skill Acquisition through defining concepts within her conceptual framework, identifying assumptions within her theory, discussing the significance of her theory as it relates to advanced practice nursing, and addressing how applicable her theory is to actual nursing practice.
Today, in the United States there are some people who do not know what a Nurse Practitioner is? Therefore, a Nurse Practioner is a nurse that “is responsible for managing health problems and coordinating health care for the perioperative patient in accordance with State and Federal rules and regulations and the nursing standards of care (assessment of health status, diagnosis, development of plan of care and treatment, implementation of treatment plan, and evaluation of patient status)” (CCI, 2016). To become a Nurse Practioner some nurses must receive a master’s, post-master’s, or a doctorate’s degree including up to 5 years of experience
It has been shown that a nurse’s level of education can become a major factor to the safety and quality of care of their patients because of this there has been an increase in studies over the years that directly examine patient outcomes in similar situations between Associate
It has grown from a non-educated nurse to one that has to be even more educated to keep up with the fast changing times with diverse topics and culture differences. It is a constant challenge for physicians and nurses to do their best in the fast changing nursing field. As nurses, we have to be constantly upgrading our education. We can’t expect anything to always be the same and to never change. Register nurses today work as a team, they work every day with physicians, pharmacists, speech and occupational therapists, just to name a few. Since nurses are primarily responsible for direct patient care and coordination, I believe that they should not be these educated on the health care
The role of an Advanced Practice Nurse (APN) is evolving as the shortage of primary care providers occurs as a result of an aging population and the implementation of Affordable Care Act (ACA) (Laurant, 2014). The advancement in medical technology, increasing aging population, and the prevalence of chronic diseases increase the expectation of public in healthcare system. In order to meet those needs various nursing roles evolved, and all those fall under the umbrella of APN (Ramis, Wu, & Pearson, 2012). Evidences support the role of APN in reducing patient length of stay, subsequent hospital costs, and functions as a recruitment strategy to encourage nurses to stay within the profession (Bauer, 2010). In order to be a successful APN, a nurse needs to have the advanced knowledge and expertise in the designated area. The APN is one who has advanced knowledge and skills in meeting the needs of a population with complex and unpredictable health needs. The skills needed to be successful as an APN is critical thinking, leadership skills, and clinical judgment in addition to the mastering of core competencies required by the National Organization of Nurse Practitioner Faculty (NONPF). For the purpose of this project I interviewed Mrs. A.C, who is an APRN for the Cardiovascular Surgeon. The main focus of the interview was to analyze the NONPF core competencies possessed by Mrs.A.C. The part of this paper includes the Description of the NONPF NP core competencies, Interview
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
Though Associate and Bachelor trained nurse learn the same skills, the Bachelor trained nurse has a deeper knowledge of quality improvement concepts, patient safety goals, and the leadership skills to assert critical decision-making. (Kearney-Nunnery, 2015, pp. 216-17) As a result, research shows that when hospitals employ a larger percentage of bachelor prepared nurses, patient outcomes improve. (Altmann, 2011) Bachelors prepared nurses have a great deal of experience in research of evidence-based practice, which plays a major role in quality and safe patient care. Nursing staff is consistently working to prevent falls, pressure ulcers, and IV infiltration, which are preventable and have the potential to lead to more serious problems. (Kearney-Nunnery, 2015) Overall, a bachelor’s degree better prepares nurses for the ever-increasing acuities of patients, many of whom have multiple health issues and comorbidities