Running head: PROGRAM GRADUATE COMPETENCY REFLECTION 1

PROGRAM GRADUATE COMPETENCY REFLECTION

Charlene Dover

Delaware Technical and Community College

NUR 460 Capstone

PROGRAM GRADUATE COMPETENCY REFLECTION 2

Program Graduate Competency Reflection

Throughout the BSN program I have been able to meet the criteria for graduating and

obtaining my Bachelor of Science in Nursing. In this program I have built upon the skills and

knowledge I obtained from my Associates Degree. The program graduate competencies (PGC’s)

are what ensure that education requirements have been for graduation. This paper will explain

how I have met the requirements and that I am prepared to finalize this step for mu nursing

career.

RN to BSN Transition NUR 300

While getting my ADN, people would ask, “are you going back for your BSN? I would

say, heck no!! Nursing school is the devil, and I’m ready to be done!”. But, here I am. I am

still currently working for the State in one of their long-term care facilities and I love my job. I

also work per diem at a local hospital, which I chose to do to help gain acute care skills and keep

myself “well-rounded”. While I love my job, I think getting my BSN opens a lot more doors for

me and will help me identify and set future goals to advance me on my career ladder. At the

time I feel that the nursing theory that my nursing philosophy correlates with is the Need Theory

by Virginia Henderson. Virginia Henderson defined nursing as “The unique function of the

nurse is to assist the individual, sick or well, in the performance of those activities to contributing

to health or its recovery that he would perform unaided if he had this necessary strength, will or

knowledge. And to do this in such a way to help him gain independence as rapidly as possible”

(Vera, 2014).

The program graduate competency achieved during the RN to BSN transition course was

PGC #1 integrate general education knowledge, skills, and aptitudes to advance nursing

education and growth in professional practice.

PROGRAM GRADUATE COMPETENCY REFLECTION 3

Global Health NUR 310

In this course I learned Nursing is such a vast field, a big reason why many people choose

the career. International/global health addresses the health of people living in low- and middle-

income countries (Global Health, n.d.). But, working with this population does not necessarily

mean working outside of your own country. According to explorehealthcareers.org, agencies that

span domestic as well as international settings are research and academic institutions,

international agencies, immigrant/refugee health organizations, other non-governmental

agencies, lending or finance agencies, multi-lateral agencies, and governmental agencies (Global

Health, n.d.). These agencies hire positions for: in-country field consultants, disaster relief

support technicians, organization development specialists, and program evaluators (Berkowitz,

2016).

Ebola was the health impact framework topic I chose for this course. The Ebola

epidemic was tragic, it was a prime example of how deep poverty and the populations that live

within the poverty suffer with lack of enough health care. Those in West Africa’s situation were

compounded by political strife, lethargic bureaucracies, and devastated economies, but the

situation remained the same (Dionne, 2014). The disease could spread easily because of easy

connections between rural areas and densely populated areas, very extensive border crossing

traffic, and lack of communications between bordering countries.

The program graduate competency achieved during this course was PGC #7 integrate

health promotion and disease prevention practices to positively impact the delivery of healthcare

to diverse populations.

Health Assessment NUR 32

PROGRAM GRADUATE COMPETENCY REFLECTION 4

While completing this course for the RN to BSN program, I learned Holistic assessments

are utilized for the nursing process for patient care. In the holistic assessment there is therapeutic

communication and the ongoing collection of objective and subjective data to help nurses

provide person centered care to their patients (Wallace, 2013). The holistic assessment focuses

on nursing diagnosis, planning, implementation and evaluation, as opposed to just physical. And

by focusing on the whole person, long-term wellness can be achieved along with short-term

relief. Holistic nursing will continue to evolve as nurses incorporate holistic principles and

practices into their personal and professional lives, and as the needs of patients and society

evolve. Yet, no matter the setting or the time, holistic nursing will retain its focus on healing the

whole person—the very foundation of holistic nursing (Klebanoff, 2013).

For this course I completed a plan of care chart that included the problem of the patient

followed by a goal or outcome which led to a plan and evaluation. The plan of care chart

included community resources for my patient to follow up with based on identified problem to

assist with reaching their goals. A plan of care chart was created after completing a health

history questionnaire and physical assessment video to summarize the findings of my patient that

stated identified health problems.

The program graduate competency achieved in this course was PGC #8 practice

professional nursing within an ethical framework.

Population and Community Health NUR 330

Since I already work in long-term care and at a hospital in acute care, I chose to

do my practicum in an elementary school with a school nurse. I was hoping this experience

would help give me balance and give me an experience very different than I am accustomed to. I

feel that working with children is quite like working with the geriatric population, they are both
PROGRAM GRADUATE COMPETENCY REFLECTION 5

dependent populations that need specific care. School nursing is a very different pace than an

acute care facility, like a hospital. What was very different than my work at the hospital and

long-term care was that with the children you must work hard to try and figure out what needs to

be treated. Children give very general answers when being asked what doesn’t feel good, or

what is wrong, sometimes they just didn’t want to be at school, especially on Mondays! School

nurses must be very detail oriented and must keep precise records on each child in the school.

Most of the time, the nurse knows some of these children for years, then the child moves on to

middle school, and I imagine that is tough.

I sincerely enjoyed this practicum experience and am very happy I chose to do school

nursing. It even piqued my interest enough that I have thought about maybe doing it as a

substitute once my bachelor’s degree is complete.

The program graduate competency achieved during this course was PGC # 6 direct

patient-centered care through advocacy, interprofessional communication, collaboration, and

delegation.

Nursing Research NUR 340

Nursing research has a tremendous impact on nursing practice. Research is what helps

find evidence for the practices created. Research is where ideas are created for improved

equipment, improved technology, more efficient patient care, and helps create health policies.

During this course I utilized foundational concepts of nursing research to complete a

problem-based research paper where I researched if providing additional days off (mental

health days), reduces nurse burnout and decreases call out incidences in a years’ time.

“Burnout can be defined as a long-lasting, work related mental condition, which is

characterized by exhaustion, dissatisfaction and low capacity” (Billeter-Koponen & Freden,

PROGRAM GRADUATE COMPETENCY REFLECTION 6

2005). High nurse-to-patient ratios, feeling unsupported, chronic overwhelm leads to high stress

and leads nurses to feel unsupported and stressed, afraid to not provide the best care, or afraid to

make a mistake nurses must call out to “get a break”. The qualitative study, quantitative study,

guideline/standard of care and articles reviewed all address burnout, and how nurse burnout

effects patient care/satisfaction.

The program graduate competency completed within this course was PGC #3 apply skills

of inquiry, analysis, and information literacy to support evidence-based professional nursing

practice.

Nursing Leadership NUR 400

In this course I developed the knowledge of types of leaders. A good leader is

supportive, mentors, coaches, and supervises. A good leader is also knowledgeable and likes to

share their knowledge. A bad leader micromanages, has no passion, and does not help the staff

further develop. Effective leaders help apply nursing theory to practice, see each staff member

as an individual and recognize their uniqueness.

Within this course I learned that they are many leadership theories from Deming's theory,

Drucker's theory, and even the transformational leadership theory. Different types of leaders

include the autocratic leader who makes decisions for the group, the bureaucratic leader who

relies on rules and policies, and the laissez-faire leader who allows staff to do as they please

using autonomy and self- regulation.

For this course, I wrote about the Connective leadership theory, the approach to

leadership is when the leader needs to promote collaboration and teamwork within the

Healthcare Organization and among other organizations in the community (Finkelman, 2016). In

my job as a Registered Nurse, I collaborate with many disciplines. I collaborate with internal
PROGRAM GRADUATE COMPETENCY REFLECTION 7

disciplines: physicians, nurse practitioners, physical therapy, dietary, certified nursing assistants.

And then external: private physician offices, specialists, lab companies, hospice agencies,

palliative care agencies, families and friends. I am one of the many that must be certain all of

my patients are receiving the best care they can get, and I have to be sure they are living to the

best of their capacity. Since I am the one with these patients just about every day, I need to be

able to speak for and communicate my patients needs and wants and be sure they are receiving

the care they deserve and the care they want. I feel this theory also includes one of the things I

do best, care.

The program graduate competency achieved in this course is PGC # 2 demonstrate

leadership skills to promote patient safety and the delivery of high-quality healthcare.

Nursing Informatics NUR 410

When I first enrolled in the nursing informatics class, I originally thought, I have no idea

what informatics is, so I figured I had no experience in it. But, once I started the research, I

realize I work informatics is embedded in just about everything we do in healthcare. According

to Scholastica (2016), nursing informatics is defined as the specialty that integrates the science of

nursing with multiple information management and analytical sciences. Its goal is to identify,

define, manage and communicate data, information, knowledge and wisdom within nursing

practice.

I completed my informatics project on Interpreters on Wheels. According to a 2018

study, a language, other than English is spoken at home in one of five households, the highest

level since World War I (Squires, 2018). Patients with limited English proficiency have

difficulty accessing managed care and utilize fewer preventative care services (Massland, Lou &

Snowden, 2010). Video interpretation services is an online technology that creates a forum
PROGRAM GRADUATE COMPETENCY REFLECTION 8

where the patient, nurse, and interpreter can see and hear each other, but with the interpreter not

having to physically being present (Massland, Lou & Snowden, 2010). Mobile video interpreters

improve access and quality of care to LEP patients. Utilizing the more accessible interpreters can

mean an increase in understanding diagnosis, treatment, medication instructions, increase

understanding of compliance, and increase patient satisfaction (Massland, Lou & Snowden,

2010).

The program graduate competency achieved during this course was PGC # 4 integrate

information management technology to improve patient outcomes.

Nursing Policy NUR 420

Nursing policy was not something I had a lot of interest in as I never considered myself a

“political” person. I did enjoy learning the process of how policies are created and how much

time it hard work they take. In the course I learned the importance of the role of the nurse as an

advocate in the legislative and regulatory processes. I also learned how a bill becomes a law, the

process and time that it takes, and how nurses can become involved in creating and improving

healthcare policies.

During this course I focused my action plan on the nursing shortage and create policies

on how to ease the shortage. I found that many States today are facing nursing shortages,

especially in the more rural areas, and the shortage is growing daily due to increased healthcare

demands. According to an Avant healthcare study in 2017: an aging population of 75 million

“baby boomers” is driving a demand of healthcare services. An estimated 20 million people now

have health insurance through The Affordable Care Act, and in just one year over 1 million

people are hospitalized or treated in an Emergency Room related to an opioid issue. Nursing

shortages have a ripple effect. When nurse staffing is short, nurses must care for more patients.
PROGRAM GRADUATE COMPETENCY REFLECTION 9

Higher nurse-patient ratios can lead to errors and higher patient mortality. Nursing shortage also

leads to nurse burnout, low morale and high turnover rates, which also has a negative impact on

patient satisfaction and care. The goal of my plan was to educate stakeholders about the urgency

of the nursing shortage crisis, hoping to receive political support for supporting nursing’s

workforce by funding nursing education. My hope was that receiving educational funding will

provide support for current nurses that are working shorthanded every day and leave work

feeling that their patients did not get their undivided attention and the time and attendance they

much desire and deserve.

The program graduate competency achieved in this course was PGC # 5 advocate for

patients and the nursing profession regarding healthcare policy at the local, state, national, and

global levels.

Nursing Capstone NUR 460

This course completed the RN to BSN program to prepare for graduation with a

Baccalaureate degree as well as to become a leader in the field of nursing. I completed practicum

hours with a hospice agency. I enjoyed seeing the process for a home health agency because the

nurses work very independently.

For this course I presented the future of Telemedicine in a group project. We presented

types of telemedicine, benefits, barriers and challenges. Telemedicine is just one example of

lifelong learning and everchanging changes in healthcare.

The program graduate competency achieved in the course is PGC # 9 demonstrate

lifelong learning that empowers personal and professional growth.

Conclusion

My personal journey through the RN to BSN program has provided me with the
PROGRAM GRADUATE COMPETENCY REFLECTION 10

knowledge and skills that I will need in my nursing career and will be helpful in wherever my

journey takes me from here. All nine graduate competencies were addressed, and all my goals

were met during my course and practicum experiences.

I am not sure where my goals will take me next. Currently my long-term care unit is a

dedicated covid-19 unit. Patients I have taken care of many years are sick with the virus, several

have already died. I have moved to a 12-hour schedule, 7 days on and 7 days off, to help ease

the staffing shortage due to illness, self-quarantines and fear. I sleep in a separate room than my

significant other, I strip my scrubs at the door as I run to the shower, I do not sleep well, and

many nights I cry. But in saying all this, I still would not change a thing about my career choice.

I love being a nurse. So, my goal right now is to stay healthy enough to continue to care for my

patients and to gain knowledge to decrease the spread of this evil virus.
PROGRAM GRADUATE COMPETENCY REFLECTION 11

References

Berkowitz, D. B. (2016). The Ebola outbreak: How nurses are helping. Retrieved from

http://nursing.columbia.edu/ebola-outbreak-how-nurses-are-helping

Finkelman, A. W. (2016). Leadership and management for nurses: Core competencies for

quality care. Boston: Pearson

Jumaa M.O., & Rendal H.P.L. (2007). Effective evidence based nursing leadership and efficient

nursing management: work-based learning lessons from a Catholic health service in

Africa. West African Journal of Nursing, 18(2), 114–125. Retrieved from

http://search.ebscohost.com.direct=true&db=c8h&AN=105970921&site=ehost-live

Global Health. (n.d.). Retrieved August 2, 2019, from

https://explorehealthcareers.org/career/public-health/global-health/

Masland, M. C., Lou, C., & Snowden, L. (2010). Use of communication technologies to cost-

effectively increase the availability of interpretation services in healthcare settings.

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992399/

Scholastica, T. C. of S. (2016, March 14). What is nursing informatics? The dynamic specialty

that could catapult your career. Retrieved from http://www.css.edu/the-sentinel-

blog/what-is-nursing-informatics.html

Squires, A. (2018). Strategies for overcoming language barriers in healthcare. Nursing

Management (Springhouse), 49(4), 20–27. doi: 10.1097/01.numa.0000531166.24481.15

Vera, Matt (2014) Virginia Henderson’s Nursing Need Theory. Nurses Labs. Retrieved from:

https://nurseslabs.com/virginia-hendersons-need-theory.php

Wallace, Sonya. (2013). The importance of holistic assessment – A nursing student perspective.

Nuritinga. 24-30.