Running head: RN TO BSN PROGRAM GRADUATE COMPETENCIES 1

RN to BSN Program Graduate Competencies Reflection

Misoon Kim

Delaware Tech Community College

Nursing Capstone NUR 460-6W1

Joshua Barnes

12/01//2020
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RN to BSN Program Graduate Competencies Reflection

As I near the completion of my bachelor’s degree of Science in Nursing (BSN) courses

at Del Tech, I will reflect on my education and the knowledge I have gained in the program. I

begin my reflection by looking at the required program graduate competencies (PGCs) needed to

demonstrate proficiency. In this paper I will discuss nine PGCs and explain how I have achieved

each one throughout the BSN courses.

Advanced Nursing Education

My BSN courses at Del Tech have increased my general knowledge and advanced my

nursing education, thereby promoting my personal and professional development (PGC 1). For

example, thanks to the BIO 130 Pathophysiology class, I gained more understanding about

disease prevention and have been able to educate my patients on ways to promote better personal

health (PGC 7). Patient education is a critical part of a nurse’s job. Some patients and family

members do not know about the nature of a disease and how best to treat it. Those nursing

classes have helped me to explain better to the patients and family members about what benefits

the patient most at that moment and what the treatment care is about.

Also, from the Technical Writing class (ENG 122) I learned how to use different kinds of

writing styles for different situations. I have used this technical writing in my job because as a

nurse I need to communicate with many different people such as doctors, patients, family

members, other health care facilities, and various organizations. For example, almost every time

I work I have to leave progress notes for my patients, which are read by many people. Also, the

documents I type at work are legal papers, so accurate communication is especially important.

Additionally, through the NUR 300 class I learned several different nursing theories. I

believe that nursing theory can provide a solid foundation for nurses to develop their own
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perspectives and philosophies. For example, Jean Watson's Theory of Human Caring encourages

holistic care and developing a transpersonal relationship with each patient (Watson, 2007).

As I progressed through the program, I developed my own nursing philosophy (based on

Jean Watson’s nursing theory) at work when I took care of my elderly patients. I think Watson’s

caring theory is more focused on patient care than any other nursing theory and places more

emphasis on proactive intervention. We nurses take care of patients who are going through

difficult times in their lives, and we are there for patients not only to give medications but also to

provide emotional and spiritual support. Through caring nursing, the patients’ health outcomes

can be maximized because nurses not only take care of patients’ medical problems but also their

emotional needs.

Leadership in Nursing

Throughout the BSN nursing classes, I have also developed other important factors in my

nursing philosophy. One of these is that I strongly believe that all nurses should be leaders and

educators. The nursing leadership class, NUR 400, assisted me in building effective leadership

and communication skills, and I was able to practice effective leadership skills at work (PGC 2).

We cannot avoid conflicts completely among nursing team members at work; however,

throughout the nursing leadership class I learned that we can use strategies to manage conflicts

effectively.

I personally think that collaborating is important because I value equality and harmony in

the workplace. Nurses work with many different people constantly such as patients, their family

members, doctors, and nursing aids. Teamwork and collaboration are expected in nursing, and

effective communication skills are required to be a good leader. Collaboration also allows co-

workers to get what each one wants, so defensiveness is minimized or eliminated. It is important
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for workers to remember that everyone is coming from a different place, and they should not take

everything personally when other people disagree with them.

I have also learned that communication is an important factor in leadership. Moreover,

communication between health care professionals is essential to promote patient safety. For

example, miscommunication during handoffs can lead to medical errors and can harm patients.

Medical errors may also jeopardize the quality of patient care. To reduce miscommunication

between caregivers and to increase health care quality, careful bedside handoffs can be helpful.

Bedside shift reports can enhance communication between leaving and arriving nurses and make

it easier to do patient-centered care. As a result, we can maximize patients’ satisfaction with their

care and reduce medical error.

Evidence-based Nursing Practice

Throughout the nursing research class, I learned the importance of employing skills of

review, analysis, and information literacy to provide evidence-based professional nursing care

(PGC 3). Nursing research is very critical for nurses to facilitate their daily practice effectively

and to get the best outcomes in patient care. Evidence-based practices will provide the nurses

with solid credibility and rationales behind the practice. When nurses fully understand and

perform the best scientific practices, the outcome of the patient care can be maximized, and the

cost of care can be reduced.

During the nursing research class, I wrote a paper discussing urinary incontinence

management with an external catheter. The reason that I chose this topic was because urinary

infection is one of the most prevalent geriatric diagnoses, and many older adults have problems

with urinary incontinence. The current practice we use in our hospital for incontinent patients is

employing a Texas condom catheter for male patients and a PureWick (an external catheter that
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suctions urine continuously) for female patients. I compared the positive and negative impacts of

using current external catheters in incontinent patient care. The research topic helped me to

investigate the best care for incontinent patients and to provide rationales for current nursing

practices.

Information Management Technology

The nursing informatics class, NUR 410, assisted me in incorporating information

management technology to improve patient outcomes (PGC 4). Health informatics can reduce

medical errors, enhance communication, and promote efficiency in patient care. Communication

is an essential part of nursing, and computer networking increases communication between

interdisciplinary health care teams. Through social and professional computer networking, health

care professionals can easily talk to each other and can share knowledge of diseases or patient

diagnoses to make better health care decisions. When knowledge is more readily shared between

providers and patients, the patient outcomes are improved.

In the nursing informatics class I also learned about flow maps and was able to

incorporate my hospital’s skin assessment process into the flow map for better and quicker

patient outcomes. For example, I suggested using telemedicine to our wound, ostomy, and

continence (WOC) nurses. Using E-health technology, the WOC nurses do not need to physically

go to patients’ bedsides to check their skin. Instead, they can examine their skin remotely and can

make treatment orders for the patient. This reduces the delay in care and helps patients to be

treated in a timely manner.

Healthcare Policy

Through the nursing policy class, NUR 420, I learned that nurses should advocate for

their patients and the nursing profession with regard to healthcare policy (PGC 5). Nurses spend
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most of the time with patients and understand their patients’ experiences better than other

professionals who do not see them on a regular basis. Nurses are leaders and advocates for their

patients. It is important for nurses to understand health care policy processes and participate in

influencing policy making in order to improve the health system for everyone.

In the nursing policy class, I wrote a paper about American health care policy and health

care disparities in the U.S. Through the research, I found out that despite spending huge amounts

of money on health care, the United States has more people dying at younger ages than almost all

other high-income countries. Also, low-income minority groups are more likely to be uninsured

or underinsured and to receive lower quality health care in America. In the paper, I suggested that

increasing access to primary care can reduce the need for more expensive forms of care, such as

hospitalizations and emergency department visits. Since taking the class, I have been paying

more attention to health care policies and thinking about ways to get involved and advocate for

ways to make a better health care system for patients and nurses.

Advocacy in Nursing

Along with the nursing policy and leadership class, many BSN nursing classes assisted

me in providing direct patient-centered care through advocacy, interprofessional communication,

collaboration, and delegation (PGC 6). Nurses can make a difference in patient care by voicing

their patient’s concerns. It is critical for nurses to be aware of the needs of patients and to get

involved in making better health care decisions for them. Advocacy is an essential principle in

nursing, and nurses play an important role as advocates for their patients in order to optimize

patient care.

It is also critically important for nurses to address patients’ needs and fears in a timely

manner--especially when they are not capable of speaking for themselves. I work in a geriatric
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unit in a hospital, and patients are frequently confused or disoriented due to mental conditions

such as dementia or delirium. When their biological problems—such as dehydration, hunger,

constipation, or urinary retention—are not attended to, elderly patients often become confused

and agitated. There have been incidents where agitated patients have physically and/or mentally

injured nurses or themselves.

I have been trying to advocate for my vulnerable geriatric patients by assessing their

needs and providing them with proper treatment. In cases like this, I usually check their

medication lists and perform a delirium work-up which includes checking their vital signs and

blood sugar levels, checking for impaction, and performing a bladder scan. After addressing

these types of issues, most patients become more comfortable and cooperative with the nursing

staff.

As nurses, we have great opportunities to advocate for our patients in many ways,

ranging from promoting health care policy changes to correcting a doctor’s order. On a daily

basis I am able to see how the little things that we can easily perform at the bedside can have a

big impact on patient comfort and care. When those basic needs are met, we can deliver our

nursing responsibilities effectively and maximize the patient outcome.

Health Promotion and Disease Prevention

Throughout the practicum experience in NUR 330 class, I have learned and put into

practice so much about integrating health promotion and disease prevention practices in the

hospice community (PGC 7). During the clinical, preventive care and disease management was

practiced by washing hands each time before and after encountering patients and their family

members. Also, I have noticed that some patients and their family members do not know what

exactly hospice care is. It is critical for nurses to inform and educate patients and their family
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members about hospice care or plan of care so that proper treatment can be delivered to patients

in a timely manner. My preceptor was very professional and knowledgeable about hospice care

and gave excellent, compassionate care to her patients.

I have also learned that because hospice care is about taking care of terminally ill

patients, taking care of family members is also equally important. Most of the family members

are sad and surprised by the patient’s sudden health event, and they have a difficult time

adjusting to the patient’s transition to hospice care. Providing support and listening to their

emotions and concerns is critical. Nurses’ professionalism and positive attitudes can lighten the

work atmosphere and make the family members feel supported.

My practicum experience definitely has helped me to understand better about

terminally ill patients and their struggles. I gained an understanding about respecting patients’

dignity and supporting their decisions as being an important part of hospice care. When I take

care of my patients and family members, I can incorporate my practicum experience into my

current practice by continuing to offer education about hospice care to my patients. I will also

keep in mind that delivering compassionate care throughout hospice care can increase patients’

dignity and enhance the quality of life at the time of their life closure.

Ethics in Nursing

The nursing ethics class gave me a chance to think about what my nursing ethics should

be and helped me to frame my own nursing ethics (PGC 8). Nursing ethics and standards will

guide nurses on how to become better leaders and advocates. The standards also provide patient

care guidelines for nurses, so that patients can get their best care. These standards are related to

ethical principles such as beneficence and nonmaleficence for the patients. One of the most

important ethical principles is nonmaleficence--avoiding causing harm to patients (American

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Nurses Association, 2014). Now I feel more comfortable in speaking up when the work

environment is not safe for the patients and the nurses.

Also, from the informatics class I learned that healthcare professionals who are involved

with informatics of patients have ethical and legal responsibilities. Nurses must understand and

follow the code of ethics which explains the principles and values of ethical practices for

professional nurses. The American Nurses Association (ANA) Code of Ethics for Nurses (2015)

addresses problems related to patients’ privacy and confidentiality and is composed of nine

provisions which state nurses’ professional ethical standards. Provision 3, 5, 7, and 8 are

especially relevant to electric health information. These standards can be helpful guidelines when

there are conflicts related to electronic health information data.

Lifelong learning

I believe that nursing is a job that requires lifelong learning. Lifelong learning to me

means continuously seeking education to develop skills and knowledge, not only for the sake of

advancement in my career but also for personal development (PGC 9). There is new information

coming out every day, and some jobs require their employees to keep up with new skills and

information. In nursing, to give the best care to our patients we change policies and practices

frequently based on the most recent research, so it is essential for nurses to stay current in the

nursing practice in order to provide safe patient care and positive patient outcomes.

To specialize my nursing skills and knowledge, I recently got my geriatric certification,

and I will need to renew it every 5 years by maintaining an active nursing license and completing

another 75 hours of education in the certification specialty (American Nurses Credentialing

Center, 2016). I am also planning to stay current in the nursing practice myself by reading

independently and keeping my education from work up to date.

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There are many job opportunities in nursing, and I want to expand my skill set by getting

further education. Even though I have already completed an associate nursing degree and am

nearing the completion of my BSN, I still feel like there is so much information in nursing that I

should know, and I want to learn more about it. I enjoyed studying when I was in nursing school

and want to continue my studies to become a more competent nurse. My long-term professional

goal for now is to become a nurse practitioner so that I will be able to provide more specialized

help to my patients.

Conclusion

On the whole, through my BSN courses at Del Tech, I have met the nine PCG objectives

to graduate with my BSN and have enhanced my general knowledge and expanded my nursing

education. Throughout my nursing career, my nursing education and philosophy will guide my

practice and patient care daily. Also, I am sure that my nursing practice and philosophy will

evolve as I continue to grow in the nursing profession. I will keep challenging myself to improve

my nursing skills and knowledge so that I might provide the best care to my patients.
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References

Alvernia University. (2016). Critical Care: The Role of Nurses as Patient Advocates. Retrieved

from https://online.alvernia.edu/articles/nurses-as-patient-advocates/

American Nurses Association. (2014). The Code of Ethics for Nurses with Interpretive

Statements. Retrieved from

https://homecaremissouri.org/mahc/documents/CodeofEthicswInterpretiveStatements201

41.pdf

American Nurses Credentialing Center. (2016). 2017 CERTIFICATION RENEWAL

REQUIREMENTS. Retrieved from

https://www.nursingworld.org/~4ac164/globalassets/certification/renewals/RenewalRequi

rements

Watson, J. (2007). Watson’s theory of human caring and subjective living experiences: Carative

factors/caritas processes as a disciplinary guide to the professional nursing practice.

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