Appendix A

PRACTICE SUMMARY PAPER

Nurs 403- Transition to Baccalaureate Nursing Practice

Purpose of Assignment
The purpose of this paper is to guide you through a process of self-reflection and self-evaluation
to discover the scope of your personal and professional development while enrolled in the
RN>BSN nursing program at Old Dominion University.

The assignment is designed to help you prepare for your Portfolio. The Practice Summary Paper
is designed to demonstrate the attainment of the 8 core competencies in general. The Portfolio
demonstrates the achievement of the Core Competencies through the attainment of specific
elements [the bullets] within the Core Competencies.

Student Approach to Assignment

I approached this assignment by reflecting on my time in the RN-BSN program. I assessed how
I completed each assignment and what I learned. I gathered all of the information about how I
fulfilled the 8 core competencies while enrolled in the nursing program. I then typed up a paper
explaining how I fulfilled each competency with specific examples.

Reason for Inclusion

I included this assignment in the portfolio because it summarizes how I fulfilled the 8 core
competencies during my time enrolled in the RN-BSN program. It also helped me to critically
think and enhanced my skills at writing a reflection.

Critical Thinking

 Uses decision-making skills in making clinical or professional judgments.

I had a post operation patient who had a fever of 102.4°F. I assessed the surgical site and found
no signs of infection. I knew from what I learned in nursing school and through my experience
that Foley catheters increase a patient’s risk of urinary tract infections. Based on the assessment
of the Foley, urine characteristics, and the 102.4°F fever, I was almost certain the patient had a
urinary tract infection. I notified the nurse practitioner who ordered a urine analysis. Once the
urine analysis confirmed the patient had a urinary tract infection, the nurse practitioner ordered
antibiotics. I administered the prescribed antibiotics for the infection.

 Evaluates nursing care outcomes through the acquisition of data and the questioning of
inconsistencies.
Patients who have subarachnoid hemorrhages have frequent headaches from vasospasms due to
blood irritating brain tissue and the arterial walls narrowing. Verapamil is prescribed to be taken
orally to reduce vasospasms by relaxing the arteries. Depending on the severity of the bleed,
some patients may require intraarterial verapamil to reduce the vasospasms.
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Nursing Practice

 Applies appropriate knowledge of major health problems to guide nursing practice.

I had a patient who had a transsphenoidal resection of a pituitary adenoma who was putting out
over 300 ml of urine an hour. I notified the endocrinologists team who ordered vasopressin. I
knew this medication is used for diabetes insipidus. The patient had diabetes insipidus because
of the transsphenoidal resection. The pituitary gland stores antidiuretic hormone until its ready
to be used. Treating the diabetes insipidus will reduce the urine output. This will help prevent
dehydration in the patient.

 Demonstrates an awareness of complementary modalities and their usefulness in

promoting health.
I educate patients on nonpharmacological techniques for pain management. These techniques
include distraction. They include changing positions while in bed, watching television, using ice
and hot packs.

Communication

 Accesses and utilizes data and information from a wide range of sources to enhance
patient and professional communication.
I assessed the trend of cerebral spinal fluid output in the external ventricular drain and explained
to the patient I was paging the neurosurgeon because the drain was not dripping when lowered. I
paged the team using the text messaging system and explained to the neurosurgeon the situation.
The neurosurgeon called back, and I explained to him on the work cellphone the trend over the
last shift.

Teaching

 Provides teaching to patients and/or professionals about healthcare procedures and

technologies in preparation for and following nursing or medical interventions.
I provided education to a patient about why they were getting an MRI. I also provided education
related to the MRI screening form and explained to the patient about the need to remove all
metal. Before the MRI I explained to the patient that the midazolam helps keep them relaxed for
the MRI.

 Provides relevant and sensitive health education information and counseling to patients
and families.
I educated a patient on the reason they had an infection was because they refused their
medications the previous night when I had them. I explained to them that the antibiotics were
used prophylactically to help prevent an infection. I explained to them the purposes of the other
medications which they refused that night as well.

 Uses informatics to enhance one’s own knowledge base to support teaching.

I used Micromedex to look up information about mirtazapine before administering it to a patient.
I then educated the patient on the common uses for mirtazapine and the drug classification.
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Using the online drug database enhanced my knowledge about the medication as well as provide
teaching to the patient.

Research

 Applies research-based knowledge from the arts, humanities, and sciences to

complement nursing practice.
I educated a patient and their family member on ways to reduce delirium. Turning off the
patient’s lights, using a facemask, and earplugs fulfills the arts domain. The use of music to help
stimulate the patient during the day covers the art. The humanities area is addressed by
educating family members about delirium and advocating for someone to stay with the patient.
Pharmacological interventions such as using melatonin to help the patient sleep at night covers
the science domain.

Leadership

 Delegates and supervises the nursing care given by others while retaining accountability
for the quality of care provided.
I delegated patients’ baths to nurse care partners. Once they report back to me that the bath was
complete, I check on my patient and make sure their room is clean and organized. I make sure
the bed is in the lowest position and the monitors are hooked up and on.

Professionalism

 Demonstrates accountability for one’s own professional practice as well as limits to

one’s own scope of practice.
I had a patient who requested pain medication. The patient’s order was for a partial dose. The
patient asked me for the rest of the hydromorphone. I explained to the patient that I would not
give them the rest of the medication and I must follow the doctor’s order. I wasted the leftover
medication. This is how I maintain accountability for my professional practice and following the
doctor’s orders is an example of limits to my own scope of practice.

Culture

 Integrates cultural knowledge of cultural diversity in performing nursing interventions.

I provided care to a Muslim patient and I asked for permission to touch the patient before
completing the patient assessment. I remember from my Cultural Group Exploration Table
assignment in my Nursing 401 class that part of the Muslim culture is a person must ask for
permission before touching someone of the opposite sex. When I had this female patient, I
respected their culture by asking her if I can complete and assessment. I explained to her that it
would involve touching her. She allowed me to complete my assessment. If this patient were
not alone, I would have asked for permission from the head of the family to respect the Muslim
culture.