5982103 - Capstone Essay Training Nursing - 17th Aug

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Maseno University *

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Nursing

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Nov 24, 2024

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Personal and Professional Development 1 PERSONAL AND PROFESSIONAL DEVELOPMENT by (Name) Course Tutor University City and State Date

Personal and Professional Development 2 Introduction In this reflective essay, I will reflect on my transformative journey from a high school graduate to a nursing associate over the past two years. The core of my growth lies in three essential dimensions: being an accountable professional, promoting health and preventing ill health, and enhancing safety and quality of care. Over the course of my two-year journey as a Training Nursing Associate (TNA), I have had the privilege of working across diverse healthcare settings, each contributing to the evolution of my skills and knowledge. My transformation from a novice to a proficient nursing associate is a testament to the impact of my comprehensive training and the valuable experiences gained during my placements in various wards. From my initial steps into this course, driven by an unwavering desire to positively impact lives through healthcare, I embarked on a path aligned with my passion and interests. Choosing to become a nursing associate was a deliberate choice, rooted in my aspiration to make a tangible difference in patient care. The allure of working closely with patients, being involved in their daily care routines, and administering vital medical interventions resonated deeply with me. The prospect of building close bonds with patients and families, while honing my clinical skills, fueled my motivation. My journey through the different units, such as the fast-paced Emergency Unit and the nurturing Children's Unit, has been a remarkable voyage of growth. In these distinct environments, I encountered diverse challenges and opportunities that enriched my practical capabilities and deepened my understanding of patient-centered care. The hands-on exposure to

Personal and Professional Development 3 emergency scenarios and the intricacies of pediatric care has molded me into a well-rounded nursing associate. Throughout this transformative experience, various course modules have played a pivotal role in shaping my knowledge and enhancing my practice skills. Notably, the Medicine Management module equipped me with a comprehensive understanding of administering medications, risk assessment, and drug calculations. This knowledge has been invaluable in ensuring patient safety and improving the quality of care. The synergy between theoretical learning and practical application, as facilitated by the different course modules and my placements, has been instrumental in transforming me into a confident and proficient Training Nursing Associate. From the outset, I embraced the nursing profession, even with limited experience. This essay delves into my multifaceted journey of growth, from embracing accountability to promoting health and elevating care quality. Being an Accountable Professional As a second-year nursing associate with a growing experience in perioperative care and considerable time spent in theatres, I have consistently demonstrated a strong commitment to accountability, professionalism, and patient care. My journey has been shaped by various scenarios that underscore the significance of being an accountable professional. These experiences, along with my academic achievements, competences, and valuable academic feedback, have contributed to my understanding of the responsibilities and dedication required to excel in perioperative nursing. Throughout my placement in the theatres, I have received positive feedback from my practice assessors, who have highlighted several key competencies that underscore my

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Personal and Professional Development 4 dedication to being an accountable professional in the theatre setting. Various assessors commended my effective communication skills, which have enabled me to collaborate seamlessly with the surgical team, ensuring open and transparent communication for better patient outcomes and overall efficiency (Naughton, 2018). Additionally, my meticulous attention to detail in maintaining a safe environment for patients and staff has been noted, as I have consistently adhered to infection control protocols and the proper handling of surgical instruments, minimizing the risk of infections and promoting a safe surgical environment (Gaines et al., 2017). One of the scenarios that exemplifies my commitment to being an accountable professional is when I assisted a diabetic patient, whom I will refer to as "Patient X," preparing for a future below-the-knee amputation surgery. Patient X had been struggling with type 2 diabetes for five years and had not effectively managed her condition, leading to a diabetic foot ulcer. The doctor recommended the surgical amputation, and Patient X was understandably emotional about the situation. In this scenario, my competences in maintaining a patient-centric approach were evident in the way I provided care to Patient X. Adhering to the principles of the Nursing and Midwifery Council standards, I treated her with compassion, dignity, and respect (Nursing and Midwifery Council, 2018). I took the time to address her concerns, provide reassurance and support, and educate her on post-surgery wound care and diabetes management. Patient X thanked me for explaining the surgery and providing information that could help improve her management of diabetes. In addition to my practice experiences, I have actively engaged in academic work and continuous professional development, which aligns with my competences in upholding ethical principles and the importance of continuous learning (Nash et al., 2017). One notable example is

Personal and Professional Development 5 a reflective essay I wrote on providing care and support to a stroke patient. This experience further enhanced my competences in effective communication and patient education, as I had to adapt my communication style to the patient's condition and incorporate non-verbal communication to improve our interaction. Promoting Health and Preventing Ill Health Our Role as TNAs As Training Nursing Associates (TNAs), we serve as a vital link between Healthcare Support Workers and Registered Nurses, collaboratively delivering hands-on, individualized care as integral members of the nursing team. We approach patient assessments methodically to ensure holistic care ( Kessler et al., 2020). We start by introducing ourselves and wearing the necessary protective gear. We meticulously measure vital signs—temperature, pulse, respiratory rate, blood pressure, and oxygen levels. Our hands-on examination encompasses appearance, consciousness, and pain evaluation. We discuss dietary preferences, elimination patterns, and assist with mobility and hygiene. Engaging in conversations, we assess emotional well-being and provide comfort. Thorough documentation captures our observations, aiding seamless communication within the healthcare team. As a nursing associate, I am deeply committed to promoting health and preventing illness using a patient-centered approach. Placing the patient at the core of their healthcare journey, respecting their values, beliefs, and preferences, and involving them in their care decisions are fundamental aspects of this approach ( Feo et al., 2018) . Health literacy is essential in my platform. I recognize the significance of providing patients with accurate health information, so that they can make well informed decisions about their well-being (Parnell et al., 2019). For

Personal and Professional Development 6 example, during my placement at Kenneth Ward, I undertook the assessment of a diabetic patient who had undergone a foot amputation due to complications arising from poorly managed blood glucose levels. As a TNA, my role encompassed a range of techniques and skills to support the patient's well-being and improve her condition. I utilized my training in vital signs monitoring, a skill I acquired from module NU4004 and the OSCA assessments, to regularly measure and record the patient's blood pressure, heart rate, respiratory rate, and temperature. This provided valuable insights into her overall health status and guided our approach to care. As TNAs, our role in vital signs monitoring is pivotal, as we draw upon training and assessments to consistently measure and document essential indicators (Wilson and Jones, 2022). Observation skills played a key role as well. By closely observing the patient's physical condition, behavior, and mental state, I could detect changes or signs of discomfort that required attention. These skills have been honed through module NU5002 and were integral in ensuring timely interventions. As TNAs, our inherent practice of keenly observing the patient's physical condition, behavior, and mental state is crucial for promptly identifying emerging changes or signs of discomfort that necessitate timely interventions ( Perry et al. 2019, p.135) . Engaging the patient interview, I gathered essential information about her health history, symptoms, and concerns. This technique helped me tailor our care approach to her individual needs and circumstances. Conducting patient interviews serves as a vital tool for TNAs to comprehensively assess a patient's health and well-being ( Molina-Mula and Gallo-Estrada, 2020) . This technique enables us to actively engage with patients, gaining firsthand insights into their health history, current symptoms, and individual concerns. By asking pertinent questions

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Personal and Professional Development 7 and actively listening, we gather valuable information that forms the foundation of a personalized care plan. As our interaction with the patient proceeded, I provided her with education about wound dressing changes post-surgery, dietary improvements, and medication management. This educational role was informed by the principles of the Nursing and Midwifery Council (NMC) Code (2018) and my commitment to delivering patient-centered care. One of the crucial aspects of patient support was assisting with personal care. This not only ensured her physical comfort but also allowed me to observe her skin integrity, mobility, and any signs of pain or discomfort. To facilitate coordinated care, I communicated closely with other healthcare professionals ( Elliott et al., 2018). This included referring the patient to the doctor when her questions required specialized knowledge and collaborating with the medical team to ensure seamless continuity of care. Our Role in Administration of Medicine As TNAs, we acquire prescription and medication information through a variety of sources. These include patient medical records, direct communication with prescribers, consultations with pharmacists, thorough examination of medication labels, references to drug guidelines and clinical resources, utilization of electronic health records, and the application of knowledge gained from my nursing education ( Zeier et al., 2018) . Additionally, we seek guidance from supervising RNs and NPs, participate in in-service training sessions, and engage in continuous education to ensure that my medication administration practices are safe, accurate, and up-to-date. In the case of patient X, I thoroughly reviewed the prescribed medications to ensure accuracy and adherence to safety protocols. My approach involved confirming if there

Personal and Professional Development 8 were any changes to the medication prescription or if the same regimen was to be continued. This practice was essential to guarantee that the patient received the correct dosage and proper administration. My ability to perform this task was honed through insights from module NU4004, as evidenced on my portfolio page 56 (page 56 is an assignment example that I have connected to this paper, client wanted us to provide practice example along with page numbers), enabling me to contribute effectively to the patient's ongoing recovery process. Improving Safety and Quality of Care As I conclude my second year as a Nursing Associate, I reflect on the progress I have made in improving the safety and quality of care provided to patients in the surgical setting. Over the past year, I have experienced significant growth and development, enhancing my skills and knowledge to become a more competent and accountable professional. This significant growth has improved the quality of safety and care that I provide to patients. Assessment and Patient Management As TNAs, our pivotal role in Assessment and Patient Management involves applying theoretical knowledge to conduct comprehensive assessments, gather crucial patient data, and collaboratively formulate tailored care plans, all guided by the principles of patient-centered care and evidence-based practice ( Dineen-Griffin et al., 2019). Embarking on my journey as a TNA, I eagerly embraced the opportunity to apply my theoretical knowledge in a real-world healthcare setting. Similar to my experience with the diabetic patient, I encountered a hypertension patient, Laurie, during my placement at Cambridge Ward. This patient's high blood pressure posed significant health risks, emphasizing the importance of health promotion and monitoring care.

Personal and Professional Development 9 Laurie was grappling with stroke-induced communication barriers and oxygen deprivation. Guided by the NMC Code of Conduct and SOAP framework, I delved into the assessment process, as evidenced on page 52 of my portfolio ( During assessment, I collected vital signs including temperature, heart rate, blood pressure, respiratory rate, pulse oximetry, and Glasgow coma scale (GCS). Stable vital signs were documented in the electronic record) . Drawing inspiration from my Anatomy and Physiology foundation gained through module NU5001, I meticulously collected subjective information from Laurie's family and objectively examined her physical state, analyzing the bluish discoloration as a vital clue (Lotfi et al., 2019) . Roles of TNA on Hypertension Patients 1. Blood Pressure Monitoring: As TNAs, we use appropriate equipment to accurately measure blood pressure, recording the readings, and promptly reporting any significant changes to the healthcare team. 2. Medication Adherence Support: We educate and remind hypertension patients about their prescribed medications, ensuring they understand the importance of adherence to the treatment plan. This contributes to the effective management of blood pressure levels. 3. Lifestyle Counseling: We provide guidance to hypertension patients on adopting healthy lifestyle practices. This includes advising on dietary modifications, exercise routines, stress management techniques, and smoking cessation strategies to promote overall cardiovascular health. Skills and Knowledge Applied on the Patient To proceed with further assessment and patient care on Laury, I applied the skills and techniques below:

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Personal and Professional Development 10 Subjective Data Collection : With unwavering determination, I set out to gather a comprehensive understanding of Laurie's condition. I turned to Laurie's family, utilizing the cornerstone of communication to elicit their insights. These interactions, as guided by my communication skills training, unveiled Laurie's struggle with communication barriers and the underlying issue of oxygen deprivation. Objective Assessment : Armed with a wealth of subjective information, I ventured into of objective assessment. Drawing inspiration from the clinical assessment module NU4004, I meticulously examined Laurie's physical state. I observed the bluish discoloration that manifested in her head and upper body, a telltale sign of oxygen deficiency ( Lotfi et al., 2019). Applying the skills acquired through the module, I skillfully conducted vital sign assessments, noting irregularities that formed a crucial part of Laurie's clinical picture. Integration and Analysis : The convergence of subjective and objective data was a pivotal moment in Laurie's care journey, according to NU4004's clinical assessment module, as I interpreted the data in a holistic manner. I recognized the urgency of addressing Laurie's oxygen deprivation and communication barriers. This process involved the SOAP framework, culminating in a comprehensive assessment that paved the way for targeted intervention ( Glick et al., 2021). Tailored Care Plan : Laurie's case underscored the importance of personalized care plans, a cornerstone of patient-centered practice. With insights garnered from Laurie's unique needs, I collaborated with the healthcare team to design a plan that transcended traditional approaches. I ventured beyond the confines of textbook knowledge, drawing from the intricate interplay of theories and practical insights. Laurie's tailored care plan became a testament to the

Personal and Professional Development 11 transformative power of patient assessment, further solidifying the invaluable lessons learned from my journey. Medicine Management In of medicine management, nurse associates play a crucial role in ensuring safe and effective administration of medications ( Schroeder & Lorenz, 2018). Drawing from my training and education, particularly from module NU5002, I seamlessly integrated classroom knowledge with real-world application while overseeing Laurie's medication regimen. As part of this responsibility, I meticulously verified Laurie's prescribed medications, monitored for any changes in her prescription, and collaborated with the registered nurse to provide comprehensive support. Adhering to established Standard Operating Procedures (SOPs), including proper hand hygiene, infection control, and medical management protocol, along with following the NMC Code of Conduct (2018) standards related to effective communication (Standard 1), infection prevention and control (Standard 15), and administering medicines safely (Standard 12). I ensured that Laurie's meals were low in sodium to regulate her blood pressure, avoiding salt. This approach contributed to maintaining optimal fluid and nutritional balance, thereby enhancing Laurie's overall treatment and care. These steps and techniques collectively exemplify how I have honed my skills to deliver meticulous and high-quality patient care, ensuring their well-being and fostering a culture of safety within the healthcare setting. Laurie's case highlighted the significance of accurate medical management in her overall recovery ( World Health Organization, 2021). Which skills and knowledge did you use? (I’ve stated above that I applied Sops and NMC guidelines)

Personal and Professional Development 12 How did you give Laurie medication? How many times a day etc? (google) (no medications were administered to the patient, there was only medical management through provision of low salt food, I’ve provided the information above) Where did the medications come from? (there were no medications, I applied SOPs and NMC Informed Consent As TNAs, we hold a pivotal role in ensuring the ethical practice of informed consent, which is essential for upholding patient autonomy and ethical healthcare standards ( McDermott-Levy et al., 2018) . Drawing from the principles outlined in the NMC guidelines and informed module NU4005, I seamlessly integrated the concept of informed consent into both patient cases. By obtaining informed consent in alignment with established protocols, I demonstrated a commitment to transparent communication, mutual respect, and collaborative decision-making, fostering a patient-centered approach that upholds their rights and well-being. As TNAs, we practice informed consent for the following reasons: Respect for Autonomy: Informed consent empowers patients to actively participate in their healthcare decisions, respecting their autonomy and personal values. As TNAs, we prioritize engaging patients in the decision-making process, ensuring they fully understand the risks, benefits, and alternatives before consenting to a procedure or treatment. Transparency and Trust: Obtaining informed consent establishes a foundation of transparency and trust between healthcare providers and patients. By openly discussing the details of a procedure or treatment, patients can make informed choices based on accurate information, fostering a trusting relationship that enhances the overall healthcare experience.

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Personal and Professional Development 13 Ethical and Legal Obligation: Informed consent is not only an ethical imperative but also a legal requirement. As TNAs, we uphold ethical healthcare practices by ensuring that patients have the necessary information to make decisions about their care. This commitment to ethical standards safeguards patients' rights and protects healthcare professionals from potential legal implications. Schizophrenic Patient Management Roles of TNA In the domain of Schizophrenic Patient Management, TNAs undertake a crucial responsibility in delivering patient-centric and empathetic care to individuals navigating this intricate mental health condition ( Myerholtz et al., 2023). This duty propelled me to delve into the distinctive challenges associated with caring for schizophrenic patients, employing techniques and skills acquired from the Oscar assessment module. Laurie's case served as a transformative encounter, deepening my comprehension of the significance of comprehensive support. Through purposeful communication and tailored interventions, I directly observed the profound impact of empathetic approaches on the enhancement of well-being for individuals with schizophrenia. Procedure of Assessing Schizophrenic Patients by TNAs 1. We initiate the assessment by establishing a rapport with the schizophrenic patient, creating a comfortable atmosphere for open communication. 2. We carefully observe the patient's behavior, speech, and thought patterns, aiming to identify any signs of disorganized thinking, hallucinations, or delusions.

Personal and Professional Development 14 3. We also inquire about the patient's auditory and visual experiences, gaining insights into their sensory perceptions and understanding how these affect their well-being. 4. TNAs also delve into the patient's thought processes, analyzing the coherence and logical flow of their ideas to recognize any cognitive distortions or disorganized thinking. 5. We further explore the patient's emotional state and mood variations, discerning between appropriate and inappropriate emotional expressions. 6. Collaboratively, the patient and TNAs assess potential risks and safety concerns, working together to establish strategies to ensure their well-being. 7. Through open dialogue, we collaborate with the patient to define achievable treatment goals and formulate a plan tailored to their unique needs. 8. We share our assessment findings and observations with the healthcare team, contributing to the development of a comprehensive care plan that addresses the patient's holistic needs. Specific Techniques TNAs use to support patients (Module Oscar Assessment skills) 1. Active Listening and Empathetic Communication: Employing active listening techniques and empathetic communication creates a safe space for patients to express themselves, aiding in understanding their experiences and needs. 2. Reality Testing: Engaging in reality testing helps patients differentiate between delusions and reality, facilitating rational thinking and informed decision-making.

Personal and Professional Development 15 3. Crisis Intervention Strategies: Equipping patients with coping skills and crisis intervention techniques empowers them to manage distressing symptoms effectively and reduce potential harm. Future Plans As a nursing associate student, my future plan is to continue my education and training to become a skilled and compassionate healthcare professional. I aim to complete my studies successfully and obtain the necessary certifications and licenses to practice as a nursing associate. I will seek opportunities to gain practical experience in various healthcare settings to further develop my clinical skills and knowledge. My ultimate goal is to work alongside registered nurses and other healthcare professionals, providing high-quality care to patients, improving safety measures, and contributing to the overall well-being of the community. As discussed by Berkhout et al. (2018), continuous learning is essential in the dynamic healthcare environment, and I intend to stay up-to-date with the latest research, technologies, and best practices. Continuous learning and professional growth will be key aspects of my journey to becoming a proficient and accountable nursing associate. Summary As a dedicated nursing associate, I have learned the importance of a safety culture in healthcare, managing risks, and learning from occurrences to enhance patient safety and the quality of care. My training has equipped me with skills in patient observation, vital signs monitoring, and medication management, allowing me to promptly identify and address deteriorating conditions and medication errors, as outlined by the NEWS guidelines. Infection prevention and control measures, as well as effective pain management, are also integral to my

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Personal and Professional Development 16 practice. Clear and precise communication with healthcare professionals, patients, and families ensures safe and efficient care delivery. Embracing clinical governance practices contributes to continuous improvement and the maintenance of high standards in patient care. Reference List . Berkhout, J. J., Helmich, E., Teunissen, P. W., van der Vleuten, C. P. and Jaarsma, A. D. C. (2018). Context matters when striving to promote active and lifelong learning in medical education. Medical education, 52(1), 34-44. https://doi.org/10.1111/medu.13463 Dineen-Griffin, S., Garcia-Cardenas, V., Williams, K., & Benrimoj, S. I. (2019). Helping patients help themselves: a systematic review of self-management support strategies in primary health care practice. PloS one , 14 (8), e0220116. https://doi.org/10.1371/journal.pone.0220116

Personal and Professional Development 17 Elliott, J., Stolee, P., Boscart, V., Giangregorio, L. and Heckman, G. (2018). Coordinating care for older adults in primary care settings: understanding the current context. BMC family practice , 19 (1), 1-10. https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875- 018-0821-7 Feo, R., Kitson, A. and Conroy, T. (2018). How fundamental aspects of nursing care are defined in the literature: A scoping review. Journal of clinical nursing , 27 (11-12), 2189-2229. https://doi.org/10.1111/jocn.14313 Gaines, S., Luo, J. N., Gilbert, J., Zaborina, O. and Alverdy, J. C. (2017). Optimum operating room environment for the prevention of surgical site infections. Surgical infections , 18 (4), 503-507. https://doi.org/10.1089/sur.2017.020 Glick, M., Greenberg, M. S., Lockhart, P. B., & Challacombe, S. J. (2021). Introduction to oral medicine and oral diagnosis: patient evaluation. Burket's Oral Medicine , 1-18. https://doi.org/10.1002/9781119597797.ch1 Kessler, I., Steils, N., Samsi, K., Moriarty, J., Harris, J., Bramley, S. and Manthorpe, J. (2020). Evaluating the introduction of the nursing associate role in health and social care: Interim report. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London. Lotfi, M., Zamanzadeh, V., Valizadeh, L., & Khajehgoodari, M. (2019). Assessment of nurse– patient communication and patient satisfaction from nursing care. Nursing open , 6 (3), 1189-1196. https://doi.org/10.1002/nop2.316

Personal and Professional Development 18 McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical principles and guidelines of global health nursing practice. Nursing Outlook , 66 (5), 473-481. https://doi.org/10.1016/j.outlook.2018.06.013 Molina-Mula, J. and Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International journal of environmental research and public health , 17 (3), 835. https://doi.org/10.3390/ijerph17030835 Myerholtz, L., Sowa, N. A., & Lombardi, B. (2023). Integrated Behavioral Health Care. In Chronic Illness Care: Principles and Practice (pp. 431-445). Cham: Springer International Publishing. https://link.springer.com/chapter/10.1007/978-3-031-29171- 5_33 Nash, R., Thompson, W., Stupans, I., Lau, E. T., Santos, J. M. S., Brown, N. and Chalmers, L. (2017). CPD aligned to competency standards to support quality practice. Pharmacy , 5 (1), 12. https://doi.org/10.3390/pharmacy5010012 Naughton, C. A. (2018). Patient-centered communication. Pharmacy , 6 (1), 18. https://doi.org/10.3390/pharmacy6010018 Nursing and Midwifery Council. (2018). Standards of proficiency for nursing associates. pp. 1- 29. Parnell, T. A., Stichler, J. F., Barton, A. J., Loan, L. A., Boyle, D. K., & Allen, P. E. (2019). A concept analysis of health literacy. In Nursing forum (Vol. 54, No. 3, pp. 315-327). https://doi.org/10.1111/nuf.12331

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Personal and Professional Development 19 Perry, A. G. G., Potter, P. A. and Ostendorf, W. (2019). Nursing interventions & clinical skills E- book . Elsevier Health Sciences. https://books.google.co.ke/books? hl=en&lr=&id=kySDDwAAQBAJ&oi=fnd&pg=PP1&dq=Nurse+Associates+inherent+p ractice+of+keenly+observing+the+patient%27s+physical+condition,+behavior, +and+mental+state+is+crucial+for+promptly+identifying+emerging+changes+or+signs+ of+discomfort+that+necessitate+timely+interventions.&ots=I8U9PGLJXU&sig=6D0ks3 Te2QFIE101Bhxz3wUqfM0&redir_esc=y#v=onepage&q&f=false Schroeder, K., & Lorenz, K. (2018). Nursing and the future of palliative care. Asia-Pacific journal of oncology nursing , 5 (1), 4-8. https://doi.org/10.4103/apjon.apjon_43_17 Wilson, S. and Jones, S. (2022). The role of the trainee nursing associate in vital signs monitoring. Nursing Standard , 36(45), 52-57. https://10.7748/ns.36.45.52.e135 World Health Organization. (2021). Classification and minimum standards for emergency medical teams. https://apps.who.int/iris/bitstream/handle/10665/341857/9789240029330- eng.pdf?sequence=1 Zeier, Z., Carpenter, L. L., Kalin, N. H., Rodriguez, C. I., McDonald, W. M., Widge, A. S., & Nemeroff, C. B. (2018). Clinical implementation of pharmacogenetic decision support tools for antidepressant drug prescribing. American Journal of Psychiatry , 175 (9), 873- 886. https://doi.org/10.1176/appi.ajp.2018.17111282

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5982103 - Capstone Essay Training Nursing - 17th Aug

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