Running head: PROFESSIONAL DEVELOPMENT PLAN

Professional Development Plan Connie Chrisman Ferris State University

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Abstract This professional development plan discusses the standards of nursing practice in relation to my personal practice. It will serve to review the strengths and weaknesses in my own practice as well as the standards of practice as set forth by the American Nurses Association (ANA). Additionally, I developed five and ten year goals and will evaluated the progress of those goals.

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Professional Development Plan The nursing profession is an evolving profession which requires nurses to remain current with todays evidence based practice standards. Within this professional development plan, I share my practice experience weaknesses and strengths as how they relate to the American Nurses Association (ANA) standards of practice. I have additionally identified five year and ten year goals with timelines based on current projections. Standards of Professional Performance Standard 7: Ethics Within the American Nurses Association Scope and Standards of Practice (ANA, 2010) contains standard 7 which discusses ethics. This section highlights 10 bullet point competencies that serve to educate the registered nurses development of ethical practice. A few of the standards are, Delivers care in a manner that preserves and protects healthcare consumer autonomy, dignity, rights, values, and beliefs and Assists healthcare consumers in self determination and informed decision-making (ANA, 2010, p. 47). I agree with all the ethical standards but have found in my own practice that some providers and nurses have difficulty with informed decision-making (ANA, 2010, p. 47). Years ago when I was an LPN, the OB manager was in a delivery and the baby was crowning. The patient was in so much pain she screamed she was not going to push anymore until she received more pain medication. The manager and the provider explained to the patient she just needed to push a few more times and the baby would be born but the patient refused to push. The manager briefly left the room and came back with a syringe of normal saline and pushed that through the patients IV. The patient stated she felt better and pushed to deliver the baby. When

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the manager told me what had happened she was laughing because she thought she was clever. I do not believe in purposely deceiving patients. This was a weakness in the managers practice. I strongly believe in informed consent. I believe a strength would have been to encourage the patient to push, not deceive her. Patients have every right to know what you are doing to them and what you are giving them. It is situations of this nature that lead to patients and families not trusting health care workers. Standard 8: Education Standard of practice 8 discusses education and the nurses responsibility to remain up to date with practice standards in her/his area of practice. The common phrase in todays health care practice is evidence based practice. This essentially means that all health care workers should be knowledgeable and practicing based on research and practice evidence versus the old adjective thats how weve always done it. Standard 8 contains ten competencies such as; Participates in ongoing education activities related to appropriate knowledge bases and professional issues and Seeks experience that reflect current practice to maintain knowledge, skills, abilities, and judgment in clinical practice or role performance (ANA, 2010, p. 49). My personal area of practice is obstetrics. I have been doing this for 12 years and have not always felt up to date with current practice standards. In 2010, I was offered an opportunity to attend a weeklong conference on breastfeeding. I jumped at the opportunity because I felt I was weak with providing current practice education and support to my patients that were breastfeeding. Up to that time the only education I had received concerning breastfeeding was during orientation from other nurses who were just repeating what they were told many years

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before. I was educating parents to breastfeed based on time not the babys ques as well as other out dated practices. After attending the conference, I had to take a test to become a Certified Lactation Counselor and I passed. I learned far more than I expected and was correct that I was wrongly educating my patients with outdated information. Attending the conference strengthened my practice and now allows me to support breastfeeding patients with current evidence based practice breastfeeding standards. It is also allowing me the opportunity to educate my peers on the benefits of breastfeeding and therefore deleting outdated information from our unit to benefit both mothers and babies. Standard 9: Evidence-Based Practice and Research I believe this standard coincides with standard 8 which discuss education. Standard nine states registered nurses should integrate evidence and research findings into practice. This requires nurses to remain educated on current evidence based practice standards within their area of specialty. There are four competencies in this standard which two of them are Incorporates evidence when initiating changes in nursing practice and Shares personal or third-party research findings with colleagues and peers (ANA, 2010, p. 51). I have been weak in remaining current with evidence-based practice standards in obstetrics until I started back to school for my BSN. It has been with additional education that I have learned the benefits of remaining current and the need to evaluated my current practices and share my findings with my peers. I have turned this weakness into a strength with the new Baby Friendly Hospital initiative that I am working on instituting at my place of employment. This initiative works to promote mother baby bonding immediately after birth, promoting and

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supporting breastfeeding, and educating colleagues, families, and the community to all the evidence-based benefits of breastfeeding. Standard 10: Quality of Practice This standard identifies 16 competencies that registered nurses should use to contribute to quality nursing practices. A few of the standards, Identifying aspects of practices important for quality monitoring and Collecting data to monitor quality and effectiveness of nursing practice (ANA, 2010, p. 52-53). I have been employed at my place of work since 2000. It wasnt until 2009 that I started to hear about quality dashboards, data collection, and auditing of charts. The manager at that time started working with the Michigan Health and Hospital Association (MHA) and their initiative called Keystone. This initiative identified ways of improving labor documentation, physician/patient planned elective inductions prior to 39 weeks gestation, and neonate outcomes. Prior to 2009, I didnt pay attention to the quality departments auditing needs, the data they obtained or what it meant to our department. This weakness on my part was due to a lack of education and self improvement. In 2009, my supervisor asked for volunteers to assist with data collection on every laboring patient that delivered at our hospital. Collecting and reviewing all the charting and all the monitor strips took an extremely long time every month but I volunteered. The reason I volunteered, I thought if we were going to have new practice standards then I would definitely be well versed on them if I was one of the volunteers. In the end, I turned out to be the only volunteer. This worked well for me, it enhanced my yearly performance evaluation, brought me up to date with the new practice standards, my peers were seeking me out for input, and most importantly, my practice was safer for my patients.

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Standard 11: Communication Standard eleven identifies communication and how the registered nurse should communicate in a variety of formats in all areas of practice. I consider two values to be the backbone of nursing which are caring and communication. There are 8 competencies involved in mastering communication standards. Two of them are, Assesses communication format preferences of healthcare consumers, families, and colleagues and Maintains communication with other providers to minimize risks associated with transfers and transition in care delivery (ANA, 2010, p. 54). My early years of practice I was definitely weak with my communication involving patients and their families. I was an LPN for seven years before obtaining my RN. In that role I was not educated to the importance of communication when caring for patients and also felt the RN was more educated to have those critical conversations. After obtaining my RN, I felt more prepared to communicate and educate my patients and families. It has been through experience, continued education, and improved knowledge base that I have strengthened my communication skills. Communication with patients, provider, and peers is at the forefront of nursing care. Due to new government requirements for pay for performance, patients now receive surveys about their hospital experience and one of the topics on the survey is communication with the nurses and providers. The new hospital reimbursement system has required hospital leaders to look at the way clinicians communicate with their patients and families, which in turn has initiated improvements in communications between nurses and their patients. One improvement in communicating with patients is the bedside shift report. This new process requires nurses to

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give change of shift reports in front of the patients to keep the patient involved in their care and allow them to correct any misinformation given between clinicians. This change in culture has been difficult for some nurses who would rather continue with the old process of giving face-toface report behind closed doors without patient involvement. Standard 12: Leadership Leadership is discussed in standard twelve and states, The registered nurse demonstrates leadership in the professional practice setting and the profession (ANA, 2010, p. 55). It comprises of 10 competencies with a few being, Treats colleagues with respect, trust, and dignity and Participates in professional organizations (ANA, 2010, p. 55). A weakness here, I do not belong to any professional organizations. In the past that has been due to a lack of interest and annual membership fees. Currently, it is due to lack of time and annual membership fees. If I were to subscribe to a professional organization it would be AWOHNN which is considered the governing organization for obstetric nurses. I am currently the manager of the unit I work on and I can attest that leadership is extremely difficult. There are times I would like to go back to floor nursing in order to reduce the stress and demands of the leadership role. Prior to management, I always treated my colleagues with respect, trust, and dignity as based on my personal values. I have a strong work ethic and I value and respect authority regardless of age or gender. Since being in this position, I have taken many leadership enhancement classes hosted by my employer. These classes are beneficial for improving communications with subordinates and peers which is important because one of the most difficult tasks of leadership is trying to engage people to new practices. A strength I have is identifying that I need to continue to take leadership classes to continually

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improve my leadership skills. Additionally, I am reading a book called Monday Morning Leadership which discusses how to communicate effectively with people in the work place. Standard 13: Collaboration Standard 13 involves collaboration and states, The registered nurse collaborates with the healthcare consumer, family, and others in the conduct of nursing practice (ANA, 2010, p. 57). The required nursing tasks have drastically increased, calling for nursing to not only complete bedside care tasks but also quality, risk, environment of safety, and many other duties that were not a part of nursing a few years ago. In order for all these additional responsibilities to be completed nursing has started collaborating to ensure all care requirements are met. For instance, it is no longer acceptable to only communicate to the provider that a patient has a history of MRSA. This information must also be communicated to infection control so they can document and ensure that all care measures have been established, acted upon, and education has been given to the patient and family concerning infection control measures outside the hospital and isolation precautions while in the hospital. Historically, nursing collaboration between departments has been a weakness within the facility I work for. However, the facility has made strides to strengthen our collaboration skills, especially over the last year with assisting each other to complete pain management audits in a timely manner, assisting each other to educate staff to new evidence-based practices, and assisting with enhancing security more efficiently to ensure the safety of our patients, their families and our staff. Standard 14: Professional Practice Evaluation Standard 14 includes eight competencies that promote, The registered nurse evaluates her or his own nursing practice in relation to professional practice standards and guidelines,

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relevant statues, rules and regulations (ANA, 2010, p. 59). Two of these are, Engages in selfevaluation of practice on a regular basis, identifying areas of strength as well as areas in which professional growth would be beneficial and Provides the evidence for practice decisions and actions as part of the informal and formal evaluation processes (ANA, 2010, p. 59). A weakness I have with this standard is evaluating my practice based on these practice standards. Until going back to school I didnt know anything about the ANA or the practice standards. I have since written a few papers and completed a power point presentation about the ANA, the Code of Ethics, and the practice standards. Completing these assignments has exponentially increased my understanding and improved my practice standards. This has strengthened my practice and I look forward to my staff becoming educated to these standards and it improving their practice as well. Standard 15: Resource Utilization There are eight standards discussed in standard 15. The ANA identifies this standard as, The registered nurse utilizes appropriate resources to plan and provide nursing services that are safe, effective, and financially responsible (ANA, 2010, p. 60). A couple of the competencies identified are, Identifies the evidence when evaluating resources and Advocates for resources, including technology, that enhance nursing practices (ANA, 2010, p. 60). Resource utilization includes many different aspects, such as: nurse-to-patient ratio, room availability, supply management, and finance management just to name a few. This is an area Im still working on perfecting therefore I consider it a weakness. Since I have become a manager I have had to take an active role in all areas that effect resource utilization. In obstetrics the hourly resource need is related to staffing. Since the beginning of the year the department I

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manage has had staffing shortages due to medical leaves and vacations. I have been advocating my up-line for more staff which has routinely been turned down. I have continued advocating and recently received permission to hire several more staff members and possibly one travel nurse. This has taught me to continue to advocate for everything I feel our patients, staff or unit needs. This experience has strengthened me with the knowledge never to quite advocating. Standard 16: Environmental Health Standard 16 discusses seven competencies. These competencies state, The registered nurse practices in an environmentally safe and healthy manner (ANA, 2010, p. 61). A few of these competencies include, Promotes a practice environment that reduces environmental health risks for workers and healthcare consumers and Assesses the practice environment for factors such as sound, odor, noise, and light that threaten health (ANA, 2010, p. 61). In 2009, I had an opportunity to become a member of the safety committee. This committee met monthly with a common goal to evaluate the hospital environment, unsafe equipment, or unsafe practices. Safety teams would evaluate pre-designated areas and complete reports on our findings. These findings would then be shared with the Safety Officer who would share them with the unit managers who would create a plan to resolve all safety violations. Prior to becoming a member of this team, I had limited knowledge related to the environment of care which identifies it as a weakness. Currently, I consider the environment of care a strength of mine because it has become second nature for me to see something in the environment that could possibly become a safety hazard for a patient, family or staff member.

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Goals Five Year Goal My five year goal would include my returning to school to obtain my BSN. I hope to have it completed by 2014. After that I would like to study to take my International Board Certified Lactation Counselor (IBCLC) test. This is a test that is only given once a year and I understand is very difficult to pass. After that I would like to study to obtain my certification in obstetrics. (Appendix A) Once again, this is a difficult certification to obtain and I would like to achieve it to better my practice and then mentor staff to obtain theirs as well for the overall benefit of our patients. I am currently in a leadership role so my career goal is to become more knowledgeable in all leadership aspects. Ten Year Goal I cant say I have a defined a ten year educational goal. (Appendix B) I hope that I will have an even greater understanding for my current job position if I am still in that role. If not, I hope I have less stress and a better quality of life due to more time with my family. I leave this up to God and the direction he wishes me to take. Evaluation I am convinced I will obtain my BSN within the timeline established (unless unforeseen circumstances arise). I am currently taking 6 credits per semester and have been doing so since fall of 2011. I am already in a leadership role within the healthcare facility I work for. This places me beyond where I ever thought I would be within my professional career. This is why I place so much faith in God. I leave myself open to his guidance.

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As I stated, I have not established any ten year educational goals. I hope to be more settled into my current role if that is still where I am. If not, I hope to be doing something I love that adds value to the nursing profession. I also hope to have quality time off to be with my family as I am very much a family oriented individual. Conclusion Throughout this paper I have shared my experiences as they relate to the standards of practice as set forth by the American Nurses Association (ANA). These practices have been identified as competencies that all nurses should utilize in their daily practice. I have shown my practice strengths and weaknesses as they pertain to the highlighted standards. I have identified five year goals and acknowledged the uncertainty of ten year goals. I expect the standards of practice to assist in strengthening my weaknesses through the attainment of my goal objectives.

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References American Nurses Association [ANA] (2010). Nursing: Scope and Standards of Practice (2nd Ed.). Silver Spring, Maryland: Author. Ferris State University, (n.d.) Ferris Catalog. Retrived from http://catalog.ferris.edu/programs/558/ Retrieved on July 29, 2012.

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Appendix A Five Year Goals Management Position Obtain BSN IBCLC Obstetrics Certification Ten Year Goal Maintain Management Improve Quality of Life Fall 2014 Summer 2016 Summer 2017 Expected Completion Unable to determine Unable to determine Completed Expected Completion Completed Done

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CHECKLIST FOR SUBMITTING PAPERS CHECK DATE, TIME, & INITIAL Yes PROOFREAD FOR: APA ISSUES

1. Page Numbers: Did you number your pages using the automatic functions of your Word program? [p. 230 and example on p. 40)] 2. Running head: Does the Running head: have a small h? Is it on every page? Is it less than 50 spaces total? Is the title of the Running head in all caps? Is it 1/2 from the top of your title page? (Should be a few words from the title of your paper). [p. 229 and example on p. 40] 3. Abstract: Make sure your abstract begins on a new page. Is there a label of Abstract and it is centered at the top of the page? Is it a single paragraph? Is the paragraph flush with the margin without an indentation? Is your abstract a summary of your entire paper? Remember it is not an introduction to your paper. Someone should be able to read the abstract and know what to find in your paper. [p. 25 and example on p. 41] 4. Introduction: Did you repeat the title of your paper on your first page of content? Do not use Introduction as a heading following the title. The first paragraph clearly implies the introduction and no heading is needed. [p. 27 and example on p. 42] 5. Margins: Did you leave 1 on all sides? [p. 229] 6. Double-spacing: Did you double-space throughout? No triple or extra spaces between sections or paragraphs except in special circumstances. This includes the reference page. [p. 229 and example on p. 40-59] 7. Line Length and Alignment: Did you use the flush-left style, and leave the right margin uneven, or ragged? [p. 229] 8. Paragraphs and Indentation: Did you indent the first line of every paragraph? See P. 229 for exceptions. 9. Spacing After Punctuation Marks: Did you space once at the end of separate parts of a reference and initials in a persons name? Do not space after periods in abbreviations. Space twice after punctuation marks at the end of a sentence. [p. 8788] 10. Typeface: Did you use Times Roman 12-point font? [p. 228]

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11. Abbreviation: Did you explain each abbreviation the first time you used it? [p. 106-111] 12. Plagiarism: Cite all sources! If you say something that is not your original idea, it must be cited. You may be citing many timesthis is what you are supposed to be doing! [p. 170] 13. Direct Quote: A direct quote is exact words taken from another. An example with citation would look like this: The variables that impact the etiology and the human response to various disease states will be explored (Bell-Scriber, 2007, p. 1). Please note where the quotation marks are placed, where the final period is placed, no first name of author, and inclusion of page number, etc. Do all direct quotes look like this? [p. 170-172]

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14. Quotes Over 40 Words: Did you make block quotes out of any direct quotes that are 40 words or longer? [p. 170-172] 15. Paraphrase: A paraphrase citation would look like this: Patients respond to illnesses in various ways depending on a number of factors that will be explored (Bell-Scriber, 2007). It may also look like this: Bell-Scriber (2007) found that [p. 171 and multiple examples in text on p. 40-59] For multiple references within the same paragraph see page 174.

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16. Headings: Did you check your headings for proper levels? [p. 62-63]. 17. General Guidelines for References: A. Did you start the References on a new page? [p. 37) B. Did you cut and paste references on your reference page? If so, check to make sure they are in correct APA format. Often they are not and must be adapted. Make sure all fonts are the same. C. Is your reference list double spaced with hanging indents? [p. 37] PROOFREAD FOR GRAMMAR, SPELLING, PUNCTUATION, & STRUCTURE

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18. Did you follow the assignment rubric? Did you make headings that address each

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major section? (Required to point out where you addressed each section.) Yes 19. Watch for run-on or long, cumbersome sentences. Read it out loud without pausing unless punctuation is present. If you become breathless or it doesnt make sense, you need to rephrase or break the sentence into 2 or more smaller sentences. Did you do this? 20. Wordiness: check for the words that, and the. If not necessary, did you omit? 21. Conversational tone: Dont write as if you are talking to someone in a casual way. For example, Well so I couldnt believe nurses did such things! or I was in total shock over that. Did you stay in a formal/professional tone? 22. Avoid contractions. i.e. dont, cant, wont, etc. Did you spell these out? 23. Did you check to make sure there are no hyphens and broken words in the right margin? 24. Do not use etc. or "i.e." in formal writing unless in parenthesis. Did you check for improper use of etc. & i.e.? 25. Stay in subject agreement. When referring to 1 nurse, dont refer to the nurse as they or them. Also, in referring to a human, dont refer to the person as that, but rather who. For example: The nurse that gave the injection. Should be The nurse who gave the injection Did you check for subject agreement? 26. Dont refer to us, we, our, within the paperthis is not about you and me. Be clear in identifying. For example dont say Our profession uses empirical data to support . . Instead say The nursing profession uses empirical data.. 27. Did you check your sentences to make sure you did not end them with a preposition? For example, I witnessed activities that I was not happy with. Instead, I witnessed activities with which I was not happy. 28. Did you run a Spellcheck? Did you proofread in addition to running the Spellcheck? 29. Did you have other people read your paper? Did they find any areas confusing? 30. Did you include a summary or conclusion heading and section to wrap up your paper? 31. Does your paper have sentence fragments? Do you have complete sentences?

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32. Did you check apostrophes for correct possessive use. Dont use apostrophes unless it is showing possession and then be sure it is in the correct location. The exception is with the word it. Its = it is. It is possessive.

Signing below indicates you have proofread your paper for the errors in the checklist: __Connie Chrisman_______________________________________DATE:__7/29/2012______