Objective 2: Provide evidence-based clinically competent care.
One of the first things that impressed me about Nursing School was that
all the courses that I had completed as prerequisites at Highline
Community College were fully employed in my first semester at PLU. Chemistry,
biology,
anatomy and physiology, developmental psychology, English, and math
were put to use immediately upon entry into Nursing School. The process
of
building upon a foundation that is already laid is how I see my progression
of providing clinically competent care. What felt like competence
in the beginning was in reality a very fragile entity, a foundation poured
but not yet cured. Now, as I come to the end of my BSN, I see a foundation
with walls rising on top of it. Some parts of the walls are already
strong
but other parts are barely started. I also see that while the foundation
is there, I will always be working on the structure, firming it up,
adding more layers, working around the obstacles.
The ability to provide evidence-based clinically competent care is
a learned process that continually promotes upward growth
and reinforces what is already known. It is not something to be attained
but rather
an attitude or belief that practice moves one closer to proficiency.
Patricia Benner, in her book From Novice to Expert: Excellence
and Power in Clinical Nursing Practice, lists 31 different nursing competencies
in seven domains by which to measure performance along a
continuum
of
nursing proficiency from novice to expert.
I am in the beginning stages of meeting this objective. When I review
my clinical evaluations and reflect on how much I have learned
I am impressed. I remember when taking a blood pressure made my blood
pressure
sky rocket
and my hands tremble. Now it is almost second nature. On
the other hand I am very aware of how much I do not know. I feel very
inadequate
at
this point in my nursing career because I have such a tenuous
grip on the basics of care. It takes so much of my concentration to make
it
through
the day that I hardly notice the bigger picture of total
care for my patients within the scope of their lives. I live for the
day when
I will
be able see the effect that my care has in relationship to
the life that the client lives. I am becoming more adept at coordinating
my care
with
the entire healthcare team. I have concentrated especially
on coordinating my care with the LPNs and the NACs. I have also begun
interacting
with the doctors and the specialty consults such as PT, OT,
hospice, nuclear
medicine, pharmacy and the social workers. I am not yet comfortable
in most of these conversations but practice makes things
go a little better
each time.
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R E L E V A N T W O R K S A M P L E S
1) Clinical Evaluations: These are my clinical
evaluations throughout Nursing School. They show that I consistently
performed at or above expected levels in all areas of care.
 Nurs 220 Evaluation
Nurs 340 Evaluation
Nurs 350 Evaluation
Nurs 370 Evaluation
Nurs 380 Evaluation
Nurs 440 Evaluation
Nurs 499 Evaluation
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