Author: mmammone

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Attaining and Protecting Your Professional Nursing

I plan to become licensed in the state of Massachusetts. Currently, Massachusetts is pending to become a nurse licensure compact state but is not currently. The application has been moved to online where a paper license is no longer issued. The application process can be done via paper but requires further steps to obtain and send the application. Massachusetts requires that you graduate from a board approved nursing program, have good character, and have passed the NCLEX. Background checks are also conducted that an individual meets the requirement to become a nurse based on any criminal activity. An individual must not have criminal convictions for a minimum of 5 years and have completed all court ordered stipulations a minimum of 1 year. Fingerprints are not a requirement under the Massachusetts Board of Nursing.

Substance abuse causing nurses to be impaired can be a dangerous thing for the nurse, other nurses, and the patients. Being impaired can correlate with making mistakes that can be life threatening to patients as well as the nurse. It is under legal obligations that a nurse must report other nurses who are impaired by substance abuse. When a nurse is suspected of substance abuse, it is important to conduct a thorough investigation and evaluation. This will look at safety, stability, and provide the person safe transportation to a safe environment. The nurse can be at risk of self-harm as they may experience shame and guilt when they realize what they have been doing. There are various resources available within and external to the organization. If unionized, they can provide support and there should be written policies based on the employer for incidents like these. External resources can look at the Massachusetts Nurses Association Peer Assistance Program, weekly nursing support groups, Massachusetts Substance Abuse Rehabilitative Program, self help groups, and SMART Recovery. If a nurse is found to be impaired, then termination of work may be the disciplinary action. Followed by this, a return-to-work agreement may be required to resume duties per protocol of employer.

In a world that is full of mistakes, it is important to always cover your back and your license when you are a nurse. Malpractice, protecting patient rights, refusing treatment, and abuse are things that  can be seen to cause a nurse to lose their license. As a nurse, you should take the proper measure to ensure that you don’t loose your license. Communication is a key part of protecting yourself and your license. Following protocols, minimize relying on coworkers, ensure social media is private, and always staying focused are keyways to protect yourself. At any moment a slip up can occur and taking the proper measures that are outlined by the employer is key.

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Post-Interview Reflection

Through this interview experience, I learned a lot about being a leader in the role of a nurse. It can take a lot of effort and drive to be a role model for other employees. Being a leader is necessary to create a safe and productive environment. I learned that through times of conflict and disagreement, it is important to put emotions aside and be a good team member to resolve issues. My clinical instructor had great awareness in both self and social. She took initiative when the group was in doubt and made sure to be a proper mediator all the time. My instructor knew that she holds a formal and informal leadership role and took her responsibilities to heart. She made sure to listen to the concerns of the staff and tried to incorporate new measures to help the efficiency of the team. Through this interview, I was most surprised by how often ethical dilemmas can present. I learned that a lot of people have a lot of different opinions, and this can make caring for patients challenging. My instructor reinforced to me that the care of the patient is the priority. She shared a few moments where she had to set aside her personal beliefs and opinions to be able to properly care for the patient. I learned about ways to deal with these situations on a personal level by talking to others to express my way of thinking. This interview allowed me the opportunity to gain important insight into being a leader within the role of a nurse. It has a lasting effect on myself when I become a nurse. I can take this information with me as I continue to learn new things. I can understand how important it is to be a leader and how to handle difficult situations. This interview process has been full of knowledge, and I appreciate my instructor for helping me.

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Preparation for Licensure

This pediatrics ATI adaptive quiz went really well for me. I felt really confident when going into this exam. For pediatrics class, we had to do two practice quizzes which were both 60 questions and we had to remediate on both exams. With this, I was very confident in my knowledge that I would be successful. I knew a lot of the content and felt like I was breezing through the exam. I did loose a little concentration towards the end of the exam. I should work on trying to make sure that I am locked in and focused for the whole entire exam. I also did make a couple silly mistakes such as reading the question wrong or accidently picking the wrong option. These things are easily fixed with practice. I feel more and more confident after each adaptive quiz I take and know this will be beneficial when I take the NCLEX.

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Pre-Interview

My clinical experiences have done a lot more than just provide me with the skills and knowledge to provide care for patients. Each rotation, I had a strong instructor who was very willing and open to helping nursing students. These instructors demonstrated the required skills to be a successful leader and nurse. I am going to interview my clinical instructor Beth Trombley, from Maine Medical Center, who demonstrated great characteristics of being a leader. This decision was not easy as each instructor had their own way of conducting things. I selected this specific individual as I got the opportunity to learn from them for two semesters. Beth is a very knowledgeable individual who takes pride in their work. She is dedicated to her craft and seeks out new learning opportunities when they arise. She has been a nurse for about 12 years and is often the charge nurse on her floor. Beth holds qualities such as having great self-awareness, communication, and influence on those around her. These ultimately lead her to being an effective leader within her floor and within the community. Her leadership position is formal as she is the charge nurse on her floor. She delegates tasks efficiently, problem solves with ease, and cooperates with other nurses and medical professions to get to the bottom of issues. With this, her leadership role can also be informal when she is not the charge nurse. In this situation, she has great experience and knowledge to be able to help others when in need. Beth has created a great reputation for herself, and I am excited to learn more about her role. I am most interested in how she manages conflict between hospital staff and the patient themselves. I am also interested in learning about how ethical situations have been handled and how they have affected her outlook on being a nurse. I look forward to this interview opportunity to better myself and to sharpen my qualities.

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Preparation for Licensure

During the pharmacology ATI, I felt like I was not doing well at all. I thought a lot of the question were challenging and required a lot of thinking and knowledge to get right. When I got my results, I was shocked to see that I got so many correct. I did not expect this while taking the exam. Bringing the options down to two was one thing I did good during the exam. I also did a good job critically thinking while answering the questions. I can take this with for the next exam. I have a strong knowledge base and just need to let it show when I take these exams. I feel like taking these exams at home and allowing myself to pause when I need it is important. I feel like I may need to take these exams at school so I am not as comfortable which can simulate an NCLEX exam when I do take it. For now, I will use the skills gained through this exam and build off of it.

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Preparation for Licensure

The medical surgical adaptive exam that was done was pretty successful. I feel like I knew a good amount of the information that was presented. Even with this, I have gain insight into topics that I need to remediate more on and go over again. This is always beneficial as it can make me a more well-rounded student. I learned more about my test taking abilities such as average time spent on each question. I was a little quick when answering the questions and this was learned through this assessment. Next time, I will focus on taking more time to really understand the question and think about the options presented. I also need to work on staying focused for the whole exam. I got lost a little before the middle of the exam which resulted in getting a span of questions wrong in a row. Taking this exam has opened up new ways on how to improve myself for the next exam.

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Career Development

There are a wide variety of skills that nurses need to be successful in providing care. Providing empathy and compassion when helping others is a necessity. Nurses have to put themselves in the shoes of the patient to better understand what they are going through. Nurses can also relate their own lives with patients so that the best care possible is given. Another skill required is having the ability to adapt and be flexible as many things can go a different way than expected. Having this skill will allow the nurse to be able to think on their toes and be able to do something a different way. Problem solving is another key part of being a nurse. This means that the nurse is able to think outside the box when presented with a challenge. These skills have been used within my clinical experiences. I have showed empathy by actively listening to the patient and responding with care. Problem solving and adapting to situations is a key element that can constantly be worked on. In future practices, I will use these skills to provide the best care that I can.

When watching the video, there were cases when a diverse population was presented that I have not served yet. In specific, there was mention of the Native American population that requires different needs than other patient populations. The video mentioned different prayers and religions that they have and how a nurse should tend to that. There possibly could be a language barrio when caring for this patient populations. Other barriers could include the Native American religion they believe in and how that affects medical decisions and procedures. Cultural humility is important when taking care of patients because it requires the nurse to think about their own beliefs while taking into consideration the beliefs of others. Nurses should be active in learning about the culture and beliefs of different patient populations. Currently, there is a lot of knowledge that I can gain about various patient populations. I would want to learn a little bit about every single cultural view so I can better the care of the various patients that I have. In doing so, can provide more equity in the care that I provide. Doing research on the diversity of the community and learning about their culture will end up being very beneficial.

When preparing for an interview there is a lot of things that can improve your odds of being successful. Success can start out with knowing the company that is interviewing you. I should have a good understanding of the mission and objectives of the hospital. I should also know exactly what the job is asking for and how I will be a good fit. Practice does go a long way when preparing for interviews. This can help build confidence and allow for a smoother and cleaner interview. During the interview, I will be asked about my strengths and weaknesses. Addressing such can be challenging and hard for some to do. When addressing strengths, it is important to have evidence to back up how you hold that quality. Characteristics such as hardworking and being a leader need to be backed by evidence such a being a captain of a sports team or keeping up with the workload of school and a job. When addressing weaknesses, there should also be follow up information. Here I can provide rational how I am working towards this quality by giving an example. Not everyone is perfect, and it is alright to hold weaknesses.

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Prepare for Transition

My first nursing job is right around the corner and I have a lot of mixed feelings. There is this feeling that I may not be successful, that I could possibly not know enough information or on the complete opposite side, I could be an amazing nurse. It is hard to gauge what the correct outcome will be until I actually work my first job. With these mixed emotions, I am excited to be a part of a strong working force whose target goal is to help people. I am most excited that I will get to select where I would like to work. This allows me to give even better care as the area of specialty is something, I am interested in.

A lot of factors will come into play when determining if I will have success on the NCLEX. The ATI nurse modules that I did will help contribute to my success. These modules talked a lot about important things such as math, procedures, and knowledge. This information is key and is a part of virtually every question on the NCLEX.

With this excitement comes a part of me that is a little anxious. I am concerned that I may not have all the right answers. I know no one does but, my personality strives on being the best that I can be. With this, I know to ask numerous questions and take a careful listen to what everyone is trying to tell me. I am also concerned that the area of specialty that I chose to work in may not be what I am most happy doing. Resolving this will only come when I have my first day on the job.

Preparing for my weekly study will be very important. This will require a proper amount of time management and dedication to a constructed schedule. A proper schedule that allows enough time for each activity is very helpful when it comes to making sure everything is done. I will set small goals that will be my building blocks to achieving the main objective. These goals will be manageable, revolve around the simple task, and be done in a timely fashion to optimize my ability.

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Presenting Change

This project has taught me an immense amount of information on the nursing process and quality control. As a group, we got to identify a current issue within the hospital and collaborate to resolve this issue. When searching for ideas for this project, we collectively agreed on researching the importance of accurate documentation of input and output. Documentation can be a tedious task and consume valuable time that could be used on face-to-face patient care yet, should not be underestimated. Adequate documentation of input and output can play a tremendous role in directing the course of treatment for patients. For example, patients with congestive heart failure tend to gain weight via the accumulation of fluid. This fluid increases the weight of the patient causing them to experience edema. These patients tend to be put on a diuretic which will reduce the amount of fluid within their system. Input and output come into play when determining how much fluid is coming out of the body versus being put in. If a diuretic is used, the patient should experience an increased output. Documentation of this output should be done adequately so that doctors can properly dose their medications and have an accurate representation of the patient’s current condition. Recording a patient’s input is just as important as it can give insight into if a patient is potentially dehydrated or malnourished. This information is vital in keeping the patient safe.

Through this project, we learned more than just what input and output is and how important it is. We also came up with a potential solution and key points to help health care staff to accurately document it. Devices such as an automated urine output device (UOPs) can allow for precise measurements of output from a patient. These devices can help reduce the tedious task of checking the patient’s urinal and allows for accurate handoff when reporting. We discovered other methods that can assist in making sure the health care team accurately documents input and output. This can include increasing the amount of education that is being done via a class online or in person. Classes are an efficient way to educate team members so that they can understand why it is important and how they can do their part in providing accurate documentation. These methods can be implemented to help increase the accuracy of the documentation that is being done.

A lot has been learned through this process and this information can be utilized later on during my practice. Nursing is an ever-changing occupation that requires extensive research and education to be successful. New technology is constantly coming out that can influence proper documentation. This project has taught me the importance of recording what a patient takes in and what they put out. This information can be shared with coworkers while being a nurse which will ultimately provide a positive benefit to the patient. This project has taught me how to collaborate with my peers to achieve a common goal in the health care setting. Quality control will always be a part of health care as we are constantly looking for new and more efficient ways to provide the best care possible. This project required extensive research and critical thinking to interpret and resolve a current issue. With this newly acquired knowledge and skill set, I will be able to further improve my future employer by participating in quality control and evidence-based practice initiatives.

Reflecting on the team process, I am able to see how I performed as a member of the group and how that affected our overall project. I have discovered that I am very effective when it comes to communication. I can help resolve conflict between members by being a mediator. I hold the capability to listen to both sides effectively and be able to help come down to a decision. These qualities can also help me later on when I am practicing as a registered nurse.

Currently, feedback on our dissemination project has yet to be completed. We await the feedback from our clinical instructor and floor personnel.

EBP2-Project-1Download

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Disaster Nursing

Nurses play a valuable role in health care but they can also play an important role when disaster strikes. There are various tasks that a nurse can do to help any disaster situation, whether it is natural or man-made. A key job that a nurse can do is assessing patients. This can be done to determine how severe patients are from the disaster. Assessing patient’s helps doctors organize who they need to treat first. Things can get pretty hectic when a disaster occurs. It is important that the nurse remains calm and collected when assessing patients. Nurses also can’t hold be afraid to tell it like it is. If a patient is near death and has a low probability of survival, the nurse needs to make the decision to provide comfort and let the patient live out the remainder of their life. Nurses can also contribute by providing patients with first aid and medications. If people are in need of help but their injuries aren’t as extensive as others, a nurse can jump in and provide first aid. This could mean stabilizing a patient with a suspected spinal cord injury or tying off a gushing wound by providing pressure. These tasks can help save patient’s lives. Medication administration is also valuable in providing comfort to patients. Pain medications can be used to help alleviate immediate pain. When dealing with all of this commotion, a nurse needs to be able to step back and think about their own safety before jumping into something that can danger themselves.

The ANA Code of Ethics can present conflicting Provisions as a nurse has a duty to care for a patient yet, care for themselves. These two Provisions can conflict each other in times of disaster. In these types of situations, a nurse has to think about themselves and the issue at hand. If saving someone’s life is going to cost your own life, then that is not worth it. A nurse can only do some much in certain circumstances. It can be challenging for a nurse to make this decision. When a nurse spends their whole career helping people in need, these decisions do not get any easier. Sometimes, a nurse may need someone else to explain to them that helping someone in a certain situation can lead to harming themselves. The judgement is left up to the nurse as they should do what they feel comfortable doing. It would not be considered a breach in one code over another when they involve endangering yourself or the patient. 

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