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Running head: PROFESSIONAL DEVELOPMENT
Professional Development
Anne M. Hendricks
Ferris State University
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Running head: PROFESSIONAL DEVELOPMENT
Abstract
Utilizing the American Nurses Association standards of professional performance as my guide I
will assess my current nursing behaviors, strengths, weaknesses, and specific future goals.
Through this evaluation I hope to demonstrate my professionalism and commitment to nursing.
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Running head: PROFESSIONAL DEVELOPMENT
Professional Development
Professional development requires one to analyze one’s skills and one’s goals in an
objective manner. A professional should be autonomous in decision making and accountable for
his or her own actions and practice. According to the American Nurses Association (ANA)
definition of quality of practice “the registered nurse systematically enhances the quality and
effectiveness of nursing practice”(ANA, 2004, p.33). This is an area of strength for me but also a
dynamic area that needs constant reassessment. Recently I saw an area of antiemetic use that
was not efficient. I identified the problem as inconsistent ordering of antiemetics which led to
unnecessary patient suffering. I utilized the pharmacy and evidence-based research to formulate
charts to help each nurse know what is the required antiemetic for particular chemotherapy
protocol. I developed documents for patient subjective complaints of nausea to monitor
effectiveness of current recommendations for quality improvement. These charts are in the
medication room in our clinic for reference. This encompasses many of the quality practice
criteria. According to ANA (2004, p.33) using creativity and innovation in practice to improve
care delivery, identifying areas of practice requiring monitoring, formulating recommendations
to improve outcomes, implementing and evaluating procedures for effectiveness are all qualities
of practice which I demonstrated.
Education, according to ANA, is attaining knowledge and competency current to nursing
practice (2004, p.35). As defined in ANA (2004, p.34) participating in educational activities
appropriate to area of expertise, self-reflection regarding learning needs, maintaining skills and
competencies, maintaining records of education and formal learning are hallmarks of this
category. I have a national certification in oncology which requires 1,000 minimum hours in
oncology practice within two-and-one-half years prior to application, and a completion of 10
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Running head: PROFESSIONAL DEVELOPMENT
contact hours of accredited continuing education in oncology nursing and successful testing at a
national level to qualify (Oncology Nursing Society). I also am PICC (peripherally inserted
central catheter) certified through Munson which requires attending a two day course, successful
completion of a test, demonstration of six successful PICC placements under supervision, and
twelve successful PICC placements per year. In my clinic I perform chart audits on a monthly
basis and assess myself and my peers for documentation errors. Through Munson I also perform
a skills day, which has specified areas to keep me current on applicable topics, and Healthstream
which are computer based courses applicable to my area of practice as an registered nurse. I have
an annual check sheet of skill performance that I must demonstrate for my supervisor and an
annual meeting with the supervisor and manager to review goals and objectives which provides
me with the guidance I need for the next year. I also must keep records regarding my credits to
maintain state nursing licensure and specialty certifications. The credits need to be organized and
available for audit. This is an area of weakness for me, I need to develop a better
filing/organizing system.
Professional Practice Evaluation: According to ANA (2004, p.36) “the registered nurse
evaluates own nursing practice in relation to professional practice standards and guidelines,
relevant statutes, rules and regulations.” A nurse provides age appropriate, and culturally
sensitive care (ANA, 2004, p.36). My strength in this area is that I provide care for all age groups
and I test annually for competency to do so. My weakness would be in the lack of cultural
diversity that I have cared for. I have cared for different populations but have only worked in
rural northern Michigan therefore exposure to a multitude of cultures is limited. I do have access
to books that describe care, but the actual experience I lack. I perform self-evaluation regularly
and set goals for myself, one being obtaining my Baccalaureate degree in nursing. I also have an
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Running head: PROFESSIONAL DEVELOPMENT
annual discussion with my peers and my manager at which I identify areas that I would like to
improve upon or achieve and my manager also makes suggestions. The goals/objectives are
written down and filed. I think that by writing specific goals down, one is more committed to
following through on them. I also read patient comments from the questionnaires that Munson
gives after a visit. I am happy to say that the comments have been very positive and motivate me
to strive to provide the best care that I can. I do concentrate on my goals throughout the year, and
I am always cognizant of my practice. I do think that an area of weakness is that sometimes I
take things personally when someone criticizes me. I also have a difficult time giving criticism. I
would like to work on this, as I feel that this is an important part of leadership.
Collegiality: According to ANA (2004, p.37) the registered nurse contributes to the
professional development of peers and colleagues. Our clinic has senior practice associate degree
nursing students which I observe, teach, and evaluate on a regular basis. Pharmacology students
often come to our clinic to observe and I take part in demonstrating the role of a nurse. We have
two new nurses in the clinic that are not yet chemotherapy certified and I take part in daily
mentoring. Our clinic is highly rated by patients, and often the comments are reflective of the
teamwork that we display.
Collaboration: ANA (2004 p.38) states that “the registered nurse collaborates with
patient, family, and others in the conduct of nursing practice.” Because of the nature of cancer
care, the education and collaboration of patient and family is critical, and I feel is one of my
strongest attributes. Patients come to the first appointment with many family members and a
great deal of anxiety. I must demonstrate patience, confidence, and knowledge. An example
would be a new colon cancer patient who is at his/her first visit. I need to place a peripherally
inserted central catheter (PICC) for medication delivery. I educate the patient/family while
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Running head: PROFESSIONAL DEVELOPMENT
assessing the patient learning ability. I realize that the patient will only remember a small portion
of the education so I provide written information (after assessing patient’s reading ability). I
contact Biederman Radiation to correlate the radiation treatment with the time the PICC will be
inserted and the chemotherapy will be done. I keep pharmacy and the physician appraised of
patient lab results. I evaluate the home situation with the patient and caregiver/s and assess
resources and needs. I make referrals for home care, social work, and financial assist as needed. I
give the patient/family information which provides phone numbers and web sites specific to their
type of cancer. Some of our patients are part of a research program and once I perform an
assessment of the patient, I contact the appropriate research nurse. I also participate in research
programs from other hospitals, such as MAYO, Karmonos, MD Anderson, University of
Michigan, DeVos; and I make sure that communications, especially critical lab values, are
performed accurately and concisely.
Ethics per ANA (2004, p.39) is the registered nurses’ integration of ethical provisions in
all areas of practice. Health Insurance Portability and Accountability Act (HIPPA) is a major part
of any nurse’s practice and mine is no exception. Every year, as part of Health Stream, I have to
perform HIPPA education in order to maintain my computer access. We are also monitored
every time we use the computer at work and can be terminated from employ if infraction is
found. I log off the computer when I am not using it to prevent anyone from using my login. I
also am careful not to use full names loudly in clinic and encourage coworkers to comply. I focus
my efforts and attention on the patient and his/her needs, wishes, quality of life. I provide
education with as much information as possible to allow the patient to make his/her own choices
for health care. I make sure that the appropriate relationship between patient and nurse is kept
and that the relationship remains professional yet therapeutic. I have many strengths in this area,
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Running head: PROFESSIONAL DEVELOPMENT
but a definite weakness is in taking care of me. Self-care has taken a back seat to life and time
constraints, but I have set a goal to play volleyball one night a week. I also am going to discuss
with my manager the possibility of 10 hour work days instead of 8 hour work days so that I
would maintain full time but have one more day per week for family, self, and school.
Research: “The registered nurse integrates research findings into practice” (ANA, 2004,
p.40). Nurses should always utilize the best available evidence in order to provide sufficient care.
I feel that in my area of practice, research is being applied constantly. I often have patients that
are in research studies which I have to follow strictly. If protocols are not followed, the research
can be tainted and patients can be removed from the study, which may be the last chance he/she
may have at a cure or prolonging of life. Often times I stay late to remove a chemotherapy pump
from a patient because it was placed at a specific time and needs to be removed at a specific
time. On an individual level, I just recently came across some information while I was
researching antiemetic usage for my evidence-based practice paper. As I was searching for
information, I had a particular patient on my mind. The patient had received three cycles of
chemotherapy from our clinic. The first cycle I had provided with the only complaint being
nausea and vomiting. The second and third cycles another nurse had provided care, and the
patient had developed progressing confusion and finally, facial tremors. The patient was taken
off his treatment because of the neurotoxicity believed to be caused from Ifofsamide (his
chemotherapy). I tried to evaluate the difference between the first and subsequent cycles, and
antiemetic usage was the only difference that I could conclude. I searched for the most recent
research on antiemetic use and the second article I found was on “Neurotoxity with the
concomitant use of Ifosfamide and Apprepitant”. The patient had been on a different antiemetic
on the first cycle and was placed on Apprepitant for nausea and vomiting complaints. The
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Running head: PROFESSIONAL DEVELOPMENT
patient was on Ifosfamide, and the neurotoxicity described in the article was confusion and
tremor! I immediately called our Oncology Pharmacist and faxed the information, I then faxed
the information to the attending Oncologist. The information was exchanged with the University
of Michigan Sarcoma Clinic, also providing care, and it was agreed to restart the patient on the
chemotherapy with an “off formulary” antiemetic as the article had suggested. So far the patient
is doing well and has been through two more complete cycles. This has been one of the most
rewarding examples of utilization of most recent evidence. I feel that research is an area that I am
evolving in and there is always room for growth.
Resource utilization: According to the ANA the nurse considers safety, effectiveness,
and cost planning in delivery of patient care (2004 p.42). This is a topic that I feel passionately
about. With increased costs and limited resources I feel that we all must be cognizant of resource
utilization. I also feel that the patient should be allowed to make informed decisions regarding
healthcare, which includes honesty regarding effectiveness. My weakness in this area is in
questioning the physician, often times the physician will continue an expensive treatment that is
causing the patient to have poor quality of life. The nurse is often the bridge of communication
between the physician, the patient and the family. The physician is treating the disease and often
times, will continue until death. The patient continues on treatment because no one gives them
the option to stop, or he/she feels the need to do it for the family, the family pushes for treatment
because they don’t understand the dying process, and they feel treatment is in the best interest of
the patient. As a nurse I listen to the subjective information and monitor the objective signs. I
then facilitate dialogue and communication with patient, family, and physician, and make the
appropriate referrals while assessing resources and needs of the patient/family.
Leadership: According to the ANA (2004, p.44) “the registered nurse provides
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Running head: PROFESSIONAL DEVELOPMENT
leadership in the professional practice setting and the practice”. Leadership is the main reason
that I have returned to school, which demonstrates my commitment to lifelong learning, I desire
growth in my personal and professional life. My strengths in this area are teamwork, mentoring,
creativity, flexibility, and coordination of care which I have explained earlier. Teamwork is
exemplified in the fact that I work in a small technical clinic and we consistently achieve the
highest outpatient satisfaction ratings. I discussed mentoring earlier when I talked about student
nurses/pharmacists being educated in the clinic. My creativity is demonstrated in the antiemetic
protocol that I developed. And I can honestly say that I am very adaptable and actually enjoy
change and view it as a challenge. Coordination I perform daily with radiation, lab, physicians,
and cancer research.
My weakness in promoting professionalism, is in initiating ideas and taking a more
authoritative role. I am a member of both the local and national Oncology Nurses Society, and I
attend regular meetings and volunteer my services but I have not run for office or taken a
leadership role. I also am on the Nurse Practice Council, but I do not get to the meetings
regularly so I am not involved in any projects. My supervisor denies me the privilege of
attending most of the time because we are short staffed. I find this embarrassing and feel that it
hinders my participation when I am allowed to attend. I am presently trying to find a solution to
this dilemma, but feel that I may have to pull my position from the council in fairness to others.
Five year plan: I plan to finish my Bachelor’s in nursing May 2013 by following a plan
that was devised at the beginning of my BSN and has been adjusted to meet my needs
throughout the program. I currently have to finish my nursing Capstone class and a 300 level
Global Consciousness credit as well as NURS 495 to complete graduate.
I will continue to work full time in the Infusion Clinic, and continue to work on my
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quality of practice by maintaining enthusiasm and seeking ways to improve the efficiency of my
nursing and improving the efficiency of the clinic. I will maintain my PICC certification through
the hospital which requires twelve successful placements per year. I will also maintain my
national Oncology certification which requires: current RN license, one year active nursing
within 36 months of application, a minimum of 1,000 hours of oncology nursing within the twoand-one-half years prior to application and proof of qualifying credit (Oncology Nursing
Certification Corporation [ONCC],2008). Credits must also be kept and organized for state
licensure. I will need to work on my filing and organizational skills which are an area identified
as a weakness.
Munson is planning to build a new cancer center in the next few years and I hope to
continue my development so that I will be able to fulfill a leadership role. One role that I recently
researched was Nurse Navigation. This role interests me and I am going to work with human
resources and try to implement a program at our new clinic. Doing this will require that I further
research this role and how to develop it for my particular area. I know several of my coworkers
are getting close to retirement and I am going to continue to work on my people skills, giving
and receiving criticism and assertiveness so that I will be considered as a leader. My
professional nursing practice will continue to evolve as I reflect the behaviors of the professional
nurse.
Ten year plan: I have been researching travel nursing and have found that most offer:
top salaries and personalized compensation packages; fully furnished, company-paid housing
and utilities; weekly pay with available direct deposit; 24 hour support team; health and dental
insurance; 401K; referral and loyalty bonus programs. According to rnvip.com website, which is
a website representing several agencies,
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Running head: PROFESSIONAL DEVELOPMENT
“travel nurses are in the top tier of healthcare workers, and they enjoy some of the
industry’s best benefit packages. It is not unusual for a travel nurse to receive a higher
average pay rate and a more attractive package of benefits than his or her counterpart in a
full-time, permanent position.” (retrieved from http://www.rnvip.com/wagesbenefits.php#paycheck)
Travel expenses, educational reimbursement, and referral incentives are negotiable items that are
offered by some agencies and should be negotiated before signing a contract. I am investigating
travel nursing right now and will not sign with an agency until I am closer to being ready to
travel (probably around 2020). I am going to continue to put 10% of my wage in a secure money
market which is currently earning 3.75%. I will continue to reassess the market for the best place
to invest. My husband and I own a business and several properties which we will sell and live off
of the interest of the invested monies. Travel nursing will provide me with additional income and
the opportunity to travel, see the country and decide where we would like to retire. I checked
with travel agencies and spouse and pets are allowed on assignment, if provided housing does
not allow pets, then an allotment toward housing will be received. We also have a 36 foot fifth
wheel with a toy hauler so we have a place to live and can bring our motorcycles. Hawaii and
Alaska are two priority states that I would like to work in and possibly Arizona, California,
Texas and Florida.
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Running head: PROFESSIONAL DEVELOPMENT
References
American Nurses Association (2004).Nursing: Scope & standards of practice. Silver Spring,
MD: Nurses Books
Oncology Nursing Certification Corporation.( n.d.). Get certified: Ocn eligibility criteria.
Retrieved November 16, 2008, from
http://www.oncc.org/getcertified/TestInformation/ocn/eligibility.shtml.
RNVip.com Treating Travel Nurses Like VIPs. (n.d.). Travel nursing pay wage and benefit
information. Retrieved November 21, 2008, from http://www/rnvip.com/wagesbenefits.php#paycheck.