Running head: PROFESSIONAL DEVELOPMENT PLAN
Professional Nursing Development Plan Paper
MiSuk Robinson
Ferris State University Nursing 324
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PROFESSIONAL DEVELOPMENT PLAN
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Professional Nursing Development Plan
The scope and standards of professional nursing practice is a dynamic process. Nursing
has and will always be about caring for people. Caring is defined as promoting health and
wellness by developing interpersonal relationships (ANA, 2010). Providing competent
healthcare requires minimum standards of practice that are applicable across all nursing roles and
specialties. The scope and standards of practice must continually be updated to meet the current
healthcare challenges while striving for safe and excellent nursing care.
My professional development plan starts with an evaluation of my current practice as a
peri-operative nurse. I will compare my clinical nursing practice against the Standards of
Professional Nursing Practice established by the American Nurses Association (ANA). I will
also reflect on the Standards of Professional Performance and how I incorporate those in my
nursing role. To grow professionally in any career a person must understand areas of strengths
and weaknesses. I will identify professional goals and a process to monitor my progress towards
achieving those outcomes. My plans will address how to balance family needs, full time career,
and educational goals. I have included the grading rubric for this assignment (see Table 1).
Standards of Professional Nursing Practice
The foundation of professional nursing practice standards includes the nursing process,
the Code of Ethics for Nurses, and the Standards of Professional Performance. The expectation
by the ANA is that every registered nurse should competently utilize the nursing process,
maintain competency of current practice standards, practice ethically, and develop patterns of
professional behaviors (ANA, 2010). These expectations support the definition of nursing as a
profession. According to Lucie Kelly some of the characteristics of a profession are
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accountability, autonomy, and organizational support of high standards of practice (Chitty and
Black, 2011).
The Nursing Process
The six steps of the nursing process for registered nurses are: assessment, diagnosis,
identifying outcomes, planning, implementation, and evaluation. This process represents the
critical thinking framework for professional nursing practice (Chitty and Black, 2011). The steps
of the nursing process guide every registered nurse through an organized system of problem
identification. This tool is essential in making sure that every patient receives safe, professional
nursing care.
Assessment. Assessment involves evaluation of physical, psychosocial, cultural,
spiritual, and pertinent diagnostic information. In surgery physical assessment includes asking
about body jewelry. Any metal jewelry that is not removed may increase the risk of burns from
electro-cautery or cause skin breakdown from positioning. (Miller, 2010). Surgical patients
often experience anxiety and verbalize fears related to anesthesia or pain control Newshan, G.,
1998). Psychosocial, cultural, and spiritual assessment provides understanding of pain
perception in the post-anesthesia recovery phase. Assessment of pre-operative diagnostic results
or identifying the need for diagnostic testing is important for surgical patients. Abnormal
laboratory results may result in cancellation of surgery. If a patient has been identified with a
low hemoglobin or platelet level then blood products may need to be available before the patient
goes to surgery.
Diagnosis. Nursing diagnosis is based on problems identified from a patient’s response
to injury or disease process. Interventions are within the scope of professional nursing practice.
The format for identifying nursing diagnosis was developed by Gordon using the pneumonic
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PSE (Chitty and Black, 2011). “P” stands for clear description of the problem. In postanesthesia recovery some patients have “ineffective breathing pattern”. “E” stands for etiology
of the identified problem. Post-operative patients may have depressed respiratory effort from
narcotics, anxiety, or surgical pain. “S” stands for signs and symptoms of the identified problem.
Symptoms are what patients describe as the problem while signs are observable behaviors that
support the symptoms. Surgical patients may state that they have a hard time breathing and
exhibit tachypnea, retractions, and decreased oxygen saturations that support the assessment of
ineffective breathing pattern. In my current practice we do not focus on nursing care plans for
surgical patients. No one consistently utilizes the care plan program although it is available in
our electronic charting program. As a professional nurse I need to utilize this program so that
competency in one of the key components of the nursing process is documented
Outcome Identification. Recognizing the expected outcomes is crucial in
individualizing nursing care plans. This process involves how the patient will contribute to the
interventions. The goals or outcomes should be measurable and attainable. Goals may be short
term or long term that encompasses discharge planning. Ineffective breathing due to anxiety
needs to be addressed differently than ineffective breathing due to post-operative pain. Short
term goals may include imagery, music therapy, or distraction to help decrease anxiety. Patient
teaching in regards to post-operative pain may include how to support an abdominal surgical site
with a pillow to breathe effectively.
Planning and Implementation. Planning and implementation is centered around patient
education. Deciding how to achieve expected outcomes requires collaboration between the
patient and healthcare providers. There are three domains of learning that should be addressed in
patient education: psychomotor, cognitive, and affective (Chitty and Black, 2011). Psychomotor
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involves physical and motor activities that can be measured in terms of time or distance.
Surgical patients with spinal anesthesia must be able to ambulate before being discharged.
Cognitive domain addresses comprehension of patient education. Successful and safe outcomes
for outpatient surgical procedures requires that patient’s understand and comply with patient
teaching (Marshall, S.I., 1999). Affective domain addresses psychosocial, cultural, and spiritual
beliefs. Patients and nurses must develop mutual trust in a short amount of time in an
ambulatory setting to be able to express affective needs. Providing information and emotional
support while treating all patients respectfully increases the level of trust with healthcare
providers (Boman, L., Anderson, J.U., Bjovell, H., 1997). Another component of planning and
implementation is the coordination of care. Other departments are often involved in getting
patients ready for surgery: laboratory, radiology, pharmacy, registration, medical records, and
housekeeping. Labs and diagnostic testing must be scheduled pre-operatively or patients must
come in earlier than scheduled on the day of surgery to make sure the results are available on
time. Registration obtains prior-authorization to ensure reimbursement for procedures otherwise
cases may need to be cancelled so that patients are not responsible for the hospital bill. As the
charge nurse I work very closely with all the departments within the hospital and physician’s
office to achieve satisfactory outcomes for surgical patients.
Evaluation. Continual evaluation of the patient, expected outcomes, and interventions
ensures competent nursing care. Expected outcomes and interventions should change as the
patient assessment changes. The expected outcome of all outpatient surgery procedures is that
the patient will be discharged on the same day. Some patients experience greater pain perception
that is not controlled with standard narcotic regimen for phase II recovery period. These patients
may need to be re-evaluated for inpatient observation instead of being discharged to home.
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Standards of Professional Performance
Nursing professionalism requires competent behavior in several areas important to
nursing. There are ten standards that relate to the nursing role: ethics, education, evidence-based
practice and research, quality of practice, communication, leadership, collaboration, professional
practice evaluation, resource utilization, and environmental health (ANA, 2010). Registered
nurses are accountable to themselves and society to demonstrate competent professional
behavior.
Ethics. The Code of Ethics for Nurses lists nine provisions for ethical practice (ANA,
2010). Provision 3 (patient advocacy) and 8 (collaboration) are the primary standards of ethical
practice for surgery. Advocating for the patient is crucial in surgery. Patients are most
vulnerable when they are unable to speak up for themselves due to analgesia or sedation.
Patients trust that healthcare providers will act on their behalf to provide safe outcomes.
Collaboration is also necessary to provide excellent nursing care. Surgery is definitely a team
approach between the surgeon, anesthesiologist, nurse, scrub technician as well as other hospital
departments.
Education. Professionalism includes having a specialized body of knowledge. Nurses
today must be knowledgeable about current standards of care specific to their nursing specialty.
Association of peri-Operative Registered Nurses (AORN) provide continuing education credits
specific to peri-operative nursing. Majority of my clinical practice standards specific to surgery
are from AORN standards.
Evidence-based Practice and Research. Best nursing practice is supported by research.
Nursing interventions must remain congruent with latest scientific information available. The
cyclical process of investigating clinical issues, literature, and theory results in research relevant
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to clinical nursing (Chitty and Black, 2011). In my role as the OR Charge Nurse I am
responsible for understanding current practice standards from AORN and the research available
to support any nursing practice change. Recently we changed the acceptable temperature range
for the intravenous fluid warmer to AORN standards based on research that indicated increased
risk of phlebitis at higher fluid temperature.
Quality of Practice. Each nurse is responsible for maintaining personal quality of
practice. Understanding and practicing the Professional Nursing Standards of Practice indicate
competence and compliance. Nurses are also responsible for the quality of practice of all
healthcare providers when acting as a patient advocate. When I follow the scope and standards
of professional nursing practice set forth by the ANA and AORN I know that I am providing safe
nursing care. I also perform chart audits to monitor quality improvement process and maintain
continuing education credits required for re-licensure in Michigan (Michigan Department of
Licensing and Regulatory Affairs, 2012).
Communication. Effective communication is vital in providing safe nursing care.
Interpersonal communication with patients and other healthcare providers is based on trust and
respect. Nurses must also be aware of psychosocial and cultural factors that impact
communication. In surgery the Universal Precaution Time Out is a national patient safety goal
targeted for decreasing wrong site-wrong procedure events (TJC, 2012). It is the nurse’s
responsibility to communicate this process in the operating room and ensure consensus of all the
healthcare providers that are present.
Leadership. Nursing leadership includes activities and behaviors that promote
advancement of the nursing profession, commitment to lifelong learning, and influencing
healthcare policy (ANA, 2010). I mentor new staff and take responsibility for department
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specific education. I am an American Heart Instructor for adult and pediatric advance life
support certification. Last summer I was nominated to participate in the Staff Leadership
Institute at Spectrum Health. I will be presenting in May my service learning project for
addressing spiritual needs of hospitalized patients which will be implemented in July at United
Memorial Hospital.
Collaboration. Implementation of the nursing process is based on collaboration between
the nurse, patient, family, and other healthcare providers. Sharing of medical information allows
for transition of care from the primary physician, surgeon, anesthesiologist, hospitalist, and
nurses. Teamwork is essential in providing comprehensive care to surgical patients. In our unit I
work very closely with the pharmacy technicians to ensure accurate medication reconciliation
records for surgical patients that need to be admitted. I also need to collaborate and
communicate when surgical patients need to be admitted. Recently our medical-surgical unit
was closed to admissions. I had to keep patients in the outpatient area for an extended period
until patients were discharged. Three weeks ago we had a very busy surgical day and we did not
have enough beds available to admit all the patients. The medical-surgical unit was able to
provide phase II recovery for our surgical patients and discharged them from the floor so that we
could continue with our surgery schedule.
Professional Practice Evaluation. Registered nurses evaluate clinical practice with
standards of care established by nursing organizations, government agencies, and place of
employment. The Scope and Standards of Nursing Practice 2nd Edition by the ANA is the
definitive guideline for professional practice standards for all registered nurses. I also use the
AORN standards that are specific to peri-operative nursing. I review and update nursing policies
that are specific to my department. I participate in annual self-evaluation and peer evaluation
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process in my department. Recently I participated in the Leadership Practices Inventory which
allows me to evaluate my leadership behaviors as identified by myself and other evaluators.
Resource Utilization. The healthcare crisis places the burden on everyone to use
available healthcare resources wisely. In my department I must balance supplies that I need to
have available for emergency cases with what I will actually use. If I do not have the appropriate
number then I risk running out of necessary supplies before the next shipment or have too many
supplies that may expire before being used. We are currently recycling many supplies such as
staplers, tourniquets, and shavers. Reprocessing certain medical equipment is a cost-containment
measure that must be evaluated against patient safety issues such as infection risk (Selvey, D.,
2001).
Environmental Health. Working in a safe and healthy environment increases safe
patient and staff outcomes. Understanding the need for isolation precautions to prevent the risk
of nosocomial infections will be critical when Hospital Care Quality Information from the
Consumer Perspective program impacts hospital reimbursement (HCAHPS, 2010). An
environmental issue that I am currently trying to update is the handling of radioactive tissue
specimen. All tissue specimen are transferred from surgery to our laboratory department then
transferred by courier to Blodgett Pathology department. There was no policy to address breast
tissue that had been injected by radioactive isotopes for nuclear medicine studies prior to surgery.
We are in the process of making sure all breast tissue that have been subjected to nuclear
medicine diagnostic testing be clearly labeled with a radioactive sticker warning and transported
in appropriate lead container to decrease the radioactive exposure (National Cancer Institute,
2009).
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Five and Ten Year Professional Goals
My professional goals are still evolving. Currently I am hoping to complete the
RN to BSN program by spring 2014. Working full time as the OR Charge Nurse has been more
challenging and time consuming than I had anticipated. In order to balance family vacations
with school and work commitments I opted to take one class for the summer and fall semester
this year. Also my tuition reimbursement benefit will only cover four classes in a twelve month
period. By graduating in 2014 I will not incur any personal expenses for completing my BSN
degree.
RN to BSN Completion Plan
Summer 2012
Fall 2012
Spring 2013
Summer 2013
Fall 2013
Spring 2014
Nursing 310
Nursing 350
Nursing 340
Nursing 440
Nursing 450
Nursing 495
Nursing 317
I have always been interested in teaching so I am considering the possibility of a MSN in
nursing education. I am reviewing the nursing program at Michigan State University (MSU) and
Ferris State University (FSU). Taking one class a semester I would need five years to complete
the MSU Wilson School of Nursing program (see Table 2). Admission requirements include a
minimum grade-point average of 3.0 (4.0 scale), BSN degree, one year of clinical nursing
experience, statistics course taken within five years, current Graduate Record Examination score,
written essay, three letters of recommendation, and all appropriate admission paperwork
including curriculum vita (MSU Wilson School of Nursing, 2012). Ferris State University MSN
program can be completed in four years taking one class a semester (see Table 3). The
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admission requirements include a BSN degree, overall grade-point average of 3.0 (4.0 scale),
current licensure as a registered nurse, and minimum of two years of clinical nursing experience
(Ferris State University, 2012). In ten years I would like to be a nursing instructor at a four year
college or university. I feel that encouraging interest in the nursing profession and teaching is
the best way to influence healthcare for the future. Currently we are facing a critical shortage of
nurse educators as identified by the National League for Nurses. By 2019 75% of current nurse
educators are expected to retire (Chitty and Black, 2011). Nursing faculty shortage was
identified as a major problem contributing to the nursing shortage in the United States
(American Association of Colleges of Nursing, 2012). There are many initiatives at the national
level to address the nursing faculty crisis including loan repayment options, increased
availability of grant money, and curriculum development to meet the growing needs of
professional nursing (Rosseter, R., 2012). Teaching opportunities should be readily available
within the next ten years regardless of where I might be living.
To monitor progress towards my goal I have posted a timeline on my desk. I have also
discussed my goals with my husband and family. Letting other people know what my
aspirations are will help me be accountable to take action. I am also incorporating these goals in
my annual evaluation at work. This will provide professional accountability to monitor progress
since my annual salary increase will be impacted by achieving identified goals. Balancing
family, work, and school requires frequent assessment and evaluation of plans. I have learned
that taking the long route to reach the final destination is healthier than taking the short cut and
not having time to enjoy life.
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References
American Association of Colleges of Nursing. (2012). Nursing shortage resources. Retrieved
from: htpp://www.aacn.nche.edu
American Nurses Association (ANA). (2010). Nursing scope and standards of practice (2nd ed.).
Silver Springs, MD: ANA.
Association of peri-Operative Registered Nurses (AORN). (2012). Retrieved from:
http://www.aorn
Boman, L., Anderson, J.U., Bjorvell, H. (1997). Needs as expressed by women after breast
cancer surgery in the setting of a short hospital stay. Scandinavian Journal of Caring
Sciences, 11(1), 25-32.
Chitty, K.K., Black, B.P. (2011). Professional nursing concepts & challenges (6th ed.).
Maryland Heights, MO: Saunders/Elsevier.
Hospital Care Quality Information from the Consumer Perspective (HCAHPS). (2010).
Retrieved from: http://www.hcahpsonline.org/facts.aspx
Marshall, S.I., Chung, F. (1999). Discharge criteria and complications after ambulatory surgery.
Anesthesia & Analgesia, 88(3), 508.
Michigan Department of Licensing and Regulatory Affairs. (2012). Retrieved from:
http://www.michigan.gov/documents
Miller,R., Eriksson, L.I., Fleisher, L.A., Wiener-Kronesh, J.P., Young, W.L. (2010). Miller’s
Anesthesia (7th ed.). Philadelphia, PA: Churchill Livingston/Elsevier.
National Cancer Institue. (2009). Radioactive specimen in histology. Retrievced from:
http://home.ccr.cancer.gov/lop/intranet/PolicyManual/SafetyOverview/radioactive.asp
Rosseter, R. (2012). Nursing faculty shortage. Retrieved from: http://www.acn.nche.edu/media
PROFESSIONAL DEVELOPMENT PLAN
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Selvey, D. (2001). Medical device reprocessing is it good for your organization? Infection
Control Today. Retrieved from: http://www.infectioncontroltoday.com/articles/2001/01
The Joint Commission. (2012). National patient safety goals. Retrieved from: http://www.tjc
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Table 1
Grading Rubric for Professional Development Plan
CATEGORY
4 points
3 points
2 points
1 points
Evaluation tool
Writing checklist
The writing
checklist is
attached, complete
and it is apparent
after reading the
paper it was used
successfully
The writing checklist is
attached, complete but it is
apparent after reading the
paper the evaluator missed
some key elements of the
writing tool
The writing checklist is Missing
attached, complete but
it is apparent after
reading the paper the
evaluator missed
several key elements
of the writing tool
Introduction
(Organization)
The introduction is
inviting, states the
main topic and
previews the
structure of the
paper.
The introduction clearly
states the main topic and
previews the structure of
the paper, but is not
particularly inviting to the
reader.
The introduction states There is no clear introduction of
the main topic, but
the main topic or structure of
does not adequately
the paper.
preview the structure
of the paper nor is it
particularly inviting to
the reader.
Sequencing
(Organization)
Details are placed
in a logical order
and the way they
are presented
effectively keeps
the interest of the
reader.
Details are placed in a
logical order, but the way in
which they are
presented/introduced
sometimes makes the
writing less interesting.
Some details are not in
a logical or expected
order, and this
distracts the reader.
Many details are not in a logical
or expected order. There is little
sense that the writing is
organized.
Grammar &
Spelling
(Conventions)
Writer makes no
errors in grammar
or spelling that
distract the reader
from the content.
Writer makes 1-2 errors in
grammar or spelling that
distract the reader from the
content.
Writer makes 3-4
errors in grammar or
spelling that distract
the reader from the
content.
Writer makes more than 4
errors in grammar or spelling
that distract the reader from the
content.
Word Choice
Writer uses vivid
words and phrases
that linger or draw
pictures in the
reader's mind, and
the choice and
placement of the
words seems
accurate, natural
and not forced.
Writer uses vivid words and
phrases that linger or draw
pictures in the reader's
mind, but occasionally the
words are used inaccurately
or seem overdone.
Writer uses words that
communicate clearly,
but the writing lacks
variety, punch or flair.
Writer uses a limited
vocabulary that does not
communicate strongly or
capture the reader's interest.
Jargon or cliches may be
present and detract from the
meaning.
PROFESSIONAL DEVELOPMENT PLAN
CATEGORY
5 points
4 points
15
3 points
2 points
Behavior analysis (accuracy, precision, clarity, relevance, depth, breadth, logic and personal
significance)
Description and Analysis of Current Strengths & Weaknesses for ANA measurement criteria in the
following standards of professional performance
Relevant, telling,
quality details give
the reader important
information that goes
beyond the obvious
or predictable.
Supporting details and
information are relevant,
but one key issue or
portion of the analysis is
unsupported.
Supporting details and
information are relevant,
but several key issues or
portions of the analysis
are unsupported.
Supporting details and
information are
typically unclear or not
related to the topic.
# 7 Ethics
# 8 Education
# 9 EBP & Research
# 10 Quality of
Practice
# 11 Communication
# 12 Leadership
# 13 Collaboration
# 14 Professional
Practice Evaluation
#15 Resource
Utilization
# 16 Environmental
Health
APA formatting literacy
Sources APA format
(Content)
All citations in text &
sources used for
quotes and facts are
credible and cited
correctly.
All citations in text &
sources used for quotes
and facts are credible and
most are cited correctly.
Most citations in text &
sources used for quotes
and facts are credible
and cited correctly.
Many citations in text
& sources used for
quotes and facts are
less than credible
(suspect) and/or are
not cited correctly.
APA format
Correct use and
placement of title
page, running head,
headers, abstract,
margin, font size,
references reference
page
Mostly correct use and
placement of title page,
running head, headers,
abstract, margin, font size,
references reference page
Some correct use and
placement of title page,
running head, headers,
abstract, margin, font
size, references
reference page
Placement of title
page, running head,
headers, abstract,
margin, font size,
references reference
page needs a lot of
imrpovement
PROFESSIONAL DEVELOPMENT PLAN
CATEGORY
5 points
4 points
16
3 points
2 points
5 and 10 year goals, action plan and evaluation
Goals
Articulates clear
Main idea is clear but the
professional goals for supporting information is
5 and 10 years within general.
the profession which
reflect the weakness
identified in the
behavior analysis
above and/or plan to
maintain compliance
with Standards.
Main idea is somewhat
clear but there is a need
for more supporting
information.
The main idea is not
clear. There is a
seemingly random
collection of
information.
Action plan
Action plan and
timelines are
consistent with the
goal statements.
Main idea is clear but the
supporting information is
general.
Main idea is somewhat
clear but there is a need
for more supporting
information.
The main idea is not
clear. There is a
seemingly random
collection of
information.
Evaluation
statement
Evaluation statement
used to measure
attainment of,
progress toward or
continuing suitability
of both 5 & 10 year
goals
Main idea is clear but the
supporting information is
general.
Main idea is somewhat
clear but there is a need
for more supporting
information.
The main idea is not
clear. There is a
seemingly random
collection of
information.
Conclusion
(Organization)
The conclusion is
The conclusion is
strong and leaves the recognizable and ties up
reader with a feeling almost all the loose ends.
that they understand
what the writer is
"getting at."
The conclusion is
recognizable, but does
not tie up several loose
ends.
There is no clear
conclusion, the paper
just ends.
Total
Table 2
Michigan State University Wilson College of Nursing: MSN Program Curriculum
Retrieved from: http://nursing.msu.edu/MSN%20Education%20Concentration/default.htm
Table 3
Ferris State University MSN Program Schedule Options
Retrieved from: http://www.ferris.edu/htmis/college/alliedhe/Nursing/MSN-program-ScheduleOptions-2011.pdf