Running head: PROFESSIONAL DEVELOPMENT PLAN
Professional Development Plan
Cathy Groggel
Ferris Nursing Program RN-BSN
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Professional Development Plan
My philosophy of nursing, simply put, is to give the best possible care I can give to each
patient, every time. I really liked Virginia Henderson’s view of the professional nurse (as cited in
Kearney-Nunnery, 2008), “Assisting the individual, sick or well, in the performance of those
activities contributing to health or recovery (or to a peaceful death) that he would perform
unaided if he had the necessary strength, will, or knowledge. And to do this in such a way as to
help him gain independence as rapidly as possible.” Patients and their families are the center of
all that we do, it is important to treat them with respect and dignity, encouraging them to
participate in their plan, and give them the tools and information that they need to care for
themselves out side of our settings. I believe I exhibit the professional behaviors of a nurse and
in this papers will compare my practice with American Nurses Association standards as cited in
the ANA, 2010, Nursing Scope and Standards of Practice.
ANA Comparison to Current Practice in Ethics
In the Standards of Professional Performance as outlined by the American Nurses
Association (2010), “The registered nurse practices ethically.”(p. 47) I feel that I meet this
standard in my practice, every patient and family deserves the right to be treated with respect to
“dignity, rights, values, and beliefs.” (ANA, 2010, p.47) I address individuals as Mr., Mrs., or
Ms.as a way of showing respect unless we have agreed to be less formal. I accept their
preferences, rituals, and styles as part of what makes them an individual. I feel it is important to
look at the person, address the questions to them, wait, and listen for the answer before I go on.
Prior to signing consents, I make sure that the patient understands and can explain in his or her
own words what he or she is agreeing to. I act as a patient advocate in the event of seeing
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something that may be unsafe or dangerous to them or others by speaking up. An example of this
would be, observing that someone contaminated an item, stopping them and getting a new one
before proceeding or breaking down the set up and starting over. We must protect our patients
from harm. I frequently will voice my opinions and offer suggestions of changing the way we do
something if it benefits the staff, the patient, or the hospital.
We use a company called Press Ganey to survey our customers. The survey results give
us the patients’ perspective on whether or not they felt the care they received was efficient, safe,
knowledgeable, understandable and timely. If we are not providing the care that the patient is
expecting, we can then look at our processes and determine how to do it better. We also use a
postoperative phone call after the patient has been discharged. The call helps us determine how
they are doing and whether or not the tools that we gave them prior to discharge were adequate
to care for themselves at home. At the time of the phone call we address questions about pain,
problems, and temperature. We use a unit scorecard to monitor the various aspects of care we
deliver. The scorecard is updated monthly and we can make adjustments to our plan if we are not
meeting our goals.
ANA Comparison to Current Practice in Education
ANA (2010) states, “The registered nurse attains knowledge and competence that reflects
current nursing practice.” (p.49) Continuing education takes place informally on a daily basis.
Every day, I learn something new in caring for my patients, whether it is from a peer, physician,
team member or the patient themselves. More formal education takes place through; monthly in
services, patient rounds, on and off site conferences, attending monthly Association for
Operating Room Nurses meetings, or reading the latest nursing journal. Every couple months our
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unit holds a journal club meeting where staff can go discuss an article pertinent to our specialty.
Our hospital also belongs to Continuing Education (CE) Direct, where we can go and earn free
continuing education credits. Peer review is another place that helps me to see how I have done
and what I should place emphasis on in the future. Peer review includes evaluation of the
technical and professional skills in the nurse’s application to the patient and their family. Every
year, each employee is required to be set goals for themselves. The goals are in three categories,
clinical excellence, customer service, and corporate effectiveness. I evaluate what I need to do, to
become better at my job and set my goals accordingly. I think, as nurses, we owe it to ourselves
to keep growing, by staying current with changes in nursing, by collaborating with our peers and
other team members, and by being accountable for our actions. I attempt to stay current with my
practice and value any opportunity; I receive, to attend a conference to enhance my knowledge
base. Currently, I am attending Ferris State University to broaden my nursing knowledge base.
ANA Comparison to Current Practice in Evidenced–Based Research
I have not conducted research, but I have been a part of two research projects. Both
projects involved medication research. We were asked to document when given, chart responses
at certain intervals, and ask questions at specified times. Using research, our surgical services
council, of which I was part of, made changes to our procedures and policies. Currently at the
hospital, policies and procedure changes need evidence based practice to support the changes.
One of the changes involved putting oxygen on patients before they leave the operating room
suite on the way to the recovery room. A study done for the Surgical Care Improvement Project
(SCIP) in which patient’s undergoing colon surgery needed to be kept normothermic and if not,
an intervention needed to take place, for example putting on a warming device. We decided that
if SCIP research indicated that it was good for colon patients we should be warming all patients,
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other than those that needed to be intentionally hypothermic. So instead of checking just colon
patients, last year, we were checking all patients and warming accordingly. SCIP has now
included it as a measure to monitor for on all patients undergoing surgery.
As I work my way through this RN-BSN program, I will be learning more about
research, how to cite sources, and use the knowledge I gain to apply it to my current practice. We
cannot practice in a silo; we need to work with others to meet healthcare needs. Sharing with
colleges and peers (as cited in ANA, 2010) is another way to integrate this into my practice.
ANA Comparison to Current Practice in Quality of Practice
Evaluating what I do in my practice is, in my mind, very similar to delivering quality
care. I want to make sure that I am delivering the right care, to the right person, at the right time.
If my patient is not meeting his or her goals, I need to look at what else needs to be in place; why
they are not meeting them, what are the obstacles to meeting them, and how we can get there? I
frequently will look back at something I did and analyze it. What things worked, what didn’t and
what I could do differently next time.
I try to help others in my profession by being supportive, listening to their frustrations
and suggestions, helping them, offering alternative solutions and by participating in peers
reviews. There are council meetings that staff needs to get out to in order to represent the unit, so
I help cover while they are gone. I participate in discussions at staff meetings, ask questions and
listen to what others have to say.
In my current practice, the use of scorecards is used to monitor nursing practice. As cited
in ANA (2010), “Using indicators to monitor quality, safety, and effectiveness of nursing
practice,” (p. 54) is a way to make sure that we are delivering quality care. We monitor safety
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reports, medication errors, falls, satisfaction scores, documentation, productivity, specimen
handling, and Surgical Care Improvement Project (SCIP) measure on a monthly basis. If targeted
goals are not met, we write action plans on how to improve, then initiate and educate the changes
by having in services, poster boards to relay the information, and by sending out communications
weekly to the staff. At a specified point in time we then evaluate whether or not the measures
improved our outcomes. If not a new plan would be formulated.
ANA Comparison to Current Practice in Communication
Communication is one of the most critical skills that a nurse needs to have and develop. It
is very important to be non-judgmental in your approach and to keep the dialogue open. A nurse
needs to be able to distinguish between a patient shaking his head yes that he understands and
true understanding. He may be shaking his head, but not understand a word you are saying.
Questioning and asking relevant questions are ways to determine adequate understanding. People
learn in different ways, therefore communication needs to take on various forms. Whether it is in
an article, poster board, book, verbal, demonstration, a team conference, a presentation, an email,
or a movie, there is a point to be made and the appropriate interpretation of that point needs to be
clear between the people involved. Our actions and expressions can alter the way we are viewed
by others so it is vital that we communicate the right message. Nurses also need to be accurate
and timely in giving and receiving information. If a patient is a do not resuscitate, to find that out
in the middle of chest compressions, is an example of not looking out for rights or welfare of the
patient or family. ANA (2010) refers to the competencies of nurse communication, the nurse,
“Maintains communication with other providers to minimize risks associated with transfers and
transition to care delivery.” (p. 54) Furthermore, nurses need to understand that a breakdown in
communication can cause errors. There can never be too much communication.
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ANA Comparison to Current Practice in Leadership
I have been in a leadership position in the hospital setting for the past twenty seven years.
I have always believed that I should treat others as I would want to be treated. My parents taught
me that as I was growing up. It holds true in any profession. Although, sometimes challenging, I
try to keep a positive attitude while working. By setting an example, being accountable for my
actions, trying to exhibit calmness in stressful situations, encouraging and helping others on the
team, being open and honest, listening, and offering timely and sensitive suggestions are ways I
feel I contribute to professional nursing leadership behaviors. As cited in ANA (2010), the
registered nurse, “Treats others with respect, trust, and dignity.” (p.55) I could not say it better. I
respect staff opinions and allow them to question mine. I could become more active in our local
chapter of Association of Operating Room Nurses (AORN) and in other professional
organizations. We all have specific knowledge and development that continues throughout our
careers, we develop skills specific to nursing, we follow a code of ethics for which we are
morally obligated to, and we use our judgment and critical thinking skills every day to care for
our patients. The care of human beings is what we are all about. We need to look at the things
that are important to the patient and the staff. We need to build relationships with nurses, patients
and families that are based on respect, honesty, and dignity while respecting any diversity that
there may be.
ANA Comparison to Current Practice in Collaboration
I think we owe it to ourselves to keep growing, by staying current with changes in
nursing, by collaborating with our peers and other team members, and by being accountable for
our actions. We cannot practice in a silo; we need to work with others to meet healthcare needs.
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Our standards of nursing practice, ANA (2010) state that the nurse, “Partners with others to
effect change and produce positive outcomes through sharing of knowledge of the healthcare
consumer and/or situation.” (p. 57) I accomplish this by; attending management seminars with
other managers where I network with colleagues, nurse manager meetings, leadership
conferences and meetings, by participating in divisional and shared governance councils, staff
meetings and various other committees and councils. Sharing of ideas, opinions and experiences
lead to a greater understanding for the members of a group. Nurses are empowered to make
decisions about the care they provide based on research. As we join and participate in professional
organizations we can stand as a united group and impact the way that nursing is perceived by the public.
The environment needs to be safe so that where all health care providers feel comfortable in
asking questions and collaborating with each other. The discussion board conversations at Ferris
also help to broaden my knowledge base and develop alternate views.
ANA Comparison to Current Practice in Professional Practice Evaluation
Although governed by the ANA and state and local authorities, my nursing practice in
outpatient surgery is based on standards and guidelines of two distinct areas; the Association of
Operating Room Nurses (AORN) and The American Society of PeriAnesthesia Nurses
(ASPAN). All policies and procedure that we develop are based on these standards of practice.
As stated in the ANA (2010), “The registered nurse evaluates her or his own nursing practice in
relation to professional practice standards and guidelines, relevant statutes, rules, and
regulations.” (p. 59). To assist others in evaluating their own practice, peer review is a necessary
component. We should always be challenging ourselves to raise the bar. We benchmark against best
practices in an effort to give the best care to our patients, and we should do this in nursing practice as
well. If something doesn’t work one way we should research a better way to do it.
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ANA Comparison to Current Practice in Resource Utilization
Do no harm. Safety needs to be at the top of the list when considering resources for our
patients. The environment in which we practice needs to be safe, whether using the five rights
when giving medications, putting side rails up on the bed, or assigning the right person qualified
to do the work. Safety reports help us monitor practices that might be jeopardizing our patient
care. We need to be able monitor our effectiveness and timeliness in our care by looking at our
outcomes and adjust that care accordingly. In order to keep our hospitals from going under, we
need to use our resources wisely in order to eliminate waste and unnecessary costs to the patient.
In surgical services, I am a member of committee that looks at new technology and products that
are being requested by surgeons. In the evaluation of those items we look at increased or
decreased cost to the facility, patient outcomes, standardization and quality.
In our current healthcare environment, we are challenged daily with the Institute of
Medicines six requirements for excellence; safe, timely, efficient, effective, equitable, and
patient and family centered care. We are always looking for ways to decrease costs; turning off
lights, not opening supplies until we are sure we need them, finding more efficient ways to do a
process, decreasing the number of steps in a process, recycling, and by eliminating waste.
Utilizing our resources with these in mind helps provide the best care possible for the patient
while maintaining a viable bottom line.
ANA Comparison to Current Practice in Environmental Health
The facility I work in is always looking at ways to improve the environment in order to
reduce injury. Safety reports are monitored and common themes are brought to the attention of
the leaders. Through patient satisfaction surveys, we have learned that the noise level at night
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and around nursing stations was too high. The units have developed action plans to improve
those areas.
Through the use of proper protective equipment we protect ourselves and others from
exposure to disease. In order to support a holistic environment, we have an atrium area that has
live trees, plants and running water to take away from the sterile hospital feel. Our hospital
supports community involvement and requires the leaders to actively participate by making it a
job performance requirement. I would like to participate more in community events sponsored by
the hospital.
Goals
I enjoy the work that I do. I feel that it is my job to make sure that the unit is compliant in
all areas of evaluation in relationship to all of our governing bodies; joint commission, centers
for Medicare and Medicade, public health department, and our surgery standards. I feel that I
need to set an example of what nursing is about. It is my job to support the staff by allowing
them to actively participate in decision making, by collaborating with them, by allowing
flexibility, and by respecting and supporting them in the decisions they make. It is important to
keep an open mind so that the people feel comfortable in confiding in me and trust that I will do
the same.
My five and ten year goals would be to maintain and enhance all the duties I perform
today. A personal goal within the next five years is to complete the RN-BSN program. I would
like to actively participate in research projects, participate in more community events, and
continue to mentor staff for succession planning. I think that right now, going back to school is
taking more time than I had anticipated. Once I have completed it, I will be able to become more
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involved in community events. I am continuously encouraging others to continue their education,
participate in the budget process and on councils, to take certification exams, and to raise the bar
on what they can accomplish. In ten years, I would like to retire. Preparing for that will require;
paying attention to investments, becoming financially stable, and succession mentoring.
Conclusion
The nurse in all settings must follow a standard of professional performance. The ANA
(2010) outlines the standards as; ethics, education, evidence-based practice and research, quality
of practice, communication, leadership, collaboration, professional practice evaluation, resource
utilization, and environmental health. I have attempted to show how my current practice reflects
those standards. My five and ten year goals have been established and revision of those goals
will be on going.
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Resources
American Nurses Association. (2010). Nursing scope and standards of practice (2nd ed., pp. 4762). Silver Spring, MD: Nursebooks.
Kearney-Nunnery, R. (2008). Advancing your career: Concepts of professional nursing (4th ed.,
pp.11). Philadelphia, PA: F. A. Davis Company.