Category: Nurse

Rehab Observation

This paper describes the experiences and learning objectives at a recent rehabilitation observation experience. The student nurse observed the roles of the physical therapy, speech therapy, and occupational therapy. The roles were explained as the processes went on, and the integration of the whole care team was observed and explained. An RN interview was conducted to better explain the occupational workload of RN compared to an acute patient setting. The focus on the system of care as a whole, and roles of each individual were all observed.

The role of the therapy team as a whole is to help the patient regain physical strengths to the best of their abilities to live their life with the fullest potentials. The Therapy team consists of occupational, physical, and speech language pathologists. Along with the therapy team the nurses play a big role in the care of these patients as well. Observing all these different aspects in rehabilitation care shows the network style of care that each patient is given. The members of the team communicate well, and each have a special role in the physical rehabilitation, but all combine for a whole concept of care for each patient. Each therapist is educated in specialties for each patient, but their practices will overlap each other’s making rehabilitation forming a very webbed center of care. Spending this time as an observer was very informative, and eye opening. A total of two hours was spent at the rehab inpatient unit at Tuomey Hospital in Sumter, SC. Upon arriving to the unit therapists were helpful in dividing our times the best they could, for the best educational experience for the student nurses.

The first hour of the day was spent with the OT (occupational therapists). The role of the occupational therapist is summarized by the WFOT website as, “Occupational therapy practice is focused on enabling individuals to change aspects of their person, the occupation, the environment, or some combination of these to enhance participation.”(wfot.org). The therapists explained the work she does as helping the patient regain their ability for the occupations of their daily life. Examples of this are the tasks such as brushing teeth, combing hair, and daily oriented tasks such as these. The patient we worked with was working on balance and fine motor movements. The patient stood, and we played connect-four. As he stood and played the game it worked the fine motor movements of the hand to play the game, and balance as the patient stood. The therapist timed the patient and let him rest after certain amount of time was reached. It was interesting how the therapist worked on physical activity such as standing and balance when that seemed more of physical therapy task. When the patient was tired, we changed to a different activity. She used the resistance bands to help him with arm strength and had him count each repetition as well. This was interesting because, not only was she working with physical needs, she also was working on cognitive needs. Asking the patient what day, and season it was, and asking him to keep track of what repetition they were on in the exercise. She explained this helped with his memory, and by working day after day it would help with over all cognition. When his time was up, he retired back to his room, and rested. The frequency of the therapy sessions occurs every day. They rotate between disciplines during the days work.

Physical therapists work can be defined as, “Their job revolves around promoting their patients’ ability to “move, reduce pain, restore function, ,and prevent disability (APTA).””(Peterson, Bryanne). The therapist was working on helping a patient with a hip replacement stand and walk. It was a painful time for this patient, but the therapy had to be done to preserve the hip. This took physical strength of both the therapist and the patient. The therapist utilized the parallel bars to help support the patient and ambulate. To remain safe the therapists utilized a gait belt and explained the importance of safety for himself and the patient by using it to help support the patient when standing and walking. Once tired from standing and walking the therapists worked with the patient to perform range of motion on the hip while the patient was sitting. He utilized the rolling logs to help the patient moved his foot back and forth working muscles surround his hip joint in the leg. He then moved to a skateboard which was interesting to watch. He used the skate board to again work with range of motion of the hip joint without extending over the 90-degree limitation from the waist. Physical therapy work demands a physical aspect of not only the patient, but therapist as well.

The last portion of the therapy was spent with a speech pathologist. “The speech therapist is primarily responsible for the assessment, and intervention of patients with swallowing dysfunctions.”(Mok,Jagadish,Yiap,Yu,Lim,Ker). Along with physical needs of rehabilitation often times patients need the therapists to also help with swallowing, and speech needs. This care is vital to patients needing this type of rehabilitation. The ability to swallow can affect the outcomes of patients tremendously. They need the abilities to eat, drink, and take meds. It is vital to sustain life. Interventions may come into play if the patient is unable to swallow correctly. The treatment from the speech pathologist was interesting as it didn’t go along with a swallow evaluation or swallowing training. The therapist worked with cognition. She showed the patient two different items, (example: umbrella, and cane), and then asked the patient to state two differences and two similarities. Patients suffering from cognitive illnesses would struggle to perform these tasks, but it shows improvement when able to comprehend these questions asked. It was interesting to watch the interaction between the patient and the speech pathologist. A different scenario of treatment was viewed than anticipated but showed how the treatments can once again integrate with each other. The OT worked with cognition as well combing these two therapies. Each therapist also included the role as educator. This is important in a patient’s physical recovery. They all were sure to educate the patient when necessary and stated how important it was to build a rapport with these patients. They expressed how it was different from an acute care setting. They see these patients every day, and the relationship built is crucial to their outcomes.

The importance of rehab is important for these patients. Along with the therapy there is also skilled nurses who work with these patients whenever they are not with therapy. The nurses play a significant role in the wellness of these patients. When speaking with nurses on this floor about the differences from the rehab setting to an acute care setting they insisted not much was different. They were still nurses who cared for patients passing medications, assessing head to toe, and normal responsibilities within the hospital. The nurse then stated, “We wear many hats on this unit. The responsibility and patient care load can be very demanding. We play the role of physical, emotional, and spiritual support.” (Deela RN) The patient load can vary on this floor. The criteria needing to be met to be on the rehab floor plays a role in their census. The nurse can take anywhere from four patients to ten. Not only does the therapy teams aid in the physical aspects of patient care, but what the patients learn while working with therapy, the nursing staff is to implement as well. The therapists are only on the floor for eight to nine hours working with every patient on a set schedule. The patient is to take what they have learned from their therapy work to apply it to their lives. The nurse plays the responsibility of enforcing that education and helping them to keep on their scheduled activities. The nurse also expressed the emotional toll it can take on a patient. Her role as a nurse can be very psych oriented. To comfort these patients who have gone through some hard diagnosis, and rehab they need the emotional support in recovery which the nurse can also provide to these patients. Nurses can also play a role as a patient cheer leader. Helping to provide that positive feedback for the patient to continue support throughout the process.

The integrated care team of therapists and nurses is imperative for the patient’s outcome. The roles of each individual are each a piece of a building block for patients’ wellness. Each therapist, and nurse are trained to specific skills settings, and workload. They all overlap in a sense that they can all work together for the patient, and each therapy has something the other therapy doesn’t, but has similarities as well. By having each member of the team with a special skill set the patient benefits as a whole. This is the best way to approach a rehabilitation setting. Each team member plays an imperative role that without the job would be much harder for the team, and perhaps not complete. It is important for the patient that care team work together and communicate about patient care.

While interviewing the RN of the floor she discussed the FIM scores of patients. She expressed the importance of having completed a FIM assessment within three days of the patient’s arrival to the unit. “The FIM is a minimum data set measuring 18 self-care items including eating, bathing, grooming, dressing upper body, dressing lower body, toileting, ,bladder management and bowel management.”(Hinkle, Cheever). Assessing these things is important to the patients care. This allows staff to understand where the patient is at in the rehabilitation process, and what still needs work. When the scale is reassessed, the progress should show with the ratings of the patient improving. The nurse explained that the facility also uses this scale for repayment from the hospital. Expressing that the scale should increase and not decrease with patient treatment. The increase in the scale numbers show the patients progress in each ADL that is graded upon assessment. It is the facilities responsibility to make sure that the assessments are done correctly and timely. The ratings of the patients in these categories show what the team needs to focus on in patients care and rehab for the best outcomes of the patients.

The care of the patient in the rehab setting allows for the patient to develope to their individual bests of each physical aspects. It is however not a place that a patient can stay forever. Discharge planning always starts upon admission. Patients discharge planning can present challenges when they do not have the ability to care for themselves. There are several places a patient may be admitted to for a long-term care versus going home to care for themselves. For the higher functioning patient who needs minimal help at home they may be discharged to home with a home health service. Other patients who suffer more deficits may need a more total care facility. Long term care facilities are also known as SNF (skilled nursing facilities) are meant for this long-term care when families or home is not safe or accessible for this patient. There are support groups in the community and online that can help a family member through these hard times. It is difficult when you are caring for your family to place them in a long-term care facility, but sometimes it’s the safest for both the family and the patient. The transfer from inpatient rehab to an outpatient setting no matter where it may be needs to be the safest for the patient.

This experience was very informational. The way that the team works together including the nurses works very well for the patient and the best outcomes. The patients are able to develop a good rapport with the staff and this shows in the therapy sessions. The whole circular motion of the therapy team and how they all work together is really a great system for the patients. The way that the therapy team works for the patients, and educated observers shows the effort and purpose in their care of the patient. One thing to take away from this experience was the way they all work together as a team. No one part of therapy is greater than other in the care teams, and by working together they show the best outcomes in the patients’ responses. As a nurse, the role that is played is very important to the patient. Being able to collaborate with everyone for the best outcome of the patient is another great take away from this observation.

Conclusion

The therapy teams and nursing staff are responsible for the best physical outcomes for the patient. The care provided will shape the outcome of the patient and future care. The care of the Occupational therapists focuses on the occupational skills of everyday living. The physical therapy team members are responsible for the physical strengths and mobility of patients. The speech therapists are there to help with acts such as swallowing and speaking. As a whole the team interacts and works together to help strengthen and support the best outcomes of patients needing rehabilitation. Working as a team is important in the outcomes and discharge planning of the patient and for the family.

References

1. Deela RN. (2019, January 29). [Personal interview by the author]. Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth’s textbook of medical-surgical nursing (14th ed.). Philadelphia: Wolters Kluwer.
2. Mok, W. Q., Jagadish, U. M., Yiap, P. L., Yu, L. H., Lim, S. M., & Ker, S. Y. (2017). An interprofessional collaboration between nurses and speech therapists to detect dysphagia early in an elderly hip fracture population. International Journal of Integrated Care (IJIC), 17. https://doi.org/10.5334/ijic.3753
3. Peterson, B. (2018, December). Children’s Technology & Engineering. Children’s Technology & Engineering, 23(2), 30-31. ezproxy.cctech.edu
4. Statement on Occupational Therapy [Fact sheet]. (2010, August 11). Retrieved from http://wfot.org

Introduction

The legal requirements and professional behaviours are set by the code of conduct for the nurses. The code of conduct for the nurses further describe the principles that are to be maintained in professional practice in order to maintain effective professional practice. This code is abided by the National law made for the nurses in Australia. The code principles apply in all situations to all kinds of nursing practice. This involves any job that a nurse utilizes, whether paid or unpaid, clinical or non-clinical, nursing skills and expertise. This involves clinical care work, clinical leadership, responsibility for clinical governance, education, research, administration, management, consultative roles, regulatory or policy development. The code also applies to all settings where a nurse may participate in these activities, including face-to-face activities, publications, or online or electronically. The nurses should be aware of the obligations which are included under the National law in order to meet the legal requirements in their practice. Reflection is a very important process in nursing practice (Wain. 2017). Using reflection, the nurses make use of their experiences in their future implications in order to give culturally safe, ethical and legal care to the patients. Gibbs reflection cycle is used for the purpose of reflection. It involves six steps namely description, feelings, evaluation, analysis, conclusion and action plan. This assessment deals with the application of legal requirements and ethical standards the nurses should follow to the case studies provided. It further includes the reflection and learnings from the case studies using the Gibbs reflection cycle.

Case study 1:

According to the policies of medical treatment act, the nurses should take consent of the patients prior to the treatment and medical procedures (Dimovska et al. 2016). It is clearly mentioned in the policies that for the beginning of the treatment of the patient the consent of the patient is necessary. It is the right of the patients to provide consent for their treatment as mentioned in the National law. If the nurses conduct the treatment without the consent of the patient, there may be many legal consequences. In the following case study, it was necessary for a student nurse to have the consent of the patient to allow her into the operation theatre to provide treatment. According to the standards for the registered nurses, the student nurses should not be allowed in the operation theatre when the patient is not giving approval. Further for the ethical and legal practice in nursing profession the consent of the patient is very important (Dimovska et al. 2016). It is necessary for the nurses to maintain the ethical and legal standards. For the student nurses it is also important to have consent of the patient and the seniors in order to have access to the operation theatre.

Reflection

During my placement in the operation theatre of the Sunshine Coast University Hospital (SCUH) I was buddied with a RN. I was provided with a list of gynaecology procedures. My first patient consented with another RN. The patient did not give consent to any student nurse to observe his situation or to help in his treatment. The RN was asking me to enter the operation theatre with her in order to assist her in the patient’s treatment. I told her that I was not allowed in the operation theatre because the patient did not give me consent to treat him even when he was given anaesthesia. I was feeling stressed in this situation because the RN was asking me to enter the operation ward, but the patient did not give me any consent to enter the operation theatre.

By the evaluation of the situation I gained knowledge how to take consent from the patient who is admitted in the operation ward profession (Lachman et al. 2015). The RN asked me to enter the operation theatre without the consent of the patient as he was under the effect of anaesthesia. According to the legal standards of nursing this was not ethical. The consent of the patient should be given for the treatment. I decided not to enter the operation theatre in order to follow the legal standards of the nursing profession (Mills. 2018).

From this case study, I analysed that for the practice in nursing as a student nurse the consent of the patient is most important for his treatment (Ausmed. 2017). The standards of registered nurses gave me a clear knowledge that it is necessary for the student nurses to follow the legal and ethical requirements. From the legal standards of nursing I have gained knowledge that it was not ethical to enter the operation theatre without the consent of the patient.

In my future implication before entering the operation theatre I should take care that the patient has provided the consent for my entry in the operation theatre (Ausmed. 2017). I will also try to make the RN aware about the complications according to the code of conduct and the national laws that the consent of the patients is important for the treatment of the patient. According to the medical treatment act, it is necessary for the nurses to follow the legal requirements of the nursing profession.

The action plan that I would plan in such cases would be to take consent form the patient for further treatment. I would try to convince the patient and be very calm so that the patient would allow me to enter the operation theatre in order to assist the RN in the process of treatment.

I would conclude from the above case study that the National law of Australia states that consent of the patient is important for the nurses for practice profession (Lachman et al. 2015). According to the medical treatment act the nurses should treat the patient only after the patient provides consent for the treatment.

Case study 2:

According to the Work Health and Safety Act 2011 (Ausmed. 2017), ‘protecting employees and patients from harm to their hygiene, security, and healthcare.’ This involves patient safety procedures for nurses and other health practitioners and implies that efficient hand washing is an important and legally needed practice at the healthcare setup. Around 1 in every 10 individual that are admitted to a healthcare provision creates an infection, which can dramatically affect their mortality and morbidity rates and increase hospital expenses. It justifies prevention of cross contamination using multi-step process involving presence of organisms on hands, transfer of microorganisms from health, survival of organisms on hands due to lack of hygiene, direct contacts with the patients leading to transmission (Ausmed. 2017).

Reflection

Being a registered nurse, I was assigned for the responsibility of administering medicines and assessing the vitals of all the patients in an emergency healthcare ward. I was working in collaboration with 3 other nurses for different patients as per the allocations by senior RN’s. I analyzed that the fellow nurses did not washed their hands while shifting from one patient to another. According to the policies set by WHO, a healthcare professional must wash their hand before and after touching a patient, before and after aseptic processes and after exposure to the patient’s body fluids such as blood, puke, and saliva. I was alarmed at their actions as their negligence could have led to serious cross contamination infections to the patients. According to standard 6 of the registered nurse standards for practice NMBA (2016), the registered nurse’s practices consistently according to the policies, guidelines, norms, laws and legislation. The nurses were not following the hand hygiene policy of the hospital that may have created serious issues in terms of their career and patient’s health and wellbeing. It has been reported that hand hygiene policies of a hospital govern the safety, and wellbeing of the patients in terms of hospital acquired infections, or nosocomial infections. I took them aside and told them the importance of following hand hygiene. I told them that every patient has different resistance toward the infections, and every patient encounters different type of infectious agents due to improper hygiene, contamination, and subsequent exposure to pathogens.

According to Dzahar (2017), feces contains 1013bacteria’s per gram, and 100-10000 microorganisms resides per cm2on the surface of skin. Improper hygiene can lead to contamination that can invite various diseases to deteriorate health of the already sick patients. The nurses took my suggestions and advices in a positive way as I told them that patients at the hospital reported higher incidences of urinary tract infection, which may have been a cause of improper hand hygiene maintenance by the nurses. I explained them the steps of washing hands while assessing the patients. According to the (Thomas. 2015), proper hand hygiene requires rolling the sleeves of shirt while washing and cleaning the palms, thumbs, fingers followed by proper drying and rinsing using a clean and uncontaminated towel. The incident taught me the importance of maintaining hand hygiene while delivering quality care to the patients in order to reduce the incidences of urinary tract infections in the hospital. The human acquired infections are monitored and regulated by the center for disease control and prevention because these infections are not present in the patient at the time of administration but are developed during treatment in the hospital (Regunath & Monergo. 2018).

According to standard 3 of registered nurse standards for practice NMBA (2017), a registered nurse should engage in safe nursing procedures to ensure better health outcomes. Improper hand hygiene tends to develop into diseases and bacterial infections such as MRSA, which can lead to death or sepsis. It can also lead to severe conditions such as HIV, viral hepatitis, and bacterial sepsis that can be detrimental to the health and wellbeing of the patients. All the health problems that results from failure to follow hand hygiene are very critical and deteriorating. A registered nurse should always follow secure and responsible processes to deliver effective results that meet people’s needs. According to standard 6 of the registered nurse standards for practice NMBA (2017), secure nursing practices of obtaining results that respond nursing requirements of patients should be followed. Hand hygiene is essential because it protects patients and employees from infection. During or after assessing or medicating a patient, hands should be washed because infection may result in patients being readmitted to the hospital that increasing their hospital bill and health problems (Ragunath & Monegro. 2018).In future I would always follow hand hygiene and teach the importance of hand hygiene to all my patients and colleagues.

Case study 3:

The NAADAC and NCC standards states that in nursing practice consumption of drugs is illegal. It has made certain legal and ethical code of conducts for the nurses (Mills. 2018). These standards states that if the nurses or the student nurses’ practice under the influence of drugs then it is not legal and ethical. The standards of NAADAC ensures that they enable and recognize the legislations for the professional practice of nursing. They ensure that the student nurses follow the legal requirements in their practice which are stated by the National laws of Australia. According to the standard of the nursing profession it is necessary to provide quality care to the patients. It has been revealed in previous studies that under the influence of drugs the quality and safe practice of nursing is not maintained, the previous studies states that the nurses can make professional errors if they do practice under the influence of drugs (NMBA. 2019). In the given case study, it was observed that the student nurse was under drug influence and came to work. It is illegal for the student nurse and against ethical practice. The legal requirements of National law were violated in this case.

Reflection

During my placement as a facilitator in the hospital I came across an incident. In that incident I noticed that one of my students came to work but he was exhibiting a strange behaviour. His behaviour was departed from his normal behaviour. He was not able to concentrate on his work and was fidgeting constantly. The student was also not able to concentrate and follow my instructions. I decided to take the student side and ask him about the problem. I investigated him about the reason behind strange behaviour. I further asked him whether he was under the influence of any drug or he had consumed alcohol. The student provided with the information that he had consumed drugs on the night before and the behaviour was the result of the same. He further informed me that he consumed the drug because of the recent death of a family member.

I felt disturbed by seeing the situation of the student. I was angry as well because he was under the influence of drugs and he came to work. After seeing his strange behaviour, I was astonished because he was a brilliant student and was always active in his work. I analysed from the situation of the student that due to the consumption of drugs he was showing a strange behaviour. I also analysed that nursing practice under the influence of drugs is not safe. This is due to the reason the under the influence of drugs then concentration power of the nurses is affected, and they can make errors in their profession (Gu et al. 2015). I also analysed that the nurses cannot work efficiently if they consume drugs a night before.

According to standard 3 of registered nurse practice standards, the nurses should provide quality and safe care to the patients (NMBA. 2017). According to the legal standards mentioned in National law of Australia, the student nurses or practitioner nurses should not treat a patient or come to work under the influence of drugs. In this situation the student came to practice under the influence of drug which was not legal and ethical in nursing practice according to the legal requirements. In my future practice I would ensure that no such students come to work under the drug influence in order to follow the law and ethics of the nursing profession (Lachman et al. 2015). According to the National law for nurses the practice under drug consumption is illegal and should not be practiced.

In this case I make the student aware of the consequences that would have taken place if he would continue the practice under the influence of drugs (Byard & Payne-James. 2015). I also made him aware of the legal complications that he had obligated and why following of the rules was necessary for the student and practitioner nurses. I concluded him the above case that according to the legal requirements of the National law the practice of student under the influence of drugs was illegal and unethical (Byard & Payne-James. 2015). I would try that in my future practice I would not allow such students to enter the classroom or the hospital premises. This would enable me to ensure that the student follows the legal and ethical professional standards.

References

1. Ausmed 2017, Hand hygiene and infection control-how effective hand washing can save lives, viewed 20th August 2019, https://www.ausmed.com/cpd/articles/hand-hygiene
2. Byard, R. & Payne-James, J 2015, ‘Elsevier’, Encyclopaedia of forensic and legal medicine, vol. 4, published 4th November, https://www.elsevier.com/books/encyclopedia-of-forensic-and-legal-medicine/byard/978-0-12-800034-2
3. Dimovska, EOF, Sharma, S, & Trebble, TM 2016, ‘Evaluation of patients’ attitudes to their care during oral and maxillofacial surgical outpatient consultations: the importance of waiting times and quality of interaction between patient and doctor’, British Journal of Oral and Maxillofacial Surgery, vol. 54, no. 5, pp. 536-541, https://doi.org/10.1016/j.bjoms.2016.02.022
4. Dzaher, A 2017, How nurses can maintain proper hand hygiene practices, viewed 23rd August 2019, https://today.mims.com/nurses-maintain-proper-hand-hygiene-practices
5. Gu, MO, Ha, Y, & Kim, J 2015, ‘Development and validation of an instrument to assess knowledge and skills of evidence‐based nursing’, Journal Clin Nurs, vol. 24, no. 9-10, pp. 1380-1393, https://www.ncbi.nlm.nih.gov/pubmed/25664762
6. Lachman, VD, Swanson, EOC, & Winland-Brown, J 2015, ‘The New Code of Ethics for Nurses with Interpretative Statements'(2015): Practical Clinical Application, Part II’, MedSurg Nursing, vol. 24, no. 5, pp. 363, https://pdfs.semanticscholar.org/6635/0a4ab5f074b30645cc984e00b9a8fc857b0c.pdf?_ga=2.225285466.1136091160.1566817782-1216468358.1566817782
7. Mills, IJ 2018, ‘Through the patient’s eyes–the importance of person-centred care in oral cancer’, British dental journal, vol. 225, no. 9, pp. 889-891, doi: 10.1038/sj.bdj.2018.923.
8. Monegro, A.F. & Ragunath, H 2018, ‘Hospital acquired infection’, Stat pearls [Internet], https://www.ncbi.nlm.nih.gov/books/NBK441857/
9. NMBA 2016, Code of conduct for the nurses, viewed 25th August 2019, https://ed-areyouprepared.com/wp-content/uploads/2019/01/Nusing-and-Midwifery-Board-Code-Advance-copy-Code-of-conduct-for-nurses-Effective-1-March-2018.pdf.
10. NMBA 2019, Legislation, viewed 25th August 2019, https://www.ahpra.gov.au/About-AHPRA/What-We-Do/Legislation.aspx.
11. Nursing and Midwifery board of Australia 2017, Registered nurse standard, viewed 26th August 2019, https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
12. Thomas, RK 2015, Practical medical procedures at a glance, John Wiley & Sons, https://books.google.com.au/books?hl=en&lr=&id=lZmLBgAAQBAJ&oi=fnd&pg=PA16&dq=Thomas,+R.K,+2015,+Practical+medical+procedures+at+a+glance.+John+Wiley+%26+Sons.&ots=_H2OlqBK4R&sig=W6a0xPcU_K8FBpUQ_KGmZvL63tI#v=onepage&q&f=false
13. Wain, A 2017, ‘Learning through reflection’, British Journal of Midwifery, vol. 25, no. 10, pp. 662-666, DOI: 10.12968/bjom.2017.25.10.662

The purpose of this paper is to explore emotional resilience as an area for improvement during my transition from a student to a registered nurse using the concepts of transition theory and reality shock (Kramer, 1974). The rationale for choosing emotional resilience is a need to improve my weaknesses in the SWOT analysis in preparation for the transition. Nurses face stressful situations during the transition due to increased patient caseloads and expectations which require them to be resilient to continue with their nursing practice (Christensen et al., 2016). The exploration of the transition process entailed a SWOT analysis to help me as a newly qualified nurse (NQN) to identify my professional strengths and areas of improvement for my future nursing practice. The discussion will include the formulation of a search question on personal resilience because the SWOT analysis showed that I need to improve in some areas before the transition. A literature review and search will be conducted through a systematic search strategy for critical appraisal.

The literature searches and review yielded three critical themes about emotional resilience‒psychological stability, leadership, and organizational culture. The chosen articles have details about the causes of emotional resilience among NQNs and how they can address the problem during the transition into nursing practice. In combination with the literature review, short and long-term action plans will be proposed to help me to prepare for and experience a smooth transition to registered nursing practice. I will develop overall ideas on the action plan to address my weaknesses in the SWOT analysis and use the opportunities I have for improvement in my nursing career.

Transition Theory

Nurses gradually move from one level of nursing career to another based on their skills and knowledge acquisition. Transition theory is pegged on the phenomenon of a continuum of life changes in nursing practice (Moran & Nairn, 2018). Transition theory explains the experiences of nurses during organizational and situational transitions which involve development, movement, or flow from one state of practice to the next. As a final year nursing student, it is useful to know about transition theory in order to predict my experiences in my new roles once qualify to be a registered nurse. The theory will help to identify the potential challenges which students might face during my first role in nursing practice, and how to use my strengths to address the problems. Therefore, knowing about transition theory will ease my transition to registered practice by helping me to foresee and prepare to overcome challenges in nursing practice.

Why nurses leave the profession is an important thing to know and transition theory is one explanation why this may be related to the NHS issues on nursing shortage and retention. The NHS is faced with a nursing shortage with more than 40,000 vacancies in nursing practice in England (RCN, 2020). The need for nurses keeps on rising despite the low nurse retention rates. The NHS will need 50,000 more nurses in the next 5 years, and the UK healthcare system must have a plan for delivering this need (RCN, 2020). The emotional resilience of nurses is important in tackling nurse shortages and staff retention by ensuring that NQNs overcome the challenges of new practice. For instance, 1 in every 5 nursing staff members leaves their place of work before the year ends (Buchan, Charlesworth, Gershlick, & Seccombe, 2019). The low retention rates have led to high staff turnover and instability of nursing care within the NHS (Buchan et al., 2019). Therefore, nurses must improve their ability to work with the NHS by properly improving their emotional resilience to stress during the first year of registered nurse practice.

NQNs face challenges that could impact their transition from a nurse student to registered practice. The risk of emotional burnout is high among the NQNs because the transition shock occurs when moving from student to registered nurse (Christensen et al., 2016). Theorists have explained the occurrence of emotional distress among the NQNs through different phenomena and phases. The new nurses experience a phase whereby they have feelings of insecurity and self-doubt due to the increased responsibilities and expectations after registration (Christensen et al., 2016). Kramer and Duchsher are renowned theorists in nursing transition who have defined the contexts of nursing transition. Kramer (1974) noted that the first few months of nursing practice are the most challenging period due to the unrealistic expectations of self and others coupled with the fears of failure, responsibility, and making mistakes. An NQN would experience these negative feelings during the initial periods of practice. Kramer (1974) called this transition theory experience a reality shock that might contribute to the NQNs leaving the nursing profession at an early stage of their career.

The NQNs go through four phases of reality shock as they try to adapt to their new work environment. The four phases of the reality shock in the transition theory are honeymoon, shock, recovery phase, and resolution (Kramer, 1974). The nurse experiences the joy of practicing as a registered nurse in the honeymoon period but starts to experience conflicting ideas and a lack of security in the shock phase which is dominated by feelings of discomfort in the new work environment. However, healing begins in the recovery phase as the NQN begins to understand the new organizational culture (Kramer, 1974). The final stage is the resolution phase whereby a nurse adjusts to the new environment and operates fully as a professional nurse. The reality shock stages are important to the transition phase to ensure NQN attains resolution faster because preparedness for transition is correlated to the reality shock (Christensen et al., 2016).

On the other hand, Duchscher expounded on the findings of Kramer to determine how NQNs adjust to the physical, social, developmental, and emotional changes during the transition (Duchscher, 2009; Lindmark et al., 2019). Nurses experience changes in their circumstances at workplaces after the transition. NQNs have gaps between pre-registration and the realities of registered nurse practice (Duchscher et al., 2019). To overcome the new practice challenges, NQNs require time and leadership support in their transition phases. The competence and confidence of nurses have been shown to increase over time after practicing their new roles (Duchscher et al., 2019).

The concept of transition in nursing practice is multidimensionally identified with a complex interaction between personal awareness, time span, difference and change, events, and critical points (Lindmark et al., 2019). The nurse must be ready to navigate through difficult clinical situations which require unwavering support from the organizational leadership. NQNs have internal feelings about their performance, and they question their competence due to fears of acting like imposters in healthcare (Christensen et al., 2016). Therefore, knowledge of the reality shock phases and the Imposter Phenomenon is important to ensure that I address challenges that could limit my self-perceived level of competence in nursing practice.

SWOT Analysis Discussion

Knowing my personal attributes that could influence my functionality as a registered nurse will help me to establish a plan to accomplish my professional ambitions in my first year as a registered nurse. The SWOT tool, as shown in Appendix 1, is an analytical approach to decision-making and planning by identifying the areas for growth as well as challenges to meeting a set objective (Longhurst et al., 2020). To complete the SWOT analysis, I evaluated the performance feedback that I got from the mentors in the booklets from years 1, 2, and 3. Feedbacks from the mentors were important as a flashback to the previous experiences during the placement to enable me to identify my strengths, weaknesses, growth opportunities, and threats to my practice as a registered nurse.

Gaining further insight through E-coach career assessments was also important in personality identification. The E-coach (2020) provided me with an opportunity to determine how my personality affected different areas of nursing practice. Through a series of career assessments, I noticed that I have poor adjustment capabilities to new roles in nursing (Ecoach, 2020). Therefore, I should update my personal resilience skills to achieve better results on my last placement.

I found the emotional resilience of nursing during the transition as the most important topic for review in this paper. My SWOT analysis showed that I should make efforts to improve my aspects of personal resilience such as organization and support networks (Ecoach, 2020). I scored average on my self-confidence which can reflect arrogance and lead to poor interpersonal relationships. In addition, my weaknesses also surround being anxious about decision-making on issues pertaining to evidence-based practice. Nurses should be educated to have a perception of belonging to the right profession (Jang et al., 2019). Therefore, I require further development of my confidence to practice clinical skills and remain stable to become emotionally resilient. To address my shortcomings in personal resilience, the assessment report indicated that I should continuously work on my level of self-confidence while ensuring that I cope with changes in the nursing profession (E-coach, 2020).

I also have strengths that will enable me to utilize the opportunities for growth in adapting new resilience skills to fit into my new practice as a registered nurse. I had high scores on problem-solving skills, giving feedback, and identification of practice gaps (E-coach, 2020). Overall, the completion of the SWOT analysis enables me to identify emotional resilience as a priority area that I should improve in order to ensure a smooth transition to register practice as an NQN.

Introduction

Trauma nursing is an intense specialty of nursing, where the skills of a trauma nurse may make the difference between life and death for a patient in distress. I will be covering some important topics regarding trauma nursing such as an introduction to trauma nursing, work environment, and emergencies seen in the field. Also, the history requires education and certification opportunities in trauma nursing. Furthermore, going into what the future of trauma nursing may face. Finally covering why I’m considering going into trauma nursing. Moving forward, these topics will elaborate more on the subject of trauma nursing.

Introduction of trauma nursing

Trauma nurses have a wide array of skills they must be proficient with to fulfill their duties. Along with some of the standard expectations of a registered nurse such as documenting, communicating and collaborating, conferring with family members, reporting cases of abuse and neglect, and administering first aid CPR when required. Trauma nurses will be expected to administer IV fluids, administer blood products, perform wound care, recognize worsening signs and symptoms in already unstable patients, and administer emergency medications, particularly during a code. Also, the trauma nurse must be able to therapeutically communicate with patients and family members, and collaborate with law enforcement whenever a trauma case may be related to criminal activity. These are an overview of skills that you would see used by a trauma nurse.

Work environment

Trauma nurses are prepared for anything that will be thrown at them while maintaining a calm resolve and working with a team. A trauma nurse will see patients of all ages, in various situations and not only know what to do but do it as quickly as possible, in fast-paced high-stakes situations. While still being able to communicate, as well as work in unison with other healthcare professionals to provide the most optimal care. Trauma nurses must also be able to compose themselves despite having to bear first-hand witness to tragedy. As you can see, preparation, resolve, and teamwork are core components of a trauma nurse.

Emergencies

Trauma nursing is a very versatile specialty, that requires deep knowledge of various emergencies. A Trauma nurse can find themselves treating patients injured related to gang violence such as stab wounds, assault and battery, gunshot wounds, and while not always related motor vehicle accidents also to name a few. Furthermore, a trauma nurse may encounter domestic-related patients such as physical abuse, or even neglect. Lastly, a trauma nurse may find themselves caring for those affected by acts of god such as those who have sustained injuries from hurricanes, tornados, floods, earthquakes, mudslides, tsunamis, and other natural disasters. As shown, a trauma nurse must be well-versed in various emergencies and how to approach each one.

History of trauma nursing

The history of trauma nursing is an interesting one, one of slow progression from untrained nurses to well-educated, well-trained specialized nurses. The earliest record in the United States of what is now known as trauma nursing would be from the Revolutionary War when George Washington mandated nurses to tend to the wounded, as well as women to supervise these nurses and facilities. Before 1890, the US military sought out untrained women to serve as nurses as stated by Mary Beachley, MS, RN. Even though the Corp of Army Nurses was known to be founded in 1901, there were limitations. Male nurses were not allowed entry into the Army Nurse Corps until some fifty years later in 1955. Though trauma is an important role for nurses, as stated it has seen a slow progression to what it is now.

Required education preparation

As with any nursing specialty, trauma nursing requires specific education to be prepared to enter the field. Trauma nursing requires completion of a two to four-year university program, therefore having an associate nursing degree or bachelor nursing degree respectively. Furthermore, trauma nursing requires the nurse to have passed the NCLEX-RN, therefore being a registered nurse. A trauma nurse must also have the trauma nursing core course (TNCC) completed, it’s a two-day long certification class that preps nurses for trauma patient care. Trauma nurses must recertify their trauma nursing core course (TNCC) every four years. While basic life support (BLS) is a standard requirement for nurse specialties across the board, trauma nurses must also be certified in advanced cardiac life support (ACLS) and some cases pediatric advanced life support (PALS) as well. As stated, that’s the specific minimum education required to become a trauma nurse.

Certification opportunities

Trauma nursing has many available certification opportunities available in their field. While depending on the workplace, sometimes the emergency nursing pediatric course (ENPC) might be seen as a requirement. The emergency nursing pediatric course, while similar to the trauma nursing core course, focuses specifically on emergencies in children. Another certification available to trauma nurses is a trauma-certified registered nurse certification (TCRN). The TCRN is recognized nationwide and has higher requirements than the other certifications such as one thousand hours or two years of trauma nursing, an RN, and 20-30 hours of coursework related to trauma. While this as a whole is focused on a trauma nurse that would operate within a hospital, it’s also worth noting that flight nurses are also considered trauma nurses which would include this certification specifically available to flight nurses, the certified flight registered nurse (CFRN) credential for nursing. In closing, trauma nurses have many certifications available to earn, which only further improve their skills.

Future of trauma nursing

Here are some factors to consider in the future of trauma nursing. According to the Bureau of Labor Statistics, the job outlook for registered nurses is expected to increase by 12% between 2018 and 2028. Even though there is expected to be an overall job growth, nurses lining up to fill those jobs may become an issue. As predicted by Robert Rossiter, as the Baby Boomer generation continues to age we’ll see a bigger demand for nurses, especially in the south and west regions of the United States. What this means for trauma nurses is that as the profession as a whole will become increasingly stretched thin by these shortages with higher patient loads in a field where nurse burnout is already playing a huge factor in staffing shortages, lower job satisfaction, and worsening patient outcomes. The pinch will be felt hard on trauma nurses where the stress and stakes are already high, they will only get higher with fewer resources. Those are the factors to consider in the future of trauma nursing.

Why are you considering this as a career path?

I am considering trauma as a career path for various reasons such as family care, personal experiences, and desired skills. I come from a healthcare family, my mother was a labor and delivery nurse and eventually moved on to teach childbirth education classes at Carroll Hospital. My aunt worked in oncology before moving into nurse management, she now works at the command center at Johns Hopkins. My grandfather at a young age was a medic in the Korean War. Even those in my family who did not pursue healthcare I often consider to be very caring people who go out of their way to help others. As my parents and other family members get older, I feel that having more knowledge regarding healthcare would be greatly beneficial to them in instances of potential traumas caused by falls. My primary reason for pursuing trauma nursing as a career is that I want to acquire the skills and knowledge that would enable me to be able to provide immediate urgent care in emergencies. These are the reasons why I want to pursue trauma nursing as a career path.

Life experience

I’ve had some experiences in my life that pointed me towards trauma care and made me feel that I was suited for it. When I was 7 years old, I was involved in a car accident not far from my home, where my father and I were hit by a drunk driver causing our vehicle to spin out. In this accident, my father’s glasses shattered on the windshield and flew back into his face. Even at the young age of 7, I immediately reacted and ran to my house to get the required assistance. In my early 20s, while riding in a car with my friends we witnessed a friend’s car go off the road and then flip back onto the road. The car fell silent and all of my friends in the car froze up not knowing what to do, I took charge of the situation, instructing them to get our car off the road and to call the emergency services. I ran as fast as I could to check on my friend whose car had flipped. I assisted them in getting out of their vehicle and used my jacket as a makeshift tourniquet until the fire department arrived. These are the first-hand experiences that led me to want to pursue trauma nursing as a career path.

Conclusion

In summary, this showcases why trauma nursing is an intense specialty of nursing. We covered what trauma nurses do, their work environment, emergencies they encounter, history, required education, certification opportunities, what the future of trauma nursing may face, and lastly why I’m considering going into trauma nursing. The importance of trauma nursing cannot be understated as trauma nurses are the first ones to treat a patient in an emergency when they reach the hospital. What trauma nurses face can be daunting, but also very rewarding. In closing, I felt doing this paper helped me better learn and prepare for what I may be facing as a trauma nurse in the future look and I look forward to the challenge.

References

1. Beachley, M. (2005). The Evolution of Trauma Nursing and the Society of Trauma Nurses. Journal of Trauma Nursing, 12(4), 105–115. doi: 10.1097/00043860-200512040-00003
2. https://search.proquest.com/docview/194497945/fulltextPDF/F60549D1209B4D63PQ/1?accountid=42022
3. Writers, R. N. S. (2019, September 2). How to Become a Trauma Nurse. Retrieved from https://www.registerednursing.org/specialty/trauma-nurse/.
4. https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage
5. https://www.sciencedaily.com/releases/2015/09/150921153457.htm
6. https://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-1
7. https://www.topnursing.org/career/trauma-nurse/
8. https://www.aacn.org/nursing-excellence/nurse-stories/trauma-team-successful-staffing-model
9. https://nurse.org/resources/trauma-nurse/
10. https://search.proquest.com/docview/2304942593/5C6C5C260D414485PQ/4?accountid=42022 

I am interested in the Nursing Bachelor’s Degree Programme. I intend to pursue a career in Adult or Mental Health nursing which offers exciting explorations and fascinating discoveries, inspiring goals and absorbing new challenges. I believe Nursing would be a good fit for me because the idea of supporting and caring for the sick in society gives me joy.

I am from Nigeria in West Africa and relocated to England to start a new life. Back then I had a third cousin who was suffering mentally but I watched my grandmother and her elder sister supporting and looking after my cousin. I could also remember during my late mum’s second to last pregnancy with my younger sister. She came home from the city to the village to be treated by the village midwife, an elderly woman called Mama Anugom who uses local medicines and herbs to treat any complicated pregnancy and other sicknesses, she was very brilliant and exceptional in her role with no formal education.

This has spanned up my desire to go for nursing as my career path to enable me to put a smile on someone’s face. I have a tremendous eagerness to make people happy and help them to live normal lives.

Nursing I know is very challenging and demanding. it involves compassion, empathy, observation, and a lot of paperwork. While working as a part-time support worker, I discovered that good interpersonal communication skills and teamwork a contributing factors in successfully supporting people who suffer from health issues.

I am unwavering and devoted and I like to keep myself busy in a challenging situation. Being passionate, diligent, and conscientious would enable me to succeed in my chosen career path. In my experience working in health and social care. I have achieved the following skills as a support worker/healthcare assistant in a care home and supported living.

Interacting with the clients, promoting a healthy lifestyle, prompting medication / helping individuals take their medications correctly, and working with team members and other care professionals to mention a few, I am confident that I will be a very strong candidate with an extremely high potential to succeed in the program.

A Nursing Bachelor Programme is an opportunity for me to pursue my specialist interests. Nursing is extremely rewarding and makes a huge impact on society enabling quick and more informed decisions on issues affecting people’s health. I would have the opportunity to interact with clients. I would further develop my personal and Nursing skills through continuing training.

I intend to work as a Nurse upon my graduation and will continue studying to obtain a master’s degree in Nursing I believe this program will provide me with a solid foundation and hands-on experience that would prepare me, not only for further studies but also for many career opportunities in the health sectors. Nursing graduates are very much in demand right now. I had a private conversation with one Nurse she gave me a lot of insight about the program, and potential job opportunities and she specifically mentioned that the program has very competent and experienced instructors. I also spoke with some nursing students who are currently studying at the university and the first thing they said to me was that I could never go wrong pursuing a Nursing career, they also mentioned that they have friends who completed the nursing program and they all gave them positive feedback, they all highlighted the fact that the program provided excellent preparation for their current career success.

I hope to learn from and network with people of diverse backgrounds and experiences. I am particularly interested in Adult Nursing, I attended college for access courses in September 2019 and I found it very informative and many of my questions and concerns were addressed by Mrs Natalie. Given my background and experience, I am confident that I am an excellent fit for the Nursing program, and from my access results, I see a strong match between the program and my interests and abilities.

I am applying for Adult Nursing as I am eager to pursue a career in which I can have a positive impact on people’s lives every day. I have always looked upon nursing and other medical professionals’ roles with respect, increasingly so during the current pandemic.

I am interested in nursing as it is a challenging and rewarding profession with lots of growth opportunities. I love to learn and want to be able to continuously develop through my career, I know that within nursing there are always ways to improve and expand my knowledge as it is an ever-changing industry and versatile field. I understand that nursing is far from easy and there will be many challenges including long and busy shifts as well as the death of patients, however, I know I can overcome these challenges.

I have researched the position of a nurse through the Nursing and Midwifery Council website and the NHS careers website and understand the role of a nurse and its importance. I believe I would be a competent nurse as I am a caring person with strong listening skills, empathy, and patience. I share the values of the NHS including treating everyone with respect and dignity, working together as a team, treating everybody equally, and having compassion.

Since November 2019 I have worked as a Recreational Assistant at a Leisure Centre. This role includes lifeguarding, cleaning, customer service, and changing equipment ready for customers. This has improved my observation and communication skills and taught me how to help customers of all types and involves acting quickly in emergencies and pressured situations. This job has also improved my attention to detail as I must be attentive always to ensure the safety of customers. During monthly training, we go over multiple common health issues and are taught to recognize the early signs of these health issues such as heart attack, stroke, asthma attack, and much more as a preventative measure so we can act early and decrease the risk, which is useful in a nursing career. During work, I have performed basic first aid on several customers and had to work with panicked and distressed customers where I needed to help them stay calm. Despite feeling incredibly stressed I have always coped well under this pressure and helped the customers as needed and not let my emotions interfere with my role.

I have also worked at a racecourse restaurant as a food runner and order taker which involves communicating with customers while working in a fast-paced environment with stress on timings and quality of service. This helped to develop my time management skills and increase my confidence around customers. Working here helped me realize I enjoy this work environment and that I enjoy being busy, working with different people, and facing different challenges every day which is a large aspect of nursing as every day is different.

I have read The Emperor of All Maladies written by Siddhartha Mukherjee which is a full biography of cancer and talks about the research and development in cancer treatment and how it changes and develops over time. Reading this interested me in the development of healthcare and how crucial and universal it is. It also encouraged me to pursue a career in nursing.

Another book I have read is Life at the Extremes written by Frances Ashcroft which is about the science of survival and investigates the physiology of humans, what our limits are, and how we differ from other animals and adapt to different conditions through scientific reasoning alongside real-life stories. The anatomy and physiology of the human body is what first interested me in Biology which led to my interest in nursing and is something that I would like to learn more about and know would be useful in a nursing career.

My face flushed as I hurriedly stuffed more napkins around me to contain the warm clear liquid that was seeping down my dress. It seemed to be surrounding me, my husband and I tried to conceal what was happening. When he lifted his voice, getting anxious I shushed him and told him to get more napkins. I remember trying to focus on my breathing. The first of the stabbing pains began just below my naval. I tried to minimize the pain and flow of the liquid by adjusting my position on the vinyl-cushioned seat. I squeezed my legs tighter together. Our waiter brought us our food without noticing I was having some distress. I was attempting to take a bite of broccoli when I looked up and spotted a paramedic rounding the corner with the hostess in tow. My thought was of concern for the poor customer who must have choked or was having chest pain of some sort. It wasn’t until he approached our table with his medical bag and clipboard in hand that I realized he was there for me! As I walked out of the restaurant I sneaked glances at other customers around me but met no eyes. It is amazing to me how people can communicate powerfully in such diverse ways. Their silence told me that someone in the crowd was concerned but did not want to be known. I think back on the night I went into labor unexpectedly because it reminds me of when I knew I wanted to make a positive change in the way people received medical care.

I had some knowledge of what to expect during childbirth due to my education received in nursing school before I “stopped out” to give birth to my first child. Three months later I rejoined the nursing class at Ohlone College, focused and determined to get my ADN and pass the NCLEX to begin working finally as a Registered Nurse. I say this because my life previous to this I had experienced many challenges. A full-time job ultimately affected my pre-requisite studies. Once back in nursing school I focused and worked hard to accel and developed a passion for nursing and the interconnected application it has in everyday life. This led my path focus has made me into a dependable and knowledgeable nurse and leader.

When I graduated in 2005 with my associate’s degree in nursing I worked at a busy telemetry/step-down unit as a new graduate RN for six months. It was there that I fully understood the art of nursing and how it involved constant learning and growth. For the next two years, I jumped at the chance to attend any educational course or in-service I could find at the hospital or volunteer in the community to continue that growth and development. I was recruited to train in the Intensive Care Unit and for five more years I honed my critical thinking skills to become a proficient critical care nurse.

Our unit was unique in that we had a mixed population of patients. We admitted children and adults to our ICU. This was a new change when I arrived at the unit and many nurses refused to learn about how to care for the pediatric population, fearing their licenses would be at stake. I volunteered to go for education courses and rounds with nurses and doctors at Oakland’s Children’s Hospital to help establish knowledge and evidence-based pediatric guidelines in our ICU.

While training in ICU I became expert at many skills including continuous renal replacement therapy for severely septic patients. I trained nurses on how to care for post-open-heart bypass and valve replacement patients requiring vasoactive drip titrations and hemodynamics. I was heavily involved in changing paper charting to the electronic medical record in our facility and was used as a resource throughout all areas of the hospital. As a “superuser” resource I took many classes of training to assist nurses in successfully documenting legally and correctly in the newly established medical record. I also took on the role of charge nurse and was able to focus my nursing knowledge and skill in other ways through educating and training nursing staff on rapid response development and stroke protocols.

I moved on to a larger facility after seven years of great learning experiences and professional development. A bit sad to go, but I was hungry for more clinical knowledge and the chance to further my nursing career. I am always so excited to learn from and network with other professionals. This key aspect of learning fuels my desire to enhance my nursing practice, helping me to evolve and grow professionally.

In my current job as charge nurse of a 27-bed combined ICU/CCU, I am involved in monitoring patient satisfaction. Every shift I visit patients who have been transferred out of our unit. I asked them how the care they received in the ICU, and if they were clear about their plan of care while with us. Usually, they have many great comments to share, but occasionally I hear about unresolved issues. I am always disheartened to hear the unpleasant ways some patients perceive they were treated and frustrated when I hear that a plan of care was never discussed, and they are still left wondering. I know then where to focus my education with the interdisciplinary team so that no patient must feel lost and scared about the care they are receiving.

Thinking back on the time nearly fifteen years ago, I was embarrassed to be escorted from a restaurant after my water broke. I arrived by private vehicle to the hospital and there was a sudden disconnect from what I had assumed needed to be communicated to me but was not. I couldn’t have an epidural and was not informed of any plan of care needed to get me through the birth of my baby successfully without unneeded worry or stress. The nurse who ushered me into a room was visibly flustered and annoyed that she had to take another patient. It seemed as if I had never discussed my birth plan with my physician. Being on the other side of it, there was no evidence of planning from either discipline. I ended up having a long nine-hour

very painful labor for no good reason. The lack of caring was palpable to me. This experience has made me very aware of the importance of effective communication and talking with patients step by step about their plan of care. In my current role as charge nurse, I am involved with educating nurses on care plan development and making sure all patients and their families are up to date and clear about what is going on with them.

Learning to function as an important member of the multidisciplinary team has allowed me to see the patient and family needs differently. Being able to concentrate on patient and family-centered care by incorporating aspects of different disciplines has inspired me to reach further. My current position has allowed me to function in a leadership role where I can share my knowledge of caring for complex critically ill patients and help coordinate care derived from evidence-based practice.

My spiritual beliefs are derived from the Bahai religion. I believe that humanity should be united and not judged or persecuted for individual religious beliefs. One of the reasons I wish to enter the Master’s in Nursing program at The University of San Francisco is because of how they truly value the individual. Similarly, they have an unbiased view of religion and act as a haven for all individuals. The University has also forged close relationships with hospitals and other nursing employment to encourage education development. Because of the alliances between the school and the place of work

More than ever before, I am highly motivated and prepared to take on the course of Learning Disability Nursing at your reputable University. I am passionate and best positioned to function effectively in this role, given my strong interest in nursing and care service provision. My passion is supported by my progressive qualifications that fit the requirements and the extensive experiences that I have accrued over the recent years in the nursing sphere.

With over 7 years of work experience in nursing and care services, I am seeking a career development opportunity that will provide me with a platform to contribute significantly to the development of healthcare services in Bristol and by extension the United Kingdom. I strongly believe this position will enable me to fulfill this aspiration and also progress my Learning Disability Nursing career further.

Without repeating the information regarding my education and qualifications I have already shared with my application, I have undertaken and passed with satisfactory grades training certifications in Mathematics, English, Health, and Social Care. The knowledge gained in these areas is valuable and I intend to bring them with me as I transition to the desired position.

In addition to my training and qualifications, I would like to emphasize the following additional transferable work experiences that will make me an asset to the Trust Wide department under the umbrella of the National Health Service (NHS).

Having worked at Trust for over 6 years I have had the privilege of working extensively in various nursing-related contexts and settings that include acute medical admission. My information provides more specific details regarding experiences garnered that would be relevant to the desired position.

My progressive work experiences have enabled me to develop meaningful and supportive professional relationships while working seamlessly as a multi-disciplinary team member and also independently with minimal supervision. To achieve this, I had to develop a high level of team spirit, attentiveness, sensitivity, and tolerance, all I strongly believe will aid me as I transition to the role of a Learning Disability nurse.

In addition to the above, I am very familiar with and competent in all the 6 Cs (care, compassion, courage, communication, commitment, and competence) central planks of Compassion in Practice as instituted in 2012 by the NHS England Chief Nursing Officer. At different times, I have had to employ and demonstrate these competencies to foster team spirit, organization, and service development. I will be pleased to bring with me these experiences and more if I am selected.

My understanding of Nursing as a profession in terms of its core values and skills has also prepared me for Learning Disability Nursing. I understand the importance of being able to anticipate and fulfill the needs of the service users, have outstanding interpersonal skills, and a remarkable ability to pay attention to details and instructions.

Over the years, I have learned to listen to patients, understand their concerns and questions, and provide appropriate responses or referrals to registered nurses are some of the main skills I possess.

I am very cognizant of and able to make strategic decisions regarding seeking advice and referring sensitive or complicated matters to trained personnel when needed. I am a firm believer, adherer, and propagator of the established protocols, procedures, and systems within the healthcare sector. I am also effective in risk management, coordination, and time management when it comes to service user care and related services. All these are part of understanding the ethics and evidence-based practices of the nursing profession, and I will continue to strive to provide good quality and evidence-based care if given the opportunity.

With the Learning Disability Nursing, I believe I will be adequately challenged to bring out the best in me, and also provide me with learning opportunities to develop myself. With my intermediate knowledge of Information Technology (IT), I can work with modern medical equipment and software used within the system. I have the drive to acquire new information and knowledge and the capacity to successfully undertake and complete relevant Diploma education or training that may be required.

I actively promote reflective practices and clinical supervision activities that are beneficial to the development of services (theoretically and practicum) within health care. And will be highly supportive of colleagues with similar quests and objectives.

To further support my suitability for the position, I am highly flexible (in terms of working hours and locations), extremely organized with personal and organizational tasks, able to multitask, and strategic in solving problems. I am disciplined, determined, and dedicated to any worthy cause I commit myself to. I value and uphold honesty, accountability, and cross-cultural respect as part of the core values of an aspiring Learning Disability nurse. They will help me to function and perform beyond expectations in the role.

It is my ultimate goal to become a fully Registered Learning Disability nurse in the next few years making significant contributions to the strengthening and improvement of the Learning Disability community Without hesitation, I know that this opportunity will propel me in the right direction towards fulfilling this goal.

In conclusion, there is a need more than ever before to increase the capacity of the nursing sector as we aim to strengthen the national responses to COVID-19 and its ravaging effects. I am passionate about working relentlessly in this role to provide clinical and social services as we fight to combat the pandemic. I will be willing to work extended hours and at various locations as may be necessary.

I thank you in advance for this opportunity and I look forward to an to hear from you, where I can further discuss more details of my suitability for the position.

I want to be a nurse because I not only sincerely care about people, but also help educate them to live healthier lives and make better lifestyle choices. The role of the nurse is accompanied by immense responsibilities. I believe that once I finish my studies, the qualities I possess will eventually make me a very competent member of the nursing team. My interest in nursing started in 2017 when my mother underwent major surgery and kept us in the hospital for a few months. I can see with my own eyes the excellent work done by the nursing staff and the nursing staff, and their dedication to this position. With the qualities I felt I already possessed, at that moment I knew that I wanted to be a nurse. In 2019, I found a job in a humanitarian organization, which showed me the suffering of disadvantaged groups. I decided that I wanted to directly influence and change the lives of those in need. In January 2020, I decided to start my nursing training career as a Nurse Assistant in a reputable hospital. During my work in the hospital, I observed, listened, observed, and participated in a series of patient needs assessments, which are valuable insights into the required patience, communication skills, and commitment to the quality of care.

The care required as a professional nurse… The course I requested today through this personal statement puts me in a good position to pass on the core values u200bu200bof nursing. I believe that the qualities that will help me learn effectively and become a competent nurse include patience and empathy, the ability to follow rules and procedures, the desire to continually improve while acting professionally, and the ability to remain competitive in everything. what I do. I am also a strong communicator and will be fully committed to my studies and can also plan my work correctly to ensure that I meet all deadlines and submission dates throughout the nursing course. I fully understand and understand the responsibilities that I will take on as a nurse, on this basis I understand why it is important to accept only students who are fully committed to their nursing studies and courses throughout the nursing industry. Up until now, throughout my life, I have acted with honesty and integrity, and I can be trusted to always maintain the highest possible standard and demonstrate confidentiality when necessary. I have studied the role of nurses in detail, including core values u200bu200band 6C’s.

I believe that I can uphold and uphold the requirements of this role. After studying the nursing course in detail, I understand that I need to invest a lot of time to complete all the relevant modules and pass them with the highest grade. In the past, each time I conducted research, I developed an action plan to ensure that I was allocating adequate time to research, write, and learn relevant aspects of the course I was participating in. I also understand that to become a qualified nurse practitioner, hard work begins in this course, and I am fully committed to putting in the work and commitment necessary for success. There are many ambitious and dedicated people applying for nursing courses. However, I feel that the hard work and commitment I will put in my studies and once I am qualified as a nurse, make me a valuable candidate for this course. I understand the responsibility of nurses, and if I have the opportunity to study this course, I will always maintain the highest standards of professionalism, competence, and commitment to quality care. Thank you for considering my application.

Nursing is a crucial part of healthcare services. Nurses have a vital role in providing not only physical support but emotional, intellectual, and social support which builds trust and confidence in patients, promoting patient recovery. Nursing is a profession that I am passionate about and want to pursue.

I have chosen to study adult nursing as I am passionate about caring for and supporting adults who require health care services. Learning about people’s care needs and finding new solutions and methods to meet these needs is my motivation to study adult nursing. I believe that nursing is a fulfilling and rewarding profession within the healthcare sector for which I am most suited to take on the role. I am also interested in studying nursing as I have a passion for meeting new people, which helps contribute to a good patient experience promoting the wellbeing of patients and enabling them to develop a positive view and outcome of health care services. Both of my parents are mental health nurses. I have been inspired by their work ethic and commitment to ensuring that their patients receive quality care. I believe that in studying adult nursing, I will have the opportunity to explore many aspects of nursing and how nurses provide support not only within a hospital but in the wider community. I am enthusiastic about learning the different methods of care that nurses employ and being in a healthcare setting and the practical component that this course provides.

I have gained knowledge and skills in studying BTEC Health and Social Care Extended Certificate. I have learned the different roles in healthcare within the hospital setting that work collaboratively for effective patient care and experience. I have also acquired observational, analytical, and evaluative skills in my A-level History, which I will apply in my nursing studies. By studying English language and literature at school, I can analyze linguistic data and information from a wide range of literary texts. This course has improved my communication and language skills. Effective communication with patients and professionals is vital in delivering care and support that enhances the quality of life of the patient.

I worked as an assistant teacher at Brookland Farms Primary School for work experience. I was able to interact with children from all backgrounds, helping them to learn and play. I also supported the teachers with their workload and worked cooperatively in a healthy environment.

In my job as a store assistant, I enjoy interacting with the customer. This has enhanced my observation, communication, organization, and teamwork skills. I use listening skills to help customers meet their different needs and provide support using empathy and care, which are also values within nursing. I enjoy going for walks, roller skating, knitting, and listening to music. These hobbies help me to relax and promote my physical and mental well-being.

Through school, I have had the opportunity to be interviewed and accepted by Al’s Pal’s Milton Keynes charity as a volunteer, in this role I will be able to support patients with cancer and their families by providing comfort, care, and companionship.

I look forward to studying nursing at your university as this course will help me prepare for this valued role and provide an experience so that I will be able to support and deliver safe care to the future public.