Nursing: Professional Capstone and Practicum Reflection


I have gained important skills, competencies, and values that I can directly apply in my practice from the Professional Capstone and Practicum course offered this semester. The blended course is designed to advance clinical role development through practice competencies in interprofessional collaboration, ethical considerations in practice, information technology, healthcare leadership and policy, etc.

Such skills can be helpful in navigating the dynamic healthcare environment characterized by heavy nursing workload, understaffing, and increasingly complex patient needs (Zwozdiak-Myers, 2012). The aim of this reflective journal paper is to provide an overall picture of the knowledge and skills I have acquired throughout the Professional Capstone and Practicum course. It also contains an integrated reflection of my strengths and weaknesses and competencies met.

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Knowledge and Skills Acquired

Throughout this course, I have learnt multiple approaches to direct-care practice that are critical in quality healthcare delivery. One such approach that I have learnt through my capstone change project on nurse practitioner collaboration is evidence-based practice. This practice approach entails a judicious use of research information to inform clinical decisions (Meehan, 2012). The aim is to provide better care through evidence-based diagnosis and therapy. Patient-centered care is another new practice approach learnt in this course. It requires nursing care decisions to be sensitive to patient or family values/needs. The third practice approach learnt is health teaching, which is premised on the view that the provision of health information to patients promotes self-care, especially after discharge.

I also gained a deep understanding of the concept of interdisciplinary collaboration in clinical care. The diversity of clinical backgrounds and specialties makes collaboration inevitable in a clinical environment. As such, I will collaborate with other nurses and physicians to ensure better diagnoses, outcomes, and interventions through improved communication and mutual respect (Meehan, 2012).

Health care delivery and clinical systems determine the quality of patient care provided. I have understood the critical role nurses play as a part of the clinical microsystem to deliver quality care. Delivering the best care to patients with complex problems is possible through my participation in interdisciplinary care teams and effective stakeholder engagement in the design and delivery of care.

Nurses have to navigate through ethical dilemmas in their day-to-day practice. I gained important insights into the ethical code that can help me handle dilemmas related to patient autonomy and anonymity and privacy of clinical information (Snelling, 2016). I understand how to select the best clinical action that could give optimal outcomes. Further, as nurses, embracing ethical considerations in practice is critical in easing patient suffering and improving the quality of nursing care.

Involvement in population health issues is another lesson I have learnt from the course. By working with communities, my role in promoting population health will involve health teaching and immunization programs, improving access to health care, and monitoring population health trends related to common public health problems. The underserved populations can also benefit from direct nursing interventions such as screening and referral to hospitals.

The other lesson I have learnt from this course relates to healthcare technology. Familiarity with new electronic technology and systems is critical in the provision of quality patient care through reduced error risk and improved provider communication. Electronic health records (EHRs) support fast and safe access and use of patient health information (Patel, Jamoom, Hsiao, Furukawa, & Buntin, 2013). Integrated communication tools help organize, store, and share clinical data between providers, leading to improved care coordination and outcomes.

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I have also had an opportunity to learn the nurses’ role in policy development and implementation. The active participation of nurses in health policy advocacy is critical as they are the professionals involved in direct patient care. According to Zwozdiak-Myers (2012), nurses can work with other decision makers to develop policies responsive to issues of health care access and quality. Through this course, I am aware of my professional role as an advocate of effective health policies.

Another important lesson I gained relates to leadership and economic models. Championing health care quality and equity through evidence-based initiatives are an important role of a nurse leader. Based on appropriate economic models and policies, the health needs unique to specific communities or underserved populations can be addressed. Further, these concepts can help in the measurement of quality and inform investment decisions.

I have also learnt about the causes and solutions to health disparities. Heath disparities exist due to social isolation, language barriers, a discriminatory health care system, limited access to coverage, and low socioeconomic status (Zwozdiak-Myers, 2012). Underserved or vulnerable populations can be supported through proactive quality initiatives. Further, a greater focus on providing culturally competent care can make the healthcare system more inclusive and responsive to underserved communities.

Discoveries about My Professional Practice

I have made multiple discoveries about my professional practice by completing this course. The first discovery is about effective communication with my patients. I have realized that I have grown in confidence and knowledge to offer culturally competent health education and convey discharge instructions to patients. I can attribute this to the cultural competence and clinical communication skills I have acquired over the past two years.

The second discovery is my improved skills in holistic care. I was able to care for diverse patients, including non-English speakers. I applied technology to engage them and address the communication barriers, resulting in improved satisfaction during their hospital stay. Patient involvement in the treatment process is the foundation of quality patient-centered care (Meehan, 2012).

My third discovery relates to interprofessional collaboration. I consider professionalism is an important value in my practice. However, initially, I experienced challenges working with some members of our team, especially with regard to clinical communication. Following this experience, I gained skills on interpersonal communication that will enable me to collaborate effectively with other professionals in clinical decisions to deliver quality patient care.

Personal Strengths and Weaknesses

My awareness of personal strengths and weaknesses has grown throughout this course. One of my strengths that surfaced through reflection journals is reflective practice. I proactively sought evidence and support from senior nurses to assess clinical problems, learn from personal experiences, and recommend interventions. Through critical reasoning, I will be able to offer evidence-based care, become a lifelong learner, and make proactive attempts to learn from the situation for years to come (Meehan, 2012). My strengths also lie in cultural competence skills, use of health informatics in communication and disease surveillance, effective time management, and teamwork when caring for patients with complex needs. I have also gained experience in patient teaching and effective clinical communication through shift-to-shift reporting.

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The course also gave me an opportunity to reflect upon my weaknesses and identify areas for improvement. I found it difficult communicating with members when in the spotlight due to the feelings of inadequacy in my skill level. To improve self-confidence in skills, I often engage my colleagues in professional socialization. My other challenges include the inability to determine medications and use most equipment. However, this semester, I have had great experiences administering medications safely and competently. I believe my skills in patient assessment and triaging have increased greatly.

Additional Resources and Abilities to Influence Optimal Outcomes

Multiple resources and abilities are necessary to influence the outcomes of clinical situations. The idea of reflective practice is a hallmark of the nursing profession. Learning from previous experiences and professional collaboration can help overcome the identified weaknesses of self-confidence, medication/equipment use, and communication. In addition, I can apply my strengths in addressing complex patient needs. Informational resources, including journal articles and publications, can be utilized to support evidence-based care and update my professional skills. Using these resources and personal strengths, I will develop confidence in my skills, abilities, and experiences to achieve optimal outcomes in a clinical situation.

Meeting the Competencies Outlined in the Course

To achieve the competencies stated at the beginning of the course, I have completed research papers and assignments on various topics. I have had an opportunity to read and synthesize scholarly literature, which constitute a hallmark of evidence-based care. Through the practicum project component of the course, I have been able to apply research evidence in my practice – nurse collaboration. Through the practicum experience, I have been equipped with skills in interprofesional collaboration and the development and implementation of quality initiatives to improve specific unit-level outcomes (Meehan, 2012). I also realize that the practice of holistic care can be achieved through reflective practice, the provision of culturally competent care, and patient involvement in care. I intend to embrace these concepts throughout my professional career.

References

Meehan, T. C. (2012). The careful nursing philosophy and professional practice model. Journal of Clinical Nursing, 21(19-20), 2905-2916. Web.

Patel, V., Jamoom, E., Hsiao, C., Furukawa, M. F., & Buntin, M. (2013). Variation in electronic health record adoption and readiness for meaningful use: 2008– 2011. Journal of General Internal Medicine, 28(7), 957–964. Web.

Snelling, P. C. (2016). The metaethics of nursing codes of ethics and conduct. Nursing Philosophy, 17(4), 229-249. Web.

Zwozdiak-Myers, P. (2012). Teacher’s reflective practice handbook: Becoming an extended professional through capturing evidence-informed practice. Florence, KY: Routledge.

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